| 引用本文: |
罗容, 潘江, 石文英, 徐敏, 柯超, 庹菲, 贺禹翔, 殷伶, 李里.章薇“解结”经验结合超声可视化引导针刺治疗颈源性头痛思路探析[J].湖南中医药大学学报,2026,46(9):1840-1846[点击复制] |
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| 章薇“解结”经验结合超声可视化引导针刺治疗颈源性头痛思路探析 |
| 罗容,潘江,石文英,徐敏,柯超,庹菲,贺禹翔,殷伶,李里 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南中医药大学, 湖南 长沙 410208) |
| 摘要: |
| 中医学认为，颈源性头痛的发生与颈项经筋失和、气血运行不畅有关，其病理表现可见筋结形成，体现“结在颈项，痛发于头”的特点。章薇教授基于《黄帝内经》“解结”理论，结合多年临床经验，凝练出以手扪结、针刺探结、温针散结的诊刺思路，强调循经触诊以辨识筋结，根据病变层次施行针刺探结，并配合温针以温通经筋。由于颈项部解剖结构复杂，传统诊刺在深部组织层次辨识、针刺路径判断及风险结构评估方面仍存在一定局限。本文在章薇教授“解结”诊刺经验指导下，引入超声可视化技术，将触诊辨结、针下探结与超声辨层相结合，探讨超声在辅助判断筋结相关软组织层次、优化针刺路径及提升操作安全性方面的应用价值，为名医经验客观化传承及颈源性头痛精准针刺提供参考。 |
| 关键词: 颈源性头痛|解结理论|结筋|超声可视化|针刺|名医经验|章薇 |
| DOI：10.3969/j.issn.1674-070X.2026.09.012 |
| 投稿时间：2026-06-15 |
| 基金项目:湖南省卫生健康委卫生科研基金一般项目(20257992);湖南省自然科学基金高校联合项目(2025JJ90069)。 |
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| An ultrasound imaging-guided acupuncture approach for cervicogenic headache treatment based on Professor ZHANG Wei's experience of “resolving knots” |
| LUO Rong, PAN Jiang, SHI Wenying, XU Min, KE Chao, TUO Fei, HE Yuxiang, YIN Ling, LI Li |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| From the perspective of Chinese medicine, cervicogenic headache (CEH) is associated with disharmony of the meridian tendons of the neck and impaired circulation of qi and blood. Its pathological manifestations include the formation of tendon knots, reflecting the characteristic that "the knots are located in the neck, while pain manifests in the head." Drawing on the "resolving knots" theory in the Huang Di Nei Jing (Huangdi's Classic of Medicine) and her years of clinical experience, Professor ZHANG Wei developed a diagnostic and needling approach centered on palpating knots, probing knots with acupuncture needles, and dispersing knots with warming needle therapy. She emphasizes palpation along the meridians to identify tendon knots, needle probing at depths appropriate to the tissue layer involved, and the use of warming needle therapy to warm and unblock the meridian tendons. Given the complex anatomy of the neck, conventional diagnostic and needling practice remains limited in identifying deep tissue layers, determining needle trajectories, and assessing anatomical structures at risk. Building on Professor ZHANG Wei's diagnostic and needling experience in "resolving knots," this paper introduces ultrasound imaging and integrates knot identification by palpation and needle probing with ultrasound-based identification of tissue layers. It explores the potential utility of ultrasound in determining the soft-tissue layers associated with tendon knots, optimizing needle trajectories, and improving procedural safety, thereby providing a reference for the objective transmission of famous physicians' experience and for precision acupuncture in the treatment of CEH. |
| Key words: cervicogenic headache|"resolving knots" theory|tendon knot|ultrasound imaging|acupuncture|famous physician’s experience|ZHANG Wei |
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