委中穴的局部解剖学研究及临床意义

Topographic research of Weizhong Acupoint (BL40) and its clinical significance

目的:为委中穴针刺提供适宜的进针深度,避免对胫神经或腘血管的损伤并发挥其最大功效。方法:用40例经甲醛固定的成人下肢标本,依据国颁标准定穴进针,解剖观测进针层次及毗邻重要的神经血管。结果:伸膝,直刺进针,针体由皮肤到腘筋膜的深度为(0.81±0.20)cm。腘筋膜深面,针体周围是大量的疏松结缔组织。针体穿腓肠肌内、外侧头之间入深面可触及粗大的胫神经和腘血管束,针体由皮肤到胫神经的深度为(1.55±0.32)cm,到腘静脉的深度为(2.84±0.38)cm。胫神经的体表投影相当于腘窝上、下角的连线。结论:委中穴针刺的适宜深度均值为1.55cm。委中穴与腘窝的筋膜组织关系密切。

Objective：To provide an appropriate depth of needle insertion in acupuncture at Weizhong （BIAO） and avoid injuring the tibial nerve and popliteal blood vessels and exert the most efficacy. Methods： Forty adult lower-limb samples by formalin fixation were used to dissect and observe the relative layered structures and adjoining important nerves and blood vessels in needling Weizhong （BL40） according to the national standard. Results：The needling depth from the skin to the popliteal fascia was （0.81±0.20）cm, when the knee joint was in extensional position and the needle was perpendicularly inserted. It was a lot of loose connective tissue around the needle body in the deep layer of the popliteal fascia. The tibial nerve and popliteal vascular bundle could be touched when the needle body past through the medial head and lateral head of gastrocnemius muscle. The needling depth from the skin to the tibial nerve and from the skin to the popliteal vein was（1.55±0.32）cm and （2.84±0.38）cm, respectively.Body surface projection of tibial nerve was located at the connected line between superior angle and inferior angle of popliteal fossa. Conclusion： It is recommended that ideal average depth of acupuncture should be 1.55 cm for perpendicular needling Weizhong （BL40）. Connective tissue of fascia distributed in popliteal fossa may be correlated with Weizhong （BL40）.