【摘要】 目的:构建针灸治疗痉挛性斜颈（spasmodic torticollis, ST）的取穴方案。方法:采用文献研究和临床调研的方法构建针灸治疗ST的取穴方案条目池，采用德尔菲法确立针灸治疗ST的取穴方案。结果:共遴选出42名专家。通过文献研究并结合临床调研，最终形成针灸治疗ST的取穴方案条目池，包括一级条目6项，二级条目21项。第1轮调查发放42份问卷，收回42份，专家积极系数为100%,专家权威系数为0.87,专家协调系数为0.23;共筛选出5种针灸疗法（毫针刺法、电针疗法、艾条灸法、温针灸疗法、头针疗法）和20项针灸疗法取穴方案。将不符合纳入标准的条目和专家建议修改或补充的条目纳入第2轮专家调查。第2轮调查发放42份问卷，收回42份，专家积极系数为100%,专家权威系数为0.92,专家协调系数为0.28。经过2轮的问卷调查后无专家提出修改意见，最终形成针灸治疗ST的取穴方案。结论:针灸治疗ST的方法主要包括毫针刺法、电针疗法、艾条灸法、温针灸疗法和头针疗法，其整体取穴方案遵循“局部取穴为主，远端取穴为辅”的原则。毫针刺法主穴选用百会、水沟、风池、天柱、合谷和太冲，通过辨经配穴与辨证配穴相结合，辅以经验取穴进行个性化配伍；电针疗法侧重刺激颈部痉挛肌群的起止点，主穴选取大椎、风池、颈夹脊（C₄～C₆）、合谷、太冲等；艾条灸法采用雀啄灸、温和灸、回旋灸等手法，主灸风池、扶突等穴位；温针灸疗法则在大椎、颈臂等主穴的基础上，根据证型加列缺、筋缩等穴位；头针疗法选取百会穴及情感区、运动区等头部特定刺激区。更多还原

【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 of0.28.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.更多还原