基于激光散斑衬比成像技术观察候气针法影响面瘫的“机信号”研究

The Qi in traditional meridians can be divided into Ying Nutrient Qi and Wei Defensive Qi. Nutrient Qi goes deeper while Defensive Qi goes under-skin. According to TCM theory, the flow of Qi can affect the flow of blood. So the flow of Defensive Qi can cause some changes in the under-skin microcirculation. Hou-Qi acupuncture therapy is a traditional therapy comes from Huangdi Neijing. The manipulator can feel the flow of Qi in human body through a needle. He can distinguish Defensive Qi, Nutrient Qi and Evil Qi. Then he will operate some skills to reinforce Defensive Qi and Nutrient Qi, and reduce Evil Qi, so the diseases can be cured. This project uses Laser Speckle Contrast Imaging to measure changes in cerebral blood flow of patients with facial paralysis while using techniques of Hou-qi acupuncture therapy, while recording heart rate variability (HRV) and blood perfusion at the same time. Analyze the effect of Hou-qi acupuncture therapy to facial paralysis, and study if there is a possible link between the flow of Defensive Qi and all the signals including the change of blood flow, HRV and blood perfusion etc. Investigate the mechanism of how the Hou-qi acupuncture therapy affect the Defensive Qi. And discuss the existence of traditional meridian Qi.

传统岭南候气针法源自《黄帝内经》，"粗守关，上守机"是其要领，医者通过持针来感应人体内经气流动，分辨出人体内营气、卫气和邪气的机信号，把握机信号特征，及时施以不同的补泻手法，调节人体状态回复正常，临床实践证实该法效果明显。根据中医"气行则血行"的理论，经气流动与浅表组织的血流变化状态同步，观察血流状况可以了解气机的变化特征。为了进一步揭示候气针法中机信号的特征，本研究应用激光散斑衬比成像技术（Laser Speckle Contrast Imaging）的大范围视场和动态监测功能，来精确实时观测浅表组织的微循环状况，同时配合心率变异性、四肢血流灌注等生理技术，全程监测针灸师所感应人体状态时的机信号，以及实施补泻干预后的状态变化，综合分析候气针法干预面瘫的影响机制。本研究结合动态和静态，多维度观察人体状态在候气针法影响下出现的机信号，探讨传统补泻手法的机制，从新的角度为经络存在提供客观依据。

本研究在传承传统候气针法，基于医者持针感应经穴机信号，实施补泻调节人体状态，疗效迅速，这一临床事实。为揭示候气针法的基本原理开展了系列实验，包括健康人的穴位意识关注试验、候气针法治疗周围性面瘫的疗效评价，常规针法治疗面瘫的临床对照观察和及健康人持针意识关注实验等。应用激光散斑衬比成像技术（Laser Speckle Contrast Imaging），从微循环角度阐释了候气针法的部分作用机制，比如意识关注前后合谷穴血流微循环存在显著差别。发现关键点“候气-守神”，医患双方都需进入“调节状态”，提炼中医科学假说“状态观”，围绕科学问题“状态是什么？”展开研究，提炼状态本质在于意识，提炼“意识心身网络和意识能动性”， 候气针法的应用，放松状态下的意识专注和内涵优化是疗效保证，整理“穴位意识论”和“心能学”等创新理论；逐步完善“人体状态学”体系，形成理论指导技术发展的思路，整理“状态针法”， 连接和优化，初步在小样本的面瘫治疗临床观察中获得疗效验证和LSCI微循环数据支持,操作更为简便易行。提出“状态观”和“状态运动”，发展中医康复学核心内涵与特色，直接推动中西医结合康复学学科的建设。