針灸 (acupuncture) 是一個獨特且有系統的臨床科學。但是許多患者對針刺治療卻心存恐懼。若利用低功率半導體雷射代替針灸,則可以避免針刺造成的恐懼感、傷口感染及直接破壞神經纖維等副作用。拔罐法是一種東方醫學遠古以來傳用的方法,對頸部、背部疼痛的舒緩有良好的功效,且治療面積大,學習容易,對於經絡的舒暢具有一定的功效。 本研究之目的是改良雷射針灸儀使其具有拔罐之功能,並評估其對於正常人及背部疼痛患者的刺激效應。此儀器利用半導體雷射針灸,結合自行改造的市售拔罐杯體,改良成具有拔罐功能的雷射針灸儀。此儀器可更換不同波長之半導體雷射頭及不同大小之拔罐杯,並可調整雷射針灸之功率輸出。實驗階段初期,評估單獨使用拔罐、單獨雷射針灸及改良式雷射針灸儀的刺激方法,對於150名健康成人之十二經絡良導絡值之影響。實驗後期,利用改良式雷射針灸儀,刺激30名上背疼痛患者之足少陽膽經上的肩井穴,並以良導絡健康檢測儀及視覺類比量表 (visual-analogue scale; VAS) 評估其療效。 實驗結果顯示,在初期分析結果中,可以觀察到不同時間參數中:單獨拔罐刺激5分鐘、10分鐘及15分鐘的結果,在刺激前後良導絡變化差異量,15分鐘與10分鐘的結果相比,具有顯著的差異(P<0.05)。單獨雷射針灸刺激5分鐘、10分鐘及15分鐘的結果,在刺激前後良導絡變化差異量,並無任何差異。而使用改良式雷射針灸刺激5分鐘、10分鐘及15分鐘的結果,在刺激前後良導絡變化差異量,均具有顯著上的差異(P<0.05)。後期實驗將改良式雷射針灸儀應用於上背痛的結果中:VAS疼痛量表顯示,經改良式雷射針灸儀刺激後,對於疼痛的減緩有顯著的差異性(P<0.01),且具有舒緩肩部緊張之效果;就經絡上來觀察,發現左右兩側之膽經均有經絡值上升之趨勢(P<0.05),而肩井穴位之良導絡數值有下降之趨勢(P<0.05)。 由傳統中醫角度觀察:肩井穴內『氣』的堆積,會造成疼痛不適,若將其排出,則可使相對應之膽經『氣』上升,達到紓緩之效果。經由實驗結果顯示,本研究使用之改良式雷射針灸儀對人體具有良性刺激作用,且有減緩疼痛之效果。
Laser acupuncture has been widely used in the treatment of pain, and cupping is a traditional Chinese treatment to adjust the Qi of the meridians. This study was aimed to determine the efficacy of diode laser acupuncture with cupping in the treatment of back pain. One hundred and fifty healthy subjects were recruited for the evaluation of effective parameters and randomly divided into 3 groups: cupping, laser acupuncture (λ= 808 nm, 10 mW, and CW , 5, 10, 15 minutes), and laser acupuncture with cupping. Thirty patients with upper back pain were treated by laser acupuncture with cupping (parameters evaluated earlier: λ= 808 nm, 10 mW, CW, and 5 minutes) on the acupoints GB21. The effects of treatment were analyzed with a Ryodoraku instrument and a VAS (visual-analogue scale). The Ryodoraku device was used to measure the conductivity of the twelve meridians before and after the experiment. In the healthy subjects, the results showed that the treatment effect of diode laser acupuncture ((λ= 808 nm, 10 mW, and CW) with cupping function was greater than that of either cupping or acupuncture. In the group of patients, the results showed that the diode laser acupuncture with cupping function could lower the level of pain and make the patients feel more comfortable (P<0.01). Therefore, the diode laser acupuncture with cupping function designed in this study could be a new device for pain treatment.