电针与手针在临床和基础中的比较研究

Comparative study of electroacupuncture and hand acupuncture in clinical and basic sciences

目的 梳理临床和基础研究中电针与手针比较的国内研究现状,为未来研究提供思路和依据。方法 系统检索中国知网(CNKI)、维普数据库(VIP)、万方数据知识服务平台及中国生物医学文献数据库(CBM)2019-04-30之前发表的中文文献,根据纳入、排除标准筛选出电针与手针作比较的研究,采用文献计量学的分析方法在临床疗效与作用机制方面进行定量分析。结果 共检索出相关文献115篇,其中临床试验45篇,基础研究70篇。临床上对于脑病、骨关节病及单纯性肥胖等疾病而言,电针的疗效略优于手针。基础研究中,电针与手针在神经—内分泌—免疫网络的调控机制方面存在差异:电针和手针既存在共同激活的脑区,又存在特异性激活的脑区;手针对穴位的刺激主要是深部痛觉感受器,电针在此基础上还影响了皮肤痛觉感受器。结论 电针与手针均是临床上常用的针刺疗法,电针可能通过不同的作用机制较手针更好地发挥镇痛作用。

Objective In order to provide ideas and basis for future research, the domestic research status of comparison between electroacupuncture and hand acupuncture in clinical and basic sciences was reviewed. Methods The Chinese literatures published before 2019-04-30 in China national knowledge internet (CNKI), Vip Chinese science and technology journal database (VIP), Wanfang database, Chinese biomedical database(CBM) were searched systematically. According to the inclusion and exclusion criteria, the comparative study of electroacupuncture and hand acupuncture was screened out, and the quantitative analysis of clinical efficacy and mechanism of action was carried out by bibliometric analysis. Results A total of 115 relevant literatures were retrieved, including 45 clinical trials and 70 basic studies. For encephalopathy, osteoarthritis and simple obesity, electroacupuncture has a slightly better therapeutic effect than hand acupuncture. In basic research, there are differences in the regulation mechanism of nerve-endocrine-immune network between electroacupuncture and hand acupuncture: electro acupuncture and hand acupuncture have both co-activated brain areas and specifically activated brain areas;the stimulation of hand acupuncture on acupoints is mainly the deep pain receptor, on this basis, electroacupuncture also affects the skin pain receptor. Conclusion Electroacupuncture and hand acupuncture are commonly used in clinical acupuncture therapy. Electroacupuncture may play a better analgesic role through different mechanisms than hand acupuncture.