循经远端巨刺配合主动运动治疗急性落枕62例疗效观察

Observation on the Therapeutic Effect of Distal Needling along Meridians Combined with Active Movement in Treating 62 Cases of Acute Stiff Neck

摘要: 目的：观察循经远端取穴巨刺法配合主动运动治疗急性落枕的止痛作用。方法：回顾性分析2024年10月至2025年8月门诊收治的62例急性落枕患者的临床资料。所有患者均采用循经远端取穴结合巨刺法治疗，针对阳明经型、督脉型、太阳经型、少阳经型及混合型分别选取健侧手三里、后溪、人中、束骨、中渚等穴位，进针得气后嘱患者带针进行颈部主动运动。治疗1次后即刻及留针30 min后参照《中医病证诊断疗效标准》及视觉模拟评分法(VAS)评价疗效。结果：62例患者中，治愈53例(85.48%)，好转7例(11.29%)，无效2例(3.22%)，总有效率为96.8%。其中47例(75.8%)在行针运动过程中疼痛即刻消失。不同分型中，太阳经型与少阳经型患者的临床症状均完全缓解。结论：循经远端巨刺配合主动运动治疗急性落枕疗效确切，具有显著的即时镇痛效应，且操作简便，值得临床推广。

Abstract: Objective: To observe the analgesic effect of distal needling along meridians combined with active movement in the treatment of acute stiff neck. Methods: The clinical data of 62 patients with acute stiff neck treated in the outpatient department from October 2024 to August 2025 were analyzed retrospectively. All patients were treated with distal acupoint selection along meridians combined with needling (contralateral needling). According to the meridian differentiation, acupoints such as Shousanli (LI10), Houxi (SI3), Renzhong (GV26), Shugu (BL65), and Zhongzhu (TE3) on the healthy side were selected respectively. After achieving “Deqi”, patients were instructed to perform active neck movements with the needles retained. The efficacy was evaluated according to the Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine and Visual Analogue Scale (VAS) immediately after manipulation and after 30 minutes of needle retention. Results: Among the 62 cases, 53 cases (85.48%) were cured, 7 cases (11.29%) improved, and 2 cases (3.22%) were ineffective, with a total effective rate of 96.8%. Notably, pain disappeared immediately in 47 cases (75.8%) during the needle manipulation and movement process. All patients of Taiyang and Shaoyang meridian types achieved complete relief of clinical symptoms. Conclusion: Distal needling along meridians combined with active movement is effective in treating acute stiff neck, characterized by significant immediate analgesic effects and simple operation, worthy of clinical promotion.