傳統中醫拔罐造成灼傷之研究

The Investigation of Burn Injury in Cupping Therapy of Traditional Chinese Medicine

余哲仰

灼傷 ； 拔罐法 ； 熱傳遞 ； Burn injury ； Cupping therapy ； Heat transfer

交通大學生醫工程研究所學位論文

2016年

碩士

陳俊勳

繁體中文

在世界各地的古老文化傳承中，傳統醫療是不可遺漏的一部分，運用「熱」於治療疾病及調理身體更是傳統中醫的精髓。長久以來，人們對於「熱」的掌握與運用，在技術上已相當的成熟，將「熱」運用到醫療的手法也相當的精湛。傳統中醫之拔罐法充分的運用「熱」，當罐器內的溫度高於身體的溫度時，熱會開始藉著傳導、對流或是輻射的方式傳遞入體內；當組織的溫度上升時，會導致血管擴張而增加治療部位的血流量，亦可加速身體的代謝。但「熱」若被過度或不當的使用，在罐器接觸到皮膚的短時間內造成，將會造成無可挽回的灼傷傷害。 傳統拔罐法的精髓在於運用熱力活絡經脈，但對加熱溫度與施作時間的掌握，仍缺乏理論驗證予以支持。本論文旨在探討傳統拔罐法的「熱」灼傷性分析，研究方法是利用ANSYS軟體進行數值計算，並採用塗彩顯示方式，用以剖析在罐器內的熱傳遞情形，藉以探討拔罐法施治時，罐內高溫空氣對於皮膚造成灼傷的評估。 杯罐絕熱條件下，經過1200秒後，罐頂及罐中心溫度皆高於37℃，唯有罐內初始溫度為75℃，於892秒溫度與皮膚達平衡，而皮膚溫度變化範圍由罐底開始慢慢地向下及向兩側擴展。罐內空氣將產生渦流且呈現多圈狀，一段時間後變短變疏，而罐外速度分布中，於罐器上方D處匯集，且越往空氣上方其速度越快，其範圍為0.1至0.3 m/s之間。杯罐不絕熱條件下，罐內的高溫在65秒時已低於40℃，且不同材質杯罐最大差異在於皮膚層，物理性質越大的材質皮膚表層向下凹的更為顯著，且深層處也更薄。 傳入皮膚之深度探討中，罐器絕熱條件下深度達30mm；杯罐不絕熱條件下深度達25mm。不同材質杯罐中，竹子保溫效果較好，皮膚的溫度也略高。最後，皮膚灼傷評估中，由於起始溫度皆很高，立即覆蓋於皮膚上都會產生灼傷現象，僅有起始溫度為75℃會造成較輕微的灼傷，其餘的起始溫度皆會造成三度灼傷甚至更嚴重的傷害。 「熱」在傳統中醫療法的定量分析，提供中醫做為施治之參酌，用以提升施治之療效，至今相當的罕見。本論文將保留傳統拔罐法存在的價值，戮力的改善長久以來在施治方面的缺失，藉由現代理論模式剖析拔罐法的灼傷傷害，對於改善傳統施治的缺失具有正面助益，足以讓傳統中醫能再現風華。

In the ancient heritage around the world, traditional medicine is an indispensable part of treatment. Using heat source to cure diseases and nursing our body are the essence of Traditional Chinese medicine. For a long time, people grasping and using of heat source technology have been quite mature, so it being applied to the medicinal technique has also been skillful. Moreover, the cupping of Traditional Chinese medicine utilizes heat source fully. When the temperature inside of the cup is higher than body, the body will begin to transfer heat by conduction, convection or radiation. As a result, when the temperature of biological tissues rises, it will cause to increase the blood flow volume of treatment site due to blood vessel dilatation. Indeed, it also can speed up body metabolism. It has many advantages but poses a risk of burning the patient if not carefully executed. The essence of traditional cupping therapy consist in utilizing heat power to promote blood circulation and regulate bodily functions. But, grasping heating temperature and time is lacking support by theoretical validation. The plans aim to discuss the heat burns analysis of the traditional cupping method. The research methods employ the ANSYS software to numerical calculations and analysis the heat transfer situations inside of the cup by coating color display. With this result, we can further discuss the influence of hot air inside of cup to skin damage by cupping therapy. At adiabatic conditions, the roof and the tank central temperature were higher than 37℃after 1200 seconds. Only initial temperature of 75℃, the air in tank and skin reach thermal equilibrium. The temperature of skin rise from bottom of the tank and slowly expand to both sides. There are vortex generated in tank and show multi-ringed shape. They gradually become short and thin. The distribution of velocity gather at the top of the tank. The range is between 0.1 and 0.3 m/s. At no adiabatic conditions, the temperature in the tank is less than 40℃ at 65 seconds. The biggest difference of different materials jar is in the layers of the skin. The larger physical properties of the material become more concave at surface of the skin and also thinner in the deep position. The result of heat transfer to the skin depth, it is 30 millimeter at adiabatic conditions and 25 millimeter at no adiabatic conditions. In the comparison of different materials, bamboo has better insulation and skin temperature is slightly higher. Finally, the result of burn injury, since starting temperature is high, all condition will cause burn injury. Only initial temperature of 75℃ will cause minor burn injury, others can cause even more serious damage. Nowadays, it is still quite rare to quantitatively analyze the heat in traditional Chinese medicine. It can offer Chinese medicine to be a consultation and enhance the efficacy of treatment. Ultimately, the plan will propose specific improvement for easily burn missing of cupping method and take a positive benefit.

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