针灸治疗功能性消化不良的证据及穴位组合:一项系统评价再评价联合数据挖掘研究  

Evidence and acupoint combinations in acupuncture for functional dyspepsia:an overview of systematic review and data mining study

作　　者：邹孟龙 胡卓瑜 龙丹 孙豪娴 朱莹 ZOU Menglong;HU Zhuoyu;LONG Dan;SUN Haoxian;ZHU Ying(Department of Gastroenterology,The First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007,China;Graduate School,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China)

机构地区：[1]湖南中医药大学第一附属医院消化科,湖南长沙410007 [2]湖南中医药大学研究生院,湖南长沙410208

出　　处：《Digital Chinese Medicine》2023年第4期369-380,共12页数字中医药（英文）

基　　金：National Natural Science Foundation of China(81874466);Natural Science Foundation of Hunan Province (2021JJ30531)。

摘　　要：目的 本研究旨在对针灸治疗功能性消化不良(FD)的meta分析和系统评价文献进行方法学质量评估,并分析其穴位组合规律。方法 分别在中国知网(CNKI)、维普数据库(VIP)、中国生物医学数据库(CBM)和万方数据库等中文数据库,以及Pub Med、Embase和Cochrane Library等英文数据库中检索针灸治疗FD的meta分析和系统评价,时间均从各个数据库建库至2022年4月30日。根据文献发表年份、研究类型、多系统评价评估问卷2(AMSTAR2)、系统评价和meta分析的首选报告条目(PRISMA)、异质性和发表偏倚6个维度计算Veritas总分评估meta分析和系统评价的方法学质量。进一步从meta分析和系统评价中提取随机对照试验(RCTs)并使用R软件(V 4.3.1)进行穴位频次、经络频次及关联规则分析。结果 经筛选后,纳入8项meta分析进行研究,其出版年份、设计类型、AMSTAR2、PRISMA、异质性及发表偏倚风险的Veritas平均分分别为4.50、8.00、4.63、4.63、4.50和6.13分。根据各个维度评分发现在审查方法的陈述、研究策略的理解、排除标准的详细列表、资金来源、个体研究的偏倚风险、异质性的解释及潜在利益冲突说明等方面尚存在不足之处。从8项meta分析中对提取的85个RCTs进行数据挖掘,共包含85个针灸处方和67个穴位。其中,频次最高的经络是足阳明胃经;频次排列前10位的穴位分别足三里、内关、中脘、太冲、天枢、公孙、胃俞、脾俞、内庭和阴陵泉。此外,关联规则分析鉴定出28条,包括二阶关联规则10条、三阶关联规则15条和四阶关联规则3条,各阶关联规则排名第一的分别是:内关→足三里、中脘+内关→足三里和中脘+太冲+内关→足三里。结论 针灸可以显著改善FD患者的临床症状,但目前该领域meta分析文献的方法学质量有待提高。此外,通过数据挖掘发现内关、足三里、中脘和太冲是治疗FD核心穴位组合。Objective To evaluate the methodological quality of papers that performed meta-analyzed and systematically reviewed acupoint selections for the treatment of functional dyspepsia(FD)and to identify the ideal acupoint combinations for FD.Methods Chinese databases including China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(VIP),China Biology Medicine(CBM),and Wanfang Database,as well as English databases including PubMed,Embase,and Cochrane Library were searched to retrieve papers about meta-analysis and systematic literature reviews on acupuncture for FD.The time span for the paper retrieval was set from the foundation of the databases to April 30,2022.The Veritas scores of the papers based on their publication year,study type,Assessment of Multiple Systematic Reviews 2(AMSTAR2),Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA),heterogeneity,and publication bias were rated to assess the methodological quality of the included studies.Then,randomized controlled trials(RCTs)were extracted from those meta-analysis papers or systematic literature reviews for analyzing acupoints frequency,meridian frequency,and association rules with the use of R software(V 4.3.1).Results Eight meta-analysis papers were included in the study after screening.The mean Veritas scores of the papers based on publication year,type of study,AMSTAR2,PRISMA,heterogeneity,and publication bias were 4.50,8.00,4.63,4.63,4.50,and 6.13,respectively.The analysis of the scores revealed insufficiencies in the reviews pertaining to the methodology,comprehension of the research strategy,detailed list of excluded studies,sources of funding,assessment of potential bias risks impact on meta-analysis results in each study,explanation of heterogeneity,and identification of potential conflicts of interest.Furthermore,a total of 85 RCTs were obtained from the eight meta-analysis papers involving 85 acupuncture prescriptions and 67 acupoints for subsequent data mining.The most commonly used meridian

关 键 词：功能性消化不良 针灸 数据挖掘 联合穴位 Veritas图 META分析 系统评价 

分 类 号：R246.1[医药卫生—针灸推拿学]