基于临床随机对照试验分析铺灸疗法的优势病种
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摘要
目的:分析现阶段铺灸疗法的适应证及优势病种,为临床治疗提供参考依据。方法:检索中国期刊全文数据库、万方、维普、PubMed等7大中英文数据库,纳入所有铺灸的临床随机对照试验(RCT)文献并进行分析,统计文献年度发表数量,文献所属各疾病系统的数量,其适应证及优势病种,研究病例数和对应的临床有效率。结果:共纳入182篇文献,铺灸的主要适应证达40种,涵盖9大疾病系统。在运动系统中适应证最多,占所有适应证的17.50%(7/40),其次为消化系统疾病,占所有适应证的15.00%(6/40)。优势病种主要分布在运动系统、呼吸系统、神经系统及妇科系统。其中,运动系统有3个优势病种,为强直性脊柱炎、腰背痛和类风湿关节炎;呼吸系统有1个优势病种,为慢性阻塞性肺病;妇科系统有1个优势病种,为原发性痛经;神经系统有1个优势病种,为卒中后瘫痪。结论:现阶段铺灸的适应证较为广泛,优势病种相对集中,以强直性脊柱炎为代表。但铺灸的适应证和优势病种是动态变化的,其治疗疾病谱仍有拓展潜力。
Objective To analyze the indications and dominant diseases of the spreading moxibustion therapy. Methods By retrieving 7 databases of both Chinese and English version, such as CNKI, WANFANG, VIP and PubMed, the eligible articles of randomized controlled trials(RCTs) treated with spreading moxibustion therapy were collected. The number of annual publications, the number of each disease system, the indications and dominant diseases involved in the related articles were analyzed statistically, as well as the number of cases and the corresponding clinical effective rates. Results A total of 182 articles were included, including 40 indications for the spreading moxibustion and covering 9 major disease systems. Specially, the indications in the motor system were maximal in number, accounting for 17.50%(7/40) of the total number of indications. The number of indications in the digestive system was on the second top, accounting for 15.00%(6/40). The dominant diseases were mainly distributed in motor system, respiratory system, nervous system and gynecological system. There were 3 dominant diseases in motor system, i.e. ankylosing spondylitis, back pain and rheumatoid arthritis; 1 dominant disease, i.e. chronic obstructive pulmonary disease in the respiratory system, 1 dominant disease, i.e. primary dysmenorrheal in the gynecological system and 1 dominant disease, i.e. post-stroke paralysis in the nervous system.Conclusion At present, the indications of the spreading moxibustion therapy are widely distributed and the dominant diseases are concentrated, representatively by ankylosing spondylitis. But, the indications and the dominant diseases of spreading moxibustion are changeable dynamically and the disease spectrum of spreading moxibustion needs to be further explored.
Objective To analyze the indications and dominant diseases of the spreading moxibustion therapy. Methods By retrieving 7 databases of both Chinese and English version, such as CNKI, WANFANG, VIP and PubMed, the eligible articles of randomized controlled trials(RCTs) treated with spreading moxibustion therapy were collected. The number of annual publications, the number of each disease system, the indications and dominant diseases involved in the related articles were analyzed statistically, as well as the number of cases and the corresponding clinical effective rates. Results A total of 182 articles were included, including 40 indications for the spreading moxibustion and covering 9 major disease systems. Specially, the indications in the motor system were maximal in number, accounting for 17.50%(7/40) of the total number of indications. The number of indications in the digestive system was on the second top, accounting for 15.00%(6/40). The dominant diseases were mainly distributed in motor system, respiratory system, nervous system and gynecological system. There were 3 dominant diseases in motor system, i.e. ankylosing spondylitis, back pain and rheumatoid arthritis; 1 dominant disease, i.e. chronic obstructive pulmonary disease in the respiratory system, 1 dominant disease, i.e. primary dysmenorrheal in the gynecological system and 1 dominant disease, i.e. post-stroke paralysis in the nervous system.Conclusion At present, the indications of the spreading moxibustion therapy are widely distributed and the dominant diseases are concentrated, representatively by ankylosing spondylitis. But, the indications and the dominant diseases of spreading moxibustion are changeable dynamically and the disease spectrum of spreading moxibustion needs to be further explored.
引文
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[24]高云,赵俊峰,郭存霞.督灸疗法对维持性血液透析患者不宁腿综合征的改善:随机对照研究[J].中国针灸,2016,36(6):597-600.
[25]宋琳琳,徐志伟,陈新旺,等.改良铺灸对脊髓损伤所致神经源性膀胱的临床疗效观察[J].中国康复医学杂志,2017,32(2):229-230.
[26]张史飞,任绍东,陈泽群,等.督灸治疗脊髓损伤后中枢性疼痛的临床效果探析[J].中国现代药物应用,2017,11(17):28-29.
[27]郑新颖.铺灸疗法治疗糖尿病周围神经病变70例临床观察[J].中国医药导报,2017,14(19):94-97.
[28]郑新颖.铺灸疗法治疗糖尿病周围神经病变的临床研究[J].实用临床医药杂志,2017,21(11):51-53.
[29]徐彦龙,徐秀梅,何天有,等.针刺"三阴穴"结合药物铺灸治疗勃起功能障碍疗效观察[J].上海针灸杂志,2017,36(5):573-577.
[30]庄克生,李连朝,李英琛,等.改良督灸法治疗脾肾两虚型原发性膜性肾病38例[J].河南中医,2016,36(10):1800-1802.
[31]Bian Z,Liu B,Moher D,et al.Consolidated standards of reporting trials(CONSORT)for traditional Chinese medicine:current situation and future development[J].Front Med,2011,5(2):171.
[2]张瑜,蔡圣朝,袁卫华.铺灸治疗老年慢阻肺近十年研究进展[J].中医外治杂志,2012,21(4):52-53.
[3]罗任.针灸治疗强直性脊柱炎的临床研究[J].中国组织工程研究,2006,10(47):142-144.
[4]张成,陈向华,金国娥,等.铺灸治疗强直性脊柱炎的临床研究进展[J].山西中医学院学报,2017,18(3):71-74.
[5]刘安国,严兴科,阚丽丽,等.铺灸疗法为主治疗强直性脊柱炎的Meta分析[J].西部中医药,2013,26(12):51-54.
[6]孙鉴.中医药临床治疗评价体系的构建[J].中国中医药现代远程教育,2014,12(1):136-137.
[7]北京协和医院世界卫生组织国际分类家族合作中心,董景五.疾病和有关健康问题的国际统计分类:第十次修订本[M].北京:人民卫生出版社,2008.
[8]胡丽萍,余曙光,郭烨,等.铺灸探新[J].辽宁中医杂志,2015(7):1307-1309.
[9]李晚桂,涂乾,辜雪鹃.督脉铺灸为主治疗早期强直性脊柱炎及对患者血清炎性细胞因子含量的影响[J].中国针灸,2010,30(3):200-202.
[10]杜文忠,张建鹏,何永刚.三伏督脉铺灸治疗强直性脊柱炎58例[J].中国针灸,2011,31(10):951-952.
[11]罗诗荣,朱月伟.“铺灸”治疗类风湿性关节炎65例临床观察[J].中国针灸,1988,18(2):8-10.
[12]谢潇侠,雷秋慧.铺灸为主治疗类风湿关节炎疗效观察[J].中国针灸,2008,28(10):730-732.
[13]何天有.何氏药物铺灸疗法[M].北京:中国中医药出版社,2010.
[14]朱现民,丁润泽,陈煦.督脉铺灸的施术关键与运用特色[J].上海针灸杂志,2014,33(10):948-950.
[15]王少敏,左祖俊,刘自刚,等.长蛇灸对早中期强直性脊柱炎炎症因子的影响[J].湖北中医药大学学报,2010,12(1):54-55.
[16]赵耀东,韩豆瑛.铺灸治疗类风湿性关节炎40例临床观察[J].西部中医药,2012,25(9):86-87.
[17]张瑜,蔡圣朝,徐雯,等.铺灸对老年慢性阻塞性肺病患者免疫功能的影响[J].上海针灸杂志,2014,33(11):1011-1012.
[18]李文丽,刘丽,孙立虹.隔物灸治疗寒湿凝滞型原发性痛经疗效分析[J].中国针灸,2006,26(7):481-432.
[19]孙立虹,葛建军,佘延芬,等.隔物灸神阙、关元穴对原发性痛经患者血清PGF2α、PGE2含量及其比值的影响[J].南京中医药大学学报,2010,26(2):108-110.
[20]张欣,尚坤,王富春.隔姜灸对原发性痛经(寒湿凝滞型)患者经络特性的调整作用与临床疗效的观察[J].时珍国医国药,2010,21(8):2011-2012.
[21]贾耿.督脉、足太阳、任脉、肾精实质试探[J].湖南中医药大学学报,2000,20(4):47-49.
[22]鲁燕,马永.督脉灸预防胃癌化疗后毒副反应的临床研究[J].中医临床研究,2014,6(26):34-35.
[23]程勤,许小方.观察督脉灸在预防胃癌化疗后毒副反应的临床疗效及安全性[J].人人健康,2016(23):149.
[24]高云,赵俊峰,郭存霞.督灸疗法对维持性血液透析患者不宁腿综合征的改善:随机对照研究[J].中国针灸,2016,36(6):597-600.
[25]宋琳琳,徐志伟,陈新旺,等.改良铺灸对脊髓损伤所致神经源性膀胱的临床疗效观察[J].中国康复医学杂志,2017,32(2):229-230.
[26]张史飞,任绍东,陈泽群,等.督灸治疗脊髓损伤后中枢性疼痛的临床效果探析[J].中国现代药物应用,2017,11(17):28-29.
[27]郑新颖.铺灸疗法治疗糖尿病周围神经病变70例临床观察[J].中国医药导报,2017,14(19):94-97.
[28]郑新颖.铺灸疗法治疗糖尿病周围神经病变的临床研究[J].实用临床医药杂志,2017,21(11):51-53.
[29]徐彦龙,徐秀梅,何天有,等.针刺"三阴穴"结合药物铺灸治疗勃起功能障碍疗效观察[J].上海针灸杂志,2017,36(5):573-577.
[30]庄克生,李连朝,李英琛,等.改良督灸法治疗脾肾两虚型原发性膜性肾病38例[J].河南中医,2016,36(10):1800-1802.
[31]Bian Z,Liu B,Moher D,et al.Consolidated standards of reporting trials(CONSORT)for traditional Chinese medicine:current situation and future development[J].Front Med,2011,5(2):171.