从“诸痛痒疮,皆属于心”探讨针刺治疗带状疱疹后遗神经痛

The Clinical Thinking of Acupuncture Treatment in Postherpetic Neuralgia Based on the Theory of “All Pain, Itchiness or Sore Disorders Connecting to the Heart”

带状疱疹后遗神经痛(postherpetic neuralgia, PHN)是带状疱疹最主要、最常见的后遗症之一。在中医里一般将NPH归为“痛证”范畴,《素问·至真要大论》中病机十九条“诸痛痒疮,皆属于心”指出具有疼痛、瘙痒、疮疡症状疾病之病机皆统括归属于心。故本文以此理论为基础,结合传统中医理论中“心”的生理特性及功能,阐释PHN发病机制与心的关系,发现PHN与“心属火”“心主神明”等密切相关,在临床上采用针刺治疗PHN时除常规针刺穴位还可从此方面选穴,拓展了临床防治PHN的思路。

Postherpetic neuralgia (PHN) is one of the most common and main sequelae of herpes zoster. In TCM, postherpetic neuralgia is classified as a “pain pattern”. The theory, “all pain, itchiness and sore disorders pertain to the heart” in 19 pathogenesis explored in Basic Questions, points out that pain, itchiness and sore is related to the function of the “heart”. Therefore, based on the theory, combined with the physiological characteristics and physiological function of “heart” in traditional Chinese medicine theory, this paper elucidates the relationship between pathogenesis of PHN and “heart”, finding out that there is a close relationship between PHN and “heart”. We can select points of treatment from this aspect when using acupuncture to treat PHN, thus attempting to guide the clinical application of acupuncture and moxibustion in prevention and treatment of PHN.