穴位的不同组织特性对电针针感的影响

Effect of acupoints with different tissue on electroacupuncture sensation

目的:评估穴位的组织特性(不同经络、组织、神经节段)对电针针感频率、强度及产生针感电流量的影响。方法:电针针刺21名健康志愿者,根据穴位不同组织特性配成5组:足三里vs阳陵泉(ST 36vs GB 34,不同经络)、内关vs大陵(PC 6vs PC 7,不同组织)、足三里vs水道(ST36vs ST 28,不同神经节段)、关元vs中脘(CV 4vs CV 12,不同神经节段)、足三里vs关元(ST36vs CV 4,不同组织、经络、神经节段)。电针频率为15Hz,电流量以受试者能忍受但不产生尖锐性疼痛为度,间断电针3次,通电时间共90s。记录酸感、麻木、胀满、沉重、麻刺、压感、钝痛、热感及冷感针感和产生针感的电流量,比较配对穴位间各种针感发生的频次、强度及电流量间的差异。结果:各种针感频次在配对穴位间差异均无统计学意义(均P>0.05),电针针刺的9种感觉中,胀满、麻木和酸感最常见和最明显,沉重、压感和麻刺次之,钝痛、热感和冷感的发生频次均较低;部分针感强度在配对穴位间存在差别,酸感、胀满、沉重感在ST 36较ST 28更强(均P<0.05),胀满、麻木在ST 36较CV 4更明显(均P<0.01),胀满在CV 4较CV 12更明显(P<0.05);电针针刺电流量在配对穴位间相近(均P>0.05)。结论:在产生针感的电流量未见明显差异的状态下,电针针感次数与穴位的不同组织间未见明显相关,穴位间针感强度的差异可能与穴位位于不同神经节段相关。不同时间电针刺激同一穴位产生的各针感频次及其强度具有相对稳定性。

Objective To evaluate the influence on frequency, intensity and the amount of current flow produced by electroacupuncture sensation of acupoints with different distributions （meridian category, tissue type and nerve innervations）. Methods Twenty-one healthy volunteers were enrolled. According to the different tissue of acu- points, paired acupoints were grouped： Zusanli （ST 36） vs Yanglingquan （GB 34） （different meridian categories）, Neiguan （PC 6） vs Daling （PC 7） （different tissue types）, Zusanli （ST 36） vs Shuidao （ST 28） （different nerve innervations）, Guanyuan （CV 4） vs Zhongwan （CV 12） （different nerve innervations）, and Zusanli （ST 36） vs Guanyuan （CV 4） （different meridian categories, tissue types and nerve innervations）. The electric frequency was 15 Hz. The electric current was under the participant＇s tolerance without sharp pain; the electroacupuneture was applied for three times with interval, 90 seconds totally. Soreness, numbness, fullness, heaviness, tingling, pres- sure, dull pain, warmness, coolness and amount of current flow were recorded, and the frequency, intensity and current amount between the paired acupoints were compared. Results There were no significant differences in frequency of needling sensations between paired points （all P~〉0.05）. In the 9 electroacupuneture sensations, full- ness. numbness and soreness were most commonly seen and obvious, heaviness, pressure and tingling came se- cond, and dull pain, warmness, and coolness occurred at lower frequency. There were differences in the intensity of acupuncture sensation between paired acupoints in part of them, the soreness, fullness and heaviness at Zusanli（ST 36） were stronger than those at Shuidao （ST 28） （all P〈.O. 05 ）; fullness and numbness at Zusanli （ST 36） were stronger than those at Guanyuan （CV 4） （both P〈0. 01）; fullness at Guanyuan （CV 4） was stronger than that at Zhongwan （CV 12） （P〈0. 05 ）; the current flow of electroacupuncture was similar between paired acupoints （all P〉O. 05）. Conclusion In the situation that there is no obvious difference in amount of current flow caused by electroacu puncture sensation, the obvious correlations between frequency of eleetroacupuncture sensation and tissue properties of acu- points are not appeared, and the difference of sensation intensity between paired acupoints may be associated with different nerve innervations. The frequency and intensity of electroaeupuncture sensation at one aeupoint are stable at different times.