软组织损伤论治与《内经》相关针灸理论探讨

发布时间：2018-05-04 17:13

本文选题：软组织损伤 + 内经　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目前,慢性劳损引发的软组织损伤疾病日益增多,对软组织损伤的论治,现代医学与传统医学各有不同。虽然临床上治疗软组织损伤性疾病的方法丰富多样,但究其基本原理都是通过松解局部或者相关联的远端软组织以改善症状。众所周知,软组织损伤相关病症为针灸治疗的优势病种,而通过各种针具、手法松解病变局部以治疗此类病症,古已有之,追溯其松解理念的源头,则发现"无问腧穴、以痛为腧、不谈补泻、直接刺脉、以松治痛"的治疗理念从《内经》就已存在。《内经》作为中医经典,向受尊崇,针灸理论从《内经》开始形成以后,就呈现高度的稳定性。以微针调气血、经络腧穴为主的治疗方法是传统针灸的主要形式,目前在临床占主导地位,经脉理论则是其理论核心,主要用来解释针灸的远隔效应,而《内经》针灸理论中最开始出现的血脉理论、形体层次辨证、对症治疗等近治理论,因其后世理论化程度较低,在目前针灸治疗理论中未能有比较恰当的表述和应有的体现。在现代针灸临床治疗中,受中医学辨证论治整体治疗的思维定式影响,针灸自身的治疗特点不能恰当体现,且对于一些针灸疗法的优势病种,主流观念的治疗理论与实际临床应用大有不同,而对其实际操作的解释也有所牵强。随着解剖学、生理学、外科学、神经学及生物力学等现代医学科学的发展,在传统针灸的基础上很多新疗法不断涌现,被赋予新的概念与理论并被冠以新的名称,演绎着本是同根,却泾渭分明的角色,然其应用工具、操作方法、治疗部位等均与传统针灸治疗理论相类似,更甚者明显"换汤不换药"。任何一个学科都在不断发展成长,传统针灸理论形成之后,在持续更新的医疗环境中被重新理解与诠释,其内涵也随之不断丰富。本文通过整理和分析现代用于治疗软组织损伤的代表性疗法,对其在治疗软组织损伤疾病时所发挥的软组织松解作用进行说明,探讨各种新针具与传统针灸的关系,以期对临床治疗有所指导,为相关临床研究提供依据;旨在对《内经》传统针灸理论中的近治理论有所阐释,对其所隐含的现代医学思想进行探讨,以期为针灸在临床优势病种治疗上提供更多的理论解释,为传统理论的现代表达提供借鉴,为针灸理论的完整构建提供思路。文章分三个部分进行论述:第一部分:概述现代医学对软组织损伤的认识以及论治。通过分析发现,现代医学对软组织损伤的病理机制研究比较丰富,在众多学说中都涉及软组织损伤后因无菌性炎症使组织粘连致瘢痕挛缩而出现疼痛,基于此,其治疗除了镇痛消炎外,主要是以松解治疗为主。软组织松解术作为外科手术中众多手术技巧之一,所占比例较小,宣蛰人首先将软组织松解术发展为一类单独的外科手术,形成软组织外科学,而后发明银质针,以针代刀治疗软组织损伤。第二部分:概述针灸推拿对软组织损伤的认识及论治。针灸作为中医的一部分,早期就有对软组织损伤的整体认识,"筋伤"以疼痛为主要症状,中医对"痛症"以"不通则痛,不荣则痛"为总的指导纲要,在对软组织损伤的治疗上也基于此则,"筋伤"多以"不通而痛",所以其治疗也主要为"疏通",各种针刺治疗及推拿治疗就是要松解其不通之处,使其通而不痛。治疗方法以针刺治疗和手法治疗为主,使用工具有不带刃的毫针、圆利针、拨针、筋针等,有带刃的针刀、刃针等,其共同特点是都具有松解软组织的作用,临床常相互结合以提高疗效。临床上,毫针以刺激作用为主,但在对于软组织损伤的论治过程中,其松解作用不可忽略不计。第三部分:整理探讨《内经》针灸理论中的软组织损伤论治理论。"皮脉肉筋骨"五体理论用于软组织损伤的形体辨证,指导具体针具和刺法的选择,依病变的层次确定针刺的深度。《内经》中对经筋病与部分痹症的认识与现代医学对于慢性软组织损伤的认识基本相符,"九针"、"对症刺法"与"解结"刺法松解软组织以治疗软组织损伤,与现代医学治疗原理相差无几。
[Abstract]:At present, the disease of soft tissue injury caused by chronic strain is increasing, and the treatment of soft tissue injury is different from that of modern medicine and traditional medicine. Although there are many ways to treat the soft tissue damaged diseases in clinical, the basic principle is to improve the symptoms by loosening the local or the related distal soft tissues. It is well known that soft tissue injury related diseases are the dominant diseases of acupuncture and moxibustion treatment, and through various needles, it looses the local lesion to treat such diseases. It has been found in ancient times and traced the source of its loosening idea. As a classic of traditional Chinese medicine, to be respected, the theory of acupuncture and moxibustion has been highly stable after the formation of "inner meridian >". The treatment method of regulating qi and blood with micro needle and meridian acupoint mainly is the main form of traditional acupuncture and acupuncture. At present, it is dominant in clinical practice, and meridian theory is the core of its theory, which is mainly used to explain the distance effect of acupuncture and moxibustion, and < within. In the theory of acupuncture and moxibustion, the theory of blood vein, physique level syndrome differentiation, symptomatic treatment and other near treatment theory have not been properly expressed and reflected in the current theory of acupuncture and moxibustion treatment. In the modern acupuncture clinical treatment, the thinking pattern of the whole treatment by TCM syndrome differentiation and treatment is influenced by the traditional Chinese medicine. The characteristics of the treatment of acupuncture and moxibustion can not be properly embodied, and for some of the dominant diseases of acupuncture and moxibustion, the treatment theory of the mainstream concept is different from the actual clinical application, and the interpretation of its actual operation is also far fetched. With the development of modern medical science, such as anatomy, physiology, surgery, neurology and biomechanics, the traditional acupuncture is in the traditional needle. On the basis of the moxibustion, many new therapies are constantly emerging. They are given new concepts and theories and are crowned with new names. It is deductive that this is the same root, but a distinct role, but its application tools, operation methods, and treatment parts are similar to the traditional acupuncture treatment theory, and more obviously "change the soup without changing the medicine". After the formation of the theory of traditional acupuncture and moxibustion, it has been re understood and annotated in the continuously updated medical environment, and its connotation is constantly enriched. In this paper, the representative therapy for the treatment of soft tissue injury is reviewed and analyzed, and the soft tissue release of the soft tissue in the treatment of soft tissue injury is explained. To discuss the relationship between the new needle and the traditional acupuncture and moxibustion, in order to guide the clinical treatment and provide the basis for the related clinical research. The aim is to explain the near treatment theory of the traditional acupuncture and moxibustion theory and discuss the modern medical thought of the acupuncture and moxibustion in order to provide more theoretical explanations for the treatment of clinical dominant diseases. It provides a reference for the modern expression of traditional theory and provides ideas for the complete construction of acupuncture and moxibustion theory. The article is divided into three parts: the first part: a summary of the understanding and treatment of the injury of soft tissue in modern medicine. Through analysis, the research of modern medicine on the mechanism of soft tissue injury is rich and involved in many theories. And the treatment of soft tissue caused by aseptic inflammation causes scar contracture of tissue to cause pain. Based on this, it is mainly treated with loosening and relieving inflammation. Soft tissue loosening is one of the many surgical techniques in surgery. Surgery, forming soft tissue surgery, and then inventing silver needle to treat soft tissue injury with needle instead of knife. The second part: summarize the understanding and treatment of soft tissue injury by Acupuncture and massage. As a part of Chinese medicine, acupuncture and moxibustion, as a part of Chinese medicine, have an overall understanding of the injury of soft tissue, "tendon injury" with pain as the main symptom, and "no pain" is "no" in Chinese medicine. The general guidelines, not proud and pain "for the general guidance, in the treatment of soft tissue damage also based on this," the "tendon injury" more "pain", so the treatment is mainly "dredge", all kinds of acupuncture treatment and massage treatment is to release its incompatibility, make it not painful. The treatment of acupuncture treatment and manipulation treatment, the use of treatment, the use of treatment, the use of treatment and the use of treatment, use of the main, use of treatment, use of treatment and use mainly, use of acupuncture and manipulation, use The tool has a needle without edge, a round needle, a needle, a needle, a needle with a blade, a needle, and so on. The common characteristic of the tool is that it has the effect of loosening the soft tissue, and it is often combined with each other to improve the curative effect. In clinical, the needles are mainly stimulated, but in the treatment of soft tissue damage, the effect of loosening can not be ignored. Third Part: discuss the theory of the treatment of soft tissue injury in the theory of internal acupuncture and moxibustion. The five body theory of "skin vein and bone" is used to identify the form of soft tissue injury, to guide the selection of specific needles and prickles, to determine the depth of acupuncture according to the level of pathological changes. The understanding of injuries basically coincides. "Nine needles", "symptomatic needling" and "Jie Jie" needles to release soft tissue to treat soft tissue injuries are almost the same as modern medical treatment principles.

【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R245

【相似文献】