基于数据挖掘学习探讨“司气海,调血压”针刺技术研究

Analysis of Rules of Channel and Acupoints Selection in Acupuncture Treatment of Essential Hypertension

目的:了解针灸治疗原发性高血压的选经取穴规律并基于此学习、探讨、领会石学敏院士"司气海,调血压"技术。方法:检索中国知网、万方数据库和重庆维普医药信息资源系统全文数据库中登载的针灸治疗原发性高血压的临床对照研究文献,筛选合格文献提取文献中腧穴并录入Excel表格进行统计分析。结果:纳入文献166篇,腧穴84个,其中奇穴11个,腧穴总使用频次872次,主穴634次,配穴238次;针灸治疗原发性高血压十四经均有涉及但其重要程度不一,其中以手阳明大肠经、足厥阴肝经、足阳明胃经所用腧穴频次最多,其次为足太阳膀胱经和足少阳胆经等;使用频次前五的腧穴依次为太冲(104次)、曲池(86次)、足三里(64次)、风池(60次)和合谷(45次);身体各部位腧穴选用频次最多的是下肢部(389次),其次为上肢部(175次)和头面颈项部(175次);选用特定穴的频次(735次)远高于非特定穴频次(137次),其中特定穴中五输穴(385次)、原穴(202次)和交会穴(199次)的使用频次明显高于其他特定穴。石学敏院士创立的"司气海,调血压"针刺技术选用的5对腧穴,4对与研究结果一致(足厥阴肝经及手足阳明经肘膝以下的五腧穴和原穴,如太冲、曲池、足三里、合谷等穴),其所属的3条经脉亦与研究结果完全一致,惟一不属于高频率的经穴人迎穴,不仅有中西医理论支持而成为处方中的主穴,而且从所属经脉(足阳明胃经)、所在部位(头面颈项部)、特定穴(交会穴)方面都符合研究结果。结论:石学敏院士"司气海,调血压"(人迎、曲池、合谷、足三里、太冲穴)治疗原发性高血压针刺技术,是大继承基础上的大创新,故对名老中医的学术传承,必须重视对中医经典、疾病中西医知识和前人成果的深入掌握、融会贯通和锲而不舍。

Objective： Basing on rules of channel and acnpoints selection in Acupuncture treatment of essential hypertension,discuss and comprehend Academician Shi＇s technique of ＂ Manage Qi hai, Regulate blood pressure＂. Methods：Searching controlled clinical research documents about primary hypertension in CNKI, WANFANG Database and VIP Medicine, then screening the eligibles to type the acupoints used into EXCEL form for statistical analysis. Results ：166 documents and 84 acupoints（ 11 extra points） are included, and total frequency of acupoints usage is 872, including 634 times usage of main acupoints and 238 times usage of matching acupoints; All the Fourteen Meridians are used in treatment of primary hypertension while their degree of importance is varied. Used frequency of acupoints on Large-Intestine Meridian of Hand-Yangming, Liver Meridian of Foot-Jueyin and Stomach Meridian of Foot-yangming are the most. Secondly are acupoints on Urine Bladder Meridian of Foot-Taiyang and Gallbladder Meridian of Foot-Shaoyang. The first five most used acupoints are Liv. 3 （ Taichong, 104 times） , LI 11 （ Quchi, 86 times） , ST 36 （ Zusanli, 64 times） , GB 20 （ Fengchi, 60 times） and LI 4 （Hegu, 45 times）; Acupoints on lower extremities are used most, then are the acupoints on upper extremities, face, head and cervical part. Used frequency of specific acupoints （735 times） is significant higher than it of non-specific acupoints （137 times）. Used frequency of Five Shu points （385 times） , Yuan-primary points （202 times） and crossing points （ 199 times） is significant higher than it of other specific acupoints. Among five pairs acupoints used in Academician Shi＇ s ＂Manage qi hai, Regulate blood pressure＂ techniques, four pairs meet the research result （ Five-shu points and Yuan-primary points of Foot-Jueyin Liver Meridian, Foot-Yangming Stomach Meridian and Hand-Yangming Large Intestine Meridian, as Taichong, Quchi, Zusanli, Hegu） , the three meridians also meet the research result. Evenfrequency of usage of Renying is not high, Academician Shi uses it as a main point in the prescription based on Eastern and Western medicine theory, it is also a specific point （ crossing pint） which belongs to Foot-Yangming Stomach Meridian and located on cervical part. Conclusion： Academician Shi＇s ＂Manage qi hai, Regulate blood pressure＂ technique （Renying, Quchi, Hegu, Zusanli, Taichong ） in treatment of primary hypertension is a huge innovation based on heritage; In academic inheritance of distinguished veteran TCM doctors, should emphasis on the TCM classics, eastern and western medicine about diseases, and predecessor＇ s spirit of achieving mastery through a comprehensive study of a subject and perseverance.