中醫古籍睡眠障礙之針灸療法

目的：探討睡眠障礙之針灸古籍及理論，進而訂出睡眠障礙之針灸取穴、配穴原則。方法：將針灸相關古籍資料匯整分類，歸納與理論分析，進一步訂出睡眠障礙之針灸取穴、配穴處方。結果：本研究搜尋針灸治療結果顯示，共得54個與睡眠障礙相關穴位，其中有21個穴道位於五俞穴，其中以井穴佔7穴比例最高，其次依序為：經穴5穴、俞穴4穴、合穴3穴、滎穴2穴；以五行屬性來看，以「金」的7個穴道比例最高、其次是「土」6個穴道、接著依序是「木」3穴、「火」3穴、「水」2穴；以經絡而言，膀胱經的穴位數量最多，但使用率最高的3個穴位中肺經佔2個穴（天府、太淵）。其次是脾（胸鄉、陰陵泉、太白、隱白）、胃經（豐隆、大巨、厲兌、條口）。多穴治療方面，膀胱經與肺經佔所有失眠配穴一半的比例，可見膀胱經與肺經在失眠選穴治療上的重要性。「備急千金要方」是記載最多失眠穴位的古書，造成睡眠障礙的原因最多為咳喘、脅痛、身脹腹堅、煩、驚、脛中寒等因素。結論：陰陽不調導致睡眠障礙的病機，包含了陰血不足與陽氣獨亢及胃氣不和。針灸療法於睡眠障礙發展出多元的治療策略。且針對肺系統的症狀、腸胃系統病症影響睡眠的因素，針灸有較多的治療策略。建議中醫師臨床診治睡眠障礙時，遇到未在古籍記載的病症時，不宜將治療策略僅聚焦於睡眠障礙，而應回歸“陰陽不調＂的病因及中醫基礎理論來選穴及配穴。

關鍵字

睡眠障礙；針灸；中醫古籍

並列摘要

Background and Purpose: To consider the classical texts and theories on acupuncture and moxibustion in related to sleep disorders in order to identify the principles involved in choosing the correct acupuncture points and how to allocate these points for the treatment of sleep disorders. Methods: By collecting and classifying the ancient texts and data on acupuncture and moxibustion, then inducing and analyzing the theories they expound in order identify the correct acupuncture points and their application. Results: The research results on acupuncture and moxibustion treatment carried out during this study indicates that a total of 54 points have been related to sleep disorders. Of those 54 points, 21 points are located by the Wushu-Points system as under the Meridians. Among these, the highest proportion that have been applied to the treatment of sleep disorders are Jîng-Points (part of the Wushu-Points system) (7 points), the next was the Jing-Points (5 points), then Yu-Points (4 points), then He-Points (3 points) and finally Ying-Points (2 points). When the Five Elements of the Chinese Herb Medicine's approach was applied, Metal-Nature-Points were greatest used (7 points), then Wood-Nature-Points (3 points), then Fire-Nature-Points (3 points) and finally Water-Nature-Points (2 points). When the Meridian theory is used, the Urinary Bladder Channel of Foot Taiyang was the most involved, while the second most important was the Lung Channel of Hand Taiyin (TianFu point, TaiYuan point), then the Spleen Channel of Foot Taiyin (Xiongxiang, Yinlingquan, Taibai, Yinbai) and finally the Stomach Channel of Foot Yangming (Fenglong, Daju, LiDui, TiaoKou). If we consider multiple treatment points, half of the points that can treat sleep disorders are located within the Urinary Bladder Channel of Foot Taiyang and the Lung Channel of Hand Taiyin. Based on this, we can conclude that these two Meridians are the most important when selecting points for treating sleep disorders. The classical text ”The Prescriptions Encyclopedia for Emergencies” records the most information about the points related to insomnia. It states that sleep disorders mostly are caused by coughing and panting, pain from the upper part of the side of the human body, edema and an overfirm abdomen, feeling annoyed, feeling shocked, coldness in shins etc. Conclusion: The causality basis for sleep disorder in terms of an imbalance of Yin and Yang include insufficiency of Yin Blood, hyper Yang Chi and disharmony of the Chi in the Stomach. Acupuncture and moxibustion treatment strategies for sleep disorders have been developed and are much diversified. Moreover, for disorders caused by symptoms of lung system, stomach and intestines, there are a range of acupuncture and moxibustion treatment strategies available. We suggest that when treating sleep disorders that were never been recorded in the classical texts in a clinic context, Chinese Medicine doctors should not only focus on sleep disorders for the treatment strategies, but should also go back to the cause of the imbalance of Yin and Yang. This would include using Chinese Medicine theories to help the choice and allocation of the correct points.

並列關鍵字

sleep disturbances ； acupuncture ； literature retrospective

被引用紀錄

余杰（2009）。氣壓式脈波量測系統之研製及應用〔碩士論文，中原大學〕。華藝線上圖書館。https://doi.org/10.6840/cycu200900341

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中醫古籍睡眠障礙之針灸療法

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