285胃痛的针药疗法

大医精诚 - 2012年12月18日 - 236 浏览

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胃痛是个统称,可能包括现代医学的急性胃炎、慢性胃炎、溃疡病、胃痉挛、胃癌、胃肠神经功能紊乱等。治疗胃痛,若论止痛,以针灸取效比较快,而有些疑难病,针药结合效果更好。针灸取穴相当简单,可分两组,一组是脾俞、胃俞、大椎、肝俞;一组是中脘、梁门、足三里、内关。第一组治本为主,第二组可治标,止痛相对快一些。王智贤老中医的体会则是用中脘配合肓俞止痛比较快。而中药治疗要抓住邪实一面,比如湿困中焦者,用楂曲平胃散比较好,胃脘压痛(腹诊)者,加枳实,大黄,干姜;口干加黄连;肝胃不和或肝逆犯脾的,柴平汤或四逆散加减;痰热的,小陷胸汤效果好;寒热错杂者,半夏泻心汤,辩证眼目在哪里呢?感觉胃中嘈杂,口干苦,脉滑。嘈杂是一种说不来的不适感。有时会感觉灼热,外在又怕寒。虚证主要有脾虚不运,用六君子汤;脾胃虚寒用附子理中汤,如果合并肾虚者,要合上六味地黄丸。胃阴伤难治,可用一贯煎合百合乌药散加减。胃痛本身可能出现在胃炎或是十二指肠溃疡,如果同是虚寒的话,胃炎用附子理中或补中益气,而溃疡用黄芪建中为好,虚寒明显可加附子。夜间痛得明显,加丹参、檀香、砂仁。针药各有所长,有些用药不好的,往往用针给治好了。

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