冠心病患者背部反应点的微循环检测

Detection of the Cutaneous Microcirculatory Blood Perfusion of Reactive Sites Located in the Back on CHD Patients

目的:通过观察和检测冠心病患者背部反应点的形态、位置及微循环改变,探讨病理状态下反应点的特异性。方法:参照腧穴诊察法,对44例冠心病患者后背进行诊察,确定反应点和心俞的位置并标记,精确测量折算成骨度分寸;对比反应点与经穴的触诊改变。用激光多普勒血流仪依次测量各点的皮肤微循环值,分析反应点和经穴在有无反应现象时微循环的差异。结果:在44例冠心病患者中,反应点与部分心俞穴触诊阳性反应,表现为硬结、条索、沙粒样改变,或压痛敏感。反应点分布于T_3～T_7节段不等,以T_5节段出现的频次最多,其次为T_4和T_6,各反应点距离后正中线的距离为夹脊穴与背俞穴之间。各节段反应点和心俞的微循环值明显高于对照点,但反应点和心俞之间未见明显差异。结论:(1)冠心病患者在后背会出现反应点,反应点分布于相对一个区域,并不完全与经穴重合;(2)反应点以及有反应的经穴皮肤微循环血流值升高;(3)反应点较无反应现象的心俞更具有特异性。

Objective:To observe the morphology,location and the change of microcirculatory blood perfusion on reactive sites of patients with coronary heart disease(CHD),and discuss the specificity of reactive sites in pathological state.Methods:Referring to acupoints diagnostic method,44 patients were examined and fixed the position of reactive sites and Xinshu(BL15)on their back.Laser Doppler flowmetry was applied to measure the cutaneous microcirculation values of both reactive sites and BL15,thus to analyze the difference between reactive sites and meridian sites under both reactive and non-reactive conditions.Results:In 44 CHD patients,all reactive sites and BL15 showed positive reactions upon palpation examination,manifesting as induration,indentation,sand-like changes and/or with painfulness.The reactive sites were distributed from the third thoracic level to the seventh thoracic level,among which the maximum number of the reactive sites located in the fifth thoracic level,followed by the reactive sites in the fourth and the sixth thoracic level.Each reaction site was located between the Huatuojiaji points and back-shu points.The cutaneous microcirculation values of both reactive sites and BL15 were significantly higher than those of the control points;however,there was no difference between reactive sites and BL15.Conclusion:The result indicated that reactive sites were settled on a specific area in CHD patients,and they were incompletely coincided with acupoints.The cutaneous microcirulation values of the reactive sites and BL15 will be increased under the pathological conditions.Compared to non-reactive BL15,the reactive sites are more specific.