| 曹书勤,陈龙豪,吕智桢,吕立江.脊柱相关疾病“脊督不通—神经易化”病机演变内涵及推拿手法治疗刍议[J].浙江中西医结合杂志,2026,36(6): |
| 脊柱相关疾病“脊督不通—神经易化”病机演变内涵及推拿手法治疗刍议 |
| Discussion on the Connotation of the Pathogenesis Evolution from |
| 投稿时间：2025-11-02 修订日期：2025-11-24 |
| DOI： |
| 中文关键词: “脊督不通—神经易化”，脊柱相关疾病，推拿手法 |
| 英文关键词: |
| 基金项目:1.国家自然科学基金面上项目（NO.82474668） 2.国家中医优势专科建设项目（国中医药医政函2024-90号） 3.国家中医药管理局高水平中医药重点学科项目（No.GJXK2023-85） 4..吕立江名老中医专家传承工作室（NO.GZS2021026） |
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| 中文摘要: |
| 脊柱为督脉“从肾贯脊”之通路，督脉并行于脊中，二者在解剖结构、生理功能及病理变化上密切相关。中医理论认为，“督脉为病”可致“脊强而厥”，而现代医学研究表明，脊柱关节错缝、督脉瘀滞可引发骨骼肌持续性紧张、疼痛麻木及姿势异常等临床表现。由于肌肉组织富含感觉与运动神经分布，其异常反射可形成自我强化的神经环路，即“神经易化”现象。因此，脊柱功能异常（如关节错缝）与神经易化状态可能相互影响，共同参与脊柱相关疾病的发生发展。脊柱推拿手法是整复关节错缝、通调督脉的有效疗法，但其作用机制尚未完全阐明。本文围绕“脊督不通-神经易化”致病假说，以中医基础理论结合现代关节神经学为理论指导，结合现代关节神经学，探讨脊柱推拿如何通过调节脊柱-神经通路，改善神经易化状态，从而恢复运动与感觉功能的平衡，为推拿治疗脊柱疾病提供理论依据。 |
| 英文摘要: |
| The spine serves as the pathway for the Governor Vessel (Du Meridian) to "connect with the kidney and traverse the spine." The Du Meridian runs parallel within the spinal column, making the two closely related in terms of anatomical structure, physiological functions, and pathological changes. Traditional Chinese Medicine (TCM) theory posits that "disorders of the Governor Vessel" can lead to "spinal rigidity and syncope." Modern medical research indicates that vertebral joint misalignment and stasis of the Du Meridian can manifest clinically as persistent skeletal muscle tension, pain, numbness, and postural abnormalities. As muscle tissue is richly innervated with sensory and motor nerves, its abnormal reflexes can form self-reinforcing neural circuits, a phenomenon known as "neural facilitation." Therefore, spinal dysfunction (e.g., joint misalignment) and the state of neural facilitation may interact, collectively contributing to the onset and progression of spinal-related disorders. Spinal Tuina manipulation is an effective therapy for correcting joint misalignment and regulating the Du Meridian, although its mechanisms of action are not fully elucidated. Centering on the pathogenic hypothesis of "Spinal Du Meridian Obstruction — Neural Facilitation," and guided by both fundamental TCM theory and modern articular neurology, this paper explores how spinal Tuina may modulate the spinal-neural pathways to improve the state of neural facilitation, thereby restoring the balance of motor and sensory functions. The aim is to provide a theoretical basis for Tuina in treating spinal diseases. |
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