从“治痿独取阳明”思辨“治痉独取宗筋”推拿治疗痉挛性斜颈的思路与方法

Thoughts and method of Tuina treatment for spasmodic torticollis from speculating “Treatment for flaccidity aims at Yangming meridian” and “Treatment for paralysis aims attendons”

痉挛性斜颈(ST)是临床疑难病,其现代发病机制尚不明确,同时中西医治疗仍处于探索阶段。ST为气血衰少,宗筋失养,带脉过引,导致筋脉拘急、颈部反张等症状,主要病机为本虚标实,窍闭神妄,经筋气乱。从《素问·痿论》“治痿独取阳明”角度出发,试图通过古人治疗痿证理论分析,探究以“治痉独取宗筋”为核心的脏腑推拿治疗ST的思路与方法。临床推拿诊治以调气通脉为核心,重视调补阴阳气血,通过明辨虚实寒热,以调冲通脉,调补阴阳气血,调整带脉功能,松解局部痉挛为主,注重结合形体的调整与精神的调和,促进气血和畅,筋脉柔和,恢复机体的整体平衡。

Spasmodic torticollis(ST)is a clinically difficult disease,and the pathogenesis is still unclear,and the treatment of traditional Chinese and Western medicineis still in the exploratory stage.ST is caused by deficiency of qi and blood,malnutrition of the penile tendon,and excessive traction of the belt meridian,leading to symptoms such as spasms of tendons and veins and opisthotonus of the neck.The main pathogenesis is deficiency in origin and excess in manifestation,blocked orifices and delirious spirit,and disorder of meridians and tendons.Starting from the perspective of“Treatment for flaccidity aims at Yangming meridian”in“SuWen·Weilun”,this paper attempts to explore the thoughts and methods of visceral massage treatment of ST with“Treatment for paralysis aims at tendons”as the core through the analysis of the ancient theory of treating flaccidity.Clinical massage diagnosis and treatment takes regulating qi and unblocking meridians as the core,attaches importance to regulating and tonifying yin,yang,qi and blood.By clearly distinguishing deficiency,excess,cold and heat,it focuses on regulating Chong meridian and unblocking meridians,regulating and tonifying yin,yang,qi and blood,adjusting the function of the belt meridian,and relieving local spasms.It also pays attention to combining the adjustment of body shape and the harmony of spirit to promote the smooth flow of qi and blood,the softness of tendons and veins,and restore the overall balance of the body.