基于数据挖掘分析针灸治疗恶性肿瘤相关性便秘的选穴及配伍规律  

Analysis of Acupoint Selection and Compatibility Rules of Acupuncture for Cancerrelated Constipation Based on Data Mining

作　　者：鲍一韧 王睿[1] BAO Yiren;WANG Rui(Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou Zhejiang 310007,China)

机构地区：[1]浙江中医药大学附属杭州市中医院,浙江杭州310007

出　　处：《新中医》2024年第21期149-154,共6页New Chinese Medicine

基　　金：国家自然科学基金青年项目(81704159);杭州市医学重点学科建设项目(2020SJZDXK05)。

摘　　要：目的:通过数据挖掘分析针灸治疗恶性肿瘤相关性便秘的选穴及配伍规律。方法:检索自建库到2023年10月31日期间中国知网、中国学术期刊数据库(万方)、中文期刊数据库(维普)、PubMed、Cochrane Library数据库有关针灸治疗恶性肿瘤相关性便秘的中英文文献,将符合标准的文献录入Excel数据库,并用Excel软件进行使用频次、使用频率的分析,运用古今医案云平台V5.0进行关联规则分析及聚类分析。结果:最终纳入28篇文献,涉及29条针灸处方、30个穴位。足阳明胃经的使用频率最高,其次为任脉、手厥阴心包经。使用频次排在前5位的腧穴是足三里、天枢、内关、上巨虚、中脘,其中足三里穴的使用频率高达19.30%。关联规则分析结果显示,内关-足三里是使用最多的穴对,其他配穴方法则以近部配穴、同名经配穴为主。聚类分析结果:将使用频次排在前10位的腧穴分为4类,分别为天枢-中脘-关元、内关-足三里、上巨虚-下巨虚及支沟-合谷-三阴交。治疗癌症术后引起肠功能障碍所致的便秘,常用腧穴为足三里、内关、上巨虚、天枢;治疗由阿片类药物不良反应引起的便秘,常用腧穴为天枢、中脘、支沟;治疗化疗相关性便秘,常用腧穴为足三里、天枢。治疗方式的使用频率从高到低依次为:电针>经皮穴位电刺激>温针灸>普通针刺>穴位贴敷。结论:对选穴及配伍规律进行分析,形成了以“足三里、内关、天枢、中脘、上巨虚”5个穴位为核心的针灸处方,电针为干预推荐手段,临床可再结合不同病因及中医证型加减穴位使用。Objective:To discuss the acupoint selection and compatibility rules of acupuncture for cancer-related constipation by data mining.Methods:The Chinese and English literatures on acupuncture for cancer-related constipation in CNKI,Wanfang,VIP,PubMed,and Cochrane Library were retrieved from the establishment of the databases to October 31,2023.The literatures in line with the standards were entered into Excel database,and the times of use and frequency of use were learned by Excel software.The association rule analysis and cluster analysis were carried out by Ancient and Modern Case Recoreds Cloud Platform(V5.0).Results:A total of 28 articles were included,involving 29 acupuncture prescriptions and 30 acupoints.The most frequently used meridian was the Stomach Meridian of Foot-Yangming,followed by the Conception Vessel and the Pericardium Meridian of Hand-Jueyin.The top five acupoints in terms of times of use were Zusanli(ST36)point,Tianshu(ST25)point,Neiguan(PC6)point,Shangjuxu(ST37)point,and Zhongwan(RN12)point.The utilization rate of Zusanli(ST36)point was up to 19.30%.According to the association analysis,Neiguan(PC6)-Zusanli(ST36)points were the most used acupoint pair,and other acupoint selections were selection of nearby areas and homonymous meridians.The cluster analysis showed that the top four types of acupoint combinations in terms of times of use were Tianshu(ST25)-Zhongwan(RN12)-Guanyuan(RN4)points,Neiguan(PC6)-Zusanli(ST36)points,Shangjuxu(ST37)-Xiajuxu(ST39)points,and Zhigou(SJ6)-Hegu(LI4)-Sanyinjiao(SP6)points.For the treatment of constipation caused by intestinal dysfunction after cancer surgery,the commonly used acupoints were Zusanli(ST36)point,Neiguan(PC6)point,Shangjuxu(ST37)point,and Tianshu(ST25)point.For the treatment of constipation caused by opioid adverse reactions,the commonly used acupoints were Tianshu(ST25)point,Zhongwan(RN12)point,and Zhigou(SJ6)point.For the treatment of chemotherapy-related constipation,the commonly used acupoints were Zusanli(ST36)point and Tianshu(ST25)point.The f

关 键 词：恶性肿瘤相关性便秘 针灸 选穴规律 数据挖掘 

分 类 号：R246.5[医药卫生—针灸推拿学]