基于“经脉-脏腑相关”理论探讨针刺治疗肠易激综合征的机制与临床应用

Mechanisms and Clinical Applications of Meridian Regulation in Acupuncture Treatment of Irritable Bowel Syndrome Based on Theory of“Meridian-Viscera Correlation”

“经脉-脏腑相关”理论解释了体表经脉穴位与内在脏腑之间的双向联系,是中医经络理论的核心内容。脏腑的生理功能失常,可通过经络的传导而反映于体表穴位。当体表感受一定刺激时,经络可将信息传导于脏腑。该理论为针刺调理经络以治疗肠易激综合征(IBS)提供了理论支持。IBS的基础病机为脾虚湿浊内蕴,大肠传导失司。针灸在缓解和改善IBS患者的临床症状上具有显著疗效,以益气健脾、渗湿止泻为原则,临床根据其不同分型选用合适腧穴。肝脾不调治宜疏肝解郁,健脾止泻;脾肾阳虚治宜温补脾肾,固肠止泻;虚实夹杂治宜寒热平调,祛湿止泻;肺失宣降,大肠腑气不通之便秘型IBS(IBS-C),治宜宣发肺气,化浊通腑。针灸治疗时应调理足太阴经、足阳明经、任脉,针刺其腧穴,并根据实际情况加用足厥阴经、足太阳经、手太阴经之腧穴。

The theory of“meridian-viscera correla⁃tion”explains the bidirectional relationship between the superficial meridian acupoints and the internal viscera,constituting the core content of traditional Chinese medicine(TCM)meridian theory.Physiological dysfunction of the viscera can be reflected on superficial acupoints through meridian conduction.When certain stimuli are applied to the body surface,the meridians can transmit information to the viscera.This theory provides theoretical support for using acupuncture to regulate meridians in the treatment of irritable bowel syndrome(IBS).The underlying pathogenesis of IBS is spleen deficiency with dampness accumulation and dysfunction of colon transmission.Acupuncture significantly alleviates and improves clinical symptoms in IBS patients by benefiting qi,invigorating the spleen,and addressing dampness to stop diarrhea.Differentiating treatment according to subtype involves selecting appropriate acupoints.Treatment strategies include soothing the liver and resolving depression strengthening the spleen and stopping diarrhea for liver-spleen disharmony,tonifying the spleen and kidney yang for spleen-kidney deficiency,and regulating cold and heat for mixed deficiency and excess syndromes.For irritable bowel syndrome with constipation(IBS-C)with lung qi failing to descend and colon obstruction,treatment focuses on promoting the dissemination of lung qi and clearing turbidity to facilitate bowel movements.Acupuncture treatment should regulate the Foot Taiyin meridian,Foot Yangming meridian,and Ren meridian,needling their respective acupoints,and additional acupoints of Foot Jueyin meridian,Foot Taiyang meridian,and Hand Taiyin meridian may be used based on individual circumstances.