关于经、穴、病、证与植物神经关系研究的思考

Perspective of Relationship among Channels,Acupoints,Disease,Syndromes and Autonomic Nerve

背景:综观历年来的文献报道,在谈到影响针刺得气的因素时,多强调医生的干预因素,如针刺手法,针刺激强度等,鲜有系统论述患者机体状态尤其是植物神经功能状态在针刺中作用的。目的:立足中医基础理论,探讨经络、腧穴、疾病、证候与植物神经关系,为影响针刺得气的机体因素提供部分科学依据。方法:以"植物神经"或"自主神经"且"针灸"或"针刺"为关键词进行检索中国期刊全文数据库(CNKI)数据库得到587篇文献,其中密切相关文献42篇。结果:在影响针刺疗效的机体因素中,经络、腧穴、疾病、证候与植物神经关系密切相关。结论:有必要在明晰经络、腧穴、疾病、证候各自与植物神经的关系的同时从患者整体角度出发开展以病人为中心的CER(comparative effectiveness research,比较效益研究)研究,为临床医生个体化的诊疗方案提供依据。

Background：Through literature review of acupuncture studies,we found the majority of studies stressed on doctors＇ intervention factors,such as acupuncture manipulation and intensity when explored the influential factors of needling sensation.There are few reviews systematically discussing the state of patients＇ body,especially the role of autonomic nerve related to its function during acupuncture.Objective：Based on the basic theory of traditional Chinese medicine,we aimed at exploring the relationship among the channels,acupoints,disease,syndromes and autonomic nerve,in order to provide scientific basis for patients＇ body as an influential factor of needling sensation.Methods：We searched Chinese National Knowledge Infrastructure（CNKI） from inception with terms of autonomic nerve or autonomic and acupuncture or acupuncture as the keyword.We obtained 587 references,and finally we included 42 papers.Results：We found that among influential factors of acupuncture efficacy,channels,acupoints,disease,syndrome were closely associated with autonomic nervous.Conclusion：It is necessary to figure out the relationship among channels,acupoints,disease,syndrome and autonomic nerve,and conduct patient-centered CER（comparative effectiveness research,comparative effectiveness research） studies from an overall perspective.