胃脘痛(tong)又稱胃痛(tong)，是以上腹胃脘部近心窩(wo)處疼痛(tong)為主(zhu)證(zheng)的(de)(de)一種(zhong)病(bing)證(zheng)。常見的(de)(de)消化(hua)系統疾病(bing)如急慢(man)性胃炎，胃及(ji)十二指腸潰(kui)瘍病(bing)，胃癌，胃神經官能癥(zheng)等，均可引起(qi)胃脘痛(tong)，俗(su)稱“心口痛(tong)”。
治胃(wei)脘痛(tong)(tong)，主穴多取內關、中脘、足三里。胃(wei)痛(tong)(tong)突(tu)然發(fa)作，兼有(you)怕冷、熱熨后疼(teng)痛(tong)(tong)減輕(qing)者加(jia)(jia)(jia)灸梁門；胃(wei)脹痛(tong)(tong)，噯(ai)氣酸腐(fu)者加(jia)(jia)(jia)內庭(ting)；痛(tong)(tong)連(lian)脅部，噯(ai)氣頻(pin)繁，因情緒波動疼(teng)痛(tong)(tong)加(jia)(jia)(jia)重(zhong)者加(jia)(jia)(jia)太沖、期(qi)門；胃(wei)隱痛(tong)(tong)，嘔吐清水(shui)，食欲(yu)不振者加(jia)(jia)(jia)灸氣海；胃(wei)灼痛(tong)(tong)，口干(gan)，大便干(gan)燥者加(jia)(jia)(jia)太溪。針(zhen)法：毫針(zhen)刺，每日1次，留針(zhen)30分(fen)鐘。虛(xu)寒性疼(teng)痛(tong)(tong)亦可加(jia)(jia)(jia)灸。
按(an)：內關(guan)主治胸(xiong)胃(wei)(wei)疾患；中脘能(neng)調理胃(wei)(wei)腑氣機(ji)，和胃(wei)(wei)止(zhi)痛；足三里(li)是(shi)治療胃(wei)(wei)痛的經驗穴(xue)(xue)。古代醫家治胃(wei)(wei)脘痛，多(duo)以內關(guan)配(pei)公(gong)(gong)孫(sun)(sun)穴(xue)(xue)。《席弘(hong)賦(fu)》云：“肚疼須是(shi)公(gong)(gong)孫(sun)(sun)妙(miao)，內關(guan)相應必然瘳。”《攔江賦(fu)》又(you)云：“心胸(xiong)之(zhi)病(bing)內關(guan)擔，臍(qi)下公(gong)(gong)孫(sun)(sun)用(yong)法攔。”《雜(za)病(bing)穴(xue)(xue)法歌(ge)》曰：“公(gong)(gong)孫(sun)(sun)內關(guan)腹痛止(zhi)。”《標幽(you)賦(fu)》說：“脾冷胃(wei)(wei)疼，瀉公(gong)(gong)孫(sun)(sun)而立愈。”又(you)說：“胸(xiong)滿腹痛刺內關(guan)。”公(gong)(gong)孫(sun)(sun)與內關(guan)相合(he)，是(shi)八(ba)脈(mo)交會(hui)穴(xue)(xue)之(zhi)一，功用(yong)甚多(duo)，即(ji)“公(gong)(gong)孫(sun)(sun)內關(guan)胃(wei)(wei)心胸(xiong)”是(shi)也。
針(zhen)灸治療(liao)胃(wei)痛，有較好的鎮痛效果，尤其對急性胃(wei)痙攣效果更(geng)佳。胃(wei)痛患者在(zai)針(zhen)灸治療(liao)的同時，應注(zhu)意(yi)調整飲(yin)食，戒煙(yan)酒，辛(xin)辣之品。飲(yin)食應定時、定量(liang)，盡(jin)量(liang)少吃多餐(can)。還(huan)要(yao)注(zhu)重調理情緒(xu)，戒惱怒(nu)，可(ke)減少復發(fa)，促(cu)進康(kang)復。對慢性胃(wei)病，要(yao)注(zhu)意(yi)堅持治療(liao)，能取得(de)較好的遠(yuan)期效果。（王維恒）
【答案】E
【答案解析】本題主要考查
胃病
的癥狀及
病機
。由于飲食停積于
胃脘
不能下行，所以胃脘部脹痛，飲食停積而腐敗故
噯氣
酸腐，
胃氣不降
所以不能食；瘀血阻滯氣機，故胃脘
疼痛
如
針刺
狀，
痛處
固定，疲血隨大便下行所以便色黑。“瘀血”和“食積”是導致多種
病癥
的(de)(de)常見基(ji)本病(bing)(bing)機，不僅能(neng)導致(zhi)胃(wei)脘疼(teng)痛更能(neng)導致(zhi)其(qi)他(ta)多(duo)種疾病(bing)(bing)，建(jian)議考生熟記瘀血”和(he)“食(shi)積”的(de)(de)基(ji)本特點(dian)，以便能(neng)舉一反三對其(qi)他(ta)的(de)(de)疾病(bing)(bing)也能(neng)迎刃而(er)解。考點(dian)臟腑辨證(zheng)筆記
古(gu)人有(you)“一(yi)(yi)針(zhen)、二灸(jiu)。三(san)湯藥”的(de)(de)說法(fa)(fa)(fa)(fa)，什(shen)么(me)意思(si)呢(ni)？就(jiu)是(shi)(shi)(shi)說過去的(de)(de)大(da)(da)夫看病(bing)(bing)，首先想(xiang)到(dao)或(huo)采(cai)(cai)用(yong)的(de)(de)治(zhi)療(liao)手段肯定是(shi)(shi)(shi)扎(zha)針(zhen)，扎(zha)針(zhen)如(ru)果(guo)(guo)解(jie)決(jue)不(bu)了，他(ta)們通常會(hui)采(cai)(cai)取(qu)灸(jiu)或(huo)推拿按摩，如(ru)果(guo)(guo)還是(shi)(shi)(shi)不(bu)起(qi)作用(yong)，他(ta)們才(cai)會(hui)給(gei)病(bing)(bing)人喝藥。這就(jiu)說明了針(zhen)灸(jiu)在疾(ji)病(bing)(bing)治(zhi)療(liao)中(zhong)(zhong)(zhong)(zhong)不(bu)僅簡(jian)單好(hao)(hao)(hao)操作，而(er)且療(liao)效非常好(hao)(hao)(hao)，特別是(shi)(shi)(shi)對脾(pi)胃(wei)(wei)(wei)(wei)(wei)病(bing)(bing)的(de)(de)治(zhi)療(liao)有(you)事可(ke)以(yi)(yi)(yi)達(da)到(dao)針(zhen)到(dao)病(bing)(bing)除(chu)的(de)(de)效果(guo)(guo)。今天小(xiao)編我(wo)就(jiu)給(gei)大(da)(da)家介紹一(yi)(yi)下(xia)古(gu)人是(shi)(shi)(shi)怎么(me)治(zhi)療(liao)胃(wei)(wei)(wei)(wei)(wei)痛(tong)(tong)(tong)(tong)(tong)的(de)(de)。 胃(wei)(wei)(wei)(wei)(wei)痛(tong)(tong)(tong)(tong)(tong)，中(zhong)(zhong)(zhong)(zhong)醫(yi)(yi)稱胃(wei)(wei)(wei)(wei)(wei)脘(wan)痛(tong)(tong)(tong)(tong)(tong)，是(shi)(shi)(shi)以(yi)(yi)(yi)上腹胃(wei)(wei)(wei)(wei)(wei)脘(wan)部(bu)近(jin)心(xin)窩處發(fa)生(sheng)疼痛(tong)(tong)(tong)(tong)(tong)為主癥(zheng)的(de)(de)疾(ji)病(bing)(bing)。引(yin)起(qi)胃(wei)(wei)(wei)(wei)(wei)痛(tong)(tong)(tong)(tong)(tong)的(de)(de)原(yuan)因(yin)(yin)(yin)(yin)很(hen)(hen)多，常見的(de)(de)有(you)胃(wei)(wei)(wei)(wei)(wei)炎、胃(wei)(wei)(wei)(wei)(wei)潰瘍及胃(wei)(wei)(wei)(wei)(wei)神經官能癥(zheng)等(deng)，我(wo)們中(zhong)(zhong)(zhong)(zhong)醫(yi)(yi)認(ren)為引(yin)起(qi)胃(wei)(wei)(wei)(wei)(wei)痛(tong)(tong)(tong)(tong)(tong)的(de)(de)主要原(yuan)因(yin)(yin)(yin)(yin)有(you)以(yi)(yi)(yi)下(xia)三(san)點：１ 受(shou)寒(han)(han)(han)：寒(han)(han)(han)邪(xie)客于胃(wei)(wei)(wei)(wei)(wei)脘(wan)，寒(han)(han)(han)主收引(yin)，之(zhi)胃(wei)(wei)(wei)(wei)(wei)氣(qi)(qi)(qi)不(bu)和而(er)痛(tong)(tong)(tong)(tong)(tong)。 ２ 肝氣(qi)(qi)(qi)橫逆(ni)犯胃(wei)(wei)(wei)(wei)(wei)：憂思(si)惱怒，氣(qi)(qi)(qi)郁傷肝，肝脈(mo)夾(jia)胃(wei)(wei)(wei)(wei)(wei)，肝失條(tiao)達(da)，橫逆(ni)犯胃(wei)(wei)(wei)(wei)(wei)，氣(qi)(qi)(qi)機阻滯，導(dao)致(zhi)胃(wei)(wei)(wei)(wei)(wei)痛(tong)(tong)(tong)(tong)(tong)。 ３ 體質因(yin)(yin)(yin)(yin)素：稟賦不(bu)足(zu)(zu)，中(zhong)(zhong)(zhong)(zhong)陽(yang)素虛，內(nei)寒(han)(han)(han)滋生(sheng)，每因(yin)(yin)(yin)(yin)飲(yin)食不(bu)慎(shen)，思(si)慮勞累。或(huo)觸及寒(han)(han)(han)邪(xie)而(er)發(fa)病(bing)(bing)。 知(zhi)道了胃(wei)(wei)(wei)(wei)(wei)痛(tong)(tong)(tong)(tong)(tong)的(de)(de)病(bing)(bing)因(yin)(yin)(yin)(yin)，我(wo)們就(jiu)來看看治(zhi)療(liao)。針(zhen)灸(jiu)治(zhi)療(liao)胃(wei)(wei)(wei)(wei)(wei)痛(tong)(tong)(tong)(tong)(tong)很(hen)(hen)簡(jian)單，不(bu)管什(shen)么(me)原(yuan)因(yin)(yin)(yin)(yin)引(yin)起(qi)的(de)(de)胃(wei)(wei)(wei)(wei)(wei)痛(tong)(tong)(tong)(tong)(tong)，只要分清疾(ji)病(bing)(bing)的(de)(de)虛實(shi)(shi)就(jiu)可(ke)以(yi)(yi)(yi)就(jiu)行(xing)治(zhi)療(liao)啦。虛實(shi)(shi)怎么(me)分呢(ni)？當然得參考脈(mo)相(xiang)(xiang)(xiang)啦。由寒(han)(han)(han)邪(xie)引(yin)起(qi)，脈(mo)相(xiang)(xiang)(xiang)一(yi)(yi)般(ban)(ban)(ban)(ban)呈(cheng)(cheng)弦緊之(zhi)相(xiang)(xiang)(xiang)，當屬(shu)實(shi)(shi)。如(ru)果(guo)(guo)肝氣(qi)(qi)(qi)郁結引(yin)起(qi)，脈(mo)相(xiang)(xiang)(xiang)一(yi)(yi)般(ban)(ban)(ban)(ban)呈(cheng)(cheng)沉弦之(zhi)相(xiang)(xiang)(xiang)，當屬(shu)實(shi)(shi)。如(ru)果(guo)(guo)是(shi)(shi)(shi)脾(pi)胃(wei)(wei)(wei)(wei)(wei)虛寒(han)(han)(han)，脈(mo)相(xiang)(xiang)(xiang)一(yi)(yi)般(ban)(ban)(ban)(ban)呈(cheng)(cheng)虛軟之(zhi)相(xiang)(xiang)(xiang)，當屬(shu)虛。 實(shi)(shi)證(zheng)一(yi)(yi)般(ban)(ban)(ban)(ban)會(hui)扎(zha)：中(zhong)(zhong)(zhong)(zhong)脘(wan)、足(zu)(zu)三(san)里(li)、內(nei)關(guan)、公孫、行(xing)間(jian)這幾個穴(xue)(xue)(xue)(xue)位，以(yi)(yi)(yi)達(da)到(dao)溫(wen)中(zhong)(zhong)(zhong)(zhong)散寒(han)(han)(han)，緩急止痛(tong)(tong)(tong)(tong)(tong)的(de)(de)作用(yong)。中(zhong)(zhong)(zhong)(zhong)脘(wan)、足(zu)(zu)三(san)里(li)一(yi)(yi)般(ban)(ban)(ban)(ban)行(xing)捻轉補(bu)(bu)法(fa)(fa)(fa)(fa)；內(nei)關(guan)、公孫、行(xing)間(jian)一(yi)(yi)般(ban)(ban)(ban)(ban)行(xing)提插瀉(xie)法(fa)(fa)(fa)(fa)；若寒(han)(han)(han)邪(xie)較(jiao)重，中(zhong)(zhong)(zhong)(zhong)脘(wan)、足(zu)(zu)三(san)里(li)多加灸(jiu)法(fa)(fa)(fa)(fa)。中(zhong)(zhong)(zhong)(zhong)脘(wan)、足(zu)(zu)三(san)里(li)分別為胃(wei)(wei)(wei)(wei)(wei)之(zhi)募穴(xue)(xue)(xue)(xue)及下(xia)合穴(xue)(xue)(xue)(xue)，功專(zhuan)溫(wen)中(zhong)(zhong)(zhong)(zhong)健(jian)胃(wei)(wei)(wei)(wei)(wei)，散寒(han)(han)(han)止痛(tong)(tong)(tong)(tong)(tong)；內(nei)關(guan)、公孫為八脈(mo)交會(hui)配(pei)穴(xue)(xue)(xue)(xue)法(fa)(fa)(fa)(fa)，擅(shan)長寬(kuan)胸理氣(qi)(qi)(qi)，行(xing)郁止痛(tong)(tong)(tong)(tong)(tong)。肝郁較(jiao)重者，選肝之(zhi)滎穴(xue)(xue)(xue)(xue)行(xing)間(jian)，疏泄肝氣(qi)(qi)(qi)，抑木扶(fu)(fu)土。 虛證(zheng)一(yi)(yi)般(ban)(ban)(ban)(ban)會(hui)選：脾(pi)俞(yu)(yu)、胃(wei)(wei)(wei)(wei)(wei)俞(yu)(yu)、中(zhong)(zhong)(zhong)(zhong)脘(wan)、關(guan)元、內(nei)關(guan)、足(zu)(zu)三(san)里(li)，以(yi)(yi)(yi)溫(wen)陽(yang)益(yi)(yi)氣(qi)(qi)(qi)，健(jian)脾(pi)養(yang)胃(wei)(wei)(wei)(wei)(wei)。以(yi)(yi)(yi)上穴(xue)(xue)(xue)(xue)位一(yi)(yi)般(ban)(ban)(ban)(ban)都要行(xing)捻轉補(bu)(bu)法(fa)(fa)(fa)(fa)，并可(ke)加用(yong)各(ge)種炙法(fa)(fa)(fa)(fa)。脾(pi)俞(yu)(yu)、胃(wei)(wei)(wei)(wei)(wei)俞(yu)(yu)為背俞(yu)(yu)穴(xue)(xue)(xue)(xue)，中(zhong)(zhong)(zhong)(zhong)脘(wan)為胃(wei)(wei)(wei)(wei)(wei)之(zhi)募穴(xue)(xue)(xue)(xue)，胃(wei)(wei)(wei)(wei)(wei)俞(yu)(yu)、中(zhong)(zhong)(zhong)(zhong)脘(wan)相(xiang)(xiang)(xiang)伍(wu)為俞(yu)(yu)募配(pei)穴(xue)(xue)(xue)(xue)法(fa)(fa)(fa)(fa)，以(yi)(yi)(yi)強健(jian)脾(pi)胃(wei)(wei)(wei)(wei)(wei)；取(qu)關(guan)元益(yi)(yi)火之(zhi)源，溫(wen)陽(yang)建中(zhong)(zhong)(zhong)(zhong)；補(bu)(bu)足(zu)(zu)三(san)里(li)，合于本腑，扶(fu)(fu)正益(yi)(yi)胃(wei)(wei)(wei)(wei)(wei)；配(pei)內(nei)關(guan)，暢利中(zhong)(zhong)(zhong)(zhong)焦(jiao)，寬(kuan)胸止痛(tong)(tong)(tong)(tong)(tong)。 小(xiao)編特別提示：雖然針(zhen)灸(jiu)效果(guo)(guo)很(hen)(hen)好(hao)(hao)(hao)，但取(qu)穴(xue)(xue)(xue)(xue)，補(bu)(bu)瀉(xie)手法(fa)(fa)(fa)(fa)都很(hen)(hen)難掌(zhang)握，最好(hao)(hao)(hao)找專(zhuan)職的(de)(de)醫(yi)(yi)師進行(xing)治(zhi)療(liao)。（作者：韓峰）
胃、十二指腸潰瘍是指僅見于胃腸道與胃液接觸部位的慢性潰瘍，又稱潰瘍病，中醫稱“胃痛”、“心痛”、“胃脘痛”范疇。
民間治療本病不乏奇方妙藥，療程短，見效快，費用低，即能消除病癥，促使潰瘍愈合，又可不動手術，愈后不再復發。
1：中成藥療法
藥名：錫類散
用法：每晚睡前用溫開水送服1－1.5克
療效：連服1個月，潰瘍愈合率優于西米替丁，有效率達91.7％
2：藥物療法
處方：生麥芽30克，白芍、茯苓各15克，海螵蛸12克，蒼術、陳皮、厚樸、神曲、雞內金、生姜各10克，桂枝、延胡各6克。吳茱萸4克，龍膽草3克，大棗4枚。
用法：水煎，日1劑，日服3次，15劑為1療程
療效：用藥1－2療程，有效率達100％。
希望對你有所幫助
1 捏(nie)揉內(nei)外(wai)關(guan)(guan)穴(xue)取坐位(wei)或者仰臥，以拇指(zhi)(zhi)、食指(zhi)(zhi)分(fen)別置于內(nei)關(guan)(guan)（將一只(zhi)手中間三指(zhi)(zhi)并攏(long)，無名指(zhi)(zhi)放在另外(wai)一只(zhi)手的(de)手腕中間橫紋的(de)中央(yang)，食指(zhi)(zhi)之間下按之凹陷并酸痛處即為內(nei)關(guan)(guan)穴(xue)）、外(wai)關(guan)(guan)（在手臂(bei)，與內(nei)關(guan)(guan)穴(xue)位(wei)置相(xiang)對）穴(xue)上，相(xiang)對用(yong)(yong)力(li)捏(nie)擠(ji)1-2分(fen)鐘，順手交(jiao)替(ti)捏(nie)揉，用(yong)(yong)力(li)大(da)小要以自己能(neng)夠忍(ren)耐為度。可緩解慢性(xing)胃炎發作時胃痛不適(shi)。
2 枳(zhi)實(shi)麥芽(ya)山楂(zha)材料：用枳(zhi)實(shi)9克(ke)，麥芽(ya)12克(ke)，山楂(zha)肉6克(ke)。
做法：將所有藥材用水煎(jian)煮(zhu)2次，混合后分上、下午服用，每日1劑。
功效：山楂具有消食(shi)導(dao)滯(zhi)和(he)胃(wei)的功效，適用于(yu)慢性(xing)胃(wei)炎飲食(shi)停(ting)滯(zhi)所(suo)引(yin)起(qi)的胃(wei)脘脹(zhang)痛(tong)、拒(ju)按，厭食(shi)者(zhe)使(shi)用。
3 大蒜玉米粥材料：玉米面(mian)50克，大蒜6瓣，糖、醋(cu)適量。
制法(fa)：將大蒜(suan)放(fang)(fang)入糖、醋中浸泡一天，玉米面(mian)熬制成粥，最后(hou)放(fang)(fang)入醋泡的蒜(suan)瓣再煮片刻即可。
功效：每日(ri)堅持，連服數日(ri)，可以(yi)養心健(jian)胃，對(dui)緩(huan)解胃痛有益(yi)。
4 地(di)龍末治胃痛材料：地(di)龍適量。
做法：將其洗凈后烤干研(yan)磨成細末，每(mei)次(ci)用溫水(shui)送服(fu)2克，每(mei)日3-4次(ci)。
功(gong)效：地龍末可以活血化(hua)瘀，理氣止痛(tong)，適用(yong)于慢性(xing)胃(wei)炎因淤血阻滯所引起的胃(wei)脘疼(teng)痛(tong)，痛(tong)有定處而拒按，疼(teng)痛(tong)如(ru)針刺或者刀割樣者食(shi)用(yong)。
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