捻转针刺手法的运动学及动力学特征研究

Research on Action Features of Acupuncturist Experts' Acupuncture Needle Twirling Skills

目的:从运动学和动力学两个角度探索捻转手法的动作特征,从而为捻转手法操作的定量化提供依据。方法:运用高精度动作捕捉系统,精确测量捻转手法的幅度、频率、力量及操作时间等指标,比较12名针灸专家和12名初学者在仿真皮肤上10次操作平补平泻捻转手法时上述数据的大小及离散程度的差异。结果:专家捻转频率离散系数显著低于初学者(P<0.01),并且专家捻转前的操作时间亦显著短于初学者(P<0.01);专家与初学者捻转幅度、频率及力量的绝对数值相比,差异均无统计学意义(P>0.05)。结论:平补平泻捻转手法的技能水平并非体现在捻转的具体幅度、频率及力量上,其动作特征主要表现在动作稳定性和熟练程度两个方面;建议将捻转频率离散度和操作时间用于捻转手法的定量评估。

Objective To observe the features of acupuncture needle twirling manipulations in order to promote the de velopment of objective and quantitative performance standards of acupuncture manipulation. Methods Twelve expert acupunc turists and 12 novices were enrolled in this study. Everyone of them was instructed to perform 10 trials of the uniform reinforcing and reducing technique of acupuncture on an artificial skin-pad that was mounted to a six-axis force transducer and each subject had his or her dominant hand index finger affixed with an infrared light emitting diode for acquiring parameters of acupuncture needle manipulation. The force transducer was used to measure the force the participant applied as they held an acupuncture needle to stimulate the skin-pad, and at the mean time, an optoelectric camera was employed to measure the position of the diode. Results In comparison with the expert acupuncturist group, the straggling coefficient of needle-twirling frequency was significantly bigger in the novice group （P〈0.01）, suggesting a higher consistency in the trial-by-trial needle-twirling operation of the expert acupuncturists. Comparison of the needle-twirling force showed that the force values of the Z-axis in both expert group and novice group were considerably higher than those of the X-axis and Y-axis in the same one group （P〈0.01）. The time of pre-needle-twirling of the novice group was markedly longer than that of the expert group （P〈0.01）, suggesting a skilled operation technique of the expert acupuncturists. No significant differences were found between the expert acupuncturist group and novice group in the needletwirling amplitude, frequency, force and total operation time （P〈05）. Conclusion Movement frequency consistency and temporal efficiency are the action features of expert acupuncturists in performing the uniform reducing-reinforcing twirling skill, which differentiates the performances of experts from novices. The assessment and training of this acupuncture skill should focus onthese kinematic features.