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白云机场路16号, 510006
2.广东省中医针灸重点实验室
3.安徽中医药大学中医学院
4.安徽中医药大学研究生院
wanglin16@gzucm.edu.cn
收稿:2024-12-26,
修回:2025-03-01,
纸质出版:2025-05-02
移动端阅览
李洪涛,黄雅琪,姚露露等.从“脑络伏邪”探析针刺辨治中风后吞咽障碍思路[J].中医杂志,2025,66(09):901-905.
LI Hongtao,HUANG Yaqi,YAO Lulu,et al.Analysis on Acupuncture in the Treatment of Post-stroke Dysphagia Based on the Theory of "Latent Pathogen in Cerebral Collaterals"[J].Journal of Traditional Chinese Medicine,2025,66(09):901-905.
李洪涛,黄雅琪,姚露露等.从“脑络伏邪”探析针刺辨治中风后吞咽障碍思路[J].中医杂志,2025,66(09):901-905. DOI: 10.13288/j.11-2166/r.2025.09.006.
LI Hongtao,HUANG Yaqi,YAO Lulu,et al.Analysis on Acupuncture in the Treatment of Post-stroke Dysphagia Based on the Theory of "Latent Pathogen in Cerebral Collaterals"[J].Journal of Traditional Chinese Medicine,2025,66(09):901-905. DOI: 10.13288/j.11-2166/r.2025.09.006.
吞咽障碍是中风病的常见并发症,结合中医学理论及现代研究,提出“邪伏脑络”是中风后吞咽障碍(PSD)的核心病机。临证根据PSD发生的部位不同分别施治,口腔期邪犯面口,清涎外泄,取穴以足少阴肾经为主,配合任脉、督脉、冲脉及脾经,以达益精填髓、祛湿通络之功;吞咽期邪遏咽喉,吞咽失常,强调疏利少阳,温补厥阴,取穴以手足少阳经为主,配合厥阴经,以达疏利肝胆、调和气血之功;食管期邪损食管,食阻不下,强调鼓动阳明,通调太阴,取穴以足阳明胃经为主,配合太阴经,以达温阳通脉,祛瘀通络之功。
Dysphagia is a common complication of stroke. Combining the principles of traditional Chinese medicine with modern research findings, it is proposed that "latent pathogen in the cerebral collaterals" constitutes the core pathogenesis of post-stroke dysphagia (PSD). In clinical practice, treatment is tailored according to the location of PSD. During the oral stage, when the pathogen invades the face and mouth, resulting in excessive salivation, acupoints are primarily selected from the foot
shaoyin
(少阴) kidney channel, in combination with
ren mai
(任脉) ,
du mai
(督脉),
chong mai
(冲脉) and the spleen channel, to replenish essence and fill the marrow, dispel dampness and unblock the channels. In the pharyngeal stage, as the pathogen obstructs the throat, disrupting normal swallowing, the therapy emphasizes dredging the
shaoyang
(少阳) channel and warming and tonifying the
jueyin
(厥阴) channel, by taking acupoints mainly from the hand and foot
shaoyang
channels, along with the
jueyin
channels, so as to soothe the liver and promote bile secretion, regulate and harmonize
qi
and blood. During the esophageal stage, where the pathogen damages the esophagus, impeding food passage, the treatment emphasizes activating the
yangming
(阳明) channels and regulating
taiyin
(太阴) channels; acupoints are mainly selected from the foot
yangming
stomach channel, along with the
taiyin
channels, aiming to warm
yang
, unblock the channels and dispel s
tasis.
中国康复医学会吞咽障碍康复专业委员会 . 中国吞咽障碍康复管理指南(2023版) [J]. 中华物理医学与康复杂志 , 2023 , 45 ( 12 ): 1057 - 1072 .
HILKENS NA , CASOLLA B , LEUNG TW , et al . Stroke [J]. Lancet , 2024 , 403 ( 10446 ): 2820 - 2836 .
LABEIT B , MICHOU E , TRAPL-GRUNDSCHOBER M , et al . Dysphagia after stroke: research advances in treatment interventions [J]. Lancet Neurol , 2024 , 23 ( 4 ): 418 - 428 .
SARNTHEIN J , ALBISSER C , REGLI L . Transcranial electrical stimulation elicits short and long latency responses in the tongue muscles [J]. Clin Neurophysiol , 2022 , 138 : 148 - 152 . doi: 10.1016/j.clinph.2022.03.016 http://dx.doi.org/10.1016/j.clinph.2022.03.016 .
汪捷敏 , 余贡献 . 球囊扩张术联合全息按摩治疗环咽肌失弛缓症的效果分析 [J]. 浙江创伤外科 , 2024 , 29 ( 9 ): 1721 - 1723 .
徐颖 , 林淑芳 , 江一静 , 等 . 针刺联合吞咽训练对脑卒中后假性球麻痹吞咽障碍患者吞咽功能的影响 [J]. 新中医 , 2024 , 56 ( 22 ): 124 - 129 .
于苗 , 丁薇 , 王悦 , 等 . 从“络损髓伤”探讨脑小血管病的病机 [J]. 中医药导报 , 2023 , 29 ( 9 ): 134 - 136,164 .
吴以岭 . 络病病机探析 [J]. 中医杂志 , 2005 , 46 ( 4 ): 243 - 245 .
李坤宁 , 张庆祥 , 徐成岩 , 等 . 伏邪病因病机特点的探析 [J]. 中国中医急症 , 2019 , 28 ( 12 ): 2170 - 2173 .
赵明芬 , 安冬青 , 汪建萍 . 试论伏邪理论的源流及发展 [J]. 中医杂志 , 2016 , 57 ( 3 ): 189 - 192 .
李澎涛 , 王永炎 , 黄启福 . “毒损脑络”病机假说的形成及其理论与实践意义 [J]. 北京中医药大学学报 , 2001 , 24 ( 1 ): 1 - 6, 16 .
王牧原 , 韩莹 , 王姿聪 , 等 . 基于吞咽造影录像检查的不同部位颅脑损伤患者吞咽障碍特征研究进展 [J]. 山东医药 , 2024 , 64 ( 17 ): 98 - 101 .
李超 , 曾妍 , 戴萌 , 等 . 不同病灶部位脑卒中患者吞咽障碍特点分析 [J]. 中华物理医学与康复杂志 , 2018 , 40 ( 1 ): 20 - 23 .
闫岩 , 鲁海 , 胡佳慧 , 等 . 针刺从“肾”论治中风后失语症理论稽古 [J]. 中国针灸 , 2020 , 40 ( 3 ): 322 - 324 .
YAO LL , YE QP , LIU Y , et al . Electroacupuncture improves swallowing function in a post-stroke dysphagia mouse model by activating the motor cortex inputs to the nucleus tractus solitarii through the parabrachial nuclei [J]. Nat Commun , 2023 , 14 ( 1 ): 810 .
王琳 , 许民栋 , 张立志 , 等 . 许能贵通督调神针刺法治疗缺血性中风学术思想介绍 [J]. 新中医 , 2018 , 50 ( 6 ): 240 - 242 .
张立志 , 许能贵 , 李如良 , 等 . 不同频率电针廉泉、风府穴治疗中风吞咽障碍临床研究 [J]. 中国针灸 , 2018 , 38 ( 2 ): 115 - 118 .
苏星星 , 汪庆庆 , 叶宇 , 等 . 针刺脾经组穴对中风后吞咽障碍康复治疗促进作用观察 [J]. 中医药临床杂志 , 2024 , 36 ( 11 ): 2215 - 2219 .
张雯 , 王非 , 金海涛 , 等 . “通关利窍”针刺法联合吞咽训练治疗脑卒中后吞咽障碍临床疗效及对表面肌电图和脑微循环的影响 [J]. 针刺研究 , 2022 , 47 ( 11 ): 1025 - 1030 .
于涛 , 徐振华 , 许能贵 , 等 . 通督调神针法治疗中风后假性球麻痹临床观察 [J]. 新中医 , 2010 , 42 ( 7 ): 86 - 88 .
张宜廷 . 基于“辨经论治”理论观察针刺丰隆、足三里治疗脑卒中后吞咽障碍疗效及对血清Glu、GABA的影响 [D]. 合肥 : 安徽中医药大学 , 2024 .
佘雅琳 , 曾婧纯 , 韦永政 , 等 . 林国华分期论治卒中后吞咽功能障碍经验撷要 [J]. 中国针灸 , 2022 , 42 ( 1 ): 79 - 82 .
叶宇 , 吴凯瑞 , 徐芳园 , 等 . 芒针透刺天突治疗中风后吞咽障碍的理论基础及临床应用探析 [J]. 湖南中医药大学学报 , 2024 , 44 ( 4 ): 606 - 611 .
0
浏览量
0
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号