针刺治疗神经性吞咽困难选穴规律文献研究

Literature Research of Acupoints Selection Principles of Acupuncture Treating Neuropathic Dysphagia

目的通过文献分析探讨针刺治疗神经性吞咽困难的临床选穴规律。方法检索中国期刊全文数据库、万方学术期刊全文数据库及Ovid gateway中1999年1月至2014年12月间所有中英文针刺治疗神经性吞咽困难临床研究文献,提取纳入文献信息建立针刺治疗神经性吞咽困难文献数据库,分别统计患者一般资料,经穴、经外穴及特定穴使用情况,经脉取穴及腧穴配伍情况。结果纳入文献51篇,涉及患者4606例、针刺处方51首。使用经穴36个,使用频次215;经外穴20个,使用频次93;特定穴13个,使用频次50。经穴中使用频次最高的前2位为廉泉(41)、风池(39),经外穴中分别为金津(20)、玉液(19),特定穴中分别为合谷(5)、足三里(5)。经脉使用频次前3位分别是任脉(62)、足少阳胆经(47)、足阳明胃经(27),合计使用率达63.3%。统计分析使用频次5次及以上的腧穴配穴情况显示,针刺治疗神经性吞咽困难以廉泉加风池作基础治疗为主,其使用频次为34(77.3%)。结论针刺治疗神经性吞咽困难基本方为廉泉、风池、翳风,多从任脉、胆经及胃经等与咽喉项部联系密切的经脉论治。

Objective To analyze and explore clinical acupoints selection principles of acupuncture treating neuropathic dysphagia by papers. Methods Review all published literature of clinical research about acupuncture treating neuropathic dysphagia in Chinese and English from Journal Full-Text Database of China National Knowledge Infrastructure, WanFang Data and Ovid gateway from January of 1999 to December of 2014. Record and include study papers information to establish paper data base of acupuncture treating neuropathic dysphagia. Make statistics of patients＇ general information, application of points of channels, points out of channels and specific points, compatibility of acupoints respectively. Results Fifty-one papers were included, involving 4606 patients and 51 acupuncture prescriptions. Thirty-six channel points were applied and the frequency was 215. Twenty extra points were applied and the frequency was 93. Thirteen specific points were applied and the frequency was 50. Among the channel points, top two frequently used were Lianquan （RN23, 41 times） and Fengchi （GB20, 39 times）. Among the channel extra points, top two frequently used were Jinjin （EX-HN12, 20 times） and Yuye （EX-HN13, 19 times）. Among specific points, top two frequently used were Hegu （LI4, 5 times） and Zusanli （ST36, 5 times）. Top three frequent meridians applied were Ren Meridian （ RN, 62 times）, Gallbladder Meridian of Foot-Shaoyang （ GB, 47 times） and Stomach Meridian of Foot-Yanginmg （ ST, 27 times）. The total usage rate was 63.3%. Statistics and analysis on compatibility of acupoints which applied frequency were more than 5 showed that acupuncture treating neuropathic dysphagia was based on basic therapy of Lianquan （RN23） and Fengchi （GB20）. The frequency was 34 （77. 3% ）. Conclusion The basic prescription of acupuncture treating neuropathic dysphagia was Lianquan （RN23）, Fengchi （GB20） and Yifeng （SJ17）, mostly treating from RN, GB, ST and other meridians closely related to throat and nuchal region.