基于“异病同治”理论探讨中风后尿失禁及尿潴留的针刺选穴规律

Acupuncture and Acupoint Selection Rules of Urinary Incontinence and Urinary Retention after Stroke Based on the Theory of Treating Different Diseases with the Same Method

[目的]基于“异病同治”理论,运用数据挖掘技术探索近十年中风后尿失禁(post-stroke urinary incontinence,PSUI)及尿潴留(post-stroke urinary retention,PSUR)的针刺选穴规律,用于指导临床。[方法]以中国知网、万方、Cochrane Library等7个中英文数据库为对象,严格按照纳入排除标准进行文献筛选,并使用Excel 2019软件建立数据库,录入选穴信息,同时运用不同统计软件进行描述性统计、关联分析及复杂网络分析。[结果]本研究共纳入文献206篇,其中PSUI文献147篇,PSUR文献59篇,结果显示针刺治疗两种疾病所取穴位高度相似,分布主要在胸腹、腰骶部,关元穴出现频数最高,足太阳膀胱经和任脉腧穴使用最多。根据关联规则分析,PSUR、PSUI两组关联性最高的腧穴组合分别是“中极-关元”“关元-气海”。复杂网络核心处方显示,两组的核心处方为“关元、中极、三阴交”组合。[结论]针刺治疗PSUI、PSUR符合中医“异病同治”理论,具有一定的取穴规律,两者以局部取穴、循经取穴为主,两者选穴均集中于腹部和腰骶部,循行于足太阳膀胱经和任脉。

[Objective]Based on the theory of“the same treatment for different diseases”,to explore the rule of post-stroke urinary incontinence(PSUI)and post-stroke urinary retention(PSUR)in the past decade to guide clinical practice through data mining.[Methods]Seven Chinese and English databases,such as China National Knowledge Infrastructure,Wanfang,and Cochrane Library,etc.,were used to screen in strict accordance with the data exclusion standards,and Excel 2019 software was used to establish the database and record the information of selected acupoints.Meanwhile,different statistical softwares were used to conduct descriptive statistics,association analysis and complex network analysis.[Results]A total of 206 articles were included in this study,of which 147 were PSUI and 59 were PSUR.The results showed that the acupoints taken by acupuncture for the two diseases were highly similar,and the distribution was mainly in the chest and abdomen and lumbosacral areast,and the frequency of Guanyuan point was the highest,and the acupoints of Bladder Meridian of Foot-Taiyang and Conception Vessel were the most frequent;and complex network core prescription display the combination was“Zhongji-Guanyuan”and“Guanyuan-Qihai”and the core prescription was“Guanyuan,Zhongji and Sanyinjiao”.[Conclusion]Acupuncture treatment of PSUI,PSUR is in line with theory of“treating different diseases with the same method”in traditional Chinese medicine and has certain rules of acupoint extraction,which is mainly local and meridian extraction.Both points are concentrated in the abdomen and lumbosacral areast,following Bladder Meridian of Foot-Taiyang and Conception vessel.