中醫藥研究論叢

254.1 以電腦斷層測量成人胸背部穴位之安全深度
TJ TCM.25(4) : 1-14, 2022
DOI : 10.6516/TJTCM.202212_25(4).0001
以電腦斷層測量成人胸背部穴位之安全深度
Safe Needling Depths of Chest and Back Acupoints in Adults
馬益群1,2 林昭庚3* 彭慶添4 黃毓銓3,5
1 中國醫藥大學中醫學院後中醫學系,台中,台灣
2 臺安醫院小兒科,台中,台灣
3 中國醫藥大學中醫學院中醫學系,台中,台灣
4 中國醫藥大學兒童醫院,台中,台灣
5 中國醫藥大學附設醫院醫學研究部,台中,台灣
【摘要】
前言:針刺治療於世界各國皆有廣泛的應用且接受此治療的人數快速增加,故安全性和治療品質廣受重視。針灸雖被廣泛認為是一項安全的治療,但仍有嚴重併發症之發生。故以現今影像技術來建立針刺安全深度之資料是非常重要的。本研究使用電腦斷層方法確立成人胸、背部穴位之針刺安全深度。
並比較不同性別和身體質量指數(BMI)下,穴位安全深度是否有差異。
方法:以回顧性方法於中國醫藥大學附設醫院成人健檢資料中,找出自2002 年1 月至2016 年1 月胸部電腦斷層掃瞄之個案。由電腦顯示出胸背部電腦斷層掃瞄之切面圖像,並測量各穴位皮膚到體內臟器的距離。
結果:本研究共收集222 個成人個案(男105 人,女117 人)。胸部穴位KI22,
KI23, SP18, SP19, PC1, CV21, CV22 和背部穴位GV10, GV11, BL17, BL45, GB21
的針刺深度和性別有顯著相關(p < 0.05)。胸部穴位KI27, KI23, ST15, ST16,
ST18, SP17, SP18, SP19, SP20, PC1, CV19 和背部穴位GV14, BL13, BL43, BL46
的針刺安全深度和BMI 有顯著相關(p < 0.05)。廣義線性回歸模式(generalized
linear regression model)分析顯示BMI 是獨立於年齡和性別更具影響胸部和背部
針刺安全深度的因素。
結論:本研究顯示多個胸部穴位的針刺安全深度和BMI 有顯著相關。因此,臨床醫師在施作胸部針刺治療時,要特別考慮BMI 的因素所造成的安全深度差異,以避免併發症之產生。
【關鍵詞】針刺安全深度、身體質量指數(BMI)、胸部、背部
Yi-Chun Ma1,2Jaung-Geng Lin3*Ching-Tien Peng4Yu-Chuen Huang3,5
1School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China
Medical University, Taichung, Taiwan
2Department of Pediatrics, Tai-An Hospital, Taichung, Taiwan
3School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
4Children’s Hospital of China Medical University, Taichung, Taiwan
5Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
【Summary】
Background: Acupuncture is now applied for treating numerous conditions. The
safety was pay more and more attention in the worldwide. Thus, it is important
to establish a reference for safe needling depth of acupoints by nowadays image
exam. In this study, we evaluated the depths to which acupuncture needles can be
inserted safely in the chest and back acupoints. We also investigated the variations
in safe depth according to sex and body mass index (BMI).
Methods: We retrospectively studied computed tomography (CT) images of adult
patients who underwent chest CT at China Medical University Hospital between
January 2002 and January 2016. The safe depths of chest and back acupoints were
measured directly from the CT images. The relationships between the safe depths
of these acupoints and sex and BMI were analyzed.
Results: Totally 222 patients were enrolled in this study, including 105 males and
117 females. The results indicated significant differences in safe needling depth
between males and females in chest acupoints KI22, KI23, SP18, SP19, PC1,
CV21, CV22 and back acupoints GV10, GV11, BL17, BL45, GB21 (p < 0.05).
Safe needling depth of chest acupoints KI27, KI23, ST15, ST16, ST18, SP17, SP18,
SP19, SP20, PC1, CV19 and back acupoints GV14, BL13, BL43, BL46 differed
significantly in different BMI groups (p < 0.05). Generalized linear regression model
revealed that BMI was the most crucial factor in determining the safe depth.
Conclusions: BMI are relevant factors in determining the safe needling depths
of chest and back acupoints. In order to prevent complication of acupuncture,
physicians should consider wide variations in needle depth when performing
acupuncture.
【Keywords】safe needling depth; BMI; chest; back