基于数据挖掘探析针刺治疗NAION的选穴规律

Study on the rules of acupoint selection for acupuncture treatment of non-arteritis anterior ischemic optic neuropathy based on data mining

目的基于数据挖掘技术探析针刺治疗非动脉炎性前部缺血性视神经病变(NAION)的选穴规律。方法检索2005年1月—2020年12月中国知网、维普、万方和PubMed数据库收录的关于针刺治疗NAION的临床研究类期刊文献,采用Excel软件建立腧穴处方数据库,将腧穴按归经、部位、类型进行分类统计,记录其使用频次。应用SPSS 26.0和Modeler 18.0软件对腧穴分别进行聚类分析和关联规则分析。结果(1)一般情况:共纳入文献36篇,涉及腧穴处方31个,经脉9条,穴位34个,总使用频次317次。(2)所属经脉:使用频次≥20次且所用腧穴≥3个的经脉有4条,分别为足太阳膀胱经(57次,16.71%)、足少阳胆经(57次,16.71%)、足阳明胃经(40次,12.62%)和手少阳三焦经(25次,7.89%)。(3)所属部位:眼周部腧穴共12穴,累计频次158次(49.84%);头部腧穴共11穴,累计频次60次(18.93%);下肢部腧穴共5穴,累计频次54次(17.04%);上肢部腧穴共4穴,累计频次41次(12.93%);腰背部腧穴共2穴,累计频次4次(1.26%)。(4)腧穴频次:排在前5位的依次为合谷(34次,10.7%)、太阳(31次,9.8%)、攒竹(30次,9.5%)、风池(25次,7.9%)、睛明(23次,7.3%)。(5)腧穴类型:排在前5位的分别是交会穴,共10个,累计频次160次(50.47%);经外奇穴,共8个,累计频次64次(20.19%);原穴,共3个,累计频次47次(14.83%);五腧穴,共5个,累计频次31次(9.78%);络穴,共2个,累计频次17次(5.36%)。(6)关联规则分析:相关性最高的前5位分别是合谷-攒竹、合谷-攒竹-太阳、合谷-风池、合谷-承泣、攒竹-承泣。(7)聚类分析:得出4类腧穴配伍,即合谷-太阳-攒竹;承泣-丝竹空-风池;睛明-球后-阳白;足三里-三阴交-光明-太冲。结论临床针刺治疗NAION遵循“腧穴所在,主治所在”的取穴原则,以手足阳经上的眼周局部和临近头部腧穴为主,并多选用交会穴和经外奇穴,同时在穴位组合上体现了远近、前后、表里配穴的特点。

OBJECTIVE To investigate the rule of acupoint selection for acupuncture treatment of non-arteritis anterior ischemic optic neuropathy(NAION)based on data mining technology.METHODS The clinical research literature published on journals on acupuncture treatment of NAION was retrieved from databases including CNKI,VIP,Wanfang and PubMed from January 2005 to January 2020.The acupoint prescription database was established with Excel software.The acupoints were classified according to the meridian tropism,location and type and their frequencies of use were recorded.SPSS 26.0 software and Modeler18.0 software were used for cluster analysis and association rule analysis of acupoints respectively.RESULTS(1)General information:A total of 36 references were included,involving 31 acupoint prescriptions,9 meridians,and 34 acupoints,with a total frequency of 317 times.(2)Meridian tropism:There were 4 meridians with frequency no less than 20 times and acupoints no less than 3,including the bladder meridian of Foot-Taiyang(57 times,16.71%),the gall bladder meridian of Foot-Shaoyang(57 times,16.71%),the stomach meridian of Foot-Yangming(40 times,12.62%),and the triple energizer meridian of Hand-Shaoyang(25 times,7.89%).(3)Location of acupoints:There were 12 acupoints around the eye,with a cumulative frequency of 158 times(49.84%).There were 11 acupoints of the head,with a cumulative frequency of 60 times(18.93%).There were 5 acupoints of the lower limb,with a cumulative frequency of 54 times(17.04%).There were 4 acupoints of the upper limb,with a cumulative frequency of 41 times(12.93%).There were 2 acupoints on the waist and back,with a cumulative frequency of 4 times(1.26%).(4)Acupoint frequency:The top five acupuncture points in the treatment of NAION were Hegu(34 times,10.73%),Taiyang(31 times,9.8%),Cuanzhu(30 times,9.5%),Fengchi(25 times,7.9%)and Jingming(23 times,7.3%).(5)Type of acupoints:The top five types of acupoints were crossing points,10 in total,with a cumulative frequency of 160 times(50.47%),extraordinary points,8 in total,with a cumulative frequency of 64 times(20.19%),yuan-primary point,3 in total,with a cumulative frequency of 47 times(14.83%),five-transport points,5 in total,with a cumulative frequency of 31 times(9.78%),and luo-connecting point,2 in total,with a cumulative frequency of seventeen times(5.36%).(6)Association rule analysis:The top five combinations with the highest correlation were Hegu-Cuanzhu,Hegu-Cuanzhu-Taiyang,Hegu-Fengchi,Hegu-Chengqi,Fengchi-Chengqi.(7)Cluster analysis:Four kinds of acupoint compatibility were obtained,including Hegu-Taiyang-cuanzhu,Chengqi-Sizhukong-Fengchi,Jingming-Qiuhou-Yangbai,Zusanli-Sanyinjiao-Guangming-Taichong.CONCLUSIONS The clinical acupuncture treatment of NAION follows the principle of"where the acupoints are,where the indications are",and focuses on the local periocular points and adjacent head acupoints on the hand and foot Yang meridian,and mostly selects the crossing points and extraordinary points.At the same time,the combination of the acupoints reflects the characteristics of near and distant,front and rear,exterior and inferior points.