醒腦開竅2013-3-22

1、1 The Clinical Practiceon XNKQ AcupunctureZheng Jian-GangThe First Teaching Hospital of Tianjin University of Traditional Chinese Medicine “醒腦開竅醒腦開竅”針法是石學(xué)敏院士針法是石學(xué)敏院士1972年針對中風(fēng)病的年針對中風(fēng)病的基本病機(jī)，即瘀血、肝風(fēng)、痰濁等病理因素蒙蔽腦竅導(dǎo)致基本病機(jī)，即瘀血、肝風(fēng)、痰濁等病理因素蒙蔽腦竅導(dǎo)致“竅閉神匿，神不導(dǎo)氣竅閉神匿，神不導(dǎo)氣”而提出的治療法則和針刺方法。而提出的治療法則和針刺方法。 XNKQ Acupuncture i

2、s raised by Shi Xue-MIN Academician in 1972. It aimed at the basic pathogenesis, such as blood stasis,liver wind,phlegm which lead to orifices closed , consciousness lost and Qi-disorder. The points on Yin meridians and Du meridian are mainly selected and standard quantitative manipulations are appl

3、ied emphatically, which are quite different from traditional point selection and acupuncture manipulations in treatment of stroke. 治治 療療 方方 法法 Treatment1.1.處處 方方 主穴：主穴：內(nèi)關(guān)內(nèi)關(guān)( (手厥陰心包經(jīng)手厥陰心包經(jīng)) ) 人中人中( (督脈督脈) ) 三陰交三陰交( (足太陰脾經(jīng)足太陰脾經(jīng)) )1. Point PrescriptionMainpoints: Neiguan(PC 6,the Pericardium Meridian o

4、f Hand-Juejin)Renzhong(DU 26,the DU Meridian)Sanjinjiao(SP 6,the Spleen Meridian of Foot-Taiyin)輔穴：輔穴：極泉極泉( (手少陰心經(jīng)手少陰心經(jīng)) ) 委中委中( (足太陽膀胱經(jīng)足太陽膀胱經(jīng)) ) 尺澤尺澤( (手太陰肺經(jīng)手太陰肺經(jīng)) )Supplementary points： Jiquan(HT 1,the Heart Meridian of Hand-shaoyin) Weizhong(BL 40,the Bladder Meridian of Foot- Taiyang) Chize(LU 5

5、, the Lung Meridian of Hand-Taiyin) 配穴：配穴：吞咽障礙加風(fēng)池、翳風(fēng)、完骨；手指握固加吞咽障礙加風(fēng)池、翳風(fēng)、完骨；手指握固加合谷；語言不利加上廉泉，金津、玉液放血；足內(nèi)合谷；語言不利加上廉泉，金津、玉液放血；足內(nèi)翻加丘墟透照海。翻加丘墟透照海。Point Modification：For difficulty of swallowing, Fengchi(GB 20),Yifeng(SJ 17) and Wangu(GB 12) are added. For failing to extend fingers with stiffness, Hegu (LI

6、 4) is added. For slurred speech, Shanglianquan(EX-HN) is added, and Jinjin(EX-HN 12) and Yuye(EX-HN13) are used with blood-letting method. For strephenopodia, penetrating method from Qiuxu(GB 40) to Zhaohai(KI 6) is used. 2.2.操作方法操作方法 Manipulation內(nèi)內(nèi) 關(guān)關(guān)Neiguan(PC 6) 直刺直刺0.50.51 1寸，采用捻轉(zhuǎn)提插結(jié)寸，采用捻轉(zhuǎn)提插結(jié)合合

7、瀉法，施手法瀉法，施手法1 1分鐘；分鐘；First puncture bilateral Neiguan(PC 6) perpendicularly for 0.5-1 cun, using combinative reducing method of lifting-thrusting and twirling-rotating the needle for 1 minute;人人 中中Renzhong(DU 26)Secondly puncture Renzhong(DU 26) obliquely upwards to the nasal septum for 0.3-0.5 cun

8、with heavy bird-pecking method until the patients eyeballs are moistened or tears flow down.向鼻中隔方向斜刺向鼻中隔方向斜刺0.30.30.50.5寸，用重雀啄法，寸，用重雀啄法，至眼球濕潤或流淚為度；至眼球濕潤或流淚為度；極極 泉泉Jiquan(HT 1)原穴沿經(jīng)下移原穴沿經(jīng)下移1 1寸，避開腋毛，直刺寸，避開腋毛，直刺1 11.51.5寸，寸，用提插瀉法，以患側(cè)上肢抽動用提插瀉法，以患側(cè)上肢抽動3 3次為度。次為度。Select Jiquan(HT 1) point at 1 cun below t

9、he original location along the heart meridian to keep away from the armpit hair, puncture perpendicularly for 1-1.5 cun with reducing method of lifting and thrusting the needle to make the affected upper limb have tic for three times.尺尺 澤澤Chize(LU 5)屈肘成屈肘成120120度角，直刺度角，直刺1 1寸，用提插瀉法，寸，用提插瀉法，使患者前臂、手指抽

10、動使患者前臂、手指抽動3 3次為度。次為度。Perpendicularly puncture Chize(LU 5) for 1 cun depth while the forearm bends to form an angle of 120 degrees with reducing manipulation of lifting and thrusting the needle until the affected arm and fingers have tic for three times.委委 中中Weizhong(BL 40)仰臥直腿抬高取穴，仰臥直腿抬高取穴，直刺直刺0.50

11、.51 1寸，施寸，施提插瀉法，使患側(cè)提插瀉法，使患側(cè)下肢抽動下肢抽動3 3次為度。次為度。Select Weizhong(BL 40) point with the supine position and the lower limb lifted, puncture perpendicularly for 0.5-1 cun, with reducing method of lifting and thrusting to make the lower limb have tic for 3 times.風(fēng)池、完骨、翳風(fēng)風(fēng)池、完骨、翳風(fēng)Fengchi(GB 20)Wangu(GB 12)Y

12、ifeng(SJ 17)針向結(jié)喉，進(jìn)針針向結(jié)喉，進(jìn)針2 22.52.5寸采用小幅度高頻率捻轉(zhuǎn)補(bǔ)法，寸采用小幅度高頻率捻轉(zhuǎn)補(bǔ)法，每穴施手法每穴施手法1 1分鐘；分鐘；Puncture Fengchi(GB 20),Wangu(GB 12) and Yifeng(SJ 17) in the direction of the laryngeal protuberance for 2-2.5 cun, with reinforcing manipulation of twirling and rotating the needle in high frequency and small amplitu

13、de for 1 minute to each acupoint.合谷針向三間穴合谷針向三間穴Hegu(LI 4)toSanjian(LI 3)進(jìn)針進(jìn)針1 11.51.5寸，采用提插瀉法，使患者第二手寸，采用提插瀉法，使患者第二手指抽動或五指自然伸展為度；指抽動或五指自然伸展為度；Puncture Hegu(LI 4) 1-1.5 cun in depth with the needle tip toward Sanjian(LI 3), with reducing method of lifting and thrusting to make the patients second fing

14、er or five fingers extended freely.上廉泉上廉泉Shanglianquan(EX-HN)針向舌根針向舌根1.51.52 2寸，用提插瀉法；寸，用提插瀉法；Puncture Shanglianquan(EX-HN) for 1.5-2 cun, with the needle tip towards the root of the tongue and reducing method of lifting and thrusting the needle.金津、玉液金津、玉液Jinjin(EX-HN12)Yuye(EX-HN13) 用三棱針點(diǎn)刺放血，出血用三棱針

15、點(diǎn)刺放血，出血1 12 2毫升；毫升；Prick Jinjin(EX-HN12) and Yuye(EX-HN13) with the three-edged needle to cause bleeding for 1-2ml.丘墟透向照海穴丘墟透向照海穴Qiuxu(GB 40)toZhaohai(KI 6)約約1.51.52 2寸，局部酸脹為度。寸，局部酸脹為度。Puncture Qiuxu (GB 40) 1.5-2 cun in depth with the needle tip toward Zhaohai(KI 6),until soreness and distension oc

16、curred locally.醒腦開竅針刺法適宜病癥醒腦開竅針刺法適宜病癥THE Suitable Diseases Of XNKQ Acupuncture1.中風(fēng)病及其并發(fā)癥的治療中風(fēng)病及其并發(fā)癥的治療 Treatment of Stroke and Complications2.神志、精神疾患的治療神志、精神疾患的治療 Treatment of consciousness and mental disorders3.厥閉脫證的治療厥閉脫證的治療 Treatment of prostration syndrome with fainting and closure 4.痛癥的治療痛癥的治療

17、Treatment of pain5.各種腦病的治療各種腦病的治療 Treatment of encephalopathy6.各種疑難雜癥的治療各種疑難雜癥的治療 Treatment of Difficult Miscellaneous Diseases1.1.中風(fēng)病及其并發(fā)癥的治療中風(fēng)病及其并發(fā)癥的治療Treatment of Stroke and ComplicationsThe Problems of Treating Apoplexy如何減輕血管神經(jīng)單元的損害、促進(jìn)重構(gòu)神經(jīng)組如何減輕血管神經(jīng)單元的損害、促進(jìn)重構(gòu)神經(jīng)組織、重建腦組織循環(huán)是神經(jīng)功能恢復(fù)的根本。中風(fēng)病織、重建腦組織循環(huán)是神經(jīng)

18、功能恢復(fù)的根本。中風(fēng)病治療的難點(diǎn)及突破點(diǎn)，聚焦在神經(jīng)與血管的新生。治療的難點(diǎn)及突破點(diǎn)，聚焦在神經(jīng)與血管的新生。How to reduce the damage of neurovascular unit, promote reconstruction of nerve tissue and brain circulation is important for neurological recovery. The treatment of stroke is focus on the regeneration of blood vessels and nerves. 目前，治療中風(fēng)病最有效的方法

19、是卒中單元，但是現(xiàn)代目前，治療中風(fēng)病最有效的方法是卒中單元，但是現(xiàn)代醫(yī)學(xué)意義上的卒中單元需要較高的軟硬件配備，無法于現(xiàn)有醫(yī)學(xué)意義上的卒中單元需要較高的軟硬件配備，無法于現(xiàn)有醫(yī)療資源基礎(chǔ)上推廣應(yīng)用。所以，如何利用有效的中醫(yī)手段醫(yī)療資源基礎(chǔ)上推廣應(yīng)用。所以，如何利用有效的中醫(yī)手段構(gòu)建符合中國特色的構(gòu)建符合中國特色的“中風(fēng)單元中風(fēng)單元”是今后重要的研究方向。是今后重要的研究方向。Currently, the stroke unit are the most effective ways to stroke, but modern medical unit requires advanced soft

20、ware and hardware which does not meet the available medical resource. Therefore, how to effectively use the traditional method to set up Chinese characteristic stroke unit is an important research direction in the future.針刺是我國治療中風(fēng)病的重要手段，也是構(gòu)建針刺是我國治療中風(fēng)病的重要手段，也是構(gòu)建“中風(fēng)中風(fēng)單元單元”的主要因素。的主要因素?！靶涯X開竅醒腦開竅”針刺法在臨床上

21、取得了針刺法在臨床上取得了顯著療效，并被國家列為重大科技推廣項目。顯著療效，并被國家列為重大科技推廣項目。Acupuncture are effective treatment in China and important factors of stroke unit. “XNKQ acupuncture” get great clinical effect, and has achieved remarkable listed by the state science and technology major promotion projects.(1)(1)椎椎- -基底動脈供血不足基底動

22、脈供血不足：針風(fēng)池、：針風(fēng)池、完谷、天柱、頸椎夾脊穴完谷、天柱、頸椎夾脊穴vertebro-basilar artery insufficiency : Puncture Fengchi (GB 20), Wangu(GB 12),Tianzhu(BL10), Cervical Jiaji Points(EX-B2).(2) (2) 吞咽障礙：吞咽障礙：針風(fēng)池、完谷、針風(fēng)池、完谷、翳風(fēng)、咽后壁點(diǎn)刺翳風(fēng)、咽后壁點(diǎn)刺Dysphgia : Puncture Fengchi (GB 20), Wangu(GB 12),Yifeng(SJ 17), Prick Posterior Pharyngeal.

23、(3) (3) 語言謇澀語言謇澀：針上廉泉、金津、玉液：針上廉泉、金津、玉液Inhibited Speech : Puncture Shanglianquan(EX-HN) , Jinjin(EX-HN12),Yuye(EX-HN13).頸頸 椎椎 夾夾 脊脊 穴穴Cervical Jiaji Points(EX-B2)(5) (5) 復(fù)視復(fù)視：針天柱、晴明、球后：針天柱、晴明、球后Double Vision: Puncture Fengchi(GB 20), Tianzhu(BL 10), Jingming(BL 1) and Qiuhou(EX-HN7)（6 6）便秘）便秘：針外水道、外歸

24、來、豐隆。：針外水道、外歸來、豐隆。 Constipation: Puncture Waishuidao(EX-CA), Waiguilai(EX-CA) and Fenglong(ST 40)(7) (7) 肩周炎肩周炎：針肩髃、肩髎、肩內(nèi)陵、：針肩髃、肩髎、肩內(nèi)陵、肩貞、肩中俞、肩外俞，痛點(diǎn)刺絡(luò)拔罐肩貞、肩中俞、肩外俞，痛點(diǎn)刺絡(luò)拔罐Periarthritis of Shoulder: Puncture Jianneiling(EX-UE), Jianliao(SJ 14), Jianzhen(SI 9), Jianzhongshu(SI 15), Jianwaishu (SI 14).Ap

25、ply blood letting and cupping method to the local pain point.(8) (8) 尿失禁、尿潴留尿失禁、尿潴留：針中極、曲骨、：針中極、曲骨、關(guān)元、局部施灸、按摩或熱敷關(guān)元、局部施灸、按摩或熱敷 Incontinence of Urine, Retention of Urine: Puncture Zhongji(RN 3),Qugu(RN 4), Sanyinjiao (SP 6), Yinlingquan(SP 9). Moxibustion is applied on the local area, while massage an

26、d hot compress are applicable too.(9) (9) 手指握固手指握固：針合谷、上八邪：針合谷、上八邪Fingers grip solid: Puncture Hegu(LI 4), Shangbaxie(EX-UE9).(10) (10) 足內(nèi)翻足內(nèi)翻：丘墟透照海：丘墟透照海Strephenopodia: Puncture Qiuxu(GB 40) to Zhaohai(KI 6)(11) (11) 血管性癡呆血管性癡呆：針百會、四神聰、：針百會、四神聰、 四白、太沖四白、太沖Vascular Dementia:Puncture Baihui (DU 20),

27、Sishencong(EX-HN1), Sibai(ST 2) and Taichong(LR 3).太太 沖沖Taichong(LR 3)(12) (12) 睡眠倒錯睡眠倒錯：針上星、神門：針上星、神門Paradoxic Sleep: Puncture Shangxing (DU 23), Shenmen(HT 7).(13) (13) 高血壓高血壓：針人迎、曲池、：針人迎、曲池、 足三里、合谷、太沖足三里、合谷、太沖 Hypertension: Puncture Renying (ST 9), Quchi(LI 11) ,Zusanli(ST36), Hegu(LI 4), Taichon

28、g(LR 3)(14) (14) 呃逆呃逆：針人中、內(nèi)關(guān)：針人中、內(nèi)關(guān)Hiccup: Puncture Renzhong(DU 26), Neiguan(PC 6)2.2.神志、精神疾患的治療神志、精神疾患的治療Treatment of consciousness and mental disorders 癔病、郁癥究其病機(jī)，氣機(jī)郁閉、神竅失宣，情迷志亂癔病、郁癥究其病機(jī)，氣機(jī)郁閉、神竅失宣，情迷志亂是為關(guān)鍵。是為關(guān)鍵。 運(yùn)用運(yùn)用“醒腦開竅醒腦開竅”針法開竅啟閉、宣發(fā)神氣、調(diào)針法開竅啟閉、宣發(fā)神氣、調(diào)神定志，可以直達(dá)病所，使心神復(fù)明，動則精神飽滿，靜則神定志，可以直達(dá)病所，使心神復(fù)明，動則精神

29、飽滿，靜則志定神寧。醒法的變通作用，對諸如神經(jīng)衰弱、癔病以及強(qiáng)志定神寧。醒法的變通作用，對諸如神經(jīng)衰弱、癔病以及強(qiáng)迫癥、抑郁癥、焦慮癥等各種神經(jīng)、精神疾患，主治廣泛，迫癥、抑郁癥、焦慮癥等各種神經(jīng)、精神疾患，主治廣泛，療效確切。療效確切。 Depression and stagnation of QI ,dysfunction of the mind and emotional upset, what are the key points of the pathogenesis of hysteria and melancholia. To induce resuscitation,relea

30、se shen-qi ,modulate the function of shen and calm the mind, we use Xing Nao Kao Qiao“ acupuncture method, which is target therapy, as well as could rebound the pure brightness of heart-spirit.XNKQ acupuncture can treat diseases such as neurasthenia, hysteria, compulsion, depressive disorder and anx

31、iety disorder etc.3.3.厥閉脫證的治療厥閉脫證的治療Treatment of prostration syndrome with fainting and closure “陰平陽秘、精神乃治；陰陽離決，精氣乃絕陰平陽秘、精神乃治；陰陽離決，精氣乃絕”，陰，陰陽失和，神氣逆亂而生閉厥。此時當(dāng)急行醒腦開竅之法陽失和，神氣逆亂而生閉厥。此時當(dāng)急行醒腦開竅之法,以奏蘇厥救逆之效。以奏蘇厥救逆之效。 “l(fā)ife activities being normally maintained when both yin and yang in equilibrium; exhaustion

32、 of vital essence when dissociation of yin and yang”. When it becomes prostration syndrome with fainting and closure, for the sake of imbalance between yin and yang and upset of vital spirit , we should use XNKQ acupunture method as soon as possible to revive the yang for resuscitation. “醒腦開竅醒腦開竅”法可

33、調(diào)節(jié)陰陽和臟腑功能，調(diào)整心經(jīng)氣血，法可調(diào)節(jié)陰陽和臟腑功能，調(diào)整心經(jīng)氣血，開啟心竅之閉，宣發(fā)心神之氣；人中穴，疏通督脈之陽，醒開啟心竅之閉，宣發(fā)心神之氣；人中穴，疏通督脈之陽，醒精明腦腑之神，共奏啟閉、醒神、蘇厥之效。因而，現(xiàn)代臨精明腦腑之神，共奏啟閉、醒神、蘇厥之效。因而，現(xiàn)代臨床各種原因所致的休克、虛脫，以及中暑、癲癇等，應(yīng)用本床各種原因所致的休克、虛脫，以及中暑、癲癇等，應(yīng)用本法急救多能起死回生。法急救多能起死回生。 XNKQ acupunture method can be used to modulate the function of yin-yang and zang-fu-org

34、ans, regulate the qi and blood of the Heart meridian, unlock the closure of heart-orifice, disperse qi of heart-spirit. Ren zhong point (DU26) could regulate the yang of DU meridian, promote the spirit of the brain. They together contribute to the effect of unlocking the closure , promoting resuscit

35、ation and recuperating life. Consequently, using XNKQ acupunture method could retrieve the life back in morden clinical situations such as shock, atrophy, sunstroke and epilepsy and so on due to various causes.4.4.痛癥的治療痛癥的治療 Treatment of pain 坐骨神經(jīng)痛坐骨神經(jīng)痛 三叉神經(jīng)痛三叉神經(jīng)痛 脊髓內(nèi)血管瘤術(shù)后疼痛脊髓內(nèi)血管瘤術(shù)后疼痛(病例病例) Sciatica

36、 Prosopalgia Postoperative pain after angioma of spinal cord 疼痛病機(jī)在于各種原因引起的經(jīng)脈氣血運(yùn)行不暢，疼痛病機(jī)在于各種原因引起的經(jīng)脈氣血運(yùn)行不暢，而經(jīng)脈氣血的流行又與心和神關(guān)系密切。神能導(dǎo)氣，氣而經(jīng)脈氣血的流行又與心和神關(guān)系密切。神能導(dǎo)氣，氣暢則道通，暢則道通，“通則不痛通則不痛”。故治以調(diào)神法，。故治以調(diào)神法，“制其神，制其神，令氣易行令氣易行”，能收，能收“以意通經(jīng)以意通經(jīng)”而達(dá)到鎮(zhèn)痛之效。而達(dá)到鎮(zhèn)痛之效。 運(yùn)用醒神之法止痛，范圍廣泛，無論感冒及內(nèi)傷頭痛；運(yùn)用醒神之法止痛，范圍廣泛，無論感冒及內(nèi)傷頭痛；痹癥關(guān)節(jié)疼痛，肌肉疼痛；兼或胃痙攣、膽道梗阻、泌痹癥關(guān)節(jié)疼痛，肌肉疼痛；兼或胃痙攣、膽道梗阻、泌尿系結(jié)石甚至心絞痛等各種內(nèi)臟絞痛，還是三叉神經(jīng)痛、尿系結(jié)石甚至心絞痛等各種內(nèi)臟絞痛，還是三叉神經(jīng)