针灸治疗急性痛风性关节炎的选穴特点探析

Analysis of the Characteristics of Acupoint Selection in the Treatment of Gout by Acupuncture

目的:总结分析近16年来针灸治疗痛风性关节炎临床研究的文献选穴特点及规律。方法:以"痛风"或"痛风性关节炎"和"针灸""针刺"或"电针"为检索词,从中国期刊全文数据库、维普期刊全文数据库、万方数据库、PubMed数据库中检索相关文献,对其选穴进行整理,分别分析主穴及配穴使用频次,并对主穴高频腧穴进行系统聚类分析及关联规则分析。结果:符合研究标准的文献118篇,涉及主穴共67个,总使用频次630次。常用主穴有三阴交、阿是穴、足三里、阴陵泉、太冲,归经以足太阴脾经、足阳明胃经、足厥阴肝经为主。关联规则显示腧穴之间相关性最高的是阿是穴-足三里-三阴交。聚类分析结果显示存在5个核心的聚类群,配穴以病变关节局部取穴为主。结论:针灸治疗痛风性关节炎注重循经取穴和局部取穴相结合,健脾益肾、清热解毒、祛湿化瘀、疏肝理气、通络止痛为主要治法。

Objective To summarize and analyze the compatibility laws and the characteristics of acupoint selection in the treatment of gout by acupuncture over the past 16 years. Methods ＂Gout＂ and ＂acupuncture＂ or ＂electroacupuncture＂ were used as search terms in the CNKI, VIP, Wanfang and PubMed databases to retrieve relevant literature. The frequency of the main acupoints and auxiliary acupoints were summarized, respectively. Association rule and hierarchical clustering analysis were used to analyze the possible rules for selecting the main acupoints. Results One hundred and eighteen studies met the inclusiven criteria, and involved 67 main acupoints with a frequency of all points of 630. The most commonly used acupoints were Sanyinjiao （SP 6）, Ashi point, Zusanli （ST 36）, Yinlingquan （SP 9）, and Taichong （LR 3）. The main acupoints mainly belonged to the Spleen Meridian of Foot-taiyin, Stomach Meridian of Foot-yangming and Liver Meridian of Foot-jueyin. Association rule analysis showed that Ashi point, Zusanli （ST 36） and Sanyinjiao （SP 6） had the highest correlation of all the selected acupoints. The clus- ter analysis showed five core clustering groups. Conclusion Acupuncture treatment of gout focuses on acupoints along meridians and the acupoints around the affected joint. The main principles in the treatment of gout are invigorating Spleen, tonifying Kidney, dissipating dampness, resolving blood stasis, clearing away heat, removing toxic substances, soothing Liver, regulating qi, dredging collaterals and relieving pain.