崔帅;崔瑾;
CUI Shuai,CUI Jin(Guiyang College of Chinese Medicine,Guiyang 550002,China)

• 1:贵阳中医学院

摘要(Abstract)：

中医拔罐疗法治疗疾病,是多种复合刺激作用于皮肤和穴位产生的综合效应。其中,罐内负压是疗效产生的主要因素。现代医学负压疗法中,对负压的作用机制也有深入研究。本文针对拔罐疗法和现代医学负压疗法的效应机制的相关研究文献进行了总结,认为罐内负压的形成与操作熟练程度、火罐大小和燃用乙醇浓度等因素有关;罐内负压与罐斑的形成密切相关。负压能够扩张血管,调节局部血流量,改善局部微循环;促进局部毛细血管和内皮细胞形态修复;促进细胞核增殖抗原的表达,显著提高创面再上皮化速度,发挥良性刺激作用,使机体功能恢复正常。
Cupping therapy of Chinese medicine is able to relieve a variety of diseases or clinical conditions,which results from the comprehensive effects of multiple types of stimulation exerted onto the regional acupoint areas.Among the stimuli,the negative pressure from cupping is one of the main factors inducing therapeutic effects.In the present paper,the authors review development of researches on the underlying mechanism of therapeutic effects of cupping-negative pressure from 1) the factor of intra-cup negative pressure;2) influence of intra-cup negative pressure on cup-blackspot formation;3) influence of cupping on regional blood vessels and blood flow;4) effect of cupping on regional ultrastructure of the capillary in the raw-surface tissue;5) effect of cupping-negative pressure on regional endothelial cells;and 6) biological effects of negative pressure drainage.Generally,cupping induced negative pressure can dilate local blood vessels to improve microcirculation,promote capillary endothelial cells repair,accelerate granulation and angiogenesis,etc.,in the regional tissues,normalizing the patients' functional state at last.

关键词(KeyWords)： 拔罐疗法;负压效应;局部微循环;超微结构;生物效应
Cupping therapy;Negative pressure effect;Regional microcirculation;Ultrastructure;Biological effects

Abstract:

Keywords:

基金项目(Foundation): 贵州省科技厅(黔科合中药字[2010]LKZ 7040号)

作者(Authors): 崔帅;崔瑾;
CUI Shuai,CUI Jin(Guiyang College of Chinese Medicine,Guiyang 550002,China)

DOI: 10.13702/j.1000-0607.2012.06.011

参考文献(References)：

• [1]王富春.刺法灸法学[M].上海:上海科学技术出版社,2009:87.Wang F C.Subject on Needling and Moxibustion Methods[M](Chin).Shanghai:Shanghai Scientific and Technical Publis-hers,2009:87.
• [2]刘兵,宋佳杉.拔罐的传统中医思维与临床应用[J].江苏中医药,2009,41(6):28-29.Liu B,Song J S.Thoughts of traditional Chinese medicine a-bout cupping and clinic application[J].Jiangsu Zhong Yi Yao(Jiangsu J Trad Chin Med,Chin),2009,41(6):28-29.
• [3]杨金生,王敬.拔罐疗法的治病机理探讨[J].中国中医基础医学杂志,1996,2(6):39-40.Yang J S,Wang J.Study on cupping therapy in the treatmentof different clinical disorclers[J].Zhongguo Zhong Yi Ji ChuYi Xue Za Zhi(Chin J Basic Med Trad Chin Med,Chin),1996,2(6):39-40.
• [4]陈利华,晋松,胡幼平.刺络拔罐法治疗痤疮的临床研究进展[J].中医药学刊,2006,24(4):688-690.Chen L H,Jin S,Hu Y P.Clinical research progress of bloodletting puncture and cupping on acne[J].Zhong Yi Yao XueKan(Chin Arch Trad Chin Med,Chin),2006,24(4):688-690.
• [5]吴振英.拔罐疗法临床应用进展[J].中国中医急症,2010,19(3):504-506.Wu Z Y.Progress on clinical application of cupping therapy[J].Zhongguo Zhong Yi Ji Zheng(J Emerg Trad Chin Med,Chin),2010,19(3):504-506.
• [6]仝小林,张志远,张斌,等.不同因素对拔火罐即刻真空压力形成的影响[J].中国针灸,1999,19(3):183-184.Tong X L,Zhang Z Y,Zhang B,et al.Effect of different fac-tors on the formation of vacuum pressure of cupping[J].Zhongguo Zhen Jiu(Chin Acu-moxi,Chin),1999,19(3):183-184.
• [7]李亚明,李铁浪,余霜泉,等.拔火罐内负压和温度动态变化的实验观察[J].湖南中医学院学报,1999,19(4):58-59.Li Y M,Li T L,Yu S Q,et al.Experimental observation ofcupping in negative pressure and changes of temperature[J].Hunan Zhong Yi Xue Yuan Xue Bao(J Hunan Coll Trad ChinMed,Chin),1999,19(4):58-59.
• [8]田宇瑛,秦丽娜,张维波.不同拔罐负压对皮肤血流量影响的初步观察[J].针刺研究,2007,32(3):184-185.Tian Y Y,Qin L N,Zhang W B.Preliminary observation onthe impact of different cupping in negative pressure on the skinblood perfusion[J].Zhen Ci Yan Jiu(Acupunct Res,Chin),2007,32(3):184-185.
• [9]赵喜新,童伯瑛,王雪霞,等.时间和压力因素对拔罐罐斑颜色影响的初步观察[J].中国针灸,2009,29(5):385-388.Zhao X X,Tong B Y,Wang X X,et al.Effect of time andpressure factors on the cupping mark color[J].Zhongguo ZhenJiu(Chin Acu-moxi,Chin),2009,29(5):385-388.
• [10]卢静,褚晓彦,王磊,等.火罐内压力变化及罐内负压对毫针进针深度影响观察[J].生物医学工程学杂志,2010,27(1):71-74.Lu J,Chu X Y,Wang L,et al.The change of negative pres-sure in the cupping-cup and its influence on the depth of fili-form-needle insertion[J].Sheng Wu Yi Xue Gong Cheng XueZa Zhi(J Biomed Engin,Chin),2010,27(1):71-74.
• [11]冯友贤.血管外科学[M].上海:上海科学技术出版社,1980:52-53.Feng Y X.Vascular Investigation on Surgery[M](Chin).Shanghai:Shanghai Scientific and Technical Publishers,1980:52-53.
• [12]袁时芳,王建宏,宁莫凡,等.彩色多普勒血流显像观察负压疗法对肢体血供的影响[J].第四军医大学学报,2000,21(12):1495-1497.Yuan S F,Wang J H,Ning M F,et al.Negative pressuretreatment promotes blood supply of limb ischemia by colorDoppler flow imaging[J].Di Si Jun Yi Da Xue Xue Bao(JForth Milit Med Univ,Chin),2000,21(12):1495-1497.
• [13]Wolthuis R A,Bergman S A,Nicogossian A E.Physiologicaleffects of locally applied reduced pressure in man[J].PhysiolRev,1974,54(3):506-567.
• [14]蒋琪霞,刘云,徐薇,等.负压伤口治疗关键技术的研究进展[J].医学研究生学报,2007,20(6):656-659.Jiang Q X,Liu Y,Xu W,et al.The technical progress onthe negative pressure wound therapy[J].Yi Xue Yan JiuSheng Xue Bao(J Med Postgraduat,Chin),2007,20(6):656-659.
• [15]蒋琪霞,胡素琴,彭青,等.负压封闭辅助闭合技术用于伤口治疗的流程设计[J].解放军护理杂志,2009,26(9B):1-3.Jiang Q X,Hu S Q,Peng Q,et al.Procedure flow design ofvacuum assisted closure technique for wound care[J].JieFang Jun Hu Li Za Zhi(Nurs J Chin People Liberat Army,Chin),2009,26(9B):1-3.
• [16]Venturi M L,Attinger C E,Mesbahi A N,et al.Mecha-nisms and clinical applications of the vacuum-assisted closure(VAC)device:a review[J].Am J Clin Dermatol,2005,6(3):185-194.
• [17]许龙顺,陈绍宗,乔骋,等.负压对创面血流量的影响[J].第四军医大学学报,2000,21(8):976-978.Xu L S,Chen S Z,Qiao C,et al.Effects of negative pressureon wound blood flow[J].Di Si Jun Yi Da Xue Xue Bao(JForth Milit Med Univ,Chin),2000,21(8):976-978.
• [18]许龙顺,乔骋,陈绍宗.负压对感染创面细菌清除率的影响[J].陕西医学杂志,2007,36(12):1590-1591.Xu L S,Qiao C,Chen S Z.Effect of negative pressure on therate of bacterial clearance in pig infected wound model[J].Shaanxi Yi Xue Za Zhi(Shaanxi Med J,Chin),2007,36(12):1590-1591.
• [19]李靖,陈绍宗,李学拥,等.封闭负压引流对创面微循环超微结构的影响[J].中国实用整形美容外科杂志,2006,17(1):75-77.Li J,Chen S Z,Li X Y,et al.Effects of vacuum-assisted-closure technique on ultrastructure of wounds’microcircula-tion[J].Zhongguo Shi Yong Zheng Xing Mei Rong Wai KeZa Zhi(Chin J Pract Aesth Plast Surg,Chin),2006,17(1):75-77.
• [20]Prelich G,Tan C K,Kostura M,et a1.Functional identityof proliferating cell nuclear antigen and a DNA polymerase-delta auxiliary protein[J].Nature,1987,326(6113):1-17.
• [21]许龙顺,乔骋,陈绍宗,等.负压对供皮区创面再上皮化速度的影响[J].西安交通大学学报:医学版,2008,29(1):57-61.Xu L S,Qiao C,Chen S Z,et al.Effect of negative pressureon the rate of skin donor site reepithelialization in pig model[J].Xi’an Jiao Tong Da Xue Xue Bao:Yi Xue Ban(J Xi’anJiaotong Univ:Med Sci,Chin),2008,29(1):57-61.
• [22]韩桂秋,陈克明.负压疗法促进创伤愈合的机制与进展[J].中国骨伤,2010,23(7):558-560.Han G Q,Chen K M.Mechanism and progressing study inpromoting wound healing with negative pressure therapy[J].Zhongguo Gu Shang(Chin J Orthop Trauma,Chin),2010,23(7):558-560.