家兔前肢少阴经五输穴穴区解剖及CT三维重建

Anatomical observation and CT three-dimensional reconstruction of Five-shu acupoints of Shaoyin Heart Meridian in rabbit’s forelimb

目的:探讨家兔前肢少阴经五输穴“少冲”“少府”“神门”“灵道”“少海”的定位及穴区形态结构。方法:家兔16只,雌雄各半。参考人体腧穴定位国家标准及家兔腧穴定位文献,运用比较解剖学的方法,明确家兔前肢少阴经五输穴的定位、针刺操作;然后针刺腧穴并进行穴区CT三维重建;再处死家兔行血管灌注,将针灸针分别刺入家兔前肢少阴经五输穴,解剖后观测针灸针与周围组织结构的关系。结果:“少冲”定位在前肢小指内侧,爪甲根角侧旁1 mm处;毗邻结构为指浅屈肌腱,第5指掌侧固有动、静脉背支,尺神经的指掌侧固有神经背支末梢。“少府”定位在前肢掌侧,横平第5掌指关节近端,第4、5掌骨间;毗邻结构为蚓状肌,第4、5指骨间肌,指掌侧总动、静脉和尺神经的指掌侧固有神经。“神门”定位在尺侧腕伸肌腱的内侧缘,当尺骨远端与尺腕骨之间;毗邻结构为尺侧腕屈肌腱、尺侧腕伸肌腱、尺动脉、尺静脉、尺神经。“灵道”定位在前肢掌侧,尺侧腕伸肌腱的内侧缘,“神门”上1.5寸;毗邻结构为尺侧腕伸肌、尺侧腕屈肌、指浅屈肌、指深屈肌、尺动脉、尺静脉、尺神经。“少海”定位在肘关节内侧,曲肘90°,臂骨内侧髁前方凹陷中;毗邻结构为旋前圆肌、臂二头肌、臂动脉、臂静脉、桡侧副动脉、桡侧副静脉、前臂内侧皮神经、正中神经。结论:家兔前肢少阴经五输穴与臂动脉及分支、臂静脉及属支、头静脉及属支、前臂内侧皮神经、正中神经和尺神经有密切关系,这可能是上述5个腧穴的形态学基础。

Objective To investigate the location and anatomical structure of“Shaochong”(HT9),“Shaofu”(HT8),“Shenmen”(HT7),“Lingdao”(HT4)and“Shaohai”(HT3)in the rabbit's forelimb.Methods Sixteen rabbits(half male and half female)were used in the present study.By referring to the national standards on the location of acupoints in the human body and the literature about the location of acupoints in the rabbit,and by using the method of comparative anatomy,the location and needling operation of the Five-shu acupoints of Shaoyin Heart Meridian on the rabbit's forelimb were defined,and these acupoints were needled and CT three-dimensional reconstruction were conducted.Then,the rabbits were killed,and intravascular perfusion was performed,followed by inserting acupuncture needles into these five acupoints for observing the anatomical relationship between the inserted acupuncture needle and the structure of surrounding tissues.Results HT9 is located at the medial side of the little finger of forelimb,about 1 mm beside the nail root,and is adjacent to the superficial flexor tendon of the finger,the dorsal branches of the proper palmar digital artery and vein,and the endings of dorsal branch of palmar digital proper nerve of the ulnar nerve on the fifth finger side.HT8 is located at the palm side of the forelimb,horizontally parallel to the proximal end of the 5th metacarpophalangeal joint and between the 4th and 5th metacarpal bones,and is adjacent to the lumbricalis,the 4th and 5th interossei,and common palmar digital artery and vein and the palmar digital proper nerve of the ulnar nerve.HT7 is located at the medial margin of the extensor carpal tendon on the ulnar side,between the distal end of the ulna and the ulnar carpal bone,and is adjacent to the tendons of flexor carpi ulnaris and extensor carpi ulnaris,ulnar artery,ulnar vein and ulnar nerve.HT4 is located at the medial border of the ulnar flexor tendon,about 1.5 cun superior to HT7,and is adjacent to extensor carpi ulnaris,flexor carpi ulnaris,flexor digitorum superficialis,flexor digitorum profundus,ulnar artery,vein and ulnar nerve.HT3 is located at the depression,medial to the condyle of humerus when the elbow is bent at 90°,its neighbor structure is composed of pronator teres,biceps brachii,brachial artery and vein,radial collateral artery,radial collateral vein,medial antebrachial cutaneous nerve and median nerve.Conclusion In the rabbit,there is a close relationship between HT9,HT8,HT7,HT4 and HT3 regions and brachial vascular and its branches,cephalic vein and its branches,medial antebrachial cutaneous nerve,median nerve and ulnar nerve,which is the morphological basis of the Five-shu acupoints of Shaoyin Heart Meridian for treating some related clinical disorders.