针刺“得气”的临床研究

发布时间：2019-03-05 19:05

【摘要】：目的针灸得气被当作针灸治疗的疗效基础,随着当前对针灸理论体系研究的深入,人们越来越重视针灸得气的问题,就目前情况而言,对于“在什么情况下能够快速得气”的问题,还没有明确的理论依据来指导临床治疗。本研究通过对临床中进行针灸治疗时出现得气的现象进行记录分析,探讨针刺得气的条件及其机制,从而为“如何实现快速得气”提供理论依据。方法本研究属于临床研究,共收集516例自2015年5月至2016年12月以来在煤炭总医院针灸科门诊治疗的病例,记录穴位针刺的得气情况,详细记录其针刺深度、行针手法、得气感觉(酸、麻、胀、痛、过电感等)、传导方向等。结果1不同针感出现频率不同:胀感出现的频率最高;其次为酸感、过电感,再次为麻感;其中痛感出现频率较少,但在临床中也有出现;然而重感、凉感、蚁行感几乎没有出现。2部位不同,针刺深度不同:头面、颈部针刺深度至少达到0.8寸时更容易出现得气;躯干、四肢针刺深度至少达到1.3寸时,更易得气;针刺后加入行针手法比单纯针刺更容易得气,直刺得气的次数要多于斜刺。3不同疾病对针刺得气会产生影响:与单纯患有腰椎间盘突出患者相比,同时患有糖尿病的患者敏感性降低,穴位得气率明显降低;风湿性关节炎患者疼痛阈值降低,疼痛敏感性增强,针刺得气率高于仅患有腰椎间盘突出的患者。结论通过对结果的分析,总结出了易得气的几种情况:在头颈部针刺深度至少0.8寸,躯干和四肢针刺深度至少1.3寸时更易得气,深刺比浅刺易得气;在针刺过程中加入补泻手法会增加得气出现率;针刺穴位周围神经血管丰富的易得气;病人机体状态对得气的出现亦有影响,例如患有风湿性关节炎的患者更容易得气,糖尿病患者不易得气等。通过以上这些研究结论,希望为临床治疗提供更为清晰明确的理论依据,提高针灸治疗的得气出现频率。
[Abstract]:Objective Acupuncture and moxibustion to obtain Qi is regarded as the curative effect foundation of acupuncture and moxibustion treatment. With the thorough research of acupuncture and moxibustion theory system, people pay more and more attention to the problem of acupuncture and moxibustion gaining Qi, as far as the current situation is concerned, There is no clear theoretical basis to guide clinical treatment. By recording and analyzing the phenomenon of Qi recovery during acupuncture and moxibustion treatment in clinic, this study discussed the condition and mechanism of acupuncture in order to provide a theoretical basis for "how to achieve rapid Qi gain". Methods from May 2015 to December 2016, 516 cases treated in the outpatient department of acupuncture department of Coal General Hospital from May 2015 to December 2016 were collected, and the Qi gain of acupuncture points was recorded, the depth of acupuncture and the manipulation of acupuncture were recorded in detail. Gas sensation (acid, hemp, distension, pain, over inductance, etc.), conduction direction, etc. Results 1the frequency of different needle sensation was different: the frequency of swelling was the highest, followed by acid sensation, over inductance and anaesthesia again, among which the frequency of pain sensation was less, but it also appeared in clinic. However, heavy sense, cool feeling, ant feeling hardly appear. 2 different parts, different needle depth: head, neck acupuncture depth of at least 0.8 inches is more prone to appear gas; Trunk, limbs acupuncture depth of at least 1.3 inches, it is easier to get gas; After acupuncture, acupuncture manipulation is easier to get gas than simple acupuncture, and the frequency of direct needling is more than that of oblique acupuncture. 3 different diseases can affect acupuncture qi: compared with patients with simple lumbar disc herniation, the number of times of direct needling is more frequent than that of oblique acupuncture. At the same time, the sensitivity of patients with diabetes mellitus was decreased, and the rate of acupoint qi recovery was significantly decreased. The pain threshold decreased and the pain sensitivity increased in patients with rheumatic arthritis. The rate of acupuncture pneumaticity was higher than that in patients with prolapse of lumbar intervertebral disc. Conclusion through the analysis of the results, it is concluded that when the depth of acupuncture is at least 0.8 inches in the head and neck, the depth of acupuncture in the trunk and limbs is at least 1.3 inches, it is easier to get gas when the depth of acupuncture in the trunk and limbs is at least 1.3 inches, and it is easier to get gas in deep acupuncture than in shallow acupuncture. In the process of acupuncture, the occurrence rate of qi can be increased by adding reinforcing and purging manipulation, and the abundant blood vessels of peripheral nerve and blood vessel of acupuncture point are easy to get gas. The condition of the patient also affects the appearance of qi, for example, the patients with rheumatoid arthritis are more likely to get the breath, and the diabetic patients are not easy to get the breath, and so on. Through the above conclusions, we hope to provide more clear and clear theoretical basis for clinical treatment, and improve the frequency of acupuncture treatment.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246

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