近17年针刺治疗膝骨关节炎取穴及配伍分析

Analysis of Acupoint Selection and Compatibility in Acupuncture Treatment of Knee Osteoarthritis in Recent Seventeen Years

目的:分析近17年针刺治疗膝骨关节炎(Knee Osteoarthritis,KOA)取穴及配伍规律,为临床优化针刺治疗KOA的方案提供参考。方法:通过计算机检索2000年1月1日至2016年12月31日17年间万方数据知识服务系统、中文科技期刊数据库及清华同方知网数据库中针刺治疗KOA的相关文献,按照纳入、排除标准筛选得到所需文献,并进行分类整理,将篇名、穴位名称录入Microsoft Excel 2010表格中,建立数据库,采用频数统计方法分别统计腧穴使用频次、归经、配伍规律等信息。结果:纳入1 563篇文献,其中取穴多以十四经穴为主(5 312次),且足阳明胃经使用频数最高(2 264次);犊鼻(944次)、内膝眼(928次)、阿是穴(816次)、阳陵泉(738次)、血海(677次)为最常用腧穴;最常用的两个腧穴配伍为犊鼻与内膝眼(726次);常用三个腧穴配伍为犊鼻、内膝眼与血海(456次)或阳陵泉(455次)。结论:针刺治疗KOA常用穴位以近端局部取穴为主,多取十四经穴,且以足阳明胃经上的穴位最为常见;穴位配伍方面,以犊鼻为主穴,分别与内膝眼或(及)血海配伍使用最多见;此外,犊鼻、内膝眼配伍阿是穴或血海或阳陵泉组成的"膝三针",可作为临床治疗KOA的针刺小组方。

Objective： To analyze the rules of acupoints selection and compatibility in acupuncture treatment of knee osteoarthritis（ KOA） in the past seventeen years,and to provide a reference for the clinical optimization of acupuncture for the treatment of KOA.Methods： The relevant literature on the treatment of KOA in the database of Wanfang Data knowledge service system,Chinese sci-tech periodical database and Tsinghua Tongfang knowledge network database within 17 years from January 1,2000 to December 31,2016 was retrieved,and the required literature was obtained according to the inclusion and exclusion criteria,and the article names and acupoint names were classified into Microsoft Excel 2010.Then the database was established,and the frequency of acupoint use,meridian tropism and compatibility were analyzed by method of frequency statistics.Results： The total of 1563 points were included,among which acupoint selection mainly focused on 14 meridians（ 5312 times）,and the highest frequency was used in the stomach meridian of Foot Yangming（ 2264 times）.The most commonly-used acupoints were Dubi（ ST 35）（ 944 times）,Neixiyan（ Ex-LE 8）（ 928 times）,Ahshi acupoint（ 816 times）,Yanglingquan（ GB 34）（ 738 times）,and Xuehai（ SP10）（ 677 times）.The most commonly used two-acupoints combinations were Dubi（ ST 35） and Neixiyan（ Ex-LE 8） for 726 times.The most commonly used three-acupoints combinations were Dubi（ ST 35） and Neixiyan（ Ex-LE 8） and Xuehai（ SP 10）for 456 times or Yanglingquan（ GB 34） for 455 times.Conclusion： The acupuncture treatment of KOA acupoints selection gives first place on near and local acupoints which mainly focus on 14 meridians,and the acupoints on the Foot Yangming Meridian are the most common ones.In terms of compatibility,Dubi（ ST 35） is the main acupoint,and often combined with Neixiyan（ Ex-LE8） and or Xuehai（ SP 10）.Besides,Dubi（ ST 35） and Neixiyan（ Ex-LE 8） are often combined with Ahshi acupoint or Xuehai（ SP 10） or Yanglingquan（ GB 34）,which is regarded as ＂ three acupuncture points on the knee＂ and can be used as a small acupuncture prescription for clinical treatment of KOA.