针刺治疗慢性阻塞性肺疾病稳定期临床研究文献分析

Literature Analysis of Clinical Study on Chronic Obstructive Pulmonary Disease at Stable Stage Treated by Acupuncture

目的基于1990年1月至2016年12月国内针刺治疗慢性阻塞性肺疾病(COPD)的临床研究文献,分析目前临床针刺治疗COPD稳定期的应用情况。方法通过计算机检索,收集针刺治疗COPD的相关文献,对治疗方法、选穴、治疗频率、疗程、针刺手法、不良反应、针感等信息进行采集与分析。结果共纳入文献32篇,其中30篇文献采用了针刺联合康复训练、艾灸、西药等其他疗法,两种治疗方式联合应用的文献16篇(50.0%),三种治疗方式联合应用的文献13篇(40.6%)。针刺方式以毫针为主(24篇,75.0%),其次为电针(8篇,25.0%)。涉及39个穴位,以膻中(21篇)、肺俞(19篇)、定喘(16篇)、肾俞(16篇)、足三里(15篇)、关元(14篇)应用最为广泛。留针时间以30分钟最为常见(17篇,53.1%),其次为20分钟(4篇,12.5%)。10篇(31.3%)文献治疗频率为每日1次;9篇(28.1%)文献治疗频率为隔日1次。14篇文献报道了针刺手法,纳入文献均未报道不良反应。结论针刺治疗COPD稳定期的治疗方式以毫针或电针联合其他疗法为主,在留针时间、治疗频率及疗程等方面各文献差异较大。

Objective To analyze current situation of application of acupuncture in the clinical treatment of chro- nic obstructive pulmonary disease （COPD） at stable stage based on domestic clinical research literature of COPD at stable stage treated with acupuncture from January 1990 to December 2016. Methods An online search was under-taken to collect pertinent literature of COPD treated with acupuncture. Therapeutic methods, acupoint selection meth- ods, treatment frequencies, courses of treatment, acupuncture manipulations, untoward reactions, needling sensations and other information were collected and analyzed. Results Thirty two articles were included in which 30 articles reported acupuncture combined with rehabilitation training, moxibustion, western medicine and other therapeutic methods, 16 articles （50. 0% ） with combined application of two therapeutic methods, 13 articles （40. 6% ） with combined application of three therapeutic methods. Among acupuncture manipulations, filiform needle （24 articles, 75.0% ） was the most popular, followed by electro-acupuncture （8 articles, 25.0% ）. Thirty-nine acupoints were included, the most widely used acupoints were Danzhong （CV 17） （21 articles）, Feishu （BL13） （19 articles）, Dingchuan （ EX-B1 ） （ 16 articles）, Shenshu （ BL 23 ） （ 16 articles）, Zusanli （ ST 36 ） （ 15 articles） and Guanyuan （CV 4） （14 articles）. The commonest needle retaining time was 30 minutes （17 articles, 53.1% ）, followed by 20 minutes （4 articles, 12.5% ）. Treatment frequency in ten articles （31.3%） was once daily, and treatment frequency in nine articles （28. 1% ） was once every other day. Acupuncture manipulations were reported in 14 articles. Unto- ward reactions were not reported in all the collected articles. Conclusion Therapeutic methods of COPD at stable stage treated with acupuncture were mainly filiform needle or electro-acupuncture combined with other therapeutic methods. There was a great difference among needle retaining time, treatment frequency and course of treatment in each article.