基于“肝郁气滞”探讨颈肩综合征病机及针灸治疗  

Discuss the Pathogenesis and Treatment of Neck-shoulder Syndrome From“Liver Depression and Qi Stagnation”

作　　者：余奕超 金瑛[2] YU Yichao;JIN Ying(The Third Clinical Medical School of Zhejiang Chinese Medical University,Hangzhou(310053),China;Quzhou Hospital of TCM Affiliated to Zhejiang Chinese Medical University)

机构地区：[1]浙江中医药大学第三临床医学院,杭州310053 [2]浙江中医药大学附属衢州市中医院

出　　处：《浙江中医药大学学报》2024年第9期1159-1162,共4页Journal of Zhejiang Chinese Medical University

基　　金：浙江省中医药科技计划项目(2021ZB325)。

摘　　要：[目的]运用五脏气机理论的“肝郁气滞”观点,对颈肩综合征的病机和治疗进行阐发。[方法]从五脏气机理论的“肝郁气滞”观点及颈肩综合征病因病机出发,探讨二者的理论契合性,同时基于此观点确定颈肩综合征的论治原则及针灸处方,并列验案一则加以佐证。[结果]“肝郁气滞”观点源于五脏气机理论中肝主气机,以肝郁为本,气滞为标。颈肩综合征病机特点在于标本虚实兼夹,主要是肝失疏泄,气机郁滞,在实的基础上化生或合并瘀、湿等实邪。从“肝郁气滞”分析颈肩综合征病机,针灸论治不仅要重视肝胆,兼顾气滞,也要重视其所演变出的瘀、湿等实邪,这些因素均与颈肩综合征发病关系密切。以“肝郁气滞”及相关理论指导颈肩综合征的治疗,应以疏通肝胆和气机为要,从针灸调和经络气机出发,并配合刃针,其针方运用的合理性获得了临床实践的支持。文中医案辨证为肝郁气滞证,治以疏肝行气止痛,运用毫针和刃针治疗,取得了较好的临床疗效。[结论]“肝郁气滞”观点与颈肩综合征病机具有契合性,为治疗颈肩综合征开辟了新思路。[Objective]To elucidate the pathogenesis and treatment of neck-shoulder syndrome based on the viewpoint of“liver depression and Qi stagnation”of the theory of five viscera Qi activity.[Methods]From the viewpoint of“liver depression and Qi stagnation”in the theory of five viscera Qi and the etiology and pathogenesis of neck-shoulder syndrome,the theoretical correspondence between the two was discussed,and based on the viewpoint of“liver depression and Qi stagnation”,it established the therapeutic principles and acupuncture prescriptions of neck-shoulder syndrome,and cited a case to support it.[Results]The viewpoint of“liver depression and Qi stagnation”is rooted in the liver governing Qi of the five viscera Qi activity theory,taking liver depression and Qi stagnation as the foundation.The pathogenesis of neck-shoulder syndrome is characterized by the mixture of asthenia and sthenia of the specimen,mainly liver dysfunction and Qi stagnation,on the basis of which it causes the formation or combination of stasis,dampness and other excess evils.To analyze the pathogenesis of neck-shoulder syndrome from“liver depression and Qi stagnation”,acupuncture treatment should not only pay attention to liver and gallbladder,take into account Qi stagnation at the same time,but also pay attention to its evolution of stasis,dampness and other pathogenic factors,which are closely related to the generation of neck-shoulder syndrome.To guide the treatment of neck-shoulder syndrome with“liver depression and Qi stagnation”and related theories,should take dredging liver and gallbladder and Qi as the key,it is required to start from the acupuncture and moxibustion to harmonize the meridian-collateral Qi activity,and cooperate with the knife-edge needle,and clinical practice supports the rationality of the theory.The medical case listed was neck-shoulder syndrome,and the syndrome was liver depression and Qi stagnation.The main treatment was to dredge liver Qi to relieve pain,and the use of acupuncture and knife-edge

关 键 词：颈肩综合征 肝郁气滞 针灸 刃针 《针灸大成》 中医理论 慢性疼痛 调节气机 

分 类 号：R245[医药卫生—针灸推拿学]