本文選題：五腧穴 + 合穴�。� 參考：《廣州中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：目的：本文對唐代及唐代以前的針灸文獻(xiàn),通過統(tǒng)計(jì)主治病癥對應(yīng)合穴的頻次,對比合穴與下合穴、合穴與原穴主治的異同,以探求合穴總體的治療病癥規(guī)律以及單個(gè)合穴的主治特點(diǎn),從而為建立合穴適宜病癥譜及臨床應(yīng)用與科研提供文獻(xiàn)及理論基礎(chǔ)。方法：一、源文獻(xiàn)選擇在《中國中醫(yī)古籍總目》、《宋以前醫(yī)籍考》、《中國醫(yī)籍通考》書籍中查找唐代及以前的針灸類、醫(yī)經(jīng)類、內(nèi)科、外科、婦科、產(chǎn)科、兒科類,對52部可能涉及合穴的醫(yī)籍按標(biāo)準(zhǔn)篩選,最終選定：《黃帝內(nèi)經(jīng)》、《針灸甲乙經(jīng)》、《難經(jīng)》、《黃帝內(nèi)經(jīng)太素》、《千金要方》、《千金翼方》和《外臺秘要》共七部醫(yī)籍。二、版本選擇中醫(yī)博大精深,古籍?dāng)?shù)目汗牛充棟。但因編輯、傳抄、刻版、增刪、修改和刻寫的文字大小、版面闊狹、印刷粗精及排版或裝訂的各種形式不同,同一本書籍就會產(chǎn)生不同版本。因此,本研究參考知名針灸文獻(xiàn)研究員著作,鑒定上述醫(yī)籍的版本,制作版本源流圖,選擇經(jīng)現(xiàn)代學(xué)者精選底本校正、較接近原書本來面目之版本作為源文獻(xiàn)。三、各醫(yī)籍所載合穴定位法和取穴法對比進(jìn)行腧穴主治歸納必須建立在各醫(yī)籍腧穴相同的基礎(chǔ)上,即建立在各醫(yī)籍中所研究腧穴的定位和取穴法必須一致的基礎(chǔ)上,否則極易導(dǎo)致張冠李戴的現(xiàn)象。因此,在檢索分析之間,首先有必要考證各醫(yī)籍的定位方法和取穴方法。四、文獻(xiàn)檢索策略在《中華醫(yī)典》中運(yùn)用計(jì)算機(jī)檢索后配合人工檢索上述所選典籍,分別以十二合穴、手三陽經(jīng)原穴和十二原穴的名稱及別名逐條搜索全文,并按標(biāo)準(zhǔn)篩選條文。五、數(shù)據(jù)標(biāo)準(zhǔn)化和數(shù)據(jù)庫建立建立標(biāo)準(zhǔn)數(shù)據(jù)庫前對病名進(jìn)行規(guī)范化,將穴名、文獻(xiàn)來源、病癥、疾病類屬、病位、刺灸法、定位等六項(xiàng)內(nèi)容利用Microsoft Access建立資料數(shù)據(jù)庫。六、分析結(jié)果采用歸類分析、歸納演繹、傳統(tǒng)闡釋、相關(guān)對比等方法對合穴適宜病癥進(jìn)行分析。結(jié)果：一、版本的選擇七部醫(yī)籍對應(yīng)較佳版本分別為：《素問》傳本中明顧從德翻刻宋本較接近宋刊本,校勘質(zhì)量較佳。《靈樞經(jīng)》傳本中以趙府居敬堂本流傳最廣,制作較佳�！峨y經(jīng)》以注本流傳,較好的版本有二,一是《難經(jīng)集注》,二是《難經(jīng)本義》。前者以“慶安本”為佳。后者以“醫(yī)統(tǒng)正脈本”為佳。現(xiàn)存《甲乙經(jīng)》為醫(yī)籍中傳世版本較差的醫(yī)籍,相對而言“六經(jīng)本”年代最早�！短亍贰叭屎退卤尽睘楝F(xiàn)存各個(gè)刊本的唯一祖本,文獻(xiàn)價(jià)值最高�！秾O真人千金方》未經(jīng)北宋校正醫(yī)書局校正的《千金要方》古本,研究價(jià)值極大�！肚Ы鹨矸健返摹霸蟮驴尽笆乾F(xiàn)存最早的復(fù)刊本,為宋版最佳翻刻本�！锻馀_秘要方》最佳版本為日本敬嘉堂的南宋刻本。二、各醫(yī)籍合穴定位法和取穴法對比七部醫(yī)籍中十二合定位與現(xiàn)代臨床不同的有曲澤穴、尺澤穴。其余諸穴基本相近。七部醫(yī)籍中同一合穴在不同醫(yī)籍中的定位及取穴方法基本一致,排除了此六部醫(yī)籍中合穴出現(xiàn)“同名異穴”的可能性。三、各醫(yī)籍的關(guān)系所選文獻(xiàn)中,年代較晚的醫(yī)籍常大量引錄較早的醫(yī)籍�！秲�(nèi)經(jīng)》和《明堂經(jīng)》是腧穴理論的來源,后者現(xiàn)已散佚,但被《甲乙經(jīng)》大量的收錄�！肚Ы鹨健冯蜓ㄖ髦味嘁涀浴都滓医�(jīng)》和《內(nèi)經(jīng)》,而《千金翼方》又大量引錄《千金要方》,《外臺秘要卷39》引自《甲乙經(jīng)》,散在其他各卷腧穴主治大多來自《千金翼方》。四、十二合穴統(tǒng)計(jì)結(jié)果唐代及唐代以前的醫(yī)籍中,合穴主治病癥98種。出現(xiàn)頻次最高者為癲病,有七個(gè)合穴可治療,涉及手、足、陰經(jīng)、陽經(jīng),因此合穴可普遍治療癲病。頻次為五個(gè)及以上的病癥有腹痛、頭痛、癲、腹脹、善驚、嘔、寒熱、狂、陰痛九個(gè)病癥,其中三個(gè)脾系病,足三里穴同時(shí)出現(xiàn)在三個(gè)病癥中,可見合穴擅長治療消化系統(tǒng)疾病,足三里尤甚。可治療“逆氣而泄”的僅有尺澤和足三里。五、單個(gè)合穴統(tǒng)計(jì)結(jié)果尺澤主治肺病及本經(jīng)病之外,還可療心痛、疝瘕、唾血、癲、嘔、泄、噦。曲澤穴主治心病及本經(jīng)病。少海穴的主要治療病癥為齒痛、狂、臂疼、腋下瘰疬等。小海穴主治頭痛、癲癇、寒熱、瘧等疾。天井穴主治胸痹心痛,上肢痹、痿等疾。曲池穴主治本經(jīng)病及風(fēng)邪相關(guān)疾病。陰陵泉、陰谷、曲泉穴主治本臟和本經(jīng)病癥。委中穴主治本腑和本經(jīng)疾病。陽陵泉穴可療本腑、相表里臟和本經(jīng)疾患。足三里可療本臟、本腑、大腸腑、小腸腑和胃經(jīng)的病癥。六、合穴和手三陽經(jīng)下合穴對比上巨虛穴治療病癥主要集中在脾胃系統(tǒng),肺系統(tǒng)和肢體經(jīng)絡(luò)類的疾病,即臟腑病癥兼經(jīng)絡(luò)病均可療。下巨虛穴較多治療肢體經(jīng)脈類、脾胃系類、肺系類、肝系及心系疾病。委陽穴治療腎系病、肛門病和肢體經(jīng)絡(luò)疾病。七、合穴和原穴對比太淵穴主要治療肺系病和肢體經(jīng)絡(luò)病,其中咳嗽、肺脹滿、喘屬于肺臟疾病,胸痹、胸痛、肘臂痛屬于經(jīng)脈所過,亦可療五官疾病。合谷穴主要治療上肢痿、上肢痹、頭面五官疾病,為大腸經(jīng)經(jīng)脈所過之病癥。亦可療大腸腑病如腸鳴。太白穴多治療脾臟病,脾臟虛實(shí)之證、脾經(jīng)所過治病均可治療。沖陽穴主要治療胃經(jīng)所過之病。其中頭痛、牙痛、面浮腫、足痹、痿及口僻等均屬于胃經(jīng)疾患。可見神門穴主要治療本臟疾患,兼本經(jīng)疾病。腕骨穴主要治療小腸經(jīng)所過之處疾患及與風(fēng)邪相關(guān)疾病。太溪穴對腎系病、心系病、肺系病及脾系病均有治療作用,可療五臟疾病。京骨穴多治療膀胱經(jīng)所過之處病癥。大陵穴既可治心臟疾病和本經(jīng)所過疾病。太沖穴對肝臟病和肝經(jīng)病均可療。丘墟穴主治膽經(jīng)所過之處疾患。結(jié)論：自《內(nèi)經(jīng)》《難經(jīng)》提出合穴主治“病在府”“逆氣而泄”和“病在胃及以飲食不節(jié)得病者”后,歷來對其理解有所爭論,本研究通過對唐代及唐代前的合穴相關(guān)醫(yī)籍進(jìn)行分析,發(fā)現(xiàn)其中“病在府者治其合”應(yīng)解為治療六腑疾病的是下合穴。并不是所有合穴均可治療“逆氣而泄”,主要是指尺澤穴和足三里穴。并非所有合穴均可治療脾胃系統(tǒng)疾病,手三陽經(jīng)合穴大多不治療消化系統(tǒng)疾病。此外合穴總體的主治病癥有98種之多,癲疾排首位。從下合穴和原穴的主治分析得出：在唐代及唐代以前手三陽經(jīng)之合穴較少治療腑病,偏重肢體經(jīng)脈疾病、心系和肺系疾病。而小腸、大腸和三焦下合于足陽經(jīng)的委陽穴、上巨虛穴和下巨虛穴則擅長治療本腑疾病,兼治本經(jīng)之經(jīng)脈所過疾患。可見,從在唐代及唐代以前醫(yī)籍的分析來看,“病在府者治其合”之“合”當(dāng)理解為下合穴更佳。原穴作為元?dú)饨?jīng)過、留止的部位,側(cè)重臟病。陰經(jīng)的原穴治療臟病和本經(jīng)疾患,六陽經(jīng)原穴多治療本經(jīng)病癥。
[Abstract]:Objective: To investigate the frequency of acupuncture and moxibustion before the Tang Dynasty and the Tang Dynasty, compare the similarities and differences between the combined acupoint and the Xiuhe acupoint and the main points of the original acupoint by the statistics and treatment of the corresponding acupoints of the corresponding acupoints, in order to find out the rules of the general treatment of the acupoints and the main characteristics of the single acupoints, so as to provide the suitable disease spectrum, clinical application and scientific research for the construction of the acupoint. Literature and theoretical basis. Methods: first, the source literature selection in the Chinese traditional Chinese medicine ancient books, "song before medical examination", < Chinese medical examination > book examination books in the Tang Dynasty and the previous acupuncture, medicine, medicine, surgery, gynecology, obstetrics, paediatrics, 52 may involve the medical records of acupoints, the final selection: < Huangdi Neijing >, < needle. Moxibustion, moxibustion, "Jing", "Huangdi", "Huangdi", "Qianjin", "thousand gold", "thousand gold wing Fang >" and "outer platform secret", are seven medical books. Two, the version selection of Chinese medicine is extensive and profound, and the number of ancient books is abundant. But the size of editing, copying, engraving, adding and deletions, the size of the revised and inscribed text, the width of the layout, the printing rough and the various forms of typesetting or binding are different. A book will produce different versions. Therefore, this study, referring to the works of well-known acupuncture literature researchers, identifies the editions of the medical records, the source flow chart of the editions, and the selection of the original edition of the modern scholar, which is closer to the original version of the original book as the source literature. Three, the acupoint location method and the acupoint method carried on the medical books are compared to the acupoints. The main treatment induction must be based on the same basis of the acupoints of various medical books, that is, on the basis of the location of acupoints and the method of taking acupoints in the medical records, which is very easy to lead to the phenomenon of the opening of the acupoints. Therefore, in the search and analysis, it is necessary to test the location method and the method of taking acupoints of the medical records first. Four, the literature retrieval strategy. After the use of computer retrieval in the Chinese medical code, the selected classics were searched by computer, and the names and names of the original points and the twelve original points were searched for the full text by twelve points, the names of the original points and the twelve original points were searched separately. Five, the standard database was established to standardize the name of the disease before setting up the standard database. Source, disease, disease class, disease, location, pricking and moxibustion, location and other six items to use Microsoft Access to establish data database. Six, the analysis results are classified analysis, induction, traditional interpretation, correlation and other methods to analyze the suitable disease of acupoints. Results: 1, the version of the selection of seven medical versions of the better versions are: < In the transmission book, the song edition is closer to the song edition than the song edition, and the quality of the collation is better. The existing < Jia a Jing > as a medical book of poor medical records in medical books is the earliest. < Tai Su > "benevolence and monastery" is the only grandparent of the existing publications. The value of the literature is the highest. "Yuan dad publication" is the earliest extant copy book, the best edition for the song edition. The best version of the "outer table" is the Southern Song of the Southern Song Dynasty. Two, the location method and the acupoint method of the medical books are compared with the seven medical books, which are different from the modern clinic. The other points are basically similar. In the seven medical books, the other points are similar. The location of the same acupoint in the different medical records and the method of taking acupoints are basically the same, excluding the possibility of "the same name different points" in the six medical books. Three, in the literature selected by the medical records, the later medical books often lead to the earlier medical records. The < Jing > and the Ming Tang Jing are the sources of the theory of acupoints, the latter has been lost, but the latter has been lost. < Jia Jing > a large number of records. < thousand gold prescription > the main treatment of acupoints is recorded from < Jia b > and < inner Sutra >, and < Qianjin wing recipe > a large number of quotes of Qianjin prescription >, "outer platform constipation 39>" is introduced from < Jia Yi Jing >, mostly from < thousand gold wing prescription >. Four, twelve acupoints statistics result in Tang and Tang Dynasty medical books, in the medical records of the Tang Dynasty, to the acupoints There are 98 kinds of disease. The highest frequency is epilepsy, and seven acupoints can be treated. It involves hand, foot, Yin meridian and Yang Meridian. Therefore, it is common to treat epilepsy. There are five or more cases with abdominal pain, headache, epilepsy, abdominal distention, nine symptoms of good shock, vomiting, cold and fever, and negative pain, of which three spleen diseases and the three ailments at the Zusanli point simultaneously. In the treatment of digestive diseases, it is very good for the treatment of digestive diseases. The only ulnar and Zusanli can be used to treat "anti gas and vent". Five, single acupoint statistics result in the main treatment of lung disease and the meridian disease. Pain, madness, arm pain, axillary struter and so on. Xiao Hai acupoint mainly treats headache, epilepsy, cold and fever, malaria and other diseases. Tianjing point is the main treatment for chest pain and heart pain, upper limb arthralgia, impotence and other diseases. The main treatment of this disease and wind pathogenic diseases. Yin mausoleum, Yin Valley, Qu Quan points to treat the dirty and the disease. The disease of Zusanli can treat the dirty, the Zang Fu, the large intestine, the small intestine and the stomach. Six, the combination of the acupoints and the three Yang meridian points is mainly concentrated in the spleen and stomach system, the lung system and the meridian diseases of the limb and collaterals, that is, the viscera disease and the meridian disease can be treated. Class, lung, liver and heart disease. The treatment of kidney disease, anal disease and extremity meridian disease. Seven, acupoint and original point Taiyuan acupoint mainly treatment of lung disease and limb meridian disease, including cough, lung fullness, lung disease, chest pain, chest pain, elbow arm pain, may also treat five diseases. Hegu acupoint is the main treatment. Limb flaccid, upper limb arthralgia and five diseases of the head and face, it is the disease of the large intestine through meridians. It can also treat the disease of the large intestine, such as the bowel disease. It can treat spleen disease, spleen deficiency and real syndrome, spleen meridian treatment can be treated. The main treatment of the disease of the stomach meridian is Chong Yang point. The main treatment of the disease. The main treatment of the disease. The carpal point is mainly to treat the diseases of the small intestine and the disease related to the wind. The point of the Tai Xi point has the therapeutic effect on the kidney disease, the heart system, the lung system and the spleen system. It can treat the diseases of the five zang organs. The disease. It can treat the liver disease and the liver meridian disease. Qiu Xu point is the main treatment of the disease of the bile. Conclusion: since the "inner meridian >" > < difficult menstruate > the main treatment of the disease in the house, "the disease is in the stomach and the diet is not diseased person". According to the analysis of the related medical records of the acupoints, it is found that the "disease in the government" should be solved for the treatment of the disease of the six Fu organs. Not all the acupoints can treat the "retrograde Qi", mainly refers to the ulnar acupoint and Zusanli point. Not all the acupoints can treat the spleen and stomach system diseases, and the most of the three yang meridians do not treat the digestive system diseases. In addition, there are 98 kinds of disease and disease in the main disease of the total acupoints. From the main treatment of the next point and the original point, it is concluded that the combination of the three yang meridians of the hands of the Tang Dynasty and the Tang Dynasty had less treatment for the Fu Fu and the diseases of the extremity meridians, the heart system and the lung system. The virtual acupoint is good at treating the disease of the Fu Fu organs. It can be seen that, from the analysis of the medical records of the Tang and Tang Dynasties, the "combination" of "the disease in the government" is better understood as the better down acupoint. The original point is used as the yuan Qi, the site of the retention and the visceral disease. The original point of the Yin meridian is used to treat the viscera and the disease, and the six Yang Meridian is used. Most of the original points are treated by the disease.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R245

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