基于健康受试者的膝关节相关腧穴痛阈量化的观察研究

Quantitative Observation of Pain Threshold of Acupoints Related to Knee Joint for Healthy People

目的通过测量健康受试者膝关节相关腧穴的机械痛阈和压痛阈,分析生理状态下穴位的痛阈特征,为构建膝骨性关节炎的穴位痛敏化诊断界值提供正常参考范围。方法采用Von Frey检测仪和WAGNER压痛仪对120例健康膝关节周围19个相关穴位进行痛阈检测,采集穴位的平均机械痛阈值和压痛阈值,分析膝关节相关穴位的痛阈表现特征。结果健康人膝关节相关穴位的机械痛阈与压痛阈表现特征一致,总体机械痛阈参考范围为51.33~53.66 g,总体压痛阈参考范围为2374.24~2500.38 gf,腰背部穴区的痛阈最高,下肢偏低;三个穴区的压痛阈差异均具有统计学意义(P<0.05);下肢远端穴区与腰背部穴区、膝关节穴区的机械痛阈差异均具有统计学意义(P<0.05),腰背部穴区与膝关节穴区机械痛阈差异无明显统计学意义(P>0.05);膝关节局部足三阴经痛阈明显低于足三阳经(P<0.05)。结论健康人膝关节相关腧穴的整体痛阈取值幅度小,痛阈呈现向心性升高的趋势,膝关节局部痛敏化现象呈现循经特异性。

Objective To detect the mechanical pain threshold and pressure pain threshold(PPT)of relevant acupoints of the knee joints of healthy people,analyze the pain threshold characteristics of acupoints in physiological state,and provide a normal reference range for the establishment of acupoints pain threshold sensitization diagnosis of knee osteoarthritis.Methods The pain threshold of 19 related acupoints of 120 healthy people’s knee joints was detected by using Von Frey detector and Wagner tenderness instrument,and the average mechanical pain threshold and PPT of acupoints were collected to analyze the pain threshold characteristics of related acupoints of knee joints.Results The mechanical pain threshold of the related acupoints of knee joint in healthy people was consistent with the characteristics of PPT.The range of mechanical pain threshold and PPT was 51.33~53.66 g and 2374.24~2500.38 gf respectively.The pain threshold in the lumbar and back area was the highest,while that in the lower extremities was low.The differences of PPT between three areas were statistically significant(P<0.05).The mechanical pain threshold of the distal lower extremities was significantly different from the lumbar and back area and the knee joint area(P<0.05),but the mechanical pain threshold between lumbar and back area and knee joint area had no difference(P>0.05).For knee joint area,the pain threshold of three yin meridians was significantly lower than three yang meridians(P<0.05).Conclusion The overall pain threshold of relevant acupoints of the knee in healthy people was small,and the pain threshold showed a characteristic of centripetal elevation,while the pain threshold of the knee joint area showed a specificity of meridian circulation.