基于随机对照试验分析杵针疗法优势病种

Analysis of dominant diseases of pestle needle therapy based on randomized controlled trials

[目的]探究杵针优势病种及应用现状,以更好指导临床和推广使用。[方法]检索中国知网(CNKI)、Pubmed等8个国内外数据库,筛选全部含有“杵针”且“针灸”的文献,运用文献计量学方法统计年度发表数量、病种分类,筛选随机对照试验(RCT)文献,RCT≥5篇确定为优势病种,选取RCT≥10篇的病种RCT进行循证评价、疗效分析。[结果]共筛选出临床文献169篇,RCT70篇,最终纳入RCT≥10篇的3个病种共计34篇RCT。杵针适应症覆盖8个疾病系统,达到40种,优势病种6个,集中在骨伤科系统的腰椎间盘突出症、颈椎病和内科系统的失眠、抑郁症、脑卒中,外科系统的糖尿病足。通过分析发现RCT≥10的3个病种均属于杵针治疗I类病谱,临床总有效率均在89%以上。[结论]现有杵针优势病种较为广泛,优势病种较为集中,以腰椎间盘突出症、颈椎病、失眠为代表。但其治疗适应症和优势病种是动态变化的,仍有拓展潜力。

[Objective]To explore the dominant diseases and application status of pestle needle,so as to better guide the clinical application and popularization.[Methods]CNKI,PubMed and other eight domestic and foreign databases were searched to screen all the literatures containing“pestle needle”and“acupuncture”.The number of published articles and classification of diseases were counted by bibliometric method.Randomized Controlled Trial(RCT)literatures were screened.RCT≥5 was identified as the dominant disease,and RCT≥10 was selected for evidence-based evaluation and curative effect analysis.[Results]A total of 169 clinical literatures and 70 RCTs were screened,and 34 RCTs with RCT≥10 were included.The indications of pestle and needle covered eight disease systems,reaching 40 kinds,and 6 dominant diseases,focusing on lumbar disc herniation and cervical spondylosis in orthopedics and traumatology system,insomnia,depression,stroke in internal medicine system,and diabetic foot in surgical system.Through analysis,it was found that the three diseases of RCT≥10 all belonged to class I disease spectrum treated with pestle needle,and the total clinical effective rate was above 89%.[Conclusion]At present,the dominant diseases of pestle and needle are more extensive and concentrated,which are represented by lumbar disc herniation,cervical spondylosis and insomnia.But its indications and dominant diseases are dynamic changes,and still have the potential to expand.