基于文献研究针灸治疗顽固性面瘫的临床取穴规律

The Law of Acupoint Selection for Acupuncture in the Treatment of Intractable Facial Paralysis Based on Literature Study

目的:探讨近年来针灸治疗顽固性面瘫的临床取穴规律及特点。方法:检索中国知网(CNKI)、维普、万方等数据库收集近10年针灸治疗顽固性面瘫的临床研究文献,应用Excel建立针灸处方数据库,对数据进行描述性分析和关联规则分析。结果:共纳入文献66篇,选穴67个。分析发现所有纳入文献中两种治疗方法相结合者最多,占59.1%。而支持度大于20%的高频穴位有18个,均分布于十四经(除手少阴心经)和经外奇穴,以足阳明胃经、经外奇穴、手阳明大肠经、足少阳胆经的使用频率最高。交会穴为使用最多的特定穴,占总频次的66.46%。穴位间相关性最高的是颊车-地仓。结论:针灸治疗顽固性面瘫重视阳经和经外奇穴,阳经又以手足阳明经、少阳经为主,经穴以地仓、颊车、阳白为主,奇穴以太阳、鱼腰、牵正为主,并以局部为主与远端相结合取穴,同时依据经络与八纲配合辨治,再兼顾其他经脉及经穴协同治疗。

Objective:To explore the laws of clinical acupoints selection and the characteristics of acupuncture in the treatment of intractable facial paralysis in the recent years.Methods:The papers about clinical study on acupuncture in treating intractable facial paralysis in the recent ten years were retrieved in CNKI,VIP and Wanfang,acupuncture prescription database was established using Excel,descriptive analysis and association rule analysis were performed.Results:A total of 66 literatures are included and 67 acupoints are selected.The analysis found that the combination of both therapies is the most in all the included literature,accounting for 59.1%.There are 18 high-frequency acupoints with a support of more than 20%,which are distributed in the fourteen meridians(except the heart meridian of hand Shaoyin)and extra nerve points,and the most frequently used acupoints are in the stomach meridian of foot Yangming,extra nerve points,the large intestine meridian of hang Yangming,gallbladder meridian of foot Shaoyang.Intersection points are the most used specific points,accounting for 66.46%of the total frequency.The acupoints with the highest correlation are Jiache(ST6)and Dicang(ST4).Conclusion:Acupuncture in the treatment of intractable facial paralysis pays attention to Yang meridians and extra nerve points,Yang meridian mainly focuses on hand and foot Yangming and Shaoyang meridians,the acupoints contain Dicang,Jiache and Yangbai(GB14),extra nerve points are Taiyang(EX-HN5),Yuyao(EX-HN4)and Qianzheng(EX-HN16),the acupoints are seletected mainly locally and combined with the distal end.Meanwhile,syndrome differentiation and treatment should be carried out according to the combination of meridians and eight principles,and the synergistic treatment of other meridians and acupoints should be considered.