从“筋”论刺治疗颈源性头痛思路探析
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摘要
颈源性头痛是由于颈椎或颈部软组织的器质性或功能性病损所引起的以慢性、单侧头部疼痛为主要表现的综合征。研究从经筋理论及软组织生物力学的角度出发,阐述颈枕部经筋与颈源性头痛的关系,通过详细的专科体查并分析评估病变经筋的状态与特点,以应力集中点、阳性反应点及神经激发点为腧辨"点"论治,探析从"筋"论刺治疗颈源性头痛的临床价值,以期为针灸治疗颈源性头痛提供新的思路。
Cervicogenic headache( CEH) is a syndrome mainly manifested as chronic lateral headache due to organic or functional damage of cervical vertebrae or neck soft tissues. This article explained the relationship between CEH and meridian sinew of cervical occipital area,from the angle of meridian sinew theory and principle of soft tissue biomechanics. By analyzing and assessing the status and characteristics of lesion of meridian sinew by detailed special examination,it also put forward the treatment should based on points differentiation,stress concentration points,positive reacted points,and neural trigger points should be used. This study aimed to explore the clinical value of acupuncture treatment based on meridian sinew theory on CEH,thus to provide a new train of thought for the treatment of CEH.
Cervicogenic headache( CEH) is a syndrome mainly manifested as chronic lateral headache due to organic or functional damage of cervical vertebrae or neck soft tissues. This article explained the relationship between CEH and meridian sinew of cervical occipital area,from the angle of meridian sinew theory and principle of soft tissue biomechanics. By analyzing and assessing the status and characteristics of lesion of meridian sinew by detailed special examination,it also put forward the treatment should based on points differentiation,stress concentration points,positive reacted points,and neural trigger points should be used. This study aimed to explore the clinical value of acupuncture treatment based on meridian sinew theory on CEH,thus to provide a new train of thought for the treatment of CEH.
引文
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[15]陈婕.《灵枢》针法结合刃针松解在颈源性头痛治疗中的应用[J].针灸临床杂志,2015,31(4):43-45.
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[17]刘建勋,林咸明.结合颈部解剖和十二经筋理论对颈源性头痛的治疗探析[J].实用中医内科杂志,2011,25(9):26-28.
[18]董有康,王艺.从“筋”论刺治疗颈源性耳鸣的临床观察[J].中国针灸,2016,36(4):369-372.
[2]Vincent MB.Headache and Neck[J].Curr Pain Headache Rep,2011,15(4):324-331.
[3]Bogduk N,Govind J.Cervicogenic headache:an assessment of the evidence on clinical diagnosis,invasive tests,and treatment[J].Lancet Neurol,2009,8(10):959-968.
[4]Blumenfeld A,Siavoshi S.The Challenges of Cervicogenic Headache[J].Curr Pain Headache Rep,2018,22(7):47.
[5]张凯,刘宇,将戈利.针刺治疗颈源性头痛疗效的系统评价[J].中国疼痛医学杂志,2013,19(11):643-647.
[6]陈军.齐刺颈夹脊穴为主治疗颈源性头痛疗效疗效观察[J].实用中医药杂志,2018,34(1):111-112.
[7]薛立公.中国经筋学[M].北京:中国古籍出版社,2009:25-26.
[8]程永.经筋实质、经筋病病机与执法探讨[J].湖南中医杂志,2011,27(5):97-99.
[9]秦玉革.《内经》经筋的实质是神经[J].中国针灸,2006,26(2):147-150.
[10]茹凯,刘天君.“经筋”实质的系统科学研究[J].北京中医药大学学报,2010,33(4):230-231.
[11]朱清广,房敏,洪水棕.“经筋病”和“骨错缝”在颈椎病中的生物力学作用[J].北京中医药,2010,29(1):34.
[12]潘旭初,宋涛,林咸明.颈源性头痛解剖学成因分析及针灸取穴治疗思路探讨[J].广西中医药大学学报,2014,17(3):83-84.
[13]秦晓旋,万琪.颈源性头痛患者头颈部肌肉触痛点针肌电检查的意义[J].江苏医药,2015,41(13):1534-1536.
[14]董有康,姜云武,王春林,等.肌肉软组织病变应力集中点及阳性反应点针刺治疗机理初探[J].针灸临床杂志,2011,27(3):57-58.
[15]陈婕.《灵枢》针法结合刃针松解在颈源性头痛治疗中的应用[J].针灸临床杂志,2015,31(4):43-45.
[16]高怀云,胡卡明,熊晶晶.神经干刺激疗法临床研究进展[J].中医学报,2012,28(7):880-881.
[17]刘建勋,林咸明.结合颈部解剖和十二经筋理论对颈源性头痛的治疗探析[J].实用中医内科杂志,2011,25(9):26-28.
[18]董有康,王艺.从“筋”论刺治疗颈源性耳鸣的临床观察[J].中国针灸,2016,36(4):369-372.