基于数据挖掘的针灸综合疗法治疗子宫内膜异位症的应用规律研究

Application Rules of Comprehensive Treatment with Acupuncture and Moxibustion for Endometriosis:a Literature Review Using Data Mining Technique

目的初步构建针灸综合疗法治疗子宫内膜异位症的数据库,运用数据挖掘技术分析其应用规律。方法于2016-07-10采用计算机检索中国知网、中文科技期刊数据库、万方数据知识服务平台、中国生物医学文献数据库、Pub Med、EMbase中与针灸治疗子宫内膜异位症有关的文献,检索时间均为建库至2016-07-10。参照《针灸学》《中药学》对纳入文献的针灸疗法、穴位及归经等主题词进行规范化处理。采用SPSS 22.0统计软件进行描述性分析,并对使用频次≥10次的穴位和中药进行系统聚类分析;采用SPSS Clementine 12.0软件对使用频次≥10次的穴位和中药进行关联规则分析。结果共纳入1992—2016年发表的合格文献72篇,治疗措施使用频次排在前4位的分别为针刺+中药(11次)、耳压+中药(4次)、腹针(4次)、雷火灸+中药(4次);针灸疗法穴位使用频次排在前3位的分别为关元(86次)、三阴交(61次)、气海(61次);在针灸疗法+中药中,中药使用频次排在前3位的分别为当归(26次)、延胡索(21次)、莪术(20次)。关联规则分析结果显示,在高频药穴中(穴位20个、中药14味),穴位与中药相关性最高的是关元-延胡索-气海。聚类分析结果显示,若将高频药穴分为2类:一类为延胡索-气海-子宫-三阴交-关元(主药穴),其余为一类(配药穴);若将高频药穴分为11类:延胡索-气海、子宫、三阴交-关元3类为主药穴,其余8类为配药穴。结论基于实际临床文献数据,针灸治疗子宫内膜异位症需结合中药等多种疗法,在辨证论治的原则上以活血化瘀、理气止痛为主,并形成一定的穴位结合中药使用规律,为临床应用提供了参考价值。

Objective To construct a database of comprehensive treatment with acupuncture and moxibustion for endometriosis and to analyze the application rules of the treatment using data mining technique.Methods On July 10th,2016,we searched the databases of CNKI,VIP,WANFANG DATA,SinoMed,PubMed and EMbase for studies about using comprehensive treatment with acupuncture and moxibustion for endometriosis collected as of July 10th,2016.The subject headings such as acupuncture and moxibustion,acupoint and channel tropism of the included articles were standardized based on the Science of Acupuncture and Moxibustion and Chinese Materia Medica.Descriptive statistic analysis was performed by using SPSS 22.0 software.Hierarchical cluster analysis was conducted to investigate the acupoints and Chinese medicines used≥10 times in the included studies.Association rule analysis of 20 acupoints and 14 Chinese medicines used most frequently(≥10 times)in the included studies was implemented by using SPSS Clementine 12.0 software.Results A total of 72 articles published from 1992 to 2016 were included.In these studies,The used therapies in top four were acupuncture and Chinese medicine treatment(11 times),ear pressure and Chinese medicine treatment(4 times),abdominal acupuncture(4 times),thunder fire moxibustion and Chinese medicine treatment(4 times);the used acupoints in top three were Guanyuan(86 times),Sanyinjiao(61 times),Qihai(61 times);the used Chinese medicines in top three were angelica sinensis(26 times),corydalis tuber(21 times),and curcuma zedoary(20 times)of the comprehensive therapy consisting of acupuncture and moxibustion and Chinese medicine.Analysis with data mining technique found that,the correlation of Guanyuan,corydalis tuber and Qihai was the closest.Hierarchical cluster analysis figured out 2 clusters:corydalis tuber,Qihai,Zigong,Sanyinjiao,Guanyuan were categorized as main acupoints and Chinese medicines,and other acupoints and Chinese medicines were categorized as ancillary acupoints and Chinese medicines or 11 clusters:corydalis tuber and Qihai,Zigong,Sanyinjiao and Guanyuan were divided into 3 categories of main acupoints and Chinese medicines,and other acupoints and Chinese medicines were divided into 8 categories of ancillary acupoints and Chinese medicines.Conclusion Comprehensive treatment consisting of acupuncture and moxibustion and Chinese medicine based on syndrome differentiation is effective for endometriosis,which may be achieved by promoting blood circulation to dissipate blood stasis and regulating qi to relieve pain.Furthermore,the application rules of acupoints combined with Chinese medicines were detected.All these provide a reference for clinical treatment of endometriosis.