基于“体表脏腑相关”的穴位敏化现象探讨腧穴的不同状态及其临床意义
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摘要
文章旨在从"体表脏腑相关"的穴位敏化现象探讨腧穴的不同状态及其临床意义。通过梳理古今医家学者们对"体表脏腑相关"的认识以及其与腧穴敏化现象、腧穴状态、腧穴状态不同对临床疗效的影响等相关文献进行归纳总结,发现腧穴起源于"体表脏腑相关"的部位敏化"手诊医学"模式;"腧穴脏腑相关"决定腧穴的不同状态"开"与"合";腧穴的状态是动态可变的,会因内脏功能状态的变化而改变其"开/合"状态,使其处于相对的"静息态"或"敏化态",以发挥其功能的强反应或弱反应;腧穴从"沉默"状态变换至"觉醒"状态的动态过程即为腧穴敏化,腧穴敏化能够使腧穴的位置、大小以及形态特征等发生相应改变,并能增强其腧穴功能,产生"小刺激大效应";腧穴敏化是机体实现自我稳态调节的基础和触发点;同时腧穴敏化也是提高针灸临床疗效的重要因素。穴位敏化现象是"体表脏腑相关"的外在体现,"体表脏腑相关"决定腧穴"开/合"的不同状态及其动态可变性,其对临床具有重要指导意义。
This paper aims to explore the different states of acupoints and their clinical significance from the phenomenon of acupoint sensitization related to ‘body surface zang-fu viscera correlation'. By combing the ancient and modern medical scholars' understanding of ‘body surface zang-fu viscera correlation' and its related effects on the clinical efficacy of acupoint sensitization,acupoint status, and different acupoint status, relevant literature is summarized. The study found that acupoints originated from the sensitization ‘hand-medical' mode of ‘body surface zang-fu viscera correlation'; acuppoints zang-fu viscera correlation' determines the different states of the acupoint ‘open' and ‘close'; the state of the acupoint is dynamically variable, it will change its ‘open/close' state due to changes in the state of visceral function, making it in a relative ‘quiet state' or ‘sensitized state' to exert a strong or weak reaction of its function; The dynamic process of changing acupoints from ‘silence' state to ‘awakening' state is sensitization of acupoints. Acupoint sensitization can change the position, size, and morphological characteristics of acupoints, and enhance the function of acupoints, resulting in ‘small stimulation result to significant effect'. Acupoint sensitization is the basis and trigger point for the body to achieve self-steady state regulation; at the same time, acupoints sensitization is also an important factor to improve the clinical efficacy of acupuncture. The phenomenon of acupoint sensitization is an external manifestation ‘body surface zang-fu viscera correlation'. The ‘body surface zang-fu viscera correlation' determines the different states and dynamic variability of acupoint ‘opening/closing', which has important guiding significance for clinical practice.
This paper aims to explore the different states of acupoints and their clinical significance from the phenomenon of acupoint sensitization related to ‘body surface zang-fu viscera correlation'. By combing the ancient and modern medical scholars' understanding of ‘body surface zang-fu viscera correlation' and its related effects on the clinical efficacy of acupoint sensitization,acupoint status, and different acupoint status, relevant literature is summarized. The study found that acupoints originated from the sensitization ‘hand-medical' mode of ‘body surface zang-fu viscera correlation'; acuppoints zang-fu viscera correlation' determines the different states of the acupoint ‘open' and ‘close'; the state of the acupoint is dynamically variable, it will change its ‘open/close' state due to changes in the state of visceral function, making it in a relative ‘quiet state' or ‘sensitized state' to exert a strong or weak reaction of its function; The dynamic process of changing acupoints from ‘silence' state to ‘awakening' state is sensitization of acupoints. Acupoint sensitization can change the position, size, and morphological characteristics of acupoints, and enhance the function of acupoints, resulting in ‘small stimulation result to significant effect'. Acupoint sensitization is the basis and trigger point for the body to achieve self-steady state regulation; at the same time, acupoints sensitization is also an important factor to improve the clinical efficacy of acupuncture. The phenomenon of acupoint sensitization is an external manifestation ‘body surface zang-fu viscera correlation'. The ‘body surface zang-fu viscera correlation' determines the different states and dynamic variability of acupoint ‘opening/closing', which has important guiding significance for clinical practice.
引文
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[12]高晓燕,欧阳希林,罗康,等.激发热敏灸感的几种方式.中医杂志,2017,58(7):623-624
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[15]万敏,周玉梅,周洁,等.腧穴敏化现象和规律探究的分析.针灸临床杂志,2017,33(3):74-77
[16]于宏君,蒋海琳,王富春.试论腧穴的生物学特性——敏化性.中国中医基础医学杂志,2016,22(12):1643-1645
[17]吴焕淦.针灸疗效与腧穴.中国中西医结合杂志,2012,32(11):1452-1457
[18]Caterina M I,Schumacher M A,Tominaga M.The capsaicin receptor:a heat activated ion channel in the pain pathway.Nature,1997,389(6653):816-821
[19]朱兵.腧穴的效应特征:广谱性和特异性.针刺研究,2016,41(5):388
[20]程斌.急性胃黏膜损伤体表敏化腧穴的动态分布观察.针刺研究,2010,35(3):193-197
[2]董亚琴,黄倩茹,万隆,等.与急性心肌缺血损伤相关体表敏化穴位的初步分布观察.中华中医药杂志,2018,33(2):672-674
[3]朱兵.腧穴可塑性:腧穴本态的重要特征.中国针灸,2015,35(11):1203-1208
[4]许金森.经络研究的现状与展望.中华中医药杂志,2016,31(11):4355-4360
[5]北京医学院基础医学系针麻原理研究形态组.家兔耳郭皮肤电阻变化与内脏疾病的关系针灸研究进展.北京:中医研究院,1981:79-92
[6]杨小梅,许金森.热敏灸的临床研究概况.中医药临床杂志,2015,27(11):1540-1545
[7]黄活石,周思远,师维,等.敏化穴与激痛点之异同.四川医学,2016,34(7):27-29
[8]Farmer A D,Aziz Q.Mechanisms and management of functional abdominal pain.J R Soc Med,2014,107(9):347-354
[9]东贵荣.腧穴本质-穴敏性与穴敏化.中国针灸学会,2017世界针灸学术大会暨2017中国针灸学会年会论文集,2017:3
[10]Li S,Melton D H,Li S.Tactil,thermal,and electrical thresholdsin Patients with and without phantomlimb pain after traumatic lower limb amputation.J Pain Res,2015(8):169-174
[11]丁宁,姜婧,王巧侠,等.腧穴敏化的生物物理特性研究进展.针灸临床杂志,2017,33(2):69-72
[12]高晓燕,欧阳希林,罗康,等.激发热敏灸感的几种方式.中医杂志,2017,58(7):623-624
[13]Latremoliere A,Woolf C J.Central sensitization:a generator ofpain hypersensitivity by central neural plasticity.J Pain,2009,10(9):895-926
[14]喻晓春,朱兵,高俊虹,等.穴位动态过程的科学基础.中医杂志,2007,48(11):971-973
[15]万敏,周玉梅,周洁,等.腧穴敏化现象和规律探究的分析.针灸临床杂志,2017,33(3):74-77
[16]于宏君,蒋海琳,王富春.试论腧穴的生物学特性——敏化性.中国中医基础医学杂志,2016,22(12):1643-1645
[17]吴焕淦.针灸疗效与腧穴.中国中西医结合杂志,2012,32(11):1452-1457
[18]Caterina M I,Schumacher M A,Tominaga M.The capsaicin receptor:a heat activated ion channel in the pain pathway.Nature,1997,389(6653):816-821
[19]朱兵.腧穴的效应特征:广谱性和特异性.针刺研究,2016,41(5):388
[20]程斌.急性胃黏膜损伤体表敏化腧穴的动态分布观察.针刺研究,2010,35(3):193-197