《黄帝内经》不同语境下“三焦”涵义考

《黄帝内经》中“三焦”一词见于22篇计40处,其中29处意义明确,历代注解无异义;4处有不同观点;另有存在校勘问题者4处;尚有三焦理、三焦下腧、三焦之源3个衍生名词。在不同语境下,29处意义明确的“三焦”分别指三焦腑、手少阳三焦经、上中下三焦,并无争议,只要在阅读过程中仔细分辨,就能够明确其所指。有争议处,为咳论篇之“三焦受之”“三焦咳”、四时气之“三焦约”、经别之“下走三焦”。4处“三焦”存在校勘问题,即“三焦”与“足三焦”、“三焦”与“上焦”(2次)、“三焦”与“三椎”。三焦理、三焦下腧、三焦之源3个衍生名词均与三焦理论有关。

Research on the body surface resistance imbalance degree at yuan-source points of three yin meridians of foot in the patients with primary dysmenorrhea

Objective:To explore whether or not the changes in body surface resistance at yuan-source points of three yin meridians of foot can specifically responds the onset of primary dysmenorrhea(PD) in females of menstrual period and the before and after,so as to provide the evidence for acupoint selection in clinic.Methods:A total of 90 cases of PD were recruited in a PD group and 90 healthy female undergraduates were recruited in a normal group.The yuan-source of points of three yin meridians of foot were selected,i.e.Taibai(太白SP3),Taichong(太冲LR3) and Taixi(太溪KI3).The acupoints for control were Xuehai(血海SP10),the non-special acupoint,Xuanzhong(悬钟GB39),the acupoint not on the relevant meridian,as well as a non-meridian point.Successively,before menstruation,on Day 1 during menstruation and on Day 3 after menstruation,the body surface resistance at the above-mentioned test sites was detected in the participants of two groups each day.The resistance imbalance degree(RID) of the bilateral acupoints was taken as the outcome indicator.The observation lasted one menstrual cycle.Results:(1) Intra-group comparison:at LR3,the RID was lower on Day 1 during menstruation than that before menstruation significantly in the normal group(P ≤0.05).There was no significant change in RID at the same time points,but RID on Day 3 after menstruation was lower significantly than that before menstruation in the PD group(P ≤0.05).At SP3,KI3,SP10,GB39 and sham acupoint,there were no significant differences in RID among different time points within the same group(all P> 0.05).(2) Intergroup comparison:there were no significant differences in RID among different time points at the same point.(all P> 0.05).Conclusion:RID at yuan-source points of three yin meridians of foot cannot specifically respond to PD.However,at LR3,before and after menstruation,RID changes are different between PD patients and healthy female undergraduates,which needs a further study in the future.

Effect comparason of thermosensitive moxibustion and estazolam on anxiety and depression in the patients of insomnia differentiated as liver qi stagnation

Objective： To observe the effect of thermosensitive moxibustion on anxiety and depression in the patients of insomnia differentiated as liver qi stagnation.Methods： From January 2015 to January 2017, 60 patients of insomnia differentiated as liver qi stagnation were collected in Shijiazhuang Municipal Chinese Medicine Hospital. According to the random number table, the patients were randomized into a moxibustion group（30 cases） and an estazolam group（30 cases）. In the moxibustion group, the thermosensitive moxibustion was adopted alternatively to the bilateral yuan-source points of the liver and gallbladder meridians. In the estazolam group, estazolam, 1 mg was prescribed for oral administration before sleep every day. After 15-day treatments, the sleep quality, the severity of anxiety and depression and the therapeutic effects were observed before and after treatment in the two groups.Results： Before treatment, the differences were not significant in the scores of Pittsburgh sleep quality index（PSQI）, the self-rating anxiety scale（SAS） and the self-rating depression scale（SDS） between the two groups（all P〉0.05）. After treatment, the scores of PSQJ, SAS and SDS were all reduced remarkably as compared with those before treatment in the two groups（all P〈0.05）. PSQI score was（6.72 ±2.311）points in the moxibustion group and was（5.37 ±2.621） points in the estazolam group. SAS score was（31.76 ± 6.511） points in the moxibustion group and was（39.62 ± 4.371） points in the estazolam group.SDS score was（35.98 ±5.161） points in the moxibustion group and was（46.38 ±4.971） points in the estazolam group. After treatment, the scores of PSQI, SAS and SDS in the moxibustion group were reduced more remarkably as compared with the estazolam group, indicating the significant differences（all P 〈0.05）. After treatment, the scores of sleep efficacy and TCM symptoms were（72.65 ± 14.36） points and（69.36 ±4.28） points respectively in the moxibustion group, better than the estazolam group, indicating the significant differences（all P〈0.05）.Conclusion： The thermosensitive moxibustion at the yuan-source points of the liver and gallbladder meridians significantly improves the sleep quality, relieves the symptoms of anxiety and depression and enhances the therapeutic effects in the patients of insomnia differentiated as liver qi stagnation. Hence,this therapy deserves to be recommended in clinical practice.