基于针刺治疗肌筋膜疼痛机制的经络实质思考  

Reflection on the Essence of Meridians and Collaterals Based on the Mechanism of Acupuncture in the Treatment of Myofascial Pain

作　　者：白震民[1] 谢俊 闫妙娥 王亚 王干一 熊仕经 康佳 李春日[4,6] BAI Zhenmin;XIE Jun;YAN Miaoe;WANG Ya;WANG Ganyi;XIONG Shijing;KANG Jia;LI Chunri(Beijing Sport University,Beijing 100084,China;Dongcheng District Maternal and Child Health Hospital,Beijing 100007,China;The First People's Hospital of Chengdu City,Chengdu 610041,Sichuan,China;Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Beijing Gulou Hospital of Chinese Medicine,Beijing 100009,China;Confucius Classroom of Traditional Chinese Medicine at Slovak Medical University,Banska Bystrica 97405,Slovak Republic)

机构地区：[1]北京体育大学,北京100084 [2]北京市东城区妇幼保健院,北京100007 [3]成都市第一人民医院,四川成都610041 [4]辽宁中医药大学,辽宁沈阳110847 [5]北京鼓楼中医院,北京100009 [6]斯洛伐克医科大学,斯洛伐克共和国班斯卡·比斯特里察州97405

出　　处：《辽宁中医药大学学报》2022年第11期12-16,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：北京中医药薪火传承“3+3”工程室站分站项目(京中医科字[2021]75号);北京高校“优质本科教材课件”(重点)项目(京教函[2020]463号);北京体育大学本科教育教学改革项目(BSUJGLX2020yb04)。

摘　　要：激痛点在定位和功能上与穴位有高度相似之处,在经络理论指导下的针刺治疗肌筋膜疼痛过程中与激痛点定位一致的穴位选穴总是不可避免,且这些治疗点发挥着重要作用。目前在肌筋膜疼痛治疗临床中,激痛点选穴已经成为主要指导原则,是传统针灸与现代肌筋膜理论结合的成果。经络学说是中医理论体系的重要基石,一直指导着针灸临床实践。然而,经络系统的解剖学基础尚未确定,虽然目前形成诸多假说,但迄今未能形成统一的定论,阻碍针灸研究的进一步创新与发展。针刺治疗肌筋膜疼痛疾病的激痛点及穴位的临床研究及基础研究启发了诸多经络实质相关的思考,文章总结分析近年来针刺治疗肌筋膜疼痛疾病的文献,着眼于临床机制分析及实验研究成果,基于最为经典的血管、神经、蛋白耦连带等相关经络实质假说,探讨经络实质,进而分析经穴及阿是穴与激痛点的相关性,基于肌筋膜及激痛点呈现穴位到经络的新视角,探索整理基于肌筋膜的经络系统的解剖学基础及功能,提供对经络实质有更加清晰的认识。In the process of acupuncture treatment of myofascial pain under the guidance of meridian theory,the selection of acupoints consistent with the location of trigger points is always inevitable,and these treatment points play an important role. At present,in the clinical treatment of myofascial pain,the selection of acupuncture points has become the main guiding principle,which is the combination of traditional acupuncture and modern myofascial theory. Meridian theory is an important cornerstone of the theoretical system of traditional Chinese medicine,which has been guiding the clinical practice of acupuncture.However,the anatomical basis of the meridian system has not been determined. Although many hypotheses have been formed,a unified conclusion has not been formed so far,which hinders the further innovation and development of acupuncture research. The clinical and basic research on the trigger points and acupoints of acupuncture in the treatment of myofascial pain has inspired many thoughts related to the essence of meridians. This paper summarizes and analyzes the literature on acupuncture treatment of myofascial pain in recent years,focuses on the analysis of clinical mechanism and experimental research results,and discusses the essence of meridians based on the most classical hypothesis of meridian essence,such as vascular,nerve and protein coupling. Furthermore,it analyzes the correlation between meridian acupoints and Ashi acupoints and trigger points,and presents a new perspective from acupoints to meridians based on myofascial and pain points. To explore and sort out the anatomical basis and function of the meridian system based on myofascial system,so as to provide a clearer understanding of the essence of meridians.

关 键 词：针刺 肌筋膜疼痛综合征 经络实质 激痛点 穴位 

分 类 号：R245[医药卫生—针灸推拿学]