四缝穴古今临床运用的文献研究

发布时间：2018-01-22 08:46

本文关键词： 四缝穴临床应用文献研究　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过探究四缝穴的起源与现代发展,展示四缝穴的临床应用;通过对相关临床报道进行文献研究,总结其古今临床实践经验,探讨四缝穴的位置特意性、作用原理及临床运用的适应症,为今后该穴的临床运用提供相关的文献依据。方法:1、通过梳理古今医籍有关四缝穴的记载(其包括穴名、定位及临床运用),探讨四缝穴的历史沿革及临床应用情况;2、搜索自数据库建库至2016年期间与四缝穴相关的文献,将国内关于运用四缝穴治病的临床研究文献作为研究对象,将文献按纳入标准进行梳理、归纳和总结,设计相应的资料提取表,并对纳入的文献中关于四缝穴的主治病症、操作方法、点刺间隔时间及后世医家对点刺后挤出的液体与疗程、病情相关性的观点进行提取;将提取所得的资料输入Excel电子表格保存,依据所治病症进行分类、归纳、整理,进行相关数据处理;通过建立图表方式分析,初步探讨四缝穴的穴位特性、临床应用特点及其运用规律。结果:1、《奇效良方》中最早记载了四缝穴的定位及主治病症,后为《针灸大成》等医籍所引载。清代以前文献对四缝穴的定位及主治病症记载较为局限,鲜有进一步阐释和医案记录。后世医家在临床实践中对四缝穴定位存在不同见解,将其运用于其他疾病的治疗取得特异性的疗效,从而大大拓展了四缝穴的定位及主治范围。2、本课题中所纳入与四缝穴临床运用相关的文献共536篇,其所涉及的病症共约74个。文献资料显示,四缝穴应用范围逐渐扩大,在现代临床中广泛运用于消化科病症和呼吸科病症,也部分运用于皮肤科、五官科和外科等多门学科病症的治疗。四缝穴虽主要运用于治疗儿科相关病症,但在成人相关疾病甚至是疑难杂症上也有运用。3、文献显示四缝穴的定位主要有5种,临床运用中5种定位也多交叉应用,但主要仍是依据《奇效良方》的记载。与四缝穴周围其他奇穴共约50个,其部分主治与四缝穴相似,但多有差异,目前无相关文献解释四缝穴与其周围其他奇穴的区别。4、四缝穴的针法多采用三棱针或注射针头点刺,纳入文献中共有41%未提及针刺的深度及间隔时间,且文献中对于针刺间隔时间的记载主要根据医家自身的经验,无量化的标准,使四缝穴治疗相关病症的试验的可重复性和客观性受影响。结论:1、四缝穴主治病症和定位演变,经历了一个漫长而复杂的过程,其最早源于明代,发展至今。由古代文献记载主治病症多为小儿猢狲劳,后多运用于治疗小儿疳疾,现后世医家的临床运用中又大大扩大了四缝穴的主治范围,不仅用于治疗各种儿科疾病,而且扩展到成人外、内、妇科,其疗效显著。因而在临床实践应注意发挥四缝穴的独特治疗作用。2、在本文献研究中,四缝穴相关的穴位其功效部分同四缝穴,但文献未提及四缝穴与其相关穴位临床作用的区别。针刺四缝穴后液体的出现与病情、临床疗效之间相关性、及其出现的原因少有研究。而现代医学对于四缝穴的作用机理,多是描述现象,实验研究仅局限于消化系统病症,无深层次的探讨;中医机理研究多从经络、古代手相、全息理论及所治病症的病因病机方面解释四缝穴的作用机理,则难以阐释其治疗呼吸科、皮肤科、外科、五官科等病症的作用机理。
[Abstract]:Objective: To explore the origin and development of modern joint four points, showing four clinical application of ex-ue10; through literature research on relevant clinical reports, and summarize the clinical experience, explore the four aperture position specially, action principle and clinical application of the indications, for the future to provide relevant reference for clinical use this point. Methods: 1, by combing the ancient medical books about four of ex-ue10 records (including point name, location and clinical application of four), ex-ue10 history and clinical application; 2, the search from database to 2016 and four ex-ue10 related literature, the domestic use of four joint clinical research literature points as the research object, the literature according to the inclusion criteria were reviewed, and summarized the design of the corresponding data extraction form, and the inclusion of the literature about the indications, four sewing hole operation method, prick The time interval and later doctors of liquid and treatment after extrusion prick, correlation between views will be extracted from the data extraction; input Excel spreadsheets saved, according to disease classification, induction, consolidation, related data processing; through the establishment of analysis chart, preliminary study of four ex-ue10 points characteristics. And using the law of clinical features. Results: 1, < > in the earliest recorded Qixiao for four of ex-ue10 positioning and indications for acupuncture, < > and other medical books cited. Before the Qing Dynasty literature on the four point positioning and joint record indications is limited, few further explanation and records record. Physicians in clinical practice of four joint positioning points have different opinions, which are applied to the treatment of other diseases have specific effect, so as to greatly expand the four sewing hole location and indications of.2, this topic In four included and ex-ue10 clinical related to the use of 536 papers, the symptoms of a total of about 74. According to the literature, four ex-ue10 application scope gradually expanded, widely used in digestive diseases and disorders in Modern Clinical Department of respiration, also part of the application in the Department of Dermatology, Department of surgery and the treatment of the five official the discipline of disease. Although four sewing hole is mainly used in the treatment of pediatric related disorders, but in adult related diseases and even have Difficult miscellaneous diseases by.3, there are 5 main types of literature shows that four sewing hole positioning, 5 positioning clinical application also cross application, but is still the main basis for the effect of < > record. And four sewing hole around other acupoints of about 50, and the four part of its attending ex-ue10 is similar, but there are many differences, there is no relevant literature to explain four sewing hole and other odd points around the difference of.4, four of ex-ue10 acupuncture with three edged needle or injection The needle prick, a total of 41% literatures did not mention the depth and time interval of acupuncture, and the literature for the interval of time according to the records of the physicians' own experience and no quantitative criteria, the four test points for the treatment of diseases related to the joint reproducibility and objectivity affected. Conclusion: 1. The evolution of four joints acupoint indications and positioning, has experienced a long and complex process, which originated from the Ming Dynasty, from the ancient literature. Since the development of indications for more children with his work, after operation for the treatment of infantile malnutrition, clinical physicians in the operation and greatly expanded the range of indications four ex-ue10 and not only for the treatment of various pediatric diseases, but also extended to adults, in gynecology, its effect is significant. So in clinical practice should pay attention to play four of ex-ue10 unique therapeutic effect of.2 in the literature study, four ex-ue10 related power point The effect with four sewing hole, but the literature did not mention the four ex-ue10 associated with the clinical effect of acupuncture acupoint. Four seam appearance and liquid point condition, the correlation between clinical efficacy, there is little research and its causes. Modern medicine for the four joint mechanism points, more experimental research is to describe the phenomenon. Only in the digestive system diseases, to explore the deep mechanism of traditional Chinese medicine research; from the meridian, the ancient palm, pathogenesis and treatment of disorders of the holographic theory to explain four of ex-ue10 mechanism, it is difficult to explain its treatment in the Department of respiration, Department of Dermatology, surgery, ENT mechanism and other diseases.

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246

【参考文献】