基于经筋理论辨治运动障碍疾病

周德生 蔡昱哲

〔摘要〕 經筋包括神经、肌肉、筋膜及肌腱、韧带等附属组织，具有坚韧柔和之性;脏腑、经脉、经筋与脑髓神机相连接。经筋系统与运动系统相关，运动障碍疾病表现为随意运动调节功能障碍，属于经筋病范畴。通过帕金森病、不宁腿综合征、肌张力障碍综合征、破伤风4个医案，阐释了运动障碍疾病有脑髓神机统摄无权，经筋拮抗失衡;筋路受阻痹闭，筋障筋结并存;经筋刚柔异性，筋缓筋急无度;经筋维稳功能失常的病机特点。基于经筋理论辨治运动障碍疾病，必须持神机、调刚柔、通筋路、熄肝风、重外治，才能涵养阴阳冲和之气，滋养全身脏腑筋脉，恢复经筋主司运动协调的功能。

〔关键词〕 经筋;经筋系统;经筋理论;运动障碍疾病;帕金森病;不宁腿综合征;肌张力障碍综合征;破伤风

〔中图分类号〕R259       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2019.05.001

〔Abstract〕 The gluten includes nerves， muscles， fascia and tendon， ligament and other ancillary tissues， with tough and soft nature; The viscera， meridians and meridian sinew are connected with the brain marrow and vital activity. The meridian sinew system is related to the moto system， and the dyskinesia disease is characterized by random motor regulation dysfunction， which belongs to the category of meridian sinew disease. In this paper， through the 4 medical cases of Parkinson's disease， restless legs syndrome， dystonia syndrome， and tetanus， the dyskinesia disease is characterized by no governance and control of the brain marrow and vital activity， unbalanced antagonism of meridian sinew， blocked and closed sinew channel， coexistence of sinew barriers and node， rigid and flexible meridian and sinew， excessive slow and irritated meridian and sinew， dysfunction of maintaining stability. Based on the theory of meridian sinew to treat dyskinesia diseases， it is necessary to hold the vital activity， adjust the rigid and soft， unblock the sinew channel， quench the liver wind， focus on external treatment， so as to nourish Yin， Yang and primordial Qi， nourish the viscera， meridians and sinew of the whole body， restore the function of motion coordination by meridian and sinew.

〔Keywords〕 meridian sinew; meridian sinew system; meridian sinew theory; dyskinesia; Parkinson's disease; restless legs syndrome; dystonia syndrome; tetanus

人的运动很复杂，包括简单的移位和高级活动如语言、书写等。广义的运动系统由中枢神经系统、周围神经、神经-肌肉接头、骨骼、肌肉、心、肺和代谢支持系统组成。锥体系与锥体外系汇聚于前角运动神经元，任何随意运动都与锥体系及锥体外系有关。运动障碍疾病主要由锥体外系结构及功能障碍所致，习惯上又称锥体外系疾病。运动障碍疾病主要表现为随意运动调节功能障碍，临床分为肌张力降低-运动过多和肌张力增高-运动减少两大类，前者表现为异常不自主运动，后者则以运动贫乏为特征，肌力、感觉及小脑功能均不受影响。……