时间因素与针刺疗效的相关性研究进展

Research Progress on Correlation Between Time Factor and Acupuncture Effect

针刺治疗与时间因素密切相关,治疗时间的变化会对疗效造成不同的影响。影响针刺疗效的时间因素包括:①针刺时机:根据病情择时选取病变脏腑对应的时辰或季节进行针刺,疗效较好;②留针时间:留针时间的长短影响针刺疗效,需根据病情控制在最佳范围;③时间间隔:针刺频次在一定程度上对疗效产生促进作用;④疗程长短:提高疗效的关键步骤是通过辨证确立最佳疗程。目前,对时间因素与针刺疗效相关性的研究已取得一些进展,但也存在很多不足:临床及实验研究的随意性较大,缺乏统一的量化标准,未对疾病进行系统归纳和研究;研究过程中未建立规范的临床指导模式,样本数量较少;对针刺作用的时效性机制研究较少。以上都使得时间因素在临床应用中有随意性和不科学性。今后的研究需在现有理论基础和临床经验基础上,充分应用现代医学资源有目的地对疾病进行归纳和研究,采用大样本随机对照实验,总结出某一类疾病与时间因素的关系,得出规范可信的结论;针刺时间的确定受体质、病位、病程等影响,可对其影响因素深入挖掘;开展对针刺作用时效性机制的研究,探求其实质与规律,使时间医学有据可循,以期为临床实践提供更好的治疗依据和方案。

Acupuncture treatment is closely related to time factors,and changes in treatment time will have different effects on the efficacy.The time factors affecting the therapeutic effect of acupuncture include:①Acupuncture timing:According to the condition of the disease,the time or season corresponding to the diseased sputum is better.②Needle retention time:The length of the needle retention effect affects the acupuncture effect,and needs to be controlled according to the condition in the best range.③ Time interval:the frequency of acupuncture promotes the effect to a certain extent.④Course length:the key step to improve the efficacy,to establish the best course of treatment through syndrome differentiation.At present,some progress has been made in the study of the relationship between time factors and acupuncture efficacy,but there are also many shortcomings:clinical and experimental research is more random,lacks uniform quantitative standards,and does not systematically summarize and study diseases;there is no standardized clinical guidance model in the process,and the number of samples is small;there are few studies on the time-effect mechanism of acupuncture.All of the above make the time factor arbitrarily and unscientific in clinical application.Future research needs to base on the existing theoretical basis and clinical experience,fully apply modern medical resources to purposefully summarize and study the disease,and use large sample randomized controlled trials to summarize the relationship between certain diseases and time factors.The conclusion that the normative and credible conclusions are made;the influence of the acupuncture time on the receptor quality,the disease position,the disease course,etc.,can be further explored;the research on the time-effect mechanism of the acupuncture effect,explore its essence and law,so that Time medicine has evidence to follow,with a view to providing better treatment basis and solutions for clinical practice.