基于“肾-髓-脑”轴和“阴跷脉”探析儿童遗尿症的病机及治疗思路  

Discussion on the Pathogenesis and Treatment of Children Enuresis Based on the Theory "Kidney-Marrow-Brain" Axis and "Yin Heel Channel (阴跷脉)"

作　　者：张博[1] 任献青[1,2] 傅文[1] 孙宇莹 刘晓羽 宋纯东[1] 张霞[1,2] 郭庆寅[1] 丁樱[1,2] ZHANG Bo;REN Xianqing;FU Wen;SUN Yuying;LIU Xiaoyu;SONG Chundong;ZHANG Xia;GUO Qingyin;DING Ying(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,450000;School of Pediatric Medicine,Henan University of Chinese Medicine)

机构地区：[1]河南中医药大学第一附属医院,河南省郑州市450000 [2]河南中医药大学儿科医学院

出　　处：《中医杂志》2024年第9期909-914,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金联合基金(U2004107);国家中医药管理局全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]76号);中国民族医药学会科研项目(2019KYXM-Z1107-49);河南省中医药科学研究专项(2022ZY1027,2023ZY2020);河南省中医学“双一流”创建科学研究专项(HSRP-DFCTCM-2023-2-13)。

摘　　要：以“肾生髓”理论为指导,从经脉循行和脏腑关系角度阐述阴跷脉循行路线与“肾-髓-脑”轴相一致的观点。据此认为“肾-髓-脑”轴功能失司和阴跷脉病是儿童遗尿症的核心病机,并从肾精不足、“肾-髓-脑”轴功能失司,阴跷脉病、下焦虚寒,阴跷脉病、冲脉失养三大方面进行阐述。提出以“一针二灸三巩固”整合针灸模式治疗儿童遗尿症,一针即以针刺调和阴阳、温阳补肾、醒脑开窍,重用阴跷脉穴(照海、交信)和八脉交会穴(外关、足临泣),配合百会、印堂、关元、气穴、大钟等;二灸即以艾灸扶正温阳、培本固元,可选用神阙、命门、悬枢;三巩固即以穴位贴敷巩固疗效,常用关元-膀胱俞、气海-志室、神阙-次髎3组穴位,以温肾固脱、调补气血。Guided by the theory of"kidney generates marrow",the study elaborates the viewpoint that the route of Yin Heel Channel(阴跷脉)is consistent with the"kidney-marrow-brain"axis from the perspective of the circulation of the meridians and the relationship between the zang-fu organs.Accordingly,it is believed that disease of Yin Heel Channel and dysfunction of the"kidney-marrow-brain"axis are the core pathogenesis of children enuresis,and it is elaborated from the following three major aspects,firstly,insufficient kidney essence,dysfunction of the"kidney-marrow-brain"axis,secondly,disease of Yin Heel Channel and deficiency and cold in lower jiao,and thirdly,disease of Yin Heel Channel and loss of nourishment of Chong Vessel.It is proposed to use the mode of"firstly needle,secondly moxibustion,and lastly consolidation"to treat children enuresis.Needle is to adjust yin and yang,warm yang and tonify kidney,and wake up the brain and open the orifices.The acupoints in Yin Heel Channel such as Zhaohai(KI 6),Jiaoxin(KI 8)and confluence points of the eight extraordinary vessels such as Waiguan(TE 5),Zulinqi(GB 41)are used,together with Baihui(GV 20),Yintang(EX-HN 3),Guanyuan(CV 4),Qixue(KI 13),Dazhong(KI 4).Moxibustion is to reinforce healthy qi and warm yang,bank up the root and consolidate the original qi by moxibustion at Shenque(CV 8),Mingmen(GV 4),and Xuanshu(GV 5).Consolidation is to use acupoints application to consolidate the therapeutic effect,and Guanyuan(CV 4)&Pangguangshu(BL 28),Qihai(CV 6)&Zhishi(BL 52),and Shenque(CV 8)&Ciliao(BL 32)are commonly used as the three groups of acupoints to warm the kidney and stop collapse,regulate and tonify the qi and blood.

关 键 词：遗尿症 阴跷脉 儿童 “肾-髓-脑”轴 

分 类 号：R272[医药卫生—中医儿科学]