针刺对不同体质人群痛阈效应研究

Effect of acupuncture for pain threshold among the groups of different constitutions

目的:观察9种不同中医体质人群在各时间点针刺痛阈效应差异,评价针刺对不同体质人群的作用。方法:采用横断面法对600例受试者进行中医体质调查,判定调查对象的中医体质类型(分为平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质9型)。对9种体质受试者均取左侧足三里穴予以均等手法针刺,留针30min。采用2390型Von Frey测痛仪于针刺前、针刺得气即刻、留针10min、留针30min、出针后15min各时间点测定受试者压痛阈值。结果:体质和时间点之间存在交互作用(P<0.05);9种体质人群针刺得气即刻(除血瘀质、气郁质、特禀质外)、留针10min、留针30min各时间点痛阈值较针刺前上升(P<0.01),且在留针30min时上升最为显著;出针后15min,仅平和质、湿热质人群痛阈值与针刺前比较差异有统计学意义(均P<0.01)。留针10min、留针30min时,与平和质相比,其他偏颇体质人群痛阈改变率明显偏低(均P<0.05)。结论:针刺足三里穴对不同体质人群的作用不同,其效应维持时间也不同。

Objective To observe the difference in acupuncture for pain threshold at different time points among the groups of 9 TCM constitutions.Methods The cross-sectional survey was adopted to investigate TCM constitutions among 600 subjects and determine 9 TCM constitution types（neutral constitution,qi-deficiency constitution,yang-deficiency constitution,yin-deficiency constitution,phlegm-damp constitution,damp-heat constitution,blood-stagnation constitution,qi-stagnation constitution,special diathesis constitution）.The same acupuncture manipulation was applied to Zusanli（ST 36）on the left side in the subjects and the needle was retained for 30 min.The tenderness threshold was detected with 2390 type Von Frey apparatus at different time points,named before acupuncture,at the moment after qi arrival,in 10 min of needle retaining,in 30 min of needle retaining and in 15 min after needle withdrawal in the subjects of 9 TCM constitutions.Results The interactive effect happened between the constitution type and time point（P〈0.05）.Among the groups of 9 TCM constitutions,the pain threshold values at the moment after qi arrival（except blood-stagnation constitution,qi-stagnation constitution,special diathesis constitution）,in 10 min of needle retaining and in 30 min of needle retaining were increased as compared with those before acupuncture separately（P〈0.01）,among which,the value increase was the most significant in 30 min of needle retaining.The differences in the pain thresholds were significant in 15 min after needle withdrawal in the groups of neutral constitution and damp-heat constitution as compared with those before acupuncture（both P〈0.01）.In 10 min of needle retaining and in 30 min of needle retaining,as compared with the group of neutral constitution,the changes in pain thresholds of the rest abnormal constitutions were apparently lower（all P〈0.05）.Conclusion Acupuncture at Zusanli（ST 36）presents different effects among the groups of different constitution types.The effect maintaining durations are different.