摘要
疼痛是情绪上的不良感受,并伴随潜在或存在的病理损伤,是机体的保护性反应与伤害刺激的预警,自世界卫生组织首次将其列入疾病分类以来,慢性疼痛不仅仅是一个病症,更作为一个病种,对相应的诊疗手段及治疗理念提出了更高的要求。中医学对痛症的研究浩如烟海,但对急、慢性疼痛并没有严格区分。因此,探究并梳理慢性疼痛的中医学认识,归纳总结其发病特点,并基于此进行临床应用,颇具现实意义。通过对张军平教授临床辨治慢性疼痛病案的整理分析,归纳了慢性疼痛的病机特点是“形-气-神”失和,具体表现为气血失和、形神失和、阴阳失和,结合慢病防治“贵在调和,妙在纠偏”的心得体会,提出了“调补气血,以和为期”“燮理阴阳,平调寒热”“调摄心神,正念干预”三法及代表方药,明确了“动静结合,内外兼修;序贯治疗,动态干预”的治疗策略,临床疗效确切。
Pain is an adverse emotional sensation accompanied by actual or potential pathological damage.It serves as a protective response and warning to harmful stimuli in the body.Since the World Health Organization first included it in disease classification,chronic pain has become not only a symptom but also a specific disease,demanding higher requirements for corresponding diagnostic and therapeutic approaches.Traditional Chinese medicine(TCM)has extensive research on pain,but it lacks a strict differentiation between acute and chronic pain.Therefore,exploring and summarizing the understanding of chronic pain in TCM,identifying its pathogenic characteristics,and based on that,applying it in clinical practice,holds practical significance.Through the analysis of Professor ZHANG Junping′s clinical treatment of chronic pain cases,the pathogenic characteristics of chronic pain were summarized as“disharmony of form-qi-spirit”.Specifically,it manifests as disharmony between qi and blood,form and spirit,and yin and yang.Based on the experience of managing chronic diseases with the principles of“emphasis on harmonization and correction”,three therapeutic methods and representative Chinese medicinal prescriptions were proposed:“regulating and supplementing qi and blood to achieve harmony”,“harmonizing yin and yang,balancing cold and heat”,and“regulating and calming the spirit with mindfulness intervention”.The treatment strategy of“combining movement and stillness,internal and external,and sequential treatment with dynamic intervention”was clarified,leading to significant clinical efficacy.
作者
王振
漆仲文
严志鹏
耿小飞
施琦
付焕杰
范新彪
张军平
WANG Zhen;QI Zhongwen;YAN Zhipeng;GENG Xiaofei;SHI Qi;FU Huanjie;FAN Xinbiao;ZHANG Junping(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China)
出处
《世界中医药》
CAS
2023年第16期2354-2357,2362,共5页
World Chinese Medicine
基金
国家自然科学基金项目(81774232)
中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者(张军平)专项资助(国中医药人教函[2021]203号)
天津市名中医(877022)
国家中医临床研究基地业务建设科研项目(JDZX2012140)。
关键词
慢性疼痛
慢病防治
气血和
阴阳和
形神和
针药并用
动静结合
汤-丸序贯
Chronic pain
Chronic disease prevention and treatment
Qi and blood harmony
Yin and yang harmony
Form and spirit harmony
Acupuncture and drug administration
Dynamic and static combination
Decoction-pill sequential
