筋病刺法的演变与经筋学说的兴衰

Evolution of acupuncture techniques for jin diseases and the rise and fall of jingjin doctrine

梳理筋病刺法的源流,发掘出其兴衰背后的根源,对于筋病刺法及其理论经筋学说的继承与创新,具有重要的启示和借鉴意义。采用语境分析、整体考察、实践检验的方法,解析“筋”“经筋”“筋急”“结筋”等筋病刺法及经筋学说基本概念,特别是对当下学术界争议最大的经筋病候治则治法涉及的3个关键概念“燔针劫刺”“以知为数”“以痛为输”进行了深度考察。厘清筋病刺法的范畴及主要刺法术式,并重点考察“燔针劫刺”“贯刺法”的起源,探讨争议较多或长期被忽略的“内热刺法”“贯刺法”“挑刺法”“分刺法”“募刺法”的演变。最后从筋与脉的关系、干针疗法与筋病刺法的异同分析入手,探讨经筋学说未来发展亟需解决的关键问题及解题思路,以供针灸学理论创新之参考。

It has the important enlightenment and reference significance for the inheritance and innovation of jin(sinew/fascia)diseases and its theoretic basis,jingjin(muscle region of meridian)doctrine by sorting out the origin of the acupuncture techniques for jin diseases and exploring the root of its rise and fall.Using context analysis,overall investigation and practice test,the paper elaborates the basic concepts,e.g.needling techniques for jin,jingjin,jinji(muscular contracture)and jiejin(knotted tendon),and jingjin doctrine.In particular,the three key concepts,i.e.fanzhen jieci(heating after needling),yizhi weishu(feelings from patients and acupuncture operators)and yitong weishu(the worst painful sites of muscle spasm)are deeply investigated.These three concepts,involved in the treatment of jingjin disorders,treatment principles and methods,are of a great controversy in the current academic circle.The author clarified the category of needling for jin disease and main needling techniques,investigated specially the origin of fanzhen jieci and guancifa(repeated needling directly on the foci),and explored the evolution of the needling methods that had been controversial or neglected for a long time,i.e.neire cifa(technique for inducing heat inside for cold obstruction),guancifa,tiaocifa(inserting the needles around the foci),fencifa(intramuscular needling)and mucifa(deep puncturing to the peritoneum or on front-mu points).Finally,from the relationship between jin and mai(meridian),and the diferences between dry needling and acupuncture technique for jin diseases,the author explored the crucial problems and countermeasures urgently required in the future development of jingjin doctrine so as to provide the references for the theoretical innovation of acupuncturemoxibustion science.