针刀“治痿间取阳明”治疗中风痉挛性偏瘫  

‘Treating Wei by effecting Yangming indirectly'for akupotomy treatment of stroke spastic hemiplegia

作　　者：许琦 李泰标 郑丁炤 谢洪武 吴心虹 何毅琪 林友益 卢胜春 宋正茂 XU Qi;LI Taibiao;ZHENG Dingzhao;XIE Hongwu;WU Xinhong;HE Yiqi;LIN Youyi;LU Shengchun;SONG Zhengmao(Fifth Hospital of Xiamen,Xiamen 361100,China;Dexing Shengchun Hospital,Dexing 334200,China)

机构地区：[1]厦门市第五医院,厦门361100 [2]江西省德兴市德兴胜春医院,江西德兴334200

出　　处：《中华中医药杂志》2024年第8期4188-4191,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：福建省科技厅引导性项目(No.2021D012);福建省卫生计生委中医药科研计划项目(No.2021zylc51);厦门市医疗卫生指导性项目(No.3502Z20214ZD1258)。

摘　　要：“治痿独取阳明”为中风偏瘫的中医重要治则。中风偏瘫具有筋急而挛(筋痿)及肌肉无力(肉痿)两种肢体失用的“痿”的表现。卢胜春依据运动解剖学及生物力学原理提出针刀治疗中风痉挛性偏瘫可取阳明之外部位,以间接作用于阳明经筋而改善肢体运动功能。如根据拮抗肌平衡主动肌原理,松解胸大肌附着点,有利于促进手阳明经筋的上抬手臂功能;如根据最符合生物力学原理,激活腘绳肌,有助于改善膝过伸,从而缓解腿部足阳明经筋的痉挛而上抬腿部;如根据核心肌群稳定的机理,激活躯干背部核心肌群,促进腹部足阳明经筋分布部位的腹部核心肌群稳定。以上“治痿间取阳明”可用中医的“从阴引阳”及调节阳明经筋气血解释。文章引用病案举证说明。‘Treating Wei by effecting Yangming indirectly'is an important Chinese medicine treatment for stroke hemiplegia.The Wei of spastic hemiplegia after stroke has two kinds of manifestations:‘muscle spasm(Jin Wei)'and‘muscle weakness(Rou Wei)'.According to the principle of sports anatomy and biomechanics,LU Shengchun proposed that akupotomye treatment of stroke spastic hemiplegia should treat other Yangming meridian parts in order to strengthen Yangming meridional tendon indirectly and improve limb motor function.For example,according to the principle of antagonistic muscle balance active muscle,the release of the attachment point of pectoralis major muscle is beneficial to relieve the muscles distributed on hand Yangming meridional tendon and to make them easier to raise the arm.For example,according to the most consistent with the principle of biomechanics,with the activation of the hamstring muscle,reduce the hyperextension of the knee joint,so as to relieve the spasm of the muscles distributed in the foot Yangming meridional tendon of leg,and then to lift the leg with the less effort.For example,according to the mechanism of core muscle stability,activate the core muscle group of the back of trunk can be beneficial to the stability of the core muscles of the front of the truck where the foot Yangming meridional tendon is distributed.The above‘treating Wei by effecting Yangming indirectly'can be explained by the traditional Chinese medicine of‘inducing yang from yin'and regulating the qi and blood of Yangming meridional tendon.The article cited the evidence of clinical studies and a clinical case.

关 键 词：卢胜春 中风痉挛性偏瘫 针刀 阳明 经筋 

分 类 号：R246.6[医药卫生—针灸推拿学] R249[医药卫生—中医临床基础]