天枢穴主治病症及配伍规律探析:基于随机临床对照试验

The Main Indications and Compatibility Rules of Tianshu(ST25)Based on Randomized Controlled Trials

目的:运用数据挖掘技术深入总结天枢穴现代主治病症及腧穴配伍规律。方法:检索自建库至2022年6月2日中国期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang)、维普资讯中文期刊服务平台(VIP)、中国生物医学文献数据库(SinoMed)、PubMed及Web of Science等数据库相关文献资料,建立天枢单穴、配伍主治病症和配伍腧穴等数据库。运用SPSS Modeler 18.0和Gephi 0.9.2等软件对纳入文献进行复杂网络分析、关联分析、聚类分析。结果:共纳入随机对照试验文献622篇,毫针刺、电针、穴位敷贴以及艾灸是天枢穴常用的干预措施。单穴主治病症12种,优势病症为便秘、腹泻等2种;配伍主治病症85种,优势病症为便秘、胃肠功能障碍、肠易激综合征、肥胖、腹泻、消化不良、溃疡性结肠炎等14种。高频配伍腧穴为足三里、中脘、上巨虚、关元等22穴,聚类分析得到4系6类天枢配伍组合,配伍经脉以任脉频次最高,阳经腧穴多于阴经。结论:天枢穴主治范围广泛,以消化系统疾病为主,便秘为核心优势病症,其高频配穴为足三里、中脘、上巨虚、关元。

Objective:Using data mining technology to analyze and summarize the modern dominant indications and compatibility regularity of Tianshu(ST25).Methods:From the establishment of the database to June 2,2022,the database was retrieved from CNKI,Wanfang,VIP,SinoMed,PubMed,Web of Science,etc.Three databases were established with the retrieved data,including single-acupoint indications database,compatible acupoints indications database and compatible acupoints database.SPSS Modeler 18.0 and Gephi 0.9.2 and other software were used to conduct complex network analysis,association analysis and cluster analysis on the included literature.Results:A total of 622 randomized controlled trials were included,and filiform acupuncture,electroacupuncture,acupoint application and moxibustion were commonly used intervention measures at ST25.There were 12 kinds of single point indications and 85 kinds of compatible acupoints indications.Among the single-acupoint indications,there were only 2 dominant ones,including constipation,diarrhea.Among the compatible acupoints indications,there were 14 dominant ones,including Constipation,gastrointestinal dysfunction,irritable bowel syndrome,obesity,diarrhea,indigestion,ulcerative colitis,etc.In the aspect of compatibility,ST25 was often used in combination with specific points,such as the crossing acupoints,the Five-shu acupoints,the lower confluent acupoints,etc.There were 22 high-frequency compatible acupoints,such as Zusanli(ST36),Zhongwan(CV12),Shangjuxu(ST39),Guanyuan(CV4),etc.The results of hierarchic cluster analysis showed that the 4 groups of acupoint prescriptions could be subdivided into 6 groups.The Ren meridians was the one with the highest frequency among the compatible meridians.Compared with the Yin meridian,the Yang meridian played a more significant role.Conclusion:ST25 can be applied in most clinical practice,especially in digestive system diseases.Constipation is the core dominant indication of ST25.Its high-frequency matching acupoints are ST36,CV12,ST39 and CV4.