基于数据挖掘的针灸治疗耳聋耳鸣临床规律探究  

Research on the Clinical Rules of Acupuncture-moxibustion in the Treatment of Deafness and Tinnitus Based on Data Mining

作　　者：李茜莹 黄琴峰[2] 董小庆 张丹[2] 杨光[1] 韩榕 孔谐和 刘婕[2] 赵越 杨延婷 马晓芃[1,2] LI Xi-ying;HUANG Qin-feng;DONG Xiao-qing;ZHANG Dan;YANG Guang;HAN Rong;KONG Xie-he;LIU Jie;ZHAO Yue;YANG Yan-ting;MA Xiao-peng(Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Research Institute of Acupuncture and Meridian,Shanghai 200030,China)

机构地区：[1]上海中医药大学,上海201203 [2]上海市针灸经络研究所,上海200030

出　　处：《上海针灸杂志》2020年第3期372-380,共9页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家重点基础研究发展计划(2015CB554501);上海市卫生计生系统优秀学科带头人培养计划项目(2017BR047);上海中医药大学预算内科研项目(18WK116)。

摘　　要：目的回顾1956年至2018年期刊发表的针灸治疗耳聋耳鸣的临床研究文献,总结归纳针灸治疗耳聋耳鸣的临床应用规律。方法检索《中医针灸信息库》、中国知网、万方学术期刊全文数据库和维普中文科技期刊数据库中的电子文献,按照纳入和排除标准筛选针灸治疗耳聋耳鸣的临床研究文献,应用《中医针灸信息库》内相关分析软件和SPSS25.0、Clementine12.0软件,运用计量分析、聚类分析及关联性分析等数据挖掘技术进行分析。结果治疗耳聋应用频次最多的穴位依次为听宫、翳风、听会、耳门、中渚、外关、太冲、风池、百会、合谷、太溪、足三里,治疗耳鸣应用频次最多的穴位依次为听宫、听会、翳风、耳门、中渚、太溪、风池、太冲、外关、足三里、侠溪,穴位选取均集中于头面部和下肢部;应用频次最高的经脉为手少阳三焦经;治疗方法以针刺、灸法、水针及电针为主。聚类分析得到针灸治疗耳聋耳鸣的共同有效聚类为听会、耳门、听宫、翳风、中渚,耳聋的另一类为太溪、足三里、外关、太冲、合谷、百会、风池,耳鸣的另一类为风池、太溪、足三里、侠溪、太冲、外关。关联性分析发现,规则支持度最高的穴位组合为耳聋-太冲-外关-中渚-翳风,耳鸣-太溪-太冲-中渚-听会-听宫-翳风。耳鸣残疾评估量表(THI)、耳鸣严重程度评估量表(TSIS)、纯音听阈测试(PTA)治疗前后比较,差异均有统计学意义(P<0.05)。结论针灸治疗耳聋耳鸣的选穴以局部取穴为主(选取头面部穴位,注重耳周穴位),辅以邻近选穴和远道取穴。建议将听宫、听会、翳风、耳门、中渚作为耳聋耳鸣针灸基础方,将针刺疗法作为首选的干预手段,加强对THI、TSIS、PTA等检测指标的应用。Objective By reviewing the clinical research literatures of acupuncture-moxibustion in the treatment ofdeafness and tinnitus published in journals from 1956 to 2018,to summarize the clinical application rules ofacupuncture-moxibustion for deafness and tinnitus.Method The Acupuncture-moxibustion Information Database ofTraditional Chinese Medicine,China National Knowledge Infrastructure(CNKI),Wanfang Academic Journal Full-textDatabase and VIP Chinese Science and Technology Journal Database were searched.The clinical research documents of acupuncture-moxibustion in the treatment of deafness and tinnitus were selected according to the inclusion and exclusion criteria.The relevant analysis software in the Acupuncture-moxibustion Information Database of Traditional Chinese Medicine,SPSS 25.0 and Clementine 12.0 were adopted,and data mining methods such as quantitative analysis,cluster analysis and association analysis were used for data analyses.Result The most frequently used acupoints for treatment of deafness were Tinggong(SI19),Yifeng(TE17),Tinghui(GB2),Ermen(TE21),Zhongzhu(TE3),Waiguan(TE5),Taichong(LR3),Fengchi(GB20),Baihui(GV20),Hegu(LI4),Taixi(KI3)and Zusanli(ST36);the most frequently used acupoints for treatment of tinnitus were Tinggong(SI19),Tinghui(GB2),Yifeng(TE17),Ermen(TE21),Zhongzhu(TE3),Taixi(KI3),Fengchi(GB20),Taichong(LR3),Waiguan(TE5),Zusanli(ST36)and Xiaxi(GB43);the selected acupoints were mostly located at the head,face and lower limb and the most commonly used meridian was the Triple Energizer Meridian of Hand Shaoyang.The main treatment methods were acupuncture,moxibustion,hydroacupuncture and electroacupuncture.According to cluster analysis,the mutual effective cluster for acupuncture-moxibustion treatment of deafness and tinnitus consisted of Tinghui(GB2),Ermen(TE21),Tinggong(SI19),Yifeng(TE17)and Zhongzhu(TE3);the effective cluster for treatment of deafness consisted of Taixi(KI3),Zusanli(ST36),Waiguan(TE5),Taichong(LR3),Hegu(LI4),Baihui(GV20)and Fengchi(GB20);the effective cluster for treatm

关 键 词：针灸疗法 耳聋耳鸣 数据挖掘 文献计量学 耳鸣残疾评估量表 耳鸣严重程度评估量表 纯音听阈测试 

分 类 号：R246.8[医药卫生—针灸推拿学]