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针灸治疗脑卒中后便秘的临床研究进展

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针灸主要通过调节脑肠轴、肠道菌群、排便反射及自主神经系统治疗脑卒中后便秘,具有价格低廉、疗效显著、副作用小的优势。针灸治疗脑卒中后便秘以循经取穴、局部取穴为主,结合辨证取穴,选穴多集中于腹部,以天枢、足三里、中脘、上巨虚、支沟、气海、关元、大肠俞、水道、合谷、大横为主;常用经络为足阳明胃经、任脉、足太阳膀胱经、足太阴脾经;局部选穴以腹部腧穴为主。现有研究存在样本量较少、缺少多中心联合试验、缺乏标准化治疗方案、评分量表的使用规范化不足等问题,今后需进一步加强大样本临床试验研究,提高研究结果的说服力,确立统一、规范的治疗方案,加强实验研究以明确针灸治疗的原理及作用机制,以期为针灸的临床应用拓宽思路。
Clinical Research Progress of Acupuncture and Moxibustion in Treatment of Constipation After Stroke
Acupuncture treatment of post-stroke constipation mainly by regulating the cerebral-intestinal axis,intestinal flora,defeca-tion reflexes,and autonomic nervous system,which has the advantages of low price,significant efficacy,and few side effects.Acupunc-ture treatment for post-stroke constipation is based on meridian-based and localized acupoints,combined with syndrome-based acu-points,and the selected acupoints are mostly focused on the abdomen,such as Tianshu,Shusanli,Zhongwan,Shangjiuxu,Zhigou,Qihai,Guanyuan,Dachangshu,Shidao,Hegu,and Daxiang acupoint;The commonly used meridians are Foot Yangming Stomach meridian,Ren meridian,Foot Taiyang Bladder meridian,and Foot Taiyin Spleen meridian;The locally selected acupoints are mainly the abdominal acu-points.However,existing studies have problems,such as small sample size,lack of multicenter joint trials,lack of standardized treatment protocols,and insufficient standardization of the use of scoring scales,etc.In the future,it is necessary to further strengthen the research on large-sample clinical trials,improve the persuasive power of the results of the study,establish a unified and standardized treatment protocol,and strengthen experimental research to clarify the principles of treatment and the mechanism of action of acupuncture with the aim of broadening the new ideas for the clinical application of acupuncture.

post-stroke constipationacupuncturecerebral-intestinal axisintestinal floradefecation reflexesautonomic nervous system

王晨、姚嘉、孙远征

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黑龙江中医药大学,黑龙江哈尔滨 150040

黑龙江中医药大学附属第二医院针灸二科,黑龙江哈尔滨 150001

脑卒中后便秘 针灸 脑肠轴 肠道菌群 排便反射 自主神经系统

2025

中医学报
河南中医药大学,中华中医药学会

中医学报

影响因子:1.264
ISSN:1674-8999
年,卷(期):2025.40(1)