基于数据挖掘的针灸治疗溃疡性结肠炎的诊疗现状与特点

Current status and characteristics of acupuncture and moxibustion in the treatment of ulcerative colitis: a study based on data mining

目的:讨论针灸治疗溃疡性结肠炎(UC)的诊疗现状与特点,为临床治疗提供参考依据。方法:采用计算机数据挖掘技术,在检索针灸治疗UC随机对照试验(RCT)文章的基础上,对相关信息进行收集、筛选、录入和提取,并建立针灸治疗UC的文献数据库。统计文献使用的诊断标准、治疗方法、腧穴经络的选择与配伍、治疗时间与疗程等。分析其诊断、治疗的现状与特点。结果:共收集到符合纳入标准的RCT文章53篇。结果表明针灸治疗UC的RCT文章呈现逐年增多的趋势。使用的诊断标准多为《溃疡性结肠炎的诊断及疗效标准》或者《对炎症性肠病诊断治疗规范的建议》;治疗方法主要是针灸配合灌肠、中西药;腧穴使用频次依次为足三里、天枢、上巨虚,其配伍以足三里-天枢,足三里-上巨虚最为常见;选取的经脉以足阳明胃经和任脉居多;证型以肝郁脾虚、脾胃虚弱和脾肾阳虚最多。整个治疗过程大多1次/d,7d左右为1个疗程,总共治疗2-3个疗程。疗效评定多使用以临床有效率为主的自拟疗效标准。缺乏远端取穴、随访与不良反应的报告。结论:表明目前针灸治疗UC以传统的中医经典理论为基础,但临床方案设计尚不能满足UC的临床特点,影响临床结论的准确性。

Objective： To explore the current status and characteristics of acupuncture and moxibustion in the treatment of ulcerative colitis（UC）, and provide references for clinical treatment. Methods： Based on the randomized controlled trial（RCT） of treating for UC by acupuncture, information were collected, screened, included and extracted with computerized data mining technology, and then the database of acupuncture for UC was established. The diagnostic criteria, treatment methods, selection and compatibility of acupoint, treatment time and session, were summarized to analyze its current status and characteristics of diagnosis and treatment. Results： Totally 53 RCTs that met the inclusive criteria were included. It was found that the paper that RCTs of treating for UC by acupuncture increased year by year. The results indicated that currently the diagnostic criterion was mainly. Diagnosis and Treatment of Ulcerative Colitis or The Inflammatory Bowel Disease Diagnosis and Treatment Recommendations. The mainstream treatment methods were acupuncture combined with enema or medications. The frequency of acupoint selections were, in order, Zusanli（ST36）, Tianshu（S25） and Shangjuxu（S37）. The most common compatibility of acupoint was Zusanli（ST36）-Tianshu（S25）-Zhongwan（CV12） and Tianshu（S25）-Qihai（CV6）. The stomach channel of footyangming and ren channel were often selected for UC. The syndromes of depressed liver with the insufficient spleen, weakness of the spleen and the stomach and insufficiency of both the spleen and the kidney dominated in all TCM syndromes of UC. The treatment was given once a day, seven days for a session and totally lasting for 2 to 3 sessions. The effective rate in clinic was considered as effective evaluation, a self-prepared effective evaluation criterion. But the lack of selection of remote acupoints, follow-up survey and adverse reaction were found in the report result. Conclusion： Currently acupuncture and moxibustion for treatment of UC based on traditional theory of Chinese medicine. But designing the scheme for UC could not be satisfied to the characteristics of UC in clinic, which would make negative influence on the accuracy of clinical conclusion.