从脑、少阳、咽的相关性探析调枢通窍针刺法在中风后吞咽障碍中的运用OA

Based on the close structural and functional associations of the Shaoyang(少 阳)channel and related zang-fu(脏腑)organs with the brain and the pharynx,this paper proposes that the pathogenesis of post-stroke dysphagia involves constraint and stagnation of the pivot mechanism,binding of phlegm and stasis,frenetic stirring of ministerial fire,and incoordination of the spirit mechanism,ultimately leading to loss of pharyngeal function.An acupuncture therapy centered on regulating the pivot and unblocking the orifice is established.Acupoints of the Shaoyang channel,including Fengchi(GB 20),Wangu(GB 12),Yifeng(SJ 17),and Waiguan(SJ 5),are selected to regulate the piv-ot and treat the root;acupoints of the Du(督)and Ren(任)channels,including Fengfu(GV 16),Lianquan(CV 23),and Tiantu(C V 22),are used to unblock the orifice and treat the branch.In addition,staged treatment can be ap-plied according to syndrome differentiation.In the acute stage with predominant phlegm turbidity,Fenglong(ST 40),Yinlingquan(SP 9),Jinjin(EX-HN 12),and Yuye(EX-HN 13)are added to resolve phlegm and facilitate orifice function.During the recovery stage with excess ministerial fire scorching the pharynx,Zulinqi(GB 41)and Zhaohai(KI 6)are added to drain fire and nourish yin;when ministerial fire disturbs the spirit,Tongli(HT 5)and Neiguan(PC 6)are added to calm the spirit and the heart.During the chronic stage with blood deficiency and collateral stasis,Zusanli(ST 36)and Sanyinjiao(SP 6)are added to nourish blood and unblock collaterals.In clinical practice,the angle and depth of needling are adjusted based on the stage of dysphagia,with the combination of elongated needles and medicinal moxibustion are used to enhance the therapeutic effect.