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：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）LowFrequencyRange:2-5HzFeature:MuscleContractionRaisethetensionofthemuscleandligamentRelievepainSuitableforflacciditysyndromeandinjuriesofmuscleandligament.

高频范围：50－100Hz特点：降低神经应激（止痛、镇静、缓解痉挛、针麻）HighFrequencyRange:50-100HzFeatures:ReducenerveirritabilityRelievepain,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ContinuousWaveForm:Feature:SinglewaveformMostcomfortablethanothersEasilytoleratedFunction: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-DenseWaveForm:Feature:Sparse,densewavealternanteach1.5secondsFeelingtwitchingNoteasilytoleratedFunction:Promotemetabolism,circulation,improvetissuenutritionEliminationofinflammatoryedema(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）IntermittentWaveForm:Feature:Nocurrent,densewavealternanteach1.5secondsHardtoadjust,feelinguncomfortableNoteasilytoleratedFunction: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）RespiratoryWaveForm:Feature:6-20times/min,andthesaw-toothwaveFunction:Enhancetheexcitabilityofnerve

andmuscleImprovebloodcirculationStimulationofthephrenicnerve(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Routine

10--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Caution

1防止各穴感觉差异过大Preventlargedifferencesfeelingbetweenacupoints

2防止短路Preventshortcircuit同侧ipsilateral－－肢体病变limbs

symptoms

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Dur