对原发性痛经寒凝血瘀证患者任、督、冲三脉经穴热学特性的研究

Thermal characteristics of conception vessel,governor vessel,and thoroughfare vessel acupoints in patients with primary dysmenorrhea with syndrome of cold coagulation and blood stasis

目的探讨原发性痛经(PD)寒凝血瘀证患者任、督、冲三脉经穴的热学特性。方法2020年10月—2021年10月招募受试者,PD寒凝血瘀证组(以下简称“患病组”)42例,脱落7例,最终35例纳入统计;正常组42名。选取躯干部脐水平以下任、督、冲脉经穴和胃经、脾经、膀胱经(第一侧线)经穴。使用红外热像仪观察并比较2组月经来潮前1~3 d、月经来潮第1天和月经结束后第3天各测试点经穴红外辐射温度的变化。结果经前、经期及经后,患病组与正常组腹部检测穴位红外辐射温度差异均无统计学意义(P>0.05)。与正常组比较,患病组月经来潮时督脉的悬枢、命门、腰俞和膀胱经的双侧气海俞、大肠俞、关元俞、中膂俞、白环俞和右肾俞、右膀胱俞、左上髎、左中髎、右下髎、右会阳红外辐射温度降低(P<0.05),月经来潮前膀胱经的双侧中膂俞、会阳和左中髎、左下髎、右白环俞红外辐射温度降低(P<0.05)。月经结束后,患病组腰骶部各检测穴位红外辐射温度与正常组比较,差异均无统计学意义(P>0.05)。结论PD寒凝血瘀证患者呈现特异性反应的穴位主要为循行督脉和膀胱经第一侧线的腰骶部的穴位,表现为红外辐射温度降低,体现了中医学对PD寒凝血瘀证的病因病机认识,提示针灸治疗时,当在此类特异性穴位行温经散寒、化瘀止痛法。

Objective We aimed to investigate the thermal characteristics of conception vessel,governor vessel,and thoroughfare vessel acupoints in patients with primary dysmenorrhea(PD)with syndrome of cold coagulation and blood stasis(hereinafter called“PD”)using infrared thermal imaging technology.Methods Subjects were recruited from October 2020 to October 2021 and divided into the PD group(n=35)and the healthy group(n=42).Conception vessel,governor vessel,and thoroughfare vessel acupoints and bilateral stomach meridian,spleen meridian,and bladder meridian(through the first side line)acupoints below the trunk umbilical level were studied.Infrared thermography was used to observe the changes in infrared radiation at various test points in PD patients 1-3 days before menstruation,on the first day of menstruation,and on the third day after the end of menstruation.Results During the menstrual cycle,infrared radiation of acupuncture points located at abdoman showed no significant difference between the PD group and the healthy group(P>0.05).Compared with the healthy group,during menstruation in the PD group we observed(i)xuánshū(DU5),mìngmén(DU4),and yāoshù(DU2)of the governor vessel and(ii)qìhǎishù(BL24),d1 chángshù(BL25),guānyuánshù(BL26),zhōnglǚshù(BL29),báihuánshù(BL30),shènshù(BL23)(right),pángguāngshù(BL28)(right),sh1 ngliáo(BL31)(left),zhōngliáo(BL33)(left),xi1 liáo(BL34)(right),and huìyáng(BL35)(right)of the bladder meridian,the infrared radiation of the above acupoints was significantly decreased(P<0.05).Before menstruation in the PD group we observed zhōnglǚshù(BL29),huìyáng(BL35),zhōngliáo(BL33)(left),xi1 liáo(BL34)(left),and báihuánshù(BL30)(right)of the bladder meridian,the infrared radiation was significantly reduced(P<0.05).We tested several acupoints in PD patients.No acupoints showed significant difference in infrared radiation between the PD group and the healthy group after menstruation(P>0.05).Conclusion Specific reactions were mainly observed in lumbosacral acupoints following the governor vessel and in the bladder meridian through the first side line.Infrared radiation was decreased,in agreement with the current understanding of the etiology and pathogenesis of cold coagulation and blood stasis syndrome in traditional Chinese medicine.Acupuncture and moxibustion could be used at these specific acupoints to dissipate cold,remove stasis,and relieve pain.