针灸治疗糖尿病周围神经病变的选穴  

Point selections for acupuncture and moxibustion in the treatment of diabetes mellitus peripheral neuropathy

作　　者：衣运玲[1] 姜军作[2] 

机构地区：[1]大连医科大学护理系,辽宁省大连市116027 [2]大连大学附属新华医院中医科,辽宁省大连市116029

出　　处：《中国临床康复》2006年第27期146-148,共3页Chinese Journal of Clinical Rehabilitation

基　　金：辽宁省教育厅科学研究计划资助(2004F055)~~

摘　　要：目的:分析、归纳针灸在治疗糖尿病周围神经病变方面繁杂多样的选穴,以期化繁为简,便于临床推广和推动针灸治疗的规范化,发挥针灸治疗的优势。方法:应用计算机检索中文全文数据库2000/20065年间针灸治疗糖尿病神经病变的相关学术论文,涉及的杂志包括《中国针灸》《中国临床康复》《中国康复理论与实践》《上海针灸杂志》等。纳入标准:治疗方法以针灸治疗为主,治疗疾病为糖尿病对称性多发性周围神经病变临床研究;排除标准:重复性实验研究。对纳入的现代文献资料进行总结分析,并结合古典文献进行讨论。结果:发现所搜寻的13篇现代文献中,治疗糖尿病周围神经病变的42个穴位聚为3大类:①其中足三里、曲池、合谷为一类,足三里为足阳明胃经合穴,也是胃的下合穴,从除燥热入手治疗消渴,又能健脾益气,以助消除痰浊瘀血;曲池为手阳明大肠经合穴,可调理大肠经经所变动所生的疾病,在此类穴位中,足三里可起到标本兼治的作用,在糖尿病周围神经病变有上肢症状时可按照局部选穴的原则选用曲池、合谷。②三阴交、太溪为一类,三阴交为足太阴脾经穴,可调脾经之气,既可健脾统血、活血化瘀,又可健脾助运、化痰祛浊;太溪为足少阴肾经输(原)穴,以滋肾阴,取此穴乃从滋阴以固其本入手,兼消其兼症。③其余37个穴位为一类,聚类无明显规律。糖尿病对称性多发性周围神经病变的病机为“气阴双亏、痰浊瘀血痹阻脉络”。分析讨论3类穴位的主治规律,发现足三里、三阴交、太溪配合可有健脾化痰、活血化瘀、益气养阴之功效。结论:足三里、三阴交、太溪三穴为主组穴处方,符合″标本兼治″的原则,随症加减,以治疗糖尿病周围神经病变,处方简练、操作方便。AIM： To analyze and Summarize the numerous point selections of acupuncture and moxibustion therapy in treatment of diabetes mellitus peripheral neuropathy （DMPN）, with the expectations of simplifying those selections, which will extend clinical application of acupuncture and moxibustion therapy, impel its standardization, and bring its advantage into full play. METHODS： An online search in Chinese Journal of Full-text Database was undertaken to identify the research papers related to acupuncture and moxibustion in treatment of DMPN published between 2000 and May 2006, involving many journals such as Chinese Acupuncture and Moxibustion, Chinese Journal of Clinical Rehabilitation, Chinese Journal of Rehabilitation Theory and Practice, Shanghai Journal of Acupuncture and Moxibustion. Inclusion criteria： Clinical studies of symmetric multiple DMPN mainly treated with acupuncture and moxibustion; Exclusion criteria： repetitive experimental trial. All the selected modern literatures were summarized combining with classical literatures. RESULTS： Among the 13 modern literatures, 42 acupoints for treating DMPN were divided into 3 types：①One type of Zusardi （ST 36）, Quchi （LI 11） and Hegtt （LI 4）. Zusanli （ST 36） was not only converging point of Stomach Meridian of Foot-Yangming, but also lower confluent point of stomach, with the effect on treating diabetes by dispelling dryness-heat, and eliminating phlegm and stasis of blood by invigorating spleen and replenishing qi; Quchi （LI 11）, converging point of Large Intestine Meridian of Hand-Yangming, could regulate the diseases induced by large intestine meridian. Thereinto Zusanli （ST 36） could treat the primary and secondary of the disease at the same time, wtaile Quchi （LI 11） and Hegu （LI 4） would be selected when upper extremity presented symptom of DMPN.②The other type of Sanyinjiao （SP 6） and Taixi （KI 3）. Sartyinjiao （SP 6）, Spleen Meridian of Foot-Taiyin acupoint, could invigorate spleen, promote blo

关 键 词：针灸疗法 处方 针灸 穴位 糖尿病并发症 糖尿病神经病变 

分 类 号：R587.1[医药卫生—内分泌]