| 摘要: | 近代相關的針灸處方研究，偏向於以疾病、醫家或古籍為分類方式，歸納針灸驗方的選穴原則及配穴規律，對於針灸處方模式，較缺少深入、系統的闡述。本研究以文獻蒐整的方法，探討針灸處方模式的定義、源流，並與中藥處方模式比較，嘗試解決在針灸處方模式未來發展上的爭議與難題。
針灸處方模式源於先秦「以痛為輸」的經驗，並在《內經》形成經絡、臟腑辨證施治的處方模式概念，注重四診、脈症合參，多為單穴處方。發展至宋、金、元，逐漸融入成熟的經絡腧穴理論，以及對於病因病機較完整的認識，以遠道循經取穴為主，局部取穴為輔，注重五輸穴及俞募穴等特定穴的運用，組成由單穴朝向複穴發展。明清時期是針灸處方的匯整積累時期，但針灸處方學並未形成如方劑學的系統學科。探究原因，發現腧穴的歸納方式仍以主治應用為主，如藥性般概約的穴性理論並不完備，難以指導辨證立法後的組方選穴。另外，由於目前尚未有一套較統整的辨證方法，而引起了某些學者認為針灸處方模式不該套用中藥處方的模式。
釐清診療思路，探究理、法、方、穴的處方模式，完整針灸處方模式中不足的理論與方法，以供臨床操作及實驗研究參考，進一步驗證完善理論，促進針灸學朝向更完善的理論醫學發展。
The art of acupuncture consists in selecting the right points and combining them in a harmonious way. A successful acupuncture treatment depends on many factors which include:
1. Correct diagnosis
2. Proper principles of treatment
3. Appropriate choice of formulas
4. Synergistic combination of points
The composition of an acupuncture prescription can give us an idea of the theoretical, as well as the clinical thinking process of the physician.It also can define the main points of acupuncture efficiency.
In recent times, relevant acupuncture prescription research has lean towards the use of disease, skilled doctors, or classical literature models as the criteria to classify the various techniques, as well as to be better able to deduce the principles and rules of formula composition, formula combination, and proven formulas. This will allow us to compare and contrast the lack or depth of the various theoretical, methodological, formulaic and points prescription models.
The research method employed in this thesis consisted of collecting, analyzing and sorting out a large amount of related documents in order to inquire into the definition, the origin and development of the prescription, and the methodology used in the application of acupuncture and moxibustion. We compare the prescription methodology used in traditional Chinese herbal medicine and Acupuncture in order to solve disputed areas between Chinese herbal prescription and acupuncture prescription models.
Acupuncture and moxibustion prescriptions styles started to arise in the early pre-Qin period. People used the experience of painful points as the location of acupuncture points. In the “Neijing”, there already existed the formation of concepts such as “disease identification and treatment application” according to “viscera and bowels” channels and network vessels”. Emphasis was placed on “the four examinations”Correlations were made between the pulse and pathoconditions, with mostly single point prescriptions.
The development extended to the Song dynasty, and gradually changed into a mature theoretical system with a complete understanding that incorporated the channels and network vessels, disease cause and disease mechanism, and emphasized the use of distal point selection with local point selections as the assistants. In addition much emphasis was stressed on the use of alarm points as well as transport points, and also points with special functions.
The Ming and Qing periods where the time when acupuncture and moxibustion prescriptions were compiled and accumulated. But acupuncture prescription studies had not yet formed and developed in the same way that herbal formula prescriptions had developed and established its own system of study.
While investigating the reason of point selection and deduction, we found that the practical indication was regarded as more significant. The point theory was approximate to the nature of herbal medicinals, but not at all complete, and difficult to guide prescription composition according to pattern identification theory
In addition, due to acupuncture not having a complete system of differentiation, it has given rise to some scholars thinking that acupuncture prescription should not be conducted in the same way as herbal formula prescriptions are.
By clarifying the train of thought used in the diagnosis and treatment, we can explore the different aspects’ such as theory, method, formula and point selection styles. We look forward to eliminating some of the misconceptions and controversies surrounding the construction of acupuncture prescriptions, as well as promote a more complete and developed theoretical medical system. |
