目的:探讨腧穴热敏态红外客观显示的可能性。方法:共纳入腰椎间盘突出症患者79例。在自然状态下采用热断层扫描成像(TTM)拍摄腰背部红外热像图,图像采集完毕,接受灸感法热敏检验(艾条悬灸腰阳关穴10min)。悬灸结束后记录患者腰阳关穴产生扩热、传热的例数,然后再进行第2次红外辐射测量,记录艾灸前后腰背部红外图像变化,比较两种检测法对腰椎间盘突出患者腰阳关穴热敏态的检测差异。结果:艾灸前腰椎间盘突出症患者腰阳关穴区红外辐射强度多数显示高温特征,与灸感法比较,其敏感性(真阳性率)为86.4%,特异性(真阴性率)为70.0%,准确性为82.3%;艾灸腰阳关穴区后,产生明显的沿腰背正中纵向扩散(督脉)或横向扩散(带脉)的红外辐射增强区域,与灸感法比较,其敏感性(真阳性率)为79.7%,特异性(真阴性率)为75.0%,准确性为78.5%。结论:(1)腰椎间盘突出症患者腰阳关穴区热敏态在一定程度上可被红外成像客观显示。(2)艾灸热敏腧穴产生的腧穴热敏现象(如扩热、传热),除了受试者的主观感觉,在一定程度上也能被红外成像客观显示。
Objective To explore the possibility of infrared objective display of the heat-sensitive (HS) acupoint. Methods In 79 cases of lumbar intervertebral disc protrusion (LIDP) patients, infrared thermograms of the lumbar and back region were taken with a thermal texture maps(TTM) method at a natural state, followed by a heat-sensitive detection with moxibustion method [moxibustion was given at Yaoyangguan (腰阳关GV 3) area for 10 min]. The cases with thermal diffusion and heat transfer on the Yaoyangguan (腰阳关GV 3) area were recorded after ceasing of the suspended moxibustion. Then the infrared thermograms were taken by TTM for the second time, and the changes of infrared thermograms of the waist-back region before and after moxibustion were recorded. Finally, the differences between moxibustion and infrared detection methods in the heat-sensitive state on Yaoyangguan (腰阳关GV 3) area were compared in the LIDP patients. Results Before moxibustion, the infrared radiation intensity most displayed high-temperature characteristics on the Yaoyangguan (腰阳关GV 3) area in the LIDP patients. Compared with the moxibustion method, the sensitivity(true positive rate) was 86.4%, the specificity (true negative rate) was 70.0%, and the accuracy was 82.3%; after moxibustion at the Yaoyangguan (腰阳关GV 3) area, the infrared radiation enhanced area obviously extended vertically along the medial waist-back (the Governor Vessel) or horizontally along the Belt Vessel. Compared with the moxibustion method, the sensitivity (true positive rate) was 79.7%, the specificity (true negative rate) was 75.0% and the accuracy was 78.5%. Conclusion The HS state of Yaoyangguan (腰阳关GV 3) area in the LIDP patients can be objectively displayed by the infrared imaging to a certain extent; moxibustion at the HS acupoint produces the thermal phenomena, such as thermal expansion and heat transfer, which can be objectively displayed to a certain extent by the infrared imaging