试论临床施灸建立温度控制标准的必要性与可行性

目的 探讨临床施灸建立温度控制标准的必要性与可行性。方法 选取16例慢性腰背痛志愿者，分别保持42 ℃、41 ℃、40 ℃、39 ℃灸温照射督脉的大椎穴、至阳穴、命门穴，记录得气感应出现前期的时间、艾灸得气累积时间、艾灸得气积分。在此基础上，研制督脉温度控制施灸装置，并比较督脉温度控制施灸装置与传统隔姜督脉灸的得气效应。结果 灸温为42 ℃时，艾灸得气的前期时间短，得气强，与其他灸温组比较，差异有统计学意义（P＜0.05）。灸温42 ℃组与灸温41 ℃组得气累积时间比较，差异无统计学意义（P＞0.05）；与灸温40 ℃、39 ℃组比较，差异具有统计学意义（P＜0.05）。与传统隔姜督脉灸组比较，督脉温度控制施灸装置组艾灸得气前期的时间显著缩短、艾灸得气累积时间显著延长、艾灸得气积分显著增加，差异均有统计学意义（P＜0.05）。结论 采用最佳灸温施灸可以缩短艾灸得气前期时间、增加艾灸得气持续时间，提高艾灸得气强度。

Necessity and Feasibility of Establishing Temperature Control Criteria for Moxibustion in Clinical Practice

Objective To investigate the necessity and feasibility of establishing temperature control criteria for moxibustion in clinical practice. Methods A total of 16 volunteers with chronic low back pain were given moxibustion at Dazhui, Zhiyang, and Mingmen acupoints of the governor vessel at a temperature of 42 °C, 41 °C, 40 °C, and 39 °C, respectively, and time to the early stage of Qi arrival, cumulative time of Qi arrival, and Qi arrival score were recorded. In addition, a temperature control device was developed for moxibustion at the governor vessel and was compared with traditional moxibustion on ginger in terms of clinical effect. Results Compared with moxibustion at the other temperatures, moxibustion at 42 °C had a significantly shorter time to the early stage of Qi arrival and a significantly higher degree of Qi arrival (P<0.05). There was no significant difference in the cumulative time of Qi arrival between the 42 °C moxibustion group and the 41 °C moxibustion group (P>0.05), while there was a significant difference in this index between the 42 °C moxibustion group and the 40 °C/39 °C moxibustion groups (P<0.05). Compared with traditional moxibustion on ginger, moxibustion with the temperature control device had a significantly shorter time to the early stage of Qi arrival, a significantly longer cumulative time of Qi arrival, and a significant increase in Qi arrival score (P<0.05). Conclusion Moxibustion at the optimal temperature can shorten the time to the early stage of Qi arrival, increase the duration of Qi arrival, and improve the intensity of Qi arrival during moxibustion.