基于数据挖掘的针刺治疗阿尔茨海默病选穴规律

Acupoint Selection Law of Acupuncture Therapy for Alzheimer’s Disease Based on Data Mining

目的分析针刺治疗阿尔茨海默病(AD)高质量文献的选穴规律。方法检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library、Embase建库至2023年10月1日针刺治疗AD的随机对照试验文献,用改良Jadad评分量表筛选,纳入高质量文献,使用Excel2010软件统计腧穴频次、部位、归经及高频腧穴,用SPSS Modeler 18.0、SPSS20.0软件进行关联规则、复杂网络及聚类分析。结果共纳入文献71篇、处方79条,涉及腧穴93个,总频次为483次,出现频次前3位的取穴部位为头面部、下肢、背部,归经前3位为督脉、胆经、胃经;高频腧穴21个,前5位为百会、四神聪、足三里、神庭、太溪,常取下肢、头面部、上肢腧穴,腧穴常位于督脉、胆经、胃经、膀胱经,亦包含经外奇穴。关联规则分析得到4组腧穴:大椎→百会、悬钟+四神聪→百会、太溪+四神聪→百会、足三里+四神聪→百会;关联度前3位的腧穴组合为百会-四神聪、百会-足三里、百会-太溪;腧穴共聚为6类。结论针刺治疗AD以头脑部与下肢远近配穴为主,取穴首选督脉及足三阳经,以生髓健脑、通督畅神为主,数据挖掘得到新处方神庭-风府-足三里-四神聪-百会,功在调理养血、交通心肾。

Objective To explore in literature of high quality on acupoint selection law in treating Alzheimer’s disease(AD).Methods Literature about randomly controlled trials(RCTs)about acupuncture for the treatment of AD was retrieved from CNKI,VIP,CBM,WanFang,PubMed,Cochrane Library and Embase from the establishment of the databases to October 1,2023.The literature was screened using an improved Jadad scoring scale to incorporate high-quality literature.Excel 2010 software was used to statistically analyze the frequency,location,meridian distribution,and high-frequency acupoints.SPSS Modeler 18.0 and SPSS 20.0 software were used to perform association rules,complex networks,and clustering analysis.Results Totally 71 articles were included,involving 79 acupoint prescriptions and 93 acupoints,with a total frequency of 483 times.The total occurrence frequency of the head and face,lower limbs and back ranked the top 3.21 high-frequency acupoints were obtained,the frequency of use of Baihui,Sishencong,Zusanli,Shenting and Taixi ranked the top 5,and the acupoints selected mainly located at lower limbs,head and face and upper limbs.The acupoints were mainly located at Governor Vessel,gallbladder meridian,stomach meridian,and bladder meridian.Association rule analysis revealed four groups of acupoints:Dazhui→Baihui,Xuanzhong+Sishencong→Baihui,Taixi+Sishencong→Baihui,Zusanli+Sishencong→Baihui;complex network analysis revealed that the top three acupoint combinations with high correlation were Baihui-Sishencong,Baihui-Zusanli,and Baihui-Taixi;acupoints were clustered into 6 categories.Conclusion Acupuncture treatment for AD mainly involves the combination of acupoints in the head,brain,and lower limbs.The preferred acupoints for selection are the Governor Vessel and the Foot Three Yang meridian,with the main focus on promoting bone marrow,strengthening the brain,and promoting the smooth flow of the Conception Vessel.Data mining has revealed a new prescription of Shenting-Fengfu-Zusanli-Sishencong-Baihui,which is used for regulating and nourishing blood,as well as communicating with the heart and kidneys.