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电针合醒脑开窍针法治疗枕臂而睡后的垂腕案

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桡神经属于臂丛神经,由于在上臂、前臂走行中贴近肱骨、桡骨,解剖定位比较表浅,极容易在发生压迫、挤压、撞击外伤时以及因感染、代谢其他因素受伤.桡神经受损是目前临床上较为常见的一种神经损伤性疾病,该疾病特征性临床表现为腕关节背伸乏力,即垂腕症,同时还可伴有感觉麻木、伸指及伸拇活动受限等其他手功能障碍症状,给患者正常的工作及生活造成严重不良影响,降低患者生活质量.目前西医治疗主要是口服营养神经药物如甲钴胺片等,必要时进一步手术移植治疗.颈神经根鞘囊肿相对于腰骶部神经根囊肿十分少见,多数患者仅通过检查发现,表现为临床无症状或囊肿所在节段神经根、神经节产生压迫症状和体征,有症状患者的症状大多十分轻微,且病因病机尚未明确,颈神经根鞘多发囊肿更是罕见.此案患者多日劳累,于桌上枕臂而睡 2 h左右后出现垂腕症,后住院行肌电图、臂丛神经成像等检查,提示桡神经受损、颈神经根鞘多发囊肿罕见病例,且检查结果提示颈神经根鞘囊肿所在节段与患肢受损神经节段有所重合.针对此案患者采用电针结合醒脑开窍针法进行治疗,配合中药汤剂口服,中医内外合治,取得满意的疗效,为临床中医治疗此类疾病提供新思路.
Treating wrist-droop after pillowing arm sleep by electroacupuncture plus mind-refreshing and orifice-opening needling method
The radial nerve belongs to the brachial plexus.Because it is close to the humerus and radius in the upper arm and forearm,and its anatomical location is relatively superficial,it is easy to be injured during extrusion,impact,infection and metabolism.As a relatively common neurological injury disease in clinical practice,radial nerve injury shows a series of clinical features of hand motor and sensory disorders,and wrist-droop is the most typical symptom,which has a negative impact on people's lives.Modern medical treatment is about oral nutritional drugs such as mecobalamin tablets,and further surgery if necessary.Compared with lumbosacral nerve root cyst,the cervical nerve root sheath cyst is rare,and multiple cysts of the cervical nerve root sheath are even more rare.Most patients'symptoms caused by compression of nerve root and ganglion at the segment where the cyst is located have no or very slight symptoms.Now,its etiology and pathogenesis are not clear.This case reported that wrist-droop occurred to one patient after sleeping on her arm on the table for about 2 hours.The results of electromyography and brachial plexus neurography showed that the radial nerve was damaged and there were multiple cysts in the cervical nerve root sheath,also showed that the segment of the cervical nerve root sheath cyst coincided with the damaged nerve segment of the affected limb.In this case,the patient was treated by electroacupuncture combined with mind-refreshing and orifice-opening needling method,and TCM decoction was taken orally.The combination of internal and external treatment of TCM has achieved satisfactory results,providing new ideas for the clinical treatment of such diseases in TCM.

ElectroacupunctureMind-refreshing and orifice-opening needling methodWrist-dropRadial nerve injuryCervical nerve root sheath cyst

林倩、徐伟辉

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湘潭医卫职业技术学院,湖南 湘潭,411100

湖南省直中医院,湖南 株洲,412000

电针 醒脑开窍针法 垂腕 桡神经受损 颈神经根鞘囊肿

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(13)
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