超声介入下内关穴得气与周围解剖组织关系观察  

Relationship between Deqi and Surrounding Anatomical Tissue of PC6 under Ultrasound Intervention

作　　者：徐培 范燕华[2] 阚厚铭 王茵萍 XU Pei;FAN Yanhua;KAN Houming;WANG Yinping(The First Clinical Medical College of Nanjing Medical University, Nanjing 210029, China;The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China;The Shaw Hospital of Nanjing Medical University, Nanjing 211166, China;The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学第一临床医学院,江苏南京210029 [2]南京医科大学第二附属医院,江苏南京210011 [3]南京医科大学附属逸夫医院,江苏南京211166 [4]南京医科大学第一附属医院,江苏南京210029

出　　处：《针灸临床杂志》2020年第10期16-20,共5页Journal of Clinical Acupuncture and Moxibustion

摘　　要：目的:在超声介入下观察毫针针刺内关穴产生得气时,不同组别毫针与周围解剖组织的距离,以及毫针进入各层解剖组织时得气强弱情况。方法:利用超声观察毫针进入内关穴各层解剖结构时,“酸胀麻重”得气感的强弱程度,记录皮肤针刺点距第一腕横纹的距离(即取穴点)、针体距正中神经的最短距离和针尖距皮肤的垂直距离(即进针深度)。结果:针刺男性、女性志愿者左侧内关穴,取穴点的距离、针体距正中神经的最短距离,进针深度差异均有统计学意义(P<0.05),右侧差异无统计学意义。不同体重指数的人仅在左侧进针深度差异有统计学意义(P<0.05),右侧差异无统计学意义(P>0.05),在取穴点、针体距正中神经的最短距离上,左右两侧差异无统计学意义(P>0.05)。左右内关穴3个距离差异均无统计学意义;毫针针刺内关,随着进针深度的增加,得气感在不同组织结构中感觉强弱不同,在指浅屈肌与指深屈肌筋膜连接集中处、在指深屈肌和旋前方肌筋膜连接集中处得气感觉强烈,肌肉层内部感觉减弱。毫针针尖有强烈得气感时,针尖在肌肉筋膜集中处有92个,肌肉层内部有28个。结论:不同性别和体重指数的内关穴得气解剖测量距离可能存在一定的差异,单独个体左右内关穴测量距离差异无统计学意义。针刺内关穴得气感与肌肉筋膜关系密切,筋膜越集中,得气感越强烈。Objective:To observe the distance of the needle and the surrounding anatomical tissues when Deqi happens,as well as to observe the sense of Deqi when the needle entered the different layer of anatomical tissues by using ultrasound.Methods:When the needle entered the anatomical structure of each layer of Neiguan point(PC6),the intensity of"sourness distension and numbness"was observed by ultrasound,and the distance between the needle point and the first transverse wrist crease(i.e.the picking point),the shortest distance between the needle body and the median nerve,and the vertical distance between the needle point and the skin(i.e.the insertion depth)were recorded.Results:There were statistically significant differences between the male and the female volunteers on the left side of PC6,in terms of the distance of the picking point,the shortest distance of the needle body from the median nerve,and the insertion depth(P<0.05);whereas there was no significant difference on the right side.Volunteers with different body mass index only had a statistical difference in the insertion depth on the left side(P<0.05),whereas no significant difference was found on the right side(P>0.05).There were no significant differences in the selection point and the shortest distance between the needle body and the median nerve on the left and right sides(P>0.05).There were no significant statistical differences in the three distances of the left and right PC6.With the increase of the insertion depth,the Deqi acquired in different tissue structures was different in strength.The Deqi obtained was strong at the joint concentration of superficial flexor and deep flexor fascia of the finger,and at the joint concentration of deep flexor and anterior rotator fascia of the finger,and the sensation inside the muscle layer was weakened.When the needle tip has a strong Deqi sense,there were 92 needle tips in the muscle fascia concentration and 28 inside the muscle layer.Conclusion:There may be some differences in the anatomical measurement distan

关 键 词：内关穴 得气 超声 肌肉筋膜 

分 类 号：R224.2[医药卫生—中医基础理论]