从“以痛为腧”探讨局部针刺对肢体继发性淋巴水肿的治疗机理  

Therapeutic mechanism of local acupuncture for secondary lymphedema of limbs based on the theory of"treating where it hurts"

作　　者：牛少辉 李贝[2] 程亚清 王唱 顾汉程 曹刚 黄强 曹建春 NIU Shaohui;LI Bei;CHENG Yaqing;WANG Chang;GU Hancheng;CAO Gang;HUANG Qiang;CAO Jianchun(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091;Beijing Emergency Medicial Center;Dongfang Hospital,Beijing University of Chinese Medicine)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]北京急救中心 [3]北京中医药大学东方医院

出　　处：《现代中医临床》2023年第5期113-116,共4页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金面上项目(No.81874473);北京中医药大学基本科研业务在读研究生项目(No.2019-JYB-XS-219);2019年度丰台区卫生健康系统科研立项一类项目(No.2019-71)。

摘　　要：从肢体继发性淋巴水肿的病因病机入手,认为本病病性“标实本虚”。标实者,金刃外邪损害经络,经络不通,血不利则为水;本虚者,水湿瘀血久留,久病伤正致虚。针灸具有疏通经络、祛邪扶正的作用,“以痛为腧”是临床针灸的重要指导理论和取穴原则。局部针刺治疗肢体继发性淋巴水肿符合本病本虚标实的病机,本病病位在局部,痛之所在,邪之所存,邪之所凑,其气必虚,局部针刺治疗本病就近逐之,疏通经络。与中药口服发挥作用的方式不同,局部针刺可以针对病灶、直接作用于病位,发挥更为直接的“疏通经络、驱邪扶正”的作用,达到治疗目的。Based on the etiology and pathogenesis of secondary lymphedema of the extremities,it is believed that the nature of this disease is a combination of"excessas the branch and deficiency as the root".For those with excess as the branch,injuries caused by metal or external pathogens damage the collateralsand obstruct the circulation of qi and blood,leading to fluidaccumulation when blood circulation is impeded."Deficiency as the root"refers to the prolonged presence of dampness,stagnated blood,and chronic illness damaging the body′s righteous qi.Acupuncture and moxibustion have the functions of promoting collateralcirculation,expelling pathogenic factors,and supporting the righteous qi.The principle of"treating where it hurts"is an important guiding theory and technique for acupuncture in clinical practice.Localized acupuncture therapy for secondary lymphedema of the extremities corresponds to the pathogenesis of both"excess as the branch"and"deficiency as the root".The disease primarily manifests locally.Where pain occurs,pathogenic factors reside,and gather.Therefore,the qi in these areas is deficient.Treating secondary lymphedema with local needling therapy focuses on the affected area,unblockingcollaterals.Unlike the mode of action of orally administered herbal medicine,localized needling therapy can directly target the lesion,exerting a more direct effect of"promoting collateralcirculation,expelling pathogenic factors,and supporting righteous qi",thus achieving the therapeutic goal.

关 键 词：肢体继发性淋巴水肿 针刺 以痛为腧 理论探讨 

分 类 号：R245[医药卫生—针灸推拿学] R26[医药卫生—中医临床基础]