'若要安,三里常不干'考辨

摘要

从文献学和医理辨析"若要安,三里常不干"出处及其临床意义,探知"若要安"诸语出南宋初年《琐碎录》.足三里艾灸原为防治"风疾"而设,以宣通脏腑气血为宜,非特指三里灸为化脓灸之意.将此句释为反复"灸疮",是对《备急千金要方》"失气阳厥"诸症才用逾百壮灸和《针灸资生经》"报灸"法的误解.三里穴保健可选指压、搓摩、深汤足浴等法;从安全性考量,寒象明显者宜以悬空、隔物等温和灸调理.%This article has analyzed the source and clinical significance of statement of "if keeping health, Zusanli (ST36) frequently being given moxibustion" based on philology and medical principles.The statement was recorded in Suosuilu (Trivial Details of Traditional Chinese Medicine) written in early Southern Song Dynasty, which was originally designed for preventing and curing wind diseases.The moxibustion on ST36 is to diffuse and unblock qi and blood of zang-fu organs, but is not to give festering moxibustion.If the statement is explained as repeated festering moxibustion, Yubaizhuang moxibution recorded in Beijiqianjinyaofang (Essential Prescriptions Worth a Thousand Gold for Emergencies) and Bao moxibution recorded in Zhenjiuzishengjing (Classic of Nourishing Life with Acupuncture and Moxibustion) used only in the condition of excessive yang deficiency will be misunderstood.Acupressure, frottage and foot bath can be selected in ST36 healthcare.Considering safety, some mild moxibustion therapies are recommended, such as suspended moxibustion and sandwiched moxibustion, in patients with obvious cold symptoms.