手手相传把脉方法在临床教学中的应用

Application of hand-to-hand pulse-taking methods in clinical teaching

目的通过在实习医师中开展手手相传把脉方法教学专项训练,提高实习医师脉诊实际操作水平。方法以手手相传把脉方法为研究对象,应用操作技能直接观察临床操作技能评估量表在专项教学前、专项教学当场及专项教学后2个月对实习医师把脉方法进行考评。结果经专项教学后,患者的姿势及实习医师的手势均得到明显的改善,3次评估之间的差异两两比较均有显著的统计学意义(P<0.01)。实习医师对患者寸口部位寻找、左右手三指排布的位置、指目触脉的手势、指目触脉深度分层这4项在专项教学前和专项教学后当场、专项教学前和专项教学后2个月之间的差异均有统计学意义(P<0.01);而专项教学后当场和专项教学后2个月之间的差异无统计学意义(P>0.05)。在专项教学后2个月内把脉方法是否正确与专项教学后2个月脉诊操作能力总评呈正相关(P<0.01)。结论手手相传把脉方法专项教学训练,使实习医师能快速应用正确的把脉方法。

Objective To improve the practical skills of pulse diagnosis among intern doctors through specialized training in hand-to-hand pulse-taking methods.Methods Using the hand-to-hand pulse-taking method as the subject,the Clinical Skills Assessment Scale for direct observation of operational skills was employed to evaluate the pulse-taking skills of intern doctors before the specialized training,immediately after the training,and two months post-training.Results After the specialized training,both the posture of the patients and the hand gestures of the intern doctors showed significant improvement,with statistically significant differences observed in the comparisons among the three evaluation periods(P<0.01).Significant differences were also noted in four aspects—locating the patient′s cunkou position,the placement of the three fingers of both hands,the hand gestures of finger-pulse contact,and the depth stratification of finger-pulse contact—between pre-training and immediately post-training,as well as between pre-training and two months post-training(P<0.01).However,there was no significant difference between the evaluations immediately post-training and two months post-training(P>0.05).Correct pulse-taking methods within two months post-training were positively correlated with the overall evaluation of pulse diagnosis operational skills at two months post-training(P<0.01).Conclusion Specialized training in hand-to-hand pulse-taking methods enables intern doctors to quickly apply correct pulse-taking techniques.