浅议六经辨治糖尿病泌汗异常

临床所见糖尿病泌汗异常的患者越来越多,其汗出表现各异。吴深涛教授用六经辨证治疗此病,认为其发生在太阳肌表,基础病机为太阳营卫不和,当治以调和营卫,《伤寒论》治此病的基础方为桂枝汤。病在少阳,不夹湿者,常用柴胡加龙骨牡蛎汤加减治疗;少阳湿热者,常用黄芩滑石汤或甘露消毒丹加减治疗。病在阳明,常用白虎加参汤加减治疗。病在太阴,常用桂枝加龙骨牡蛎汤合玉屏风散加减治疗。病在少阴,少阴寒化者,常用桂枝加附子汤加减治疗;少阴热化者,常用当归六黄汤或知柏地黄丸加减治疗。病在厥阴,常用青蒿鳖甲汤、地骨皮饮或连梅汤加减治疗。为适应复合病机,临床需多经合治,常能取得良效。     

Cases on the clinical application of needling wei method 刺卫法临床应用举隅

In the paper, two medical cases, i.e. carpal tunnel syndrome and acute chest soft tissue contusion, are treated and reported with acupuncture kinesitherapy, in which the needles are inserted shallowly and no sensation of deqi is required in the guidance of subcutaneous shallow puncture and “pain point as the acupoint”. The mechanism of needling wei method is summarized.     

赵瑞华教授治疗产后身痛经验

产后身痛是指产褥期内出现肢体或关节酸楚、疼痛、麻木、重着，日久不愈，延续至产褥期以后者。文章总结了赵瑞华教授治疗产后身痛的经验，赵教授谨遵产后身痛“气虚百节开张”的病机特点，治疗以调补脾胃气血、调和营卫阴阳、调畅气机升降为关键，兼以散寒除湿，活血止痛，通阳除痹等，临床疗效显著，并附验案2则详述。     

柴胡桂枝汤妇科治验撷菁

柴胡桂枝汤最早见于《伤寒论》,该方是小柴胡汤与桂枝汤各半之合方,具有和解少阳,调和营卫之功效.方中以小柴胡汤和解少阳,畅达枢机,治少阳半表半里,以桂枝汤调和营卫,解肌祛风,治太阳之表,适用于太阳少阳并病.导师赵瑞华教授对柴胡桂枝汤临证具有独到的思路及见解,随证加减用于治疗多种妇科杂病见枢机不利,营卫不和者,文中例举经断...     

The influence of different methods of acupuncture on skin surface perfusion

Objective

To compare the effects on the body surface of different kinds of placebo/sham acupuncture with that of traditional needling sensation acupuncture.

Methods

Point Neiguan (PC 6) of 29 healthy subjects, 19 males and 10 females, was stimulated with needling sensation, shallow, placebo and deep acupuncture at the non-acupoint. After stimulation with different methods of acupuncture, the change in perfusion of the micrangium in the skin surface around the elbow joint, with Point Quze (PC 3) as its center, was observed with laser Doppler blood-flow imaging.

Results

Judging from the absolute value of perfusion of the skin surface micrangium, several methods of acupuncture can cause change in blood flow. The ratio of blood-flow perfusion in the meridian area in and around Quze declined before and after needling insertion in needling sensation acupuncture and shallow acupuncture. This observation did not occur in placebo and non-acupoint acupuncture. Needling sensation acupuncture at an acupoint can relatively reduce the perfusion of the micrangium in the projective area of the meridian where the acupoint is located on the body surface (P<0.05), indicating the specificity of meridians.

Conclusions

Stimulation of an acupoint or a point on the body surface with any type of acupuncture can cause change in blood flow in the skin near the needling point. However, the biological mechanism underlying this phenomenon needs to be further explored.     

A Study on the Classification and the ‘Catching’ of the ‘Arrived Qi’ in Acupuncture

This essay studies the phenomenon of ‘obtaining of qi’ in acupuncture. Combined with clinical practice, the authors think that it was a habitual misunderstanding in the past to equate ‘needling sensation’ to ‘obtaining of qi’ in acupuncture practice. The two concepts are different and are related with each other. The authors have also classified the phenomenon of ‘obtaining of qi’ according to its depth in the skin layer. Based on the research achievements in neuroscience, the authors propose the study on ‘catching’ the specific cerebrations, so as to reveal the essence of ‘obtaining of qi’.     

基于“不温则痛”桂枝汤加减治疗顽固性痛痹理论探讨

痹证病程缠绵,经久不愈,给患者的工作和日常生活带来了极大的影响,反复治疗阳气亏虚,加之风寒湿邪从外侵犯,太阳经气受累,营卫失调。导师孙西庆教授根据临床经验,提出"不温则痛",机体阳气不振,脾肾阳虚,肢体失却温煦。临证以桂枝汤加温肾阳药物取得较好效果,减轻了患者痛苦。     

Studien zum Lingshu als Beitrag zur Bewertung klinischer Akupunkturstudien: – Punktlokalisation,Stichtiefe, De Qi

Background

Clinical trials on acupuncture use a variety of control methods, such as sham acupuncture, minimal acupuncture, and placebo. Frequently, needle insertion on non-classical acupuncture points (“minimal acupuncture”) is employed for this purpose. The aim of such clinical trials is to evaluate specific effects of acupuncture. There is a controversial discussion regarding the appropriateness of comparing “true” acupuncture to “minimal acupuncture”.Minimal and verum acupuncture are distinguished by various criteria, such as “localisation”, “depth of needle insertion”, and “induction of de qi”.

Aim

This study is dedicated to the question of what information the Huang Di Neijing, specifically the Lingshu-compilation which extensively focuses on needling techniques, has to offer regarding the above mentioned criteria, and their importance for successful acupuncture. In relation to this, it will be discussed if the definition of “minimal acupuncture” as used in the German Acupuncture Trials, is feasible.

Methods

The entire original text of the Huang Di Neijing Lingshu was searched for information regarding “point localisation”, “insertion depth”, and “induction of “de qi”. The paragraphs in question were compiled and probed on statements regarding the efficacy of treatment. These subsequently were compared to the technique of “minimal acupuncture” as in the German Acupuncture Trials (ART, GERAC).

Results

The analysis of the Lingshu shows that neither a specific point localisation, nor a certain insertion depth or the induction of de qi are clearly and in all cases relevant for a successful therapy. Rather, the Lingshu offers specific indications for superficial needling. Sites of acupoint localisation aren't clearly defined and the induction of de qi is not understood as mandatory for a successful therapy.

Conclusion

The criteria distinguishing „verum acupuncture” from „minimal acupuncture” as practiced in many clinical trials don't correspond to the early practice of acupuncture as documented in the Lingshu. This can be a possible explanation for the good clinical results of minimal acupuncture in a number of clinical trials.However, for further discussions of this problem the developments and the clinical evolution present-day acupuncture has undergone since the ancient times have to be held in account.     

浅谈杨继洲“通关交经”针法的操作和临证应用

通过对《针灸大成》中"通关交经"针法在理论上的反复研习,又经临床中不断实际操作验证,认为仅依从《针灸大成·三衢杨氏补泻》"通关交经法"中描述的方法操作不容易出现通关过节、飞经走气的效果,若能将"通关交经法"与"运气法""提气法"三者综合运用,则可明显提高在四肢远端穴位做向心性传导时通关过节、气至病所的几率.临床据此"通关交经"针法操作,气至病所,一穴即可取得较佳之临床疗效.     

Analyses of the characteristics of diarrhea by acupuncture treatment in ancient times

The data concerning the treatment of diarrhea by acupuncture in 62 ancient books are computerized and thus show that the ancient acupuncturists primarily used the acupoints of the conception vessel, stomach meridian, bladder meridian, and the foot yin meridians.As to the location, the acupoints on the abdomen, back,exterior side of leg and the hands and feet are used. The common techniques are moxibustion, hot compression,needling, blood letting, navel application and so on.     

《伤寒论》“发于阳”“发于阴”索解

"发于阳""发于阴"指人体感受风寒之邪,阳经及其络脉乃至皮部出现以发热恶寒为代表的症状,阴经及其络脉乃至皮部出现以无热恶寒为代表的症状,疾病处于表证期。阳经受邪发热,阴经受邪无热,此为常;阳经受邪亦有不发热者,阴经受邪反有发热者,此为变。《伤寒论》第7条和第131条两处"发于阳""发于阴"含义相同,均为就表证而言。邪在皮毛经络,为感邪之初,病之始,故为"发"。"阳"指阳经及其络脉乃至皮部;"阴"指阴经及其络脉乃至皮部。从病程上看,处于表证期,即邪气入经以及入经之前;从病位上看,邪在体表、经络,无涉脏腑。相较而言,阳经表证更为明显,邪在络脉常已出现相应症状,从病之"发"到病之"衰",时间较长,所以说,发于阳七日愈,发于阴六日愈。     

关于“得气”的古今认识和近10年研究情况的分析

ObjectiveWith the development of science of acupuncture and moxibustion, people have, in the knowledge of “deqi”, developed from subjective level to the quantitative level, and discovered many factors influencing the “deqi” of acupuncture. In this report, the relationship between “deqi” and these factors was explored in terms of different acupuncture methods and quantity and depth of stimulus.MethodsAncient literature about “deqi”, as well as related literature for clinical and basic research on “deqi” in recent 10 years were systematically collected.Results(1) Cerebral functional imaging technology and the scale of “deqi” were the most common quantitative indexes for “deqi” in recent 10 years. (2) There were many factors influencing “deqi” in acupuncture, which involved personal physiological status, nature of disease, anatomical features under the acupoint, different acupuncture methods, quantity and depth of stimulus, etc. Different acupuncture methods, quantity and depth of stimulus would bring different influences on and mechanisms of “deqi”.Conclusions(1) “Deqi” is not equal to needling sensation; (2) recessive needling sensation should be re-recognized; (3) the sensation of doctor should be paid attention; (4) The meaning of “deqi” should be re-defined and re-understood.     

浅刺针法探微

目的；探讨浅刺疗法的可行性，方法：从古代文献和近年临床研究入手分析浅刺针法的作用。结果：针刺浅层即可激发经气，且可避免过多地刺伤组织。结论：应在针灸临床上推广浅刺针法。     

韩景献教授针灸排刺三法

韩景献教授的排刺三法是根据病位深浅及治疗部位的不同,分为皮部、经筋、经脉排刺三法。皮部排刺治疗皮部表面的病症,其特点是浅刺至皮;经筋排刺治疗经筋疾患,其特点是不拘泥经筋循行分布的规律,常涉及多经的经筋;经脉排刺以循经取穴为原则,可分为经脉病排刺及脏腑病排刺,经脉病排刺治疗经脉某一段的局部病变,脏腑病排刺治疗与经脉循行出入相关的脏腑的病变,其中背俞穴排刺用于治疗以自主神经功能障碍为主的胸腹内脏器及系统的病变,枕三经排刺用于治疗小脑疾患引起的眩晕共济失调等症状。     

从阴引阳，从阳引阴理论及临床应用

“从阴引阳,从阳引阴”是针灸学治疗原则之一。阴阳并不局限于经脉之阴阳,可指经络、脏腑、表里、气血之阴阳,上下、左右部位之阴阳等。因此临床应用有5种方法,即取背俞、腹募穴;以右治左,以左治右;以阳或阴经之穴,治疗阴或阳经之病;位置相对的二穴透刺;上病取下,下病取上。     

针刺远端单穴治疗足跟痛的临床应用

通过针刺远端单穴治疗足跟痛的5个验案,介绍一穴单用治疗足跟痛的临床应用.采取单刺风池、下关、肩奇、后溪、足跟等远端一穴,配合足跟部运动,能够迅速有效地缓解疼痛,促使功能恢复.结果表明单刺远端穴位有利于经脉运行通畅,施行手法促使针感传导,配合局部运动以发挥穴位的最佳功效,不但方法简便,操作容易,而且效果显著,实用安全,值得推广应用.     

于志强教授“疏木调冲”法治疗乳癖经验

于志强教授,从事中医临床、科研工作四十余载,勤于临床,学验俱丰。于教授认为乳癖的发生多由冲任失调、肝木不疏引发,治疗当以"疏木调冲"为要务。并自拟"疏木调冲汤"配合针灸治疗乳癖,取得良好效果。     

国医大师贺普仁教授辨治白癜风经验

贺普仁教授认为白癜风以先天禀赋不足为内因,饮食不节,情志失调,外邪乘虚侵袭肌腠,脉络瘀阻或局部跌扑损伤,瘀血阻滞经脉是基本病机。根据病情分为进展期与稳定期,不同分期选取不同治法,进展期采用温和灸;稳定期根据辨证或选用火针配合毫针,或选用放血拔罐配合毫针,或3种方法皆用,但以调和气血、通经活络为总则,善用背俞穴调理脏腑阴阳气血,通过调理膀胱经气来治疗肺之病变,重视调神及情绪疏导,主张局部多针密刺、浅刺。     

以“温润通”立法分期辨治痛性糖尿病周围神经病变

痛性糖尿病周围神经病变(PDPN)是糖尿病难治的并发症之一,缓解患者疼痛是治疗的难点,该病中医病名为“消渴病痛痹”,针对其阴阳气血亏虚,痰瘀痹阻脉络的本虚标实之病机特点,以“温润通”立法,即“温经散寒,濡润导阳,通络止痛”,按照病变进程分期辨治,早期治以温经养血,化痰通络为主,中期治以散寒止痛,温经通络为主,后期治以濡润益气,导阳通络为主,其中通法贯穿治疗始终。对于顽固性疼痛,可酌情选用川乌头、草乌头等辛温之品以温通经络,散寒止痛;久病入络者可加虫类药物,以化瘀通络,涤痰剔络。临证应辨病辨证相结合,以达最佳治疗效果。     

Significance of “Deqi” Response in Acupuncture Treatment: Myth or Reality

Acupuncture has been practiced in China for over 2000 years to treat a variety of diseases based on the “meridian theory,” as described in the “Yellow Emperor's Classics of Internal Medicine.” Deqi refers to the excitation of qi or vital energy inside meridians by acupuncture needle stimulation. Patients often experience multidimensional and intense needling sensations such as numbness, soreness, distention, heaviness, dull pain, and sharp pain during acupuncture stimulation. Deqi is considered as an important parameter in the process of achieving therapeutic effectiveness in acupuncture treatment. Understanding this phenomenon from neurophysiological aspects is important for clinical practice and enables practitioners to perform quantitative acupuncture evaluation to obtain a reliable prognosis of acupuncture treatment. This review paper describes our current knowledge and understanding of Deqi from a physiological aspect.