基于数据挖掘的功能性腹泻中医选穴规律及证型、治法分布探析

Exploration and analysis of the distribution of TCM acupoint selection,syndrome types and treatment methods of functional diarrhea based on data mining

目的:基于中国知网,利用中医传承计算平台(V3.0)探析中医针灸治疗功能性腹泻的选穴规律及特点。方法:检索中国知网2009年1月1日-2021年7月10日中医药及针灸(含中西医结合)治疗功能性腹泻的相关文献,提取其中穴位组成、证型及治法信息。在完成筛选后建立好数据库,运用中医传承计算平台(V3.0)的频数统计、关联规则分析、聚类分析等方法,统计不同穴位使用频率,不同证型及治法出现频率,分析穴位配伍规律及关联、聚类效果。结果:证型、治法部分纳入41篇。41篇文献中涵盖证型58个,涉及15个证型,频次前三位为脾虚湿困证(16),脾胃虚弱证(8),脾肾阳虚证(8)。涵盖治法37条,涉及25个治法,频次前三位为健脾益气(12),化湿止泻(11),温补脾阳(6);穴位部分纳入的文献共有40篇,筛选出43首穴位方,涉及穴位36个,使用频次>5的穴位共10个。使用频次前3位分别为天枢(30)、上巨虚(16)、大肠俞(16)。常用穴位配伍10个,支持度>30%的为上巨虚-天枢、大肠俞-天枢,聚为3类时聚类效果较好。结论:脾虚是功能性腹泻的关键病机,治疗上应重视补脾气,温脾阳以治本,同时兼顾化湿止泻以治标。配穴注重远近、阴阳、前后相结合,运用俞募、合募等经典配穴原则,达到缓解功能性腹泻患者临床症状的作用。以数据统计分析为依据考究穴位的配伍组合对提高功能性腹泻的临床疗效具有重要意义。

Objective:Based on CNKI,using traditional Chinese Medicine Inheritance computing platform(V3.0),to explore the rules and characteristics of acupoint selection of acupuncture in the treatment of functional diarrhea.Methods:CNKI from January 1,2009 to July 10,2021 was searched for literatures on the treatment of functional diarrhea with traditional Chinese medicine and acupuncture(including integrative medicine).After the completion of the screening,the database was established,and the frequency statistics,association rule analysis,cluster analysis and other methods of Traditional Chinese Medicine Inheritance Computing Platform(V3.0)were used to count the frequency of different acupoints,the frequency of different syndrome types and treatment methods,and analyze the compatibility law of acupoints and the effect of association and cluster.Results:41 papers were included in syndrome type and treatment.There are 58 syndrome types in 41 literatures,involving 15 syndrome types.The top three frequency are spleen deficiency and dampness syndrome(16),spleen stomach weakness syndrome(8),spleen kidney yang deficiency syndrome(8).It covers 37 therapeutic methods,involving 25 therapeutic methods.The top three frequency are invigorating spleen and replenishing Qi(气)(12),resolving dampness and stopping diarrhea(11),warming and tonifying spleen Yang(阳)(6);there are 40 literatures included in the acupoint part,43 acupoint prescriptions are selected,involving 36 acupoints,and 10 acupoints are used more than 5 times.The top three use frequency were Tianshu(天枢)(30),Shangjuxu(上巨虚)(16)and Dachangshu(大肠俞)(16).There were 10 commonly used acupoints,and those with more than 30% support were Shangjuxu-Tianshu and Dachangshu-Tianshu.The clustering effect was better when they were grouped into three groups.Conclusion:Spleen deficiency is the key pathogenesis of functional diarrhea.In the treatment,we should pay attention to tonifying spleen Qi,warming spleen yang to treat the root cause,and at the same time,we should also pay attention to resolving dampness and stopping diarrhea to treat the symptoms.The combination of distance,Yin(阴)and Yang,front and back should be emphasized in acupoint matching,and the classic acupoint matching principles such as Shu Mu(俞募)and He Mu(合募)should be used to relieve the clinical symptoms of FD patients.It is of great significance to study the compatibility of acupoints on the basis of statistical analysis of data to improve the clinical efficacy of functional diarrhea.