血海取穴方法探讨  

Discussion on methods for locating Xuehai(SP10)acupoint

作　　者：徐沙丽 钟晓玲 纪峰[1] 陈采益[1] 罗彩云 林驰[1] XU Sha-li;ZHONG Xiao-ling;JI Feng;CHEN Cai-yi;LUO Cai-yun;LIN Chi(College of Acupuncture and Moxibustion,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;The Third People’s Hospital,Fujian University of Traditional Chinese Medicine,Fuzhou 350108)

机构地区：[1]福建中医药大学针灸学院,福州350122 [2]福建中医药大学附属第三人民医院,福州350108

出　　处：《针刺研究》2022年第2期185-188,共4页Acupuncture Research

基　　金：福建省自然科学基金资助项目(No.2018J05140);国家自然科学基金青年项目(No.82004457)。

摘　　要：血海定位明确,但取法模糊,造成针灸临床取穴不统一,疗效受影响,针灸教学中初学者因无法准确取穴而困惑。问题主要在于:(1)运用骨度分寸法结合体表标志法时,取穴的姿势应为伸膝还是屈膝无定论;(2)运用前述方法时遇到股内侧肌肉菲薄、体表投影模糊者找寻肌肉隆起最高点有难度;(3)血海简便取穴法应用广泛,是否可以替代前述方法而实现精准定穴?以问题为导向,笔者回顾历年教材和相关针灸著作,查阅有关文献,探析血海的标准定位、标准取穴以及简便取穴方法。综合各家观点,笔者认为血海当于伸膝姿势取穴,先用骨度分寸法髌底至髌尖2寸定出"髌底内侧端上2寸"的横坐标;再用体表标志法,令患者绷腿收缩股内侧肌,肌肉隆起明显者,最高点是穴,隆起不明显者可取股内侧肌内外缘之中线为纵坐标,与横坐标相交而定穴。简便取穴法操作易产生误差,虽有参考价值,但不能替代骨度分寸法和体表标志法。The position of Xuehai(SP10)is clear,but its locating method is vague,resulting in the disunity of clinical application and even possibly affecting the curative effect.Also,when learning the meridians and acupoints,the beginners are often confused by this issue possibly due to:(1)when the bone-length proportional measurement combined with anatomic symbol(combination method)was adopted,it is not clear that the patient should take a posture of knee extension or knee flexion;(2)when the combination method used,it is difficult to find the highest point of muscle eminence in the case of patient with thin vastus medialis muscle and fuzzy body surface projection;(3)the simple method for locating SP10 is widely used at present,can it replace the combination method to locate this acupoint accurately?Guided by these questions,we,in the present paper,reviewed the rela-ted textbooks,works and other literature to explore the standard position of SP10,and the standard and simple methods for locating this acupoint.Comprehending various opinions,we hold that SP10 should be positioned under the extended knee posture,then,the acupoint’s horizontal ordinate“2 cun superior to the medial end of the base of the patella”is determined by using bone-length proportional measurement to measure 2 cun from the bottom to the tip of the patella.Then,the body surface anatomic symbol method is used,when,the patient is asked to stretch the leg and contract the vastus medialis muscle,the highest spot of muscular eminence is the SP10.If the patient’s muscular protuberance is not obvious,the middle line between the medial and lateral margins of the vastus medialis muscle is used as the vertical ordinate,and its intersection with the abscissa is SP10.The simple method is easy in operation and has a reference value,but may frequently produce errors,hence,it is not a substitution for the combination method.

关 键 词：血海 腧穴定位 骨度分寸法 体表标志法 

分 类 号：R245.2[医药卫生—针灸推拿学]