本文選題：軟組織損傷 + 內(nèi)經(jīng)��； 參考：《南京中醫(yī)藥大學》2017年碩士論文

【摘要】：目前,慢性勞損引發(fā)的軟組織損傷疾病日益增多,對軟組織損傷的論治,現(xiàn)代醫(yī)學與傳統(tǒng)醫(yī)學各有不同。雖然臨床上治療軟組織損傷性疾病的方法豐富多樣,但究其基本原理都是通過松解局部或者相關(guān)聯(lián)的遠端軟組織以改善癥狀。眾所周知,軟組織損傷相關(guān)病癥為針灸治療的優(yōu)勢病種,而通過各種針具、手法松解病變局部以治療此類病癥,古已有之,追溯其松解理念的源頭,則發(fā)現(xiàn)"無問腧穴、以痛為腧、不談補瀉、直接刺脈、以松治痛"的治療理念從《內(nèi)經(jīng)》就已存在。《內(nèi)經(jīng)》作為中醫(yī)經(jīng)典,向受尊崇,針灸理論從《內(nèi)經(jīng)》開始形成以后,就呈現(xiàn)高度的穩(wěn)定性。以微針調(diào)氣血、經(jīng)絡(luò)腧穴為主的治療方法是傳統(tǒng)針灸的主要形式,目前在臨床占主導(dǎo)地位,經(jīng)脈理論則是其理論核心,主要用來解釋針灸的遠隔效應(yīng),而《內(nèi)經(jīng)》針灸理論中最開始出現(xiàn)的血脈理論、形體層次辨證、對癥治療等近治理論,因其后世理論化程度較低,在目前針灸治療理論中未能有比較恰當?shù)谋硎龊蛻?yīng)有的體現(xiàn)。在現(xiàn)代針灸臨床治療中,受中醫(yī)學辨證論治整體治療的思維定式影響,針灸自身的治療特點不能恰當體現(xiàn),且對于一些針灸療法的優(yōu)勢病種,主流觀念的治療理論與實際臨床應(yīng)用大有不同,而對其實際操作的解釋也有所牽強。隨著解剖學、生理學、外科學、神經(jīng)學及生物力學等現(xiàn)代醫(yī)學科學的發(fā)展,在傳統(tǒng)針灸的基礎(chǔ)上很多新療法不斷涌現(xiàn),被賦予新的概念與理論并被冠以新的名稱,演繹著本是同根,卻涇渭分明的角色,然其應(yīng)用工具、操作方法、治療部位等均與傳統(tǒng)針灸治療理論相類似,更甚者明顯"換湯不換藥"。任何一個學科都在不斷發(fā)展成長,傳統(tǒng)針灸理論形成之后,在持續(xù)更新的醫(yī)療環(huán)境中被重新理解與詮釋,其內(nèi)涵也隨之不斷豐富。本文通過整理和分析現(xiàn)代用于治療軟組織損傷的代表性療法,對其在治療軟組織損傷疾病時所發(fā)揮的軟組織松解作用進行說明,探討各種新針具與傳統(tǒng)針灸的關(guān)系,以期對臨床治療有所指導(dǎo),為相關(guān)臨床研究提供依據(jù);旨在對《內(nèi)經(jīng)》傳統(tǒng)針灸理論中的近治理論有所闡釋,對其所隱含的現(xiàn)代醫(yī)學思想進行探討,以期為針灸在臨床優(yōu)勢病種治療上提供更多的理論解釋,為傳統(tǒng)理論的現(xiàn)代表達提供借鑒,為針灸理論的完整構(gòu)建提供思路。文章分三個部分進行論述:第一部分:概述現(xiàn)代醫(yī)學對軟組織損傷的認識以及論治。通過分析發(fā)現(xiàn),現(xiàn)代醫(yī)學對軟組織損傷的病理機制研究比較豐富,在眾多學說中都涉及軟組織損傷后因無菌性炎癥使組織粘連致瘢痕攣縮而出現(xiàn)疼痛,基于此,其治療除了鎮(zhèn)痛消炎外,主要是以松解治療為主。軟組織松解術(shù)作為外科手術(shù)中眾多手術(shù)技巧之一,所占比例較小,宣蟄人首先將軟組織松解術(shù)發(fā)展為一類單獨的外科手術(shù),形成軟組織外科學,而后發(fā)明銀質(zhì)針,以針代刀治療軟組織損傷。第二部分:概述針灸推拿對軟組織損傷的認識及論治。針灸作為中醫(yī)的一部分,早期就有對軟組織損傷的整體認識,"筋傷"以疼痛為主要癥狀,中醫(yī)對"痛癥"以"不通則痛,不榮則痛"為總的指導(dǎo)綱要,在對軟組織損傷的治療上也基于此則,"筋傷"多以"不通而痛",所以其治療也主要為"疏通",各種針刺治療及推拿治療就是要松解其不通之處,使其通而不痛。治療方法以針刺治療和手法治療為主,使用工具有不帶刃的毫針、圓利針、撥針、筋針等,有帶刃的針刀、刃針等,其共同特點是都具有松解軟組織的作用,臨床常相互結(jié)合以提高療效。臨床上,毫針以刺激作用為主,但在對于軟組織損傷的論治過程中,其松解作用不可忽略不計。第三部分:整理探討《內(nèi)經(jīng)》針灸理論中的軟組織損傷論治理論。"皮脈肉筋骨"五體理論用于軟組織損傷的形體辨證,指導(dǎo)具體針具和刺法的選擇,依病變的層次確定針刺的深度�！秲�(nèi)經(jīng)》中對經(jīng)筋病與部分痹癥的認識與現(xiàn)代醫(yī)學對于慢性軟組織損傷的認識基本相符,"九針"、"對癥刺法"與"解結(jié)"刺法松解軟組織以治療軟組織損傷,與現(xiàn)代醫(yī)學治療原理相差無幾。
[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.

【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R245

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