基于数据挖掘探索改善脓毒症危重评分和预后的针刺选穴规律  

Explore the Acupoint Selection Rule of Acupuncture to Improve the Critical Score and Prognosis of Sepsis Based on Data Mining

作　　者：舒传爱 盛林保 李奕祺[1] SHU Chuan′ai;SHENG Linbao;LI Yiqi(College of Traditional Chinese Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,Fujian,China;The Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong,China)

机构地区：[1]福建中医药大学中医学院,福建福州350122 [2]广州中医药大学第二临床医学院,广东广州510006

出　　处：《医学信息》2025年第9期20-26,共7页Journal of Medical Information

基　　金：福建省妇科微创与整合盆底临床研究中心课题(编号:科技[2023]2号-X202206-临床中心)。

摘　　要：目的基于数据挖掘探索改善脓毒症危重评分和预后的针刺选穴规律。方法计算机检索PubMed、Embase、The Cochrane of Library、中国知网(CNKI)、万方(WanFang Data)、维普(VIP)和中国生物医学文献(CBM)数据库,搜集针刺治疗脓毒症患者的临床试验,检索时限均从建库至2023年3月1日。利用Microsoft Office Excel 2016、IBM SPSS Statistics 27.0、IBM SPSS Modeler 18.0软件进行频数统计、聚类分析、关联规则分析。结果共纳入69个临床试验,涉及43个腧穴,总应用265次,其中应用频次最多的前3位腧穴分别为足三里、天枢、上巨虚。按照腧穴归经所属,涉及十四经脉及经外奇穴,其中应用频次前3的经脉分别为足阳明胃经、任脉、足太阴脾经和手阳明大肠经。按照特定穴归属,涉及十三类特定穴,排在前3的特定穴为合穴、下合穴、募穴。按照腧穴归属部位划分,主要以四肢和腹部穴位为主。对应用频次>5的腧穴进行聚类分析,当距离为20时得到4个穴位处方,分别是天枢-上巨虚-中脘-下巨虚-足三里、气海-下脘-关元、合谷-曲池、内关-三阴交。关联规则分析按支持度百分比进行降序排序显示,前3位腧穴对分别是天枢-足三里、上巨虚-天枢、上巨虚-足三里。结论临床针刺治疗脓毒症时可将足阳明胃经和任脉上的足三里、天枢、上巨虚、下巨虚、关元、中脘、下脘作为主穴处方,并适当配伍曲池-合谷通腑泄热和三阴交-内关补阴等穴位,再根据具体临床表现及证型分类配伍相关腧穴。Objective To explore the acupoint selection rule of acupuncture for improving sepsis critical score and prognosis based on data mining.Methods PubMed,Embase,The Cochrane Library,CNKI,WanFang Data,VIP and CBM databases were searched by computer to collect clinical trials of acupuncture in the treatment of sepsis patients from the establishment of the database to March 1,2023.Microsoft Office Excel 2016,IBM SPSS Statistics 27.0 and IBM SPSS Modeler 18.0 software were used for frequency statistics,cluster analysis and association rule analysis.Results A total of 69 clinical trials were included,involving 43 acupoints,with a total of 265 times of application,he top three acupoints with the highest frequency of application were Zusanli,Tianshu and Shangjuxu.According to the acupoints,the fourteen meridians and extra-meridian acupoints were involved.The first three meridians of application frequency were the stomach meridian of foot-yangming,Ren meridian,the spleen meridian of foot-taiyin and the large intestine meridian of hand-yang-ming.According to the attribution of specific acupoints,there were 13 types of specific acupoints,and the first three specific acupoints were He point,lower he point and front-mu point.According to the classification of acupoints,mainly in the limbs and abdominal acupoints.Cluster analysis was performed on acupoints with application frequency>5,when the distance was 20,four acupoint prescriptions were obtained,which were Tianshu-Shangjuxu-Zhongwan-Xiajuxu-Zusanli,Qihai-Xiawan-Guanyuan,Hegu-Quchi,and Neiguan-Sanyinjiao.Association rule analysis showed that the top three acupoints were Tianshu-Zusanli,Shangjuxu-Tianshu and Shangjuxu-Zusanli according to the descending order of support percentage.Conclusion In clinical acupuncture treatment of sepsis,Zusanli,Tianshu,Shangjuxu,Xiajuxu,Guanyuan,Zhongwan and Xiawan on the stomach meridian of foot-yangming and Ren meridian can be used as the main acupoint prescription,and Quchi-Hegu Tongfu Xiere and Sanyinjiao-Neiguan Buyin and other acupoints ca

关 键 词：数据挖掘 脓毒症 针刺 选穴规律 预后 

分 类 号：R245[医药卫生—针灸推拿学] R631[医药卫生—中医临床基础]