基于“气血衰、气道涩”探析背俞八阵刺血疗法治疗围绝经期失眠

Exploring the Blood-Pricking Cupping at Back-Shu Bazhen Points in Treatment of Perimenopausal Insomnia with Based on the Theory of “Decline of Qi and Blood” and “Stagnation of Qi Passage”

摘要: 围绝经期失眠(PMI)是女性围绝经期常见且严重影响生活质量的病症，目前西医治疗存在适应证限制、不良反应及依赖性等不足。本文基于《内经》“气血衰、气道涩”理论，提出PMI核心病机多为“虚实夹杂”，以肝肾亏虚、气血衰少为本，六郁阻滞、气机失调为标，二者互为因果，形成恶性循环。在此理论指导下，系统介绍四川省第一中医医院马界主任医师创立的背俞八阵刺血疗法。该疗法以背俞穴为中宫，按八卦方位构建内、中、外八阵穴，通过点穴松解、刺血拔罐相结合，调脏通郁、疏通经络、调和营卫，达到“引阳入阴”安神之效。文中结合验案一例，进一步阐明该疗法在疏肝解郁、行气活血、滋肾安神方面的具体应用与疗效。该疗法内外同调、补泻兼并，操作规范，疗效确切，为围绝经期失眠的临床治疗提供了新的思路与方法。

Abstract: Perimenopausal insomnia (PMI) is a common condition in women during the perimenopausal period that severely impairs quality of life. Current Western medical treatments have limitations such as restricted indications, adverse reactions, and dependence. Based on the theory of “decline of qi and blood” and “stagnation of qi passage” from the “Huangdi Neijing”, the paper proposes that the core pathogenesis of PMI is predominantly a “mixture of deficiency and excess”: deficiency of liver and kidney, as well as decline and insufficiency of qi and blood constitute the root, while the six depression obstruction and qi movement disorder constitute the manifestation. The two are mutually causal, forming a vicious cycle. Guided by this theory, this paper systematically introduces the therapy of “blood-pricking cupping at Back-Shu Bazhen points” pioneered by Chief Physician Ma Jie from Sichuan First Hospital of Traditional Chinese Medicine. This therapy takes the Back shu points as the central palace and constructs inner, middle, and outer Bazhen points according to the eight trigrams directions. By combining acupoint pressing and loosening with blood-pricking cupping, it regulates the viscera to relieve depression, dredges the meridians, and harmonizes the nutritive and defensive qi, thereby achieving the effect of “guiding yang into yin” to calm the spirit. A case example is provided to further illustrate the specific application and efficacy of this therapy in soothing the liver to relieve depression, promoting qi and blood circulation, nourishing the kidney, and calming the mind. This therapy simultaneously regulates both the interior and exterior, combines reinforcement and reduction, has standardized procedures, and demonstrates definite efficacy, offering a new approach and method for the clinical treatment of perimenopausal insomnia.