基于影像解剖的肾俞穴针刺危险深度研究

Study of the Dangerous Needling Depth of Shenshu(BL23)Based on Imaging Anatomy

目的应用磁共振影像,分析肾俞穴解剖结构和进针层次,测量针刺危险深度,明确危险深度与体型的关系,为肾俞穴的针刺安全提供依据,为肾俞穴的临床应用提供参考,为针刺量效关系的探讨提供基础数据。方法用磁共振仪采集140例健康成年志愿者肾俞穴的断面图像,分析解剖结构,测量肾俞穴直刺危险深度。结果左右肾俞穴直刺时的平均危险深度值,男性分别为(10.0±1.1)cm、(9.9±1.2)cm,女性分别为(8.0±1.2)cm、(8.1±1.2)cm。危险深度值与体型显著正相关;左、右肾俞平均危险深度,肥胖者分别为(11.2±1.0)cm、(11.5±1.3)cm,超重者为(10.3±1.0)cm、(10.3±1.0)cm,正常者为(8.8±1.7)cm、(8.9±1.1)cm,过轻者为(7.0±1.0)cm、(7.1±1.0)cm;男性体质量指数正常者的肾俞穴危险深度值显著大于女性(P<0.01)。结论肾俞穴常规针刺深度直刺0.5~1寸,即使对体型过轻者,也具有极高安全性。对体型正常、超重、肥胖者,根据临床需要还可适度增加1~1.5寸。

Objective To measure the dangerous needling depth and determine its correlation with the physique by analyzing the anatomic structure and needle insertion layers of Shenshu(BL23)acupoint using magnetic resonance imaging(MRI),and to provide evidence for the needling safety of Shenshu,provide references for the clinical application of Shenshu,and offer basic data to discuss the dose-effect relationship in acupuncture.Method The sectional images of Shenshu acupoint were collected from 140 healthy adult volunteers using the MRI scanner to analyze the anatomical structure and measure the dangerous depth of perpendicular needling at this point.Result The average dangerous depth of perpendicular needling at Shenshu was(10.0±1.1)cm on the left side and(9.9±1.2)cm on the right side in males,and(8.0±1.2)cm on the left side and(8.1±1.2)cm on the right side in females.There was a positive correlation between the dangerous depth and the physique.The average dangerous needling depth was(11.2±1.0)cm on the left side and(11.5±1.3)cm on the right side in obese subjects,(10.3±1.0)cm and(10.3±1.0)cm in those overweight,(8.8±1.7)cm and(8.9±1.1)cm in those with a normal weight,and(7.0±1.0)cm and(7.1±1.0)cm in those underweight.The dangerous needling depth at Shenshu was significantly larger in males with a normal body mass index than in females(P<0.01).Conclusion The conventional depth in perpendicular acupuncture at Shenshu is 0.5-1 Cun,which is safe even for underweight people and can be properly increased 1-1.5 Cun for those with a normal weight,and overweight and obese people.