不同材质针灸针温针灸温度时间曲线分析  

Analysis on the temperature-time curve in warm needling manipulation with acupuncture needles of different materials

作　　者：林琳[1] 程珂[1,2] 沈雪勇 LIN Lin;CHENG Ke;SHEN Xue-yong(School of Acupuncture-Moxibustion and Tuina,Shanghai University of TCM,Shanghai 201203,China;Shanghai Research Center for Acupuncture and Meridians,Shanghai 201203)

机构地区：[1]上海中医药大学针灸推拿学院,上海201203 [2]上海市针灸经络研究中心,上海201203

出　　处：《中国针灸》2019年第12期1301-1307,共7页Chinese Acupuncture & Moxibustion

基　　金：国家重点基础研究发展计划（973计划）项目：2015CB554505;上海市进一步加快中医药事业发展三年行动计划项目：ZY(2018-2020)-CCCX-2001-05;上海中医药大学“杏林学者”计划项目

摘　　要：目的:分析铜针、银针、金针和不锈钢针温针灸温度时间曲线特性,探索临床温针灸疗法最适宜的温度范围和针具材质。方法:纳入10例健康受试者,通过数字测温仪测量不同灸量(1.2 g或1.5 g艾)不锈钢针、铜针、金针和银针温针灸过程中针与皮肤接触处针体的温度时间曲线,记录人体对以上各种温针灸的初始热痛阈(开始感觉到烫的温度)和灼热痛阈(感到很烫但尚能耐受的温度)。通过问卷调查受试者在不同温针灸过程中的舒适感、热感、不良反应以及对各种温针灸的接受度。结果:温针灸过程中,受试者初始热痛阈为(42.8±2.7)℃,灼热痛阈为(46.7±2.9)℃。温热刺激最强的为1.5 g艾银针温针灸,达到的最高温度为(55.5±6.3)℃,其次依次为1.2 g艾银针温针灸(52.9±4.2)℃,1.5 g艾金针温针灸(46.6±3.7)℃,1.5 g艾铜针温针灸(46.6±1.9)℃,1.2 g艾铜针温针灸(43.1±1.5)℃及1.5 g艾不锈钢针温针灸(41.7±0.9)℃。各温针灸在初始热痛阈43℃以上的维持时间依次为银针1.5 g艾持续480 s,银针1.2 g艾持续325 s,金针1.5 g艾持续270 s,铜针1.5 g艾持续185 s,铜针1.2 g艾持续42 s,不锈钢针1.5 g艾持续0 s。受试者对不同温针灸的热度评分[即视觉模拟量表(VAS)评分]由高到低依次为1.5 g艾银针、1.2 g艾银针、1.5 g艾铜针、1.5 g艾金针、1.2 g艾铜针、1.5 g艾不锈钢针,6种温针灸热度VAS评分比较,差异有统计学意义(P<0.001)。受试者对银针1.5g艾温针灸舒适度感受显著低于其他5种温针灸(P<0.05)。有3例受试者认为银针1.5 g艾温针灸太烫而不能忍受,大部分受试者表示愿意接受这6种温针灸(接受率70.0%~100.0%)。除9例受试者在银针1.5 g艾温针灸后出现起泡,6种温针灸过程中均未见严重不良反应。结论:人体温针灸的初始热痛阈和灼热痛阈分别为43℃和47℃,这是临床较适宜的艾灸温度范围。银针温针灸的热刺激较强,当温度超过一定�Objective To analyze the characteristics of the temperature-time curve in warm needling manipulation with the acupuncture needles made of copper,silver,gold and stainless steel and explore the applicable temperature range and most suitable needle materials of warm needling manipulation in clinical practice.Methods A total of 10 healthy subjects were included.Using the digital thermometer,with different moxibustion dose(1.2 g or 1.5 g,moxa),the temperature was measured at the site where the skin contacts with the needle body during the warm needling manipulation with stainless steel needle,copper needle,gold needle and sliver needle separately.The initial heat pain threshold(the temperature when hot feeling started)and the burning pain threshold(feeling very hot but tolerable)were recorded when using the different needles mentioned above.Through the subject questionnaire,the comfort degree,the heat sensation,the adverse reaction and the acceptability to warm needling manipulation with the different needles were investigated.Results During the warm needling manipulation,the initial heat pain threshold was(42.8±2.7)℃ and the burning pain threshold was(46.7±2.9)℃.The strongest warm stimulation was presented in the warm needling manipulation with 1.5 g moxa and silver needle and the highest temperature was(55.5±6.3)℃,followed by(52.9±4.2)℃ with 1.2 g moxa and silver needle,(46.6±3.7)℃ with 1.5 g moxa and gold needle,(46.6±1.9)℃ with 1.5 g moxa and copper needle,(43.1±1.5)℃with 1.2 g moxa and copper needle and(41.7±0.9)℃ with 1.5 g moxa and stainless steel needle.The sequence of the maintaining time of the initial heat pain threshold over 43℃ was 480 s with silver needle and 1.5 moxa,325 s with silver needle and 1.2 g moxa,270 s with gold needle and 1.5 g moxa,185 s with copper needle and 1.5 g moxa,42 s with copper needle and 1.2 g moxa and 0 s with stainless steel needle and 1.5 g moxa successively.The heat score graded by the subjects to the warm needling manipulation with different needles

关 键 词：温针灸 铜针 不锈钢针 银针 金针 热痛阈 温度 

分 类 号：R245.3[医药卫生—针灸推拿学]