八髎穴主治规律临床文献研究
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摘要
目的:总结临床文献中八髎穴的主治规律。方法:电子检索中国期刊全文数据库(CNKI,1979—2017年)、中文科技期刊数据库(VIP,1989—2017年)、中国生物医学光盘数据库(CBM,1979—2017年)和PubMed(1966—2017年)中使用八髎穴治疗疾病的临床相关文献,对纳入文献进行分析,总结八髎穴主治疾病和常用治疗方式,以及常见主治疾病的常用配穴、治疗方式、治疗频次、疗程及疗效。结果:共纳入临床文献160篇,使用八髎穴治疗泌尿系统疾病的文献占43.75%(70/160),其次是妇科疾病(34/160,21.25%)、肛肠科疾病(23/160,14.38%)、运动系统疾病(16/160,10.00%)等;就具体疾病而言,卒中后排尿障碍文献占比最多(26/160,16.25%),其次是脊髓损伤神经源性膀胱(15/160,9.38%)、痛经(14/160,8.75%)、便秘(14/160,8.75%)等;使用电针干预八髎穴治疗常见病的临床文献占30.36%(34/112),其次是普通针刺(30/112,26.79%)、温针灸(11/112,9.82%)、推拿(9/112,8.04%)等,治疗频次以每日1次常见,不同疾病的常用配穴、疗程各不相同,使用八髎穴为主治疗常见疾病的有效率可达75%以上。结论:临床上以八髎为主穴可用于治疗泌尿系统、运动系统、妇科、肛肠科、男科等多个系统或专科的疾病,主治疾病以卒中后排尿障碍、脊髓损伤神经源性膀胱、痛经和便秘等为主;在治疗方法上,以电针和普通针刺常见,治疗频次以每日1次常见,可根据不同疾病选择不同配穴和具体疗程,使用八髎穴治疗常见疾病的有效率较高,安全性好、不良反应少。
Objective To summarize the indication rules of Baliao points(bilateral BL 31, 32, 33 and 34) based on the clinical literature research. Methods The relevant articles of clinical research on the treatment with Baliao points were retrieved electronically from CNKI(1979 to 2017), VIP(1989 to 2017), CBM(1979 to 2017) and PubMed(1966 to 2017). The paper were collected and analyzed. The indications, common therapeutic methods, common acupoint combination, treatment frequency, treatment duration and therapeutic effects of Baliao points were summarized. Results A total 160 articles were collected, of them, 43.75%(70/160) of the articles were related to the treatment of urinary diseases, followed by the gynecological diseases(34/160, 21.25%), proctologic diseases(23/160, 14.38%) and motor system diseases(16/160, 10.00%). Regarding the individual disease, the articles for post-stroke urination disorder were of the highest proportion(26/160, 16.25%), followed by neurogenic bladder induced by spinal injury(15/160, 9.38%), dysmenorrheal(14/160, 8.75%) and constipation(14/160, 8.75%). Regarding the therapeutic method, the electroacupuncture intervention accounts for 30.36%(34/112), followed by the common acupuncture(30/112, 26.79%), warm acupuncture(11/112, 9.82%) and tuina therapy(9/112, 8.04%). The treatment was given commonly once a day. The point combinations and the treatment duration were different in terms of individual case. The effective rates of common disorders were up to over 75%. Conclusion In clinic, Baliao points are mainly used for the disorders in the urinary system, gynecological department, proctology department, motor system, andrology department, etc., or for particular diseases. The main indications are post-stroke urination disorder, neurogenic bladder induced by spinal injury,dysmenorrheal and constipation. Regarding the therapeutic method, electroacupuncture and common needling techniques are adopted generally. The treatment is given generally once a day. The point combination and treatment duration are different in individual case. The treatment with Baliao points is high in the effective rates for the common disorders, good in safety and less in adverse reactions.
Objective To summarize the indication rules of Baliao points(bilateral BL 31, 32, 33 and 34) based on the clinical literature research. Methods The relevant articles of clinical research on the treatment with Baliao points were retrieved electronically from CNKI(1979 to 2017), VIP(1989 to 2017), CBM(1979 to 2017) and PubMed(1966 to 2017). The paper were collected and analyzed. The indications, common therapeutic methods, common acupoint combination, treatment frequency, treatment duration and therapeutic effects of Baliao points were summarized. Results A total 160 articles were collected, of them, 43.75%(70/160) of the articles were related to the treatment of urinary diseases, followed by the gynecological diseases(34/160, 21.25%), proctologic diseases(23/160, 14.38%) and motor system diseases(16/160, 10.00%). Regarding the individual disease, the articles for post-stroke urination disorder were of the highest proportion(26/160, 16.25%), followed by neurogenic bladder induced by spinal injury(15/160, 9.38%), dysmenorrheal(14/160, 8.75%) and constipation(14/160, 8.75%). Regarding the therapeutic method, the electroacupuncture intervention accounts for 30.36%(34/112), followed by the common acupuncture(30/112, 26.79%), warm acupuncture(11/112, 9.82%) and tuina therapy(9/112, 8.04%). The treatment was given commonly once a day. The point combinations and the treatment duration were different in terms of individual case. The effective rates of common disorders were up to over 75%. Conclusion In clinic, Baliao points are mainly used for the disorders in the urinary system, gynecological department, proctology department, motor system, andrology department, etc., or for particular diseases. The main indications are post-stroke urination disorder, neurogenic bladder induced by spinal injury,dysmenorrheal and constipation. Regarding the therapeutic method, electroacupuncture and common needling techniques are adopted generally. The treatment is given generally once a day. The point combination and treatment duration are different in individual case. The treatment with Baliao points is high in the effective rates for the common disorders, good in safety and less in adverse reactions.
引文
[1]沈雪勇.经络腧穴学[M].北京:中国中医药出版社,2016:103-104.
[2]李柏文,李铁,胡秀武,等.八髎穴的临床应用概况[J].针灸临床杂志,2012,28(12):61-65.
[3]刘慧霞,刘海燕,张士表.电针八髎在妇产科的临床应用[J].中国中医药信息杂志,2009,16(4):88.
[4]王宛彭,刘鸿恩,刘红.八髎穴的临床应用[J].吉林中医药,2002,22(6):44.
[5]崔震洋.芒针透刺八髎穴结合针刺头穴足运感区治疗中风后尿失禁的临床观察[D].哈尔滨:黑龙江中医药大学,2015.
[6]卞永禄.温针灸八髎穴结合穴位注射治疗脑卒中后尿失禁的临床观察[J].内蒙古中医药,2014,33(35):92-93.
[7]徐海蓉.针刺治疗膀胱过度活动症的系统评价及中风后急迫性尿失禁电针疗效的RCT研究[D].北京:中国中医科学院,2010.
[8]唐虹,杨廷彦,常有军,等.盆底肌生物反馈和电刺激联合针刺治疗脊髓损伤后神经源性膀胱的疗效[J].贵州医科大学学报,2016,41(11):1314-1317.
[9]Asher GN,Coeytaux RR,Chen W,et al.Acupuncture to initiate labor(Acumoms 2):a randomized,sham-controlled clinical trial.[J].J Matern Fetal Neonatal Med,2009,22(10):843-848.
[10]薛雅红.针刺结合生物反馈治疗功能性肛门直肠痛机理的基础与临床研究[D].南京:南京中医药大学,2010.
[11]于海逸,李邦雷,李传成.针灸刀针刺八髎穴治疗阳萎临床观察[J].中国针灸,1997,17(9):542.
[12]许远建.割治八髎穴治疗男性勃起功能障碍36例[J].陕西中医,2007,28(8):1068-1069.
[13]石国芳,罗连芬,黄小瑾,等.八髎穴封闭治疗盆腔慢性炎症51例疗效观察[J].贵阳中医学院学报,2010,32(4):59.
[14]聂龙英,谢静,杨红霞.八髎穴注射治疗盆腔炎81例临床观察及护理[J].中国科技信息,2008(21):230.
[15]周惠芬,丁曙晴,丁义江,等.八髎穴(骶后孔)定位、测量与取穴方法研究[J].中国针灸,2013,33(8):703-707.
[16]李汪,刘志顺.中髎穴定位、进针点和操作刍议[J].中国针灸,2013,33(11):1050-1051.
[17]宋新,田顺亮,张欣.八髎穴定位及其在推拿治疗青春期痛经中的应用[J].按摩与导引,2003,19(2):48.
[18]余汝堂,陈忠孝,杨新东,等.骶后孔解剖学定位及其临床意义[J].中国临床解剖学杂志,2007,25(4):406-408.
[19]李柏文.八髎穴临床操作规范与局部解剖结构研究[D].长春:长春中医药大学,2014.
[20]马帅,胡雪艳,王列.不同深度针刺八髎穴治疗中风后尿失禁随机对照研究[J].针灸临床杂志,2017,33(7):44-47.
[21]许国杰,肖少卿,姚刚.电针深刺八髎穴治疗压力性尿失禁的疗效观察[J].现代诊断与治疗,2014,25(24):5551-5552.
[22]Liu Z,Liu Y,Xu H,et al.Effect of Electroacupuncture on urinary leakage among women with stress urinary incontinence:a randomized clinical trial[J].JAMA,2017,317(24):2493-2501.
[23]刘新娟.八髎穴温针灸治疗阳痿31例[J].光明中医,2017,32(15):2227-2229.
[24]白丽敏,姜国华.神经解剖学[M].北京:中国中医药出版社,2011:51-52.
[25]李文生.局部解剖学[M].上海:复旦大学出版社,2016:217-221.
[26]刘洋,卫彦,寇吉友.实用腧穴解剖学[M].北京:科学出版社,2017:221-227.
[27]廖利民.尿失禁诊断治疗学[M].北京:人民军医出版社,2012:11-14.
[28]张玉海.膀胱排尿功能障碍[M].北京:人民卫生出版社,2000:101-102.
[29]金洵,丁义江,王玲玲,等.针刺治疗慢性功能性便秘疗效观察[J].中国针灸,2010,30(2):97-101.
[30]雒树东,高振平.医用局部解剖学[M].北京:人民卫生出版社,2015:259.
[31]高维滨.神经病针灸新疗法[M].北京:人民卫生出版社,2002:127-130.
[32]芦海涛,山磊,杨凌宇,等.脑卒中后尿失禁的临床研究[J].中国康复理论与实践,2010,16(9):813-814.
[33]de Seze M,Gallien P,Denys P,et al.Intravesical glucidic capsaicin versus glucidic solvent in neurogenic detrusor overactivity:a double blind controlled randomized study[J].Neurourol Urodyn,2006,25(7):752-757.
[34]钟兰,蓝群,陈晓莉,等.电热隔药贴灸对老年前期大鼠大脑皮质单胺类神经递质含量的影响[J].中国针灸,2004,24(4):55-58.
[35]杜艳军,田青,宋杰,等.艾灸对老年鼠乙酰胆碱含量及胆碱脂酶活性影响的研究[J].湖北中医杂志,2007,29(1):3-4.
[36]邹洋洋,丁曙晴,周惠芬,等.八髎穴治疗出口梗阻型便秘的机制探讨[J].针刺研究,2015,40(5):427-430.
[37]郑英慧.温针灸八髎穴治疗寒凝血瘀型原发性痛经的临床研究[D].广州:广州中医药大学,2017.
[2]李柏文,李铁,胡秀武,等.八髎穴的临床应用概况[J].针灸临床杂志,2012,28(12):61-65.
[3]刘慧霞,刘海燕,张士表.电针八髎在妇产科的临床应用[J].中国中医药信息杂志,2009,16(4):88.
[4]王宛彭,刘鸿恩,刘红.八髎穴的临床应用[J].吉林中医药,2002,22(6):44.
[5]崔震洋.芒针透刺八髎穴结合针刺头穴足运感区治疗中风后尿失禁的临床观察[D].哈尔滨:黑龙江中医药大学,2015.
[6]卞永禄.温针灸八髎穴结合穴位注射治疗脑卒中后尿失禁的临床观察[J].内蒙古中医药,2014,33(35):92-93.
[7]徐海蓉.针刺治疗膀胱过度活动症的系统评价及中风后急迫性尿失禁电针疗效的RCT研究[D].北京:中国中医科学院,2010.
[8]唐虹,杨廷彦,常有军,等.盆底肌生物反馈和电刺激联合针刺治疗脊髓损伤后神经源性膀胱的疗效[J].贵州医科大学学报,2016,41(11):1314-1317.
[9]Asher GN,Coeytaux RR,Chen W,et al.Acupuncture to initiate labor(Acumoms 2):a randomized,sham-controlled clinical trial.[J].J Matern Fetal Neonatal Med,2009,22(10):843-848.
[10]薛雅红.针刺结合生物反馈治疗功能性肛门直肠痛机理的基础与临床研究[D].南京:南京中医药大学,2010.
[11]于海逸,李邦雷,李传成.针灸刀针刺八髎穴治疗阳萎临床观察[J].中国针灸,1997,17(9):542.
[12]许远建.割治八髎穴治疗男性勃起功能障碍36例[J].陕西中医,2007,28(8):1068-1069.
[13]石国芳,罗连芬,黄小瑾,等.八髎穴封闭治疗盆腔慢性炎症51例疗效观察[J].贵阳中医学院学报,2010,32(4):59.
[14]聂龙英,谢静,杨红霞.八髎穴注射治疗盆腔炎81例临床观察及护理[J].中国科技信息,2008(21):230.
[15]周惠芬,丁曙晴,丁义江,等.八髎穴(骶后孔)定位、测量与取穴方法研究[J].中国针灸,2013,33(8):703-707.
[16]李汪,刘志顺.中髎穴定位、进针点和操作刍议[J].中国针灸,2013,33(11):1050-1051.
[17]宋新,田顺亮,张欣.八髎穴定位及其在推拿治疗青春期痛经中的应用[J].按摩与导引,2003,19(2):48.
[18]余汝堂,陈忠孝,杨新东,等.骶后孔解剖学定位及其临床意义[J].中国临床解剖学杂志,2007,25(4):406-408.
[19]李柏文.八髎穴临床操作规范与局部解剖结构研究[D].长春:长春中医药大学,2014.
[20]马帅,胡雪艳,王列.不同深度针刺八髎穴治疗中风后尿失禁随机对照研究[J].针灸临床杂志,2017,33(7):44-47.
[21]许国杰,肖少卿,姚刚.电针深刺八髎穴治疗压力性尿失禁的疗效观察[J].现代诊断与治疗,2014,25(24):5551-5552.
[22]Liu Z,Liu Y,Xu H,et al.Effect of Electroacupuncture on urinary leakage among women with stress urinary incontinence:a randomized clinical trial[J].JAMA,2017,317(24):2493-2501.
[23]刘新娟.八髎穴温针灸治疗阳痿31例[J].光明中医,2017,32(15):2227-2229.
[24]白丽敏,姜国华.神经解剖学[M].北京:中国中医药出版社,2011:51-52.
[25]李文生.局部解剖学[M].上海:复旦大学出版社,2016:217-221.
[26]刘洋,卫彦,寇吉友.实用腧穴解剖学[M].北京:科学出版社,2017:221-227.
[27]廖利民.尿失禁诊断治疗学[M].北京:人民军医出版社,2012:11-14.
[28]张玉海.膀胱排尿功能障碍[M].北京:人民卫生出版社,2000:101-102.
[29]金洵,丁义江,王玲玲,等.针刺治疗慢性功能性便秘疗效观察[J].中国针灸,2010,30(2):97-101.
[30]雒树东,高振平.医用局部解剖学[M].北京:人民卫生出版社,2015:259.
[31]高维滨.神经病针灸新疗法[M].北京:人民卫生出版社,2002:127-130.
[32]芦海涛,山磊,杨凌宇,等.脑卒中后尿失禁的临床研究[J].中国康复理论与实践,2010,16(9):813-814.
[33]de Seze M,Gallien P,Denys P,et al.Intravesical glucidic capsaicin versus glucidic solvent in neurogenic detrusor overactivity:a double blind controlled randomized study[J].Neurourol Urodyn,2006,25(7):752-757.
[34]钟兰,蓝群,陈晓莉,等.电热隔药贴灸对老年前期大鼠大脑皮质单胺类神经递质含量的影响[J].中国针灸,2004,24(4):55-58.
[35]杜艳军,田青,宋杰,等.艾灸对老年鼠乙酰胆碱含量及胆碱脂酶活性影响的研究[J].湖北中医杂志,2007,29(1):3-4.
[36]邹洋洋,丁曙晴,周惠芬,等.八髎穴治疗出口梗阻型便秘的机制探讨[J].针刺研究,2015,40(5):427-430.
[37]郑英慧.温针灸八髎穴治疗寒凝血瘀型原发性痛经的临床研究[D].广州:广州中医药大学,2017.