目的:观察不同腧穴配伍对颈型颈椎病患者体表肌电即时效应的影响,探讨腧穴配伍之间的相互作用及规律。方法:90例颈型颈椎病患者前后进行3种不同腧穴配伍的针刺,远部取穴组(A组:昆仑、后溪);近部取穴组(B组:风池、天柱);远近取穴组(C组:昆仑、后溪、风池、天柱),采用自身前后对照,观察针刺前后体表肌电(Surface Electromyography,SEMG)平均振幅值,测量肌电积分(Integrated Electromyography,IEMG)及肌电均方根(Root Mean Square,RMS)均值,计算肌电振幅变化率,组内比较不同腧穴配伍针刺前后对体表肌电即时效应影响的差异,组间比较各组针刺后差异。结果:组内针刺前后比较,A、B、C组的肌电平均振幅值、肌电振幅变化率、IEMG、RMS差异有统计学意义(P<0.05)。组间针刺后比较,A、B、C组针刺后肌电平均振幅值、肌电振幅变化率、IEMG、RMS都有不同程度的改变,但无显著性差异(P>0.05)。结论:不同腧穴配伍的针刺治疗均可以明显改善颈部前屈的耐疲劳性;针刺对颈型颈椎病的治疗作用与取穴数目的多少无关,并不能简单地认为腧穴配伍越多,疗效就会越好。
Objective To observe the influence of different acupoint combinations on immediate effect of surface electromyography of patients with cervical spondylosis, and to explore the interactions and laws among different acupoint combinations. Methods Acupuncture in three kinds of different acupoint combinations was conducted on 90 patients with cervical spondylosis（three groups）： group A [distal point selection group： Kūnlún（昆仑 BL 60） and Hòuxī（后溪 SI 3）]; group B [local point selection group： Fēngchí（风池 GB 20） and Tiānzhù（天柱 BL 10）]; group C（distal and local point selection group： BL 60, SI 3, GB 20 and BL 10）. Self control before and after treatment was adopted to observe the mean value of surface electromyography（SEMG） amplitude, to measure the mean values of integrated electromyography（IEMG） and electromyography root mean square（RMS）, and to calculate the variation rate of electromyography amplitude of trapezius on the affected side of patients before and after acupuncture. The differences of influences of different acupoint combinations on immediate effect of surface electromyography were compared intra-group, and the differences among the three groups after acupuncture were also compared. Results According to the intragroup comparison before and after acupuncture, the differences of mean value of electromyography amplitude, variation rate of electromyography amplitude, IEMG and RMS were both statistically significant（all P〈0.05）. According to the inter-group comparison after acupuncture, the mean value of electromyography amplitude, variation rate of electromyography amplitude, IEMG and RMS varied in different degrees, however, the differences were not significant（all P〉0.05）; there was no significant difference in the total effective rate among the three groups（P〉0.05）. Conclusion Acupuncture treatment in different acupoint combinations can increase IEMG and RMS and reduce mean value of electromyography amplitude and variation r
