脐针配合中药治疗中风后呃逆的 临床疗效

Clinical Efficacy of Umbilical Acupuncture Combined with Traditional Chinese Medicine in the Treatment of Hiccup after Stroke

摘要: 中风后呃逆是脑血管疾病常见并发症，尤其多见于脑干出血、大面积梗死等危重病例，常呈顽固性发作，易伴发消化道出血、情绪异常等问题，严重影响患者康复进程与预后。目前西医疗法存在不良反应多、疗效有限等不足，而中医疗法在该病治疗中展现出独特优势。本文基于临床实践，以1例脑干出血后并发顽固性呃逆的患者为研究对象，采用脐针“右降四针”配合中药四逆散合橘皮竹茹汤联合治疗，观察临床疗效并探讨其作用机制。结果显示，患者经1次脐针治疗后呃逆症状即明显缓解，中药治疗2剂后发作频次与持续时间显著减轻，连续治疗10天后症状完全消失，且无明显不良反应。研究表明，脐针可通过调节脏腑气机、平衡阴阳以止呃，中药方剂能兼顾疏肝、和胃、益气等多重功效，二者协同作用可快速改善中风后呃逆的核心病机(阴阳失调、气血逆乱、胃失和降)，临床疗效确切、安全性高。本文旨在为中风后顽固性呃逆的中医综合治疗提供临床参考，丰富相关病症的辨证分型与治疗方案。

Abstract: Post-stroke hiccup is a common complication of cerebrovascular diseases, especially frequent in severe cases such as brainstem hemorrhage and large-area cerebral infarction. It often presents as intractable episodes, easily complicated by gastrointestinal bleeding, emotional disorders and other problems, which seriously affect the rehabilitation process and prognosis of patients. At present, Western medicine therapies have disadvantages such as numerous adverse reactions and limited efficacy, while traditional Chinese medicine (TCM) has shown unique advantages in the treatment of this disease. Based on clinical practice, this study took a patient with intractable hiccup complicated by brainstem hemorrhage as the research object, and adopted combined treatment with umbilical acupuncture “Right-Descending Four Needles” plus TCM prescription Sini San combined with Jupi Zhuru Tang, to observe the clinical efficacy and explore its mechanism. The results showed that the patient’s hiccup was significantly relieved after one session of umbilical acupuncture; the frequency and duration of attacks were markedly reduced after 2 doses of herbal medicine; and the symptoms completely disappeared after 10 consecutive days of treatment, with no obvious adverse reactions. The study indicates that umbilical acupuncture can stop hiccup by regulating visceral qi movement and balancing Yin and Yang, while the TCM formula exerts multiple effects including soothing the liver, harmonizing the stomach, and replenishing qi. The synergistic effect of the two can rapidly improve the core pathogenesis of post-stroke hiccup (imbalance of Yin and Yang, disorder of qi and blood, failure of stomach qi to descend), with definite clinical efficacy and high safety. This paper aims to provide clinical reference for the comprehensive TCM treatment of intractable post-stroke hiccup and enrich the syndrome differentiation and therapeutic regimens for related diseases.