从“肾邪客”探析腘部三穴在肾病中的临床应用

Exploration of Clinical Application of Three Acupoints in Popliteal Region in Kidney Diseases Through“Invasion of Pathogenic Factors into Kidney”

“肾邪客”出自《灵枢·邪客》,其中记载“肾有邪,其气留于两腘”,说明肾与腘之间存在密切的气血联系。腘是肾受邪时邪气瘀血留滞严重之处,腘部疼痛等异常表现对肾相关疾病有重要的提示作用。肾为邪客,病因多为邪气恶血留滞,病机多为邪盛气血同病,症状多为拘挛痹痛。委中、阴谷、委阳为临床常用的腘部三穴,根据“肾邪客”与腘的相互关系,委中穴可用于治疗恶血寒湿客于肾引起的腰椎间盘突出型腰痛,阴谷穴可用于治疗寒水邪气客于肾引起的慢性肾脏病,委阳穴可用于治疗湿热邪气客于肾引起的慢性肾小球肾炎。

“Invasion of pathogenic factors into the kidney”is derived from the chapter titled“Invasion of Pathogenic Factors into the Body”in Ling Shu(Spiritual Pivot),which records that“If there is pathogenic factor in the kidney,it will reach the two popliteal fossae”.It shows that there is a close connection between the kidney and the popliteal region in terms of qi and blood.The popliteal fossae are areas where the pathogenic qi and blood stasis accumulate severely when the kidney is invaded by pathogenic factors.Abnormal manifestations,such as pain in the popliteal region,play an important role in indicating kidney-related diseases.When kidney is invaded by pathogenic factors,the disease primarily caused by stagnation of pathogenic qi and blood stasis,and the pathological mechanism is mainly characterized by excessive accumulation of pathogenic factors affecting both qi and blood,resulting in symptoms such as muscle stiffness,cramps,and pain.Weizhong(BL40),Yingu(KI10),and Weiyang(BL39)are commonly used acupoints in the popliteal region in clinical practice.According to the mutual relationship between“invasion of pathogenic factors into the kidney”and the popliteal fossaes,Weizhong can be used to treat low back pain in lumbar disc herniation caused by blood stasis,cold and dampness affecting the kidney,Yingu can be used to treat chronic kidney disease caused by cold water affecting the kidney,and Weiyang can be used to treat glomerulonephritis caused by dampness-heat affecting the kidney.