基于数据挖掘探讨针刺治疗老年抑郁症的选穴规律

Discussion on acupoint selection rules in the treatment of late-life depression by acupuncture based on data mining

目的:分析针刺治疗老年抑郁症(Late-life Depression,LLD)的选穴规律,为临床提供选穴依据。方法:检索中国知网、万方、中国生物医学文献数据库和维普全文数据库自建库至2021年11月有关针刺治疗LLD的文献,使用频数、关联及聚类分析对符合纳入标准的研究的选穴规律进行统计分析。结果:共纳入文献33篇,涉及57个腧穴,数据分析发现针刺治疗LLD多取督脉、膀胱经、心包经、肝经、脾经和肾经腧穴,以头面部配伍下肢部腧穴为主,使用频率最高的腧穴依次为百会穴、印堂穴、太冲穴、内关穴、三阴交穴。聚类分析将高频腧穴分为4类:(1)太冲穴、合谷穴;(2)百会穴、印堂穴;(3)神门穴、内关穴、三阴交穴;(4)四神聪穴,足三里穴。结论:针刺治疗LLD选穴常以疏肝解郁调神,兼调心脾肾为治则,可取百会穴、印堂穴、太冲穴、合谷穴、内关穴、神门穴、三阴交穴作为主穴,在此基础上根据具体的病因病机辨证加减。

Objective:To analyze the acupoint selection rules of acupuncture in the treatment of LLD,and to provide the basis for clinical acupoint selection.Methods:China National Knowledge Infrastructure,Wanfang,China Biomedical Literature Database and VIP Database were searched for literature on acupuncture treatment of LLD from the establishment of the database to November 2021.Frequency,correlation analysis and systematic cluster analysis were performed to statistically analyze the acupoint selection rules that met the inclusion criteria.Results:A total of 33 articles were included,involving 57 acupoints.Data analysis showed that acupuncture treatment of LLD mostly took governor meridian,bladder meridian,pericardium meridian,liver meridian,spleen meridian and kidney meridian acupoints,with head and face acupoints combined with lower limb acupoints.The most frequently used acupoints are Baihui(GV20),Yintang(GV29),Taichong(LR3),Neiguan(PC6)and Sanyinjiao(SP6).Systematic cluster analysis divides high-frequency acupoints into four categories:(1)Taichong(LR3),Hegu(LI4);(2)Baihui(GV20),Yintang(GV29);(3)Shenmen(HT7),Neiguan(PC6),Sanyinjiao(SP6),(4)Sishencong(EX-HN1),Zusanli(ST36).Conclusion:Acupoint selection of treating LLD by acupuncture is often based on the principles of soothing the liver,relieving depression and regulating the mind,spleen and kidney.Baihui(GV20),Yintang(GV29),Taichong(LR3),Neiguan(PC6)and Sanyinjiao(SP6)can be selected as the main points.On this basis,according to the specific etiology and pathogenesis of syndrome differentiation.