Objectives: To observe the changes of skin blood flow perfusion at Waiguan (TE 5) caused by mild moxibustion with moxa stick and infrared mild moxibustion using laser speckle contrast imaging technology, and to compare the microcirculatory effect during and after both moxibustion methods and explore the dose-response relationship of moxibustion.
Methods: Twenty-four healthy participants were treated with mild moxibustion with moxa stick and infrared mild moxibustion at left Waiguan (TE 5). The record started when the skin temperature reached (44±1) °C, and both moxibustion methods were provided within this temperature range. The 20-minute moxibustion process was divided into four stages (5, 10, 15, and 20 min) using interpolation method, and each participant completed eight interventions with a minimum 24-hour interval between different interventions. The skin surface temperature of the left Waiguan (TE 5) was monitored when both moxibustion interventions were given for 10 min using a TES1306 thermocouple thermometer. The skin microcirculatory blood perfusion units (MBPU) of left Waiguan (TE 5) was measured using a PSIN-01087 laser speckle blood flow imager 1 min before moxibustion, at 5, 10, 15, 20 min during moxibustion and continuously for 20 min after moxibustion in each intervention.
Results: The skin surface temperature of the left Waiguan (TE 5) remained within the range of (44±1) °C during both moxibustion methods, with no statistically significant difference (P>0.05). Compared with that before moxibustion, the MBPU of the left Waiguan (TE 5) was increased significantly at 5, 10, 15, and 20 min of both moxibustion methods (P<0.05, P<0.01). Compared with moxibustion for 10, 15 and 20 min, the MBPU of the left Waiguan (TE 5) of moxibustion for 5 min was lower in both moxibustion methods (P<0.01). For both moxibustion methods with the same moxibustion course, the MBPU of the left Waiguan (TE 5) 20 min after intervention was significantly higher than that at 1 min before moxibustion (P<0.001), and there was no significant difference in MBPU between 1 min before moxibustion and 20 min after moxibustion among different groups (P>0.05). Within the same moxibustion method, the MBPU of the left Waiguan (TE 5) 20 min after moxibustion with the intervention of 5 min was lower compared to that of 10, 15, and 20 min of moxibustion (P<0.001), with no significant differences between 10, 15, and 20 min of moxibustion (P>0.05).
Conclusions: When controlling the skin temperature at Waiguan (TE 5) within (44±1) °C, infrared mild moxibustion has similar effects on skin microcirculatory blood perfusion as traditional mild moxibustion with moxa sticks. From a dose-response perspective, microcirculation reached a stable state after 10 min of moxibustion, and moxibustion interventions lasting for more than 10 min shows better therapeutic effects.
目的: 利用激光散斑血流成像技术观察艾条温和灸与红外线温和灸引起的外关穴皮肤血流灌注量变化，比较两种灸法施灸过程中与撤灸后的微循环效应，探讨灸法的量效关系。方法: 纳入24名健康受试者，于左侧外关穴分别进行艾条温和灸与红外线温和灸，在穴区皮肤温度达到（44±1）℃开始计时，保持在这个温度范围内进行两种灸法干预。采用插值法将20 min施灸过程分解为5、10、15、20 min 4个时程依次进行，每位健康受试者均完成8次试验，不同时程的试验间隔24 h以上。采用TES1306型热电偶测温仪监测两种灸法干预10 min时程左侧外关穴皮肤表面温度。采用PSIN-01087型激光散斑血流仪监测每次试验灸前1 min，施灸5、10、15、20 min，撤灸后连续20 min左侧外关穴皮肤的微循环血流灌注量（MBPU）。结果: 两种灸法施灸过程中左侧外关穴皮肤表面温度均在（44±1） ℃范围，两种灸法穴位皮肤表面温度比较，差异无统计学意义（P>0.05）。两种灸法施灸5、10、15、20 min 4个时点的左侧外关穴MBPU均较灸前升高（P<0.05，P<0.01）；与灸10 、15、20 min比较，两种灸法灸5 min时左侧外关穴MBPU偏低（P<0.01）。两种灸法相同时程比较，撤灸后20 min内左侧外关穴MBPU均较灸前1 min升高（P<0.001），灸前1 min、撤灸后20 min内左侧外关穴MBPU组间比较差异无统计学意义（P>0.05）。相同灸法不同时程撤灸后效应比较，干预5 min时程撤灸后20 min内左侧外关穴MBPU低于干预10、15、20 min时程（P<0.001），干预10、15、20 min时程两两比较，差异无统计学意义（P>0.05）。结论: 精准控制穴区皮肤温度达到（44±1）℃时，红外线温和灸对皮肤MBPU的作用与传统艾条温和灸具有同等效应；从量效关系方面看，施灸 10 min时微循环进入稳定状态，干预时程达10 min以上灸疗效果更好。.
Keywords: blood flow perfusion; dose-response relationship; infrared mild moxibustion; mild moxibustion; mild moxibustion with moxa stick; moxibustion temperature.