2007-2016年围绝经期综合征针灸选穴规律研究

摘要

Objective: To discuss the acupoints selection pattern in acupuncture-moxibustion treatment of perimenopausal syndrome (PMS) from 2007 to 2016. Methods: Clinical literatures related to PMS treated with acupuncture-moxibustion published from 2007 to 2016 were collected from Chinese Biomedical Literature Database (CBM), Chongqing VIP Database (CQVIP), China National Knowledge Infrastructure (CNKI), and Wanfang Academic Journal Full-text Database (Wanfang). The retrieved data underwent descriptive analysis, cluster analysis and association pattern analysis to determine the acupoints selection principle in acupuncture-moxibustion treatment of PMS. Results: The top five acupoints used in acupuncture-moxibustion treatment of PMS were Sanyinjiao (SP 6), Shenshu (BL 23), Guanyuan (CV 4), Baihui (GV 20), and Shenmen (HT 7). The leading 4 meridians were Bladder Meridian, Conception Vessel, Spleen Meridian, and Governor Vessel. The clustering analysis showed that the 5 core acupoint groups were: ① Sanyinjiao (SP 6); ② Shenshu (BL 23) and Guanyuan (CV 4); ③ Baihui (GV 20), Shenmen (HT 7), Zusanli (ST 36), Ganshu (BL 18) and Taichong (LR 3); ④ Taixi (KI 3), Pishu (BL 20), Xinshu (BL 15), Qihai (CV 6) and Neiguan (PC 6); ⑤ Sishencong (EX-HN 1), Zhongwan (CV 12), Hegu (LI 4), Yintang (GV 29), Fengchi (GB 20), Zhongji (CV 3) and Feishu (BL 13). The three most significant acupoints were Sanyinjiao (SP 6), Shenshu (BL 23) and Guanyuan (CV 4). Acupoint groups based on syndrome differentiation included: ① Hegu (LI 4), Zhongwan (CV 12) and Sishencong (EX-HN 1); ② Feishu (BL 13), Zhongji (CV 3), Fengchi (GB 20) and Yintang (GV 29); ③ Xinshu (BL 15), Pishu (BL 20), Qihai (CV 6), Neiguan (PC 6) and Taixi (KI 3);④ Ganshu (BL 18), Zusanli (ST 36), Shenmen (HT 7), Taichong (LR 3) and Baihui (GV 20). The analysis of association pattern elaborated that Shenshu (BL 23) and Sanyinjiao (SP 6) won the highest support rate in the paired groups; Ganshu (BL 18), Shenshu (BL 23) and Sanyinjiao (SP 6) had the highest support rate among the acupoint groups. Conclusion: The data mining results of acupuncture-moxibustion treatment of PMS substantially conform to the general principle in traditional acupuncture-moxibustion theories, able to reflect the acupoints selection and grouping pattern and provide references for acupuncture-moxibustion treatment of PMS.%目的:探析2007-2016年针灸治疗围绝经期综合征(PMS)的选穴规律.方法:收集、整理2007-2016年中国生物医学文献数据库(CBM)、重庆维普(CQVIP)、中国知网(CNKI)和万方数据库(Wanfang)中针灸治疗PMS的临床文献,建立PMS的现代针灸临床处方数据库,采用描述性分析、聚类分析和关联规则分析明确针灸治疗PMS的选穴规律.结果:针灸治疗PMS所选穴位频次位居前五位的是三阴交、肾俞、关元、百会和神门.所选经脉频次前四位的是膀胱经、任脉、脾经和督脉.聚类分析结果显示:治疗PMS的5个核心用穴群为 ①三阴交;②肾俞和关元;③百会、神门、足三里、肝俞和太冲;④太溪、脾俞、心俞、气海和内关;⑤ 四神聪、中脘、合谷、印堂、风池、中极和肺俞.重点用穴为三阴交、肾俞和关元.辨证用穴群为①合谷、中脘和四神聪;②肺俞、中极、风池和印堂;③心俞、脾俞、气海、内关和太溪;④肝俞、足三里、神门、太冲和百会.关联规则分析显示穴对配伍支持度最高的为肾俞和三阴交;穴组支持度最高的为肝俞和肾俞配三阴交.结论:针灸治疗PMS文献的数据挖掘结果与传统医学中针灸治疗理论的一般规律基本相符,能够反映出PMS的临床选穴常用组合规律,可为临床针灸治疗PMS提供参考.