基于古籍文献的针灸治疗意识障碍选穴规律数据挖掘

Data Mining of Acupoint Selection Rules for Treatment of Disorders of Consciousness based on Ancient Classics

目的采用数据挖掘技术梳理中医古籍文献中针灸治疗意识障碍的选穴规律。方法以第5版《中华医典》为数据来源,对先秦至清末(公元前221年至公元1912年)的中医古籍进行检索,纳入针灸治疗意识障碍的相关条文,对穴位处方中腧穴使用频次、腧穴归经及特定穴的使用情况进行统计分析,并对组穴进行关联规则分析及复杂网络分析。结果共纳入古籍条文164条,源自27部古籍,涉及组穴的条文有105条、单穴59条,共包含96个腧穴、使用总频次521次。使用频次前五位的腧穴为百会(频次30次,频率5.76%,下同)、大敦(29次,5.57%)、隐白(24次,4.61%)、合谷(23次,4.41%)、足三里(22次,4.22%);腧穴分布涉及十二正经及任脉、督脉、经外奇穴,其中排名前三位的经脉依次为足太阳膀胱经(66次,12.67%)、督脉(65次,12.48%)、足厥阴肝经(60次,11.52%);特定穴使用频次最高的为五输穴中的井穴(137次,23.70%),其次为交会穴(136次,23.53%)。关联规则分析及共现网络图显示,中冲-大敦、厉兑-隐白为常用腧穴组合;复杂网络分析显示,“百会、水沟、大敦、中冲、间使、气海”和“隐白、厉兑、涌泉”为核心腧穴组合。结论古籍中针灸治疗意识障碍常选用百会、水沟、大敦、中冲、间使、气海、隐白、厉兑、涌泉等腧穴,选穴符合扶正祛邪、醒脑开窍的治疗原则,并注重井穴及交会穴的使用。

Objective To analyze the rule of acupoint selection in the treatment of disorders of consciousness(DOC)with acupuncture and moxibustion,through data mining of Chinese medicine ancient classics.Methods The relevant provisions of acupuncture and moxibustion in the treatment of DOC in the fifth edition of Chinese Medical Classics(《中华医典》)from pre-Qin to the end of Qing Dynasty(221BC to 1912AD)were retrieved.The frequency of acupoints,the channel entry of acupoints and the use of specific acupoints were analyzed,and the acupoints group were analyzed using association rules and complex network.Results A total of 164 items from 27 ancient classics were included,involving 105 acupoints group items and 59 single-point items,covering 96 acupoints with a total frequency of 521 times.The top five frequently used acupoints were Baihui(GV 20,30 times,5.76%),Dadun(LR 1,29 times,5.57%),Yinbai(SP 1,24 times,4.61%),Hegu(LI 4,23 times,4.41%)and Zusanli(ST 36,22 times,5.22%).All twelve main channels,Ren Mai(任脉),Du Mai(督脉)and extra points were involved.The most commonly involved channels were the Foot Taiyang(太阳)Bladder channel(66 times,12.67%),Du Mai(65 times,12.48%)and theFoot Jueyin(阴)Liver channel(60 times,11.52%).The well-jing points(井穴)in the five-shu points(五输穴,137 times,23.70%)were most frequently used,followed by confluence points(136 times,23.53%).The association rule analysis and co-occurrence network diagram showed that the top two acupoints combinations were Zhongchong(PC 9)-Dadun and Lidui(ST 45)-Yinbai.Through complex network analysis,“Baihui,Shuigou(GV 26),Dadun,Zhongchong,Jianshi(PC 5)and Qihai(CV 6)"and“Yinbai,Lidui and Yongquan(KI 1)"were the core acupoint combinations.Conclusion The commonly used acupoints are Baihui,Shuigou,Dadun,Zhongchong,Jianshi,Qihai,Yinbai,Lidui and Yongquan of acupuncture and moxibustion in the treatment of DOC in ancient classics.It is in line with the treatment principles of reinforcing healthy qi and dispelling pathogen,refreshing the brain and opening the orifices,and pays attention to the combined use of well points and confluence points.