针灸治疗原发性痛经的取穴现状分析

目的:总结原发性痛经针灸腧穴的运用规律,为临床针灸治疗原发性痛经取穴方案的优化和制订提供依据。方法:查阅1989～2008年中国医用信息资源系统(维普)数据库中所有针灸治疗原发性痛经的文献,对穴位选取进行统计分析。结果:针灸治疗原发性痛经取穴主要分布于任脉与足太阴脾经,部位主要集中在腹部、下肢及腰背部;交会穴占很大优势;对于单穴的使用,次髎、三阴交、神阙、十七椎、地机具有初步的研究意义。结论:应用任脉与足三阴经的交会穴配伍组方对原发性痛经取穴方案的优化和制订具有重要参考意义。     

针灸治疗原发性痛经的选穴规律分析

目的 系统评价针灸治疗原发性痛经的选穴规律.方法 通过检索中国知网(CNKI)、维普数据库(VIP)、万方数据库和PubMed数据库,纳入建库至2021年3月公开发表的针灸治疗原发性痛经临床文献,统计并整理其针灸处方,运用数据挖掘技术分析其选穴用经规律.结果 共纳入临床文献253篇,涉及68个穴位,总频数为1720.频...     

针灸治疗原发性痛经临床观察

目的：观察针灸治疗原发性痛经的临床疗效。方法：将114例患者随机分治疗组（60例）和对照组（54例）。治疗组取中极、三阴交、子宫、配穴进行针灸;观察组口服中药月月舒冲剂,两组治疗三个月后观察临床疗效。结果：治疗组治愈率60.0%,总有效率95.0%;对照组治愈率46.3%,总有效率77.8%。两组疗效比较,治疗组疗效优于观察组。结论：针灸治疗原发性痛经效果显著,方法简便、安全,无明显不良后果。     

针灸治疗原发性痛经的研究进展

妇女在月经前后或月经中发生周期性小腹疼痛或痛引腰骶,甚至剧痛晕厥者,称为痛经。本病以青年妇女多见。西医学分为原发性与继发性痛经两类,其中生殖器官无器质性病变者称为原发性痛经（PD）或功能性痛经,常发生于月经初潮后不久的未婚或未孕的年轻妇女,常于婚后或分娩后自行消失[1]。原发性痛经的临床表现为经期或行经前后小腹疼痛,     

近年来针灸治疗原发性痛经临床概况

原发性痛经为妇科常见疾病,针灸治疗原发性痛经疗效好,见效快,痛苦少,无副作用,操作简便。现就近年来针灸治疗原发性痛经的临床研究概述如下。     

针灸治疗原发性痛经的研究

目的 介绍近年来国内针灸治疗原发性痛经的状况,寻求有效治疗方案.方法 从选穴、治疗方法等角度进行综述.结论 针灸治疗原发性痛经疗效可靠,但目前临床取穴及诊疗手段的繁简仍存在一些亟待解决的问题.     

针灸加敷脐治疗原发性痛经58例

目的：观察针灸加敷脐治疗原发性痛经（PD）的疗效。方法：将116例原发性痛经患者随机分为2组，治疗组（A组）58例采用针灸加敷脐疗法；对照组（B组）58例口服益母草冲剂治疗。结果：治疗组与对照组疗效及起效时间比较，差异均有非常显著性（P〈0.01）。结论：针灸加敷脐治疗原发性痛经疗效优越。     

针灸治疗原发性痛经研究进展

痛经（Dysmenorrhea）是妇科临床常见病证，是指妇女在经期或经期前后，出现小腹或腰部疼痛，甚至痛及腰骶，每随月经周期而发，严重者可伴恶心、呕吐、冷汗淋漓、手足厥冷，甚至昏厥的病证。对痛经发病率的文献报道差别颇大，国内有文献报道其发生率约30％～80％。     

温针灸配合超短波治疗原发性痛经临床研究

目的：观察温针灸配合超短波治疗原发性痛经的临床疗效。方法：将100例原发性痛经患者随机分为治疗组和对照组,每组50例。治疗组采用温针灸配合超短波治疗,对照组口服布洛芬缓释胶囊治疗,3个疗程结束后由专人进行疗效评价。结果：治疗组治愈率为62．0％,总有效率98．0％;对照组治愈率为26．0％,总有效率82.0％,两组比较差异具有统计学意义（P〈0．05）。结论：温针灸配合超短波治疗原发性痛经疗效显著,方法简便。     

针灸加敷脐治疗原发性痛经58例

目的:观察针灸加敷脐治疗原发性痛经(PD)的疗效。方法:将116例原发性痛经患者随机分为2组,治疗组(A组)58例采用针灸加敷脐疗法;对照组(B组)58例口服益母草冲剂治疗。结果:治疗组与对照组疗效及起效时间比较,差异均有非常显著性(P<0.01)。结论:针灸加敷脐治疗原发性痛经疗效优越。     

Effectiveness and Safety of Moxibustion Robots on Primary Dysmenorrhea: A Randomized Controlled Pilot Trial

Objective: To conduct a pilot trial to explore the effectiveness and safety of moxibustion robots in treating primary dysmenorrhea (PD) and evaluate its feasibility in clinic. Methods: A total of 70 participants with PD were allocated to either moxibustion robot (MR) group (35 cases) or manual moxibustion (MM) group (35 cases) using computer-generated randomization. One acupoint Guanyuan (CV 4) was selected to receive moxa heat stimulation. Two groups of participants were given 3 menstrual cycles of MM and MR treatment respectively (once a day, 5 days a session) and received another 3 menstrual cycles follow-up. The degree of pain was evaluated by short-form McGill pain questionnaire (SF-MPQ) and the symptoms of dysmenorrhea were evaluated by Cox Menstrual Symptom Scale (CMSS). The safety was measured by the occurrence rate of adverse events (AEs), including burns (blisters, red and swollen), itching, bowel changes, menstrual cycle disorder, menorrhagia and fatigue, etc. Results: A total of 62 patients completed the trial, 32 in MR group and 30 in MM group. Compared with baseline, scores of SF-MPQ and CMSS significantly decreased in both groups (P<0.05), and no significant difference was observed between the two groups in the 3rd and 6th menstrual cycles (P>0.05). The total occurrence rate of AEs in MR group was 2.1%, which was significantly lower than MM group (7.2%, P<0.05). Conclusion: MR has the same effect as MM at SF-MPQ and CMSS in patients with PD. However, MR is safer than MM (Trial registration No. ChiCTR1800018236).     

Acupuncture Treatment for Post-Stroke Dysphagia: An Update Meta-Analysis of Randomized Controlled Trials

Objective

To explore the effectiveness and safety of acupuncture in patients with post-stroke dysphagia by an update meta-analysis.

Methods

Potentially eligible RCTs aimed to evaluate the effects of acupuncture vs. non-acupuncture treatments, such as rehabilitation training or routine medication on the swallowing difficulty after stroke were searched from PubMed, Cochrane Library, China National Knowledge Infrastructure, and other database from the earliest record to June 2016. Patient demographics, regimens for acupuncture, type of controls, methods of randomization, and measurements of the clinical symptoms of dysphagia were retrieved. The relative risk (RR) and 95% confidence interval (CI) of effective rate of dysphagia was calculated after intervention performed following admission. Subgroup analyses and a metaregression analysis were performed to describe the heterogeneity.

Results

Twenty-nine RCTs comprising 2,190 patients were included. The included studies had a medium quality grade based on the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklist. Acupuncture therapy provided a higher effective rate compared with nonacupuncture treatments [RR=1.33, 95% confidence interval (CI), 1.25 to 1.43]. Subgroup and meta-regression analyses suggested that acupuncture intensity and measurement method were main sources of heterogeneity and resulted in a significant difference for pooled effect size. No severe adverse events were documented in these RCTs.

Conclusions

Our meta-analysis provides a new evidence supporting the efficacy and safety of acupuncture in treatment to post-stroke dysphagia in short-term compared with rehabilitation or medication. More high-quality and large-scale research studies are needed.

     

随机对照试验质量评价标准的比较分析

目的系统收集并分析随机对照试验质量评价的相关标准并初步探究其演进规律,为标准的使用者提供参考与指导。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库等数据库,并用Google等搜索引擎在互联网上查找相关资料。由两位评价员独立筛选文献,提取资料。遴选出具有代表性的标准进行对比分析。结果初检出3282篇文献,筛选相关随机对照试验质量评价标准31个,对遴选出的具有代表性的21个标准进行对比分析。其中,10个标准适用于所有类型的随机对照试验,11个标准针对药物、针灸等特定领域。标准主要从方法学质量和报告质量两个方面对随机对照试验进行评价。本研究对随机对照试验质量评价标准的发展历程进行了初步探究。结论目前随机对照试验的质量评价标准较多,评价内容、条目不一致。建议使用者根据研究内容和目的针对性地选用随机对照试验的质量评价标准。     

针灸治疗糖尿病胃轻瘫随机对照试验文献质量评价

目的对针灸治疗糖尿病胃轻瘫随机对照试验文献质量进行分析,为进一步的临床试验研究提供参考。方法检索近30年针灸治疗糖尿病胃轻瘫临床研究文献,采用循证医学的原则及评价方法,制定临床文献评价及信息采集表,对纳入文献进行分析和评价。结果检索到符合纳入标准的临床对照试验文献21篇,在样本量估算、疾病诊断标准及疗效判定标准、盲法和分配隐藏、随机化实施、随访及病例脱失剔除情况、结局指标选择、安全性观察、结论推导等方面存在一些问题。结论针灸治疗糖尿病胃轻瘫的临床研究文献存在样本量较少、研究方法实施不严谨、结局指标选取不统一的缺点,尚不能得出针灸优于其他疗法的确切结论,故有必要进一步做多中心、大样本及高质量的临床试验研究。     

针灸治疗糖尿病胃轻瘫随机对照试验文献质量评价

目的 对针灸治疗糖尿病胃轻瘫随机对照试验文献质量进行分析,为进一步的临床试验研究提供参考.方法 检索近30年针灸治疗糖尿病胃轻瘫临床研究文献,采用循证医学的原则及评价方法,制定临床文献评价及信息采集表,对纳入文献进行分析和评价.结果 检索到符合纳入标准的临床对照试验文献21篇,在样本量估算、疾病诊断标准及疗效判定标准、盲法和分配隐藏、随机化实施、随访及病例脱失剔除情况、结局指标选择、安全性观察、结论推导等方面存在一些问题.结论 针灸治疗糖尿病胃轻瘫的临床研究文献存在样本量较少、研究方法实施不严谨、结局指标选取不统一的缺点,尚不能得出针灸优于其他疗法的确切结论,故有必要进一步做多中心、大样本及高质量的临床试验研究.     

原发性痛经选穴规律及分析

目的:统计总结近5年来针刺对原发性痛经的选穴规律,以指导临床针刺处方。方法:查阅中国知网期刊全文数据库近5年来相关文献,对其选穴进行总结。结论:针刺治疗原发性痛经疗效肯定,处方优化以进一步指导临床。     

头针治疗帕金森病：一项随机对照试验的系统评价

Objective: To evaluate the effectiveness of scalp acupuncture (SA), a modern acupuncture technique specialized to neurological disorders, in managing motor function and symptoms for Parkinson''s disease (PD) patients. Methods: Two independent reviewers extracted data from all of the randomized clinical trials (RCTs) that assessed the efficacy of SA for PD compared with conventional therapies (CTs). Sixteen electronic databases were searched. The risk of bias was appraised with the Cochrane Collaboration tool, and the reporting of the included studies was evaluated by the Consolidated Standards of Reporting Trials (CONSORT) 2010 checklist and the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines. Results: In total, 4 RCTs met the inclusion criteria. As assessed by the Unified PD Rating Scale (UPDRS), 2 RCTs showed that SA combined with CTs proved superior to CTs alone [60 cases; weighted mean difference, –3.94; 95% confidence interval (CI), –6.05 to –1.84, P=0.01; I2=0%]. Based on the Webster scale, however, 3 RCTs showed no superior effect of SA when combined with CTs with high heterogeneity (154 cases; risk ratio, 1.29; 95% CI, 0.79 to 2.12, P=0.30; I2=84%). The Cochrane risk of bias, adherence to the CONSORT and the STRICTA checklist showed that the quality of all the included RCTs was generally low. Conclusions: The result of our systematic review and meta-analysis suggested that the effectiveness of SA for PD is promising, however, the evidence is not convincing. A sham-controlled RCT design that adheres to the CONSORT and STRICTA guidelines to overcome methodological weakness and that includes a large sample size is strongly recommended to confirm the precise effect of SA on PD.     

循经远取与局部取穴针刺改善胃肠功能的临床疗效差异

目的:按照CONSORT声明和STRICTA标准,通过实施设计严谨的临床研究,对循胃经远取及局部取穴改善胃肠功能的疗效进行客观评价,为两种经典取穴疗效差异的存在提供依据。方法:采用中央随机,将合纳入标准的FD患者1∶1随机分为循胃经远取组和局部取穴组接受治疗。治疗采用HANS电针仪,治疗频率为1次/d,30 min/次,连续5 d1个疗程,疗程期间休息2 d,共治疗4个疗程,并于疗程结束后第4 w、12 w进行随访。以症状积分和尼平消化不良指数(Nepean Dyspepsia Index,NDI)量表中生活质量部分为评价指标,评价各时间点的疗效。结果:循经远取与局部取穴均能持续改善FD的症状以及提高生活质量,这种改善作用于治疗第2 w即显效,并可持续至治疗结束后12 w。循经远取组针刺对PDS型症状及生活质量的改善优于局部取穴组针刺,而2组对EPS型症状改善疗效相当。循经远取组针刺对生活质量的疗效优势主要体现在认识控制领域、食物领域及干扰领域。结论:循经远取与局部取穴对FD(脏腑疾病的代表)的疗效具有差异性。     

Syndrome Pattern and Its Application in Parallel Randomized Controlled Trials

Syndrome pattern (SP) is a core concept of Chinese medicine (CM) and is used to diagnose and treat patients based on an overall analysis of symptoms and signs. This study aimed to systematically review randomized controlled trials (RCTs) using the SP concept and to demonstrate how the SP concept could be applied to the study design of parallel RCTs, considering a gold standard of clinical research. After conducting a brief systematic review by way of a PubMed search, we analyzed how the SP concept was applied to the design of RCT in a CM herbal medicine trial. We then formulated possible research questions, applied the SP concept to answer the research questions, and suggested possible RCT designs to be used for conducting future trials. Fourteen RCTs were included in our systematic review, and three key points of the SP concept were formulated for the design of parallel RCTs: the time point of SP diagnosis between before and after randomization; the relationship between the international classification of diseases (ICD) and SP for the inclusion of target population; and the proper diagnostic method of SP. In this study, we formulated three possible research questions and then suggested perspectives for five possible RCT models arrived at using SP concepts. Future trials applying SP concept to RCTs should overcome the shortcomings of past SP trials, moving CM forward from experience-based to evidence-based medicine.     

中药穴位贴敷治疗原发性痛经临床分析

目的：观察中药穴位贴敷治疗原发性痛经的临床疗效。方法：2005—2010年门诊就诊的原发性痛经病人100例,50例采用中药贴敷于气海、关元、神阙三个穴位,50例病人不用中药,只在相应穴位处贴敷。结果：2个疗程后,中药穴位贴敷治疗痛经有效率98%,不用中药贴敷治痛经有效率32%。结论：中药穴位贴敷治疗原发性痛经疗效确切,安全可靠。