基于复杂网络的针刺治疗老年性痴呆选穴规律分析  

Analysis on acupoint selection rules of acupuncture for Alzheimer's disease based on complex network

作　　者：于臻[1] 徐家淳 覃启京 倪道艳 张玉莲[2] YU Zhen;XU Jia-chun;QIN Qi-jing;NI Dao-yan;ZHANG Yu-lian(Tianjin University of TCM,Tianjin 300193,China;Department of Acupuncture-Moxibustion and Encephalopathy,the Second Affiliated Hospital of Tianjin University of TCM,Tianjin 300250;Department of Encephalopathy,Guangxi lntermational Zhuang Medicine Hospital)

机构地区：[1]天津中医药大学,天津300193 [2]天津中医药大学第二附属医院脑病针灸科,天津300250 [3]广西国际壮医医院脑病科

出　　处：《中国针灸》2019年第5期551-555,共5页Chinese Acupuncture & Moxibustion

基　　金：天津市科技计划项目:15ZXLCSY00020;国家中医药管理局中医药标准化项目:SATCM-2015-BZ(273)

摘　　要：目的:通过复杂网络技术,探讨现代临床中针刺治疗老年性痴呆的选穴规律。方法:收集2017年12月前收录在中国期刊全文数据库(CNKI)中的相关临床研究文献,采用Microsoft Excel 2010建立数据库,运用Gephi 0.8.2软件建立复杂网络模型并分析其拓扑结构。结果:最终纳入81篇符合要求的文献,提取出114条腧穴处方;构建的针刺治疗老年性痴呆腧穴处方复杂网络具有小世界效应和无标度特性,重要腧穴以百会、四神聪、风池、印堂、神门、神庭、足三里、丰隆、太冲为主,腧穴配伍以百会与内关、神门、三阴交最为常见,且多为远近配穴;运用k-core优化腧穴处方,29个核心腧穴以督脉及局部头颈部使用腧穴个数及频次最多,且82.76%为特定穴,以交会穴居多,进行社团划分后可归为以虚证或实证为主两类。结论:局部选穴是现代临床中针刺治疗老年性痴呆的首选,远近配穴最为常用,特定穴是其核心用穴,临证中注重调神、病证结合、标本同治与虚实兼顾。Objective To explore the acupoint selection rules of acupuncture for Alzheimer’s disease(AD)in modern clinical practice by complex network technology.Methods The relevant articles of clinical trials were retrieved from CNKI published before December 2017.Using Microsoft Excel 2010,the database was established.Using Gephi 0.8.2 software,the complex network mode was built and its topological structure was analyzed.Results Finally,81 articles were eligible and 114 acupoint prescriptions were extracted.The constructed complex network of acupoint prescriptions for AD was characteristics as small world effect and scale-free property,the crucial acupoints included Baihui(GV 20),Sishencong(EX-HN 1),Fengchi(GB 20),Yintang(GV 29),Shenmen(HT 7),Shenting(GV 24),Zusanli(ST 36),Fenglong(ST 40)and Taichong(LR 3).In acupoint combination,Baihui(GV 20),Neiguan(PC 6),Shenmen(HT 7)and Sanyinjiao(SP 6)were the most common,and the combination of the distal and nearby points was predominant.Using k-core for acupoint optimization,29 core acupoints were screened and they were mostly located on the governor vessel and the head and neck,with the highest use frequency.82.76%of acupoints were specific acupoints and the influential points were dominant.Using community structure partition,these acupoints were classified into two groups,i.e.deficiency syndrome and excess syndrome.Conclusion The selection of local acupoints is the first choice in acupuncture treatment for AD.The combination of distal and nearby points is the most common and the special points are the core.In clinical practice,the great consideration is provided on mind regulation,integration of disease and symptoms,the mutual treatment of the primary and the secondary as well as the deficiency and the excess.

关 键 词：老年性痴呆 针刺 选穴规律 复杂网络 

分 类 号：R246[医药卫生—针灸推拿学]