基于数据挖掘探讨针灸治疗卒中后认知障碍的取穴规律

Study on the Rules of Acupoint Selection in Acupuncture Treatment of Post-stroke Cognitive Function Impairment Based on Data Mining

目的:探讨针灸治疗卒中后认知障碍临床常用穴位的归经、部位、刺灸法的选择及穴位联合使用特点,为临床治疗提供依据。方法:检索中文期刊全文数据库(China national knowledge infrastruc-ture,CNKI)、万方数据知识服务平台(WANFANG DATA,WF)、维普期刊全文数据库(VIP)、SinoMed,从建库至2019年5月的相关文献,按照纳入标准收集针灸治疗卒中后认知障碍的处方,采用SPSS Statistics 25.0对数据进行描述性分析及聚类分析,采用SPSS modeler 18.0进行关联规则分析。结果:共收集到6类针灸治疗措施,总处方179条,高频腧穴多为局部取穴的头部穴位,以宣散局部壅滞之气血,醒神开窍养髓。督脉穴位使用最多,且从特定穴的使用中发现多选用督脉与其他经脉的交会穴,以调节督脉的经气,疏通脑络,使脑神得养。从关联规则结果来看,置信度最高的关联穴组是百会-四神聪-风池等,支持度最高的穴组是百会-四神聪。通过聚类分析可得到百会-神庭-四神聪等2个聚类群。结论:针灸治疗卒中后认知障碍有简、廉、便、验的优势,该研究结果为优化选穴提高疗效提供了线索。

Objective:To provide the basis for clinical acupuncture by exploring the meridian tropism,location of clinical commonly-used acupoints,the selection of acupuncture method and the characteristics of combined use of acupoints for acupuncture in the treatment of post-stroke cognitive function impairment(PSCI).Methods:After retrieving the related papers from CNKI,Wanfang,VIP and SinoMed from database building to May,2019,the prescriptions of acupuncture for the treatment of PSCI were collected in light of the inclusion criteria,SPSS Statistics 25.0 was used to perform descriptive analysis and cluster analysis of the data,SPSS modeler 18.0 was adopted to carry out association rules analysis.Results:Six acupuncture therapeutic measures and 179 total prescriptions were collected,high-frequency acupoints are mostly head acupoints for local acupoints selection,it can disperse the stagnated Qi and blood,induce resuscitation,open the orifices and nourish the marrow.The acupoints of governor meridian are used most frequently according to meridian tropism,the intersection points of governor meridian and other meridians are often selected from the use of specific points,which could regulate meridian Qi of governor meridian,dredge brain collaterals to nurture the brain.The acupoint group with the highest confidence was Baihui(DU20),Sishencong(EX-HN1),Fengchi(GB20)and others from the results of association rules,the acupoint group with the highest support was Baihui and Sishencong,two clusters of Baihui,Shenting(DU 24)and Sishencong were obtained through cluster analysis.Conclusion:Acupuncture has the advantages of being simple,inexpensive,convenient and effective in the treatment of post-stroke cognitive impairment,and the research results could provide the clue for optimizing acupoint selection and improving therapeutic effect.