膀胱經背俞穴之部位及排列順序與臨床診治意義

目的：將膀胱經背俞穴的部位及排列順序和臟腑生理病理及臨床診療進行結合，揭示其與中醫生理病理及各類通經關係高度相關的概念。方法：對古代典籍及現代文獻中有關膀胱經背俞穴的部位及主治作用論述進行收集整理與分析，探討與歸納膀胱經背俞穴之部位及排列順序與臨床診治意義。結果：膀胱經背俞穴的部位安排，分為上中下三部，分別司循環呼吸的心肺功能區；司消化作用的肝膽脾胃功能區; 司泌尿生殖的腎膀胱功能區。膀胱經背俞穴排列順序，涵蓋中醫基礎理論的五行生剋關係及各類通經法則，包含表裏經、手足同名經、俞募配穴，也包含源自於內經的五門十變法和臟腑通治法之概念。結論：背俞穴的精細巧妙排列，加強了中醫理論中的經絡基礎，補充闡釋經絡及穴位治療之中醫診療思路。背俞穴為臟腑之氣轉注於背的腧穴，是經氣運輸的通路，也是聯繫身體內外的樞紐，故能反映人體內臟生理、病理的變化，以作為診斷的依據，也可用於治療各類臟腑急重症與慢性病，有直接且快捷的療效，因此常被廣泛應用於臨床。若能理解背俞穴之部位及排列順序與臟腑生理病理間的涵義，將能夠更提升臨床診斷與治療水準。本文針對膀胱經背俞穴排列順序的診療意義進行初探及初步結論，其所含的相關意義仍需更多專家先輩的參與，及應用更先進嚴謹的研究方法來加以探討。

關鍵字

膀胱經；背俞穴；通經概念；五門十變；臟腑通治

並列摘要

Objective：To study on relation of Back-Shu points locations and orders with the Chinese medicine physiology, pathology, diagnosis and treatments. Methods：Searched ancient books and the articles involving the Back-Shu points location and main symptoms. Analysis of the literature data to explain the characteristics of clinical treatment with the Back-Shu points locations and orders. Results：The location of the Back-Shu points can divided into three parts, upper block, middle block and lower block which indicated the cardio-pulmonary function, the digestive function and genitourinary function. The order of the Back-Shu points reflected many Chinese medicine physiology, pathology and many kinds of ideas of the promotion of flow in meridians, such as, ＂Wu Mun Shie Bein＂, ＂Zang Fu Tong Jih＂, superficial inner meridians, the same name at hand and foot, ＂Shu-Mu point＂et al. Conclusion：The cleverly arranged Back-Shu points, can strengthen the foundation of traditional Chinese medicine meridian theory, explain the thinking process of Chinese medicine clinical practice. Back-Shu points transported the meridians qi, contacted the inner and outside of the body, it can reflect the physiological and pathological changes in human organs, as a basis for diagnosis, often widely used to treat severe acute and chronic diseases with direct and fast effect. If we can understand the implications of the order of Back-shu point more, we may able to enhance the clinical diagnosis and treatment levels. This paper was preliminary conclusion, the relevance of contains remains more expert participation and more advanced methods to be explored.