基于“少阴少阳为枢”探讨卒中后假性延髓性麻痹的病机与证治

Exploration of Pathogenesis and Syndrome Treatment of Poststroke Pseudobulbar Palsy Based on "Shaoyin and Shaoyang Being Pivot"

卒中后假性延髓性麻痹的病因病机为少阳、少阴枢机不利,气机升降失常,导致气滞、血瘀、痰凝闭阻口舌颃颡等官窍,引起言语及吞咽功能障碍。神机失用,不能导气于官窍是形成卒中后假性延髓性麻痹的根源。少阳少阴为枢,气机通过胆、三焦、心、肾的气化,使气血精华升降出入,产生神机。故作为脑卒中后的独立症状,在治疗上应重视调和脑神的重要性,运用导气针法调节少阳、少阴枢机,有利于平复患者情绪,调神定志,使升降逆乱之气各归其位。

The etiology and pathogenesis of poststroke pseudobulbar palsy after stroke is that pivot dysfunction of Shaoyang and Shaoyin as well as the abnormal rise and fall of the Qi movement, both of which lead to Qi stagnation, blood stasis, Phlegm coagulating and blocking the mouth, tongue, nasopharynx and other organ orifices, causing speech and swallowing dysfunction.The dysfunction of the spiritual mechanism and the inability to channel Qi to the official orifices are the root causes of poststroke pseudobulbar palsy.Shaoyang and Shaoyin act as pivots, and the Qi movement went through the Qi transformation of the Gallbladder, Sanjiao, Heart, and Kidney, and then the essence of Qi and Blood rises and falls, comes into and out of the body, resulting in the normal spiritual conditions.Therefore, as an independent symptom after stroke, great attention should be paid to the importance of reconciling the brain and mind in treatment.The use of Qi-guiding acupuncture to regulate the pivots of Shaoyang and Shaoyin is helpful in calming the patient′s emotions, regulating the mind and fixing the spirit, hence the chaotic rising and falling Qi would return to their proper places.