摘要
Objective By sorting and analyzing pertinent modern studies targeting auricular point therapy treating primary insomnia(PI),to summarize the point selection rules and clinical efficacy of using auricular points alone or combining it with other therapies in treating PI.Methods A search on China National Knowledge Infrastructure(CNKI),Wanfang Academic Journal Full-text Database(Wanfang),Chongqing VIP Database(CQVIP),PubMed,Springer and Ovid were conducted from January 1,1998 till January 31,2020.Point selection,diagnostic criteria and Pittsburgh sleep quality index(PSQI)in the eligible studies were analyzed and summarized.Results The difference in PSQI before and after using auricular point therapy alone was more significant than that of using Chinese medication alone(P<0.05),but less significant than that of combining auricular point therapy and acupuncture-moxibustion and Chinese therapeutic massage(tuina)(P<0.05).In the included studies,Shenmen(TF_(4))was the most commonly used(370 times),followed by Heart(CO_(15)),which was 344 times,and Subcortex(AT_(4)),which was 325 times.In terms of auricular points distribution,points in the auricular concha were the most commonly used(1500 times),followed by those in the antitragus(474 times)and triangular fossa(387 times).Correlation analysis showed that Shenmen(TF_(4))and Liver(CO_(12)),Sympathetic(AH6a)and Heart(CO_(15))were used together more often,followed by Shenmen(TF_(4)),Liver(CO_(12)),Spleen(CO_(13)),Kidney(CO_(10))and Subcortex(AT_(4)),and then Shenmen(TF_(4)),Liver(CO_(12)),Sympathetic(AH6a),Subcortex(AT_(4))and Heart(CO_(15)).Cluster analysis showed that the auricular points used for PI can be divided into 6 clusters in 2 major groups.One group was Heart(CO_(15)),Subcortex(AT_(4)),Shenmen(TF_(4)),Sympathetic(AH6a),Spleen(CO_(13)),Kidney(CO_(10)),Liver(CO_(12))and Endocrine(CO_(18));the other was Occiput(AT3),Stomach(CO_(4)),Pancrease-gallbladder(CO_(11)),Chuiqian(LO_(4)),Small Intestine(CO_(6)),Central Rim(AT_(2,3,4i))and Sanjiao(CO_(17)).In terms of patterns in traditional Chinese medicine,the pattern of dual deficiency of heart and spleen accounted for the largest proportion in the studies of using auricular points alone or combining it with other treatments to treatment PI,and then it was the pattern of liver depression transforming into fire.Conclusion In treatment of PI with auricular points alone or combo therapy involving auricular points,Shenmen(TF_(4))was commonly used,and the commonly used point group consisted of Shenmen(TF_(4)),Liver(CO_(12)),Sympathetic(AH_(6a))and Heart(CO_(15)).Auricular point therapy can be taken as a complementary therapy in treating PI.
目的:通过归纳分析耳穴疗法治疗原发性失眠(PI)的现代相关文献,总结单用耳穴或耳穴联合其他疗法治疗PI的选穴规律及临床疗效.方法:采用计算机检索中国知网(CNKI)、万方学术期刊全文数据库(Wanfang)、重庆维普数据库(CQVIP)和PubMed、Springer、Ovid数据库,检索时间为1998年1月1日至2020年1月31日,对符合纳入标准的文献的选穴、诊断标准和匹兹堡睡眠质量指数(PSQI)进行分析总结.结果:单独耳穴疗法治疗前后PSQI的差值高于单独中药疗法(P<0.05),低于耳穴疗法联合针灸推拿(P<0.05).所纳入文献中神门使用最多(370次),心次之(344次),再次为皮质下(325次).从耳穴分布部位看,耳甲穴位应用频次最多(1500次),其次为对耳屏部位(474次),再次为三角窝部位(387次).关联性分析显示,神门与肝、交感及心合用的几率较大,其次为神门、肝、脾、肾和皮质下,再次为神门、肝、交感、皮质下和心.聚类分析显示,耳穴治疗PI的穴位可以分为6个群集,两大类,一类为心、皮质下、神门、交感、脾、肾、肝和内分泌;另一类为枕、胃、胰胆、垂前、小肠、缘中和三焦.从中医证型看,耳穴单用或联合其他疗法治疗PI的文献中以心脾两虚证最多,其次为肝郁化火证.结论:耳穴单用或联合其他疗法治疗PI的常用穴位为神门,常用的配伍穴组为神门与肝、交感和心.耳穴疗法可作为治疗PI的辅助疗法.
作者
Yang Qiu-hong
Xie Chen
胡向丽;陈芳(School of Acupuncture-moxibustion and Tuina,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Jiangwan Hospital,Hongkou District,Shanghai,Shanghai 200434,China;Shanghai Research Institute of Acupuncture and Meridian,Shanghai 200030,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)
基金
国家自然科学基金,No.81804200
上海市卫生和计划生育委员会科研课题,No.20174Y0063。
