从病位病机探讨子宫腺肌病继发性痛经的针灸诊治思路

Discussion on the acupuncture and moxibustion thoughts of diagnosis and treatment for secondary dysmenorrhea of adenomyosis on the basis of disease location and pathogenesis

从病位病机的角度探讨针灸治疗子宫腺肌病继发性痛经的诊治思路。临床诊治中,以"理、法、方、穴、术"为纲,基于本病"瘀阻胞宫,冲任失调"的病机特点,注重明辨病位,确立活血化瘀、调理冲任的基本治法。随病期不同而"通""调"结合,且各有偏重,即经期重在行气活血、通经止痛,以足太阴脾经穴和经验效穴为主,常取地机、三阴交、次髎、十七椎穴,经间期重在调和冲任气血及脏腑功能,治本为主,以足太阴脾经、任脉穴为主,常取三阴交、关元、子宫、足三里穴,并配合合理的补泻手法。

To discuss the acupuncture and moxibustion thoughts of diagnosis and treatment for secondary dysmenorrhea of adenomyosis on the basis of disease location and pathogenesis.In clinic,we take the ＂principle,method,prescription,acupoint and technic＂ as the outline,paying attention to identify disease location and establishing the method of ＂promoting blood to remove stasis,regulating thoroughfare vessel and conception vessel＂ on the basis of the pathogenesis of ＂stasis obstructing uterus,disharmony of thoroughfare vessel and conception vessel＂.The prescription combines ＂dredging＂ with ＂conditioning＂,and the emphasis should be different in different periods.In menstrual period,we put emphasis on activating the circulation of qi and blood as well as clearing meridians to relieve pain and choose the acupoints on the spleen meridian of foot-taiyin and experimental points,such as Diji（SP 8）,Sanyinjiao（SP 6）,Ciliao（BL 32）,Shiqizhui（EX-B 8）.In the intermenstrual period,we regulate the qi and blood of thoroughfare vessel and conception vessel,and the function of viscera.The acupoints for the disease root are mainly at spleen meridian of foot-taiyin and conception vessel,such as Sanyinjiao（SP 6）,Guanyuan（CV 4）,Zigong（EX-CA 1）,Zusanli（ST 36）.And the reinforcing and reducing technic are applied accordingly.