Lin Yu-Fen, Lu Jian-Min, Su Yan-Na, Zhong Ze-Bin, Zhang Zuo-Dan
Quanzhou Medical College, Quanzhou 362010, Fujian Province, China.
The Affiliated People's Hospital of Quanzhou Medical College, Quanzhou 362000, Fujian Province.
Zhen Ci Yan Jiu. 2017 Dec 25;42(6):527-32. doi: 10.13702/j.1000-0607.2017.06.012.
To observe the clinical effect of heat sensitive moxibustion (HSM) and its regularity of acupoint heat-sensitization in the treatment of allergic rhinitis (AR) patients.
Seventy patients with AR were randomly divided into HSM and manual acupuncture groups (=35/group). For patients of the HSM group, acupoints Yintang (EX-HN 3), bilateral Yingxiang (LI 20), Shangxing (GV 23), Tongtian (BL 7), Feishu (BL 13), Hegu (LI 4), etc. were used, and for patients of the manual acupuncture group, bilateral LI 20 and LI 4, Bitong (EX-HN 8) and EX-HN 3 were needled and stimulated with uniform reinforcing-reducing needling method. The treatment was conducted once every other day, for 20 days, with 3 days' interval between two 10 days. The symptoms of sneezing, running nose, nasal obstruction, and nasal itching were scored as 1, 2 and 3 points according to their severity. The signs of turbinate-nose cavity bottom/nasal septum correlation, morphological state (swelling or not) of inferior nasal concha and color of nasal mucosa, appearance (deviation or polyp) of the middle turbinate and nasal septum were scored as 1, 2 and 3 points according to their severity. The total score equaled to symptom score plus nasal sign score. The distribution of heat sensitization acupoints for effectively improving AR were recorded.
The total effective rate of 82.86%(29/35) in the HSM group had no marked difference in comparison with that of 74.29%(26/35) in the manual acupuncture group (>0.05). After the treatment, the total scores of symptoms and nasal signs of both HSM and manual acupuncture groups were significantly reduced in comparison with their own individual pre-treatment (<0.01), and those in the HSM group were significantly decrased than those in the manual acupuncture group (<0.05). In 35 patients of the HSM group, among the detected 57 acupoints, the most frequently sensitive acupoints were LI 20, EX-HN 3, EX-HN 8, Shangyintang, BL 13, Shenque(CV 8), GV 23, Fengchi(GB 20), Die'e and Dazhui (GV 14) in sequence, mainly covering the Governor Vessel, Large Intestine Meridian of Hand-yangming(LI), and Bladder Meridian of Foot-taiyang(BL), and characterized by heat conduction, heat diffusion, diathermancy, non-thermal (mainly itching) sensation, thermal sensation mainly in the deep tissue and in the distant part rather than in the body surface and the local part.
HSM has a positive effect on improvement of AR, when applied, acupoints LI 20, EX-HN 3, EX-HN 8, Shangyintang, BL 13, CV 8, GV 23, GB 20, Die'e and GV 14 are highly recommended.
观察热敏灸治疗变应性鼻炎(AR)患者的临床疗效及其穴位热敏化规律。
将70例AR患者随机分为热敏灸组和手针组(每组35例)。热敏灸组选用印堂(EX-HN 3)、双侧迎香(LI 20)、上星(GV 23)、通天(BL 7)、肺俞(BL 13)、合谷(LI 4)等穴位;手针组针刺双侧LI 20、LI 4、鼻通(EX-HN 8)和EX-HN 3,并采用平补平泻手法行针刺激。治疗隔日1次,共20天,两个10天疗程之间间隔3天。打喷嚏、流鼻涕、鼻塞和鼻痒症状根据严重程度分别记为1、2、3分。下鼻甲与鼻腔底部/鼻中隔关系、下鼻甲形态状态(是否肿胀)、鼻黏膜颜色、中鼻甲和鼻中隔外观(是否偏曲或有息肉)等体征根据严重程度分别记为1、2、3分。总分等于症状评分加鼻部体征评分。记录有效改善AR的热敏化穴位分布情况。
热敏灸组总有效率为82.86%(29/35),与手针组的74.29%(26/35)相比,差异无统计学意义(>0.05)。治疗后,热敏灸组和手针组的症状和鼻部体征总分均较各自治疗前显著降低(<0.01),且热敏灸组低于手针组(<0.05)。在热敏灸组的35例患者中,在所检测的57个穴位中,最常出现敏感的穴位依次为LI 20、EX-HN 3、EX-HN 8、上印堂、BL 13、神阙(CV 8)、GV 23、风池(GB 20)、蝶腭和大椎(GV 14),主要分布于督脉、手阳明大肠经(LI)和足太阳膀胱经(BL),其特点为有热传导、热扩散、透热、非热(主要为瘙痒)感觉、热感主要在深部组织和远处而非体表及局部。
热敏灸对改善AR有积极作用,应用时,推荐选用LI 20、EX-HN 3、EX-HN 8、上印堂、BL 13、CV 8、GV 23、GB 20、蝶腭和GV 14等穴位。