Disease spectrum and strategy of acupuncture and moxibustion in treatment of encephalopathy

DU Yuanhao

doi:10.13703/j.0255-2930.20231218-0001

您当前的位置：

首页 >

文章列表页 >

Disease spectrum and strategy of acupuncture and moxibustion in treatment of encephalopathy

Forum | 更新时间：2024-06-03

- Disease spectrum and strategy of acupuncture and moxibustion in treatment of encephalopathy
- Chinese Acupuncture & Moxibustion Vol. 44, Issue 4, Pages: 367-371(2024)
- 作者机构：
  
  1.天津中医药大学第一附属医院天津市名中医工作室，天津300381
  2.天津中医药大学医史文献研究中心，天津 301617
- 作者简介：
- 基金信息：
- DOI：10.13703/j.0255-2930.20231218-0001
  CLC：
- Received：18 December 2023，
  
  Online First：05 February 2024，
  
  Published：12 April 2024
- 稿件说明：
移动端阅览
杜元灏.脑病针灸治疗的病谱与策略思考[J].中国针灸,2024,44(4):367-371.

DU Yuanhao.Disease spectrum and strategy of acupuncture and moxibustion in treatment of encephalopathy[J].Chinese Acupuncture & Moxibustion,2024,44(04):367-371.
杜元灏.脑病针灸治疗的病谱与策略思考[J].中国针灸,2024,44(4):367-371. DOI： 10.13703/j.0255-2930.20231218-0001.

DU Yuanhao.Disease spectrum and strategy of acupuncture and moxibustion in treatment of encephalopathy[J].Chinese Acupuncture & Moxibustion,2024,44(04):367-371. DOI： 10.13703/j.0255-2930.20231218-0001.

摘要

概述目前针灸治疗脑病的病谱，分析针灸治疗脑病临床研究存在的问题，提出针灸治疗脑病的可能策略。针灸治疗脑病的病谱包括23种中枢神经系统（脊髓上中枢）疾病和33种精神与行为障碍病症。针灸治疗脑病的临床研究存在3方面问题：高质量的临床证据不足、针灸治疗脑病的中医理论研究不足和针灸治疗脑病的规律研究不足。笔者提出针灸治疗脑病的五大策略，即刺激脑功能障碍相关的外周神经干，引发外周与中枢的交互作用，并强调自主性康复训练的重要意义，尽早促进脑功能重组；通过刺激三叉神经与蝶腭神经节来改善脑循环、脑代谢；刺激外周神经末梢分布密度高及在脑躯体感觉区投射面积大的部位，以引起较强的脑反应，从而可能对静息状态下脑默认模式网络的工作方式异常起到调整作用；刺激迷走神经改善情绪、抑制脑神经元异常放电，选择星状神经节刺激点以调节下丘脑功能；在治疗脑病的基础上，结合具体情况与症状、体征分类治疗。

Abstract

The paper presents the summary of the spectrum of encephalopathy treated with acupuncture and moxibustion and the analysis on the existing questions in its clinical research

and proposes the potential strategies on treatment of encephalopathy with acupuncture and moxibustion. The spectrum of encephalopathy includes 23 diseases of central nervous system (superspinal center) and 33 kinds of mental and behavioral disorders. There are three problems in clinical research of acupuncture and moxibustion for encephalopathy

i.e. lack of high-quality clinical evidences

inadequate support from theoretic study of TCM and limited study on the rules of treatment. Hence

the author proposes five strategies on the treatment of encephalopathy with acupuncture and moxibustion

i.e. ① stimulating the peripheral nerve trunk associated with brain dysfunction

triggering the interaction between peripheral and central nerves and emphasizing the autonomic rehabilitation training to promote the reorganization of brain function; ② improving the cerebral circulation and metabolism by stimulating the trigeminal nerve and sphenopalatine ganglion; ③ stimulating the sites with high-dense distribution of peripheral nerve endings and the large projection area in the somatosensory region of the brain to induce strong brain responses

which may adjust the abnormal operation of the default mode network in the resting state; ④ stimulating the vagus nerve to improve the mood

suppressing the abnormal firing of brain neurons and stimulating the sites with the stellate ganglion distributed to modulate the hypothalamic function; ⑤ delivering the therapeutic regimens in association with the specific conditions and symptoms

and the classification of the physical signs on the base of the treatment of encephalopathy.

关键词

Keywords

references

世界卫生组织 . 疾病和有关健康问题的国际统计分类(第1卷) [M ] .北京协和医院世界卫生组织国际疾病分类合作中心编译. 北京 : 人民卫生出版社 , 1996 .

吴江 . 神经病学 [M ] . 2版 . 北京 : 人民卫生出版社 , 2010 .

郝伟 , 陆林 . 精神病学 [M ] . 8版 . 北京 : 人民卫生出版社 , 2018 .

杜元灏 , 李晶 , 孙冬纬 , 等 . 中国现代针灸病谱的研究 [J ] . 中国针灸 , 2007 , 27 ( 5 ): 373 - 378 .

Jacqueline Filshie , Adrian White , Mike Cummings . 西方医学针刺 [M ] .杜元灏主译. 北京 : 人民卫生出版社 , 2021 .

Nudo RJ , Wise BM , SiFuentes F , et al . Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct [J ] . Science , 1996 , 272 ( 5269 ): 1791 - 1794 .

韩济生 . 神经科学纲要 [M ] . 北京 : 人民卫生出版社 , 1993 .

杜元灏 , 冀健民 . 醒脑开窍针法中水沟穴作用探讨 [J ] . 中国针灸 , 2001 , 21 ( 9 ): 535 - 536 .

陈宜张 . 分子神经生物学 [M ] . 北京 : 人民军医出版社 , 1995 .

秦海霞 , 赵文瑞 , 喻婧 , 等 . 失眠患者静息态脑网络的改变: 网络内与网络间的功能连接异常 [J ] . 心理科学进展 , 2019 , 27 ( 2 ): 289 - 300 .

刘文洪 , 罗光华 , 赵衡 , 等 . 卒中后抑郁患者默认静息态脑默认网络变化特点及节点脑区之间的关系 [J ] . 临床合理用药杂志 , 2018 , 11 ( 7 ): 22 - 24 .

Johansson O , Wang L , Hilliges M , et al . Intraepidermal nerves in human skin: PGP 9.5 immunohistochemistry with special reference to the nerve density in skin from different body regions [J ] . J Peripher Nerv Syst , 1999 , 4 ( 1 ): 43 - 52 .

丁文龙 . 系统解剖学 [M ] . 3版 . 北京 : 人民卫生出版社 , 2018 .

Nemeroff CB , Mayberg HS , Krahl SE , et al . VNS therapy in treatment-resistant depression:clinical evidence and putative neurobiological mechanisms [J ] . Neuropsychopharmacology , 2006 , 31 ( 7 ): 1345 - 1355 .

Park MC , Goldman MA , Carpenter LL , et al . Vagus nerve stimulation for depression: rationale, anatomical and physiological basis of efficacy and future prospects [J ] . Acta Neurochir Suppl , 2007 , 97 ( Pt 2 ): 407 - 416 .

朱兵 . 系统针灸学——复兴“体表医学” [M ] . 北京 : 人民卫生出版社 , 2015 .

李仲廉 . 临床疼痛治疗学 [M ] . 天津 : 天津科学技术出版社 , 1994 .

张荣宝 . 植物性神经系统生理与临床 [M ] . 北京 : 人民卫生出版社 , 1994 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

A new model of precision acupuncture regulation for emotional disorders based on the AI4S paradigm

New concepts and methods for future clinical research on acupuncture and moxibustion

LYU Jingshan's experience in treatment of post-stroke depression with acupuncture and moxibustion

Efficacy prediction of acupuncture and moxibustion combined with conventional treatment for PCOS-IR based on real-world data: machine learning and interpretability analysis

Refractory diabetic ulcer induced by recurrent herpes simplex treated with shallow lining-up fire needling therapy with filiform needle

Related Author

ZHAO Yanan

LUO Yi

GU Xiaochai

XIN Chen

ZHAO Chen

RONG Peijing

WANG Yu

YAN Shiyan

Related Institution

Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences

Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences

International Acupuncture and Moxibustion Innovation Institute, Beijing University of CM

School of Acupuncture-Moxibustion and Tuina, Beijing University of CM

Department of Acupuncture and Moxibustion, Shanxi Provincial Hospital of Acupuncture and Moxibustion

⁰