中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (15): 3913-3919.doi: 10.12307/2025.871

• 骨科植入物Orthopedic implants • 上一篇    下一篇

股骨头坏死穴位敏化现象的对照分析

姚可心1，阳一丹1，李亚鹏2，朱烜烨1，王秋苑2，郭珈宜1，2，刘又文2，岳  辰2   

  1. 1河南中医药大学骨伤学院，河南省郑州市   450046；2河南省洛阳正骨医院(河南省骨科医院)，河南省洛阳市   471002
  • 接受日期:2024-12-20 出版日期:2026-05-28 发布日期:2025-11-07
  • 通讯作者: 郭珈宜，主任中医师,河南中医药大学骨伤学院，河南省郑州市，450046；河南省洛阳正骨医院(河南省骨科医院)，河南省洛阳市 471002 刘又文，主任医师，河南省洛阳正骨医院(河南省骨科医院)，河南省洛阳市 471002 岳辰，博士，副主任医师，河南省洛阳正骨医院(河南省骨科医院)，河南省洛阳市 471002
  • 作者简介:姚可心，女，2000年生，河南省洛阳市人，汉族，河南中医药大学在读硕士，主要从事骨关节病方面的研究。
  • 基金资助:
    河南省中医药传承与创新人才工程(仲景工程)中医药拔尖人才(豫卫中医函2021 15号)，项目负责人：郭珈宜；2023年度国家中医药管理局科技项目，平乐正骨防治膝骨关节炎的体系构建、评价及推广应用(GZY-KJS-2023-012)，项目负责人：郭珈宜

A controlled analysis of phenomenon of acupoint sensitization in osteonecrosis of the femoral head

Yao Kexin1, Yang Yidan1, Li Yapeng2, Zhu Xuanye1, Wang Qiuyuan2, Guo Jiayi1, 2, Liu Youwen2, Yue Chen2   

  1. 1College of Orthopedics and Traumatology, Henan University of Chinese Medicine, Zhengzhou 450046, Henan Province, China; 2Luoyang Orthopedic Hospital of Henan Province (Orthopedic Hospital of Henan Province), Luoyang 471002, Henan Province, China
  • Accepted:2024-12-20 Online:2026-05-28 Published:2025-11-07
  • Contact: Guo Jiayi, Chief TCM physician, College of Orthopedics and Traumatology, Henan University of Chinese Medicine, Zhengzhou 450046, Henan Province, China; Luoyang Orthopedic Hospital of Henan Province (Orthopedic Hospital of Henan Province), Luoyang 471002, Henan Province, China Liu Youwen, Chief physician, Luoyang Orthopedic Hospital of Henan Province (Orthopedic Hospital of Henan Province), Luoyang 471002, Henan Province, China Yue Chen, MD, Associate chief physician, Luoyang Orthopedic Hospital of Henan Province (Orthopedic Hospital of Henan Province), Luoyang 471002, Henan Province, China
  • About author:Yao Kexin, Master candidate, College of Orthopedics and traumatology, Henan University of Chinese Medicine, Zhengzhou 450046, Henan Province, China
  • Supported by:
    Henan Province Traditional Chinese Medicine Inheritance and Innovation Talent Project (Zhongjing Project) Traditional Chinese Medicine Top Talents, No. 2021 15 (to GJY); 2023 National Administration of Traditional Chinese Medicine Science and Technology Project, System Construction, Evaluation and Promotion of Pingle Bone Correction for the Prevention and Treatment of Knee Osteoarthritis, No. GZY-KJS-2023-012 (to GJY)

PDF

15

摘要：

文题释义：

股骨头坏死：是指由于多种原因导致股骨头血运不良，从而引起骨细胞缺血、坏死、骨小梁断裂、股骨头塌陷的一种病变。股骨头坏死的发病机制尚不完全明确，慢性疼痛是其常见的临床症状。
穴位敏化现象：指在某些病理状态下，体表特定区域(如穴位)发生感觉异变，使得其对各种刺激的敏感度增加。这种现象不单是特殊的病理表象，还是针灸施治的有效位点，研究表示在存在敏化现象的穴位施针，可能具有提高临床疗效的作用。

摘要
背景：在多种涉及慢性肌肉骨骼疼痛的疾病中，穴位会表现出敏化现象，这在针灸治疗中具有重要的靶向价值。然而，这种敏化现象是否出现在股骨头坏死患者中尚不明确。
目的：通过与健康对照组的比较，探讨股骨头坏死患者的穴位是否会出现敏化现象。
方法：测量50例股骨头坏死患者患侧和非患侧6个穴位及3个非穴位的机械压力痛阈值，患侧6个常用于治疗股骨头坏死的髋部局部穴位包括承扶(BL36)、秩边(BL54)、居髎(GB29)、环跳(GB30)、气冲(ST30)和髀关(ST31)，同时也选定了髋关节前侧、外侧和后侧每侧各一个，共3个非穴位点。同时测量50例与患者在性别和年龄上匹配的健康对照受试者相同部位的痛阈值。所有测量均在单一时间点进行。
结果与结论：①36%-60%的股骨头坏死患者在患侧穴位的机械压力痛阈值低于非患侧穴位，提示存在外周敏化；②34%-48%的股骨头坏死患者在非患侧穴位的痛阈值低于健康对照组相应侧的穴位，提示存在中枢敏化；③在股骨头坏死患者中，患侧所有穴位的敏化程度显著高于所有非穴位(P < 0.05)；但在非患侧，穴位与非穴位之间的敏化差程度异不显著；④此次研究首次提供了与股骨头坏死相关的穴位敏化证据，刺激尤其是在患侧的敏化穴位，可能有助于缓解股骨头坏死的疼痛。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: ">股骨头坏死, 疼痛, 外周敏化, 中枢敏化, 穴位, 机械压痛阈值

Abstract: BACKGROUND: Acupoints are known to be sensitized in various disorders involving chronic musculoskeletal pain, which may be useful to target during acupuncture. However, whether such acupoint sensitization occurs in osteonecrosis of the femoral head is unclear. 
OBJECTIVE: To examine whether acupoints are sensitized in osteonecrosis of the femoral head patients through comparison with healthy controls. 
METHODS: Mechanical pressure pain thresholds were measured at 6 acupoints and 3 non-acupoints on the affected and unaffected sides of 50 patients with osteonecrosis of the femoral head. The 6 local acupoints on the affected side of the hip that were commonly used to treat osteonecrosis of the femoral head included Chengfu (BL36), Zhibian (BL54), Juliao (GB29), Huantiao (GB30), Qichong (ST30), and Biguan (ST31). At the same time, three non-acupoints were selected, one on each side of the anterior, lateral, and posterior sides of the hip joint. The pain thresholds of the same parts of 50 healthy control subjects matched with the patients in sex and age were also measured. All measurements were performed at a single time point.
RESULTS AND CONCLUSION: (1) Acupoints on the affected side of 36%-60% of osteonecrosis of the femoral head patients showed a mechanical pressure pain threshold that was lower than acupoints on the unaffected side, suggesting peripheral sensitization. (2) Acupoints on the unaffected side of 34%-48% of patients showed a pain threshold that was lower than acupoints on the corresponding side of healthy controls, suggesting central sensitization. (3) Among patients with osteonecrosis of the femoral head, sensitization was significantly higher at all acupoints than at all non-acupoints on the affected side (P < 0.05), but it did not differ significantly between acupoints and non-acupoints on the unaffected side. (4) This study provides the first evidence of acupoint sensitization associated with osteonecrosis of the femoral head. Stimulating sensitized acupoints, particularly on the affected side, may help mitigate pain in the disorder.  

Key words: osteonecrosis of the femoral head, pain, peripheral sensitization, central sensitization, acupoints, mechanical tenderness threshold

中图分类号: