三阴交单穴得气对原发性痛经寒湿凝滞证患者针刺效应的影响研究  

Study on the effect of acupunctureat Sanyinjiao(SP6)with Deqi on patients with primary dysmenorrhea with cold-dampness stagnation syndrome

作　　者：林驰[1] 徐沙丽 钟晓玲 萨喆燕 郭婉清 罗彩云 朱佳敏 黄顺艳 LIN Chi;XU Shali;ZHONG Xiaoling;SA Zheyan;GUO Wanqing;LUO Caiyun;ZHU Jiamin;HUANG Shunyan(College of Acupuncture and Moxibustion,Fujian University of Chinese Medicine,Fuzhou,Fujian,350122,China;Meridian Research Institute,Fujian Academy of Chinese Medical Sciences,Fuzhou,Fujian,350003,China;Department of Ultrasound,the Third People's Hospital Affiliated to Fujian University of Chinese Medicine,Fuzhou,Fujian,350108,China;Department of Acupuncture and Moxibustion,the Third People's Hospital Affiliated to Fujian University of Chinese Medicine,Fuzhou,Fujian,350108,China)

机构地区：[1]福建中医药大学针灸学院,福建福州350122 [2]福建省中医药科学院经络研究所,福建福州350003 [3]福建中医药大学附属第三人民医院超声科,福建福州350108 [4]福建中医药大学附属第三人民医院针灸科,福建福州350108

出　　处：《甘肃中医药大学学报》2023年第6期88-94,共7页Journal of Gansu University of Chinese Medicine

基　　金：国家自然科学基金青年项目(82004457);福建省自然科学基金项目(2018J05140)。

摘　　要：目的观察三阴交单穴得气对原发性痛经寒湿凝滞证患者针刺效应的影响。方法采取随机对照试验与双层次统计分析比较的设计,先将纳入患者采用随机数字表法分为促使得气组(32例)和避免得气组(29例)进行第一层次比较,均针刺双侧三阴交穴进行干预。采用视觉模拟评分法(VAS)进行针刺前后月经疼痛程度评估,并记录8个时间点(针刺前,针刺即刻,留针5,10,15 min,起针即刻,起针后5,10 min)双侧三阴交及其相邻近的脾经沿线穴位(漏谷、地机、阴陵泉、血海)的体表红外热像温度,分别作为主、客观针刺效应观察指标。采用受试者针感临床评价量表评估患者针刺得气实际情况,并以此为依据将患者重新分为实际得气组(47例)、实际不得气组(14例),进行第二层次比较。结果1)促使得气组实际得气率为93.75%(30/32),避免得气组实际得气率为58.62%(17/29)。2)第一层次比较,2组针刺后VAS评分均较同组针刺前明显降低(P<0.01),但组间比较差异无统计学意义(P>0.05);2组各时间点经穴体表红外热像温度比较差异均无统计学意义(P>0.05)。3)第二层次比较,针刺后实际得气组VAS评分较针刺前明显降低(P<0.01),实际不得气组针刺前后比较差异无统计学意义(P>0.05);实际得气组在一些时间点个别穴位的体表红外热像温度明显高于实际不得气组(P<0.05)。结论针刺三阴交穴只有达到得气才具有镇痛效应,得气可促使三阴交及其相邻近的脾经沿线穴位体表红外热像温度升高。Objective To observe the effect of acupuncture at Sanyinjiao(SP6)on patients with primary dysmenorrhea with cold-dampness stagnation syndrome.Methods A randomized controlled trial and a two-level statistical analysis were designed.First the patients were randomly divided into two groups:promoting Deqi group(n=32)and avoiding Deqi group(n=29)and carried out the fist-level comparison.Both groups were intervened by acupuncture at both Sanyinjiao points.Visual analog scale(VAS)was used to evaluate the pain degree of menstrual period before and after acupuncture respectively,and the body surface infrared thermal image temperature of bilateral Sanyinjiao and its adjacent points along the spleen meridian[Lougu(SP7),Diji(SP8),Yinlingquan(SP9),Xuehai(SP10)]at 8 time points(before the needling,the moment inserting the needle,retaining the needle for 5,10,15 min,the moment withdrawing the needle,5,10 min after needling)were observed and recorded,as the main subjective and objective observation indexes of acupuncture effect.The clinical evaluation scale of needling sensation was used to evaluate the actual Deqi response in patients,and according to its results,the patients were re-divided into actual with Deqi group(47 cases)and without Deqi group(14 cases),and the second-level comparison was carried out.Results 1)The actual Deqi ratio of the promoting Deqi group was 93.75%(30/32),and the actual Deqi rario of the avoiding Deqi group was 58.62%(17/29).2)In the first level comparison,VAS score of both groups after acupuncture was significantly lower compared with that before acupuncture in the same group(P<0.01),but there was no statistical significance between groups(P>0.05).There was no significant difference in the infrared thermal image temperature between the two groups at each time point(P>0.05).3)At the second level,VAS score of the actual with Deqi group after acupuncture was significantly lower than that before acupuncture(P<0.01),but there was no statistical significance in the actual without Deqi group before and af

关 键 词：原发性痛经 寒湿凝滞证 三阴交 毫针针刺 得气 针刺效应 视觉模拟评分法评分 红外热像温度 

分 类 号：R246.3[医药卫生—针灸推拿学]