后溪穴实体解剖结构研究OA

Objective To investigate the gross anatomical(physical)structures underlying the Houxi(SI3)acupoint.Methods 1)We searched the Duxiu Academic Database and the Zhonghua Yidian Classical Literature Database for ancient texts describing the location of Houxi,and summarized the historical location descriptions.(2)Twenty volunteers were enrolled;based on the locations reported in classical texts,thumb-tip pressure was applied on the skin to identify sites eliciting an acupoint sensation,which were marked as the surface projection points of the acupoint.B-mode ultrasound was used to observe which tissue structures were compressed by the fingertip.(3)Ten volunteers were selected for needling:according to the literature-based location,filiform needles were inserted at different depths and directions in and around the marked area;when a clear acupoint sensation occurred,B-mode ultrasound was used to observe which structure the needle tip contacted.(4)Ten fresh human upper-limb specimens were dissected for observation of the anatomical structures corresponding to the Houxi acupoint.(5)Based on the dissection result,volunteers were examined by ultrasound to locate the anatomical structure;thumb-tip pressure was applied to that structure and to surrounding tissues to compare perceived sensations and test whether a distinct acupoint sensation occurred only when the dissected structure was pressed.(6)Under ultrasound guidance,filiform needles were used to puncture the dissected structure and adjacent tissues in volunteers to compare sensations,testing whether a distinct acupoint sensation occurred only when the needle tip contacted the anatomically identified structure.Results 1)Classical texts describe Houxi as located"on the posterior depression of the basal joint of the little finger on its lateral side."(2)When acupoint sensation was evoked by surface pressure,ultrasound showed the pressed site corresponded to the ulnopalmar aspect of the neck of the 5th metacarpal.(3)When needling evoked acupoint sensation,ultrasound showed the needle tip contacted the structure at the ulnopalmar aspect of the neck of the 5th metacarpal.(4)Systematic layered dissection and sectional anatomy revealed that the structure contacted by the needle tip is the osseous foramen located at the ulnopalmar aspect of the neck of the 5th metacarpal.(5)Under ultrasound,pressure on the ulnopalmar aspect of the 5th metacarpal neck produced a distinct acupoint sensation that was different from sensations elicited at surrounding sites,and this distinct sensation occurred only when pressure reached the osseous region at the 5th metacarpal neck.(6)Ultrasound-guided needle puncture of the osseous foramen at the ulnopalmar aspect of the 5th metacarpal neck elicited a distinct acupoint sensation only when the needle tip contacted that osseous structure,compared with puncture of surrounding tissues.Conclusion The physical(gross anatomical)correlate of the Houxi acupoint is located at the osseous foramen on the ulnopalmar aspect of the neck of the fifth metacarpal.