基于古今医案云平台探究针灸治疗脑卒中后尿失禁的选穴规律
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R246.6

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山东省中医药高层次人员培训项目专项(鲁卫中医药科教字〔2021〕6号);齐鲁卫生与健康领军人才项目(鲁卫人才字〔2020〕3号)


Discussion on Point Selection Rules of Acupuncture and Moxibustion in Treating Post- Stroke Urinary Incontinence Based on Ancient and Modern Medical Record Cloud Platform
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    摘要:

    目的:采用数据挖掘技术分析针灸治疗脑卒中后尿失禁(PSUI) 的临床选穴规律。方法:通过检索中英文数据库, 收集有关针灸治疗PSUI 的临床文献, 建立针灸处方数据库, 应用古今医案云平台(V2.3.5) 进行统计分析、关联分析和社团分析,探讨针灸治疗PSUI 的腧穴应用特点及其规律。结果:纳入文献108 篇,涉及针灸处方98 首,运用穴位统计功能得出腧穴79 个。PSUI 与关元、中极、气海、三阴交等穴位的相关程度较强。使用频次≥19 次的腧穴有13 个,使用频次排在前5 位的分别是关元、中极、次髎、肾俞、三阴交。关元、中极、气海、三阴交为针灸治疗PSUI 的核心腧穴处方。相互关系最强的穴对是关元-中极。干预措施常用针刺、电针和温针灸。经络以任脉、膀胱经、脾经为主;腧穴部位以背腰臀部、胸腹部和下肢部为主;特定穴以交会穴、募穴为主。结论:针灸治疗PSUI 的腧穴和干预措施具有显著的规律性,其遵循近部取穴为主,辨证选穴为辅,佐以远部选穴和对症选穴的选穴原则;阴病治阴;腧穴以特定穴为主,注重俞募配穴;腧穴部位具有显著的神经节段性效应规律;干预措施以针刺为主,电针和温针灸为辅。以上规律可进一步指导临床实践。

    Abstract:

    Abstract: Objective: To analyze the clinical point selection rules of acupuncture and moxibustion in treating post-stroke urinary incontinence(PSUI) based on data mining. Methods:By searching the Chinese and English databases, clinical literature on acupuncture and moxibustion in the treatment of PSUI were collected to establish database of acupuncture and moxibustion prescriptions. Ancient and Modern Medical Record Cloud Platform(V2.3.5) was used for statistical analysis, association analysis and community analysis. This paper discussed the characteristics and rules of point application in the treatment of PSUI by acupuncture and moxibustion. Results: A total of 108 literature were enrolled, involving 98 acupuncture and moxibustion prescriptions, 79 points were obtained by the function of point statistics. PSUI had a strong correlation with Guanyuan point(RN 4),Zhongji point(RN 3),Qihai point(RN 6),Sanyinjiao point(SP 6) and other points. There were 13 points used more than or equal to 19 times, and the top five were Guanyuan point,Zhongji point,Ciliao point(BL 32),Shenshu point(BL 23),and Sanyinjiao point. Guanyuan point,Zhongji point,Qihai point and Sanyinjiao point were the core point prescriptions in the treatment of PSUI by acupuncture and moxibustion. The point pair with the strongest correlation was Guanyuan point and Zhongji point. The common intervention measures were acupuncture, electroacupuncture and warming- needle moxibustion. The main meridians were conception vessel, bladder meridian and spleen meridian;the points were mainly at the back,waist and buttocks,chest and abdomen and lower limbs; the specific points were mainly crossing point and alarm point. Conclusion: The treatment of PSUI by acupuncture and moxibustion has significant regularity in points and intervention measures. It follows the principle of selecting points mainly from the near, supplemented by selecting points based on syndrome differentiation,as well as selecting points from the far and symptomatic point selection. Yin diseases are treated through the yin;specific points are the main;special attention should be paid to the combination of back- shu points and front- mu points. The points have significant regularity in ganglionic effects; the intervention measures are mainly acupuncture, followed by electroacupuncture and warming- needle moxibustion. The above rules can further guide clinical practice.

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路运萍,颜晓,周悦,张潇斌,夏庆昌,马玉侠.基于古今医案云平台探究针灸治疗脑卒中后尿失禁的选穴规律[J].新中医,2022,54(18):121-127

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  • 在线发布日期: 2022-09-28
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