基于《脾胃论》探讨“老十针”结合中药治疗功能性消化不良

Treatment of Functional Dyspepsia with “Old Ten Needles” and Chinese Herbal Medicine Based on the “Treatise on the Spleen and Stomach”

摘要: 功能性消化不良(FD)是临床常见的功能性胃肠病，中医多从“胃痞”“痞满”论治，其核心病机在于脾胃升降失常。“老十针”是北京已故名老中医王乐亭先生依据《脾胃论》“补中益气汤”方义设计的针灸处方，全方具有“理气健脾、升清降浊”之功。本文从脾胃升降理论出发，系统阐释“老十针”联合中药治疗FD的理论基础与临床应用经验，并结合临床分型(脾胃虚弱证、肝胃不和证、寒热错杂证)提出具体治疗方案，通过典型病例展示针药结合的疗效优势。文章指出，“老十针”的穴位配伍充分体现了“调中健脾、升清降浊”的治则，与中药内服形成内外协同、动静结合的整合治疗模式，旨在为FD的中医临床治疗提供理论与实践参考。在此基础上，本文进一步从神经影像学、脑肠互动和生物–心理–社会医学模式等现代研究视角，阐释“老十针”联合中药治疗FD的潜在机制，探讨中医“脾胃升降”理论与现代脑肠轴学说的内在关联，以期为FD的中医临床治疗提供理论与实践参考，推动中医经典理论与现代生命科学的对话与融合。

Abstract: Functional dyspepsia (FD) is a common functional gastrointestinal disorder in clinical practice. In traditional Chinese medicine (TCM), it is often treated under the categories of “gastric stuffiness” (Wei Pi) and “fullness and distention” (Pi Man), with its core pathogenesis lying in the dysfunction of the spleen and stomach in ascending and descending. The “Old Ten Needles” is an acupuncture prescription designed by the late renowned TCM master Wang Leting from Beijing based on the principle of Buzhong Yiqi Decoction from the “Treatise on the Spleen and Stomach”. The entire prescription has the functions of “regulating qi, strengthening the spleen, ascending the clear, and descending the turbid”. Starting from the theory of ascending and descending of the spleen and stomach, this paper systematically elucidates the theoretical basis and clinical application experience of the “Old Ten Needles” combined with Chinese herbal medicine in treating FD. It also proposes specific treatment plans based on clinical subtypes (spleen-stomach deficiency pattern, liver-stomach disharmony pattern, and cold-heat complex pattern) and demonstrates the advantages of the integrated acupuncture-herbal therapy through typical case studies. The article points out that the acupoint combination of the “Old Ten Needles” fully embodies the therapeutic principle of “regulating the middle, strengthening the spleen, ascending the clear, and descending the turbid,” forming an integrated treatment model of internal-external synergy and dynamic-static combination together with oral Chinese herbal medicine, aiming to provide theoretical and practical references for the TCM clinical treatment of FD. On this basis, this paper further explains the potential mechanisms of the “Old Ten Needles” combined with Chinese herbal medicine in treating FD from modern research perspectives such as neuroimaging, brain-gut interaction, and the biopsychosocial medical model. It also explores the intrinsic relationship between the TCM theory of “ascending and descending of the spleen and stomach” and the modern brain-gut axis theory, in order to offer theoretical and practical references for TCM clinical treatment of FD and to promote the dialogue and integration between classical TCM theories and modern life sciences.