中药穴位贴敷的现代研究进展

Modern research progress in external application of traditional Chinese medicine to acupoints

中医外治法历史悠久、内容丰富,是人类的智慧结晶,起源于早期人类在生产劳动及与自然和疾病的斗争中发现某些树枝、草茎采用熏蒸、涂敷、贴敷等外用方法使其直接作用于体表可发挥治疗疥疾、祛虫等功效,外治法由此形成。“凡病多从外入,故医有外治法”,外治法是中医外科最大的优势及特色所在,穴位贴敷法作为中医外治法之一,运用穴位具有通过经络沟通脏腑以调和阴阳的生理特点充分发挥中药外治法的优势。穴位贴敷法萌芽于早期社会,形成于春秋战国时期,完善于宋明时期,成熟于清代,期间各朝代医家对该法的探索、认识以及应用,使穴位贴敷法具备了较为成熟的外治理论。经现代研究证明,贴敷给药可避免肝首过效应以及对胃肠道的刺激,提高生物利用度,穴位贴敷是结合了中医中药与经络理论的治疗手段,可产生穴位的刺激与调节作用、药物的药效作用以及两者的叠加作用,对机体产生调节气血、平衡阴阳等多重影响,可广泛应用于疾病的治疗。该文通过查阅文献,从穴位贴敷法的应用概况、对皮肤免疫的影响、对神经-炎症机制的调节、与人体循环网络之间的联系及其剂型的发展等方面进行概述,以期为进一步开展相关研究奠定基础。

Traditional Chinese medicine(TCM) has a long history and abundant experience in external therapy, which marks human wisdom. In the early history of human, people found that fumigation, coating, and sticking of some tree branches and herb stems can help alleviate scabies and remove parasites in productive labor, which indicates the emergence of external therapy. Pathogen usually enters the body through the surface, so external therapy can be used to treat the disease. External therapy is among the major characteristic of surgery of TCM. As one of the external therapies in TCM, external application to acupoints smooths the zang-fu organs through meridians and collaterals, thereby harmonizing yin and yang. This therapy emerged in the early society, formed the Spring and Autumn Period and the Warring States Period, improved in the Song and Ming dynasties, and matured in the Qing dynasty. With the efforts of experts in history, it has had a mature theory. According to modern research, it can avoid the first-pass effect of liver and the gastrointestinal irritation and improve the bioavailability of Chinese medicine. Based on the effect of Chinese medicine and the theory of meridian and collateral, it can stimulate the acupoints, exert regulatory effect on acupoints, and give full play to the efficacy of TCM and the interaction of the two. Thereby, it can regulate qi and blood and balance yin and yang, thus being widely used in the treatment of diseases. In this paper, the use of external application to acupoints, the effect on skin immunity, the regulation of neuro-inflammatory mechanism, the relationship between acupoint application and human circulation network, and the development of its dosage form were summarized through literature review. On this basis, this study is expected to lay a foundation for further research.