从肝论治周围性面瘫浅析

文章信息/Info

• Title:从肝论治周围性面瘫浅析

• 卷期:2024年22卷14期

• 作者:王若琛1，赵婧1,3，王兴臣2

• 1.山东中医药大学第一临床医学院，山东 济南，250014；2.山东中医药大学第二附属医院神经内科，山东 济南，2500013；3.山东中医药大学第二临床医学院，山东，济南，250014

• Author(s):Wang Ruochen1, ZHAO Jing1,3, WANG Xingchen2

• 1. The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250014, China; 2. Department of Neurology, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 2500013, Shandong, China; 3. The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, China

• 关键词周围性面瘫  肝  中医

• Keywords:  Peripheral facial paralysis ; liver ; Chinese medicine

• 摘要:周围性面瘫是由于面部神经管内面神经的非特异性炎症导致的周围性面肌瘫痪。西医目前尚未完全阐明其发病机制，治疗方面，西医多采用糖皮质激素、抗病毒、营养神经等药物对症治疗，但其中仍有30%的患者会出现反复发作[1]，更有甚者会遗留较重的后遗症，给患者带来身心上的损伤。传统医学善立足于经络、脏腑等整体论治，在治疗该病时取得了较大的成效，然各医家多擅从阳明论治面瘫，从肝论治者少。笔者结合临床发现，周围性面瘫一病与肝十分密切。本文将从周围性面瘫的病因病机、临床表现、治疗方面浅析肝与周围性面瘫的关系，为中医药诊治周围性面瘫提供新的方向。                                                                                                                                                                                

• AbstractPeripheral facial palsy is peripheral facial muscle paralysis due to non-specific inflammation of the facial nerves within the facial nerve tube.Western medicine has not yet fully elucidated its pathogenesis, and in terms of treatment, Western medicine mostly uses corticosteroids, antivirals, nutritional nerves and other drugs for symptomatic treatment.However, 30% of these patients will still have recurrent seizures, and even more severe sequelae will be left behind, causing physical and mental damage to patients.Traditional medicine is based on the meridians, organs and other holistic treatment, in the treatment of the disease has achieved great results, but the doctors are good at treating facial paralysis from Yang Ming, and there are fewer people from the liver.Combined with clinical findings, peripheral facial paralysis is very closely related to the liver. In this paper, the relationship between liver and peripheral facial palsy will be analyzed from the etiology, clinical manifestations and treatment of peripheral facial palsy, and provide a new direction for the diagnosis and treatment of peripheral facial palsy in traditional Chinese medicine.

  周围性面瘫在现代医学中又称贝尔神经麻痹或面神经炎，是一种以面部表情肌群运动功能障碍为主要特征的一种疾病。它是一种常见病、多发病，不受年龄限制。在中医古典文献中，该病当属“口僻”的范畴，其中张介宾《类经十七卷·疾病类六十九》进一步强调：“僻，歪斜也。”点明其症状多表现为口眼歪斜，患者往往无法完成皱眉、闭眼、鼓腮等动作。而正是由于该病的症状多表现为肌肉的损伤，使得大部分医家认为该病当从阳明论治。但追溯其病因病机可见，该病多是由于风邪致病，临床表现亦有口干口苦等肝脏受邪的表现，且在治疗方面由肝论治者也取得了较好的疗效。