1.浙江中医药大学第三临床医学院,浙江省杭州市滨江区滨文路548号,310053
2.浙江中医药大学附属第三医院
liangyiwww@126.com
收稿:2021-12-12,
修回:2022-03-27,
纸质出版:2022-06-02
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郑思懿,黄孝笑,刘祎玥等.基于表型多样性和定位不确定性的阿是穴探寻规律浅析[J].中医杂志,2022,63(11):1026-1031.
ZHENG Siyi,HUANG Xiaoxiao,LIU Yiyue,et al.Brief Analysis of the Rules for Detecting Ashi Points based on Phenotype Diversity and Positioning Uncertainty[J].Journal of Traditional Chinese Medicine,2022,63(11):1026-1031.
郑思懿,黄孝笑,刘祎玥等.基于表型多样性和定位不确定性的阿是穴探寻规律浅析[J].中医杂志,2022,63(11):1026-1031. DOI: 10.13288/j.11-2166/r.2022.11.007.
ZHENG Siyi,HUANG Xiaoxiao,LIU Yiyue,et al.Brief Analysis of the Rules for Detecting Ashi Points based on Phenotype Diversity and Positioning Uncertainty[J].Journal of Traditional Chinese Medicine,2022,63(11):1026-1031. DOI: 10.13288/j.11-2166/r.2022.11.007.
基于对阿是穴内涵的认识,剖析阿是穴表型多样性、定位不确定性等特性,进而探究阿是穴探寻规律。认为阿是穴作为参照患者主观反馈来定位的穴位,其广义、狭义之别应考量患者的主观感受。狭义阿是穴可以理解为医者按、捏局部可引起疼痛激发、缓解、消失的点或区域,或由患者自发产生且表现为痛觉异常或痛觉过敏的点或区域;广义阿是穴可以理解为所有异常反应点的统称,包括除疼痛感外的酸、麻、胀、重、热、凉、蚁行感、触电感等感觉异常以及皮肤色泽的改变、局部隆起或凹陷及皮下结节等形态异常。基于现代检测技术革新和穴位敏化研究,将痛反应点(痛敏化点)、热敏化点、耳穴阳性反应点等穴位敏化现象归于阿是穴的典型具象表型;但阿是穴表型具有多样性,并不仅仅局限于此。阿是穴探寻需综合考虑疾病种类、穴位特有属性等因素,不同表型阿是穴的探寻规律亦存在一定差异,进一步揭示阿是穴探查规律依赖于更多临床客观研究实施和先进检测技术革新。
This paper discussed the phenotype diversity and positioning uncertainty of
ashi
points based on the meaning of the connotation, and explored the rules for detecting
ashi
points. It is believed that
ashi
points refer to the points of sensitivity or discomfort which may be chosen due to the patients' subjective feedback, and have broad and narrow senses with difference in the patient's subjective feeling. The
ashi
points in a narrow sense are the points or areas where pain is caused, relieved or eliminated through press or pinch of the local area by the doctors, or where allodynia or hyperalgesia is spontaneously generated and manifested in patients. The
ashi
points in a broad sense refers to a general term of abnormal reaction points, including abnormal sensations other than pain such as soreness, numbness, heaviness, heat, cool, formication, and electical sensation, as well as morphological abnormalities such as changes in skin color, local bumps or depression, and subcutaneous nodules. Based on modern technological innovation of detection and researches on acupoint sensitization, the phenomena such as pain response points (pain sensitization points), heat-sensitization points, and positive reaction auricular points are considered as typical concrete phenotypes of
ashi
points, which are diverse and not limited to this. The exploration of
ashi
points needs to comprehensively consider factors such as the types of diseases and the unique attributes of acupoints, and has certain variation in the rules across different phenotypes. More objective clinical researches and technology innovation of detection are needed to deepen the interpretation of the rules for detecting
ashi
points.
叶永铭 , 赵宏 , 刘志顺 , 等 . 阿是穴研究概况 [J]. 北京中医 , 2006 , 25 ( 10 ): 633 - 636 .
李茜 , 吴明霞 . 阿是穴的临床应用 [J]. 中医临床研究 , 2021 , 13 ( 2 ): 146 - 148 .
蒲勤 . 阿是穴双针平刺配合乳没散外敷综合治疗急性颈肩部软组织挫伤300例 [J]. 中医杂志 , 2010 , 51 ( S2 ): 225 .
陈日新 , 许能贵 , 伊凡 . 重视腧穴状态 提高针灸疗效 [J]. 江西中医药 , 2011 , 42 ( 1 ): 9 - 11 .
楚洪波 , 徐明 . 阿是穴在临床中的运用 [J]. 长春大学学报(自然科学版) , 2007 , 17 ( 5 ): 108 - 110 .
张树剑 . 阿是取穴法源流论 [J]. 中国针灸 , 2013 , 33 ( 2 ): 165 - 167 .
陈艳杰 , 赵雪 , 高旸 . 阿是穴的狭义与广义之分 [J]. 西部中医药 , 2012 , 25 ( 1 ): 55 - 56 .
杨日松 . 近代西方医学“激痛点”与传统针灸学“腧穴”的比较研究 [D]. 哈尔滨 : 黑龙江中医药大学 , 2011 .
宣蛰人 . 宣蛰人软组织外科学:上卷 [M]. 上海 : 文汇出版社 , 2009 : 2 - 5 .
张文兵 , 陈羽霄 . 反阿是穴:肌肉起止点疗法及其临床应用 [J]. 上海中医药杂志 , 2002 , 36 ( 3 ): 42 - 43 .
朱兵 . 穴位敏化现象及其生物学意义 [J]. 中国针灸 , 2019 , 39 ( 2 ): 115 - 121 .
胡明岸 , 刘迈兰 , 黄河 , 等 . 从阿是穴与穴位敏化的关系探讨针灸治病选穴原则 [J]. 中华中医药杂志 , 2020 , 35 ( 11 ): 5477 - 5479 .
SMYTHE HA , MOLDOFSKY H . Two contributions to understanding of the “fibrositis” syndrome [J]. Bull Rheum Dis , 1977 , 28 ( 1 ): 928 - 931 .
高希言 . 中国针灸辞典 [M]. 郑州 : 河南科学技术出版社 , 2002 : 791 .
TRAVELL J , RINZLER SH . The myofascial genesis of pain [J]. Postgrad Med , 1952 , 11 ( 5 ): 425 - 434 .
MENSE S . How do muscle lesions such as latent and active trigger points influence central nociceptive neurons? [J]. J Musculoskelet Pain , 2010 , 18 ( 4 ): 348 - 353 .
SHAH JP , THAKER N , HEIMUR J , et al . Myofascial trigger points then and now: a historical and scientific perspective [J]. PM R , 2015 , 7 ( 7 ): 746 - 761 .
杨国法 , 靳聪妮 , 原苏琴 . 阿是穴的现代医学解析 [J]. 中国针灸 , 2012 , 32 ( 2 ): 180 - 182 .
SIMONS DG . New aspects of myofascial trigger points: etiological and clinical [J]. J Musculoskelet Pain , 2004 , 12 ( 3/4 ): 15 - 21 .
SHAH JP , GILLIAMS EA . Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome [J]. J Bodyw Mov Ther , 2008 , 12 ( 4 ): 371 - 384 .
刘乡 . 以痛制痛:针刺镇痛的基本神经机制 [J]. 科学通报 , 2001 , 46 ( 7 ): 609 - 616 .
萧友山 . 从赤羽氏法(经络诊断治疗法)的临床看经络现象 [J]. 中医杂志 , 1958 , 4 ( 7 ): 480 - 484 .
陈日新 , 康明非 , 陈明人 . 岐伯归来:论腧穴“敏化状态说” [J]. 中国针灸 , 2011 , 31 ( 2 ): 134 - 138 .
陈日新 , 康明非 . 腧穴热敏化及其临床意义 [J]. 中医杂志 , 2006 , 47 ( 12 ): 905 - 906 .
XIE DY , JIANG YX , CHEN RX , et al . Study on the thermesthesia features of heatsensitive acupoints in patients with knee osteoarthritis [J]. J Acupunct Tuina Sci , 2016 , 14 ( 2 ): 110 - 114 .
OVECHKIN A , LEE SM , KIM KS . Thermovisual evaluation of acupuncture points [J]. Acupunct Electrother Res , 2001 , 26 ( 1/2 ): 11 - 23 .
田宁 , 陈日新 , 谢兵 , 等 . 支气管哮喘患者热敏穴红外辐射特征研究 [J]. 上海针灸杂志 , 2014 , 33 ( 2 ): 174 - 176 .
余婷 , 许巍 , 焦琳 , 等 . 基于文献计量学探讨近5年热敏灸研究现状 [J]. 中医药导报 , 2021 , 27 ( 4 ): 174 - 177,182 .
柏琳 . 基于文献数据挖掘的穴位敏化现象与规律研究 [D]. 成都 : 成都中医药大学 , 2017 .
CHEN RX , LV ZM , HUANG DD , et al . Efficacy of suspended moxibustion in stroke rats is associated with a change in tail temperature [J]. Neural Regen Res , 2013 , 8 ( 12 ): 1132 - 1138 .
宋云娥 , 徐放明 , 唐成林 , 等 . 基于ReHo方法的原发性痛经静息态功能磁共振成像研究 [J]. 世界科技研究与发展 , 2012 , 34 ( 3 ): 501 - 505 .
熊俊 , 周星辰 , 谢洪武 , 等 . 穴位热敏态脑机制功能性磁共振研究思路探讨 [J]. 中华中医药杂志 , 2021 , 36 ( 1 ): 41 - 44 .
叶肖麟 . 国外针刺疗法的新发现:耳针疗法介绍 [J]. 上海中医药杂志 , 1958 , 17 ( 12 ): 45 - 48 .
OLESON TD , KROENING RJ , BRESLER DE . An experimental evaluation of auricular diagnosis: the somatotopic mapping or musculoskeletal pain at ear acupuncture points [J]. Pain , 1980 , 8 ( 2 ): 217 - 229 .
BUTT MF , ALBUSODA A , FARMER AD , et al . The anatomical basis for transcutaneous auricular vagus nerve stimulation [J]. J Anat , 2020 , 236 ( 4 ): 588 - 611 .
曹昺焱 , 饶毅 , 庄威 , 等 . 从骨骼肌张力传递解读反阿是穴的治疗效果 [J]. 中国针灸 , 2021 , 41 ( 2 ): 217 - 220 .
梁玲君 , 李良松 . 浅谈阿是穴与“反阿是穴” [J]. 河南中医 , 2016 , 36 ( 8 ): 1471 - 1473 .
谢丁一 , 陈日新 . “阿是之法”是腧穴精准定位之法 [J]. 中华中医药杂志 , 2016 , 31 ( 2 ): 602 - 604 .
WILLIAMS ACC , CRAIG KD . Updating the definition of pain [J]. Pain , 2016 , 157 ( 11 ): 2420 - 2423 .
姜召彩 , 王锦琰 , 罗非 . 预期调节疼痛的认知神经机制 [J]. 中国临床心理学杂志 , 2013 , 21 ( 6 ): 916 - 919 .
WILLER JC , BOUHASSIRA D , LE BARS D . Neurophysiological bases of the counterirritation phenomenon: diffuse control inhibitors induced by nociceptive stimulation [J]. Neurophysiol Clin , 1999 , 29 ( 5 ): 379 - 400 .
梁宜 . 方剑乔痛证针灸治疗精要 [M]. 北京 : 中国中医药出版社 , 2017 : 205 .
朱兵 . 经脉循行与身体分节的对应 [J]. 针刺研究 , 2021 , 46 ( 10 ): 815 - 820 .
谢丁一 , 陈彦奇 , 李巧林 , 等 . 陈日新热敏灸临床安全操作经验 [J]. 中华中医药杂志 , 2020 , 35 ( 4 ): 1869 - 1871 .
魏建子 , 沈雪勇 , 毛慧娟 , 等 . 甲状腺机能亢进症患者内关穴伏安特性研究 [J]. 上海中医药大学学报 , 2008 , 22 ( 6 ): 23 - 25 .
章毓清 , 丁光宏 , 沈雪勇 , 等 . 正常人和冠心病人穴位红外辐射光谱的差异性 [J]. 中国针灸 , 2004 , 24 ( 12 ): 34 - 37 .
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