【作者】 王聪扬；

【导师】 李素荷；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2011， 硕士

【摘要】 背景随着社会的进步,生活水平的提高,糖尿病已经成为严重影响人类健康的日益严重的公共卫生问题。糖尿病相关的急慢性并发症严重威胁着患者的健康甚至生命,糖尿病为终生性疾病,本身及其并发症危害极大,目前尚无根治方法,导致医疗费用急剧增长,给患者、家庭和社会造成了沉重的负担。中医针灸治疗糖尿病研究在继承和发展中医学术的基础上,吸取现代糖尿病研究的营养,走中西医结合之路,辨证与辨病相结合,糖尿病的发病机制与中医病机相结合,宏观辨证与微观辨证相结合,中医文献与中西医临床相结合,古为今用,中西医学优势互补,尤其是经络理论指导下的针灸疗法,对糖尿病的治疗是一种很好的选择。目前治疗糖尿病涉及经络理论的方法主要包括针灸、推拿,有单纯针灸、推拿治疗的报道,大多数为结合中药治疗及中西医结合治疗,方法繁多,但缺乏系统的总结与理论的归纳。因此本研究对这个思路和目的,做了一个文献归纳和理论探讨的系统研究,希望对后期的研究起到参考作用。目的本论文拟用中医文献学的研究方法,运用检索和信息频次分析的手段,对各类与经络理论指导相关的方法治疗糖尿病的文献资料进行定性定量分类,探索糖尿病的临床辨证论治治疗情况和针灸治疗糖尿病的临床规律。通过对针灸治疗糖尿病文献的分析,对经络理论指导下的针灸、推拿在治疗糖尿病上的应用规律进行总结,尝试发现治疗糖尿病的穴位选择、经络选择的特点,发现针灸治疗糖尿病的选穴选经规律,进而可以更好地指导临床。寻求在经络理论指导下的糖尿病治疗的理论总结,完善经络理论的指导意义,更好地指导临床针灸、推拿等经络辩证疗法开展对糖尿病的治疗,以期探索新的思路。方法通过中国生物医学文献数据库、中国中医药科技文献数据库、中国期刊全文数据库、维普信息资源系统,采用计算机检索和人工检索方法检索了1991-2011年在国内发表的针灸治疗糖尿病的文献报道,限定了来源为省部级以上及国家核心医学生物期刊,将其进行系统整理,纳入符合标准的文献142篇。对文中常用穴位、经络进行统计、归类,并对临床常见糖尿病常用配穴进行统计,从而对针灸治疗糖尿病的穴位选用,经络辩证规律进行总结归纳。结果1.从文献来源看,属于课题文献的比率从1991-1995年的20%、1996-2000年的40%、2001-2005年44.4%到2006-2011年44.6%,基本是逐年提高的。2.在选穴上,前后出现的穴位多达83个,其中频次排名前三的足三里占9.8%,三阴交占8.5%,肾俞占6.9%,三个穴位累计达25.2%,超过了总频次的四分之一。3.在选经上,文献中前后使用的经络和奇经八脉共计有15条,其中使用频次最高的6条经脉分别为胃经、脾经、膀胱经、肾经、任脉、大肠经,其有使用的经穴,占了总穴位的62.3%。4.针灸疗法使用上,单纯针灸治疗糖尿病及其相关病症的比例为44.4%,针灸配合其它的治疗手段占55.6%。结论针灸治疗糖尿病的经络和穴位选择范围比较广泛,但重点涉及的经脉和使用的穴位却比较集中。经脉和经穴多集中在和水谷水液代谢有关的脏腑联系的经脉穴位,如胃经、脾经、膀胱经、肾经、大肠经和足三里、三阴交、太溪、脾俞、肾俞,提示在治疗针灸治疗糖尿病的临床实践中,要重点关注这些经脉及其经穴。更多还原

【Abstract】 BackgroundAlong with social progress, improved living standards, diabetes has become an increasingly serious impact on human health, serious public health problem. Acute and chronic complications of diabetes-related serious threat to health and even life of patients, diabetic disease for life, great harm to itself and its complications is currently no cure, resulting in rapid growth of medical costs to patients, families and societies a heavy burden. Acupuncture treatment of diabetes research in the inheritance and development of Chinese academic, based on the lessons of modern diabetes, nutrition, and take the road of Integrative Medicine, the combination of differentiation with disease, the pathogenesis of diabetes and the combination of TCM, differentiation and macro-microcosmic syndrome combining Chinese and Western medicine clinical literature and the combination of past serve the present, Chinese and Western medicine complement each other, especially under the guidance of meridian acupuncture treatment of diabetes is a good choice. The current treatment of diabetes involves the meridian theory methods include acupuncture, massage, a simple acupuncture, massage therapy reported, mostly combined with traditional Chinese medicine and Integrative Medicine, the method many, but the lack of systematic and theoretical summary of induction. Therefore, this study and the purpose of this idea to do a literature reviews and theoretical study of the system, hope to play a reference role in the later study.PurposeThis paper intends to use the TCM literature research methods, frequency of use of information retrieval and analysis tools, guidance on the types of meridian theory and method of treatment of diabetes-related qualitative and quantitative classification of literature, exploring the clinical diagnosis and treatment of diabetes cases and acupuncture treatment diabetes in law. Acupuncture treatment of diabetes on the analysis of the literature, under the guidance of the meridian acupuncture, massage in the treatment of diabetes on the summary of the application of law to try to find points of diabetes treatment options, choose the characteristics of the meridian and found that acupuncture points selected by the selection of diabetes law, and thus can better guide clinical. Seeking guidance in the meridian theory theoretical summary of the treatment of diabetes, and improve guidance for the meridian theory, to better guide clinical acupuncture, massage therapy and other meridian dialectical treatment of diabetes carried out in order to explore new ideas.MethodThrough the Chinese Biomedical Literature Database, a database of Chinese scientific literature of Chinese medicine, China Academic Journal, VIP information resources system, using computer search and manual search methods to retrieve the 1991-2011 published in China reported in the literature of acupuncture treatment of diabetes, limits source of provincial level or above, and the national core medical biotechnology journals, its systematic arrangement, included in the standard literature 142. Commonly used acupuncture points on the paper, the meridian for statistics, classification, and common clinical diabetes commonly used acupoints for statistics, which points to the use of acupuncture for treating diabetes, the dialectical law of the meridian are summarized.Results1.From the literature sources of view, the literature is the ratio of subjects to 20% from 1991-1995 2000 1996-2001-2005 40% 44.4% to 44.6% for 2006-2011, the basic is increasing year by year.2. The selection of points on the points before and after as many as 83, in which the frequency of the top three full three years 9.8% 8.5% Sanyinjiao, Shenshu 6.9%, three points accumulated up to 25.2%, more than a quarter of the total frequency.3. After the election, the literature and eight extra meridians before and after the use of a total of 15, in which the 6 most frequently used meridians were stomach, spleen, Bladder, kidney, Ren, large intestine, that they have to use Meridian, accounting for 62.3% of the total points.ConelusionAcupuncture points for treating diabetes wider range of options, but the focus is more concentrated use of acupuncture points. Meridian Design is also more choice of the points, but the key dialectical use is also relatively concentrated. Acupoints and meridians are more concentrated in the valley of water metabolism and water-related meridian points associated organs, such as stomach, spleen, Bladder, kidney, large intestine, suggesting that acupuncture in the treatment of diabetes in clinical practice, we should focus on These meridians and acupoints.更多还原