基于数据挖掘探究经皮经颅电刺激治疗卒中后运动障碍刺激参数应用规律  

Study on Application Law of Stimulation Parameters of Transcutaneous and Transcranial Electrical Stimulation for Post-Stroke Movement Disorders Based on Data Mining

作　　者：修靖云 马良宵[1,2] 马凌慧 孙天祎 钱旭 张秦墉 王修琰 XIU Jingyun;MA Liangxiao;MA Linghui;SUN Tianyi;QIAN Xu;ZHANG Qinyong;WANG Xiuyan(School of Acupuncture-Moxibustion and Tuina,Beijing University of Chinese Medicine,Beijing 100029,China;The Key Unit of National Administration of Traditional Chinese Medicine,Evaluation of Characteristic Acupuncture Therapy,Beijing 100029,China)

机构地区：[1]北京中医药大学针灸推拿学院,北京100029 [2]国家中医药管理局针灸特色疗法评价重点研究室,北京100029

出　　处：《中国中医药信息杂志》2024年第3期42-47,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家重点研发计划(2020YFC2007303);国家自然科学基金面上项目(82274655)。

摘　　要：目的 基于数据挖掘探究经皮穴位电刺激(TEAS)及经颅直流电刺激(tDCS)治疗卒中后运动障碍的刺激参数应用规律。方法 检索中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台、中国生物医学文献数据库、PubMed、Web of Science 2000年1月-2023年5月发表的相关临床研究文献,进行质量评价后建立数据库。采用频次分析、关联规则及复杂网络分析探究核心腧穴及电刺激参数应用规律。结果 共纳入文献79篇,提取128组数据。TEAS核心腧穴主要包括外关、手三里、足三里、合谷、内关、阳陵泉等,上下肢最常用配伍为手三里-外关、阳陵泉-足三里;电刺激参数中频率选择多样,100 Hz最常用,刺激弛缓型偏瘫上肢腧穴时亦多选用2 Hz;其他电刺激参数应用较一致,多选用脉宽200~250μs的双向对称方波,刺激强度以患者耐受为度。t DCS刺激电极多置于脑部M1运动区在头皮的投影,安全刺激强度为1~2 mA。结论 采用TEAS治疗卒中后运动障碍应根据卒中后不同康复阶段患者肌肉状态选择刺激腧穴及电刺激参数,尤需关注刺激频率的选择。Objective To explore the application low of stimulation parameters of transcutaneous electrical acupoint stimulation(TEAS)and transcranial direct current stimulation(tDCS)for post-stroke movement disorders based on data mining.Methods The relevant clinical research literature was retrieved from CNKI,Wanfang Data,VIP,CBM,PubMed and Web of Science from January 2000 to May 2023.A database was set up after quality assessment.Frequency analysis,association rules and complex network analysis were used to explore the application law of core acupoints and electrical stimulation parameters.Results A total of 79 articles were included and 128 groups of data were contained.For TEAS,the core acupoints included Waiguan(TE5),Shousanli(LI10),Zusanli(ST36),Hegu(LI4),Neiguan(PC6),Yanglingquan(GB34),etc.,while the most commonly used acupoint combinations of upper limb and lower limb were Shousanli(LI10)-Waiguan(TE5)and Yanglingquan(GB34)-Zusanli(ST36).Among the electrical stimulation parameters of TEAS,the frequencies used vary widely,and 100 Hz was most commonly used,while 2 Hz TEAS was also mainly used for stimulating acupoints located on upper limbs in the treatment of flaccid paralysis. The application of other electrical stimulation parameters was relatively consistent. Thebidirectional symmetrical square-wave with 200-250 μs pulse-width was used in majority of studies. The stimulusintensity was mostly determined by patient tolerance. For tDCS, stimulation electrodes were often positioned on theprojection of the primary M1, and the safe stimulus intensity was mostly set as 1 to 2 mA. Conclusion In thetreatment of post-stroke movement disorders, appropriate acupoints and electrical stimulation parameters of TEASshould be determined on the muscle strength and muscle tension of stroke patients at different stages after stroke,particularly the selection of electric stimulating frequency.

关 键 词：卒中后运动障碍 经皮穴位电刺激 经颅直流电刺激 电刺激参数 数据挖掘 

分 类 号：R277.733[医药卫生—中医学] R2-05