文献类型：期刊文献

中文题名：李菊莲运用针药结合分期论治周围性面瘫经验

英文题名：Li Ju-lian′s Experience of Treating Peripheral Facial Paralysis with Combination of Acupuncture and Medicine by Stages

作者：罗莹瑞[1];李菊莲[2];李娜[1];宁子铭[1]

第一作者：罗莹瑞

机构：[1]甘肃中医药大学,甘肃兰州730000;[2]甘肃中医药大学附属医院,甘肃兰州730020

第一机构：甘肃中医药大学

年份：2022

卷号：42

期号：4

起止页码：542

中文期刊名：河南中医

外文期刊名：Henan Traditional Chinese Medicine

语种：中文

中文关键词：周围性面瘫;分期论治;缪刺法;牵正散;李菊莲

外文关键词：peripheral facial paralysis;treatment by stages;contralateral collateral needling;Symmetry-Correcting Powder;Li Ju-lian

摘要：李菊莲主任医师将周围性面瘫分为急性期、恢复期、后遗症期,分期论治周围性面瘫。李老师在面瘫急性期重用风穴,用泻法以祛风,常用穴位:风池、风府、太冲;发病初期用缪刺法针刺健侧,取穴宜少,手法宜轻,常选用双侧耳尖点刺放血以活血祛风。李老师在针刺治疗的基础上采用牵正散辨证加减治疗,常加白芷、菊花等引经药,直达病所。风寒阻络者加荆芥、防风、紫苏叶;风热阻络者加金银花、连翘、夏枯草;瘀血阻络者加桃仁、红花、鸡血藤;痰瘀互结者加瓜蒌、胆南星。此外,药物除内服外,将药渣与葱白同煎,外熏于面部。面瘫恢复期,李老师主张针刺患侧,常可一针透两穴或多穴,且可使用电针。面瘫后遗症期,李老师常在远端取穴时加入穴性偏补益的穴位,用药在祛风通络的同时,加入益气养血之品,以扶正祛邪。同时,后遗症期患者病情向愈,处于针刺疲劳期,可选用穴位埋线法,一方面可持续刺激穴位,另一方面,可缓和患者畏针情绪。
Chief physician Li Ju-lian divides peripheral facial paralysis into acute stage,recovery stage and sequelae stage,and treats it by stages.In the acute stage of facial paralysis,Professor Li heavily uses wind points,dispels wind by purgation.The commonly-used points include Fengchi(GB 20),Fengfu(DU 16) and Taichong(LV 3).In the early stage of onset,contralateral collateral needling is used to acupuncture the healthy side.The points should be fewer and the manipulation should be lighter.Bilateral ear tip pricking and bloodletting are often used to promote blood circulation and dispel wind.On the basis of acupuncture treatment,Professor Li adopts the syndrome differentiation of Modified Symmetry-Correcting Powder,and often adds meridian-guiding drugs such as Baizhi(Radix Angelicae Dahuricae) and Juhua(Flos Chrysanthemi),etc.to reach the disease location.For those with wind and cold blocking collaterals,Jingjie(Herba Schizonepetae),Fangfeng(Radix Saposhnikoviae) and Suye(Folium Perillae) can be added.For those with wind and heat blocking collaterals,Jinyinhua(Flos Lonicerae Japonicae),Lianqiao(Fructus Forsythiae) and Xiakucao(Spica Prunellae) can be added.For those with blood stasis blocking collaterals,Taoren(Semen Persicae),Honghua(Flos Carthami) and Jixueteng(Caulis Spatholobi) can be added.For those with phlegm and blood stasis in complexity,Gualou(Fructus Trichosanthis) and Dannanxing(Rhizoma Arisaematis cum Bile) can be added.Besides oral administration,the drug residue can be fried with Congbai(Bulbus Allii Fistulosi) and smoked on the face.In the recovery period of facial paralysis,Professor Li advocates acupuncture on the affected side.One needle can often penetrate two or more points,and electroacupuncture can be used.In the sequelae period of facial paralysis,Professor Li often adds points with partial tonic when taking points at the far end.When using drugs to dispel wind and dredge collaterals,she also adds products that replenish qi and nourish blood,so as to strengthen healthy qi and dispel pathogens.At the same time,in the sequelae period,the patient′s condition is getting better and in the acupuncture fatigue period.Acupoint catgut-embedding method can be selected,which can continuously stimulate points on the one hand and alleviate the patient′s fear of acupuncture on the other hand.