【摘要】：目的針灸得氣被當(dāng)作針灸治療的療效基礎(chǔ),隨著當(dāng)前對(duì)針灸理論體系研究的深入,人們?cè)絹碓街匾曖樉牡脷獾膯栴},就目前情況而言,對(duì)于“在什么情況下能夠快速得氣”的問題,還沒有明確的理論依據(jù)來指導(dǎo)臨床治療。本研究通過對(duì)臨床中進(jìn)行針灸治療時(shí)出現(xiàn)得氣的現(xiàn)象進(jìn)行記錄分析,探討針刺得氣的條件及其機(jī)制,從而為“如何實(shí)現(xiàn)快速得氣”提供理論依據(jù)。方法本研究屬于臨床研究,共收集516例自2015年5月至2016年12月以來在煤炭總醫(yī)院針灸科門診治療的病例,記錄穴位針刺的得氣情況,詳細(xì)記錄其針刺深度、行針手法、得氣感覺(酸、麻、脹、痛、過電感等)、傳導(dǎo)方向等。結(jié)果1不同針感出現(xiàn)頻率不同:脹感出現(xiàn)的頻率最高;其次為酸感、過電感,再次為麻感;其中痛感出現(xiàn)頻率較少,但在臨床中也有出現(xiàn);然而重感、涼感、蟻行感幾乎沒有出現(xiàn)。2部位不同,針刺深度不同:頭面、頸部針刺深度至少達(dá)到0.8寸時(shí)更容易出現(xiàn)得氣;軀干、四肢針刺深度至少達(dá)到1.3寸時(shí),更易得氣;針刺后加入行針手法比單純針刺更容易得氣,直刺得氣的次數(shù)要多于斜刺。3不同疾病對(duì)針刺得氣會(huì)產(chǎn)生影響:與單純患有腰椎間盤突出患者相比,同時(shí)患有糖尿病的患者敏感性降低,穴位得氣率明顯降低;風(fēng)濕性關(guān)節(jié)炎患者疼痛閾值降低,疼痛敏感性增強(qiáng),針刺得氣率高于僅患有腰椎間盤突出的患者。結(jié)論通過對(duì)結(jié)果的分析,總結(jié)出了易得氣的幾種情況:在頭頸部針刺深度至少0.8寸,軀干和四肢針刺深度至少1.3寸時(shí)更易得氣,深刺比淺刺易得氣;在針刺過程中加入補(bǔ)瀉手法會(huì)增加得氣出現(xiàn)率;針刺穴位周圍神經(jīng)血管豐富的易得氣;病人機(jī)體狀態(tài)對(duì)得氣的出現(xiàn)亦有影響,例如患有風(fēng)濕性關(guān)節(jié)炎的患者更容易得氣,糖尿病患者不易得氣等。通過以上這些研究結(jié)論,希望為臨床治療提供更為清晰明確的理論依據(jù),提高針灸治療的得氣出現(xiàn)頻率。
[Abstract]:Objective Acupuncture and moxibustion to obtain Qi is regarded as the curative effect foundation of acupuncture and moxibustion treatment. With the thorough research of acupuncture and moxibustion theory system, people pay more and more attention to the problem of acupuncture and moxibustion gaining Qi, as far as the current situation is concerned, There is no clear theoretical basis to guide clinical treatment. By recording and analyzing the phenomenon of Qi recovery during acupuncture and moxibustion treatment in clinic, this study discussed the condition and mechanism of acupuncture in order to provide a theoretical basis for "how to achieve rapid Qi gain". Methods from May 2015 to December 2016, 516 cases treated in the outpatient department of acupuncture department of Coal General Hospital from May 2015 to December 2016 were collected, and the Qi gain of acupuncture points was recorded, the depth of acupuncture and the manipulation of acupuncture were recorded in detail. Gas sensation (acid, hemp, distension, pain, over inductance, etc.), conduction direction, etc. Results 1the frequency of different needle sensation was different: the frequency of swelling was the highest, followed by acid sensation, over inductance and anaesthesia again, among which the frequency of pain sensation was less, but it also appeared in clinic. However, heavy sense, cool feeling, ant feeling hardly appear. 2 different parts, different needle depth: head, neck acupuncture depth of at least 0.8 inches is more prone to appear gas; Trunk, limbs acupuncture depth of at least 1.3 inches, it is easier to get gas; After acupuncture, acupuncture manipulation is easier to get gas than simple acupuncture, and the frequency of direct needling is more than that of oblique acupuncture. 3 different diseases can affect acupuncture qi: compared with patients with simple lumbar disc herniation, the number of times of direct needling is more frequent than that of oblique acupuncture. At the same time, the sensitivity of patients with diabetes mellitus was decreased, and the rate of acupoint qi recovery was significantly decreased. The pain threshold decreased and the pain sensitivity increased in patients with rheumatic arthritis. The rate of acupuncture pneumaticity was higher than that in patients with prolapse of lumbar intervertebral disc. Conclusion through the analysis of the results, it is concluded that when the depth of acupuncture is at least 0.8 inches in the head and neck, the depth of acupuncture in the trunk and limbs is at least 1.3 inches, it is easier to get gas when the depth of acupuncture in the trunk and limbs is at least 1.3 inches, and it is easier to get gas in deep acupuncture than in shallow acupuncture. In the process of acupuncture, the occurrence rate of qi can be increased by adding reinforcing and purging manipulation, and the abundant blood vessels of peripheral nerve and blood vessel of acupuncture point are easy to get gas. The condition of the patient also affects the appearance of qi, for example, the patients with rheumatoid arthritis are more likely to get the breath, and the diabetic patients are not easy to get the breath, and so on. Through the above conclusions, we hope to provide more clear and clear theoretical basis for clinical treatment, and improve the frequency of acupuncture treatment.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246

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