基于“形神兼顾、动静结合”理论防治颈椎病刍议

郭凤红; 范鹏; 刘冬银; 王雷

doi:10.16766/j.cnki.issn.1674-4152.003001

基于“形神兼顾、动静结合”理论防治颈椎病刍议

doi: 10.16766/j.cnki.issn.1674-4152.003001

郭凤红¹,
范鹏^2, ,,
刘冬银³,
王雷⁴

1.
秦皇岛市中医医院科教科, 河北秦皇岛 066000
2.
秦皇岛市中医医院康复科
3.
秦皇岛市中医医院重症医学科
4.
秦皇岛市中医医院针灸科

基金项目:

河北省秦皇岛市科学技术研究与发展计划项目 201902A123

第七批全国老中医药专家学术经验继承工作项目国中医药人教函〔2022〕76号

河北省中医药管理局科技项目 2020371

详细信息

通讯作者:
范鹏，E-mail：fanpeng14@126.com

中图分类号: R681.55
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- HTML全文浏览量: 61
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- 被引次数: 0
出版历程
- 收稿日期: 2022-11-15

Prevention and treatment of cervical spondylosis based on the theory of "balancing body and mind, combining motion and quiescence"

1.
Science and Education Department, Qinhuangdao Hospital of Traditional Chinese Medicine, Qinhuangdao Hebei 066000, China

摘要

摘要: 颈椎病(cervical spondylosis, CS)是临床常见病、多发病。随着社会发展，人们工作节奏加快，生活压力加大，颈椎病发病率不断上升，且呈年轻化趋势，其属中医“痹症”“项痹”等范畴，一般认为病位在颈部筋骨，基本病机是筋骨受损，经络气血阻滞不通，往往存在粘连、瘢痕、挛缩，硬化、钙化和骨化等病理改变。笔者根据多年临床经验，提出“形神兼顾、动静结合”的理论防治颈椎病，认为筋骨失衡是颈椎病的主要病机，调形是治疗的基础。脊柱部的经筋相当于维持脊柱平衡的错综复杂而规律的生物力线，既要静态平衡，也要动态稳定。调形可通过采用针刺、艾灸、推拿等方法刺激对应经筋，重建颈椎的力学平衡，以达到筋柔骨正的目的。同时，形病多伴神病，需重视治神在治疗颈椎病中的应用。治神能够减轻消极情志因素对病情及临床疗效的影响。治神不仅要注意调节机体功能状态之神，恢复神之统帅调节功能，还要改善人们对不良生活方式的认知，从而减少颈椎病的发生及复发。笔者还运用动静结合理论指导临床诊查和治疗，使诊断精准化，治疗精细化，从而起到更有效的防治作用。“形神兼顾、动静结合”理论的综合运用，临床中取得了满意疗效。
- 形神 /
- 动静 /
- 颈椎病 /
- 理论探讨 /
- 综合疗法 /
- 临床
Abstract: Cervical spondylosis (CS) is a common, frequently-occurring clinical disease. Due to accelerated work pace and increased life stress amid a progressing society, CS shows an increasing incidence and a trend of younger onset age. CS is considered as Bi syndrome or neck Bi in traditional Chinese medicine, and the lesion site is generally thought at the sinews and bones of the neck, and the basic pathogenesis is that there are damages in sinews and bones, and blockages in qi and blood in meridians in the neck, manifest often as adhesion, scar, contracture, sclerosis, calcification, ossification and other pathological changes. We put forward strategies relevant to the theory of "balancing body and mind, combining motion and quiescence" for the prevention and treatment of CS based on many years of clinical experiences. We think that sinew-bone imbalance is the major pathogenesis of CS, and improving physical constitution and function is the foundation of treatment. The spinal tendons are deemed as the intricate and regular lines of biological forces that maintain the balance of the spine, both statically and dynamically. Physical constitution and function can be improved by stimulating the corresponding meridians with acupuncture, moxibustion, massage and other methods to reconstruct the mechanical balance of the cervical spine, so as to achieve the purpose of softening the tendons and straightening the bones. As the physical problem often coexists with the emotional problem, importance should be attached to the use of emotion-based interventions in treating CS, which can reduce the influence of negative emotional factors on the condition and clinical efficacy. During the delivery of emotion-based interventions, attention should be given to enhancing patients' emotional state to improve their physical functions, and restoring the regulatory function of positive emotions, as well as increasing their awareness of unhealthy lifestyles, so as to reduce the occurrence and recurrence of CS. We also use the theory of "combining motion and quiescence" to guide clinical diagnosis and treatment of CS, which contributes to making an accurate diagnosis and delivering a precise treatment, resulting in better preventive and therapeutic effects. The comprehensive application of the theory of "balancing body and mind, combining motion and quiescence" has facilitated the achievement of satisfactory clinical effects.
- Body and mind /
- Motion and quiescence /
- Cervical spondylosis /
- Theoretical discussion /
- Comprehensive therapy /
- Clinical
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参考文献(25)

[1]	中华外科杂志编辑部. 颈椎病的分型、诊断及非手术治疗专家共识(2018)[J]. 中华外科杂志, 2018, 56(6): 401-402. Editorial Department of Chinese Journal of Surgery. The experts consensus on the classification, diagnosis and non-surgical treatment of cervicalspondyUsis (2018)[J]. Chinese Journal of Surgery, 2018, 56(6): 401-402.
[2]	胡奇志. 针灸治疗颈椎病的研究进展[J]. 中国保健营养, 2020, 30(31): 43. https://www.cnki.com.cn/Article/CJFDTOTAL-XJZY202206044.htm HU Q Z. Advances of Studies on Acupuncture and Moxibustion for Treatment of Cervical Spondylosis[J]. Chinese Journal of Integrative Nursing, 2020, 30(31): 43. https://www.cnki.com.cn/Article/CJFDTOTAL-XJZY202206044.htm
[3]	赵明宇, 张荣, 张向东. 慢性筋骨病内外兼治的临床诊疗辨证思维[J]. 风湿病与关节炎, 2022, 11(1): 52-55. https://www.cnki.com.cn/Article/CJFDTOTAL-FSBG202201014.htm ZHAO M Y, ZHANG R, ZHANG X D. Clinical Diagnosis, Treatment and Dialectical Thinking of Internal and External Treatment of Chronic Musculoskeletal Diseases[J]. Rheumatism and Arthritis, 2022, 11(1): 52-55. https://www.cnki.com.cn/Article/CJFDTOTAL-FSBG202201014.htm
[4]	闫雪峰, 郁金岗. 神经根型颈椎病中西医发病机制及诊断概述[J]. 内蒙古中医药, 2022, 41(1): 167-168. https://www.cnki.com.cn/Article/CJFDTOTAL-NZYY202201092.htm YAN X F, YU J G. The pathogenesis and diagnosis of radiculopathy of cervical spondylosis[J]. Inner Mongolia Journal of Traditional Chinese Medicine, 2022, 41(1): 167-168. https://www.cnki.com.cn/Article/CJFDTOTAL-NZYY202201092.htm
[5]	梁龙, 于杰, 周帅琪, 等. 基于经筋理论探讨颈椎病的发病机制及颈部锻炼的分期论治[J]. 中华中医药杂志, 2020, 35(8): 4201-4204. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202008111.htm LIANG L, YU J, ZHOU S Q, et al. Discussion on the pathogenesis of cervical spondylosis and the treatment by stage of cervical exercise based on the theory of meridian tendon[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2020, 35(8): 4201-4204. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202008111.htm
[6]	罗鹏飞, 李宁, 谢兴文, 等. 基于"筋骨平衡"理论探讨旋转手法治疗颈椎病的生物力学机制研究进展[J]. 中医正骨, 2020, 32(9): 46-49. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYZG202009009.htm LUO P F, LI N, XIE X W, et al. Advancement of research on biomechanical mechanism of rotation manipulation for treatment of cervical spondylopathy: an investigation based on sinew-bone equilibrium theory[J]. The Journal of Traditional Chinese Orthopedics and Traumatology, 2020, 32(9): 46-49. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYZG202009009.htm
[7]	黄学成, 叶林强, 伍子贤, 等. 基于"筋出槽、骨错缝"理论探讨神经根型颈椎病的CT特征[J]. 中华中医药杂志, 2019, 34(8): 3483-3487. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201908033.htm HUANG X C, YE L Q, WU Z X, et al. Discussion on CT features of cervical spondylotic radiculopathy based on the theory of channel blockage and joint displacement[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2019, 34(8): 3483-3487. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201908033.htm
[8]	范莉丛, 于海波, 刘永锋. 从肝脾肾-筋肉骨平衡论治"骨错缝、筋出槽"所致颈性眩晕及其临床思考[J]. 中国中医急症, 2018, 27(8): 1403-1404, 1411. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJZ201808024.htm FAN L C, YU H B, LIU Y F. Treatment and Clinical Thinking of Cervical Vertigo Caused by the Dislocation of Bone and Soft Tissue Injury from the Balance between Liver, Spleen and Kidney and Soft tissue, Muscle and Bone[J]. Journal of Emergency in Traditional Chinese Medicine, 2018, 27(8): 1403-1404, 1411. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJZ201808024.htm
[9]	杨钦, 周红海, 胡梦婷, 等. 浅析颈椎病相关动静力学平衡[J]. 颈腰痛杂志, 2021, 42(1): 131-133, 139. https://www.cnki.com.cn/Article/CJFDTOTAL-JYTZ202101039.htm YANG Q, ZHOU H H, HU M T, et al. Analysis on the static and dynamic balance of cervical spondylosis[J]. The Journal of Cervicodynia and Lumbodynia, 2021, 42(1): 131-133, 139. https://www.cnki.com.cn/Article/CJFDTOTAL-JYTZ202101039.htm
[10]	张强, 卢洁, 张天民. 基于人体弓弦力学解剖系统理论的颈椎病病理构架研究[J]. 中国医药导报, 2018, 15(21): 146-149. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY201821036.htm ZHANG Q, LU J, ZHANG T M. Study on cervical spondylosis of pathological structure based on human bowstring mechanics anatomical system[J]. China Medical Herald, 2018, 15(21): 146-149. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY201821036.htm
[11]	刘福水, 方婷, 周凡媛. 针刀"调筋治骨"法治疗颈椎病力学机制探讨[J]. 中华中医药学刊, 2018, 36(12): 2862-2865, 3094. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS201812010.htm LIU F S, FANG T, ZHOU F Y. Discussion on Mechanical Mechanism of Acupotomy with Theory of Treating Bone Disorders Through Regulating Muscles in Treatment of Cervical Spondylosis[J]. Chinese Archives of Traditional Chinese Medicine, 2018, 36(12): 2862-2865, 3094. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS201812010.htm
[12]	於浩, 马勇, 郭杨, 等. 从筋骨理论探讨脊柱退行性疾病的病机与手法治则[J]. 中华中医药杂志, 2020, 35(8): 4194-4196. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202008109.htm YU H, MA Y, GUO Y, et al. Discussion on pathogenesis and principles of manipulation treatment of spine degenerative diseases from physical tendons and bone theory[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2020, 35(8): 4194-4196. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202008109.htm
[13]	杨超, 吕立江, 王玮娃, 等. 基于"筋骨失衡, 以筋为先"理念探讨颈型颈椎病的治疗[J]. 中医正骨, 2019, 31(4): 64-65, 69. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYZG201904018.htm YANG C, LYU L J, WANG W W, et al. Investigation on the treatment of neck-type cervical spondylopathy based on the concept of "Treat sinew-bone imbanlance by treating sinews firstly"[J]. The Journal of Traditional Chinese Orthopedics and Traumatology, 2019, 31(4): 64-65, 69. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYZG201904018.htm
[14]	陈佳丽, 林星星, 张文静. 从时空角度探讨经筋理论的架构[J]. 中医杂志, 2017, 58(7): 552-555. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201707004.htm CHEN J L, LIN X X, ZHANG W J. Exploration of the Framework of Meridian Sinew Theory from Space-time Aspect[J]. Journal of Traditional Chinese Medicine, 2017, 58(7): 552-555. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201707004.htm
[15]	杨威, 郭斯印, 易志勇, 等. 基于《灵枢·经筋》论经筋[J]. 风湿病与关节炎, 2021, 10(3): 50-53. https://www.cnki.com.cn/Article/CJFDTOTAL-FSBG202103013.htm YANG W, GUO S Y, YI Z Y, et al. On Channel Sinew Based on The Spiritual Pivot. Channel Sinews[J]. Rheumatism and Arthritis, 2021, 10(3): 50-53. https://www.cnki.com.cn/Article/CJFDTOTAL-FSBG202103013.htm
[16]	姜玉雯, 陈春凤, 朱纪阳, 等. "施氏十二字养生功"改善颈椎病患者抑郁、焦虑情绪的临床应用与研究[J]. 中国初级卫生保健, 2020, 34(12): 80-83. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW202012026.htm JIANG Y W, CHEN C F, ZHU J Y, et al. Clinical Application and Research of Using "Shi's Twelve Word Life Cultivation Skill" to Improve Depression and Anxiety in Patients with Cervical Spondylosis[J]. Chinese Primary Health Care, 2020, 34(12): 80-83. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW202012026.htm
[17]	张若冰. 推拿改善颈型颈椎病员工焦虑状态: 疼痛缓解的中介作用[J]. 中国疼痛医学杂志, 2018, 24(12): 927-931. https://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ201812013.htm ZHANG R B. Massage improves anxiety status of employees with cervical spondylosis(type Ⅱ): the mediation of pain relief[J]. Chinese Journal of Pain Medicine, 2018, 24(12): 927-931. https://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ201812013.htm
[18]	刘亚梅, 檀立端, 林琳, 等. 颈椎病伴发情绪障碍危险因素的病例对照研究[J]. 中国医药导报, 2020, 17(5): 117-120, 124. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202005030.htm LIU Y M, TAN L D, LIN L, et al. A case-control study on the risk factors of cervical spondylosis associated with emotional disorders[J]. China Medical Herald, 2020, 17(5): 117-120, 124. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202005030.htm
[19]	孟文君, 魏昕, 柴小青, 等. 急性、慢性疼痛病人的痛阈及焦虑状态的比较[J]. 中国疼痛医学杂志, 2018, 24(1): 40-44. https://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ201801011.htm MENG W J, WEI X, CAI X Q, et al. Comparison of pain threshold and anxiety status in patients with acute or chronic pain[J]. Chinese Journal of Pain Medicine, 2018, 24(1): 40-44. https://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ201801011.htm
[20]	张幻真, 陈乐春, 陈进城, 等. 通督调神推拿手法干预神经根型颈椎病合并焦虑状态的临床研究[J]. 光明中医, 2020, 35(24): 3932-3935. https://www.cnki.com.cn/Article/CJFDTOTAL-GMZY202024035.htm ZHANG H Z, CHEN L C, CHEN J C, et al. Clinical Study on Manipulation of Dredging the Governor Vessel and Regulating Mentality Massage in the Intervention of Nerve Root Type Cervical Spondylosis with Anxiety State[J]. Guangming Journal of Chinese Medicine, 2020, 35(24): 3932-3935. https://www.cnki.com.cn/Article/CJFDTOTAL-GMZY202024035.htm
[21]	王元新, 薛爱荣, 徐鹏, 等. 醒脑开窍针法联合督脉灸治疗脊髓型颈椎病40例[J]. 中医研究, 2021, 34(4): 30-32. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYJ202104011.htm WANG Y X, XUE A R, XU P, et al. 40 cases of cervical spondylotic myelopathy treated by Xingnao Kaiqiao acupuncture combined with moxibustion for regulating pulse[J]. Traditional Chinese Medicinal Research, 2021, 34(4): 30-32. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYJ202104011.htm
[22]	谢福. 八段锦锻炼对颈椎病颈痛疗效的影响[J]. 颈腰痛杂志, 2020, 41(1): 119-120. https://www.cnki.com.cn/Article/CJFDTOTAL-JYTZ202001039.htm XIE F. Effect of Baduanjin Exercise on cervical spondylosis and neck pain[J]. The Journal of Cervicodynia and Lumbodynia, 2020, 41(1): 119-120. https://www.cnki.com.cn/Article/CJFDTOTAL-JYTZ202001039.htm
[23]	刘艳, 唐鸣歧, 江波, 等. 传统功法五禽戏在颈型颈椎病康复护理中的应用[J]. 中华全科医学, 2022, 20(8): 1430-1433. doi: 10.16766/j.cnki.issn.1674-4152.002615 LIU Y, TANG M Q, JIANG B, et al. Application of traditional Wuqinxi exercises in rehabilitation nursing of cervical spondylopathy[J]. Chinese Journal of General Practice, 2022, 20(8): 1430-1433. doi: 10.16766/j.cnki.issn.1674-4152.002615
[24]	王强, 孙国栋, 马金健, 等. 基于生物力学及本体感觉分析探讨运动控制训练在颈椎病防治中的应用[J]. 辽宁中医药大学学报, 2020, 22(11): 204-209. https://www.cnki.com.cn/Article/CJFDTOTAL-LZXB202011049.htm WANG Q, SUN G D, MA J J, et al. Application of Motion Control Exercise in the Prevention and Treatment of Cervical Spondylosis Based on Biomechanics and Proprioceptive Analysis[J]. Journal of Liaoning University of Traditional Chinese Medicine, 2020, 22(11): 204-209. https://www.cnki.com.cn/Article/CJFDTOTAL-LZXB202011049.htm
[25]	邓仁龙. 针刺运动疗法治疗颈型颈椎病临床观察[J]. 健康必读, 2019(35): 26. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYAO202210044.htm DENG R L. Clinical observation of acupuncture exercise therapy for cervical spondylosis[J]. Essential Reading for Health, 2019(35): 26. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYAO202210044.htm