%0 Journal Article
%T Disease spectrum and strategy of acupuncture and moxibustion in treatment of encephalopathy.
%A DU Y
%J Zhongguo Zhen Jiu
%V 44
%N 4
%D 2024 Apr 12
%M 38621721
暂无%R 10.13703/j.0255-2930.20231218-0001
%X The paper presents the summary of the spectrum of encephalopathy treated with acupuncture and moxibustion and the analysis on the existing questions in its clinical research, and proposes the potential strategies on treatment of encephalopathy with acupuncture and moxibustion. The spectrum of encephalopathy includes 23 diseases of central nervous system (superspinal center) and 33 kinds of mental and behavioral disorders. There are three problems in clinical research of acupuncture and moxibustion for encephalopathy, i.e. lack of high-quality clinical evidences, inadequate support from theoretic study of TCM and limited study on the rules of treatment. Hence, the author proposes five strategies on the treatment of encephalopathy with acupuncture and moxibustion, i.e. ① stimulating the peripheral nerve trunk associated with brain dysfunction, triggering the interaction between peripheral and central nerves and emphasizing the autonomic rehabilitation training to promote the reorganization of brain function; ② improving the cerebral circulation and metabolism by stimulating the trigeminal nerve and sphenopalatine ganglion; ③ stimulating the sites with high-dense distribution of peripheral nerve endings and the large projection area in the somatosensory region of the brain to induce strong brain responses, which may adjust the abnormal operation of the default mode network in the resting state; ④ stimulating the vagus nerve to improve the mood, suppressing the abnormal firing of brain neurons and stimulating the sites with the stellate ganglion distributed to modulate the hypothalamic function; ⑤ delivering the therapeutic regimens in association with the specific conditions and symptoms, and the classification of the physical signs on the base of the treatment of encephalopathy.<BR>概述目前针灸治疗脑病的病谱，分析针灸治疗脑病临床研究存在的问题，提出针灸治疗脑病的可能策略。针灸治疗脑病的病谱包括23种中枢神经系统（脊髓上中枢）疾病和33种精神与行为障碍病症。针灸治疗脑病的临床研究存在3方面问题：高质量的临床证据不足、针灸治疗脑病的中医理论研究不足和针灸治疗脑病的规律研究不足。笔者提出针灸治疗脑病的五大策略，即刺激脑功能障碍相关的外周神经干，引发外周与中枢的交互作用，并强调自主性康复训练的重要意义，尽早促进脑功能重组；通过刺激三叉神经与蝶腭神经节来改善脑循环、脑代谢；刺激外周神经末梢分布密度高及在脑躯体感觉区投射面积大的部位，以引起较强的脑反应，从而可能对静息状态下脑默认模式网络的工作方式异常起到调整作用；刺激迷走神经改善情绪、抑制脑神经元异常放电，选择星状神经节刺激点以调节下丘脑功能；在治疗脑病的基础上，结合具体情况与症状、体征分类治疗。.