倒丁字取穴法治疗顽固性呃逆的临床体会

呃逆是临床常见病、多发病,中医、西医对其有不同的理解,中医认为其基本病机为胃气上逆,胸膈被扰:西医认为,呃逆的产生主要是由于膈肌、膈神经、迷走神经或中枢神经等受到刺激后引起的一侧或双侧的膈肌阵发性痉挛,伴有吸气期声门突然关闭,从而发出短促响亮的特别声音,并将持续痉挛超过48 h未停止的呃逆称为顽固性呃逆。根据中医辨证论治原则,按照不同的临床症状将顽固性呃逆分为寒邪犯胃证、心胃火盛证、肺胃气逆证、肝郁犯胃证、脾胃失和证、痰热蕴胃证、胃阴亏乏证、胃肾两虚证等8个证型,进而针对顽固性呃逆患者的不同证型,采取头项针倒丁字取穴法为主,体针辨证配穴为辅的针刺治疗方法,并通过自拟顽固性呃逆评分量表的评分结果对患者治疗前后的病情进行比较,从而分析其临床疗效并对其机制进行初步探讨。

Clinical Experience of Intractable Hiccup Treatment by Inversed Ding Pattern Acupoints Selection Method

Hiccup is a clinical frequently- occurring common disease. There are different opinions between the Western and the traditional Chinese medicine. We Chinese medicine consider it is caused by adverse rising of stomach qi while the Western medicine believes the reason is paroxysmal spasm of the diaphragm by stimulation of diaphragm,phrenic nerve and pneumogastric nerve or the central nervous,along with the abrupt turn off of the glottis to make a brief and aloud sound. They name the sustaining spasm overpass 48 hours the intractable hiccup. According to the principle of treatment based on the syndrome differentiation,the Chinese classify intractable hiccup into eight types by different syndromes such as the cold evil invading the stomach,intense heart and stomach fire,reversed flow of lung and stomach qi,liver depression invading the stomach,disharmony of spleen and stomach,phlegm- heat stasis in lung,deficiency of lung yin,both deficiency of stomach and kidney,aiming at the different types we choose the inversed Ding pattern acupoints selection method accompanied by the body acupoints,comparing the patients treatment consequence with the grades of the self- made intractable hiccup form,analyzing its clinical effect and discuss its mechanism preliminarily.