论“益髓醒神”针刺方案治疗中风后失语的理论内涵
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摘要
中医学认为"肾藏精、精生髓、髓通脑、脑为髓之海",且"脑之为言在也,人精在脑",故采取"益髓醒神"针刺治疗中风后失语,从"醒神为纲、益髓为本、开窍为要"立论贯穿治疗,将中医理论与现代医学相结合,提出脑—肾—髓相关学说,为中风后失语提供精准辨治思路,规范了中风后失语针刺治疗,提高其临床疗效,具有重要的临床意义。
In traditional Chinese medicine,it's well believed that"kidney stores essence,essence produces marrow,marrow fills up the brain and the brain is the sea of marrow",and"the brain governing words and mind". Therefore,arousing brain and nourishing marrow method in acupuncture is applied in post-stroke aphasia treatment with the support of principle,arousing brain,nourishing marrow,and resuscitating spirit. Combining the theory of traditional Chinese medicine with modern medicine model,the theory of brain—kidney—marrow has been put forward,which has a significant clinical value on providing a method for more precise syndrome differentiation and treatment,regulating the therapy of acupuncture for post-stroke aphasia,and improving the clinical effect.
In traditional Chinese medicine,it's well believed that"kidney stores essence,essence produces marrow,marrow fills up the brain and the brain is the sea of marrow",and"the brain governing words and mind". Therefore,arousing brain and nourishing marrow method in acupuncture is applied in post-stroke aphasia treatment with the support of principle,arousing brain,nourishing marrow,and resuscitating spirit. Combining the theory of traditional Chinese medicine with modern medicine model,the theory of brain—kidney—marrow has been put forward,which has a significant clinical value on providing a method for more precise syndrome differentiation and treatment,regulating the therapy of acupuncture for post-stroke aphasia,and improving the clinical effect.
引文
[1]朱蕾,张梅,余亮,等.首发卒中患者6年后预后及其危险因素的前瞻性研究[J].新疆医科大学学报,2017,40(7):909-912.
[2]刘威,李燕梅.中风失语症病机概述[J].中医临床研究,2013,4(24):121-122.
[3]赵嫦莹,童钟,黄春荣,等.针灸结合语言康复训练治疗中风后失语症的临床研究[J].实用中西医结合临床,2016,16(8):9-11.
[4]常静玲,高颖,李胜利,等.针刺配合语言康复治疗脑卒中后运动性失语[J].中国康复理论与实践,2010,9(1):58-59.
[5]常静玲,王爱琴,李胜利,等.中医综合康复干预下中风后失语的中医证候及临床症状演变探究[J].环球中医药,2016,16(8):1020-1023.
[6]莫小琴,罗燕,郑景辉.金津、玉液放血治疗中风失语系统评价[J].辽宁中医药大学学报,2016,18(2):127-129.
[7]张玉萍.针刺哑门及廉泉治疗中风失语症的临床效果观察[J].中国中医药现代远程教育,2013,11(12):48-49.
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[9]沈岩.中风失语症的选穴原则及综合治疗[J].中医药学报,2013,41(4):88-89.
[10]常静玲,高颖,孙塑伦.“形神合一”理论指导下的脑卒中后失语康复治疗与评价[J].中华中医药杂志,2013,28(9):2523-2527.
[11]常静玲,刘剑,高颖.论中风后失语从肾论治的理论渊源及现代生物学基础研究[J].中华中医药杂志,2012,27(7):1904-1907.
[12]霍磊,傅凯丽,赵曼丽,等.调神益髓针刺法结合康复训练治疗脑卒中后平衡功能障碍临床观察[J].上海针灸杂志,2016,38(2):149-152.
[13]李金成.益髓填精法治疗中医脑病研究简况[J].实用中医内科杂志,2014,30(7):182-183.
[14]李胜,傅立新,黄小冬.针灸治疗卒中后失语的方法学分类[J].辽宁中医杂志,2011,22(3):545-547.
[15]聂文彬.针灸益脑调神法治疗脑卒中运动性失语疗效观察[J].北京中医药,2011,35(12):938-939.
[16]钱小路,尤艳利,舒适,等.荣脑醒神针法治疗卒中后抑郁的卫生经济学评价[J].浙江中医药大学学报,2015,39(9):700-703.
[17]张玲,韩运潮.醒脑开窍及补肾益髓法治疗老年痴呆100例[J].中国民康医学,2010,28(22):2863+2951.
[18]张作记.《内经》髓理论探析[J].上海中医药杂志,1991,25(3):40-42.
[19]周鸿飞.中医学“神”的涵义研究[D].北京:中国中医科学院,2006.
[20]蔡光先,瞿岳云,肖子曾.中医神-脏相关论[J].中国中医基础医学杂志,2010,16(12):1085-1088.
[21]郑炜.髓学说初探[J].上海中医药杂志,1992,26(12):39-41.
[22]米建平,余焯燊,赵晓红.“醒脑开窍”法治疗卒中后抑郁症的探讨[J].辽宁中医药大学学报,2009,11(8):30-31.
[23]王琦.形神一体的形神观[J].中华中医药杂志,2012,27(3):652-654.
[24]张雪亮,李维贤.中医脑髓理论初探[J].浙江中医学院学报,1991,15(4):4-6.
[25]崔远武,张连城,李强,等.中医“肾脑系统”的初步构建[J].天津中医药,2015,32(3):142-145.
[26]贺军,徐文安,洪玉娥.卒中后失语患者抑郁的量表评定[J].医学综述,2010,16(12):1898-1901.
[27]刘洋,王雅芹.“醒脑开窍”针刺法配合康复疗法治疗脑卒中失语100例临床观察[J].临床和实验医学杂志,2013,15(8):637-638.
[28]向建桥.针灸治疗中风失语的疗效观察[J].世界最新医学信息文摘,2015,12(84):91-92.
[29]高雁鸿,粟茂.头针治疗脑卒中后失语的临床观察[J].四川中医,2014,32(2):144-146.
[30]谭洁,张泓,韩国栋,等.针灸治疗失语症临床文献的回顾性分析[J].中国针灸,2016,36(4):431-436.
[31]张定戎,陈军.针刺金津玉液对中风失语患者言语功能恢复的作用[J].中国地方病防治杂志,2016,31(10):1188-1189.
[32]Xiao J,Zhang H,Chang JL,et al.Effects of electro-acupuncture at Tongli(HT 5)and Xuanzhong(GB 39)acupoints from functional magnetic resonance imaging evidence[J].Chin J Integr Med,2016,22(11):846-854.
[33]Zhu D,Chang J,Freeman S,et al.Changes of functional connectivity in the left frontoparietal network following aphasic stroke[J].Front Behav Neurosci,2014,22(11):167-170.
[34]Ochfeld E,Newhart M,Molitoris J,et al.Ischemia in broca area is associated with broca aphasia more reliably in acute than in chronic stroke[J].Stroke,2010,41(2):325-330.
[35]李红枝.头针配合功能训练治疗中风失语疗效观察[J].中西医结合心脑血管病杂志,2010,8(5):553-554.
[36]姚利民,高凤梅.针刺配合康复治疗对脑卒中早期病人功能恢复的影响[J].中西医结合心脑血管病杂志,2006,4(6):488-489.
[37]Mac Pherson H,Green G,Nevado A,et al.Brain imaging of acupuncture:comparing superficial with deep needling[J].Neurosci Lett,2008,434(1):144-149.
[38]孔繁一,唐倩,胡玲香.针刺治疗卒中后皮层下失语的机制研究进展[J].针灸临床杂志,2006,22(9):56-58.
[39]陈文,顾红卫,马维平,等.针刺足三里、悬钟对缺血性中风患者脑血管功能的影响:多中心随机对照研究[J].中国针灸,2006,6(12):851-853.
[2]刘威,李燕梅.中风失语症病机概述[J].中医临床研究,2013,4(24):121-122.
[3]赵嫦莹,童钟,黄春荣,等.针灸结合语言康复训练治疗中风后失语症的临床研究[J].实用中西医结合临床,2016,16(8):9-11.
[4]常静玲,高颖,李胜利,等.针刺配合语言康复治疗脑卒中后运动性失语[J].中国康复理论与实践,2010,9(1):58-59.
[5]常静玲,王爱琴,李胜利,等.中医综合康复干预下中风后失语的中医证候及临床症状演变探究[J].环球中医药,2016,16(8):1020-1023.
[6]莫小琴,罗燕,郑景辉.金津、玉液放血治疗中风失语系统评价[J].辽宁中医药大学学报,2016,18(2):127-129.
[7]张玉萍.针刺哑门及廉泉治疗中风失语症的临床效果观察[J].中国中医药现代远程教育,2013,11(12):48-49.
[8]常静玲,高颖.电针语言相关组穴对1例左侧颞、顶、枕交界区损伤卒中后运动性失语患者的语言学评价及影像学探讨[J].北京中医药大学学报:中医临床版,2012,19(4):1-5.
[9]沈岩.中风失语症的选穴原则及综合治疗[J].中医药学报,2013,41(4):88-89.
[10]常静玲,高颖,孙塑伦.“形神合一”理论指导下的脑卒中后失语康复治疗与评价[J].中华中医药杂志,2013,28(9):2523-2527.
[11]常静玲,刘剑,高颖.论中风后失语从肾论治的理论渊源及现代生物学基础研究[J].中华中医药杂志,2012,27(7):1904-1907.
[12]霍磊,傅凯丽,赵曼丽,等.调神益髓针刺法结合康复训练治疗脑卒中后平衡功能障碍临床观察[J].上海针灸杂志,2016,38(2):149-152.
[13]李金成.益髓填精法治疗中医脑病研究简况[J].实用中医内科杂志,2014,30(7):182-183.
[14]李胜,傅立新,黄小冬.针灸治疗卒中后失语的方法学分类[J].辽宁中医杂志,2011,22(3):545-547.
[15]聂文彬.针灸益脑调神法治疗脑卒中运动性失语疗效观察[J].北京中医药,2011,35(12):938-939.
[16]钱小路,尤艳利,舒适,等.荣脑醒神针法治疗卒中后抑郁的卫生经济学评价[J].浙江中医药大学学报,2015,39(9):700-703.
[17]张玲,韩运潮.醒脑开窍及补肾益髓法治疗老年痴呆100例[J].中国民康医学,2010,28(22):2863+2951.
[18]张作记.《内经》髓理论探析[J].上海中医药杂志,1991,25(3):40-42.
[19]周鸿飞.中医学“神”的涵义研究[D].北京:中国中医科学院,2006.
[20]蔡光先,瞿岳云,肖子曾.中医神-脏相关论[J].中国中医基础医学杂志,2010,16(12):1085-1088.
[21]郑炜.髓学说初探[J].上海中医药杂志,1992,26(12):39-41.
[22]米建平,余焯燊,赵晓红.“醒脑开窍”法治疗卒中后抑郁症的探讨[J].辽宁中医药大学学报,2009,11(8):30-31.
[23]王琦.形神一体的形神观[J].中华中医药杂志,2012,27(3):652-654.
[24]张雪亮,李维贤.中医脑髓理论初探[J].浙江中医学院学报,1991,15(4):4-6.
[25]崔远武,张连城,李强,等.中医“肾脑系统”的初步构建[J].天津中医药,2015,32(3):142-145.
[26]贺军,徐文安,洪玉娥.卒中后失语患者抑郁的量表评定[J].医学综述,2010,16(12):1898-1901.
[27]刘洋,王雅芹.“醒脑开窍”针刺法配合康复疗法治疗脑卒中失语100例临床观察[J].临床和实验医学杂志,2013,15(8):637-638.
[28]向建桥.针灸治疗中风失语的疗效观察[J].世界最新医学信息文摘,2015,12(84):91-92.
[29]高雁鸿,粟茂.头针治疗脑卒中后失语的临床观察[J].四川中医,2014,32(2):144-146.
[30]谭洁,张泓,韩国栋,等.针灸治疗失语症临床文献的回顾性分析[J].中国针灸,2016,36(4):431-436.
[31]张定戎,陈军.针刺金津玉液对中风失语患者言语功能恢复的作用[J].中国地方病防治杂志,2016,31(10):1188-1189.
[32]Xiao J,Zhang H,Chang JL,et al.Effects of electro-acupuncture at Tongli(HT 5)and Xuanzhong(GB 39)acupoints from functional magnetic resonance imaging evidence[J].Chin J Integr Med,2016,22(11):846-854.
[33]Zhu D,Chang J,Freeman S,et al.Changes of functional connectivity in the left frontoparietal network following aphasic stroke[J].Front Behav Neurosci,2014,22(11):167-170.
[34]Ochfeld E,Newhart M,Molitoris J,et al.Ischemia in broca area is associated with broca aphasia more reliably in acute than in chronic stroke[J].Stroke,2010,41(2):325-330.
[35]李红枝.头针配合功能训练治疗中风失语疗效观察[J].中西医结合心脑血管病杂志,2010,8(5):553-554.
[36]姚利民,高凤梅.针刺配合康复治疗对脑卒中早期病人功能恢复的影响[J].中西医结合心脑血管病杂志,2006,4(6):488-489.
[37]Mac Pherson H,Green G,Nevado A,et al.Brain imaging of acupuncture:comparing superficial with deep needling[J].Neurosci Lett,2008,434(1):144-149.
[38]孔繁一,唐倩,胡玲香.针刺治疗卒中后皮层下失语的机制研究进展[J].针灸临床杂志,2006,22(9):56-58.
[39]陈文,顾红卫,马维平,等.针刺足三里、悬钟对缺血性中风患者脑血管功能的影响:多中心随机对照研究[J].中国针灸,2006,6(12):851-853.