经筋理论指导下的针刀松解术治疗痉挛性斜颈1例

Acupotomy Lysis Guided by Meridian Sinew Theory for Spasmodic Torticollis: A Case Report

摘要: 本文报告1例经筋理论指导下的针刀松解术治疗痉挛性斜颈的诊疗经过。患者男性，30岁，以“头颈部不自主歪向左侧3月余”为主诉就诊。基于经筋理论进行辨证，病机为外邪侵袭，结聚于筋，导致“横络”卡压，经气不通，筋脉失养而拘急。治疗上以“解结调衡”为原则，采用针刀对督脉及足三阳经筋的筋结点进行系统性松解。经治疗后，患者颈部僵痛、头部震颤及歪斜角度当即显著改善。随访一月，疗效稳定。结果表明，以经筋理论为指导的针刀松解术，通过解除筋膜链异常张力、恢复颈部力学平衡，是治疗痉挛性斜颈的一种有效方案，为本病的治疗提供了中医外治法的新思路。

Abstract: This paper reports the diagnosis and treatment process of a case of spasmodic torticollis treated with acupotomy lysis guided by the meridian sinew theory. The patient was a 30-year-old male who presented with the chief complaint of “involuntary head tilting to the left side for over 3 months”. Based on the meridian sinew theory, the pathogenesis was identified as the invasion of external pathogens accumulating in the sinews, leading to the compression of “transverse collaterals”, obstruction of meridian qi, malnourishment of sinews and vessels, and consequent spasticity. The treatment principle of “releasing knots and regulating balance” was adopted, utilizing acupotomy to systematically release the sinew nodes along the Governor Vessel and the sinew regions of the three foot-yang meridians. After a single treatment, the patient’s neck stiffness and pain, head tremor, and tilt angle showed immediate and significant improvement. At the one-month follow-up, the therapeutic effect remained stable. The results indicate that acupotomy lysis guided by the meridian sinew theory, by relieving abnormal tension in the fascial chains and restoring mechanical balance of the neck, is an effective approach for treating spasmodic torticollis. This provides a new perspective from traditional Chinese medicine external therapies for the management of this condition.