针灸足三里穴位周围肌肉微循环的超声造影评估  

Contrast-Enhanced Ultrasound Evaluation of Muscle Microcirculation Around Zusanli Point in Acupuncture

作　　者：徐振宏[1] 柳漂漂 王筱颖 王泽城 吕国荣[1] 林煜芬 吴家祥 XU Zhenhong;LIU Piaopiao;WANG Xiaoying;WANG Zecheng;LV Guorong;LIN Yufen;WU Jiaxiang(Department of Ultrasound,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China;不详)

机构地区：[1]福建医科大学附属第二医院超声科,福建泉州362000 [2]福建医科大学附属泉州第一医院超声科,福建泉州362000 [3]泉州医学高等专科学校,福建泉州362000

出　　处：《中国医学影像学杂志》2024年第7期726-730,共5页Chinese Journal of Medical Imaging

基　　金：泉州市科技项目(2021C053R)。

摘　　要：目的探讨超声造影评价正常人足三里穴位针灸前后局部肌肉微循环情况的价值。资料与方法前瞻性收集2018年9月—2020年5月于福建医科大学附属第二医院超声科就诊的72例健康志愿者,分别于针灸前、针灸得气最强时、针灸后2h进行超声造影,观察胫前肌内微血管血流灌注情况,分析感兴趣区中的小动脉、肌肉组织和小静脉,获得时间-强度曲线和造影剂渡越时间(CTTs)。采用针灸者结合受灸者的客观评分标准评价针感。于针灸前、针灸得气最强时、针灸后2 h检测胃泌素、血浆促胃动力素、胆囊收缩素、胰泌素水平。结果①针灸得气最强时,胫前肌动脉-肌肉间、肌肉-静脉间、动脉-静脉间CTTs明显缩短,与针灸前及针灸后2h比较,差异均有统计学意义(P均<0.001),针灸前及针灸后2hCTTs差异无统计学意义(P>0.05);②针灸得气最强时,志愿者血清内胃泌素、血浆促胃动力素、胆囊收缩素、胰泌素水平升高,与针灸前及针灸后2h比较,差异均有统计学意义(P均<0.001),针灸前及针灸后2h差异无统计学意义(P>0.05);③针灸得气最强时,胃泌素、血浆促胃动力素、胆囊收缩素、胰泌素水平与胫前肌动脉-肌肉间、肌肉-静脉间、动脉-静脉间CTTs均呈正相关(r=0.360~0.702,P<0.001)。结论针刺足三里得气最强时,可造成骨骼肌周围微循环改变,导致CTTs明显缩短,同时也能促进胃肠道的分泌功能。Purpose To explore the application of contrast-enhanced ultrasound in evaluating the local muscle microcirculation before and after acupuncture at Zusanli point in normal people.Materials and Methods A total of 72 healthy volunteers who visited the Department of Ultrasound,the Second Affiliated Hospital of Fujian Medical University from September 2018 to May 2020 were prospectively collected,all subjects performed ultrasound contrast before acupuncture,acupuncture with strongest deqi,and two hours after acupuncture to observe the blood flow perfusion of the microvessels in the tibialis anterior muscle.The pre-selected areas of interest the small arteries,muscle tissues and venules in the middle were analyzed to obtain the time-intensity curve and contrast transit time(CTTs)perfusion parameters.Needle sensation was evaluated using objective scoring criteria for acupuncture combined with moxibustion recipients.Gastrin,plasma gastrin,cholecystokinin,and secretin were measured in all subjects before acupuncture,when acupuncture had the strongest deqi,and two hours after acupuncture.Results①CTTs of arterial-muscle,muscle-venous and arterial-venous of the tibialis anterior muscle at acupuncture with strongest deqi were significantly shorter than those at before acupuncture and two hours after acupuncture(all P<0.001),and there was no significant difference in CTTs before and after acupuncture and moxibustion(P>0.05);②when acupuncture deqi was strongest,serum gastrin,plasma prokinetics,cholecystokinin,and secretin were significantly increased compared with those before acupuncture and two hours after acupuncture,with statistically significant difference(all P<0.001),while there was no significant difference in these parameters between before acupuncture and two hours after acupuncture(P>0.05);③when acupuncture had the strongest deqi,there were positive correlations between gastrin,plasma prokinetic hormone,cholecystokinin,and secretin values and CTTs of arterial-muscle,muscle-venous,and arterial-venous(r=0.360-0.7

关 键 词：针灸疗法 超声检查 造影剂 穴 足三里 骨骼肌 微循环 

分 类 号：R445.1[医药卫生—影像医学与核医学] R245[医药卫生—诊断学]