基于补阳泻阴理论探讨对穴治疗中风后上肢痉挛性瘫痪的原理

Based on the Theory of Reinforcing Yang and Reducing Yin, the Principle of Paired Acupoints in the Treatment of Post-Stroke Spastic Paralysis of the Upper Limbs

摘要: 中风后上肢痉挛性瘫痪在中医古典医籍中无直接对应病名，依其临床表现可归属于中医“筋经病”范畴，2017年国家中医药管理局将其规范命名为中风后痉挛性瘫痪。随着社会快速发展，人们生活方式、饮食结构、观念的改变，临床上本病发生呈年轻化趋势，中风后有80%患者会出现肢体功能障碍，且有超近60%的患者在6个月后仍然遗留上肢或手功能障碍，这些后遗症会给患者的日常生活、心理及经济状况造成一系列影响。中医治疗本病的方法多种多样，本文基于“阴急阳缓”的病机及“补阳泻阴”的治则，探析对穴治疗本病的原理，列举治疗中风后上肢痉挛的常见对穴，通过补泻相反的针刺手法调和阴阳动态平衡，以期在目前临床实践的基础上为对穴治疗本病提供病机与治疗原则的理论阐述。

Abstract: Post-stroke spastic paralysis of the upper limbs does not have a direct corresponding disease name in the classical medical books of traditional Chinese medicine, and can be classified as “tendon and meridian disease” in traditional Chinese medicine according to its clinical manifestations, and in 2017, the State Administration of Traditional Chinese Medicine named it spastic paralysis after stroke. With the rapid development of society, people’s lifestyle, dietary structure, and concept changes, the occurrence of this disease is a younger trend in clinical practice. Approximately 80% of patients experience limb dysfunction following a stroke, and nearly 60% continue to have upper limb or hand dysfunction six months later. These sequelae will have a series of impacts on patients’ daily life, psychological and economic status. Based on the pathogenesis of “Yin Urgency and Yang Slowness” and the treatment principle of “Reinforcing Yang and reducing Yin”, this article explores the principle of acupuncture in the treatment of this disease, lists the paired acupoints for the treatment of upper limb spasm after stroke, and reconciles the dynamic balance of yin and yang through acupuncture opposite to the acupuncture technique of tonifying and laxative, in order to provide a theoretical exposition of the pathogenesis and treatment principles for the treatment of this disease with Paired acupoints.