基于“病因、病位、病性、病势”浅析子宫腺肌症的针灸治疗思路

Treatment ideas of acupuncture and moxibustion for adenomyosis based on"etiology,location,nature and development of disease"

以辨证论治为核心,辨明子宫腺肌症的病因、病位、病性、病势,探讨针灸治疗子宫腺肌症的诊疗思路。将脏腑辨证和经络辨证相结合,顺应月经周期,遵循“急则治其标,缓则治其本”的原则,月经期以止痛、祛瘀为主,非月经期以调整脏腑虚实为主。重视冲任二脉调理,并予健脾、调肾、疏肝之法。以足太阴脾经、足少阴肾经、任脉穴为主,经期可取次髎、十七椎、子宫、地机、四关穴;经后期主取足三里、三阴交、太溪;经间期以关元、卵巢、气海为主;经前期可取关元、气海、神阙,配伍公孙、内关、间使。根据病情动态演变,配合适宜的针灸补泻手法。

Focusing on the syndrome/pattern differentiation to determine treatment,the approaches to the diagnosis and treatment of acupuncture and moxibustion for adenomyosis are explored by identifying the etiology,location,nature and development of disease.The syndromes/patterns of adenomyosis are differentiated in view of both zangfu and meridian theories.The treatment is delivered complying with the menstrual cycle and the basic rule of treatment,"treating the symptoms in the acute stage,while the root causes in the recovery stage".During menstrual period,stopping pain and eliminating stasis are dominant;while during the other days of menstrual cycle,regulating zangfu dysfunction(excess or deficiency)is emphasized.In general,the functions of the thoroughfare vessel and the conception vessel should be specially considered and adjusted,and the principles of treatment include strengthening the spleen,regulating the kidney and soothing the liver.Acupoints are selected mainly from the spleen meridian of foot-taiyin,the kidney meridian of foot-shaoyin and the conception vessel.Ciliao(BL 32),Shiqizhui(EX-B 8),Zigong(EX-CA 1),Diji(SP 8)and four-gate points(bilateral Hegu[LI 4]and Taichong[LR 3])are used in menstrual period;Zusanli(ST 36),Sanyinjiao(SP 6)and Taixi(KI 3)in postmenstrual phase;Guanyuan(CV 4),Luanchao(Ovary,Extra)and Qihai(CV 6)in intermenstrual phase;while,Guanyuan(CV 4),Qihai(CV 6)and Shenque(CV 8),combined with Gongsun(SP 4),Neiguan(PC 6)and Jianshi(PC 5)in premenstrual phase.According to the dynamic development of patient's conditions,the reinforcing or reducing techniques of acupuncture and moxibustion are feasibly applied in treatment of adenomyosis.