基于数据挖掘推拿治疗颈性眩晕取穴规律研究

Study on Point Selection Rules of Tuina for Cervical Vertigo Based on Data Mining

目的:基于数据挖掘研究推拿治疗颈性眩晕的取穴规律。方法:通过计算机检索中国期刊全文数据库(CNKI)、中国生物医学文献数据库(SinoMed)、维普期刊数据库(VIP)、万方医学数据库自建库至2022年6月收录的推拿治疗颈性眩晕的临床文献,建立数据库并运用数据挖掘技术对推拿处方进行描述性分析、关联规则分析及聚类分析。结果:共纳入文献98篇,处方110首,共涉及穴位98个,总用穴频次806,使用频率>10%的有3条经脉,依次为足少阳胆经、督脉、足太阳膀胱经,累计使用频率58.68%,单穴频次≥15的穴位有13个,分别为风池、肩井、风府、太阳、百会、大椎、天宗、印堂、天柱、合谷、肩外俞、率谷及头维,特定穴以五腧穴、络穴、八脉交会穴、原穴及背俞穴为主。关联规则分析显示风池-肩井、风池-风府-肩井是支持度最高的穴对和穴组。通过对频次≥15的穴位进行聚类分析,可将穴位分为2大类,主要涉及头面部穴位,以及局部颈椎穴位。结论:推拿治疗颈性眩晕选穴多以阳经为主,其中以足少阳胆经穴位为主,治以温经通络、益气升阳。穴位配伍应以颈椎局部取穴为主,配以头面部穴位共治,通过恢复颈椎筋骨平衡治疗眩晕。

Objective:To explore the point selection rules of tuina for cervical vertigo based on data mining.Methods:By searching the China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(SinoMed),VIP Journal Database(VIP),and Wanfang Medical Database,the clinical literature on tuina therapy for cervical vertigo collected from the establishment of the database to June2022 was obtained.The database was established and data mining techniques were used to perform descriptive analysis,association rule analysis,and cluster analysis on tuina prescriptions.Results:A total of 98 literature and 110 prescriptions were included,involving a total of 98 points.The total frequency of points used was 806,and there were 3 channels with a frequency greater than 10%,namely the foot shaoyang gallbladder channel,the governor vessel,and the foot taiyang bladder channel.The cumulative frequency of use was 58.68%.There were 13 points with a single point frequency ≥ 15,including Fengchi point(GB 20),Jianjing point(GB 21),Fengfu point(DU 16),Taiyang point(EX-HN5),Baihui point(DU20),Dazhui point(DU 14),Tianzong point(SI 11),Yintang point(EX-HN3),Tianzhu point(BL 10),Hegu point(LI 4),Jianwaishu point(SI 14),Shuaigu point(GB 8),and Touwei point(ST 8).Specific points were mainly five transport points,collaterals-connecting points,eight confluence points,yuan-source point,and back-shu point.Association rule analysis showed that Fengchi-Jianjing and Fengchi-Fengfu-Jianjing were the most supported point pairs and groups.By conducting the clustering analysis on points with a frequency≥15,points can be divided into two categories,mainly involving scalp and facial points,as well as local cervical points.Conclusion:The selection of points for the treatment of cervical vertigo with tuina is mostly based on the yang channels,with points of the foot shaoyang gallbladder channel being the main ones.The treatment is to warm the channels,unblock the collaterals,and boost qi and raise yang.Point compatibility should mainly focus on selecting local points on the cervical spine,being combined with the treatment of scalp and facial points,to restore the balance of the cervical spine muscles and bones for the treatment of vertigo.