针灸治疗功能性阳痿诊疗特点的文献分析

Literature Analysis on Diagnosis and Treatment of Acupuncture and Moxibustion in Treating Functional Impotence

目的：探讨针灸治疗功能性阳痿的诊疗特点和规律,并结合作者临床经验及盆底神经解剖特点提出诊疗方案。方法：电子检索中国知网（CNKI,1979—2014年）、万方数据库（Wanfang Data,1990—2014年）、中国医院知识总库（CHKD,1979—2014年）、Pub Med（1979—2014年）中针灸治疗功能性阳痿的文献,分析总结治疗常用的针灸干预措施、辨证和选穴特点、治疗频次、总治疗时间、疗效、随访及安全性。结果：纳入38篇文献中,运用针刺治疗者占42.11%（16/38）;使用辨病选穴者占52.63%（20/38）,具体穴位为关元（21/38,55.26%）、肾俞（16/38,42.11%）、三阴交（15/38,39.47%）、中极（11/38,28.95%）、次髎（11/38,28.95%）、命门（8/38,21.05%）;治疗频次1次/d占60.53%（23/38）;总治疗时间为8周者占13.16%（5/38）;有效率处于78%～100%之间;文献随访率低,仅占10.53%（4/38）。入选文献中未见到不良反应的报道。结论：针灸治疗功能性阳痿有较高的有效率,但多数文献缺乏随机对照和随访观察,尚需更高质量的研究进一步明确针灸治疗阳痿的有效值,同时,推荐方案：深刺中髎,前5周1次/d,后3周隔日1次,共治疗8周。

Objective： To explore the diagnose and treatment rules of acupuncture and moxibustion in treating functional impotence,and to propose treatment protocols after combining the clinical experience and the characteristic of pelvic floor nervus. Methods： Literatures related to functional impotence treated by acupuncture and moxibustion in CNKI（ 1979—2014）,Wanfang Date（ 1990—2014）,CHKD（ 1979—2014）,Pub Med（ 1979—2014） were retrieved,and the intervene measures related to acupuncture and moxibustion,clinical characteristics of syndrome differentiation and acupuncture points selection method,frequency,total treatment time,treatment effect,follow-up study and safety in treating functional impotence by acupuncture and moxibustion were summarized and analyzed. Results： Among the included 38 articles,studies involving acupuncture treating functional impotence took account for 42. 11%（ 16 /38）; 52. 63% of the studies used acupuncture points selection method by differentiation of disease; the main acupuncture points were Guanyuan（ RN4,55. 26%,21 /38）,Shenshu（ BL23,42. 11%,16 /38）,Sanyinjiao（ SP6,39. 47%,15 /38）,Zhongji（ RN3,28. 95%,11 /64）,Ciliao（ BL32,28.95%,11 /38）,Mingmen（ DU4,21. 05%,8 /38）. The treating frequency of 60. 53% of the studies was once a day; the total treatment time of 13. 16% studies was 8 weeks; the effective rate varied from 78% to 100% with different intervene measures; the follow-up rate was only 10. 53%（ 4 /38）; there was not any adverse reactions reported in these literatures. Conclusion： Acupuncture and moxibustion treating functional impotence has high efficient,but most of the literatures were not randomized,controlled and follow-up studies,so it needs higher quality researches to confirm the actual effective value of acupuncture and moxibustion treating functional impotence. Recommended program is treating functional impotence by deeply inserting Zhongliao（ BL33） acupoint once a day for the first 5 weeks and once every other day in the following 3 weeks.