热敏灸申脉照海穴治疗失眠的研究进展与展望

失眠,是常见的困扰人们的疾病之一,表现为入睡困难,睡后多梦,早醒、易醒,醒后难以入睡,甚至彻夜不眠,常伴有头晕、健忘、心悸等症,可出现不同程度的焦虑不安、记忆力减退等,严重影响患者的工作效率及日常生活。临床上热敏灸疗法治疗失眠有显著的疗效,且具有操作方便、无副反应、经济费用低等优点。祖国医学认为失眠的基本病机为阳不入阴,而申脉通于阳跷,照海通于阴跷,只有当阴阳跷脉通畅,生理功能正常,才能共同濡养眼目,保持“昼精夜瞑”,拥有良好的睡眠。笔者归纳整理了跷脉理论指导下的针灸疗法、热敏灸治疗失眠的临床应用及相关机制,以及在跷脉理论指导下的热敏灸(申脉、照海为主)治疗失眠的临床应用等方面,将近10年来热敏灸治疗失眠的相关文献进行归纳梳理,以期对临床研究有所帮助。

Effect of pricking Shenmai(申脉 BL 62) and Zhaohai(照海 KI 6) on daytime arousal of patients with chronic insomnia:a randomized controlled trial

Objective To compare the different efficacy in treating patients with chronic insomnia by pricking,acupuncture and estazolam.Methods Sixty patients were divided into pricking group（group A）,acupuncture group（group B） and western medicine group（group C） according to the random number table,with 20 cases in each group.In group A,hook-type needles were applied on Shenmai（申脉 BL 62） and Zhaohai（照海 Kl 6） bilaterally by piercing the skin,a small amount of mucus was squeezed and subcutaneous fibers were broken;in group B,disposable acupuncture needles were applied by needling BL 62 and Kl 6 bilaterally at the depth of 0.5 cun;in group C,patients were asked to take 1 mg estazolam once a day at bedtime.The three groups were observed for 28 days,and Epworth scores and improvement of symptoms in daytime dysfunction were recorded.Results The total effective rate of improvement of symptoms in daytime dysfunction of group A（100%,20/20） was superior to that of group B（70%,14/20）,and the differences were statistically significant（P〈0.05）;the total effective rates of group A and group B were superior to that of group C（25%,5/20）,and the differences were statistically significant（P〈0.01,P〈0.05）.In terms of Epworth scores,the efficacy of group A was significantly superior to that of group B（13.35±2.85 vs 11.10±3.88,P〈0.05）,the efficacy of group A was superior to that of group C（13.35±2.85 vs 5.30±3.28,P〈0.01）,and the efficacy of group B was superior to that of group C（11.10±3.88 vs 5.30±3.28,P〈0.01）.Epworth scores significantly decreased in each group after treatment（P〈0.01）.Conclusion The therapy of pricking BL 62 and Kl 6 for patients of chronic insomnia was effective,daytime sleepiness was relieved and daytime dysfunctions were improved,and the therapy was superior to estazolam,and more advantageous than acupuncture.

针刺列缺、照海配合药物治疗慢性咽炎疗效观察

目的观察针刺列缺、照海配合药物治疗慢性咽炎的临床疗效。方法将60例慢性咽炎患者随机分为治疗组和对照组,每组30例。治疗组采用针刺列缺、照海穴配合口服清咽甘露丸治疗,对照组采用口服清咽甘露丸治疗。比较两组治疗前后证候积分及临床疗效。结果治疗组总有效率为96.7%,对照组为83.3%,两组比较差异具有统计学意义(P<0.05)。两组治疗后证候积分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后证候积分与对照组比较,差异具有统计学意义(P<0.05)。结论针刺列缺、照海配合口服清咽甘露丸是一种治疗慢性咽炎的有效方法。

针刺照海申脉为主治疗不寐症临床观察

目的:观察针刺照海、申脉穴为主治疗不寐症的临床疗效。方法:将78例不寐症患者随机分为治疗组(40例)和对照组(38例)。治疗组采用补照海、泻申脉为主配合辨证分型取穴治疗,对照组单纯按辨证分型取穴治疗,进行疗效对比观察。结果:治疗组治愈率为62.5%,总有效率为97.5%,对照组分别为31.6%和68.4%,两组疗效比较差异具有非常显著性意义(P<0.01)。结论:针刺照海、申脉为主治疗不寐症具有较好的疗效。

Comparative study on skin temperature response to menstruation at acupuncture points in healthy volunteers and primary dysmenorrhea patients

OBJECTIVE:To assess skin temperature response to menstruation at acupuncture points in primary dysmenorrhea(PD) patients and healthy volunteers so as to explore acupuncture point specificity in reflecting diseases in the light of skin temperature.METHODS:Fifty-two PD patients and 49 healthy volunteers were recruited.Skin temperature measurements were performed with a skin temperature assessment device at 10 points.Absolute difference between skin temperature of the same point on the left and right side is used as main outcome measure.RESULTS:On the first day of menstruation, when menstrual pain attacking in PD patients, a significant increase in skin temperature difference was detected at Taixi(KI 3) compared with the healthy group(P < 0.01).A significant reduction in skin temperature difference was detected at Taixi(KI 3) in the first day of menstruation compared with those values in the third day after menstruation(P < 0.01)in the healthy group.On the third day after menstruation, a significant reduction in skin temperature difference was found at Zhongdu(LR 6) in PD group compared with the healthy group(P < 0.05).No significant differences of skin temperature were detected at other points(P > 0.05).CONCLUSION:The skin temperature difference at menstruation-relevant points in PD patients did not all change significantly more than those in women without PD.Significant difference was only found in Taixi(KI 3), the Yuan-source point of Kidney meridian.

照海穴临床应用四则

总结归纳照海穴的临床应用,并列举其治疗失眠、慢性咽炎、尿潴留和神经性皮炎验案四则。

呼吸补泻针法调节营卫不和型失眠患者昼夜节律的临床观察

目的:观察呼吸补泻针法对营卫不和型失眠患者睡眠质量及昼夜节律的调节作用。方法:将58例原发性失眠患者(营卫不和型)随机分为呼吸补泻组29例和常规针法组29例,针刺干预1个月(共12次),观察治疗前后匹兹堡睡眠质量量表(PSQI)、睡眠-觉醒时间、抑郁自评量表(SDS)、焦虑自评量表(SAS)变化。结果:与常规针法组比较,治疗12次后呼吸补泻组PSQI评分显著降低(P<0.01),睡眠质量、入睡时间、睡眠时长、睡眠效率与睡眠障碍情况显著改善(P<0.05,P<0.01)。与治疗前比较,两组SAS、SDS评分均显著下降(P<0.01)。呼吸补泻组总有效率为96.6%(28/29),显著优于常规针法组的72.4%(21/29)(P<0.01)。结论:呼吸补泻针法对营卫不和型失眠患者昼夜节律的调节作用优于常规针法,在睡眠质量及睡眠-觉醒周期调节方面改善显著。

毫针补泻疗法治疗失眠症

中医针灸循经补泻法治疗失眠症有独到的疗效。对于失眠症,西医有西医的治法,中医有中医的疗法。但目前没有特别好的治疗方法来缩短病程以及减轻患者痛苦。文章运用《黄帝内经》中提到的针灸补泻法治疗失眠症,并循经"迎而泻之,随而补之",泻实补虚,调和阴阳。毫针循经迎随补泻法通过循经调理经脉和脏腑而治本,对于治疗失眠症效果显著。通过分析针灸补泻法治疗失眠症,从天地人统一整体探析毫针循经补泻法治疗失眠症的临床应用,以求从古人的针灸方法中寻求治疗失眠症的方法创新,并提供参考和借鉴。