基于随机对照试验探索雷火灸疗法的适应证及高频病种  

Discussion on Indications and High Frequency Disease of Thunder and Fire Moxibustion Therapy Based on Randomized Controlled Trials

作　　者：王洋 胡汉通 金娇娇 韩德雄[1,2] WANG Yang;HU Hantong;JIN Jiaojiao;Han Dexiong

机构地区：[1]浙江中医药大学附属第三医院,浙江杭州310000 [2]浙江中医药大学第三临床医学院,浙江杭州310053 [3]天津市河西医院,天津300202

出　　处：《新中医》2022年第16期144-150,共7页New Chinese Medicine

基　　金：浙江省自然科学基金项目(LY20H270011);浙江省中青年临床名中医项目(浙中医药[2017]27号);浙江省卫生创新人才项目(浙卫办[2021]40号);浙江中医药大学附属第三医院医药卫生科技计划项目青年项目(ZS20YA03)。

摘　　要：目的:基于随机对照试验(RCT)文献探索雷火灸疗法在临床中的应用,分析其主要临床适应证及高频病种,为临床治疗提供依据。方法:检索中国知网(CNKI)、万方医学网数据库、重庆维普数据库、PubMed等7大中英文数据库,纳入雷火灸的RCT文献,参照《疾病和有关健康问题的国际统计分类(ICD-10)》对纳入文献中相应病种进行分类,统计分析雷火灸RCT文献各年度发表趋势,雷火灸治疗各大疾病系统的文献数量,归纳总结其主要适应证及高频病种。结果:共纳入88篇合格文献,各年度发表趋势显示,雷火灸RCT文献最早发表于1996年;1996—2010年文献发表数量较少,仅7篇;从2011年开始,文献发表量呈波动性上升趋势,2018—2020年发表量达到顶峰。雷火灸疗法涉及12大疾病系统,其在RCT临床研究中的主要适应证达50种。在妇产科疾病中的适应证最多,占所有适应证的22.00%(11/50);其次为消化系统疾病,占所有适应证的20.00%(10/50)。高频病种主要分布于肌肉骨骼系统和结缔组织疾病、五官疾病、影响健康状态因素及泌尿生殖系统疾病中。其中,肌肉骨骼系统和结缔组织疾病有1个高频病种,为膝骨性关节炎;五官疾病有1个高频病种,为变应性鼻炎;影响健康状态的因素有1个高频病种,为化疗后副作用;泌尿生殖系统疾病有1个高频病种,为术后泌尿功能紊乱。经Meta分析,运用雷火灸疗法治疗12大疾病系统疾病的总有效率优于对照组[OR=4.36,95%CI(3.69,5.15),P<0.00001]。亚组分析结果提示,除外精神和行为障碍疾病[OR=3.52,95%CI(0.65,19.17),P=0.15],雷火灸治疗12大疾病系统疾病中其余系统疾病的总有效率均优于对照组。结论:现阶段雷火灸在针灸RCT研究中的适应证较为广泛,高频病种相对集中,以膝骨性关节炎、变应性鼻炎、化疗后副作用等为代表。Objective:To explore the clinical application of thunder and fire moxibustion therapy based on the randomized controlled trials(RCT)l iteratures,analyze the main clinical indications and high frequency disease,and provide evidence for clinical treatment.Methods:Seven major Chinese and English databases including CNKI,Wanfang Medical Network Database,Chongqing VIP Database and PubMed were searched,RCT literatures of thunder and fire moxibustion were included,and corresponding diseases in the included literatures were classified according to The International Statistical Classification of Diseases and Related Health Problems 10th Revision(ICD-10).The annual publication trend of RCT literatures of thunder and fire moxibustion and the number of literatures of thunder and fire moxibustion for the treatment of major disease systems were analyzed statistically,and the main indications and high frequency disease were summarized.Results:A total of 88 qualified literatures were included.The trend of publication in each year showed that the RCT literatures of thunder and fire moxibustion were first published in 1996.From 1996 to 2010,only seven articles were published.Since 2011,the volume of literature published showed an upward trend of volatility,and reached its peak from 2018 to 2020.Thunder and fire moxibustion therapy involved 12 major disease systems,and its main indications in RCT clinical studies amounted to 50 kinds.The indications in gynecology and obstetrics diseases were the most,accounting for22.00%(11/50)of all indications;diseases of digestive system followed,accounting for 20.00%(10/50)of all indications.The high frequency disease were mainly distributed in musculoskeletal system and connective tissue diseases,diseases of five sensory organs,factors affecting health status and urogenital system diseases.Among them,there was one dominant disease in musculoskeletal system and connective tissue diseases,which was osteoarthritis of the knee;there was one dominant disease in diseases of five sensory organs,which

关 键 词：雷火灸 随机对照试验 适应证 高频病种 文献研究 

分 类 号：R245[医药卫生—针灸推拿学]