数据挖掘分析透刺法治疗脑卒中后肌张力增高的选穴规律

Analysis of laws of acupoint selection in penetrating acupuncture treatment of spasticity after stroke based on data mining

目的:使用数据挖掘技术分析透刺法治疗脑卒中后肌张力增高的选穴规律。方法:在中国知网、维普和万方数据库检索从建库以来至2020年12月8日所有透刺法治疗卒中后肌张力增高的临床研究文献,对其进行描述性分析、聚类分析和关联规则分析。结果:透刺法治疗卒中后肌张力增高的治疗方法多选用单纯透刺或配合康复训练,取穴集中在四肢,使用频率高的穴组依次为曲池透少海、外关透内关、合谷透后溪、太冲透涌泉、阳陵泉透阴陵泉、肩髃透臂臑。聚类分析得出,肩髃透臂臑、阳陵泉透悬钟聚为第一类,阴陵泉透阳陵泉、三阴交透悬钟、合谷透后溪、太冲透涌泉聚为第二类,丘墟透照海单独聚为第三类,其余透穴组聚为第四类。关联规则分析得出,曲池透少海和外关透内关的支持度最高,悬钟透三阴交和外关透内关、悬钟透三阴交和曲池透少海的置信度最高。配穴思路大多从以下两个方面着手:一为拮抗肌透刺法,以肩髃透臂臑和阳陵泉透悬钟为代表取穴;二为调衡阴阳透刺法,以阴陵泉透阳陵泉、三阴交透悬钟、合谷透后溪、太冲透涌泉为代表取穴。结论:基于数据挖掘技术总结出的透刺治疗卒中后肌张力增高的选穴规律符合临床治疗思路,对于指导临床应用有一定的参考价值。

Objective:To analyze laws of acupoint selection in penetrating acupuncture treatment of spasticity after stroke by using data mining.Methods:All the clinical research literatures of penetrating acupuncture in the treatment of spasticity after stroke from the establishment of the database to December 8,2020 were searched in Chinese National Knowledge Infrastructure(CNKI),VIP and Wanfang Database,and descriptive analysis,cluster analysis and association rule analysis were carried out.Results:The spasticity after stroke was mainly treated by simple penetrating acupuncture or combined with rehabilitation training,and the acupoints were concentrated on the limbs.The acupoints with high frequency of penetrating acupuncture treatment were Quchi(曲池)through Shaohai(少海),Waiguan(外关)through Neiguan(内关),Hegu(合谷)through Houxi(后溪),Taichong(太冲)through Yongquan(涌泉),Yanglingquan(阳陵泉)through Yinlingquan(阴陵泉)and Jianyu(肩髃)through Binao(臂臑).Cluster analysis showed that Jianyu through Binao and Yanglingquan through Xuanzhong(悬钟)were clustered into the first type,Yinlingquan through Yanglingquan,Sanyinjiao(三阴交)through Xuanzhong,Hegu through Houxi and Taichong through Yongquan were clustered into the second type,Qiuxu(丘墟)through Zhaohai(照海)were clustered into the third group,and the other acupoints were clustered into the fourth group.According to the analysis of association rules,Quchi through Shaohai and Waiguan through Neiguan had the highest degree of support,while Xuanzhong through Sanyinjiao and Waiguan through Neiguan,Xuanzhong through Sanyinjiao and Quchi through Shaohai had the highest confidence.The idea of matching acupoints mostly started from the following two aspects:one was antagonistic muscle penetration needling method,which was represented by Jianyu through Binao and Yanglingquan through Xuanzhong,and the other was regulating yin-yang penetrating needling method.Yinlingquan through Yanglingquan,Sanyinjiao through Xuanzhong,Hegu through Houxi,Taichong through Yongquan were the representatives.Conclusion:The laws of acupoints selection in treatment of spasticity after stroke based on data mining have certain reference value for guiding clinical application.