基于“三维五法”浅论顽固性面瘫针灸证治思路  

A Brief Discussion on Diagnosis and Treatment Strategies for Refractory Facial Paralysis by Acupuncture Therapy Based on‘Three Dimensions and Five Methods’

作　　者：杨禾财 刘征[2] 李艳凤[1] 马琳 于楠楠 YANG Hecai;LIU Zheng;LI Yanfeng;MA Lin;YU Nannan(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《针灸临床杂志》2024年第8期85-89,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：黑龙江省自然科学基金联合引导项目,编号:LH2022H083;黑龙江省中医药管理局国医大师学术思想传承科研项目,编号:GY2022-06;黑龙江中医药大学“优秀创新人才支持计划”,编号:2018RCD10。

摘　　要：顽固性面瘫是指面神经炎经过两个月治疗后,半年以内面部肌肉症状仍恢复效果不佳者,以气血亏虚为本,随病程挟瘀血、痰浊等成本虚标实之象。三维五法是龙江医学流派传承工作室优势病种临床推广项目之一,即点、线与面(腧穴、经络和经筋)三维结合,刮痧、拔罐、针法、灸法和中药五法并用。本研究基于此,提出“点、线、面”三维、“头、腹、胫”三维和“听、动、化”三维,“经颅重复针刺刺激疗法、扎跳法、滞针提拉法、调气畅血法与腹脑同轴法”五法,在现代医学对顽固性面瘫辨病的基础上,通过病证结合、态靶结合,将多种中医特色临床有效治法有机融合起来,对持续性面肌无力、口眼歪斜、眼睑闭合不全和病后情绪障碍等进行多途径、多环节与多靶点的诊疗,发挥中医药靶向治病、调态辨证的优势。Refractory facial paralysis refers to facial neuritis has been treated for two months,but the facial muscle symptoms still show poor recovery within six months.The underlying cause is a deficiency of Qi and blood,which,over the course of the disease,is accompanied by signs of blood stasis and phlegm stagnation,presenting as a root deficiency and branch excess pattern.The‘three dimensions and five methods’is one of the clinical promotion projects for advantageous disease by the Longjiang Medical School Inheritance Studio.It integrates three dimensions(points,lines,and surfaces)involving acupoints,meridians,and sinew meridians,with fives methods,including gua sha,cupping,acupuncture,moxibustion and herbal medicine.Based on this,this study proposes three-dimensional approaches:point-line-surface,head-abdomen-shin,and hearing-movement-transformation.It introduces five methods:repeated transcranial acupuncture stimulation,jumping acupuncture methods,stagnation needling lifting method,Qi regulation and blood circulation methods,and abdominal-brain coaxial methods.These methods are applied on the basis of modern medical diagnosis of refractory facial paralysis,integrating various effective traditional Chinese medical treatments.This approach aims to address persistent facial muscle weakness,facial asymmetry,incomplete eyelid closure and post-illness emotional disturbances through multiple pathways,multiple steps,and multiple targets,highlighting the advantages of TCM in targeted disease treatment and dialectical state adjustment.

关 键 词：顽固性面瘫 三维五法 针灸疗法 

分 类 号：R246.6[医药卫生—针灸推拿学]