灸法独立干预病症谱及其高频病症的循证医学评价研究
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摘要
目的：
本研究从文献计量学角度系统研究灸法独立干预病症谱,并选取代表性的高频病症带状疱疹、褥疮、胎位不正,运用循证医学理念和方法,对其治疗性文献进行循证评价并提炼能够指导临床实践的证据信息,为今后的灸法循证评级及临床证据研究提供示范。
方法：
按照针灸病谱和文献计量学的研究方法,全面系统的检索国内外大型文献数据库,预先制定有效合理的检索策略。然后筛选合格的临床研究文献,根据国际疾病分类与编码系统(ICD-10)统计纳入文献的病症运用频次。用文献管理器实现文献检索、筛选、纳入、分类的批处理流程,最终基于现代文献逐步构建灸法独立干预病症谱。
选取3个代表性的高频病症带状疱疹、褥疮、胎位不正,采用循证医学的方法,运用《针灸循证临床指南》推荐的质量评价方法,结合国际通行的CONSORT22条标准及STRICTA的6条标准,进行严格而系统的质量评价。对纳入的灸法临床研究文献,依次分为系统评价/Meta分析、临床随机对照试验、病例系列观察、个案研究等类型,对同质性较高的随机对照试验进行Meta分析,分析软件采用RevMan5.0.20。
按照四类灸法临床常见问题进行临床证据分析,即(1)灸法与空白组、安慰剂组的疗效比较；(2)灸法与常规治疗、标准阳性对照的疗效比较；(3)不同针法灸法之间疗效比较；(4)灸法与其他措施综合运用。由此,提炼出每一个病症的灸法循证治疗证据。
结果：
1.本次文献研究共纳入502篇合格文献,得到了15类病症系统,100种病症,其中包括西医疾病85种、西医症状5种、中医病症10种。各系统疾病按频次排序如下：传染病与寄生虫病：共8种病症、62篇文献；呼吸系统病症：共3种病症、26篇文献；肌肉骨骼系统与结缔组织病症：共14种病症、57篇文献；精神和行为障碍：共4种病症、22篇文献；泌尿生殖系统病症：共11种病症、58篇文献；内分泌、营养和代谢病症：共1种病症、6篇文献；皮肤和皮下组织病症：共4种病症、16篇文献；妊娠和产褥期病症：共4种病症、24篇文献；神经系统病症：共11种病症、38篇文献；损伤、中毒和外因的某些后果：共4种病症、30篇文献；消化系统病症：共17种病症、86篇文献；血液及造血系统病症：共5种病症、14篇文献；循环系统病症：共5种病症、20篇文献；眼及附属器疾病：共4种病症、8篇文献；肿瘤：共5种病症、36篇文献。
2.灸法治疗带状疱疹的循证医学评价研究
①灸法与西药比较治疗带状疱疹的Meta分析
纳入15篇合格RCT研究。共1167例受试者。灸法与西药比较,Meta分析显示临床总有效率RR=1.31,95%CI (1.12,1.53), P<0.00001,差异有统计学意义。其中4项研究的疼痛VAS评分MD=-1.63,95%CI (-2.60,-0.65), P=0.001,差异有统计学意义。灸法治疗带状疱疹在临床症状改善方面优于常规西药,止痛效果更佳。
②灸法治疗带状疱疹的临床证据分析
2007和2011年国内发表的2项灸法治疗带状疱疹疗效的系统评价/Meta分析,结果显示有限证据支持灸法治疗带状疱疹的有效性,表现在临床症状改善或治愈率方面,但由于纳入文献质量较低,需要更多高质量的临床试验证据来进一步验证。
灸法与常规西药的疗效比较有3项RCT研究比较灯火灸与阿昔洛韦+曲马多+维生素B1的疗效差异,西药包括抗病毒药、维生素类、免疫调节剂等,结果显示灯火灸在止痛、临床总有效率和治愈率方面很可能有疗效优势。1项RCT研究比较壮医药线点灸与重组人干扰素、维生素合用的疗效差异,结果显示壮医药线点灸在临床总有效率和治愈率方面均有疗效优势。另外各有1项RCT研究分别比较实按灸与阿昔洛韦；麦粒灸与阿昔洛韦+维生素B1+甲钴胺；悬灸与阿昔洛韦+甲钴胺；热敏灸与消炎痛。结果表明这些灸法与常规西药比较,可能有不同程度的疗效优势。
5项RCT分别比较不同类型的刺法灸法。结果显示铺棉灸在治愈率、结痂时间、镇痛效果均优于刺络拔罐；热敏灸在改善患者疼痛、提高临床治愈率、总有效率方面优于针刺拔罐,也优于电针；壮医药线点灸与火针比较尚没有疗效优势。
灸法与其他措施配合的研究有35篇,与西药比较的有15篇,涉及综合措施包括铺棉灸+围刺+电针、铺棉灸+梅花针叩刺、药笔灸+电针、悬灸+针刺、热敏灸十穴位注射；对照西药包括抗病毒药(阿昔洛韦)、维生素类(维生素B族、维生素B1、维生素B12)、干扰素诱导剂(聚肌胞,具有光谱抗病毒和免疫调节功能)。研究结果均显示灸法配合其他刺法灸法治疗带状疱疹疗效优于西药。5篇RCT为灸法结合西药治疗,结果显示与单用西药相比,灸法结合西药效果更佳。
3.灸法治疗褥疮的循证医学评价研究。
①灸法与西医常规比较治疗褥疮的Meta分析
纳入18篇合格RCT研究。共928例受试者。Meta分析显示临床总有效率RR=1.28,95%CI(1.15,1.42),P<0.00001,差异有统计学意义。6项研究的平均痊愈时间MD=-7.03,95%CI(-8.52,-5.54),P<0.00001。差异有统计学意义。艾灸对照红外线照射、艾灸配合常规治疗对照单纯常规、艾灸配合药物外敷对照常规治疗在提高褥疮临床总有效率和缩短痊愈时间有一定优势。
②灸法治疗褥疮的临床证据分析
目前国内尚无灸法治疗褥疮的系统评价/Meta分析,也无相关多中心临床研究文献报道,多从灸法与常规治疗疗效优势比较、灸法配合其他措施增强疗效两方面进行研究。其中灸法与常规治疗比较治疗褥疮的文献6篇,均为RCT、无高质量研究。涉及的灸法包括悬灸和热敏灸；对照的常规治疗包括局部疮面使用抗生素类(百多邦软膏、庆大霉素)、维生素类(维生素C、维生素B1)及654-2混合液涂擦和红外线照射,这些治疗措施或单用或联合应用。研究结果均为灸法治疗褥疮疗效优于常规治疗。
灸法与其他措施配合治疗褥疮的文献研究有21篇,与西医常规清创换药比较的有14篇,涉及综合措施包括悬灸+中药(生肌散、美皮康、湿润烧伤膏、九华膏、生肌玉红膏、烫伤药水、土黄连敷料、紫花烧伤膏)、悬灸+西药(重组人表皮生长因子、康惠尔溃疡贴、碘伏纱块、利福平、红霉素软膏、苯唑西林钠+呋喃西林液+高渗盐水+T D T照射)、悬灸+中西药(湿润烧伤膏+金霉素眼膏)(可参见后附表1)；对照西医常规清创换药包括抗生素类(庆大霉素、呋喃西林、复方磺胺甲恶唑)、维生素类(复合维生素B2)。研究结果均显示灸法配合其他治疗措施治疗褥疮疗效优于西医常规清创换药。2篇RCT为灸法结合清创换药治疗,结果显示与单独清创换药相比,灸法结合清创换药效果更佳。
2.灸法治疗胎位不正的循证医学评价研究
①灸法与常规处理比较治疗胎位不正的Meta分析
纳入5篇合格RCT,共915例受试者。灸法对照膝胸卧位法临床总有效率比较,RR=1.38,95%CI (1.27,1.50), P<0.00001,差异有统计学意义。艾灸至阴穴对照膝胸卧位法纠正胎位不正在提高临床总有效率方面有一定优势。
③灸法治疗胎位不正的循证证据分析
灸法与西医常规比较治疗胎位不正的文献15篇,均为RCT研究、高质量研究偏少。涉及的灸法包括温和灸、生姜外敷等；对照的西医常规为采用胸膝卧位法。研究结果均为灸法治疗胎位不正疗效优于西医常规。1项系统评价/Meta分析显示,有限证据支持灸法治疗胎位不正的有效性,表现在临床胎头倒转成功率方面。
1项RCT比较不同时间的隔姜灸至阴矫正胎位臀先露。结果显示晚上21点到21点30分隔姜灸至阴矫正胎位臀先露优于白天灸疗,结果具有统计学意义。1项RCT显示艾灸三阴交与艾灸至阴治疗胎位不正比较,两组总有效率无统计学差异。
灸法与其他措施配合的研究有11篇,与西药比较的有4篇,涉及综合措施包括艾灸+当归芍药散、艾灸+仰卧抬臀位、艾灸+侧卧位、艾灸+胸膝卧位、艾灸+正胎汤、艾灸+转胎方、艾灸+氦氖激光照射、艾灸+电针、艾灸+按压耳穴；对照组为单纯艾灸至阴穴、西医常规为胸膝卧位。研究结果均显示灸法配合其他刺法灸法治疗胎位不正疗效优于西医常规和单纯艾灸。4篇RCT为灸法结合西药治疗,结果显示与单纯西医常规相比,灸法结合其他措施效果更佳。
结论：
1.灸法独立干预的病症谱是体现灸法自身特点和优势的重要方面。此次研究发现,灸法独立干预的病症谱范围还是比较广的,约占整个针灸病症谱的1／4。位居前列的病症系统有肌肉骨骼系统与结缔组织病症、消化系统病症、泌尿生殖系统病症、神经系统病症等。这与针灸病症谱的高频系统的范围是一致的。不同的是精神和行为障碍的病症较少。文献频次较为集中的病症有痛经、带状疱疹、胎位不正、哮喘、褥疮、失眠、腹泻等。这些病症可能是灸法独立干预的优势病症,值得进一步深入研究。
2.高频病症的循证医学评价研究证明：
1)灸法治疗带状疱疹在临床症状改善方面优于常规西药,止痛效果更佳。不同类型的刺法灸法比较,铺棉灸在治愈率、结痂时间、镇痛效果均优于刺络拔罐；热敏灸在改善患者疼痛、提高临床治愈率、总有效率方面优于针刺拔罐,也优于电针；壮医药线点灸与火针比较尚没有疗效优势。与单用西药相比,灸法结合西药效果更佳。
2)艾灸配合常规治疗或药物外敷在提高褥疮临床总有效率和缩短痊愈时间有一定优势。灸法配合其他治疗措施治疗褥疮疗效优于西医常规清创换药。
3)艾灸至阴穴对照膝胸卧位法纠正胎位不正在提高临床总有效率方面有一定优势。
Objective
This study from the Bibliometrics study moxibustion independent intervention system disease spectrum, and select some representative high-frequency symptoms of herpes zoster, bedsore, abnormal fetal position, using the principle of evidence-based medicine and evidence-based evaluation method, for the treatment of literature and refined to guide clinical practice of evidence information, provide a model for future moxibustion study on evidence-based rating and clinical evidence.
Methods
According to the research method of acupuncture and moxibustion disease spectrum and the literature metrology, comprehensive and systematic retrieval of large document databases at home and abroad, a retrieval strategy effective and reasonable. According to the international classification of diseases and the coding system (ICD-10), the clinical research literatures of qualified, disorders using frequency statistics into the document. Batch process with the document manager to achieve the literature retrieval, screening, classification, into the final, based on modern literature gradually build moxibustion independent intervention disease spectrum. Selecting3representative high frequency conditions of herpes zoster, bedsore, malposition, methods of evidence-based medicine, using "on the quality evaluation method of clinical guidelines recommend acupuncture", with6standards of the international CONSORT22standards and STRICTA, evaluate the quality of strict system. The inclusion of the moxibustion clinical research literature, in turn, type analysis of randomized clinical trials, observational case series and case study, as a system evaluation of\/Meta, randomized controlled trial of homogeneous Meta analysis, analysis software using RevMan5.0.20. Clinical evidence analysis according to the common problems of four types of Moxibustion in clinical, compared the effect of moxibustion and the blank group, placebo group; comparison of curative effect of the moxibustion and conventional therapy, a standard positive control; the comparison of curative effect between different acupuncture moxibustion; comprehensive use of the moxibustion and other measures. Thus, refines every disease moxibustion evidence-based therapy.
Results
1. the literature study included502qualified papers, obtained15kinds of disease system,100kinds of disease, including western medicine disease85, western medicine, Chinese medicine symptoms of5types and10kinds of diseases. The systemic diseases according to the frequency order as follows:infectious and parasitic diseases:a total of8diseases,62articles; respiratory disorder:a total of3diseases,26articles; disorder of the musculoskeletal system and connective tissue:a total of14diseases,57articles; the mental and behavioral disorders:a total of4kinds of disease,22articles; genitourinary system diseases:a total of11diseases,58articles; endocrine, nutritional and metabolic disorders:a total of1diseases,6articles; the skin and subcutaneous tissue disease:a total of4kinds of disease,16articles; pregnancy and puerperal disease:a total of4kinds of disease,24pieces of literature; nervous system disorders:a total of11diseases,38articles; some consequences of injury, poisoning and external causes:a total of4kinds of disease,30articles; digestive system diseases:a total of17diseases,86articles; disorder of blood and hematopoietic system:a total of5diseases,14articles; the circulatory system disease:a total of5diseases,20articles; ocular and adnexal diseases:a total of4diseases,8articles; tumor:a total of5diseases,36articles.
2. Research on evidence-based medicine evaluation of2methods in the treatment of herpes zoster
①Analysis of Meta of moxibustion and Western medicine in the treatment of herpes zoster
The15included qualified RCT study. A total of1167subjects. Comparison of moxibustion and Western medicine, Meta analysis showed that the total clinical efficiency of RR=1.31,95%CI (1.12,1.53), P<0.00001, the difference was statistically significant. The4study pain VAS score of MD=-1.63,95%CI (-2.60, -0.65), P=0.001, the difference was statistically significant. Moxibustion for treatment of herpes zoster is better than the conventional western medicine in the clinical symptoms, analgesic effect.
②Analysis of clinical evidence of Moxibustion in the treatment of herpes zoster
An evaluation system of\/Meta2on2007and2011published in treatment of herpes zoster, the results show the effectiveness of the limited evidence in support of herpes zoster treated by moxibustion, reflected in the improvement of clinical symptoms and cure rate, but because the literatures of low quality, need more high quality evidence from clinical trials to further verify. Effect of moxibustion and conventional western medicine comparison of3RCT comparative study of the efficacy between lamp moxibustion and A Silowe+tramadol+vitamin B1, western medicine including antiviral drugs, vitamins, immunomodulator, results display lamp moxibustion therapeutic advantage in pain, the clinical total effective rate and cure rate are very likely to.1RCT comparative study of the strong effect of medicated thread moxibustion and recombinant human interferon, vitamin and differences, results showed that the medicated thread moxibustion in the total clinical efficiency has advantage of curative effect and cure rate. In addition to the1RCT study were compared and pressing moxibustion moxibustion and aciclovir in aciclovir;+vitamin B1++methylcobalamin methylcobalamin; moxibustion and acyclovir; thermal moxibustion and indomethacin. The results show that the moxibustion and conventional western medicine, may have the advantage of curative effect in different degree.
Comparison of5RCT are different types of needling and moxibustion method. The results showed that cotton moxibustion in the cure rate, analgesic effect, scabby time are better than those of blood-letting puncture and cupping; thermal moxibustion in ameliorating pain of the patients, improve the clinical cure rate, the total efficiency is better than acupuncture cupping, is better than Electroacupuncture; Zhuang medicine medicated thread moxibustion and acupuncture is no advantage of curative effect comparison.
Research of moxibustion and other measures are35, and Western medicine are15, involving the comprehensive measures including cotton moxibustion+by acupuncture round, cotton Moxibustion plus plum-blossom needle, moxibustion, moxibustion medicine pen+EA+acupuncture, thermal moxibustion+acupoint injection; control of Western medicine including antiviral (o famciclovir), vitamins (vitamin B, vitamin B1, vitamin B12), interferon inducer (polyinosinic, with spectral antiviral and immunomodulatory function). The results showed that moxibustion combined with other acupuncture moxibustion for treatment of herpes zoster is superior to Western medicine.5RCT for moxibustion combined with western medicine treatment, results show that compared with simple western medicine, moxibustion combined with western medicine effect.
3. Research on evidence-based medicine evaluation3moxibustion for treatment of bedsore.
①Analysis of Meta of moxibustion and conventional western medicine treatment of bedsore
The18included qualified RCT study. A total of928subjects. Meta analysis showed that the total clinical efficiency of RR=1.28,95%CI (1.15,1.42), P <0.00001, the difference was statistically significant. The average recovery time of MD=-7.036study,95%CI (-8.52,-5.54), P<0.00001. The difference was statistically significant. Moxibustion, moxibustion control infrared radiation control routine, moxibustion combined with medicine conventional therapy in the control improved bedsore total clinical efficiency has certain advantages and shorten the healing time of conventional treatment.
②Analysis of clinical evidence of moxibustion for treatment of bedsore At present there is no domestic evaluation system\/Meta moxibustion treatment of bedsore analysis, no related multi-center clinical research literature reports, from the moxibustion and conventional treatment of moxibustion combined with other measures of comparative advantage, two curative effect research. The moxibustion and conventional therapy in treating bedsore of6references, are RCT, no high quality studies. The moxibustion moxibustion and includes thermal moxibustion; conventional treatment control include the use of antibiotics in local wound (Bactroban ointment, gentamicin), vitamins (vitamin C, vitamin B1) and654-2mixed liquid inunction and infrared radiation, these treatments or single or combined use of. The results are better than the conventional treatment of moxibustion treatment of decubitus ulcer.
Moxibustion with other measures with the literature on treating bedsore of21articles, dressing change compared with the routine debridement and14 articles, involving the comprehensive measures including Moxibustion plus traditional Chinese medicine (born muscle scattered, Mepilex border, moist burn cream, ointment Jiuhua, Shengjiyuhong ointment, scald lotion, coptis root dressing, purple burn ointment), moxibustion plus Western Medicine (recombinant human epidermal growth factor, Comfeel ulcer strap, Hide Sa, rifampicin, erythromycin ointment, oxacillin sodium+Furacilin Solution and hypertonic saline+T D T irradiation), western medicine moxibustion+(MEBO plus oculentum aureomycin)(see attached1); control routine cleaning wound dressing including antibiotics (gentamicin, nitrofurazone, compound sulfamethoxazole), vitamins (vitamin B2). The results showed that moxibustion combined with other therapeutic measures for treating bedsore is better than that of routine debridement dressing.2RCT for moxibustion combined with debridement and dressing treatment, results show that compared with the single debridement dressing, moxibustion combined with debridement and dressing effect.
2. moxibustion for treatment of malposition of the evidence-based medicine evaluation studies
①Analysis of moxibustion and conventional treatment comparison treatment of malposition of the Meta
The5included qualified RCT, a total of915subjects. Moxibustion control knee chest decubitus method the total clinical efficiency comparison, RR=1.38,95%CI (1.27,1.50), P<0.00001, the difference was statistically significant. Moxibustion Zhiyin control has certain advantages knee-chest position method to correct the fetal position is not increasing the total clinical efficiency.
②moxibustion for treatment of malposition of the evidence analysis Moxibustion and conventional western medicine treatment of malposition of the literature of15references, both studies, high quality RCT less. The mild moxibustion, moxibustion including ginger herbs; control of conventional western medicine for the use of knee-chest position method. The results were treated by moxibustion malposition curative effect is better than that of routine western medicine.1system evaluation\/Meta analysis shows, limited effectiveness evidence in support of the moxibustion treatment of malposition of fetal head back, in the clinical success rate.
1RCT comparison of different time of moxibustion with ginger to Yin correction of fetal breech presentation. The results showed21PM to twenty-one thirty separated ginger moxibustion Zhiyin correcting fetal breech presentation is better than daytime moxibustion, the results with statistical significance. Moxibustion Sanyinjiao and moxibustion to Yin in the treatment of malposition of comparison between the1RCT display, the total efficiency of two groups had no statistical difference.
Research of moxibustion and other measures are11, and Western medicine are4, involving the comprehensive measures including Danggui Shaoyao Powder, moxibustion moxibustion++supine carry breech, moxibustion, moxibustion++lateral knee-chest position, moxibustion, moxibustion++positive fetal soup to fetal side, moxibustion plus He-Ne laser irradiation, electroacupuncture, moxibustion moxibustion++press the ear; the control group for the pure moxibustion Zhiyin, routine for the knee-chest position. The results showed that moxibustion combined with other acupuncture moxibustion treatment of malposition of curative effect is better than that of routine western medicine and simple moxibustion.4RCT for moxibustion combined with western medicine treatment, results show that compared with conventional western medicine, moxibustion combined with other measures.
Conclusion
1. independent intervention on disease spectrum is an important aspect of its own characteristics and advantages of moxibustion. The study found that moxibustion independent intervention, disease spectrum range is quite wide, about the whole acupuncture disease spectrum of1/4. In the forefront of the system disorder of musculoskeletal system and connective tissue diseases, disorder of digestive system, genitourinary system diseases, nervous system diseases. The high frequency system acupuncture disease spectrum range is consistent. Different is less symptoms of mental and behavioral disorders. Document frequency is more concentrated disorder dysmenorrhea, herpes zoster, malposition, asthma, bedsore, insomnia, diarrhea etc.. These symptoms may be moxibustion independent intervention advantage condition, it is worth further study.
2. high frequency conditions that study medicine evaluation:
1) moxibustion for treatment of herpes zoster is better than the conventional western medicine in the clinical symptoms, analgesic effect. Comparison of needling and moxibustion method of different types, cotton moxibustion in the cure rate, analgesic effect, scabby time are better than those of blood-letting puncture and cupping; thermal moxibustion in ameliorating pain of the patients, improve the clinical cure rate, the total efficiency is better than acupuncture cupping, is better than Electroacupuncture; Zhuang medicine medicated thread moxibustion and acupuncture is no advantage of curative effect. Compared with simple western medicine, moxibustion combined with western medicine effect.
2) moxibustion combined with conventional therapy or drug in improving the bedsore clinical total effective rate has certain advantages and shorten the healing time. Moxibustion with other therapeutic measures for treating bedsore is better than that of routine debridement dressing.
3) moxibustion Zhiyin control has certain advantages knee-chest position method to correct the fetal position is not increasing the total clinical efficiency.
本研究从文献计量学角度系统研究灸法独立干预病症谱,并选取代表性的高频病症带状疱疹、褥疮、胎位不正,运用循证医学理念和方法,对其治疗性文献进行循证评价并提炼能够指导临床实践的证据信息,为今后的灸法循证评级及临床证据研究提供示范。
方法：
按照针灸病谱和文献计量学的研究方法,全面系统的检索国内外大型文献数据库,预先制定有效合理的检索策略。然后筛选合格的临床研究文献,根据国际疾病分类与编码系统(ICD-10)统计纳入文献的病症运用频次。用文献管理器实现文献检索、筛选、纳入、分类的批处理流程,最终基于现代文献逐步构建灸法独立干预病症谱。
选取3个代表性的高频病症带状疱疹、褥疮、胎位不正,采用循证医学的方法,运用《针灸循证临床指南》推荐的质量评价方法,结合国际通行的CONSORT22条标准及STRICTA的6条标准,进行严格而系统的质量评价。对纳入的灸法临床研究文献,依次分为系统评价/Meta分析、临床随机对照试验、病例系列观察、个案研究等类型,对同质性较高的随机对照试验进行Meta分析,分析软件采用RevMan5.0.20。
按照四类灸法临床常见问题进行临床证据分析,即(1)灸法与空白组、安慰剂组的疗效比较；(2)灸法与常规治疗、标准阳性对照的疗效比较；(3)不同针法灸法之间疗效比较；(4)灸法与其他措施综合运用。由此,提炼出每一个病症的灸法循证治疗证据。
结果：
1.本次文献研究共纳入502篇合格文献,得到了15类病症系统,100种病症,其中包括西医疾病85种、西医症状5种、中医病症10种。各系统疾病按频次排序如下：传染病与寄生虫病：共8种病症、62篇文献；呼吸系统病症：共3种病症、26篇文献；肌肉骨骼系统与结缔组织病症：共14种病症、57篇文献；精神和行为障碍：共4种病症、22篇文献；泌尿生殖系统病症：共11种病症、58篇文献；内分泌、营养和代谢病症：共1种病症、6篇文献；皮肤和皮下组织病症：共4种病症、16篇文献；妊娠和产褥期病症：共4种病症、24篇文献；神经系统病症：共11种病症、38篇文献；损伤、中毒和外因的某些后果：共4种病症、30篇文献；消化系统病症：共17种病症、86篇文献；血液及造血系统病症：共5种病症、14篇文献；循环系统病症：共5种病症、20篇文献；眼及附属器疾病：共4种病症、8篇文献；肿瘤：共5种病症、36篇文献。
2.灸法治疗带状疱疹的循证医学评价研究
①灸法与西药比较治疗带状疱疹的Meta分析
纳入15篇合格RCT研究。共1167例受试者。灸法与西药比较,Meta分析显示临床总有效率RR=1.31,95%CI (1.12,1.53), P<0.00001,差异有统计学意义。其中4项研究的疼痛VAS评分MD=-1.63,95%CI (-2.60,-0.65), P=0.001,差异有统计学意义。灸法治疗带状疱疹在临床症状改善方面优于常规西药,止痛效果更佳。
②灸法治疗带状疱疹的临床证据分析
2007和2011年国内发表的2项灸法治疗带状疱疹疗效的系统评价/Meta分析,结果显示有限证据支持灸法治疗带状疱疹的有效性,表现在临床症状改善或治愈率方面,但由于纳入文献质量较低,需要更多高质量的临床试验证据来进一步验证。
灸法与常规西药的疗效比较有3项RCT研究比较灯火灸与阿昔洛韦+曲马多+维生素B1的疗效差异,西药包括抗病毒药、维生素类、免疫调节剂等,结果显示灯火灸在止痛、临床总有效率和治愈率方面很可能有疗效优势。1项RCT研究比较壮医药线点灸与重组人干扰素、维生素合用的疗效差异,结果显示壮医药线点灸在临床总有效率和治愈率方面均有疗效优势。另外各有1项RCT研究分别比较实按灸与阿昔洛韦；麦粒灸与阿昔洛韦+维生素B1+甲钴胺；悬灸与阿昔洛韦+甲钴胺；热敏灸与消炎痛。结果表明这些灸法与常规西药比较,可能有不同程度的疗效优势。
5项RCT分别比较不同类型的刺法灸法。结果显示铺棉灸在治愈率、结痂时间、镇痛效果均优于刺络拔罐；热敏灸在改善患者疼痛、提高临床治愈率、总有效率方面优于针刺拔罐,也优于电针；壮医药线点灸与火针比较尚没有疗效优势。
灸法与其他措施配合的研究有35篇,与西药比较的有15篇,涉及综合措施包括铺棉灸+围刺+电针、铺棉灸+梅花针叩刺、药笔灸+电针、悬灸+针刺、热敏灸十穴位注射；对照西药包括抗病毒药(阿昔洛韦)、维生素类(维生素B族、维生素B1、维生素B12)、干扰素诱导剂(聚肌胞,具有光谱抗病毒和免疫调节功能)。研究结果均显示灸法配合其他刺法灸法治疗带状疱疹疗效优于西药。5篇RCT为灸法结合西药治疗,结果显示与单用西药相比,灸法结合西药效果更佳。
3.灸法治疗褥疮的循证医学评价研究。
①灸法与西医常规比较治疗褥疮的Meta分析
纳入18篇合格RCT研究。共928例受试者。Meta分析显示临床总有效率RR=1.28,95%CI(1.15,1.42),P<0.00001,差异有统计学意义。6项研究的平均痊愈时间MD=-7.03,95%CI(-8.52,-5.54),P<0.00001。差异有统计学意义。艾灸对照红外线照射、艾灸配合常规治疗对照单纯常规、艾灸配合药物外敷对照常规治疗在提高褥疮临床总有效率和缩短痊愈时间有一定优势。
②灸法治疗褥疮的临床证据分析
目前国内尚无灸法治疗褥疮的系统评价/Meta分析,也无相关多中心临床研究文献报道,多从灸法与常规治疗疗效优势比较、灸法配合其他措施增强疗效两方面进行研究。其中灸法与常规治疗比较治疗褥疮的文献6篇,均为RCT、无高质量研究。涉及的灸法包括悬灸和热敏灸；对照的常规治疗包括局部疮面使用抗生素类(百多邦软膏、庆大霉素)、维生素类(维生素C、维生素B1)及654-2混合液涂擦和红外线照射,这些治疗措施或单用或联合应用。研究结果均为灸法治疗褥疮疗效优于常规治疗。
灸法与其他措施配合治疗褥疮的文献研究有21篇,与西医常规清创换药比较的有14篇,涉及综合措施包括悬灸+中药(生肌散、美皮康、湿润烧伤膏、九华膏、生肌玉红膏、烫伤药水、土黄连敷料、紫花烧伤膏)、悬灸+西药(重组人表皮生长因子、康惠尔溃疡贴、碘伏纱块、利福平、红霉素软膏、苯唑西林钠+呋喃西林液+高渗盐水+T D T照射)、悬灸+中西药(湿润烧伤膏+金霉素眼膏)(可参见后附表1)；对照西医常规清创换药包括抗生素类(庆大霉素、呋喃西林、复方磺胺甲恶唑)、维生素类(复合维生素B2)。研究结果均显示灸法配合其他治疗措施治疗褥疮疗效优于西医常规清创换药。2篇RCT为灸法结合清创换药治疗,结果显示与单独清创换药相比,灸法结合清创换药效果更佳。
2.灸法治疗胎位不正的循证医学评价研究
①灸法与常规处理比较治疗胎位不正的Meta分析
纳入5篇合格RCT,共915例受试者。灸法对照膝胸卧位法临床总有效率比较,RR=1.38,95%CI (1.27,1.50), P<0.00001,差异有统计学意义。艾灸至阴穴对照膝胸卧位法纠正胎位不正在提高临床总有效率方面有一定优势。
③灸法治疗胎位不正的循证证据分析
灸法与西医常规比较治疗胎位不正的文献15篇,均为RCT研究、高质量研究偏少。涉及的灸法包括温和灸、生姜外敷等；对照的西医常规为采用胸膝卧位法。研究结果均为灸法治疗胎位不正疗效优于西医常规。1项系统评价/Meta分析显示,有限证据支持灸法治疗胎位不正的有效性,表现在临床胎头倒转成功率方面。
1项RCT比较不同时间的隔姜灸至阴矫正胎位臀先露。结果显示晚上21点到21点30分隔姜灸至阴矫正胎位臀先露优于白天灸疗,结果具有统计学意义。1项RCT显示艾灸三阴交与艾灸至阴治疗胎位不正比较,两组总有效率无统计学差异。
灸法与其他措施配合的研究有11篇,与西药比较的有4篇,涉及综合措施包括艾灸+当归芍药散、艾灸+仰卧抬臀位、艾灸+侧卧位、艾灸+胸膝卧位、艾灸+正胎汤、艾灸+转胎方、艾灸+氦氖激光照射、艾灸+电针、艾灸+按压耳穴；对照组为单纯艾灸至阴穴、西医常规为胸膝卧位。研究结果均显示灸法配合其他刺法灸法治疗胎位不正疗效优于西医常规和单纯艾灸。4篇RCT为灸法结合西药治疗,结果显示与单纯西医常规相比,灸法结合其他措施效果更佳。
结论：
1.灸法独立干预的病症谱是体现灸法自身特点和优势的重要方面。此次研究发现,灸法独立干预的病症谱范围还是比较广的,约占整个针灸病症谱的1／4。位居前列的病症系统有肌肉骨骼系统与结缔组织病症、消化系统病症、泌尿生殖系统病症、神经系统病症等。这与针灸病症谱的高频系统的范围是一致的。不同的是精神和行为障碍的病症较少。文献频次较为集中的病症有痛经、带状疱疹、胎位不正、哮喘、褥疮、失眠、腹泻等。这些病症可能是灸法独立干预的优势病症,值得进一步深入研究。
2.高频病症的循证医学评价研究证明：
1)灸法治疗带状疱疹在临床症状改善方面优于常规西药,止痛效果更佳。不同类型的刺法灸法比较,铺棉灸在治愈率、结痂时间、镇痛效果均优于刺络拔罐；热敏灸在改善患者疼痛、提高临床治愈率、总有效率方面优于针刺拔罐,也优于电针；壮医药线点灸与火针比较尚没有疗效优势。与单用西药相比,灸法结合西药效果更佳。
2)艾灸配合常规治疗或药物外敷在提高褥疮临床总有效率和缩短痊愈时间有一定优势。灸法配合其他治疗措施治疗褥疮疗效优于西医常规清创换药。
3)艾灸至阴穴对照膝胸卧位法纠正胎位不正在提高临床总有效率方面有一定优势。
Objective
This study from the Bibliometrics study moxibustion independent intervention system disease spectrum, and select some representative high-frequency symptoms of herpes zoster, bedsore, abnormal fetal position, using the principle of evidence-based medicine and evidence-based evaluation method, for the treatment of literature and refined to guide clinical practice of evidence information, provide a model for future moxibustion study on evidence-based rating and clinical evidence.
Methods
According to the research method of acupuncture and moxibustion disease spectrum and the literature metrology, comprehensive and systematic retrieval of large document databases at home and abroad, a retrieval strategy effective and reasonable. According to the international classification of diseases and the coding system (ICD-10), the clinical research literatures of qualified, disorders using frequency statistics into the document. Batch process with the document manager to achieve the literature retrieval, screening, classification, into the final, based on modern literature gradually build moxibustion independent intervention disease spectrum. Selecting3representative high frequency conditions of herpes zoster, bedsore, malposition, methods of evidence-based medicine, using "on the quality evaluation method of clinical guidelines recommend acupuncture", with6standards of the international CONSORT22standards and STRICTA, evaluate the quality of strict system. The inclusion of the moxibustion clinical research literature, in turn, type analysis of randomized clinical trials, observational case series and case study, as a system evaluation of\/Meta, randomized controlled trial of homogeneous Meta analysis, analysis software using RevMan5.0.20. Clinical evidence analysis according to the common problems of four types of Moxibustion in clinical, compared the effect of moxibustion and the blank group, placebo group; comparison of curative effect of the moxibustion and conventional therapy, a standard positive control; the comparison of curative effect between different acupuncture moxibustion; comprehensive use of the moxibustion and other measures. Thus, refines every disease moxibustion evidence-based therapy.
Results
1. the literature study included502qualified papers, obtained15kinds of disease system,100kinds of disease, including western medicine disease85, western medicine, Chinese medicine symptoms of5types and10kinds of diseases. The systemic diseases according to the frequency order as follows:infectious and parasitic diseases:a total of8diseases,62articles; respiratory disorder:a total of3diseases,26articles; disorder of the musculoskeletal system and connective tissue:a total of14diseases,57articles; the mental and behavioral disorders:a total of4kinds of disease,22articles; genitourinary system diseases:a total of11diseases,58articles; endocrine, nutritional and metabolic disorders:a total of1diseases,6articles; the skin and subcutaneous tissue disease:a total of4kinds of disease,16articles; pregnancy and puerperal disease:a total of4kinds of disease,24pieces of literature; nervous system disorders:a total of11diseases,38articles; some consequences of injury, poisoning and external causes:a total of4kinds of disease,30articles; digestive system diseases:a total of17diseases,86articles; disorder of blood and hematopoietic system:a total of5diseases,14articles; the circulatory system disease:a total of5diseases,20articles; ocular and adnexal diseases:a total of4diseases,8articles; tumor:a total of5diseases,36articles.
2. Research on evidence-based medicine evaluation of2methods in the treatment of herpes zoster
①Analysis of Meta of moxibustion and Western medicine in the treatment of herpes zoster
The15included qualified RCT study. A total of1167subjects. Comparison of moxibustion and Western medicine, Meta analysis showed that the total clinical efficiency of RR=1.31,95%CI (1.12,1.53), P<0.00001, the difference was statistically significant. The4study pain VAS score of MD=-1.63,95%CI (-2.60, -0.65), P=0.001, the difference was statistically significant. Moxibustion for treatment of herpes zoster is better than the conventional western medicine in the clinical symptoms, analgesic effect.
②Analysis of clinical evidence of Moxibustion in the treatment of herpes zoster
An evaluation system of\/Meta2on2007and2011published in treatment of herpes zoster, the results show the effectiveness of the limited evidence in support of herpes zoster treated by moxibustion, reflected in the improvement of clinical symptoms and cure rate, but because the literatures of low quality, need more high quality evidence from clinical trials to further verify. Effect of moxibustion and conventional western medicine comparison of3RCT comparative study of the efficacy between lamp moxibustion and A Silowe+tramadol+vitamin B1, western medicine including antiviral drugs, vitamins, immunomodulator, results display lamp moxibustion therapeutic advantage in pain, the clinical total effective rate and cure rate are very likely to.1RCT comparative study of the strong effect of medicated thread moxibustion and recombinant human interferon, vitamin and differences, results showed that the medicated thread moxibustion in the total clinical efficiency has advantage of curative effect and cure rate. In addition to the1RCT study were compared and pressing moxibustion moxibustion and aciclovir in aciclovir;+vitamin B1++methylcobalamin methylcobalamin; moxibustion and acyclovir; thermal moxibustion and indomethacin. The results show that the moxibustion and conventional western medicine, may have the advantage of curative effect in different degree.
Comparison of5RCT are different types of needling and moxibustion method. The results showed that cotton moxibustion in the cure rate, analgesic effect, scabby time are better than those of blood-letting puncture and cupping; thermal moxibustion in ameliorating pain of the patients, improve the clinical cure rate, the total efficiency is better than acupuncture cupping, is better than Electroacupuncture; Zhuang medicine medicated thread moxibustion and acupuncture is no advantage of curative effect comparison.
Research of moxibustion and other measures are35, and Western medicine are15, involving the comprehensive measures including cotton moxibustion+by acupuncture round, cotton Moxibustion plus plum-blossom needle, moxibustion, moxibustion medicine pen+EA+acupuncture, thermal moxibustion+acupoint injection; control of Western medicine including antiviral (o famciclovir), vitamins (vitamin B, vitamin B1, vitamin B12), interferon inducer (polyinosinic, with spectral antiviral and immunomodulatory function). The results showed that moxibustion combined with other acupuncture moxibustion for treatment of herpes zoster is superior to Western medicine.5RCT for moxibustion combined with western medicine treatment, results show that compared with simple western medicine, moxibustion combined with western medicine effect.
3. Research on evidence-based medicine evaluation3moxibustion for treatment of bedsore.
①Analysis of Meta of moxibustion and conventional western medicine treatment of bedsore
The18included qualified RCT study. A total of928subjects. Meta analysis showed that the total clinical efficiency of RR=1.28,95%CI (1.15,1.42), P <0.00001, the difference was statistically significant. The average recovery time of MD=-7.036study,95%CI (-8.52,-5.54), P<0.00001. The difference was statistically significant. Moxibustion, moxibustion control infrared radiation control routine, moxibustion combined with medicine conventional therapy in the control improved bedsore total clinical efficiency has certain advantages and shorten the healing time of conventional treatment.
②Analysis of clinical evidence of moxibustion for treatment of bedsore At present there is no domestic evaluation system\/Meta moxibustion treatment of bedsore analysis, no related multi-center clinical research literature reports, from the moxibustion and conventional treatment of moxibustion combined with other measures of comparative advantage, two curative effect research. The moxibustion and conventional therapy in treating bedsore of6references, are RCT, no high quality studies. The moxibustion moxibustion and includes thermal moxibustion; conventional treatment control include the use of antibiotics in local wound (Bactroban ointment, gentamicin), vitamins (vitamin C, vitamin B1) and654-2mixed liquid inunction and infrared radiation, these treatments or single or combined use of. The results are better than the conventional treatment of moxibustion treatment of decubitus ulcer.
Moxibustion with other measures with the literature on treating bedsore of21articles, dressing change compared with the routine debridement and14 articles, involving the comprehensive measures including Moxibustion plus traditional Chinese medicine (born muscle scattered, Mepilex border, moist burn cream, ointment Jiuhua, Shengjiyuhong ointment, scald lotion, coptis root dressing, purple burn ointment), moxibustion plus Western Medicine (recombinant human epidermal growth factor, Comfeel ulcer strap, Hide Sa, rifampicin, erythromycin ointment, oxacillin sodium+Furacilin Solution and hypertonic saline+T D T irradiation), western medicine moxibustion+(MEBO plus oculentum aureomycin)(see attached1); control routine cleaning wound dressing including antibiotics (gentamicin, nitrofurazone, compound sulfamethoxazole), vitamins (vitamin B2). The results showed that moxibustion combined with other therapeutic measures for treating bedsore is better than that of routine debridement dressing.2RCT for moxibustion combined with debridement and dressing treatment, results show that compared with the single debridement dressing, moxibustion combined with debridement and dressing effect.
2. moxibustion for treatment of malposition of the evidence-based medicine evaluation studies
①Analysis of moxibustion and conventional treatment comparison treatment of malposition of the Meta
The5included qualified RCT, a total of915subjects. Moxibustion control knee chest decubitus method the total clinical efficiency comparison, RR=1.38,95%CI (1.27,1.50), P<0.00001, the difference was statistically significant. Moxibustion Zhiyin control has certain advantages knee-chest position method to correct the fetal position is not increasing the total clinical efficiency.
②moxibustion for treatment of malposition of the evidence analysis Moxibustion and conventional western medicine treatment of malposition of the literature of15references, both studies, high quality RCT less. The mild moxibustion, moxibustion including ginger herbs; control of conventional western medicine for the use of knee-chest position method. The results were treated by moxibustion malposition curative effect is better than that of routine western medicine.1system evaluation\/Meta analysis shows, limited effectiveness evidence in support of the moxibustion treatment of malposition of fetal head back, in the clinical success rate.
1RCT comparison of different time of moxibustion with ginger to Yin correction of fetal breech presentation. The results showed21PM to twenty-one thirty separated ginger moxibustion Zhiyin correcting fetal breech presentation is better than daytime moxibustion, the results with statistical significance. Moxibustion Sanyinjiao and moxibustion to Yin in the treatment of malposition of comparison between the1RCT display, the total efficiency of two groups had no statistical difference.
Research of moxibustion and other measures are11, and Western medicine are4, involving the comprehensive measures including Danggui Shaoyao Powder, moxibustion moxibustion++supine carry breech, moxibustion, moxibustion++lateral knee-chest position, moxibustion, moxibustion++positive fetal soup to fetal side, moxibustion plus He-Ne laser irradiation, electroacupuncture, moxibustion moxibustion++press the ear; the control group for the pure moxibustion Zhiyin, routine for the knee-chest position. The results showed that moxibustion combined with other acupuncture moxibustion treatment of malposition of curative effect is better than that of routine western medicine and simple moxibustion.4RCT for moxibustion combined with western medicine treatment, results show that compared with conventional western medicine, moxibustion combined with other measures.
Conclusion
1. independent intervention on disease spectrum is an important aspect of its own characteristics and advantages of moxibustion. The study found that moxibustion independent intervention, disease spectrum range is quite wide, about the whole acupuncture disease spectrum of1/4. In the forefront of the system disorder of musculoskeletal system and connective tissue diseases, disorder of digestive system, genitourinary system diseases, nervous system diseases. The high frequency system acupuncture disease spectrum range is consistent. Different is less symptoms of mental and behavioral disorders. Document frequency is more concentrated disorder dysmenorrhea, herpes zoster, malposition, asthma, bedsore, insomnia, diarrhea etc.. These symptoms may be moxibustion independent intervention advantage condition, it is worth further study.
2. high frequency conditions that study medicine evaluation:
1) moxibustion for treatment of herpes zoster is better than the conventional western medicine in the clinical symptoms, analgesic effect. Comparison of needling and moxibustion method of different types, cotton moxibustion in the cure rate, analgesic effect, scabby time are better than those of blood-letting puncture and cupping; thermal moxibustion in ameliorating pain of the patients, improve the clinical cure rate, the total efficiency is better than acupuncture cupping, is better than Electroacupuncture; Zhuang medicine medicated thread moxibustion and acupuncture is no advantage of curative effect. Compared with simple western medicine, moxibustion combined with western medicine effect.
2) moxibustion combined with conventional therapy or drug in improving the bedsore clinical total effective rate has certain advantages and shorten the healing time. Moxibustion with other therapeutic measures for treating bedsore is better than that of routine debridement dressing.
3) moxibustion Zhiyin control has certain advantages knee-chest position method to correct the fetal position is not increasing the total clinical efficiency.
引文
1.陶晓雁,殷仕洁,毛湄,等.从近10年灸法文献看灸法的特色与优势[J],辽宁中医杂志,2008年第35卷第4期：591-593.
2张仁,刘坚.中国民间奇特灸法[M].上海：上海科技出版社,第1版：2.
3汉·张仲景.伤寒论[M].北京：人民卫生出版社,2005,第1版.
4黄帝内经素问[M].北京：人民卫生出版社,2005,第1版.
5晋·皇甫谧.针灸甲乙经[M].北京：人民卫生出版社,2006,第1版.
6南北朝·陈延之.小品方新辑[M].上海：上海中医学院出版社,1993,第1版.
7晋·葛洪.肘后备急方[M].合肥：安徽科学技术出版社,1983,第1版
8张仁,刘坚.中国民间奇特灸法[M].上海：上海科技出版社,2004,第1版.
9张登本.王熹医学全书[M].北京：中国中医药出版社,2006,第1版.
10元·朱震亨.丹溪心法[M].北京：人民卫生出版社,2005,第1版：328.
11许敬生.罗天益医学全书[M].北京：中国中医药出版社,2006,第1版.
12郭程军.山东艾叶与野艾叶的挥发油比较研究[J].中草药,2001,32(6)：500-503.
131莉,鲁建江,顾承志.微波法测定不同季节艾叶中总挥发油的含量[J].数理医药学杂志,2001,4(3)：287.
14胡世林.中国道地药材论丛[M].第一版,北京：北京中医古籍出版社,1997：23,89,105.
15赵吉平译.艾燃烧生成物的自由基清除作用[J].国外医学2中医中药分册[J],1992,14(3)：60.
16黄秋风译.关于艾的燃烧生成物中含有的抗氧化作用物质[J].国外医学2中医中药分册,1989,11(5)：47.
17刘农虞,张京英,张蕊,等.不同灸质、灸量对动物血中5-羟色胺、组织胺含量的影响[J].中国针灸,1995,25(5)：29-30.
18张英.不同灸治时程对免疫功能的影响[J].中国针灸,1998,18(8)：488-490.
19邓海平,沈雪勇,丁光宏.艾灸与经络穴位红外辐射特性.中国针灸,2004,24(2)：105-108.262Shanghai JAcu-mox, Jan 2009, Vol 28, No 1.
20钱存泽,钱进,白耀辉.近红外仿灸仪的研制与临床应用[J].红外技术,1991,13(6)：27.
21沈雪勇,丁光宏,褚君浩,等.传统艾灸与替代物灸和人体穴位红外辐射光谱比较[J].红外与毫米波学报,2003,22(2)：123-126.
22杨华元,肖元春,刘堂义,等.隔物灸的近红外光谱辐射特性测定[J].上海针灸杂志,2003,22(9)：15.
23谢延,李丽红.艾灸关元、足三里对衰老小鼠免疫功能影响的试验研究[J].贵阳中医学院学报,2003,25(2)：44.
24唐照亮,宋小鸽,侯正明,等.艾灸肾俞延缓衰老的实验研究[J].安徽中医学院学报,1999,18(5)：53.
25高希言,封丽华,李卫红,等.艾灸督脉穴对亚急性衰老小鼠自由基与免疫器官的影响[J].河南中医学院学报,2003,18(5)：22.
26艾双春.电热隔药灸对老年人微量元素的影响[J].针灸临床杂志,2001,17(10)：44-46.
34国务院信息化工作办公室“政府信息资源开发利用政策研究课题组”.加强我国政府信息资源开发利用的若干问题.中国信息界,2005(2)：10-11
35刘雅娟,王岩.用文献计量学评价基础研究的几项指标探讨：论文、引文和期刊影响因子.科研理,2000(1)
36文献计量学方法在科学评价中的应用探讨高俊宽,图书情报知识,2005年4月(104)：14-17
37费宇彤.近10年国际针刺临床文献分析[J].中国中医药信息杂志,2006,13(4).
38杨家,吴丽萍,郭义.2005年SCI源期刊针刺论文总结分析[J].中国针灸,2007,27(4).
39陈文,黄娟,黄爱明,等.2000—2006年《中国针灸》论文质量分析[J].中国针灸,2008,28(1)： 67-68.
40董燕.2007年针刺研究领域文献生产力及文献研究特点分析[J].中国中医药信息,2009,169,
41高靓.2007年SCI源期刊针刺论文分析[J].中国针灸,2009,29(6).
42邓宏勇,许吉.2000—2007年Medline数据库收录针灸文献分析[J].中国针灸,2009,29(2).
43王超,郭义.2008年SCI源期刊发表的针刺文献分析[J].中国针灸,2010,30(9).
44朱黎婷,李凝,夏晨,朱毅.2009年SCI源期刊针刺论文总结分析[J]. 辽宁中医药大学学报,2010,12(9).
45李宁,赵雨,王成伟,李佳,等.2000—2008年针灸治疗中风后肢体痉挛研究的文献计量学分析[J].针灸临床杂志,2009,25(12).
46黄琴峰.针灸治疗便秘临床规律探讨[J].辽宁中医杂志,2009,36(3).
47黄琴峰.针灸治疗不孕症临床规律探讨[J].辽宁中医杂志,2010,37(11).
48黄琴峰.针灸治疗带状疱疹临床规律探讨[J].针灸临床杂志,2010,26(07).
49王成伟,李宁,毛兵考.针灸治疗慢性功能性便秘文献计量学研究与评价[J].华西医学,2010,5(3).
50王京京,王巧妹,孟宏,等.针灸治疗慢性疲劳综合征施治规律探讨[J].中国中医药信息杂志,]2010,17(1).
51李永明.来自东方的针灸热[J].世界周刊,2001,10：16-19.
52扩展针灸治疗现代疾病谱的问题与对策,刘文红,张凯,蒋戈利,邢军,刘玉珍,山东中医杂志2008年7月第27卷第7期：446-448
53杜元灏.现代针灸病谱[M].北京：人民卫生出版社,2008.
54杜元灏,肖延龄.现代针灸临床病谱的初步探讨[J].中国针灸,2002,22(5)：347—350.
55杜元灏,肖延龄.现代针灸临床病谱的初步探讨[J].中国针灸,2002,22(5)：347—350.
56 World Health Organization. Acupuncture:review and analysis of reports on controlled clinical trials [OL]. http://whqibdoc.who.int/public-tion/2002/9241545437.pdf,2008.
57 National Institutes of Health Consensus Panel. Acupuncture:National Institutes of Health Consensus Development Conference Statement [OL]. http://consensus.nih.gov/1997/1997acupuncture107html. htm,2007.
58邹蓓蕾.精神及行为障碍针灸病谱研究[D].天津中医药大学硕士学位论文.
59任辉.泌尿生殖系统针灸病谱的研究[D].天津中医药大学硕士毕业论文,2007.
60王涵.神经系统针灸病谱的研究[D].天津中医药大学硕士毕业论文,2007.
61杜元灏,李桂平,林雪.消化系统针灸病谱的研究[J].针灸临床杂志,200622(3)：1-2.
62范刚启,王玲玲,王启才,等.神经系病针灸临床病谱和治疗方案的优选[J].中国针灸,2003.23(8)：477-479.
63黄琴峰.消化系统针灸疾病谱现代文献计量分析与评价[J].中国针灸,2007.27(10)：769-772.
64齐丽珍,黄琴峰,黄颖，从现代中医期刊透视针灸疾病谱[J].上海针灸杂志,25(11)：46-51.
65费宇彤,杨德强,胡凌娟,等.当代针刺临床优势病种的文献计量学研究[J].中国针灸,2007,27(3)：229-232.
66协和医院世界卫生组织国际疾病分类合作中心编译.疾病和有关健康问题的国际统计分类[M].10版.北京：人民卫生出版社,1996：89-800.
67杜元灏,李晶,孙东炜,等.中国现代针灸病谱的研究[J].中国针灸,2007,27(5)：373-379.
68熊俊,杜元灏,黎波等,现代针灸疾病谱的发展历史与研究现状.辽宁中医杂志2009年第36卷第12期：2155-2157
69郭旭,刘保延,刘志顺,赵宏,循证针灸临床实践指南结构特点及方法学探讨,循证医学2008年4月第8卷第2期：104-108
70梁繁荣,吴曦,李瑛,中国循证针灸学研究现状-5展望,天津中医药2006年12月第23卷第6期：441-444
71刘屹吴滨,刘巍, 何竟等,循证医学与针灸临床防治性研究文献评价,Chinese Acupuncture&Moxibustion, Feb12002, Vol122No12
72白玲,引进5临床证据6的几点思考,科技与出版,2007年第3期：49-50
73郭旭,刘保延,赵宏,循证针灸临床实践指南方法学研究初探,中国循证医学杂志2008,8(3)：203,-205
74 Moher D, Jadad A R, Nichol G, et al. Assessing the quality of randomized controlled trials:an annotated bibliography of scales and checklists[J]. Control Clin Trials,1995, 16(1):62-73.
75 Verhagen A P, de Vet H C, de Bie R A, et al. The Delphi List:a criteria list for quality assessment of randomized clinical trials for conducting systematic re-views developed by Delphi consensus[J]. J Clin Epide- miol,1998,51(12):1235-1241.
76 Jadad A R, Moore R A, Carroll D, et al. Assessing the quality of reports of randomized clinical trials:is blin-ding necessary[J]. Control Clin Trials,1996,17(1):1-12.
77 Begg C, Cho M, Eastwood S, et al. Improving the quality of reporting of randomized controlled trials:the CONSORT statement[J]. JAMA,1996,276(8):637-639.
78李宁,王丹琳,王成伟等,关于针灸医学临床随机对照试验研究的思考,中国针灸,2007年7月第27卷第7期
79刘志顺,刘保延,彭唯娜,等.《循证针灸临床实践指南》文献质量评价标准,中国针灸2009年1月第29卷第1期：81-83
80刘志丹,李海燕,宋毅,等.针灸治疗中风运动功能障碍随机对照临床研究文献系统评价,上海针灸杂志,2008年11月第27卷第11期：38-42
81王凡,张彤, 刘毅,针灸治疗坐骨神经痛的系统评价,世界中医药,2007年11月第2卷第6期：354-355
82高李,蒋振亚,李金存,等.针灸治疗卒中后抑郁RCT的质量分析,上海针灸杂志,2006年3月第25卷第3期：35-37
83王澍欣,洪文等,耳针治疗痤疮临床研究文献质量的调查,中国针灸,2002年12月第22期：847-849
84何竟,黄长琼,刘屹,针灸治疗小儿脑瘫的临床文献质量评价和思考,中国针灸,2002年10月第22卷第10期：704-706
85彭唯娜,赵宏,刘志顺,等.电针治疗血管性痴呆的系统评价,中国针灸2004年5月第24卷第5期：297-301
86王丽平,解越,针灸治疗卒中后吞咽困难的系统评价,中国针灸,2006年2月第26卷第2期：141-146
87罗胜,罗思文,针灸治疗腰椎间盘突出症的系统分析,针灸临床杂志,2005年第21卷第6期：10-14
88徐旭东,吴宇驹,电针对抑郁症治疗效果的Meta分析临床精神医学杂志,2008年第18卷第2期：111-112
89陈文,马维平,俞海虹等,针灸治疗椎-基底动脉供血不足综合征的Meta分析,中国中医药信息杂志,2009年8月第16卷第8期：107-112
90郭佳.对比分析针灸临床研究与国际接轨差距[J].中国针灸,2004,24(1)：3-6.
91廖茄利.不同针灸方法治疗带状疱疹临床观察[D].成都中医药大学,四川,成都.2009.
92李万高.棉花灸治疗带状疱疹30例疗效观察[J].实用中医内科杂志.2007,21(4)：97-98.
93潘慧芬,张志萍.棉花灸治疗带状疱疹33例临床观察[J].中医药导报.2009,15(07)：58-59.
94胥林波,任飞,龙绍疆,等.铺棉灸法治疗带状疱疹疗效观察[J].四川中医.2003,21(08)：82-83.
95钟江,林辰.壮医药线点灸治疗带状疱疹后遗神经痛疗效分析[J].中国民族医药杂志.2008,7(07)：18-19.
96林辰,杨建萍,陈攀.标准化壮医药线点灸治疗疱疹后遗神经痛的疗效及安全性研究[J].河北中医.2011,33(08)：1189,1251.
97王华,任建生.壮医点灸法治疗带状疱疹[J].四川中医.1991,(10)：49.
98林辰,杨建萍,陈攀.壮医药线点灸治疗带状疱疹后遗神经痛及对患者生活质量的影响[J].陕西中医.2011,32(08)：1047-1048.
99胡卡明,王承平.灯草灸治疗带状疱疹的临床报道附：65例病例报告[J].成都中医药大学学报.2000,23(01)：33-34.
100唐植纲,朱姗姗.灯火灸治疗带状疱疹42例临床观察[J].湖南中医杂志.2011,27(03)：34-35.
101林凌峰,赖宏忠,吴仁定.灯芯围灸法治疗带状疱疹的疗效观察[J].中国针灸.2004,S(01)：26-27.
102姜雪原,胡永红.艾灸治疗带状疱疹50例[J].陕西中医.2010,31(08)：1050-1051.
103杨来香.艾条灸治疗带状疱疹后遗神经痛的疗效观察[J].井冈山学院.2009,30(06)：94-97.
104王见良,求晓恩.艾炷灸治疗带状疱疹临床疗效观察[J].浙江中医药大学学报.2010,34(03)：412-404.
105竺炯,郭胜,赖永贤.麦粒灸治疗急性期带状疱疹40例疗效观察[J].上海针灸杂志.2003,22(04)：10-11.
106郑春爱,徐立.艾灸治疗带状疱疹的临床随机对照试验Meta分析[J].针灸临床杂志,2011,27(11)：47-50.
107赵婷,王映辉.针灸治疗带状疱疹随机对照试验的系统评价[J].上海针灸杂志.2007,26(6)：30-34.
108黄瑾明,林辰.壮医药线点灸学[M].南宁：广西民族出版社.2006：169.
109王盟,宋玉华.艾灸法治疗带状疱疹临床观察[J].针灸临床杂志,2009,15(12)：30-31.
110阮永队,魏文著,谢炎烽,等.腧穴热敏化艾灸治疗带状疱疹后遗神经痛临床观察[C].针灸治疗痛症国际学术研讨会论文集,北京,2009.
111梁美爱,段权.热敏灸治疗带状疱疹后遗神经痛临床观察[J].辽宁中医药大学学报.2010,12(6)：186-188.
112陈攀,林辰,杨建萍.药线点灸法与火针法治疗带状疱疹后神经痛的疗效对比分析[J].中华中医药杂志.2012,27(7)：1847-1849.
113刘佳.铺棉灸疗法治疗带状疱疹随机对照试验的临床疗效评价[D].成都中医药大学博士学位论文,成都,2009.
114杨军雄,向开维,张玉学.铺药棉灸法为主治疗带状疱疹：多中心随机对照研究[J].中国针灸.2012,32(5)：417-422.
115李雪薇,左甲,黄卫玲,等.铺棉灸操作规范及在皮肤病中的应用[J].中国针灸.2010,30(3)：218-220.
116岳增辉,何新群,姜京明,等.闪火灸法治疗带状疱疹的临床对照实验研究[C].中国针灸学会经络分会第十届学术会议论文集,2009.
117王晨瑶,方剑乔.变频电针配合改良药笔灸法治疗带状疱疹后遗神经痛[J].针刺研究,2012,27(1)：64-66.
118姜蓉,梁超,姜涛.腧穴热敏灸配合穴位注射治疗带状疱疹后遗神经痛临床观察[J].新中医,2011,43(4)：84-85.
119朱炯,吴怡峰.刺络拔罐配合悬灸治疗带状疱疹疗效观察[J].上海针灸杂志,2007,26(11)：22-25.
120赵东风.壮医药线点灸与针挑疗法联合治疗带状疱疹临床观察[J].辽宁中医药大学学报,2010,12(8)：170-172.
121徐媛.艾灸配合美皮康治疗压疮的临床护理观察[J].中国现代药物应用.2011,19(5)：109-110.
122姚德云.艾灸在褥疮治疗中的作用[J].现代医药卫生.2006,22(23)：3461.
123陆静波.艾灸局部治疗压疮Ⅲ期的疗效观察与护理[J].上海护理.2005,5(3)：28-29.
124朱晓玲.艾灸合生肌散治护中风后褥疮32例临床观察[J].中医药临床杂志.2009,21(6)：551-552.
125郑威,陈旭军.艾灸治疗压疮36例护理体会[J].中外健康文摘.2011,22(8)：357-358.
126代微,张黎.艾灸压疮临床疗效观察[J].现代临床医学.2006,32(2)：128.
127陶艳,胡艳霞,杨文斌.艾条熏灸加红霉素软膏外涂治疗Ⅱ期压疮患者的疗效观察[J].医学信息.2011,24(4)：179-180.
128蒋红梅.土黄连敷料联合艾灸治疗溃疡期压疮的疗效观察[J].护理研究.2012,26(5)：1313-1314.
129管银芳.美宝湿润烧伤膏、金霉素眼膏联合艾灸治疗Ⅰ、Ⅱ度压疮疗效观察[J].临床合理用药.2011,6A(4)：77.
130陈娟娟,唐卫民,谭素萍.生肌玉红膏加艾灸治疗压疮效果观察[J].护理学杂志.2006,21(08)：12-13.
131谭晓慧,王欢.艾灸配合湿润烧伤膏治疗压疮疗效观察及护理体会[J].新疆医科大学学报.2011,34(03)：330-333.杂志
132苏成珍,吴雪,韦素琼,等.紫花烧伤膏加用艾灸治疗Ⅱ～Ⅲ期褥疮疗效观察[J].中国中医急症.2010,19(09)：1506-1507.
133韦香葵.艾条温灸配合外用重组人表皮生长因子治疗褥疮14例[J].内科.2011,6(05)：451-452.
134施翠芬,张翠蓉,王智琴.热敏灸治疗Ⅱ期、Ⅲ期压疮的临床疗效观察[J].护士进修杂志.2012,27(6)：549-551.
135张翠蓉,肖慧华.腧穴热敏化艾灸疗法治疗压疮的疗效观察[J].中华中医药杂志.2010,25(03)：478-479.
136耿芙蓉,王俊.艾灸配合利福平治疗褥疮的效果观察[J].中华实用中西医杂志.2003,3(16)：641.
137林艾玲,王昌荣,于丽瑛.药物加艾灸治疗褥疮的临床观察[J].男方护理杂志.1996,3(2)：7-81.
138武伟,周平,黄启惠.抗生素和高渗盐水外敷联合艾灸、TDT照射治疗褥疮效果[J].泸州医学院学报.2003,26(6)：557-558.
139余晓林.艾灸配合康惠尔溃疡贴治疗与护理压疮16例[J].湖北中医杂志,2010,32(12)：54-55
140林冬梅.艾灸配合碘伏外敷褥疮在社区患者的应用和研究[J].中外医学研究,2011,09(2)：65-66
141温杏良,陈惠冰,昊晓霞,李智.九华膏结合艾灸促进压疮早期愈合疗效观察[J].中医临床研究,2011,03(5)：70-71
142卢爱莲. 碘伏在褥疮疮护理中的应用[J]. 护理学杂志,2000,15(5)： 285-286
143董梅德,赵彦萍,王晓鹏,冯翠萍.湿润烧伤膏结合艾条灸治疗溃疡期压疮临床效果观察[J].新疆中医药,2011,29(5)：22-23
144林艾玲,王昌荣,于丽瑛.药物加艾灸治疗褥疮的临床观察[J].南方护理学报,1996,(2)
145杨运宽,茅敏,胡幼平,等.艾灸至阴穴矫治胎位不正的多中心随机对照临床研究[J].中医杂志.2007,48(12)：1097-1098,1121.
146陈英.艾灸至阴穴治疗胎位不正80例[J].陕西中医.2007,28(03)：334-335.
147杨伟伟,郑雯.艾条温和灸矫正胎位不正126例观察[J].浙江中医药大学学报.2008,32(03)：386,392.
148陈英,杨卫杰,曹晶晶.纯艾条温和灸治疗胎位不正100例[J].光明中医.2010,25(05)：816-817.
149霍瑞霞.氦氖激光照射加纯中药艾灸至阴穴纠正臀先露疗效观察[J].护理研究.2010,24(08)：2015-2016.
150刘迈兰,兰蕾,唐勇,梁繁荣.针灸治疗肩先露的系统评价.中国循证医学杂志,2009,9(8)：840-843.
151王燕.艾条灸至阴矫正胎位不正的验证性研究[D].成都中医药大学,2007
152刘金莲,金玲燕.生姜外敷至阴穴治疗胎位不正的效果观察[J].中外医疗,2007,24：54.
153赖灶金.隔姜灸至阴穴矫正胎位臀先露80例疗效观察[J].新中医,2003,35(8)：59.
154李贺.悬灸三阴交治疗胎位不正临床观察[J].上海针灸杂志,2006,25(12)：11-12.
155庄爱珠.艾灸配合当归芍药散纠正胎位不正80例观察[J].实用中医药杂志,2004,20(2)：61.
156周勇,韩郁翠.艾灸至阴结合仰卧抬臀位纠正胎位不正42例[J].针灸临床杂志,2005,21(8)：41.
157刘辉春,孙桂霞,马先翠.艾灸至阴穴配合侧卧位矫治臀位的临床观察[J].中国社区医师杂志,2001,17(12)：40-41.
158杜艳华,薛爱景.中西医结合纠正胎位不正50例临床观察[J].现代中西医结合杂志,2005,14(20)：2727.
159周萍.正胎汤配合艾灸治疗胎位不正30例[J].山东中医杂志,2010,29(3)：157-158.
160叶东霞.艾灸至阴穴配合转胎方治疗胎位不正100例[J].福建中医药,2004,35(5)：24.
161于霞,李景辉.灸法配合电针治疗胎位不正127例[J],2009,18(4)：54.
162赵斌妹,徐志荣,彭冬梅.灸法加按压耳穴治疗胎位不正60例[J].中国民康医学,2008,20(10)： 1007.
2张仁,刘坚.中国民间奇特灸法[M].上海：上海科技出版社,第1版：2.
3汉·张仲景.伤寒论[M].北京：人民卫生出版社,2005,第1版.
4黄帝内经素问[M].北京：人民卫生出版社,2005,第1版.
5晋·皇甫谧.针灸甲乙经[M].北京：人民卫生出版社,2006,第1版.
6南北朝·陈延之.小品方新辑[M].上海：上海中医学院出版社,1993,第1版.
7晋·葛洪.肘后备急方[M].合肥：安徽科学技术出版社,1983,第1版
8张仁,刘坚.中国民间奇特灸法[M].上海：上海科技出版社,2004,第1版.
9张登本.王熹医学全书[M].北京：中国中医药出版社,2006,第1版.
10元·朱震亨.丹溪心法[M].北京：人民卫生出版社,2005,第1版：328.
11许敬生.罗天益医学全书[M].北京：中国中医药出版社,2006,第1版.
12郭程军.山东艾叶与野艾叶的挥发油比较研究[J].中草药,2001,32(6)：500-503.
131莉,鲁建江,顾承志.微波法测定不同季节艾叶中总挥发油的含量[J].数理医药学杂志,2001,4(3)：287.
14胡世林.中国道地药材论丛[M].第一版,北京：北京中医古籍出版社,1997：23,89,105.
15赵吉平译.艾燃烧生成物的自由基清除作用[J].国外医学2中医中药分册[J],1992,14(3)：60.
16黄秋风译.关于艾的燃烧生成物中含有的抗氧化作用物质[J].国外医学2中医中药分册,1989,11(5)：47.
17刘农虞,张京英,张蕊,等.不同灸质、灸量对动物血中5-羟色胺、组织胺含量的影响[J].中国针灸,1995,25(5)：29-30.
18张英.不同灸治时程对免疫功能的影响[J].中国针灸,1998,18(8)：488-490.
19邓海平,沈雪勇,丁光宏.艾灸与经络穴位红外辐射特性.中国针灸,2004,24(2)：105-108.262Shanghai JAcu-mox, Jan 2009, Vol 28, No 1.
20钱存泽,钱进,白耀辉.近红外仿灸仪的研制与临床应用[J].红外技术,1991,13(6)：27.
21沈雪勇,丁光宏,褚君浩,等.传统艾灸与替代物灸和人体穴位红外辐射光谱比较[J].红外与毫米波学报,2003,22(2)：123-126.
22杨华元,肖元春,刘堂义,等.隔物灸的近红外光谱辐射特性测定[J].上海针灸杂志,2003,22(9)：15.
23谢延,李丽红.艾灸关元、足三里对衰老小鼠免疫功能影响的试验研究[J].贵阳中医学院学报,2003,25(2)：44.
24唐照亮,宋小鸽,侯正明,等.艾灸肾俞延缓衰老的实验研究[J].安徽中医学院学报,1999,18(5)：53.
25高希言,封丽华,李卫红,等.艾灸督脉穴对亚急性衰老小鼠自由基与免疫器官的影响[J].河南中医学院学报,2003,18(5)：22.
26艾双春.电热隔药灸对老年人微量元素的影响[J].针灸临床杂志,2001,17(10)：44-46.
34国务院信息化工作办公室“政府信息资源开发利用政策研究课题组”.加强我国政府信息资源开发利用的若干问题.中国信息界,2005(2)：10-11
35刘雅娟,王岩.用文献计量学评价基础研究的几项指标探讨：论文、引文和期刊影响因子.科研理,2000(1)
36文献计量学方法在科学评价中的应用探讨高俊宽,图书情报知识,2005年4月(104)：14-17
37费宇彤.近10年国际针刺临床文献分析[J].中国中医药信息杂志,2006,13(4).
38杨家,吴丽萍,郭义.2005年SCI源期刊针刺论文总结分析[J].中国针灸,2007,27(4).
39陈文,黄娟,黄爱明,等.2000—2006年《中国针灸》论文质量分析[J].中国针灸,2008,28(1)： 67-68.
40董燕.2007年针刺研究领域文献生产力及文献研究特点分析[J].中国中医药信息,2009,169,
41高靓.2007年SCI源期刊针刺论文分析[J].中国针灸,2009,29(6).
42邓宏勇,许吉.2000—2007年Medline数据库收录针灸文献分析[J].中国针灸,2009,29(2).
43王超,郭义.2008年SCI源期刊发表的针刺文献分析[J].中国针灸,2010,30(9).
44朱黎婷,李凝,夏晨,朱毅.2009年SCI源期刊针刺论文总结分析[J]. 辽宁中医药大学学报,2010,12(9).
45李宁,赵雨,王成伟,李佳,等.2000—2008年针灸治疗中风后肢体痉挛研究的文献计量学分析[J].针灸临床杂志,2009,25(12).
46黄琴峰.针灸治疗便秘临床规律探讨[J].辽宁中医杂志,2009,36(3).
47黄琴峰.针灸治疗不孕症临床规律探讨[J].辽宁中医杂志,2010,37(11).
48黄琴峰.针灸治疗带状疱疹临床规律探讨[J].针灸临床杂志,2010,26(07).
49王成伟,李宁,毛兵考.针灸治疗慢性功能性便秘文献计量学研究与评价[J].华西医学,2010,5(3).
50王京京,王巧妹,孟宏,等.针灸治疗慢性疲劳综合征施治规律探讨[J].中国中医药信息杂志,]2010,17(1).
51李永明.来自东方的针灸热[J].世界周刊,2001,10：16-19.
52扩展针灸治疗现代疾病谱的问题与对策,刘文红,张凯,蒋戈利,邢军,刘玉珍,山东中医杂志2008年7月第27卷第7期：446-448
53杜元灏.现代针灸病谱[M].北京：人民卫生出版社,2008.
54杜元灏,肖延龄.现代针灸临床病谱的初步探讨[J].中国针灸,2002,22(5)：347—350.
55杜元灏,肖延龄.现代针灸临床病谱的初步探讨[J].中国针灸,2002,22(5)：347—350.
56 World Health Organization. Acupuncture:review and analysis of reports on controlled clinical trials [OL]. http://whqibdoc.who.int/public-tion/2002/9241545437.pdf,2008.
57 National Institutes of Health Consensus Panel. Acupuncture:National Institutes of Health Consensus Development Conference Statement [OL]. http://consensus.nih.gov/1997/1997acupuncture107html. htm,2007.
58邹蓓蕾.精神及行为障碍针灸病谱研究[D].天津中医药大学硕士学位论文.
59任辉.泌尿生殖系统针灸病谱的研究[D].天津中医药大学硕士毕业论文,2007.
60王涵.神经系统针灸病谱的研究[D].天津中医药大学硕士毕业论文,2007.
61杜元灏,李桂平,林雪.消化系统针灸病谱的研究[J].针灸临床杂志,200622(3)：1-2.
62范刚启,王玲玲,王启才,等.神经系病针灸临床病谱和治疗方案的优选[J].中国针灸,2003.23(8)：477-479.
63黄琴峰.消化系统针灸疾病谱现代文献计量分析与评价[J].中国针灸,2007.27(10)：769-772.
64齐丽珍,黄琴峰,黄颖，从现代中医期刊透视针灸疾病谱[J].上海针灸杂志,25(11)：46-51.
65费宇彤,杨德强,胡凌娟,等.当代针刺临床优势病种的文献计量学研究[J].中国针灸,2007,27(3)：229-232.
66协和医院世界卫生组织国际疾病分类合作中心编译.疾病和有关健康问题的国际统计分类[M].10版.北京：人民卫生出版社,1996：89-800.
67杜元灏,李晶,孙东炜,等.中国现代针灸病谱的研究[J].中国针灸,2007,27(5)：373-379.
68熊俊,杜元灏,黎波等,现代针灸疾病谱的发展历史与研究现状.辽宁中医杂志2009年第36卷第12期：2155-2157
69郭旭,刘保延,刘志顺,赵宏,循证针灸临床实践指南结构特点及方法学探讨,循证医学2008年4月第8卷第2期：104-108
70梁繁荣,吴曦,李瑛,中国循证针灸学研究现状-5展望,天津中医药2006年12月第23卷第6期：441-444
71刘屹吴滨,刘巍, 何竟等,循证医学与针灸临床防治性研究文献评价,Chinese Acupuncture&Moxibustion, Feb12002, Vol122No12
72白玲,引进5临床证据6的几点思考,科技与出版,2007年第3期：49-50
73郭旭,刘保延,赵宏,循证针灸临床实践指南方法学研究初探,中国循证医学杂志2008,8(3)：203,-205
74 Moher D, Jadad A R, Nichol G, et al. Assessing the quality of randomized controlled trials:an annotated bibliography of scales and checklists[J]. Control Clin Trials,1995, 16(1):62-73.
75 Verhagen A P, de Vet H C, de Bie R A, et al. The Delphi List:a criteria list for quality assessment of randomized clinical trials for conducting systematic re-views developed by Delphi consensus[J]. J Clin Epide- miol,1998,51(12):1235-1241.
76 Jadad A R, Moore R A, Carroll D, et al. Assessing the quality of reports of randomized clinical trials:is blin-ding necessary[J]. Control Clin Trials,1996,17(1):1-12.
77 Begg C, Cho M, Eastwood S, et al. Improving the quality of reporting of randomized controlled trials:the CONSORT statement[J]. JAMA,1996,276(8):637-639.
78李宁,王丹琳,王成伟等,关于针灸医学临床随机对照试验研究的思考,中国针灸,2007年7月第27卷第7期
79刘志顺,刘保延,彭唯娜,等.《循证针灸临床实践指南》文献质量评价标准,中国针灸2009年1月第29卷第1期：81-83
80刘志丹,李海燕,宋毅,等.针灸治疗中风运动功能障碍随机对照临床研究文献系统评价,上海针灸杂志,2008年11月第27卷第11期：38-42
81王凡,张彤, 刘毅,针灸治疗坐骨神经痛的系统评价,世界中医药,2007年11月第2卷第6期：354-355
82高李,蒋振亚,李金存,等.针灸治疗卒中后抑郁RCT的质量分析,上海针灸杂志,2006年3月第25卷第3期：35-37
83王澍欣,洪文等,耳针治疗痤疮临床研究文献质量的调查,中国针灸,2002年12月第22期：847-849
84何竟,黄长琼,刘屹,针灸治疗小儿脑瘫的临床文献质量评价和思考,中国针灸,2002年10月第22卷第10期：704-706
85彭唯娜,赵宏,刘志顺,等.电针治疗血管性痴呆的系统评价,中国针灸2004年5月第24卷第5期：297-301
86王丽平,解越,针灸治疗卒中后吞咽困难的系统评价,中国针灸,2006年2月第26卷第2期：141-146
87罗胜,罗思文,针灸治疗腰椎间盘突出症的系统分析,针灸临床杂志,2005年第21卷第6期：10-14
88徐旭东,吴宇驹,电针对抑郁症治疗效果的Meta分析临床精神医学杂志,2008年第18卷第2期：111-112
89陈文,马维平,俞海虹等,针灸治疗椎-基底动脉供血不足综合征的Meta分析,中国中医药信息杂志,2009年8月第16卷第8期：107-112
90郭佳.对比分析针灸临床研究与国际接轨差距[J].中国针灸,2004,24(1)：3-6.
91廖茄利.不同针灸方法治疗带状疱疹临床观察[D].成都中医药大学,四川,成都.2009.
92李万高.棉花灸治疗带状疱疹30例疗效观察[J].实用中医内科杂志.2007,21(4)：97-98.
93潘慧芬,张志萍.棉花灸治疗带状疱疹33例临床观察[J].中医药导报.2009,15(07)：58-59.
94胥林波,任飞,龙绍疆,等.铺棉灸法治疗带状疱疹疗效观察[J].四川中医.2003,21(08)：82-83.
95钟江,林辰.壮医药线点灸治疗带状疱疹后遗神经痛疗效分析[J].中国民族医药杂志.2008,7(07)：18-19.
96林辰,杨建萍,陈攀.标准化壮医药线点灸治疗疱疹后遗神经痛的疗效及安全性研究[J].河北中医.2011,33(08)：1189,1251.
97王华,任建生.壮医点灸法治疗带状疱疹[J].四川中医.1991,(10)：49.
98林辰,杨建萍,陈攀.壮医药线点灸治疗带状疱疹后遗神经痛及对患者生活质量的影响[J].陕西中医.2011,32(08)：1047-1048.
99胡卡明,王承平.灯草灸治疗带状疱疹的临床报道附：65例病例报告[J].成都中医药大学学报.2000,23(01)：33-34.
100唐植纲,朱姗姗.灯火灸治疗带状疱疹42例临床观察[J].湖南中医杂志.2011,27(03)：34-35.
101林凌峰,赖宏忠,吴仁定.灯芯围灸法治疗带状疱疹的疗效观察[J].中国针灸.2004,S(01)：26-27.
102姜雪原,胡永红.艾灸治疗带状疱疹50例[J].陕西中医.2010,31(08)：1050-1051.
103杨来香.艾条灸治疗带状疱疹后遗神经痛的疗效观察[J].井冈山学院.2009,30(06)：94-97.
104王见良,求晓恩.艾炷灸治疗带状疱疹临床疗效观察[J].浙江中医药大学学报.2010,34(03)：412-404.
105竺炯,郭胜,赖永贤.麦粒灸治疗急性期带状疱疹40例疗效观察[J].上海针灸杂志.2003,22(04)：10-11.
106郑春爱,徐立.艾灸治疗带状疱疹的临床随机对照试验Meta分析[J].针灸临床杂志,2011,27(11)：47-50.
107赵婷,王映辉.针灸治疗带状疱疹随机对照试验的系统评价[J].上海针灸杂志.2007,26(6)：30-34.
108黄瑾明,林辰.壮医药线点灸学[M].南宁：广西民族出版社.2006：169.
109王盟,宋玉华.艾灸法治疗带状疱疹临床观察[J].针灸临床杂志,2009,15(12)：30-31.
110阮永队,魏文著,谢炎烽,等.腧穴热敏化艾灸治疗带状疱疹后遗神经痛临床观察[C].针灸治疗痛症国际学术研讨会论文集,北京,2009.
111梁美爱,段权.热敏灸治疗带状疱疹后遗神经痛临床观察[J].辽宁中医药大学学报.2010,12(6)：186-188.
112陈攀,林辰,杨建萍.药线点灸法与火针法治疗带状疱疹后神经痛的疗效对比分析[J].中华中医药杂志.2012,27(7)：1847-1849.
113刘佳.铺棉灸疗法治疗带状疱疹随机对照试验的临床疗效评价[D].成都中医药大学博士学位论文,成都,2009.
114杨军雄,向开维,张玉学.铺药棉灸法为主治疗带状疱疹：多中心随机对照研究[J].中国针灸.2012,32(5)：417-422.
115李雪薇,左甲,黄卫玲,等.铺棉灸操作规范及在皮肤病中的应用[J].中国针灸.2010,30(3)：218-220.
116岳增辉,何新群,姜京明,等.闪火灸法治疗带状疱疹的临床对照实验研究[C].中国针灸学会经络分会第十届学术会议论文集,2009.
117王晨瑶,方剑乔.变频电针配合改良药笔灸法治疗带状疱疹后遗神经痛[J].针刺研究,2012,27(1)：64-66.
118姜蓉,梁超,姜涛.腧穴热敏灸配合穴位注射治疗带状疱疹后遗神经痛临床观察[J].新中医,2011,43(4)：84-85.
119朱炯,吴怡峰.刺络拔罐配合悬灸治疗带状疱疹疗效观察[J].上海针灸杂志,2007,26(11)：22-25.
120赵东风.壮医药线点灸与针挑疗法联合治疗带状疱疹临床观察[J].辽宁中医药大学学报,2010,12(8)：170-172.
121徐媛.艾灸配合美皮康治疗压疮的临床护理观察[J].中国现代药物应用.2011,19(5)：109-110.
122姚德云.艾灸在褥疮治疗中的作用[J].现代医药卫生.2006,22(23)：3461.
123陆静波.艾灸局部治疗压疮Ⅲ期的疗效观察与护理[J].上海护理.2005,5(3)：28-29.
124朱晓玲.艾灸合生肌散治护中风后褥疮32例临床观察[J].中医药临床杂志.2009,21(6)：551-552.
125郑威,陈旭军.艾灸治疗压疮36例护理体会[J].中外健康文摘.2011,22(8)：357-358.
126代微,张黎.艾灸压疮临床疗效观察[J].现代临床医学.2006,32(2)：128.
127陶艳,胡艳霞,杨文斌.艾条熏灸加红霉素软膏外涂治疗Ⅱ期压疮患者的疗效观察[J].医学信息.2011,24(4)：179-180.
128蒋红梅.土黄连敷料联合艾灸治疗溃疡期压疮的疗效观察[J].护理研究.2012,26(5)：1313-1314.
129管银芳.美宝湿润烧伤膏、金霉素眼膏联合艾灸治疗Ⅰ、Ⅱ度压疮疗效观察[J].临床合理用药.2011,6A(4)：77.
130陈娟娟,唐卫民,谭素萍.生肌玉红膏加艾灸治疗压疮效果观察[J].护理学杂志.2006,21(08)：12-13.
131谭晓慧,王欢.艾灸配合湿润烧伤膏治疗压疮疗效观察及护理体会[J].新疆医科大学学报.2011,34(03)：330-333.杂志
132苏成珍,吴雪,韦素琼,等.紫花烧伤膏加用艾灸治疗Ⅱ～Ⅲ期褥疮疗效观察[J].中国中医急症.2010,19(09)：1506-1507.
133韦香葵.艾条温灸配合外用重组人表皮生长因子治疗褥疮14例[J].内科.2011,6(05)：451-452.
134施翠芬,张翠蓉,王智琴.热敏灸治疗Ⅱ期、Ⅲ期压疮的临床疗效观察[J].护士进修杂志.2012,27(6)：549-551.
135张翠蓉,肖慧华.腧穴热敏化艾灸疗法治疗压疮的疗效观察[J].中华中医药杂志.2010,25(03)：478-479.
136耿芙蓉,王俊.艾灸配合利福平治疗褥疮的效果观察[J].中华实用中西医杂志.2003,3(16)：641.
137林艾玲,王昌荣,于丽瑛.药物加艾灸治疗褥疮的临床观察[J].男方护理杂志.1996,3(2)：7-81.
138武伟,周平,黄启惠.抗生素和高渗盐水外敷联合艾灸、TDT照射治疗褥疮效果[J].泸州医学院学报.2003,26(6)：557-558.
139余晓林.艾灸配合康惠尔溃疡贴治疗与护理压疮16例[J].湖北中医杂志,2010,32(12)：54-55
140林冬梅.艾灸配合碘伏外敷褥疮在社区患者的应用和研究[J].中外医学研究,2011,09(2)：65-66
141温杏良,陈惠冰,昊晓霞,李智.九华膏结合艾灸促进压疮早期愈合疗效观察[J].中医临床研究,2011,03(5)：70-71
142卢爱莲. 碘伏在褥疮疮护理中的应用[J]. 护理学杂志,2000,15(5)： 285-286
143董梅德,赵彦萍,王晓鹏,冯翠萍.湿润烧伤膏结合艾条灸治疗溃疡期压疮临床效果观察[J].新疆中医药,2011,29(5)：22-23
144林艾玲,王昌荣,于丽瑛.药物加艾灸治疗褥疮的临床观察[J].南方护理学报,1996,(2)
145杨运宽,茅敏,胡幼平,等.艾灸至阴穴矫治胎位不正的多中心随机对照临床研究[J].中医杂志.2007,48(12)：1097-1098,1121.
146陈英.艾灸至阴穴治疗胎位不正80例[J].陕西中医.2007,28(03)：334-335.
147杨伟伟,郑雯.艾条温和灸矫正胎位不正126例观察[J].浙江中医药大学学报.2008,32(03)：386,392.
148陈英,杨卫杰,曹晶晶.纯艾条温和灸治疗胎位不正100例[J].光明中医.2010,25(05)：816-817.
149霍瑞霞.氦氖激光照射加纯中药艾灸至阴穴纠正臀先露疗效观察[J].护理研究.2010,24(08)：2015-2016.
150刘迈兰,兰蕾,唐勇,梁繁荣.针灸治疗肩先露的系统评价.中国循证医学杂志,2009,9(8)：840-843.
151王燕.艾条灸至阴矫正胎位不正的验证性研究[D].成都中医药大学,2007
152刘金莲,金玲燕.生姜外敷至阴穴治疗胎位不正的效果观察[J].中外医疗,2007,24：54.
153赖灶金.隔姜灸至阴穴矫正胎位臀先露80例疗效观察[J].新中医,2003,35(8)：59.
154李贺.悬灸三阴交治疗胎位不正临床观察[J].上海针灸杂志,2006,25(12)：11-12.
155庄爱珠.艾灸配合当归芍药散纠正胎位不正80例观察[J].实用中医药杂志,2004,20(2)：61.
156周勇,韩郁翠.艾灸至阴结合仰卧抬臀位纠正胎位不正42例[J].针灸临床杂志,2005,21(8)：41.
157刘辉春,孙桂霞,马先翠.艾灸至阴穴配合侧卧位矫治臀位的临床观察[J].中国社区医师杂志,2001,17(12)：40-41.
158杜艳华,薛爱景.中西医结合纠正胎位不正50例临床观察[J].现代中西医结合杂志,2005,14(20)：2727.
159周萍.正胎汤配合艾灸治疗胎位不正30例[J].山东中医杂志,2010,29(3)：157-158.
160叶东霞.艾灸至阴穴配合转胎方治疗胎位不正100例[J].福建中医药,2004,35(5)：24.
161于霞,李景辉.灸法配合电针治疗胎位不正127例[J],2009,18(4)：54.
162赵斌妹,徐志荣,彭冬梅.灸法加按压耳穴治疗胎位不正60例[J].中国民康医学,2008,20(10)： 1007.