基于经络知热感度测定法探究原穴在失眠证型辨识中的应用

Exploring Application of Yuan-Source Points in Identification of InsomniaSyndromes Based on Measurement of Thermal Sensitivity of Meridians

目的:运用经络知热感度测定法测量十二正经原穴在各证型失眠患者中的热敏状态及经络虚实变化,探究原穴在失眠证型辨识中的应用。方法:对符合原发性失眠标准的72例患者进行中医辨证分型,运用经络知热感度测定法测定其十二经原穴的测量值、中位数、热敏系数及不均衡点出现率,归纳总结其阳性穴位点,探究不同证型经络虚实的改变情况。结果:本研究纳入的失眠患者中证型分布以心脾两虚为主,肝火扰心次之。测量值方面,心脾两虚证与肝火扰心证患者的原穴在合谷、神门、大陵、太溪、京骨及冲阳穴差异有统计学意义(P<0.05),心脾两虚型测量值的平均水平均高于肝火扰心型;热敏系数方面,两组的热敏系数在合谷、神门、大陵、太溪、太冲及冲阳穴差异有统计学意义(P<0.05),心脾两虚证失眠患者合谷、神门、大陵、太溪及冲阳穴热敏系数的平均水平高于肝火扰心证,肝火扰心证失眠患者在太冲穴的热敏系数高于心脾两虚证;不均衡点出现率方面,两证型在腕骨、阳池、神门及冲阳穴的不均衡穴点出现率差异存在统计学意义(P<0.05);在经络的虚实改变上,心脾两虚证经络改变以虚寒为主,肝火扰心证以实热为主。结论:原穴的热敏状态可为探察经络虚实改变、辨别失眠证型及指导治疗选穴提供参考依据。

Objective:To measure the thermal sensitivity status of the Yuan-source points of 12 normal meridians in patients with insomnia of different patterns and the deficient or excessive changes of meridians,thus to explore the application of Yuan-source points in the pattern identification of insomnia.Methods:In the TCM syndrome differentiation of 72 patients,who met the criteria of primary insomnia,the measurement value,median,thermal sensitivity coefficient and unbalanced point occurrence rate of the 12 Yuan-source points were determined by measurement of thermal sensitivity of meridians.The positive points were summarized to explore the deficient or excessive changes of different meridians.Results:The syndrome distribution in insomnia patients included in this study was mainly deficiency of Heart and Spleen,followed by Liver-fire disturbance.In terms of measured values,there were statistical differences in the Yuan-source points of Hegu(LI4),Shenmen(HT7),Daling(PC7),Taixi(KI3),Jinggu(BL64)and Chongyang(ST42)between the deficiency syndrome of Heart and Spleen and the syndrome of Liver-fire disturbance(P<0.05),and the average values of the deficiency syndrome of Heart and Spleen were higher than those of the syndrome of Liver-fire disturbance.In terms of heat sensitivity coefficient,there were statistical differences in LI4,HT7,PC7,KI3,Taichong(LR3)and ST42 between the two syndromes(P<0.05);the heat sensitivity coefficients of LI4,HT7,PC7,KI3 and ST42 were higher in the deficiency syndrome of Heart and Spleen than those in the syndrome of Liver-fire disturbance,however,the heat sensitivity coefficient of LR3 was higher in the syndrome of Liver-fire disturbance than that in the deficiency syndrome of Heart and Spleen.In terms of the occurrence rate of unbalanced points,there were statistical differences in Wangu(SI4),Yangchi(SJ4),HT7 and ST42 between the two syndromes(P<0.05).In terms of the deficient or excessive changes of meridians,the Heart-Spleen deficiency syndrome was mainly manifested with deficiency-cold,and Liver-fire disturbance was mainly manifested with excessive-heat.Conclusion:The heat-sensitive state of the Yuan-source points can provide a reference for exploring the deficient or excessive changes of meridians,identifying insomnia syndrome and guiding the points selection.