近10年针灸及相关辅助疗法促进压疮愈合研究进展

Research progress of acupuncture and the related adjuvant therapy for promoting pressure ulcer healing in recent 10 years

目的:探讨近10年针灸及相关辅助疗法促进压疮愈合的研究进展。方法:通过检索中国期刊全文数据库(CNKI)、维普数据库(VIP)和PubM ed数据库,搜集整理从2008年1月至2017年12月的针灸及相关辅助疗法治疗压疮的文献,从临床研究和基础研究两方面进行分析、归纳、总结其研究进展和相关作用机制。结果:通过筛选,最终获得针灸及相关辅助疗法治疗压疮的文献78篇,其中中文71篇、英文7篇。压疮治疗方法使用频率最高的为艾灸单用或艾灸联合其他辅助措施的疗法,其次是局部围刺疗法、电针疗法以及其他经皮电神经刺激、神经肌肉电刺激、激光疗法等干预手段,均能不同程度促进压疮的愈合。其作用机制可能与调节局部血液灌注量、血管内皮生长因子分化迁移、血管生成、超氧化物歧化酶(SOD)及内皮型一氧化氮合酶/一氧化氮(eNOS/NO)信号通路等以促进组织的迁移、增殖有关。结论:针灸及相关辅助疗法治疗压疮疗效比较确切,国内外基于压疮治疗的研究呈现出多样化的特点,但关于作用机制的研究还很有限。

Objective To summarize the research progress of acupuncture-moxibustion and the related adjuvant therapy for promoting pressure ulcer healing in recent 10 years and explore the future research direction. Methods By retrieving Chinese Journal Full-text Database(CNKI), VIP Database(VIP) and PubMed database, dated from January 2008 through to December 2017, the articles for the treatment of pressure ulcers with acupuncture-moxibustion and the related adjuvant therapy were collected. In terms of clinical research and experimental research, the research progress and the related effect mechanisms were analyzed and summarized. Results Through screening, 78 articles for the treatment of pressure ulcer with acupuncture-moxibustion and the adjuvant therapy were collected finally, of which, 71 articles were Chinese and 7 articles were English. The therapies with the highest frequency for pressure ulcer were the simple moxibustion or moxibusiton combined with other adjuvant measures. The local surrounding needling therapy, electroacupuncture, transcutaneous electrical nerve stimulation(TENS), neuromuscular electrical stimulation(NMES) and laser therapy were followed by regarding the use frequency. All of these interventions promoted the healing of pressure ulcers to different degrees. The underlying mechanisms were related to the regulation of the local blood perfusion, differentiation and migration of vascular endothelial growth factor, angiogenesis, superoxide dismutase SOD and eNOS/NO signaling pathway so as to promote tissue migration and proliferation. Conclusion Acupuncture-moxibustion and the related adjuvant therapies achieve the definite therapeutic effects on pressure ulcers. The researches on the treatment of pressure ulcers at home and abroad are diversified, but it is still limited in the research on the effect mechanism.