“调神运脾通腑”针刺治疗卒中后消化不良理论探析

A theoretical analysis of“regulating the spirit,mobilizing the spleen and clearing the fuorgans”acupuncture in the treatment of post-stroke dyspepsia

文章从针刺调节胃肠的蠕动功能,结合脾、胃、肝、肾、脑的相互关系理论,探讨卒中后消化不良的发病机制:脑窍蒙闭,脾不升清,胃不降浊,肝失疏泄,肾阳虚衰,导致中焦气机阻滞,久则痞满。中风后患者因瘀血、肝风、痰浊等病理因素蒙蔽脑窍,“窍闭神匿,神不导气”,窍闭神匿,五脏六腑功能失摄,中焦脾胃功能受损,脾清阳不升,胃浊阴不降,引起胃肠功能失调而致消化不良。文章提出卒中后消化不良的关键病机理论为“窍闭神匿,中焦失司”,针刺以“调神运脾通腑”为治则,调神是运脾通腑的前提,运脾是通腑的基础;确立了“调神运脾通腑”选穴和针刺手法规范:针法首先立足于“调神”,百病之始,皆本于神,凡刺之法,先醒其神,神清则五脏安;脾胃为后天生化气血之本,以维持后天脏腑的生理功能,治痞满时运脾升清和胃有助于五脏六腑气血的濡养;同时也重视和胃通腑降浊之法,痞满日久,累及脏腑,脾胃之气受损严重,脾不运化,胃不降浊,导致胃不受纳的恶性循环,日久胃肠道积食燥热,进一步导致五脏六腑功能失调。文章在此理论基础上创新了中风后消化不良的病机治则理论。

The paper discusses the pathogenesis of post-stroke dyspepsia from the theory that acupuncture regulates the peristaltic function of the stomach and intestines,combined with the interrelationship between the spleen,stomach,liver,kidney and brain:The brain orifice is closed,the spleen does not ascend the essence,the stomach does not descend the turbid,the liver loses drainage,and the kidney Yang(阳)is deficient,which leads to blockage of Qi(气)in the middle part of the body,which results in prolonged fullness.Post-stroke patients have their brain orifices clouded by pathological factors such as blood stasis,liver wind and phlegm.“The orifice is closed and the spitit is hidden,the spitit does not guide Qi”,the spleen and stomach are impaired,the spleen Yang does not rise,and the stomach Yin(阴)does not descend,causing gastrointestinal dysfunction and resulting in indigestion.It is proposed that the key pathogenic theory of post-stroke dyspepsia is“the orifice is closed and the spitit is hidden,and the middle part of the body is not in charge”,and acupuncture is based on the principle of“regulating the spirit,mobilizing the spleen and clearing the fu-organs”.The selection of acupuncture points and acupuncture techniques for“regulating the spirit,mobilizing the spleen and clearing the fu-organs”are stablished.The acupuncture method is based on“regulating the spirit”,the beginning of all diseases are based on the spirit,where the method of acupuncture first wakes up its spirit,when the spirit is clear,the five organs are in peace.The spleen and stomach are the basis for the biochemistry of Qi and blood in the lower part of the body to maintain the physiological functions of the internal organs,and treating the abnormalities and fullness of the spleen to promote the ascending and harnonizing stomach helps to moisten Qi and blood of the five viscera and six fu-organs.At the same time we also pay attention to the method of harmonizing the stomach and the internal organs to lower the turbidity,because fullness for a long term can affect the internal organs,if there are serious damage to the spleen and stomach Qi,the spleen does not transport,the stomach does not lower the turbidity,further leading to a vicious circle,in which the stomach does not receive,which causes the accumulation of food and heat in the gastrointestinal tract over time,further leading to dysfunction of the five viscera and six fu-organs.This paper innovates a new theory of the pathogenesis and treatment of post-stroke dyspepsia based on this theory.