目的:基于数据挖掘方法，总结并分析随机对照试验中电针治疗周围性面瘫(PFP)的腧穴谱及刺激参数，为规范电针治疗PFP提供参考依据。方法:通过检索国家知识基础设施数据库(CNKI)、中文科技期刊数据库(CCD)、中国学术期刊数据库(CSPD)、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library和Web of Science等数据库，按照纳入标准和排除标准筛选电针治疗PFP的临床研究文献，提取文献基本资料、腧穴选择、腧穴归经、电针刺激频率、刺激强度、刺激波形、刺激时长、疗程、结局指标、安全性评价和有效率等信息，建立数据库，采用频数分析方法总结文献中选取的腧穴和电针参数的使用规律。结果:共纳入186篇文献，电针治疗PFP使用频率最高的腧穴为地仓穴，其次为阳白穴、颊车穴、太阳穴、下关穴、四白穴、翳风穴、合谷穴和牵正穴等，腧穴归经以足阳明胃经、经外奇穴、足少阳胆经和手阳明大肠经为主;电针刺激参数中波形多以疏密波为主;刺激时间以30 min为主，刺激强度多以患者面部肌肉跳动且能耐受为度;刺激频率以1 Hz和30～40次/min居多;观察指标以House-Brackmann面神经功能分级为主。结论:电针治疗PFP的随机对照试验研究显示，其腧穴选择相对一致，但在临床试验中缺乏统一的电针刺激参数，且大量研究并未提及PFP的分期选穴及电针的分期治疗，结局指标不规范，安全性评价较少，缺乏严谨性。目前缺乏明确指南来规范指导电针治疗PFP的临床实践，亟需大样本、多中心临床试验来评估电针治疗PFP不同分期的选穴及具体操作参数，并根据PFP的分期及证型制定合理规范的标准以指导临床应用，使临床操作规范化，临床治疗科学化，临床疗效最大化。
Acupoint Spectrum and Stimulation Parameters in Randomized Controlled Trials on Electroacupuncture for Peripheral Facial Paralysis
Objective:To summarize and analyze the acupoint spectrum and stimulation parameters of electroacupuncture(EA)treatment for peripheral facial paralysis(PFP)based on data mining methods,providing a reference for standardizing EA therapy for PFP.Methods:Clinical research literature on EA treatment for PFP was selected through searches in databases such as CNKI,CCD,CSPD,CBM,PubMed,Cochrane Library,and Web of Science.Inclusion and exclusion criteria were applied to extract basic information,acupoint selection,acupoint meridian tropism,EA stimulation frequency,intensity,waveform,duration,treatment course,outcome indicators,safety assessments,and efficacy rates.A database was established,and frequency analysis was performed to summarize the usage patterns of selected acupoints and EA parameters.Results:A total of 186 articles were included.The acu-point most frequently used for EA treatment of PFP was Dicang(ST4),followed by Yangbai(GB14),Jiache(ST6),Taiyang(EX-HN5),Xiaguan(ST7),Sibai(ST2),Yifeng(TE17),Hegu(LI4),and Qianzheng.The primary meridian tropisms were the stomach meridian of foot Yangming,extraordinary points,gallbladder meridian of foot Shaoyang,and large intestine meridian of hand Yang-ming.Among the EA stimulation parameters,the predominant waveform was dense-sparse waves.The most common stimulation du-ration was 30 min,with intensity adjusted to induce muscle contractions tolerable to the patient.The most frequently used stimula-tion frequencies were 1 Hz and 30 to 40 times/min,while the primary outcome indicator was the House-Brackmann grading system for facial nerve function.Conclusion:The randomized controlled trial research on EA treatment for PFP shows relatively consistent acupoint selection.However,there is a lack of standardized EA stimulation parameters in clinical trials,and many studies do not specify acupoint selection by stages or treatment stages.Outcome indicators are often inconsistent,and safety evaluations are infre-quent,indicating a lack of rigor.Currently,there are no clear guidelines to standardize clinical practice for EA treatment of PFP.Large-sample,multi-center clinical trials are urgently needed to assess acupoint selection and specific operational parameters for different stages of PFP,and to establish reasonable and standardized criteria based on PFP stages and syndrome types to guide clini-cal application,standardize clinical operations,and maximize treatment efficacy.
万方数据
维普
