针灸治疗脑卒中后痉挛性瘫痪的临床研究进展  

Progress of Clinical Research on Acupuncture in Treatment of Spastic Paralysis after Stroke

作　　者：何玲玲 毛立亚 李明 HE Lingling;MAO Liya;LI Ming(Gansu University of Chinese Medicine,Lanzhou,Gansu 730000;Affiliated Hospital of Gansu University of Chinese Medicine,Lanzhou,Gansu 730000)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃中医药大学附属医院,甘肃兰州730000

出　　处：《中医康复》2025年第4期6-12,共7页Traditional Chinese Medicine Rehabilitation

基　　金：甘肃省自然科学基金(21JR11RA151);甘肃省自然科学基金(24JRRA555);甘肃中医药大学附属医院院内创新基金项目(gzfy-2023-08)。

摘　　要：脑卒中后痉挛是引起脑卒中后高致残率的主要原因之一,可造成患者肌肉短缩、姿势异常、疼痛和关节挛缩,导致运动模式异常,从而影响患者日常生活功能,并制约了患者偏瘫肢体的康复,目前西医治疗效果不突出。中医认为,脑卒中后痉挛性瘫痪属“筋病”“痉证”的范畴,病位在脑,与筋、肝肾、气血密切相关,基本病机为气滞血瘀、痰浊阻窍,脑络不通、脉络痹阻。本文通过系统归纳近年针灸治疗脑卒中后痉挛性偏瘫的临床研究,从普通针刺(醒脑开窍针刺法、针刺拮抗肌法、针刺夹脊穴法、巨刺疗法)、电针、特殊针刺疗法(毫火针、水针、腹针、针刀、穴位埋线)、灸法、联合治疗进行综述,发现针灸治疗脑卒中后痉挛临床已取得客观疗效,其可促进神经重塑,恢复患者运动功能,还可调节全身气血及脏腑功能,但针灸治疗该疾病的手法操作、选穴配穴和刺激量等方面仍需进一步梳理总结。Post-stroke spasticity is one of the main causes of high disability rate after stroke,which can cause muscle shortening,postural abnormality,pain and joint contracture,resulting in abnormal movement patterns,thus affecting the daily life function of patients and restricting the rehabilitation of hemiplegic limbs,and the current Western medical treatment is not prominent.The theory of traditional Chinese Medicine believes that post-stroke spastic paralysis belongs to the category of"tendon disease"and"spasm syndrome",which is located in brain and is closely related to tendons,liver and kidney,and qi and blood.The basic pathogenesis is qi stagnation and blood stasis,phlegm turbidity obstructing the orifices,which causes blocked cerebral collaterals and obstructed meridians.In this paper,we summarize the clinical studies of acupuncture for post-stroke spastic hemiplegia in recent years,and review the results from ordinary acupuncture(brain-opening acupuncture,acupuncture antagonist muscle method,acupuncture pinch point method,giant stabbing therapy),electroacupuncture,special acupuncture therapies(millimeters of fire,water acupuncture,abdominal needling,needle knife,acupuncture point embedded thread),moxibustion,and combined therapy,and find that acupuncture for post-stroke spasticity has already achieved objective efficacy in the clinic,and can promote neural remodeling to restore the patient's motor function,and can also regulate the whole body qi and blood and internal organs function,but acupuncture for this disease still needs to be further sorted out and summarized.It can promote neural remodeling,restore patients'motor function,and regulate the whole body's qi and blood and the function of internal organs.However,the manipulation,point selection and stimulation volume of acupuncture for the treatment of this disease still need to be further sorted out and summarized.

关 键 词：脑卒中 痉挛性瘫痪 针灸 醒脑开窍针刺法 针刺拮抗肌法 毫火针 

分 类 号：R74[医药卫生—神经病学与精神病学]