摘要
目的:采用高频肌骨超声技术实时动态观察针刺人体足三里穴"得气"的过程,对针刺"得气"时针体所触及的经穴局部组织结构特征及周围组织进行相关性研究,为临床和教学提供针刺"得气"现象的客观证据。方法:选取健康志愿者60名(男、女各30名),针刺双侧足三里穴至"得气"状态,在肌骨超声技术实时、动态观察下,记录最强"得气"感时针尖与皮肤表面、胫骨的距离,在各解剖层次位置分布特点以及受性别、左右侧的影响。结果:针刺60名受试者双侧足三里穴共120个穴位点,肌骨超声图像显示"得气"最强时针尖与皮肤表面的垂直距离为(25.32±5.82)mm,与胫骨的距离为(5.45±0.55)mm;针尖所处局部组织结构层次主要分布为:胫骨前肌肌层靠近深筋膜处46个,胫骨前肌与趾长伸肌相交处筋膜上62个,共108个穴点(108/120,90%);针尖位于胫骨前肌与趾长伸肌相交处筋膜上或胫骨前肌肌层靠近筋膜处获得最强"得气"感,其中52个为男性,56个为女性,53个属左侧经穴,55个属右侧经穴。结论:当针尖位于肌筋膜旁及筋膜集中处"得气"感最强,提示针刺足三里穴"得气"的主要组织结构是肌筋膜,这种相关性与性别、部位(左右侧)的差异不明显。
Objective To observe the dynamic changes of ultrosonographic images of Zusanli （ST 36） area during Deqi after inserting acupuncture needles, so as to provide objective evidence for clinical Deqi. Methods Sixty healthy volunteers （30 men and 30 women） were recruited in the present study. The subjects were asked to take a supine position on a test-bed, sterilized disposable filiform needles were perpendicularly inserted into bilateral ST 36 till Deqi （without lifting, thrusting and twirling）, when, high-resolution ultrasound scanning was conducted over the regional skeletal muscles by using a radio-frequency （5- 12 MHz） coil probe （Philips IU Elite Ultrasound Diagnostic Instrument） after smearing a layer of gel at the skin of ST 36. Results Among these 120 points of the 60 volunteer subjects, a marked Deqi was obtained from 108 points （consisting of 90% ） including 52 points in men and 56 in women, and 53 at the left ST 36 and 56 at the right ST 36. Ultrosonographic scanning displayed that when a strongest Deqi feeling was obtained from bilateral ST 36 in these 60 volunteers, the acupuncture needle-tip was about （25.32±5.82） mm in the vertical depth, and was （5.45±0.55） mm lateral to the tibia, involving the anterior tibial muscle near the deep fascia in 46 acupoints, and the intersection fascia of anterior tibial muscle and extensor digitorum Iongus in 62 acupoints. Conclusion The anterior tibial muscle near the deep fascia and the intersection fascia of anterior tibial muscle and extensor digitorum Iongus around ST 36 are involved in strongest Deqi. There are no significant differences in the gender and location （left and right）.
出处
《针刺研究》
CAS
CSCD
北大核心
2017年第5期444-448,共5页
Acupuncture Research
基金
重庆市中医院院内培育课题(No.2014-2-42)
关键词
肌骨超声
针刺
足三里
得气
Musculoskeletal ultrasound scanning
Acupuncture
Zusanli（ST 36）
Deqi
