基于数据挖掘技术探讨经皮穴位电刺激治疗脑卒中后肢体功能障碍的腧穴及参数应用规律  

Exploring Acupoints and Parameter Application Patterns of TEAS for Treating Post-Stroke Limb Dysfunction Based on Data Mining Techniques

作　　者：张雨晴 吕元昊 邓士哲 刘健[1,2,3,4] ZHANG Yuqing;LYU Yuanhao;DENG Shizhe;LIU Jian(The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China;Key Laboratory of Acupuncture Therapy for Brain Diseases of State Administration of Traditional Chinese Medicine,Tianjin 300381,China;Tianjin Key Laboratory of Acupuncture and Moxibustion,Tianjin 300381,China)

机构地区：[1]天津中医药大学第一附属医院,天津300381 [2]国家中医针灸临床医学研究中心,天津300381 [3]国家中医药管理局脑病针刺疗法重点研究室,天津300381 [4]天津市针灸学重点实验室,天津300381

出　　处：《针灸临床杂志》2024年第12期47-55,共9页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家重点研发计划,编号:2018YFC1706001;天津中医药大学第一附属医院“拓新工程”基金,编号:ZD202103。

摘　　要：目的:应用数据挖掘技术分析经皮穴位电刺激(TEAS)治疗脑卒中后肢体功能障碍的临床选穴及参数应用规律。方法:自建库至2023年11月30日中国期刊全文数据库(CNKI)、万方数据库(Wanfang)、维普数据库(VIP)、中国生物医学文献数据库(SinoMed)以及PubMed数据库和Embase数据库已公开发表的TEAS治疗脑卒中后肢体功能障碍的临床研究文献,利用Excel 2019、SPSS Modeler18.0、Cytoscape及SPSS26.0软件建立临床处方数据库并对数据进行描述性分析、关联规则分析和聚类分析。结果:共纳入文献101篇,涉及处方106条,腧穴62个,总应用频次466次。外关穴使用频次最高,常选用的经脉为手阳明大肠经;部位以上肢频次最高;特定穴多用合穴;腧穴关联度最高的穴位组合为外关-手三里;聚类分析将高频腧穴聚为4个有效类别。TEAS刺激波形以断续波最常用,刺激频率多采用100 Hz,刺激时长多用30 min,电流强度多以耐受/最大耐受为度。结论:TEAS治疗脑卒中后肢体功能障碍的选穴规律体现出“治痿独取阳明”“腧穴所在,主治所及”“平衡阴阳”等中医思想,并重视特定穴的应用。今后应继续深化TEAS参数研究,规范参数报道,提高研究的可重复性。Objective:To explore acupoints and parameter application patterns of transcutaneous electrical acupoint stimulation(TEAS)for treating post-stroke limb dysfunction based on data mining techniques.Methods:Clinical research literature on TEAS for post-stroke limb dysfunction were retrieved from CNKI,Wanfang,VIP,SinoMed,PubMed and Embase,starting from the establishment of the database to November 30,2023.Excel 2019,SPSS Modeler18.0,Cytoscape and SPSS26.0 were used to create a clinical prescription database and perform descriptive analysis,association rule analysis and cluster analysis based on the data.Results:A total of 101 articles were included in the literature,involving 106 prescriptions and 62 acupoints,with application frequency of 466 times in total.Waiguan(TE5)was the most frequently used acupoint,with the most commonly selected meridian being the Hand-Yangming Large Intestine Meridian,and the highest frequency of use was on the upper limbs.He-sea points were often chosen within specific points.The acupoint combination with the highest association is TE5-Shousanli(LI10).Cluster analysis grouped the high-frequency acupoints into four effective categories.The most commonly used stimulation waveform for TEAS was the intermittent wave,with a stimulation frequency of mostly 100 Hz,a duration of 30 mins,and current intensity set at tolerance or maximum tolerance.Conclusion:The acupoint selection pattern of TEAS for treating post-stroke limb dysfunction reflects traditional Chinese medicine principles such as‘treating atrophy by selecting Yangming alone’,‘the therapeutic scope of acupoints’and‘the balance of Yin and Yang’,while also emphasizing the application of specific acupoints.Future research should further deepen the study of TEAS parameters,standardize parameter reporting,and enhance the reproducibility of research.

关 键 词：经皮穴位电刺激 脑卒中 肢体功能障碍 数据挖掘 腧穴 参数 

分 类 号：R245.9[医药卫生—针灸推拿学]