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[近20年针刺治疗银屑病的临床研究及选穴规律]

[Clinical research and the rules of acupoint selection on acupuncture treatment of psoriasis in the past 20 years].

作者信息

Hu Ming-Hui, Duan Xing-Wu, Han Si-Wei, Zhu Jia-Yin

机构信息

Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing 100700, China.

出版信息

Zhen Ci Yan Jiu. 2024;49(9):993-1000. doi: 10.13702/j.1000-0607.20230416.

Abstract

OBJECTIVES

To sum up clinical researches and the rule of acupoint selection on the treatment of psoriasis by acupuncture and moxibustion in the past 20 years, so as to provide new ideas and reference for improving the clinical effect of acupuncture for psoriasis.

METHODS

Research papers, published from January 1, 2002 to December 31, 2022 in both Chinese and English, were searched from databases of China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (WanFang), and Chinese Science and Technology Journal (CSTJ), PubMed, Embase and Web of Science by using key words of psoriasis, psoriases, psoriasis vulgaris, acupuncture, needle, acupoint and moxibustion. Then, Microsoft Excel 2021 was used for data entry, extraction and sorting of the included literature, data extraction mainly includes diagnostic criteria, treatment methods, treatment frequency, total course of treatment, selection of acupoints, efficacy evaluation and outcomes. SPSS Modeler 18.1 software was used to make analysis on the association rules of acupoints.

RESULTS

A total of 26 papers were included, and the diagnostic criteria of clinical studies on acupuncture treatment of psoriasis are constantly updated. Of the 26 clinical studies, 23 had both treatment group and control group, 21 were randomized controlled trials. The main methods for treatment of psoriasis included fire needle, acupuncture, electroacupuncture, acupuncture combined with moxibustion or fire needle, fire needle plus western medicines, etc. with the acupuncture combined with moxibustion, and fire needle combined with western medicines being most frequently used. The observation index and clinical efficacy evaluation were effective rate, psoriasis area and severity index, dermatology life quality index, Traditional Chinese Medicine syndrome score, etc., with the effective rate being about 40% to 100%. Comparison of clinical efficacy of acupuncture in treating psoriasis showed that the simple fire needle, simple acupuncture, acupuncture combined with moxibustion, fire needle or acupuncture combined with western medicines were superior to simple western medicines, etc. In regard to acupoint selection, a total of 35 acupoints were found in the 26 studies included, among which the top 5 frequently used were Ashi points (skin lesion region), Geshu (BL17), Feishu (BL13), Ganshu (BL18) and Quchi (LI11), and there were strong association rules among BL17, BL13, BL18 and Shenshu (BL23).

CONCLUSIONS

Acupuncture is safe and effective in the treatment of psoriasis, and acupuncture combined with moxibustion and fire acupuncture needle combined with western medicines are recommended as the main intervention method, with Ashi-point, BL13, BL17, BL18 and BL23 as the main acupoints.

摘要

目的

总结近20年针灸治疗银屑病的临床研究及选穴规律,为提高针灸治疗银屑病的临床疗效提供新思路和参考。

方法

通过中国知网(CNKI)、万方数据知识服务平台、维普中文科技期刊数据库、PubMed、Embase及Web of Science数据库,以银屑病、牛皮癣、寻常型银屑病、针刺、针、穴位、艾灸为关键词,检索2002年1月1日至2022年12月31日发表的中英文研究论文。然后,使用Microsoft Excel 2021对纳入文献进行数据录入、提取和整理,数据提取主要包括诊断标准、治疗方法、治疗频次、总疗程、穴位选择、疗效评价及结果。运用SPSS Modeler 18.1软件对穴位关联规则进行分析。

结果

共纳入26篇文献,针灸治疗银屑病的临床研究诊断标准不断更新。26项临床研究中,23项设有治疗组和对照组,21项为随机对照试验。银屑病的主要治疗方法包括火针、针刺、电针、针刺联合艾灸或火针、火针加西药等,其中针刺联合艾灸、火针联合西药最为常用。观察指标及临床疗效评价为有效率、银屑病面积和严重程度指数、皮肤病生活质量指数、中医证候评分等,有效率约为40%至100%。针灸治疗银屑病临床疗效比较显示,单纯火针、单纯针刺、针刺联合艾灸、火针或针刺联合西药优于单纯西药等。穴位选择方面,纳入的26项研究共发现35个穴位,其中使用频次排名前5的为阿是穴(皮损部位)、膈俞(BL17)、肺俞(BL13)、肝俞(BL18)和曲池(LI11),且BL17、BL13、BL18和肾俞(BL23)之间存在较强的关联规则。

结论

针灸治疗银屑病安全有效,推荐针刺联合艾灸、火针联合西药作为主要干预手段,以阿是穴、BL13、BL17、BL18、BL23为主要穴位。

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