运气学说如何结合子午、八法流注针法的理论研究
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摘要
早在2000多年前,我国医籍经典名著《内经》,就曾精辟地描绘了时间生物医学的雏模,提出了人体功能随月盈亏而变动,应四时变化而呈现阴阳消长以及强调临床辨证论治必须遵循“因时制宜”等宝贵意见。另一方面,《易经》是《内经》的活水源头,《内经》汲取了易理,又进行了创造性的应用,尤其是《内经》中“五运六气”或“运气学说”理论受易理的影响很大,是中医重要基础理论,也是研究自然界气候变化及其对物候、病候影响的学科,可以说是对《易经》阴阳五行理论的发展。
传统的古典治疗法“子午流注”、“灵龟八法”、“飞腾八法”都是以时间为条件的取穴针灸方法。子午、八法流注都是从《易经》的“天人相应”观的影响下产生的。子午流注是运用干支纪时原理在十二经五输穴上按时开穴的针法。灵龟、飞腾八法是在周易八卦、河图、洛书的基础上,吸收了《灵枢·九宫八风》的内容,结合人体十二经脉与奇经八脉的气血会合规律,取八脉交会穴配合八卦,按时日干支进行推算,逐日按时取穴的方法。而干支纪时原本属于五运六气的理论,故可以说子午、八法流注的理论皆源于运气学说。目的
运气学说的气化原理不但能印证全年五运、六气变化之一般规律,更能印证其特殊规律。但子午流注取穴法以定时性及固定性的起穴规律为主,缺乏受外界气化影响的非定时性及非固定性的起穴规律。因此,还不能达到驾御人体气血与外界气化盛衰规律同步的最隹时机开阖穴位。
只一方面,灵龟、飞腾八法引进了《周易》八卦方位和运气干支纪时取穴,但这种固定方位及定时性的取穴规律,同样是缺乏对应外界气化盛衰包括时空因素方面对人体影响而作出针对性及灵活性的取穴规律。运气理论不仅体现了时间气化规律,还蕴藏方位气化规律。
方法
作者认为引进运气学说的气化原理于子午流注将能改善疗效及加强其时间医学优势。另结合运气学说与八法流注亦可增强疗效及提升其时空医学优势。
结合运气学说与子午流注的方法包括:
1)体质因素方面-人类胎育长养受五运六气的影响和制约;
2)自然环境中运气因素方面-
·以运气原理打开闭穴;
·根据运气的胜、复、郁、发规律开五腧穴;
·按运气太过不及开阴阳经井穴;
·以司天、在泉之气的盛衰互开阴阳经穴;
·在气化不及和脏气被郁气所抑时,可以选用原穴进行调整;
·按六气的变化及三阴三阳的盛衰进行阴阳经互用和互取交会穴;
·按运气理论:“运太过则抑其胜,运不及则资其源”协助纳子法中“虚则补其母,实则泻其子”的效果。结合运气学说与八法流注的方法包括:
1)体质因素方面-人类胎育长养受五运六气的影响和制约;
2)空间方位因素方面-根据《内经》对运气气化的阐述,运气气化存在正化日和邪化日两类气化现象。正化日对方位的影响不大,邪化日则对方位影响较大。邪气日气化失常,可导致风、寒、湿、热、燥、火六气受害,由于六气和以洛书八卦为内核的九宫八风图的方位是相对应的,因而导致某宫受灾。八法流注可配合这种运气异常气化方位说,按灵龟或飞腾八法有关规律选配穴位,以纠正邪化日对方位影响亦即对人体所造成的影响。
上述运气学说结合子午、八法流注的理论研究之衍生关系如下面图示:
运气学说结合子午、八法流注的理论衍生关系图
临床研究
由于上述理论研究为全新课题,须进行临床验证,以测试其可行性。为了检测本课题理论用于临床方面的可行性,本研究采用了靳三针疗法对小儿脑发育迟滞的病例进行《探索性临床研究》(Pilot Clinical Study)试验。本课题研究病例来源于靳瑞教授主管的广州中医药大学新药开发研究中心广中门诊部。依据统一诊断标准、纳入标准、排除标准确定合格受试对象。由于这类小儿脑发育迟滞的病例不多,临床研究共收集到20个案例,随机抽样分为三组,第一、二组每组7人,第三组6人。虽然病例数量未及统计学的样本数量要求,但作为一创新性疗法的初步《探索性研究》(Pilot Study)是可以接受的。
临床试验之初步探索性研究是以靳三针作为基本治疗手法及定为第一组的基本组,以靳三针加入子午流注作为第二组的比较组,以靳三针加入子午流注并结合运气学说作为第三组的比较组。第一组(7例):靳三针疗法-靳三针疗法以“弱智四项”(即四神针、颞三针、脑三针、智三针)为主方,再按患儿具体症状配以适当配方,例如:“舌三针”、“手智针”、“足智针”等。第二组(7例):靳三针加纳子法-第二组患儿除了采用靳三针外加上子午流注中的纳子法。纳子法按患儿治疗时的值辰按经取穴,由于诊所治病时间多集中在上午七时至下午一时。各时辰的配穴为:七时至九时为辰时采用胃经原穴冲阳;九时至十一时为巳时采用脾经的输穴太白;十一时至十三时为午时采用心经的井穴少冲。第三组(6例):靳三针加纳子法并结合运气-本组治疗法除了上面第二组的针法外,还采用运气学说:按当年的中运太过或不及,把握运气胜、复、郁、发契机即以运气理论指导针灸选穴。由于当年是戊子年,中运是火运太过;上半年司天是少阴君火;下半年在泉是阳明燥金。中运、司天都是火,加之在泉之气是阳明燥金,燥火伤津,选择五腧穴须能降火生津解燥。故选用手厥阴心包经水穴曲泽。
结果
三组均在首次治疗前和治疗1月后、治疗2月后、治疗3月后当天分别封各种症状评分。各项研究结果如下:
(1)由于一方面每组的病例不多,只有六、七个人,无统计上的意义,但看疗效的列表和分析图的趋势,它们是有等级关系和疗效关系的,即是有实际意义的。另一方面,患儿的不同症状有12种之多,但不是每个患儿都拥有所有的症状,实际上除了语言表达障碍是全部三组20个患儿皆有外,只有另外3种症状包括注意力、多动症、刻板行为是每组都有病例,但每种症状分别在全部三组中合共只有8个、8个、4个病例,数量实在太少,很难作有意义的比较。
(2)以语言表达障碍症状在全部三组20个患儿皆有为例,可以看出三组治疗后3月语言表达情况疗效和总有效率比较,虽然差异无统计意义,但从实际数字看,试验1组和试验2组均为71.4%,而试验3组的总有效率为83.3%,比试验1组和试验2组多出差不多12%。
(3)若以总显效率作比较,更能显示试验3组疗效的特出。治疗3月后,试验1组,7名语言表达障碍患者,4名患者有效,1名患者显效;试验2组,7名语言表达障碍患者,3名患者有效,2名患者显效;试验3组,6名语言表达障碍患者,2名患者有效,3名患者显效。即试验3组的总显效率50%大大高于试验1组的14.3%和试验2组的26.6%。由分析图可以看出,三组在治疗语言表达障碍时,各月的平均积分呈递减趋势。但试验1组和试验2组比较试验3组的递减趋势更为明显。
(4)试验1、2、3组的疗效不受年龄、性别、病情轻重的影响。
(5)试验1、2、3组的针剌治疗经临床研究证明其安全,无不良反应。
结论
综上所述,在本次探索性临床研究中,虽然病例样本数量未能达到具统计学上有意义的结论,但从语言表达障碍的实际疗效比较,运气结合子午流注即“靳三针组+纳子法+运气组”比起其它两组的疗效是较优胜的;从总实际显效率看,运气结合子午流注就更明显高于其余两组。故可以说运气结合子午流注对提高实际疗效是颇有潜质并可作进一步临床研究探讨的。
Introduction :
Early more than 2000 years ago, the Chinese classic medical treatise "Neijing (内经)" depicted incisively the embryo of the chronotherapy, putting forward valuable ideas such as body functions changed according to the lunar's waxed and waned, the weakening and strengthening of yin and yang associated to the season change, and the clinical syndrome differentiation and treatment emphasized compliance with the principle of 'adopt measures according to time'. On the other hand, having inspiration source from "Yijing (易经)", "Neijing" drew knowledge from the philosophical principles of "Yijing" and put into creative application. In particular, the theories of "Five Elements' Movements and Six Climatic Qi's (五运六气)" ("Five Movements and Six Qi's") or the principles of "Movements and Qi's Theory (运气学说)" in "Neijing" were greatly influenced by the principles of "Yijing". Those theories have provided important theoretical basis for the Chinese medicine and also became research subjects for climate change in nature and their impact on phenology and symptom. They could be deemed as the development of "The Theory of Yin-Yang and Five Elements (阴阳五行理论)" in "Yijing".
The traditional classical treatments such as "Midnight-Noon Ebb-Flow Acupuncture(子午流注)”("Midnight-Noon") and "Eight Techniques Ebb-Flow Acupuncture (八法流注)" ("Eight Techniques") including "Eight Magic Turtle Techniques for Acupuncture (灵龟八法)" ("Magic Turtle") and " Eight Flying and Rising Techniques for Acupuncture (飞腾八法)" ("Flying-Rising"), all were therapies about acupuncture and moxibustion in accordance with conditions based on time. "Midnight-Noon" and "Eight Techniques" were brought forth by the influence of the theory of "Nature and Man Correspond to Each Other (天人相应)" advocated in "Yijing". "Midnight-Noon" refers to an acupuncture technique on opening points on the twelve Meridians (十二经) and five Shu Points (五输穴) according to time by applying the principle of the chronological method of "Heavenly Stems and Earthly Branches(天干地支)". "Magic Turtle" and "Flying-Rising" were built on the basis of classic works such as "Eight Diagrams of Yijing (周易八卦)”、"Hetu (河图)" and "Luoshu (洛书) " , drawing from the knowledge of "Lingshu's Nine Palaces and Eight Winds (灵枢·九宫八风)"and incorporating the converge rules of the twelve meridians of human body and the "qi and blood (气血)" of "Eight Extraordinary Meridians (奇经八脉)".Both of these two "Eight Techniques" methods made use of the "Eight Confluence Points of Eight Extraordinary Meridians (八脉交会穴)" with the "Eight Diagrams (八卦)”, and the points were selected by applying calculation of the chronological method of "Heavenly Stems and Earthly Branches". The theory of "Heavenly Stems and Earthly Branches" was one of the theories from the "Five Movements and Six Qi's" and thus the theories of "Midnight-Noon" and the "Eight Techniques " were considered to be originated from the principles of "Movements and Qi's Theory".
Objective :
The qi mechanism of "Movements and Qi's Theory" not only verified the general laws of variations of "Five Movements and Six Qi's" for the whole year, but also gave proof to its extraordinary rules. "Midnight-Noon" emphasized on scheduled and fixed point selection rules, lacking non-scheduled and non-fixed point selection rules influenced by external qi. As a result, it could not be able to take the best advantage of synchronization of excess and deficiency law between qi and blood of the body and external qi to open and close points.
On the other hand, "Magic Turtle" and "Flying-Rising" introduced point selection techniques connecting the "Eight Diagrams" bearing, "Movements and Qi's Theory" and the chronological method of "Heavenly Stems and Earthly Branches" of "Yijing". However, this kind of fixed bearing and scheduled point selection rule did not offer ways to respond to the impact of excess and deficiency of external qi, including time and space factors, on human body so as to achieve directed and flexible point selection rule. "Movements and Qi's Theory" not only acknowledge the mechanism of time and qi but also contains the rules on bearing and qi.
Method :
In the opinion of the writer, by introducing the qi mechanism of "Movements and Qi's Theory" to "Midnight-Noon", it will achieve better curative effect and improve its advantage on chronotherapy. Moreover, by integrating the "Movements and Qi's Theory" with "Eight Techniques", it will also increase the curative effect and enhance its advantage on chrono-spatial medicine.
The methods of integrating "Movements and Qi's Theory" with "Midnight-Noon" include:
1) the physique factor - the development of human embryo is affected and restricted by "Five Movements and Six Qi's";2) the "Movements and Qi's" factors in the natural environment:-
·open the "Bi (Close) Point (闭穴)" based on the "Movements and Qi's Theory";
·open the "Five Shu Acupuncture Points (五腧穴)" based on the "Excess, Revenge, Stagnation and Release (胜、复、郁、发)" mechanism of the "Movements and Qi's Theory";
·open the "Jing (Well) Point (井穴) of Ying and Yang Meridians (阴阳经井穴)"according to the excess or deficiency state of the "Movements and Qi's";
·open the "Yin and Yang Meridian Points (阴阳经穴)”jointly according to the excess and deficiency of "Heaven Qi (司天之气)"and "Spring Qi
·in case of the depression of external qi and the suppression of ""Internal-organs' Qi(脏气)”by "Stagnant Qi (郁气)", the "Yuan (Source) Point (原穴)" can be used to modulate;
·inter-operation and inter-access of "Confluence Points (交会穴)" between Yin and Yang Meridians according to change of Six Qi's and the wane and wax of "Three Yins and Three Yangs (三阴三阳)";
·based on the principle of "Suppressing the Overpower in case of Excess Movement and Supplementing the Source in case of Deficient Movement (运太过则抑其胜,运不及则资其源)" in the "Movements and Qi's Theory"to support the effect of "In a Deficiency, Tonify the Maternal Viscus and in an Excess, Purge the Offspring (虚则补其母,实则泻其子)" in one of "Midnight-Noon" methods of "Nazi Method(纳子法)”;
The methods of integrating "Movements and Qi's Theory" with "Eight Techniques" include:
1) the physique factor - the development of human embryo is affected and restricted by "Five Movements and Six Qi's";
2) spatial and bearing factor - according to the description of "Movements and Qi's Theory" in "Neijing" , "Movements and Qi's" exhibits the two qi phenomenons, namely "Normal Days (正化日)" and "Abnormal Days (邪化日)". "Normal Days" have little impact on bearing while "Abnormal Days" have relatively greater impact on bearing. The disorder of Qi in "Abnormal Days" may cause harm to six kinds of qi (wind, chills, dampness, heat, dryness and fire). As the "Six Qi's (六气)" were in line with the bearings of "Lingshu's Nine Palaces and Eight Winds" which were mainly based on "Eight Diagrams" of "Luoshu ", it caused damage to the "Palaces". "Eight Techniques" could work with this "Movements and Qi's" abnormal qi bearing theory, based on the related mechanism of "Magic Turtle" and "Flying-Rising" to select acupoints so as to remedy the impact of "Abnormal Days" on bearing, i.e. the impact on human body.
The diagram below shows the derivative relationship of the theoretical study of integrating "Movements and Qi's Theory"with "Midnight-Noon" and "Eight Techniques" as mentioned above:
Clinical Study:
Since the above theoretical study is a brandnew subject, clinical test is needed so as to verify its feasibility.
In order to test the feasibility of the subject theory on clinical practice, this research undertook the "Pilot Clinical Study" by applying Jin's 3-Needle Technique on Mentally Handicapped Children.
The research studied the source cases from the Guangzhong Outpatient Department of Guangzhou University of Traditional Chinese Medicine Research Center under the supervision of Professor Jinrui. The target group under study was identified based on the uniform diagnostic criteria, inclusive criteria and exclusive criteria. Since cases of this kind of mentally handicapped children were rare, only 20 cases were collected for the clinical research. The research targets were divided into three groups at random. The first and second groups each had 7 persons and the third group had 6 persons. Although the number of cases did not meet the number of sample required by Statistics, the preliminary pilot study as a mean for creative treatment method was regarded as acceptable.
The preliminary pilot study of the clinical test used "Jin's 3-Needle Technique (靳三针)" as the basic treatment method and set Group 1 as the basic group. For Group 2, treatment integrating Jin's 3-Needle Technique with "Nazi Method" of "Midnight-Noon" was applied while for Group 3, treatment integrating Jin's 3-Needle Technique with "Nazi Method" of“Midnight-Noon" plus "Movements and Qi's Theory" was used for comparison.
Group 1 (7 cases): Jin's 3-Needle Technique Treatment - It uses the main prescription "Four Items of Mental Retardation (弱智四项)" (namely "The Four Spirit Points (四神针)", "The 3-Points in the Temporal Area (颞三针)", "The 3-Occipital Points (脑三针)" and "The 3-Points for Intelligence(智三针)") as the principal prescription for treatment, and apply appropriate supplementary prescriptions, such as "The 3-Tongue Points (舌三针)", "The 3-Intellect Points on the Hand/Arm(手智针) " and "The 3-Intellect Points on the Foot(足智针)", according to the specific symptoms of the sick children.
Group 2 (7 cases): Jin's 3-Needle Technique With Nazi Method - In addition to the use of Jin's 3-Needle Technique, the Nazi Method in "Midnight-Noon" was also applied for the sick children of Group 2. Under the Nazi Method, points were selected by meridians based upon the time and periods when treating the sick children. Since the treatment time in the clinic is mostly from 7 a.m. to 1 p.m., the point selections according to different time are as follows: use the "Yuan Point Chongyang (St.42) of Stomach Meridian (胃经原穴冲阳)" during Chen Period (辰时) from 7 to 9 a.m., use the "Shu Point Taibai (Sp.3) of Spleen Meridian(脾经输穴太白)" during Ji Period (巳时) from 9 to 11 a.m., use the "Jing Point Shaochong (H.9) of Heart Meridian (心经井穴少冲)" during Wu Period (午时) from 11 a.m. to 1 p.m..
Group 3 (6 cases): Jin's 3-Needle Technique With Nazi Method plus "Movements and Qi's Theory" -Apart from the acupuncture methods of Group 2 above, the treatment of this group also applied "Movements and Qi's Theory". Based on the "Excess (太过)" or "Deficiency (不及)" of "Central Movement (中运)" in a particular year, the treatment grasped the opportunity of "Excess (胜)”、"Revenge (复)”、"Stagnation (郁)”、"Release (法)" to select points with the help of "Movements and Qi's Theory". Since the chronological order of the year of treatment in 2008 was Wuzi (戊子) Year, the Central Movement was the "Excess Fire Movement (火运太过)" and during the first half of the year, "Heaven Qi(司天)" was "Emperor's Fire of Shao Yin (少阴君火)" while "Spring Qi (在泉)" was "Dry Metal of Yang Ming (阳明燥金)" during the second half of the year. "Central Movement" and "Heaven Qi" were both "Fire (火)" and the "Spring Qi" was "Dry Metal of Yang Ming", which impaired the fluid due to dryness-heat, the selection of the "Five Shu Acpuncture Points" should be able to lower the heat, produce the body fluids and relieve dryness. Thus, the "Shui (Water) Point Quze (P.3) of Pericardium Meridian of Hand (手厥阴心包经水穴曲泽) " was used.
Result:
Three Groups were received assessment for the symptoms before and after the first month treatment, on the date immediate after two months treatment and three months treatment respectively. The results of each study were as follows:
(1) Since limited cases were picked for each group (six or seven patients only), they offered no statistical meaning. However, from the tables of the curative effects and the tendency of the analysis graphs, they showed ranking and healing relationships and represented a practical meaning. On the other hand, the sick children had up to 12 different kinds of symptoms, but not every sick child had all the symptoms. In fact, apart from all the 20 sick children of the three groups had language handicapped, only three other symptoms, including attentiveness, hyperkinetic (ADD) and stereotype, were found in each group. However, each of these three symptoms in all of the three groups has only 8 cases, 8 cases and 4 cases respectively in total. The number of cases was too small to make any meaningful comparison.
(2) For the common cases of language handicapped in the 20 sick children of all three groups, it showed that after three months therapy of the three groups (though the difference had no statistical meaning due to the small number of cases), by comparison of the curative effect on the language expression and the total "Effectual Rate", both of Pilot Group 1 and Pilot Group 2 were 71.4%, whereas Pilot Group 3 was 83.3%, nearly more than 12% in comparison with Pilot Group 1 and Pilot Group 2.
(3) By taking the total "Effectual Rate for Marked Improvement" for comparison, it can show the remarkable curative effect of Pilot Group 3. After three months therapy of treating the language handicapped, 4 out of 7 mentally handicapped patients in Pilot Group 1 took effect and 1 patient got marked improvement. For Pilot Group 2, 3 out of 7 mentally handicapped patients took effect and 2 patients got marked improvement. For Pilot Group 3, 2 out of 6 mentally handicapped patients took effect and 3 patients got marked improvement. The total "Effectual Rate for Marked Improvement" of Pilot Group 3 was 50% much higher than that of Pilot Group 1(14.3%) and Pilot Group 2(26.6%). From the analysis graphs, it shows that when treating the language handicapped, the three groups appeared a descending trend in average score for each month. The descending trend in both of Pilot Groups 1 and 2 were more significant than that of Pilot Group 3.
(4) The curative effect of Pilot Groups 1, 2 and 3 was not affected by the factors of age, sex and the degree of illness.
(5) Pilot Groups 1, 2 and 3's acupuncture treatment in the above Pilot Clinical Study was proved to be safe and did not have any adverse side effect.
Conclusion :
In conclusion, although the number of cases in this Pilot Clinical Study did not reach a meaningful conclusion in statistics, from the comparison of the practical effect on the language handicapped, integration of "Movements and Qi's Theory" with "Midnight-Noon", i.e. "the Jin's 3-Needle Group + Nazi Method + Movements and Qi's Group", had a better curative effect than the other two groups. For the total "Effectual Rate for Marked Improvement", the treatment of integrating "Movements and Qi's Theory" with "Midnight-Noon" was obviously higher than that of the other two groups. Thus, integration of "Movements and Qi's Theory" with "Midnight-Noon" would be a potential way to improve the practical curative effect and further clinical research could be undertaken.
传统的古典治疗法“子午流注”、“灵龟八法”、“飞腾八法”都是以时间为条件的取穴针灸方法。子午、八法流注都是从《易经》的“天人相应”观的影响下产生的。子午流注是运用干支纪时原理在十二经五输穴上按时开穴的针法。灵龟、飞腾八法是在周易八卦、河图、洛书的基础上,吸收了《灵枢·九宫八风》的内容,结合人体十二经脉与奇经八脉的气血会合规律,取八脉交会穴配合八卦,按时日干支进行推算,逐日按时取穴的方法。而干支纪时原本属于五运六气的理论,故可以说子午、八法流注的理论皆源于运气学说。目的
运气学说的气化原理不但能印证全年五运、六气变化之一般规律,更能印证其特殊规律。但子午流注取穴法以定时性及固定性的起穴规律为主,缺乏受外界气化影响的非定时性及非固定性的起穴规律。因此,还不能达到驾御人体气血与外界气化盛衰规律同步的最隹时机开阖穴位。
只一方面,灵龟、飞腾八法引进了《周易》八卦方位和运气干支纪时取穴,但这种固定方位及定时性的取穴规律,同样是缺乏对应外界气化盛衰包括时空因素方面对人体影响而作出针对性及灵活性的取穴规律。运气理论不仅体现了时间气化规律,还蕴藏方位气化规律。
方法
作者认为引进运气学说的气化原理于子午流注将能改善疗效及加强其时间医学优势。另结合运气学说与八法流注亦可增强疗效及提升其时空医学优势。
结合运气学说与子午流注的方法包括:
1)体质因素方面-人类胎育长养受五运六气的影响和制约;
2)自然环境中运气因素方面-
·以运气原理打开闭穴;
·根据运气的胜、复、郁、发规律开五腧穴;
·按运气太过不及开阴阳经井穴;
·以司天、在泉之气的盛衰互开阴阳经穴;
·在气化不及和脏气被郁气所抑时,可以选用原穴进行调整;
·按六气的变化及三阴三阳的盛衰进行阴阳经互用和互取交会穴;
·按运气理论:“运太过则抑其胜,运不及则资其源”协助纳子法中“虚则补其母,实则泻其子”的效果。结合运气学说与八法流注的方法包括:
1)体质因素方面-人类胎育长养受五运六气的影响和制约;
2)空间方位因素方面-根据《内经》对运气气化的阐述,运气气化存在正化日和邪化日两类气化现象。正化日对方位的影响不大,邪化日则对方位影响较大。邪气日气化失常,可导致风、寒、湿、热、燥、火六气受害,由于六气和以洛书八卦为内核的九宫八风图的方位是相对应的,因而导致某宫受灾。八法流注可配合这种运气异常气化方位说,按灵龟或飞腾八法有关规律选配穴位,以纠正邪化日对方位影响亦即对人体所造成的影响。
上述运气学说结合子午、八法流注的理论研究之衍生关系如下面图示:
运气学说结合子午、八法流注的理论衍生关系图
临床研究
由于上述理论研究为全新课题,须进行临床验证,以测试其可行性。为了检测本课题理论用于临床方面的可行性,本研究采用了靳三针疗法对小儿脑发育迟滞的病例进行《探索性临床研究》(Pilot Clinical Study)试验。本课题研究病例来源于靳瑞教授主管的广州中医药大学新药开发研究中心广中门诊部。依据统一诊断标准、纳入标准、排除标准确定合格受试对象。由于这类小儿脑发育迟滞的病例不多,临床研究共收集到20个案例,随机抽样分为三组,第一、二组每组7人,第三组6人。虽然病例数量未及统计学的样本数量要求,但作为一创新性疗法的初步《探索性研究》(Pilot Study)是可以接受的。
临床试验之初步探索性研究是以靳三针作为基本治疗手法及定为第一组的基本组,以靳三针加入子午流注作为第二组的比较组,以靳三针加入子午流注并结合运气学说作为第三组的比较组。第一组(7例):靳三针疗法-靳三针疗法以“弱智四项”(即四神针、颞三针、脑三针、智三针)为主方,再按患儿具体症状配以适当配方,例如:“舌三针”、“手智针”、“足智针”等。第二组(7例):靳三针加纳子法-第二组患儿除了采用靳三针外加上子午流注中的纳子法。纳子法按患儿治疗时的值辰按经取穴,由于诊所治病时间多集中在上午七时至下午一时。各时辰的配穴为:七时至九时为辰时采用胃经原穴冲阳;九时至十一时为巳时采用脾经的输穴太白;十一时至十三时为午时采用心经的井穴少冲。第三组(6例):靳三针加纳子法并结合运气-本组治疗法除了上面第二组的针法外,还采用运气学说:按当年的中运太过或不及,把握运气胜、复、郁、发契机即以运气理论指导针灸选穴。由于当年是戊子年,中运是火运太过;上半年司天是少阴君火;下半年在泉是阳明燥金。中运、司天都是火,加之在泉之气是阳明燥金,燥火伤津,选择五腧穴须能降火生津解燥。故选用手厥阴心包经水穴曲泽。
结果
三组均在首次治疗前和治疗1月后、治疗2月后、治疗3月后当天分别封各种症状评分。各项研究结果如下:
(1)由于一方面每组的病例不多,只有六、七个人,无统计上的意义,但看疗效的列表和分析图的趋势,它们是有等级关系和疗效关系的,即是有实际意义的。另一方面,患儿的不同症状有12种之多,但不是每个患儿都拥有所有的症状,实际上除了语言表达障碍是全部三组20个患儿皆有外,只有另外3种症状包括注意力、多动症、刻板行为是每组都有病例,但每种症状分别在全部三组中合共只有8个、8个、4个病例,数量实在太少,很难作有意义的比较。
(2)以语言表达障碍症状在全部三组20个患儿皆有为例,可以看出三组治疗后3月语言表达情况疗效和总有效率比较,虽然差异无统计意义,但从实际数字看,试验1组和试验2组均为71.4%,而试验3组的总有效率为83.3%,比试验1组和试验2组多出差不多12%。
(3)若以总显效率作比较,更能显示试验3组疗效的特出。治疗3月后,试验1组,7名语言表达障碍患者,4名患者有效,1名患者显效;试验2组,7名语言表达障碍患者,3名患者有效,2名患者显效;试验3组,6名语言表达障碍患者,2名患者有效,3名患者显效。即试验3组的总显效率50%大大高于试验1组的14.3%和试验2组的26.6%。由分析图可以看出,三组在治疗语言表达障碍时,各月的平均积分呈递减趋势。但试验1组和试验2组比较试验3组的递减趋势更为明显。
(4)试验1、2、3组的疗效不受年龄、性别、病情轻重的影响。
(5)试验1、2、3组的针剌治疗经临床研究证明其安全,无不良反应。
结论
综上所述,在本次探索性临床研究中,虽然病例样本数量未能达到具统计学上有意义的结论,但从语言表达障碍的实际疗效比较,运气结合子午流注即“靳三针组+纳子法+运气组”比起其它两组的疗效是较优胜的;从总实际显效率看,运气结合子午流注就更明显高于其余两组。故可以说运气结合子午流注对提高实际疗效是颇有潜质并可作进一步临床研究探讨的。
Introduction :
Early more than 2000 years ago, the Chinese classic medical treatise "Neijing (内经)" depicted incisively the embryo of the chronotherapy, putting forward valuable ideas such as body functions changed according to the lunar's waxed and waned, the weakening and strengthening of yin and yang associated to the season change, and the clinical syndrome differentiation and treatment emphasized compliance with the principle of 'adopt measures according to time'. On the other hand, having inspiration source from "Yijing (易经)", "Neijing" drew knowledge from the philosophical principles of "Yijing" and put into creative application. In particular, the theories of "Five Elements' Movements and Six Climatic Qi's (五运六气)" ("Five Movements and Six Qi's") or the principles of "Movements and Qi's Theory (运气学说)" in "Neijing" were greatly influenced by the principles of "Yijing". Those theories have provided important theoretical basis for the Chinese medicine and also became research subjects for climate change in nature and their impact on phenology and symptom. They could be deemed as the development of "The Theory of Yin-Yang and Five Elements (阴阳五行理论)" in "Yijing".
The traditional classical treatments such as "Midnight-Noon Ebb-Flow Acupuncture(子午流注)”("Midnight-Noon") and "Eight Techniques Ebb-Flow Acupuncture (八法流注)" ("Eight Techniques") including "Eight Magic Turtle Techniques for Acupuncture (灵龟八法)" ("Magic Turtle") and " Eight Flying and Rising Techniques for Acupuncture (飞腾八法)" ("Flying-Rising"), all were therapies about acupuncture and moxibustion in accordance with conditions based on time. "Midnight-Noon" and "Eight Techniques" were brought forth by the influence of the theory of "Nature and Man Correspond to Each Other (天人相应)" advocated in "Yijing". "Midnight-Noon" refers to an acupuncture technique on opening points on the twelve Meridians (十二经) and five Shu Points (五输穴) according to time by applying the principle of the chronological method of "Heavenly Stems and Earthly Branches(天干地支)". "Magic Turtle" and "Flying-Rising" were built on the basis of classic works such as "Eight Diagrams of Yijing (周易八卦)”、"Hetu (河图)" and "Luoshu (洛书) " , drawing from the knowledge of "Lingshu's Nine Palaces and Eight Winds (灵枢·九宫八风)"and incorporating the converge rules of the twelve meridians of human body and the "qi and blood (气血)" of "Eight Extraordinary Meridians (奇经八脉)".Both of these two "Eight Techniques" methods made use of the "Eight Confluence Points of Eight Extraordinary Meridians (八脉交会穴)" with the "Eight Diagrams (八卦)”, and the points were selected by applying calculation of the chronological method of "Heavenly Stems and Earthly Branches". The theory of "Heavenly Stems and Earthly Branches" was one of the theories from the "Five Movements and Six Qi's" and thus the theories of "Midnight-Noon" and the "Eight Techniques " were considered to be originated from the principles of "Movements and Qi's Theory".
Objective :
The qi mechanism of "Movements and Qi's Theory" not only verified the general laws of variations of "Five Movements and Six Qi's" for the whole year, but also gave proof to its extraordinary rules. "Midnight-Noon" emphasized on scheduled and fixed point selection rules, lacking non-scheduled and non-fixed point selection rules influenced by external qi. As a result, it could not be able to take the best advantage of synchronization of excess and deficiency law between qi and blood of the body and external qi to open and close points.
On the other hand, "Magic Turtle" and "Flying-Rising" introduced point selection techniques connecting the "Eight Diagrams" bearing, "Movements and Qi's Theory" and the chronological method of "Heavenly Stems and Earthly Branches" of "Yijing". However, this kind of fixed bearing and scheduled point selection rule did not offer ways to respond to the impact of excess and deficiency of external qi, including time and space factors, on human body so as to achieve directed and flexible point selection rule. "Movements and Qi's Theory" not only acknowledge the mechanism of time and qi but also contains the rules on bearing and qi.
Method :
In the opinion of the writer, by introducing the qi mechanism of "Movements and Qi's Theory" to "Midnight-Noon", it will achieve better curative effect and improve its advantage on chronotherapy. Moreover, by integrating the "Movements and Qi's Theory" with "Eight Techniques", it will also increase the curative effect and enhance its advantage on chrono-spatial medicine.
The methods of integrating "Movements and Qi's Theory" with "Midnight-Noon" include:
1) the physique factor - the development of human embryo is affected and restricted by "Five Movements and Six Qi's";2) the "Movements and Qi's" factors in the natural environment:-
·open the "Bi (Close) Point (闭穴)" based on the "Movements and Qi's Theory";
·open the "Five Shu Acupuncture Points (五腧穴)" based on the "Excess, Revenge, Stagnation and Release (胜、复、郁、发)" mechanism of the "Movements and Qi's Theory";
·open the "Jing (Well) Point (井穴) of Ying and Yang Meridians (阴阳经井穴)"according to the excess or deficiency state of the "Movements and Qi's";
·open the "Yin and Yang Meridian Points (阴阳经穴)”jointly according to the excess and deficiency of "Heaven Qi (司天之气)"and "Spring Qi
·in case of the depression of external qi and the suppression of ""Internal-organs' Qi(脏气)”by "Stagnant Qi (郁气)", the "Yuan (Source) Point (原穴)" can be used to modulate;
·inter-operation and inter-access of "Confluence Points (交会穴)" between Yin and Yang Meridians according to change of Six Qi's and the wane and wax of "Three Yins and Three Yangs (三阴三阳)";
·based on the principle of "Suppressing the Overpower in case of Excess Movement and Supplementing the Source in case of Deficient Movement (运太过则抑其胜,运不及则资其源)" in the "Movements and Qi's Theory"to support the effect of "In a Deficiency, Tonify the Maternal Viscus and in an Excess, Purge the Offspring (虚则补其母,实则泻其子)" in one of "Midnight-Noon" methods of "Nazi Method(纳子法)”;
The methods of integrating "Movements and Qi's Theory" with "Eight Techniques" include:
1) the physique factor - the development of human embryo is affected and restricted by "Five Movements and Six Qi's";
2) spatial and bearing factor - according to the description of "Movements and Qi's Theory" in "Neijing" , "Movements and Qi's" exhibits the two qi phenomenons, namely "Normal Days (正化日)" and "Abnormal Days (邪化日)". "Normal Days" have little impact on bearing while "Abnormal Days" have relatively greater impact on bearing. The disorder of Qi in "Abnormal Days" may cause harm to six kinds of qi (wind, chills, dampness, heat, dryness and fire). As the "Six Qi's (六气)" were in line with the bearings of "Lingshu's Nine Palaces and Eight Winds" which were mainly based on "Eight Diagrams" of "Luoshu ", it caused damage to the "Palaces". "Eight Techniques" could work with this "Movements and Qi's" abnormal qi bearing theory, based on the related mechanism of "Magic Turtle" and "Flying-Rising" to select acupoints so as to remedy the impact of "Abnormal Days" on bearing, i.e. the impact on human body.
The diagram below shows the derivative relationship of the theoretical study of integrating "Movements and Qi's Theory"with "Midnight-Noon" and "Eight Techniques" as mentioned above:
Clinical Study:
Since the above theoretical study is a brandnew subject, clinical test is needed so as to verify its feasibility.
In order to test the feasibility of the subject theory on clinical practice, this research undertook the "Pilot Clinical Study" by applying Jin's 3-Needle Technique on Mentally Handicapped Children.
The research studied the source cases from the Guangzhong Outpatient Department of Guangzhou University of Traditional Chinese Medicine Research Center under the supervision of Professor Jinrui. The target group under study was identified based on the uniform diagnostic criteria, inclusive criteria and exclusive criteria. Since cases of this kind of mentally handicapped children were rare, only 20 cases were collected for the clinical research. The research targets were divided into three groups at random. The first and second groups each had 7 persons and the third group had 6 persons. Although the number of cases did not meet the number of sample required by Statistics, the preliminary pilot study as a mean for creative treatment method was regarded as acceptable.
The preliminary pilot study of the clinical test used "Jin's 3-Needle Technique (靳三针)" as the basic treatment method and set Group 1 as the basic group. For Group 2, treatment integrating Jin's 3-Needle Technique with "Nazi Method" of "Midnight-Noon" was applied while for Group 3, treatment integrating Jin's 3-Needle Technique with "Nazi Method" of“Midnight-Noon" plus "Movements and Qi's Theory" was used for comparison.
Group 1 (7 cases): Jin's 3-Needle Technique Treatment - It uses the main prescription "Four Items of Mental Retardation (弱智四项)" (namely "The Four Spirit Points (四神针)", "The 3-Points in the Temporal Area (颞三针)", "The 3-Occipital Points (脑三针)" and "The 3-Points for Intelligence(智三针)") as the principal prescription for treatment, and apply appropriate supplementary prescriptions, such as "The 3-Tongue Points (舌三针)", "The 3-Intellect Points on the Hand/Arm(手智针) " and "The 3-Intellect Points on the Foot(足智针)", according to the specific symptoms of the sick children.
Group 2 (7 cases): Jin's 3-Needle Technique With Nazi Method - In addition to the use of Jin's 3-Needle Technique, the Nazi Method in "Midnight-Noon" was also applied for the sick children of Group 2. Under the Nazi Method, points were selected by meridians based upon the time and periods when treating the sick children. Since the treatment time in the clinic is mostly from 7 a.m. to 1 p.m., the point selections according to different time are as follows: use the "Yuan Point Chongyang (St.42) of Stomach Meridian (胃经原穴冲阳)" during Chen Period (辰时) from 7 to 9 a.m., use the "Shu Point Taibai (Sp.3) of Spleen Meridian(脾经输穴太白)" during Ji Period (巳时) from 9 to 11 a.m., use the "Jing Point Shaochong (H.9) of Heart Meridian (心经井穴少冲)" during Wu Period (午时) from 11 a.m. to 1 p.m..
Group 3 (6 cases): Jin's 3-Needle Technique With Nazi Method plus "Movements and Qi's Theory" -Apart from the acupuncture methods of Group 2 above, the treatment of this group also applied "Movements and Qi's Theory". Based on the "Excess (太过)" or "Deficiency (不及)" of "Central Movement (中运)" in a particular year, the treatment grasped the opportunity of "Excess (胜)”、"Revenge (复)”、"Stagnation (郁)”、"Release (法)" to select points with the help of "Movements and Qi's Theory". Since the chronological order of the year of treatment in 2008 was Wuzi (戊子) Year, the Central Movement was the "Excess Fire Movement (火运太过)" and during the first half of the year, "Heaven Qi(司天)" was "Emperor's Fire of Shao Yin (少阴君火)" while "Spring Qi (在泉)" was "Dry Metal of Yang Ming (阳明燥金)" during the second half of the year. "Central Movement" and "Heaven Qi" were both "Fire (火)" and the "Spring Qi" was "Dry Metal of Yang Ming", which impaired the fluid due to dryness-heat, the selection of the "Five Shu Acpuncture Points" should be able to lower the heat, produce the body fluids and relieve dryness. Thus, the "Shui (Water) Point Quze (P.3) of Pericardium Meridian of Hand (手厥阴心包经水穴曲泽) " was used.
Result:
Three Groups were received assessment for the symptoms before and after the first month treatment, on the date immediate after two months treatment and three months treatment respectively. The results of each study were as follows:
(1) Since limited cases were picked for each group (six or seven patients only), they offered no statistical meaning. However, from the tables of the curative effects and the tendency of the analysis graphs, they showed ranking and healing relationships and represented a practical meaning. On the other hand, the sick children had up to 12 different kinds of symptoms, but not every sick child had all the symptoms. In fact, apart from all the 20 sick children of the three groups had language handicapped, only three other symptoms, including attentiveness, hyperkinetic (ADD) and stereotype, were found in each group. However, each of these three symptoms in all of the three groups has only 8 cases, 8 cases and 4 cases respectively in total. The number of cases was too small to make any meaningful comparison.
(2) For the common cases of language handicapped in the 20 sick children of all three groups, it showed that after three months therapy of the three groups (though the difference had no statistical meaning due to the small number of cases), by comparison of the curative effect on the language expression and the total "Effectual Rate", both of Pilot Group 1 and Pilot Group 2 were 71.4%, whereas Pilot Group 3 was 83.3%, nearly more than 12% in comparison with Pilot Group 1 and Pilot Group 2.
(3) By taking the total "Effectual Rate for Marked Improvement" for comparison, it can show the remarkable curative effect of Pilot Group 3. After three months therapy of treating the language handicapped, 4 out of 7 mentally handicapped patients in Pilot Group 1 took effect and 1 patient got marked improvement. For Pilot Group 2, 3 out of 7 mentally handicapped patients took effect and 2 patients got marked improvement. For Pilot Group 3, 2 out of 6 mentally handicapped patients took effect and 3 patients got marked improvement. The total "Effectual Rate for Marked Improvement" of Pilot Group 3 was 50% much higher than that of Pilot Group 1(14.3%) and Pilot Group 2(26.6%). From the analysis graphs, it shows that when treating the language handicapped, the three groups appeared a descending trend in average score for each month. The descending trend in both of Pilot Groups 1 and 2 were more significant than that of Pilot Group 3.
(4) The curative effect of Pilot Groups 1, 2 and 3 was not affected by the factors of age, sex and the degree of illness.
(5) Pilot Groups 1, 2 and 3's acupuncture treatment in the above Pilot Clinical Study was proved to be safe and did not have any adverse side effect.
Conclusion :
In conclusion, although the number of cases in this Pilot Clinical Study did not reach a meaningful conclusion in statistics, from the comparison of the practical effect on the language handicapped, integration of "Movements and Qi's Theory" with "Midnight-Noon", i.e. "the Jin's 3-Needle Group + Nazi Method + Movements and Qi's Group", had a better curative effect than the other two groups. For the total "Effectual Rate for Marked Improvement", the treatment of integrating "Movements and Qi's Theory" with "Midnight-Noon" was obviously higher than that of the other two groups. Thus, integration of "Movements and Qi's Theory" with "Midnight-Noon" would be a potential way to improve the practical curative effect and further clinical research could be undertaken.
引文
1.黄帝内经素问/[唐]王冰 编著(王冰医学全书/张登本等主编)-北京:中国中医药出版社,2006.3
2.玄珠密语/[唐]王冰编著(王冰医学全书/张登本等主编)-北京:中国中医药出版社,2006.3
3.天元玉册/[唐]王冰编著(王冰医学全书/张登本等主编)-北京:中国中医药出版社,2006.3
4.图解黄帝内经素问/刘越 图解.-北京:人民卫生出版社,2003.9
5.黄帝内经太素;黄帝内经明堂/[唐]杨上善撰注;李云点校.-北京:学苑出版社,2007.6
6.灵枢经/[宋]史崧 整理;杨鹏举等 教注.-北京:学苑出版社,2008.4
7.黄帝八十一难经/[战国]扁鹊 撰;高丹枫,王琳 校注.-北京:学苑出版社,2007.4
8.素问入式运气论奥/[宋]刘温舒 原著;张立平 校注.-北京:学苑出版社,2008.10
9.琼瑶发明神书/[宋]琼瑶贞人 撰.-据清道光二十八年成申倍元堂刻本
10.子午流注针经/[金]何若愚 撰;阎明广 注.-据日本抄宣德壬子广勤书堂新 本抄本
11.针经指南/[元]窦汉卿 撰著;见[元]窦桂芳《针灸四书》.-北京:人民卫生出版社,1983
12.扁鹊神应玉龙经/[元]王国瑞 撰著.-商务影印本,见四库全书珍本初集医家类
13.类经/[明]张介宾 编著.-北京:人民卫生出版社,1982.11
14.类经图翼/[明]张介宾 著.-北京:人民卫生出版社,1980.4重印
15.中医与易学(即《类经图翼》、《类经附翼》组成)/[明]张介宾 原著;方向红校理.-北京:学苑出版社,1993.8
16.运气易览/[明]汪石山 著(汪石山医学全书/高尔鑫主编).北京:中国中医药出版社,1999.8
17.针灸大全/[明]徐凤 撰.-北京:人民卫生出版社,1973
18.针灸聚英/[明]高武 撰.-上海:上海科学技术出版社,1961
19.针灸大成/[明]杨继洲 撰.-北京:人民卫生出版社,1973
20.医学入门/[明]李梃 撰.-万历年间吴郁堂藏本
21.针灸逢源/[清]李学川 撰.-上海:上海科学技术出版社,1987.8
22.针灸时间治疗概论/靳瑞,赖新生,靳子豪 编著.-上海:上海翻译出版公司,1990.5
23.子午流注与灵龟八法(修订本)/郑魁山 编著.-兰州:甘肃省科学技术出版社,1995.3
24.子午流注、灵龟飞腾八法大全/漆浩,董晔 主编.-北京:中国医药科技出版社,1995.6重印
25.最佳时间针灸法 / 刘炳权 编著.-山东:山东科学技术出版社,1987.10
26.八卦与时间医学/刘炳权,苏祥编著.-广州:广东科技出版社,1995.5
27.中医气象学/刘炳权,唐玉兰编著.-广州:广东科技出版社,2005.2
28.周易与中医学/杨力著.-3版(修订本).-北京:北京科学技术出版社,2002.3重印
29.中医运气学/程绍恩编著.-北京:北京科学技术出版社,1986.6重印
30.中医运气学/杨力著.-2版.-北京:北京科学技术出版社,2006.5重印
31.中医疾病预测学/杨力著.-北京:北京科学技术出版社,2006.5重印
32.子午点穴疗法/陆汉韬,谭士玲编著.-广西:广西科学技术出版社,2002.6重印
33.占典时间治疗学/曹欣荣,詹永康编著.-长沙:湖南科学技术出版社,1984.2.
34.最佳时间针灸精义/李友林,刘清国主编.-北京:学苑出版社,2003.7
35.时辰治疗学/祝恒琛主编.-北京:华夏出版社,2006.6
36.中医运气学解秘/田合禄,田蔚著.-太原:山西科学技术出版社,2001.12
37.五运六气临床应用大观/田合禄,周晋香等著.-太原:山西科学技术出版社,2005.4(2006.4重印)
38.实用时间针法秘要:周易与针灸学/箫进顺编著.-北京:人民军医出版社,2007.10
39.运气学说/余金城编著.-台北:五洲出版社,2004.9
40.实用运气学说/黄天锡,刘含堂主编.-北京:学苑出版社,2005.2
41.实用时间针法/朴联友主编.-北京:人民卫生出版社,2006.11
42.开启中医之门-运气学导论/李阳波讲述;刘力红等整理.-北京:中国中医药出版社,2005.11
43.独穴针灸疗法/刘昭,周晨华著译.-北京:人民卫生出版社,2005.2
44.五运六气/任应秋编著.-上海:上海科学技术出版社,1959.12
45.运气学说(增订版)/任应秋著.-2版.-上海:上海科学技术出版社,1982.5重印
46.运气学研究/张年顺,方文贤著.-重庆:重庆出版社,1993.3
47.运气论奥谚解/日本冈本为竹编著; 承为奋译.-江苏:江苏人民出版社,1959.8重印
48.中医气象学/张廷枢编著.-成都:四川科学技术出版社,1991.9
49.中医气象学与养生防病/李铁君,陈燕燕著.-北京:人民卫生出版社,1994.5
50.运气医学/曹培琳著.-太原:山西科学技术出版社,1991.8
51.中国运气学/刘杰著.-济南:黄河出版社,1990.6
52.中国八卦运气/刘杰著-青岛:青岛出版社,1999.1
53.中医时间医学理论及应用/瞿岳云,许建平,潘远根著.-重庆:重庆出版社,1993.11
54.中医时间证治学纲要/程士德主编.-北京:人民卫生出版社,1994.3
55.中医时辰治疗学/祝恒琛主编.-北京:华夏出版社,1998.5
56.中医运气学说解读/张景明,陈震霖编著.-北京:人民军医出版社,2008.1
57.中西医结合时间治疗学/胡剑北编著.-安徽:安徽科学技术出版社,2008.5
58.易医时间诊疗/任得泽,明易编著.-北京:中国中医药出版社,2006.3
59.时间针法入门/朴联友主编.-北京:人民卫生出版社,2008.1
60.运气与临床/汪德云编著.-安徽:安徽科学技术出版社,1990.12
61.针灸脑病学/赖新生主编.-北京:人民卫生出版社,2006.6
62.五运六气详解与应用/权依经,李民听编著.-甘肃:甘肃科学技术出版社,1987.6
63.阴阳五行运气八卦在中医学中的应用/曹培林编著.-太原:山西科学技术出版社,1999.10
64.黄帝虾慕经/不著撰人.-北京:中医古籍出版社,1984.1
65.时间医学与针灸万年历/方云鹏,方本正编著.-西安:陕西科学技术出版社,2002.1
66.中国八卦针经/刘杰著.-2版.-青岛:青岛出版社,2008.1
67.圆运动的古中医学/彭子益著;李可主校.-北京:中国中医药出版社,2007.6(2007.8重印)
68.中医时间医学全书/漆浩,陈利苹主编.-北京:学苑出版社,2008.1
69.太极太玄体系/郑军著.-北京:中国社会科学出版社,1992
70.靳瑞针灸传真/袁青编著.-北京:人民卫生出版社,2006.12
71.靳三针疗法解说(中英对照)/袁青等编著.-上海:上海科学技术文献出版社,2004.6
72.周易与中医运气/杨力著.-台北:建宏出版社,2002.2
i.司徒铃.子午流注取穴法治疗417例病证疗效观察.新中医,1985,3:28
ii.郑军.干支纪年和五运六气来源的重新发现.中国医药学报,1988,1:15
iii.汪德云.从人体胚胎发育期看运气学说. 中医药学报,1984,(3):11-12
iv.汪德云.小儿疾病与其胚胎发育期之间内在规律的探讨.北京中医学院学报,1984,(4):2-13
2.玄珠密语/[唐]王冰编著(王冰医学全书/张登本等主编)-北京:中国中医药出版社,2006.3
3.天元玉册/[唐]王冰编著(王冰医学全书/张登本等主编)-北京:中国中医药出版社,2006.3
4.图解黄帝内经素问/刘越 图解.-北京:人民卫生出版社,2003.9
5.黄帝内经太素;黄帝内经明堂/[唐]杨上善撰注;李云点校.-北京:学苑出版社,2007.6
6.灵枢经/[宋]史崧 整理;杨鹏举等 教注.-北京:学苑出版社,2008.4
7.黄帝八十一难经/[战国]扁鹊 撰;高丹枫,王琳 校注.-北京:学苑出版社,2007.4
8.素问入式运气论奥/[宋]刘温舒 原著;张立平 校注.-北京:学苑出版社,2008.10
9.琼瑶发明神书/[宋]琼瑶贞人 撰.-据清道光二十八年成申倍元堂刻本
10.子午流注针经/[金]何若愚 撰;阎明广 注.-据日本抄宣德壬子广勤书堂新 本抄本
11.针经指南/[元]窦汉卿 撰著;见[元]窦桂芳《针灸四书》.-北京:人民卫生出版社,1983
12.扁鹊神应玉龙经/[元]王国瑞 撰著.-商务影印本,见四库全书珍本初集医家类
13.类经/[明]张介宾 编著.-北京:人民卫生出版社,1982.11
14.类经图翼/[明]张介宾 著.-北京:人民卫生出版社,1980.4重印
15.中医与易学(即《类经图翼》、《类经附翼》组成)/[明]张介宾 原著;方向红校理.-北京:学苑出版社,1993.8
16.运气易览/[明]汪石山 著(汪石山医学全书/高尔鑫主编).北京:中国中医药出版社,1999.8
17.针灸大全/[明]徐凤 撰.-北京:人民卫生出版社,1973
18.针灸聚英/[明]高武 撰.-上海:上海科学技术出版社,1961
19.针灸大成/[明]杨继洲 撰.-北京:人民卫生出版社,1973
20.医学入门/[明]李梃 撰.-万历年间吴郁堂藏本
21.针灸逢源/[清]李学川 撰.-上海:上海科学技术出版社,1987.8
22.针灸时间治疗概论/靳瑞,赖新生,靳子豪 编著.-上海:上海翻译出版公司,1990.5
23.子午流注与灵龟八法(修订本)/郑魁山 编著.-兰州:甘肃省科学技术出版社,1995.3
24.子午流注、灵龟飞腾八法大全/漆浩,董晔 主编.-北京:中国医药科技出版社,1995.6重印
25.最佳时间针灸法 / 刘炳权 编著.-山东:山东科学技术出版社,1987.10
26.八卦与时间医学/刘炳权,苏祥编著.-广州:广东科技出版社,1995.5
27.中医气象学/刘炳权,唐玉兰编著.-广州:广东科技出版社,2005.2
28.周易与中医学/杨力著.-3版(修订本).-北京:北京科学技术出版社,2002.3重印
29.中医运气学/程绍恩编著.-北京:北京科学技术出版社,1986.6重印
30.中医运气学/杨力著.-2版.-北京:北京科学技术出版社,2006.5重印
31.中医疾病预测学/杨力著.-北京:北京科学技术出版社,2006.5重印
32.子午点穴疗法/陆汉韬,谭士玲编著.-广西:广西科学技术出版社,2002.6重印
33.占典时间治疗学/曹欣荣,詹永康编著.-长沙:湖南科学技术出版社,1984.2.
34.最佳时间针灸精义/李友林,刘清国主编.-北京:学苑出版社,2003.7
35.时辰治疗学/祝恒琛主编.-北京:华夏出版社,2006.6
36.中医运气学解秘/田合禄,田蔚著.-太原:山西科学技术出版社,2001.12
37.五运六气临床应用大观/田合禄,周晋香等著.-太原:山西科学技术出版社,2005.4(2006.4重印)
38.实用时间针法秘要:周易与针灸学/箫进顺编著.-北京:人民军医出版社,2007.10
39.运气学说/余金城编著.-台北:五洲出版社,2004.9
40.实用运气学说/黄天锡,刘含堂主编.-北京:学苑出版社,2005.2
41.实用时间针法/朴联友主编.-北京:人民卫生出版社,2006.11
42.开启中医之门-运气学导论/李阳波讲述;刘力红等整理.-北京:中国中医药出版社,2005.11
43.独穴针灸疗法/刘昭,周晨华著译.-北京:人民卫生出版社,2005.2
44.五运六气/任应秋编著.-上海:上海科学技术出版社,1959.12
45.运气学说(增订版)/任应秋著.-2版.-上海:上海科学技术出版社,1982.5重印
46.运气学研究/张年顺,方文贤著.-重庆:重庆出版社,1993.3
47.运气论奥谚解/日本冈本为竹编著; 承为奋译.-江苏:江苏人民出版社,1959.8重印
48.中医气象学/张廷枢编著.-成都:四川科学技术出版社,1991.9
49.中医气象学与养生防病/李铁君,陈燕燕著.-北京:人民卫生出版社,1994.5
50.运气医学/曹培琳著.-太原:山西科学技术出版社,1991.8
51.中国运气学/刘杰著.-济南:黄河出版社,1990.6
52.中国八卦运气/刘杰著-青岛:青岛出版社,1999.1
53.中医时间医学理论及应用/瞿岳云,许建平,潘远根著.-重庆:重庆出版社,1993.11
54.中医时间证治学纲要/程士德主编.-北京:人民卫生出版社,1994.3
55.中医时辰治疗学/祝恒琛主编.-北京:华夏出版社,1998.5
56.中医运气学说解读/张景明,陈震霖编著.-北京:人民军医出版社,2008.1
57.中西医结合时间治疗学/胡剑北编著.-安徽:安徽科学技术出版社,2008.5
58.易医时间诊疗/任得泽,明易编著.-北京:中国中医药出版社,2006.3
59.时间针法入门/朴联友主编.-北京:人民卫生出版社,2008.1
60.运气与临床/汪德云编著.-安徽:安徽科学技术出版社,1990.12
61.针灸脑病学/赖新生主编.-北京:人民卫生出版社,2006.6
62.五运六气详解与应用/权依经,李民听编著.-甘肃:甘肃科学技术出版社,1987.6
63.阴阳五行运气八卦在中医学中的应用/曹培林编著.-太原:山西科学技术出版社,1999.10
64.黄帝虾慕经/不著撰人.-北京:中医古籍出版社,1984.1
65.时间医学与针灸万年历/方云鹏,方本正编著.-西安:陕西科学技术出版社,2002.1
66.中国八卦针经/刘杰著.-2版.-青岛:青岛出版社,2008.1
67.圆运动的古中医学/彭子益著;李可主校.-北京:中国中医药出版社,2007.6(2007.8重印)
68.中医时间医学全书/漆浩,陈利苹主编.-北京:学苑出版社,2008.1
69.太极太玄体系/郑军著.-北京:中国社会科学出版社,1992
70.靳瑞针灸传真/袁青编著.-北京:人民卫生出版社,2006.12
71.靳三针疗法解说(中英对照)/袁青等编著.-上海:上海科学技术文献出版社,2004.6
72.周易与中医运气/杨力著.-台北:建宏出版社,2002.2
i.司徒铃.子午流注取穴法治疗417例病证疗效观察.新中医,1985,3:28
ii.郑军.干支纪年和五运六气来源的重新发现.中国医药学报,1988,1:15
iii.汪德云.从人体胚胎发育期看运气学说. 中医药学报,1984,(3):11-12
iv.汪德云.小儿疾病与其胚胎发育期之间内在规律的探讨.北京中医学院学报,1984,(4):2-13