基于隐结构和频繁项集挖掘膝骨关节炎针刺辨证选穴规律研究

Acupoint Selection Law of Knee Osteoarthritis Based on Data Mining Methods of Lantern Structure Model and Frequency Item Set

目的探索针刺治疗膝骨关节炎(KOA)的辨证选穴规律。方法检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(重庆维普)、中国生物医学文献数据库(CBM)、PubMed、Embase、Web of Science、Cochrane Library建库至2022年11月9日针刺辨证选穴治疗KOA相关文献,提取证型、症状、选穴信息构建数据库,利用Lantern5.0及Weka3.9.6软件,采用隐结构模型、聚类分析及频繁项集对辨证选穴规律进行分析。结果纳入文献95篇,涉及患者5458例,包含症状141个,其中高频症状为活动受限、疼痛、重着等;主要证型有阳虚寒凝、风寒湿痹、肝肾亏虚、气滞血瘀证。“症状-腧穴”频繁项集5项,包括“重着+活动受限+昼轻夜重”-“阳陵泉+犊鼻”等;“证型-症状-腧穴”频繁项集4项,包括“气滞血瘀”-“刺痛+痛有定处+活动受限”-“血海+梁丘+内膝眼”等。结论肝肾亏虚及风寒湿痹是KOA的常见证型,针刺治疗KOA多以内膝眼、犊鼻、阳陵泉、梁丘、足三里为主穴,临床辨证配穴。

Objective To explore the acupoint selection law of knee osteoarthritis(KOA).Methods The literature on acupuncture for KOA was retrieved in the databases of China National Knowledge Infrastructure(CNKI),Wanfang data,information Chinese Periodical Service Platform(VIP),China Biomedical Literature Database(CBM),PubMed,Embase,Web of Science and Cochrane Library from the establishment of the databases to November 9,2022.The information of syndromes,symptoms and acupoint selections were extracted to build a database of KOA.Lantern 5.0 and Weka 3.9.6 software,the lantern structure model,clustering analysis and frequent item set were used to analyze the acupoint selection law based on syndrome differentiation in acupuncture treatment of KOA.Results A total of 95 articles with 5458 medical cases were included in final screening,involving 141 symptoms.The high-frequency symptoms are limitation of motion,pain,and heaviness,etc.The main syndrome types are Yang deficiency and cold coagulation,wind cold dampness arthralgia,liver and kidney deficiency,qi stagnation and blood stasis.Five frequency items sets of“symptom-acupoint”were identified,including“heavy+limitation of motion+light in the day and heavy in the night-Yanglingquan(GB34)+Dubi(ST35)”,etc.Four of the frequent“syndrome-symptom-acupoint”sets were identified,including“qi stagnation and blood stasisstabbing pain+pain with a fixed location+limitation of motion-Xuehai(SP10)+Liangqiu(ST34)+Neixiyan(EXLE4)”,etc.Conclusion Liver and kidney deficiency and wind-cold-dampness arthralgia are common syndromes of KOA.Acupuncture for KOA selects Neixiyan(EX-LE4),Dubi(ST35),Yanglingquan(GB34),Liangqiu(ST34)and Zusanli(ST36)as main acupoints,and selects other acupoints based on clinical symptoms.