基于古代文献的痰证针灸取穴思路的探究

Exploration on the rules of acupoints selection for phlegm disorder treated with acupuncture and moxibustion based on ancient literature study

目的:分析古代医籍针灸治疗痰证的取穴思路,指导现代临床治疗。方法:以"痰"为检索词检索《中华医典》,根据纳入排除标准筛选文献,建立数据库,进行穴位及穴位与经脉、分布部位、特定穴频数统计和穴位配伍分析。结果:痰证治疗使用频次最高的腧穴为足三里、中脘;三阳经应用频次高于三阴经;常用经脉为任脉、足太阳膀胱经、督脉;胸腹部穴位高频出现;应用特定穴频次高于非特定穴,特定穴按照频次高低排序为交会穴、募穴、络穴等。膻中与足三里配伍出现频次最高。结论:古代医家针灸治疗痰证取穴重视调理脾胃功能及调畅气机,符合中医痰证治疗原则。作为针灸优势,注重特定穴兼取局部穴位,注重"阴病治阳"的整体观念。

Objective To analyze the rules of acupoints selection for phlegm disorder in treatment with acupuncture and moxibustion in ancient literature so as to provide guidance to clinical treatment of phlegm disorder.Methods The word"phlegm"was taken as the search term and the relevant articles were retrieved from Zhonghuayidian(Dictionary of Chinese Medicine).According to the inclusion and exclusion criteria,the articles were screened and the database was set up.The analysis was conducted on acupoint selection,the correlation with meridians involved and distribution location,as well as the use frequency of specific points and acupoint combination.Results It was found that in treatment of phlegm disorder,the highest frequently used acupoints were Zusanli(ST36)and Zhongwan(CV12).The use frequency of three yang meridians was higher than that of three yin meridians.The commonly involved meridians were the Conception Vessel,Bladder Meridian of Foot-taiyang and the Governor Vessel.The acupoints located in the chest and abdomen were highly used.The use frequency of specific points was higher than that of non-specific ones.The sequence of the use frequency of specific points,from high to low,is the crossing point,the front-mu point and luo-connecting point.The combination of Danzhong(CV17)and Zusanli(ST36)is of the high frequency.Conclusion Ancient medical scholars focus on regulating spleen and stomach functions,as well as qi activity in treatment of phlegm disorder with acupuncture and moxibustion,which is coincident with the treatment principle of phlegm disorder in traditional Chinese medicine.In treatment,acupuncture-moxibusiton is characterized as laying the emphasis on the specific points,the local acupoints and the holistic idea as"regulation of yang for yin disorder".