《伤寒杂病论》针灸治疗特色

张仲景施针用灸,范围明确,依病性而定。三阳用针,刺其腧而泄其邪、防传变、理经气。三阴用灸,灸其穴而壮其阳、温经脉、煦百骸。阳证用针,阴证用灸是其常,针刺祛邪,艾灸扶正是其变,随其兼证的差异,选择相应的医治措施。张仲景临证脉症合参,辨证之后精确把握病位,再考虑疾病寒热虚实,选用治法,病机同则治同,病机异则治异。《伤寒杂病论》论治六经病,充分发挥了针灸经络理论,主要体现在:一,病候与《灵枢》经络病候的相似性;二,病变部位的相同处;三,张仲景不仅明辨经络病变,更利用经络来解释病候。《伤寒杂病论》针刺防变的学术思想主要体现在两个方面,一,治未病,杜其萌。二,治已病,防传变。《伤寒杂病论》对危重证候的阐述包括诊断与救治两方面。危重证候的诊断主要体现在体温、脉搏、神志和呼吸频率等方面;救治上,见阳衰阴盛之危象,用汤药恐不济急,乃灸其厥阴,温阳复脉;出现厥利无脉的危重证候,急灸关元、气海。《伤寒杂病论》中涉及针灸的知识虽零散分布,但其书中的针灸特色,不仅继承、完善并发展了东汉以前的针灸学术思想,更对临床有重要指导意义。

Characteristics of Acupuncture and Moxibustion in Treatise on Cold Damage Diseases

When Zhang Zhong-jing applied acupuncture and moxibustion,the scope was clear,depending on the nature of the disease.For diseases of three-yang meridians,he used acupuncture to purge pathogens,prevent transmission and change,and regulate meridian qi.For diseases of three-yin meridians,he used moxibustion to strengthen yang,warm meridians and all bones of body.For yang syndrome,he used acupuncture to remove pathogens;for yin syndrome,he used moxibustion to strengthen healthy qi.According to the difference of syndrome,the corresponding treatment measures were chosen by him.Zhang Zhong-jing′s considered clinical syndrome and pulse syndrome together.After syndrome differentiation,he accurately grasped the disease location,and then considered cold and heat,deficiency and excess of the disease,selected the proper treatment method.If the pathogenesis was the same,the treatment would be the same,and if the pathogenesis was different,the treatment would be different.In Treatise on Cold Damage Diseases,the discussion about the treatment of six-meridian diseases has given full play to the theory of meridian and collateral of acupuncture and meridians,which is mainly reflected in the following three aspects:①There are similarities between the syndrome and the meridian-collateral syndrome of in The Spiritual Pivot.②There are similarities between lesion locations.③Zhang Zhong-jing not only distinguished the pathological changes of meridians exactly,but also used meridian and collateral to explain the symptoms.The academic thought of acupuncture for preventing transmission and change in Treatise on Cold Damage Diseases is mainly reflected in two aspects:One is to treat the disease before its onset,the other is to cure the existing disease and control its development.In Treatise on Cold Damage Diseases,there are two aspects of critical syndrome:diagnosis and treatment.The diagnosis of critical syndrome mainly depends on body temperature,pulse,mind and respiratory rate,etc.In terms of treatment,for yang declining and yin flourishing,using decoction may not save the urgency,so jueyin can be given moxibustion to warm yang and restore pulse.For reversal cold limbs with hardly perceivable pulse,Guanyuan(BL 26)and Qihai(BL 24)should be given moxibustion as quickly as possible.Although acupuncture-moxibustion related knowledge in Treatise on Cold Damage Diseases is scattered,its characteristics not only inherit,improve and develop the acupuncture-moxibustion academic thought before the Eastern Han Dynasty,but also have important guiding significance for clinical practice.