结合针刺治疗三叉神经痛探讨针刺靶点问题

Target points: a discussion on acupuncture treatment of primary trigeminal neuralgia

本文从中医腧穴学出发,结合西医解剖学、神经学理论,探讨穴位深度与针刺靶点问题,分析了一直以来针刺和选穴操作不规范的原因及针刺神经节、神经孔的理论依据;以原发性三叉神经痛为例,提出将下关、攒竹、四白、夹承浆定位于蝶腭神经节及相应神经孔(眶上孔、眶下孔及颏孔)的针刺方法;认为规范穴位针刺靶点,既符合针刺临床试验干预措施报告标准对针刺细节的国际化要求,也有利于针灸技术的规范化研究,对于临床规避风险、提高针刺疗效具有现实意义。

In this paper, issues of acupuncture using target points and depth of needling were discussed based on the theory of traditional Chinese medicine acupoints and combined with anatomical and neurological research of Western medicine. The theoretical evidence of acupuncture on nerve foramen and ganglion and the reasons for being nonstandard operating on acupoints were analyzed. This study summarized the method of using acupuncture at Xiaguan （STT）, Cuanzhu （BL2）, Sibai （ST2） and Jiachengjiang acupoints to align with the spheno-palatine ganglion and additional nerve foramen （supraorbital, infraorbital and mental foramina） to treat primary trigeminal neuralgia. This study adhered to the Standards for Reporting Interventions in Clinical Trials of Acupuncture and helped in development of study standardization for acupuncture processes. The authors hoped that should help in significantly diminishing risk and improving therapeutic efficacy in clinic.