从《傅青主女科》“因虚而逆”探讨针灸治疗妊娠恶阻

Exploring Acupuncture and Moxibustion Treatment for Hyperemesis Gravidarum from the Perspective of “Adverse Flow Due to Deficiency” in Fu Qingzhu’s Obstetrics and Gynecology

摘要: “因虚而逆”理论由傅青主提出，认为妇人妊娠恶阻的基本病机是脾失健运，痰湿内生，治法为平肝补血，兼以健脾和胃。妊娠恶阻是由多种病因共同导致的疾病，在治疗方面，强调补虚降逆、标本同治。本研究以《傅青主女科》中的“因虚而逆”为理论基础，探讨妊娠恶阻的核心病机，并重点探讨针灸通过辨经选穴(如内关、足三里、中脘等)以健脾和胃、平冲降逆的现代应用与机制。治疗上拟采用“补虚降逆”的针灸方法，通过调补脾胃、滋肾平肝以“补虚”，疏调气机、和胃止呕以“降逆”，旨在恢复中焦升降之机，有效缓解呕吐症状，为针灸治疗妊娠恶阻提供新思路。

Abstract: The theory of “Adverse Flow Due to Deficiency”, proposed by Fu Qingzhu, posits that the fundamental pathogenesis of hyperemesis gravidarum in women lies in spleen dysfunction leading to internal generation of phlegm-dampness. The therapeutic principle focuses on soothing the liver and nourishing blood, supplemented by fortifying the spleen and harmonizing the stomach. As a condition arising from multiple etiological factors, the treatment of hyperemesis gravidarum emphasizes tonifying deficiency and downbearing counterflow, addressing both the root cause and symptomatic manifestations simultaneously. Based on the theoretical framework of “Adverse Flow Due to Deficiency” from Fu Qingzhu’s Obstetrics and Gynecology, this study explores the core pathogenesis of hyperemesis gravidarum. It particularly examines the modern application and mechanisms of acupuncture and moxibustion in fortifying the spleen and harmonizing the stomach, as well as calming the Chong Vessel and downbearing counterflow, through meridian differentiation and point selection (e.g., Neiguan [PC6], Zusanli [ST36], Zhongwan [CV12]). The proposed acupuncture treatment adopts the method of “Tonifying Deficiency and Downbearing Counterflow”. This involves “tonifying deficiency” by regulating and supplementing the spleen-stomach, enriching the kidney, and soothing the liver, and “downbearing counterflow” by dredging qi movement, harmonizing the stomach, and arresting vomiting. The aim is to restore the ascending and descending functions of the Middle Jiao, effectively alleviate vomiting symptoms, and thereby provide a novel perspective for acupuncture in treating hyperemesis gravidarum.