井穴刺絡放血療法治療中風意識障礙的機制探討

華穎 田青 孫文軍

摘要 刺絡放血是一種傳統中醫治法，可治療多種疾病。井穴為五俞穴之首，位于四肢末端，針感強烈，易于激發經氣。井穴刺絡放血在中風意識障礙的急救中發揮了一定的作用，古今中外的醫家多有應用，療效肯定。井穴刺絡放血治療中風神昏基于一定的中醫理論基礎，產生了一系列的治療作用。從現代醫學角度來說，指尖與大腦存在密切的聯系，指尖放血通過多方面機制發揮改善腦代謝、保護腦組織等作用。井穴刺絡放血操作簡便、療效確切，在中風意識障礙的治療中值得進一步研究、推廣和應用。

關鍵詞 井穴;刺絡放血;中風;意識障礙;臨床;機制;神昏;急救

Abstract Collateral bloodletting is a traditional Chinese medicine（TCM）therapy which is used in a variety of diseases.The well point is the first of five transport points， which is located at the distal end of extremities.The sense of needling is strong there which is easy to stimulate meridian qi.Collateral bloodletting at well points plays a certain role in the first aid of stroke with disturbance of consciousness， which has been widely used in ancient and modern times， and its curative effect is certain.The treatment of stroke with disturbance of consciousness by collateral bloodletting at well points is based on a certain theoretical foundation of TCM and has produced a series of therapeutic effects.From the perspective of modern medicine， there is a close relationship between fingertips and the brain.Fingertip bloodletting can improve brain metabolism and protect brain tissue through various mechanisms.Collateral bloodletting at well points is simple and effective.It is worthy of further research， popularization and application in the treatment of stroke with disturbance of consciousness.

Key Words Well points; Collateral bloodletting; Stroke; Disturbance of consciousness; Clinic; Mechanism; Unconsciousness; First aid

中圖分類號：R245.31+2 文獻標識碼：A doi：10.3969/j.issn.1673-7202.2019.10.057

刺絡放血療法是在中醫基礎理論指導下，運用三棱針、采血針、梅花針等針具，在體表血絡充足處或穴位上點刺出血，以祛除病邪、調和氣血、平衡陰陽從而防治疾病的一種方法[1]。井穴為五輸穴之一，多位于四肢末端、爪甲之側，因其位置表淺、針感強烈、易于激發經氣，被廣泛用于多種疾病的治療當中[2]。井穴刺絡放血因具有醒神開竅、調理氣機之作用，古往今來在中風意識障礙的治療中多有應用，療效肯定，筆者在臨床工作中，亦觀察到刺絡放血療法能明顯改善中風意識障礙患者的臨床癥狀，現將其作用機制進行整理和探討。

1 井穴刺絡放血治療中風意識障礙的歷史源流

放血療法古已有之，早在《五十二病方》中便有關于砭石劃破癰腫、排膿放血治療疾病的記載。……