基于数据挖掘技术探讨巨刺法治疗卒中后偏瘫的选穴规律

Discussion on the Acuppoint Selection Rules of Acupuncture in the Treatment of Post-stroke Hemiplegia by Opposing Needling Based on Data Mining Technique

【目的】采用数据挖掘技术探讨巨刺法治疗卒中后偏瘫的选穴规律。【方法】检索中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方学术期刊全文数据库(Wanfang)、中国生物医学文献数据库(SinoMed)、PubMed、Web of Science自建库至2023年9月收录的巨刺法治疗卒中后偏瘫的相关文献。采用Microsoft Excel 2019建立数据库并对腧穴进行描述性分析;采用SPSS Modeler 18.0进行关联规则分析并绘制高频腧穴共现网络图;采用SPSS Statistics 26.0对腧穴进行层次聚类分析并绘制树状图。【结果】(1)共纳入104篇文献,提取针灸处方136条,涉及腧穴107个,总频次1267次;(2)腧穴使用频次前10位的分别为合谷、曲池、足三里、肩髃、外关、阳陵泉、三阴交、手三里、太冲、悬钟;(3)所选经脉主要为手、足阳明经及足少阳经;(4)选穴多在上、下肢及头项部;(5)在腧穴配伍方面,合谷-曲池的支持度最高;(6)前25位高频腧穴可分为4个有效聚类群;(7)巨刺常联合头针、康复训练、普通针刺等方法治疗卒中后偏瘫。【结论】现代巨刺法治疗卒中后偏瘫重视阳经的使用,同时亦选用阴经穴位调和阴阳,疏通经络,重视腧穴的近治作用,遵循中医治病整体观。

Objective To explore the acupoint selection rules of opposing needling in the treatment of post-stroke hemiplegia by using data mining technology.Methods CNKI,VIP,Wanfang,SinoMed,PubMed and Web of Science were searched for relevant literature on the treatment of post-stroke hemiplegia by opposing needling from the establishment of the database to September 2023.Microsoft Excel 2019 was used to establish a database and perform descriptive analysis of acupoints.SPSS Modeler 18.0 was used to analyze the association rules and draw the co-occurrence network diagram of high-frequency acupoints.SPSS Statistics 26.0 was used to perform hierarchical cluster analysis on acupoints and draw a tree diagram.Results①A total of 104 articles were included,and 136 acupuncture prescriptions were extracted,involving 107 acupoints,with a total frequency of 1267 times.②The top 10 acupoints were Hegu(LI4),Quchi(LI11),Zusanli(ST36),Jianyu(LI15),Waiguan(SJ5),Yanglingquan(GB34),Sanyinjiao(SP6),Shousanli(LI10),Taichong(LR3),Xuanzhong(GB39).③The selected meridians were mainly hand,foot yangming meridian and foot shaoyang meridian.@The acupoints were mostly selected in the upper and lower limbs and head and neck.In terms of acupoint compatibility,Hegu(LI4)-Quchi(LI11)has the highest support.@The top 25 high-frequency acupoints can be divided into four effective clustering groups.Opposing needling often combined with scalp acupuncture,rehabilitation training,ordinary acupuncture and other methods to treat hemiplegia after stroke.Conclusion Modern opposing needling attaches importance to the use of yang meridians in the treatment of post-stroke hemiplegia.At the same time,it also selects yin meridians and acupoints to harmonize yin and yang,unblock meridians and collateral,attach importance to the near-treatment effect of acupoints,and follow the holistic view of Chinese medicine treatment.