摘要
目前,灸法治疗中风后肩手综合征多采用热敏灸、温针灸、雷火灸、隔药饼灸法等,也有运用民族特色灸法、艾慈灸、天灸、麦粒灸或联合其他疗法治疗者,总体疗效较好,且简便安全、无不良反应、易被患者接受。目前研究亦存在一些不足之处,如临床研究样本量较少,缺乏多中心、大样本的系统性研究,循证医学证据不足;临床治疗方法多样,同一灸法的临床取穴各异,操作方法及疗程尚不统一,未形成标准的规范化治疗方案;疗效评价缺乏统一标准,不利于各研究结果的对比分析;结局指标多为主观量表评分,客观性不足;对于灸法作用机制的研究较少,多局限于临床疗效观察等。此外,不同研究中温针灸的治疗结果存在一定差异,取穴、操作标准存在不同。因此在今后的研究中,需进一步完善试验设计,增加客观化疗效评价指标,加强高质量、大样本的随机对照研究,形成疗效确切、适用于临床推广应用的规范化治疗方案,同时,加强对灸法作用机制的研究,进一步阐明灸法的作用机理,为临床治疗提供更多的科学依据。
At present,moxibustion therapy for shoulder-hand syndrome after stroke mainly adopts heat sensitive moxibustion,warmneedle acupuncture,Leihuo moxibustion,medicine cake separated moxibustion,etc.There are also moxibustion with national characteristics,Aici moxibustion,Tian moxibustion,wheat grain moxibustion or combination of other therapies.The overall effect is good,simple,safe,no adverse reactions and easy to be accepted by patients.At present,there are also some deficiencies in the research,such as the small number of clinical research samples,the lack of multi center,large sample of systematic research,the lack of evidence-based medicine evidence;there are various clinical treatment methods,different acupoints selected in the same moxibustion therapy,different operation methods and treatment courses,and no standardized treatment plan has been formed;the lack of a unified standard for efficacy evaluation is not conducive to the comparative analysis of various research results;most of the outcome indicators are subjective scale scores,which were not objective enough;there are few researches on the mechanism of moxibustion,mostly limited to the observation of clinical effect.In addition,there are some differences in the treatment results of warmneedle acupuncture in different studies,and there are different points selection and operation standards in each study.Therefore,in the future research,it is suggested to further improve the experimental design,increase the objective evaluation index of curative effect,form a standardized treatment scheme with exact curative effect and suitable for clinical application through strict high-quality and large sample randomized controlled study,meanwhile,strengthen the research on the mechanism of moxibustion,further clarify the mechanism of moxibustion,and provide more for its clinical treatment scientific basis.
作者
周小炫
谢敏
王舰
余友金
林淑芳
郑约保
ZHOU Xiaoxuan;XIE Min;WANG Jian;YU Youjin;LIN Shufang;ZHENG Yuebao(Rehabilitation Hospital Affiliated to Fujian University of Chinese Medicine,Fuzhou Fujian China 350003;Fujian Key Laboratory of Rehabilitation Technology,Fuzhou Fujian China 350003;Fuzhou Hospital of Chinese Medicine)
出处
《中医学报》
CAS
2020年第5期1006-1011,共6页
Acta Chinese Medicine
基金
福建省科技厅科技平台建设项目(2015Y2001)
福建省卫生健康科研人才培养项目(2019-1-75)
福建中医药大学校管科研课题(XB2018043)。
关键词
灸法
肩手综合征
中风
热敏灸
温针灸
雷火灸
隔药饼灸
艾灸
moxibustion therapy
shoulder-hand syndrome
stroke
heat sensitive moxibustion
warm-needle acupuncture
Leihuo moxibustion
cake separated moxibustion
moxibustion
