摘要
失眠的根本病机为阳不入阴,病位在心,与肝胆、脾胃、肺、肾关系密切,先天禀赋、个性特征、内伤七情、饮食不节、病理产物等均为发病的相关因素,脏腑功能失调、气机失常、气血亏虚等均是其重要病机.推拿疗法治疗失眠的方法有:单纯推拿疗法(循经推拿疗法、点穴推拿疗法、腹部推拿疗法等)、推拿联合针刺疗法、推拿联合中药、推拿联合拔罐、推拿联合其他疗法等.推拿治疗失眠仍存在以下不足:(1)手法、穴位、治疗部位的选择繁杂不一,难以对不同手法以及不同穴位的疗效进行比较;(2)手法的力度、频率、刺激量没有统一的标准;(3)采用的疗效评价标准不统一,多为临床主观评价量表,缺少客观指标证据;(4)缺少病例回访报道,对推拿有无长期疗效、复发率高低研究较少;(5)缺少多中心、大样本、双盲对照试验;(6)缺少高质量外文文献,国外多将推拿作为失眠的补充疗法,相关研究较少,中文文献多注重研究推拿对失眠的有效性,对于其作用机制的研究较少.
Abstract
The basic pathogenesis of insomnia is that yang cannot enter yin,and the disease is in the heart,closely related to the liver,gallbladder,spleen,stomach,lung and kidney.The congenital endowment,personality characteristics,emotional disorders,irregular di-ets,pathological products,etc.are all related factors of the disease.The dysfunction of the viscera,qi disorder movement,qi-blood defi-ciency,etc.are all important pathogenesis.The methods of tuina therapy for insomnia include simple tuina therapy(such as tuina along the affected meridian;point-pressing tuina therapy;abdominal tuina therapy,etc.),tuina combined with acupuncture therapy,tuina combined with Chinese drugs,tuina combined with cupping,tuina combined with other therapies,etc.However,there are still the follow-ing shortcomings in the treatment of insomnia with tuina:(1)The choice of manipulation,point and treatment site is complicated,mak-ing it difficult to compare the efficacy of different manipulations and different points;(2)There is no unified standard for the strength,frequency and stimulation of the manipulation;(3)The evaluation criteria for the efficacy are not unified,most of which are clinical sub-jective evaluation scales,lacking objective evidence;(4)There is a lack of case visit reports,and there are few studies on the long-term efficacy and recurrence rate of tuina;(5)There is a lack of multi-center,large sample,double-blind controlled trials;(6)There is a lack of high-quality foreign literature.Many foreign countries mostly use tuina as a supplementary therapy for insomnia,with few related stud-ies.Chinese literature mostly focuses on the effectiveness of tuina for insomnia,with few studies on its mechanism of action.
基金项目
区域中医(推拿专科)诊疗中心项目(963042)
2023年国家优势中医药重点学科建设项目(2023ZDXK002)
国家中医药管理局中医药传承与创新"百千万"人才工程(岐黄工程)项目(885022)
第七批全国老中医药专家学术经验继承工程项目(202276)
维普
万方数据