基于古今医案云平台分析针刺治疗中风后认知障碍选穴规律

Acupoint selection rules of post-stroke cognitive impairment treated with acupuncture based on ancient and modern medical record cloud platform

目的:应用古今医案云平台软件(V1.5)分析针刺治疗中风后认知障碍(PSCI)的选穴规律。方法:检索中国期刊全文数据库(CNKI)、万方数据库(Wanfang)、维普数据库(VIP)、中国生物医学文献数据库(SinoM ed)、PubM ed、EMbase、Cochrane Library、Web of Science数据库中已公开发表的针刺治疗PSCI的随机对照研究文献,提取数据并建立处方数据库,采用古今医案云平台软件(V1.5)对数据进行分析。结果:最终纳入185篇文献,共涉及腧穴91个,应用频次共1174次。针刺治疗PSCI应用频次前5位的腧穴分别是百会(151次)、神庭(97次)、四神聪(83次)、内关(69次)、三阴交(64次);常选用经脉为督脉;常应用腧穴多分布于头面颈项部;应用频次前5位的穴对有百会-神庭(89次)、百会-四神聪(79次)、百会-内关(59次)、百会-三阴交(56次)、百会-足三里(51次);关联性最强的穴位组合为神庭→百会;聚类分析将所有穴位分为6大类,主要核心处方为百会、神庭、四神聪、足三里、内关、三阴交。结论:针刺治疗PSCI的选穴以督脉穴为主、多应用头面颈项部穴位,临床治疗可以百会、神庭、四神聪、足三里、内关、三阴交为主穴,但需结合不同症状辨证施治。

Objective To analyze the acupoint selection rules of post-stroke cognitive impairment(PSCI)treated with acupuncture by ancient and modern medical record cloud platform(V1.5).Methods The published randomized controlled trial(RCT)literature of PSCI treated with acupuncture was retrieved from CNKI,Wanfang,VIP,SinoM ed,PubM ed,EMbase,Cochrane Library and Web of Science,and the data was extracted to establish prescription database.The ancient and modern medical record cloud platform(V1.5)was used to analyze the data.Results A total of 185 articles was included,involving 91 acupoints,the total using frequency was 1174 times.The top 5 acupoints in frequency of PSCI treated with acupuncture were Baihui(GV 20,151 times),Shenting(GV 24,97 times),Sishencong(EX-HN 1,83 times),Neiguan(PC 6,69 times)and Sanyinjiao(SP 6,64 times);the most involved meridian was the governor vessel,and the generally used acupoints were mainly distributed in the head,face and neck.The top 5 acupoint combinations in frequency were Baihui(GV 20)-Shenting(GV 24,89 times),Baihui(GV 20)-Sishencong(EX-HN 1,79 times),Baihui(GV 20)-Neiguan(PC 6,59 times),Baihui(GV 20)-Sanyinjiao(SP 6,56 times)and Baihui(GV 20)-Zusanli(ST 36,51 times).The acupoint combination with the strongest association was Shenting(GV 24)→Baihui(GV 20).There were 6 acupoint cluster groups according to the cluster analysis,and the main core prescription was Baihui(GV 20),Shenting(GV 24),Sishencong(EX-HN 1),Zusanli(ST 36),Neiguan(PC 6)and Sanyinjiao(SP 6).Conclusion Acupoints on the governor vessel,and distributed in head,face and neck are the main acupoints for PSCI treated with acupuncture,Baihui(GV 20),Shenting(GV 24),Sishencong(EX-HN 1),Zusanli(ST 36),Neiguan(PC 6)and Sanyinjiao(SP 6)can be used as the main acupoints,but it is still necessary to combine with syndrome differentiation.