针灸疗法在脑卒中后偏瘫患者中的临床治疗进展*

作者：龙 凤，向 勇，陈益敏，廖康林，肖 鹏，刘哨兵

单位：湖北民族大学附属民大医院，湖北 恩施 445000

引用：引用：龙凤，向勇，陈益敏，廖康林，肖鹏，刘哨兵.针灸疗法在脑卒中后偏瘫患者中的临床治疗进展[J].中医药导报,2025,31(4):127-131.

DOI：10.13862/j.cn43-1446/r.2025.04.021

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摘要：中医学认为脑卒中后偏瘫为“瘫证”“痿证”范畴，针灸疗法具有疏经通络、祛瘀活血、开窍醒脑的功效，对于脑卒中后偏瘫有良好治疗效果。通过查阅国内外相关文献报道，从中医对脑卒中后偏瘫的病因病机、针灸治疗脑卒中后偏瘫的机制、针灸治疗在脑卒中偏瘫中应用等方面进行总结，以期为脑卒中偏瘫患者的临床治疗提供参考。脑卒中后偏瘫的病因病机涉及邪盛正虚、热极生风、气虚血瘀、情志所伤等。针灸通过调节神经递质、调节内分泌、调剂免疫系统及开放细胞因子或炎症信号通路，发挥其治疗效应。在脑卒中后偏瘫的治疗中，针灸的应用涵盖了调和阴阳针刺法、夹脊穴针刺法、拮抗肌针刺法、巨刺法、缪刺法、经筋刺法及灸法等多种技术。

关键词：脑卒中；偏瘫；针灸疗法；应用现状；研究进展

Abstract：

In traditional Chinese medicine (TCM), post-stroke hemiplegia is categorized as "paralysis syndrome (Tan Zheng)" or "flaccidity syndrome (Wei Zheng)." Acupuncture therapy, known for its effects of dredging meridians, promoting blood circulation to remove stasis, and restoring consciousness, demonstrates significant therapeutic efficacy in treating post-stroke hemiplegia. By reviewing relevant domestic and international literature, this article summarizes the etiology and pathogenesis of post-stroke hemiplegia in TCM theory, the mechanisms of acupuncture therapy, and its clinical applications, aiming to provide references for clinical practice. The etiology and pathogenesis of post-stroke hemiplegia involve excessive pathogenic factors with deficient healthy qi, wind generated by extreme heat, qi deficiency with blood stasis, and emotional disturbances. Acupuncture exerts therapeutic effects by regulating neurotransmitters, modulating endocrine and immune systems, and activating cytokine or inflammatory signaling pathways. In clinical practice, acupuncture techniques for post-stroke hemiplegia include Yin-Yang balancing acupuncture, Jiaji (EX-B2) acupoint acupuncture, antagonist muscle acupuncture, contralateral needling (Ju Ci), cross-meridian needling (Miu Ci), meridian-sinew acupuncture, and moxibustion.

Key words：stroke; hemiplegia; acupuncture therapy; application status; research advances

发布时间：2025-12-20

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