本文選題：得氣　切入點(diǎn)：經(jīng)穴效應(yīng)　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：背景:經(jīng)穴是針灸的主要刺激部位,經(jīng)穴效應(yīng)是針灸治療起效的基礎(chǔ)。得氣,是針刺入腧穴后患者和醫(yī)者感受到的一種特殊針刺感應(yīng)。從古至今,得氣一直被認(rèn)為是針刺治療過(guò)程中的關(guān)鍵步驟,和針刺療效密切相關(guān)。在針刺的諸多適應(yīng)癥中,針刺鎮(zhèn)痛是研究最多、了解最深的領(lǐng)域,研究發(fā)現(xiàn)得氣與針刺鎮(zhèn)痛效應(yīng)密不可分,所以可將疼痛類(lèi)疾病作為研究得氣與針刺療效關(guān)系的一個(gè)突破口,有針對(duì)性的進(jìn)行集中深入研究。疼痛類(lèi)疾病原發(fā)性痛經(jīng)是年輕女性的常見(jiàn)病、多發(fā)病,病源豐富,并且針刺治療效果顯著,因此是研究得氣與針刺療效關(guān)系的適宜疾病載體。目的:以疼痛類(lèi)疾病原發(fā)性痛經(jīng)(PD)為研究載體,系統(tǒng)評(píng)價(jià)得氣對(duì)原發(fā)性痛經(jīng)患者經(jīng)穴效應(yīng)的影響。方法:檢索10個(gè)文獻(xiàn)數(shù)據(jù)庫(kù)(中國(guó)知網(wǎng),維普,萬(wàn)方,中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù),Cochrane Library CENTRAL,MEDLINE,Embase,AMED,CINAHL Plus,PsycINFO)、5 個(gè)臨床試驗(yàn)注冊(cè)庫(kù)、論文后參考文獻(xiàn)和灰色文獻(xiàn)網(wǎng)站OpenGrey。時(shí)間從建庫(kù)至2017年5月1日,沒(méi)有語(yǔ)種和發(fā)表狀態(tài)限制。收集單純針刺經(jīng)穴得氣對(duì)比不得氣或不同得氣要素(得氣強(qiáng)度、出現(xiàn)時(shí)間、持續(xù)時(shí)間、傳導(dǎo)與放射和得氣感成分)治療PD的隨機(jī)對(duì)照試驗(yàn)(RCTs)和半隨機(jī)對(duì)照試驗(yàn)(q-RCTs)。研究質(zhì)量按照Cochrane偏倚風(fēng)險(xiǎn)評(píng)估工具5.1.0評(píng)價(jià)。若研究間臨床異質(zhì)性小且12≤75%,采用RevMan5.3.5進(jìn)行定量綜合,否則進(jìn)行定性綜合。結(jié)果:納入6項(xiàng)RCTs,共645例患者。因臨床異質(zhì)性大只進(jìn)行定性綜合,結(jié)果:①針刺經(jīng)穴得氣或不得氣均具有緩解PD疼痛和焦慮的效應(yīng);得氣時(shí)緩解疼痛的效應(yīng)優(yōu)于不得氣時(shí)或與不得氣時(shí)相當(dāng),得氣時(shí)緩解焦慮的效應(yīng)與不得氣時(shí)相比無(wú)差異;②得氣程度越高、得氣穴位數(shù)越多,針刺經(jīng)穴在緩解PD疼痛、癥狀和減少疼痛時(shí)間方面的效應(yīng)越好;③得氣率越高,針刺經(jīng)穴緩解PD焦慮的效應(yīng)越好,但緩解疼痛的效應(yīng)無(wú)變化;④得氣出現(xiàn)越快并且氣至病所,針刺經(jīng)穴緩解PD疼痛的效應(yīng)起效越快;⑤有溫?zé)岬脷飧谢蛴袀鲗?dǎo)放射至病所的溫?zé)岬脷飧?針刺經(jīng)穴緩解PD疼痛和癥狀的效應(yīng)越好。結(jié)論:有限的結(jié)果表明:針刺經(jīng)穴得氣或不得氣均具有治療效應(yīng);得氣程度增高、穴位數(shù)增多、得氣率增高、有溫?zé)岬脷飧谢蛴袀鲗?dǎo)放射至病所的溫?zé)岬脷飧?可能增強(qiáng)了 PD患者經(jīng)穴的治療效應(yīng);得氣出現(xiàn)快并且氣至病所可能加快了 PD患者經(jīng)穴治療效應(yīng)的起效速度。當(dāng)前結(jié)果能在一定程度上驗(yàn)證中醫(yī)"氣至而有效""氣速效速"的理論,可為針灸臨床運(yùn)用得氣理論提供初步的循證醫(yī)學(xué)依據(jù),而且足以說(shuō)明有必要進(jìn)行更多高質(zhì)量的深入研究。但由于納入研究的數(shù)量少,方法學(xué)質(zhì)量、報(bào)告質(zhì)量不高以及潛在的偏倚,還不能明確得氣對(duì)PD患者經(jīng)穴效應(yīng)的影響如何。本研究方案已在PROSPERO平臺(tái)注冊(cè):CRD42016038518。
[Abstract]:Background: the meridian point is the main stimulating part of acupuncture and moxibustion, and the effect of meridian point is the basis of acupuncture treatment. Deqi has been regarded as a key step in the treatment of acupuncture and is closely related to the efficacy of acupuncture. Among the many indications of acupuncture, acupuncture analgesia is the most studied and well understood field. It has been found that qi is closely related to acupuncture analgesia, so pain diseases can be regarded as a breakthrough in the study of the relationship between Qi acquisition and acupuncture effect. Primary dysmenorrhea is a common disease in young women. Therefore, it is a suitable disease carrier to study the relationship between qi and acupuncture effect. Objective: to study the effect of primary dysmenorrhea (PDD) on painful diseases. Methods: ten literature databases (China Zhiwang, Weipu, Wanfang) and Chinese biomedical literature database (Cochrane Library CENTRALLAL MEDLINELE Embase, CINAHL Plusia PsycINFOONTAL) were systematically evaluated for the effect of dysmenorrhea on the acupoint effect in patients with primary dysmenorrhea. Methods: five clinical trial registries were retrieved from 10 literature databases (China Zhiwang, Weipu, Wanfang, China Biomedical Literature Database). From the establishment of the database to May 1st 2017, there are no language and publication state restrictions. Duration, The quality of the study was evaluated according to the Cochrane bias risk assessment tool 5.1.0. If the clinical heterogeneity was small and 12 鈮，

本文編號(hào)：1570902