目的:观察膝骨关节炎(knee osteoarthritis, KOA)患者热敏态腧穴温度觉阈值特征,为临床依据腧穴敏化状态取穴提供科学依据。方法:纳入肿胀型KOA患者4,例,应用温度觉定量测定技术,分别测定患者血海、内膝眼、阴陵泉的热觉阈、热痛阈、热耐痛阈,根据每个腧穴是否出现热敏灸感分为热敏组和非热敏组,比较两组温度觉阈值差异。结果:血海热敏组的热觉阈、热痛阈和热耐痛阈值分别为(38.21±2.03)℃、(44.4,±1.8,)℃和(48.,9±0.,4)℃,非热敏组分别为(3,.,,±1.93)℃、(42.91±2.0,)℃和(4,.9,±1.14)℃;内膝眼穴热敏组的热觉阈、热痛阈和热耐痛阈值分别为(3,.4,±1.,,)℃、(44.,,±1.,3)℃和(4,.48±0.4,)℃,非热敏组为(3,.92±1.,9)℃、(42.,2±1.94)℃和(4,.,3±0.41)℃;阴陵泉穴热敏组的热觉阈、热痛阈和热耐痛阈值分别为(3,.30±2.23)℃、(44.39±1.92)℃和(4,.,,±0.,8)℃,非热敏组为(3,.0,±1.8,)℃、(42.,3±1.88)℃和(4,.91±0.,2)℃;经统计学处理,热敏组三个穴位(血海、内膝眼和阴陵泉)的热觉阈值、热痛阈值和热耐痛阈值均高于非热敏组同名穴位的相应测量值,差异均具有统计学意义(P<0.01)。结论:肿胀型KOA患者热敏态腧穴与非热敏态腧穴具有不同温度觉阈值特征,热敏态腧穴热觉阈、热痛阈和热耐痛阈值均高于非热敏态腧穴。
Objective:To observe the thermesthesia thresholds of the heat-sensitive acupoints in patients with knee osteoarthritis (KOA), and to provide scientific evidence for acupoint selection based on acupoint sensitization. Methods:Forty-six patients with KOA of swelling type were recruited. By using the quantitative thermesthesia testing, the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance at Xuehai (SP 10), Neixiyan (EX-LE 4) and Yinlingquan (SP 9) were detected. The subjects were then divided into heat-sensitive groups and non-heat-sensitive groups according to whether there was a phenomenon of heat-sensitive moxibustion sensation at each acupoint, to compare the thermesthesia thresholds between the two groups. Results: The thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively (38.21±2.03)℃ , (44.4,±1.8,)℃ and (48.,9±0.,4)℃ in the heat-sensitive group of Xuehai (SP 10), versus (3,.,,±1.93)℃ , (42.91±2.0,)℃ and (4,.9,±1.14)℃ in the non-heat-sensitive group of Xuehai (SP 10); the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively (3,.4,±1.,,)℃ , (44.,,±1.,3) , and (4,.48±0.4,) in the heat℃℃-sensitive group of Neixiyan (EX-LE 4), versus (3,.92±1.,9)℃ , (42.,2±1.94)℃ and (4,.,3±0.41)℃ in the non-heat-sensitive group of Neixiyan (EX-LE 4); the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively (3,.30±2.23)℃ , (44.39±1.92)℃ and (4,.,,±0.,8)℃ in the heat-sensitive group of Yinlingquan (SP 9), versus (3,.0,±1.8,)℃ , (42.,3±1.88)℃ and (4,.91±0.,2)℃ in the non-heat-sensitive group of Yinlingquan (SP 9). The statistical analyses showed that the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance of each heat-sensitive group (all the three acupoints) were significantly higher than those of each corresponding non-heat-sensitive group (P<0.01). Conclusion:There were differences in the thermesthesia thresholds between heat-sensitized and non-heat-sensitized acupoints in patients with KOA of swelling type; and the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance of the heat-sensitized points were significantly higher than those of the non-heat-sensitized ones.