易和康复技术分期论治中风后偏瘫理论初探

The theoretical research on Yi He rehabilitation in staging treatment of post-stroke hemiplegia

易和康复技术融合传统中医康复治疗与物理医学和康复医学理念,是分期论治中风后偏瘫的临床康复疗法。本文以“易”“和”源流注疏为基础,梳理中医学与西医学医易相通、体用通和的观点。基于中风后偏瘫病机探析“易”“和”内涵,认为本病是微观机体“失易”与宏观功用“失和”综合导致“紧”的运动模式与异“动”的病理进程,具体包括阳气移易、形质失用,筋脉反易、神机失调,脑络变易、形神失守。以“松静”康复观为指导,易和康复技术在中风后偏瘫康复各期具有不同的作用机制:弛缓期易阳以静、和形以松,以被动康复模式维持外周运动链;痉挛期易神以静、和筋以松,以助动康复模式改善中枢运动功能重塑性;相对恢复期易络以静、和脏以松,以主动康复模式形成中枢-外周-中枢康复闭环控制。

Yi He Rehabilitation,which is based on traditional Chinese rehabilitation treatments and rehabilitation principles from modern medicine,is effective in staging treatment of post-stroke hemiplegia.This paper systematically discusses the origin and annotation of Yi and He from the perspectives of traditional Chinese medicine and modern medicine.The medicinal connection between Yi and the body and its function is related to unobstructed attunement.Based on the connotation of Yi and He,we believe that the pathogenesis of post-stroke hemiplegia is the comprehensive result of abnormal effects of Yi on the organism at the microscopic level and abnormal effects of He on function at the macroscopic level,featured as tense muscle movement and a pathological process of abnormal motion,including the disturbance of yang qi with body dysfunction,the disorder of spirit with sinews and vessels with diversion,and the variation of brain collateral with physical and mental inconsistency.By inducing relaxation and calmness,Yi He rehabilitation takes effect in staging treatment of post-stroke hemiplegia with characteristic mechanisms.First,by calming ascending yang and relaxing the disordered body in periods of relaxation,it can achieve the maintenance function of the kinematic chain peripherally with passive rehabilitation.Second,by calming the disordered spirit and relaxing the inhibited meridian sinews in spasmodic periods,it can reconstruct the neural plasticity of motor function centrally with assistive rehabilitation.Third,by calming damaged brain collateral and relaxing the impassable zang organs in the recovery period,it can close the central-peripheral-central loop of rehabilitation with active rehabilitation.