| 王茸,许军峰,俞晓阳.石学敏院士治疗中风后吞咽障碍的临床思路辨析[J].浙江中医药大学学报,2022,46(1):65-68. |
| 石学敏院士治疗中风后吞咽障碍的临床思路辨析 |
| Academician SHI Xuemin‘s Clinical Experience in the Treatment of Stroke Dysphagia |
| DOI：10.16466/j.issn1005-5509.2022.01.010 |
| 中文关键词: 中风后吞咽障碍 醒脑 调神 利窍 针刺手法量化 医案 名医经验 石学敏 |
| 英文关键词: stroke dysphagia restoring consciousness regulating the mind promote the orifices quantification of acupuncture manipulation medical records experience of famous doctors SHI Xuemin |
| 基金项目:广东省重点领域研发计划(2020B1111100007) |
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| 中文摘要: |
| [目的] 总结石学敏院士治疗中风后吞咽障碍的经验。[方法] 通过临床跟师、临证记录及参阅文献，从病因病机、治则治法、临证治疗特色三个层面总结石学敏院士治疗中风后吞咽障碍的临床经验，并附医案佐证。[结果] 石学敏院士认为中风后吞咽障碍发生的根本原因是本虚标实，即风、火、痰、瘀等邪趁虚而入，破坏人体阴阳平衡而致神窍阻遏，神机失用，关窍闭阻，故将治疗立足于“醒脑”“醒神”“调神”，将治则概括为调神导气、滋补三阴、通关利窍三方面，创立了以内关、人中、三阴交、风池、完骨、翳风为主穴的“通关利窍”针刺法。石院士认为中风病多责于神，故提出“调神”是核心；强调整体与局部相结合，标本同治，因人而异；并将针刺手法量学化。所举验案以中风后吞咽障碍、左侧肢体不遂为主，治以调神导气、滋补三阴、通关利窍，以标准“通关利窍”针刺法操作，随症加减，疗效确切。[结论] 石学敏院士治疗中风后吞咽障碍谨守“醒脑、调神”之大法，强调整体与局部相结合，标本同治，因人而异，临床疗效满意，并将针刺手法量效化，便于临床应用及推广。 |
| 英文摘要: |
| [Objective] To sum up Academician SHI Xuemin‘s clinical experience and academic thoughts in the treatment of stroke dysphagia. [Methods] Through following Academician SHI Xuemin‘s clinical work， recording， sorting out and analyzing the medical records of Academician SHI Xuemin in the treatment of stroke dysphagia， this paper introduced Academician SHI Xuemin‘s clinical experience in the treatment of stroke dysphagia from the three aspects: Etiology and pathogenesis， treatment principle and method， clinical treatment characteristics， and provided evidence with a medical case. [Results] Academician SHI Xuemin believes that the root cause of dysphagia after stroke is deficiency of origin and excess of substance， that is， wind， fire， phlegm， blood stasis and other evils take advantage of the deficiency， destroy the balance of Yin and Yang of the human body and it further leads to the inhibition of the divine orifices， the failure of spiritual mechanism and orifices， so the treatment of stroke dysphagia is based on “restoring consciousness”“inducing resuscitation” and “regulating the mind”， and the treatment principles are summarized as three aspects: Regulating the mind and guiding Qi， nourishing the three Yin， dredging the orifice， and the acupuncture method of “consciousness restoring and orifice opening” is established， which is mainly composed of Neiguan， Renzhong or Yintang， Sanyinjiao， Fengchi， Wangu and Yifeng. Academician SHI thinks that stroke is mostly due to the spirit， so he puts forward “regulating the mind” as the core; and emphasizes the combination of the whole and the local， the treatment of the symptoms and the root causes， and varies from person to person; and standardizes acupuncture manipulation. The case was of mainly dysphagia and left limb failure after stroke， the treatment was to regulate the mind and guide Qi， nourish the three Yin， and promote the orifices， used the standard “consciousness restoring and orifice opening” acupuncture method and obtained the exact curative effect. [Conclusion] In the treatment of stroke dysphagia， Academician SHI Xuemin strictly abides by the principle of “inducing resuscitation and regulating the mind”. He emphasizes the combination of the whole and the local， the treatment of the symptoms and the root causes， the clinical effect varies from person to person， and the acupuncture technique is dose-effective， which is convenient for clinical application and promotion. |
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