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咽部及卜-颌部
因为心为五脏六腑之大主,肺、脾、肾、胃、胆等经脉皆 入心,所以其他脏腑的病症,均可影响到心而发生心痛,《灵 枢•厥病第二十四》就详细论述了肾心痛、胃心痛、脾心痛、 肝心痛、肺心痛的症状和针灸治疗方法,其中提到的“處心 痛,手足清至节,心痛甚,旦发夕死,夕发旦死”,与心肌梗 塞极为相似.现在-般的说法是张仲景创立7■排证论治的方 法*我不M意这一观点,如果不否认经络辨证是一种辨证方法
的话,那么经络辨证的方法在《灵枢》中已经较为完备了9所 以准确的说法应该是张仲景创立了六经辨证的方法,而不是辨 证论治的方法.
<1)内关
针剌内关(图32)治疗心绞痛有很多的临床报道,也有 不少的实验研究以阐明其机理。 출장 ,为什么内关对 心绞痛有较好的疗效呢?
《灵枢•经脉第卜》“手心主之别,名曰内关,去腕二 寸,出于两筋之间,循经以上系于心包,络心系。实则心痛, 虚则为头强,取之两筋间也。”因为内关是心包经的络穴,从 此处别出一条分支既“上系于心包”,又“络心系”,所以针刺 内关就可以治疗心痛等一切心病。此外,内关还是八脉交会穴 之,通阴维脉,《难经•第二十九难》□: “阴维为病苦心 痛。”说明针刺内关治疗心痛还与调理阴维脉有关。
也正因为内关穴对心痛有确实的疗效,所以后人在四总穴 歌“肚腹三里留,腰背委中求,头项寻列缺,面口合谷收”的 基础上又加上了一句“心胸内关谋”,变成了五总穴歌^
(2)至阳
中国人民解放军第266医院内二科主任王维庭主任医师于 1987年在《中两医结合杂志》第4期t报道了按压至阳穴 (图30>治疗心绞痛的方法。我大约记得其发现用至阳穴治疗 心绞痛的过程是这样的:有…个奇怪的病人,每次心绞痛发 作,必将背紧靠于墙上就可缓解,此病人微有驼背,后来他仔 细观察.靠于墙上的部位正是第7胸椎棘突下的至阳穴。他就 출장 ,起效时间多数为5〜10秒,于是他便 发表了《按压至阳穴缓解心绞痛临床实验观察》一文,之后他
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