文献类型：期刊文献

中文题名：医患者针感性质与穴区组织结构关系探讨

英文题名：Exploration of the relationship between the patient’s and doctor’s needle sensation and the tissue structure of the acupoints area

作者：贾静[1];马重兵[1];王觉[1];严兴科[1]

第一作者：贾静

机构：[1]甘肃中医药大学,兰州730000

第一机构：甘肃中医药大学

年份：2022

卷号：37

期号：10

起止页码：5573

中文期刊名：中华中医药杂志

外文期刊名：China Journal of Traditional Chinese Medicine and Pharmacy

收录：CSTPCD;;北大核心:【北大核心2020】；CSCD:【CSCD2021_2022】；

基金：甘肃省自然科学基金项目(No.21JR1RA266)。

语种：中文

中文关键词：针感;得气;组织结构;患者主观感受;针刺

外文关键词：Needle sensation;Needling response;Tissue structure;Patient’s subjective feeling;Acupuncture

摘要：针感是临床用来判断针刺是否得气的标准之一,穴位局部的组织结构是产生针感的基础,穴区局部的组织结构不同,产生的针感也不尽相同。笔者通过梳理针感的性质,对针感与组织结构之间的对应关系进行分析总结,认为医者针下的跳动性针感与穴位局部的肌肉或神经干受到突发性刺激有关;医者针下的沉紧涩滞感多因穴区结缔组织缠绕针身,或源于穴区局部肌肉中的肌梭感受器受到针体刺激。患者接受针刺时的酸胀感源于穴区局部肌肉、肌腱或骨膜受到针体刺激,而针尖刺激穴区神经干多可使患者产生麻感、蚁行感、跳动感、放射感;毫针刺激到穴区周围的血管或神经末梢可使患者产生痛感;针刺时患者自觉穴区局部的“寒”或“热”感与该区域皮肤中温度感受器和游离神经末梢相关。但由于针感多复合出现,且针感的产生受诸多因素影响,故未来可结合具体影响因素或病种,探索得气针感产生的机制及针感与临床疗效之间的关系,以期为得气针感机制的研究提供一定的参考。
Needle sensation is one of the criteria used clinically to evaluate if acupuncture stimulation elicits deqi.The local tissue structure of the acupoints is the basis for needle sensation. The local tissue structure is varied;resulting needle sensation is not the same. This paper analyzes and summarizes the correspondence between needle sensation and tissue structure by collating different categories of needle sensation, and concludes that the throbbing needle sensation of the practitioner is associated with sudden stimulation of the muscles or nerve trunks in the local area of the acupoints. the sinking and tight sensation of the doctor is mostly due to the connective tissue wrapped around the body of the needle, or from the stimulation of the muscle shuttle receptors in the local muscles of the acupoints by the needle. Patients needle sensation of soreness and swelling mostly originate from the local muscles, tendons or periosteum of the acupuncture point area, which stimulated by the needle body. While the patient’s numbness, ant climbing, throbbing, and radiation sensation are mostly due to the nerve trunk stimulated by the needle tip;and the patient’s ache sensation is due to the stimulation of the blood vessels or nerve endings around the acupoint area by the needle. The localized ‘cold’ or ‘hot’ sensation felt by the patient is related to the temperature receptors and free nerve endings in the skin of the area. However, since needling sensation occurs in various combinations and is influenced by many factors, its mechanism and its relationship with clinical efficacy could be explored future by combining specific influencing factors or disease types, to provide a certain reference for the study of needling sensation mechanism.