穴位低电阻特性在贝尔面瘫的观察

【作者】 黄健；

【导师】 沈卫东；

【作者基本信息】 上海中医药大学 ， 中医学（专业学位）， 2019， 硕士

【摘要】 目的:通过测量观察贝尔面瘫患者以及正常人的左右手部原穴、井穴、以及3个非穴位点的皮肤电阻,分析探讨贝尔面瘫患者与正常人之间以及面瘫患者治疗前后的手部测试点的皮肤电阻相关性。为穴位皮肤电学特性的进一步研究提供拓展性思路,为贝尔面瘫的诊治提供依据,并为中医治未病的特色提供现代科学的支持。方法:本研究从2018年9月到2019年3月收集了在上海中医药大学附属曙光医院针灸科病房就诊符合本研究诊断标准和纳入标准的60名患者作为治疗组;从社区招募符合正常人纳入标准的60人作为对照组,使用Fluke万用表测量手部各个经络的6个井穴、6个原穴以及3个非穴位测试点(详见正文)的相关皮肤电阻。对住院治疗病人进行以针灸为主的综合治疗,对于阶段治疗结束的病人进行皮肤电阻的第二次测试作分析。结果:1.治疗组58人(2人脱落)与对照组60人比较显示:1.1.右侧面瘫患者右手太渊、大陵、神门和左手的中冲穴以及左侧面瘫患者左手合谷、太渊的皮肤电阻值小于对照组的数据,P<0.05,差异具有统计学意义。1.2.左侧面瘫患者的少商,拇指尺侧非穴测试点,商阳,无名指桡侧非穴测试点,少冲,合谷和腕骨(共7对)的皮肤电阻左右比小于对照组的,右侧面瘫患者的少泽和阳池(共2对)左右比大于对照组的,P<0.05,差异具有统计学意义。1.3.分析右利手的52名患者和53名正常人数据,得出一致的统计结果。2.治疗组治疗前后的数据比较显示:2.1.治疗组治疗前的少商,拇指尺侧非穴测试点,商阳,食指尺侧非穴测试点,少冲,少泽,阳池,太渊和神门(共9对)的皮肤电阻患健比小于治疗后的数值,P<0.05,差异具有统计学意义。2.2.右面瘫患者治疗前的少商,拇指尺侧非穴测试点,商阳,食指尺侧非穴测试点,关冲,少冲,少泽,阳池,腕骨和神门(共10对)的皮肤电阻患健比小于治疗后的数值,P<0.05,差异具有统计学意义。左面瘫患者数据分析结果均无统计学差异。2.3.右利手右面瘫患者治疗前的少商,拇指尺侧非穴测试点,商阳,食指尺侧非穴测试点,无名指桡侧非穴测试点,少冲,阳池和腕骨(共8对)的皮肤电阻患健比小于治疗后的数值,P<0.05,差异具有统计学意义。右利手左面瘫患者数据分析结果均无统计学差异。结论:1.左侧面瘫患者左手合谷和太渊以及右侧面瘫患者右手太渊、大陵、神门共5个原穴和1个井穴,右面瘫左手中冲,的穴位电阻低于对照组数据。2.面瘫患病状况可以反映在经穴电阻左右比,左面瘫患者的少商、商阳、少冲、合谷和腕骨穴位以及拇指尺侧和无名指桡侧非穴测试点的电阻左右比值低于正常人,右面瘫患者少泽和阳池穴位的电阻左右比值高于正常人,即患侧电阻相对健侧的变得较低。3.面瘫患者治疗后的皮肤电阻患健比高于治疗前的数值,即康复治疗后患侧电阻相对健侧的恢复得更多。4.右利手人群右侧肢体经络活动较多,左侧肢体经络活动较少,当罹患单侧面瘫时人体经穴电阻特性受右侧面瘫影响比左侧面瘫的小。5.右利手人群在康复治疗过程中,右侧面瘫患者患侧经穴电阻特性恢复比左侧面瘫患者的更明显。更多还原

【Abstract】 Objective: To measure the skin resistance on Jing acupoints,Yuan acupoints and 3 non-acupoints located on the hands of both Bell palsy(BP)patients and normal people,to analyze and investigate the correlation between the collected data of BP patients and those of the normal people as well the changes between the pre-treatment data and post-treatment data.The purpose is to develop new methods for the study of the electrical characteristics of certain acupoints,to collect evidence for the Bell palsy diagnosis and treatment,and to provide modern scientific support to implement the Traditional Chinese Medicine(TCM)concept of early prevention of related disease,eventually.Methods: This study included 60 hospitalized BP patients who met the treatment group inclusion criteria in Shanghai Shuguang Hospital Department of Acupuncture from September 2018 to March 2019.60 normal people who met the control group inclusion criteria were collected in the communities.For both groups,skin resistance were measured on the 6 Yuan acupoints and 6 Jing acupoints,and 3 other non-acupoints on both hands,using Fluke digital meter.The treatment group received TCM acupuncture and moxibustion,etc.After the course of ward treatment,the Bell palsy patients would receive the second round of measurement for analysisResults: 1.The analysis of treatment group of 58 eligible patients(2 lost cases)and the control group of 60 people shows: 1.1.The skin resistance values of the left-side BP patients’ left hand He Gu and Tai Yuan as well the right-side BP patients’ right hand Tai Yuan,Da Ling,Shen Men,and the left hand Zhong Chong were smaller than those of the control group,P<0.05.The difference was statistically significant.1.2.The skin resistance left/right ratios of the left-side BP patients’ Shao Shang,ulnar thumb non-acupoint,Shang Yang,radialis ring finger non-acupoint,Shao Chong,He Gu and Wan Gu testing points(7 in total)were smaller than those of the control group’s,while the left/right ratios of right-side BP patients’ Shao Ze and Yang Chi(2 in total)were greater than those of the control groups,P<0.05.The difference was statistically significant.1.3.The further analysis of 52 right-handed BP patients and 53 right-handed normal people data shows the same results as above.2.The analysis between the pre-treatment and the post-treatment data shows: 2.1.The skin resistance affected-side/unaffected-side ratios of the pre-treatment BP patients’ Shao Shang,ulnar thumb non-acupoint,Shang Yang,ulnar index finger non-acupoint,Shao Chong,Shao Ze,Yang Chi,Tai Yuan and Shen Men testing points(9 pairs in total)were smaller than those of the post-treatment,P<0.05.The difference was statistically significant.2.2.The skin resistance affected-side/unaffected-side ratios of the pre-treatment right-side BP patients’ Shao Shang,ulnar thumb non-acupoint,Shang Yang,ulnar index finger non-acupoint,Guan Chong,Shao Chong,Shao Ze,Yang Chi,Wan Gu and Shen Men testing points(10 pairs in total)were smaller than those of the post-treatment,P<0.05.The difference was statistically significant.There was no statistical difference in the left-side case.2.3.The skin resistance affected-side/unaffected-side ratios of the pre-treatment right-handed right-side BP patients’ Shao Shang,ulnar thumb non-acupoint,Shang Yang,ulnar index finger non-acupoint,radialis ring finger non-acupoint,Shao Chong,Yang Chi and Wan Gu testing points(8 pairs in total)were smaller than those of the post-treatment,P<0.05.The difference was statistically significant.There was no statistical difference in the left-side caseConclusions: 1.The skin resistance values of 5 hand Yuan points,namely the left-side BP patients’ left hand He Gu and Tai Yuan as well the right-side BP patients’ right hand Tai Yuan,Da Ling,Shen Men,along with 1 Jing point,the left hand Zhong Chong,were smaller than those of the control group.2.The status of BP patients would reflect in the skin resistance left/right ratios,in that the skin resistance left/right ratios of the left-side BP patients’ Shao Shang,ulnar thumb non-acupoint,Shang Yang,radialis ring finger non-acupoint,Shao Chong,He Gu and Wan Gu testing points were smaller than those of the control group’s,while the left/right ratios of right-side BP patients’ Shao Ze and Yang Chi were greater than those of the control groups.The skin resistance of the affected-side became relatively lower than that of the non-affected side. 3.The post-treatment skin resistance affected/non-affected ratios of the BP patients were greater that those of the pre-treatment data,i.e.the recovery of the affected-side acupoint skin resistance was relatively better than that of the non-affected’s.4.For the right-handed people,the right-side meridians had more daily activities than the left-side hand meridians;when being affected with BP,the right-side BP patients’ would have less impact compared with the left-side BP patients’.5.During the rehabilitation and treatment process,the recovery of right-handed right-side BP patients’ acupoint skin resistance would be more apparent than that of the left-side BP patients’.更多还原