摘要
目的:现在世界各国的医疗界都希望针灸医学、补充和替代医学的科学化、客观化以及西洋医学和针灸医学、补充和替代医学相结合的结合医学得到发展。包括针灸医学在内的传统医学、补充和替代医学对于预防和改善由于各种精神压力所致的身心过紧张症,各种不定愁诉,慢性疼痛和生活习惯病具有显著的疗效。西洋医学和针灸医学、补充和替代医疗的根本区别在于治疗手段的不同。针灸医学、补充和替代医疗是以自然治愈力为基本点,确立医患之间的良好关系,运用细致、柔和的治疗手段,通过调节患者自身的机能从而达到治疗目地的一种医学。中国传统医学的古典医籍《黄帝内经》中强调∶“治神”是针灸治疗的根本原则。这里所说的“治神”是指生命活动的总称,同时也意味着大脑的机能。“治神”是调节身心两个方面自愈力的中心-脑的功能。这在治疗上是非常重要的,因此,“治神”是传统医学中的关键性概念。特别是针灸医学、补充和替代医疗在施术时使患者得气的手法比较多,认为得气是促进“治神”的重要因素,在此,把“治神”作为针灸医学、补充和替代医疗、结合医疗的共同的疗效机理来考虑、以“治神”的古典概念客观化,科学化为目的,进行了研究。对象方法:研究对象为健康成人以及各种疾患患者计120例。关于治效原理的研究内容:①从脑波等电位分布图EEG、阳电子放射断层摄影法PET所见到的治效原理的科学化。②应用多变量解析法解明“治神”理论,并通过应用文献学,脑科学,核科学,身心医学,计量医学的方法进行了综合的分析与探讨。结果:①得气的脑波等电位分布图的能量的变化虽然涉及到全皮质领域,特别是从头顶叶到前头叶最为明显。分别分析症例可见α带域的输出势力明显增大、θ波带域的输出势力也有增大。②从PET(positron emission tomograpy)像上可以看到,针刺激时的“得气”可以使旧皮质到新皮质出现一过性激活、使广范围的脑细胞受到影响。通过针灸的通电刺激局部脑血流量变化平均为15-20ml/100g脑组织/min。X综合分析EEG和PET的结果、可以认为伴随针灸医学、补充和替代医疗的施术而至的得气、对于包括A10神经在内的广范围的脑神经细胞产生了影响、解消了古皮质(情动脑)和新皮质之间的差异、调整了自律神经的机能、复活了包括视床下部在内的脑干部细胞(生命脑)的功能,从而达到了提高自然治愈力的效果。③把“治神”作为是复杂的因子相联系的多次元的现象类型来考虑,进行疼痛愁诉的多变量分析,确立了疼痛制御与“治神”具有共通性的理论模型。结论:包括西洋医学,针灸医学、补充和替代医学、结合医学在内的所有医疗行为的最终目的在于治愈“身心如一”存在的全人的病人的疾病。对于病人来说“全愈”是治疗的最终目的。在此方面西洋医学的治愈和针灸医学、补充和替代医学、结合医学的治愈没有任何区别。通过“治神”理论的模式不仅可以说明针灸医学、补充和替代医学、结合医学的治效原理,同时也能够解明疾病,宗教治愈的根本原理。不同的国家和地区,包括针灸医学在内的补充和替代医学的临床的实态是多种多样的。可以说,因其具有多样性,才有临床的本质和发展的原动力。因此,首先,在尊重“多样性”的基础上,再深入到多样性的根本当中去,寻找出普遍的要因,构成假说,站在全人医疗的观点上,通过进行“假说验证”,就将可能确立世界通用的针灸医学、补充和替代医学学问的体系化。
Objectives： At present, what the medical circles around the world need the most is the scientification and objectification of acupuncture medicine and complementary/alternative medicine （CAM）, and the development of integrative medicine into which Western medicine, acupuncture medicine and coinplementary/altemative medicine are merged.Fundamental differences between Western medicine and acupuncture and complementary/alternative medicines are in the methods of treatment. Methods of treatment for acupuncture medicine and complementary/alternative medicine are characterized by the emphasis on the ＂Healer Within＂ as the starting point of ＂healing＂, the establishment of a favorable therapist-patient relationship （the space）, and the use of subtle and mild forms of treatment to alleviate the symptoms and regulate the functions of the patient.＂Inner Canon of Huangdi＂, a classic of acupuncture medicine in China has emphasized that the idea of ＂Control Shen＂ is the fundamental principles of acupuncture therapy. ＂Shen （the spirit ）＂ in this context is a general term for life activities and also refers to the functioning of the brain. Thus, ＂Control Shen＂ is the key concept of acupuncture medicine, which indicates that controlling the cerebral function as the center of natural healing power, both in physical and mental aspects, is most important in therapeutic effects. Traditional medicine and complementary/alternative medicine especially have many treatment methods that induce comfortable stimuli （de-qi） is considered to be an important factor that gives impetus to ＂Control Shen （spirit）＂. Thus, we figured that the principles of therapeutic effects that are commen to acupuncture medicine, complementary/alternative medicine and integrative medicine is ＂Control Shen＂ and conducted a study for the purpose of objectification and scientification of the classic concept of ＂Control Shen＂. Methods： Subjects for the study were 120 persons consisting of healthy adults and patients with various ailments. Study on mechanisms of therapeutic effects was divided into two categories： （1） Scientification of principles of the therapeutic effects based on EEG topogram and positron CT （PET） data; （2） Theoretical understanding of ＂Control Shen＂ by applying multiple classification analysis method. Each category was comprehensively analyzed using an interdisciplinary approach that applied philology, brain science, nuclear medicine, psychosomatic medicine and medicometries.Results ： （1） Changes in EEG power of the EEG topogram under ＂de-qi＂ were observed in all cortical regions, especially in the area from the frontal lobe to the occipital lobe. Assessment of each case revealed that the changes could be categorized into two types： a type where only the alpha wave power increased, and a type where both alpha wave power and theta wave power increased. （2） Cerebral function images by PET revealed that ＂de-qi＂ transiently invigorated both the palecortex and the neocortex and affected a wide range of cranial nerve cells. Variation in regional cerebral blood flow （rCBF） induced by the electric needle stimulation was 15 - 20 ml/ 100 g brain tissue/rain in average. It was indicated that de-qi associated with the treatment therapy of acupuncture and complementary/alternative medicines affected a wide range of brain nerve cells, including the A10 nerve, settled the friction between the paleocortex （the emotional brain） and the neocortex （ the intellectual brain）, controlled the autonomic function, and activate the brainstem （the living brain） including the hypothalamus, leading to enhancement of natural healing power. （3） We considered ＂control Shen＂ as a multidimensional phenomenon pattern involving complicated factors, and established a theoretical model common to pain control and ＂Control Shen＂ by multivariate analysis of pain complaints. Conclusion ： The most important behavioral objective for medicine, including Western medicine, acupuncture medicine, complementary/ alternative medicine and integrative medicine, is healing of the patient, who is regarded as a ＂ur, ity of the body and mind＂ （a whole existence）. Healing is everything to the patient, and there is no distinction between Western medical therapy, acupuncture medical therapy, complementary/alternative medical therapy, and integrative medical therapy.Modeling of ＂control Shen＂ theory allowed us to reveal and understand not only the principles of therapeutic effects of traditional, complementary/alternative and integrative medicines but also the fimdamental principles of disease therapy and religious therapy.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2007年第3期131-138,共8页
China Journal of Traditional Chinese Medicine and Pharmacy
关键词
针灸医学
补充
替代医学
疗效机理
治神理论
模式
acupuncture medicine
complementary and alternative medicine
integrative medicine
mechanisms of therapeutic effects
theoretical model of Control Shen （the spirit）
