古代文献中皮内针治疗妇科疾病的规律浅析

Textual Research on the Treatment of Gynecological Diseases with Intradermal Acupuncture

目的检索皮内针治疗妇科疾病的相关古籍文献,探讨古代医者运用类皮内针法诊治妇科疾病的规律。方法以“针”“刺”“针法”“刺法”“浅针”“浅刺”等为检索词,检索涉及针灸妇科学发展源流的全部古籍,选取其中针刺深度二分及二分以下治疗妇科疾病的腧穴,分析其分布、归经、主治病症等。结果共检索了31部古籍,纳入相关条文93条,涉及穴位22穴,其中19穴属于特定穴;主治妇科疾病18种,其中月经不调占比最多,占15.80%;条文涉及妇科疾病涵盖了月经病、带下病、妊娠病、产后病、妇科杂病5个方面,其中妇科杂病最多,占39.47%。结论皮内针发源于《黄帝内经》中“静以久留”理论,可应用于月经不调、妇科炎症性疾病、产后缺乳、不孕症、前阴病各类妇科疾病,可选择蠡沟、足临泣、下髎作为妇科疾病的基础取穴,并结合辨证、辨病进行加减。其取穴规律可为现代皮内针治疗妇科疾病提供参考。

Objective To explore the rules of intradermal acupuncture for treating gynecological diseases by ancient physicians based on the relevant ancient books of traditional Chinese medicine(TCM).Methods Comprehensive searching of the ancient TCM books involving application of acupuncture in treating gynecological diseases was conducted with the keywords of“needle”“acupuncture”“acupuncture manipulation”“superficial needling”and“superficial acupuncture”.The acupoints with the needling depth of two fen or less were selected and analyzed in terms of distribution,meridian tropism,and indications.Results From 31 ancient TCM books,93 relevant records were retrieved,covering 22 acupoints(including 19 specific acupoints).These records mainly concerned the treatment of 18 gynecological diseases,among which irregular menstruation accounted for the highest proportion(15.80%).Among the gynecological diseases(menstrual,leukorrheal,pregnancy-related,postpartum,and miscellaneous gynecological diseases)mentioned,miscellaneous gynecological diseases were the most common,accounting for 39.47%.Conclusion Intradermal acupuncture is derived from the theory of retaining the needle at the acupoint for a long period of time in order to enrich healthy qi in the Huangdi's Internal Classic(Huang Di Nei Jing).This therapy is effective for diverse gynecological diseases including irregular menstruation,inflammatory diseases,postpartum hypogalactia,infertility,and anterior vaginal diseases.Key acupoints including Ligou(LR5),Zulinqi(GB41),and Xialiao(BL34)can be adopted,which can be customized based on syndrome differentiation and disease identification.The rules of acupoint selection give insights into the modern treatment of gynecological disease with intradermal acupuncture.