超声引导下颈夹脊穴埋线层次与得气的初步研究  

Preliminary study on depth of embedded catgut and qi arrival at cervical Jiaji(EX-B 2)under ultrasound guidance

作　　者：孙文善[1] 楚宁宁[1] 封燕婷 王余民[1] 马伊磊[1] 姜国芳[1] 

机构地区：[1]复旦大学附属上海市第五人民医院中医科,上海200240

出　　处：《中国针灸》2015年第9期931-934,共4页Chinese Acupuncture & Moxibustion

基　　金：上海市卫生局科研基金资助项目:20124077

摘　　要：目的:探讨埋线针感与埋线层次深度的关系,以提高埋线进针和线体植入的安全性。方法:选择20例健康成年人,在超声影像下观察颈部夹脊穴的结构,并在超声引导下进行埋线,采用二维成像方式观察颈部夹脊穴的解剖结构以及埋线时进针过程,应用高频超声采集颈部C5夹脊穴影像,测定从皮肤表面到达夹脊穴各层次结构的深度,同时应用疼痛视觉模拟量表(VAS)对进针夹脊穴不同组织层次时患者的针感进行评分,并连续随访记录夹脊穴局部持续感觉时间。结果:超声引导下可以清晰显示颈部夹脊穴的解剖结构和组织层次,从表皮到达皮下组织、斜方肌、头夹肌、头半棘肌、颈半棘肌、多裂肌和椎弓的平均深度男性与女性比较差异均有统计学意义(均P<0.01);在进针过程中不同组织层次感觉明显不同,得气感在斜方肌层、头夹肌层、头半棘肌层、颈半棘肌和多裂肌层次均可出现,在肌筋膜胀痛感最为显著;按照常规进针深度约2.5cm,埋线针可达多裂肌层,埋线后局部针感持续平均时间为(72.0±10.2)h。结论:超声引导下颈部夹脊穴埋线层次清晰,可以实现进针和植入线体材料的可视化,明确得气与进针层次的关系,同时提高微创埋线治疗颈椎病植入层次的准确性和安全性。Objective To explore the relationship between the needling sensation of catgut embedding therapy and the depth of embedded catgut so as to improve the safety of the needle insertion and catgut implantation of the therapy.Methods Twenty healthy adults were selected.Under the ultrasound,the structure of the cervical Jiaji（EX-B 2）was observed.In the ultrasound guidance,the catgut was embedded.The two-dimensional imaging method was adopted to observe the anatomic structure and the procedure of needle insertion at the cervical Jiaji（EX-B 2）.The high-frequency ultrasound was used to collect the images at Jiaji（EX-B 2）of C5 and determine the depths from the skin surface to the different layers of the point.Additionally,the visual analogue scale（VAS）was adopted to score the needling sensations when the needle inserted at different layers.The persistent sensation duration in the local area was followed continuously.Results Under the ultrasound,the anatomic structure and tissue layers of cervical Jiaji（EX-B 2）were displayed clearly.The difference was significant in the average depth from the skin surface to the subcutaneous tissue,trapezius,splenius capitis,semispinalis capitis,semipinalis cervicis,multifidus and vertebral arch between the males and females（allP〈0.01）.During the needle insertion,the sensations were apparently different when the implantation went to different layers.The qi arrival presented when the catgut was embedded to the trapezius,splenius capitis,semispinalis capitis,semipinalis cervicis and multifidus.But the distending pain was the most significant when in the myofascial.Commonly,the embedded catgut 2.5cm in length may be implanted deeply to the multifidus and the local needling sensation lasted averagely for（72.0±10.2）h.Conclusion Under the ultrasound guidance,the depth of embedded catgut is clearly displayed at cervical Jiaji（EX-B 2）.The needle insertion and the implanted material are visible,and the relationship between qi arrival and the layer of needle inserti

关 键 词：颈椎病 埋线疗法 超声引导 夹脊穴 得气 

分 类 号：R245.9[医药卫生—针灸推拿学]