基于数据挖掘探究针灸治疗面肌痉挛的选穴规律

Study on Rules of Acupoint Selection in the Treatment of Facial Spasm by Acupuncture Based on Data Mining

【目的】基于数据挖掘技术探讨针灸治疗面肌痉挛的选穴和配伍规律。【方法】计算机检索2010年1月至2020年9月中国知网(CNKI)、中国生物医学文献数据库(SinoMed)、维普数据库(VIP)及万方数据库(Wanfang)中有关针灸治疗面肌痉挛的相关文献。采用Microsoft Excel 2013建立面肌痉挛的针灸处方数据库并进行描述性分析,采用IBM SPSS Modeler 14.1及IBM SPSS Statistics 25.0进行关联分析及系统聚类分析。【结果】共纳入45篇文献,共计77组针灸处方,涉及74个腧穴。描述性分析显示,干预措施使用频次最高为毫针刺法,其中,以巨刺法最为常用;辨证分型最常见为虚风内动证;腧穴分析结果显示,取穴以手足阳明经、头面部穴位为主,使用频次前5位的腧穴依次为合谷、四白、地仓、太冲、太阳;关联分析显示,支持度最高的穴对为"合谷-太冲",复杂网络分析显示,核心穴位为"太冲-合谷-地仓-颧髎-太阳-四白";系统聚类分析得出4个聚类群:"合谷、太冲、阿是穴、风池""颊车、下关""足三里""翳风、百会、颧髎、地仓、太阳、攒竹、四白"。【结论】针灸治疗面肌痉挛当以息风止痉,补气养血,兼调养心神为治疗原则,可采用巨刺法,取穴以手足阳明经、头面部穴位为主,建议以太冲-合谷-地仓-颧髎-太阳-四白作为核心穴组,配合辨证取穴。

Objective To investigate the rules of acupoint selection and compatibility of acupuncture treatment of facial spasm based on data mining technology. Methods The literatures related to acupuncture in the treatment of facial spasm from January 2010 to September 2020 were retrieved from CNKI, SinoMed, VIP and Wanfang databases. Microsoft Excel 2013 was used to establish the acupuncture prescription database of facial spasm and to conduct the descriptive analysis and IBM SPSS Modeler 14.1 and IBM SPSS Statistics 25.0 were used for correlation analysis and systematic cluster analysis. Results A total of 45 articles and 77 groups of acupuncture prescriptions involving 74 acupoints were included. Descriptive analysis showed that the most frequently used intervention was the filiform needling method,among which the giant needling method was the most commonly used. The syndrome of internal stirring of deficiency wind the most common type of syndrome differentiation;The results of acupoint analysis showed that acupoints were mainly selected on the hand-and foot-Yangming meridians and on the head and face. The top 5 acupoints in the frequency of use were Hegu(LI4),Sibai(ST2),Dicang(ST4),Taichong(LR3)and Taiyang successively;The association analysis showed that the point pair with the highest degree of support was “Hegu(LI4)-Taichong(LR3)”, and complex network analysis showed that the core point was“Taichong(LR3)-Hegu(LI4)-Dicang(ST4)-Dicang(ST4)-Taiyang(EX-HN)-Sibai(ST2)”. Four cluster groups were obtained by systematic cluster analysis:“Hegu(LI4),Taichong(LR3),Ashi Acupoint,Fengchi(GB20)”,“Jiache(ST6), Xiaguan(ST7)”,“Zusanli(ST36)”,“Yifeng(SJ7), Baihui(DU20), Quanliao(SI18),Quanliao(SI18), Dicang(ST4), Taiyang(EX-HN), Cuanzhu(BL2)and Sibai(ST2)”. Conclusion The therapeutic principle in the treatment of facial spasm should be extinguishing wind to ceasespasm,replenishing qi and nourishing blood,combined with regulating the mind. The giant acupuncture method can be adopted,and the acupoints should be mainly selected on hard-and foot-Yangming meridians and on head and face. It is suggested that “Taichong(LR3)-Hegu(LI4)-Dicang(ST4)-Quanliao(SI18)-Taiyang(EX-HN)-Sibai(ST2)”as the core points to make syndrome differentiation and acupoint selection.