基于数据挖掘技术探讨巨刺治疗脑卒中后遗症的选穴规律

Acupoints Selection Rule of Opposing Needling in Treating Stroke Sequelae Based on Date Mining Technology

目的:运用数据挖掘技术分析巨刺治疗脑卒中后遗症的临床选穴规律。方法:检索从建库—2021年12月31日中国期刊全文数据库(CNKI)、万方数据库(Wanfang)、维普数据库(VIP)与中国生物医学文献数据库(SinoMed)中已公开发表的巨刺治疗脑卒中后遗症的临床研究文献,提取数据并建立处方数据库;利用Microsoft Excel 2019进行腧穴频次分析,使用Apriori算法进行腧穴关联规则分析,使用SPSS26.0进行聚类分析。结果:最终纳入98篇文献,共涉及针刺处方170条,腧穴116个,总应用频次1034次。巨刺治疗脑卒中后遗症类型中以卒中后偏瘫为主,占比90.82%;腧穴应用频次最高的是合谷穴;常选用的经脉为手足阳明经;部位以四肢部频次最高;特定穴应用以合穴、交会穴为主;腧穴关联度最高的组合为曲池-合谷;聚类分析将高频腧穴聚为5个有效类别。结论:巨刺治疗脑卒中后遗症注重辨症与辨证相结合,选穴规律体现出“治痿独取阳明”“从阴引阳、从阳引阴”的治疗思想,以疏通经络、调和气血与平衡阴阳为治疗原则。

Objective:To analyze the clinical acupoints selection rule of opposing needling in treatment of stroke sequelae based on data mining technology.Methods:The clinical studies stroke sequelae treated by opposing needling were retrieved from CNKI,Wanfang,VIP and SinoMed from the database establishment to December 31,2021,and the data were extracted and the prescription database was established.Microsoft Excel 2019 was used for acupoints frequency analysis,Apriori algorithm was used for acupoints association rule analysis,and SPSS26.0 was used for cluster analysis.Results:98 pieces of literature were included,involving 170 acupuncture prescriptions and 116 acupoints,with a total application frequency of 1034 times.Hemiplegia was the main type of stroke sequelae treated by opposing needling,which accounted for 90.82%.The acupoint with highest application frequency was Hegu(LI4);the meridians were often selected were hand Yangming meridian and foot Yangming meridian;the high-frequency acupoints were mainly distributed in the four limbs;the specific points were mainly He-sea points and crossing points;the acupoints combination with highest correlation degree was Quchi(LI11)-LI4;cluster analysis grouped high-frequency acupoints into 5 effective categories.Conclusion:Opposing needling pays attention to the combination of symptom differentiation and syndrome differentiation in treatment of stroke sequelae.The law of acupoints selection reflects the treatment idea of‘treating flaccid paralysis only with Yangming meridian’and‘inducing Yang from Yin and inducing Yin from Yang’.The treatment principle is to dredge meridians,harmonize Qi and blood and balance Yin and Yang.