本文選題：金伯華 + “金氏針法要論”��； 參考：《北京中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：本文是本學(xué)生跟師金伯華教授學(xué)習(xí)三年來(lái),對(duì)金老學(xué)術(shù)思想、臨床經(jīng)驗(yàn)較系統(tǒng)的學(xué)習(xí)總結(jié)。主要包含四方面內(nèi)容：金伯華教授學(xué)術(shù)思想淵源、金伯華教授學(xué)術(shù)思想概述、金伯華教授診療經(jīng)驗(yàn)、金氏華佗夾脊督脈溫針灸治療強(qiáng)直性脊柱炎腎虛督寒證的臨床研究。1金伯華教授學(xué)術(shù)淵源金伯華教授學(xué)術(shù)思想形成,主要包括(1)參軍學(xué)醫(yī),抗美援朝：華北軍政大學(xué)白求恩醫(yī)校學(xué)習(xí)和朝鮮戰(zhàn)場(chǎng)戰(zhàn)傷搶救,打下了堅(jiān)實(shí)的西醫(yī)基礎(chǔ)；(2)中醫(yī)之路,名家熏陶：通過(guò)第二中醫(yī)門診部和北京中醫(yī)醫(yī)院學(xué)習(xí)工作,吸取金針王樂亭、賀普仁、夏壽人等針灸名家學(xué)術(shù)精華；(3)精研典籍,風(fēng)格獨(dú)特：通過(guò)中醫(yī)經(jīng)典大專班和四部經(jīng)典著作研究班學(xué)習(xí),精讀《黃帝內(nèi)經(jīng)》、《傷寒論》、《針灸大成》等中醫(yī)典籍,形成自己風(fēng)格獨(dú)特的針、灸、藥并用的臨床診療思路和金氏針法操作技法。(4)中西結(jié)合,攻克疑難：主持北京市科委“八五攻關(guān)規(guī)劃——中藥研制‘追風(fēng)速’注射液穴位注射及針灸治療類風(fēng)濕性關(guān)節(jié)炎”研究,取得國(guó)家專利。項(xiàng)目研究報(bào)告、學(xué)術(shù)論文獲“北京市衛(wèi)生局科技成果獎(jiǎng)”及世界傳統(tǒng)醫(yī)學(xué)“生命力杯”獎(jiǎng)。2金伯華教授學(xué)術(shù)思想概述結(jié)合金老《金氏針灸臨床精粹》、《金伯華痹證治驗(yàn)集》、《針壇巾幗金伯華》等專著,根據(jù)金伯華教授針灸方要理論及臨床跟師所得,深化和升華金老學(xué)術(shù)觀點(diǎn),創(chuàng)新性的總結(jié)提出由：“治病求源、病多氣郁”,“診法獨(dú)到、觀察入微”,“以調(diào)為要、心腎為綱”,“針?biāo)幉⒂�、相得益彰�?“善用單穴、手針治痛”,“刺法手法、自成一家”等六方面要素組成的“金氏針法要論”。2.1以《內(nèi)經(jīng)》理論為指導(dǎo),臨證必謹(jǐn)守中醫(yī)整體觀念、辨證施治之基本大法,治病必求其源。強(qiáng)調(diào)對(duì)疑難雜癥須追根溯源,認(rèn)為氣郁致病為當(dāng)今主要病機(jī)。2.2診斷方法獨(dú)到,注重經(jīng)絡(luò)局部診察,如中風(fēng)病人,觀舌下系帶兩側(cè)血管變化,初步判斷患者屬于出血或者梗死;面癱患者通過(guò)翳風(fēng)穴壓痛反應(yīng)判斷疾患輕重轉(zhuǎn)歸等。2.3主張凡病要重“調(diào)”,使之達(dá)到陰陽(yáng)平衡,才能治愈疾病。臨床辨證重視心腎,心者,五臟六腑之大主；腎者,,先天之本。善用內(nèi)關(guān)、膻中、鳩尾調(diào)心神,腎俞、命門、太溪調(diào)理腎精。2.4重視針灸藥結(jié)合,崇尚針?biāo)幉⒂?指出針灸科醫(yī)師必須針灸中藥協(xié)同治療,臨床用藥做到理法方藥,以六經(jīng)辨證為主；針灸做到理法方穴,以經(jīng)絡(luò)辨證為主。臨床治療胸痹、脫發(fā)、頑固性便秘等療效顯著。2.5擅長(zhǎng)單穴治病,手針治痛。臨床常以曲池穴治療脅痛、胃腹痛；太溪治療咽干,腎虛頭痛；手針足跟穴治療跟痛癥,及靈活應(yīng)用下睛明等。2.6精研內(nèi)經(jīng)刺法,并獨(dú)創(chuàng)了柳刺、齒輪刺、梅花刺等特殊刺法。臨床常遠(yuǎn)端取穴,上病下取或下病上取,使針感趨向于病痛部,運(yùn)用金氏燒山火法,治療癱瘓麻痹、寒濕痹痛、四肢厥冷、脘腹寒痛等病證。臨癥擅長(zhǎng)刺絡(luò)放血,廣泛應(yīng)用于各類疾患,如丹毒、濕疹、痛風(fēng),還有類風(fēng)濕性關(guān)節(jié)炎,頭痛,面癱、頸椎病等。3金伯華教授診療經(jīng)驗(yàn)根據(jù)“金氏針法要論”的學(xué)術(shù)思想,分析金老獨(dú)特的診療方法及針?biāo)幉⑿械膶W(xué)術(shù)特點(diǎn)。以金老針灸治療類風(fēng)濕性關(guān)節(jié)炎、中風(fēng)、面癱、強(qiáng)直性脊柱炎、抑郁癥、肥胖癥等疑難雜癥的寶貴經(jīng)驗(yàn)入手,通過(guò)金老獨(dú)特病因病機(jī)、診斷要點(diǎn),治療要點(diǎn)、典型病例分析,全面介紹金老診療經(jīng)驗(yàn)。4金氏華佗夾脊督脈溫針灸治療強(qiáng)直性脊柱炎腎虛督寒證的臨床研究在繼承金伯華教授治療強(qiáng)直性脊柱炎臨床經(jīng)驗(yàn)基礎(chǔ)上,運(yùn)用金氏針法華佗夾脊督脈溫針灸治療強(qiáng)直性脊柱炎腎虛督寒證患者臨床觀察。目的(1)評(píng)價(jià)金氏針法華佗夾脊督脈溫針灸對(duì)強(qiáng)直性脊柱炎腎虛督寒證的臨床療效。(2)探索金氏針刺方法及華佗夾脊穴不同定位取穴方法對(duì)強(qiáng)直性脊柱炎療效差別。方法采用隨機(jī)、對(duì)照、單盲的研究方法,將符合納入標(biāo)準(zhǔn)的強(qiáng)直性脊柱炎腎虛督寒證門診患者63例,按照1：1的比例,隨機(jī)分為治療組32例和對(duì)照組31例。治療組金氏針法華佗夾脊(棘突旁開1寸)、督脈溫針灸,對(duì)照組常規(guī)針法華佗夾脊穴(棘突旁開0.5寸)督脈溫針灸,記錄治療前、后枕墻距、胸廓活動(dòng)度、Schorber試驗(yàn)、脊柱痛VAS評(píng)分等；并以ASAS20、BASDAI指數(shù)、中醫(yī)臨床療效評(píng)定等作為主要療效評(píng)價(jià)指標(biāo),治療療程為三月,評(píng)價(jià)臨床療效。結(jié)果經(jīng)過(guò)統(tǒng)計(jì)分析,中醫(yī)臨床療效評(píng)定治療組與對(duì)照組的總體有效率、ASAS20改善、BASDAI評(píng)分的比較,治療組優(yōu)于對(duì)照組。治療組及對(duì)照組治療前后比較,脊柱痛VAS評(píng)分、胸廓活動(dòng)度、枕墻距、Schorber試驗(yàn)差異均有統(tǒng)計(jì)學(xué)意義；治療前后兩組間比較,脊柱痛VAS評(píng)分、胸廓活動(dòng)度評(píng)分、枕墻距評(píng)分、Schorber試驗(yàn)評(píng)分差異有統(tǒng)計(jì)學(xué)意義。實(shí)驗(yàn)室觀察指標(biāo),ESR、CRP治療組治療前后比較,差異有統(tǒng)計(jì)學(xué)意義,對(duì)照組治療前后比較、治療前后兩組間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論本研究在繼承金伯華教授“金氏針法要論”學(xué)術(shù)思想和臨床經(jīng)驗(yàn)基礎(chǔ)上,開展隨機(jī)對(duì)照研究。發(fā)現(xiàn)金氏針法及常規(guī)針刺法治療強(qiáng)直性脊柱炎腎虛督寒證治療前后均有療效；金氏針法與常規(guī)刺法相比較,對(duì)BASDAI評(píng)分、ASAS20、中醫(yī)臨床療效評(píng)定均有明顯改善；并對(duì)各項(xiàng)臨床觀察指標(biāo)如脊柱痛VAS評(píng)分、胸廓活動(dòng)度評(píng)分、枕墻距評(píng)分均有統(tǒng)計(jì)學(xué)意義,治療組優(yōu)于對(duì)照組。實(shí)驗(yàn)室觀察指標(biāo),ESR檢查、CRP檢查治療組治療前后比較,差異有統(tǒng)計(jì)學(xué)意義。通過(guò)對(duì)華佗夾脊穴古今文獻(xiàn)分析及金老臨床取穴,治療強(qiáng)直性脊柱炎,遵循夾脊穴棘突旁開1寸法,擴(kuò)大了臨床應(yīng)用范圍。夾脊穴向脊柱方向斜刺45°深刺法,為深刺夾脊穴治療督脈、膀胱經(jīng)疑難雜癥,“骨痹刺骨”、“針至病所”,提高臨床療效提供了取穴依據(jù)。
[Abstract]:This article is a summary of the academic thoughts and clinical experience of Professor Jin Bohua for three years. It mainly includes four aspects: Professor Jin Bohua's academic thought origin, Professor Jin Bohua's academic thoughts, Professor Jin Bohua's experience in diagnosis and treatment, and the treatment of ankylosing spondylitis by the golden Hua Tuo Jiaji's Jiaji meridian temperature acupuncture and moxibustion The clinical study of kidney deficiency and cold syndrome of the kidney.1, Professor Jin Bohua's academic origin of Professor Jin Bohua's academic thought, mainly included (1) military medical treatment, anti American aggression and aid Dynasty: the Bethune Medical School of North China military and Political University and the war wounded rescue in the Korean battlefield, and laid a solid foundation for western medicine; (2) the road of traditional Chinese medicine and famous edification: through second outpatient departments of traditional Chinese medicine and Beijing Chinese Medicine Hospital study work, absorb the golden needle Wang Leting, He Puren, Xia life and other famous acupuncture and moxibustion elite academic essence; (3) fine research classics, style unique: through traditional Chinese medicine class and four classics study class, intensive reading < Huangdi Neijing > < Shang Han theory >, < acupuncture and moxibustion >, etc., to form a unique style of acupuncture, moxibustion, and medicine. And the clinical diagnosis and treatment ideas and Jinshi acupuncture manipulation techniques. (4) combine the Chinese and western, conquer the difficulties: preside the Beijing Municipal Science and Technology Commission "85 key plan - the research on the development of the Chinese medicine development 'chpursuing Feng speed' injection acupoint injection and acupuncture and moxibustion for rheumatoid arthritis. The academic ideas of Professor Jin Bohua, the prize for scientific and technological achievements of the Bureau and the life cup of traditional medicine of the world, combined with Jin Lao "Jin's acupuncture clinical essence, < Jin Bohua's arthralgia syndrome treatment set >," Jinbo Hua of the needle altar ", and so on. According to Professor Jin Bo Hua's acupuncture and moxibustion prescription in theory and clinical practice, Jin Bohua will deepen and sublimate the academic viewpoint of golden age and innovation. The summary of sex is: "cure the source, the disease is more qi stagnation", "the diagnosis method is unique, the observation and the micro", "the key to the heart and the kidney", "the acupuncture and the medicine and the use, the complement each other", "the good use of the single point, the hand acupuncture treatment pain", "the prickly method, one's own family" and other six elements, "Jinshi needling essential theory",.2.1 is guided by the theory of < Nei Jing >. It is necessary to observe the whole concept of traditional Chinese medicine, the basic law of syndrome differentiation and treatment. It must be traced to the source. It should be traced to the source. It is considered that qi depression is a unique diagnostic method for the main pathogenesis of.2.2, and pays attention to the local diagnosis of the meridians, such as the stroke patients, the changes of the blood vessels on both sides of the sublingual lace, and the preliminary judgement that the patient belongs to bleeding or infarction. Patients with facial paralysis through Yifeng acupoint pressure pain response to judge the severity of the disease and other.2.3 main tenments to "tune" in order to achieve the balance of yin and yang to cure the disease. Clinical syndrome differentiation attaches importance to the heart and kidney, the heart, the five viscera and six organs of the main; the kidney, the innate nature. Good use of Neiguan, mutton, dove tail, Shen Shu, life gate, Tai Xi conditioning kidney essence.2.4 attention. Acupuncture and moxibustion medicine combination, advocating acupuncture and drug use, pointed out that acupuncture and moxibustion physicians must be treated with acupuncture and moxibustion in coordination with traditional Chinese medicine. The clinical medication should be rational and prescriptions, based on the syndrome differentiation of six meridians; acupuncture and moxibustion achieve the principle and method of acupuncture and meridian syndrome. The clinical treatment of chest obstruction, alopecia and intractable constipation is a significant.2.5. Acupoint treatment of hypochondriac pain, stomach abdominal pain; Tai Xi treatment of pharynx dry, kidney deficiency headache; hand acupuncture point heel acupoint treatment with pain syndrome, and flexible application of the.2.6 Jing Jing Jing Jing Jingyan method, and original special thorn method of willow thorns, gear spines, plum blossom spines and so on. The treatment of paralysis paralysis, cold dampness and arthralgia, limbs cold, abdominal cold pain, etc. is good at thorns and collaterals, widely used in various diseases, such as erysipelas, eczema, gout, rheumatoid arthritis, headache, facial paralysis, cervical spondylosis, and so on,.3 professor Jin Bohua's experience is based on the academic thought of "Jinshi needling important theory", analyzing the unique diagnosis of Jin Lao With the valuable experience of treating rheumatoid arthritis, stroke, facial paralysis, ankylosing spondylitis, depression, obesity and other difficult miscellaneous diseases, Jin Lao's unique etiological pathogenesis, diagnosis points, treatment points, typical case analysis, and general introduction of golden old diagnosis and treatment experience.4 Jinshi Hua Tuo pinch ridge are introduced. Clinical study on the treatment of ankylosing spondylitis with acupuncture and moxibustion in the treatment of ankylosing spondylitis by Professor Jin Bohua's clinical experience on the basis of clinical experience in the treatment of ankylosing spondylitis, the clinical observation of the patients with ankylosing spondylitis and kidney deficiency and cold syndrome treated with the Jinshi needle method of Hua Tuo Jiaji temperature acupuncture and moxibustion. Objective (1) to evaluate the temperature acupuncture and moxibustion of the Jinshi needle method Hua Tuo Jiaji. The clinical curative effect of ankylosing spondylitis kidney deficiency and governor cold syndrome. (2) explore the curative effect difference between Jinshi acupuncture method and Hua Tuo Jiaji acupoint different location method for ankylosing spondylitis. Method a randomized, controlled, single blind study method, 63 cases of patients with ankylosing spondylitis with kidney deficiency and governor cold syndrome, according to the standard, according to the proportion of 1:1, are followed. The treatment group was divided into 32 cases in the treatment group and 31 cases in the control group. The Hua Tuo clip (1 inches by the spinous process) in the treatment group, the warm acupuncture and moxibustion at the governor vein, the normal needle method of the Hua Tuo Jiaji point (0.5 inches by the spinous process) in the control group, were recorded before the treatment, the posterior occipital wall distance, the thoracic activity degree, the Schorber test, the spinal pain VAS score, and so on, and the ASAS20, BASDAI index, Chinese medicine, and so on. Clinical efficacy evaluation as the main evaluation index, the treatment course was March, evaluation of clinical efficacy. Results through statistical analysis, the clinical efficacy of Chinese medicine treatment group and the control group overall efficiency, ASAS20 improvement, BASDAI score comparison, the treatment group is better than the control group. The treatment group and the control group before and after the treatment of spinal pain VAS evaluation The difference between the two groups of the two groups, the spinal pain VAS score, the thoracic activity score, the occipital wall distance score and the Schorber test score were statistically significant before and after the treatment. The differences in the laboratory observation index, the ESR, CRP treatment group before and after treatment were statistically significant, and the control group was statistically significant. The control group was statistically significant. Compared before and after treatment, the difference between the two groups before and after treatment was not statistically significant. Conclusion this study carried out a randomized controlled study on the basis of the academic thought and clinical experience of Professor Jin Bohua's "Jinshi needling important theory", and found that the Jinshi needle method and conventional acupuncture treatment had curative effect before and after the treatment of ankylosing spondylitis kidney deficiency and governor cold syndrome. Compared with the conventional pricking method, the BASDAI score, ASAS20, and the clinical efficacy of traditional Chinese medicine were improved obviously, and the clinical observation indexes such as VAS score of spinal pain, the thoracic activity degree and the occipital wall distance score were statistically significant. The treatment group was superior to the control group. The test room observation index, the ESR examination, and the CRP examination group were treated before the treatment. The difference has statistical significance. Through the analysis of ancient and modern literature of Hua Tuo Jiaji acupoint and golden old clinical acupoint, the treatment of ankylosing spondylitis, followed by the method of 1 inches by the side of the spine of Jiaji point, expanded the clinical application. The method of 45 degree deep puncture to the direction of the spine to the spinal column, for the treatment of the Du Meridian with the deep stab Jiaji point, the bladder meridian, "bone arthralgia bone" "Acupuncture points to the disease" to improve clinical efficacy, provides the basis for selecting points.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.1;R249

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