基于复杂网络分析针灸治疗带状疱疹后遗神经痛的应用特点

Application Characteristics of Acupuncture and Moxibustion in the Treatment of Postherpetic Neuralgia Based on Complex Network Analysis

目的利用复杂网络分析针灸治疗带状疱疹后遗神经痛(PHN)的应用特点,为临床针灸治疗提供选穴、刺灸法应用依据和治疗思路。方法检索中国知网(CNKI)、万方数据知识服务平台(万方数据)、维普中文期刊服务平台(VIP)、PubMed、WebofScience收录的针灸治疗PHN临床研究文献。根据纳入、排除标准筛选文献,通过Excel2019建立针灸治疗PHN数据库,运用SPSSModeler18.0软件建模,进行关联规则分析,利用Gephi0.10.1软件进行复杂网络分析。结果共纳入237篇文献,提取262条针灸处方数据,涉及115个腧穴,总使用频次为1432,使用频次前10位腧穴分别为阿是穴(214次)、夹脊穴(198次)、足三里(74次)、太冲(74次)、三阴交(66次)、合谷(65次)、阳陵泉(62次)、血海(60次)、支沟(53次)、曲池(52次)。关联规则分析显示,相关性最高的腧穴组合为阿是穴-夹脊穴。腧穴处方复杂网络k-core层次分析和社团分析最终得到2个核心腧穴群。疗法分析显示,毫针针刺为针灸治疗PHN最常用的干预措施;证型-腧穴分析显示,PHN频次最高的证型为肝经郁热、瘀血阻络与脾经湿热;补泻-腧穴分析显示,操作手法以平补平泻为主。结论针灸治疗PHN以局部取穴为主,常选用阿是穴、夹脊穴,注重与远端腧穴的配合,多根据不同证型取其表里经的配穴,采用平补平泻手法进行操作,常用毫针针刺配合电针、刺络拔罐等疗法,可为针灸治疗PHN提供临床参考。

Objective To analyze the application characteristics of acupuncture and moxibustion in the treatment of postherpetic neuralgia(PHN)using complex networks;To provide clinical acupuncture and moxibustion treatment with application basis for acupoint selection,acupuncture and moxibustion,and treatment ideas.Methods The clinical research literature on acupuncture and moxibustion treatment for PHN was retrieved from CNKI,Wanfang Data,VIP,PubMed and Web of Science.The literature was screened according to the inclusion and exclusion criteria,and Excel 2019 was used to establish an acupuncture and moxibustion treatment PHN database.SPSS Modeler 18.0 software was used for modeling and association rule analysis,and Gephi 0.10.1 software was used for complex network analysis.Results Totally 237 articles were included,and 262 acupuncture and moxibustion prescriptions data were extracted,involving a total of 115 acupoints,with a total use frequency of 1432 times.The top 10 most frequently used acupoints were Ashi acupoint(214 times)and Jiaji acupoint(198 times),Zusanli(74 times),Taichong(74 times),Sanyinjiao(66 times),Hegu(65 times),Yanglingquan(62 times),Xuehai(60 times),Zhigou(53 times),and Quchi(52 times).The association rule analysis showed that the acupoint combination with the highest correlation was Ashi acupoint-Jiaji acupoint.K-core hierarchical analysis and community analysis on the complex network of the acupoint prescriptions obtained two core acupoint groups.Therapy analysis showed that filiform needle acupuncture was the most commonly used intervention for acupuncture treatment of PHN;syndrome type-acupoint analysis showed that the syndrome types with the highest frequency of PHN were liver meridian heat stagnation,blood stasis and collaterals obstruction,and spleen meridian damp-heat;tonic and diarrhea-acupoint analysis showed that the main operating techniques were neutral-tonifying and neutral-discharging.Conclusion Acupuncture and moxibustion treatment for PHN mainly selects local acupoints,Ashi acupoint and Jiaji acupoint are often selected,and focusing on the cooperation with distal acupoints.The external and internal meridians are mostly selected according to different syndrome types.The operation is performed using neutral-tonifying and neutral-discharging techniques.Commonly used filiform acupuncture combined with electro-acupuncture,pricking,cupping and other therapies.The application characteristics can provide clinical reference for the treatment of PHN.