应用CT测量天鼎穴针刺安全深度及角度的研究  

Research on application of CT in measuring security depth and angle of acupuncture at Tianding Point to brachial plexus

作　　者：谢伟[1] 张树源[2] 张宝 陈曦[1] 石磊[1] 薛任[1] 王涛[1] 麻增林 方继良[3] Xie Wei;Zhang Shuyuan;Zhang Bao;Chen Xi;Shi Lei;Xue Ren;Wang Tao;Ma Zenglin;Fang Jiliang(Department of Radiology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]北京中医药大学附属护国寺中医医院放射科,北京100035 [2]北京中医药大学附属护国寺中医医院针灸科,北京100035 [3]中国中医科学院广安门医院放射科,北京100053

出　　处：《中国中西医结合影像学杂志》2020年第1期8-11,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：北京市西城区优秀人才培养资助项目(20180002)。

摘　　要：目的:应用CT测量不同体型患者针刺天鼎穴的针刺安全深度及角度,并探讨针刺安全深度与颈围、罗氏指数的相关性。方法:搜集不同年龄患者135例,按罗氏指数分为瘦长型(A组)、中间型(B组)和矮胖型(C组)3组,每组45例。每组随机选择15例针刺穴位后行CT扫描,以确定针刺路径,其余标记皮肤针刺点后扫描。以C6横突前结节为骨性标志,应用横轴位图像测量针刺点至C6横突前结节的针刺安全深度。以两侧胸锁乳突肌外缘连线为基准线,测量针刺角度。比较3组针刺深度和角度的差异,评估3组安全深度与颈围、罗氏指数的相关性。结果:A组针刺深度:右侧(26.83±0.74)mm,左侧(26.21±1.64)mm;角度:右侧(14.00±1.87)°,左侧(14.25±1.30)°。B组针刺深度:右侧(30.38±1.80)mm,左侧(30.49±2.07)mm;角度:右侧(13.50±1.12)°,左侧(13.50±1.50)°。C组针刺深度:右侧(35.15±9.63)mm,左侧(34.98±9.87)mm;角度:双侧均(13.63±1.87)°。3组针刺深度两两比较差异有统计学意义(均P<0.05),3组针刺角度两两比较差异无统计学意义(均P> 0.05)。A组与C组的针刺深度与颈围呈正相关(P<0.05),3组针刺深度与罗氏指数均呈正相关(均P<0.05)。结论:临床可参考3组针刺安全深度,根据安全深度与颈围、罗氏指数的相关性回归方程,适当改变不同体型患者针刺深度,对达到针刺目的并规避针刺风险有一定帮助。Objective:To measure the security depth and angle of acupuncture at Tianding Point to brachial plexus in different body types by CT scan,and to assess the correlation between the security depth and the neck circumference,the correlation between the security depth and the Rohrer’s index. Methods:A total of 135 patients of different age were selected and all patients were classified into three groups according to the Rohrer’s index,including asthenic type(Group A),moderate type(Group B) and endomorphy type(Group C),and there were 45 patients in each group. Fifteen patients that had been acupunctured before they were examined by CT scan in each group at random,which it could make sure the route of acupuncture. While the others that had been made a sign on the skin were examined. Anterior tubercle of C6 transverse process was made as a bone marker,and to measure the security depth of acupuncture with axial images from the sign on the skin to anterior tubercle of C6 transverse process. The link of both sides of external margin of cleidomastoid was determined into the datum line,and to measure the angle of acupuncture. The difference in depth and angle among different groups was compared respectively. The correlations between the security depth and the neck circumference,and that between the depth and the Rohrer’s index were evaluated and compared respectively.Results:In Group A,the security depth on right was(26.83±0.74)mm,and(26.21±1.64)mm on left,the angle on right was(14.00±1.87)°,and(14.25±1.30)° on left. In Group B,the security depth on right was(30.38±1.80)mm,and(30.49±2.07)mm on left,the angle on right was(13.50±1.12)°,and(13.50±1.50)° on left. In Group C,the security depth on right was(35.15±9.63)mm,and(34.98±9.87)mm on left,the angle was(13.63±1.87)° on both sides. There were statistically significant difference in the security depth among different groups(all P<0.05). The angle showed no significant difference among different groups(all P> 0.05). The security depth of Group A and Group

关 键 词：体层摄影术 X线计算机 针刺 穴 天鼎 安全深度 角度 

分 类 号：R246[医药卫生—针灸推拿学] R816[医药卫生—中医临床基础]