筋骨针治疗中风后上肢痉挛性偏瘫经验

Experience of Physique Needle in the Treatment of Spastic Hemiplegia of Upper Limb after Stroke

目的中风后痉挛性偏瘫属中医"经筋病"范畴,主要病机为阴阳气血失衡,治疗上以疏通经络、放松肌肉挛缩为原则,"筋骨针"则能够解除痉挛肌肉筋膜等部位的粘连、瘢痕、挛缩、堵塞、无菌性炎症刺激等对肌梭、Ⅰa、γ等神经纤维的刺激,从而达到明显减少神经冲动传入及传出,缓解或解除肌痉挛的目的,文章介绍筋骨针治疗痉挛瘫的经验。方法采用"筋骨针"对痉挛部位进行松解、剥离,破坏部分肌梭感受装置,切开腱的部分腱器可使肌肉松弛,切断部分Ⅰa类纤维,减少冲动的传入。选一例病例作为典型案例,予以筋骨针治疗。结果经筋骨针治疗后,患者肢体肌力、肌张力,及患肢关节活动疼痛度、关节活动范围均较治疗前有改善。结论 "筋骨针"不仅具有传统针刺法的作用,还能快速松解肌肉筋膜的机械压迫,松解局部软组织粘连痉挛以迅速止痛,消除炎性反应,改善局部炎性反应和免疫反应,达到明显的缓解或解除肌痉挛的目的。

Objective To introduce the experience of physique needle in the treatment of spastic hemiplegia of upper limb after stroke.Spastic hemiplegia after stroke belongs to the category of "aponeurotic system disease"in traditional Chinese medicine. The main etiology and pathogenesis is the imbalance between the economy’s yin-yang and qi and blood. The Jingo needle can relieve some questions of spasmodic muscle fascia,such as adhesion,scar contracture,and block,aseptic inflammation stimulation on muscle spindle,Ⅰa,γ,etc.The stimulation of nerve fibers significantly reduces the impulse and the incoming and outgoing,to achieve the goal of the apparent ease or remove muscle spasm. Method The spasmodic site was loosened,peeled off,and part of the muscle spindle perception device was destroyed by physique needle. The partial tendon apparatus of the tendon incision could relax the muscle,cut off some type Ⅰa fibers,and reduce the afferent of impulse. This article selects a case as a typical case,and gives acupuncture treatment of muscles and bones. Result Not only the physique needle has the function of the traditional acupuncture,also can quickly relieve the mechanically compression of muscle,and release the adhesion tendon of local soft tissue to remove the inflammatory reaction and pain,to improve the local inflammatory response and immune response,and to achieve the objective of the apparent ease or remove muscle spasm inflammatory reaction. Conclusion The physique needle can enhance the local inflammatory response and immune response to achieve the objective of the apparent ease or remove muscle spasm.