| 蔡妍,袁晨逸,杨婷,等.论火针在肺癌伴恶性胸腔积液中的应用[J].浙江中医药大学学报,2023,47(5):553-558. |
| 论火针在肺癌伴恶性胸腔积液中的应用 |
| Study on Application of Heated Needle in the Treatment of Lung Cancer with Malignant Pleural Effusion |
| DOI：10.16466/j.issn1005-5509.2023.05.018 |
| 中文关键词: 火针 针刺 门海俞募 阿是穴 选穴原则 肺癌 恶性胸腔积液 机制 |
| 英文关键词: heated needle acupuncture acupoint of Men, Hai, Shu, Mu Ashi Point acupoint selection scheme lung cancer malignant pleural effusion mechanism |
| 基金项目:浙江省中医药科技计划项目(2019ZZ011)；浙江省中医药(中西医结合)重点学科建设项目(2017-XK-A12) |
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| 中文摘要: |
| [目的] 基于脏腑辨证原则、“门海俞募”选穴原则与“阿是穴”理论，阐释火针治疗肺癌伴恶性胸腔积液(malignant pleural effusion，MPE)的理论依据及诊疗经验，为针灸治疗肺癌伴MPE提供新的思路。 [方法] 通过传统文献学方法，围绕肺癌伴MPE的脏腑辨证原则，探寻“门海俞募”理论与“阿是穴”理论的现代应用，从火针集针、灸于一体的特性入手，归纳总结火针治疗肺癌伴MPE的选穴、配伍、治疗手法及注意事项，对火针针刺腧穴治疗肺癌伴MPE的思路及依据进行剖析，并结合验案进行佐证。 [结果] 火针治疗肺癌伴MPE时，应从肺、脾、肝、肾四脏和膀胱、三焦两腑所对应的经络入手，以门穴、海穴、俞穴、募穴为基础，结合经验穴和局部“阿是穴”的选穴原则，同时结合火针的“温通”作用，配合巨刺法、围刺法两种刺法，为火针治疗MPE提供新的治疗思路。所举案例中患者诊断为悬饮，辨证为脾肾阳虚证，治疗选取局部围刺，将病邪困于局部，阻断了邪气向四周扩散；配合“冲门、液门、幽门、照海、关元、水道”和“脾俞、肾俞、三焦俞、章门、京门、石门”，扶助正气、调和阴阳、通行气血。[结论] 通过脏腑辨证原则、“门海俞募”选穴原则与“阿是穴”理论三者相结合治疗肺恶性肿瘤伴MPE，见效快，疗程短，疗效确切，对于火针的临床应用和肺癌并发症的治疗大有裨益。 |
| 英文摘要: |
| [Objective] To explore the diagnosis and treatment experience and theoretical basis of acupuncture by heated needle in the treatment of lung cancer with malignant pleural effusion(MPE)， based on the principle of pattern differentiation of Zang-Fu organs and the acupoint selection scheme of “Men， Hai， Shu， Mu” as well as the principle of “Ashi Point”， so as to provide a new idea for acupuncture treatment of lung cancer with MPE. [Methods] Through the research methods of traditional literature， focusing on the principle of pattern differentiation of lung cancer with MPE， exploring the modern application of the acupoint selection principle of “Men， Hai， Shu， Mu” and the principle of “Ashi Point”， starting from the characteristics of acupuncture by heated needle which combines the efficacy of acupuncture and moxibustion， and summarizing the acupoint selection scheme， compatibility， treatment methods and matters needing attention of fire acupuncture by heated needle for the treatment of lung cancer with MPE. The train of thought and basis of heated needle acupuncture at acupoints in the treatment of lung cancer with MPE were analyzed， and a clinical case was supported. [Results] In the treatment of lung cancer with MPE， the exploration of the mechanism should start with the corresponding meridians four Zang organs(viscera) including lung， spleen， liver and kidney and two Fu organs(bowels) including tri-Jiao and bladder， on the basis of Men(Door) acupoint， Hai(Sea) acupoint， Shu acupoint， Mu acupoint， combined with the principle of selecting acupoints of empirical acupoint and surrounding acupuncture of local “Ashi Point”. At the same time， it should be combined with the effect of “warming and dredging” of heated needle acupuncture， combined with Juci(giant needling) and Weici(surrounding needling)， to provide new therapeutic ideas for heated needle acupuncture in the treatment of MPE. In the case mentioned， the patient was diagnosed as suspended drink， and the syndrome differentiation was Yang deficiency of the spleen and kidney， and local acupuncture was selected for the treatment， which trapped the disease evil in the local area and blocked the spread of evil Qi in all directions； cooperating with “Chongmen， Yemen， Youmen， Zhaohai， Guanyuan， Shuidao” and “Pishu， Shenshu， Sanjiaoshu， Zhangmen， Jingmen， Shimen” to help healthy Qi， harmonize Yin and Yang， and dredge Qi and blood. [Conclusion] Combining the principle of syndrome differentiation of Zang-Fu organs， the acupoint selection principle of “Men， Hai， Shu， Mu” and the principle of “Ashi Point” in the treatment of lung cancer with MPE has the advantages of quick effect， short course of treatment and definite curative effect， which is of great benefit to the clinical application of heated needle acupuncture and the treatment of complications of lung cancer. |
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