基于“不通则痛”理论探讨穴位埋线治疗痛经的临床思路

Exploring the Clinical Approach to Acupoint Catgut Embedding Therapy for Dysmenorrhea Based on the “Obstruction Leads to Pain” Theory

摘要: 痛经作为妇科常见病，中医以“不通则痛”为核心病机，强调气血瘀滞、冲任失调致病的动态过程。本文基于该理论，探讨穴位埋线疗法通过“长效刺激–疏通经络–调和气血”的作用机制治疗痛经的临床思路。研究指出，气滞、寒凝、血瘀等病理因素导致冲任胞宫气血壅滞，形成“因滞致瘀–因瘀致痛”的恶性循环。穴位埋线通过生物可降解线体对穴位的持续性刺激，突破传统针刺时效局限，结合“辨滞选穴–以线通络”的精准干预模式，针对不同证型(如气滞血瘀、寒凝血瘀、虚实夹杂)分层施治。未来需进一步结合现代技术解析埋线通络的生物学机制，优化选穴方案，并通过多中心研究验证其普适性。本文以期为痛经治疗提供融合中医理论特色与现代适应性的新策略，为妇科痛证研究拓展理论与实践参考。

Abstract: Dysmenorrhea, a common gynecological disorder, is rooted in the traditional Chinese medicine (TCM) pathogenesis of “obstruction leads to pain”, which emphasizes the dynamic process of qi-blood stasis and imbalance of the thoroughfare and conception vessels. Based on this theory, this study explores the clinical approach of acupoint catgut embedding therapy for dysmenorrhea through its mechanism of “long-term stimulation, unblocking meridians, and harmonizing qi-blood”. The research highlights that pathological factors such as qi stagnation, cold congelation, and blood stasis lead to the stagnation of qi and blood in the thoroughfare and conception vessels and the uterine system, forming a vicious cycle of “stagnation causing stasis, and stasis causing pain”. Acupoint catgut embedding overcomes the time-limited efficacy of traditional acupuncture by utilizing biodegradable threads to provide sustained stimulation at specific acupoints. Combined with a targeted intervention model of “selecting acupoints based on stagnation patterns and unblocking meridians with threads”, this therapy is applied hierarchically for different syndromes (e.g., qi stagnation with blood stasis, cold congelation with blood stasis, and deficiency-excess complex). Future studies should integrate modern technology to elucidate the biological mechanisms of meridian unblocking through catgut embedding, optimize acupoint selection protocols, and validate its universality via multicenter trials. This study aims to provide a novel strategy for dysmenorrhea treatment that integrates TCM theoretical principles with modern adaptability, offering theoretical and practical insights for research on gynecological pain disorders.