近十年针灸治疗顽固性面瘫选穴规律分析

Analysis of Acupoint Selection Rules in the Treatment of Intractable Facial Paralysis by Acupuncture and Moxibustion in Recent Ten Years

目的:基于数据挖掘技术探析近十年针灸治疗顽固性面瘫的选穴规律。方法:检索2013年1月至2023年1月发表在中国期刊全文数据库(CNKI)、万方(Wanfang)、维普(CQVIP)及PubMed数据库中针灸治疗顽固性面瘫的临床文献,建立处方数据库,应用excel、SPSS 20.0对穴位进行频次、频率统计及聚类分析,应用IBM SPSS Modeler 18.0和Cytoscape 3.9.0进行关联规则分析及网络图可视化的升级。结果:共纳入140条穴位处方,80个腧穴,用穴总频次为1464次。使用频次前3位的腧穴依次是地仓(85.00%)、阳白(82.86%)、颊车(82.14%),头面部腧穴使用最多,常用的奇穴为太阳(54.29%)。常选胃经、大肠经、胆经。特定穴中交会穴、原穴、下合穴应用最多。关联规则分析中置信度与支持度最高的组合为地仓-颊车。聚类分析获得2个腧穴聚类群。结论:针灸治疗顽固性面瘫以阳明经、少阳经及太阳经为主,地仓-颊车-阳白为核心穴位组合,重视远近配穴、经筋论治及对神经的刺激。

Objective To explore the acupoint selection law of acupuncture and moxibustion in the treatment of intractable facial paralysis based on data mining technology in recent ten years.Methods Clinical literatures published in CNKI,Wanfang database,CQVIP,and PubMed database from January 2013 to January 2023 were retrieved.Prescription database was established.Excel,SPSS 20.0 was used for frequency statistical analysis and cluster analysis of acupoints,SPSS Modeler was used for association rule analysis of acupoints,and Cytoscape 3.9.0 was used for visual upgrading.Results A total of 140 acupoint prescriptions and 80 acupoints were included,and the total frequency of acupoint use was 1464 times.The first three acupuncture points with highest frequency in treatment of intractable facial paralysis were Dicang(ST4)(85.00%),Yangbai(GBl4)(82.86%)and Jiache(ST6)(82.14%),with the most used acupoints on the head and face.The commonly used extra point are Taiyang(EX-HN5)(54.29%).The meridians are oftenthestomach meridian,largeintestinemeridian,gallbladder meridian;Among thespecial points,crossing point,yuan-primary point and lower he-sea point are most used.The highest combination of confidence andsupport inassociation rule analysis was Dicang(ST4)-Jiache(ST6).Two acupoint clusters were obtained by cluster analysis.Conclusion Yangmingmeridian,ShaoyangMeridianand TaiyangMeridian were the main meridians of acupuncture and moxibustion in the treatment of intractable facial paralysis.Dicang(ST4),Jiache(ST6)and Yangbai(GBl4)are the core acupoint combinations.Attention was paid tolocal and distant acupoint combinations,the treatment of musculature zones and the stimulation of nerve.