现代文献中针灸治疗耳鸣的选穴规律研究  

Study on rules of acupuncture point selection for tinnitus treatment in modern literature

作　　者：林育珊 卢标清[2] LIN Yushan;LU Biaoqing(Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528400,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]中山市中医院,广东中山528400

出　　处：《上海中医药杂志》2020年第12期21-27,共7页Shanghai Journal of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20161265)。

摘　　要：目的运用数据挖掘方法研究现代文献中针灸治疗耳鸣的选穴规律,为临床治疗耳鸣提供更为有效、科学的针灸处方思路参考。方法采用计算机检索相关数据库中1960年1月1日至2018年12月31日期间针灸治疗耳鸣的相关文献,统计分析所选腧穴出现的频次、归经、部位、特性及证型适用情况,并进一步采用聚类分析、关联规则及神经网络模型挖掘分析其中的选穴规律。结果 (1)共得到220篇符合要求的文献,其中中文文献214篇,英文文献6篇。(2)研究文献中作为主穴使用的腧穴共69个,选用频率较高(>20%)的穴位依次为听会、听宫、翳风、耳门、中渚、风池、百会。针灸治疗耳鸣根据患者的证型不同,配穴各异,如肝肾亏虚类证型(肝肾不足、肾精亏虚、肾虚)选用频次较高的配穴依次为太溪、肾俞、关元。(3)针灸治疗耳鸣的选穴涉及部位主要包括头颈、四肢、背部和腹部;其中主穴集中在头部,约占68.91%,且耳周是选穴最集中的部位;配穴多集中在下肢,约占59.32%。(4)针灸治疗耳鸣的主穴中三焦经选用频次最高,其次是胆经、小肠经;配穴中胃经选用频次最高,其次是肝经、胆经。(5)针灸治疗耳鸣的腧穴(包括主穴、配穴)重视特定穴的运用,占比达52.17%,其中五输穴的运用最多,且配穴多为特定穴。(6)聚类分析发现,听宫、翳风、听会是针灸治疗耳鸣的核心主穴组合。(7)关联规则分析表明,关联性最强的两主穴组合为风池-听会,关联性最强的三主穴组合为中渚、听会-耳门,关联性最强的四主穴组合为中渚、翳风、听会-耳门。(8)神经网络模型图可见,"听宫、听会、中渚、翳风、耳门"5个腧穴间的关联程度比较强。结论针灸治疗耳鸣的处方中多为主穴与配穴相结合,主穴多为耳周局部循经取穴,配穴为远端循经取穴及辨证取穴相结合,同时耳鸣针灸处方重视对特定穴的选用;临床取穴Objective To study rules of acupuncture point selection for tinnitus treatment in modern literature based on data mining to provide more effective and scientific reference for acupuncture prescriptions for clinical treatment of tinnitus. Methods The relevant literatures of acupuncture treatment of tinnitus from January 1, 1960 to December 31, 2018 were retrieved from databases, and the frequency, meridian tropism, location, characteristics and indications of the selected acupoints were statistically analyzed. Cluster analysis, association rules and neural network model were further used to mine and analyze the rules of acupoint selection. Results(1) A total of 220 articles were obtained, including 214 articles written in Chinese and 6 articles in English.(2)There were 69 acupoints used as the main points in the research literature. The acupoints selected with a higher frequency of use(over 20%) were Tinghui(GB 2), Tinggong(SI 19), Yifeng(SJ 17), Ermen(SJ 21), Zhongzhu(SJ 3), Fengchi(GB 20) and Baihui(DU 20) in turn. Acupuncture treatment of tinnitus varied according to the syndromes of patients, as shown in the combination of points. For example, the complementary points selected with a higher frequency were Taixi(KI 3), Shenshu(BL 23) and Guanyuan(RN 4) in turn for the syndromes of liver and kidney deficiency(including liver and kidney deficiency, kidney essence deficiency and kidney deficiency).(3)The acupoints selected for tinnitus treatment mainly located at the head and neck, limbs, back and abdomen, among which, the main points locating at the head,especially around the ears, accounting for 68.91%, while the complementary points accounting for 59.32% mainly located in the lower limbs.(4)Most main points selected for tinnitus treatment were on the Sanjiao meridian, followed by Gallbladder meridian and Small Intestine meridian. Most complementary points selected for tinnitus treatment were on the Stomach meridian, followed by Liver meridian and Gallbladder meridian.(5)Selected acupoints( including main points

关 键 词：耳鸣 针灸 腧穴 经络 选穴规律 数据挖掘 

分 类 号：R246.81[医药卫生—针灸推拿学]