灸感法与红外法检测原发性三叉神经痛患者下关穴热敏态的对比研究

Comparative research of moxibustion and infrared method in testing heat-sensitive state at Xiaguan(ST 7) in primary trigeminal neuralgia

目的:探讨腧穴热敏态红外客观显示的可能性。方法:共纳入合格受试者54例。在自然状态下采用热断层扫描成像(TTM)拍摄面部红外热像图,图像采集完毕,进行灸感法热敏检测,即用艾条悬灸下关穴(患侧)10min,悬灸结束后记录患者下关穴产生扩热、传热的例数。然后进行第2次红外辐射检测,记录艾灸前后面部红外图像变化,比较两种检测法对受试者下关穴(患侧)热敏态的检测差异。结果:艾灸前红外检测患者下关穴区(患侧)的红外辐射强度多数显示低温特征,其敏感性(真阳性率)为65.6%,特异性(真阴性率)为68.2%,准确性为66.7%。艾灸下关穴区(患侧)后,沿面颊部产生明显片状扩散的红外辐射增量区,其敏感性(真阳性率)为81.8%,特异性(真阴性率)为81.0%,准确性为81.5%。结论:(1)原发性三叉神经痛患者下关穴(患侧)区热敏态在一定程度上可被红外成像客观显示。(2)艾灸热敏腧穴产生的腧穴热敏现象,不仅是受试者的主观感觉,且在一定程度上也能被红外成像客观显示。

Objective To explore the possibility of the infrared objective displaying of heat-sensitive state of acupoint. Methods Fifty-four qualified subjects were enrolled. In the natural state, thermal tomography （TTM） was adopted to shoot the thermograms on the face. After the thermograms collection, the thermo-sensitive detection with moxibustion was applied. The suspending moxibustion with moxa stick was used at Xiaguan （ST 7, affected side） for 10 min. The cases with heat extension and transmission at the acupoint were recorded at the end of moxibustion. In following, the second infrared radiation detection was done so as to record the changes in the in frared images on the face before and after moxibustion and compare the difference in the heat-sensitive state at Xiaguan （ST 7, affected side） in the subjects between two detection methods. Results Before moxibustion, the infrared radiation intensity at Xiaguan （ST 7, affected side） in the patients displayed mostly low temperature feature and its sensibility （true positive rate） was 65. 6%, the specificity （true negative rate） was 68.2% and the accuracy was 66.7%. After moxibustion at Xiaguan （ST 7, affected side）, there was an obvious block-diffused increment area of infrared radation along the cheek and its sensitivity （true positive rate） was 81.8%, the specifici- ty （true negative rate） was 81.0% and the accuracy was 81. 5% as compared with the moxibustion detection. Conclusion （1） The heat-sensitive state at Xiaguan （ST 7, affected side） in the patients of primary trigeminal neuralgia can be objectively displayed by infrared imaging to a certain extent. （2） The acupoint heat-sensitization produced by moxibustion is not only the subjective sensation of the subjects, but also can be objectively displayed by infrared imaging to a certain extent.