基于“肝主筋,心藏神”理论针药并用治疗不宁腿综合征验案1例

A Case Study of Acupuncture Combined with Medication in the Treatment of Restless Leg Syndrome Based on the Theory of"Liver Governing Tendon and Heart Storing Spirit"

不宁腿综合征是以双下肢神经系统感觉功能障碍为主的一种疾病,主要表现为双下肢运动感觉功能亢进,伴皮肤感觉障碍,在运动或走路时缓解,夜间症状严重程度加重,患者常常伴有严重的睡眠障碍。不宁腿综合征在中医学中没有与之相应的名称,但因与古籍中症状相似被归为“腿风”“痉证”等范畴。该病的病机是本虚标实,本虚多为肝肾阴虚,标实多为瘀血阻滞,其中以肝肾阴虚为本,且贯穿于整个病程的始终。肝主筋,筋得肝养,才能运动灵活有力。心藏神,心得血养,才能安然睡眠。因此,治疗上当以心肝为纲,主以针刺通经活络,中药缓急止痛,配合艾灸温通经脉,以达到标本兼治的目的,临床中往往效果良好,治愈率高。

Restless leg syndrome is a disease primarily characterized by sensory dysfunction in the lower limb nervous system.It mainly manifests as heightened sensory perception in the lower limbs during movement,accompanied by sensory disorders in the skin.Symptoms are relieved during physical activity or walking and worsen in severity at night,often leading to significant sleep disturbances.In traditional Chinese medicine(TCM),there is no equivalent term for restless leg syndrome,but due to similar symptoms described in ancient texts,it could be categorized as"leg wind"or"cramp syndrome".The pathogenesis of this condition involves asthenia in origin and sthenia in superficiality.Asthenia in origin is often related to yin deficiency in the liver and kidneys,while sthenia in superficiality involves stasis of blood circulation.Liver and kidney yin deficiency is the core factor throughout the disease.The liver governs the tendons,and only when the tendons are nourished by the liver can they move flexibly and powerfully.The heart stores the spirit,and only when the heart is nourished by blood can peaceful sleep be achieved.Therefore,in treatment,the focus should be on the heart and liver.Acupuncture is used to stimulate the meridians and dredge the collaterals and Chinese herbal medicine is employed to address urgency and pain relief,accompanied by moxibustion to warm and invigorate the meridians and vessels,aiming to achieve a balanced approach of addressing both the root and the symptoms.This approach often yields positive clinical outcomes and high recovery rates.