宣丽华教授脐针治疗贝尔麻痹经验

XUAN Lihua’s Experience in Treating Bell’s Palsy with Navel Acupuncture

[目的]介绍宣丽华教授运用脐针疗法分期论治贝尔麻痹的临床经验。[方法]通过临床跟诊和访谈的方式从病因病机、分期治法和治疗特点各方面总结宣教授运用脐针治疗贝尔麻痹的经验,并附验案一则。[结果]宣教授认为贝尔麻痹的基本病机为正气亏虚,风邪侵袭,急性期主要矛盾为风邪入络而致经气阻滞治以祛风通络,脐针处方用山泽通气配合离位,恢复期正虚邪滞,或兼夹痰湿痹阻治当健脾益气、温阳化湿通络,处方选择健脾三针或生阳三针后遗症期因虚致瘀治疗以补益气血为要多选择健脾三针或四正位。施针时当安神定志进针定位宜精准选穴以一穴多义为佳。所举验案中患者诊断为急性期贝尔麻痹,证型为风热袭络治疗以脐针山泽通气、朱雀三针为基础方发病10d后加用下关穴等局部针刺共奏疏风泻热通络之效,见效快患、者恢复良好。[结论]宣教授运用脐针疗法治疗贝尔麻痹,谨守体虚受风之病机分期辨证论治,临床疗效可观,值得推广学习。

[Objective]To introduce Professor XUAN Lihua’s clinical experience in treating Bell’s palsy by syndrome differentiation at different stages using navel acupuncture.[Methods]Through clinical follow-up and interviews,Professor XUAN Lihua’s experience in treating Bell’s palsy with navel acupuncture was summarized from the aspects of etiology and pathogenesis,staged treatment and treatment characteristics,and a case was attached to prove.[Results]Professor XUAN believes that the basic pathogenesis of Bell’s palsy is deficiency of healthy Qi and invasion of wind evil.The main contradiction in acute stage is that wind evil enters collaterals and causes Qi blockage in meridian,the treatment principle is to expel the wind and dredge the collaterals,and the navel acupuncture prescription is Shanze ventilation combined with Li location.In the recovery stage,patients are diagnosed as deficiency of health Qi and stagnation of evil,or combined with phlegm and dampness blocking,the treatment should be invigorating the spleen and replenishing Qi,warming Yang,removing dampness and dredging the collaterals,three needles for strengthening the spleen and three needles for generating Yang are commonly used prescriptions.In the sequelae stage,deficiency of health Qi leads to blood stasis,the treatment of replenishing Qi and blood is of importance,three needles for strengthening the spleen and four positive positions are mostly chosen.When administering acupuncture,it is necessary to calm the mind,the positioning of acupoints should be accurate,it is better if one point has multiple meanings.In the case cited,the patient was diagnosed as Bell’s palsy of acute stage,and the syndrome was wind-heat attacking the collaterals.The treatment was based on navel acupuncture methods of Shanze ventilation and Zhuque three needles.After 10 days of onset,local acupuncture such as Xiaguan(ST7)was added to remove the wind,clear the heat and dredge the collaterals,the effect was quick and the patient recovered well.[Conclusion]Professor XUAN uses navel acupuncture to treat Bell’s palsy,grasps the pathogenesis of healthy Qi deficiency and wind evil invasion,and gives prescriptions according to syndrome differentiation by stages,the clinical effect is considerable,her experience is worthy of promoting and learning.