针刺提插补泻法对血虚证模型家兔RBC、Hb的影响

【作者】 许安萍；

【导师】 睢明河；

【作者基本信息】 北京中医药大学 ， 针灸推拿学， 2011， 硕士

【摘要】 针刺补泻手法是针刺手法的重要组成部分,更是临床取得疗效的关键环节。针刺提插补泻法作为一种单式补泻手法,同时也是最基础、最常用的一种针刺补泻手法,因其理论价值以及对临床的指导意义,历来都倍受各代医家的重视。但是由于历代医家对针刺提插补泻手法的论述侧重点各有不同,导致后世对提插补泻法的理解产生了一定的分歧。因此本实验利用现代的研究方法,借助血虚证动物模型对针刺提插补泻手法进行研究,观察血虚证家兔在不同手法处理后其外周血中相关指标的变化规律,探讨提插补泻手法与其效应的关系,为进一步研究针刺补泻手法奠定基础。研究目的：(1)研究针刺提插补法与提插泻法对血虚证模型家兔所产生的补泻效果是否不同；(2)探讨对于血虚证模型家兔,针刺提插补法的效果是否优于提插泻法；(3)科学评价针刺提插补泻手法。实验方法：将60只家兔随机分为5组：A组(空白组)、B组(模型对照组)、C组(留针组)、D组(提插补法组)、E组(提插泻法组),后三组统称为治疗组。A组不进行任何处理,正常同步喂养。除A组外,其余四组均采用放血加适当限食的方法制备血虚证模型。造模成功后,B组：只做捆绑固定,不进行任何治疗,让其自然恢复；C组：针刺家兔双侧足三里进行治疗,不做补泻手法,留针15分钟；D组：针刺家兔双侧足三里进行治疗,按预先录制好的操作口令行提插补法；E组：针刺家兔双侧足三里进行治疗,按预先录制好的操作口令行提插泻法。隔天治疗一次,共计10次。分别于造模前、造模后、治疗结束后的第2天、第17天、第32天在家兔耳缘静脉取血,检测外周血中的红细胞计数以及血红蛋白含量。采用SAS8.2软件对数据进行统计分析。实验结果：(1)造模前,各组家兔红细胞计数和血红蛋白含量组间比较P>0.05,说明各组间无显著性差异,均衡可比。造模后,造模各组即B、C、D、E组家兔的红细胞计数和血红蛋白含量均明显下降,分别与造模前比较,B、C、D、E组均有显著差异(P<0.05),并且红细胞计数和血红蛋白含量两者下降均>20%。另外,造模后,造模各组与空白组比较均有显著差异(P<0.05)。说明采用放血加适当限食的方法制备血虚证模型造模成功。针刺处理前,B、C、D、E各组组间比较P>0.05,说明各组间无显著性差异,均衡可比。(2)针刺处理结束后第2天、第17天、第32天,B、C、D、E组家兔外周血RBC和Hb均明显升高,分别与针刺处理前比较,均有显著差异(P<0.05)。对B、C、D、E组家兔的RBC和Hb在针刺处理结束后的第2天、第17天、第32天这3个时间点分别进行组内比较,均无统计学差异(P>0.05)。对各组家兔的RBC和Hb在针刺处理结束后的第2天、第17天、第32天这三个时间点进行组间比较,均无统计学差异(P>0.05)。实验结论：(1)在本实验中,重插轻提的提插补法组与重提轻插的提插泻法组在虚证的病理状态下无明显差异,未显示出补泻效应,提示可能与手法产生的刺激量相同有关。(2)在本实验中观察模型对照组和各治疗组,结果显示各治疗组经针刺处理后的效果与模型对照组自然恢复的效果未显示明显差异,说明机体的虚实状态可能是针刺治疗过程中产生补和泻的不同效应的主要影响因素。(3.)本实验对重插轻提的提插补法和重提轻插的提插泻法从频率和幅度方面进行精确细致的量化,可以看做是对针刺提插补泻手法规范化的初步探讨。更多还原

【Abstract】 Acupuncture reinforcement and reduction is not only the important part of acupuncture manipulation, but also the key of obtaining curative effect in clinical. Acupuncture lifting-thrusting reinforcement and reduction is a single manipulation of reinforcement and reduction, which is the most basic and the most commonly used, so it is always valued by doctors historically because of its theoretical value, and the clinical guide significance. But doctors of later generations have divergences about lifting-thrusting reinforcement and reduction due to the different emphasis of the discussions on it through the ages. Therefore, using modern experimental research method to demonstrate effectively lifting-thrusting reinforcement and reduction is necessary completely.Objective:(1) To study whether the effect is different between lifting-thrusting reinforcement method and lifting-thrusting reduction method on blood-deficiency rabbits; (2) To study whether the effect of lifting-thrusting reinforcement method is better than lifting-thrusting reduction method on blood-deficiency rabbits; (3) To evaluate objectively acupuncture manipulation of lifting-thrusting reinforcement and reduction.Methods:Sixty rabbits were randomly and evenly assigned to five groups:A group (blank group), B group (model control group), C group (retaining needle group), D group (lifting-thrusting reinforcement group), E group (lifting-thrusting reduction group). The last three groups were called treating groups. The A group was not done any treatment, just synchronously fed. Besides A group, the rabbits of other four groups were established blood-deficiency model by bleeding and restricting diet. After making blood-deficiency model, B group:just bound without any treatment and recover spontaneously; C group:acupuncture both "Zusanli" (ST 36) of rabbits without any reinforcing and reducing methods and retain needle for 15 minutes; D group: acupuncture both "Zusanli" (ST 36) of rabbits with lifting-thrusting reinforcement method in accordance with prerecorded manipulating word of command; E group: acupuncture both "Zusanli" (ST 36) of rabbits with lifting-thrusting reduction method in accordance with prerecorded manipulating word of command. Do treatment every other day,10 times totally. Blood samples were collected from the ear margin veins for examine RBC and Hb at both before and after making blood-deficiency model and also after acupuncture treatment of the 2 day、the 17 day and the 32 day respectively. Use the SAS 8.2 statistical software for statistical analysis of data.Results:(1) Before making blood-deficiency model, there are no difference both RBC and Hb among five groups, P>0.05. It indicated that all five groups were not significant different and could be compared with each other.After making blood-deficiency model, values of RBC and Hb of B group, C group, D group and E group which were made blood-deficiency model all decreased obviously. Compared with before making blood-deficiency model respectively, the difference of the four groups were all statistically significant P<0.05 and the decrease of both RBC and Hb were more than 20%. In addition, after making blood-deficiency model there were significant different between four groups which were made blood-deficiency model and blank group, P<0.05. It indicated that we succeeded in establishing blood-deficiency model by bleeding and restricting diet.Before acupuncture treatment, there are no difference both RBC and Hb among B group, C group, D group and E group, P>0.05. It indicated that all four groups were not significant different and could be compared with each other.(2) After acupuncture treatment, blood samples were collected from the ear margin veins for examine RBC and Hb at the 2 day、the 17 day and the 32 day respectively. It showed that values of RBC and Hb of B group, C group, D group and E group all increased obviously. Compared with RBC and Hb before acupuncture treatment respectively, the difference of the four groups were all statistically significant,P<0.05. Compared with RBC and Hb among after acupuncture treatment of the 2 day, the 17 day and the 32 day of B group, C group, D group and E group respectively, it showed that there were not significant difference among the three time points in each one of the four groups, P>0.05. Compared with RBC and Hb among B group, C group, D group and E group after acupuncture treatment of the 2 day、the 17 day and the 32 day respectively, it showed that there were not significant difference among the four groups at each one of the three time points.Conclusion:(1) In this experiment, there was no significant difference between lifting-thrusting reinforcement group with thrusting heavy and lifting light and lifting-thrusting reduction group with lifting heavy and thrusting light in the weak condition, and it didn’t showed effect of reinforcement or reduction. It indicated that it might be related to the same quantity of stimulus produced by operation. (2) In this experiment, we observed model control group and treating groups. The results showed that there was no significant different effect between treating groups with acupuncture and model control group with spontaneous recovery. It indicated that maybe body condition of deficiency or excess is the main influencing factor of producing reinforcement effect or reduction effect in acupuncture therapeutic process. (3) Lifting-thrusting reinforcement and reduction method was quantized precisely from the frequency and the amplitude in experiment.,which could be seen as preliminary discussion to the standard of acupuncture reinforcement and reduction method.更多还原