第59节：慢性病可以这样去治(7)
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5.中风后遗症——这样治就能重新站起来采用健侧、患侧同时治疗，无外乎”平衡”二字。龙腾小说网ltxs520.com不平衡又如何呢？打个比喻，狼妈妈下了一窝小狼，由于出生先后和发育的原因，有的个大强壮，有的则十分弱小，在喂奶的时候，总是强的比弱的先抢到奶水。这就造成了强的总能得到营养，而弱的越来越差。健康一侧就好比强壮的幼崽，在机体里总能抢夺到绝大部分气血，而弱小的患侧就永远抢不到气血，永远没有滋养，无法恢复。而这个治则解决的就是两者之间的不平衡，让它们重新站在同一个起点上，从而使身体的气血得以重新均衡分配，当患侧解决了气血滋养的问题，康复也就指日可待了。
缺血性脑血管疾病通常没有死亡的危险，却使很多人只能瘫痪在床，与轮椅为伴，生活无法自理。西医对于偏瘫后遗症基本上没有任何有效的治疗，除借助中医的针灸、按摩以及一些理疗手段外，让患者尽早地进行康复训练成了西医的必修课。我在国外的一家康复医院目睹了这种康复训练，病人非常痛苦，是医生和患者之间强行的对抗性治疗：用特定的器械将患侧屈曲萎缩的肢体固定，然后强行拉直，以患者耐受度为限，真是像上刑一样，患者在心理和身体上都非常抵触，疗效可想而知。几个月下来，基本上没有什么实质性的进展，患者还饱受身体和心灵的摧残。
在中医方面，古代医家对中风后遗症的论述很少，且在认知上多有误区，认为是外感风邪所致，以散风通络为治疗大法。此法治疗面瘫或有疗效，要治疗卧床不起的偏瘫则百无一效。直到清代出了医学大家王清任，主张”中风无风”，是身体气血亏少所致，发明治偏瘫名方”补阳还五汤”，才使得治疗中风偏瘫有了正确的理论依据。现代医家治疗此病时也大多以本方为基础，加减出入。此方对于早期较轻的偏瘫确有疗效，但是王清任先生自己也说：”此法虽良善之方，然病久气太亏，肩膀脱落二三指缝，胳膊屈而扳不直，脚孤拐骨向外倒，哑不能言一字，皆不能愈之症。”药物的作用有限，所以更多的人把最后的希望寄托在针灸上。虽然从各种媒介多次听说针灸治疗偏瘫的神技，但事实并不如此乐观。走访一下各大中医院的针灸科，能治好半年以上偏瘫后遗症的针灸大夫绝对是凤毛鳞角。为什么会这样呢？主要是治疗的方法有误。
这里浅谈一下在治疗中风偏瘫中我的一些看法与经验，对于用心于此病的医者或许能有些帮助。
古人立方先立法，万变不离其宗，方只是法的一个实例，用以说明此法如何应用，非此法必用此方。而现今的人多执著于方子本身，忽略了立法是用方的先决条件，用一方而治纷繁百症的现象比比皆是——不是方子疗效不好，是使用方子的人不善于发挥它们的效用。
以补阳还五汤为例，现在治疗中风无不将其视为首选，再加上地黄饮子、镇肝熄风汤等几个方，套来套去，难以见效。清任先生说”半身无气便半身不遂”，是说病果而非病因，因何半身无气？如果是单纯气虚者果便为因，直接用补阳还五汤即可药到病除;但临床上纯虚的患者很少，皆是杂因致虚，或气郁，或痰结，或血滞，或肝风实，或肾阴虚，杂然纷呈，直接用补阳还五汤难以见效。抱一方而治百病、守株待兔的治疗思路实在不可取。
应该根据清任先生当初确立此方的思路来治疗中风后遗症，而不必要非使用这个方子。不遂是因半身无气，只要将气血灌注到无气的一侧就可成功。我这里要提的就是”导引灌注法”。
传统的治疗，针对患侧断流的原因多用药来治疗，而针对患侧的肌肉萎缩、功能衰退则采用只注重于瘫痪一侧的针灸、按摩等等的理疗治疗，但往往效果不理想，为何呢？把患侧比喻成北方旱季的庄稼田，本身就缺乏水源肥料，此时按摩针灸无异于在干裂的大地上翻地、松土，而无法引来河水（气血）的灌溉，此时再好的种子、再辛勤的耕作也不要期望会有收获。而劳动又白费患侧有限的气血，患者如何能得以康复？此时再看看健康一侧，就好比南方的水田，饱受着水灾暴雨的蹂躏，气血过剩而无处发泄。如果能将两地的资源重新分配一下多好！所以我采取的措施便是”南水北调”，重新分配气血资源，原则是：”健侧流而不留，患侧留而不流，抒其所欲发，勿强开其所闭。”流是疏通推动之意，留是静候保存之意。可选用于砭、针、灸、按摩、拔罐、导引诸法中，在患侧的干涸之田中挖井、修渠、建水库，做好基础设施的准备工作，然后就静候气血的到来。此时患侧本无气血，即使强行打开通道也得不到灌注，只能等。与此同时，治理健侧气血泛滥之地，用按摩健侧的方法使这里郁积过剩的气血可以流向患侧事先挖好的水库、河渠和水井，从而解决患侧的饥渴（气血不足）。
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