基于“筋结–触发点”浅论针康解结法治疗顽固性面瘫

A Brief Discussion on the Therapeutic Thought of Acupuncture-Rehabilitation Knot-Releasing Therapy for Refractory Facial Paralysis Based on “Muscle Knots-Trigger Points”

摘要: 顽固性面瘫是指面神经炎经过治疗2个月后面部肌肉症状仍恢复效果不佳者，因其病情迁延不愈，且发病机理契合气血亏虚为本、瘀沫痰交结为标的病机，故而常在面部产生筋结。筋结与康复医学的触发点相似且相关。本文基于筋结与触发点的密切关系，以及二者对顽固性面瘫病情的影响，结合中医与康复医学两理论体系，取各自治疗触发点/筋结之所长，将双体系的治疗视角互补，从而提出“温通熨调”、“强通泻调”、“轻通围歼”和“梳理训练”的“针康解结疗法”治疗顽固性面瘫，以期为临床应用解结疗法治疗顽固性面瘫提供新视角与新思路。

Abstract: Refractory facial paralysis denotes facial neuritis with poor recovery of facial muscle symptoms after 2 months of treatment. Owing to its prolonged course and pathology featuring qi-blood deficiency (root cause) and interbinding of blood stasis, fluid retention and phlegm (superficial manifestation), muscle knots often develop on the face. These knots are similar to and associated with “trigger points” in rehabilitation medicine. Based on the close association between muscle knots and trigger points, and their effects on the condition, this article integrates Traditional Chinese Medicine (TCM) and rehabilitation medicine theories, drawing on their respective strengths in treating these points/knots to complement therapeutic perspectives. Thus, “Acupuncture-Rehabilitation Knot-Releasing Therapy” (with four approaches: “Warm Unblocking & Ironing Regulation”, “Intensive Unblocking & Purgation Regulation”, “Mild Unblocking &Encirclement Elimination”, and “Combing Training”) is proposed for treating refractory facial paralysis. This study aims to offer new perspectives for clinically applying knot-releasing therapy in managing refractory facial paralysis.