【作者】 柯敬莲；

【导师】 王黎；

【作者基本信息】 广州中医药大学 ， 中医学， 2012， 硕士

【摘要】 研究背景十二经筋为经络系统的重要组成部分,研究经筋理论对于中医基础理论,尤其对经络学说研究具有实质的意义,而且经筋病的范围涉及较广,除一些运动神经系统疾病外,临床上一些疑难病症在经筋理论指导下治疗也取得很好的疗效。然而,经筋理论一直没有得到足够的重视,关于经络的研究报道较多,而关于经筋的研究相对较少。近年来由于民族特色疗法的兴起,特别是壮族医生运用经筋理论治疗疾病取得很好的疗效,且相关研究报导也较多,逐渐引起人民的关注。随着关注度的增加,相关的临床试验及研究报道文章也日益增多,证实经筋疗法的有效性。关于经筋理论的生理病理等有不同的观点,且在学术上也没有达成共识,临床运用方法也日益增多,目前尚没有经筋理论现代文献的科学系统研究。目的及意义随着经筋理论研究的发展,国内发表了大量与经筋理论相关的文献,但文献和资料都是零碎未经梳理。纵观国内这方面的研究论文中,尚缺乏该领域的文献计量学研究,未能对经筋理论的研究现状和发展趋势作总体把握。本研究就是采用文献计量学的分析方法,对经筋理论的现代文献进行归纳统计分析,研究经筋的理论及临床运用,比较经筋运用的方法等,以丰富经络理论系统,完善经筋理论,进一步探讨经筋理论的现代发展及临床运用,以便于更好指导科学研究及临床运用,同时为今后对该学术的研究工作提供一些思路和依据。研究内容及方法本研究采用文献计量学的方法,采用定量手段,通过对1984年到2011年期间国内公开发表的经筋理论的相关文献进行归纳统计分析,分析其年代文献量、文献地区分布、期刊载文量、临床研究状况等指标,并重点研究经筋理论的临床运用状况。研究结果及结论本研究结果显示研究经筋理论的文献量持续增长,特别是2009年以来,研究经筋处于相当活跃的阶段,跟2009年经筋学会成立有着密切的关系,一个学会的成立促进该学科的发展。同时可以预测在今后相当一段时间内,国内有关经筋理论的研究将不断深入,相应的文献量将持续增加。文献的地区分布呈明显的不均衡状态,除广西外,文献主要产地分布在东部沿海经济较发达地区,西部地区的文献量明显少,一方面提示经筋病的发病率可能存在地区差异,另一方面也提示对经筋理论科研投入存在地区差异。说明这方面科研活动的活跃程度与当地的科研环境、经济实力有着相当大的关系。其中北京处于领先地位,发文主要出自于中国中医科学院针灸研究所经筋病研究室。而广西仅次于北京,主要以黄敬伟带头研究的壮医经筋疗法为主,也是这一学科的热点。追踪这些核心地区机构的选题导向,从而可了解经筋研究的重点和发展趋势。国内刊物收录经筋理论的文献中,排名前9种刊物的载文量占总载文量近三分之一,其中,7种为中医药类杂志,另外两种是中国针灸学会经筋诊治专业委员会论文集与黑龙江中医药大学硕士论文,从中可以看出黑龙江中医药大学对经筋的研究处于较热地位,这些刊物也是获取经筋理论信息的重要来源,是该领域必不可少的参考工具。另外排名靠前刊物为2种针灸杂志,这些杂志是经筋理论发表成果的主要阵地。分析经筋理论运用的优势病种,骨科是经筋理论运用所占病种最多的学科,274篇文献中涉及的病种有39种,骨科22种,且所占的文献量最多105篇,52.5%。其中常用于颈椎病及膝关节炎,文献量分别为27篇、25篇。其次为内科,以神经内科为主,中风后遗症是经筋理论运用的优势病种,包括有中风后四肢痉挛状态、中风后肩痛、中风后肩手综合症及中风后三角肌萎缩。经筋理论临床运用方法主要两大方面,针刺及推拿手法；针具方面则有传统毫针、火针、锋勾针、圆刃针、圆利针、小针刀六种；其中以毫针使用最为广泛,这跟锋勾针、圆刃针、圆利针、小针刀需要较强的解剖基础外,还需要较高的操作能力；另外由于这些操作较疼痛,有时需要局部麻醉的铺助,患者接受程度相对较低,这两方面影响这些方法的推广及运用。更多还原

【Abstract】 BackgroundMeridian-Musle Region Theory(MMRT) is an important part of the meridian system, especially for the Basic Theory of Traditional Chinese Medicine. MMRT involves a wider range of tendon diseases, in addition to some of the motor nerve system diseases and some incurable diseases. However, MMRT has not been given sufficient attention, more studies have reported on the meridian, relatively few studies on it. In recent years, due to the rise of the national characteristics therapy, especially Zhuang doctors use MMRT to treat many diseases, and more researches coverage, so the MMRT gets more attention.In recent years, an increasing number articles confirmed on MMRT.There is no consensus of the Physiological and pathological or usages about MMRT yet. Objective and significanceWith the development of theoretical studies of MMRT, a great number of MMRT have been published in our nation, but the information of MMRT is the odds and ends without statistical processing. It is insufficient of bibliometrics analysis research in this domin, and unable to grasp the overall situation and development trend of MMRT study. In this study, bibliometric analysis is sused on MMRT of moeden literature, end to rich meridian theory, improve the MMRT, and further explore the modern development and clinical use, to provide some ideas and the basis for the future research.Contents and methodsThis research adopts the method of biblimetrics analysis and the means of quantification to statistically analyze the articles about MMRT which were published officially and published in our nation from1984to2011. It will analyze the annual amount of the articles, the region distribution of the articles, the periodical distribution of the articles, the research style of the articles, clinical research of the articles,etc.Results and ConclusionThe results of this study shows that the amount of the articles about MMRT keeps on growing, and the research of the realm is placed in a rather active stage especially after2009. So we can predict that the domestic research of MMRT go deep and the relevant amount of articles will keep on increasing for a period of time in future. The regional distribution of the literature showed the equilibrium outside of Guangxi, the literature major outputs distributed in the eastern coastal economically developed areas, the literature of the western region is significantly less, on the one hand, there may be regional differences prompted by the incidence of tendon disease, on the other hand, prompted by the reinforcement of scientific research into the existence of regional differences. Description of the research activities in the level of activity with the local research environment, economic strength has a significant relationship. Beijing is in the leading position, issued a document from Disease Research Center at the China Academy of Traditional Acupuncture Institute by tendons. Guangxi second only to Beijing, Huang Jingwei take the lead in research. Track these core topics of regional institutions oriented, in order to understand the focus of the study by the tendons and the development trend.Domestic publications, ranked in the top9kinds of journals Papers which have nearly one-third of total articles. Among the9kinds of papers, there is7kinds of Chinese medicine class magazine, the other are Chinese Acupuncture and Moxibustion Societies by tendon diagnosis and treatment professionals Committee of Heilongjiang University of TCM. These two papers are very important to get the impormation of MMRT. And the two top-ranking journals are acupuncture magazines, these magazines are the main positions for the MMRT.Analysis of the advantages of the use of MMRT, orthopedics reinforcement theory to use the share of disease most subjects.274artcles involved in39kinds of diseases,22kinds of orthopedic literature and the share of the amount of up to105articles,52.5%. And it is commonly used in knee arthritis and cervical spondylosis. The second commonly use is neurology, and the diseases are stroke sequelae, such as limb spasticity.Two main aspects of the methods of MMRT, acupuncture and massage techni ques; needles include traditional acupuncture needle, fire needle, crochet, round edge needle, round sharp needle, small needle-knife; and the use of needles is the most widely used. Maybe the causes of a need a strong anatomical basis, but also require higher operating capacity; addition, as these operations than the pain, so the other5needles are less use.更多还原