基于数据挖掘探讨针灸治疗卒中后运动性失语选穴规律  

Exploration on the acupoint selection law of acupuncture and moxibustion in treating broca aphasia after stroke based on data mining

作　　者：马慧 纪昌春 张荣妮 饶享 幸雨 赵婧宇 Ma Hui;Ji Changchun;Zhang Rongni;Rao Xiang;Xing Yu;Zhao Jingyu(College of Acupuncture and Moxibustion,Shaanxi University of Chinese Medicine,Xianyang 712046,China;Department of Acupuncture and Moxibustion,Shaanxi Traditional Chinese Medicine Hospital,Xi'an 710003,China;Department of Acupuncture and Moxibustion,Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021,China)

机构地区：[1]陕西中医药大学针灸推拿学院,咸阳712046 [2]陕西省中医医院针灸科,西安710003 [3]西安市中医医院针灸科,西安710021

出　　处：《国际中医中药杂志》2025年第2期256-261,共6页International Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82074560);陕西省卫生健康高层次人才(团队)计划领军人才项目(2024年);陕西中医药大学研究生创新能力提升项目(CXSJ202425)。

摘　　要：目的探讨针灸治疗卒中后运动性失语的取穴规律。方法检索中国期刊全文数据库(CNKI)、中文科技期刊数据库(重庆维普)、中国学术期刊数据库(万方数据)、中华医学期刊全文数据库、中国生物医学文献服务系统(SinoMed)、PubMed、Web of Science及Embase建库至2024年5月31日有关针灸治疗卒中后运动性失语的RCT文献。采用Excel 2021、SPSS Statistics 27.0、SPSS Modeler 18.0及Cytoscape 3.9.1软件进行腧穴频次统计,以及聚类和关联规则及核心共现网络分析。结果共纳入文献87篇,涉及针灸处方100首,穴位/穴区101个,共涉及6个分型,其中廉泉(35次)、金津(35次)、玉液(34次)应用较多;选穴主要分布在头面部、颈项部及下肢部,所属经脉主要为督脉、任脉;特定穴以原穴为主,其次为络穴;特殊针法中头针使用频次最高(88次);高频穴位/穴区聚类分析得到“金津-玉液-廉泉-百会-哑门”等5个有效类群,关联性最强的穴位组合为金津和玉液;核心共现网络分析显示,单穴使用频次最多的穴位为廉泉与金津,两穴关联程度最高为金津-玉液。结论针灸治疗卒中后运动性失语多从“醒脑为纲、益髓为本、开窍为要”立论,以脏腑经络理论作为指导,通过疏通经络、益髓醒脑、启闭开音功效,实现对语言功能的恢复。Objective To explore the acupoint selection law of acupuncture and moxibustion in the treatment of broca aphasia after stroke.Methods RCT articles about acupuncture and moxibustion treatment for broca aphasia after stroke were retrieved from CNKI,VIP,Wanfang Data,China Medical Journal Full-text Database,SinoMed,PubMed,Web of Science and Embase database from the establishment of the databases to May 31,2024.Excel 2021,SPSS Statistics 27.0,SPSS Modeler 18.0 and Cytoscape 3.9.1 software were used to analyze the frequency of acupoint,clustering,association rules and core co-occurrence network.Results A total of 87 articles were included,involving 100 acupuncture and moxibustion prescriptions and 101 acupoints/acupoint area,involving 6 types,including Lianquan(CV 23)(35 times),Jinjin(EX-HN12)(35 times)and Yuye(EX-HN13)(34 times).The selected acupoints were mainly distributed in the head,face,neck and lower limbs,and the meridians were mainly Governor Vessel and Conception Vessel;the specific acupoints were mainly original acupoints,followed by collaterals acupoints,and scalp acupuncture was used most frequently in special acupuncture(88 times).According to the clustering analysis of high-frequency acupoints/acupoint area,there were five effective groups,such as"Jinjin(EX-HN12)-Yuye(EX-HN13)-Lianquan(CV 23)-Baihui(GV 20)-Yamen(GV 15)".The core co-occurrence network analysis showed that the acupoints used most frequently were Lianquan(CV 23)and Jinjin(EX-HN12),and the highest correlation between the two acupoints was Jinjin(EX-HN12)-Yuye(EX-HN13).Conclusions Acupuncture and moxibustion for the treatment of broca aphasia after stroke is often based on"awakening the brain as the outline,benefiting the marrow as the foundation,and resuscitation".Under the guidance of the theory of Zang-fu meridians and collaterals,through dredging the meridians and collaterals,tonifying the brain and opening and closing the sound,the recovery of language function can be achieved.

关 键 词：卒中 卒中后运动性失语 针灸 取穴规律 聚类分析 数据挖掘 

分 类 号：R246.6[医药卫生—针灸推拿学]