专题:针灸

针刺得气研究现状及思考

  • 王伟
展开
  • 华中科技大学同济医学院附属同济医院神经科, 武汉 430030
王伟,教授,研究方向为神经病学,电子信箱:wwang@vip.126.com

收稿日期: 2019-01-14

  修回日期: 2019-04-30

  网络出版日期: 2019-08-27

New research progress and thought in de qi induced by acupuncture

  • WANG Wei
Expand
  • Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

Received date: 2019-01-14

  Revised date: 2019-04-30

  Online published: 2019-08-27

摘要

针灸疗效得到世界公认,但如何传承数千年针灸的治疗经验和标准化针灸刺激手法,尤其是临床上如何确定有效的针灸刺激量,成为针灸研究、应用,乃至向世界传播的难题。基于中医传统理论和针刺得气的现代研究进展,思考了得气理论的意义,并提出得气是针灸取得最佳疗效的一个重要前提,在研究如何充分发挥针灸治疗作用及评价针灸疗效时,得气是不可或缺的重要参数的见解。针灸临床试验应进一步纳入得气的客观量化评价体系,科学地探索得气现象背后的生物学机制,阐明得气与疗效之间的关系。

本文引用格式

王伟 . 针刺得气研究现状及思考[J]. 科技导报, 2019 , 37(15) : 43 -48 . DOI: 10.3981/j.issn.1000-7857.2019.15.006

Abstract

The efficacy of acupuncture is recognized worldwide. However, how to pass on thousands of years treatment experience, standardize acupuncture stimulation techniques, especially how to determine the optimal dosage of acupuncture stimulation in clinical practice, has been a conundrum in acupuncture research, application and even its dissemination across the world. At present, there has been significant progress in the research of de qi. De qi can be evaluated quantitatively and its mechanism is basically clarified. The correlation between de qi and clinical outcomes has been recently confirmed through our clinical trial of treating Bell's palsy by acupuncture with de qi. Our study has found that acupuncture with de qi can significantly improve the function of facial muscles and quality of life of Bell's palsy patients. For the first time, our study highly integrates traditional de qi and modern evaluation methods, and has attracted considerable international media coverage. This study provides an example for the further in-depth research in traditional Chinese medicine and objective evaluation of the efficacy of acupuncture. Keywords acupuncture; de qi; efficacy evaluation; Bell's palsy

参考文献

[1] Patil S, Sen S, Bral M, et al. The role of acupuncture in pain management[J]. Current Pain & Headache Reports, 2013, 20(4):22.
[2] National Institutes of Health. Acupuncture[J]. NIH Consens Statement, 1997, 15(5):1-34.
[3] 刘保延. 建立临床疗效评价体系助推针灸国际化[J]. 中国针灸, 2018, 38(5):545-546. Liu Baoyan. Establishment of clinical efficacy evaluation system to promote internationalization of acupuncture and moxibustion[J]. Chinese Acupuncture & Moxibustion, 2018, 38(5):545-546.
[4] 刘保延. 解放思想创新机制、筹划针灸大科学研究计划[J]. 中国针灸, 2017, 37(1):1. Liu Baoyan. Emancipation of mind, innovation of mechanism and planning of acupuncture and moxibustion science research program[J]. Chinese Acupuncture & Moxibustion, 2017, 37(1):1.
[5] Zhang L L, Chu Q, Wang S, et al. Is sham acupuncture as effective as traditional Chinese acupuncture? It's too early to say[J]. Chinese Journal of Integrative Medicine, 2016, 22(7):483-489.
[6] Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine[J]. Cochrane Database of Systematic Reviews, 2016(6):CD001218.
[7] Ee C, Xue C, Pirotta M, et al. Acupuncture for menopausal hot flashes:A randomized trial[J]. Annals of Internal Medicine, 2016, 164(3):146-154.
[8] Hinman R S, McCrory P, Pirotta M, et al. Acupuncture for chronic knee pain:A randomized clinical trial[J]. JAMA, 2014, 312(13):1313-1322.
[9] Scharf H P, Mansmann U, Streitberger K, et al. Acupuncture and knee osteoarthritis:A three-armed randomized trial[J]. Annals of Internal Medicine, 2006, 145(1):12-20.
[10] Linde K, Streng A, Jürgens S, et al. Acupuncture for patients with migraine:A randomized controlled trial[J]. JAMA, 2005, 293(17):2118-2125.
[11] Assefi N P, Sherman K J, Jacobsen C, et al. A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia[J]. Annals of Internal Medicine, 2005, 143(1):10-19.
[12] Moffet H H. Sham acupuncture may be as efficacious as true acupuncture:A systematic review of clinical trials[J]. Journal of Alternative and Complementary Medicine, 2009, 15(3):213-216.
[13] 余炜昶, 黄光英, 张明敏, 等. 缝隙连接蛋白Cx43基因在针刺镇痛中的作用[J]. 中国针灸, 2007, 27(3):195-198. Yu Weichang, Huang Guangying, Zhang Mingmin, et al. The role of connexin 43 gene in acupuncture analgesia[J]. Chinese Acupuncture & Moxibustion, 2007, 27(3):195-198.
[14] Goldman N, Chen M, Fujita T, et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture[J]. Nature Neuroscience, 2010, 13(7):883-888.
[15] Han J S. Acupuncture analgesia:Areas of consensus and controversy[J]. Pain, 2011, 152(Suppl 3):S41-S48.
[16] Asghar A U, Green G, Lythgoe M F, et al. Acupuncture needling sensation:The neural correlates of deqi using fMRI[J]. Brain Research, 2010, 1315:111-118.
[17] Hui K K, Liu J, Marina O, et al. The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST36 as evidenced by fMRI[J]. Neuroimage, 2005, 27(3):479-496.
[18] 方继良, Hui KS Kathleen, Nixon Erika, 等. 针刺太冲穴得气及疼痛激发相对抗的脑功能网络效应fMRI研究[J].中国中西医结合影响学杂志, 2012, 10(1):4-9. Fang Jiliang, Hui KS Kathleen, Nixon Erika, et al. De qi and Sharp pain during acupuncture at Taichong eliciting the opposite functional brain network effects:An fMRI study[J]. Chinese Imaging Journal of Integrated Traditional and Western Medicine, 2012, 10(1):4-9.
[19] Kong J, Kaptchuk T J, Polich G, et al. An fMRI study on the interaction and dissociation between expectation of pain relief and acupuncture treatment[J]. Neuroimage, 2009, 47(3):1066-1076.
[20] Kong J, Gollub R L, Rosman I S, et al. Brain activity associated with expectancy-enhanced placebo analgesia as measured by functional magnetic resonance imaging[J]. Journal of Neuroscience, 2006, 26:381-388.
[21] Kong J, Gollub R, Huang T, et al. Acupuncture de qi, from qualitative history to quantitative measurement[J]. J ournal of Alternative and Complementary Medicine, 2007, 13(10):1059-1070.
[22] Asghar A U, Green G, Lythgoe M F, et al. Acupuncture needling sensation:The neural correlates of deqi using fMRI[J]. Brain Research, 2010, 1315:111-118.
[23] White P, Bishop F, Hardy H, et al. Southampton needle sensation questionnaire:Development and validation of a measure to gauge acupuncture needle sensation[J]. Journal of Alternative and Complementary Medicine, 2008, 14(4):373-379.
[24] Kong J, Fufa D T, Gerber A J, et al. Psychophysical outcomes from a randomized pilot study of manual, electro, and sham acupuncture treatment on experimentally induced thermal pain[J]. The Journal of Pain, 2005, 6(1):55-64.
[25] Spaeth R B, Camhi S, Hashmi J A, et al. A longitudinal study of the reliability of acupuncture de qi sensations in knee osteoarthritis[J]. Evidence-based Complementary and Alternative Medicine, 2013, 2013:204259.
[26] Kong J, Fufa D T, Gerber A J, et al. Psychophysical outcomes from a randomized pilot study of manual, electro, and sham acupuncture treatment on experimentally induced thermal pain[J]. The Journal of Pain, 2005, 6(1):55-64.
[27] Xu S B, Huang B, Zhang C Y, et al. Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy:A randomized controlled trial[J]. Canadian Medical Association Journal, 2013, 185(6):473-479.
[28] Fletcher J. Acupuncture-No sham[J]. Canadian Medical Association Journal, 2013, 185(6):459.
[29] Zhang C Y, Xu S B, Huang B, et al. Needle sensation and personality factors influence therapeutic effect of acupuncture for treating bell's palsy:A secondary analysis of a multicenter randomized controlled trial[J]. Chinese Medical Journal, 2016, 129(15):1789-1794.
[30] Tian D S, Xiong J, Pan Q, et al. De qi, a threshold of the stimulus intensity, elicits the specific response of acupoints and intrinsic change of human brain to acupuncture[J]. Evidence-based Complementary and Alternative Medicine, 2014, 2014:914878.
[31] 胡妮娟, 林驰, 李静, 等. 得气与针刺疗效关系的思考[J]. 中国针灸, 2014, 34(4):413-416. Hu Nijuan, Lin Chi, Li Jing, et al. Remarks on the relationship between de qi and effect of acupuncture[J]. Chinese Acupuncture & Moxibustion, 2014, 34(4):413-416.
[32] 石学敏.中国针灸奇术[M]. 天津:天津科技翻译出版公司, 1992:28-29. Shi Xuemin. Chinese acupuncure and moxibustion[M]. Tianjing:Tianjin Science and technology Translation and Publishing Company, 1992:28-29.
文章导航

/