张荆柳1，罗声2，王海娟2 ，钟　玲2 ，谢燕和2

摘要：通过探讨壮医药线点灸之扶阳功效，拓宽和发展壮医药线点灸的内涵，以期为完善壮医药线点灸学体系提供有益的参考。

关键词：壮医药线点灸；扶阳

Study on the Strengthing Yan effect of the Zhuang Medicine Medicated Thread Moxibustion

Jingliu ZHANG1,Shengshui LUO2,Haijuan WANG2, Ling ZHONG2,Yanhe XIE2

Abstract：By exploring the strengthing yan effect of the Zhuang medicine medicated thread moxibustion ,broaden and develop the connotation of Zhuang medicine medicated thread moxibustion,in order to provide a useful reference for improving the Zhuang medicine mdicated thread moxibustion.

Keywords:Zhuang medicine medicated thread moxibustion；strengthing yan

      壮医药线点灸是壮医独特疗法，本疗法具有通痹、消炎、消肿散结、止痛、止痒等功效而广泛应用于内、外、妇、儿、皮肤科、五官等科疾病中，而其扶阳作用缺鲜为人知，现仅就壮医药线点灸之扶阳功效进行探讨。

1 壮医药线点灸疗法

1.1理论基础

      壮医药是我国传统医学重要的组成部分，它是壮族人民长期与疾病作斗争的经验总结，其理论独特，内涵丰富，治法及用药特色鲜明，疗效确切，在中国传统医学史上占有重要地位。我国著名壮医专家黄汉儒教授曾在《壮医基础理论体系》中提出壮医以阴阳为本的观点，具体体现以下两方面：

1.1.1对病证的认识

      壮医认为，疾病只包含“阳证”和“阴证”两种病证，临床症状表现为热证、实证者多为阳证，表现为寒证、虚证者多为阴证；壮医在临床上对疾病进行阴阳辨证，有助于预测疾病的转归，如病证由阴转阳，预示病势趋于好转或向愈，若由又阳转阴，提示病势趋向恶化，多预后不良[1]。因此，疾病的阴阳辨证是壮医诊断疾病过程不可缺漏的一环。

1.1.2对病机的认识

      壮医以阴阳为本，认为疾病的产生是因气血平衡失调所致，概言之“疾患并非无中生，乃系气血不均衡”，而气又为阳，血又为阴，当外邪侵袭人体，正邪相争，引起人体脏腑气血功能失常，最终导致阴阳的失调，简言之，阴阳失调是导致疾病发生、发展的根本因素[2]。

1.2定义

      壮医药线点灸法属于壮医特色的外治法，是壮医临床预防和治疗疾病的重要方法之一，其形成和发展已有百年历史，其适用范围甚广，对内、外、妇、儿、皮肤科、五官等科疾病中表现的寒、热、肿、痛、麻、痒均可采用本法治疗，具有简便、低廉、快捷、安全可靠等特点[3]。

壮医药线点灸是在壮医理论的指导下，选用经壮药炮制的苎麻线，将其一端在灯火上点燃，待之形成圆珠炭火时迅速而敏捷地将此炭火直接灸灼于人体的穴位或部位，做到快、稳、准、轻[4]。

      壮医强调阴阳为本的观点，壮医药线点灸作为壮医特色的外治法之一，故可认为壮医药线点灸对人体阴阳的平衡有一定的调节作用。

2.扶阳理论

2.1思想渊源

       扶阳思想可上溯至《周易》、《黄帝内经》等经典著作中。《周易》中大量文字论述了阴阳关系中阳主阴从的观点，如开篇即云：“成象之谓乾，效法之谓坤”，“天尊地卑，乾坤定矣，卑高以陈，贵贱位矣……乾知大始，坤作成无，乾以易知，坤以简能”，后又云：“大哉乾元，万物资始，乃统天”，“至哉坤元，万物资生，乃顺天”。乾为阳，坤为阴，“阳”既为万物肇始之源，又是善终之根，揭示了“阳”在宇宙万事万物发生、发展、变化中居于主导地位，“阴”为从属地位，充分体现了“扶阳”的思想[5]。《黄帝内经》认为，阳气贯穿于人体生命活动的始终，是人体机能活动中最至关重要的，人类的生、长、壮、老、已无不与阳气有着密切的联系，故以通过扶阳达到治疗、预防疾病的目的[6]。如《素问•生气通天轮》曰：“阳气者，若天与日，失其所则寿而不彰，故天运当以日光明。是故阳因而上，卫外者也，”又曰：“凡阴阳之要，阳秘乃固。”

2.2扶阳的意义

       卢铸之在《阳气盛衰轮》中说：“阳气者，乃化生精血、津液之本源，为人生立命的根本。”卢氏认为阳气是构成和维持人体生命活动的最基本物质，是人立命之本[7]。阳气为人一身之主宰，人体阳气充足则身强体健，一旦不足，则百病丛生，正如宋代名医窦材在《扁鹊心书》中所云：“夫人之真元乃一身之主宰，真气壮则人强，真气虚则人病，真气脱则人死”，此处真气即为阳气[8]。预示我们在防治疾病的过程中，不忘扶助阳气，时时重视顾护阳气，以恢复“阴平阳秘”的正常生理状态。

2.3扶阳的缘由

随着社会的发展，人们的物质生活日趋富裕有足，即“阴”的一面不曾减少，反而需要消耗这些物质能源“阳”的一面日益亏损[9]。同时，生活节奏加快，压力增大，致人体阳气损伤严重，表现为“上火”等症状，实则为阳气“烦劳则张”，失其潜藏[10]。再之当代大多中医医师，受西医学的影响，不辨阴阳，不求经旨，滥用苦寒剂、激素、抗生素等，所用之药无不攻伐人体阳气[11]。张存悌教授将人体阳气受损的原因归纳总结为以下方面：伤于寒者仍多；中西医化的影响；受温病学说影响，滥用苦寒；不求经旨，不辨阴阳；过度劳倦，烦劳伤阳；房劳伤肾；睡眠不足导致阳气受损；滥用抗生素、激素；慢性病多发，阳虚者居多[12-13]。

       综上所述，现代疾病的基本态势为“阴盛阳虚”，扶阳法则正切中病机，可见，运用扶阳法治疗现代疾病是势在必行。

3 壮医药线点灸功能特性体现扶阳

       宋代医家所著《扁鹊心书》中提出扶阳三法，即“灼艾第一，丹药第二，附子第三”，可见，扶阳首倡用灸法[14]。中医学认为，灸法能温经通络，散结消瘀，激发人体正气，增强机体抗邪能力，壮医药线点灸属于灸法范畴，以其温热、药效及对“皮部-络脉-经脉-脏腑”的刺激，激发经气，促进气血运行，发挥温壮脏腑阳气的功效，从而达到预防、治疗疾病的目的[15-16]。在这个意义上来说，壮医药线点灸为扶阳疗法。

      医学的不断进步，后人在前人的基础上创新与发展了扶阳法，明代医家张介宾从理论和临床两方面丰富了扶阳法，张氏认为气虚、阳虚、火衰为同类疾病，其关联密切，并把补气、温阳、益火均归属于扶阳的范畴[17]。据报道，庞勇运用壮医药线点灸法调治阳虚质、气虚质亚健康人群，阳虚质者选取百会、大椎、命门、腰阳关、关元、足三里等穴位，气虚质者选取心俞、肺俞、肝俞、脾俞等穴位，通过康奈尔医学量表评价调治效果，结果发现壮医药线点灸法可有效改善阳虚质亚健康状态[18-19]。冻疮的发生除了因感受寒邪外，还与患者素体阳虚密切相关，宋宁运用壮医药线点灸法，点灸梅花穴、中脘、肺俞、足三里等穴治疗冻疮患者，结果显示其总有效率达100%，治愈率达83.6%，临床疗效显著[20]。黄瑾明等通过观察壮医药线点灸对小白鼠腹腔巨噬细胞吞噬鸡红细胞功能的影响，证实壮医药线点灸具有增强机体免疫功能的功效，其作用机理可能是通过局部刺激，激活神经内分泌系统从而调节免疫反应，最终促进疾病的转归[21-22]。从壮医药线点灸的临床应用及其作用机理来看，壮医药线点灸法体现扶阳功效。

4.结语

       通过探讨，我们发现壮医药线点灸具有明确的扶阳作用，对于气虚、阳虚类疾病有较好的疗效，其取材简便，操作简单，安全有效，经济实惠，且无姜附过量中毒之弊端，患者易于接受，医生易于掌握，值得临床推广。

参考文献

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Study on theEffects ofStrengthening Yang of the Zhuang Medicine Medicated Thread Moxibustion

JingliuZhang,ShengshuiLuo,Haijuan Wang, Ling Zhong,YanheXie

Abstract：Tobroaden and develop the connotation of Zhuang Medicine Medicated Thread Moxibustion to provide a useful reference for improving the Zhuang Medicine Medicated Thread Moxibustion by exploring theeffects ofstrengthening yang of the Zhuang Medicine Medicated Thread Moxibustion, 

Key words：Zhuang Medicine Medicated Thread Moxibustion；Strengthening Yang

Zhuang Medicine Medicated Thread Moxibustion is a unique therapy for Zhuang Medicine. Given its effects of Tongbi, anti-inflammatory, detumescence, pain relief, and itching relief, this therapy is widely used to cure diseases in internal medicine, surgery, gynecology, pediatrics, dermatology, ENT and other departments. Nevertheless, its Strengthening Yang effect is little known. In view of this, this paper will probe into the Strengthening Yang effect of the Zhuang Medicine Medicated Thread Moxibustion.

1. Therapy of Zhuang Medicine Medicated Thread Moxibustion

1.1 Theoretical Basis

Zhuang Medicine is a vital part of traditional Chinese medicine, which is an experience summary of Zhuang people’s long-term struggle against diseases. With unique theories, rich connotation, distinctive characteristics of treatmentand pharmacy, as well as explicit curative effect, this therapy has played an important role in the history of traditional Chinese medicine. Professor Huang Hanru, a famous expert of Zhuang Medicine in China, once put forward the view in the book TheBasic Theory System of Zhuang Medicine that Zhuang Medicine is based on Yin and Yang, which is specifically embodied by the following two aspects:

1.1.1Understanding of Disease Syndrome

Zhuang Medicine believes that disease only contains two kinds of disease syndromes- “Yang Syndrome”and“YinSyndrome”. Clinical symptoms manifested as heat syndrome,evidence syndrome is mostly 

Yang Syndrome and cold syndrome, deficiency syndrome is mostly Yin Syndrome.Zhuang Medicinedifferentiates Yin and Yangsyndromesclinically, which is helpful to predict the prognosis of disease. If the disease syndrome transforms from Yin to Yang, it can be predicted that the patient’s condition tends to improve or heal. Contrarily, if the disease syndrome transforms from Yang to Yin, it is suggested that patient’s condition tends to deteriorate, mostly for poor results of the treatment. [1] Therefore, the Yin and Yang differentiationof disease is an indispensable link in the process of diseasediagnosis in Zhuang Medicine.

1.1.2Understanding of Pathogenesis

Zhuang Medicine is based on Yin and Yang,and it considers that disease is caused as a result of the disequilibriumbetween Qi and blood. In a word,“Illness is not a fabrication, but it is due to disequilibrium betweenQi and blood’’.Qi is Yang, and blood is Yin. When the external evil elements attack the body,its positive elements fight againstthem,which causes Qi and blood functions disorderof the viscera of the body. Eventually itleads to the imbalance betweenYin and Yang. In short, the imbalance of Yin and Yang is the fundamental factor accounting for the occurrence and development of disease.[2]

1.2 Definition

Zhuang Medicine Medicated Thread Moxibustion belongs to the external therapy of Zhuang Medicine feature, which is one of the significant ways of the clinicalprecaution and treatment of disease of Zhuang Medicine. It has been a hundred-year history since the formation and development of Zhuang Medicine Medicated Thread Moxibustion. It has an excessively wide scope of application and is effective for the treatment of cold, fever, swell, pain, paralysis and itchmanifested in the diseases of internal medicine, surgery, gynecology, pediatrics, dermatology, ENT and other departments, which is characterized by convenience, cheapness, swiftness and safety. [3]

Under the guidance ofZhuang Medicine theories, Zhuang Medicine Medicated Thread Moxibustion means by selecting ramie threads which have been processed by Zhuang Medicines, and then sparking one end by lights, swiftly and astutelyauterizing directly the charcoal fire on the acupuncture points or positions by the time theramie threads form into ballpointcharcoal fire, reaching the goal of swiftness, steadiness, accurateness and lightness.[4]

Zhuang Medicineemphasizes the standpoint that Yin and Yang are essential, and as one of the external therapies of Zhuang Medicine features, Zhuang Medicine Medicated Thread Moxibustion is regarded as of some regulation functions for keeping the balance between Yin and Yang in human body.

2. Theory of Strengthening Yang

2.1Ideological Origin

The ideology of Strengthening Yang can be dated from classic works such as Book of Changes and The Yellow Emperor’s Canon. The viewpoint about the relationship between Yin and Yang that Yang is superior to Yin is discussedat great length in Book of Changes.For instance,it is mentioned in the openings that the hexagram capable of creating a living is Qian while the one keeping the development is Kun. And then it is also mentioned that “...the relationship of Qian and Kun is confirmed by Heaven’s being noble and Earth’s being humble......”and“...Qian is for originating while Kun is for developing...”. Qian is equal to Yang and Kun is equal to Yin. Yang is the source of all things and the root of hospice, which is superordinate and reveals its leadership of everything in the universe happening, developing and changing.Whereas Yin is subordinate and suggests the thought of Strengthening Yang. [5] It’s believed in the Yellow Emperor’s Canon that Yang runs through the activities of the human body and is the most vital thing in the human body’s functional activities. And one’s sufferance of birth, growth, oldness and death in his life are all connected with Yang, so treatment and prevention of disease can be achieved by Strengthening Yang. [6]As is said in “Su Wen • Angry Heaven”, “...the Yang of the human body is as important as the sun in the sky. If the Yang loses its normal position and cannot play its important role, people will lose their life or die, and their vital functions will be weak. Therefore, the normal operation of the celestial body is manifested by the general illumination of the sun, and the Yang of the person should also be on the outside, and protect the body against evil spirits...” and “...the key point of Yin and Yang is reinforcing Yang.”

2.2The Meaning of Strengthening Yang

Lu Zhuzhi once said in his book The Circulation of Yang Qi, “Yang Qi, is the origin of blood and fluid, and the root of one’s life.” Lu believed that Yang Qi is the most basic substance that constitutes and sustains the life activities of human bodies, which is the foundation of human beings. [7] Yang Qi decides the condition of ourbody. When it is sufficient, one can keep fit, otherwise, diseases will invade. Just as Dou Cai, the prominent doctor in Song Dynasty once said in Bian Que’s Book about Hearts, “Zhen Yuan is the master factor of our body. More it is, more powerful we are; less it is, more weak we will be; and one cannot survive once there is no Zhen Yuan in his body.” Here Zhen Yuan actually refers to Yang Qi. [8] The theories above indicate that during the process of prevention and treatment of disease, we must remember to keep Yang Qi and attach great importance to it constantly. Thus we can regain our health and return to the normal condition of “the balance of Yin and Yang”.

2.3 The necessity of Strengthening Yang

With the development of the society, people are enabled to live a better life with more material wealth. In that case, however, “Yin” has not been diminished while “Yang”, which is required to consume these material energies, is at an increasing loss. [9] Meanwhile, the pace of life is quickening and we are under greater pressure. As a result, Yang Qi is badly damaged and this will cause our suffering from excessive internal heat. So we must keep regular exercise to restore Yang Qi. [10] Additionally, most of contemporary Chinese traditional doctors have been influenced by western medicine, cannot distinguish Yin and Yang, neglecting the traditional theories, and even abuse anti-cold and heat-clearing electuary, hormone and antibiotic as well. All those drastic medicines will hurt Yang Qi in our body. [11]Professor Zhang Cunti summed up the causes of human Yang Qi damage to the following aspects: (1) There are still many people suffering with cold body. (2) The Westernization of Chinese traditional medicine. (3) The influence of seasonal febrile diseases’ theory. (4) The abuse of anti-cold and heat-clearing electuary. (5) Without the guidance of traditional books as well as clear distinction between Yin and Yang. (6) Excessive tiredness. (7) Excessive sexual behaviors. (8) Insufficient sleep. (9) The abuse of antibiotic and hormone. (10) Chronic diseasesmainly caused by the lack of Yang Qi. [12-13]

To sum up, the basic situation of modern disease is “excessive Yin causing Yang deficiency”, so Strengthening Yang is the solution for the source of disease. According to this, we can predict that using Strengthening Yang to treat the modern disease is imperative.

3 The Strengthening Yang reflected in the functionality of Zhuang Medicine Medicated Thread Moxibustion

In the book Bian Que’s Book about Hearts ,which is written by the Song medical scientist, three ways are put up to strengthen Yang. That’s to say,“First, burning wormwood, second using Dan medicine, third is monkshood”. This shows that moxibustion is the first option for Strengthening Yang. [14] Traditional Chinese medicine believes moxibustion can warm the meridian and unchoke the venation,eliminate the formation, encourage the healthy Qi of body, and enhance the ability to withstand illness. Zhuang Medicine Medicated Thread Moxibustion belongs to the moxibustion, which uses the warm, pesticide effect and the stimulation of cortex-venation-meridian-viscera to motivate channel qi and to improve the movement of qi and blood as well as to develop the function of warming the viscera Yang Qi . All this is for preventing and curing disease. [15-16]In this sense, the Zhuang Medicine Medicated Thread Moxibustion is the Strengthening Yang therapy.

With the constant progress of medicine, the descendants brought forth and push forward Strengthening YangMethod on the basis of the efforts of their ancestors. Zhang Jiebin, a medical scientist of the Ming Dynasty, who enriched Strengthening YangMethod theoretically and clinically, held the view that deficiency of Qi, deficiency of Yang, decline of vital gate fire were the same kinds of diseases, which were tightly correlated. He alsoattributed tonifying Qi, warming Yang and benefiting fire to the acupoints of Strengthening Yang, such as Fan point, Guanyuan point andTsusanli point. For those who were of Qi deficiency, the acupuncture points of Hsinshu, Fei shu, Kan shu and Pishu were chosen. Therecuperative medical care efficiencywas evaluated byCornell Medical Scale, and the result shows that Zhuang Medicine Medicated Thread Moxibustion can effectively improve the sub-health status of those who are of deficiency of Yang. [18-19] The occurrence of chilblainswere not only caused bycold-pathogen, but also were tightly related to patients who were of innate deficiency of Yang in the body. Song Ning used Zhuang Medicine Medicated Thread Moxibustion to acupuncture the Meihua acupoint, Middle Part of Gastric Cavity, Feiyu and tsusanli points to treat chilblain patients, and the result showed that the total effective rate reached 100%, while the recovery rate reached 83.6%, proving to be of notableclinical effect. [20] Huang Jinming confirmed that Zhuang Medicine Medicated Thread Moxibustionhas the function of enhancingimmune function by observing the effect of Zhuang Medicine Medicated Thread Moxibustion to mice abdominalmacrophages’ functions of devouring chicken red blood cells. The mechanism of actionmight be activating neuroendocrine system to adjust immune reaction through local stimulation, and eventually promote disease prognosis. [21-22] From the perspective of clinical application of Zhuang Medicine Medicated Thread Moxibustion and its mechanism of action, it can be seen that Zhuang Medicine Medicated Thread Moxibustion shows functions of Strengthening Yang.

4. Epilogue

According to the exploration, we find that Zhuang Medicine Medicated Thread Moxibustionis of specificStrengthening Yangfunction, which can effectively cure diseases ofQi and Yang deficiency. It is convenient to draw materials and easy for application. It is safe and effective,economical and affordable, as well as without the setback of intoxication brought by excessive ginger utilization.Patients can more easily accept the therapy, while doctors can easily master it. Allthese prove that Zhuang Medicine Medicated Thread Moxibustion is worthy of beingpopularizedclinically.

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