針灸治療皮膚病的實證與臨床進展

針灸療法可直達病所來治療皮膚病，能疏通人體經絡、改善局部血液循環，且成本較低，副作用反應小，易於被患者接受。為了評價針灸治療皮膚病症的臨床療效，期望為實證等級針灸病譜的劃分提供客觀依據，我們第一步驟是先選擇20世紀具有代表性的五部針灸臨床著作和世界衛生組織出版的針灸治療43種病，共6部文獻，通過統計、分析、歸納，初步得知，針灸能治療394個病症，有72種病症在6部文獻的一半以上有共同報導，這些病症基本上代表了現代針灸臨床較為常見並有較好療效的病譜。其中，皮膚科病症包含蕁麻疹、濕疹、白癬、面部尋常痤瘡、膿泡疹、風疹、汗皰疹、頑癬、皮膚瘙癢症、帶狀皰疹、神經性皮炎、斑禿、牛皮癬、神經性脫髮、白癜風，共計16個病症。其中，皮膚病被記錄在以上書本中出現的次數，分別是蕁麻疹4次，帶狀疤疹與神經性皮炎各3次。這些病症出現次數基本上代表了現代針灸臨床較為常見並有較好療效的病譜。第二步驟是尋找先前已經從PubMed、Ovid、Cochrance圖書館、EM Base、中國生物醫學文獻資料庫、中國知網、維普全文期刊資料庫、萬方資料庫等為檢索源，全面收集針灸治療皮膚病症臨床試驗文獻，對符合納入標準的文獻已經有進行Meta分析，從其中找出針灸治療皮膚病已經有比較可靠的實證醫學證據的病種，然後再去蒐集整理各種針灸療法治療該類皮膚病的文獻。本文共整理出尋常性痤瘡、蕁麻疹、濕疹、黃褐斑、帶狀疱疹、銀屑病、神經性皮炎總共七個病種，簡介各種針灸手段有效治療上述皮膚病的步驟。整理文獻過程也發現，對於治療皮膚病機轉研究比較少。目前的臨床研究仍對於病源樣本與臨床療效沒有統一的評價標準，同時也需要較大樣本及多中心的研究，如此才有益於肯定針灸治療皮膚病的療效。

關鍵字

針灸；皮膚病；尋常性痤瘡；蕁麻疹；濕疹；黃褐斑；帶狀疱疹；銀屑病；神經性皮炎

並列摘要

Acupuncture and moxibustion therapy can treat skin diseases directly at the disease site, dredge the body's meridians, improve local blood circulation, and has low cost, small side effects, and is easy to be accepted by patients. In order to evaluate the clinical efficacy of acupuncture and moxibustion in the treatment of skin diseases, we hope to provide an objective basis for the classification of empirical grades of acupuncture and moxibustion disease spectrum. Our first step is to select five representative acupuncture clinical works in the 20th century and acupuncture treatment of 43 diseases published by the World Health Organization, There are a total of 6 literatures on various diseases. Through statistics, analysis and summarization, it is preliminarily learned that acupuncture can treat 394 diseases, and 72 diseases are commonly reported in more than half of the 6 literatures. These diseases basically represent the comparatively modern clinical practice of acupuncture and moxibustion. It is common and has good curative effect. Among them, dermatological diseases include urticaria, eczema, white ringworm, facial acne vulgaris, pustular rash, rubella, herpes rash, stubborn ringworm, pruritus, herpes zoster, neurodermatitis, alopecia areata, psoriasis, and neuropathic alopecia , Vitiligo, a total of 16 symptoms. Among them, the number of occurrences of skin diseases recorded in the above books are 4 times for urticaria, 3 times for rash zoster and 3 times for neurodermatitis. The frequency of occurrence of these diseases basically represents the more common clinical acupuncture and moxibustion spectrum with better curative effect. The second step is to search for a comprehensive collection of acupuncture and moxibustion treatments from PubMed, Ovid, Cochrance Library, EM Base, Chinese Biomedical Literature Database, CNKI, Weipu Full-text Journal Database, Wanfang Database, etc. as search sources. Clinical trial literature for diseases, Meta-analysis has been performed on the literature that meets the inclusion criteria to find out the disease types for which acupuncture treatment of skin diseases has more reliable empirical medical evidence, and then collect and sort out various acupuncture therapies to treat this type of skin Disease literature. This article sorts out a total of seven diseases including acne vulgaris, urticaria, eczema, chloasma, herpes zoster, psoriasis, and neurodermatitis, and introduces the steps of various acupuncture methods to effectively treat the above-mentioned skin diseases. The process of sorting out the literature also found that there are relatively few studies on the treatment of skin disease mechanisms. The current clinical research still does not have a unified evaluation standard for the source of the disease and the clinical efficacy. At the same time, a larger sample and multi-center research are needed to confirm the efficacy of acupuncture and moxibustion in the treatment of skin diseases.