针刺疗法的安全性及相关因素分析

Study on the reasons of acupuncture-related adverse events

目的:通过系统的文献回顾,客观分析存在的问题、阐明其原因,以促进针刺疗法的安全使用。方法:检索中国期刊全文数据库(CNKI,1980年—2010年),维普中文科技期刊全文数据库(VIP,1989年—2010年),查找有关针刺安全性的文献。提取病种、不良事件类型、例数及结局,进行分类总结。结果:筛选后纳入针刺相关的不良事件文献119篇,共683例不良事件(死亡23例):器官和组织损伤281例(41.14%),感染36例(5.27%),晕针348例(50.95%)。分析发现,95%以上的创伤性事件和感染性事件发生在基层卫生院和私人诊所,多由未经良好专业培训的针灸从业人员操作不当和消毒不严导致。结论:针刺疗法临床疗效较好,但未经专业培训的人员操作不当可引起不良事件发生。因此,有必要对基层的针灸从业人员进行培训和考核,确保针刺安全及合理使用。

Objective： The purpose of this article is to analyze the Adverse Events（AE） of acupuncture and its relative influence factors,clarify its causes and ensure the safey of acupuncture through systematic review of literatures.Methods： We searched all clinical studies and AE reports of acupuncture from January 1980 to December 2010 published in the literature in China Full-text journal databases.Data about diseases,type of adverse events,the number of cases and outcomes were exetracted and analyzed.Results： One hundred and nineteen articles were inclued,including 683 cases of AE after acupuncture.Twenty three patients died.The adverse events were classified into three categories： traumatic events,infections and other adverse events.The most frequent adverse events were fainting.The second were pneumothorax.Over 95% of the traumatic and infections events occurred in the primary health centers and private clinics,were caused by acupuncturists with questionable training.Conclusion： The AE associated with acupuncture were frequently caused by improper operation.Therefore,it is necessary to train and assess the acupuncturists from primary health department and clinics.