目的 探讨膝骨性关节炎患者体表痛敏点数量、压痛阈的时空动态分布规律。方法 招募51例膝骨性关节炎患者，使用WAGNER压痛仪检测膝骨性关节炎相关穴位及最近痛敏点的压痛阈值。每名患者每周固定时间检测1次，共检测4次。观察患者痛敏点数量、敏化程度的变化，比较各穴位最近痛敏点4次痛阈值的变化，比较不同时间点不同经络痛敏点痛阈值的差异。结果 ①膝周痛敏点数量随时间点推移逐渐增加，痛敏点敏化程度呈上升趋势（P < 0.05）。患者鹤顶、血海、梁丘、内膝眼、犊鼻、阴陵泉、膝关、曲泉、足三里、阳陵泉、委中、委阳、阴谷最近痛敏点的压痛阈值随病程推移呈下降趋势（P < 0.05）。②足三阴经、胃经、胆经、膀胱经痛敏点压痛阈值随时间点推移呈下降趋势（P < 0.05），足三阴经、膀胱经痛敏点压痛阈值低于胃经、胆经（P < 0.05）。结论 患膝骨性关节炎病理状态下，随病程进展相关穴位附近痛敏点发生数量增加、压痛阈降低规律性动态“敏化”反应，这些痛敏点的动态变化可能与腧穴扩大效应有关。痛敏点压痛阈分布具有规律性，与经络相关。

Objective To investigate the temporal and spatial distribution of the number of pain sensitive points and pressure pain threshold in patients with knee osteoarthritis.Methods Fifty-one patients with osteoarthritis of the knee were recruited and tested for pressure pain thresholds at points related to knee osteoarthritis and at the nearest pain-sensitive point using the WAGNER pressure pain meter. Each patient was tested once a week at a scheduled time, for a total of 4 times. The patients were observed for changes in the number and degree of sensitization of pain-sensitive points, compared the changes in pain thresholds of the nearest pain-sensitive point at each point four times, and compared the differences in pain thresholds of different meridian pain-sensitive points at different time points.Results ① The number of pain sensitivity points around the knee gradually increases over time. The sensitization degree of pain sensitive points showed an upward trend (P < 0.05). The pressure pain threshold of the nearest pain sensitive points of Heding (EX-LE2), Xuehai (SP10), Liangqiu (ST34), Neixiyan (EX-LE4), Dubi (ST35), Yinlingquan (SP9), Xiguan (LR7), Ququan (LR8), Zusanli (ST36), Yanglingquan (GB34), Weizhong (BL40), Weiyang (BL39) and Yingu (KI10) points showed a downward trend (P < 0.05). ② The pressure pain threshold of pain sensitive points of three yin meridians of foot, stomach meridian, gallbladder meridian and bladder meridian decreased with time (P < 0.05). The pressure pain threshold of pain sensitive points of foot three yin meridian and bladder meridian was lower than that of stomach meridian and gallbladder meridian (P < 0.05).Conclusion Under the pathological state of knee osteoarthritis, as the course of the disease progresses, the number of hyperalgesia points near the relevant acupoints increases and the press pain threshold decreases. The dynamic changes of these pain points may be related to the expansion effect of acupoints. The distribution of pain sensitivity point pressure pain threshold is regular and related to meridian.

R245.9

国家自然科学基金委员会重大项目（81590951）：穴位敏化现象和规律的临床研究，负责人：梁繁荣。