三间穴实体解剖结构  

Anatomical structure of Sanjian acupoint

作　　者：赵延茹 董丽琨 亓恒涛 齐耀东 王铁铮 郭朝帅 王春霖 赵祖耀 王强 孟宪国 王增涛[2,5] ZHAO Yanru;DONG Likun;QI Hengtao;QI Yaodong;WANG Tiezheng;GUO Chaoshuai;WANG Chunlin;ZHAO Zuyao;WANG Qiang;MENG Xianguo;WANG Zengtao(College of Sports Medicine and Rehabilitation,Shandong First Medical University,Taian 271000,China;不详)

机构地区：[1]山东第一医科大学运动医学与康复学院,山东泰安271000 [2]山东大学医学融合与实践中心 [3]山东第一医科大学附属省立医院超声科 [4]山东第一医科大学附属省立医院医学影像科 [5]山东第一医科大学附属省立医院手足外科

出　　处：《山东医药》2023年第9期8-11,共4页Shandong Medical Journal

摘　　要：目的探寻三间穴的实体解剖结构。方法①检索读秀学术搜索、《中华医典》古籍数据库,查阅包含三间穴定位的古籍,整理归纳古人对三间穴定位的描述。②检索中国知网包含三间穴的文章,查阅《中华人民共和国国家标准·经穴名称与定位》中关于三间穴的描述,整理归纳今人对三间穴的定位。③选取30名志愿者,对古今文献中三间穴的不同体表定位点进行指尖按压,确定出现“穴感”位置。④选取10名志愿者,参考古籍与现代文献整理归纳的穴位定位,在第2掌骨颈区域多个部位与不同深度用毫针针刺穴位,确定针刺出现“穴感”时针尖所在的解剖位置。⑤选取新鲜成人上肢解剖标本10侧,根据手指按压与针刺所确定的三间穴位置进行显微解剖,探寻穴位的实体解剖结构。⑥选取10名志愿者,针刺三间穴出现“穴感”时,用B超确认针尖所在位置。⑦选取10名志愿者,超声显像仪找到解剖所发现的三间穴实体结构,B超引导下针刺验证三间穴位置。结果①古籍描述三间穴位于手大指次指本节后内侧陷者中。②现代文献描述三间穴在第2掌指关节桡侧近端凹陷中。③指尖按压出现“穴感”位置在第2掌指关节近端,桡掌侧凹陷处。④针刺第2掌指关节近端桡掌侧凹陷处时“穴感”最强烈。⑤显微解剖发现三间穴处是骨滋养血管穿入第2掌骨颈桡掌侧的“骨门”。⑥针刺三间穴出现“穴感”时,针尖位于第2掌骨颈桡掌侧的“骨门”。⑦B超下证实第2掌骨颈桡掌侧的“骨门”是三间穴实体解剖结构。结论三间穴实体解剖结构是第2掌骨颈桡掌侧骨门。Objective To investigate the anatomical structure of Sanjian acupoint.Methods①The ancient people's descriptions of Sanjian were summarized by searching the Duxiu Academic and Chinese Medical Canon database and ancient Chinese medical books.②The modern people's descriptions of Sanjian were summarized by searching China National Knowledge Infrastructure(CNKI)and The People's Republic of China National Standards·Nomenclature and Loca⁃tion of Meridian Points.③The"acupoint sensation"location was determined by fingertip pressing on thirty volunteers'body surfaces based on the summarization of ancient and modern people's descriptions.④By referring to the acupoint positioning summarized in ancient and modern literature,the exact match of the Sanjian"acupoint sensation"location was defined by acupuncturing the different points and depths in the neck region of the second metacarpal bones of ten volunteers.⑤The anatomical structure of Sanjian was determined by microdissection on ten sides of fresh adult upper limb anatomical specimens.⑥The location of the needle tip was demarcated by B-ultrasound when the needle tip touched the"acupoint sensation"point on ten volunteers.⑦We used ultrasonography to find the physical structure of Sanjian discovered by anatomy,and then acupuncture was conducted under the guidance of B-ultrasound to verify the position of Sanjian acupoint on ten volunteers.Results①The ancient books recorded the location of Sanjian was in the depression on the hand and the second finger of the posterior inner part of the node.②Modern literature described Sanjian was in the depression of the proximal radial side of the second metacarpophalangeal joint.③Through finger press,"acupoint sensation"appeared in the second metacarpophalangeal joint proximal end,radial volar depression.④"Acupoint sensation"was the strongest when acupuncture was performed at the second metacarpal and phalangeal joint proximal radial volar depression.⑤Microdissection revealed that this point was the'hilum of bone'

关 键 词：腧穴 三间穴 解剖 实体解剖 骨门 

分 类 号：R224.2[医药卫生—中医基础理论]