基于复杂网络探析针灸治疗非特异性腰痛的腧穴配伍规律

Analysis on Rules of Acupoint Compatibility in Acupuncture Treatment of Nonspecific Low Back Pain Based on Complex Network Technique

基于复杂网络和关联规则挖掘针灸治疗非特异性腰痛的腧穴配伍规律。为针灸治疗非特异性腰痛选穴组方提供循证依据。本文通过检索中国知网、维普资讯中文期刊服务平台、万方数据知识服务平台、PubMed关于针灸治疗非特异性腰痛的临床研究文献,根据纳入和排除标准筛选出相关文献,建立针灸处方数据库。运用SPSS Modeler 18.1软件进行腧穴间关联规则分析,并运用Gephi 0.9.7软件进行复杂网络分析,包括“k-core层次分析”和“社团分析”。结果表明,最终筛选出107篇符合标准的文献,采集汇总了152条治疗非特异性腰痛的针灸处方,包括腧穴103个,腧穴使用的总频次为962次。所使用腧穴以足太阳膀胱经为主,其中肾俞的使用频次最高,其次是委中、大肠俞。关联规则分析显示委中-肾俞的支持度最高;阿是穴-委中的置信度最高。通过复杂网络分析发现肾俞、委中、阿是穴、大肠俞、腰阳关等15个腧穴为针灸治疗非特异性腰痛的主要腧穴。结论:临床中针灸治疗非特异性腰痛选穴以足太阳膀胱经为主,辨证取穴为辅,同时注重特定穴、经外奇穴及远端腧穴的配合。

Objective:To explore the compatible rules of acupoints in the treatment of nonspecific low back pain(NLBP)with acupuncture and moxibustion based on complex networks and association rules so as to provide evidence-based basis for composing best acupoint recipes.Methods:The clinical papers about acupuncture treatment of NLBP were searched from CNKI,VIP,Wanfang and PubMed.According to our inclusive and exclusive criteria,the collected papers were screened out to set up a database.SPSS Modeler 18.1 software was used for analysis of association rules among acupoints,and Gephi 0.9.7 software was used for complex network analysis,including"k-core hierarchical analysis"and"community analysis".Results:In the end,107 papers meeting the criteria were selected and 152 acupuncture prescriptions for the treatment of NLBP were collected,including 103 acupoints,and the total frequency of acupoints was 962 times.The main acupoints used were the bladder meridian of foot-Taiyang,among which Shenshu(BL23)was the most frequently used,followed by Weizhong(BL40)and Dachangshu(BL25).The association rules analysis showed that the highest degree acupoints was Weizhong and Shenshu.The highest levels of confidence were Ashipoint-Weizhong(BL40).Through complex network analysis,15 acupoints including Shenshu(BL23),Weizhong(BL40),Ashipoint,Dachangshu(BL25)and Yaoyangguan(GV3),etc,were found to be the main acupoints for the treatment of NLBP.Conclusion:In clinical acupuncture and moxibustion treatment of NLBP acupoints were mainly selected by the bladder meridian of foot-Taiyang,supplemented by syndrome differentiation.At the same time,attention should be paid to the specific acupoints,odd points outside the meridian and the coordination of the distal acupoints.