王颖三寸毫针深刺“曲垣”辨治颈肩综合征
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摘要
王颖教授认为颈肩综合征系脉络空虚或痹阻,深层肌肉受损,表现多介于颈椎病颈型与神经根型之间,并伴不同程度肩周肌肉张力增高,临床多误诊为肩关节周围炎。使用三寸毫针深刺局部穴位,使针体直达病所,加快得气速度,疏通经络,助气行血。王颖强调显效关键是得气,正乃"刺之要,气至而有效","气速至而速效,气迟至而不治";肌痹无论病变部位大小,都需用深刺。特别指出适度深刺,可加速得气,提高针刺治疗效果;须熟知人体解剖结构,方可既提高针刺疗效又保证医疗安全,所谓"深浅不得,反为大贼,内动五脏,后生大病"。按"以痛为腧"原则,选肩颈部颈夹脊、风池、天柱、肩中俞、肩外俞、曲垣、肩井、秉风、肩胛缝周边阿是穴、胸椎周围阿是穴等;曲垣向内下斜刺,可刺及浅层斜方肌与菱形肌以及深层竖棘肌,提高针刺疗效。应尽量使针尖朝向压痛点或条索处适度深刺;压痛点常随疾病好转而改变,每次针刺前应重新找寻痛点,及时调整针刺部位;须专心体会针下感觉,缓缓刺入;留针禁止变换体位,以免发生气胸,即使患者体态较丰腴,亦不可加大肩部穴位针刺角度。
WANG Yingbelieves that the department of neck and shoulder syndrome choroid emptiness or blockage, deep muscle damage, between manifestations of cervical disease and cervical nerve root type, and with varying degrees of shoulder muscle tension increased, clinically misdiagnosed as shoulder inflammation around the joints. Use three-inch needle deep puncture local points, the needle body directly to disease and accelerate the speed to get gas, to clear the meridians, to help gas Blood Circulation. Ying emphasized markedly key is to get gas, n is a "thorn to the gas to effective," "speed to air and quick, without gas late to cure"; muscle paralysis whether the lesion size, are required deep needling. In particular moderately deep puncture, can accelerate to get gas, improve the therapeutic effect of acupuncture; to be familiar with human anatomy, both to improve the efficacy of acupuncture before and ensure medical safety, called "depth shall not, for the big anti-thief, moving within five internal organs, epigenetic serious illness. " Press the "pain as Shu" principle, shoulder and neck JIAJI election, wind pool, Tianzhu, Yu shoulder in, shoulder Yu, Qu Yuan, shoulder well, Ping Feng, shoulder seam surrounding Ashi, thoracic around Afghanistan is the point, etc; Qu Yuan under obliquely inwardly to stab and shallow trapezius and rhomboid muscle and deep vertical spine muscle, improve the efficacy of acupuncture. Should as far as possible toward the tip of the cable or tenderness at moderately deep puncture; tenderness often with disease improvement and change, before each acupuncture should be re looking for pain points, to adjust the puncture site; experience shall concentrate on feeling under the needle, prick slowly into; needle prohibit changing position, in order to avoid the occurrence of pneumothorax, even if the patient relatively plump body, acupuncture also can not increase the shoulder angle.
WANG Yingbelieves that the department of neck and shoulder syndrome choroid emptiness or blockage, deep muscle damage, between manifestations of cervical disease and cervical nerve root type, and with varying degrees of shoulder muscle tension increased, clinically misdiagnosed as shoulder inflammation around the joints. Use three-inch needle deep puncture local points, the needle body directly to disease and accelerate the speed to get gas, to clear the meridians, to help gas Blood Circulation. Ying emphasized markedly key is to get gas, n is a "thorn to the gas to effective," "speed to air and quick, without gas late to cure"; muscle paralysis whether the lesion size, are required deep needling. In particular moderately deep puncture, can accelerate to get gas, improve the therapeutic effect of acupuncture; to be familiar with human anatomy, both to improve the efficacy of acupuncture before and ensure medical safety, called "depth shall not, for the big anti-thief, moving within five internal organs, epigenetic serious illness. " Press the "pain as Shu" principle, shoulder and neck JIAJI election, wind pool, Tianzhu, Yu shoulder in, shoulder Yu, Qu Yuan, shoulder well, Ping Feng, shoulder seam surrounding Ashi, thoracic around Afghanistan is the point, etc; Qu Yuan under obliquely inwardly to stab and shallow trapezius and rhomboid muscle and deep vertical spine muscle, improve the efficacy of acupuncture. Should as far as possible toward the tip of the cable or tenderness at moderately deep puncture; tenderness often with disease improvement and change, before each acupuncture should be re looking for pain points, to adjust the puncture site; experience shall concentrate on feeling under the needle, prick slowly into; needle prohibit changing position, in order to avoid the occurrence of pneumothorax, even if the patient relatively plump body, acupuncture also can not increase the shoulder angle.
引文
[1]黄帝内经灵枢[M].北京:人民卫生出版社,1963:3.
[2]黑龙江祖国医药研究所.针灸大成校释[M].北京:人民卫生出版社,1984:182.
[3]王颖,张晓露.传统针刺深度与现代临床针刺深度的差别探讨[J].时珍国医国药,2015,26(5):1187-1188.
[4]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京中医药大学出版社,1994.
[5]石学敏,戴锡孟,王键.中医内科学[M].北京:中国中医药出版社,2013:409.
[6]许扬,赵英凯,程建斌.颈肩综合征的临床辩证思路与治疗方法探讨[J].中国针灸,2007,27(5):379-382.
[7]耿惠萍.针灸治疗颈肩综合征临床心得[J].中国中医急症,2010,19(5):796.
[8]唐宏亮,卢栋明,黎丽群,等.“肩三针”治疗肩周炎临床研究的系统评价[J].辽宁中医杂志,2015,42(5):933-936.
[9]金秀兰,王文远,李瑞.平衡针治疗对肩关节周围炎活动度的影响[J].上海针灸杂志,2013,32(5):325-327.
[10]陈璐.电针配合刺络拔罐治疗颈肩综合征疗效观察[J].上海针灸杂志,2013,32(4):304-305.
[11]张汉卿.平衡针与四维牵引调曲并用治疗颈肩综合征临床研究[J].针灸临床杂志,2013,29(3):22-26.
[12]周勇忠,张友忠,杨贵尊,等.针刀闭合松解配合整脊微调治疗颈肩综合征[J].中国骨伤,2013,26(8):702-704.
[13]严振国,张兆丰.天髎、曲垣、秉风、天宗穴的矢状断面解剖[J].辽宁中医杂志,1980(12):33-35.
[14]张红娟.长针斜刺结合运动疗法治疗慢性菱形肌损伤的疗效观察[J].中国运动医学杂志,2012,31(7):623-624.
[15]贾建平,陈生弟.神经病学[M].7版.北京:人民卫生出版社,2013:58.
[16]柏树令,应大君.系统解剖学[M].8版.北京:人民卫生出版社,2013:347-350.
[17]黄帝内经素问[M].北京:人民卫生出版社,1963.
[18]郑成瑶,成海燕,曲由,等.韩景献教授运动针法治愈急性颈肩综合症1例[J].针灸临床杂志,2012,28(4):23-24.
[19]杜曜宇,吴炜翰,李应昆.毫针为针具的浮针疗法治疗颈肩综合征62例[J].光明中医,2014,29(9):1926-1927.
[20]刘耀岽.针刺结合中药从肝胆论治颈肩综合征[J].中医临床研究,2014,6(16):27-28.
[21]邹伟,马慧慧,于学平,等.齐刺结合烧山火针法治疗颈肩综合征临床观察[J].上海针灸杂志,2014,33(7):660-661.
[22]董有康,姜云武,王春林,等.肌肉软组织病变应力集中点及阳性反应点针刺治疗机理初探[J].针灸临床杂志,2011,27(3):57-58.
[2]黑龙江祖国医药研究所.针灸大成校释[M].北京:人民卫生出版社,1984:182.
[3]王颖,张晓露.传统针刺深度与现代临床针刺深度的差别探讨[J].时珍国医国药,2015,26(5):1187-1188.
[4]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京中医药大学出版社,1994.
[5]石学敏,戴锡孟,王键.中医内科学[M].北京:中国中医药出版社,2013:409.
[6]许扬,赵英凯,程建斌.颈肩综合征的临床辩证思路与治疗方法探讨[J].中国针灸,2007,27(5):379-382.
[7]耿惠萍.针灸治疗颈肩综合征临床心得[J].中国中医急症,2010,19(5):796.
[8]唐宏亮,卢栋明,黎丽群,等.“肩三针”治疗肩周炎临床研究的系统评价[J].辽宁中医杂志,2015,42(5):933-936.
[9]金秀兰,王文远,李瑞.平衡针治疗对肩关节周围炎活动度的影响[J].上海针灸杂志,2013,32(5):325-327.
[10]陈璐.电针配合刺络拔罐治疗颈肩综合征疗效观察[J].上海针灸杂志,2013,32(4):304-305.
[11]张汉卿.平衡针与四维牵引调曲并用治疗颈肩综合征临床研究[J].针灸临床杂志,2013,29(3):22-26.
[12]周勇忠,张友忠,杨贵尊,等.针刀闭合松解配合整脊微调治疗颈肩综合征[J].中国骨伤,2013,26(8):702-704.
[13]严振国,张兆丰.天髎、曲垣、秉风、天宗穴的矢状断面解剖[J].辽宁中医杂志,1980(12):33-35.
[14]张红娟.长针斜刺结合运动疗法治疗慢性菱形肌损伤的疗效观察[J].中国运动医学杂志,2012,31(7):623-624.
[15]贾建平,陈生弟.神经病学[M].7版.北京:人民卫生出版社,2013:58.
[16]柏树令,应大君.系统解剖学[M].8版.北京:人民卫生出版社,2013:347-350.
[17]黄帝内经素问[M].北京:人民卫生出版社,1963.
[18]郑成瑶,成海燕,曲由,等.韩景献教授运动针法治愈急性颈肩综合症1例[J].针灸临床杂志,2012,28(4):23-24.
[19]杜曜宇,吴炜翰,李应昆.毫针为针具的浮针疗法治疗颈肩综合征62例[J].光明中医,2014,29(9):1926-1927.
[20]刘耀岽.针刺结合中药从肝胆论治颈肩综合征[J].中医临床研究,2014,6(16):27-28.
[21]邹伟,马慧慧,于学平,等.齐刺结合烧山火针法治疗颈肩综合征临床观察[J].上海针灸杂志,2014,33(7):660-661.
[22]董有康,姜云武,王春林,等.肌肉软组织病变应力集中点及阳性反应点针刺治疗机理初探[J].针灸临床杂志,2011,27(3):57-58.