【作者】 郭珊珊；

【导师】 陈少宗；

【作者基本信息】 山东中医药大学 ， 针灸推拿学， 2010， 硕士

【摘要】 目的：在B超下观察针刺阳陵泉穴对慢性炎性胆囊运动功能的影响,并探讨留针时间长短对胆囊运动影响的时效规律,为治疗慢性胆囊炎的最佳留针时间、针刺频次提供临床参考。方法：本研究观察18例符合纳入标准的慢性胆囊炎患者,随机分为留针60’组,留针30组,分别记录2个方案中不同时间点B超下的胆囊容积,并进行统计分析。结果：1.每组针前、针后不同时间点的胆囊容积均不同(P<0.05),针刺即时、10’、30’与针前比较均有显著差异(P<0.05)；2.留针60分钟与留针30分钟对胆囊收缩功能的影响无明显区别(P>0.05)；3.将每组10’-20’、20’-30’各进行比较,胆囊容积变化均有显著差异(P<0.05)；4.两组均在30分钟时胆囊容积达到最小值,与针前相比有显著差异(P<0.05)；5.留针30’组在50分钟(起针后20分钟)时针刺作用衰减为最佳诱导期的一半,而留针60’组在60分钟结束后尚未进入半衰期状态；6.留针60’组在针刺30-60分钟期间,胆囊未再发生快速而强烈的舒缩运动,而是维持在一种稳定的高张力状态；留针30’组在起针后的前20分钟内,胆囊容积曲线迅速大幅抬高,：起针后也未再发生快速而强烈的舒缩运动,而是维持在一种稳定的低张力状态。结论：1.针刺对慢性胆囊炎患者的胆囊运动具有双向良性调节作用,针刺是促进胆囊的收缩、还是促进胆囊的扩张取决于胆囊的张力状态；2.针刺阳陵泉穴能够明显促进慢性炎性胆囊的张力性舒缩运动；3.初步认为两组的最佳诱导期(胆囊最大收缩数值)均为30分钟；4.留针60分钟和留针30分钟对胆囊收缩程度影响并不大,留针60’组对胆囊动力学影响的半衰期(针刺作用衰减为最佳诱导期一半的时间)大于半小时,留针30’组半衰期为20分钟；5.针刺治疗慢性胆囊炎或胆石症的留针时间以30分为宜。更多还原

【Abstract】 Objective:To explore the time-effect rule of chronic cholecystitis patient’s gallbladder movement on acupuncture in yanglingquan acu-point under different conditions,and provides the clinical reference on best needle retaining time and acupuncture frequency through observation on effect of patient’s gallbladder movement and compare the differences at different time points with ultrasonic scanning.Methods: The research consist of 18 chronic cholecystitis patients, randomly divide the patients who meet the inclusion criteria into 2 groups in the term of doctor order, group A(needle retaining 60’)and group B(needle retaining 30’),record the gallbladder volume at different time points in both groups with ultrasonic scanning,and carries on the statistical analysis. Results:1.There are significant differences on the impact on gallbladder volume at different time points of before and after acupuncture between two groups(P<0.05), and there are differences between after acupuncture immediately、10’、30’and before treatment(P<0.05); 2.There are no remarkable difference in retaining the needle for 60’ or 30’(P>0.05);3.There are significant differences after acupuncture 10’-20’、20’-30’between group A and B(P<0.05);4.There are remarkable differences in both groups between before acupuncture and after acupuncture 30mins,when the gallbladder volume reaches its least(P<0.05);5.Group B reaches its half-life at 50mins while group A doesn’t reach its in the full 60mins;6.In the period of acupuncture 30mins-60mins, the gallbladder has no fast and intense diastole movement and contractive motion in Group A,but is maintains at one kind of stable high tensity condition.In treatment 20mins for the group B,the gallbladder volume curve rapid raises largely, after has the needle, there has no fast and intense diastole movement and contractive motion, but maintains at one kind of stable low tension condition.Conclusion:1.Needling had a bidirectional,benignity control action,which depended on the functional situation of the body;2.Acupuncture in yanglingquan acu-point has promotive effect and time-effect rule to gallbladder movement;3.We may preliminary view that the best induction periods of both groups are 30 mins;4.Retain needles for 30mins and 60mins has no significant differences on effect of gallbladder contraction degree,the half-life of needle retaining 30’ group is 20mins and of needle retaining 60’is over an hour;5. In a word the best needling time to cure chronic cholecystitis is 30mins.更多还原