艾灸治疗失眠的临床应用规律分析  

Analysis of Clinical Application Regularity in Moxibustion Treatment of Insomnia

作　　者：董小庆 黄琴峰[2] 谢晨[2] 杨延婷 韩榕 李茜莹 孔谐和 杨光[1] 吴焕淦[2] 马晓芃[1,2] Dong Xiaoqing;Huang Qinfeng;Xie Chen;Yang Yanting;Han Rong;Li Xiying;Kong Xiehe;Yang Guang;Wu Huangan;Ma Xiaopeng(Yueyang Clinical Medical School,Shanghai University of Traditional Chinese Medicine,Shanghai 201203;Shanghai Research Institute of Acupuncture and Meridian,Shanghai 200030,China)

机构地区：[1]上海中医药大学岳阳临床医学院,上海201203 [2]上海市针灸经络研究所,上海200030

出　　处：《世界科学技术-中医药现代化》2019年第8期1615-1621,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：上海市卫生和计划生育委员会上海市卫生计生系统优秀学科带头人培养计划(2017BR047)：艾灸对慢性炎性内脏痛大鼠脊髓背角自噬的调节作用及其机制研究，负责人：马晓芃;国家科技部重点基础研究发展计划“973计划”项目（2015CB554501）:艾灸效应的启动机制及其内源性调节作用的机理研究，负责人：吴焕淦

摘　　要：目的回顾1959年至2018年发表的灸法治疗失眠的临床文献,总结归纳灸法治疗失眠的临床应用规律。方法检索《中医针灸信息库》、中国期刊全文数据库(清华同方)、万方数字化期刊(万方)、中文科技期刊全文数据库(维普),按照纳入和排除标准筛选灸法治疗失眠的临床研究文献,进行计量分析、聚类分析和关联性分析。结果艾灸治疗失眠应用频次较高的穴位依次为百会、三阴交、神门、足三里;足太阳膀胱经穴应用频次最高,其次是督脉穴和肾经穴。下肢部的腧穴使用频次最高,其次为头面部、背部。关联性较高的穴对为内关、足三里、神门、百会和三阴交,关联性较高的治疗方法为艾条灸配合针刺。灸法配合中药的总有效率最高,其次为灸法配合针刺,疗效均优于单纯灸法(均P<0.05)。对比灸法、灸药并用、灸刺并用疗法治疗前后的PSQI评分,灸法与灸药并用疗法比较差异有统计学意义(P<0.05),与灸刺并用比较差异无统计学意义(P>0.05)。结论灸法治疗失眠的组方中主要穴对为内关、足三里、神门、百会和三阴交。配合疗法中灸刺结合的使用频率最高,但灸法配合中药疗法的有效率最高,对于PSQI评分的改善程度亦最大。Objective To summarize the clinical application regularity in moxibustion treatment of insomnia by reviewing the clinical literatures on moxibustion therapy for insomnia published from 1959 to 2018. Methods The clinical literatures on moxibustion treatment of insomnia were retrieved in Chinese Medicine Acupuncture-moxibustion Information Database, China National Knowledge Infrastructure, Chinese Journal of Science and Technology of VIP,WanFang Database. The studies were screened according to the inclusion and exclusion criteria, and then underwent bibliometric analysis, cluster analysis and association rule analysis. Results The most frequently used acupoints in treating insomnia with moxibustion were Baihui(GV20), Sanyinjiao(SP6), Shenmen(HT7) and Zusanli(ST36). The most frequently used meridian was the Bladder Meridian of Foot Taiyang, followed by the Governor Vessel and the Kidney Meridian. The acupoints of the lower extremities were used most frequently, followed by those of the head-face region and the back. Neiguan(PC6), Zusanli(ST36), Shenmen(HT7), Baihui(GV20) and Sanyinjiao(SP6) showed the most significant correlation among the acupoint pairs. Moxa-stick moxibustion plus acupuncture showed the most significant correlation among the treatment methods. Moxibustion plus Chinese medication produced the highest total effective rate,followed by moxibustion plus acupuncture, both higher than the rate produced by moxibustion alone(P < 0.05).Regarding the post-treatment change in the Pittsburgh Sleep Quality Index(PSQI) score, moxibustion was significantly different from moxibustion plus medication(P < 0.05), but insignificantly different from moxibustion plus acupuncture(P > 0.05). Conclusion The main points that make up the prescription for moxibustion treatment of insomnia are Neiguan(PC6), Zusanli(ST36), Shenmen(HT7), Baihui(GV20) and Sanyinjiao(SP6). Although the combination of moxibustion and acupuncture is most frequently used, moxibustion plus Chinese medication produces the highest effective rate and the

关 键 词：灸法 针灸疗法 失眠症 匹兹堡睡眠指数 中医药信息数据库 文献计量学 数据挖掘 

分 类 号：R245.81[医药卫生—针灸推拿学]