基于络病理论探讨针推治疗宫颈癌术后下肢淋巴水肿  

Treatment of Lower Limb Lymphedema After Cervical Cancer Surgery with Acupuncture and Tuina Based on Theory of Collateral Disease

作　　者：王鑫锴 周艳丽[1,2] 李想[1] 李胜男 王季平 赵慧琳 申一星 牛骏崴 WANG Xinkai;ZHOU Yanli;LI Xiang;LI Shengnan;WANG Jiping;ZHAO Huilin;SHEN Yixing;NIU Junwei(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;The Third Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450008)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第三附属医院,河南郑州450008

出　　处：《中医学报》2025年第5期955-959,共5页Acta Chinese Medicine

基　　金：国家自然科学基金面上项目(82474655);河南省中医药科学研究专项课题项目(2024ZY2087)。

摘　　要：从络病理论角度探讨宫颈癌术后下肢淋巴水肿(lower limb lymphedema,LLL)的病因病机为络脉受金刃所伤,又因络气虚滞或郁滞以致气机紊乱、气化不利,不能推动血运致脉络瘀阻,“血不利则为水”进而引发水肿。故LLL属本虚标实之证,其主要病机特点为“虚、瘀、水”。根据“经脉所过、主治所及”的原则,选取足三阴经和足三阳经由经调络,从“气、血、水”论治,通过点、拨、捋的推拿手法,温通经络、调和气血,并辅以针刺引流,化瘀利水,从而减轻患肢水肿状态,达到标本兼治的效果。The etiology and mechanism of lower limb lymphedema(LLL)of lower limbs after cervical cancer are discussed based on the theory of collateral disease,and the cause and mechanism is that the collaterals are injured by blades.The etiology and pathogenesis of LLL is the injury of collaterals by blades,and due to the deficiency and stagnation or Qi stagnation of collaterals,resulting in Qi disorders and dysfunction of Qi transformation,which can not promote the blood transportation and lead to stasis and stagnation of collaterals,and the"stagnated blood injucing Water stagnation"and then lead to edema.Therefore,LLL belongs to syndrome of deficiency in root and excess in symptom,and its main pathogenesis is characterized by"deficiency,stasis and Water".According to the principle of"treating on where the meridian passes means the corresponding Zang and Fu being treated",we selected the Foot Three Yin meridian and Foot Three Yang meridian and adjust the collateral through meridians.We treat the disease from the perspective of"Qi,blood and Water".Through the Tuina techniques of pointing,plucking and rubbing long distance with hand or fingers,we warmed the meridian and harmonized the Qi and blood,and supplemented with the drainage of needles to eliminate blood stasis and promote the flow of Water,thus reducing the edema state of the affected limbs and achieving the effect of both symptomatic and radical treatment.

关 键 词：宫颈癌术后下肢淋巴水肿 络病理论 推拿 针刺引流 

分 类 号：R246.3[医药卫生—针灸推拿学]