从结果到前提:针刺得气概念的演变及其对补泻刺法的影响OA
From result to premise:evolution of the concept of acupuncture-induced deqi and its effect on reinforcing-reducing acupuncture technique
针刺"得气"首见于《黄帝内经》,是针灸技法理论里最重要的概念之一,也是表述针灸效应的代表性术语,其判断及描述主要依赖主观感觉和经验,而机体对针灸刺激的反应及影响因素又颇为复杂,古今针灸医家虽无不重视,认识却并不一致,概念不免模糊.基于古代文献的理论分析,文章认为,《黄帝内经》针刺论述中的"得气",尚未术语化;得气内涵经历巨大变化,从补泻的"结果"变为补泻的"前提";得气认识引发补泻操作从体现"通天之气"到围绕"针下之气"的术式变革.文章提出,认识得气需要考虑针刺反应整体及其历史语境;阐明其本质特征和实际意义,是当代针灸理论体系构建和经验传承的关键问题之一;诊脉以助判断得气及针刺效应仍具有临床实用价值.
The concept of deqi in acupuncture was first documented in Huangdi Neijing(The Yellow Emperor 's Inner Classics).It is one of the most fundamental concepts in the theory of acupuncture techniques and serves as a representative term for describing acupuncture effect.The relevant judgement and description of it primarily rely on subjective perception and experiences.The response to acupuncture stimulation in the body and its influencing factors are highly complex.Although acupuncture practitioners throughout history have all recognized their importance,their understanding remains inconsistent,leading to inevitable conceptual ambiguity.Based on theoretical analysis of ancient literature,this article argues that the concept of deqi discussed in the acupuncture-related sections of Huangdi Neijing has not yet been formalized into a standardized term.The connotation of deqi has undergone significant transformation,evolving from the"result"of reinforcing-reducing technique to its"premise".The understanding of deqi initiates the development of reinforcing-reducing technique,from"qi communicating with heaven and earth"to"qi beneath needle".The article proposes:understanding deqi should consider the overall reaction of acupuncture and its historical context,elucidating its essential characteristics and practical significance is one of the key issues in constructing the contemporary theoretical framework of acupuncture and preserving its empirical knowledge,and determining deqi and acupuncture efficacy by pulse diagnosis still retain their clinical practical value.
赵京生
中国中医科学院针灸研究所,北京 100700
得气气至针下之气针下感针刺反应针刺补泻刺灸法《黄帝内经》
deqiarrival of qiqi beneath needlesensation beneath needleacupuncture responsereinforcing and reducing of acupuncturetechniques of acupuncture and moxibustionHuangdi Neijing
《中国针灸》 2026 (8)
1256-1268,13
国家自然科学基金资助项目:81873241
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