基于数据挖掘分析针灸治疗慢性腰肌劳损的选穴规律

Analysis on Acupoint Selection Laws of Acupuncture and Moxibustion in the Treatment of Chronic Lumbar Strain Based on Data Mining Method

目的:运用数据挖掘技术分析针灸治疗慢性腰肌劳损的选穴规律,以期为临床治疗慢性腰肌劳损提供依据。方法:检索2000年1月1日至2022年4月1日中国知网、中国生物医学文献数据库、维普数据库、万方数据库、PubMed和Web of Science中有关针灸治疗慢性腰肌劳损的文献,根据纳入标准及排除标准筛选文献并提取针灸处方,建立Excel文本数据库,并进行频数分析;采用SPSS Modeler Subscription进行关联规则分析;采用SPSS 20.0进行聚类分析。结果:共提取340首针灸处方,涉及104个腧穴,累计使用频数1887。针灸治疗慢性腰肌劳损使用频数较多的腧穴依次为肾俞、委中、阿是穴等;使用频数较多的腧穴归经统计主要为足太阳膀胱经和督脉;特定穴主要为背俞穴;腧穴所在部位以腰背部为主,其次是下肢。关联规则分析显示核心穴对为肾俞-委中、肾俞-阿是穴、肾俞-大肠俞、肾俞-阿是穴-委中、肾俞-大肠俞-委中、肾俞-阿是穴-大肠俞、委中-阿是穴-大肠俞、肾俞-腰阳关。聚类分析显示腧穴可分为5类:第1类为环跳、承山、秩边、昆仑、阳陵泉,第2类为肾俞、大肠俞、委中、阿是穴,第3类为夹脊穴,第4类为腰阳关、命门,第5类为关元俞、气海俞、次髎、膈俞。结论:针灸治疗慢性腰肌劳损以常规针刺结合其他疗法为主,选穴主要选取足太阳膀胱经腧穴、督脉腧穴及阿是穴,以局部取穴和上下配穴两种取穴规律为主。

Objective:To analyze the laws of acupoint selection of acupuncture and moxibustion in the treatment of chronic lumbar strain by using data mining method.Methods:The relevant literatures on chronic lumbar strain treated by acupuncture and moxibustion in China Knowledge Network(CNKI),China biomedical literature database(Sinomed),VIP database,Wangfang database,Web of Science and PubMed were searched from January 1,2000 to April 1,2022.The literatures were selected according to the inclusion criteria and exclusion criteria,and the acupuncture and moxibustion prescriptions were extracted.Then the Excel text database was established for frequency analysis.SPSS Modeler Subscription was used for association rule analysis.SPSS Statistics 20.0 was used for cluster analysis.Results:A total of 340 acupuncture prescriptions were selected and extracted with a total of 104 acupoints,with a cumulative use frequency of 1887 times.The acupoints frequently used in the treatment of chronic lumbar strain are Shenshu(BL 23),Weizhong(BL 40)and Ashi points(non-fixed point).The most commonly used meridians are the Bladder Meridian of Foot-Taiyang and Du Meridian.Back-shu points are mainly selected for specific points.The selected acupoints are mainly lower back acupoints,followed by lower limbs.The core point pairs of main point correlation analysis are Shenshu(BL 23)-Weizhong(BL 40),Shenshu(BL 23)-Ashi(non-fixed point),Shenshu(BL 23)-Dachangshu(BL 25),Shenshu(BL 23)-Ashi points(non-fixed point)-Weizhong(BL 40),Shenshu(BL 23)-Dachangshu(BL 25)-Weizhong(BL 40),Shenshu(BL 23)-Ashi(non-fixed point)-Dachangshu(BL 25),Weizhong(BL 40)-Ashi points(non-fixed point)-Dachangshu(BL 25)and Shenshu(BL 23)-Yaoyangguan(GV 3).Cluster analysis showed that the acupoints used were divided into 5 categories.The first category includes Huantiao(GB 30),Chengshan(BL 57),Zhibian(BL 54),Kunlun(BL 60)and Yanglingquan(GB 34).The second category includes Shenshu(BL 23),Dachangshu(BL 25),Weizhong(BL 40)and Ashi points(non-fixed point).The third category includes Jiaji points(EX-B2).The fourth category includes Yaoyangguan(GV 3)and Mingmen(GV 4).The fifth category includes Guanyuanshu(BL 26),Qihaishu(BL 24),Ciliao(BL 32)and Geshu(BL 17).Conclusion:Acupuncture combined with other therapies are usually used in the treatment of chronic lumbar muscle strain.The acupoints of the Bladder Meridian of Foot-Taiyang,Du Meridian and Ashi points(non-fixed point)are selected,with mainly two selection methods,including local point selection and up-down point selection.