针刺前后得气感的定性与定量认识初探--一份来自华西医学院的研究报告

Primary discussion of qualitative and quantitative recognition on deqi after acupuncture:a study report of West China School of Medicine

目的:明确医学生对针刺得气感的认识,揭示得气感定性与定量的规律,了解其是否为影响针刺疗法临床运用的因素。方法:以随堂问卷的形式对华西临床医学班的86名健康学生针刺合谷穴或足三里穴前后理解和体会到的得气感进行调查研究。结果:1得气是一种较为复杂的复合性感觉,具有胀痛、胀满感、疼痛等多种感觉特性;2得气是一种轻中度的感受,麻省总医院针感量表(MASS)10分制评分中只有胀痛感(4.69±2.83)、胀满感(4.39±2.91)、酸胀感(3.93±2.93)达到中度5分左右的感受分值,而其余刺痛(1.89±2.02)等感觉多在2分左右,为轻度的感受;3针刺前后刺痛感、胀痛感、胀满感、酸胀感等得气定量评分比较差异有统计学意义(均P<0.05)。结论:针刺得气感是一种以"胀、酸、痛、麻"为主的轻中度复杂感觉;作为侵入性治疗,毫针刺入机体会对受试者心理造成一定影响,这种主观感受可能成为患者选择针刺治疗的影响因素。

Objective To determine the recognition of healthy medical students on deqi after acupuncture, reveal the qualitative and quantitative rules of deqi and understand whether these rules are the factors of the clinical application of acupuncture therapy. Methods The class questionnaires were used for the investigation study on the understanding of deqi after acupuncture at Hegu （LI 4） or Zusanli （ST 36） in 86 healthy students in the clinical medicine class. Results ①Deqi was a kind of complicated compound feelings, with many sensation qualities such as distending pain, distension and pain. ②Deqi was a kind of mild and moderate sensations. In 10-score credit system of Massachusetts General Hospital acupuncture sensation scale （MASS）, the scores of distending pain （4. 69 ± 2.83）, distension （4.39±2.91） and soreness and distension （3.93±2.93） were around 5 （moderate degree）, the scores of stabbing pain （1.89±2.02） were around 2 （mild degree）. ③The differences in the quantitative scores were significant for stabbing pain, distending pain, distention, soreness and distention and the others before and after treatment （all P〈0.05）. Conclusion Deqi of acupuncture is the mild and moderate complicated sensations manifested as distension, soreness, pain and numbness. As the invasive therapy, the filiform needle puncture will bring a certain psychological impacts on the receptors. The subjective sensation is possibly the factor for the pa- tients＇ selection of acupuncture treatment.