针灸治疗阻塞性睡眠呼吸暂停低通气综合征的优势方案筛选  

Optimal regimen screening of acupuncture and moxibustion for obstructive sleep apnea hypopnea syndrome

作　　者：宋玉强 付渊博[1,2] 孙三峰 温雅丽 刘银霞[1] 孙洁 杜鑫 张雪婷[1] 沈琳博 李柏洁 于寒 李青黛 SONG Yuqiang;FU Yuanbo;SUN Sanfeng;WEN Yali;LIU Yinxia;SUN Jie;DU Xin;ZHANG Xueting;SHEN Linbo;LI Bajie;YU Han;LI Qingdai(Department of Acupuncture and Moxibustion,Beijing Hospital of TCM Affiliated to Capital Medical University,Beijing Key Laboratory of Acupuncture Neuromodulation,Beijing 100010,China;Department of Rehabilitation,Beijing Huairou District Hospital of TCM,Beijing 101400;Department of Integrated Chinese and Western Medicine Rehabilitation,Beijing Xiaotangshan Hospital)

机构地区：[1]首都医科大学附属北京中医医院针灸科,针灸神经调控北京市重点实验室,北京100010 [2]北京市怀柔区中医医院康复科,北京101400 [3]北京小汤山医院中西医结合康复科

出　　处：《中国针灸》2025年第2期242-248,共7页Chinese Acupuncture & Moxibustion

基　　金：北京市科学技术委员会——首都临床特色诊疗技术研究及转化应用项目:Z221100007422078;北京市医院管理中心“登峰”人才培养计划团队项目:DFL20241001;2021年度“扬帆”计划重点医学专业(重点扶持专业)——中西医结合康复项目:ZYLX202140。

摘　　要：目的:筛选针灸治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的优势方案,为临床决策提供依据。方法:检索中国期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang)、维普资讯中文期刊服务平台(VIP)、中国生物医学文献数据库(SinoMed)、PubMed、Web of Science(WOS)及Cochrane Library共7个中英文数据库收录的针灸治疗OSAHS的随机对照试验(RCT)文献,采用改良Jadad量表评分对证据质量进行评价,确立评价指标并运用多指标决策分析法筛选针灸治疗OSAHS的优势方案。结果:共纳入10篇RCT文献,针灸治疗OSAHS的优势方案为采用毫针疗法,穴取廉泉、膻中、中脘及双侧孔最、脾俞、丰隆、足三里、阴陵泉、照海,中脘、足三里采用补法,脾俞、丰隆施以泻法,余穴予平补平泻法,每10 min行针1次,留针30 min,每天1次,每周5次,连续治疗4周。纳入的文献多未详细描述患者的病情程度,干预方式以毫针为主,取穴以廉泉、旁廉泉等局部穴为主,多以呼吸暂停低通气指数及最低血氧饱和度为评价指标,并参考公认标准进行疗效评定,对安全性评价关注不足,方法学方面存在报告不充分及质量偏低的局限性。结论:针灸治疗OSAHS以毫针疗法为主,重视局部取穴,但现有研究水平有待提高。Objective To screen the optimal regimen of acupuncture and moxibustion for obstructive sleep apnea hypopnea syndrome(OSAHS),so as to provide the evidences for clinical decision-making.Methods From 7 databases in Chinese and English i.e.the Full-Text Database of China Journal Network(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),VIP Information Chinese Journal Service Platform(VIP),Chinese Biomedical Literature Database(SinoMed),PubMed,Web of Science(WOS)and Cochrane Library,randomized controlled trial(RCT)articals of OSAHS treated with acupuncture and moxibustion were searched.The quality of evidence was evaluated with the modified Jadad scale,the evaluation index was established and the optimal regimen of acupuncture and moxibustion for OSAHS was screened by multi-index decision analysis.Results A total of 10 RCTs were included,and the filiform needling therapy was optimal in treatment of OSAHS.The acupoints included Lianquan(CV23),Danzhong(CV17),Zhongwan(CV12),and bilateral Kongzui(LU6),Pishu(BL20),Fenglong(ST40),Zusanli(ST36),Yinlingquan(SP9)and Zhaohai(KI6).Zusanli(ST36)received the reinforcing method,Pishu(BL20)and Fenglong(ST40)were stimulated with the reducing technique,and the rest acupoints with the uniform reinforcing-reducing.Each acupoint was manually manipulated once every 10 min during the needle retention for 30 min.Acupuncture was delivered once a day,5 times a week and for consecutive 4 weeks.Among the included literature,the severity of disease was not reported in detail,the filiform needling was the dominant intervention,the local acupoints such as Lianquan(CV23)and Panglianquan(Extra)were mainly selected.The apnea-hypopnea index and the minimum oxygen saturation were taken as the evaluation indexes,and the effect was evaluated in reference to the generally accepted standards.The attention to safety evaluation was insufficient,the report on methodology was not adequate and the quality was low.Conclusion Filiform needling is the dominant therapy of acupuncture and moxibustion for OSAHS,

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 针灸 优势方案筛选 多指标决策 

分 类 号：R246.81[医药卫生—针灸推拿学]