苟春雁主任运用“外四关穴”临床经验撷要  

Chief physician GOU Chunyan's clinical experience in the application of Wai Si Guan points

作　　者：于本画 豆江移 王毅刚[2] 苟春雁 YU Benhua

机构地区：[1]成都中医药大学,四川成都611137 [2]重庆市中医院,重庆400020

出　　处：《中医临床研究》2024年第22期85-89,共5页Clinical Journal Of Chinese Medicine

基　　金：【苟春雁】2024年重庆市医学领军人才项目(渝财社[2024]61号),王毅刚全国名中医工作室。

摘　　要：关于“四关”的定义,历代学者颇有争议。自明代徐凤在《针灸大全》正式提出“四关穴”这一词始,后世医家多将四关穴定义为手足的合谷、太冲四穴。然而,追溯《灵枢》原文记载,仍有许多医家指出合谷、太冲只是作为“四关”的举例,并不能代表“四关”的完整含义。研究根据《灵枢》所载“四关”定义及腧穴自身特性,通过将内四关、外四关对比,引申出外关穴、足临泣穴为“外四关穴”的讨论。外关穴、足临泣穴作为窦汉卿《针经指南》中所载八脉交会穴,既能治疗手、足少阳经本经的病变,还可治疗经气所通的奇经病变。苟春雁主任因其与传统“合谷穴、太冲穴”相配伍的“内四关穴”在结构部位上有其共性,在经络功能上互为补充,而将其总结为“外四关穴”。较之传统“内四关穴”,“外四关穴”具有转枢、调神开郁、调节诸经、溢蓄气血、调养经筋等功能。苟春雁主任临床运用“外关穴、足临泣穴”配伍,注重穴法相应,将处方遣穴与针刺手法相结合,形成了独特的临床诊疗经验。“外四关穴”在对神志病、月经病、胸胁腰腹部疾病、头面疾病等的治疗中具有重要的应用价值,为中医针灸治疗提供了一种有效的选择。There has been considerable controversy among scholars regarding the definition of Siguan(四关) in the history of traditional Chinese medicine. Since XU Feng's Complete Works of Acupuncture and Moxibustion in the Ming Dynasty first formally proposed the Siguan points, later generations of medical practitioners mostly defined the Siguan points as Hegu(LI4) and Taichong(LR3) acupoints. However, when tracing back to the original text of Ling Shu(《 灵枢 》), many medical scholars have pointed out that Hegu point and Taichong point are just examples mentioned in the text, and cannot represent the complete meaning of Siguan points. This article, based on the definition of Siguan points as recorded in Ling Shu Jing and the characteristics of the acupoints themselves, contrasts the internal and external Siguan points, leading to a discussion on the inclusion of Waiguan(SJ5) and Zulinqi(GB41) as external Siguan points. Waiguan point and Zulinqi point, as recorded in DOU Hanqing's Guide to Acupuncture are the confluence points of eight extraordinary meridians. They can not only treat the diseases of the hand and foot Shaoyang meridians, but also treat the diseases of extra meridians. Chief physician GOU Chunyan categorized Waiguan and Zulinqi as Wai Siguan points due to their structural similarity and complementary meridian functions with the traditional internal Siguan points(内四关) of Hegu point and Taichong point. Compared to the traditional internal Siguan points, the external Siguan points possess functions such as pivot transformation, spirit regulation, adjustment of various meridians, accumulation and nourishment of Qi and blood. Chief physician GOU Chunyan's clinical application of the combination of Waiguan point and Zulinqi point emphasizes the correspondence of acupoint methods, integrating prescription selection with acupuncture techniques, thereby forming unique clinical diagnostic and treatment experience. The external Siguan points have significant clinical application value in the treatment of c

关 键 词：外关穴 足临泣穴 四关穴 针灸 八脉交会穴 

分 类 号：R249[医药卫生—中医临床基础]