电针防治术后认知功能障碍的文献计量学及选穴分析

Bibliometrics and acupoint selection analysis of electroacupuncture in the prevention and treatment of postoperative cognitive dysfunction

目的分析电针防治术后认知功能障碍(postoperative cognitive dysfunction,POCD)相关随机对照试验(RCT)的研究现状,归纳文献特征、选穴及择经规律。方法系统检索PubMed、Cochrane library、Web of Science、Embase、CBM、CNKI、VIP及WanFang数据库,获取从建库至2023年2月收录的相关文献。结果纳入电针防治POCD的RCT文献共38篇。从纳入的文献特征来看,尽管文献数量较少,但文献量随着时间总体呈现不断增长趋势;被收录的期刊类型大部分为国内期刊,SCI类型的国际期刊收录的较少。从课题基金的支持情况看,近年来,国家对于电针治疗POCD的临床研究也有较多的基金资支持,从资助的类型看,省、市级及国家级课题占据主要部分,而高校课题的资助比例则较少。从临床观察指标来看,主要以减少POCD的发生率,改善认知功能评分,减少肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-1β、S100β因子的表达为主。从选穴规律发现,电针防治POCD的高频选穴依次为内关穴、百会穴、合谷穴、足三里穴、神庭穴、神门穴、四神聪穴、三阴交穴、太冲穴、大椎穴、本神穴;而高频择经规律依次为督脉、手厥阴心包经、手阳阴大肠经、足阳明胃经、手少阴心经、奇穴、足少阳胆经、足太阴脾经及厥阴肝经、足太阳膀胱经及足少阴肾经。结论本研究归纳了电针治疗POCD的临床研究现状以及目前电针治疗POCD的选穴和择经规律,对临床运用电针治疗POCD具有一定的指导意义,同时也为后续相关研究提供理论依据和选穴参考。

Objective The research status of randomized controlled trials(RCTs)related to electroacupuncture in the prevention and treatment of postoperative cognitive dysfunction(POCD)was analyzed,and the characteristics of literatures,acupoint selection,and meridian selection were summarized.Methods We systematacially searched the databases of PubMed,Cochrane library,Web of Science,Embase,CBM,CNKI,VIP,and WanFang,and obtained the related literatures from the establishment of the databases to February 2023.Results A total of 38 RCT articles were included in the prevention and treatment of POCD by electroacupuncture.According to the characteristics of the literatures included,although the number of studies was still small,the amount of literatures showed an overall increasing trend with time.Most of the journals included were domestic journals,while the international journals of SCI type were few.From the point of view of the support of funding projects,in recent years,the state also had more funding support for the clinical research of electroacupuncture treatment of POCD.From the type of funding,provincial,municipal,and national projects occupied the main part,while the proportion of university projects showed less.According to the clinical observation indexes,it was mainly concerned on reducing the incidence of POCD,improving the cognitive function score,and reducing the expressions of tumor necrosis factor(TNF)-α,interleukin(IL)-6,IL-1β,and S100β.From the law of acupoint selection,it was found that the high-frequency acupoints of electroacupuncture for the prevention and treatment of POCD were Neiguan,Baihui,Hegu,Zusanli,Shenting,Shenmen,Sishencong,Sanyinjiao,Taichong,Dazhui,and Benshen acupoints.The high-frequency meridians selected were Governor Meridian,hand Jueyin pericardial Meridian,hand Yang Yin Colorectal Meridian,foot Yangming stomach Meridian,hand Shaoyin Heart Meridian,strange acupoints,foot Shaoyang gallbladder Meridian,foot Taiyin spleen Meridian and Jueyin liver Meridian,and foot Taiyang bladder Meridian and foot Shaoyin Kidney Meridian.Conclusions This study summarizes the clinical research status of electroacupuncture in the treatment of POCD and the rules of acupoint selection and meridian selection of electroacupuncture in the treatment of POCD,which has a certain guiding significance for clinical application of electroacupuncture in the treatment of POCD,and provides theoretical basis and reference for follow-up researches.