古代针灸治疗神经性吞咽障碍选穴规律分析

Acupoint selection rules of neurogenic dysphagia treated with acupuncture and moxibustion in ancient times

基于数据挖掘技术,分析《中华医典》中先秦至清末针灸治疗神经性吞咽障碍的选穴规律。检索第5版《中华医典》中针灸治疗神经性吞咽障碍的相关文献,按纳入、排除标准进行筛选,并按腧穴析出原则提取治疗处方。采用SPSS 21.0和Clementine12.0软件进行聚类分析和关联规则分析。共筛提取出191条针灸处方,涉及腧穴45个。针灸治疗神经性吞咽障碍使用频次前5位的腧穴为颊车、地仓、列缺、廉泉、水沟;最常涉及的经脉为胃经、督脉、任脉;腧穴分布以头面颈部、上肢部为主;特定穴中运用频次最高的为交会穴,其次为八脉交会穴。关联分析获得强关联腧穴配伍11组,其中合谷-颊车居首位;聚类分析获得9个腧穴聚类群。古代针灸治疗神经性吞咽障碍以合谷、颊车、地仓、水沟、承浆为配伍核心腧穴,强调远近配穴及随症取穴。

Acupoint selection rules of neurogenic dysphagia treated with acupuncture and moxibustion from pre-Qin to late Qing Dynasty in Chinese Medical Classics were analyzed based on data mining.The literature regarding acupuncture and moxibustion for neurogenic dysphagia was searched and screened according to the inclusion and exclusion criteria in Chinese Medical Classics(5 th Edition),the prescriptions were extracted according to the principle of acupoint extraction.The SPSS 21.0 and Clementine 12.0 were used to perform the cluster analysis and association rule analysis.A total of 191 acupuncture and moxibustion prescriptions were screened and extracted,including 45 acupoints.The top 5 acupoints of acupuncture and moxibustion for neurogenic dysphagia in frequency were Jiache(ST 6),Dicang(ST 4),Lieque(LU 7),Lianquan(CV 23),Shuigou(GV 26).The most involved meridians were the stomach meridian,the governor vessel and the conception vessel.The main acupoints were distributed in the scalp face neck and upper limbs.The most frequently used specific acupoints was crossing points,next was eight confluence points.There were 11 acupoint combinations with strong association according to the association rule analysis,and the top one acupoint combination was Hegu(LI 4)-Jiache(ST 6).There were 9 acupoint cluster groups according to the cluster analysis.Hegu(LI 4),Jiache(ST 6),Dicang(ST 4),Shuigou(GV 26)and Chengjiang(CV 24)were core acupoints for neurogenic dysphagia treated with acupuncture and moxibustion in ancient times,besides,selecting proximal and distal acupoints and selecting acupoints according to symptoms were emphasized.