基于数据挖掘探析单纯性肥胖的针刺辨证及取穴规律

Analysis on Acupuncture Syndrome Differentiation and Acupoint Selection Rules of Simple Obesity Based on Data Mining

目的:通过挖掘针刺治疗单纯性肥胖的文献,探讨针刺治疗单纯性肥胖辨证分型及选用规律。方法:收集近20年针刺治疗单纯性肥胖的临床文献,筛选得到文献145篇,病例数共11355例,建立Excel数据库,进行统计分析。结果:单纯性肥胖针刺辨证分型主要以气滞类为主,其中肝郁气滞为主要证型;其次为脾虚类,脾虚湿盛为主要证型。针刺治疗选穴以五腧穴中合穴、手足阳明经募穴以及交会穴为主,使用频次方面五腧穴为360次,其中合穴占70.27%;募穴为308次,其中胃经募穴及大、小肠经募穴依次占32.46%、34.09%、25.97%;交会穴为207次。具体选穴以足三里、三阴交、天枢、中脘为主穴,其中三阴交占50.72%,关元占38.64%。结论:肝郁气滞证为单纯性肥胖人群主要证型;针刺治疗原则以"辨病为主,辨证为辅",从脾胃论治,同时兼顾疏肝理气、调畅气机;选穴原则以特定穴(合穴、募穴、交会穴)为主,再按证型配穴,方可取得良好的临床疗效。

Objective:To explore the classification and selection of acupuncture treatment for simple obesity by digging up the literature on acupuncture treatment for simple obesity.Methods:Clinical literatures on acupuncture treatment of simple obesity in the past 20 years were collected,145 literatures were screened and the total number of cases was 11355.Excel database was established for statistical analysis.Results:The syndrome types of simple obesity mainly include Qi stagnation,among which liver Qi stagnation was the main syndrome type.The second type was spleen deficiency,and spleen deficiency dampness was the main syndrome type.The selected acupoints for acupuncture treatment were mainly the five-Shu points Zhong-He acupoints,hand-foot Yangming meridian Mu acupoints and intersection acupoints.There were 308 times of enplacement points,among which gastric enplacement points and large and small intestine enplacement points accounted for 32.46%,34.09%and 25.97%respectively.The intersection hole was 207 times.The selected points are Zusanli,Sanyinjiao,Tianshu and Zhongwan,among which Sanyinjiao accounts for 50.72%and Guanyuan for 38.64%.Conclusion:The syndrome of Qi stagnation of liver is the main syndrome of simple obesity.The principle of acupuncture treatment is"differentiation of disease as the main,dialectical as the auxiliary",treating from spleen and stomach,simultaneously taking into account the liver regulating Qi,regulating Qi.The principle of selecting acupoints is to select specific acupoints(combined acupoints,raised acupoints and intersecting acupoints),and then match acupoints according to syndrome type to obtain good clinical efficacy.