基于复杂网络分析的针刺治疗围绝经期抑郁症腧穴配伍规律探讨

Compatibility Law of Acupoints for Acupuncture Treating Perimenopausal Depressive Disorder Based on Complex Network Analysis

目的运用复杂网络技术探析针刺治疗围绝经期抑郁症不同处方的腧穴配伍规律。方法检索中国知网(CNKI)、维普期刊数据库(VIP)、万方数据库(WF)、中国生物医学文献数据库(CBM)、PubMed数据库截至2020年1月14日公开发表的针灸治疗抑郁症的临床研究文献,按照预先制定的纳入排除标准进行筛选,建立针灸治疗围绝经期抑郁症的处方数据库,采用IBM SPSS MODLDER对数据行关联规则分析,后利用Gephi软件对复杂网络示意图进行分析展示。结果现代针刺治疗围绝经期抑郁症,配穴方法以局远配穴为主,最常取膀胱经、任脉和督脉腧穴,特定穴中背俞穴、五腧穴和募穴为常用。复杂网络分析发现其核心腧穴为百会、印堂、三阴交、太冲、心俞、肝俞、肾俞、内关、合谷、神门、太溪、足三里、四神聪;关联规则分析表明针刺治疗围绝经期抑郁症的核心腧穴组合为五组,即百会-印堂、百会-三阴交-太冲、太冲-合谷、百会-内关和心俞-肝俞-肾俞,其配伍规律与围绝经期抑郁症肾虚肝郁、肝郁气滞、心肾不交、心神不宁和肝郁脾虚的常见证型相一致。结论针刺治疗围绝经期抑郁症配穴明显多于单穴使用,以局远配穴为主,核心腧穴组合可作为不同证型的核心处方应用,体现了中医辨证论治的基本原则。

Objective To explore the compatibility law of acupoints in modern acupuncture treatment of perimenopausal depressive disorder by using complex network technology.Methods The clinical research literature on acupuncture treatment of depression published on CNKI,VIP,WF,CBM and PubMed were selected from the establishment time to January 14,2020.According to the pre-established inclusion and exclusion criteria,a database of acupuncture prescriptions for perimenopausal depressive disorder was established.The IBM SPSS MODLDER database was used for the association rules,and then Gephi software was used for complex network diagram.Results In the clinical study of modern acupuncture in the treatment of perimenopausal depressive disorder,the acupoints on the bladder meridian,Ren and Du meridians were most commonly used,and the specific acupoints back Shu points,five Shu points and front-Mu points were commonly used.According to the analysis of complex network,it was found that Baihui(DU20),Yintang(EX-HN3),Sanyinjiao(SP6),Taichong(LR3),Xinshu(BL15),Ganshu(BL18),Shenshu(BL16),Neiguan(PC6),Hegu(LI4),Shenmen(HT7),Taixi(KI3),Zusanli(ST36)and Sishencong(EX-HN1)were the core acupoints.The analysis of association rules showed that the core acupoint combination of acupuncture in the treatment of peri-menopausal depression can be divided into five groups,including Baihui(DU20)-Yintang(EX-HN3),Baihui(DU20)-Sanyinjiao(SP6)-Taichong(LR3),Taichong(LR3)-Hegu(LI4),Baihui(DU20)-Neiguan(PC6)and Xinshu(BL15)-Ganshu(BL18)-Shenshu(BL16).The compatibility rule was consistent with the common syndrome of perimenopausal depressive disorder,such as kidney deficiency and liver stagnation,liver Qi stagnation,disharmony between heart and kidney,upsetting and stagnation of liver Qi and spleen deficiency.Conclusion The core acupoint combination of acupuncture in the treatment of perimenopausal depressive disorder can be used as the core prescription of different syndrome types,which embodies the basic principle of syndrome differentiation and treatment of traditional Chinese medicine.