《肩周炎循证针灸临床实践指南》解读

Explanation on Evidence-based Guidelines of Clinical Practice with Acupuncture and Moxibustion:Periarthritis of Shoulder

2015年《肩周炎循证针灸临床实践指南》作为中国针灸学会标准已正式发布出版。本文从指南目的、指南方法学、指南适用疾病范围、具体推荐方案主体等方面进行解读,为针灸临床医生使用该《指南》提供便利。该《指南》在全面检索针灸治疗肩周炎文献,采纳国内外当前最佳证据、专家经验、患者价值观,借用证据质量与推荐强度分级系统(GRADE)方法,参考古代、近现代名老针灸专家临床经验,结合全国大范围专家共识的基础上制定而成,以期为针灸临床治疗肩周炎提供可靠证据,确保治疗的安全性和有效性。本《指南》建议针灸治疗肩周炎采用分期施治原则;急性期以缓解疼痛为主,针灸取穴以循经选取远端腧穴为主,强刺激,并配合局部腧穴;慢性期及功能恢复期以纠正肩关节功能活动障碍为主,针灸治疗采用病因辨证与经络辨证相结合,取穴以局部腧穴为主,并配合循经及病因辨证取穴。

TheEvidence-based Guidelines of Clinical Practice with Acupuncture and Moxibustion： Periarthritisof Shoulder（Guidelines for short） was officially published as a standard of China Association of Acupuncture and Moxibustion in 2015.From the purpose, methodology,scope, indication,recommended protocol,etc.,this was explained to provide convenience for clinical use of acupuncturists. ThisGuidelines was developed based onGuidelines comprehensive search of literature regarding acupuncture for periarthritis of shoulder,the adoption of best evidence, expert experience,patient value across the world, methods of evidence quality and GRADE,references of clinical experience of famous acupuncturists in the ancient and modern time and expert consensus in the national level,which was hoped to provide solid evidence of acupuncture clinical treatment for periarthritis of shoulder to ensure the safety and effectiveness.In thisGuidelines,the stage-by-stage treatment principle of acupuncture for periarthritis of shoulder was recommended. In the acute stage, the treatment aim was to relieve the pain,and distal acupoints along the meridians were selected with strong stimulation; the local acupoints were combined. In the chronic stage and rehabilitation stage,the treatment aim was to improve the dysfunction of shoulder joint,and acupuncture treatment was based on syndrome differentiation of etiology and meridian; the local acupoints were mainly selected,combined with acupoints based on etiology and acupoints along meridians.