【摘要】：目的:利用激光散斑血流成像系統(tǒng)和問卷調(diào)查開展對循經(jīng)感傳經(jīng)脈現(xiàn)象及特點(diǎn)的研究,觀察記錄針刺“陽陵泉”穴、經(jīng)脈非穴以及非經(jīng)非穴時(shí)循經(jīng)感傳伴隨的遠(yuǎn)端穴位血流灌注變化以及循經(jīng)感傳主觀感覺的情況,探索整理循經(jīng)感傳的散斑微循環(huán)變化與主觀感覺特征。方法:本研究以健康志愿者為研究載體,所有受試者全部來自遼寧中醫(yī)藥大學(xué)2012級-2013級的本科學(xué)生,選取受試者28例,納入24例。分別針刺受試者的陽陵泉穴,經(jīng)脈非穴以及非經(jīng)非穴,每次針刺間隔時(shí)間最短為24小時(shí)。針刺過程中應(yīng)用循經(jīng)感傳的調(diào)查問卷記錄受試者出現(xiàn)感傳的主觀感覺以及各種感覺的VAS評分,同時(shí)利用激光散斑血流成像系統(tǒng)觀察循經(jīng)感傳伴隨的遠(yuǎn)端腧穴的血流變化。結(jié)果:1.根據(jù)調(diào)查問卷的結(jié)果,將循經(jīng)感傳度分為Ⅰ、Ⅱ、Ⅲ、Ⅳ四個(gè)等級,Ⅰ級:局部針感明顯,但并未出現(xiàn)循經(jīng)感傳;Ⅱ級:局部針感明顯,同時(shí)出現(xiàn)循經(jīng)感傳,向下傳至光明穴處,約為外踝尖上5寸,或向上感傳至膝陽關(guān)穴,約為陽陵泉上3寸;Ⅲ級:局部針感明顯,循經(jīng)感傳向下傳至外踝尖處,或向上感傳至風(fēng)市穴,約為乆橫紋上7寸處;Ⅳ級:局部針感明顯,感傳向下至腳趾或腳背,或向上感傳至環(huán)跳穴,約為股骨大轉(zhuǎn)子最凸點(diǎn)與骶管裂孔連線的外1/3與中1/3交點(diǎn)處。若感傳未傳到下一級則將循經(jīng)感傳度歸為上一級。針刺陽陵泉組的循經(jīng)感傳度明顯優(yōu)于經(jīng)脈非穴組與非經(jīng)非組(P0.05)。2.針刺陽陵泉穴與經(jīng)脈非穴,其感傳基本循經(jīng)傳導(dǎo);針刺非經(jīng)非穴其感傳路線不明確,其中疑似膽經(jīng)感傳2例,疑似胃經(jīng)感傳8例,感傳路線不明確者10例。3.針刺過程中出現(xiàn)酸、麻、脹、痛四種主觀感覺,各種針感出現(xiàn)的頻率以及VAS評分均無統(tǒng)計(jì)學(xué)差異。將Ⅰ、Ⅱ、Ⅲ級感傳視為低級感傳、Ⅳ級感傳視為高級感傳,陽陵泉組高級感傳VAS評分高于低級感傳,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);經(jīng)脈非穴組低級感傳與高級感傳VAS評分比較沒有統(tǒng)計(jì)學(xué)差異(P0.05)。4.比較針刺陽陵泉穴、經(jīng)脈非穴與非經(jīng)非穴出針前后肢端穴位的血流微循環(huán)變化,陽陵泉組竅陰、俠溪、足臨泣、丘墟出針后的血流值均較進(jìn)針前升高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);經(jīng)脈非穴組與非經(jīng)非穴組出針前后肢端穴位血流降低,差異沒有統(tǒng)計(jì)學(xué)意義(P0.05)。5.陽陵泉組在出針后竅陰穴的血流值與循經(jīng)感傳度呈正相關(guān)(P0.01),經(jīng)脈非穴組與非經(jīng)非穴組出針后各穴的血流值與循經(jīng)感傳度無相關(guān)性(P0.05)。6.比較分析陽陵泉組與經(jīng)脈非穴組低、高等級感傳與肢端穴位血流相關(guān)性。陽陵泉組低級感傳與各穴血流無相關(guān)性,高級感傳在井穴竅陰與原穴丘墟處的血流值呈正相關(guān);經(jīng)脈非穴組低、高級感傳,與其遠(yuǎn)端各穴血流值均無相關(guān)性。結(jié)論:1.針刺膽經(jīng)陽陵泉穴、經(jīng)脈非穴與非經(jīng)非穴均能激發(fā)感傳,陽陵泉組循經(jīng)感傳度明顯優(yōu)于經(jīng)脈非穴組與非經(jīng)非穴組,說明循經(jīng)感傳具有經(jīng)穴特異性。2.針刺陽陵泉穴,出針后肢端穴位的血流值均較進(jìn)針前升高;針刺經(jīng)脈非穴與非經(jīng)非穴,出針后肢端穴位血流值無改變,進(jìn)一步論證經(jīng)穴的特異性。3.針刺陽陵泉穴引起循經(jīng)感傳并且伴隨肢端穴位血流值的升高,其循經(jīng)感傳度越高,伴隨的肢端穴位血流值越高,說明循經(jīng)感傳具有循經(jīng)特異性,提示皮膚表面微循環(huán)可作為循經(jīng)感傳的機(jī)理進(jìn)一步探討。
[Abstract]:Objective: To study the phenomenon and characteristics of meridian transmission by laser speckle blood flow imaging system and questionnaire survey, observe and record the changes of blood perfusion of distal acupoints accompanied by sensory transmission along meridian when acupuncture at "Yanglingquan", non-meridian acupoints and non-meridian acupoints, and explore the situation of sensory transmission along meridian. Methods: A total of 28 subjects from Liaoning University of Traditional Chinese Medicine (Liaoning University of Traditional Chinese Medicine, Grade 2012-2013) were enrolled in this study. They were acupunctured at Yanglingquan point, non-acupoints of meridians and non-acupoints of non-meridians. The shortest time was 24 hours. The subjective sensation and VAS scores of various sensations were recorded by the questionnaire of sensory transmission along meridians. The hemorheological changes of distal acupoints accompanied by sensory transmission along meridians were observed by laser speckle flow imaging system. Results: 1. Sensory transmission along meridians was divided into two groups according to the results of the questionnaire. Grade I, II, III, IV, Grade I: Local needle sensation is obvious, but there is no transmission along the meridian; Grade II: Local needle sensation is obvious, at the same time, there is transmission along the meridian sensation, down to the bright point, about 5 inches above the outer malleolus tip, or up to the knee Yangguan point, about 3 inches above Yanglingquan; Grade III: Local needle sensation is obvious, down to the outer malleolus tip. Or upward sensation to Fengshi acupoint, about 7 inches above the horizontal lines; Grade IV: Local sensation of needle is obvious, sensory transmission down to toe or toe back, or upward sensation to Huantiao acupoint, about the most salient point of the greater trochanter of the femur and sacral canal hiatus hiatus connecting the outer 1/3 and 1/3 intersection point. Acupuncture of Yanglingquan and non-meridian acupoints has a basic sensory transmission along meridians; acupuncture of non-meridian acupoints has an unclear route of sensory transmission, including 2 cases of suspected gallbladder channel sensory transmission, 8 cases of suspected gastric channel sensory transmission, 10 cases of unclear route of sensory transmission. There was no significant difference in the frequency and VAS score among the four kinds of subjective sensations. Regarding grade I, II and III sensory transmission as low-level sensory transmission, grade IV sensory transmission as high-level sensory transmission, the VAS score of Yanglingquan group was higher than that of low-level sensory transmission, and the difference was statistically significant (P 0.05). There was no statistically significant difference (P 0.05). 4. Compared with the changes of blood microcirculation at the extremity points before and after acupuncture at Yanglingquan, non-acupoints and non-acupoints, the blood flow values of Qiaoyin, Xiaxi and Zulin in Yanglingquan group were higher than those before acupuncture (P 0.05). There was no significant difference (P 0.05). 5. There was a positive correlation between the blood flow of Qiaoyin acupoints and the sensory transmission along meridians in Yanglingquan group (P 0.01). There was no correlation between the blood flow of non-acupoint group and non-acupoint group (P 0.05). There was no correlation between the low-grade sensory transmission and the blood flow of the extremity acupoints in Yanglingquan group, and the high-grade sensory transmission was positively correlated with the blood flow of the orifice-yin of Jing acupoints and the hilly ruins of the original acupoints. Yanglingquan group is superior to non-acupoint group and non-acupoint group, indicating that sensory transmission along meridians has meridian specificity. 2. Acupuncture Yanglingquan point, the blood flow value of limb acupoints after needling is higher than that before needling. Acupuncture non-acupoint and non-acupoint of meridian has no change in blood flow value of limb acupoints after needling. 3. Acupuncture at Yanglingquan points leads to sensory transmission along the meridian and increases the blood flow value of the limb acupoints. The higher the sensory transmission along the meridian, the higher the blood flow value of the limb acupoints accompanied by the sensory transmission along the meridian, which indicates that sensory transmission along the meridian is specific, suggesting that skin surface microcirculation can be used as a mechanism for sensory transmission along the meridian.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 柏芳芳;譚亞芹;苗茂;翟偉;王琦;劉亮;;循經(jīng)感傳與中醫(yī)體質(zhì)相關(guān)性研究[J];中國針灸;2016年10期

2 周明亮;賈文睿;王健彤;王培;郭麗紅;睢明河;;電針“陽陵泉”穴對急性膽囊炎家兔白細(xì)胞計(jì)數(shù)和膽囊壁厚度的影響[J];針刺研究;2015年03期

3 鄧甜甜;姚遠(yuǎn);高玉;董寶強(qiáng);;齊刺膽的下合穴對膽絞痛豚鼠β-EP和CCK-8影響的研究[J];針灸臨床雜志;2014年10期

4 許永勝;張玲玲;孟子琪;曹銳;董寶強(qiáng);;齊刺陽陵泉對膽絞痛豚鼠IL-1β、IL-6的影響[J];山西中醫(yī);2014年03期

5 馮林松;顧春飛;郁林海;胡劍飛;汪韜;徐國權(quán);褚永悅;;針刺對260例急性膽絞痛鎮(zhèn)痛作用的療效觀察[J];云南中醫(yī)學(xué)院學(xué)報(bào);2014年01期

6 韓鵬;胡新穎;何鑫;;淺談古代醫(yī)家臨床應(yīng)用陽陵泉心悟[J];中醫(yī)臨床研究;2014年04期

7 孔平;楊暉;鄭剛;謝銀月;林為民;;激光散斑血流成像技術(shù)研究新進(jìn)展[J];光學(xué)技術(shù);2014年01期

8 鄭淑霞;許金森;陳凌;潘曉華;蘭彩蓮;;經(jīng)絡(luò)阻滯現(xiàn)象中家兔心臟M_3受體含量變化的初步觀察[J];中華中醫(yī)藥雜志;2013年10期

9 陳少宗;魏凌波;郭珊珊;;電針陽陵泉對慢性炎性低張力膽囊動力學(xué)影響的時(shí)效規(guī)律初步觀察[J];針灸臨床雜志;2013年09期

10 張維波;榮培晶;趙晏;韓立煒;;中國與瑞典科學(xué)家聯(lián)手破解循經(jīng)感傳現(xiàn)象之謎[J];中國科學(xué)基金;2013年05期

相關(guān)會議論文 前1條

1 梁繁榮;;經(jīng)穴效應(yīng)特異性初步研究[A];中國針灸學(xué)會2009學(xué)術(shù)年會論文集（上集）[C];2009年

相關(guān)重要報(bào)紙文章 前1條

1 馮盛才;;能量傳遞系統(tǒng)理論揭示經(jīng)絡(luò)實(shí)質(zhì)[N];中國中醫(yī)藥報(bào);2013年

相關(guān)碩士學(xué)位論文 前1條

1 王健彤;電針“陽陵泉”穴對急性膽囊炎家兔腫瘤壞死因子-α和膽囊B超的影響[D];北京中醫(yī)藥大學(xué);2016年

，

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