基于“上病下治”探讨下肢穴位在针灸治疗血管性痴呆中的应用规律

Discussion on Rules of Lower Extremities Acupoint Selection for Vascular Dementia Based on"Shangbing Xiazhi"

目的分析下肢穴位在针灸治疗血管性痴呆中的应用规律。方法以“血管性痴呆”“针灸”“针刺”为关键词组合检索中国期刊全文数据库、万方和维普数据库近10年国内发表的针灸治疗血管性痴呆的临床研究文献,应用数据挖掘技术,分析下肢穴位在针灸治疗血管性痴呆中的应用规律。结果共纳入106篇相关文献,相关穴位33个。结果显示针灸治疗血管性痴呆下肢穴位主要归属的经脉为胃经与脾经,使用频数较多的穴位为足三里、三阴交、太溪、太冲、丰隆、血海与悬钟,其中使用频数高的穴位主要为特定穴。穴位聚类分析显示第一大类由委中、大钟-涌泉-阴陵泉组成;第二大类由足三里-三阴交、悬钟-血海-太溪-丰隆-太冲组成。关联规则分析显示穴位间相关性最高的是丰隆-三阴交-足三里→太溪。结论在针灸治疗血管性痴呆中,基于“上病下治”配伍使用下肢穴位进行治疗可产生协同作用,增强临床疗效。

Objective To analysis the rules of lower extremities acupoint in the treatment of vascular dementia.Method China National Knowledge Infrastructure(CNKI),Wanfang database,and VIP database were searched with the keywords"vascular dementia"and"acupuncture",and the clinical research literature on acupuncture treatment of vascular dementia published in China in recent ten years were included.Data mining techniques were applied to analyze the rules of lower extremities acupoint in the treatment of vascular dementia.Results A total of 106 related literature and 33 acupoints were included.The results showed that the main meridians of lower extremities acupoints were stomach and spleen meridians,and the acupoints with high frequency,mainly specific acupoints were Zusanli,Sanyinjiao,Taixi,Taichong,Fenglong,Xuehai,and Xuanzhong.The analysis of acupoint clustershowed the first category consists of Weizhong,Dachong-Yongquan,and Yinlingquan.The second category was composed of Zusanli-Sanyinjiao,Xuanzhong-Xuehai-Taixi-Fenglong-Taichong.Association rule analysis showed that the highest correlation between acupoints was Fenglong-Sanyinjiao-Zusanli and Taixi.Conclusion For the treatment of vasular dementia by acupuncture and moxibustion,the lower extremities acupoints combined with"Shangbing Xiazhi"can produce synergistic effect and enhance clinical efficacy.