针灸治疗闭经诊疗特点的文献分析

目的探讨针灸治疗闭经的诊疗特点和规律。方法电子检索中国知网(CNKI,1979～2012年)、中文科技期刊全文数据库(VIP,1989～2012年)、中国生物医学光盘数据库(CBM,1979～2012年)、PUBMED(1966～2012年)中针灸治疗闭经的文献,分析总结常用的针灸干预措施、闭经证型分布,针灸对其治疗时的辨证和选穴特点、针灸频次、疗程、疗效、随访、安全性。结果纳入18篇文献中,体针治疗闭经占61.11%(11/18);针灸临床辨治闭经时常用的证型有气血不足(27.78%,5/18)、气滞血瘀(22.22%,4/18);入选的文献中使用辨病选穴的文献有8篇,占44.44%(8/18),出现频次较高的穴位是关元(8/18,44.44%)、三阴交(7/18,38.89%)、中极(5/18,27.78%)、气海(5/18,27.78%)、肾俞(5/18,27.78%)、中脘(5/18,27.78%),基于中医证型的取穴或配穴所选穴位集中来自于脾经、胃经、任脉;针灸治疗频次每天1次占55.56%(10/18);针灸治疗1个月经周期后观察疗效占38.89%(7/18);针灸治疗闭经的有效率随不同干预措施存在差异,在72.72%～100%之间;针灸治疗闭经的文献随访率不高,仅占5.56%(1/18)。入选文献中未见到对针灸治疗闭经的不良反应的报道。结论针灸临床治疗闭经以体针常见;针灸临床辨治闭经时常用的证型有气血不足、气滞血瘀;针灸治疗闭经取穴方式常见为辨病选穴,具体是关元、三阴交、中极、气海、肾俞、中脘;基于中医证型的取穴或配穴所选穴位多取自脾经、胃经、任脉;针灸每天1次,一般治疗1个月经周期后评价疗效,在临床上多被采用。针灸治疗闭经疗效肯定,安全性较好。

Literature analysis of diagnosis and treatment of acupuncture and moxibustion for amenorrhea

[ Abstract] Objective To explore the diagnosis and treatment of acupuncture and moxibustion for amenorrhea. Methods we searched the literatures related to amenorrhea treated by acupuncture and moxibustion in CNKI （ 1979 - 2012 ） , VIP （ 1989 - 2012 ） , CBM （ 1979 - 2012 ） , PUBMED （ 1966 - 2012 ） , then summarized the intervene measures related to acupuncture and moxibustion, amenorrhea distribution of TCM syndromes, clinical characteristics of syndrome differentiation and acupuncture points selection method, frequency, treatment course, treatment effect, follow-up study, safety in treating arnenorrhea by acupuncture and moxibustion. Results In the collected 18 articles, the percentage of article involved in treating amenorrhea by body acupuncture was 61.11% （11/18 ） ;the most frequent syndrome was pattern of qi and blood deficiency （27. 78% ,5/18 ）and pattern of qi stagnancy and blood stasis （22. 22%,4/18 ）. The article involved in acupuncture points selection method by differentiation of disease was 44.44% （8/18）. The main acupuncture points chose in the 18 articles in the frequency order were Guanyuan （8/18, 44. 44% ）, Sanyinjiao （7/18, 38. 89% ）, Zhongji （5/18, 27.78% ）, Qihai （5/18, 27.78% ）, Shenshu（5/18, 27. 78% ）, Zhongwan （5/18, 27. 78% ）. The acupuncture points selected or matched based on syndrome types of amenorrhea concentrated among the spleen meridian, the stomach meridian and the conception vessel; the percentage of treating frequency of once a day was 55.56% （10/18）; the percentage of treating course of 1 menstrual cycle was 38.89% （7/18） ; the effective rate showed a lot of variation from 72. 72% - 100% varied with intervene measures; the follow-up rate was not high, only 5.56% （ 1/18 ） ; there was not any adverse reactions reported in the collected literature. Conclusions In treating amenorrhea by acupuncture and moxibustion, body acupuncture was the most frequent method; pattern of qi and blood deficiency and pattern of qi stagnancy and blood stasis were the most frequentlyused pattern in clinic; acupuncture points selection by disease differentiation was the most common method. The main acupuncture points applied in amenorrhea were Guanyuan, Sanyinjiao, Zhongji, Qihai, Shenshu, Zhongwan; the acupuncture points selected or matched based on syndrome types of amenorrhea concentrated among the spleen meridian, the stomach meridian and the conception vessel; once a day frequency, 1 menstrual cycle therapy course were regular and wide use in treating amenorrhea by acupuncture an moxibustion; acupuncture and moxibustion can be employed to treat amenorrhea effectively and safely.