针灸治疗椎动脉型颈椎病临床用穴规律分析

摘要

Objective To summarize the characteristics and principles of acupoints seletion in the treatment of cervical spondylosis of vertebroarterial type(CSA).Method The RCTs for acupuncture treatment for CSA were searched from CNKI journal database(1915 to July,2013)and Wanfang database(1990 to July,2013),and the acu-points were recorded and analyzed using Excellfor statistic analysis.Results A total 207 articles involving 84 acu-points were included.The total frequency of usage was 1154 times including Fengchi(GB20)171 times,Cervical Jiaji 149 times and Baihui(DU20)110 times et cetera.There were 63 main acupoints for CSA with using frequency 848 times,and Fengchi(GB20)was most frequently used one(164 times).While Zusanli (ST36)was most frequently used (23 times)among the 60 match acupoints with using frequency 306 times.The fourteen meridians were all cov-ered,of which the most acupoints selected from was the bladder meridian of foot Taiyang (14 acupoints)and the most frequently used one was gallbladder meridian of foot Shaoyang (233 times).The main acupoints were selected at the local of lesion,and the match acupoints in the distal.Different specific points were widely used.Conclusion The lo-cal acupoints selection of meridian is an important method of acupuncture in the treatment of CSA,and the distal acu-points selection is an beneficial supplement for acupuncture treatment in patients with different TCM syndrome types of CSA.%目的：总结与分析针灸治疗椎动脉型颈椎病的临床用穴特点和规律。方法检索1915年至2013年7月 CNKI 期刊数据库及1990年至2013年7月万方数据库针灸治疗椎动脉型颈椎病（CSA）的临床随机对照（RCT）文献，对所用腧穴进行统计归纳分析。结果纳入文献207篇，涉及84个腧穴，使用总频次1154次，其中风池171次、颈夹脊149次、百会110次；涉及主穴63个，使用频次848次，以风池164次频次最高；配穴60个，使用频次306次，以足三里23次频次最高。十四经脉腧穴均有涉及，其中以足太阳膀胱经腧穴选用最多，为14个；而腧穴使用频次最高的为足少阳胆经，总使用频次233次。主穴重视局部腧穴，配穴以远端腧穴为主，五输穴、原穴、络穴、交会穴、下合穴等特定穴运用广泛。结论循经局部取穴是针灸治疗 CSA的重要方法，配穴远端取穴是针灸治疗不同中医证型 CSA 患者的有益补充。