| 张洁,杨帆,张泽元,等.基于“治痿独取阳明”运用外治法治疗桡神经损伤的临证体会[J].浙江中医药大学学报,2024,48(10):1269-1273. |
| 基于“治痿独取阳明”运用外治法治疗桡神经损伤的临证体会 |
| Clinical Experience of Treating Radial Nerve Injury with External Treatments Based on“ Treatment for Flaccid Paralysis Aim?ing at Yangming Meridian” |
| DOI：10.16466/j.issn1005-5509.2024.10.011 |
| 中文关键词: 桡神经损伤 痿证 治痿独取阳明 瘀血阻滞 活血化瘀 针刺 中药熏洗 外治 |
| 英文关键词: radial nerve injury flaccidity syndrome treatment for flaccid paralysis aiming at Yangming meridian stasis block promoting blood circulation and removing blood stasis acupuncture traditional Chinese medicine fumigation and washing external treatment |
| 基金项目:嘉兴市脑血管病中西医结合康复研究重点实验室建设项目(嘉科高﹝2022﹞12号) |
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| 中文摘要: |
| [目的] 阐发基于“治痿独取阳明”运用外治法治疗桡神经损伤的体会。[方法] 立足桡神经损伤的症状表现，探析其病因病机，并深入分析“治痿独取阳明”的内涵，以经典条文为指导，阐发运用外治法治疗桡神经损伤的策略，并举典型医案进行论证。[结果]桡神经损伤的成因不外乎虚实，虚证包括脾胃虚衰、肝肾亏虚，实证包括湿热、瘀血、痰浊阻滞，易发为虚实夹杂证。“治痿独取阳明”非独专注脾胃，同时也并非一味补益脾胃之虚，而是重视以调理脾胃为核心，辨别虚实，兼顾五脏，以疏通和补益气血为根本。在“治痿独取阳明”指导下的外治策略可总结为“针灸治病，重取阳明”“穴位按摩，推行气血”“中药外用，活血通络”“康复锻炼，辅以理疗”“中西并举，效捷为要”，临床上诸多手段灵活配合，能够收获显著效果。所举医案中，患者因车祸损伤桡神经而发病，辨为瘀血阻滞之痿证，治以活血化瘀、通络止痛，综合运用针刺、推拿以及中药熏洗等手段，治疗1月患者手腕活动自如，收效显著。[结论]“ 治痿独取阳明”非独补益脾胃之虚，而是重在畅达阳明气血，使得气机和调，生化正常。该理论开创了从活血化瘀角度论治桡神经损伤的思路，重视发挥针刺、推拿及中药熏洗等外治法的优势。 |
| 英文摘要: |
| [Objective] To elucidate the experience of treating radial nerve injury with external treatment based on“ treatment for flaccid paralysis aiming at Yangming meridian”. [Methods] Based on the symptoms and manifestations of radial nerve injury， the etiology and pathogenesis were analyzed， and the connotation of“ treatment for flaccid paralysis aiming at Yangming meridian” was deeply analyzed.The strategies of treating radial nerve injury with external treatment were expounded with the guidance of classical articles， and a typical medical case was presented for demonstration. [Results] The causes of radial nerve injury are nothing more than deficiency and excess. The deficiency symptoms are deficiency of the spleen and stomach， deficiency of the liver and kidney， and the excess symptoms include dampness， heat， blood stasis， phlegm turbidity block， and it is easy to be mixed with deficiency and excess.“ Treatment for flaccid paralysis aiming at Yangming meridian” not only focuses on the spleen and stomach， but also not blindly tonifying the spleen and stomach，but paying attention to regulating the spleen and stomach as the core， distinguishing deficiency and excess， taking into account the five viscera， and clearing and tonifying Qi and blood as the fundamental. The external treatment strategy under the guidance of“ treatment for flaccid paralysis aiming at Yangming meridian” can be summarized as“ use acupuncture treatment， and focus on selecting Yangming”“use acupressure to promote Qi and blood”“ external use of traditional Chinese medicine to promote blood circulation and remove meridian obstruction”“ rehabilitation exercise， supplemented by physiotherapy” and “ combining Chinese and western， and get results quickly”，clinical flexible cooperation of many means can harvest significant results. In the medical case cited， the patient suffered from the radial nerve injury due to a car accident， and identified as the flaccidity syndrome of blood stasis block. The treatment was based on the principle of promoting blood circulation and removing blood stasis， clearing the channels and relieving pain， and the comprehensive use of acupuncture， massage and traditional Chinese medicine fumigation and washing was used to treat the patient’s wrist freely for one month，with remarkable results. [Conclusion]“ Treatment for flaccid paralysis aiming at Yangming meridian” is not only tonifying the deficiency of the spleen and stomach， but focusing on dredging Yangming Qi and blood， and producing normally. The theory guides the thinking of treating radial nerve injury from the angle of promoting blood circulation and removing blood stasis， attaches importance to the advantages of acupuncture， massage and traditional Chinese medicine fumigation and washing. |
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