从《内经》、《儒门事亲》、《针灸大成》探讨刺络放血疗法的应用
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摘要
研究背景
刺络放血疗法,又称之刺血疗法,《内经》中称之为“刺留血”,是在中医针灸学中的一种历史悠久、方法独特的治疗手段。他的理论基础建筑在“血气不和,百病乃变化而生”的基础上；“宛陈则除之”,则是刺络放血疗法的应用实践大法。在《内经》162篇文章中,论及此法就有60余篇之多,涉及刺络放血疗法的原则、针具的选择、刺营出血的方法等内容。不但古代有众多医家擅长使用此法,现代临床上也经常运用,因此该治疗研究,对于提高治疗的效果,具有极其重要的意义。
研究目的和内容
刺络放血,起源甚早,《内经》中涵盖范围广,后世医家世代相传,成效显著。目前,对于刺络放血的研究,大多为医籍或历代医家的相关的认识,难以深入探讨,缺乏系统性整理分析。通过本次研究对古代文献的系统整理和理论分析,归纳古代的刺血运用方法、经验和规律、禁忌症等,为现代临床医学研究与应用提供依据；并认识刺络放血与经络、腧穴、针刺等有关理论、概念和方法的相互关联,并从《儒门事亲》、《针灸大成》中去探讨分析并总结刺络放血疗法的适应症、禁忌症,揭示《内经》、《儒门事亲》、《针灸大成》对今日刺络放血在临床上的影响。
研究方法
本研究综合运用历史文献研究方法、学术史方法、理论分析方法,梳理刺络放血的相关文献资料,从针灸理论学术演变的历史角度去考虑刺络放血疗法,分析认识刺络放血理论的学术内涵及其与经脉理论的学术关联。研究结果和结论
本研究认为：1.刺络放血疗法的发展历程大致可分为2个阶段：1)《内经》中的针刺治法,以刺络放血疗法的记载量最多。主治病症不再局限于外科病症,已包括疼痛、脏腑疾病、全身性疾病等；刺络放血部位多取四肢远端及头面部和关节处,以及某些腧穴或经脉上；并重视对血脉的观察,其颜色、形态的改变是选择刺络放血部位的重要依据；对刺络放血之法的理论提升较为明显,被纳入经络理论之中,刺络放血的部位选择和主治作用受到经脉理论的强烈影响,络脉理论对于刺络放血的解说具有重要的意义与作用。2)后世医家对刺络放血的认识,时间较长,论述却很少,仅仅是引述经文和条文,或有所发挥,在有关腧穴内容中有一定论及,基本未出经典条文的范围。极少数医家对刺络放血论述颇有新意,以张从正《儒门事亲》为主。所治病症的范围、病种,反不如《内经》面广丰富,而以局部外科病症占多数,与经脉理论的关联也不甚紧密。而在杨继洲《针灸大成》中刺血疗法注重在于活血止痛、清热解毒等治疗作用上,刺络放血部位根据不同病证而有多种选择,采用刺穴位、刺血络等方法,根据体质、季节、部位决定放血量,对于放血工具及禁忌也有所叙述但与经脉理论、相关机理的关联也不甚紧密。2.《内经》载述的刺络放血,反映了针灸理论尤其是经脉理论发展的中间环节或过渡阶段。刺络放血从早期的基本以局部痈脓出血为主,到《内经》中常与针刺腧穴合用,再到经典经脉理论确立后刺络放血的式微。可以看得出来其中的演变过程,从早期的对血脉理论的重视进入针灸学的体系,到后世医家对针刺的转向,刺血疗法逐渐逐渐的边缘化。
本次研究揭示了《内经》在刺络放血疗法史上的地位。虽然刺络放血疗法在《儒门事亲》、《针灸大成》中都有不同程度的发展,但基本上都未超出《内经》的范畴。而在现今临床应用刺络放血疗法治疗的疾病虽然较古代有所扩大,但主要还是脱离不了实证、热证、急证为主的各科疾病,针对于刺络放血的禁忌症、注意事项等等方面仍旧以《内经》为主。刺络放血疗法是传统医学疗法中最具特色的一种疗法,该疗法简便廉价、副作用较少、起效迅速值得在临床上推广及应用。
Background
Stab winding bloodletting therapy, also called the thorn blood therapy, called the "thorn blood" in neijing, is one of in the traditional Chinese medicine acupuncture has a long history and unique method of treatment. His theory foundation construction in the flesh, everything is change "on the basis of;"Chen is in addition to the" nanyang, is stab winding bloodletting therapy application solution. In162article in neijing, deals with this method there is more than60, involving stab winding bloodletting therapy principles, selection of needle, stab camp bleeding method [1-3]. Not only has many ancient doctor is good at using this method, the modern clinical also often use, so the therapy research, to improve the effectiveness of treatment, has the extremely vital significance.
Research purposes
Stab winding bloodletting, origin is very early, cover a wide range in neijing, the later the acknowledgement from generation to generation, the effect is remarkable. At present, the thorn bloodletting winding research, most of the medical books of past dynasties doctor or related knowledge, difficult to delve into, the lack of systematic analysis. System through the study of ancient literature and theoretical analysis, summing up the ancient blood use method, experience and regularity, contraindications and so on, provide a basis for modern medicine research and clinical application; Piercing and understand complex bloodletting and channels and collaterals, acupoints, acupuncture and other relevant theories, concepts and methods of correlation, and from "although things close","acupuncture dacheng" to explore analysis and summarize collaterals in the bloodletting therapy indications, contraindications, reveal neijing,"although things close","acupuncture dacheng" to today's thorn bloodletting in the clinical effect of the ice.
Research method
This study integrated use of historical documents research method, method of academic history, theoretical analysis method, combing stab winding bloodletting of related literature, from the evolution history of acupuncture and moxibustion theory academic Angle to consider thorn bloodletting therapy for the analysis understanding thorn bloodletting winding theory academic connotation and the theory of meridians academic association.
The research results and conclusions
Think this study:1. Thorn bloodletting therapy winding development process can be roughly divided into two stages:1) acupuncture treatment in neijing, with thorn bloodletting therapy recorded amount up to the ice. Attending disease is no longer limited to the surgical conditions, including pain, visceral diseases, systemic diseases, etc.; Stab winding bleed more distal limbs and head face and joints, as well as certain aperture or meridians; And attaches great importance to the observation of the blood, the color, shape change is important basis of choose thorn bloodletting winding parts; Method of thorn bloodletting winding theory to promote relatively obvious, is built into the channels and collaterals theory, thorn bloodletting role in site selection and attending winding is affected by the strong theory of meridians and collaterals theory for definitions of thorn bloodletting winding has the vital significance and role.2) the later physicians understanding of thorn bloodletting winding, time is longer, rarely, just quoting scripture and provisions, or play, discussed in relevant acupoints in content to a certain extent, basic not out the scope of the classic articles. That very few physicians on thorn bloodletting winding is quite interesting, and is given priority to with zhang from is "although things close". Scope, disease, cure diseases by the rich as neijing area wide, and with local surgical disease in the majority, and the theory of meridians is also not very closely. In Yang Jizhou acupuncture dacheng, pay attention to is to invigorate the thorn blood therapy in pain relief, heat-clearing and detoxicating therapy effect, thorn bloodletting winding parts according to different diseases and has a variety of options, the methods of acupuncture points, thorn blood, blood determined according to the constitution, season, area, for bloodletting tool and the taboo is related to but meridians theory, relevant mechanism is also not very closely.2. Presented in neijing, thorn bloodletting winding, reflects the acupuncture and moxibustion theory especially the theory of meridians in the development of the intermediate links, or a transitional phase. Stab winding bleeding from the early basic is given priority to with local carbuncle pus, bleeding, to share, often with acupuncture acupoints in neijing, stab to classical meridians theory established after winding bloodletting of decay. Can see the evolution process, from the early into the acupuncture to the attention of the veins theory system, to the later doctor for acupuncture, thorn blood therapy gradually gradually marginalized.
This study reveals the neijing in stab winding position in the history of bloodletting therapy. Although stab winding bloodletting therapy in although things close,"acupuncture dacheng" has a different degree of development, but generally not beyond the category of neijing. In current clinical application of thorn bloodletting therapy to treat the disease although the ancient winding, but mostly from the empirical and heat certificate, certificate of disease in all the subjects, for complex contraindications to bleed, and matters needing attention, etc are still predominantly neijing. Stab winding bloodletting therapy is the most distinctive of traditional medicine therapy treatments, this therapy is simple, cheap, less side effects and take effect quickly is worth in clinical promotion and application.
刺络放血疗法,又称之刺血疗法,《内经》中称之为“刺留血”,是在中医针灸学中的一种历史悠久、方法独特的治疗手段。他的理论基础建筑在“血气不和,百病乃变化而生”的基础上；“宛陈则除之”,则是刺络放血疗法的应用实践大法。在《内经》162篇文章中,论及此法就有60余篇之多,涉及刺络放血疗法的原则、针具的选择、刺营出血的方法等内容。不但古代有众多医家擅长使用此法,现代临床上也经常运用,因此该治疗研究,对于提高治疗的效果,具有极其重要的意义。
研究目的和内容
刺络放血,起源甚早,《内经》中涵盖范围广,后世医家世代相传,成效显著。目前,对于刺络放血的研究,大多为医籍或历代医家的相关的认识,难以深入探讨,缺乏系统性整理分析。通过本次研究对古代文献的系统整理和理论分析,归纳古代的刺血运用方法、经验和规律、禁忌症等,为现代临床医学研究与应用提供依据；并认识刺络放血与经络、腧穴、针刺等有关理论、概念和方法的相互关联,并从《儒门事亲》、《针灸大成》中去探讨分析并总结刺络放血疗法的适应症、禁忌症,揭示《内经》、《儒门事亲》、《针灸大成》对今日刺络放血在临床上的影响。
研究方法
本研究综合运用历史文献研究方法、学术史方法、理论分析方法,梳理刺络放血的相关文献资料,从针灸理论学术演变的历史角度去考虑刺络放血疗法,分析认识刺络放血理论的学术内涵及其与经脉理论的学术关联。研究结果和结论
本研究认为：1.刺络放血疗法的发展历程大致可分为2个阶段：1)《内经》中的针刺治法,以刺络放血疗法的记载量最多。主治病症不再局限于外科病症,已包括疼痛、脏腑疾病、全身性疾病等；刺络放血部位多取四肢远端及头面部和关节处,以及某些腧穴或经脉上；并重视对血脉的观察,其颜色、形态的改变是选择刺络放血部位的重要依据；对刺络放血之法的理论提升较为明显,被纳入经络理论之中,刺络放血的部位选择和主治作用受到经脉理论的强烈影响,络脉理论对于刺络放血的解说具有重要的意义与作用。2)后世医家对刺络放血的认识,时间较长,论述却很少,仅仅是引述经文和条文,或有所发挥,在有关腧穴内容中有一定论及,基本未出经典条文的范围。极少数医家对刺络放血论述颇有新意,以张从正《儒门事亲》为主。所治病症的范围、病种,反不如《内经》面广丰富,而以局部外科病症占多数,与经脉理论的关联也不甚紧密。而在杨继洲《针灸大成》中刺血疗法注重在于活血止痛、清热解毒等治疗作用上,刺络放血部位根据不同病证而有多种选择,采用刺穴位、刺血络等方法,根据体质、季节、部位决定放血量,对于放血工具及禁忌也有所叙述但与经脉理论、相关机理的关联也不甚紧密。2.《内经》载述的刺络放血,反映了针灸理论尤其是经脉理论发展的中间环节或过渡阶段。刺络放血从早期的基本以局部痈脓出血为主,到《内经》中常与针刺腧穴合用,再到经典经脉理论确立后刺络放血的式微。可以看得出来其中的演变过程,从早期的对血脉理论的重视进入针灸学的体系,到后世医家对针刺的转向,刺血疗法逐渐逐渐的边缘化。
本次研究揭示了《内经》在刺络放血疗法史上的地位。虽然刺络放血疗法在《儒门事亲》、《针灸大成》中都有不同程度的发展,但基本上都未超出《内经》的范畴。而在现今临床应用刺络放血疗法治疗的疾病虽然较古代有所扩大,但主要还是脱离不了实证、热证、急证为主的各科疾病,针对于刺络放血的禁忌症、注意事项等等方面仍旧以《内经》为主。刺络放血疗法是传统医学疗法中最具特色的一种疗法,该疗法简便廉价、副作用较少、起效迅速值得在临床上推广及应用。
Background
Stab winding bloodletting therapy, also called the thorn blood therapy, called the "thorn blood" in neijing, is one of in the traditional Chinese medicine acupuncture has a long history and unique method of treatment. His theory foundation construction in the flesh, everything is change "on the basis of;"Chen is in addition to the" nanyang, is stab winding bloodletting therapy application solution. In162article in neijing, deals with this method there is more than60, involving stab winding bloodletting therapy principles, selection of needle, stab camp bleeding method [1-3]. Not only has many ancient doctor is good at using this method, the modern clinical also often use, so the therapy research, to improve the effectiveness of treatment, has the extremely vital significance.
Research purposes
Stab winding bloodletting, origin is very early, cover a wide range in neijing, the later the acknowledgement from generation to generation, the effect is remarkable. At present, the thorn bloodletting winding research, most of the medical books of past dynasties doctor or related knowledge, difficult to delve into, the lack of systematic analysis. System through the study of ancient literature and theoretical analysis, summing up the ancient blood use method, experience and regularity, contraindications and so on, provide a basis for modern medicine research and clinical application; Piercing and understand complex bloodletting and channels and collaterals, acupoints, acupuncture and other relevant theories, concepts and methods of correlation, and from "although things close","acupuncture dacheng" to explore analysis and summarize collaterals in the bloodletting therapy indications, contraindications, reveal neijing,"although things close","acupuncture dacheng" to today's thorn bloodletting in the clinical effect of the ice.
Research method
This study integrated use of historical documents research method, method of academic history, theoretical analysis method, combing stab winding bloodletting of related literature, from the evolution history of acupuncture and moxibustion theory academic Angle to consider thorn bloodletting therapy for the analysis understanding thorn bloodletting winding theory academic connotation and the theory of meridians academic association.
The research results and conclusions
Think this study:1. Thorn bloodletting therapy winding development process can be roughly divided into two stages:1) acupuncture treatment in neijing, with thorn bloodletting therapy recorded amount up to the ice. Attending disease is no longer limited to the surgical conditions, including pain, visceral diseases, systemic diseases, etc.; Stab winding bleed more distal limbs and head face and joints, as well as certain aperture or meridians; And attaches great importance to the observation of the blood, the color, shape change is important basis of choose thorn bloodletting winding parts; Method of thorn bloodletting winding theory to promote relatively obvious, is built into the channels and collaterals theory, thorn bloodletting role in site selection and attending winding is affected by the strong theory of meridians and collaterals theory for definitions of thorn bloodletting winding has the vital significance and role.2) the later physicians understanding of thorn bloodletting winding, time is longer, rarely, just quoting scripture and provisions, or play, discussed in relevant acupoints in content to a certain extent, basic not out the scope of the classic articles. That very few physicians on thorn bloodletting winding is quite interesting, and is given priority to with zhang from is "although things close". Scope, disease, cure diseases by the rich as neijing area wide, and with local surgical disease in the majority, and the theory of meridians is also not very closely. In Yang Jizhou acupuncture dacheng, pay attention to is to invigorate the thorn blood therapy in pain relief, heat-clearing and detoxicating therapy effect, thorn bloodletting winding parts according to different diseases and has a variety of options, the methods of acupuncture points, thorn blood, blood determined according to the constitution, season, area, for bloodletting tool and the taboo is related to but meridians theory, relevant mechanism is also not very closely.2. Presented in neijing, thorn bloodletting winding, reflects the acupuncture and moxibustion theory especially the theory of meridians in the development of the intermediate links, or a transitional phase. Stab winding bleeding from the early basic is given priority to with local carbuncle pus, bleeding, to share, often with acupuncture acupoints in neijing, stab to classical meridians theory established after winding bloodletting of decay. Can see the evolution process, from the early into the acupuncture to the attention of the veins theory system, to the later doctor for acupuncture, thorn blood therapy gradually gradually marginalized.
This study reveals the neijing in stab winding position in the history of bloodletting therapy. Although stab winding bloodletting therapy in although things close,"acupuncture dacheng" has a different degree of development, but generally not beyond the category of neijing. In current clinical application of thorn bloodletting therapy to treat the disease although the ancient winding, but mostly from the empirical and heat certificate, certificate of disease in all the subjects, for complex contraindications to bleed, and matters needing attention, etc are still predominantly neijing. Stab winding bloodletting therapy is the most distinctive of traditional medicine therapy treatments, this therapy is simple, cheap, less side effects and take effect quickly is worth in clinical promotion and application.
引文
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