从经筋理论探讨痉病的临床特点

Clinical Characteristics of Convulsive Disease From the Aspect of the Theory of Tendons

痉病是人体全身或局部经筋强直为主要表现的疾病,其临床表现多种多样,不仅仅拘泥于项背强直等症状。病因主要包括外感与内伤,外感多属实证,起病快,病情急,若治疗得当,预后较好;内伤多属虚证或虚实夹杂症,外感失治、误治可转变成虚证,治疗较为困难,预后较差。基于经筋理论,认为痉病的病因病机为邪壅经络或肝肾亏损,致筋脉失养出现而挛急,风、火、痰、瘀、虚等多种病理因素夹杂其中,故对于痉病的治疗必须根据其病因的不同、疾病的缓急,采用驱邪通络、熄风止痉、醒神开窍、补益肝肾等治疗方法。

Convulsive disease mainly manifests as general or local tendons stiffness. The clinical manifestations are various and not merely stiffness of the back. The causes mostly include exogenous and endogenous ones; exogenous ones pertain to excess syndrome with quick onset and acute condition,and with proper treatment,the prognosis is favorable; endogenous diseases pertain to deficiency syndrome or intermingling of excess and deficiency. Treatment failure and therapeutic error of exogenous ones may transform into deficient syndrome,which is hard to treat and the prognosis is poor. Based on the theory of tendons,the etiology and pathogenesis of convulsive disease is the obstruction of meridians and collaterals or deficiency of the liver and kidney leading to malnourishment of the tendons,spasm and intermingling of various pathogenic factors such as wind,fire,phlegm,blood stasis and deficiency. Therefore,for the treatment of convulsive disease,methods of eliminating pathogens and unblocking collaterals,calming wind and stopping convulsion,clearing mind and opening orifices or tonifying liver and kidney can be selected according to the different cause,mild or acute nature of the disease.