世界中医药

作者	单位
王佳1，翟炎冰1,2，赵世同2，程延君1,2，刘志顺1	1 中国中医科学院广安门医院针灸科，北京，100053； 2 北京中医药大学，北京，100029

摘要点击次数: 1135

全文下载次数: 1420

中文摘要:

目的：探讨针灸治疗创伤性脊髓损伤所致二便、运动及感觉功能障碍的诊疗特点，为临床治疗方案优化提供依据。方法：电子检索中国知网（CNKI，1997—2015年）、万方数据库（Wan-Fang Data，1997—2015年）、维普数据库（VIP Date，1997—2015年）、PUBMED（1997—2015年）中关于针灸治疗创伤性脊髓损伤的文献，总结具体的干预措施、治疗介入时机、辨证及选穴特点、治疗频次、总治疗时间、疗效及其评价指标、随访及其安全性。结果：针灸治疗创伤性脊髓损伤导致的二便、运动及感觉功能障碍以单纯电针为主，占40.82%（20/49），介入时机多在发病3个月以内；其辨证特点以辨病结合辨主症为主，占81.63%（40/49）；膀胱功能障碍以下腹部和腰骶部的任脉和膀胱经的中极、关元、肾俞、次髎及损伤部位夹脊穴为主；肠道功能障碍以下肢部和腹部的胃经和任脉的天枢、关元、上巨虚及损伤部位的夹脊穴、督脉穴为主；运动和感觉功能障碍以四肢部和背部的膀胱经、大肠经和胆经的阳陵泉、曲池、合谷、环跳、委中及损伤部位夹脊穴等为主；治疗频次以1次/d，1周5～6次为多，占63.27%（31/49）；总治疗时间处于1～29周不等，以4周为最常见。针灸治疗二便、运动及感觉功能障碍的疗效为75.0%～96.7%，随访示有一定远期疗效，未出现不良反应报道。结论：针灸治疗创伤性脊髓损伤所致二便、运动及感觉功能障碍有一定的疗效，但由于多数是非随机对照文献，且其疗效标准不一，故确切疗效有待于进一步临床研究证实；针灸治疗安全性较高。

English Summary:

To explore the diagnose and treatment of acupuncture and moxibustion for bowel and bladder dysfunction, motor and sensory dysfunction caused by Traumatic Spinal Cord Injury, and provide evidences for the optimization of clinical treatment plan. Methods: The researchers searched the literatures related to acupuncture and moxibustion treatment on Traumatic Spinal Cord Injury on CNKI (1997—2015), Wan-Fang Data (1997—2015), VIP Data (1997—2015) and PUBMED (1997—2015), then summarized the specific interventional measures, intervention time of the treatment, clinical characteristics of syndrome differentiation and acupuncture points selection, the frequency of the treatment, total treatment course, treatment effect and evaluating indexes, follow-up study and safety in the treatment of acupuncture and moxibustion on Traumatic Spinal Cord Injury. Results: Among the collected articles, solely treatment of electro-acupuncture took first place on the dysfunction of bowel and bladder, and dysfunction of motor and sensory caused by Traumatic Spinal Cord Injury, which took up to 40.82% (20/49); the first intervention time was mainly in no more than 3 months; 81.63% (40/49) of the characteristics of method was mainly on the combination of differentiation of disease and main symptom; The points of Zhongji, Guanyuan, Shenshu, Ciliao in Conception Vessel and Bladder Meridian and Jiaji points of lesion location, which were located at the abdomen and lumbosacral portion, were frequently used to treat bladder dysfunction; the points of Tianshu, Guanyuan, Shangjuxu in Stomach Meridian and Conception Vessel located at lower limbs and abdomen, Jiaji points of lesion location and Governor Vessel acupoints were commonly used to treat bowel dysfunction; the points of Yanglingquan, Quchi, Hegu, Huantiao, Weizhong in Bladder Meridian, Large Intestine Meridian and Gallbladder Meridian located in the limbs and back, and Jiaji of lesion location were usually used to treat motor and sensory dysfunction. The most common treating frequency were once a day and five to six times a week, which took up to 63.27% (31/49); the total treatment course was from 1 to 29 weeks and the most commonly used course was 4 weeks; the effective rate varied from 75.0% to 96.7% on diagnose and treatment of acupuncture and moxibustion for bowel and bladder dysfunction, motor and sensory dysfunction; the follow-up study showed that it had some long-term effect and there was no adverse reaction reported in these literatures. Conclusion: The treatment of acupuncture and moxibustion has some effectiveness on bowel and bladder dysfunction, motor and sensory dysfunction caused by traumatic spinal cord injury. However, most literatures are non-randomized controlled trials and lack unified criterion of therapeutical effect, the exact curative effect still remains to be proved by further clinical studies. The safety of the treatment of acupuncture and moxibustion is higher.

查看全文查看/发表评论下载PDF阅读器