基于数据挖掘技术探讨针灸治疗腰椎间盘突出症术后综合征选穴规律

Acupoin Selection Rules of Acupuncture and Moxibustion in Treating Postoperative Syndrome of Lumbar Disc Herniation Based on Data Mining Technology

目的采用数据挖掘方法探讨针灸治疗腰椎间盘突出症术后综合征的临床选穴规律。方法检索中国生物医学文献数据库(CBM)、中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(维普网)、PubMed、Cochrane Libarary建库至2020年4月20日收录的针灸治疗腰椎间盘突出症术后综合征的临床研究文献,建立针灸处方数据库,进行描述性分析、聚类分析及关联规则分析,对选穴规律进行总结。结果共纳入60篇文献,91条处方,涉及腧穴83个,总频次749次,高频腧穴(频次≥10)为环跳、委中、肾俞、阿是穴、夹脊穴等19个;选穴位置主要集中在下肢部、背部;高频经脉为足太阳膀胱经和足少阳胆经;特定穴共使用35个、340次,占总频次的45.4%。聚类分析得到5个有效聚类群:大肠俞,承扶,秩边,腰眼,肾俞,环跳,夹脊穴;命门,腰阳关;阳陵泉,足三里,悬钟;委中,承山,殷门,昆仑,关元俞;三阴交。关联规则分析得到以环跳、夹脊穴、肾俞、委中、秩边、承扶、大肠俞、腰眼为核心的组方。结论腰椎间盘突出症术后综合征取穴集中在腰背及下肢部,以阳经经穴为主,重视阿是穴和局部取穴,所选腧穴多为特定穴,穴位下多有神经伴行;针灸处方重视辨经取穴,补益肝肾。

Objective To analyze the acupoint selection rules of acupuncture and moxibustion in treating postoperative syndrome of lumbar disc herniation by data mining.Methods Clinical research literature of acupuncture and moxibustion in treating postoperative syndrome of lumbar disc herniation were retrieved from the databases of CBM,CNKI,Wanfang Data,VIP,PubMed and Cochrane Library.The retrieval time was from the database establishment to April 20,2020.The acupuncture and moxibustion database was established.Descriptive analysis,cluster analysis and association rule analysis were used to summarize the rules of acupoint selection.Results Totally 60 articles were included,involving 91 prescriptions and 83 acupoints,with a total frequency of 749 times.The high frequency acupoints were 19 acupoints of Huantiao(GB30),Weizhong(BL40),Shenshu(BL23),Ashixue(Ashi),Jiajixue(EX-B2),etc.The location of acupoints was mainly in the lower limbs and back.The high frequency meridians were Bladder Meridian of Foot-Taiyang and Gallbladder Meridian of Foot-Shaoyang.A total of 35 specific acupoints were used,with a frequency of 340 times,accounting for 45.4%of the total frequency.Five groups were obtained by cluster analysis:Dachangshu(BL25),Chengfu(BL36),Zhibian(BL54),Yaoyan(EX-B7),Shenshu(BL23),Huantiao(GB30),Jiajixue(EX-B2);Mingmen(GV4),Yaoyangguan(GV3);Yanglingquan(GB34),Zusanli(ST36),Xuanzhong(GB39);Weizhong(BL40),Chengshan(BL57),Yinmen(BL37),Kunlun(BL60),Guanyuanshu(BL26);Sanyinjiao(SP6).Analysis showed the core prescription for association rules:Huantiao(GB30),Jiajixue(EX-B2),Shenshu(BL23),Weizhong(BL40),Zhibian(BL54),Chengfu(BL36),Dachangshu(BL25),Yaoyan(EX-B7).Conclusion Postoperative syndrome of lumbar disc herniation acupoint selection is concentrated on the back of the waist and the lower extremities,with yang meridians as the main acupoints,focusing on Ashi acupoints and local acupoints.Most of the selected acupoints are specific points,and most of the acupoints are accompanied by nerves.The prescription pays attention to the differentiation of meridians and acupoints and the nourishing of liver and kidney.