壮医水蛭疗法治疗痛症的理论源流、临床实践与护理应用综述

Review on Theoretical Origin, Clinical Practice, and Nursing Application of Zhuang Medicine Leech Therapy in Treating Pain

摘要: 痛症作为全球性的健康挑战，其治疗面临常规疗法副作用多、易依赖等局限。壮医水蛭疗法作为一种历史悠久的民族特色外治法，近年来在痛症管理中显示出潜在价值。文章通过系统梳理相关文献，旨在综述该疗法的理论源流、现代科学机制、临床应用证据及护理模式。结果表明，该疗法根植于壮医“三道两路”理论，其镇痛作用主要归因于水蛭唾液中的活性成分所具有的抗凝、抗炎、改善微循环及促进组织修复等多重药理效应。临床研究显示，该疗法在类风湿关节炎、痛风性关节炎、膝骨关节炎、慢性外侧上髁炎、慢性腰痛及肌筋膜炎等多种痛症中，能有效缓解疼痛、改善功能，且常与“壮医临证施护”、“IKAP模式”等整合护理结合以提升疗效。结论认为，壮医水蛭疗法治疗痛症具有其理论独特性与现代科学依据，临床应用前景广阔，但当前证据多来源于小样本研究，未来需开展更多设计严谨的大样本随机对照试验以夯实其证据基础，并推动临床操作的规范化。

Abstract: Pain is a global health challenge, and its treatment faces limitations such as side effects and dependence on conventional therapies. Zhuang medicine leech therapy as a long history of ethnic characteristics of external treatment in recent years in pain management shows potential value. This article aims to summarize the theoretical origin, modern scientific mechanism, clinical application evidence, and nursing mode of this therapy by systematically sorting out relevant literature. The results showed that this therapy was rooted in the theory of “three paths and two paths” of Zhuang medicine, and its analgesic effect was mainly attributed to the multiple pharmacological effects of anticoagulant, anti-inflammatory, improving microcirculation, and promoting tissue repair of active components in leech saliva. Clinical studies have shown that this therapy can effectively relieve pain and improve function in rheumatoid arthritis, gouty arthritis, knee osteoarthritis, chronic lateral epicondylitis, chronic low back pain, and myofascitis, and is often combined with integrated care such as “Zhuang medicine clinical nursing” and “IKAP model” to improve the curative effect. In conclusion, Zhuang medicine leech therapy has its unique theory and modern scientific basis in treating pain, and has a broad prospect in clinical application. However, the current evidence mostly comes from small sample studies, and more large sample randomized controlled trials with rigorous design should be carried out in the future to consolidate its evidence base and promote the standardization of clinical operation.