针刺治疗排尿性晕厥验案  

A test case of acupuncture treatment for micturition syncope

作　　者：赵欣佳 范林鹃 焦琮舒 陈璐[1,2] 申鹏飞 ZHAO Xinjia;FAN Linjuan;JIAO Congshu;CHEN Lu;SHEN Pengfei

机构地区：[1]天津中医药大学第一附属医院,天津300380 [2]国家中医针灸临床医学研究中心,天津300380

出　　处：《中医临床研究》2024年第30期130-132,共3页Clinical Journal Of Chinese Medicine

摘　　要：排尿性晕厥系血管功能障碍性晕厥,属于反射性晕厥,以排尿刺激为诱因,发作时意识丧失,发作后意识完全恢复,状如常人,临床并不常见,现将针刺治疗排尿性晕厥验案1例整理如下:患者甲,男,66岁,因“排尿后眩晕不止1个月余”于2021年11月30日就诊。症见:排尿后眩晕伴恶心,右手五指指尖麻木,右耳及右侧头部自觉不适,寐欠安,纳少,二便调,舌红少苔,脉弦,沉取无力而缓。西医诊断:排尿性晕厥;中医诊断:厥证(肝肾两虚之气厥)。治则:益精填髓,滋水涵木,醒神开窍。治法:调神针法结合丛刺中极穴。取穴:C2~C7段颈夹脊穴、风池穴、天柱穴、百会穴、四神聪穴、四白穴、印堂穴、神庭穴、上星穴、头维穴、膻中穴、气海穴、关元穴、中极穴、合谷穴、太冲穴、太溪穴。留针30 min,一日1次,1周为一个疗程。1个疗程后患者排尿后眩晕伴恶心的症状明显改善,但偶有反复,排便时仍需家属陪同。2个疗程后排尿后眩晕症状少有发作,无需他人陪同。申鹏飞主任医师师从石学敏院士,擅长针刺治疗脑血管疾病,基于石学敏院士“治神”学术思想,申师认为“调神”在针刺治疗疾病中起关键作用,本案中申师采用调神针法结合中极穴丛刺法针对排尿、晕厥两大主症进行辨证施治,标本兼顾,疗效良好。Micturition syncope is a type of syncope with vascular dysfunction, which belongs to reflex syncope. It is induced by urination stimulation, the consciousness of patients is lost during the attack, and the consciousness of patients is completely recovered after the attack. Its clinical case is not common, one test case of acupuncture treatment of micturition syncope is summarized as follows: The patient A, a 66-year-old male, visited the doctor on November 30, 2021 due to ‘dizziness after urination which last more than one month'. Symptoms included dizziness with nausea after urination, numbness of the fingertips of the right five fingers, discomfort of the right ear and right head, insomnia, less appetite, normal urination and stool, red tongue with less moss, string pulse, which is sink, weak and slow. Western medicine diagnosis is micturition syncope. TCM diagnosis is Jue syndrome(Qi syncope of liver and kidney deficiency). The principle of treatment is replenishing essence and filling marrow, nourishing water and wood, awakening the spirit and opening the orifices. Treatment of Tiaoshen acupuncture combined with cluster acupuncture at Zhongji acupoint(RN3) is given. Acupoint selection: C2-C7 cervical Jiaji(EX-B2), Fengchi(GB20), Tianzhu(BL10), Baihui(DU20), Sishencong(EX-HN1), Sibai(ST2), Yintang(EX-HN3), Shenting(DU24), Shangxing(DU23), Touwei(ST8), Danzhong(RN17), Qihai(RN6), Guanyuan(RN4), Zhongji, Hegu(LI4), Taichong(LR3), Taixi(KI3). The needle was retained for 30 min, once a day, and 1 week was a course of treatment. After 1 course of treatment, the symptoms of vertigo and nausea after urination were obviously relieved, but it occasionally repeated, and family members were still required to accompany the defecation. After 2 courses of treatment, vertigo symptoms rarely occurred during urination and the patient did not need to be accompanied by others. Chief physician SHEN Pengfei, who learned from Academician SHI Xuemin, is good at acupuncture treatment of cerebrovascular diseases. Based on Academicia

关 键 词：排尿性晕厥 厥证 中极穴 丛刺 

分 类 号：R277.5[医药卫生—中医学]