基于复杂网络分析针灸治疗炎性肠病的选穴规律

Rules of acupoint selection in treatment of inflammatory bowel disease with acupuncturemoxibustion based on complex network analysis

目的:利用复杂网络技术分析针灸治疗炎性肠病(IBD)的选穴和腧穴配伍规律,为针灸治疗IBD选穴组方提供参考。方法:检索中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台、PubMed、Embase数据库中针灸治疗IBD的临床研究文献,筛选文献并提取针灸处方,建立针灸治疗IBD数据库。运用Microsoft Excel 2021软件统计腧穴的使用频次、频率、归经和特定穴使用情况,运用SPSS Modeler 18.0软件对处方进行关联规则分析,运用Gephi 0.9.5软件绘制腧穴共现网络图、k-core网络图、社团分析图。结果:共纳入156篇符合标准的文献,包含175条针灸处方,涉及75个腧穴,腧穴使用累计使用频次为1378次,平均每个处方约8个腧穴。天枢、足三里、关元、中脘、脾俞为针灸治疗IBD使用频次前5位的腧穴,足阳明胃经、足太阳膀胱经和任脉为使用频次前3位的经脉,募穴为使用频次最高的特定穴,足三里-天枢为针灸治疗IBD的高频穴对。运用复杂网络中的k-core层次分析优化腧穴处方,可得到天枢、足三里、关元、中脘、脾俞、大肠俞、上巨虚、肾俞、气海、三阴交、命门、行间、阴陵泉、内庭、太冲、下巨虚、水分、神阙、肝俞、胃俞、合谷、曲池22个核心腧穴,进行社团分析后可以分为3类核心腧穴群。结论:通过复杂网络分析发现针灸治疗IBD的选穴原则以胸腹部局部选穴为主,同时注重远近配穴,根据辨证分型加减腧穴,对特定穴中的募穴应用广泛。以上结论可为针灸治疗IBD提供选穴思路。

Objective To analyze the rules of acupoint selection and compatibility of acupuncture and moxibustion in treatment of inflammatory bowel disease(IBD)based on complex network technology and provide the reliable evidences for acupoint selection in treatment of this disease with acupuncture and moxibustion.Methods The clinical studies on acupuncture-moxibustion treatment of IBD were searched from the databases including CNKI,Wanfang,VIP,PubMed and Embase.The studies were screened and the acupoint prescriptions were extracted to set up the database of acupuncture-moxibustion treatment for IBD.Using Microsoft Excel 2021 software,the use times of acupoint,the use frequency(%)of acupoint,meridian tropism and the use of special point were imported.With SPSS Modeler 18.0 software adopted,the association rules were analyzed on the acupoint prescriptions.The acupoint co-occurrence network diagram,k-core network diagram,and community analysis diagram were drawn by Gephi 0.9.5 software.Results A total of 156 studies were included,composed of 175 acupoint prescriptions,75 acupoints,with 1378 use times in total and around 8 acupoints in one prescription.Regarding the top use frequency,Tianshu(ST25),Zusanli(ST36),Guanyuan(CV4),Zhongwan(CV12)and Pishu(BL20)were listed.The top meridians involved were the foot-yangming stomach meridian,the foot-taiyang bladder meridian and the Conception Vessel.The front-mu point had been used with the highest frequency among the special points.ST36 and ST25 were a pair of points with the highest frequency in treatment.The k-core hierarchical analysis was adopted to optimize acupoint prescriptions,and 22 core acupoints were obtained,i.e.ST25,ST36,CV4,CV12,BL20,Dachangshu(BL25),Shangjuxu(ST37),Shenshu(BL23),Qihai(CV6),Sanyinjiao(SP6),Mingmen(GV4),Xingjian(LR2),Yinlingquan(SP9),Neiting(ST44),Taichong(LR3),Xiajuxu(ST39),Shuifen(CV9),Shenque(CV8),Ganshu(BL18),Weishu(BL21),Hegu(LI4)and Quch(i LI11),which were classified into three core acupoint groups by community analysis.Conclusion Through complex network analysis,it is found that the local acupoints on the chest and abdomen are generally selected in treatment with acupuncture-moxibustion for IBD,the combination of the nearby and distal points is considered simultaneously,and the acupoint prescription is modified according to syndrome/pattern differentiation;and among special points,the front-mu point is widely used in treatment.All of these rules provide the ideas for the acupoint selection of acupuncture-moxibustion in treatment of IBD.