基于数据挖掘对推拿治疗膝骨关节炎取穴规律的研究

Research on the rules of acupoint selection for the treatment of knee osteoarthritis with massage based on data mining

目的采用数据挖掘技术分析推拿治疗骨性膝关节炎(KOA)临床腧穴使用规律。方法在Pub Med医学文献检索服务系统、中国知网(CNKI)、维普资讯网(VIP)、万方数据知识服务平台检索推拿治疗KOA的研究文献,检索时间段为2000年1月至2017年12月,对所采集的治疗方式、腧穴及其所属经脉特点进行分析,运用描述、关联和聚类分析等数据分析技术,分别研究其外在特征和内在联系。结果共62篇中文文献纳入统计分析,其中,血海(74.19%)为使用频率最高的腧穴,下肢的腧穴使用频率最高(96.13%),这些腧穴主要分布在膝关节周围。通过关联性分析发现,梁丘、血海、内膝眼、阳陵泉相互间连接较强。聚类分析研究发现主穴有犊鼻、内膝眼、足三里、梁丘、阳陵泉、阴陵泉等。血海、梁丘和内膝眼、阳陵泉是最核心的两个穴位组,位于其上一层次的是阴陵泉和足三里,最外层是鹤顶。结论通过数据挖掘技术分析,得出了临床治疗KOA的腧穴使用的内在规律,推拿治疗膝关节骨性关节炎以局部取穴为主,更为重视病变部位筋骨气血的调节,这为临床推拿治疗KOA提供选穴参考依据。

Objective To analyze the rules of clinical acupoints selection for the treatment of knee osteoarthritis（KOA） with massage by data mining technique. Methods The literatures on massage treatment of KOA were searched in Pub Med, China National Knowledge Infrastructure（CNKI）, VIP（VIP）, and Wanfang Data, and the search period was from January 2000 to December 2017. The treatment methods, acupoints and their meridians characteristics were analyzed, then data analysis techniques such as description, association and cluster analysis were used to study the external characteristics and internal relations. Results A total of 62 Chinese literatures were included in the statistical analysis. Among them, Xuehai（74.19%） was the most frequently used acupoint; the acupoints of the lower extremities were used most frequently（96.13%）, which were mainly distributed around the knee joint. Through correlation analysis,it was found that Liangqiu, Xuehai, Neixiyan, and Yanglingquan were strongly connected with each other. Cluster analysis showed that the main points were Dubi, Neixiyan, Zusanli, Liangqiu, Yanglingquan, Yinlingquan, and so on. Xuehai,Liangqiu, Neixiyan, and Yanglingquan were the two core acupoint groups. The upper level is Yinlingquan and Zusanli,and the outermost layer is Heding. Conclusion Through the analysis by data mining technology, the internal rules of the use of acupoints in clinical treatment of KOA is obtained. Massage treatment of knee osteoarthritis use local acupoints as a focus, paying more attention to the regulation of the sinews, bones, qi and blood in the lesions. This study can provide a reference point for the selection of acupoints for clinical massage treatment of KOA.