| ObjectiveThyroid nodules are the most common type of thyroid disease,and the efficacy of acupuncture and moxibustion for thyroid disease has been proven by numerous literatures and clinical studies.But at the same time,it should be recognized that the clinical feature of acupuncture and moxibustion is the meridian dialectic,especially the identification of the disease position as the core,but at present,most doctors have insufficient emphasis and emphasis on the meridian dialectic in acupuncture treatment.Based on ancient literature and clinical practice experience,we believe that regardless of the meridian circulation and symptoms,the selection of acupuncture prescriptions of ancient and modern physicians,the acupuncture treatment rules,and the etiology and pathogenesis of disease,thyroid diseases are closely related to the Yangming Meridian of the hand,and the three yang meridians of the hand are related to neck diseases to varying degrees.The acupoint is a specific part of the body's internal organs and meridians,qi and blood transfused on the body surface,reflecting the dynamic changes of human life activities.Its body surface position,physiological function,pathological response,and therapeutic effect are in line with the body's visceral qi and blood.The strength and weakness are constantly changing.Therefore,by exploring the specific changes of specific meridian and acupoints under specific disease states,clinical diagnosis and syndrome differentiation and treatment can be guided more pertinently,which has research value.Purpose and meaningThrough the examination and comparison of thyroid nodules patients and healthy subjects'meridian and acupoint reaction phenomena in upper limbs of the three yang channels of the hand,summarizing and analyzing their distribution and response characteristics.MethodTaking 33 patients with thyroid nodules(Observation group)and 33 healthy subjects(control group)as the research objects,using traditional meridian examination method to examine positive reactants(abnormal morphology of cords,nodules,softness,depressions,etc.)and the occurrence of tenderness at the upper limb circulation site of the three yang meridians of the hand,and determine the fixed pressure(15N)VAS score of the tender points;using the human tenderness mechanics quantitative tester to determine the relative pain threshold of the tender points.(the relative pain threshold=tenderness threshold of the tenderness point-enderness threshold of heteroganglia non-acupoint non-tender point).This study takes the rate of positive reactants,the rate of tenderness and the fixed pressure VAS score and the relative pain threshold of the tender points as an observation indicator.Subjects can start medical examination after signing informed consentResult1.Comparison of the incidence of positive reactants of the three yang meridians of the hand(1)Comparison of the occurrence rate of meridian positive reactants?Comparison within the group:the two groups of subjects showed the most positive reactants in the large intestine meridian.Among them,the incidence of positive reactants in the large intestine meridian in the observation group was significantly higher than that in the sanjiao meridian and the small intestinal meridian(P<0.01).The incidence of positive reactants in the sanjiao meridian was significantly higher than that of the small intestine meridian(P<0.01).The incidence of positive reactants in the large intestine meridian in the control group was significantly higher than that in the small intestine meridian(P<0.01).There was no statistically significant difference in the incidence of positive reactants between the sanjiao meridian,the large intestine meridian and the small intestine meridian(all P>0.05)?Comparison between the groups:Compared with the control group,the incidence of positive reactants in the large intestine meridian and the sanjiao meridian in observation group was significantly higher than that of the control group(P<0.01).There was no statistically significant difference in the incidence of positive reactants in the small intestinal meridian(P>0.05).(2)Comparison of the incidence of positive reactants at acupointsThe positive reactants(abnormal morphology such as ropes,nodules,softness,depression,etc.)appeared in the two groups of subjects were mostly distributed in the upper arm.The positive reactants of large intestine meridian are mostly concentrated in the "Shouwuli-Binao"section.Among them,the incidence of positive reactants in Shouwuli of the observation group was 31.8%,in Binao of the observation group was 33.3%,both are significantly higher than the control group with the same name(P<0.01);the positive reactants of Sanjiao meridian are mostly distributed in the section of "Qinglengyuan-Xiaoluo",the incidence of positive reactants in the observation group(18.2%)was higher than that in the control group(4.5%)(P<0.05);the positive reactants small intestine meridian are scattered in the upper arm,and there is no obvious distribution regularity.2.Comparison of the incidence of tenderness of the three yang meridians of the hand:(1)Comparison of the occurrence rate of meridian tenderness:?Comparison within the group:the tenderness rate of the large intestine meridian in the observation group was significantly higher than that of the sanjiao meridian and the small intestine meridian(P<0.01),and the sanjiao meridian was significantly higher than the small intestine meridian(P<0.01).In the control group,the tenderness rate of the large intestine meridian was significantly higher than that of the sanjiao meridian and the small intestine meridian(P<0.01),but there was no statistically significant difference in the tenderness rate between the sanjiao meridian and the small intestine meridian(P>0.05).?Comparison between groups:the tenderness rate of the large intestine meridian and the sanjiao meridian of the observation group was significantly higher than that of the control group(P<0.01),but there was no statistically significant difference in the tenderness of the small intestine meridian between the two groups(P>0.05).(2)Comparison of incidence of tenderness at acupoints:The distribution of tenderness of the three yang meridians of the hand is:on the forearm,both two groups had hypertensive pain rates in the "Xialian(L18)-Shousanli(LI10)"line along the large intestine meridian,but there was no statistically significant difference between the groups(P>0.05);on the upper arm,both two groups had hypertensive pain rates in the"Zhouliao(LI12)-Shouwuli(LI13)" and Binao(LI14)in the large intestine meridian,but the observation group has extensive tenderness in the "Quchi(LI11)-Jianyu(LI15)" circulatory line.The tenderness of sanjiao meridian in both groups of subjects was concentrated in the"Qinglengyuan(TE11)-Xiaoluo(TE12)" line.And he tenderness of the small intestine meridian in both groups was scattered on the upper arm,and there was no obvious regularityFurther comparing the incidence of tenderness at acupoints between the two groups,the results showed:?meridian points:in the large intestine meridian,the incidence of tenderness in the observation group of Zhouliao(LI12),Shouwuli(LI13),Binao(LI14),Jianyu(LI 15),Quchi(LI11)respectively is 68.2%,65.2%,54.5%,28.8%,27.3%,all significantly higher than the control group with the same name(all P<0.01).The incidence of tenderness in Sanjiao meridian points Xiaoluo(TE12)(22.7%)and Qinglenyuan(TE11)(18.2%)in the Observation group was higher than that of the acupoint with the same name in the control group,and the differences between the groups were statistically significant(all P<0.05).?non-meridian points in the large intestine meridian,the incidence of tenderness in the observation group 1 cun under the Shouwuli(LI13)(74.2%)was higher than that in the control group(10.6%),the differences are statistically significant(P<0.01).in thesanjiao meridian,the incidence of the point that 1 cun under Xiaoluo(TE12)(9.1%)in the observation group was higher than that in the control group(0.0%),the difference was statistically significant(P<0.05).(3)VAS score of fixed pressure value:comparing the acupoints of the same name with high tenderness rate and statistical difference between the two groups,the Observation group Zhouliao(LI12),Shouwuli(LI13),Binao(LI14),Qinglengyuan(TE1 1),The fixed pressure value VAS scores of Xiaoluo(LI12)were significantly higher than those of the same name in the control group,and the differences between the groups were statistically significant[Zhouliao,Shouwuli,Binao(all P<0.01);Xiaoluo,Qing Leng Yuan(all P<0.05)].(4)Relative pressure pain threshold:The relative pressure pain thresholds of Zhouliao(LI12),Shouwuli(LI13),Binao(LI14),Qinglengyuan(TE11),Xiaoluo(LI12)in the Observation group were all higher than those of the same name in the control group,and the differences between each point group were statistically significant Significance[Zhouliao,Shouwuli,Binao,Qinglengyuan(all P<0.01);Xiaoluo(P<0.05)].Conclusion(1)The positive reactants of the large intestine meridian and the sanjiao meridian in the observation group were higher than the control group in the incidence of tenderness and tenderness,which initially indicated that the two meridians were related to the pathological state of thyroid nodules.(2)The incidence of positive reactants and tenderness at acupoints of the meridian of the large intestine are significantly higher than that of the sanjiao meridian,and there is more widespread tenderness at the circulatory site of the upper arm.It shows that the relationship between the large intestine meridian and thyroid disease is closer,so more attention should be paid to the examination of the classics in the clinic,and it also provided evidence for treating thyroid disease based on the large intestine meridian(3)In patients with thyroid nodules,the positive reaction of Sanyang Meridian in the hand is mostly distributed in the upper arm,suggesting that there may be a closer relationship between the acupoints on the upper arm and thyroid disease.Among them,Zhouliao(LI12),Shouwuli(LI13),Binao(LI14),Qinglengyuan(TE11)Xiaoluo(LI12)are more specific than other acupuncture points. |
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