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在综合癌症中心的实时临床实践中,穴位选择、目标症状与中医诊断之间的关联。

Association Between Acupoint Selection, Target Symptoms, and Traditional Chinese Medicine Diagnosis in Real-Time Clinical Practice in a Comprehensive Cancer Center.

机构信息

The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Integr Cancer Ther. 2020 Jan-Dec;19:1534735420928490. doi: 10.1177/1534735420928490.

Abstract

Acupuncture intervention in actual practice is rarely reported and may be different from that applied in acupuncture research. To review acupuncture practice in an integrative medicine clinic and characterize the association between targeted symptoms, traditional Chinese medicine (TCM) diagnosis, and acupoint selection. We reviewed outpatient acupuncture records from March 2016 to April 2018. Statistical analyses were applied to characterize referral symptoms and associated TCM diagnosis as well as acupoint selection. The final analysis included 5393 acupuncture records (1264 patients). Twelve TCM diagnosis components were identified in the referral symptoms of pain, neuropathy, xerostomia, and hot flashes. Pain was associated with 78 different TCM diagnoses (combinations of TCM diagnosis components). Total of 217 different acupoints were used in the acupuncture treatments (1739) for neuropathy. The acupoint yintang was used in 73.8% of the visits for neuropathy, yet only in 26.5% ( < .001) of the treatments when patients had a TCM diagnosis of qi deficiency, qi stagnation, and blood stagnation. Similarly, both consistencies and variations were seen in acupoint selection with each targeted symptom and its associated TCM diagnoses. TCM diagnosis was not homogeneous among acupuncture treatments for a single referral symptom. In contrast to most of the research on acupuncture for symptom control, there were considerable variations in acupoint selection among treatments for the same symptom in a clinical setting. Future research is needed to examine the clinical relevance of a fixed intervention structure in acupuncture research and the value of individualized acupuncture treatment.

摘要

针刺干预在实际实践中很少被报道,可能与针刺研究中的应用不同。为了回顾整合医学诊所的针刺实践,并描述靶向症状、中医(TCM)诊断和穴位选择之间的关联。我们回顾了 2016 年 3 月至 2018 年 4 月的门诊针刺记录。应用统计分析方法描述转诊症状及相关 TCM 诊断和穴位选择。最终分析包括 5393 例针刺记录(1264 例患者)。在疼痛、神经病变、口干和热潮红的转诊症状中确定了 12 个 TCM 诊断成分。疼痛与 78 种不同的 TCM 诊断(TCM 诊断成分的组合)相关。在治疗神经病变的 217 种不同穴位中(1739 种),穴位印堂被用于 73.8%的神经病变就诊,但当患者的 TCM 诊断为气虚、气滞和血瘀时,仅用于 26.5%(<.001)的治疗。同样,在针对每种靶向症状及其相关 TCM 诊断的穴位选择中,都存在一致性和变异性。在针对单一转诊症状的针刺治疗中,TCM 诊断并不一致。与大多数关于针刺控制症状的研究相反,在临床环境中,针对同一症状的治疗中,穴位选择存在相当大的差异。需要进一步研究来检验针灸研究中固定干预结构的临床相关性以及个体化针灸治疗的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/7287401/a155d6753b6e/10.1177_1534735420928490-fig1.jpg

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