基于数据挖掘的眼针疗法临床应用特点研究

Features of clinical application of eye acupuncture therapy revealed by data mining

目的:挖掘眼针疗法在临床应用中的特点,探讨眼针疗法的优势病种及应用规律。方法:以"眼针"为检索词检索中国期刊全文数据库(CNKI)、万方数据库、中国生物医学文献数据库1980年至2017年的眼针临床应用相关文献及《中华眼针》《眼针实践录》和《彭静山眼针疗法研究》的眼针医案。采用数据挖掘技术,进行收集、整理、筛选、录入、审核、数据提取、统计分析。总结眼针疗法的优势病种、针刺方法、行针手法、选穴原则、疗效。结果:眼针疗法临床应用广泛,所收集178篇期刊文献共涉及7个疾病科属42种疾病,以内科疾病应用频次最多(19种),其次是头面躯体痛证(7种)。眼科治疗各科疾病疗效显著,有效率均在91%以上;在纳入的期刊文献中,循经取穴使用146次,看眼取穴使用14次,病位取穴使用153次;进针方法以眶外横刺法为主(81篇),留针时长以15～30min较多,多采用刮动针柄法行针(34篇),总治疗频次以11～20次居多。医案部分涉及疾病53种,内科病种最多(37种),以中风后遗症(34次)和面瘫(11次)最为多见;取穴原则以看眼取穴为主(129篇),进针方法多采用眶外横刺法(102篇),留针时长不一;痊愈率均在90%以上,其余为显效。结论:眼针疗法治疗的疾病广泛且效果显著,特别是对内科中风后遗症和各种急慢性痛证的应用优势突出。

Objective To investigate the features,dominant indications and application regularities of eye acupuncture therapy in clinical practice.Methods We first collected original articles,academic dissertations,conference articles,and case reports from databases of CNKI,Wanfang,and Chinese biomedical literature(CBM)from Jan.1 of 1980 to Dec.31 of 2017,and medical records from medical books of Zhonghua Yan Zhen(Chinese Eye Acupuncture Therapy),Yanzhen Shijian Lu(Records of Application of Eye Acupuncture Therapy),and Peng Jing-shan’s Yanzhen Liaofa Yanjiu(Peng Jing-shan’s Eye Acupuncture Therapy)by using keyword of'eye acupuncture'.Then,we established an'Eye-acupuncture Database'after sorting,screening,typing-in,checking,and extraction of the collected data by SQL server 2005 and 2005 Analysis Services(SASS),followed by analysis of the dominant indications,needling methods,needle manipulations,principles for acupoint selection,and clinical effect.Results Among the 850 articles retrieved,178 were eligible to be subjected to analysis,including 42 disorders/diseases in 7 categories.The eye acupuncture therapy has the highest application frequency for 19 types of disorders/diseases of the internal medicine,such as sequela of apoplexy,hiccup,insomnia,vertigo,hypertension,etc.,followed by head and body pain(7 types:headache,lumbago,sciatica,shoulder pain,etc.),disorders of the ophthalmology and otorhinolaryngology(deafness,squinting eyes,dry eye syndrome,amblyopia,etc.),traumatic injury,gynecopathy,acute pain(biliary colic,renal colic).The effect rate was 95.87%for disorders of the gynecopathy,95.54%for head and body pain,94.53%for traumatic skin injury,92.16%for emergency,91.98%for disorders of the five sense organs,91.43%for problems of the internal medicine,etc.Regarding the principle of acupoint selection,acupoints were chosen mainly according to the meridian running(146 articles),local region of the eye(14 articles)and diseased location(153 articles).A total of 157 articles have a marked description about the needling methods,including horizontal needling(81 articles),intra-orbital straight needling(22 articles),extra-orbital oblique needling(13 articles),etc.The duration of needle retaining was mostly from 15 to 30 minutes,and the handle-scraping was frequently adopted(34 articles),and the overall treatment frequency ranged from 11 to 20 times.In regard to the medical records,a total of 53 types of disorders were involved,including 37 types of the internal medicine such as stroke sequelae(34 articles),facial paralysis(11 articles),etc.The acupoints were selected according to the local region of eye(129 articles),the needle insertion involved horizontal needling(102 articles),and cured rate reported was higher than 90%.Conclusion Eye acupuncture therapy is widely used for a variety of disorders and has a positive effect,particularly for stroke sequelae and various acute and chronic pain problems.