摘要
目的:回顾1963—2018年针灸治疗中风后吞咽障碍的临床文献,归纳总结针灸治疗中风后吞咽障碍的临床应用规律。方法:在《中国针灸信息库》、中国知网、万方全文数据库和重庆维普数据库中检索针灸治疗中风后吞咽障碍的相关文献,按照纳入和排除标准筛选文献,应用《中国针灸信息库》内相关分析软件、SPSS 21.0和Clementine 12.0软件进行计量分析、关联性分析及聚类分析。结果:应用频次最高的穴位依次是廉泉、风池、金津、玉液、翳风;应用频次最高的经络为足少阳胆经,以头颈部取穴为主。特定穴中以交会穴最为常用。关联性分析和聚类分析的结果显示,关联性最高的是风池、廉泉、金津与玉液穴对,在聚类分析中被聚为同一类;翳风、完骨、足三里、丰隆及三阴交等穴被聚为另一类。最常选用的治疗方法为针刺、针药结合及针刺结合功能训练。刺血疗法、药物治疗和针刺治疗的关联性最强。效应指标中最常选用洼田饮水试验、电视透视造影吞咽检查(VFSS)及标准吞咽功能评定(SSA)。结论:针灸治疗中风后吞咽障碍以局部取穴为主,辅以近部或远道取穴。主穴多取廉泉、风池、金津及玉液,配穴建议从内关、水沟、翳风、完骨、太冲、丰隆、足三里、三阴交、合谷及风府中选取。治疗时针刺疗法常与药物治疗、功能训练相结合。效应指标建议选用VFSS或用洼田饮水试验和SSA联合评价疗效和误吸情况。
Objective:To review the clinical research literature about acupuncture in the treatment of post-stroke dysphagia from 1963 to 2018,and to summarize and conclude the clinical regularity.Methods:Literatures on acupuncture and moxibustion in treating post-stroke dysphagia were reviewed from Chinese acupuncture information database,China National Knowledge Infrastructure,Wanfang Database,and Chinese Journal of Science and Technology of VIP,which were all searched by computer,screened according to inclusion and exclusion criteria,and the quantitative analysis,correlation analysis and clustering analysis were conducted by using SPSS and Clementine 12.0 software.Results:Lianquan(CV23),Fengchi(GB20),Jinjin(EX-HN12),Yuye(EX-HN13)and Yifeng(TE17)were the most frequently used acupoints,and the acupoints of gallbladder meridian of Foot-Shaoyang were often selected in the treatment process,with acupoints in the head and neck regions as the main points.Confluent acupoints were the most commonly used among specific points.The results of correlation analysis and cluster analysis showed that the acupoint pair with the highest correlation was those of GB20,CV23,EX-HN12 and EX-HN13,which were classified into the same category in the cluster analysis.TE17,Wangu(GB12),Zusanli(ST36),Fenglong(ST40)and Sanyinjiao(SP6)were grouped into another category.Acupuncture,combination of acupuncture and medication,as well as acupuncture combined with functional training were the most commonly used treatment methods.The correlation between acupuncture and pricking blood therapy,medication therapy and acupuncture was the strongest.Efficacy indexes include water swallow test,Videofloroscopic Swallowing Study(VFSS)and Standardized Swallowing Assessment(SSA).Conclusion:Local points are mainly used in the treatment of post-stroke dysphagia by acupuncture.CV23,GB20,EX-HN12 and EX-HN13 are the main points.For the auxiliary points,it is suggested to choose from Neiguan(PC6),Shuigou(GV26),TE17,GB12,Taichong(LR3),ST40,ST36,SP6,Hegu(LI4)and Fengfu(GV16).Acupuncture therapy is always combined with medication and rehabilitation training.VFSS is recommended as the index of effect,combined with water swallow test and SSA to evaluate the efficacy and aspiration.
作者
韩榕
黄琴峰
李茜莹
董小庆
杨延婷
杨光
孔谐和
张丹
谢晨
马晓芃
HAN Rong;HUANG Qinfeng;LI Xiying;DONG Xiaoqing;YANG Yanting;YANG Guang;KONG Xiehe;ZHANG Dan;XIE Chen;MA Xiaopeng(Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China)
出处
《针灸临床杂志》
2020年第5期48-55,共8页
Journal of Clinical Acupuncture and Moxibustion
基金
国家重点基础研究发展计划(973计划)项目,编号:2015CB554501
上海市卫生系统优秀学科带头人培养计划项目,编号:2017BR047。
关键词
针灸疗法
中风
吞咽障碍
计量分析
关联性分析
聚类分析
Therapy of acupuncture and moxibustion
Stroke
Dysphagia
Quantitative analysis
Correlation analysis
Clustering analysis
