腰部针灸取穴的一种新方法探析

Discussion and Analysis of A Novel Method for Lumbar Acupoint Location in Acupuncture-moxibustion

目的研究健康成年人腰椎棘突高度差异的规律,提出新的腰部针灸取穴方法。方法选取健康成年志愿者32名(男性11名、女性21名),由检查者应用棘突高度定位法,对其进行L3棘突的体表定位并进行标记,再拍摄腰部CT,然后观察L3棘突的体表触诊定位准确率;同时通过CT三维重建测量L1~L5的棘突高度,并对其测量结果进行统计分析。结果87.5%(28名)的被检者可以准确定位在L3,而12.5%(4名,3女1男)的被检者体表触诊定位在L2。L3与L4和L4与L5的棘突高度差异存在统计学意义(P<0.05);棘突高度女性比男性低,但是两者间差异无统计学意义(P>0.05)。结论通过总结腰椎各棘突高度的差异,得出棘突高度在矢状面上的规律为L2≈L3>L4>L5,为临床针灸取穴提供一种简易可行的腰椎定位方法。

Objective To study the rule of the height variation of lumbar spinous process between healthy adults and to put forward a novel method for lumbar acupoint location in acupuncture-moxibustion.Method Thirty-two healthy adult volunteers(11 males and 21 females)were recruited.The examiner located and marked the L3 spinous process on the body surface using the locating method based on spinous process height,followed by CT scan of the lower back to observe the accuracy rate of the location of L3 spinous process on the body surface by palpation.The spinous process height from L1 to L5 was also measured using the three-dimensional CT reconstruction.The measurement results were statistically analyzed.Result The location of L3 was correctly identified in 87.5%of the 28 subjects,while 12.5%(4 subjects including 3 females and one male)of the subjects got the L3 marked at L2.There were significant differences in the spinous process height between L3 and L4,and between L4 and L5(P<0.05);the spinous process was lower in females than in males but the difference was statistically insignificant(P>0.05).Conclusion According to the variation in the height of lumbar spinous processes,the pattern of the spinous process height in the sagittal plane can be concluded as L2≈L3>L4>L5,which provides an easy-to-operate lumbar vertebrae location method for locating acupoints in acupuncture-moxibustion treatment in clinical practice.