| 引用本文: |
张燕, 韦永坤, 李德华.基于“筋结缓急”辨治浅析李德华刃针治疗面肌痉挛经验[J].湖南中医药大学学报,2026,46(7):1459-1464[点击复制] |
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| 基于“筋结缓急”辨治浅析李德华刃针治疗面肌痉挛经验 |
| 张燕,韦永坤,李德华 |
| (重庆市万盛经济技术开发区中医院, 重庆 400800;成都中医药大学附属医院, 成都 610072) |
| 摘要: |
| 面肌痉挛是临床常见的颅神经疾病。李德华教授基于经筋理论，认为其核心病位在面部经筋，病理关键在于气血缠结凝滞于筋，形成体表可触及的“筋结”。针对“筋结”的内在异质性，李德华教授创立了“筋结缓急”辨治体系，将其精分为“拘挛态”（气机逆乱，筋急为结）与“粘连态”（痰瘀互结，形滞成络）。临证时，通过精细触诊辨别二态，分别施以刃针“震颤松筋解结法”（调达气机、舒缓筋急）与“恢贯透刺割筋法”（破结通络、松解形滞）。本文将系统性总结其辨治思路与操作要点，并附典型医案，以期为临床提供新的诊疗视角。 |
| 关键词: 面肌痉挛|筋结缓急|刃针|辨治思路|名医经验|李德华 |
| DOI：10.3969/j.issn.1674-070X.2026.07.019 |
| 投稿时间：2026-05-01 |
| 基金项目:重庆市科卫联合中医药科研项目（2026ZYYB046）。 |
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| LI Dehua's experience in treating hemifacial spasm with blade acupuncture based on differentiating and treating "sinew nodes caused by spasm or adhesion states" |
| ZHANG Yan, WEI Yongkun, LI Dehua |
| (TCM Hospital of Wansheng Economic and Technological Development Area, Chongqing 400800, China;Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, China) |
| Abstract: |
| Hemifacial spasm (HFS) is a common cranial nerve disorder in clinical practice. Based on the meridian-sinew theory, Professor LI Dehua posits that the core location lies in the facial meridian sinews, and its pivotal pathogenesis lies in the impediment and stagnation of qi and blood within sinews, eventually forming palpable "sinew nodes" on the body surface. Targeting the inherent heterogeneity of these "sinew nodes," Professor LI Dehua has established a pattern differentiation and treatment system of "sinew nodes caused by spasm or adhesion states," which further subdivides sinew nodes into the spastic state (dysfunction counterflow of qi activity induces sinew spasm and nodules) and the adhesive state (intermingled phlegm and blood stasis causes collateral mass stagnation). In clinical practice, meticulous palpation is performed to distinguish the two subtypes. The Zhenchan Songjin Jiejie Fa (the vibratory sinew relaxation and nodule release manipulation with blade acupuncture) is applied for the spastic state to regulate and unblock qi movement and relieve sinew tension, while the Huiguan Touci Gejin Fa (the dredging penetrating sinew-dissecting needling) is adopted for the adhesive state to dissolve nodes, unblock collaterals, and release structural stagnation. This paper systematically summarizes Professor LI's differentiation and treatment logic and key operational essentials, supplemented with typical medical cases, aiming to provide innovative diagnosis and treatment perspectives for clinical practice of HFS. |
| Key words: hemifacial spasm|sinew nodes caused by spasm or adhesion states|blade acupuncture|differentiation and treatment strategies|famous physician's experience|LI Dehua |
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