针刺治疗脑卒中后感觉障碍研究进展
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摘要
脑卒中作为一种具有高发病率、高致残率和高病死率的急性脑血管疾病已成为我国第一位病死原因,也是中国成年人残疾的首要原因。脑卒中后会因脑损伤致使感觉传导通路受阻,无法完成正常的神经冲动而产生的一系列感觉障碍,严重影响了患者继续生活。这种感觉障碍在中医属中风后麻痹的范畴,认为脾肾阴虚,风寒湿邪入侵,阻塞气机血脉致使气血无以濡养经络是其主要的病因病机。针刺作为一种治疗脑卒中后感觉障碍的中医药特色疗法,能有效的改善患者的临床症状。目前用于该病治疗的针刺疗法主要包括皮肤针疗法、电针疗法和刺络疗法,除此之外,针药综合疗法和中频脉冲电等特殊疗法在临床的治疗方面也有着显著效果。该文就脑卒中后感觉障碍的病因病机和近年来针刺治疗脑卒中后感觉障碍的进展作一综述,以期为今后脑卒中后感觉障碍的临床治疗提供参考依据。
Cerebral stroke as an acute disease with high morbidity,disability and mortality,has become the first cause of death in China and the primary cause of adult disability in China. After stroke,a series of sensory disorders caused by brain injury will result in the obstruction of sensory conduction pathway and the inability to complete normal nerve impulses,which seriously affect the patients' continuing life. This kind of sensory disorder belongs to the category of paralysis after apoplexy. It is considered that the main etiology and pathogenesis are deficiency of spleen and kidney,invasion of wind,cold and dampness evil,and obstruction of Qi and blood vessels,causing Qi and blood to nourish the meridians and meridians.Acupuncture as a traditional Chinese medicine characteristic therapy for sensory disorders after stroke,can effectively improve the clinical symptoms of patients. At present,acupuncture therapy mainly includes skin acupuncture therapy,electroacupuncture therapy and acupuncture therapy. In addition,the combination of acupuncture and medicine and the special therapy such as intermediate frequency pulse electrotherapy also have remarkable effect in clinical treatment. This article reviews the etiology and pathogenesis of sensory disorders after stroke and the progress of acupuncture in treating poststroke sensory disorders in recent years in order to provide a reference for the clinical treatment of poststroke sensory disorders.
Cerebral stroke as an acute disease with high morbidity,disability and mortality,has become the first cause of death in China and the primary cause of adult disability in China. After stroke,a series of sensory disorders caused by brain injury will result in the obstruction of sensory conduction pathway and the inability to complete normal nerve impulses,which seriously affect the patients' continuing life. This kind of sensory disorder belongs to the category of paralysis after apoplexy. It is considered that the main etiology and pathogenesis are deficiency of spleen and kidney,invasion of wind,cold and dampness evil,and obstruction of Qi and blood vessels,causing Qi and blood to nourish the meridians and meridians.Acupuncture as a traditional Chinese medicine characteristic therapy for sensory disorders after stroke,can effectively improve the clinical symptoms of patients. At present,acupuncture therapy mainly includes skin acupuncture therapy,electroacupuncture therapy and acupuncture therapy. In addition,the combination of acupuncture and medicine and the special therapy such as intermediate frequency pulse electrotherapy also have remarkable effect in clinical treatment. This article reviews the etiology and pathogenesis of sensory disorders after stroke and the progress of acupuncture in treating poststroke sensory disorders in recent years in order to provide a reference for the clinical treatment of poststroke sensory disorders.
引文
[1]潘丹,郎伯旭,金城钟,等.针刺配合放血疗法治疗脑卒中后感觉障碍疗效观察[J].上海针灸杂志,2016,35(7):782-785.
[2]冯晓东,高玲莉,李瑞青,等.拔罐放血疗法对脑卒中后偏侧感觉障碍的临床疗效观察[J].中国康复理论与实践,2015,21(10):1206-1208.
[3]毛显禹,黄建平,朱文宗,等.点穴对脑卒中后偏侧感觉功能障碍的效果[J].中国康复理论与实践,2016,22(10):1141-1144.
[4]周游飞,王德强,薄智慧,等.脑卒中后肩关节本体感觉障碍的研究进展[J].中国康复医学杂志,2016,31(7):805-808.
[5]高竹颖.透刺法配合电针治疗脑卒中后偏身感觉障碍的临床观察[D].哈尔滨:黑龙江中医药大学,2016.
[6]雷婉慈.腹针治疗脑卒中后偏身感觉障碍的临床研究[D].广州:广州中医药大学,2012.
[7]何华.肾虚痰瘀是中风后遗症的基本病机[J].山东中医药大学学报,2006,30(2):104-107.
[8]王金桥.试论脾虚血亏是中风后遗症的主要病机[J].浙江中西医结合杂志,2010,20(7):410-411.
[9]王悦,柴学森,胡广东.头针结合体针治疗脑卒中后假性延髓麻痹所致吞咽障碍[J].针灸临床杂志,2011,27(9):22-23.
[10]任永新,杜敏,王素芳,等.头体针组穴交替治疗假性球麻痹60例[J].陕西中医,2006,27(5):605-606.
[11]孙华,包飞,王道海,等.头针配合体针治疗中风假性球麻痹疗效观察[J].中国康复理论与实践,2006,12(7):599-600.
[12]曾纪伟,何扬子,杨小奇,等.项针配合常规针刺治疗缺血性中风50例临床研究[J].江苏中医药,2011,43(1):59-60.
[13]陆军伟,孙建华.颈项针为主治疗假性球麻痹疗效观察[J].上海针灸杂志,2009,28(7):262-265.
[14]高维滨,刘勇,倪金霞,等.项针治疗中风后假性延髓麻痹的临床研究[J].上海针灸杂志,2009,28(1):18-20.
[15]孙辉.项针治疗脑卒中后假性延髓麻痹40例[J].针灸临床杂志,2012,28(5):13-15.
[16]李敏,孙建华,陆军伟,等.项五针治疗中风后延髓麻痹吞咽困难疗效观察[J].中国针灸,2009,29(11):873-875.
[17]刘峻,王良辰.眼针疗法治疗假性球麻痹吞咽障碍临床观察[J].辽宁中医药大学学报,2011(5):219-220.
[18]罗立欣,于秀,白丽,等.眼针治疗中风后吞咽困难35例疗效观察[J].实用中医内科杂志,2011,25(3):97-98.
[19]项小林,杨婷婷.双侧头皮透刺电针疗法结合穴位注射治疗中风后遗症疗效观察[J].中国全科医学,2011,14(23):2701-2703.
[20]王红梅.电针治疗中风后遗症[J].中国民族民间医药,2010,19(22):100.
[21]滕秀英,王晨燃.不同频率电针治疗脑卒中后偏身感觉障碍疗效观察[J].上海针灸杂志,2017,36(7):781-784.
[22]叶晓春,巴东娇,赵普,等.不同频率电针刺激治疗神经根型颈椎病临床研究[J].上海中医药杂志,2015,49(4):65-67.
[23]牛犇.电针与神经肌肉电刺激疗法治疗脑卒中所致吞咽障碍的疗效比较[J].按摩与康复医学,2015,6(24):40-41.
[24]王蓉芸,林贤雷,孙秋华.经皮穴位电刺激干预卒中后疲劳的临床研究[J].上海针灸杂志,2017,36(1):14-16.
[25]刘华,刘仲杰,施土生.刺络放血法治疗中风偏瘫麻木症疗效观察[J].中国针灸,2006,26(5):337-338.
[26]周黎,周智梁.刺血疗法对脑梗死致偏身感觉障碍患者脑血流的影响[J].上海针灸杂志,2010,29(2):83-85.
[27]刘明.十宣放血治疗中风后遗症手臂麻木[J].中国针灸,2003,23(1):34-35.
[28]吴萍,丁德光.刺络结合穴位注射治疗中风后偏身麻木症临床研究[J].湖北中医杂志,2018(2):125.
[29]金泽,刘承薇.针刺结合刺络疗法治疗中风后偏身感觉障碍的临床观察[J].针灸临床杂志,2013(7):25-26.
[30]陈艳萍.针刺配合刺络拔罐治疗脑卒中后偏身感觉障碍临床研究[J].河南中医,2017,37(1):87-89.
[31]唐利军.中风参芪通络胶囊联合针刺治疗中风恢复期假性球麻痹的疗效分析[J].内蒙古中医药,2017,36(Z2):20-21.
[32]杨盼盼.通络解语丸配合针刺治疗中风后假性球麻痹临床观察[D].郑州:河南中医药大学,2016.
[33]姜晓维.血府逐瘀汤联合针刺治疗中风后假性球麻痹100例临床观察[J].内蒙古中医药,2013,32(32):8-9.
[34]房金凤,谢云亮,王启林.脑血管病致假性球麻痹中频脉冲康复护理[J].中国城乡企业卫生,2014,29(5):135-136.
[35]余智.病灶头皮反射区埋线治疗脑卒中后感觉障碍临床研究[J].中国针灸,2014,34(7):631-635.
[36]毛显禹,黄建平,朱文宗,等.点穴对脑卒中后偏侧感觉功能障碍的效果[J].中国康复理论与实践,2016,22(10):1141-1144.
[2]冯晓东,高玲莉,李瑞青,等.拔罐放血疗法对脑卒中后偏侧感觉障碍的临床疗效观察[J].中国康复理论与实践,2015,21(10):1206-1208.
[3]毛显禹,黄建平,朱文宗,等.点穴对脑卒中后偏侧感觉功能障碍的效果[J].中国康复理论与实践,2016,22(10):1141-1144.
[4]周游飞,王德强,薄智慧,等.脑卒中后肩关节本体感觉障碍的研究进展[J].中国康复医学杂志,2016,31(7):805-808.
[5]高竹颖.透刺法配合电针治疗脑卒中后偏身感觉障碍的临床观察[D].哈尔滨:黑龙江中医药大学,2016.
[6]雷婉慈.腹针治疗脑卒中后偏身感觉障碍的临床研究[D].广州:广州中医药大学,2012.
[7]何华.肾虚痰瘀是中风后遗症的基本病机[J].山东中医药大学学报,2006,30(2):104-107.
[8]王金桥.试论脾虚血亏是中风后遗症的主要病机[J].浙江中西医结合杂志,2010,20(7):410-411.
[9]王悦,柴学森,胡广东.头针结合体针治疗脑卒中后假性延髓麻痹所致吞咽障碍[J].针灸临床杂志,2011,27(9):22-23.
[10]任永新,杜敏,王素芳,等.头体针组穴交替治疗假性球麻痹60例[J].陕西中医,2006,27(5):605-606.
[11]孙华,包飞,王道海,等.头针配合体针治疗中风假性球麻痹疗效观察[J].中国康复理论与实践,2006,12(7):599-600.
[12]曾纪伟,何扬子,杨小奇,等.项针配合常规针刺治疗缺血性中风50例临床研究[J].江苏中医药,2011,43(1):59-60.
[13]陆军伟,孙建华.颈项针为主治疗假性球麻痹疗效观察[J].上海针灸杂志,2009,28(7):262-265.
[14]高维滨,刘勇,倪金霞,等.项针治疗中风后假性延髓麻痹的临床研究[J].上海针灸杂志,2009,28(1):18-20.
[15]孙辉.项针治疗脑卒中后假性延髓麻痹40例[J].针灸临床杂志,2012,28(5):13-15.
[16]李敏,孙建华,陆军伟,等.项五针治疗中风后延髓麻痹吞咽困难疗效观察[J].中国针灸,2009,29(11):873-875.
[17]刘峻,王良辰.眼针疗法治疗假性球麻痹吞咽障碍临床观察[J].辽宁中医药大学学报,2011(5):219-220.
[18]罗立欣,于秀,白丽,等.眼针治疗中风后吞咽困难35例疗效观察[J].实用中医内科杂志,2011,25(3):97-98.
[19]项小林,杨婷婷.双侧头皮透刺电针疗法结合穴位注射治疗中风后遗症疗效观察[J].中国全科医学,2011,14(23):2701-2703.
[20]王红梅.电针治疗中风后遗症[J].中国民族民间医药,2010,19(22):100.
[21]滕秀英,王晨燃.不同频率电针治疗脑卒中后偏身感觉障碍疗效观察[J].上海针灸杂志,2017,36(7):781-784.
[22]叶晓春,巴东娇,赵普,等.不同频率电针刺激治疗神经根型颈椎病临床研究[J].上海中医药杂志,2015,49(4):65-67.
[23]牛犇.电针与神经肌肉电刺激疗法治疗脑卒中所致吞咽障碍的疗效比较[J].按摩与康复医学,2015,6(24):40-41.
[24]王蓉芸,林贤雷,孙秋华.经皮穴位电刺激干预卒中后疲劳的临床研究[J].上海针灸杂志,2017,36(1):14-16.
[25]刘华,刘仲杰,施土生.刺络放血法治疗中风偏瘫麻木症疗效观察[J].中国针灸,2006,26(5):337-338.
[26]周黎,周智梁.刺血疗法对脑梗死致偏身感觉障碍患者脑血流的影响[J].上海针灸杂志,2010,29(2):83-85.
[27]刘明.十宣放血治疗中风后遗症手臂麻木[J].中国针灸,2003,23(1):34-35.
[28]吴萍,丁德光.刺络结合穴位注射治疗中风后偏身麻木症临床研究[J].湖北中医杂志,2018(2):125.
[29]金泽,刘承薇.针刺结合刺络疗法治疗中风后偏身感觉障碍的临床观察[J].针灸临床杂志,2013(7):25-26.
[30]陈艳萍.针刺配合刺络拔罐治疗脑卒中后偏身感觉障碍临床研究[J].河南中医,2017,37(1):87-89.
[31]唐利军.中风参芪通络胶囊联合针刺治疗中风恢复期假性球麻痹的疗效分析[J].内蒙古中医药,2017,36(Z2):20-21.
[32]杨盼盼.通络解语丸配合针刺治疗中风后假性球麻痹临床观察[D].郑州:河南中医药大学,2016.
[33]姜晓维.血府逐瘀汤联合针刺治疗中风后假性球麻痹100例临床观察[J].内蒙古中医药,2013,32(32):8-9.
[34]房金凤,谢云亮,王启林.脑血管病致假性球麻痹中频脉冲康复护理[J].中国城乡企业卫生,2014,29(5):135-136.
[35]余智.病灶头皮反射区埋线治疗脑卒中后感觉障碍临床研究[J].中国针灸,2014,34(7):631-635.
[36]毛显禹,黄建平,朱文宗,等.点穴对脑卒中后偏侧感觉功能障碍的效果[J].中国康复理论与实践,2016,22(10):1141-1144.