从“衄乃解”探讨刺络疗法配合益气养阴法治疗痤疮病的运用思路  

Treatment Ideas of Acne with Blood-letting Puncture and Cupping Based on“Healing after Bleeding”and“supplementing qi and nourishing yin”Theory

作　　者：盛瑜 刘灿 黄莺[1] SHENG Yu;LIU Can;HUANG Ying(Dermatology Department,The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610072;College of Acupuncture-Moxibustion and Tuina,Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610072)

机构地区：[1]成都中医药大学附属医院皮肤科,四川成都610072 [2]成都中医药大学针灸推拿学院,四川成都610072

出　　处：《按摩与康复医学》2023年第6期80-83,共4页Chinese Manipulation and Rehabilitation Medicine

基　　金：成都中医药大学临床医学院研究生重点课题(CXZD2021011)。

摘　　要：刺络疗法治疗痤疮效果显著,但目前各种操作方式不一,现有理论不能详尽指导临床操作。因此,本文从《伤寒论》46条“衄乃解”入手,讨论“血汗同源,衄可代汗”的机制;同时从“阳明主面”理论出发,归纳整理“皮部-孙脉-络脉”理论的皮表层次,提出了“阳郁初起,针刺宜浅,见血即止”,“壅而成疮,针刺其周,血变乃止”以及“久病入络,针刺宜深,血尽乃止”的操作范式;并指出气血充足为运用刺络疗法的前提,津液脱失为刺络疗法的禁忌症,基于此浅析了黄莺教授“布雾汤”配合刺络疗法治疗痤疮的用药经验,以期为临床提供参考。Blood-letting puncture and cupping is an effective treatment of acne.However,there are different operational paradigms at present,probably because the existing theories are not perfect and cannot guide the specific clinical operation.Therefore,this paper discusses the mechanism of“blood and sweat have the same origin,and blood can replace sweat”based on“healing after bleeding”,Article 46 of the Treatise on Typhoid Fever.At the same time,based on the theory that“Yangming meridians dominate the face”,we summarized the theory of“Muscle regions-Minute collaterals–Collaterals”of the skin surface,and proposed the operational paradigm of“When yang qi has just begun to stagnate,shallow needling is appropriate,with a small amount of bleeding as a sign of cessation”,“The congestion of qi will evolve into acne,and needling the area around it is appropriate,with the change in blood color as a sign of cessation”,“Long-term pathological state will affect the collaterals,deep needling is appropriate,with no more bleeding as a sign of cessation”.It is also pointed out that sufficient qi and blood is a prerequisite for the use of blood-letting puncture and cupping,and loss of fluid is a contraindication to this therapy,based on which we analyze Professor Huang Ying's experience in the treatment of acne with"Buwu Tang"and acupuncture therapy for clinical reference.

关 键 词：刺络疗法 痤疮 十二皮部 络脉 阳明病 

分 类 号：R246.7[医药卫生—针灸推拿学]