{"id":13998,"date":"2025-05-13T10:53:12","date_gmt":"2025-05-13T00:53:12","guid":{"rendered":"https:\/\/tcmdrma.com\/?p=13998"},"modified":"2025-05-13T10:55:43","modified_gmt":"2025-05-13T00:55:43","slug":"%e4%b8%ba%e4%bb%80%e4%b9%88%e6%9c%89%e4%ba%9b%e7%96%bc%e7%97%9b%e5%8f%8d%e5%a4%8d%e5%8f%91%e4%bd%9c%ef%bc%9f-%e4%ba%94%e5%a4%a7%e5%86%85%e5%9b%a0%e4%b8%8e%e5%af%b9%e7%ad%96","status":"publish","type":"post","link":"https:\/\/tcmdrma.com\/zh-hans\/%e4%b8%ba%e4%bb%80%e4%b9%88%e6%9c%89%e4%ba%9b%e7%96%bc%e7%97%9b%e5%8f%8d%e5%a4%8d%e5%8f%91%e4%bd%9c%ef%bc%9f-%e4%ba%94%e5%a4%a7%e5%86%85%e5%9b%a0%e4%b8%8e%e5%af%b9%e7%ad%96\/","title":{"rendered":"\u4e3a\u4ec0\u4e48\u6709\u4e9b\u75bc\u75db\u53cd\u590d\u53d1\u4f5c\uff1f-\u4e94\u5927\u5185\u56e0\u4e0e\u5bf9\u7b56"},"content":{"rendered":"
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在临床实践中，我们经常会遇到这样一种情况：患者反反复复地遭受疼痛的折磨，却总是“头痛医头、脚痛医脚”。他们只知道靠吃 Panadol（或其他止痛药）缓解，或者反复去按摩、推拿，暂时舒缓后没过几天又卷土重来；有的去扎针，然而针灸效果也是一时，无法长久维持。遇到这种顽固性、反复发作的疼痛，我们就必须回到中医的根本——把脉，探寻内在病机，找出疼痛根源，然后对症下药，才能真正实现长效缓解。<\/p>\n

下面，我将结合数年临床经验，总结出五种最常见的“内因”类型，帮助大家梳理和理解长期、反复疼痛的内在原因。<\/p>\n

\n
\n<\/div>\n

一、寒邪凝滞<\/h2>\n

特点：<\/strong> 脉象浮紧，表面似有一层“寒气”<\/p>\n

    \n
  • 发病机制：<\/strong> 寒主收引，遇寒则筋脉受阻，血行不畅，导致全身或局部出现剧烈、持续的疼痛。<\/li>\n
  • 临床表现：<\/strong> 疼痛冷痛，遇寒加剧，遇热或搓揉有一定缓解。<\/li>\n
  • 治疗要点：<\/strong> 必须先解表散寒<\/strong>，通阳散寒之后，疼痛才能完全缓解，否则无论局部怎么处理，效果都有限。<\/li>\n<\/ul>\n
    \n
    \n<\/div>\n

    二、痰浊阻络<\/h2>\n

    特点：<\/strong> 活动受限、麻木感明显，脉象滑或濡<\/p>\n

      \n
    • 发病机制：<\/strong> 痰浊壅盛，阻塞经络，气血不通则痛。<\/li>\n
    • 临床表现：<\/strong> 如肩周炎（五十肩）运动受限，抬举困难；或伴随针刺感、麻木感，甚至肢体沉重。<\/li>\n
    • 治疗要点：<\/strong> 以化痰祛浊、通络止痛<\/strong>为主，兼以活血化瘀，方能恢复经络畅通。<\/li>\n<\/ul>\n
      \n
      \n<\/div>\n

      三、血瘀刺痛<\/h2>\n

      特点：<\/strong> 疼痛固定、刺痛明显，脉涩沉<\/p>\n

        \n
      • 发病机制：<\/strong> 血行不畅，瘀血内停，经脉受阻。<\/li>\n
      • 临床表现：<\/strong> 疼痛部位固定不移，性质多为刺痛或针刺样；夜间加重，难以入睡。<\/li>\n
      • 治疗要点：<\/strong> 以活血化瘀、散结止痛<\/strong>为主，需要药物去血瘀，或局部放血治疗。<\/li>\n<\/ul>\n
        \n
        \n<\/div>\n

        四、虚弱不足<\/h2>\n

        虚症的疼痛多见“肾虚”和“血虚”两大类。<\/p>\n

          \n
        1. 肾虚腰痛<\/strong>\n
            \n
          • 机制：<\/strong> 肾为先天之本，主藏精、主骨。肾虚则腰骶失养，易反复腰痛。<\/li>\n
          • 表现：<\/strong> 腰酸无力，畏寒怕冷，夜尿多，舌淡苔白。<\/li>\n
          • 对策：<\/strong> 只有采取补肾的方法进行治疗，补足肾气才是解决腰痛的治本之道。<\/li>\n<\/ul>\n<\/li>\n
          • 血虚麻木<\/strong>\n
              \n
            • 机制：<\/strong> 血为血脉之源，血虚则营养不足，经脉失养，出现麻木或隐痛。<\/li>\n
            • 表现：<\/strong> 牵扯性疼痛、麻木感，面色苍白，舌淡脉细。<\/li>\n
            • 对策：<\/strong> 只有采取补血行血的方法进行治疗才可能根本改善，气血不足的人是最容易出现疼痛反反复复的。<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n
              \n

              很多坐骨神经痛患者，就是因为血虚或肾虚未补，局部针灸、推拿只能“治标”而难治本，故易复发。<\/p>\n<\/blockquote>\n

              \n
              \n<\/div>\n

              五、气机郁结<\/h2>\n

              特点：<\/strong> 脉象弦，疼痛常伴胀闷，情绪波动影响明显<\/p>\n

                \n
              • 发病机制：<\/strong> 气滞则血行不畅，气机不畅则疼痛。<\/li>\n
              • 临床表现：<\/strong> 肋下不适、胁肋胀痛，情志郁结、抑郁焦虑时加剧；按之胀痛而非刺痛。<\/li>\n
              • 治疗要点：<\/strong> 以行气解郁、调畅气机<\/strong>为主，方可奏效。<\/li>\n<\/ul>\n
                \n
                \n<\/div>\n

                总结与建议<\/h2>\n
                  \n
                1. 精准辨证，找准内因<\/strong>\n
                    \n
                  • 只有把“寒”“痰”“瘀”“虚”“郁”中的哪一种（或几种）作为核心，才能对症下药。<\/li>\n<\/ul>\n<\/li>\n
                  • 对症治疗，水到渠成<\/strong>\n
                      \n
                    • 确认病机后，配伍相应中医方剂，并结合针灸、推拿等多种手段，效果更佳。<\/li>\n<\/ul>\n<\/li>\n
                    • 坚持调理，疗程要足够<\/strong>\n
                        \n
                      • 各种内因引起的疼痛，需要通过持续治疗才能根治。一次两次的临时缓解，只能延缓疼痛，而非消除根本。<\/li>\n<\/ul>\n<\/li>\n
                      • 综合调护，配合日常养生<\/strong>\n
                          \n
                        • 例如寒邪体质者注意保暖、饮食温补；痰浊体质者少吃油腻生冷；血虚者宜补血养脉；肝郁者保持情志舒畅。<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n

                          只有在脉诊抓准病机、方药靶向施治，并辅以日常的养生调护，才能真正让疼痛迎刃而解，恢复健康、重获生活质量。希望今天分享的五大“内因”能帮助大家更好地理解反复疼痛的根源，也为临床实践和日常自我保健提供指引。<\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":13999,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","footnotes":""},"categories":[180],"tags":[],"class_list":["post-13998","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-180"],"acf":[],"uagb_featured_image_src":{"full":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain.jpg",2560,1706,false],"thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-150x150.jpg",150,150,true],"medium":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-300x200.jpg",300,200,true],"medium_large":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-768x512.jpg",768,512,true],"large":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-1024x682.jpg",1024,682,true],"1536x1536":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-1536x1024.jpg",1536,1024,true],"2048x2048":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-2048x1365.jpg",2048,1365,true],"blog-large":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-669x272.jpg",669,272,true],"blog-medium":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-320x202.jpg",320,202,true],"recent-posts":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-700x441.jpg",700,441,true],"recent-works-thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-66x66.jpg",66,66,true],"fusion-200":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-200x133.jpg",200,133,true],"fusion-400":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-400x267.jpg",400,267,true],"fusion-600":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-600x400.jpg",600,400,true],"fusion-800":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-800x533.jpg",800,533,true],"fusion-1200":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-1200x800.jpg",1200,800,true],"portfolio-full":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-940x400.jpg",940,400,true],"portfolio-one":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-540x272.jpg",540,272,true],"portfolio-two":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-460x295.jpg",460,295,true],"portfolio-three":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-300x214.jpg",300,214,true],"portfolio-five":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-177x142.jpg",177,142,true],"woocommerce_thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-500x333.jpg",500,333,true],"woocommerce_single":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-700x466.jpg",700,466,true],"woocommerce_gallery_thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2025\/05\/recurring-pain-100x100.jpg",100,100,true]},"uagb_author_info":{"display_name":"Max Ma","author_link":"https:\/\/tcmdrma.com\/zh-hans\/author\/tcmdrma-com\/"},"uagb_comment_info":0,"uagb_excerpt":null,"_links":{"self":[{"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts\/13998","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/comments?post=13998"}],"version-history":[{"count":2,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts\/13998\/revisions"}],"predecessor-version":[{"id":14002,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts\/13998\/revisions\/14002"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/media\/13999"}],"wp:attachment":[{"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/media?parent=13998"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/categories?post=13998"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/tags?post=13998"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}