秋风起，艾灸养生虽好，还须当心低温烫伤

近年来，艾灸作为传统中医的一部分，备受大众推崇和追捧成为养生保健的方式。艾灸作为中医灸法的一种， 是使用艾叶制成的各种艾灸材料，通过产生的艾热刺激体表穴位或特定部位，借助灸火的温热，艾草的作用，经络的传导来激发平衡经气的活动。到了秋冬季节，天气转凉，很多人会想到去尝试做艾灸来养生保健， 以期能达到温经通络，补气活血，排毒祛湿的目的。但是， 殊不知，艾灸使用操作不当，容易引起低温烫伤， 养生不成，反倒受罪。

今年3月份，上海瑞金医院烧伤科就收治了一个11个月大的宝宝，因为艾灸治疗导致双侧小腿III度烫伤，皮肤不仅有红肿水泡，还有棕黑色的焦痂，需要进行削痂及植皮手术，家人痛心不已。起因是宝宝反复咳嗽，家长想要提高其免疫力，送去私人机构艾灸治疗发生的低温烫伤。

宁波的一个90后女孩因为睡眠不好去了一家养生会馆艾灸，感觉手臂皮肤发痛发红，以为是经络不通就继续治疗，但过了几天还是疼而且出了水泡，以为是在排湿气，结果一直没好，去了医院才知道是低温烫伤，耽误治疗所以出现感染，发展成了III度烫伤，一个多月里每天跑医院不说，还有可能遗留疤痕。

日前，家住上海的92岁的蒋老伯听说艾灸足三里对身体好，就在家里给86岁的老伴做了艾灸。老俩口自己揣摩了一下足三里的位置，就做上了，虽然老伴感觉有些疼，但还是坚持了20分钟。没想到疼了一晚，辗转反侧，第二天还出了一个鸭蛋大小的大水泡。赶紧去了医院，医生说这是深II度低温烫伤，而且创面伤口比较深，需要隔天换药，起码要数月才会好。

As one of the traditional Chinese treatments, moxibustion is now very popular. It is hoped to invigorate health effectively and defer senility to prevent disease and increase in life span. The goal of moxibustion is to bring the body into balance and ensure a consistent and smooth flow of qi. Balance is achieved by the burning of moxa (ai ye in Chinese herbal medicine), or dried mugwort (artemesia vulgaris in Latin), close to or directly to stimulate the acupoints on the skin. The heat allows the herb's medicinal properties to penetrate the body through the meridians. It can help stimulate sluggish, deficient or stagnated qi with the introduction of therapeutic heat. In autumn and winter season, people would think about the moxibustion therapy aiming to stimulate the flow of qi in the body which can help to improve blood circulation, dispel cold and dampness, and strengthen the immune system.However, it has potential hazards of low heat scald when it is performed inappropriately and cause unnecessary pain and burden.

低温烫伤是指皮肤长时间接触高于体温的低热物体而造成的烫伤。比如皮肤接触70℃的温度持续一分钟，近60℃的温度持续五分钟以上，或高于45℃两小时以上，会有可能造成烫伤。 在艾灸导致的低温烫伤中，是由于皮肤在加热后的艾灸持续作用下，局部温度升高，热量进入真皮浅层向真皮深层及皮下各层组织的渐进性损害。低温烫伤和高温烫伤不同，虽然表面看起来面积不大，皮肤上也仅有有红肿水泡表现，但因为低温热源持续作用，热能蓄积向深部传导而创面加深，严重者可能会造成深部组织坏死，需要数月到一两年才会恢复，留下疤痕，甚至有些还需要手术植皮治疗。就像我们平时的烤红薯是一样，表皮还好，里面却已经是煨熟。刚开始烫伤了因为表面看上去不严重还容易被忽视，以为是轻度的浅表的烫伤而延误治疗，而且一不小心创面就容易引起感染，从II度发展为III度的的伤口，恢复很慢。

Low heat scald burn refers to injury to the skin or other tissues caused by exposing tolow heatsourcesexcessively. An approximate one-minute exposure to 70℃, a five-minute expose to 60℃, or above two- hours exposure to 45℃ will result in low heat scald burns. In moxibustion therapy, heat is transferred  from heating agent moxa to skin.  The sharp increase in skin temperature leads to the injury involvingepidermis, superficial and deep dermis and subcutaneous tissue. Compared with other scald burns, the surface area that has been affected is not significant. It may only presented with skin redness, swelling and blisters. However, the heat continuously penetrate to the deep tissue resulting indegeneration and necrosis might be the primary cause of deep burn. The recovery is very slow and it can take a few months to years. These wounds may heal with scarring andsometime skin grafting may be required to achieve closure of the wounded area. Treatment might be delayed because the skin surface damages are seemed as minor as first-degree burns in the early stage.  In addition, the subsequentinfection may occur to make the burn worse from second-degree to third-degree.

1.老年人

老年人皮肤厚度随之年龄增长而变薄。而且随着年龄渐长，反应变慢，皮肤神经末梢的敏感性下降,肢体感觉迟钝,对热和疼痛刺激的敏感性低。即使正规操作，温度距离时间合适， 仍有可能造成低温烫伤。

2.患有糖尿病周围神经病变，脉管炎，中风后遗症，卧床的人群

患有糖尿病周围神经病变，脉管炎，中风后遗症，卧床的人群因为末梢循环障碍神经功能受损， 所以痛温觉减退，迟钝，对温度和痛觉不敏感。

3.儿童

儿童也是低温烫伤的高发人群，因为与成年人相比他们的皮肤比较薄而且娇嫩，所以在较短的时间内会发生更深的皮肤损害。

Who Is at Risk for Low HeatScald?

1. Older adults

Skin becomes thinner and more prone to injury with aging.  Age-related changesalso includeslower reaction time and sensory impairment. The changes of ability to feel the pain and temperaturecan increase the risk of low heat scalds. Over time, feeling how hot the moxibustion is or react to pain stimuli can become difficult.  This can lead to low heat scalds despite of proper practice, appropriate distance between moxa and skin  and duration.

2. People with certain medical conditions

People with certain medical conditions, such as diabetic neuropathy, vasculitis or post stroke. These conditions cause damages to nerve endingsresulting in abnormal in pain and temperature sensation.

3. Children

Children are also the most vulnerable population because they have thinner skin than adults so their skin burns more deeply in less time.

用艾灸治疗来保健养生一年四季都可以进行，可以调节气血和体质，不过不是所有人的体质都适合艾灸，而且艾灸对技术和手法是有一定要求的。所以在使用艾灸前，建议要先去寻求有专业资质的中医医生的意见，请医生辨证论治，判断是否适合艾灸。请医生指导选取适合的艾灸部位和适宜的灸治时间，或者在正规的医院接受灸疗，而不是去街边美容院或在家里自己盲目艾灸。

Moxibustion can be performed year-round to increase blood circulation,  tonify energy,  stimulate the smooth flow of qi and boost the immune. Unfortunately, not everyone can have moxibustion done on them. In addition, comprehensive training is required for use of moxibustion therapy. It is better to seek advice from qualified Chinese medicine practitioner first to assess whether it is suitable to undergo moxibustion therapy. Doctors will guide the appropriate acupoints, type of the moxibustion and duration according to the  individual’s constitution. The experience of heat from moxibustion will also vary depending on individual’s condition. Extreme care and caution are required during the moxibustion procedure.  Avoid perform moxibustion therapy at home without clear instruction and guidance from professionals.

低温烫伤后第一时间是在流动清洁的室温冷水下进行冲洗20分钟，可以帮助降温，减少烫伤部位的余热对皮肤组织的损伤，然后用消毒纱布浸湿常温的清水或生理盐水冷敷，但不能用冰水冲洗或冰敷，以防加重损伤。如果已经有了水泡，不要自行挑破，可以去医院进行清创处理，切记不要在创面涂抹酱油，醋，牙膏，润肤霜，黄油，油膏，或传统土方之类，以防创面感染。艾灸引起的低温烫伤通常刚开始看上去表浅，但损害程度比较深，较难通过表面判断，建议还是要及时就医以免延误治疗。

What To Do If You Get Low Heat Scald

First thing to do is to use room temperature running water on the affected skin for twenty minutes. It helps to cool the area and reduce the heat injury to the tissues. Apply normal saline or cool water compress on the burned areas.  Avoid ice and cold water. Keep the area clean and do not apply soybean sauce, vinegar, toothpaste, creams, ointments, butter, or other home remedies.Low heat scalds may appear superficial initially, and then become deeper over time. Moxibustion induced scalds warrant medical attention because they can affect the inside of the body, even if skin damage is minor.

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