基于阳化内风理论探讨针刺治疗突发性聋的取穴思路

The Acupoint Selection Idea for Acupuncture in the Treatment of Sudden Hearing Loss based on the Theory of“Yang Transforming into Internal Wind”

基于阳化内风理论,系统梳理叶桂《临证指南医案》中关于突发性聋病机的认识,从木失水涵、木郁火炽、土虚木乘三种病机角度分析论治。根据叶桂提出的“通以治标、清上实下”治法指导针刺取穴,以开窍熄风为主,重视局部取穴,选穴为听宫、翳风、风池、风府;再结合辨证,针对三种病机分别予滋水涵木法选穴太冲、太溪、肾俞、三阴交,清泻肝胆法选穴太冲、行间、阳陵泉、足临泣,抑木扶土法选穴合谷、太冲、足三里、中脘。

Based on the theory of“yang transforming into internal wind”,this paper systematically summarized the pathogenesis of sudden hearing loss in YE Gui's Case Records as a Guide to Clinical Practice(《临证指南医案》),and analyzed the treatment method from three types of pathogenesis including wood losing water nourishment,wood constraint transforming into fire,and earth insufficiency with wood attacking.Acupoint selection conforms to YE Gui's treatment principle that“treating the branch by unblocking,and clearing the upper and firming the lower”.Firstly,it is suggested to put focus on opening the orifice and extinguishing wind,pay attention to the local acupoints,and select acupoints including Tinggong(SI 19),Yifeng(TE 17),Fengchi(GB 20),and Fengfu(GV 16).Secondly,three methods are suggested for three pathogenesis based on syndrome differentiation,which are nourishing water to moisten wood with Taichong(LR 3),Taixi(KI 3),Shenshu(BL 23)and Sanyinjiao(SP 6),clearing and draining liver and gallbladder with Taichong(LR 3),Xingjian(LR 2),Yanglingquan(GB 34)and Zulinqi(GB 41),and restraining wood and reinforcing earth with Hegu(LI 4),Taichong(LR 3),Zusanli(ST 36)and Zhongwan(CV 12).