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中医药研究论丛
 222.10 针灸诊治心脏疾病探讨
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TJ TCM.22(2) : 91-106, 2019
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针灸诊治心脏疾病探讨
Review of Acupuncture Theory in Diagnosis and Treatment of Acupuncture of Heart Diseases
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陈中奎1 沈邑颖2 陈怡真1,3*
1 佛教慈济医疗财团法人花莲慈济医院中医部，花莲，台湾
2 佛教慈济医疗财团法人关山慈济医院中医科，台东，台湾
3 国立东华大学教育与潜能开发学系教育研究所，花莲，台湾
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【摘要】
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心为君主之官，主宰人体生理与精神一切活动，文献指出无症状心肌梗塞(silent myocardial ischemia) 为心肌梗塞过世的主因(1,9)。西医使用精密仪器与检测来监控心脏状态，当疾病症状出现时加以治疗。《灵枢·本脏》云：「视其外应，以知其内藏，则知所病矣。」本文将论述如何藉由望诊及经络系统进行诊察，及早发现心脏疾病的先兆以进行事先预防和治疗，达到中医治未病的概念，以减少或减缓突发心肌梗塞之憾事。关於心脏疾病的中医治疗，病性多属气血阻滞，以《灵枢·九针十二原》：「宛陈则除之」原则，使用拨罐、放血疗法使气血循环通畅；病位上心肌梗塞常见反射区域与心、小肠经循行部位、通经系统延伸相应部位相叠，包含颈肩胸背腋各部。治疗时审因辨证论治，兼顾病性与病位，才能让疾病问题根除，透过中医四诊诊察心脏疾病先兆，卫教病人减少繁重工作、注意保暖、重视身体警讯，进而提早预防心脏疾病为首要工作。心脏是个精密的器官，一生跳动数十亿次，适切的预防和治疗让其机能更长久是医师与病人共同努力的方向。
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【关键词】无症状心肌梗塞、针灸、拨罐、放血、经络系统
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Jhong-Kuei Chen1 Yi-Ying Shen2 Yi-Chen Chen1,3*
1Department of Chinese Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
2Department of Chinese Medicine, Kuanshan Tzu Chi Hospital, Taitung, Taiwan
3Department of Education and Human Potentials Development, National Dong-Hwa
University, Hualien, Taiwan
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【Summary】
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Heart is a speechless organ. If we always ignore its impaired, it should be unfortunately to become a tragedy. At present, silent myocardial ischemia is the major factor of lethal myocardial ischemia(1,9).
In western medicine (WM), various precise instruments are used for monitoring the heart conditions, and corresponding treatments will be delivered when the diseases occur. However, traditional Chinese medicine (TCM) emphasizes the prevention of disease. As Inner Canon of Huangdi (Huangdi Neijing) says, “The observation of external manifestations of viscera can reveal the physical conditions inside the body, so as to identify the diseases that may occur.” The prevention and treatment will be launched timely if the heart disease can be detected by the inspection of four-meridian-collateral system which includes twelve meridians, twelve meridian divergences, meridian sinew (Jingjin),as well as collaterals (table 1). In the view point of TCM, heart disease is due to qistagnation and blood stasis, therefore, both cupping and blood-letting therapy can be applied for promoting the circulation of qi and blood. Besides, not only heart meridian and small-intestine meridian, but also other corresponding locations related to the extension of both meridians mentioned above are the common reflexion areas of myocardial infarction (table 2). As a result, the treatment should focus on the nature and location of the disease. The prevention of heart diseases should be considered as the foremost task, via TCM four diagnostic methods for detecting heart diseases, as well as hygiene education for reminding patients, such as reducing workload, keeping warm and paying attention to signs of the body. The heart is a delicate organ with billions of beats during the whole life, which is worthy of being attached great importance by every single person.
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【Keywords】silent myocardial ischemia, acupuncture, cupping, blood-letting,meridians
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