摘要
目的 探索鱼际穴实体解剖结构.方法 ①查阅归纳古籍中鱼际穴定位及其演变.②25 名志愿者鱼际区域分区按压,确定出现"穴感"位置并标记.③在标记处用毫针针刺观察有无穴感,并根据产生穴感时针尖所在位置、深度参照断层解剖图谱确定穴体初步判定穴体的三维定位.④在10 侧新鲜人体上肢标本上,根据体表按压和针刺确定的鱼际穴穴体的位置进行显微解剖,探索穴位实体解剖结构.⑤针刺志愿者鱼际穴出现穴感时,用B超确认针尖所在位置.⑥用超声显像仪在10 名志愿者手鱼际部找到鱼际穴穴体位置,在B超引导下针刺该位置与其周围组织,验证其区别.结果 ①古籍中鱼际穴定位,从鱼际部的散脉中逐渐缩小至"舟角沟"以远的凹陷处.②分区按压,恒定出现穴感位置在"舟角沟"远端.③针刺"舟角沟"远端时穴感最强烈.④显微解剖发现鱼际穴处有拇对掌肌肌支及其伴行血管进入肌肉.⑤针刺鱼际穴出现强烈穴感时,针尖位于拇对掌肌肌门处.⑥B超下证实拇对掌肌肌门是鱼际穴实体解剖结构.结论 鱼际穴主穴穴体位于"舟角沟"远端,为拇对掌肌肌门处,另有多个穴体散在分布于整个鱼际区,其中鱼际中、近部皮肤浅静脉丰富区穴体分布相对密集.
Abstract
Objective To explore the anatomical structure of the Yuji acupoint(LU 10).Methods ① Referencing ancient texts regarding the positioning and evolution of the Yuji acupoint.②Employing partition pressure on the thenar area of 25 volunteers to determine the position eliciting an"acupoint sensation",marking these locations accordingly.③ Conducting filiform needle acupuncture on the marked areas to observe acupoint sensations.Preliminary three-dimensional positioning of the acupoint body was determined by referencing cross-sectional anatomical atlases based on the needle's location and depth during sensation.④ Performing microscopic dissection on fresh upper limb specimens from ten individuals to explore the anatomical structure at the acupoint positions identified through surface pressure and acupuncture.⑤ Using ultrasonography to confirm the needle tip position during strong acupoint sensations at the Yuji point during acupuncture sessions.⑥ Identifying the location of Yuji in the hands of ten volunteers using an ultrasound imaging instrument.Acupuncture under ultrasonographic guidance verified the differentiation between acupoint locations and surrounding tissues.Results ①Ancient texts described the Yuji acupoint's location gradually narrowing from scattered vessels on the thenar to a depression beyond the"scaphoid-trapezium groove".②Consistently,partition pressure consistently induced sensations in the distal"scaphoid-trapezium groove".③The most intense acupoint sensations occurred upon needling the distal end of the"scaphoid-trapezium groove".④Microscopic dissection revealed that the muscular branches of the pollicoparpal muscle and their accompanying vessels enter the muscle at the Yuji point.⑤ Strong acupoint sensations correlated with the needle tip positioned at the muscle hilum of the opponens pollicis.⑥Ultrasound imaging confirmed that the muscle hilum of the opponens pollicisasthe solid anatomical structure of the Yujiacupoint.Conclusion The primary acupoint of Yuji is located at the distal end of the"scaphoid-trapezium groove",which is at the hilum of the opponens pollicis.Additionally,multiple other acupoints are dispersed throughout the thenar area,with relatively dense distribution of acupoint bodies in regions rich in superficial skin veins in the middle and proximal thenar area.
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