Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China; Department of Clinical Medicine of Traditional Chinese and Western Medicine, North Sichuan Medical University, Nanchong, China.
Complement Ther Med. 2023 Dec;79:102997. doi: 10.1016/j.ctim.2023.102997. Epub 2023 Oct 21.
Acupuncture is often used as an adjunctive therapy for gastric ulcer (GU). However, there is still a lack of evidence on the appropriate and optimal interventions for acupuncture. This study aimed to optimize the acupuncture treatment of gastric ulcers based on expert consensus for guiding acupuncturists in clinical practice.
To conduct this study, research evidence was gathered from databases in both Chinese and English. After discussion, preliminary clinical questions were developed. Following three rounds of multidisciplinary clinical expert consultation, the initial consensus questionnaire was formed after testing and modification by team members. A Delphi consensus was ultimately reached to answer the questionnaire and develop guidance for acupuncture treatment. A 9-point Likert-type scale was used to measure the agreement of expert consensus, where a score of 80% between 7 and 9 was defined as "agreement."
After two rounds of Delphi voting, a total of 35 items reached an agreement. These items can be roughly divided into 6 domains. According to expert consensus, the application of acupuncture for gastric ulcer should follow a semistandardized approach. Based on the syndrome differentiation, the main acupoints recommended are Zusanli (ST36), Zhongwan (CV12), Neiguan (PC6), and Sanyinjiao (SP6), while the adjunct acupoints include Taichong (LR3), Guanyuan (CV4), Xuehai (SP10), and Taixi (KI3). In the experience of experts, adverse events associated with acupuncture are typically mild and often manifest as subcutaneous hematomas.
There is a lack of definitive acupuncture guidelines that can effectively determine the optimal therapeutic approach for the treatment of gastric ulcer. This expert consensus provides recommendations for clinical research and practice of acupuncture, with a particular focus on the selection of acupoints. However, further exploration through rigorous studies is necessary due to the limited availability of clinical evidence.
针刺常被用作胃溃疡（GU）的辅助治疗方法。然而，对于针刺的适当和最佳干预措施仍缺乏证据。本研究旨在基于专家共识优化针刺治疗胃溃疡，以指导临床医生进行临床实践。
为进行这项研究，从中文和英文数据库中收集研究证据。讨论后，提出了初步的临床问题。经过三轮多学科临床专家咨询，经过团队成员的测试和修改，形成了初始共识问卷。最终通过德尔菲共识回答问卷并制定针刺治疗指南。采用 9 分 Likert 量表来衡量专家共识的一致性，7-9 分之间 80%的分数定义为“一致”。
经过两轮德尔菲投票，共有 35 项达成一致。这些项目大致可分为 6 个领域。根据专家共识，针刺治疗胃溃疡应遵循半标准化方法。根据辨证，推荐的主要穴位是足三里（ST36）、中脘（CV12）、内关（PC6）和三阴交（SP6），而辅助穴位包括太冲（LR3）、关元（CV4）、血海（SP10）和太溪（KI3）。在专家经验中，针刺相关的不良事件通常是轻微的，通常表现为皮下血肿。
目前缺乏能有效确定治疗胃溃疡最佳治疗方法的明确针灸指南。本专家共识为针刺的临床研究和实践提供了建议，特别强调了穴位的选择。但是，由于临床证据有限，需要通过严格的研究进一步探索。
