基于复杂网络探讨针灸促进肠癌术后胃肠功能恢复选穴规律

Acupoints selection rules of acupuncture and moxibustion for promoting gastrointestinal function recovery after intestinal cancer surgery based on complex network analysis

目的:运用复杂网络技术探讨针灸促进肠癌术后胃肠功能恢复的选穴规律。方法:计算机检索PubMed、Embase、Cochrane Library、中国知网(CNKI)、万方数据知识服务平台(Wanfang)、维普资讯中文期刊服务平台(VIP)、中国生物医学文献数据库(SinoMed)中从建库至2023年5月9日收录的针灸促进肠癌术后胃肠功能恢复的相关文献。根据纳入、排除标准筛选文献,建立针灸促进肠癌术后胃肠功能恢复数据库。运用IBM SPSS Modeler 18.0进行关联规则分析,IBM SPSS Statistics 26.0进行聚类分析,Gephi0.9.2进行复杂网络分析。结果:纳入文献255篇,涉及113个腧穴,总使用频次为1080次,频数前5的腧穴为足三里、上巨虚、天枢、中脘、内关;经络选用以胃经、任脉和脾经为主;下合穴、五输穴、交会穴、募穴为常用特定穴。关联规则分析显示支持度最高的穴组是足三里-上巨虚(33.82%),其次为足三里-天枢(23.53%)、足三里-中脘(23.53%)、足三里-内关(22.43%)。聚类分析得到3个有效聚类群。通过复杂网络分析,最终得到两个核心腧穴群,分别为背部-下肢俯卧位腧穴群及腹部-四肢仰卧位腧穴群。干预措施主要为毫针针刺及电针。手法的运用多为平补平泻,强关联穴位为上巨虚、足三里;其次为提插捻转泻法,强关联穴位为天枢、中脘;总体而言泻法的运用多于补法。结论:针灸促进肠癌术后胃肠功能恢复以健运脾胃、培元固本、调畅气机为主要治则,多选取胃经、任脉和脾经特定穴,多采用毫针针刺、平补平泻手法,发挥针刺双向调节的特点和优势。

Objective To investigate the selection rules of acupoints for promoting gastrointestinal function recovery after colorectal cancer surgery using complex network technology.Methods Relevant literatures on acupuncture and moxibustion for promoting gastrointestinal function recovery after colorectal cancer surgery were searched from databases including PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,VIP Chinese Journal Service Platform,and SinoMed from retrieved to May 9,2023.Literatures were selected based on inclusion and exclusion criteria,and a database of acupuncture and moxibustion for promoting gastrointestinal function recovery after intestinal cancer surgery was established.Association rule analysis was performed using IBM SPSS Modeler 18.0.Clustering analysis was performed using IBM SPSS Statistics 26.0.Complex network analysis was conducted using Gephi0.9.2.Results A total of 255 articles were included,covering 113 acupoints,with a total usage frequency of 1080 times.The top 5 frequently used acupoints were Zusanli(ST36),Shangjuxu(ST37),Tianshu(ST25),Zhongwan(CV12),and Neiguan(PC6).The meridians predominantly used were the Stomach Meridian,Conception Vessel,and Spleen Meridian.Commonly used specific acupoints included lower he-sea points,five shu acupoints,crossing points,and mu-front acupoints.Association rule analysis showed that the acupoint combination with the highest support degree was ST36-ST37(33.82%),followed by ST36-ST25(23.53%),ST36-CV12(23.53%),and ST36-PC6(22.43%).Clustering analysis identified 3 effective clusters.Complex network analysis revealed two core groups of acupoints:the back-lower limb prone position group and the abdomen-limb supine position group.Intervention measures primarily involved filiform needle acupuncture and electroacupuncture.Uniform reinforcing-reducing method was mostly used techniques,with strongly associated acupoints being ST37 and ST36;lifting-thrusting and twisting reducing method came secondly,with strongly associated acupoints being ST25 and CV12.Overall,reducing technique was used more frequently than reinforcing technique.Conclusion Acupuncture and moxibustion for promoting gastrointestinal function recovery after intestinal cancer surgery focuses on strengthening and harmonizing the spleen and stomach,cultivating the body’s foundation,and regulating qi flow.The specific acupoints on the Stomach Meridian,Conception Vessel,and Spleen Meridian were mainly selected,and filiform needle acupuncture and uniform reinforcing-reducing technique were mainly used to realize the bidirectional regulation characteristics and advantages of acupuncture.