基于玄府理论探讨颈性眩晕机制及治疗

To Explore Mechanism and Treatment of Cervical Vertigo Based on Xuanfu Theory

摘要: 颈性眩晕属中医学“眩晕”“眩冒”范畴，中医学认为其病位在脑，由风湿痰瘀火邪或体虚诱发。现代人因长时间低头伏案工作，保持同一个姿势造成颈椎负荷过重，平常不注重颈椎功能锻炼，颈椎力学平衡遭到破坏，颈椎退变、钩椎关节增生等因素机械压迫椎动脉及其附属的交感神经纤维，椎动脉血供障碍加之交感神经受刺激造成眩晕、呕吐、恶心症状。玄府学说认为玄府与血脉和经络彼此渗灌，相互为用，可转运神机、输布元气津液、渗灌血液、调节阴阳。玄府主司开阖，以通为用。颈部玄府郁闭、神机气血失运导致血脉和经络一并郁闭，最终导致脑玄府失于濡养是颈性眩晕的病机。无论内治外治法，颈性眩晕都遵循开通玄府这一总治则。同时，临床治疗玄府疾病时也应注重治未病，不令外玄府感邪，不令内玄府郁闭则眩晕可愈。本文检索近年文献，基于玄府理论为中医治疗颈性眩晕提供新思路。

Abstract: Cervical vertigo belongs to the category of “Xuan Yun” and “Xuan Mao” in traditional Chinese medicine. It is believed that the disease is located in the brain and induced by wind-dampness, phlegm stasis, and fire evil or body deficiency. Because modern people work for a long time, keep the same posture, resulting in excessive cervical load, usually do not pay attention to cervical functional exercise, cervical spine mechanical balance is destroyed, cervical spine degeneration, unchivertebrae joint hyperplasia, and other factors mechanical compression of the vertebral artery and its affiliated sympathetic nerve fibers, vertebral artery blood supply disorders combined with sympathetic nerve stimulation, resulting in dizziness, vomiting, and nausea. Xuanfu theory holds that Xuanfu and blood vessels and meridians permeate each other and serve each other, which can transport divine machinery, transport vital body fluid, permeate blood, and regulate Yin and Yang. Xuanfu master division open and close, to general use. The closure of the neck and the loss of Qi and blood of the divine machinery lead to the closure of the blood vessels and meridians together, and ultimately lead to the loss of the brain. Regardless of internal and external treatment, cervical vertigo follows the general treatment principle of opening Xuanfu. At the same time, the clinical treatment of Xuanfu disease should also pay attention to the treatment of no disease, do not make the external Xuanfu feel evil, do not make the internal Xuanfu closed, vertigo can be healed. Based on the theory of Xuanfu, this paper provides a new idea for the treatment of cervical vertigo.