《针灸大成》治疗膝关节炎选穴规律探析

An Analysis of Rules of Point Selection in Treating Knee Arthritis in Great Compendium of Acupuncture and Moxibustion

目的:通过对《针灸大成》治疗膝关节炎的针灸处方及选穴规律进行整理分析,为临床针灸治疗该病提供选穴参考。方法:采用《中华医典》第5版《针灸大成》中所载治疗膝关节炎的针灸处方为研究对象,整理归纳其配穴处方、常用穴位、穴位归经及特定穴运用。结果:符合纳入标准的文献条文72条,穴位54个,共计用穴频次118次。其中,单穴处方最多,频次为55次,频率为76.4%,配穴处方频次17次,频率为23.6%;常用穴位(前8位)中使用频次最高的为阳陵泉,其次为足三里、委中、风市、膝关、阴市、三阴交、行间;经脉使用频次最高的为足少阳胆经;在治疗膝关节炎的54个穴位中,属于特定穴的有41个,频率为75.9%;五输穴使用频次最多,达到56次,频率为47.5%。结论:《针灸大成》治疗膝关节炎临床用穴少而精,选穴以足三阳经穴为主,主要为足少阳胆经经穴,以局部取穴和循经取穴为主,多运用特定穴治疗。

Objective:To analyze of acupuncture-moxibustion prescriptions and point selection rules in treating knee arthritis in Great Compendium of Acupuncture and Moxibustion in order to provide reference for clinical acupuncture and moxibustion.Methods:The acupuncture-moxibustion prescriptions for treating knee arthritis in Great Compendium of Acupuncture and Moxibustion in Chinese Medical Classics 5 th Edition were selected as the research objects,the matching-point prescriptions,commonly used points,point meridian tropism and specific point application were summarized.Results:According to the inclusion criteria,there were 72 articles and 54 points,with a total of 118 points frequency.Among them,the single-point prescriptions were the most frequently used,with the frequency of 55 times and the frequency rate of 76.4%.The matching-point prescriptions had frequency of 17 times and the frequency rate of 23.6%.The most frequently used points(the first top 8) were Yanglingquan(GB 34),followed by Zusanli(ST 36),Weizhong(BL 40),Fengshi(GB 31),Xiguan(LV 7),Yinshi(ST 33),Sanyinjiao(SP 6) and Xingjian(LV 2).The most frequently used meridian was the gallbladder meridian of foot shaoyang.Among the 54 points for treating knee arthritis,41 belonged to specific points,with the frequency of 75.9%.The frequency of five transport point was the highest,reaching 56 times,with the frequency of 47.5%.Conclusion:In Great Compendium of Acupuncture and Moxibustion,the clinical use of points for treating knee arthritis is few and precise.The selected points are mainly the ones of foot three-yang meridian,especially the points of gallbladder meridian of foot shaoyang,focusing on local points and points along meridians,and more specific points are used for treatment.