【作者】 田丽莉；

【导师】 张成博；

【作者基本信息】 山东中医药大学 ， 中医医史文献， 2010， 博士

【摘要】 周围性面瘫,现代医学称为特发性面神经麻痹、面神经炎或贝尔麻痹,是一种急性发作的单侧面颊筋肉弛缓性疾病,以口眼歪斜为主要症状,多由于正气不足,脉络空虚,风寒、风热之邪侵袭面部,致使经气阻滞,经脉失于濡养,筋肉纵缓不收而发病。遵照文献研究“辨章学术,考镜源流”的基本方法,查阅历代针灸及中医重要医籍及现代相关文献,对针灸治疗周围性面瘫的相关文献进行梳理,以期明确周围性面瘫的演进过程和发展脉络,分析总结古今针灸防治周围性面瘫的特点,提出针灸防治周围性面瘫的基本思路。立足中医文献研究的基本方法,搜集历代及近代50年间有关针灸防治周围性面瘫的文献,对周围性面瘫的病位、病因病机、临床表现、针灸取穴、配伍、针法、灸法以及其他形式的针灸疗法等的古今认识进行对比分析,整理总结古今针灸防治周围性面瘫的施治特点,并对今后亟待解决的有关问题给予讨论。通过对古今针灸防治周围性面瘫的文献进行对比研究,提出了针灸防治周围性面瘫的基本思路：明确病位,辨别病因,谨守病机是针灸防治周围性面瘫的基本前提；适当选穴,合理配伍是针灸防治周围性面瘫的重要基础；舒筋活络,调畅气血,辨证施治是针灸防治周围性面瘫的基本治则；借鉴现代医学理论及医学技术是明确诊断、正确施治的优化方式；“先定位,再分期,后辨证”三步法是提高周围性面瘫疗效的关键；未病先防,既病防变,瘥后防复是针灸防治周围性面瘫的主导思想；综合施治,医患配合是提高临床疗效的重要保证。更多还原

【Abstract】 Peripheral facial paralysis is also known as idiopathic facial palsy, facial neuritis or Bell’s palsy and refers to an acute disease with unilateral facial muscle torpor. Its main symptom is facial distortion. It is mainly caused by weakness of healthy qi, deficiency of meridians, and invasion of the face by pathogenic wind-cold and wind-heat, which results in the obstruction of meridian qi, malnutrition of meridians, torpor of tendons; which then causes the disease.According to the basic method of literature research, which is to distinguish academic standpoints and observe the origin and development of academic theses; The important ancient acupuncture-moxibustion (abbrev. as acu-moxi) and Chinese medical books and modern documents related to peripheral facial paralysis were collected and consulted, the articles on peripheral facial paralysis with acu-moxi were summarized to reveal the evolution process and development of peripheral facial paralysis with acu-moxi, and the characteristics to prevent and treat peripheral facial paralysis in ancient and modern times were analyzed. And then the basic thoughts to prevent and treat peripheral facial paralysis with acu-moxi are put forward.Based on the basic method of literature research of TCM, the related documents in ancient and the articles in about recent 50 years were collected, and the ideas on the location of disease, etiology and pathogenesis, clinical manifestations, selection and compatible application of acupoints, the methods and techniques of acu-moxi, the other forms of acu-moxi therapies in ancient and modern times were compared and analyzed, the characteristics of prevention and treatment on peripheral facial paralysis with acu-moxi were summarized, the related problems urgently needing to be solved in the future were discussed.By the control research of documents in ancient and modern times, the core tenets of preventing and treating peripheral facial paralysis with acu-moxi were summarized as follows:the basic precondition is identifying location of the disease, distinguishing the origin of disease, grasping the pathogenesis cautiously. The important foundation is the proper selection and compatible application of acupoints; the basic therapeutic principles are to relax muscles, activate blood flow, regulate qi and blood, diagnose and treat basing on differentiation of syndromes; the optimized mode is to ascertain diagnosis, treat properly by borrowing modern medical theories and techniques; the key to improve curative effect is the three-step approach which is "locating position of disease first, dividing into different periods second, diagnosing basing on differentiation of syndromes last"; the predominant thought is "prevention before disease onset, preventing the disease from exacerbating, preventing recrudescence after cure"; the important guarantee is treating with synthetic therapies and cooperation between doctors and patients.更多还原