张卫华应用“三步三针法”治疗肩周炎经验

ZHANG Wei-hua’s Experience in Treating Scapulohumeral Periarthritis with"Three-step and Three-needle Therapy"

张卫华创的中医尺胫针疗法在治疗躯体软组织损伤痛、骨筋伤病等方面疗效确切,为进一步推广张卫华的诊疗方法,以肩周炎为例对其经验进行探析。张卫华认为本病早期以寒邪为主,风寒湿三邪合袭肩部,致局部经脉瘀阻、气血凝滞,以肩部疼痛为主要临床表现,宜以温经通络、疏通气血、止痛为法。应用三步三针法(尺胫针、动针法、双层围刺法)治疗,第一步应用尺胫针镇痛,患者尺部位于本部,针刺该部可疏调气血,活血通络;第二步动针法是在尺胫针即刻止痛基础上给予肩部主被动活动,更好发挥针刺行气作用;第三步巩固效果用双层环绕刺法,针对局部疼痛中心点环绕多向刺法以求快速得气和较强针感,激发经气运行。三步法结合,使肩部气血渐通,疼痛渐消,关节则利。

ZHANG Wei-hua’s original traditional Chinese medicine ulnar tibial acupuncture therapy was effective in the treatment of body soft tissue injury pain and bone tendon injury.In order to further pro moted ZHANG’s diagnosis and treatment method,this paper took periarthritis of shoulder as an example to explore his experience.Zhang believed that the early stage of the disease was dominated by cold evil,and the combination of wind,cold and dampness attack the shoulder,resulting in local meridian stasis and stagnation of Qi and blood.Shoulder pain was the main clinical manifestation.It was appropriate to warm the meridians,dredge Qi and blood,and relieve the pain.It can be treated with three-step and three-needle therapy(ulnar tibial needling,moving needling,double layer encircling needling).The first step was to apply ulnar tibial needle for analgesia.The patient’s ulnar part was located at this part.Acupuncture at this part could dredge Qi and blood,activate blood circulation and dredge collaterals.The second step of moving acupuncture was to give active and passive activities to the shoulder on the basis of immediate pain relief by ulnar tibial acupuncture,so as to give better effect of acupuncture in promoting Qi.The third step was to consolidate the effect by double layer encircling needling.Around the central point of local pain,multi-directional needling was used to obtain Qi quickly and strong needling sensation to stimulated the movement of channel Qi.The combination of three steps can gradually dredged the Qi and blood of the shoulder,eliminated the pain,and cured the joint pain.