穴位深度考

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Title:	穴位深度考 Review on the history and practice of the needling depth of acupoints
Authors:	劉育祺
Contributors:	中醫學系碩士班
Keywords:	穴位深度;針刺深度;針刺安全;得氣深度;針灸 acupoint depth;needling depth;safety depth;de-qi depth;acupuncture
Date:	2011-07-28
Issue Date:	2011-10-17 16:05:50 (UTC+8)
Publisher:	中國醫藥大學
Abstract:	針刺的療效已無庸置疑，而其穴位取穴標準也有規範，但穴位深度至今卻尚未有定論。在「穴位深度考」研究中，將會搜集從古至今的穴位深度論述，包括典籍、各國教科書、期刊論文研究等，作系統性的回顧。在回顧的結果中，針灸典籍內之穴位針刺深度和現代教科書之穴位針刺深度有統計上的差異，因此臨床穴位針刺深度不可完全依照典籍之規定，現今必須重視穴位針刺安全深度的研究，以建立正確的臨床穴位針刺深度規範。首先，必須先對安全深度的意義與單位加以定義，以建立正確針刺安全深度觀念後才能有共同的語言溝通。在進行研究方面，現代研究方法有斷面解剖和放射影像技術等的不同，研究對象也有屍體和活體的差別，建議未來的針刺深度研究方法應以放射影像技術為主，研究對象則建議為活體，且必須根據個體的差異，如性別、身高、體重、身體質量指數（BMI）等，去進行穴位針刺安全深度統計分析；另外特殊體型的研究，如兒童等，也必須另討論之。本研究了解針刺深度的歷代變化與現代的差異，分析現代針刺安全深度的研究模式，並試圖歸納其優、缺點，以提供未來研究針刺深度者更好的思路，以及如何與臨床應用相互呼應。除此之外，希望藉由此回顧，建議WHO訂定安全深度標準化，讓臨床針刺工作者有臨床規範和依據。 Acupuncture has become a popular therapy worldwide and is considered to be safe, if practiced by a registered acupuncturist. However, if the appropriate depth of needle insertion is exceeded beyond its recommended level of safety, there may be serious consequences, especially in areas such as the chest and back, such as pneumothorax or bleeding of internal organs. While ancient Chinese medical texts and modern acupuncture textbooks state the desired needling depth for each acupoint, the depths of some acupoints vary greatly between different documents. Previous studies on the safety of acupoint needling depths have been performed either with computer tomography (CT) scanning or with autopsy specimens. These investigations have failed to reach consensus as to identical definitions and units regarding safe acupoint needling depths. Moreover, some studies have failed to account for differences between individuals, such as sex, height, weight, and body mass index (BMI). The present study reviewed data from ancient texts, more recently published papers and acupuncture textbooks on the needling depth of acupoints. The study aim was to determine safe needling depths for acupoints and recommend best use of CT or magnetic resonance imaging (MRI) for measuring the safe needling depth of acupoints in alive humans. Such data can then be analyzed by statistical methods such as a multiple regression to predict the safe needling depth for each acupoint. This study also seeks to promote worldwide standardization of acupuncture depth.
Appears in Collections:	[School of Chinese Medicine] Theses & dissertations

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