针灸治疗压力性尿失禁的用穴规律分析

Analysis of the Regularity of Acupuncture Points in the Treatment of Stress Urinary Incontinence

目的分析针灸治疗压力性尿失禁的用穴规律,为临床治疗提供循证医学证据。方法检索科技核心期刊中针灸治疗压力性尿失禁的临床研究文献,分析用穴规律。结果35篇文献中共选用腧穴37个,总频次为275次,其中35个为十四经穴位,总频次为272次,2个为经外奇穴,总频次为3次。十四经穴位是针灸治疗压力性尿失禁的主要处方用穴,经外奇穴应用较少。十四经穴位中,关元、三阴交、中极、肾俞、气海、足三里和次髎等穴位是高频用穴,而子宫、横骨、四满等24个穴位应用较少。按所在部位分类,用穴主要集中在腹部,其次是下肢和骶部,其他部位用穴较少。除2个经外奇穴外,其余用穴可归入9条经脉,其中膀胱经与任脉是用穴频率最高的经脉,其次是脾经、胃经、督脉和肾经,其余经脉用穴较少。35篇文献均有特定穴应用,35个经穴中28个为特定穴,用穴总频次为269次,排除重复计数后为184次,占到了总用穴频次的66.91%。特定穴中交会穴与俞募穴是主要类型,占比为72.36%。关联正相关性最好的配对分别是关元-气海、关元-中极-气海、关元-中极-三阴交-气海、中极-关元-次髎。将频次在15次以上的腧穴进行配伍聚类分析,结果发现百会-中髎-会阳-次髎-肾俞、三阴交-足三里-气海-中极-关元分别组成有效集群。结论针灸治疗压力性尿失禁用穴有规律可循,可据此指导临床治疗。

Objective:To analyze the regularity of acupuncture points in the treatment of stress urinary inconti⁃nence.Methods:Clinical research literature on acupuncture and moxibustion treatment of stress urinary inconti⁃nence in core scientific journals was retrieved and the regularity of acupoint application was analyzed.Results:There were 37 acupoints selected in 35 literatures,with a total frequency of 275 times;among them,35 acupoints were fourteen meridians with a total frequency of 272 times,2 acupoints were extra meridians with a total frequen⁃cy of 3 times.The acupoints of the fourteen meridians were the main prescription points for the treatment of stress urinary incontinence by acupuncture and moxibustion,and the acupoints of extra meridians were rarely applied.Among the 14 meridian acupoints,Guanyuan,Sanyinjiao,Zhongji,Shenshu,Qihai,Zusanli and Ciliao were used with high frequency,while 24 acupoints such as Zigong,Henggu and Siman were seldom used.According to the lo⁃cation,the acupoints were mainly used in the abdomen,followed by the lower limbs and sacrum,and there were fewer acupoints in other parts.Except for the 2 extra acupoints,the other acupoints could be classified into nine meridians,among which bladder meridian and Ren meridian were the most frequent ones,followed by spleen me⁃ridian,stomach meridian,Du meridian and kidney meridian,and the rest were less used.Among the 35 literatures,28 of the 35 meridians were specific acupoints,and the total frequency of acupoint use was 269 times;the number was 184 times after repetitions were excluded,accounting for 66.91%of the total frequency of acupoint use.Among the specific acupoints,intersecting acupoints and Shu and Mu acupoints were the main types,accounting for 72.36%.The best pairings of positive correlation were Guanyuan-Qihai,Guanyuan-Zhongji-Qihai,Guanyuan-Zhongji-Sanyinjiao-Qihai,and Zhongji-Guanyuan-Ciliao.The results showed that Baihui-Zhongliao-Huiyang-Cil⁃iao-Shenshu and Sanyinjiao-Zusanli-Qihai-Zhongji-Guanyuan were effective clusters.Conclusion:Acupuncture points for the treatment of stress urinary incontinence are regular and can be used to guide clinical treatment.