电针参数与临床应用

电针参数与临床应用ThePracticeandParametersoftheElectronicAcupuncture福建中医药大学学院针灸学院吴强AcupunctureCollegeofFujianUniversityofTraditionalChineseMedicineE-mail：[e-mail]为什么用电针？WHY?替代Alternation取代Substitution规范Normalization经济Economical怎样用电针？HOW?用针的本意？PurposeofNeedling?用电的本意（主or辅）?Purposeofcurrent(dominantorassisting)?电针参数Parameters频率Frequency波型Waveform强度Intensity刺激时间Duration间隔时间Interval连接方式Connection频率Frequency低频30HzLF高频30Hz（50－100Hz）HF低频范围：2－5Hz特点引起肌肉收缩提高肌肉韧带张力缓解止痛（痿证，各种肌肉、韧带损伤）LowFrequencyRange:2-5HzFeature:MuscleContractionRaisethetensionofthemuscleandligamentRelievepainSuitableforflacciditysyndromeandinjuriesofmuscleandligament.高频范围：50－100Hz特点：降低神经应激（止痛、镇静、缓解痉挛、针麻）HighFrequencyRange:50-100HzFeatures:ReducenerveirritabilityRelievepain,spasmandinducesedation,acupunctureanesthesia波型Waveform连续波ContinuousWave疏密波Distant-DenseWave断续波IntermittentWave呼吸波RespiratoryWave连续波形态特点波型单一感觉最舒适易耐受功能依频率而定ContinuousWaveForm:Feature:SinglewaveformMostcomfortablethanothersEasilytoleratedFunction:Dependsonfrequency疏密波形态特点疏、密波交替各1.5秒感觉跳跃不易耐受功能促进代谢、循环，改善组织营养消除炎性水肿（止痛、肌无力等）Distant-DenseWaveForm:Feature:Sparse,densewavealternanteach1.5secondsFeelingtwitchingNoteasilytoleratedFunction:Promotemetabolism,circulation,improvetissuenutritionEliminationofinflammatoryedema(relievepain,gravis)断续波形态特点无电流与密波各1.5秒难调节、多不适感不易耐受功能提高肌肉组织的兴奋性（痿证、瘫痪等）IntermittentWaveForm:Feature:Nocurrent,densewavealternanteach1.5secondsHardtoadjust,feelinguncomfortableNoteasilytoleratedFunction:Enhancetheexcitabilityofmuscle(flacciditysyndromeandparalysis)呼吸波形态特点6-20次/分，锯齿形波功能提高神经肌肉兴奋性改善气血循环刺激膈神经（人工电呼吸）RespiratoryWaveForm:Feature:6-20times/min,andthesaw-toothwaveFunction:EnhancetheexcitabilityofnerveandmuscleImprovebloodcirculationStimulationofthephrenicnerve(simulateartificialrespiration）强度Intensity感觉阈←-----------------→痛阈弱←-------强度--------→强性別男↓女↑年龄老↑少↓虚实虚↑实↓SensoryThresholdPainThresholdIntensityWeakStrongGenderAgeDeficiency/ExcessMaleFemaleOldYoungDeficiencyExcess刺激时间Duration常规Routine10--30分钟min局部（体表）Portion(Surface)整体（脏腑）Holisticview(Zang-Fuorgans)刺激時间（局部）Duration(portion)实证Excess长时间（30分钟）Long(30min)虚证Deficiency短时间（3-5分钟×2-3次）Short(3-5min×2-3round)刺激時间（整体）Duration(HolisticView)实证Excess长时间（30分钟）Long(30min)虚证Deficiency？刺激间隔时间Interval急性期Acutestage每天1－2次或隔日1次1-2times/dayoreveryotherday慢性期Chronicstage每周1次（防止耐受，舒适为度）onceperweek（comfortnottolerance)连接方式Connection常规方式Routine注意事项Caution1防止各穴感觉差异过大Preventlargedifferencesfeelingbetweenacupoints2防止短路Preventshortcircuit同侧ipsilateral－－肢体病变limbssymptoms对侧contralateral－－脏腑病变organssymptoms临床应用举隅ClinicalCases鎮痛Analgesia波型Form频率Freq强度Intensity时间Duration连接Conn间隔Interval急性期Acute连续con高频HF强Strong长Long同或对ipsi/contr2-3次/w慢性期Chron1次/w治标Temp连续con高频HF强Strong长Long同或对ipsi/contr2-3次/w治本Permt连续con低频LF弱Weak短Short同ipsi痿证Flacciditysyndrome波型Form不拘Random频率Frequency低Low强度Intensity弱Weak刺激时间Duration短Short连接方式Connection同侧Ipsilateral间隔时间Interval稍長abitlonger脏腑虚证DeficiencysymptomsofZang-Fu波型Form不拘Random频率Frequency低Low强度Intensity弱Weak刺激时间Duration稍長abitlonger连接方式Connection对侧Contralateral间隔时间Interval稍長abitlonger脏腑实证ExcessivesymptomsofZang-Fu波型Form连续波Continuouswave频率Frequency高High强度Intensity强Strong刺激时间Duration稍長abitlonger连接方式Connection对侧Contralateral间隔时间Interval稍短abitshorter思考Reflection电针电针用电还是用针？Current?Needle?Whichisthepoint?谢谢！Thanks!