妇科相关疾病牵涉痛与穴位敏化的关系

Correlation Between Referred Pain Region and Acupoints Sensitization in Gynecological Diseases

目的观察妇科相关疾病牵涉痛分布区域与穴位敏化的关系,探讨局部区域穴位敏化的规律性分布。方法通过临床试验与动物实验相结合的方法,针对妇科常见病(原发性痛经、盆腔炎、卵巢囊肿等)引发的相应神经支配皮节区域牵涉痛进行探讨。临床研究部分通过自身对照,以触诊法对全身体表皮肤进行探查,观察并统计7所教学医院的934例妇科相关疾病患者体表压痛敏感、皮肤局部区域形态异常改变。动物实验部分,大鼠9只以子宫内注射芥子油作为模型组,另有大鼠6只注射生理盐水为对照组,比较两组大鼠尾静脉注射伊文思蓝后体表蓝色渗出点部位及个数。结果妇科相关疾病患者体表牵涉痛及皮肤局部组织结构异常表现多分布于下腹部(59. 04%)、双下肢内侧(52. 97%)、腰背部及骶部(49. 18%),与穴位重叠或临近。子宫炎模型大鼠体表渗出点亦集中于下腹部、双下肢、腰背部及骶部。结论妇科相关疾病的靶器官(子宫、卵巢)发生病变时,其相应节段(T10-S1)神经支配的体表区域出现规律性的敏化反应。

Objective To observe the relationship between the distribution areas of referred pain and acupoints sensitization in gynecological diseases,and to explore the regular distribution of acupoints sensitization in local areas.Methods Through the combination of clinical trials and animal experiments,the pain of the corresponding innervation dermatome region caused by primary dysmenorrhea,pelvic inflammatory disease and ovarian cysts was discussed.In the self-control clinical research,the whole body surface skin was explored by palpation method,and the surface tenderness sensation and abnormal changes in local area of 934 cases of gynecological related diseases in 7 teaching hospitals were observed and counted. In the animal experiment,9 rats were injected intrauterine injection of mustard oil as the model group,and other 6 rats were injected with normal saline as the control group. The number and parts of blue spots in the 2 groups of rats after being injected with Evans blue in the tail vein were compared. Results The gynecological diseases involved in the body surface pain and skin tissue abnormalities were mostly distributed in the lower abdomen( 59. 04%),the inside of the lower limbs( 52. 97%),the lower back and the sacral region( 49. 18%),overlapping or adjacent to the acupuncture points. The surface exudation points of the model rats with hysteritis were also concentrated in the lower abdomen,the lower limbs,the lower back and the sacral region.Conclusion When disease of the target organs such as uterus,ovary occur,the sensitization reaction of the surface of the corresponding segment( T10-S1) innervation occurs regularly.