环跳穴定位法探析

Probe into the Method of Locating Huantiao (GB30) Acupoint

摘要: 环跳应用于坐骨神经痛、下肢痿痹及髋关节周围病变的临床疗效佳，运用频次高，但笔者发现初学者或临床经验不丰富的医生常无法准确定位而感到困惑，导致临床上取穴不准而影响疗效。主要问题在于：1) 寻找股骨大转子及骶管裂孔有难度。及环跳简便定位法能否实现精准定穴？2) 临床实际操作中，俯卧位下环跳穴的定位方法与侧卧位时的定位方法是否一致？以上述问题为导向，笔者研究历年针灸教材和相关著作，并查阅相关文献，探讨环跳的标准定位沿革、标准定位方法及俯卧位下的定位方法。综合各家观点，笔者认为环跳简便定位法易产生误差，应采用体表标志画线法，俯卧位时环跳的定位与侧卧位时定位方法一致，均粗定位骶管裂孔与股骨大转子最凸点连线外1/3与内2/3的交点，再结合腧穴诊察手法进行细定位。

Abstract: The use of Huantiao (GB30) in sciatica, lower limb impotence and periacetabular lesions is clinically effective and frequently used, but the author finds that beginners or doctors with little clinical ex-perience are often confused by the inaccurate positioning of the acupuncture points, which leads to inaccuracy in clinical practice and affects the efficacy of the treatment. The main problems are: 1) Difficulty in locating the greater trochanter of the femur and the sacral fissure. Can the simple posi-tioning method and the circular jumping method be used to pinpoint the points? 2) In clinical prac-tice, is the positioning of the Huantiao (GB30) points in the prone position consistent with that in the lateral position? Using the above questions as a guide, the author studied previous acupuncture textbooks and related works, and reviewed relevant literature to explore the standard positioning history of the Huantiao (GB30), the standard positioning method and the positioning method in the prone position. Comprehending various opinions, the positioning of the Huantiao (GB30) in the prone position is the same as that in the lateral position, with coarse positioning at the intersection of the outer 1/3 and inner 2/3 of the line between the sacral fissure and the most convex point of the greater trochanter, followed by fine positioning in combination with acupuncture point diagno-sis techniques.