摘要
目的:利用复杂网络技术分析针灸治疗踝关节扭伤的腧穴配伍规律及刺灸法应用特点,为临床针灸治疗踝关节扭伤提供选穴、刺灸法应用依据和治疗思路。方法:检索中国知网(CNKI)、万方数据知识服务平台、维普资讯中文期刊服务平台、PubMed数据库中针灸治疗踝关节扭伤的临床研究文献。根据纳入、排除标准筛选文献,建立针灸治疗踝关节扭伤数据库。运用SPSS Modeler 18.0软件建模,进行关联规则分析,利用Gephi 0.9.2软件进行复杂网络分析。结果:共纳入201篇文献,提取出236条针灸处方,共涉及61个腧穴,总使用频次为846次,使用频次前10的腧穴分别为阿是穴(109次)、昆仑(79次)、解溪(70次)、丘墟(68次)、申脉(63次)、阳陵泉(59次)、太溪(53次)、照海(52次)、悬钟(37次)、商丘(34次)。描述性分析结果显示,经脉选用以足少阳胆经(181次)、足太阳膀胱经(153次)、足少阴肾经(116次)、足阳明胃经(105次)、足太阴脾经(53次)为主;关联规则结果显示,相关性最高的腧穴组合为“昆仑—解溪”,其次是“昆仑—太溪”,体现了踝关节扭伤多以局部选穴为主的原则。对201条主穴处方进行复杂网络“k-core层次分析”和“社团分析”,最终得到2个核心腧穴群。治疗方法显示,毫针针刺为针灸治疗踝关节扭伤最常用的干预措施,补泻手法常以泻法与平补平泻为主,少有运用补法。结论:通过复杂网络分析发现针灸治疗踝关节扭伤具有一定的特点,以局部选穴为主,同时注重与经外奇穴等远端腧穴的配合,临证中注重刺灸法效应特异性,可为针灸治疗踝关节扭伤的临床治疗提供借鉴。
Objective To analyze the compatibility regularities of acupoints and the application characteristics of needling-moxibustion methods in the treatment of ankle sprain by using complex network technology,so as to provide the basis and treatment ideas.Methods The clinical research articles on acupuncture treatment of ankle joint sprain published from November 2011 to November 2021 were retrieved from databases of CNKI,Wanfang Data knowledge service platform,VIP information Chinese journal service platform and PubMed by using key words of“acupuncture”“moxibustion”“acupuncture and moxibustion”“ankle injury”“ankle sprain”“injured ankle”and“syndesmotic injuries”.After screening these articles according to our inclusion and exclusion criteria,a database of acupuncture treatment of ankle sprain was established.Then,analysis on the occurrence frequency of acupoints and their related meridians,and methods of needling manipulation,and the association rule analysis(quantitative analysis)about the closeness between acupoints,and the degree of support and confidence coefficient were conducted for acquiring the acupoint combinations with higher correlation in the compatibility using Apriori algorithm after modeling(with IBM SPSS Modeler18.0 software).Gephi 0.9.2 software was used to make complex network analysis,for which“k-core hierarchical analysis”and“community analysis”were used as the methods to analyze the network structure of acupoints,and the confidence value was used as the index to measure the importance of acupoints.Results A total of 201 articles meeting the criteria were collected,including 196 articles in Chinese and 5 in English.A total of 236 acupuncture prescriptions were extracted,involving 61 acupoints,with a total frequency of occurrence being 846.The top 10 acupoints were Ashi point,Kunlun(BL60),Jiexi(ST41),Qiuxu(GB40),Shenmai(BL62),Yanglingquan(GB34),Taixi(KI3),Zhaohai(KI6),Xuanzhong(GB39)and Shangqiu(SP5),with the occurrence frequency being 109,79,70,68,63,59,53,52,37 and 34,respectively.The results of descriptive analysis showed that the top 5 meridians were Gallbladder Meridian of Foot-shaoyang,Bladder Meridian of Foot-taiyang,Kidney Meridian of Foot-shaoyin,Stomach Meridian of Foot-yangming and Spleen Meridian of Foot-taiyin,with the frequency being 181,153,116,105 and 53,respectively.Complex network analysis displayed that after“k-core hierarchical analysis”and“Community division”,two communities were reserved,mainly involving 15 core acupoints such as Ahshi point,GB40,ST14,BL62,GB34,KI6,BL60,KI3,GB39,Zusanli(ST36),SP5;Taichong(LR3),Zulinqi(GB41),Sanyinjiao(SP6)and Rangu(KI2).The results of association rule analysis showed that the most relevant acupoint combination is“BL60-ST41”(support degree 34.83%),followed by“BL60-KI3”(support degree 26.37%),reflecting the principle of selection of local acupoint for ankle sprain.The therapeutic methods are filiform needle acupuncture,and the reducing technique and uniform reinforcing and reducing manipulation are the most commonly used approaches,but the reinforcing method is rarely used.Conclusion In the treatment of ankle sprain,local acupoints and Ashi points are mainly used,in combination with reducing or uniform reinforcing and reducing manipulations,as well as the method of needling and moxibustion,which provides a good reference for clinical practice.
作者
李亚楠
张义情
温静
刘冉冉
张莘
贾春生
LI Ya-nan;ZHANG Yi-qing;WEN Jing;LIU Ran-ran;ZHANG Xin;JIA Chun-sheng(Institute of Acupuncture Moxibustionand Tuina,Hebei University of Chinese Medicine,Shijiazhuang 050200,China;Hebei Key Laboratory of Acupunctureand Moxibustion Specificity Effects,Shijiazhuang 050091)
出处
《针刺研究》
CAS
CSCD
北大核心
2023年第2期204-210,共7页
Acupuncture Research
基金
国家自然科学基金项目(No.81072883、81173342、81473773)。
关键词
踝关节扭伤
针灸
数据挖掘
复杂网络
腧穴配伍
Ankle sprain
Acupuncture
Data mining
Complex network analysis
Acupoint compatibility
