022针灸名家论针灸系列(一):彭静山的针灸六要

大医精诚 - 2008年11月16日 - 1,927 浏览

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     现在社会,有名的不一定明白,著作多的未必是大家。中医界不少人医家倾其一生,可能写了一本小书,但价值很大,而那些动不动就主编大部头的,未必有多少真料。彭静山是当代针灸名家,其著作不算多,《针灸秘验》是其临床实践的总结,其中也有些是祖传的宝贵经验。其提出的针灸六要,有一定见地:

   

1.  辨证精:单靠特效穴,就像用药单用特效药一样,不能十全。要学会辨证,侠溪治肝阳上亢之眩晕效佳,而血虚、痰浊则少效;合谷和内庭治牙痛常用,但下牙痛因牙髓炎、齿龈炎而发,要取脾经和肾经穴位。腰痛有肾虚、外伤、寒湿等原因,光靠委中不行。

2.  取穴准,膏盲穴应肩胛骨展开取,养老穴要转手向胸取。背俞穴要熟悉解剖,学会摸数椎骨。左右穴的筛选,取双穴还是取单穴,取健侧或患侧,皆应准确恰当,方为有效。左右穴位的选取时,必须依该病所出现的经络失调情况,选取最易促使经络恢复相对平衡的穴位。如右腿痛,检查经络,发现右足少阳经为实证,左侧为虚证,那么取阳陵泉时,若单施补法,可取左阳陵;单施泻法,可取右阳陵。若取双穴时,可左补右泻。

3.  手法明:针灸得气很关键,是取效的标志。针下沉紧,得气要妙。如不得气,则要调整针刺位置、角度、深度;属体质和病情因素,要用手循经点按,以催气至!

4.  善妙用:临证选方贵在随机灵活。胃脘痛一般选中脘、内关、足三里,当痛及少腹与胸胁时,即要选配肝经穴位;若出现胀满、纳呆、消化不良时,要选配脾经穴位。这样按病机加减用穴,比单守主穴效力显著。对于验方,也不可机械地搬用,既要符合辨证,又要符合病机。如人迎、太冲、合谷是治疗肝阳偏亢而眩晕的一张良方,但对肾阴虚或痰浊的眩晕即不易获效。即使症状有所缓解也是暂时的。

5.  病适应:针灸适用于功能失调的疾患。对某些器质性疾患亦有—定的疗效,如视神经萎缩、小儿麻痹后遗症等。对一些慢性炎症、传染病如菌痢、百日咳、肝炎等;寄生虫病如疟疾、蛔虫等均有一定疗效。

  6贵于恒:要和患者沟通分析病情,需要一定的恒心坚持,才能治愈疾病。

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