《脉经》三关病候的腧穴应用规律探析

Regularities of application of acupoints to relieving clinical indications of Sanguan(cun,guan and chi,three places at the wrist where the pulse is usually taken)in classical book Mai Jing(Pulse Classic)

《脉经》三关病候,在腧穴选择上的主要规律是"看部取穴"与"凭脉取穴"。此外,王叔和依据脉形确定病候性质,选择对腧穴的操作方法和刺激强度,即"凭脉针灸""凭脉补泻"。《脉经》的三关病候源于《素问·三部九候论》,又受《伤寒论》《金匮要略》的影响,延续了张仲景"脉-证-治"的临床思路,补充了针灸治疗的内容,又影响了《针灸甲乙经》《千金要方》的腧穴主治。因此,有必要从针灸临床的视角解读《脉经》,探索早期针灸临床诊疗思维和实践模式。

According to indications of Sanguan(cun,guan and chi,three places at the wrist where the pulse is usually taken)described in book Mai Jing(Pulse Classic),the selection of acupoints is based on the location of problems and pulse conditions.WANG Shu-he(201-280,a well-known physician of the Wei and Jin dynasties)chose the operation method and stimulating intensity according to the nature of clinical disorders,that is,performing acupuncture or moxibusion in accordance with pulse conditions,or performing reinforcing or reducing needling manipulations based on pulse conditions.Clinical indications of Sanguan described in Mai Jing originate from Suwen:Sanbu Jiuhou Lun(Plain Questions:Discussion on Three Portions and Nine Pulse-takings) and are also influenced by Shanghan Lun(Treatise on Cold Damage Diseases)and Jingui Yao Lue(Synopsis of Prescriptions of the Golden Chamber).It inherits ZHANG Zhong-jing’s clinical thinking of"pulse-syndrome-treatment"and supplements the content of acupuncture and moxibustion treatment,and also influenced the contents of indications of acupoints in book Zhenjiu Jiayi Jing(A-B Classic of Acupuncture and Moxibustion)and Qian Jin Yao Fang(Essential Prescriptions Worth a Thousand Gold).For this reason,it is necessary to unscramble the Mai Jing from clinical perspective of acupuncture and moxibustion,and to explore the thinking and practice mode of clinical diagnosis and treatment of clinical conditions by acupuncture and moxibustion.