针灸治疗重症肌无力如何取穴—一项数据挖掘研究  

Acupoints Selection for Myasthenia Gravis:a Data Mining Study

作　　者：孔琪 姚菁怡 戴宗昊 纪军[3] 陈立铭[1] 吴焕淦[3] Kong Qi;Yao Jingyi;Dai Zonghao;Ji Jun;Chen Liming;Wu Huangan(Yueyang Hopital,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shanghai Putuo District Central Hospital,Shanghai 200062,China;Shanghai Institute of Acupuncture,Moxibustion and Meridians,Shanghai 200030,China)

机构地区：[1]上海中医药大学附属岳阳医院,上海200437 [2]上海市普陀区中心医院,上海200062 [3]上海市针灸经络研究所,上海200030

出　　处：《世界科学技术-中医药现代化》2021年第2期647-654,共8页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：上海市卫生和计划生育委员会上海中医药事业发展三年行动计划项目(ZY(2018-2020)-CCCX-2004-01):针灸特色技术应用及其神经免疫学机制研究,负责人:吴焕淦。

摘　　要：目的针灸治疗MG可能有一定疗效,但治疗方案不够标准化,且迄今尚无对针灸治疗MG的组方规律的研究。故本文采用数据挖掘等方法以探究目前针灸治疗MG的核心经脉、穴位的选取方案,为针灸治疗MG的临床应用提供参考。方法运用Excel 2015版对取穴归经的频次进行统计和计算,使用SPSS 23.0对取穴归经的处方进行加权聚类分析和T检验;利用SPSS Modeler18.0构建Apriori算法对穴位及经脉进行关联性分析。结果总纳入针灸处方68条。归经分析中阳经的应用频次显著高于阴经(P<0.01);足三阳经在频次和关联性分析中均占前位;聚类分析得到了4个聚类群。取穴分析中总使用频次最高的穴位为足三里。眼肌型MG和全身型MG的取穴不同,关联规则显示眼肌型的主要穴位配伍是阳白、足三里、攒竹、鱼腰;全身型的主要穴位配伍为足三里、三阴交、合谷、阳陵泉。通过聚类分析,眼肌型和全身型分别得到了4个和3个聚类群。结论针灸临床治疗MG主要以足三阳经和足三里作为核心经、穴,依据西医分型中医辨证选穴施治。治疗眼肌型MG配合攒竹、阳白、鱼腰等近端取穴,全身型配合三阴交、合谷、阳陵泉等,辨证加减治疗。Objective To provide reference for the clinical application of acupuncture treatment of Myasthenia Gravis(MG),which may have certain efficacy,but the treatment protocol is not standardized enough,and there is no research on the grouping pattern of acupuncture treatment of MG so far.Therefore,this paper uses data mining and other methods to investigate the current selection scheme of core meridians and acupuncture points for acupuncture treatment of MG.Methods The frequency of taking acupuncture points to meridians was counted and calculated using Excel version 2015,and the prescriptions of taking acupuncture points to meridians were subjected to weighted cluster analysis and ttest using SPSS 23.0;the SPSS Modeler 18.0 was used to construct the Apriori algorithm for correlation analysis of acupuncture points and meridians.Results 68 Acupuncture Prescriptions were included.The frequency of application of Yang Meridians was significantly higher than that of Yin Meridians(P<0.01).The frequency and association of the Foot Three Yang Meridians were the highest.The most frequently used acupoints in the analysis of acupoint selection were Zusanli(St36).There's a difference between MG and systemic MG.Association rules show that the main acupoints of OPHTHALMIC type are Yangbai(GB14),Zusanli(St36),Cuanzu(BL2),Yuyao(EX-HN4),and the main acupoints of systemic type are Zusanli(St36),Sanyinjiao(SP6),Hegu(LI4)and Yanglingquan(GB34).Cluster analysis,ocular muscle type and systemic type were used to obtain 4 and 3 clusters,respectively.Conclusion the Core Meridians and acupoints of the clinical acupuncture treatment are the Three Yang Meridians and the Three Li Meridians of the foot,which are selected according to the differentiation of symptoms and signs in Western medicine.Eye Muscle type with Cuanzhu(BL2),Yangbai(GB14),Yuyao(EX-HN4)and other proximal point selection,body type with Sanyinjiao(SP6),Hegu(LI4),Yanglingquan(GB34),and so on,adjust the acupoint prescription according to the pattern differetiation.

关 键 词：针灸 重症肌无力 取穴规律 数据挖掘 

分 类 号：R245[医药卫生—针灸推拿学]