基于“辨经论治”探析中风后吞咽障碍的针刺治疗撷要  

A brief analysis of treating post-stroke dysphagia by acupuncture based on meridian differentiation

作　　者：凌美娟 程红亮[2] 张宜廷 叶宇 LING Meijuan

机构地区：[1]安徽中医药大学,安徽合肥230000 [2]安徽中医药大学第二附属医院,安徽合肥230000

出　　处：《中医临床研究》2024年第31期74-78,共5页Clinical Journal Of Chinese Medicine

基　　金：安徽省临床医学研究转化专项项目(202304295107020123)。

摘　　要：吞咽障碍是中风后常见的并发症之一,临床表现为吞咽乏力、饮水呛咳、舌强语謇等,常对中风患者机体功能康复产生严重影响。目前,针刺疗法已被证实可有效治疗本病,但治疗方案多以局部取穴为主,尚未形成统一、标准的针刺方案,不利于临床推广和运用,且鲜有针对本病的经络辨证针刺疗法。经络学说是针灸理论的关键组成部分,经络辨证针刺疗法有网络周身气血、维持阴阳平衡、传递疾病信息的重要作用,对针灸临床实践具有极为重要的指导作用,根据经络的循行分布、功能特性、病理变化及其与脏腑的相互联系可以判断疾病分布在何经、何络及相关脏腑,以及病性的寒热、虚实等。本研究分析中风后吞咽障碍“阴阳失调,经脉不通,咽喉受累”之病机,结合经络学说与咽喉疾病的关系,以“辨经论治”为指导,揭示针刺从督任脉通络调神、少阴经宣窍益髓、脾胃经治血化痰,以及局部对症选穴出发治疗中风后吞咽障碍,可达到阴阳平衡,经脉畅通,饮食得下之目的,并举医案一则进行探讨,寻找最佳的针灸治疗组合方案,为针刺治疗中风后吞咽障碍提供参考方案。Dysphagia is one of the common complications after stroke,which is characterised by weak swallowing,choking Don drinking water,and stiff tongue and impeded speech,and often has a serious impact on the functional recovery of stroke patients.At present,acupuncture therapy has been proved to be effective in the treatment of this disease,but the programme is mostly based on local acupoint selection,and has not yet formed a unified and standard acupuncture programme,which is not conducive to the clinical promotion and application,and there are few meridian differentiation and acupuncture therapies on this disease.The theory of meridian and collaterals is a key component of acupuncture and moxibustion.Acupuncture therapy based on meridian differentiation plays an important role in connecting Qi(气)and blood throughout the whole body,maintaining the balance of Yin(阴)and Yang(阳),and transmitting disease information,and plays an extremely important role in guiding the clinical practice of acupuncture and moxibustion.According to the circulation distribution,functional characteristics,pathological changes of meridians and collaterals,and their interconnection with Zang-Fu organs(脏腑),the location of the disease in what meridians and collaterals and related internal organs can be distinguished,as well as the coldness,heat,deficiency and excess of the disease.By analyzing the pathogenesis of post-stroke dysphagia,such as Yin and Yang disorder,impenetrable meridians,and throat involvement,and combining the relationship between the meridian and collaterals theory and pharyngeal diseases,this paper takes treatment based on meridian differentiation as a guide to reveal that acupuncture on post-stroke dysphagia can achieve the purposes of balance of Yin and Yang,the smooth flow of meridians,and normal eating and drinking with the starting points of selecting Du meridian(督脉)and Ren meridian(任脉)acupoints to regulate mind,selecting Shaoyin(少阴)meridian acupoints to expel orifice and benefit marrow,selecting spleen

关 键 词：辨经论治 中风后吞咽障碍 针刺 经络学说 

分 类 号：R255.2[医药卫生—中医内科学]