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基于数据挖掘技术探究针灸治疗脑卒中相关性肺炎的腧穴配伍规律

Acupoint Compatibility Rules of Acupuncture for Stroke-Associated Pneumonia Based on Data Mining Technology
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摘要 目的运用数据挖掘技术探究针灸治疗脑卒中相关性肺炎(SAP)的腧穴配伍规律。方法检索中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science中关于针灸治疗SAP的随机对照试验,检索时限为建库至2024-02-18。将检索到的文献资料导入EndNote X9文献管理软件,去除重复发表的文献后由两名研究人员独立根据文献纳入和排除标准进行文献筛选,由两名研究人员参考Cochrane手册5.1.0推荐的偏倚风险评估工具进行文献质量评价。提取文献中的处方腧穴并录入到Excel 2021中,建立针灸治疗SAP的处方数据库。统计腧穴使用频次、归经、部位、特定穴。利用SPSS ModeleR18.0中的Apriori算法对使用频次>15的腧穴进行关联规则分析,绘制网状关系图,分析核心腧穴。运用SPSS Statistics 26.0对使用频次>15的腧穴进行聚类分析并绘制树状图。结果最终纳入文献98篇,其质量均为B级。98篇文献中共有98条腧穴处方,涉及100个腧穴,总使用频次为755,使用频次排名前3位的腧穴分别为肺俞穴(52次)、合谷穴(41次)、足三里穴(40次),总使用频次排名前3位的经络分别为足太阳膀胱经(105次,涉及15个腧穴)、手太阴肺经(102次,涉及8个腧穴)、足阳明胃经(97次,涉及13个腧穴),总使用频次排名前3位的部位分别为上肢(212次,涉及22个腧穴)、头颈部(206次,涉及28个腧穴)、下肢(191次,涉及22个腧穴)。100个腧穴中有70个腧穴为特定穴,总使用频次排名前3位的特定穴分别为交会穴(194次,涉及20个腧穴)、合穴(99次,涉及6个腧穴)、原穴(91次,涉及5个腧穴)。关联规则分析结果显示,共得到12条关联规则,使用频次排名前3位的关联规则为合谷穴-太冲穴、足三里穴-曲池穴、合谷穴-曲池穴。网状关系图分析结果显示,核心腧穴为合谷穴、太冲穴、足三里穴、曲池穴。聚类分析结果显示,当标度选择12时,腧穴可分为4个聚类:(1)聚类1:太渊穴、中府穴、列缺穴、天突穴、三阴交穴、尺泽穴、大椎穴;(2)聚类2:曲池穴、太冲穴、合谷穴、足三里穴、丰隆穴;(3)聚类3:廉泉穴、百会穴、风池穴;(4)聚类4:肺俞穴。结论针灸治疗SAP的选穴以肺俞穴、合谷穴、足三里穴为主,主要涉及足太阳膀胱经、手太阴肺经、足阳明胃经,主要集中在上肢、头颈部、下肢,主要以交会穴、合穴、原穴为特定穴,主要以合谷穴-太冲穴、足三里穴-曲池穴、合谷穴-曲池穴为关联规则,以合谷穴、太冲穴、足三里穴、曲池穴为核心腧穴,并根据患者的证型选取相应的配穴。 Objective To investigate the acupoint compatibility rules of acupuncture foRstroke-associated pneumonia(SAP)based on data mining technology.Methods CNKI,VIP,Wanfang Data,CBM,PubMed,Cochrane Library,Embase,and Web of Science were searched by computeRfoRthe randomized controlled trials of acupuncture foRSAP;the retrieval time was from the establishment of the database to 2024-02-18.The retrieved literature was imported into EndNote X9 literature management software,literature screening was performed by two researchers independently according to the literature inclusion and exclusion criteria afteRremoving duplicate publications,and literature quality evaluation was performed by two researchers with reference to the risk of bias assessment tool recommended by the Cochrane Handbook 5.1.0.Prescribed acupuncture points from the literature were extracted and entered into Excel 2021 to establish a prescription database foRacupuncture foRSAP.The frequency of use,meridian tropism,sites,and specific points of acupoints were counted.Association rules of acupoints with a frequency of use>15 were analyzed by the Apriori algorithm in SPSS ModeleR18.0,the mesh relationship diagram was drawn,and the core acupoints were analyzed.SPSS Statistics 26.0 was used to analyze the clustering of acupoints with a frequency of use>15 and to draw a dendrogram.Results A total of 98 articles were ultimately included,all of which were rated as B-level in quality.Among these 98 articles,there were 98 acupoint prescriptions involving 100 acupoints,with a total use frequency of 755 times.The top 3 acupoints in terms of frequency of use were Feiyu(52 times),Hegu(41 times),and Zusanli(40 times).The top 3 meridians in terms of total frequency of use were the Foot Taiyang BladdeRMeridian(105 times,involving 15 acupoints),the Hand Taiyin Lung Meridian(102 times,involving 8 acupoints),and the Foot Yangming Stomach Meridian(97 times,involving 13 acupoints).The top 3 body regions in terms of total frequency of use were the uppeRlimbs(212 times,involving 22 acupoints),the head and neck(206 times,involving 28 acupoints),and the loweRlimbs(191 times,involving 22 acupoints).Out of 100 acupoints,70 were specific points.The top 3 specific points in terms of total frequency of use were the crossing point(194 times,involving 20 acupoints),the He-sea point(99 times,involving 6 acupoints),and the Yuan-primary point(91 times,involving 5 acupoints).The association rules analysis results showed that there were 12 association rules,the top 3 association rules in terms of frequency of use were Hegu-Taichong,Zusanli-Quchi,and Hegu-Quchi.The analysis of the network relationship diagram showed that the core acupoints were Hegu,Taichong,Zusanli,Quchi.The clusteRanalysis results showed that when the scale was set to 12,the acupoints could be divided into fouRcategories:(1)clusteR1:Taiyuan,Zhongfu,Lieque,Tiantu,Sanyinjiao,Chize,Dazhui;(2)clusteR2:Quchi,Taichong,Hegu,Zusanli,Fenglong;(3)clusteR3:Lianquan,Baihui,Fengchi;(4)clusteR4:Feiyu.Conclusion In acupuncture foRSAP,the acupoints selected are mainly Feiyu,Hegu and Zusanli,mainly involving the Foot Taiyang Bladder Meridian,Hand Taiyin Lung Meridian,and Foot Yangming Stomach Meridian,with a focus on the uppeRlimbs,head and neck,and loweRlimbs.The specific points are mainly crossing point,He-sea point,and Yuan-primary point.The main associated rules are mainly Hegu-Taichong,Zusanli-Quchi,and Hegu-Quchi.The core acupoints are Hegu,Taichong,Zusanli,Quchi.And the corresponding matching points are selected according to the patient's syndrome type.
作者 李大进 王婷 荣燕 尤敏 李春标 陈冲 刘艺 程张阳 LI Dajin;WANG Ting;RONG Yan;YOU Min;LI Chunbiao;CHEN Chong;LIU Yi;CHENG Zhangyang(School of Nursing,Anhui University of Chinese Medicine,Hefei 230012,China;Nursing Department,the Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230061,China;Operating Room,Anhui Provincial Hospital,Hefei 230001,China)
出处 《实用心脑肺血管病杂志》 2024年第11期62-69,共8页 Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金 安徽省高等学校人文社会科学研究项目(SK2021A0341) 安徽省高等学校科学研究项目(2023AH050784,2023AH050857)。
关键词 肺炎 脑卒中相关性肺炎 针灸疗法 腧穴 数据挖掘 Pneumonia Stroke associated pneumonia Acupuncture moxibustion therapy Acupoints Data mining
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