Figure What is the original basis for the division of meridians and collaterals, the fourth edition of the Chinese medicine textbook of acupuncture and moxibustion edited by Liang Fong and Wang Hua
? What is the nature of the meridians has always been the core issue in the study of modern acupuncture and moxibustion theory, and its conclusions will directly affect the inheritance, innovation, development and international dissemination of acupuncture and moxibustion. Some scholars believe that the basis of meridians is blood vessels, some think that they are nerves, some think that they are sensory phenomena, and some think that they are interstitial connective tissues and fascia that have been ignored by anatomy. function” observed by the person inside.
Any kind of understanding comes from practice, and is In practice, it has been continuously developed and improved, and Chinese medicine is no exception. The medical theories left by the ancients are not static, and they are constantly being practiced, verified, corrected and perfected. Due to the limitations of history, the ancestors’ research on medicine is mainly based on the macroscopic observation and summary of the effect of medical practice, inferring possible internal connections (this reasoning may be correct or incorrect). From the current point of view of evidence-based medicine, some theories cannot find a corresponding material basis (perhaps the theories themselves are defective or even wrong, and it is even less possible to find substantive proofs). Today’s attention is paid, and some traditional theories (can not be called theories) cannot be verified, which easily makes people suspicious of traditional Chinese medicine and is not conducive to the development of traditional Chinese medicine. If another way of thinking, combined with the basic knowledge of modern anatomy, physiology, metabolism and endocrinology, to explain the phenomenon of meridians from the aspects of nerve-humor regulation and local micro-regulation of organs and tissues, may make people more convincing.
Even the classics need to evolve with the times.
The following is reproduced below: Chief Physician Wang Yan, Department of Traditional Chinese Medicine, China-Japan Friendship Hospital An article in this article is for reference by people who are concerned about the meridians of traditional Chinese medicine, and may get some enlightenment.
Interpretation from the clinical point of view of acupuncture and moxibustion The relationship between meridian theory and nerves2020-04-121190
Chief Physician Wang Yan
Top threeDepartment of Traditional Chinese Medicine, China-Japan Friendship Hospital
< span>Combining my experience of more than 20 years of clinical acupuncture work in a comprehensive (tertiary) hospital, I interpret the relationship between meridian theory and nerves from the perspective of clinical acupuncture treatment. It is proposed that the principle of acupuncture and moxibustion should be studied from the bioelectric activity level of acupuncture and moxibustion on the viscera and tissues, so that the current acupuncture and moxibustion treatment mechanism and principle and modern medicine can be better integrated and combined with each other, and the results will “inspire and complement each other”. “To promote the study of the essence of meridians and the development of modern neurology and physiology.
This article is based on my own (pure Western medicine) Comprehensive tertiary hospitals have been engaged in clinical acupuncture and moxibustion for more than 20 years, and they feel that the development of modern medicine is changing with each passing day. Although acupuncture has developed rapidly in the decades since the founding of the People’s Republic of China and has made remarkable achievements, it is relatively lagging behind compared with modern medicine.
This lag is by no means our acupuncture treatment (Operation) The means are backward; but the interpretation of the mechanism and principle of acupuncture and moxibustion does not meet the standards of modern science.
The formation of TCM meridian theory is the In the practice of acupuncture and moxibustion in the treatment of diseases, a general summary of a series of symptoms (symptoms) appearing in a simple manner is described, and a theoretical system is gradually formed.
Due to the history of modern China, the It is isolated from the development of the nervous system and circulatory system, etc., which are most closely related to it, and the reason why it has not been replaced by other theories may be related to the advanced exposition of the concept of life as a whole in the meridian theory of traditional Chinese medicine; and Only one hundred years of history are concerned with the limitations of neurological research in modern medicine.
As the meridian theory to guide clinical acupuncture and moxibustion, the country has invested a lot in meridian research over the years. .
but this is just a repetition of the classic meridian No specific tissue independent of nerves and blood vessels has been found. There is no major breakthrough or substantial progress in the substantive research of meridians, and it is very difficult to use them to guide modern clinical acupuncture.
In the modern clinical treatment of acupuncture, although electroacupuncture has been widely used, There is no ready-made interpretation of traditional Chinese medicine and meridian theory. The direct reason for this result is that meridian theory has reached an ultimate interpretation after thousands of years of development. At present, its reality is reflected in the absolute stability of meridian theory, and any new theory is difficult to Intervention.
Once faced with other theories , it reflects the first is exclusion, the second is the inability to cover, and ultimately affects the update and development of the entire theoretical system.
< span class="data-color--tt-darkmode-b0b2b7"> At present, there is no major breakthrough or substantial progress in the essence of meridians. Since it is a theory, it should be realistic and cover the basic principles of modern medicine.
Due to the working environment, the author has to use the current Some acupuncture and moxibustion clinical and meridian research literatures reported that the principle of meridian and acupuncture treatment was explained to them (patients, Western medicine practitioners, and acupuncture teaching), gradually gaining popularity and acceptance.
A summary is as follows:
Currently, those who actively choose acupuncture treatment in acupuncture clinic Patients are the most common movement system, various joints, muscles and soft tissue pain. The clinical focus is on the selection of acupuncture and moxibustion treatment methods, and the TCM syndrome differentiation and treatment of diseases and pains “cold is warm (remains); Many received good clinical results.
In acupuncture treatment, most of the acupuncture points are selected locally. “Abandoning the scriptures and abandoning the acupoints” mainly focuses on the Ashi acupoints. The application of meridian theory in the treatment of such diseases is not prominent. The substantive study of the meridians from these diseases is undoubtedly ‘seeing the leopard in the tube’.
Involves peripheral nerve stimulation Pain, even if the theory of meridian circulation can be used to explain the disease, but the treatment is still based on the acupoints with nerve trunks distributed under the acupoints.
Such as cervical spondylosis (radiculopathy) Causes numbness of the arms and hands, and it is more effective to take Neck Jiaji acupoint for treatment [1]. In addition, if most of the trigeminal neuralgia is distributed according to the anatomy of the involved trigeminal nerve, local or adjacent acupoints are used for treatment [2]; the same is true for sciatica (P, N, P).
“Spiritual Pivot”: “Husband Ten The two meridians belong to the internal organs, and the external collaterals are related to the limbs.” Therefore, acupuncture and moxibustion can best reflect the theory of meridians in the treatment of diseases of the five internal organs and six organs.
In the clinical treatment of acupuncture, we put ‘Jing’ is understood as nerve; ‘collateral’ is understood as blood (vessel) tube. If we emphasize the functional integration of nerve and blood vessel, that is, inseparability, it is more similar to the function of meridian.
In fact, both central and peripheral nerve The conduction of the nerve is an electrical (N synapse)-chemical (N-junction)-electrical process, and the chemical process of the nerve junction is closely related to the blood (vessel) vessels and is inseparable.
Modern medicine for vascular regulation of lateral angle of spinal cord The research of the center shows that the blockage of its conduction pathway can lead to the decline of blood supply and function of the zang-fu organs.
It can be said that the nerve and its conduction mechanism represent Most of the essence of the meridian.
Among the twelve meridians, the most The meridians and acupoints of ‘advanced understanding’—the bladder meridian of Foot Taiyang (points), its name and distribution are consistent with the internal organs innervated by the autonomic nerve of the spinal cord nerve segment! The bladder meridian (points) describes the viscera with high accuracy. Although the elaboration is not as accurate as modern biology, it can be used to explain the principles of acupuncture and moxibustion in the treatment of visceral diseases, which can be easily understood from the perspective of modern medicine.
Feishu point of bladder meridian is located at T3 1.5 cun below the spinous process. Modern meridian studies have clarified that Feishu points and the lungs have spinal ganglion cell axonal connections. Although Feishu points are not as accurate as modern biology, they are quite and absolutely remarkable at the scientific level and understanding of human beings at that time. .
Modern neuroanatomy, physiology, pathology, etc. are less than a hundred years old! The TCM meridian theory that we are currently applying with a history of thousands of years can still explain the principles of acupuncture and moxibustion in the treatment of visceral diseases in clinical practice, and can enable people to explain its correctness and effectiveness from the perspective of modern medicine.
We choose the bladder meridian to Feishu point Mainly, acupoint injection of vitamin B group was used to cure a case of severe respiratory muscle paralysis caused by silver krait poisoning.
and for subacute allergic spinal cord Inflammation and syringomyelia patients (one case each) were treated with bladder meridian acupoint injection for a long time, which effectively controlled the progression and deterioration of the disease without any side effects.
These prompt us, acupoint injection of bladder meridian Acupoints can not only treat the corresponding viscera diseases, but also an effective method to promote the recovery of spinal cord function. The advancement of the bladder meridian (points) of Foot-Taiyang is also reflected in the fact that there is no named acupoints under the T8 spinous process.
In clinical acupuncture, traditional Chinese and Western medicine are the most The two things that are difficult to understand are “Qi” and “Electricity”. The ancients said, “Qi and blood are synonymous with blood.” If the “Qi” is understood as “the bioelectric activity level based on the viscera tissue”.
It is not difficult to understand that the meridian theory has ” There is no such thing as “connecting qi”. Furthermore, it is not difficult to understand that the therapeutic principle of electro-acupuncture is integrated into the meridian system.
Modern medicine’s effect on the human body’s electricity (EKG , EEG) activity research has been used for many years, but it can be said to be relatively superficial, such as the low ECG voltage displayed by EKG and the low amplitude of brain alpha wave displayed by EEG, which are considered “no” in clinical practice. There are very few studies, and it is more regrettable that there are almost zero studies on the electrical activity of solid organs such as lungs, liver, and pancreas, and some studies have proved that the process of female ovulation is also accompanied by electrical activity.
It is certain that the The research on the relationship between electrical activity and function has practical significance. At present, it is not the lack of effective research methods and instruments, but the lack of understanding that “electrical activity is also an important factor affecting organ function activities”.
Zi’s “Qi” and Organs “Electricity” activity, which will be the common language point of “bridge” between Chinese and Western medicine. Analysis of the reason why the research on the electrical activity of human organs in modern medicine has not made much progress may be related to the lack of means of therapeutic intervention in modern medicine, and this is the strength of our acupuncture (electro-acupuncture treatment).
Anhui conducts research on gastrointestinal electrophysiology For many years, gastric motility research has achieved great results in clinical research of acupuncture and moxibustion. EEG studies have shown that patients with diarrhea have “extremely active intestinal electrical activity in the left lower abdomen”; patients with constipation have “extremely active intestinal electrical activity in the right lower abdomen”.
These results are helpful for our clinical guidance of acupuncture and moxibustion. Diarrhea or constipation, whether it is acupoint selection, selection of operation, and implementation of treatment methods have enlightening significance and more accurate scientific prompts.
The bioelectricity of such organs and tissues Once the activity level research progresses, it will not only explain the principles of acupuncture and moxibustion treatment, but also reveal the role of the human body, especially the electrical activity of the internal organs, in the entire physiological function activities, which will greatly improve our understanding of the human body’s own physiological functions. revise.
Research on the principles of acupuncture and moxibustion can be Start with the impact of spines on the electrical activity of the body. In the electromyography (MEG) examination, there are “insertion potential, action potential, resting potential”, etc. Among them, the “insertion potential” is directly related to the acupuncture operation, so it is not difficult to understand that the reinforcing and reducing treatment of acupuncture is Through the change of electrical potential along the nerve conduction to the spinal cord, and then through the integration of the spinal cord to affect the electrical activity of the organ changed due to the disease, so as to restore its function.
From this, it can be known that acupuncture treatment The biggest feature of the drug is the two-way benign regulation of the functions of the human body’s viscera, and the effect of drugs on the nerves can be said to be “overcorrection”, which is essentially different from it.
From this perspective, it can be understood that various The pathogenic factors cause gastrointestinal hyperfunction (intestinal spasm)/(intestinal paralysis). After acupuncture and moxibustion at Zusanli point, the intestinal peristalsis tends to be normal, and it will not produce (intestinal spasm) P (intestinal paralysis) like drugs, and there is no overcorrection. .
Another example is acupuncture (ovarian maintenance) This is also the difference between the effects of female estrogen (E) and drug treatment. However, the effect of acupuncture on nerves is to make them tend to return to normal physiological levels, and the effect is not as strong as that of drugs. Therefore, the effect of acupuncture should not be exaggerated in clinical treatment.
“Deficiency is made up; At present, there is no substantive standard for quantification of clinical tonic and reducing manipulations, and most of them are based on the feelings of patients receiving acupuncture treatment. The operation that is gentle and has little adverse stimulation is called “replenishing method”; the operation that is heavy and stimulated is called “reducing method”.
Even the same patient is related to his functional status and the needles and techniques used by the doctor. These can be used to formulate quantitative standards for replenishing and reducing according to the potential changes generated by acupuncture operations, similar to the principle of electromyography.
At present, modern medicine has special It is the bioelectric activity level of the zang-fu organs, and the research on the influencing factors in the occurrence and development of many diseases is insufficient; the application of modern medicine cannot fully explain the principles of acupuncture and moxibustion and the phenomena of meridians, which are the directions we need to focus on.
Therefore, meridian research should be based on modern physiology It is a good starting point to analyze and study the phenomena of acupuncture and moxibustion meridians that have not been covered by the known parts of it, and interactive research with modern neurology, physiology and other disciplines.
It can be said that the meridian theory is a modern neurology Research resources.
Of course, the principle of acupuncture cannot be simply In addition and subtraction with modern medical principles, it is not simple to compare high and low; instead, we should identify the position in “mutual complementation”, find breakthroughs in “mutual inspiration”, and improve and develop in terms of giving play to characteristics and advantages.
This is the requirement of the times for acupuncture, It is also one of the important conditions for acupuncture to better meet the needs of society. Things in the world are constantly developing and improving, and so is acupuncture, that is, meridian research.
The above-mentioned relationship between meridians and nerves in this article ” Hypothesis”, it doesn’t matter even if it turns out to be wrong in the future, it’s better than doing a little “do nothing” in the research of “meridian essence” when I have been engaged in acupuncture and moxibustion clinical work for more than 20 years. purpose.