基于聚类分析研究针刺治疗中风后运动性失语的选穴规律

Acupoint Selection Rule of Acupuncture Therapy for Post-Stroke Motor Aphasia Based on Hierarchical Cluster Analysis

目的研究针刺治疗中风后运动性失语的临床选穴规律。方法从CNKI、万方、维普、三大中文数据库收集全库符合中风后运动性失语诊断的临床文献396篇,运用数据挖掘技术进行筛选,观察临床针刺治疗中风后运动性失语的穴位使用频数与频率。通过聚类分析,采用Ward法进行聚类,以平方欧式距离(SED)作为度量,以凝聚过程反应聚类分析过程,以系统树状图表示分析结果。结果396篇文献中,提取出59篇符合运用针刺治疗中风后运动性失语的文献,其中,使用频数排名前5位的穴位依次为廉泉、金津、玉液、百会、通里。以SED为度量,聚类结果可分为聚三类(SED<5)、聚二类(5<SED<15),以聚三类结果最符合选穴规律情况。结论临床针刺治疗中风后运动性失语的选穴规律主要可以聚成三类,主要以“局部取穴、辨经取穴和辨证取穴”为基础。该研究为临床治疗中风后运动性失语选穴提供依据。

Objective To study the clinical rule of acupoint selection in the treatment of post-stroke motor aphasia by acu⁃puncture.Methods A total of 396 clinical literatures were collected from CNKI,Wan Fang and VIP Chinese databases,which were in line with the diagnosis of post-stroke motor aphasia.The acupoint usage frequency in clinical acupuncture treatment of post-stroke motor aphasia was observed by data mining.Through cluster analysis,Ward method was used for cluster analysis.Square European distance(SED)was taken as the measurement,the process of cluster analysis was expressed by the reaction of agglomeration process,and the analysis results were represented by the system tree graph.Results Among the 396 literatures,59 literatures in line with the application of acupuncture in the treatment of post-stroke aphasia were extracted.Among them,the top 5 acupoints were Lianquan(RN23),Jinjin(Ex-HN13),Yuye(Ex-HN14),Baihui(DU20)and Tongli(HT5).Using SED as a measure,the clustering results could be divided into the third cluster(SED<5)and the second cluster(5<SED<15),and the third cluster results were most consistent with the rule of acupoint selection.Conclusion The rules of acupoint selection in clinical acupuncture treatment of post-stroke motor aphasia can be divided into three categories,which are mainly based on"lo⁃cal acupoint selection,meridian differentiation and syndrome differentiation",providing the basis for clinical treatment of post-stroke motor aphasia.