{"id":9163,"date":"2024-06-06T01:50:27","date_gmt":"2024-06-06T01:50:27","guid":{"rendered":"https:\/\/tcmdrma.com\/%e3%80%90%e5%8c%bb%e6%a1%88%e3%80%91%e9%92%88%e7%81%b8%e6%b2%bb%e7%96%97%e5%8f%b3%e8%84%9a%e8%b8%9d%e6%97%a7%e4%bc%a4%e5%a4%8d%e5%8f%91\/"},"modified":"2025-05-09T11:26:46","modified_gmt":"2025-05-09T01:26:46","slug":"%e3%80%90%e5%8c%bb%e6%a1%88%e3%80%91%e9%92%88%e7%81%b8%e6%b2%bb%e7%96%97%e5%8f%b3%e8%84%9a%e8%b8%9d%e6%97%a7%e4%bc%a4%e5%a4%8d%e5%8f%91","status":"publish","type":"post","link":"https:\/\/tcmdrma.com\/zh-hans\/%e3%80%90%e5%8c%bb%e6%a1%88%e3%80%91%e9%92%88%e7%81%b8%e6%b2%bb%e7%96%97%e5%8f%b3%e8%84%9a%e8%b8%9d%e6%97%a7%e4%bc%a4%e5%a4%8d%e5%8f%91\/","title":{"rendered":"\u3010\u533b\u6848\u3011\u9488\u7078\u6cbb\u7597\u53f3\u811a\u8e1d\u65e7\u4f24\u590d\u53d1"},"content":{"rendered":"

患者，男，四十岁，亚裔，主诉为右脚踝酸痛。患者在两年前曾经脚踝扭伤，接受过理疗师和针灸师的治疗，包括选用电针治疗等，据称花了较长时间的治疗方愈。近期未受外力触发，自觉脚踝外侧酸痛异常，并导致无法入睡，需服用药物止痛。<\/p>\n

刻下症状为右脚踝局部水肿，两侧脚踝明显内翻，而右侧更为明显。患者体型较壮实，右侧脚踝不堪受力，故而跛行。昆仑穴附近触觉肌肉紧张。<\/p>\n

该患者的情况为虚实夹杂，而以局部经络的虚为主。治疗上也是以补为主，兼顾疏通局部经络。经过三四次针灸后已有显效，患者再来的时候，已经可以正常走路且酸痛基本消失。考虑到患者这种情况属于久病，且局部脚踝内翻变形，因此见效之后仍需要继续进行一段时间的巩固治疗。<\/p>\n

这里要说明和讨论几个问题：<\/p>\n

其一，我们作为治疗者应该常常自省我们是否给患者提供了最有效的治疗方法，这也是我的老师经常跟我说过的话。作为脚踝扭伤这种急性病，这位患者之前经过相当长时间治疗才好。这个时候，以极大的概率已经不是治疗师治好的了，而是患者通过自己身体的代偿，疼痛自行消失了。这种案例非常多见。但这种疼痛的消失是有代价的，局部发生了变形。而这种变形没有办法构建一个稳定的再平衡关系，所以，过了一段时间，疼痛还会回来，而且从实性症状，变成了虚性症状，治疗难度也增加很多。<\/p>\n

其二，西医体系的治疗方法中喜欢使用辅助工具，比如局部用绷带固定，用特制的鞋垫纠正脚的外翻和内翻。这个医案中的患者都有用过。这些方法同中医的治疗理念，至少跟我自己的治疗理念是不符的。我在针灸治疗过程中，是要求患者进行活动的。因为不活动，气血不流通。生命能量是流动的，在动的过程中去纠正和恢复的效果是最好的。我也不认为采用鞋垫纠正是一个好方法。除了同样的道理以外，鞋垫不可能贴在脚上一辈子不拿下来，这样人体很难通过正确的调整方式而自我纠偏，从而回到天然中正的状态。<\/p>\n

其三，还是我一直强调的虚实概念。西医的治疗体系中，没有阴阳虚实的概念，客观的来讲，这种局部经络出现虚性症状，在其他治疗体系下是无法进行有效治疗的。这本来是中医治疗的强项，但是现在很多中医的治疗思维也完全西化，不看虚实，即使是虚性症状，也都喜欢采取电针、放血、针刀等这种消耗性的“饮鸩止渴”式的治法，就算短期获效，也难免不留遗憾。<\/p>\n

 <\/p>\n

 <\/p>\n

注意：中医根据个体差异所采取的治疗手段和治疗效果亦有差异，医案分享不构成治疗建议。<\/p>\n

\n

NO.059<\/p>\n","protected":false},"excerpt":{"rendered":"

患者，男，四十岁，亚 […]<\/p>\n","protected":false},"author":1,"featured_media":9164,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","footnotes":""},"categories":[76],"tags":[],"class_list":["post-9163","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-76"],"acf":[],"uagb_featured_image_src":{"full":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle-150x150.jpg",150,150,true],"medium":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle-300x169.jpg",300,169,true],"medium_large":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"large":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"1536x1536":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"2048x2048":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"blog-large":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",482,272,false],"blog-medium":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle-320x180.jpg",320,180,true],"recent-posts":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"recent-works-thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle-66x37.jpg",66,37,true],"fusion-200":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle-200x113.jpg",200,113,true],"fusion-400":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle-400x226.jpg",400,226,true],"fusion-600":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"fusion-800":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"fusion-1200":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"portfolio-full":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"portfolio-one":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",482,272,false],"portfolio-two":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle-460x259.jpg",460,259,true],"portfolio-three":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle-300x169.jpg",300,169,true],"portfolio-five":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle-177x100.jpg",177,100,true],"woocommerce_thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"woocommerce_single":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle.jpg",500,282,false],"woocommerce_gallery_thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/ankle-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":"患者，男，四十…","_links":{"self":[{"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts\/9163","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=9163"}],"version-history":[{"count":1,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts\/9163\/revisions"}],"predecessor-version":[{"id":13913,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts\/9163\/revisions\/13913"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/media\/9164"}],"wp:attachment":[{"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/media?parent=9163"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/categories?post=9163"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/tags?post=9163"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}