针灸治疗偏瘫后肩痛的新思路

A new thinking of acupuncture and moxibustion treatment of shoulder pain after hemiplegia

从解剖学和生理学的角度分析肩痛的致因为:①肩胛骨下降、后缩;②肱骨内收、内旋;③上肢屈肌痉挛。拟定出预防和治疗肩痛的针灸处方为:软瘫期取肩井、肩中俞、巨骨、天宗、肩、极泉;痉挛期取巨骨、肩、天宗、肩、消泺、上廉、温溜,同时配合背部膀胱经和肩周的拔罐疗法。从而说明肩痛不仅是肩关节的问题,而且涉及到整个患侧的肩胛带肌群和上肢伸肌的肌肉群。

Analysis from anatomy and physiology indicates that causes of shoulder pain are ① decline and afterconstriction of the scapula; ② the adduction and intorsion of the humerus ; ③the spasm of the upper limb flexor. The acupuncture and moxibustion prescriptions stipulated for prevention and treatment of shoulder pain are Jianjing （GB 21）, Jianzhongshu （SI 15）, Jugu （LI 16）, Tianzong （SI 11）, Jianliao （SJ 14）, Jiquan （HT 1） at the flaccid hemiplegia, and Jugu （LI 16）, Jianyu （LI 15）, Tianzong （SI 11）, Jianliao （SJ 14）, Xiaoluo （SJ 12）, Shanglian （LI 9）, Wenliu （LI 7） at the spastic hemiplegia , in combination with cupping at the Urinary Bladder Meridian on the back and around shoulder. Thus, it is indicated that shoulder pain not only is involved in the shoulder joint but also in all muscle groups of the shoulder girdle and the upper limb extensor at the affected side.