부산대학교 도서관

目的：应用 Flir-SC620型红外热像仪,观察针刺三阴交穴对寒湿凝滞型原发性痛经患者关元和三阴交穴体表温度的影响,分析寒湿凝滞型痛经患者关元和三阴交穴体表温度变化可否作为寒湿凝滞型痛经的辅助诊断依据及针刺效应和针刺得气效应的客观指标。方法纳入6例健康受试者及30例痛经患者,分为健康对照组、寒凝对照组、期望得气组和期望不得气组。两对照组不予针刺,期望得气组与期望不得气组均针刺双侧三阴交穴30 min,记录针感。应用红外热像仪检测各组关元穴、双侧三阴交穴体表温度40 min,每10 min 记录1次,并计算出0～10 min、10～20 min、20～30 min、30～40 min 及0～30 min、0～40 min 等各时段温度。依据得气感的有无判断实际是否得气,并将期望得气组分为期望得气实际得气组(以下简称期得实得组)和期望得气实际未得气组(以下简称期得实未得组)；将期望不得气组分为期望不得气实际得气组(以下简称期不得实得组)和期望不得气实际未得气组(以下简称期不得实未得组)。应用 SPSS17.0统计软件,采用重复测量方差分析法对相关数据进行统计。结果与健康对照组(6例)比较,寒凝对照组(6例)关元穴在0～30 min 及0～40 min 时段温度显著降低(P＜0.05)；左侧三阴交穴在0～40 min 时段温度显著降低(P＜0.05),左、右侧三阴交穴在30～40 min 时段温度均显著降低(P＜0.05)。与寒凝对照组比较,期得实得组(12例)及期不得实得组(11例)关元穴在0～30 min 及0～40 min 时段温度显著升高(P＜0.05)；期不得实得组左侧三阴交穴在0～40 min 时段温度显著升高(P＜0.05),左、右侧三阴交穴在30～40 min时段温度均显著升高(P＜0.05)。期得实未得组患者有0例,期不得实未得组患者仅1例,无法统计。结论初步认为,关元和三阴交穴体表红外热像温度降低可以作为辅助诊断寒凝型痛经的临床诊断依据之一。关元穴体表红外热像温度升高可以作为三阴交穴针刺效应循经特异性的客观指标之一。
Objective By using infrared thermal imager (Flir-SC620), to observe the effect of needling Sanyinjiao (SP6) on the skin temperature at Guanyuan (CV4) and Sanyinjiao in patients with primary dysmenorrhea (PD) of cold and dampness stagnation pattern, and to explore the probability of using infrared thermal imaging for diagnosis and as an objective index for evaluating the action and needling qi of acupuncture. Method Thirty-six subjects were recruited and divided into four group, a health control group (group A), a control group of PD of cold and dampness stagnation pattern (group B), a needling-qi-expected group (group C) and a needling-qi-unexpected group (group D). Group A and B were not given acupuncture treatment, while group C and D were treated with acupuncture at bilateral Sanyinjiao with needles retained for 30 min, and the needling sensations were recorded. The infrared thermal imager was used to detect the skin temperature at Guanyuan and bilateral Sanyinjiao for 40 min for each group, and the temperature was recorded every 10 min. The temperature during different periods of time, 0-10 min, 20-20 min, 20-30 min, 30-40 min, 0-30 min, and 0-40 min were then calculated. In group C, those obtained the needling qi sensation were further grouped into C-1 and those didn’t obtain the sensation were into C-2; in group D, those obtained needling qi sensation were further grouped into D-1 and those didn’t obtain the sensation were into D-2. SPSS 17.0 was adopted for data processing, and the data were analyzed by using MANOVA of repeated measuring. Result Compared to group A (6 cases), the temperature at Guanyuan in group B (6 cases) was significantly decreased during 0-30 min and 0-40 min (P<0.05), the temperature at the left Sanyinjiao during 0-40 min in group B was significantly decreased (P<0.05), and the temperatures at bilateral Sanyinjiao during 30-40 min in group B significantly dropped (P<0.05). Compared to group B, the temperatures at Guanyuan during 0-30 min and 0-40 min in group C1 (12 cases) and group D1 (11 cases) were significantly increased (P<0.05), the temperature at left Sanyinjiao during 0-40 min in group D1 was significantly increased (P<0.05), and the temperatures at bilateral Sanyinjiao during 30-40 min in group D1 were significantly increased (P<0.05). There was no case in group C2 and only 1 case in group D2, hence, the data were not enough for analysis. Conclusion Decrease of the infrared temperature at Guanyuan and Sanyinjiao can be taken as one of the diagnostic criteria for dysmenorrhea of cold stagnation pattern. Increase of the infrared temperature at Guanyuan can be regarded as one of the objective evidences for the along-meridian transmission characteristic in needling Sanyinjiao.