基于正交设计的针刺治疗内毒素发热兔补泻效应影响因素的研究  

Study on influencing factors of reinforcing-reducing effect of acupuncture on rabbits with fever caused by endotoxin based on orthogonal design

作　　者：崔光卫 程怀锦 施舍 范神栋 王凡[4] CUI Guang-wei;CHENG Huai-jin;SHI She;FAN Shen-dong;WANG Fan(Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shanghai Hudong Hospital,Shanghai 200120,China;Institute of Acupuncture and Tuina,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137 [2]上海中西药大学附属岳阳中西医结合医院,上海200437 [3]上海沪东医院,上海200120 [4]上海中医药大学针灸推拿学院,上海201203

出　　处：《中华中医药杂志》2021年第8期4951-4955,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81603687)。

摘　　要：目的:以内毒素发热兔为研究对象,采用正交设计研究影响针刺补泻效应的主次因素和针刺参数的最佳组合,为针刺补泻手法的临床应用提供理论依据和方法。方法:选取60只新西兰兔分为:正常组、模型组、留针组和9组手法组,每组5只,其余9组手法组采用提插手法针刺“曲池穴”进行治疗。9种针刺提插手法采用L9(34)正交表对三因素(作用力方向、频率和施术时间)三水平安排实验,通过观察血清发热因子IL-1β、IL-6和TNF-α含量研究上述三因素的主次关系。结果:三因素对针刺效应的影响大小依次是作用力方向>施术时间>频率,其中作用力方向对IL-1β、IL-6和TNF-α的影响差异均有统计学意义(P<0.01);施术时间对IL-6和TNF-α影响差异有统计学意义(P<0.01),频率对IL-1β影响差异有统计学意义(P=0.05)。结论:不同因素对针刺治疗实热证兔的疗效不同,其中作用力方向对疗效的影响最大;针刺治疗实热证兔的最佳提插手法参数为重提轻插、留针期间手法刺激时长3min、频率60次/min。Objective:Taking the rabbits with fever caused by endotoxin as the research object,the orthogonal design was used to study the primary and secondary factors affecting the reinforcing-reducing effect of acupuncture and the best combination of acupuncture parameters,so as to provide theoretical basis and research methods for the clinical application of acupuncture reinforcing and reducing manipulation.Methods:A total of 60 New Zealand rabbits were selected,including normal group,model group,needle retention group and 9 manipulation groups,5 in each group.The other 9 groups of rabbits with excess heat syndrome were treated with acupuncture Quchi(LI 11).The experiment of 9 kinds of acupuncture lifting-thrusting methods was arranged according to a L9(34)orthogonal table,including 3 factors(force direction,frequency and operation time)and 3 levels.To identify the primary and secondary in the 3 factors,the levels of IL-1β,IL-6 and TNF-αin serum were detected by ELISA assay.Results:The factor influencing the acupuncture effectiveness from major to minor in turn was force direction>operation time>frequency.The force direction had significant effects on IL-1β,IL-6 and TNF-α(P<0.01),operation time had significant effects on IL-6 and TNF-α(P<0.01),and frequency had significant effects on IL-1β(P=0.05).Conclusion:Different factors have different therapeutic effects on rabbits with excess heat syndrome,among which the force direction has the greatest influence on the curative effect.The best parameters of lifting-thrusting manipulation for treating rabbits with excess heat syndrome are heavy lifting and light thrusting,3min during needle retention,and frequency at 60 times in one minute.

关 键 词：提插补泻 针刺效应 正交设计 内毒素 动物模型 实热证 因素 

分 类 号：R245[医药卫生—针灸推拿学]