针刺辅助麻醉用于颅脑外科手术选穴分析

目的 研究针刺辅助麻醉用于颅脑外科手术的选穴规律.方法 检索20部针灸著作及1989年1月至2010年12月中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、美国国立生物医学中心(PubMed)针刺麻醉或针药复合麻醉应用于颅脑外科手术的文献570篇,符合纳入标准的文献312篇,总结针刺辅助麻醉用于颅脑外科手术文献的穴位应用频次、穴位选用情况及经络使用情况.结果 使用频数排名前10位的体穴由高到低依次是:风池、安眠、鱼腰、攒竹、率谷、颔厌、金门、太冲、上星、颧髎；穴位选用以近端取穴、循经远端取穴、耳穴为主；经络的选用督脉、足少阳胆经、足太阳膀胱经及手少阳三焦经为主.结论 颅脑外科针麻手术采用手术部位近端(局部)与远端(循经或在神经节段的远端)的配合可以最大限度的增强开颅针麻的麻醉效果,并符合针刺麻醉的神经生理学基础.

Analysis on Point Selection of Acupuncture-assisted Anesthesia for Brain Surgery

ObjectiveTo research the point selection of acupuncture-assisted anesthesia for brain surgery.MethodsTwenty books on acupuncture and 570 articles on acuanesthesia or acupuncture combined with anesthesia for brain surgery in China National Knowledge Internet(CNKI),CQVIP database,PubMed from January 1989 to December 2010 were researched and 312 articles were met the inclusion criteria.The acupoint application frequency,acupoint selection and meridian selection were analyzed.ResultsPoints of the top ten frequency from high to low were: Fengchi(GB20),Anmian(Quiet Sleep,EX),Yuyao(EX-HN4),Cuanzhu(BL2),Shuaigu(GB8),Hanyan(GB4),Jinmen(BL63),Taichong(LR3),Shangxing(GV23) and Quanliao(SI18).The local points,distant points along meridian and ear points were mainly selected.The common used meridians were Governor Vessel,Gallbladder Meridian of Foot Shaoyang,Bladder Meridian of Foot-Taiyang and Triple energizer meridian of Hand-Shaoyang.ConclusionThe combined selection of local and distant points in acupuncture-assisted anesthesia for brain surgery could enhance the effect obviously and conform to the neurophysiologic basis of acuanesthesia.