针刺治疗脑瘫儿童的症状分类特征和用穴经验分析

Analysis on Characteristics of Symptom Classification and Acupoint Application Experience in Acupuncture Treatment for Children with Cerebral Palsy

目的基于症状对脑瘫患儿分类,找到不同脑瘫亚群的特征性症状及取穴经验,提高脑瘫针刺治疗的准确性和稳定性。方法基于西安中医脑病医院电子病历,筛选入院接受针刺治疗的7岁以下脑瘫患儿,通过结构化的脑瘫病历文本提取入院刻下症和针刺治疗处方,利用数据挖掘方法划分不同脑瘫人群,寻找亚群的症状特征和针刺处方。结果701例脑瘫儿童中接受针刺治疗的小儿脑瘫常见症状有22个、常用穴位15个。有636例成为患者相似网络中的节点,从网络中分析出运动发育延迟程度、姿势障碍和伴随症状皆有差异的4类特征人群,并找到各类亚群对应的特征性头针、体针用穴。结论可依据特异性症状评估脑瘫患儿类型,为不同脑瘫患儿亚群针刺治疗方案的制定提供参考。

Objective To classify children with cerebral palsy(CP) based on symptoms,explore the characteristic symptoms and acupoint regularity in the treatment of different CP subgroups,and improve the accuracy and stability of acupuncture treatment of CP.Methods Based on the electronic medical records(EMR) of Xi’an encephalopathy hospital of traditional Chinese medicine,children with CP under 7 years old who were admitted to the hospital for acupuncture treatment were selected,and the symptoms and acupuncture prescriptions were extracted from the structured medical records.Different subgroups of CP were divided by data mining method to find the symptom characteristics and acupuncture prescriptions of the subgroups.Results A total of 22 common symptoms of CP and 15 common acupoints used in the treatment were shown in 701 patients.And 4 subgroups were found in the patient similarity network(PSN) of 636 children with CP.These subgroups had different degrees of motor retardation,postural disorders and accompanying symptoms.The characteristic acupoints of the scalp and body corresponding to each subgroup were found.Conclusion The type of children with CP can be decided according to the specific symptoms.This study provides a reference for the design of acupuncture treatment for different subgroups of children with CP.