哑门穴针刺角度研究.docVIP

哑门穴针刺角度研究 　　［摘要］目的：取得哑门穴针刺角度的安全范围。方法：取1120例MRI正中矢状位T1加权像，分别测量体表哑门穴至水平相对寰、枢椎椎间的连线与体表哑门穴至枕骨大孔后缘连线、寰椎后弓上缘连线所夹的角度，并由计算机进行数据处理。结果：得出哑门穴安全针刺角度，男性为16.27±7.68～29.46±7.32度，女性18.46±4.81～33.61±7.83度。且向上斜刺的危险角度范围与头颅俯仰程度呈负相关，即头颅后仰角度越大，刺入枕骨大孔的危险角度范围越小。针刺哑门穴的正确体位是仰头针刺。 　　［主题词］穴，哑门；针刺方向；针刺深度 　　Study on the Angle of Needling Point Yamen(GV 15) 　　Zhao Chuanxiang1, Lü Xiuhua2 (1. Department of Acup-Moxibustion, Affiliated Hospital of Tianjin Academy of TCM, Tianjin 300020, China; 2. Section of Imagology, General Hospital of Chinese General Company of Railway Construction) 　　［Abstract］Purpose To study on the safe angle range of needling Yamen (GV 15). Methods The angles from the body surface of Yamen (GV 15) to the joint line between the level opposide atlas and axis, and the joint line between body surface of Yamen point and posterior margin of the great occipital foramen, upper margin of arcus posterior atlantis were measured respectively in 1120 cases of T1 weighted image of median sigittal position with MRI, and the data were processed by computer. Results The safe angle range for needling Yamen (GV 15) were: 16.27±7.68～29.46±7.23 degrees for males and 18.46±4.81―33.61±7.83 degrees for females; the danger angle of upward oblique insertion was negatively correlated with the extension of bowing and raising the head, that is, the larger the angle of backward raising the head, the smaller the range of danger angle of needling into the great occipited foramen. The correct body position for needling Yamen point is raising the head. 　　［Key words ］]Point GV 15 (Yamen); Needling Direction; Needling Depth 　　哑门穴隶属于督脉，为与阳维脉交会穴，是治疗诸多病症的要穴。此穴位于后正中线发际上0.5寸，水平与寰枢椎椎间相对，深部为延髓与脊髓延续部分，上邻枕骨大孔。深刺与向上斜刺均具有很大危险性，而浅刺则难以得气，影响疗效。各版本针灸专著对哑门穴刺法的论述大相径庭，使临床医生难以适从。笔者借助MRI正中矢状层面T1加???像高清晰的直观图像，测量哑门穴斜刺的安全角度，经统计学处理，归纳出有关数据，以供临床借鉴。 　　 　　1对象和方法 　　 　　1.1观察对象1 　　993年8月～1995年7月间，在中国铁道建设总公司总医院行头颅扫描者(排除颅底畸形患者)。男714人，年龄18～81岁，平均50.45±12.46岁；女406人,年龄18～86岁，平均46.12±13.11岁。 　　1.2扫描方法 　　MRI检查使用FONARB3000永磁型扫描装置，磁强