针刺穴区不同组织结构对得气针感及穴区肌电的影响初探  

Characteristics of“deqi”and myoelectricity in different tissue structures of acupoint

作　　者：陆凤燕 陈安莉[2] 张雯晰 赵玉雪 刘群[2] 辛娟娟 周晨[2] 白万柱 高俊虹[2] 喻晓春[2] LU Feng-yan;CHEN An-li;ZHANG Wen-xi;ZHAO Yu-xue;LIU Qun;XIN Juan-juan;ZHOU Chen;BAI Wanzhu;GAO Jun-hong;YU Xiao-chun(Third Affiliated Hospital of Zhejiang Chinese Medical University.Hangzhou 310005,China;Institute of Acupuncture and Moxibusion,China Academy of Chinese Medical Sciences,Beijing 100700)

机构地区：[1]浙江中医药大学附属第三医院,杭州310005 [2]中国中医科学院针灸研究所,北京100700

出　　处：《针刺研究》2021年第2期136-144,共9页Acupuncture Research

基　　金：国家自然科学基金项目(No.81973758);中央级公益性科研院所基本科研业务费自主选题项目(No.ZZ11-048、ZZ-ZR2017004、ZZ08010)。

摘　　要：目的:探讨穴区不同组织结构针刺对施针者和受试者得气针感及穴区肌电的影响。方法:招募20例健康受试者,按随机原则均接受4种不同组织结构针刺:足三里穴皮肤层针刺、复方利多卡因乳膏皮肤麻醉下足三里穴(肌肉组织为主)针刺、无皮肤麻醉下足三里穴(全穴)针刺、无皮肤麻醉下犊鼻穴针刺。参考主观针感量表(MASS)录音记录行针期间施针者和受试者的针感变化,同时记录受试者穴区肌电。分析各组针感的出现率、强度,施针者和受试者针感的关系,以及各针感出现时的积分肌电值(iEMG)与针刺前的比值。结果:足三里穴皮肤层针刺以锐痛感、刺感最明显,皮肤麻醉和无皮肤麻醉下足三里针刺均以胀感、钝痛感、酸感及施针者手下沉紧感最明显。无皮肤麻醉下犊鼻穴针刺以胀感为主,但强度不如足三里穴明显。在皮肤麻醉和无皮肤麻醉下足三里针刺组中,受试者胀感和施针者手下沉紧感均呈正相关关系,受试者胀感一般先于施针者手下沉紧感约5 s出现;当出现受试者胀感及施针者手下沉紧感时,iEMG高于针刺前2~3倍。结论:受试者胀感、钝痛感、酸感以及施针者手下沉紧感等得气针感主要产生于肌肉组织,受试者胀感与施针者手下沉紧感常相伴产生,施针者手下沉紧感可能与针刺诱发的局部肌肉收缩活动有关。Objective To investigate the effect of acupuncture in different tissue structures on deqi and the electromyography of acupoint area.Methods Twenty healthy subjects,respectively accepted 4 kinds of needling stimulation,i.e.stimulating skin at Zusanli(ST36),stimulating ST36 with and without skin anesthesia using compound lidocaine cream,and stimulating at Dubi(ST35)without skin anesthesia.Deqi sensation of the acupuncturist and subjects were measured according to MGH Acupuncture Sensation Scale(MASS)during needling,and the myoelectricity around the acupoints was recorded simultaneously.The occurrence rate and intensity of the different deqi sensations,the relationship between the acupuncturist’s and subjects’deqi sensations,and the integrated electromyogram(iEMG)were analyzed.Results Sharp pain and tingling were the main sensations during skin needling at ST36.Fullness,dull pain,soreness and acupuncturist’s tightness were the main sensations during needling with or without skin anesthesia at ST36.Fullness was the main sensation during needling at ST35,while the intensity was lower than that during needling at ST36.A positive correlation in the intensity was found between subjects’fullness and acupuncturist’s tightness during needling with or without skin anesthesia at ST36.The subjects’fullness appeared earlier about 5 seconds than acupuncturist’s tightness.The iEMGs during subjects’fullness and acupuncturist’s tightness were 2-3 times of that before needling.Conclusion Deqi sensations such as subjects’fullness,dull pain,soreness and acupuncturist’s tightness are mainly related to the activity of the muscles under the acupoints.Subjects’fullness and acupuncturist’s tightness always appear together.Acupuncturist’s tightness may be mediated by the muscle stretch reflex induced by needling stimulation.

关 键 词：得气 针感 穴区组织 肌电 

分 类 号：R245.31[医药卫生—针灸推拿学]