针灸治疗产后抑郁的选穴配伍规律探析

Analysis of regularity of acupoint selection and compatibility of acupuncture in the treatment of postpartum depression

目的:探讨针灸治疗产后抑郁的临床选穴配伍规律。方法:检索中国期刊全文数据库、中国生物医学文献数据库、万方数据知识服务平台、维普期刊全文数据库及英文数据库Pubmed、Cochrane Library、Embase从建库到2021年2月针灸治疗产后抑郁的临床研究文献,运用数据挖掘技术,对选取的腧穴、经络等进行频次统计,对使用频次较高的腧穴进行聚类分析。结果:共检索到相关文献372篇,最终纳入42篇,共涉及处方65条、腧穴80个。使用频次最高的腧穴依次为百会(43次)、三阴交(42次)、太冲(38次)、内关(38次)、足三里(32次)和神门(28次),选穴多集中在膀胱经(86次,13个腧穴)、督脉(73次,10个腧穴)和肝经(58次,5个腧穴),特定穴中交会穴(158次,19个腧穴)、五输穴(123次,17个腧穴)、原穴(86次,6个腧穴)及背俞穴(76次,7个腧穴)等使用广泛。通过聚类分析得出4个有效聚类群(百会-三阴交、太冲-内关、心俞-肝俞-脾俞-关元、合谷-气海-期门)以及一组主穴(百会-三阴交-太冲-内关-足三里-神门)和两组辨证配穴(合谷-气海-期门、心俞-肝俞-脾俞-关元-四神聪)。结论:产后抑郁以多虚、多瘀、多郁为主要病机特点,针灸治疗产后抑郁在选穴上更注重调气、调血、调神,并运用远近配穴、前后配穴等多种配穴方法。以百会、三阴交、太冲、内关、足三里和神门为主穴,腧穴配伍上侧重调畅气机(合谷-气海-期门)和养血调神(心俞-肝俞-脾俞-关元-四神聪)。

Objective To analyze the regularity of acupoint selection,and compatibility of acupuncture in the treatment of postpartum depression.Methods Articles both in English and Chinese published in databases of CNKI,Wanfang,VIP,Chinese biomedical literature database(SinoMed),PubMed,Embase,Cochrane Library from the inception to February of 2021 were retrieved by using key words“acupuncture”or“moxibustion”or“electroacupuncture”or“acupoint application”or“acupoint burying”or“acupoint injection”or“fire needling”and“postpartum depression”or“puerperal depression”.The frequencies of selected acupoints and meridians were counted by using data mining technology,and the points with high frequency were analyzed by cluster analysis.Results A total of 42 articles were included,containing 65 prescriptions and 80 points.The highest frequency of acupoints were Baihui(GV20),Sanyinjiao(SP6),Taichong(LR3),Neiguan(PC6),Zusanli(ST36)and Shenmen(HT7).The most frequently selected channels were Bladder Meridian,Governor Meridian and Liver Meridian.Among the specific points,intersection points,five-shu points,yuan-source points and back-shu points were widely used.Through cluster analysis,four effective cluster groups[GV20-SP6,LR3-PC6,Xinshu(BL15)-Ganshu(BL18)-Pishu(BL20)-Guanyuan(CV4),Hegu(LI4)-Qihai(CV6)-Qimen(LR14)]were obtained,as well as a group of main points(GV20-SP6-LR3-PC6-ST36-HT7)and two groups of matching points[LI4-CV6-LR14 and BL15-BL18-BL20-CV4-Sishencong(EX-HN1)].Conclusion Through data mining technology,this paper summarized the acupoint selection and compatibility law of acupuncture in the treatment of postpartum depression,focusing on regulating Qi,blood and spirit,so as to provide reference for guiding the clinical acupuncture treatment and scientific research of postpartum depression.