背兪穴 接診에 關한 考察

洪文燁,朴元煥 동국대학교 한의학연구소 2000 東國韓醫學硏究所論文集 Vol.8 No.2

한의학의 診斷에는 望·聞·問·切의 四診法과 여러 가지의 辨證體系, 즉 氣血津液辨證, 臟腑辨證, 六經辨證, 衛氣營血辨證, 三焦辨證, 四象體質辨證 등이 응용되어 지고 있으며, 또한 그와 더불어 症狀·證候鑑別診斷法등이 선택적으로 활용되어 지고 있다. 이러한 廣範圍한 診斷方法가운데 切診은 손가락 및 손바닥의 感覺을 運用해서 一定部位를 觸指, 按壓하는 檢査方法으로써 切脈診과 按診으로 크게 나눌 수 있다. 이중 按診이란 손을 사용하여 직접 환부에 觸摸 按壓하여 이상변화를 알아내고 나아가서는 疾病의 部位와 性質과 病情의 輕重 등의 內部의 變化와 體表의 反應을 觀察하여 重要한 辨證資料를 얻는 診斷方法의 한 種類를 말한다. 또한 按診에는 按肌表, 按手足, 按胸腹,, 按兪穴診法등을 들 수 있다. 背兪穴의 診斷法은 經絡이라는 反應路를 通하여 體表에 發現되는 壓痛, 自發痛, 緊張, 弛緩, 硬結 및 條索狀物 등의 現象으로 부터 內部臟器의 病變을 診斷하는 方法이다. 이에 著者는 按診의 內容과 方法을 연구하면서 十二經脈의 始動病 所生病을 알아보고 穴位診斷의 方法 및 注意點등을 아울러 정리하므로써 다음과 같은 結論을 얻었다. 1. 兪穴운 各 臟腑의 邪氣가 注入하는 곳으로 臟病 寒症 虛症의 의미를 내포한 陰性病症 治療에 重要한 곳이다. 2. 兪穴의 觸診 卽 母指로서 脊椎棘突起 左右側을 按壓하여서 上向이나 下向으로 推壓指하면 棘突起의 突, 陷凹, 緊張, 弛緩 및 壓痛의 出現部位에 따라 系統別 疾患을 判斷할 수 있다. 3. 實際 臨床에서 患者의 診斷 治療에 있어서 背部按診은 重要한 診斷의 한 領域으로 빠뜨리지 말고 꼭 參考하여야 할 것으로 思料된다. 4. 臟腑疾患에 대한 診斷方法의 多樣化와 治療領域의 擴大 및 治療率의 上昇을 위해 背部兪穴의 正確한 認識과 兪穴按診을 통하여 正確한 診斷이 되었으면 한다. The diagnosis in Oriental medicine is done by inspection, auscultation and olfaction, interrogation, four diagnostics of pulse feeling and palpation, and various system of identification like identification according to Qi(vital energy), Xue and body fluids, identification according to fair principles, identification according to principles of Wei, Qi, Ying and Xue, identification according to SanjiaoIthe triple heater), identification accordmg to four type physical constitution. Sometimes, symptoms and diagnosis techniques according to symptoms is selectively applied for the Qagnosis. Among them the pulse feeling and palpation diagnosis technique using the sense of finger and palm of the hand is divided into feeling of pulse and palpation and pressing maneuver. Pressing maneuver is a diagnosis technique pressing and rubbing the affected part in order to attain data of identification including inside and outside condition of the body with regard to the nature, condition and relative seriousness of disease. There are palpation of the slun, palpation the hand and foot, palpation the chest and the abdomen, palpation shu points in pressing maneuver. The diagnosis of the Back Shu points is a technique to examine the change of disease condition from pressure ache, spontaneous ache, tension, relaxation, soliddication revealed through channels and collaterals. I investigates starting disease and an attack of disease of twelve pulse and pulse condition through the study relative to the substance and technique of pressing maneuver, and adjusts diagnosis techniques of a region for acupuncture and matters to be attended. The conclusions are as follows. 1. The Shu or stream points in which pathogenic factors go are important to medical treatment of dormant diseases like bowels disease, cold symptom complex and insufficiency symptom complex. 2. Disease classified by system is diagnosed by the condition of process part like protrusion, cave-in, tension, relaxation, pressure ache through palpating the Shu or stream points, that is pressing upward or downward left and right sides of the backbone process by hands. 3. In real clinic pressing maneuver of one s back side is very important to patient's diagnosis treatment. Thus, pressing maneuver of one s back side have to be done without omission. 4. Diagnosis must be accomplished through the perception about the diversity of diagnosis technique of bowels disease, the exact knowledge about pressing maneuver of one s back side for enlargement of treatment range and rising of treatment rate, and pressing maneuver of the Shu or the stream points.

金櫃要略의 常見腹證에 관한 硏究

홍문엽,박선동,박원환 동국대학교 한의학연구소 1999 東國韓醫學硏究所論文集 Vol.8 No.1

The subject of Abdominal syndrome in the field of Jin Kui Yao Lue takes a quarter of the whole research quantity, and has greatly contributed to the development of diagnoses due to the well-growth of syndrome differentiation through 'the differentiation of symtoms and signs based on prescriptions'-centered abdominals syndrome. Since then, while the diagnostic has been developed mainly in the field of pulse feeling and the inspection of the tongue, application of the abdominal diagnostic has not been continuously improved because of special historical and social environments. Recently, since interest in the differentiation of symtoms and signs based on abdominal syndrome has been raised by emphasis of Oriental diagnostic methods and medical treatment which have led to the study of Abdominal Syndrome in Jin Kui Yao Lue. The following is the results of the study. 1. Jin Kui Yao Lue abdominal syndmme is categorized into all abdominal symptoms Epigastric symptoms, Hypochondrium symptoms, and Lower abdomen symptoms. 2. Subjective symptoms and Objective symptoms have been found in Abdominal syndrome, and Subjective symptoms have been more often than Objective symptoms. Both of the symptoms have been found more to co-exist in abdominal syndromes. 3. More cases of fullness of abdomen symptoms in All abdominal symptoms, a smaller number of cases in Taiyang disease, Yangming disease, disease involving all three yang, Tayin disease and Jueyin disease have been found, but there have not been found in Shaoyin disease. 4. More cases of Epigastric fullness and rigidity in Epigastric symptoms, Epigastirc throbs in Palpitation symptoms, and sense of fullness-in-chest in Abdominal syndrome of chest and hypochondrium have been recognized. 5. Any regularity caused by abdominal symptoms has not been identified. 6. Diagnosis of the abdomen caused by abdominal symptoms has been identified in Epigastric fullness, Epigastric pain, Epigastric procrastination, Epigastric throb, fullness of abdomen and distension of lower abdomen.

금궤요략의 상견복증(常見腹證)에 관한 연구(硏究)

홍문엽,박선동,박원환,Hong, Mun-Yeup,Park, Sun-Dong,Park, Won-Hwan 동국대학교 한의학연구소 1999 東國韓醫學硏究所論文集 Vol.8 No.1

금궤요략은 후한말기(後漢末期) 장기(張機)가 지은 임상의학(臨床醫學) 전문서적(專門書籍)으로써, 리(理) 법(法) 방(方) 약(藥)이 갖추어진 독창적(獨創的)인 변증론치체계(辨證論治體系)를 수립하고 있으며, 특히 복증(腹證)에 관한 내용을 중(重)히 다루고 있고, 방증변증(方證辨證)이 중심(中心)이 되어 복증(腹證)을 통한 변증(辨證)이 매우 발달되어 있어서 진단학(診斷學)의 발전(發展)에 크게 기여하였다. 이후 진단학(診斷學)의 발전(發展)은 진맥(診脈), 진설(診舌)을 위주로 했으며, 복진(腹診)의 운용(運用)에 대해서는 역사적으로 사회적인 특수한 배경으로 인하여 계속 발전되지 못하였다. 최근 한의학적(韓醫學的) 진단방법(診斷方法)과 치료방법(治療方法)이 매우 강조되어 활발한 연구가 계속 진행되면서 복증변증(腹證變證)에 관한 관심이 매우 집중되고 있기에, 복부진단(腹部診斷)에 관한 연구(硏究)의 한 방법(方法)으로써 금궤요략에 실려있는 상견복증(常見腹證)에 관련된 내용(內容)을 정리한 결과(結果) 약간의 지견(知見)을 얻었다. The subject of Abdominal syndrome in the field of Jin Kui Yao Lue takes a quarter of the whole research quantity, and has greatly contributed to the development of diagnoses due to the well-growth of syndrome differentiation through 'the differentiation of symptoms and signs based on prescriptions'-centered abdominal syndrome. Since then, while the diagnostic has been developed mainly in the field of pulse feeling and the inspection of the tongue, application of the abdominal diagnostic has not been continuously improved because of special historical and social environments. Recently, since interest in the differentiation of symptoms and signs based on abdominal syndrome has been raised by emphasis of Oriental diagnostic methods and. medical treatment which have led to the study of Abdominal Syndrome in Jin Kui Yao Lue. The following is the results of the study. 1. Jin Kui Yao Lue abdominal syndrome is categorized into all abdominal symptoms Epigastric symptoms, Hypochondrium symptoms, and Lower abdomen symptoms. 2. Subjective symptoms and Objective symptoms have been found in Abdominal syndrome, and Subjective symptoms have been more often than Objective symptoms. Both of the symptoms have been found more to co-exist in abdominal syndromes. 3. More cases of fullness of abdomen symptoms in All abdominal symptoms, a smaller number of cases in Taiyang disease, Yangming disease, disease involving all three yang, Tayin disease and Jueyin disease have been found, but there have not been found in Shaoyin disease. 4. More cases of Epigastric fullness and rigidity in Epigastric symptoms, Epigastric throbs in Palpitation symptoms, and sense of fullness-in-chest in Abdominal syndrome of chest and hypochondrium have been recognized. 5. Any regularity caused by abdominal symptoms has not been identified. 6. Diagnosis of the abdomen caused by abdominal symptoms has been identified in Epigastric fullness, Epigastric pain, Epigastric procrastination, Epigastric throb, fullness of abdomen and distension of lower abdomen.

신수혈의 침자극과 황기약침이 실험용 생쥐의 면역활성물질인 IL-1 α의 遺傳子發現에 미치는 影響

申相習,朴元煥,洪文燁,李泰均,崔達永 대한동의병리학회 1999 동의생리병리학회지 Vol.13 No.2

체내의 환경을 항상적으로 유지하는 생체방어체계에는 면역활성물질이 있으며, 이러한 면역활성물질의 적절한 발현이 생체의 항상성을 유지하는데 작용하게 된다. 이에 한의학에서는 생체의 항상성 유지와 체내의 면역력 증가를 위해 많은 요법들이 시행되어 왔는데, 그 중 자침요법과 약침요법이 많이 응용되고 있다. 그러나 침자극과 약침의 효과에 대한 기전은 기대하는 만큼 제시되지 못하고 있다. 이에 본 논문은 침자극과 약침의 효과에 대한 기전을 밝히는 방법의 일환으로서 면역활성물질인 IL-1α가 補腎臟, 振氣化, 祛水濕, 强腰脊, 益水壯火 등의 穴性이 있는 신수혈(BL23)의 침자극과 황기약침처치를 통해 어떻게 발현하는가를 관찰하였다. 그 결과, 면역 증강 작용을 나타내는 cytokine IL-1α 에 대한 침자극의 반응은 관찰되었고, 황기약침에 의한 IL-1α 의 발현은 명확하지 않았다. 그러므로 신수혈을 이용한 cytokine IL-1α의 추적은 황기약침의 효과보다 침자극의 효과에 대한 근거를 추측할 수 있을 것이며, 뿐만 아니라 침자극에 의한 면역반응정도를 통해 질병의 진행상태를 나타내는 진단지표로서 활용가능성이 있을 것이다. Acupuncture and Radix Astragali aqua-acupuncture stimuli have long been used to cure human diseases. However, it still remains to be unknown on its action mechanism, physiological and biochemical aspects. Thus, many attempts were made to show the scientific background covering the above mentioned mechanisms. Most recent studies show that these tests improve blood circulatory system and increase leucocyte counts. In this study, we have applied the acupuncture stimuli to mouse Sinsu(BL23), which is a stimulative point of oriental medicine, to see if cytokine such as IL-1α can be detected. Mice were treated with lipopolysaccharide(LPS) for inflammation induction, and then reverse transcriptase-polymerase chain reaction (RT-PCR) using each primer set was performed to trace the amounts of mRNA. The results are as follows ; 1. The RT-PCR product using IL-1α primers was detected as 450 bp on agarose gels and the IL-1α gene was not expressed in normal mice at 15 min after the removal of acupuncture. However, it was gradually increased indicating a faint expression after 30 min. 2. IL-1α was expressed in LPS-treated mice 30 min after the acupuncture was pulled out, and expressed most highly at 3 h after the removal of acupuncture. The gene expression of LPS-treated mice were more effective than those of normal mice. 3. IL-1α was not expressed in normal mice and LPS-treated mice from 30 min to 3hs. after Radix Astragali aqua-acupuncture stimulation. Therefore, a tracing the gene expression of cytokine IL-1α can be used more not only for a basis of the effect of acupuncture stimulation but a diagnosis guide through the immunological action than the effect of Radix Astragali aqua-acupuncture. Moreover, we need to further study the cytokine's expression in Radix Astragali aqua-acupuncture stimulation.