基于数据挖掘技术探讨针灸治疗稳定期COPD的用穴及配伍规律

Exploration on the Clinical Points and Compatibility of Acupuncture-moxibustion Treatment of Chronic Obstructive Pulmonary Disease at Stable Period Based on Data Mining

目的 采用数据挖掘方法探索针灸治疗慢性阻塞性肺疾病稳定期的临床用穴及配伍规律。方法 收集针灸治疗稳定期慢性阻塞性肺疾病相关现代文献,建立针灸治疗稳定期慢性阻塞性肺疾病处方数据库,对所收集的数据进行关联规则和聚类分析,找寻针灸治疗稳定期慢性阻塞性肺疾病的临床用穴规律以及配伍规律特点。结果 (1)共纳入文献115篇,涉及51个穴位,其中在临床上最常用的腧穴有肺俞、足三里、肾俞、定喘、膻中等;(2)针灸治疗稳定期慢性阻塞性肺疾病穴位选择主要以临近肺脏的背腰部、胸腹部为主,常用的经脉也主要以足太阳膀胱经、任脉、足阳明胃经为主,特定穴的使用包括背俞穴、交会穴、五输穴、募穴、八会穴等;(3)在关联规则方面“,肺俞-足三里”以支持度54.78%排在第一“,肺俞-肾俞“”肺俞-定喘”分别排在二、三位;(4)聚类分析获得4个大类主要腧穴聚类群。结论 本研究发现针灸治疗稳定期慢性阻塞性肺疾病选穴多以局部选穴、辩证选穴为主,多选取膀胱经上的背俞穴,配伍方法以前后配穴法、上下配穴法为主,推荐以肺俞、肾俞、脾俞、足三里、定喘为主要选穴,结合辩证论治选取丰隆、大椎、风门、中府、列缺等穴位进行配伍使用。

Objective To explore the clinical points and compatibility law of acupuncture and moxibustion in the treatment of chronic obstructive pulmonary disease(COPD) at stable stage by using data mining method. Methods Modern literature related to acupuncture and moxibustion in the treatment of stable COPD was collected, and the prescription database of acupuncture and moxibustion in the treatment of stable COPD was established. Association rules and cluster analysis were conducted on the collected data to find the clinical acupoint rule and compatibility rule characteristics of acupuncture and moxibustion in the treatment of stable COPD. Results(1)A total of 115 references were included, involving 51 acupoints, among which the most commonly used acupoints were Feishu(BL13), Zusanli(ST36), Shenshu(BL23), Dingchuan(EX-B1), and Danzhong(RN17).(2)Acupuncture and moxibustion in the treatment of chronic obstructive pulmonary disease at the stable stage mainly selects the back and waist, chest and abdomen near the lung, and the commonly used meridians mainly include the Bladder Meridian, Ren Meridian and Stomach Meridian.The specific points include back-shu point, confluent points,five-shu point, front-mu point,eight influential points and etc.(3)In terms of association rules, "Feishu(BL13)-Zusanli(ST36)" ranked first with 54.78% support, "Feishu(BL13)-Shenshu(BL23)" and "Feishu(BL13)-Dingchuan(EX-B1)" ranked second and third respectively.(4)Four main acupoint clusters were obtained by clustering analysis. Conclusion In this study, it was found that local and dialectical acupoints were mainly selected for the treatment of stable COPD by acupuncture and moxibustion. back-shu point on the Bladder Meridian was mainly selected, and the combination of front and back acupoints and up and down acupoints were mainly selected. Feishu point(B13), Shenshu point(BL23), Pishu point(BL20), Zusanli point(ST36), and Dingchuan point(EX-B1) were recommended as the main points. Combined with dialectical treatment, Fenglong point(ST40), Dazhui point(DU14), Fengmen point(BL12), Zhongfu point(LU1), Lieque point(Lu7) were selected for compatibility.