摘要
重症肌无力是由神经与肌肉之间的信号传递出现障碍引起的一种慢性自身免疫性神经肌肉疾病,主要特征是骨骼肌的易疲劳性和肌无力,临床上可出现上眼睑下垂、复视、四肢乏力、吞咽障碍、呼吸困难等相关症状。西医学对该病的认识仍有不足,该病主要与免疫功能失调、内分泌功能紊乱、遗传等多种因素相关,治疗方面并无确切的特效药,以对症治疗为主。目前治疗以胆碱酯酶抑制剂及手术为主,只能延缓疾病进展且不良反应较大。本病可归属于中医学“痿证”范畴,其发生与脾胃亏虚、肝肾亏虚、骨髓失养、正虚邪侵、阳经阻滞等密切相关。中医可通过辨病、辨证选择合适的穴位及中药,通过芒针透刺疗法及中药汤剂以发挥联合作用,缓解患者相关症状。坚持针药结合治疗可减少西药的不良反应,比手术安全性更高,费用更低,标本兼治。本研究主要总结陈幸生教授运用芒针透刺疗法联合中药治疗重症肌无力的临床经验。陈幸生教授认为,重症肌无力病机关键在于脾胃亏虚,气血生化无源,脏腑功能失调;治疗上以健脾益气、激发经络阳气、疏通经络为原则,采用芒针透刺疗法联合中药,取得了显著疗效。研究将从病因病机、治疗方法、典型病例等方面进行阐述,为中医治疗重症肌无力提供相关思路。
Myasthenia gravis is a chronic autoimmune neuromuscular disorder caused by impaired signal transmission between nerves and muscles,primarily characterized by easy fatigue and muscle weakness of skeletal muscles.Clinically,the disease may manifest as related symptoms such as ptosis of the upper eyelid,diplopia,limb weakness,dysphagia,and respiratory distress.Western medicine’s understanding of this disease remains limited,which is mainly related to a variety of factors such as immune dysfunction,endocrine dysfunction,and genetics.There is no definitive specific to treat this disease effectively,and the main treatment is symptomatic treatment.Current approaches primarily include cholinesterase inhibitors and surgical interventions,which can only delay the progression of the disease and show relatively significant adverse reactions.In traditional Chinese medicine(TCM),this disease can be classified under the category of flaccidity syndrome,and its pathogenesis is closely related to spleen-stomach deficiency,liver-kidney deficiency,and inadequate nourishment of the bone marrow,which results in constitutional weakness with pathogen invasion,and obstruction of Yang(阳)meridians.TCM employs disease differentiation and syndrome differentiation to select appropriate acupuncture points and Chinese medicinal materials,and exerts the comprehensive effect of filiform needle penetration therapy and TCM decoction to alleviate patients’symptoms.The combination of acupuncture and medication in treatment can reduce the adverse reactions of Western medicine,offering higher safety than surgery and lower costs,and addressing both the root cause and symptoms.Professor CHEN Xingsheng’s clinical experience in treating myasthenia gravis by elongated needle penetration therapy plus Chinese medicinal materials is summarized mainly in this study.Professor CHEN Xingsheng believes that the key pathogenesis of myasthenia gravis lies in spleen-stomach deficiency,leading to insufficient production of Qi(气)and blood,and disrupted organ functions.The treatment is guided by the principles of invigorating the spleen and replenishing Qi to stimulate Yangqi(阳气)for dredging meridians and collaterals.By integrating elongated needle penetration therapy with Chinese medicinal materials,significant therapeutic effects have been obtained.In this study,the etiology and pathogenesis,treatment methods,and typical cases will be elaborated to provide insights for TCM-based management of myasthenia gravis.
出处
《中医临床研究》
2025年第28期81-85,共5页
Clinical Journal Of Chinese Medicine
基金
安徽省卫生健康委员会项目——安徽中医药大学第二附属医院陈幸生名中医工作室(中发展〔2022〕5号)
安徽省中医药学术流派传承工作室建设项目——广德张氏芒针疗法流派工作室(皖中医药发展秘〔2021〕30号)。
关键词
重症肌无力
芒针
透刺
经络
Myasthenia gravis
Elongated needle
Penetrating acupuncture
Meridians and collaterals
