推拿治疗神经根型颈椎病的选穴及手法应用规律

Exploration on the Selection of Acupoints and Application of Manipulation in the Treatment of Cervical Spondylotic Radiculopathy by Tuina

目的:运用数据挖掘技术分析推拿治疗神经根型颈椎病(CSR)的手法及选穴规律。方法:检索中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普中文期刊服务平台(VIP)、PubMed、Web of Science2013年1月1日至2023年12月1日收录的推拿治疗CSR临床研究文献,筛选后建立推拿处方数据库,采用Microsoft Excel 2019进行描述性统计分析,SPSS modeler 18.0进行关联规则分析,Cytoscape 3.9.1构建数据可视化网络图。结果:共纳入文献128篇,涉及腧穴70个,手法32种。高频腧穴为风池、肩井、天宗等,常用经脉为足少阳胆经、手阳明大肠经和手太阳小肠经,腧穴多分布在颈项、上肢和肩背,以交会穴、五输穴居多,腧穴关联规则分析得到15组关联规则,风池-肩井-天宗-风府-曲池的关联度较高。手法类型以挤压类和运动关节类手法为主,高频推拿手法为拿法、按揉法和点法等,手法关联规则分析得到18组关联规则,拿法-点法-按操法-[扌衮]法-拔伸法的关联度较高。结论:推拿治疗CSR以祛风散寒、活血通络、调衡筋骨为原则,可发挥推拿手法和经络腧穴的协同作用。

Objective:To analyze the manipulation and point selection rule of tuina in the treatment of cervical spondylotic radiculopathy(CSR)by using data mining technology.Methods:The clinical research literature on CSR for tuina therapy collected from China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(Wanfang Data),VIP Chinese Journal Service Platform(VIP),PubMed,and Web of Science from January 1,2013 to December 1,2023 were searched.After screening,tuina prescription database was established.Microsoft Excel 2019 was used for descriptive statistical analysis,SPSS modeler 18.0 was used for association rule analysis,and data visualization network diagram was constructed.Results:A total of 128 articles were included in the literature,involving 70 acupoints and 32 techniques.The high-frequency acupoints were Fengchi(GB20),Jianjing(GB21),Tianzong(SI11),and etc.The commonly used meridians were foot-shaoyang gallbladder meridian,hand-yangming large intestine meridian,and hand-sun small intestine meridian.The acupoints were mostly distributed in the neck,upper limbs,and back of the shoulder,and the majority of them were Jiaohui points and Wuzhong points.The analysis of acupoint association rules resulted in 15 sets of association rules,with a high degree of association of Fengchi(GB20)-Jianjing(GB21)-Tianzong(SI11)-Fengfu(DU16)-Quchi(LI11).The main types of techniques were extrusion-type and motion-joint-type,and the high-frequency tuina techniques include Na method,pressing and kneading method,pointing method,and etc.The analysis of the association rules of the techniques resulted in 18 sets of association rules,with a high degree of association of Na method-point method-pressing method-Gun method-stretching method.Conclusion Tuina therapy for CSR is based on the principles of dispelling wind and dispersing cold,activating blood circulation and regulating tendons and bones,and utilizing the synergistic effects of tuina techniques and meridian acupoints.