关于如何进行针刺得气定性定量判断的思考

Thinking of the Qualitative and Quantitative Measurement of Needling Qi

针灸学理论认为,得气是影响针刺疗效的重要因素之一。得气与否的判断(定性)和得气强弱程度的判断(定量)是得气与效应相关性试验研究中的关键环节之一。该文通过分析国内外相关文献发现,得气定性多以得气感的有无为依据,另有少数研究是以自行划定的得气临界值或范围进行判断;得气定量则分别采用因子分析法、以指数平滑法为基础的MASS指数、加权平均法、得气感得分之和等方法进行判断。该文认为,可将得气分为整体得气和得气感感觉成分两方面,前者主要用于判断得气与否及程度如何,后者主要用于判断该得气感包含哪种感觉成分及其程度。在目前的得气与效应关系研究中,可分别从单穴一次针刺和多穴多次针刺入手,全方位开展得气的定性定量研究,以寻求既能契合针灸学理论又不违背临床实际的得气定性定量判断方法。

Acupuncture-moxibustion theory believes that needling sensation is a crucial factor in influencing acupuncture efficacy. Judgment of occurrence of needling qi （qualitative measurement） and the intensity of needling qi （quantitative measurement） is the key section in studying the relationship between needling qi and efficacy. According to the relevant literatures, the judgment of the occurrence of needling qi mostly depended on the needling sensations, while a small amount of researches mentioned self- determined threshold or range of needling qi; the quantity of needling qi was measured by factor analysis, Massachusetts General Hospital Acupuncture Sensation Scale （MASS） based on exponential smoothing method, weighted average, addition of needling sensation score, etc. This article holds that the needling qi should be divided into two parts： overall needling qi and needling sensation components, the former referring to the occurrence and intensity of needling qi, and the latter for judging the different sensations and intensity. Currently, the studies on needling qi and efficacy should begin with single treatment at single point and multiple treatments at multiple points, to generally estimate the quality and quantity of needling qi, for seeking a qualitative and quantitative measurement in accordance with both acupuncture-moxibustion theory and clinical practice.