躯干背区刮痧血管解剖学探究.docVIP

躯干背区刮痧血管解剖学探究 　 作者：余汝堂，楼新法，唐茂林，蒋松鹤，周文辉 【摘要】 目的:观察背区体被组织的血管分布，为刮痧疗法提供血管形态学依据。方法:选用10具新鲜成人捐献尸体，采用巨微解剖、全身动脉放射显影技术及图像分析技术，观察分析背区体被组织的血管来源、分支和吻合情况。结果:①背区皮肤通过许多结缔组织纤维束与深筋膜相连，使背区体被组织厚而致密，移动性小。②背区血供主要来自肌皮穿支，穿支数较多，密度也较大。③背区皮动脉互相吻合成网，较粗的吻合支形成有明显方向性的纵行和横行的链式血管吻合。结论:本研究提供详细的躯干背区体被组织的血管解剖数据，为刮痧等疗法的临床设计和作用机理探讨提供解剖学依据。 【关键词】 背区；血管；刮痧 Abstract: Objective: To observe the vascular distribution of the tegumental tissue on the back of the trunk for providing the morphological basis for the scraping therapy. Methods: Ten fresh, adult cadavers contributed were selected. Techniques of macro-and microscopic dissection, radiological imaging of the arterials of the whole body and imaging analysis were used to observe and analyze the vascular origins, branches and the anastomoses in the tegumental tissues on the back area. Results: ①The skin of the back connected to the deep fascia through many connective tissue fibers, so that the tegumental tissues on the back area were thickened, dense and less mobility. ②The blood supply on the back area originated mainly from the perforating rami of the musculo-cutaneous arteries. The number of the perforating rami was much and the density of these rami was larger. ③The cutaneous arteries on the back area anastomosed each other to constitute nets. The thicker arterial anastomosing branches formed anastomoses with obvious longitudinal and transverse vascular chain. Conclusion: The detailed vascular anatomical data of the tegumental tissue on the back area of the trunk are provided for the clinical design of the scraping therapy and the mechanism. Key words: back area; blood wessels; scraping therapy 刮痧疗法千百年来在我国广为流传，至今在南方还广泛运用。刮痧施术部位在经络皮部，刮痧出痧过程与血管密切相关，但有关经络皮部的血管形态学研究鲜有报道[1]。躯干背区是传统刮痧疗法的常用部位，解剖学上的体被组织（包括皮肤、皮下组织）也与经络皮部密切相关。为此，我们从形态学角度，主要采用放射造影方法与电脑图像分析技术，观察分析背区体被组织的血管来源、分支和吻合情况，以期为刮痧等疗法的临床设计和作用机理探讨提供解剖学依据。 1 材料和方法 1.1 动脉造影与巨微解剖 新鲜成人整尸标本（5具，10侧）按中医骨度折量定位法标经定穴。采用改良的全身动脉放射显影技术[2]，将新鲜成人整尸标本全身动脉注射显影剂（明胶-氧化铅混悬液）后，首先仔细解剖取下整个背区的体被组织平铺于硬纸板上拍摄X线片，再逐层解剖背区其余部分并配合