从筋论治中风后痉挛性偏瘫探析
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摘要
笔者通过研究筋的生理病理特点,历代医家的论述以及现代学者的研究,认为筋有着连接并约束关节,主持运动的功能,生理上与肝、肾、脾等脏腑及十二正经联系密切。当其在感受外邪,或体质虚弱,或过度劳损,或脏腑疾病,或饮食不节,或情志所伤,或失治误治等致病因素影响时,筋的生理功能发生异常,从而形成筋病,筋病主要有筋急与筋纵两种状态。笔者发现中风后痉挛性偏瘫患者的临床表现与筋急极为相似,所以笔者认为筋急的致病因素应当同样适用于中风后痉挛性偏瘫,在解除致病因素,使筋脉恢复濡养之后,其病理状态会得到改善。且有笔者的临床经验及诸多临床案例对笔者观点有着很好的支持。因此,笔者认为医者在治疗中风后痉挛性偏瘫时,可以"扶正祛邪,舒筋缓急"为治疗原则,准确辨证,采取相应的治疗方法,祛除致病因素,即可获得令人满意的疗效。
Through the study of the physiological and pathological characteristics of the tendons, the discussion of successive doctors and the research of modern scholars, the author thinks that the tendons have the function of connecting and restraining the joints, presiding over the movement, and are closely related to the liver, kidney, spleen and other viscera and the twelve meridians. When it is affected by pathogenic factors such as external pathogenic factors, or weak constitution, or excessive strain, or viscera disease, or eating disorders, or emotional injuries, or maltreatment, etc., abnormal physiological functions of tendons occur, thus forming tendons disease, which mainly consists of two states: tendons acute and tendons vertical. The author finds that the clinical manifestation of spasmodic hemiplegia after stroke is very similar to that of spasmodic hemiplegia, so the author believes that the pathogenic factor of spasmodic hemiplegia after stroke should be the same as that of spasmodic hemiplegia. After removing the pathogenic factor and restoring the recuperation of the spasmodic veins, the pathological state would be improved. And the author's clinical experience and a number of clinical cases have a good support for the author's view. Therefore, the author believes that when treating spasmodic hemiplegia after stroke, the medical practitioners can "strengthen the body resistance to eliminate pathogenic factors" and "relax the muscles and joints", which should be the treatment principle, accurate dialectics combined with corresponding treatment methods could dispel the pathogenic factors and can obtain satisfactory curative effect.
Through the study of the physiological and pathological characteristics of the tendons, the discussion of successive doctors and the research of modern scholars, the author thinks that the tendons have the function of connecting and restraining the joints, presiding over the movement, and are closely related to the liver, kidney, spleen and other viscera and the twelve meridians. When it is affected by pathogenic factors such as external pathogenic factors, or weak constitution, or excessive strain, or viscera disease, or eating disorders, or emotional injuries, or maltreatment, etc., abnormal physiological functions of tendons occur, thus forming tendons disease, which mainly consists of two states: tendons acute and tendons vertical. The author finds that the clinical manifestation of spasmodic hemiplegia after stroke is very similar to that of spasmodic hemiplegia, so the author believes that the pathogenic factor of spasmodic hemiplegia after stroke should be the same as that of spasmodic hemiplegia. After removing the pathogenic factor and restoring the recuperation of the spasmodic veins, the pathological state would be improved. And the author's clinical experience and a number of clinical cases have a good support for the author's view. Therefore, the author believes that when treating spasmodic hemiplegia after stroke, the medical practitioners can "strengthen the body resistance to eliminate pathogenic factors" and "relax the muscles and joints", which should be the treatment principle, accurate dialectics combined with corresponding treatment methods could dispel the pathogenic factors and can obtain satisfactory curative effect.
引文
[1]周仲瑛.中医内科学[M].北京:中国中医药出版社,2007:304.
[2]齐江敏,张天生,郝重耀.艾灸治疗中风后痉挛性偏瘫41例临床观察[J].中医临床研究,2015,7(12):120-121.
[3]王新华.中医基础理论[M].北京:人民卫生出版社,2001:386.
[4]施雯馨.内经经筋理论的现代发展[D].北京:北京中医药大学,2009.
[5]刘金洪,方剑桥.十二筋经探讨[J].中国针灸,1998,18(05):281-284.
[6]周仲瑛.中医内科学[M].北京:中国中医药出版社,2007:473.
[7]张聪聪,马亮亮.针刺阳陵泉治手臂筋急1则[J].中国民间疗法,2017,25(09):15.
[8]赵宏伟,张伟光,李丹牧,等.经筋疗法治疗腰腿痛的临床观察[J].针灸临床杂志,2004,20(09):13.
[9]吉学群,张智龙.项针加腹针治疗中风痉挛性偏瘫疗效观察[J].中国针灸,2009,29(12):961-965.
[10]陈波燕.隔姜灸结合针刺治疗中风后痉挛性瘫痪的临床研究[D].广州:广州中医药大学,2012.
[11]周炜,王丽平.腹针治疗脑血管病后痉挛性瘫痪的疗效观察[J].中国针灸,2005,25(11):757-759.
[12]安永泉.中西医结合治疗脑卒中后遗阴虚风动型痉挛性偏瘫的效果分析[J].当代医药论丛,2018,16(09):201-202.
[13]苏巧珍,蔡业峰,卢明,等.舒筋颗粒治疗脑卒中后痉挛性偏瘫疗效观察[J].中国康复理论与实践,2013,9(12):728-729.
[2]齐江敏,张天生,郝重耀.艾灸治疗中风后痉挛性偏瘫41例临床观察[J].中医临床研究,2015,7(12):120-121.
[3]王新华.中医基础理论[M].北京:人民卫生出版社,2001:386.
[4]施雯馨.内经经筋理论的现代发展[D].北京:北京中医药大学,2009.
[5]刘金洪,方剑桥.十二筋经探讨[J].中国针灸,1998,18(05):281-284.
[6]周仲瑛.中医内科学[M].北京:中国中医药出版社,2007:473.
[7]张聪聪,马亮亮.针刺阳陵泉治手臂筋急1则[J].中国民间疗法,2017,25(09):15.
[8]赵宏伟,张伟光,李丹牧,等.经筋疗法治疗腰腿痛的临床观察[J].针灸临床杂志,2004,20(09):13.
[9]吉学群,张智龙.项针加腹针治疗中风痉挛性偏瘫疗效观察[J].中国针灸,2009,29(12):961-965.
[10]陈波燕.隔姜灸结合针刺治疗中风后痉挛性瘫痪的临床研究[D].广州:广州中医药大学,2012.
[11]周炜,王丽平.腹针治疗脑血管病后痉挛性瘫痪的疗效观察[J].中国针灸,2005,25(11):757-759.
[12]安永泉.中西医结合治疗脑卒中后遗阴虚风动型痉挛性偏瘫的效果分析[J].当代医药论丛,2018,16(09):201-202.
[13]苏巧珍,蔡业峰,卢明,等.舒筋颗粒治疗脑卒中后痉挛性偏瘫疗效观察[J].中国康复理论与实践,2013,9(12):728-729.