基于循经感传探讨通经接气法结合电针治疗神经根型颈椎病

Discussion on Tongjing Jieqi Acupuncture Combined with Electroacupuncture in the Treatment of Cervical Spondylotic Radiculopathy Based on Propagated Sensation along Channels

摘要: 神经根型颈椎病是颈椎病的常见类型之一，多由颈椎间盘退变、钩椎关节增生、椎间孔狭窄及周围软组织慢性劳损等因素刺激或压迫神经根而发病，临床以颈肩部疼痛、上肢放射痛、麻木及颈椎活动受限为主要表现。中医学虽无完全对应病名，但可据其症候特点归入“项痹”“颈肩痛”“痹证”等范畴，其病机多与风寒湿邪侵袭、久劳伤筋、气血瘀滞、经络痹阻及肝肾亏虚有关。针灸治疗本病具有疏通经络、调和气血、缓急止痛和改善功能的优势。通经接气法重在催气、守气、接气与引气，使针感循经传导并趋向病所；电针则可在得气基础上给予连续、稳定且相对可控的刺激，从而增强镇痛、抗炎和神经调节效应。循经感传是针刺后酸、麻、胀、重、走窜等感觉沿经脉方向传导的特殊现象，也是理解“气至病所”和针刺靶向效应的重要切入点。本文从循经感传视角出发，结合通经接气法源流、针刺手法特点、电针治疗神经根型颈椎病的相关研究及经络机制文献，探讨通经接气法结合电针治疗神经根型颈椎病的理论依据、作用特点与协同机制，以期为该疗法的临床应用和后续机制研究提供参考。

Abstract: Cervical spondylotic radiculopathy is one of the common subtypes of cervical spondylosis. It is mostly caused by irritation or compression of the nerve root induced by factors including cervical intervertebral disc degeneration, hyperosteogeny of uncovertebral joint, intervertebral foramen stenosis and chronic strain of surrounding soft tissues. Clinically, it is mainly characterized by cervicoscapular pain, radiating pain of the upper extremity, numbness and limited cervical mobility. Although there is no exactly corresponding disease name in traditional Chinese medicine (TCM), it can be classified into the categories of “xiangbi (neck bi)”, “cervicoscapular pain” and “bi syndrome” based on its clinical manifestations. Its pathogenesis is mostly associated with invasion of wind-cold-dampness pathogens, chronic strain damaging tendons, qi-blood stagnation, meridian obstruction and liver-kidney deficiency. Acupuncture therapy for this disease boasts the advantages of dredging meridians, regulating qi and blood, alleviating acute pain and improving bodily functions. The meridian-dredging and qi-connecting method focuses on promoting qi arrival, retaining qi, connecting qi and guiding qi, enabling needle sensation to conduct along meridians and converge at the lesion site. On the basis of qi arrival, electroacupuncture can provide continuous, stable and relatively controllable stimulation, thereby enhancing analgesic, anti-inflammatory and neuromodulatory effects. Propagated sensation along meridians (PSM) is a specific phenomenon where sensations such as soreness, numbness, distension, heaviness and migrating diffusion conduct along the course of meridians after acupuncture, and it is also a critical entry point for understanding “qi reaching the affected area” and the targeted effect of acupuncture. From the perspective of propagated sensation along meridians, this paper integrates the origin and development of the meridian-dredging and qi-connecting method, characteristics of acupuncture manipulation, relevant studies on electroacupuncture for cervical spondylotic radiculopathy, and literature on meridian mechanisms to discuss the theoretical basis, functional characteristics and synergistic mechanism of the combination of meridian-dredging and qi-connecting method and electroacupuncture for cervical spondylotic radiculopathy, so as to provide reference for the clinical application of this therapy and subsequent mechanistic research.