“从阴引阳法”从腹治腰的临床思路探究  

A study on the clinical thinking of treating waist from abdomen based on the theory of inducing Yang from Yin

作　　者：袁世伟 朱泽智 张冰婷 陈桢华 刘思宇 YUAN Shiwei

机构地区：[1]厦门大学附属龙岩中医院,福建龙岩364000

出　　处：《中医临床研究》2024年第10期134-137,共4页Clinical Journal Of Chinese Medicine

基　　金：龙岩市科技计划项目(2022LYF17060;2022LYF17061)。

摘　　要：腰痛属中医“痹病”范畴,病位在筋、骨,中医理论认为其是因风、寒、湿邪致经筋挛缩不伸。现代医学认为腰痛的原因仍与椎间盘相关,而忽视来源于其周围肌群、关节、神经的关联。笔者在临床观察中发现,对于仅有轻微的椎间盘膨出却存在明显的疼痛症状,运用常规针刺治疗后疗效欠佳,此类腰痛常与患者腹部区域出现相关性阳性反应点密切相关。当在腰痛局部施术难以获效时,可对其腹区进行查体,并对腹区阳性点进行针刺,即从阴引阳治法可获显效。正如《黄帝内经》:“用针之要,在于知调阴与阳。”即在常规治疗收效甚微时,可应用针刺配合手法,从阴引阳,调节阴阳平衡,恢复“阴平阳秘”的状态,符合中医治病理念的阴阳整体观。笔者临证中总结腰痛的发生、轻重与脊柱的结构密切相关。大多数医师将腰痛的焦点集中在腰椎后侧,忽略腹肌和髂腰肌。又因“腹属阴,腰背属阳”,《黄帝内经》:“故善用针者,从阴引阳,从阳引阴。”有别于痹证治疗时“以痛为腧”的原则,故认为“从腹治腰”是关键。文章以腰痛治腹的诊疗为主,根据中医经络理论结合现代筋膜学理论及生物力学,基于临床实录对腰痛病的治疗经验加以阐述,以飨同道。Low back pain belongs to the category of arthralgia disease in traditional Chinese medicine,which is located in tendons and bones.TCM theory holds that it is due to the contraction of meridian tendons caused by wind,cold and dampness.Modern medicine believes that the cause of low back pain is still related to the intervertebral disc,while ignoring the relationship between the muscles,joints and nerves around it.In the clinical observation,the author found that for the patients with slight intervertebral disc bulge but obvious pain symptoms,the curative effect was not good after routine acupuncture treatment.This kind of low back pain was closely related to the positive reaction point in the abdominal area of the patients.When it is difficult to be effective in the local treatment of low back pain,physical examination can be carried out in the abdominal area and acupuncture can be carried out on the positive points in the abdominal area,that is,the method of inducing Yang(阳)from Yin(阴)can be effective.Just as Huangdi Neijing(《黄帝内经》):“The key to using needles is to know how to adjust Yin and Yang.”That is,when the conventional treatment shows little effect,acupuncture combined with manipulation can be used to induce Yang from Yin,adjust the balance of Yin and Yang,and restore the state of Yin and Yang in equilibrium.The holistic view of Yin and Yang of the treatment concept of traditional Chinese medicine are consistent.The author concludes that the occurrence and severity of low back pain are closely related to the structural function of spinal stability.Most doctors focus on the posterior side of the lumbar spine,ignoring the abdominal and iliopsoas muscles.Abdomen belongs to Yin,and waist and back belongs to Yang.Huangdi Neijing:“Therefore,those who are good at using needles will induce Yang from Yin,and induce Yin from Yang.”The above views are different from the principle of acupuncture at pain point in the treatment of arthralgia syndrome,so it is considered that“treating waist from

关 键 词：腰痛 从腹治腰 从阴引阳 针刺 手法 

分 类 号：R255.6[医药卫生—中医内科学]