基于数据挖掘针灸治疗卵巢功能早衰的腧穴运用规律研究

Rule of Acupoints Selection in Treatment of POF Based on Data Mining

目的:运用数据挖掘技术分析针灸治疗卵巢功能早衰(POF)的选穴规律,并探讨高频核心腧穴的用穴思路及其病机。方法:以“卵巢功能早衰”和“针刺”或“针灸”或“电针”或“温针灸”或“灸法”或“针药并用/并举/结合”为关键词,检索并筛选建库—2023年6月16日的中国知网、万方数据库与维普平台中针灸治疗POF的相关文献,记录及整理文献中的针灸处方,运用数据挖掘技术对腧穴进行描述性分析、聚类分析及关联分析。结果:共筛选出符合要求的文献67篇,提取出91组腧穴处方。针灸治疗POF使用频次前5位的腧穴依次是关元、三阴交、肾俞、足三里及子宫;最常选取的经脉为足太阳膀胱经、任脉及足太阴脾经;特定穴方面,主要以交会穴(239次)、募穴(116次)、背俞穴(110次)和五输穴(107次)为主。关联规则分析所获最紧密的穴对为关元→三阴交、三阴交→足三里和关元→足三里。通过聚类分析获得3类处方:(1)神庭、本神、百会、中脘、卵巢、天枢、大赫、太溪、太冲、足三里、血海、归来、中极和气海;(2)脾俞、肝俞、命门、肾俞和次髎;(3)关元、三阴交和子宫。结论:针灸治疗POF的思路以补肾益精为主,佐以调肝养心、疏肝扶脾。

Objective:To analyze the rule of acupoints selection in treatment of premature ovarian failure(POF) based on data mining,and to explore the idea of using high-frequency core acupoints and the pathogenesis.Methods:The key words of ‘premature ovarian failure',‘acupuncture',‘acupuncture and moxibustion',‘electro-acupuncture',‘needle-warming moxibustion',‘moxibustion',and ‘combination of acupuncture and medication' were used to screen relevant literature about the treatment of POF from the databases of CNKI,Wanfang and VIP.The acupuncture prescriptions were recorded and sorted out,and the descriptive analysis,cluster analysis and correlation analysis of acupoints were carried out by using data mining technology.Results:A total of 67 pieces of literature meeting the criteria were selected and 91 sets of acupoint prescriptions were concluded.The top 5 acupoints frequently used in treatment of POF were Guanyuan(RN4),Sanyinjiao(SP6),Shenshu(BL23),Zusanli(ST36) and Zigong(EX-CA1).The most commonly involved meridians were Foot Taiyang Bladder Meridian,Ren Channel and Foot Taiyin Spleen Meridian.In terms of specific points,the main points were confluent points(239 times),front-Mu points(116 times),back-Shu points(110 times) and five-Shu points(107 times).The closest point pairs obtained by association rule analysis were RN4 → SP6,SP6 → ST36 and RN4 → ST36.Through cluster analysis,three kinds of prescriptions were obtained,including Shenting(DU24),Benshen(GB13),Baihui(DU20),Zhongwan(RN12),Luanchao,Tianshu(ST25),Dahe(KI12),Taixi(KI3),Taichong(LR3),ST36,Xuehai(SP10),Guilai(ST29),Zhongji(RN3) and Qihai(RN6);Pishu(BL20),Ganshu(BL18),Mingmen(DU4),BL23 and Ciliao(BL32);RN4,SP6 and EX-CA1.Conclusion:The treatment of POF by acupuncture and moxibustion is mainly to supplement Kidney-essence,assisted by regulating Liver and nourishing Heart,soothing Liver and strengthening Spleen.