筋骨针治疗中风后上肢痉挛性偏瘫经验
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摘要
目的中风后痉挛性偏瘫属中医"经筋病"范畴,主要病机为阴阳气血失衡,治疗上以疏通经络、放松肌肉挛缩为原则,"筋骨针"则能够解除痉挛肌肉筋膜等部位的粘连、瘢痕、挛缩、堵塞、无菌性炎症刺激等对肌梭、Ⅰa、γ等神经纤维的刺激,从而达到明显减少神经冲动传入及传出,缓解或解除肌痉挛的目的,文章介绍筋骨针治疗痉挛瘫的经验。方法采用"筋骨针"对痉挛部位进行松解、剥离,破坏部分肌梭感受装置,切开腱的部分腱器可使肌肉松弛,切断部分Ⅰa类纤维,减少冲动的传入。选一例病例作为典型案例,予以筋骨针治疗。结果经筋骨针治疗后,患者肢体肌力、肌张力,及患肢关节活动疼痛度、关节活动范围均较治疗前有改善。结论 "筋骨针"不仅具有传统针刺法的作用,还能快速松解肌肉筋膜的机械压迫,松解局部软组织粘连痉挛以迅速止痛,消除炎性反应,改善局部炎性反应和免疫反应,达到明显的缓解或解除肌痉挛的目的。
Objective To introduce the experience of physique needle in the treatment of spastic hemiplegia of upper limb after stroke.Spastic hemiplegia after stroke belongs to the category of "aponeurotic system disease"in traditional Chinese medicine. The main etiology and pathogenesis is the imbalance between the economy's yin-yang and qi and blood. The Jingo needle can relieve some questions of spasmodic muscle fascia,such as adhesion,scar contracture,and block,aseptic inflammation stimulation on muscle spindle,Ⅰa,γ,etc.The stimulation of nerve fibers significantly reduces the impulse and the incoming and outgoing,to achieve the goal of the apparent ease or remove muscle spasm. Method The spasmodic site was loosened,peeled off,and part of the muscle spindle perception device was destroyed by physique needle. The partial tendon apparatus of the tendon incision could relax the muscle,cut off some type Ⅰa fibers,and reduce the afferent of impulse. This article selects a case as a typical case,and gives acupuncture treatment of muscles and bones. Result Not only the physique needle has the function of the traditional acupuncture,also can quickly relieve the mechanically compression of muscle,and release the adhesion tendon of local soft tissue to remove the inflammatory reaction and pain,to improve the local inflammatory response and immune response,and to achieve the objective of the apparent ease or remove muscle spasm inflammatory reaction. Conclusion The physique needle can enhance the local inflammatory response and immune response to achieve the objective of the apparent ease or remove muscle spasm.
Objective To introduce the experience of physique needle in the treatment of spastic hemiplegia of upper limb after stroke.Spastic hemiplegia after stroke belongs to the category of "aponeurotic system disease"in traditional Chinese medicine. The main etiology and pathogenesis is the imbalance between the economy's yin-yang and qi and blood. The Jingo needle can relieve some questions of spasmodic muscle fascia,such as adhesion,scar contracture,and block,aseptic inflammation stimulation on muscle spindle,Ⅰa,γ,etc.The stimulation of nerve fibers significantly reduces the impulse and the incoming and outgoing,to achieve the goal of the apparent ease or remove muscle spasm. Method The spasmodic site was loosened,peeled off,and part of the muscle spindle perception device was destroyed by physique needle. The partial tendon apparatus of the tendon incision could relax the muscle,cut off some type Ⅰa fibers,and reduce the afferent of impulse. This article selects a case as a typical case,and gives acupuncture treatment of muscles and bones. Result Not only the physique needle has the function of the traditional acupuncture,also can quickly relieve the mechanically compression of muscle,and release the adhesion tendon of local soft tissue to remove the inflammatory reaction and pain,to improve the local inflammatory response and immune response,and to achieve the objective of the apparent ease or remove muscle spasm inflammatory reaction. Conclusion The physique needle can enhance the local inflammatory response and immune response to achieve the objective of the apparent ease or remove muscle spasm.
引文
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[2]钟长明,刘庆芳,金红阳,等. Effects of acupuncture and balance facilitation of muscular tension on the early rehabilitation of patients with stroke and hemiplegia[J].中国临床康复,2002,22(23):3612-3613.
[3] AKKAYA T,UNLU E,ALPTEKIN A,et al. Neurolytic phenol blockade of the obturator nerve for severe adductor spasticity[J].Acta Anaesthesiologica Scandinavica,2010,54(1):79-85.
[4]史军月,张新亚,张春红.中风后痉挛性瘫痪的理论认识及针灸研究进展[J].针灸临床杂志,2015,31(3):85-87.
[5]刘婧,鲍春龄,张桂波,等.阴阳调衡透刺法对中风后痉挛瘫患者行走功能重建的影响[J].上海针灸杂志,2014,33(1):7-10.
[6]王宁,李志峰,吴海红.火针疗法治疗中风后痉挛性偏瘫的临床疗效观察[J].针刺研究,2015,40(4):304-308.
[7] MAIA MON,DANTAS CG,FILHO LX,et al. The effect of Alpinia zerumbet essential oil on post-stroke muscle spasticity[J]. Basic Clin Pharmacol Toxicol,2016,118(1):58-62.
[8] TROMPETTO C,MARINELLI L,Mori L,et al. Pathophysiology of asticity:Implications for Neurorehabilitation[J]. Biomed Res Int,2014,35(4):90-96.
[9]郎建英.靳三针疗法结合康复训练治疗缺血性中风后痉挛性偏瘫的疗效研究[D].广州:广州中医药大学,2011.
[10]吴汉卿,吴军尚.中医筋骨三针疗法[M].北京:人民卫生出版社,2014:18-19.
[2]钟长明,刘庆芳,金红阳,等. Effects of acupuncture and balance facilitation of muscular tension on the early rehabilitation of patients with stroke and hemiplegia[J].中国临床康复,2002,22(23):3612-3613.
[3] AKKAYA T,UNLU E,ALPTEKIN A,et al. Neurolytic phenol blockade of the obturator nerve for severe adductor spasticity[J].Acta Anaesthesiologica Scandinavica,2010,54(1):79-85.
[4]史军月,张新亚,张春红.中风后痉挛性瘫痪的理论认识及针灸研究进展[J].针灸临床杂志,2015,31(3):85-87.
[5]刘婧,鲍春龄,张桂波,等.阴阳调衡透刺法对中风后痉挛瘫患者行走功能重建的影响[J].上海针灸杂志,2014,33(1):7-10.
[6]王宁,李志峰,吴海红.火针疗法治疗中风后痉挛性偏瘫的临床疗效观察[J].针刺研究,2015,40(4):304-308.
[7] MAIA MON,DANTAS CG,FILHO LX,et al. The effect of Alpinia zerumbet essential oil on post-stroke muscle spasticity[J]. Basic Clin Pharmacol Toxicol,2016,118(1):58-62.
[8] TROMPETTO C,MARINELLI L,Mori L,et al. Pathophysiology of asticity:Implications for Neurorehabilitation[J]. Biomed Res Int,2014,35(4):90-96.
[9]郎建英.靳三针疗法结合康复训练治疗缺血性中风后痉挛性偏瘫的疗效研究[D].广州:广州中医药大学,2011.
[10]吴汉卿,吴军尚.中医筋骨三针疗法[M].北京:人民卫生出版社,2014:18-19.