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[1]張海寧,范順,王曉宇,等.基于德爾菲法構(gòu)建針灸治療痙攣性斜頸的取穴方案[J].中醫(yī)正骨,2025,37(03):46-52.
　ZHANG Haining,FAN Shun,WANG Xiaoyu,et al.Constructing an acupoint selecting protocol for acupuncture and moxibustion treatment of spasmodic torticollis based on Delphi method[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(03):46-52.
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基于德爾菲法構(gòu)建針灸治療痙攣性斜頸的取穴方案()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期數(shù):
2025年03期
頁碼:
46-52
欄目:
調(diào)查研究
出版日期:
2025-03-20

文章信息/Info

Title:
Constructing an acupoint selecting protocol for acupuncture and moxibustion treatment of spasmodic torticollis based on Delphi method
作者:
張海寧; 范順; 王曉宇; 李華南; 張瑋; 包安; 王君實; 王建伍; 王金貴
天津中醫(yī)藥大學(xué)第一附屬醫(yī)院,天津 300381
Author(s):
ZHANG Haining; FAN Shun; WANG Xiaoyu; LI Huanan; ZHANG Wei; BAO An; WANG Junshi; WANG Jianwu; WANG Jingui
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China
關(guān)鍵詞:
斜頸;  針灸療法;  取穴;  德爾菲技術(shù)
Keywords:
torticollis;  acupuncture moxibustion therapy;  acupoint locating;  Delphi technique
摘要:
目的:構(gòu)建針灸治療痙攣性斜頸(spasmodic torticollis,ST)的取穴方案。方法:采用文獻研究和臨床調(diào)研的方法構(gòu)建針灸治療ST的取穴方案條目池,采用德爾菲法確立針灸治療ST的取穴方案。結(jié)果:共遴選出42名專家。通過文獻研究并結(jié)合臨床調(diào)研,最終形成針灸治療ST的取穴方案條目池,包括一級條目6項,二級條目21項。第1輪調(diào)查發(fā)放42份問卷,收回42份,專家積極系數(shù)為100%,專家權(quán)威系數(shù)為0.87,專家協(xié)調(diào)系數(shù)為0.23; 共篩選出5種針灸療法(毫針刺法、電針療法、艾條灸法、溫針灸療法、頭針療法)和20項針灸療法取穴方案。將不符合納入標準的條目和專家建議修改或補充的條目納入第2輪專家調(diào)查。第2輪調(diào)查發(fā)放42份問卷,收回42份,專家積極系數(shù)為100%,專家權(quán)威系數(shù)為0.92,專家協(xié)調(diào)系數(shù)為0.28。經(jīng)過2輪的問卷調(diào)查后無專家提出修改意見,最終形成針灸治療ST的取穴方案。結(jié)論:針灸治療ST的方法主要包括毫針刺法、電針療法、艾條灸法、溫針灸療法和頭針療法,其整體取穴方案遵循“局部取穴為主,遠端取穴為輔”的原則。毫針刺法主穴選用百會、水溝、風(fēng)池、天柱、合谷和太沖,通過辨經(jīng)配穴與辨證配穴相結(jié)合,輔以經(jīng)驗取穴進行個性化配伍; 電針療法側(cè)重刺激頸部痙攣肌群的起止點,主穴選取大椎、風(fēng)池、頸夾脊(C4～C6)、合谷、太沖等; 艾條灸法采用雀啄灸、溫和灸、回旋灸等手法,主灸風(fēng)池、扶突等穴位; 溫針灸療法則在大椎、頸臂等主穴的基礎(chǔ)上,根據(jù)證型加列缺、筋縮等穴位; 頭針療法選取百會穴及情感區(qū)、運動區(qū)等頭部特定刺激區(qū)。
Abstract:
Objective:To construct an acupoint selecting protocol for acupuncture and moxibustion treatment of spasmodic torticollis(ST).Methods:An item pool of acupoint selecting protocol for acupuncture and moxibustion treatment of ST was constructed through literature research and clinical investigation,and the Delphi method was employed to establish the final acupoint selecting protocol.Results:Forty-two experts were selected.Through literature research and clinical investigation,an item pool of acupoint selecting protocol for acupuncture and moxibustion treatment of ST was formed,including 6 primary items and 21 secondary items.In the first round of the expert survey,42 questionnaires were handed out,all of which were returned and valid,with an expert response rate of 100%,an expert authority coefficient of 0.87,and an expert coordination coefficient of 0.23.Five acupuncture and moxibustion therapies(filiform needle acupuncture,electroacupuncture,moxibustion with moxa stick,needle-warming moxibustion,and scalp acupuncture)and 20 acupoint selecting protocols were selected.The items failed to meet the inclusion criteria and the ones suggested for modification or supplementation by experts were included in the second round of expert survey.In the second round of the expert survey,42 questionnaires were handed out,all of which were returned and valid,with an expert response rate of 100%,an expert authority coefficient of 0.92,and an expert coordination coefficient of 0.28.After the second round of expert survey,no further modifications were proposed by the experts,and the final acupoint selecting protocol for acupuncture and moxibustion treatment of ST was established.Conclusion:The acupuncture and moxibustion therapies for ST mainly include filiform needle acupuncture,electroacupuncture,moxibustion with moxa stick,needle-warming moxibustion,and scalp acupuncture.The overall acupoint selecting protocol follows the principle of prioritizing local acupoints and supplemented by distal acupoints.For filiform needle acupuncture therapy,the main acupoints include Baihui(GV20),Shuigou(GV26),Fengchi(GB20),Tianzhu(BL10),Hegu(LI4),and Taichong(LR3),with personalized combinations based on meridian differentiation,syndrome differentiation,and empirical acupoint selection.The electroacupuncture therapy focuses on stimulating the origin and insertion points of neck spastic muscle group,mainly selecting the acupoints such as Dazhui(GV14),Fengchi(GB20),Jingjiaji(C4-C6),Hegu(LI4),and Taichong(LR3).Moxibustion with moxa stick therapy adopts manipulations such as sparrow-pecking moxibustion,mild moxibustion,and circling moxibustion,mainly acting on the acupoints such as Fengchi(GB20)and Futu(LI18).Dazhui(GV14)and Jingbi are commonly selected in needle-warming moxibustion therapy,and acupoints such as Lieque(LU7)and Jinsuo(GV8)are added according to the syndrome.Scalp acupuncture therapy mainly targets Baihui(GV20)and acupoints in the specific stimulation areas such as the emotional and motor regions.

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備注/Memo

備注/Memo:
基金項目:天津市中醫(yī)藥重點領(lǐng)域科研項目(2024001); 天津市南開區(qū)中醫(yī)藥傳承創(chuàng)新發(fā)展示范試點項目(20240204001); 天津中醫(yī)藥大學(xué)第一附屬醫(yī)院“拓新工程”基金科研課題(YB202118)
通訊作者:王金貴 E-mail:[email protected]
更新日期/Last Update: 1900-01-01