据人迎寸口脉法实施针刺补泻治疗高血压病临床的研究.docVIP

据人迎寸口脉法实施针刺补泻治疗高血压病临床的研究 　　(1.东南大学附属中大医院,江苏南京210029;2?南京中医药大学) 　　[摘　要]　运用人迎寸口脉法指导实施针刺补泻手法治疗Ⅱ期高血压病患者60例,随机分为3组,每组20例。3组均依照人迎寸口脉法辨别阴阳虚实。治疗Ⅰ组20例,针刺以补虚泻实;治疗Ⅱ组20例,无论虚实均采用平补平泻法;治疗Ⅲ组20例,针刺以补实泻虚。于针刺前后分别观察3组经颅多普勒超声血流仪(简称TCD)指标与临床疗效。经统计学处理,治疗Ⅰ组针刺疗法明显优于治疗Ⅱ组及Ⅲ组,P0.01;治疗Ⅱ组与治疗Ⅲ组之间差异也有显著性意义,P0.01。提示人迎寸口脉法可以用于指导针灸临床辨证与针刺补泻手法的实施。? 　　[主题词]人迎诊法;高血压/针灸疗法,补泻方法;针刺补泻;寸口诊法TreatmentofHypertensionbyAcupuncturewithReinforcing?reducingManeuverBasedonRenyingandCunkouDiagnosisGaoJianyun1,ZhaoJings heng2,DongHuang1(1.ZhongdaHospitalaffiliatedtoDongnanUniversity,Nanjing210029,Ji angsuProvince;2.NanjingCollegeofTCM) 　　[Abstract]Acupuncturewithreinforcing?reducingmaneuverchosenbasedontheRenyingandCunkoudiagnosiswasusedfor treating60casesofhypertension,whichwereevenlydividedinto3groupsatrandom.Yin,yang ,deficiencyandexcesstypesweredifferentiatedinallthe3groupsbasedontheRenyinga ndCunkoudiagnosis.Reinforcingforthedeficiencyandreducingfortheexcesswerea ppliedingroupⅠ,evenreinforcingandreducingingroupⅡ,andreinforc?ingfortheexcessandreducingforthedeficiencyingroupⅢ.TheindicesweredeterminedbyaDopplerultrasonicblood?flowmonitor,andclinicaltherapeuticeffectswereevaluatedbeforeandafterthet reatments.ThecurativeeffectingroupⅠwassignificantlysuperiortothateithering roupⅡoringroupⅢ(P0?01).Therewasalsoasignificantdifferenceintheeffectbetween groupⅡandgroupⅢ(P0?01).ItisindicatedthatRenyingandCunkoudiagnosiscanbeusedfordiffer entiationofclinicalcasesandapplicationofthereinforcing?reducingmaneuver.? 　　[Keywords]RenyingDiagnosis;Hypertension/acupther;Reinforcing?reducing/methods;MethodsofReinforcing?reducing;CunkouDiagnosis 　　人迎寸口脉法就是通过比较人迎与寸口两处的脉动变化以诊察疾病、判断病位病性、指导治疗的一种方法。中医经典著作《内经》对其依据、方法、意义等在理论上都有颇为详尽的阐述。人迎是指足阳明经循行所过的喉结旁颈总动脉搏动处,反映体表及十二经脉之阳的情况;寸口是指手太阴经循行所过的手腕后桡动脉搏动处,反映内脏及十二经脉之阴的情况。正常人人迎脉与寸口脉的搏动程度大小基本相同,只是在寒温不同季节略有差异,而患者人迎脉与寸口脉相比其搏动程度存在着较大的差异。通过比较人迎脉、寸口脉搏动的大小情况,可以判断经脉的虚实与疾病的性质,从而指导临床针灸补泻手法的实施。? 　　人迎寸口脉法实施针刺补泻的具体方法:人迎脉动大于寸口脉动,反映阳气过盛而阴气不足,针刺以泻阳经而补阴经;寸口脉动大于人迎脉动,反映阴气过盛而阳气不足,针刺则泻阴经而补阳经。所补泻之经脉,均为表里经。? 　　为了进一步阐述经络