基于数据挖掘探讨耳穴干预原发性痛经的辨证选穴规律  

Rules of syndrome differentiation and acupoint selection of auricular acupoint intervention for primary dysmenorrhea based on data mining

作　　者：赵洁 刘晓辉 代楠[1] 聂亚杰 章晓菲 刘雪琴 张颖 ZHAO Jie;LIU Xiaohui;DAI Nan;NIE Yajie;ZHANG Xiaofei;LIU Xueqin;ZHANG Ying(School of Nursing,Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China;The Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450002,Henan,China;School of Nursing,Sanquan College,Xinxiang Medical College,Xinxiang 453513,Henan,China)

机构地区：[1]河南中医药大学护理学院,河南郑州450046 [2]河南省中医院,河南郑州450002 [3]新乡医学院三全学院护理学院,河南新乡453513

出　　处：《护士进修杂志》2024年第21期2274-2280,共7页Journal of Nurses Training

基　　金：2023年度河南省中医药文化与管理研究项目(编号:TCM2023009)。

摘　　要：目的通过数据挖掘技术探讨耳穴干预原发性痛经(primary dysmenorrhea,PD)的辨证选穴规律。方法系统检索Cochrane Library、CINAHL、Web of Science、PubMed、Embase、知网、中国生物医学文献数据库、万方、维普数据库中关于耳穴干预PD的随机对照试验,检索时限为建库至2024年3月31日。提取耳穴处方并构建数据库,使用IBM SPSS Statistics 26.0、SPSS Modeler 18.0、Cytoscape 3.7.2软件分别进行频次分析、关联分析、聚类分析及复杂网络分析。结果共纳入45篇文献,提取耳穴处方60项,涉及28种耳穴,累计频次314次。使用频次较高的耳穴是内分泌、内生殖器、神门、肾、肝、交感、皮质下、脾;三角窝和耳甲部位耳穴占比较高;关联分析形成以肝-神门-内生殖器-内分泌-交感-肾为基础的核心耳穴组合;聚类分析发现4类有效聚类群;临床以实证为主要证型,配合辨证配穴、随证加减则疗效更佳;主要干预措施是耳穴贴压,每日刺激量多集中在3~5次,单次刺激时长多为1~2 min,从经前7 d开始,到经后3 d结束,每3 d更换药贴,两耳交替贴压,共干预3个月经周期。结论耳穴干预PD以调和冲任、调理气血为治疗原则,建议配合辨证取穴、随证加减,并进一步规范临床操作方案。Objective To explore the law of syndrome differentiation and acupoint selection of auricular acupoint intervention in primary dysmenorrhea(PD)through data mining technology.Methods The Cochrane Library,CINAHL,Web of Science,PubMed,Embase,CNKI,CBM,Wanfang,and VIP databases were systematically searched for randomized controlled trials on auricular acupoint intervention for PD,and the search time was from inception of the database to March 31,2024.The auricular prescription was extracted and the database was constructed,and IBM SPSS Statistics 26.0,SPSS Modeler 18.0,and Cytoscape 3.7.2 software were used for frequency analysis,correlation analysis,cluster analysis,and complex network analysis.Results A total of 45 articles were included,and 60 ear acupoint prescriptions were extracted,involving 28 kinds of ear acupoints,with a cumulative frequency of 314 times.The auricular points with higher frequency of use were endocrine,internal genital,Shenmen,kidney,liver,sympathetic,subcortical,and spleen;The proportion of auricular points in triangular fossa and auricular concha was relatively high;Correlation analysis formed a core auricular point combination based on liver-Shenmen-internal genitalia-endocrine-sympathetic-kidney;Cluster analysis found 4 effective clusters;Clinically,the main syndrome type was excess syndrome,combined with syndrome differentiation and acupoint matching,and the addition and subtraction with syndrome,the curative effect was better;The main intervention measure was auricular point sticking,and the daily stimulation amount was mostly concentrated in 3-5 times,and the duration of single stimulation was mostly 1-2 min,and from 7 days before menstruation to the end of 3 days after menstruation,the drug paste was changed every 3 days,the two ears were alternately pressed,and a total of 3 menstrual cycles were intervened.Conclusion Auricular intervention for PD is based on the principle of reconciling Chong and Ren and regulating qi and blood,and it is recommended to cooperate with syndrome different

关 键 词：原发性痛经 耳穴干预 选穴规律 证-穴关系 数据挖掘 复杂网络 

分 类 号：R248[医药卫生—中医临床基础] R711.51[医药卫生—中医学]