首页|运用强心复脉法针药结合治疗四肢不利病验案

运用强心复脉法针药结合治疗四肢不利病验案

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四肢不遂、言语不利等神经系统病症多起病隐匿,致病原因不明,病情发展较快,现代医学诊疗效果不理想,为临床疑难病.中医认为此属"风病"范畴,病名为风痱.《备急千金要方》《太平圣惠方》等古医籍记载此类病症和心脏中风有关.心风包括外风和内风,外风责之于内虚外中,内风由心脏阴阳气血异常变动而化风.心风内动,导致心主血脉和主神志功能失常,进而导致血脉失和,机体失养,神机失用,日久则精神离散,形神不一,这或许是风痱病发生发展的机制,而心脏功能失常是疾病发生发展的主要矛盾.治疗时,以红景天、丹参、人参、附子等为君药,强心复脉,恢复心脏功能,臣以西洋参、党参、黄芪、紫河车等补益气血,以天麻、独活、羌活、麻黄、防风等祛除外风,全蝎、蜈蚣、黑蚂蚁等虫类药搜剔内风,佐以麦冬、天冬等护阴,还需使药大枣、沙参、干姜、川贝母等固护脾胃肺气.同时以温针刺法温阳化气、疏经通络,祛除肢体经络风邪,并促进脏腑气化,缩短病程,从整体上达到阴平阳秘、血气调和、形神合一的状态.文章从心风理论分析风痱病的发病机制,并创新运用强心复脉、祛风通络法,针药结合治疗此类病症,体现了中医以心脏为中心的脏腑辨证思维,为现代医学心身疾病、神经系统疾病的诊疗提供更多思路与方法.
A proven case of treating limb dysfunction diseases by acupuncture plus medicine for strengthening the heart and restoring the pulse
Some nervous system diseases,such as limb failure and speech impairment,are clinically difficult diseases with unclear causes and rapid development,which cannot be diagnosed by modern medicine.TCM believes that it belongs to the category of wind disease,which is called Fengfei(风痱).The ancient medical books such as Beiji Qianjin Yaofang(《备急千金要方》)and Taiping Shenghuifang(《太平圣惠方》)record that such diseases are related to heart-wind.The heart-wind includes external wind and internal wind.The external wind is caused by exogenous viruses invasion.The internal wind is caused by the imbalance of Yin(阴)and Yang(阳)in the heart,which is caused by unstable heart-Qi(心气).The internal movement of heart wind causes the dysfunction of heart governing blood vessels and mind,which lead to the heart to lose control of blood and mind.And then the body lost nourishment,consciousness can not play a normal role,over time,the spirit and shape are discrete.Perhaps it is the mechanism of the development of Fengfei.Cardiac dysfunction is the main contradiction of disease occurrence.In treatment,Hongjingtian(Radix et Rhizoma Rhodiolae Crenulatae),Danshen(Radix et Rhizoma Salviae Miltiorrhizae),Renshen(Radix Ginseng),Fuzi(Radix Aconiti Lateralis Preparata)are used as monarch drugs to strengthen heart and restore heart function.Xiyangshen(Radix Quinquefolii),Dangshen(Radix Codonopsis),Huangqi(Radix Astragali),Ziheche(Placenta Hominis)are used as minister drugs to tonify Qi and blood.Tianma(Rhizoma Gastrodiae),Duhuo(Radix Angelicae Pubescentis),Qianghuo(Rhizoma et Radix Notopterygii),Mahuang(Herba Ephedrae),Fangfeng(Radix Saposhnikoviae),etc.,are usecl to dispel external wind.And Quanxie(Scorpio),Wugong(Scolopendra),black ant and other insect medicines are used to search for internal wind.Adjuvants such as Maidong(Radix Ophiopogonis)and Tiandong(Radix Asparagi)are used to protect Yin(阴).It is also necessary to use medicines such as Dazao(Fructus Jujubae),Shashen(Radix Glehniae),Ganjiang(Rhizoma Zingiberis),Chuanbeimu(Bulbus Fritillariae Cirrhosae)to strengthen the spleen,stomach and lung Qi.The methods of warming Yang,dispersing Qi,dredging meridians and dredging collaterals can dispel pathogenic wind in meridians and promote viscera gasification,so they are used to shorten the course of disease,so as to achieve the state of harmony between Yin and Yang,and blood and Qi,and unity of form and spirit as a whole.This article discusses the pathogenesis of Fengfei from the heart wind theory and innovative use of strengthening the heart,restoring pulse,dispelling wind and dredging collaterals,combination of acupuncture and TCM medicine to treat such diseases.It embodies the heart-centered viscera syndrome differentiation thinking of TCM,and provides more ideas for the diagnosis and treatment of psychosomatic diseases and nervous system diseases in modern medicine.

Limb dysfunctionAphasiaHeart windStrengthening the heart and restoring the pulseAcupuncture plus medicine

宋婉玲

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甘肃省白银市妇幼保健院,甘肃 白银,730900

四肢不利 失语 心风 强心复脉 针药结合

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(10)
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