不同穴位针刺蝶腭神经节深度及方向的研究

Study on needling depth and direction from different acupoints to sphenopalatine ganglion

目的:观测下关、颧髎、"蝶腭"穴的体表位置,及各穴至蝶腭神经节的针刺深度和针刺方向。方法:15具成年男性尸体,面部左右共30侧,对其面侧区进行由浅入深的解剖。以下关、颧髎、"蝶腭"穴各穴针刺至蝶腭神经节方向为穿刺入路,电动钻带克氏针穿刺延伸至对侧区域,坐标定位法测量各穴的对应穿刺点。结果:①体表位置:"蝶腭"穴与颧髎的体表距离为21 mm,与下关的体表距离为17 mm。②各穴针刺蝶腭神经节的深度:下关为49.9 mm,"蝶腭"穴为46.9 mm,颧髎为46.6 mm。③对应穿刺点坐标定位:下关针刺方向为前内上,对应于对侧的太阳和瞳子髎的中点处附近区域,对应穿刺点距对侧丝竹空的距离为17.6 mm;"蝶腭"穴针刺方向为后内上,对应穿刺点与颧弓水平线的距离为33 mm,与目外眦垂直线的距离为42 mm;颧髎针刺方向为后内上,对应穿刺点与两外耳门连线的距离为28 mm,头部正中线旁开62 mm。结论:了解下关、颧髎、"蝶腭"穴的体表位置、针刺深度、针刺方向,为临床针刺蝶腭神经节提供了依据。

Objective To observe and survey the location of Xiaguan （ST 7）, ＂Die＇e＂ and Quanliao （SI 18） on the surface, and the needling depth and direction from the 3 points to sphenopalatine ganglion. Methods Fifteen corpses （30 sides） of adult male were fixed by 10% formalin. The lateral areas of face were dissected from the surface to the deep on the 3 acupoints： the electric drill with the kirschner wire punctured towards the sphenopalatine ganglion and extended to the contralateral areas according to different directions of puncturing sphenopalatine ganglion from the 3 acupoints. The corresponding puncturing points of the 3 acupoints were measured by the coordinate location method. Results （1） Surface location： the distance between Quanliao （SI 18） and ＂Die＇e＂ was 21 mm and the distance between Xiaguan （ST 7） and ＂Die＇ e＂ was 17 ram; （2） Inserting depth of each point to sphenopalatine ganglion： the depths of Xiaguan （ST 7）, ＂Die＇e＂ and Quanliao （SI 18） were 49. 9 ram, 46.9 mm and 46.6 mm, respectively; （3） The coordinate location of the corresponding puncturing points： the puncturing direction of Xiaguan （ST 7） was anterointernal upper corresponding to the area of connecting center between contralateral Taiyang （EXHN 5） and Tongziliao （GB 1）, the distance between the corresponding inserting point of Xiaguan （ST 7） and Sizhukong （TE 23） was 17.6 ram; the puncturing direction of ＂Die＇ e＂ point was posterointernal upper, and the horizontal distance from the corresponding puncture point to the zygomatic arch was 33 mm and the vertical distance from the corresponding puncture point to the eyes＇ outer canthus was 42 mm; the puncturing direction of Quanliao （SI 18） was posteriointernal upper and the distance between the corresponding inserting point and the area of contralateral parietal tuber, the distance between the corresponding inserting point of Quanliao （SI 18） and the connecting line of bilateral external acoustic pore was 28 mm, the distance between the corresponding inserting point of Quanliao （SI 18） and the medial line of the head was 62 mm. Conclusion Understanding the surface location, inserting depths and the general puncturing directions of the 3 points can provide basis for puncturing the sphenopalatine ganglion in clinical practice.