针刺治疗脑卒中取穴规律研究

Study on the Rules of Acupuncture Points Selection in the Treatment of Stroke

针刺治疗脑卒中的取穴规律:以近部取穴为原则,选取的均为头、面、颈项部腧穴;以近部取穴为原则,选取的穴位以四肢腧穴为主,特别是患侧肢体的腧穴。在治疗脑卒中后吞咽障碍时,最常用五个穴位分别为:廉泉、风池、翳风、金津、玉液,且头颈面部的取穴频次为79. 30%;在治疗脑卒中后偏瘫时,最常用的五个穴位分别是:曲池、足三里、合谷、肩髃、百会,且四肢的选穴频次最多,频率达75. 46%。但是针刺所取穴位由于个体差异很难统一。脑卒中后患者常伴有不同程度的肢体麻木、感觉障碍,医者无法通过询问患者判断自己选取的穴位是否准确,缺少患者的感觉作为佐证,脑卒中后偏瘫容易引起肌肉萎缩,这对于腧穴的定位以及针刺的深度都会有一定的影响,医者只能以自己的临床经验作为取穴依据,而最终的康复效果也与取穴是否精准有着密不可分的关系。

The rules of acupoint selection in the treatment of stroke are as follows:according to the principle of selecting the acupoints in the local area,the acupoints of head,face and neck can be selected.According to the principle of selecting the acupoints in the local area,the selected acupoints are mainly limb ones,especially those of affected limbs.In the treatment of dysphagia after stroke,the five most commonly used acupoints are Lianquan(RN 23),Fengchi(GB 20),Yifeng(SJ 17),Jinjin(EX-HN12)and Yuye(EX-HN13),and the frequency of acupoint selection of head,neck and face is 79.30%.In the treatment of hemiplegia after stroke,the five most commonly used acupoints are Quchi(LI 11),Zusanli(ST 36),Hegu(LI 4),JIanyu(LI 15),Baihui(DU 20),and the frequency of selecting acupoints in limbs is the highest,reaching 75.46%.However,it is difficult to unify the acupoints selected by acupuncture because of individual differences.After stroke,patients are often accompanied by varying degrees of limb numbness and sensory disturbance.Doctors can not judge whether the acupoints they choose are accurate by asking patients,lack of patients’sensation as evidence.Hemiplegia after stroke is prone to muscle atrophy,which has a certain impact on the location of acupoints and the depth of acupuncture.Doctors can only choose acupoints on the basis of their own clinical experience,and the final rehabilitation effect is closely related to the accuracy of acupoint selection.