患者针感与医生手下感之间相关性:一项随机对照试验的二次分析  

The correlation between the patient’s needling sensation and the physician’s hand feeling:secondary analysis of a randomized controlled trial

作　　者：林驰[1] 郭婉清 萨喆燕 罗彩云 钟晓玲 徐沙丽 翁劲松 LIN Chi;GUO Wanqing;SA Zheyan;LUO Caiyun;ZHONG Xiaoling;XU Shali;WENG Jingsong(Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;The Third People’s Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350108,China;Institute of Meridian Research,Fujian Academy of Chinese Medical Sciences,Fuzhou 350003,China;Fujian Provincial Geriatric Hospital,Fuzhou 350003,China)

机构地区：[1]福建中医药大学,福州350122 [2]福建中医药大学附属第三人民医院,福州350108 [3]福建省中医药科学院经络研究所,福州350003 [4]福建省老年医院,福州350003

出　　处：《上海针灸杂志》2024年第9期1034-1039,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金青年项目(82004457);福建中医药大学针灸学科开放课题(XZJ2024007)。

摘　　要：目的分析同为针刺得气指征的患者针感与医生手下感的相关性。方法将一项随机对照试验原始数据进行二次分析,62例原发性痛经寒湿凝滞证患者随机分为A组32例和B组30例。两组均针刺双侧三阴交穴,A组采用促使得气方法(深刺、粗针、行手法)干预,B组采用避免得气方法(浅刺、细针、不行手法)干预。二次分析聚焦A组数据,采用《受试者针感临床评价量表》评估患者主观感受(针感强度、时间和成分),采用自制量表评估医生手下感强度,分析两者之间相关性。结果患者主观感受的3个指标之间呈两两正向直线相关(P<0.05)。12种常见得气感成分中有7种与针感持续总时间明显正向直线相关(P<0.05)。不属于得气感之刺痛与患者针感强度具有正向直线相关(P<0.05)。单次行针后患者针感持续时间同该次行针时医生手下感强度具有正向直线相关(P<0.05)。医生手下感总强度与患者针感强度、得气感成分总强度未见明显线性相关(P>0.05),却与患者麻感强度正向直线相关(P<0.05)。结论三阴交单穴针刺时,患者针感强度易受非得气之刺痛感的干扰,其与医生手下感强度表现为不会线性同步增加,但该穴处患者针感持续时间和单一得气感成分麻感不受刺痛感干扰,与医生手下感强度表现出同步增加。故科研中应重视得气感时间指标和医生手下感的记载。Objective To analyze the correlation between the patient’s needling sensation and the physician’s hand feeling,both the indicators of the arrival of Qi in acupuncture.Method A secondary analysis was performed on the raw data from a randomized controlled trial,in which 62 participants with primary dysmenorrhea due to cold-dampness retention were randomized into group A(32 cases)and group B(30 cases).Both groups received acupuncture at bilateral Sanyinjiao(SP6).Group A was intervened by methods that boosted the arrival of Qi(deep needle insertion,thick needle,and needling manipulations),and group B was intervened by methods that avoided the arrival of Qi(shallow needle insertion,thin needle,and no needling manipulations).The secondary analysis focused on the data of group A,using the clinical evaluation scale of needling sensation of participants to evaluate the patient’s subjective feelings(intensity,duration,and components of needling sensation)and a self-made scale to assess the physician’s hand feeling intensity to analyze their correlation.Result The three parameters of the patient’s subjective feeling showed a pairwise positive linear correlation(P<0.05).Of the 12 Qi-arrival sensation components,7 presented a notable positive linear correlation with the total duration of needling sensation(P<0.05).Pricking pain,which does not belong to the Qi-arrival sensation,showed a positive linear connection with the patient’s needling sensation intensity(P<0.05).After a single time of needling manipulation,there was a positive linear correlation between the duration of the patient’s needling sensation and the physician’s hand feeling(P<0.05).The total intensity of the physician’s hand feeling had no significant linear connection with the patient’s needling sensation intensity and the total Qi-arrival component intensity(P>0.05)but had a positive linear correlation with the patient’s numbing sensation intensity(P<0.05).Conclusion When needling Sanyinjiao,the patient’s needling sensation intensity t

关 键 词：针刺 穴 三阴交 得气 针感 

分 类 号：R245[医药卫生—针灸推拿学]