電針參數(shù)與臨床應(yīng)用

ThePracticeandParametersoftheElectronicAcupuncture福建中醫(yī)藥大學(xué)學(xué)院針灸學(xué)院吳強AcupunctureCollegeofFujianUniversityofTraditionalChineseMedicineE-mail：為什么用電針？WHY

替代Alternation取代Substitution規(guī)范

Normalization

經(jīng)濟Economical怎樣用電針？HOW用針的本意？PurposeofNeedling

用電的本意（主or輔）Purposeofcurrent(dominantorassisting)電針參數(shù)

Parameters

頻率Frequency

波型

Waveform

強度

Intensity

刺激時間

Duration

間隔時間

Interval

連接方式

Connection頻率Frequency

低頻<30HzLF高頻>30Hz（50－100Hz）HF

低頻范圍：2－5Hz特點引起肌肉收縮提高肌肉韌帶張力緩解止痛（痿證，各種肌肉、韌帶損傷）LowFrequencyRange:2-5HzFeature:MuscleContractionRaisethetensionofthemuscleandligamentRelievepainSuitableforflacciditysyndromeandinjuriesofmuscleandligament.

高頻范圍：50－100Hz特點：降低神經(jīng)應(yīng)激（止痛、鎮(zhèn)靜、緩解痙攣、針麻）HighFrequencyRange:50-100HzFeatures:ReducenerveirritabilityRelievepain,spasmandinducesedation,acupunctureanesthesia

波型

Waveform

連續(xù)波ContinuousWave

疏密波

Distant-DenseWave

斷續(xù)波

IntermittentWave

呼吸波

RespiratoryWave連續(xù)波形態(tài)

特點波型單一

感覺最舒適

易耐受功能依頻率而定ContinuousWaveForm:Feature:SinglewaveformMostcomfortablethanothersEasilytoleratedFunction:Dependsonfrequency疏密波形態(tài)特點

疏、密波交替各1.5秒感覺跳躍不易耐受功能促進(jìn)代謝、循環(huán)，改善組織營養(yǎng)消除炎性水腫

（止痛、肌無力等）Distant-DenseWaveForm:Feature:Sparse,densewavealternanteach1.5secondsFeelingtwitchingNoteasilytoleratedFunction:Promotemetabolism,circulation,improvetissuenutritionEliminationofinflammatoryedema(relievepain,gravis)斷續(xù)波形態(tài)特點無電流與密波各1.5秒難調(diào)節(jié)、多不適感不易耐受功能提高肌肉組織的興奮性（痿證、癱瘓等）IntermittentWaveForm:Feature:Nocurrent,densewavealternanteach1.5secondsHardtoadjust,feelinguncomfortableNoteasilytoleratedFunction:Enhancetheexcitabilityofmuscle(flacciditysyndromeandparalysis)呼吸波形態(tài)特點6-20次/分，鋸齒形波功能提高神經(jīng)肌肉興奮性改善氣血循環(huán)刺激膈神經(jīng)（人工電呼吸）RespiratoryWaveForm:Feature:6-20times/min,andthesaw-toothwaveFunction:Enhancetheexcitabilityofnerve

andmuscleImprovebloodcirculationStimulationofthephrenicnerve(simulateartificialrespiration）強度

Intensity

感覺閾←-----------------→痛閾

弱←-------強度--------→強

性別男↓女↑年齡老↑

少↓虛實虛↑

實↓

SensoryThresholdPainThresholdIntensityWeakStrongGenderAgeDeficiency/ExcessMaleFemaleOldYoungDeficiencyExcess刺激時間

Duration

常規(guī)Routine

10--30分鐘min

局部（體表）Portion(Surface)

整體（臟腑）Holisticview(Zang-Fuorgans)

刺激時間（局部）Duration(portion)實證Excess長時間（30分鐘）Long(30min)

虛證Deficiency短時間（3-5分鐘×2-3次）Short(3-5min×2-3round)刺激時間（整體）Duration(HolisticView)實證Excess

長時間（30分鐘）Long(30min)虛證Deficiency？刺激間隔時間

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，舒適為度）

onceperweek（comfortnottolerance)

連接方式Connection

常規(guī)方式Routine

注意事項Caution

1防止各穴感覺差異過大Preventlargedifferencesfeelingbetweenacupoints

2防止短路Preventshortcircuit同側(cè)ipsilateral－－肢體病變limbs

symptoms

對側(cè)

contralateral－－臟腑病變organssymptoms臨床應(yīng)用舉隅

ClinicalCases鎮(zhèn)痛Analgesia波型Form頻率Freq強度Intensity時間Duration連接Conn間隔Interval急性期Acute連續(xù)con高頻HF強Strong長Long同或?qū)psi/contr2-3次/w慢性期Chron1次/w治標(biāo)Temp連續(xù)con高頻HF強Strong長Long同或?qū)psi/contr2-3次/w治本Permt連續(xù)con低頻LF弱Weak短Short同ipsi痿證Flacciditysyndrome

波型Form不拘Random

頻率Frequency低Low

強度Intensity弱Weak刺激時間Duration短Short

連接方式Connection同側(cè)Ipsilateral

間隔時間Interval稍長abitlonger臟腑虛證DeficiencysymptomsofZang-Fu

波型Form不拘Random

頻率Frequency低Low

強度Intensity弱Weak刺激時間Duration稍長abitlonger

連接方式Connection

對側(cè)Contralateral

間隔時間Interval稍長abitlonger臟腑實證ExcessivesymptomsofZang-Fu

波型Form

連續(xù)波

Continuouswave

頻率Frequency

高

High

強度Intensity

強

Strong刺激時間Dur