胃脘下俞之穴名、定位及主治考

Verification of theacupoint name, location and efficacy of point Weiwanxiashu (EX-B3)

胃脘下俞属经外奇穴,是现代针灸临床中常用来治疗糖尿病的第一要穴。该穴位于第八胸椎棘突下,后正中线旁开1.5寸。胃脘下俞从古至今穴名演变颇多,各医家对其定位的认识也不尽相同,临床上对胃脘下俞的主治病症稍有争议。为更好地认识该穴,笔者通过查阅古籍及建国后高等中医院校教材和国家标准等资料,分析从古至今对胃脘下俞描述的演变过程,从理论依据、解剖结构及神经分布等方面出发,对该穴穴名、定位和主治进行考证探讨。结果发现,现代教材及国家标准对该穴的认识描述与古籍有所出入。胃脘下俞应重新命名为胃管下俞,定位应为:背部,第八胸椎棘突下方一穴,左右旁开各1.5寸处两穴,计三穴。本穴的主治应为:呕吐、呃逆、胸胁痛;消渴、咽喉干、胰腺炎;胃痛、腹痛。

Although the point Weiwanxiashu(EX-B3) pertains to be extraordinary points, it is the most important for modern acupuncture and moxibustion to treat diabetes. It is located in the same level as the inferior border of the spinous process of the eighth thoracic vertebra, 1.5 cun lateral to the posterior median line. Since ancient times,Weiwanxiashu(EX-B3) has evolved quite a lot about its name, different doctors have different comprehension of its location. Clinically, there is some controversy about its indications. In order to deeper understand the acupoints, through reading ancient books, textbook of universities and colleges of Traditional Chinese Medicine after the founding of the People’s Republic of China and national standards, the author analysed the evolution of its description from ancient times to the present. From the theoretical basis, anatomical structure and nerve distribution, the name, location and indications of this acupoint were investigated. The result showed that the understanding description of this acupoint in modern textbooks and national standards is different from that in the ancient literature. It is believed that the point should be renamed as Weiguanxiashu. It should be located on the back, one point below the spinous process of the eighth thoracic vertebra, two acupoints are 1.5 cun on the left and right. Its main functions should be vomit, hiccup, pain in the hypochondrium;diabetes, dry throat, pancreatitis;stomachache, bellyache.