• 成都中醫(yī)藥大學(xué)（成都，610075） 1 針灸推拿學(xué)院，2 附屬醫(yī)院推拿科;

【摘要】　目的　 觀察循膀胱經(jīng)彈撥法干預(yù)亞健康狀態(tài)方案的療效及優(yōu)勢(shì)，并規(guī)范其技術(shù)標(biāo)準(zhǔn)，為臨床提供安全有效的治療技術(shù)范例。　方法　 2009年3月-2010年8月，采用多中心、分層區(qū)組隨機(jī)、平行對(duì)照的臨床研究方法，選擇亞健康狀態(tài)受試者360例，隨機(jī)分為傳統(tǒng)組、彈撥組、復(fù)合組，每組120例。觀察受試者干預(yù)前后的臨床癥狀積分、血沉、血漿乳酸、全血黏度（切變率分別為1、5、30、200/s）的變化，及有效性和安全性。　結(jié)果　 共305例完成試驗(yàn)，其中傳統(tǒng)組97例，彈撥組102例，復(fù)合組106例。彈撥組、復(fù)合組的總體療效與傳統(tǒng)組比較差異有統(tǒng)計(jì)學(xué)意義（P lt;0.05），彈撥組與復(fù)合組比較差異無統(tǒng)計(jì)學(xué)意義（P lt;0.05）。干預(yù)后彈撥組、復(fù)合組的臨床癥狀積分、血沉、血漿乳酸、全血黏度與傳統(tǒng)組比較差異有統(tǒng)計(jì)學(xué)意義（P lt;0.05）；彈撥組與復(fù)合組臨床癥狀積分、血液乳酸全血黏度（切變率分別為1、200/s）差異無統(tǒng)計(jì)學(xué)意義（P gt;0.05），血沉、全血黏度（切變率分別為5、30/s）差異有統(tǒng)計(jì)學(xué)意義（P lt;0.05）。各組各指標(biāo)干預(yù)后前后自身比較差異均有統(tǒng)計(jì)學(xué)意義（P lt;0.05）。　結(jié)論　 推拿能有效地改善亞健康狀態(tài)，復(fù)合組療效最佳，彈撥組其次，傳統(tǒng)組較差。循膀胱經(jīng)彈撥法對(duì)亞健康狀態(tài)的干預(yù)有效性較傳統(tǒng)推拿更好。
【Abstract】　Objective　 To observe the efficacy and advantages of flicking and poking along bladder channels in intervening sub-health state and regulate the technical standards for clinical treatment techniques, in order to provide safe and effective treatment criteria. 　Methods　 Multi-centered, stratified randomized and parallel controlled clinical research methods were adopted in this study. From March 2009 to August 2010, 360 subjects with sub-health status were randomly divided into traditional group, flicking and poking group, and combining group with 120 cases in each group. The changes of clinical symptoms, erythrocyte sedimentation rate, plasma lactate, and whole blood viscosity (shear rates of 1, 5, 30, 200/s) as well as the efficacy and safety were observed.　Results　 A total of 305 patients completed the trial, including 97 in the traditional group, 102 in the flicking and poking group, and 106 in the combining group. The general efficacy for the flicking and poking group and the combining group was significantly different from that for the traditional group (P lt;0.05), while there was no significant difference between the flicking and poking group and the combining group. After the intervention, the clinical symptom score, erythrocyte sedimentation rate, plasma lactate, and whole blood viscosity of the flicking and poking group and the combining group were significantly different from those of the traditional group (P lt;0.05). The clinical symptom score, plasma lactate and whole blood viscosity (shear rates of 1, 200/s) of the flicking and poking group and the combining group were not significantly different (P gt;0.05), while erythrocyte sedimentation rate, and whole blood viscosity (shear rates of 5, 30/s) between those two groups were significantly different (P lt;0.05). All the above mentioned indexes before and after intervention in each group were statistically different (P lt;0.05).　Conclusion　 Massage can improve the sub-health state, and the combining method has the best efficacy followed by flicking and poking, while traditional method has a poor efficacy. Intervening sub-health state with flicking and poking along bladder channels has a better efficacy than the traditional method of massage.

引用本文： 徐僥,藍(lán)嵐,李川,羅建,羅才貴. 循膀胱經(jīng)彈撥法干預(yù)亞健康狀態(tài)方案的優(yōu)化研究. 華西醫(yī)學(xué), 2011, 26(4): 485-489. doi: 復(fù)制

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7. 　韓標(biāo), 孔晶, 劉偉, 等. 亞健康狀態(tài)軀體癥狀自評(píng)量表的編制及信度、效度檢驗(yàn)[J]. 中國(guó)心理衛(wèi)生雜志, 2007, 21(6): 382-384.
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12. 　Levine PH, Jacobson, Pocinki AG, et al. Clinical, epidemiologic, and virologic studies in four clusters of the chronic fatigue syndrome[J]. Arch Inter Med, 1992, 152(8): 1611-1616.
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14. 　Jason LA, Richman JA, Rademaker AW, et al. A community-based study of s chronic fatigue syndrome[J]. Arch Intern Med, 1999, 159(18): 21-29.
15. 　Sharpley A, Clements A, Hawton K, et al. Do patients with "pure" chronic fatigue syndrome (neurasthenia) have abnormal sleep?[J]. Psychosom Med, 1997, 59(6): 592-596.
16. 　MacHale SM, Lawrie SM, Cavanagh JT, et al. Cerebral perfusion in chronic fatigue syndrome and depression[J]. Br J Psychiatry, 2000, 176(6): 550-556.
17. 　Nawab SS, Miller CS, Dale JK, et al. Self-reported sensitivity to chemical exposures in five clinical populations and healthy controls[J]. Psychiatry Res, 2000, 95(1): 67-74.
18. 　王艷會(huì), 欒兆鴻. 亞健康與血液流變學(xué)[J]. 中國(guó)血液流變學(xué)雜志, 2006, 16(1): 138-145.
19. 　陳安宇, 王銳. 血液細(xì)胞阻抗的測(cè)量與臨床意義的探索[J]. 中國(guó)醫(yī)學(xué)物理學(xué)雜志, 2004, 21(1): 33-35.
20. 　鐘玉昆. 亞健康問題與防治研究成果的研究[J]. 廣東微量元素科學(xué), 2002, 9(5): 60-64.
21. 　張昌福. 試論亞健康狀態(tài)與微循環(huán)障礙的關(guān)系[J]. 中國(guó)血液流變學(xué)雜志, 1998, 8(2): 15-17.
22. 　王雪梅, 宋清玲, 任從棉, 等. 臨潼礦泉水浴對(duì)亞健康軍人血漿乳酸、總二氧化碳的影響[J]. 中國(guó)療養(yǎng)醫(yī)學(xué), 2007, 16(10): 577-578.
23. 　李江山, 胡志希, 吳嵐. 全經(jīng)推拿法對(duì)亞健康狀態(tài)甲襞微循環(huán)及心理的影響[J]. 湖南中醫(yī)雜志, 2007, 23(3): 19-20.
24. 　李守棟, 吳云川, 馬榮連, 等. 推拿對(duì)延遲性肌肉酸痛模型大鼠血清乳酸、乳酸脫氫酶的影響[J]. 陜西中醫(yī), 2009, 30(12): 1684-1685.
  1. 1. 　趙商勛. 亞健康流行學(xué)研究進(jìn)展[J]. 中華中西醫(yī)雜志, 2009, 10(1): 18-20.
  2. 2. 　王育學(xué). 亞健康——21世紀(jì)健康新概念[M]. 江西: 江西科學(xué)技術(shù)出版社, 2002: 18.
  3. 3. 　閆伯華. 亞健康的流行病學(xué)研究進(jìn)展[J]. 現(xiàn)代預(yù)防醫(yī)學(xué), 2005, 32(5): 465-466.
  4. 4. 　中華中醫(yī)藥學(xué)會(huì)亞健康分會(huì). 亞健康的中醫(yī)臨床研究指導(dǎo)原則（試行）[S]. 世界醫(yī)藥學(xué)會(huì)聯(lián)合亞健康專業(yè)委員會(huì)暨首屆世界亞健康學(xué)術(shù)大會(huì), 2005, 12.
  5. 5. 　劉保延, 何麗云, 謝雁鳴, 等. “亞健康狀態(tài)調(diào)查問卷”的設(shè)計(jì)思想與內(nèi)容結(jié)構(gòu)[J]. 中國(guó)中醫(yī)基礎(chǔ)醫(yī)學(xué)雜志, 2007, 13(5): 382-383.
  6. 6. 　李海峰, 陳曉, 金如鋒. 亞健康證候測(cè)試量表的編制和信效度分析[J]. 陜西中醫(yī), 2007, 28(5): 565-567.
  7. 7. 　韓標(biāo), 孔晶, 劉偉, 等. 亞健康狀態(tài)軀體癥狀自評(píng)量表的編制及信度、效度檢驗(yàn)[J]. 中國(guó)心理衛(wèi)生雜志, 2007, 21(6): 382-384.
  8. 8. 　馬寰. 亞健康狀態(tài)中醫(yī)證候流行病學(xué)調(diào)查[D]. 天津: 天津中醫(yī)學(xué)院, 2004.
  9. 9. 　于春泉. 亞健康狀態(tài)中醫(yī)證候流行病學(xué)調(diào)查[D]. 天津: 天津中醫(yī)學(xué)院, 2005.
  10. 10. 　中華人民共和國(guó)衛(wèi)生部. 中藥新藥臨床研究指導(dǎo)原則[S]. 2002.
  11. 11. 　Theorell T, Blomkvist V, Lindh G, et al. Critical life events, infections, and symptoms during the year preceding chronic fatigue syndrome (CFS): an examination of CFS patients and subjects with a nonspecific life crisis[J]. Psychsom Med, 1999, 61(3): 304-310.
  12. 12. 　Levine PH, Jacobson, Pocinki AG, et al. Clinical, epidemiologic, and virologic studies in four clusters of the chronic fatigue syndrome[J]. Arch Inter Med, 1992, 152(8): 1611-1616.
  13. 13. 　Linde A, Anderson B, Steveson SB, et al. Serum levels of lymphokines and soluble cellular receptors in primary Epstein-Barr virus infection and in patients with chronic fatigue syndrome[J]. J Infect Dis, 1992, 165(6): 994-1000.
  14. 14. 　Jason LA, Richman JA, Rademaker AW, et al. A community-based study of s chronic fatigue syndrome[J]. Arch Intern Med, 1999, 159(18): 21-29.
  15. 15. 　Sharpley A, Clements A, Hawton K, et al. Do patients with "pure" chronic fatigue syndrome (neurasthenia) have abnormal sleep?[J]. Psychosom Med, 1997, 59(6): 592-596.
  16. 16. 　MacHale SM, Lawrie SM, Cavanagh JT, et al. Cerebral perfusion in chronic fatigue syndrome and depression[J]. Br J Psychiatry, 2000, 176(6): 550-556.
  17. 17. 　Nawab SS, Miller CS, Dale JK, et al. Self-reported sensitivity to chemical exposures in five clinical populations and healthy controls[J]. Psychiatry Res, 2000, 95(1): 67-74.
  18. 18. 　王艷會(huì), 欒兆鴻. 亞健康與血液流變學(xué)[J]. 中國(guó)血液流變學(xué)雜志, 2006, 16(1): 138-145.
  19. 19. 　陳安宇, 王銳. 血液細(xì)胞阻抗的測(cè)量與臨床意義的探索[J]. 中國(guó)醫(yī)學(xué)物理學(xué)雜志, 2004, 21(1): 33-35.
  20. 20. 　鐘玉昆. 亞健康問題與防治研究成果的研究[J]. 廣東微量元素科學(xué), 2002, 9(5): 60-64.
  21. 21. 　張昌福. 試論亞健康狀態(tài)與微循環(huán)障礙的關(guān)系[J]. 中國(guó)血液流變學(xué)雜志, 1998, 8(2): 15-17.
  22. 22. 　王雪梅, 宋清玲, 任從棉, 等. 臨潼礦泉水浴對(duì)亞健康軍人血漿乳酸、總二氧化碳的影響[J]. 中國(guó)療養(yǎng)醫(yī)學(xué), 2007, 16(10): 577-578.
  23. 23. 　李江山, 胡志希, 吳嵐. 全經(jīng)推拿法對(duì)亞健康狀態(tài)甲襞微循環(huán)及心理的影響[J]. 湖南中醫(yī)雜志, 2007, 23(3): 19-20.
  24. 24. 　李守棟, 吳云川, 馬榮連, 等. 推拿對(duì)延遲性肌肉酸痛模型大鼠血清乳酸、乳酸脫氫酶的影響[J]. 陜西中醫(yī), 2009, 30(12): 1684-1685.