1.广州中医药大学针灸康复临床医学院,广东省广州市白云区机场路12号,510000
2.广州中医药大学第一附属医院
zhuanglixing@163.com
收稿:2022-11-25,
修回:2023-01-30,
纸质出版:2023-05-02
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陈缘缘,范靖琪,卢玮婧等.针刺分期治疗帕金森病相关疲劳[J].中医杂志,2023,64(09):963-967.
CHEN Yuanyuan,FAN Jingqi,LU Weijing,et al.Staged Treatment of Parkinson's Disease-related Fatigue by Acupuncture[J].Journal of Traditional Chinese Medicine,2023,64(09):963-967.
陈缘缘,范靖琪,卢玮婧等.针刺分期治疗帕金森病相关疲劳[J].中医杂志,2023,64(09):963-967. DOI: 10.13288/j.11-2166/r.2023.09.017.
CHEN Yuanyuan,FAN Jingqi,LU Weijing,et al.Staged Treatment of Parkinson's Disease-related Fatigue by Acupuncture[J].Journal of Traditional Chinese Medicine,2023,64(09):963-967. DOI: 10.13288/j.11-2166/r.2023.09.017.
介绍针刺分期治疗帕金森病相关疲劳的体会。帕金森病相关疲劳的病机以本虚为主,起于肝肾阴虚,进一步累及心脾,且阴损及阳,久而耗伤阳气。根据帕金森病不同时期的病因病机和临床特点分期治疗帕金森病相关疲劳,灵活变换针刺治疗方案。早期以肝风内动为主,宜平肝理脾,以颤三针(四神针、四关、风池穴)加减;中期以心脾两虚为主,宜调神健脾,以调神针法穴组加减(如四神针、神庭、印堂、神门、三阴交、足三里、太冲等);晚期以肾阳亏虚为主,宜通督补阳,以督脉经穴加减。同时兼顾湿、痰、瘀等病理因素,在补虚的基础上进行辨证配穴以通行化滞。
This paper introduced the experience of treating Parkinson's disease-related fatigue (PDRF) with acupuncture by stages. The pathogenesis of PDRF is mainly the deficiency of the root, initially manifested as deficiency of the liver and kidney
yin
, which further affects the heart and spleen; and as
yin
impairment will affect
yang
,
yang qi
consumption is induced after a long time. It is suggested to treat the PDRF by stages with flexible acupuncture plan according to the etiology, pathogenesis and clinical characteristics of Parkinson's disease in different periods. In the early stage, as internal stirring of liver wind is the main pathogenesis, it is appropriate to calm the liver and rectify the spleen by performing
tremor three needles
(颤三针) at Sishen points, Siguan points i.e.bilateral Hegu (LI 4) and bilateral Taichong (LR 3), and Fengchi (GB 20) in modification. In the middle stage, the deficiency of the heart and the spleen is the main pathogenesis, for which the method of regulating the mind and fortifying the spleen is suggested, and the mind-regulating acupoints with modifications are used including Sishen points, Shenting (GV 24), Yintang (DU 29), Shenmen (TF4), Sanyinjiao (SP 6), Zusanli (ST 36), Taichong (LR 3) and others. In the late stage when kidney
yang
depletion is predominant, it is advisable to unblock the Governer Vessel and supplement
yang
, and use the acupoints of the Governer Vessel
with modifications. At the same time, pathological factors such as dampness, phlegm, and stasis should be dealt with, and it is important to unblock the movement and resolve stagnation while supplementing deficiency.
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