PBL教学法在《针灸学》中的应用效果循证评价

目的:评估PBL教学法在《针灸学》教学中的应用前景,为改进《针灸学》教学提供有效循证依据。方法:系统全面检索当前相关临床研究文献,按照循证医学五级分类标准,对于能够评价标准的证据,从高到低选用,采用Epidata 2建立评价表数据库。采用统一编制的"文献质量评价信息证据采集表",对近年来发表的《针灸学》教学中PBL教学法应用的临床研究文献进行质量评价。结果:9篇文献符合研究需要。缺少高质量A级文献证据,B级文献证据4篇,C级文献证据2篇,D文献级证据3篇。结论:PBL教学模式与传统教育模式比较有明显优越性,符合教学改革的新趋势。     

Study on the thermesthesia features of heat-sensitive acupoints in patients with knee osteoarthritis

Objective

To observe the thermesthesia thresholds of the heat-sensitive acupoints in patients with knee osteoarthritis (KOA), and to provide scientific evidence for acupoint selection based on acupoint sensitization.

Methods

Forty-six patients with KOA of swelling type were recruited. By using the quantitative thermesthesia testing, the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance at Xuehai (SP 10), Neixiyan (EX-LE 4) and Yinlingquan (SP 9) were detected. The subjects were then divided into heat-sensitive groups and non-heat-sensitive groups according to whether there was a phenomenon of heat-sensitive moxibustion sensation at each acupoint, to compare the thermesthesia thresholds between the two groups.

Results

The thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively (38.21±2.03) °C (44.47±1.8,) °C and (48.59±0.74) °C in the heat-sensitive group of Xuehai (SP 10), versus (36.76±1.93) °C, (42.91±2.05) °C and (46.95±1.14) °C in the non-heat-sensitive group of Xuehai (SP 10); the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively (37.47±1.77) °C, (44.55±1.63) °C, and (47.48±0.47) °C in the heat-sensitive group of Neixiyan (EX-LE 4), versus (35.92±1.69) °C, (42.72±1.94) °C and (45.53±0.41) °C in the non-heat-sensitive group of Neixiyan (EX-LE 4); the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively (37.30±2.23) °C, (44.39±1.92) °C and (47.76±0.58) °C in the heat-sensitive group of Yinlingquan (SP 9), versus (36.06±1.86) °C, (42.63±1.88) °C and (45.91±0.72) °C in the non-heat-sensitive group of Yinlingquan (SP 9). The statistical analyses showed that the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance of each heat-sensitive group (all the three acupoints) were significantly higher than those of each corresponding non-heat-sensitive group (P<0.01).

Conclusion

There were differences in the thermesthesia thresholds between heat-sensitized and non-heat-sensitized acupoints in patients with KOA of swelling type; and the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance of the heat-sensitized points were significantly higher than those of the non-heat-sensitized ones.

     

论热敏灸探感定位是阿是之法的传承与发展

从腧穴的原始概念文献记载探讨阿是之法的内涵及其临床意义,阐明阿是之法的精髓是以患者对力的敏感为标准来定位腧穴。热敏灸疗法的临床应用,则说明热敏灸探感定位是以出现热敏灸感为标准来判定腧穴。两者虽均以患者感觉为标准,但热敏灸探感定位是从另一新的角度、采用新的方法来定位腧穴。认为热敏灸探感定位是阿是之法的传承与发展。     

血府逐瘀汤治疗美尼尔氏综合症60例疗效分析

血府逐瘀汤出自清代医家王清任的《医林改错》,用于治疗"胸中血府血瘀"所致诸证的活血祛瘀、行气止痛之常用方剂。美尼尔氏综合症是临床上的高发病,应用血府逐瘀汤治疗,疗效显著。