"互联网+"混合教学模式是中医高等院校教育发展的动力和机遇.该研究立足疫情防控常态化背景下经络腧穴学课程的教学实际,结合互联网+网络教学平台软件的普及、应用,坚持以学生为中心的教育理念,设计经络腧穴学混合教学模式并开展教学实践,发现课程教学效果良好、学生学习积极性高.由此可见,互联网+混合教学模式是对中医针灸教学方法的创新以及对中医高等院校人才培养的有益探索,值得进一步推广.

在经络腧穴学传统教学过程中,存在多学科知识之间的关联、理论与实践的衔接、教师传授与学生接纳的交流反馈等难题,授课模式亟待改革创新.近年来伴随网络平台和虚拟仿真技术的快速发展,一些教学软件和工具被研发并应用于医学教学过程中.运用虚拟仿真技术建立经络腧穴学互动可视化教学平台,并科学合理地设计教学模块,或许可有效解决教学过程中的难题.这是虚拟仿真技术运用于经络腧穴学教学模式的创新探索.

互联网的快速发展与信息技术在教育领域的不断渗透与融合,引发了教学理念、教学模式和学习方式的重大变化与发展.翻转课堂、混合式教学对于促进教育教学创新发展、开展教学改革、促进学习革命有着重要的意义及影响.基于对经络腧穴学实训课传统教学的情况分析,结合以学生为中心、翻转课堂、混合式教学的价值理念,设计并开展了基于翻转课堂的线上线下混合式教学模式,并对其实施情况进行反思,以期为混合式教学模式在针灸学相关课程中的改革、学科创新发展的广泛开展和应用提供一定的实践基础与借鉴价值.

点穴课是经络腧穴学的重要实践课程.学生是教学设计的起点,结合当下以学生为中心的教学模式,设计引导学生自主、合作学习的教学方法至关重要.学生模特在点穴课的教学实践中扮演着越来越重要的角色,但其存在一定局限性,且大学生心理被忽视等问题.此文将以学生模特为抓手,优化学生模特分组和安排,完善教学设计,关注大学生心理健康发展,注重医学素养和思政教育,以期为实践课程教育提供新思路.

目的:观察改良聚乙丙交酯(PGLA)线平刺透穴束带埋线法配合耳穴刺激对肝郁气滞型肥胖患者肥胖指标及焦虑与抑郁等负性情绪的影响.方法:将60例肝郁气滞型单纯性肥胖患者随机分为两组,均在常规营养科指导以及耳穴刺激的基础上,对照组30例采用羊肠线穴位埋线,治疗组30例采用改良PGLA线平刺透穴束带法埋线,采用Inbody S10人体成分仪观察肥胖相关指标及焦虑、抑郁自评量表负性情绪变化,记录患者首次食欲下降时间、治疗总次数以及不良反应.结果:两组患者在治疗前各项肥胖指标差异统计学意义(P＞0.05);两组患者治疗后肥胖相关指标以及焦虑、抑郁自评分均较治疗前有所改善,差异具有统计学意义(均P ＜0.05);其中,治疗组首次食欲下降时间较对照组缩短,差异具有统计学意义(P＜0.05),治疗总次数较对照组减少,差异具有统计学意义(均P ＜0.05);治疗3个疗程后,治疗组腰围疗效明显优于对照组,疼痛、皮下硬结等不良反应均低于对照组,差异具有统计学意义(P＜0.05).结论:改良PGLA线平刺透穴束带埋线法配合耳穴刺激能有效降低肥胖相关指标,改善负性情绪,降低不良反应.

[目的]观察周期序贯针灸疗法对原发性痛经(primary dysmenorrhea,PD)患者疼痛症状及焦虑情绪的影响.[方法]选择2017年1月至2018年6月丹阳市人民医院针灸科门诊就诊的PD患者90例,随机分为药物组、常规针刺组和序贯针灸组,每组各30例.药物组予布洛芬缓释胶囊口服,常规针刺组采用常规针灸方案,序贯针灸组采用择期序贯针灸治疗方案,共治疗3个月经周期.采用视觉模拟评分(visual analogue score,VAS)量表、COX痛经症状量表(COX menstrual symptom scale,CMSS)及汉密尔顿焦虑量表比较治疗前、治疗后以及3个月随访期患者疼痛、痛经症状以及焦虑情绪评分.[结果]各组患者治疗后疼痛评分、痛经症状评分以及情绪评分均较治疗前改善(均P<0.01).治疗后序贯针灸组与药物组疼痛评分均低于常规针刺组(均P<0.01),序贯针灸组严重程度评分显著低于药物组和常规针刺组(P<0.01,P<0.05),序贯针灸组及常规针刺组情绪评分显著低于药物组(P<0.01,P<0.05),且序贯针灸组低于常规针刺组(P<0.01).随访期药物组患者的疼痛、症状以及情绪评分等均与治疗前差异无统计学意义(P>0.05),常规针刺组与序贯针灸组各项评分均显著低于治疗前(均P<0.01),且序贯针灸组疗疼痛评分、痛经症状严重程度评分及情绪评分显著低于常规针刺组(P<0.01,P<0.05,P<0.05).[结论]周期序贯针灸疗法可有效减轻PD患者的疼痛程度、痛经症状以及情绪焦虑状态,其疗效优于常规针灸疗法及常规药物疗法.

Background: Acupuncture and moxibustion have been proven to be conducive to improving the ovarian reserve. However, the mechanism of pre-moxibustion on Tripterygium glycosides (TG)-induced ovarian damage has not been previously reported. Method: Female rats were randomly divided into 5 groups: control, model (75 mg/kg TG, 14 days), preventive moxibustion 1 (PM1, receiving moxibustion for 4 weeks before TG administration), preventive moxibustion 2 (PM2, receiving moxibustion for 2 weeks before TG administration and another 2 weeks during TG administration), and preventive moxibustion 3 (PM3, receiving 4 weeks of moxibustion during TG administration). The estrous cycle of the animal was recorded after TG administration. Rats were sacrificed 14 days after TG administration. The reproductive hormones profiles in serum, ovary, and hypothalamic tissues were analyzed. Result: Pre-moxibustion could revert abnormal estrous cycles, relieve follicle damage, and improve abnormal secretion of reproductive hormones resulting from ovarian damage. However, both PM2 and PM3 were more effective than PM1. In addition, PM2 disclosed more advantages in regulating reproductive hormones abnormalities, while PM3 performed better in follicular development. Conclusion: In combination, the findings of this study suggest that pre-moxibustion is effective in protecting the ovary from damage in TG-induced ovarian damage rats. But different time points correspond to different modulation targets and mechanisms.

OBJECTIVE:To observe the effect of electroacupuncture (EA) at "Ashi" acupoint and "Kunlun" (BL60) on elastic modulus, histopathological changes and expression of myogenic regulatory factors in gastrocnemius(GM) contusion rats, so as to explore the therapeutic effect of local acupoint selection and acupoint selection along channel. METHODS:Male SD rats were randomly divided into blank control (n＝5), model (n＝15), Ashi-point (n＝15) and BL60 (n＝15) groups. The acute GM contusion model was established by striking (free falling) the GM with a homemade hitter. EA (0.5 to 1.0 mA, 2 Hz/10 Hz) was applied to Ashi-point (local focus) and BL60 for 30 min 24 h after muscle injury. The elasticity maximum (Emax) of gastrocnemius muscle was measured by using an ultrasonic device. Histopathological changes were observed after H．E. stain, and the number of Myogenic differentiation(MyoD)- and Myogenin (MyoG)-positive cells was detected by using immunohistochemistry. RESULTS:After mdeling, the Emax value of GM was significantly increased from the 3rd h to 7th day in comparison with pre- injury of muscle (P<0.05), and was markedly increased on the 3rd day and obviously lower on day 7 in the Ashi-point group than in the model group (P<0.05). The numbers of MyoD- and MyoG-positive cells of GM were significantly increased on day 7 in the model group than in the blank control group (P<0.05), and both further increased in Ashi-point on day 3 and 5, and MyoG-positive cells further increased in BL60 group on day 5 and in Ashi-point group on day 7 relevant to the model group(P<0.05). The therapeutic effect of EA-Ashi-point was apparently superior to that of BL60 in up-regulating Emax on day 3 and in up-regulating the number of MyoD-positive cells on day 3 and 5 (P<0.05). H．E. stain showed disordered arrangement of muscle fibers, infiltration of inflammatory cells, increase of intercellular space, and edema on day 3 after modeling (which was milder in the Ashi-point group); and gradual fusion and thickening of new born muscle fibers with obvious connective tissue hyperplasia converged to the lesioned region on day 7 in the model group (convergence of new born muscle cells to the lesion region in both EA groups, and more complete tissues in the Ashi-point group). CONCLUSION:EA of Ashi-point and BL60 can up-regulate the expression of myogenic regulatory factors MyoD and MyoG of GM tissue in GM contusion rats, which may contribute to its function in promoting recovery of muscle elasticity. The role of EA-Ashi-point is superior to that of EA-BL60.

To assess the effects of electro-acupuncture (EA) on glycemic control, myocardial inflammation, and the progression of diabetic cardiomyopathy in mice with type 2 diabetes. Db/Db mice received EA at PC6+ST36 (DM-Acu), non-acupoint simulation (DM-Sham), or no treatment (DM). EA was applied for 30 min per day, 5 days a week for 4 weeks. Heart function was assessed by echocardiography. Myocardium was assessed by RT-PCR, immunoblotting, and histology. Serum TNF-α, IL-1α, IL-1β, IL-6, and IL-8 were measured. DM-Acu, but not DM-Sham, reduced fasting blood glucose without affecting body weight. DM decreased systolic function. DM-Acu, but not DM-Sham, attenuated the decrease in systolic function. Heart weight was significantly smaller in the DM-Acu than in the DM and DM-Sham groups. Percent fibrosis and apoptosis were reduced in the DM-Acu, but not the DM-Sham, group. Serum levels of IL-1α, IL-1β, IL-6, IL-8, ICAM-1, MCP-1, and TNF-α were significantly lower in the DM-Acu than in the DM or DM-Sham groups. Protein levels of P-Akt and P-AMPK and mRNA levels of phosphoinositide-3-kinase regulatory subunit 6 (PIK3r6) were significantly higher in the DM-Acu group. Myocardial mRNA and protein levels of insulin-like growth factor 1 receptor (IGF1R) were significantly lower in the DM and DM-Sham groups compared with the DM-Acu group. EA reduced serum glucose; prevented DM-induced hypertrophy and deterioration of systolic function, inflammation, and fibrosis; and restored IGF1R, P-Akt, and P-AMPK levels in mice with type 2 diabetes mellitus.

从伏邪理论及治未病角度探析慢性盆腔炎(CPID)的发病机理及治疗思路.CPID涉及到的伏邪包含伏寒、伏湿、伏瘀,而正气亏虚是发病的根本原因.只有当正邪双方的平衡状态被打破,伏邪才会趁机而发.因此,邪气势弱时“未病”状态的早期干预,对CPID的防治有重要意义.逆针灸是基于针灸对CPID的切实疗效及不足之处而提出的可行方法.逆针灸具有保护子宫功能、抗炎镇痛、改善焦虑、调节免疫状态的作用,对CPID的防治有一定的理论基础及应用前景.其介入时机以发病早期及缓解期最佳,治疗时应注重散伏寒、利伏湿、化伏瘀,将扶正祛邪、调理冲任贯穿始终.

This study explored the characteristics of operating site and stimulation methods of umbilical therapy in the prevention and treatment of allergic rhinitis through the analysis of relevant clinical research literatures. It is believed that the special anatomical features of the navel are the structural basis for the effect of umbilical therapy. The characteristics of holographic embryos, the relationship of Shenque (CV8) and meridians of Lung, Spleen and Kidney, and its overall regulating action of strengthening yang to build the original-qi play an important role in the prevention and treatment of allergic rhinitis. Based on the characteristics of operating site of the umbilical treatment, and the key of the etiology and pathogenesis of the disease, the stimulation method is mainly focused on cupping, moxibustion, and drug application; flash cupping or long-term retained cupping are often used in the umbilical cupping, which should reach a certain amount of stimulation. Mild moxibustion with moxa stick and moxibustion with moxa box dominate in the umbilical moxibustion. The acrid herbs of warming yang are often used in the umbilical application, which can be combined with umbilical moxibustion, and the effects complements each other.

目的:观察穴位埋线对单纯性肥胖大鼠的治疗作用及对脂肪和肝脏组织中肥胖相关基因表达的影响.方法:将40只大鼠分成两组,一组为空白组8只,用普通饲料喂养16周;另一组为高脂组32只,用高脂饲料喂养,先喂养12周,建立食源性肥胖大鼠模型,再将造模成功的16只肥胖模型大鼠按随机数字表分为埋线组和模型组,每组8只.比较各组大鼠的体重、体脂、血脂等的差异,用HE染色观察各组大鼠脂肪细胞的形态差异,用酶联免疫吸附试验(ELISA)检测血清瘦素含量,用q-PCR检测大鼠脂肪组织中过氧化物酶体增殖物激活受体-α(PPARα)、过氧化物酶体增殖物激活受体-γ(PPARγ)、解偶联蛋白1(UCP1)以及肝脏组织中PPARα、PPARγ、肉毒碱棕榈酰转移酶1(CPT1)的表达.结果:与模型组大鼠相比,埋线组大鼠体重明显下降(P＜0.01),肾周脂肪和附睾脂肪量明显减少(P ＜0.01或P＜0.05),血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)明显降低(均P＜0.01),血清高密度脂蛋白胆固醇(HDL-C)明显升高(P＜0.01),血清瘦素含量明显下降(P＜0.01);脂肪及肝脏组织中的PPARα表达明显升高(P＜0.01),脂肪及肝脏组织中的PPARγ表达明显降低(P＜0.01或P＜0.05),肝脏组织中的CPT1及脂肪组织中的UCP1表达明显上升(均P＜0.05).结论:穴位埋线对肥胖大鼠能够有效减轻其体重,减少内脏脂肪量,降低血脂水平,降低血清瘦素的含量,下调脂肪和肝脏组织中PPAR-γ的表达,上调脂肪组织中PPARα、UCP1及肝脏组织中PPARα、CPT1的表达,从而达到治疗肥胖的目的.

本文通过对中国知网、维普、万方等数据库中自建库至2018年5月应用脐疗法防治过敏性鼻炎(Allergic rhinitis,AR)的期刊类临床文献的研究分析,探讨其疗效特点及治疗作用.认为脐疗法与其他疗法配用,能发挥协同作用,对AR既有确切的近期疗效,更具良好的持久作用,在停治后巩固疗效,防止复发方面有着重要意义.针对AR的病机关键,脐疗可发挥益肺固表、调理脾胃、补肾培元的作用,体现出治病求本、整体调节的优势.这一作用的发挥主要基于脐(神阙穴)的部位特性及经络联系的效应传导路径.

Hyperlipidemia casts great threats to humans around the world. The systemic co-expression and function enrichment analysis for this disease is limited to date. This study was to identify co-expression modules to explore hyperlipidemia-associated functional pathways. Gene expression data of human hyperlipidemia (GSE17170) were downloaded from the Gene Expression Omnibus (GEO) database. We evaluated the top 3,000 genes with the highest average expression, with which the co-expression modules were constructed in weighted correlation network analysis (WGCNA).Cluster analysis was then applied to visualize the interaction relationships of these modules. By gene ontology (GO) and KEGG functional enrichment analysis, we finally investigated the function enrichment of co-expression genes from important modules in the Database for Annotation, Visualization, and Integrated Discovery (DAVID) database (https://david.ncifcrf.gov/summary.jsp).(15) Thirteen co-expression modules were constructed for 3,000 genes in the 70samples. Interaction relationships of hub genes between pairwise modules showed high confidence. In functional enrichments of the co-expression modules, genes in Modules 3 and 4 were significantly enriched in biological processes and pathways that are associated with ubiquitination-for example, GO:0016567 (protein ubiquitination) and hsa04120 (ubiquitin-mediated proteolysis). We inferred these two modules as key modules associated with hyperlipidemia. Additionally, GO:0098609 (cell-cell adhesion) was enriched in four modules, suggesting an important function in hyperlipidemia. In conclusion, Protein ubiquitination may play important roles in human hyperlipidemia. All the discoveries made in this study enrich understanding of the pathogenesis of hyperlipidemia and might contribute much to the development of diagnosis and outcome evaluation of this disease.

脐疗法对过敏性鼻炎的防治作用,是在辨证论治的基本理论指导下,辨证求因、按证选方、对证用药这一完整的过程中体现出来的.脐(神阙穴)是脐疗发挥效应的结构基础:其中医功能的特殊性决定了它可补益元气、调畅气机、调理肺卫并使药物循经传至病所;而在胚胎发育过程中其解剖位置的特殊性又是与呼吸系统直接或间接发生联系的根本所在.基于全息胚理论的脐疗法可通过发挥神经——体液等的一系列调节,使机体预防免疫功能增强,具有疗效明确、操作简单、无不良反应等特点,在过敏性鼻炎的防治方面较有优势.

OBJECTIVETo observe the effect of moxibustion pretreatment at different time on serum hormone levels in diminished ovarian reserve (DOR) rats, so as to explore its protective mechanisms.METHODSForty female SD rats were randomly divided into control, model, moxibustion-1 (moxibustion was given 4 weeks before modeling), moxibustion-2 (moxibustion was given 2 weeks before modeling and 2 weeks from the 1st day on after modeling ) and moxibustion-3 (moxibustion was given 4 weeks from the 1st day on after modeling) groups (n=8 rats in each group). The DOR model was established by gavage of Tripterygium Glycosides (75 mg/kg) once daily for 14 days. Grain-moxibustion was applied to "Shenshu" (BL23) and "Guanyuan" (CV4) for 7 cones, 5 times a week for 4 weeks. The body weight and the ovary weight were recorded for calculating the ovarian index. The levels of serum anti-mullerian hormone (AMH), follicle stimulating hormone (FSH), estradiol (E2), androgen (T) and dehydroepiandrosterone (DHEA) were detected by ELISA.RESULTSAfter modeling, ovarian index and serum AMH levels were obviously decreased (P<0.05), and the levels of serum FSH, E2, T and DHEA were significantly increased in contrast with the control group (P<0.05). Following intervention and compared with the model group, the serum FSH and DHEA levels of each moxibustion group were significantly reduced (P<0.05), the AMH levels significantly increased and E2 and T contents significantly decreased in the moxibustion-2 and moxibustion-3 groups (P<0.05). The serum FSH, E2 and T contents in moxibustion-2 group were obviously lower than those of the moxibustion-1 and moxibustion-3 groups (P<0.05).CONCLUSIONMoxibustion pre-treatment can improve ovarian reserve function in DOR rats, while the effect is different with different intervention time, and the best intervention time is pre-occurrence and early stage of DOR.

背景 目前疾病医学逐渐出现向健康医学转变的趋势,医学干预的切入点逐渐提前."治未病"是中医预防医学思想的重要体现,而逆针灸是其重要手段之一.目的 观察逆针"丰隆"穴对大鼠肥胖的预防作用及对转录因子过氧化物酶体增值物激活受体γ(PPAR-γ)的影响.方法 研究时间为2016年5—7月.将4周龄SPF级雄性大鼠24只随机分为空白组、模型组和逆针组,每组8只.模型组和逆针组进行高脂饲料喂养,空白组进行普通饲料喂养,为期12周,造模同时进行针刺干预,逆针组大鼠固定在自制固定器上,待大鼠平静后,逆针双侧"丰隆"穴区域每周3次,空白组和模型组同步抓取固定,不干预.干预期间每周测量并记录各组大鼠体质量,干预12周后检测各组大鼠肾周脂肪组织重量、脂肪细胞形态学、血清瘦素水平及脂肪组织中转录因子PPAR-γ表达水平.结果 干预第8周,模型组大鼠体质量高于空白组(P<0.05);干预第12周,模型组、逆针组大鼠体质量高于空白组(P<0.05),逆针组大鼠体质量小于模型组(P<0.05).模型组、逆针组大鼠肾周脂肪组织重量大于空白组(P<0.05);逆针组大鼠肾周脂肪组织重量低于模型组(P<0.05).模型组大鼠脂肪细胞面积较空白组大鼠明显增大,新生脂肪细胞较多;逆针组大鼠脂肪细胞较模型组明显面积减小,新生脂肪细胞较少;模型组大鼠脂肪细胞平均面积大于空白组、逆针组(P<0.05).模型组大鼠血清瘦素水平高于空白组(P<0.01);逆针组大鼠血清瘦素水平低于模型组(P<0.01).模型组大鼠脂肪组织中转录因子PPAR-γ表达水平高于空白组(P<0.05);逆针组大鼠脂肪组织中转录因子PPAR-γ表达水平低于模型组(P<0.05).结论 逆针"丰隆"穴可以有效预防大鼠肥胖,改善脂肪代谢的异常状态,其机制可能与改善瘦素抵抗及调节脂肪组织中PPAR-γ的表达有关.

背景 阿是穴是针灸治疗骨骼肌损伤的常用穴位.然而,其在急性骨骼肌损伤后的干预时机尚未有相关报道.目的 观察不同时机电针阿是穴对腓肠肌钝挫伤大鼠腓肠肌高频超声成像评分、血清肌酸激酶(CK)水平的影响.方法 2017年9月,将清洁级健康成年雄性SD大鼠60只随机分为空白组(n=6)、模型组(n=18)、24 h电针组(n=18)、72 h电针组(n=18).除空白组外,模型组、24 h电针组、72 h电针组均参照本课题组前期研究的方法 建立腓肠肌急性钝挫伤模型,并采用超声成像技术进行评定.由于动物无言语表达能力,研究中阿是穴的选取以局部病灶(即腓肠肌肌腹的中点,辅以超声进行病灶定位)作为针刺部位.除空白组外,各组造模后3、5、7 d分别抓取不同的6只大鼠进行以下操作:24 h电针组在钝挫伤后24 h进行1次针刺治疗,72 h电针组在钝挫伤后72 h进行1次针刺治疗.模型组与2个电针组同步抓取与固定,但不做电针干预.空白组不做任何处理.记录各组大鼠造模后3、5、7 d超声分级评分表评分.评分后处死,记录各组大鼠造模后3、5、7 d血清CK水平.结果 模型组、24 h电针组、72 h电针组大鼠造模后即刻、3、5、7 d超声分级评分表评分比较,差异均无统计学意义(P>0.05).造模后3 d、24 h电针组大鼠不同时间点造模后即刻超声分级评分表评分与干预后超声分级评分表评分差值大于模型组、72 h电针组(P<0.05).模型组大鼠造模后3、5、7 d血清CK水平均高于空白组(P<0.05);24 h电针组大鼠造模后5、7 d血清CK水平均高于空白组(P<0.05);72 h电针组大鼠造模后3 d血清CK水平低于模型组,5、7 d血清CK水平均高于空白组(P<0.05).结论 电针阿是穴能有效促进大鼠腓肠肌钝挫伤后的组织修复,损伤后24 h电针阿是穴治疗能较早地促进组织修复.

目的 观察逆针灸贴脐法对季节性过敏性鼻炎的临床防治效果.方法 将102例临床确诊为季节性过敏性鼻炎的患者以随机数字表法分为春秋组、秋季组和对照组,每组各34例,最终纳入统计分析的患者共93例(秋季组脱落2例,对照组脱落7例).贴脐药物以桂枝汤合玉屏风散、苍耳散组成.春秋组分别于立春前4周和立秋前4周贴脐,秋季组仅在立秋前4周贴脐,对照组则无任何干预措施.各组在干预前与干预后均进行鼻症状积分(TNSS)与鼻结膜炎生活质量调查问卷(RQLQ)评分,进行临床疗效评定.结果 与干预前和对照组比较,春秋组及秋季组经干预后TNSS及RQLQ总分下降(P<0.05);春秋组在立春前干预后的疗效与秋季组比较,差异无统计学意义(P>0.05);春秋组立秋前干预后的总有效(70.59％)高于本组立春前干预(58.82％)及秋季组(53.13％);长病程的有效率(27.78％)低于短病程的有效率(75.00％);不同证候的总有效率依次为肺气虚寒证(69.70％),肾阳不足证(46.67％),脾气虚弱证(38.89％).结论 逆针灸贴脐法能有效防治季节性过敏性鼻炎,改善患者的临床症状,提高生活质量,疗效与治疗次数、病程长短及证候类型相关,为该病的防治提供新思路.

“阳常有余,阴常不足”和“阳非有余,阴常不足”两种观点分别由金元四大家之一的朱丹溪和明代著名医家张景岳提出.两种观点截然相反,后世医家亦各执一理,争执不休未有定论.文章作者认为,两种理论之间不存在直接的冲突,之所以存在争论是因为两医家对阴阳的含义指代不清,笼统地将生理的阴阳和病理的阴阳统称为阴阳,以致有阳气有余和不足的歧义.文章将阴阳细分为具有促进生理功能的正阴、正阳和导致病理变化的邪阴、邪阳,以此四分法调解“阳常有余,阴常不足”和“阳非有余,阴长不足”之争,为这一理论争鸣提供新的视角.