针刺研究2025，Vol.50Issue(2)：224-231,8.DOI:10.13702/j.1000-0607.20240807
针灸诊查之要,贵在医患共"知"
The key to acupuncture-moxibustion diagnosis and examination lies in the"knowledge"of both doctors and patients—revisiting the"Yi Zhi Wei Shu,Yi Tong Wei Shu"
摘要
Abstract
The correct selection of the stimulated site is the key to the effectiveness of acupuncture and moxibustion.In the present paper,we propose that in the treatment of Jingjin(muscle,tendon,fascia,ligament,etc.)disease,the stimulated position of acupuncture or moxibustion should be determined by careful examination,rather than only selection of the fixed acupoints.The"Yi Zhi Wei Shu"(以知为数"Zhi"i.e."knowledge"),means:the limit of the number of acupuncture or moxibustion treatment sessions is according to the therapeutic effect(improvement or cured)of a disease achieved,while the"Yi Tong Wei Shu"("以痛为输")refers to needling the site where the pain is,i.e.Ashi point,recorded in book Lingshu.Jingjin(Miraculous Pivot:Aponeurotic Structure along Meridians),are the basic principles and methods for the treatment of Jingjin disease.The ancient physicians and modern doctors have different understandings on the selection of number of treatment sessions,and the stimulation of Ashi-points.Combining the meaning of"Zhi"of"Yi Zhi Wei Du"("以知为度"meaning that the herb-medicines can be taken until the clinical condition has been improved to a certain extent,and it is not necessary to stop the medicines until it is completely cured)in Shang Han Za Bing Lun(Treatise on Febrile and Miscellaneous Diseases)for the first time,we hold that the"Zhi"of"Yi Zhi Wei Shu"reflects the doctors'ability to grasp the rules of diagnosis and treatment of diseases,that is,doctors'professional"cognition".We also propose that the saying"Yi Zhi Wei Shu,Yi Tong Wei Shu"refers to guiding how to determine the stimulated spots of acupuncture or moxibustion for Jingjin disease.It is by no means to choose the pain site complained by the patient,but the doctor's judgement is according to the patient's perception of tenderness proposed during physical examination such as touching and pressing,which is the patient's"Zhi".The saying"Yi Zhi Wei Shu,Yi Tong Wei Shu"could be understood that the determination of the stimulated spots of acupuncture and moxibustion for Jingjin disease should be based on the doctor's professional"cognition".During the physical examination,the doctor makes a judgment on the patient's"knowledge of pain site",so as to determine the treatment points,that is,the"Zhi"of both doctors and patients should be achieved.Furthermore,combined with the theory of acupuncture and moxibustion in the treatment of Jingjin disease,tension-type headache,postherpetic neuralgia,primary trigeminal neuralgia and other diseases and heat-sensitive moxibustion theory,the connotation and clinical application value of"Yi Zhi Wei Shu,Yi Tong Wei Shu"are explained,in order to provide enlightenment for the determination of stimulated points of acupuncture and moxibustion.关键词
针刺/艾灸/以知为数/以痛为输/经筋病Key words
Acupuncture/Moxibustion/"Yi Zhi Wei Shu"/"Yi Tong Wei Shu"/Jingjin disease引用本文复制引用
李昕蔚,高帆,刘慧林,刘璐,游伟,魏嘉,程金莲,李彬,闫世艳,李子祎,邵冰..针灸诊查之要,贵在医患共"知"[J].针刺研究,2025,50(2):224-231,8.基金项目
北京市医院管理中心"扬帆"计划临床技术创新项目(No.ZLRK202324) （No.ZLRK202324）
北京市医院管理中心"登峰"人才培养计划团队项目(No.DFL20241001) （No.DFL20241001）
首都卫生发展科研专项项目(No.首发2024-2-2235) （No.首发2024-2-2235）
