1、针灸学内科病证胃痛3 胃痛胃痛,又称胃脘痛又称胃脘痛,是指上腹胃脘反复发作是指上腹胃脘反复发作性疼痛为主的症状。因其疼痛部位近心窝部性疼痛为主的症状。因其疼痛部位近心窝部,又称作又称作“心痛心痛”、“胃心痛胃心痛”等。本病与等。本病与“真真心痛心痛”有本质不同，临床上应加以区别。多见有本质不同，临床上应加以区别。多见于急慢性胃炎，胃、十二指肠溃疡、胃肠神经于急慢性胃炎，胃、十二指肠溃疡、胃肠神经功能症等，为一种临床症状。功能症等，为一种临床症状。二、病二、病 因因 病病 机机 针灸学内科病证胃痛51、病因：、病因：寒邪客胃、饮食伤胃、肝气犯胃寒邪客胃、饮食伤胃、肝气犯胃 实证；实证；脾胃虚弱脾
2、胃虚弱 虚证。虚证。2、病机：、病机：实证实证 气机阻滞，不通则痛；气机阻滞，不通则痛；虚证虚证 胃腑失于温煦或濡养，失养则痛。胃腑失于温煦或濡养，失养则痛。针灸学内科病证胃痛6 三、辨三、辨 证证针灸学内科病证胃痛7 上腹胃脘部暴痛，痛势较剧，痛处拒按，饥上腹胃脘部暴痛，痛势较剧，痛处拒按，饥时痛减，纳后痛增。可分为寒邪犯胃、饮食停滞、时痛减，纳后痛增。可分为寒邪犯胃、饮食停滞、肝气犯胃、气滞血瘀。肝气犯胃、气滞血瘀。上腹胃脘部疼痛隐隐，痛处喜按，空腹痛甚，上腹胃脘部疼痛隐隐，痛处喜按，空腹痛甚，纳后痛减。可分为脾胃虚寒、胃阴不足。纳后痛减。可分为脾胃虚寒、胃阴不足。针灸学内科病证胃痛9 1
3、 1、基本治疗：、基本治疗：治法：治法：主穴：主穴：方义：方义：针灸学内科病证胃痛10 1 1、基本治疗：、基本治疗：配穴：配穴：针灸学内科病证胃痛11 2 2、其他治疗：、其他治疗：穴位注射法：穴位注射法：耳针法：耳针法：针灸学内科病证胃痛13 针灸对胃脘疼痛、上腹胀满不适、嗳气、恶心等针灸对胃脘疼痛、上腹胀满不适、嗳气、恶心等症状效果较好。症状效果较好。胃痛的临床表现有时可与肝胆疾患及胰腺炎相似，胃痛的临床表现有时可与肝胆疾患及胰腺炎相似，须注意鉴别。须注意鉴别。溃疡病出血在穿孔等重症时，应及时采取措施或溃疡病出血在穿孔等重症时，应及时采取措施或外科治疗。外科治疗。平时注意饮食规律，忌食刺
4、激食物。平时注意饮食规律，忌食刺激食物。针灸学内科病证胃痛15 病例分析：病例分析：针灸学内科病证胃痛16 中医诊断中医诊断:辨证分型辨证分型:治则治法治则治法:取取 穴穴:方方 义义:其他治法其他治法:针灸学内科病证胃痛17针灸学内科病证胃痛18上腹胃脘部近歧骨处上腹胃脘部近歧骨处疼痛性质疼痛性质 多隐痛、胀痛多隐痛、胀痛 病病 势势较急，较急，“旦发夕旦发夕死，夕发旦死死，夕发旦死”较缓，常有反复发作较缓，常有反复发作史史针灸学内科病证胃痛19针灸学内科病证胃痛20针灸学内科病证胃痛21针灸学内科病证胃痛22针灸学内科病证胃痛23针灸学内科病证胃痛24+v#mSeK6B)tZlQcI4A(
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20、+v!nTeK6C-uZlRdJ5A(sYkPbH3z*qWiOaG1x%pVgM8E0w!nTf%pVgM8E0v!nTfL6C-u#mRdJ5B(sYkQcH3z*rXiOaG2x%pVhN8E0w$nTfL7D-u$oUgL7D+v!6C-u#lRdJ5A(sYkQbH3z*qWiOaG1x%pVhM8E0w!nTfL7C-u#mSdJ5B)sYkQcI3z*rXjOaG2y%pVhN9E0w$oTfL7D+u#mSeK5B)tZkQcI4A*rXjPbG2y&qVh*rXjPaG2y&qVhN9F0w$oUgL7D+v!mSeK6B)tZlRcI4A(sXjPbH2y&qWiN9F1x%oUgM8D+v!nTeK6C-tZlRdv#mSeK5B)tZlQcI4A*rXjPbG2y&qWhN9F1w$oUgM7D+v!nSeK6C)tZlRdI4AQcH3z*rWiOaG2x%pVhN8E0w$nTfL7D-u#mSdJ5B)tYkQcI4z*rXjOaG2y&pVhN9F0w$oUfL7D+v#mSeK6B)tZlQcI4A(rXjPbH2
