“若要安,三里常不干”考辨
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摘要
从文献学和医理辨析"若要安,三里常不干"出处及其临床意义,探知"若要安"诸语出南宋初年《琐碎录》。足三里艾灸原为防治"风疾"而设,以宣通脏腑气血为宜,非特指三里灸为化脓灸之意。将此句释为反复"灸疮",是对《备急千金要方》"失气阳厥"诸症才用逾百壮灸和《针灸资生经》"报灸"法的误解。三里穴保健可选指压、搓摩、深汤足浴等法;从安全性考量,寒象明显者宜以悬空、隔物等温和灸调理。
This article has analyzed the source and clinical significance of statement of "if keeping health,Zusanli( ST36) frequently being given moxibustion"based on philology and medical principles.The statement was recorded in Suosuilu( Trivial Details of Traditional Chinese Medicine) written in early Southern Song Dynasty,which was originally designed for preventing and curing wind diseases. The moxibustion on ST36 is to diffuse and unblock qi and blood of zang-fu organs,but is not to give festering moxibustion. If the statement is explained as repeated festering moxibustion,Yubaizhuang moxibution recorded in Beijiqianjinyaofang( Essential Prescriptions Worth a Thousand Gold for Emergencies) and Bao moxibution recorded in Zhenjiuzishengjing( Classic of Nourishing Life with Acupuncture and Moxibustion)used only in the condition of excessive yang deficiency will be misunderstood. Acupressure,frottage and foot bath can be selected in ST36 healthcare. Considering safety,some mild moxibustion therapies are recommended,such as suspended moxibustion and sandwiched moxibustion,in patients with obvious cold symptoms.
This article has analyzed the source and clinical significance of statement of "if keeping health,Zusanli( ST36) frequently being given moxibustion"based on philology and medical principles.The statement was recorded in Suosuilu( Trivial Details of Traditional Chinese Medicine) written in early Southern Song Dynasty,which was originally designed for preventing and curing wind diseases. The moxibustion on ST36 is to diffuse and unblock qi and blood of zang-fu organs,but is not to give festering moxibustion. If the statement is explained as repeated festering moxibustion,Yubaizhuang moxibution recorded in Beijiqianjinyaofang( Essential Prescriptions Worth a Thousand Gold for Emergencies) and Bao moxibution recorded in Zhenjiuzishengjing( Classic of Nourishing Life with Acupuncture and Moxibustion)used only in the condition of excessive yang deficiency will be misunderstood. Acupressure,frottage and foot bath can be selected in ST36 healthcare. Considering safety,some mild moxibustion therapies are recommended,such as suspended moxibustion and sandwiched moxibustion,in patients with obvious cold symptoms.
引文
[1]国家中医药管理局.关于发布《中国公民中医养生保健素养》的公告:国中医药办发[2014]15号[A/OL].(2014-06-06)[2016-06-06].http://www.satcm.gov.cn/e/action/Show Info.php?classid=193&id=19562.State Administration of Traditional Chinese Medicine.About release the announcement of“Traditional Chinese Health Care Accomplishment for Chinese Citizens”:SATCM Office[2014]15[A/OL].(2014-06-06)[2016-06-06].http://www.satcm.gov.cn/e/action/Show Info.php?classid=193&id=19562.
[2]马烈光.中医养生保健学[M].北京:中国中医药出版社,2009:166.MA LG.Health Care Science of Traditional Chinese Medicine[M].Beijing:China Press of Traditional Chinese Medicine,2009:166.
[3]吴焕淦,刘慧荣,马晓芃,等.灸法学[M].上海:上海科学技术出版社,2016:77.WU HG,LIU HR,MA XP,et al.Moxibustion Methodology[M].Shanghai:Shanghai Scientific and Technical Publishers,2016:77.
[4]田从豁,臧俊岐.中国灸法全书[M].哈尔滨:黑龙江科学技术出版社,2013:559.TIAN CH,ZANG JQ.Chinese Pandect of Moxibustion Methods[M].Haerbin:Heilongjiang Science and Technology Press,2013:559.
[5]张奇文.中医灸法大全[M].天津:天津科学技术出版社,1993:654.ZHANG QW.A Complete Collection of Moxibustion Methods[M].Tianjin:Tianjin Science and Technology Press,1993:654.
[6]张静静.不同艾灸刺激量对环磷酰胺化疗小鼠骨髓组织黏附分子含量影响的量效关系研究[D].郑州:河南中医药大学,2015.ZHANG JJ.Research on the effects of different moxibustion stimulating quantity on the content of inter cellular adhesion molecule-1(ICAM-1)and vascular cell adhesion molecule-1(VCAM-1)in bone marrow tissue of mice induced by CTX[D].Zhengzhou:Henan University of Chinese Medicine,2015.
[7]鲁娟.观察腧穴局部微循环特征和不同灸法对足三里穴位局部温度与微循环的影响[D].成都:成都中医药大学,2013.LU J.Observing the chiropractics of points’microcirculation and the affect of different moxibustions to zusanli’s temperature and microcirculation[D].Chengdu:Chengdu University of Traditional Chinese Medicine,2013.
[8]赵建新.灸足三里穴临床应用[J].河北中医,1997,19(4):33.ZHAO JX.Clinical application of moxibustion on Zusanli(ST36)[J].Hebei Journal of Traditional Chinese Medicine,1997,19(4):33.
[9]郑益民.用针之要毋忘其神[J].上海中医药杂志,1985,25(12):30.ZHENG YM.To be mindful of acupuncture spirit[J].Shanghai Journal of Traditional Chinese Medicine,1985,25(12):30.
[10]谢波,王玲玲.灸疮促发的意义及方法[J].江苏中医药,2013,45(12):53-55.XIE B,WANG LL.Meaning and methods of promoting moxibustion boils[J].Jiangsu Journal of Traditional Chinese Medicine,2013,45(12):53-55.
[11]杨继洲.针灸大成[M].北京:人民卫生出版社,2006:419.YANG JZ.Zhenjiudacheng[M].Beijing:People’s Health Publishing House,2006:419.
[12]孙思邈.备急千金要方[M].太原:山西科学技术出版社,2010.SUN SM.Beijiqianjinyaofang[M].Taiyuan:Shanxi Science and Technology Publishing House,2010.
[13]张杲.医说[M].王旭光,张宏,校注.北京:中国中医药出版社,2009.ZHANG G.Yi Shuo[M].Annotated by WANG XG,ZHANG H.Beijing:China Press of Traditional Chinese Medicine,2009.
[14]永2).四库全书总目[M].北京:中华书局,1981:866.YONG R.Sikuquanshu Zongmu[M].Beijing:Zhonghua Book Company,1981:866.
[15]周守忠.养生类纂[M].太原:山西人民出版社,1987:105.ZHOU SZ.Yangshengleizuan[M].Taiyuan:Shanxi People’s Publishing House,1987:105.
[16]金礼蒙.医方类聚:第9分册[M].盛增秀,陈勇毅,王英,重校.北京:人民卫生出版社,2006:560.JIN LM.Yifangleiju:Book 9[M].Re-proofread by SHENG ZX,CHEN YY,WANG Y.Beijing:People’s Health Publishing House,2006:560.
[17]胡道静.中国古代典籍十讲[M].上海:复旦大学出版社,2004:228-236.HU DJ.Ten Studies of Chinese Ancient Books[M].Shanghai:Fudan University Press,2004:228-236.
[18]温革.分门琐碎录[M]//顾廷龙.续修四库全书:第975分册.影印本.上海:上海古籍出版社,2002:47.WEN G.Fenmensisuilu[M]//GU TL.Continuation Compilation of Sikuquanshu[Photocopy].Book 975.Shanghai:Shanghai Ancient Books Publishing House,2002:47.
[19]华振红.《分门琐碎录》校注[M].成都:巴蜀书社,2009:1-5.HUA ZH.Annotation of“Fenmensuosuilu”[M].Chengdu:Bashu Publishing House,2009:1-5.
[20]张如安.新见明抄本《分门琐碎录》“医药类”述略[J].宁波大学学报(人文科学版),2015,28(3):43-46.ZHANG RA.On the Newly-discovered Handwritten Copy of Medical Records in“Fenmensuosuilu”[J].Journal of Ningbo University(Humanities Edition),2015;28(3):43-46.
[21]俞弁.续医说[M].邢秋娟,校注.长沙:湖南科学技术出版社,2014:20.YU B.Xuyishuo[M].Annotated by XING QJ.Changsha:Hunan Science and Technology Press,2014:20.
[22]范晔.后汉书[M].北京:中华书局,1973:1527.FAN Y.Houhanshu[M].Beijing:Zhonghua Book Company,1973:1527.
[23]巢元方.诸病源候论[M].鲁兆麟,点校.沈阳:辽宁科学技术出版社,1997.CHAO YF.Zhubingyuanhoulun[M].Proofread by LU ZL.Shenyang:Liaoning Science and Technology Publishing House,1997.
[24]王怀隐,田文敬.《太平圣惠方》校注:第3册[M].郑州:河南科学技术出版社,2015:92.WANG HY,TIAN WJ.Annotation of Taipingshenghuifang:Book 3[M].Zhengzhou:Henan Science and Technology Press,2015:92.
[25]陈自明.妇人大全良方[M].北京:人民卫生出版社,1985:101.CHEN ZM.Furendaquanliangfang[M].Beijing:People’s Medical Publishing House,1985:101.
[26]杜预,孔颖达.春秋左传正义[M]//阮元.十三经注疏.北京:中华书局,1980:1806.DU Y,KONG YD.Chunqiuzuozhuan Zhengyi[M]//RUAN Y.Shisanjing Zhushu.Beijing:Zhonghua Book Company,1980:1806.
[27]王执中.针灸资生经[M].黄龙祥,黄幼民,整理.北京:人民卫生出版社,2007:108.WANG ZZ.Zhenjiuzishengjing[M].Sorted by HUANG LX,HUANG YM.Beijing:People’s Medical Publishing House,2007:108.
[28]赵京生.针灸学基本概念术语通典[M].北京:人民卫生出版社,2014:39.ZHAO JS.Terminology of Basic Acupuncture Concepts[M].Beijing:People’s Medical Publishing House,2014:39.
[29]郑玄,贾公彦.周礼注疏[M]//阮元.十三经注疏.北京:中华书局,1980:810.ZHENG X,JIA GY.Zhoulizhushu[M]//RUAN Y.Shisanjing Zhushu.Beijing:Zhonghua Book Company,1980:810.
[30]汪机.针灸问对[M].南京:江苏科学技术出版社,1985:94.WANG J.Zhenjiuwendui[M].Nanjing:Jiangsu Science and Technology Publishing House,1985:94.
[31]李守先.《针灸易学》校注[M].高希言,陈素美,陈亮,校注.郑州:河南科学技术出版社,2014:54.LI SX.Annotation of Zhenjiuyixue[M].Annotated by GAO XY,CHEN SM,CHEN L.Zhengzhou:Henan Science and Technology Press,2014:54.
[32]廖润鸿.勉学堂针灸集成[M].沈爱学,包黎恩,点校.北京:人民卫生出版社,1994:41.LIAO RH.Mianxuetang Zhenjiujicheng[M].Proofread by SHEN AX,BAO LE.Beijing:People’s Medical Publishing House,1994:41.
[33]李东垣.兰室秘藏[M].文魁,丁国华,整理.北京:人民卫生出版社,2005:54.LI DY.Lanshimicang[M].Sorted by WEN K,DING GH.Beijing:People’s Medical Publishing House,2005:54.
[2]马烈光.中医养生保健学[M].北京:中国中医药出版社,2009:166.MA LG.Health Care Science of Traditional Chinese Medicine[M].Beijing:China Press of Traditional Chinese Medicine,2009:166.
[3]吴焕淦,刘慧荣,马晓芃,等.灸法学[M].上海:上海科学技术出版社,2016:77.WU HG,LIU HR,MA XP,et al.Moxibustion Methodology[M].Shanghai:Shanghai Scientific and Technical Publishers,2016:77.
[4]田从豁,臧俊岐.中国灸法全书[M].哈尔滨:黑龙江科学技术出版社,2013:559.TIAN CH,ZANG JQ.Chinese Pandect of Moxibustion Methods[M].Haerbin:Heilongjiang Science and Technology Press,2013:559.
[5]张奇文.中医灸法大全[M].天津:天津科学技术出版社,1993:654.ZHANG QW.A Complete Collection of Moxibustion Methods[M].Tianjin:Tianjin Science and Technology Press,1993:654.
[6]张静静.不同艾灸刺激量对环磷酰胺化疗小鼠骨髓组织黏附分子含量影响的量效关系研究[D].郑州:河南中医药大学,2015.ZHANG JJ.Research on the effects of different moxibustion stimulating quantity on the content of inter cellular adhesion molecule-1(ICAM-1)and vascular cell adhesion molecule-1(VCAM-1)in bone marrow tissue of mice induced by CTX[D].Zhengzhou:Henan University of Chinese Medicine,2015.
[7]鲁娟.观察腧穴局部微循环特征和不同灸法对足三里穴位局部温度与微循环的影响[D].成都:成都中医药大学,2013.LU J.Observing the chiropractics of points’microcirculation and the affect of different moxibustions to zusanli’s temperature and microcirculation[D].Chengdu:Chengdu University of Traditional Chinese Medicine,2013.
[8]赵建新.灸足三里穴临床应用[J].河北中医,1997,19(4):33.ZHAO JX.Clinical application of moxibustion on Zusanli(ST36)[J].Hebei Journal of Traditional Chinese Medicine,1997,19(4):33.
[9]郑益民.用针之要毋忘其神[J].上海中医药杂志,1985,25(12):30.ZHENG YM.To be mindful of acupuncture spirit[J].Shanghai Journal of Traditional Chinese Medicine,1985,25(12):30.
[10]谢波,王玲玲.灸疮促发的意义及方法[J].江苏中医药,2013,45(12):53-55.XIE B,WANG LL.Meaning and methods of promoting moxibustion boils[J].Jiangsu Journal of Traditional Chinese Medicine,2013,45(12):53-55.
[11]杨继洲.针灸大成[M].北京:人民卫生出版社,2006:419.YANG JZ.Zhenjiudacheng[M].Beijing:People’s Health Publishing House,2006:419.
[12]孙思邈.备急千金要方[M].太原:山西科学技术出版社,2010.SUN SM.Beijiqianjinyaofang[M].Taiyuan:Shanxi Science and Technology Publishing House,2010.
[13]张杲.医说[M].王旭光,张宏,校注.北京:中国中医药出版社,2009.ZHANG G.Yi Shuo[M].Annotated by WANG XG,ZHANG H.Beijing:China Press of Traditional Chinese Medicine,2009.
[14]永2).四库全书总目[M].北京:中华书局,1981:866.YONG R.Sikuquanshu Zongmu[M].Beijing:Zhonghua Book Company,1981:866.
[15]周守忠.养生类纂[M].太原:山西人民出版社,1987:105.ZHOU SZ.Yangshengleizuan[M].Taiyuan:Shanxi People’s Publishing House,1987:105.
[16]金礼蒙.医方类聚:第9分册[M].盛增秀,陈勇毅,王英,重校.北京:人民卫生出版社,2006:560.JIN LM.Yifangleiju:Book 9[M].Re-proofread by SHENG ZX,CHEN YY,WANG Y.Beijing:People’s Health Publishing House,2006:560.
[17]胡道静.中国古代典籍十讲[M].上海:复旦大学出版社,2004:228-236.HU DJ.Ten Studies of Chinese Ancient Books[M].Shanghai:Fudan University Press,2004:228-236.
[18]温革.分门琐碎录[M]//顾廷龙.续修四库全书:第975分册.影印本.上海:上海古籍出版社,2002:47.WEN G.Fenmensisuilu[M]//GU TL.Continuation Compilation of Sikuquanshu[Photocopy].Book 975.Shanghai:Shanghai Ancient Books Publishing House,2002:47.
[19]华振红.《分门琐碎录》校注[M].成都:巴蜀书社,2009:1-5.HUA ZH.Annotation of“Fenmensuosuilu”[M].Chengdu:Bashu Publishing House,2009:1-5.
[20]张如安.新见明抄本《分门琐碎录》“医药类”述略[J].宁波大学学报(人文科学版),2015,28(3):43-46.ZHANG RA.On the Newly-discovered Handwritten Copy of Medical Records in“Fenmensuosuilu”[J].Journal of Ningbo University(Humanities Edition),2015;28(3):43-46.
[21]俞弁.续医说[M].邢秋娟,校注.长沙:湖南科学技术出版社,2014:20.YU B.Xuyishuo[M].Annotated by XING QJ.Changsha:Hunan Science and Technology Press,2014:20.
[22]范晔.后汉书[M].北京:中华书局,1973:1527.FAN Y.Houhanshu[M].Beijing:Zhonghua Book Company,1973:1527.
[23]巢元方.诸病源候论[M].鲁兆麟,点校.沈阳:辽宁科学技术出版社,1997.CHAO YF.Zhubingyuanhoulun[M].Proofread by LU ZL.Shenyang:Liaoning Science and Technology Publishing House,1997.
[24]王怀隐,田文敬.《太平圣惠方》校注:第3册[M].郑州:河南科学技术出版社,2015:92.WANG HY,TIAN WJ.Annotation of Taipingshenghuifang:Book 3[M].Zhengzhou:Henan Science and Technology Press,2015:92.
[25]陈自明.妇人大全良方[M].北京:人民卫生出版社,1985:101.CHEN ZM.Furendaquanliangfang[M].Beijing:People’s Medical Publishing House,1985:101.
[26]杜预,孔颖达.春秋左传正义[M]//阮元.十三经注疏.北京:中华书局,1980:1806.DU Y,KONG YD.Chunqiuzuozhuan Zhengyi[M]//RUAN Y.Shisanjing Zhushu.Beijing:Zhonghua Book Company,1980:1806.
[27]王执中.针灸资生经[M].黄龙祥,黄幼民,整理.北京:人民卫生出版社,2007:108.WANG ZZ.Zhenjiuzishengjing[M].Sorted by HUANG LX,HUANG YM.Beijing:People’s Medical Publishing House,2007:108.
[28]赵京生.针灸学基本概念术语通典[M].北京:人民卫生出版社,2014:39.ZHAO JS.Terminology of Basic Acupuncture Concepts[M].Beijing:People’s Medical Publishing House,2014:39.
[29]郑玄,贾公彦.周礼注疏[M]//阮元.十三经注疏.北京:中华书局,1980:810.ZHENG X,JIA GY.Zhoulizhushu[M]//RUAN Y.Shisanjing Zhushu.Beijing:Zhonghua Book Company,1980:810.
[30]汪机.针灸问对[M].南京:江苏科学技术出版社,1985:94.WANG J.Zhenjiuwendui[M].Nanjing:Jiangsu Science and Technology Publishing House,1985:94.
[31]李守先.《针灸易学》校注[M].高希言,陈素美,陈亮,校注.郑州:河南科学技术出版社,2014:54.LI SX.Annotation of Zhenjiuyixue[M].Annotated by GAO XY,CHEN SM,CHEN L.Zhengzhou:Henan Science and Technology Press,2014:54.
[32]廖润鸿.勉学堂针灸集成[M].沈爱学,包黎恩,点校.北京:人民卫生出版社,1994:41.LIAO RH.Mianxuetang Zhenjiujicheng[M].Proofread by SHEN AX,BAO LE.Beijing:People’s Medical Publishing House,1994:41.
[33]李东垣.兰室秘藏[M].文魁,丁国华,整理.北京:人民卫生出版社,2005:54.LI DY.Lanshimicang[M].Sorted by WEN K,DING GH.Beijing:People’s Medical Publishing House,2005:54.