基于“通督升阳”理论浅析针刺治疗“颈项痰丘”

Analysis of Acupuncture Treatment of “Phlegm Mound on the Nape of the Neck” Based on “Tongdu Shengyang” Theory

摘要: 本文基于“通督升阳”理论探讨针刺治疗“颈项痰丘”(即“富贵包”)的思路。文章指出，该病以督脉阳气亏虚、清阳受阻为本，风寒湿邪侵袭、痰湿瘀结为标，病变集中于大椎穴周围。其发展可分为三阶段：外邪侵袭未成包、阴盛痰湿成包期及久病成瘀筋骨变。治疗上主张“通督升阳”，采用腰、颈、头三位一体的针刺策略：腰部取腰俞、腰夹脊等穴以补肾阳、助督阳；颈项部取大椎、风池、天柱等穴以温阳化湿、松解肌肉；头部取百会等穴以升阳开窍、养脑醒神，以期为中医治疗颈项痰丘提供系统理论依据和治疗路径。

Abstract: This study explores the acupuncture treatment of “Phlegm Mound on the Nape of the Neck” (commonly known as “Dowager Hump”) based on the “Tongdu Shengyang” theory. The article identifies this condition as rooted in Yang deficiency and obstructed clear Yang along the Governor Vessel, with symptoms of wind-cold-dampness invasion and phlegm-dampness stasis, primarily affecting the Dazhui acupoint area. The progression can be divided into three stages: initial invasion without mass formation, yin excess with phlegm-dampness accumulation, and chronic stagnation leading to musculoskeletal changes. The therapeutic approach emphasizes “Tongdu Shengyang”, employing a three-dimensional strategy that integrates lumbar, cervical, and cranial acupuncture: lumbar points like Yaoshu and Yaojiaji to tonify kidney Yang and assist Governor Yang; cervical points such as Dazhui, Fengchi, and Tianzhu to warm Yang, resolve dampness, and relax muscles; and cranial points including Baihui to elevate Yang, open orifices, nourish the brain, and invigorate consciousness. This framework provides a systematic theoretical basis and therapeutic pathway for traditional Chinese medicine in treating neck phlegm masses.