基于1719份病历的孤独症谱系障碍针刺取穴规律研究

Rule of Acupuncture Point Section for Autism Spectrum Disorder Based on 1719 Medical Records

目的:通过对孤独症谱系障碍(ASD)患者临床实际诊疗病例资料进行数据挖掘分析针刺治疗的取穴规律,为临床治疗方案的优化提供参考。方法:对1719份ASD患者的病历中针刺治疗的数据进行提取,采用Excel 2019建立穴位处方数据表,利用古今医案云平台V2.2.3、Gephi 0.9和Liquorice等软件应用分层网络分析、聚类分析和关联分析的方法,对针刺治疗ASD的核心穴位处方进行挖掘。结果:所有患者的针刺治疗处方中共包含51个腧穴(穴区),主要分布在十四经脉、靳三针穴区、头穴区、经外奇穴。基于分层网络分析得到核心处方包括17个核心腧穴(穴区),其中8个主要核心腧穴(穴区):百会、神门、内关、四神针、智三针、语言一区、涌泉、脑户;9个次要核心腧穴(穴区):语言三区、语言二区、肝俞、悬钟、太冲、心俞、肾俞、太溪、三阴交。聚类分析结果可将针刺治疗ASD的高频腧穴分为5类。第1类:百会、语言三区、语言二区、语言一区、四神针;第2类:内关、神门;第3类:脑户、悬钟、涌泉;第4类:肝俞;第5类:风池、心俞。结论:研究发现ASD的针刺治疗在选穴方面存在一定的规律,体针和头针并用,体针以调脏腑平衡为主,头针以调神和对症治疗为主,可为临床针刺治疗ASD的取穴思路提供参考。

Objective:This study aims to analyze the point selection pattern for acupuncture treatment of autism spectrum disorder(ASD)based on data mining of clinical medical records,which is expected to provide a reference for optimizing the clinical treatment plan.Methods:The data on acupuncture treatment in the medical records of 1719 patients with ASD were collected,and the data table of acupuncture prescriptions was established with Excel 2019.Via the ancient and modern medical record cloud platform V2.2.3,Gephi 0.9,and Liquorice,hierarchical network analysis,cluster analysis,and association analysis were performed to explore the core acupuncture prescriptions for ASD.Results:The acupuncture prescriptions involved a total of 51 acupoints(acupuncture point areas),which were mainly distributed in the 14 meridians,Jinsan point area,head point area,and extra point.The core prescriptions yielded by hierarchical network analysis included 17 core acupoints(acupuncture point areas):8 major acupoints(acupuncture point zones)of“Baihui”(GV 20),“Shenmen”[TF(4)],“Neiguan”(PC 6),Four Spirit Points,3-Points for Intelligence,First Language Area,“Yongquan”(KI 1),and“Naohu”(GV 17),and 9 minor points(acupuncture point areas)of Third Language Area,Second Language Area,“Ganshu”(BL 18),“Xuanzhong”(GB 39),“Taichong”(LR 3),“Xinshu”(BL 15),“Shenshu”(BL 23),“Taixi”(KI 3),and“Sanyinjiao”(SP 6).Cluster analysis classified the high-frequency acupoints for the treatment of ASD by acupuncture into five categories:category 1 of“Baihui”(GV 20),Third Language Area,Second Language Area,First Language Area,and Four Spirit Points,category 2 of“Neiguan”(PC 6)and“Shenmen”[TF(4)],category 3 of“Naohu”(GV 17),“Xuanzhong”(GB 39),and“Yongquan”(KI 1),category 4 of“Ganshu”(BL 18),and category 5 of“Fengchi”(GB 20)and“Xinshu”(BL 15).Conclusion:The study found the rule in point selection for acupuncture treatment of ASD:Both body acupuncture and head acupuncture were performed,with body acupuncture mainly regulating the balance of the internal organs and head acupuncture modulating the spirit and for the symptomatic treatment.This study can serve a reference for point selection in the acupuncture treatment of ASD.