针灸调体治疗上热下寒型疾病探析

上热下寒体质是阳虚体质的亚临床类型,是上热下寒型疾病发生的体质土壤。临床表现上热则心胸头面常见火热上炎之证,下寒则并见中焦、下焦阳虚寒盛之象。既有阳虚体质兼夹气虚、阴虚、痰湿、湿热、气郁、瘀血等复杂的体质因素,又有与阳虚体质不完全相同或一致的生理、病理、心理、情绪、性格等形神构成的特殊性。针灸应对策略应清上热、温下寒、调中焦脾胃,以温下寒和调中焦为主,兼以引火归元,使阳气归于本位。首选督脉、任脉等调阴补阳的经脉,配神阙、气海、关元、大椎、中枢、肾俞、命门等常用调理阳虚体质的基础穴位,以隔物灸、温针灸或麦粒灸等温灸为主行综合调治;上热下寒型疾病临床针灸干预需兼顾胆肺不降、脾胃不和、心肝火旺、气血虚弱等证型,同时,在上点刺放舌下络脉金津、玉液之郁热瘀血,在下灸涌泉引火归元。

Analysis on Acupuncture and Moxibustion in Regulating Constitutions and Treating Diseases of Upper-heat and Lower-cold Type

Upper-heat and lower-cold constitution is the subconstitution of yang-deficiency constitution,which is the root for all upper-heat and lower-cold diseases.Syndrome of heat and fire flaming upward appeared on the chest,face and head with excessive cold symptoms in the middle and lower energizer are the main manifestations of this constitution,which is similar with yang-deficiency constitution but combined with qi deficiency,yin deficiency,phlegm dampness,damp-heat,qi stagnation and blood stasis,so it is different from yang-deficiency constitution in physiology,pathology,psychology,emotions and personality.The acupuncture treatment principles include:clearing heat in upper energizer,warming lower energizer,regulating spleen and stomach in middle energizer,as well as returning fire to its source.Acupoints are selected usually from governor vessel and conception vessel,other acupoints such as Shenque,Qihai,Guanyuan,Dazhui,Zhongshu,Shenshu,Mingmen etc.are selected for moxibustion.Indirect moxibustion,warm needing and moxibustion or grain-sized moxibustion were used to treat the disease.The gallbladder and lung qi failing to descend,the spleen and stomach disharmony,hyperactivity of the heart and liver,deficiency of qi and blood should be considered as well as other methods such as pricking Jinjun,Yuye of sublingual collaterals for bleeding and moxibustion yongquan acupoint.