文献类型：期刊文献

中文题名：基于经筋理论探讨脑卒中后痉挛性偏瘫与良肢位摆放

英文题名：Discussion on spastic hemiplegia and good limb position after stroke based on the theory of meridian and tendon

作者：王一楠[1];刘硕[1];杨秀娟[1];杨志军[1];朱田田[1];张金保[1];梁永林[1]

第一作者：王一楠

机构：[1]甘肃中医药大学,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2023

卷号：15

期号：24

起止页码：35

中文期刊名：中医临床研究

外文期刊名：Clinical Journal Of Chinese Medicine

基金：甘肃省“十四五”教育规划课题(GS[2021]GHB1862)。

语种：中文

中文关键词：脑卒中;痉挛性偏瘫;经筋理论;良肢位摆放

外文关键词：Stroke;Spastic hemiplegia;Meridian and tendon theory;Good limb position

摘要：脑卒中是一种难治性疾病,具有高致残率和致死率。脑卒中后的痉挛性偏瘫是其主要后遗症之一,主要表现为上肢屈肌痉挛呈折刀状,下肢过伸呈划圈样步态,临床存在治疗费用高、周期长、疗效差等问题,严重影响患者日常生活。良肢位摆放作为一种早期介入、贯穿全程的治疗方法,能够有效纠正痉挛性偏瘫的肢体异常,改善患者的生活质量。经筋理论是我国中医经典理论的一种,在长期实践中对脑卒中后痉挛性偏瘫有重要的指导意义。文章首先阐述了经筋的分布特点与经筋理论的临床应用,利用经筋理论分析了脑卒中后痉挛性偏瘫与经筋病变之间的关系,提炼出“上肢屈肌痉挛为阴急阳缓,下肢伸肌痉挛为阳急阴缓”的脑卒中后痉挛性偏瘫的发病机制,从而依据“病在筋,调在筋”理论,从经筋理论角度分析良肢位摆放对于脑卒中后痉挛性偏瘫的意义及仰卧位、健侧卧位、患侧卧位下的良肢位摆放具体操作。最后从经筋理论角度分析良肢位摆放改善痉挛性偏瘫的临床报道,得出经筋理论指导下的良肢位摆放能更清晰地认识患者的痉挛特征,有效避免关节挛缩、压疮等并发症的结论。文章立足于经筋理论,以全新角度理解良肢位摆放并对其设计提供临床思路,以期为读者提供参考。
Stroke is a refractory disease with high disability and fatality rate.Spasmodic hemiplegia after stroke is one of the main sequelae,mainly manifests as upper limb flexor spasm in the shape of a folding knife,lower limb hyperextension in the shape of a circular gait.There are clinical problems such as high treatment costs,long cycle,poor efficacy and other problems,which seriously affect the daily life of patients.As an early intervention and whole-course treatment,good limb position can effectively correct spastic hemiplegia and improve patients’quality of life.The theory of meridian and tendon is one of the classical theories of traditional Chinese medicine,which has important guiding significance for spastic hemiplegia after stroke in long-term practice.In this paper,the distribution characteristics of the meridians and tendons and the clinical application of the meridian and tendon theory are firstly expounded.The relationship between spastic hemiplegia and the meridian and tendon after stroke is analyzed by applying the theory of meridian and tendon,and the pathogenesis of spastic hemiplegia after stroke is summarized as“upper limb flexor spasm is characterized as Yin(阴)being urgent and Yang(阳)being slow”while“lower limb extensors pasm is characterized as Yang being urgent and Yin being slow”.Based on the classic theory of“The disease lies in tendons and the regulation lies in tendons”,the significance of good limb position for spastic hemiplegia after stroke and the specific operation of good limb position under supine position,healthy lateral position and affected lateral position are analyzed from the perspective of the meridian meridian theory.Finally,the clinical reports on the amelioration of spastic hemiplegia by good limb position are analyzed from the perspective of the theory of meridian and tendon,and it is concluded that good limb position under the guidance of the theory of meridian and tendon can better recognize the spasticity characteristics of patients and effectively avoid the complications such as joint contracture and pressure sore.Based on the theory of meridian and tendon,this paper tries to understand the good limb position from a new perspective and provides clinical ideas for its design,so as to provide reference for readers.