近二十年针灸治疗癫痫病临床取穴规律分析

Analysis of Acupuncture Point Selection Patterns for Epilepsy Treatment in the Past 20 Years

摘要: 目的：通过数据挖掘，分析近二十年来针灸治疗癫痫病的取穴规律。方法：通过计算机检索2000年1月1日至2023年12月12日CNKI、PubMed、SinoMed、VIP、WanFang中针灸治疗癫痫的临床观察文献并建立数据库，利用SPSS 27.0进行描述性分析，统计纳入腧穴的使用频次、频率、归经、分布，并制作直观图，同时对高频腧穴进行探索性因子分析、系统聚类分析。采用SPSS Modeler 18.0软件绘制关联规则网络图并依据Apriori算法对高频腧穴进行关联规则分析。采用Gephi 0.10.1软件绘制高频腧穴共现网络图。结果：共纳入54篇文献，针灸处方116条，涉及腧穴89个，总频次882次，纳入研究患者2847例。腧穴频次前5位为百会(78次)、丰隆(52次)、水沟(44次)、大椎(43次)、内关(43次)、鸠尾(40次)、太冲(40次)；经脉频次前3位为督脉、足太阳膀胱经、足阳明胃经；腧穴分布最多为头面颈项；特定穴频次前3位是五输穴、络穴、原穴；鬼门十三针频率为12.36%。经关联规则分析，针灸治疗癫痫的高支持度穴对是百会–太冲、百会–太冲–鸠尾、百会–神门、百会–内关–太冲。探索因子分析提取的6个公因子为针灸治疗癫痫病的常用腧穴组合。结论：针灸治疗癫痫病多取头颈项部穴位和阳经穴位以调摄阳气，进而安神、养神、守神；核心穴位为百会、内关、太冲、丰隆、神门，并根据态靶辨证，随态辨治，随靶加减，为临床进行多途径、多环节、多靶点治疗提供参考依据。

Abstract: Objective: To summarize and analyze the pattern of acupuncture points for epilepsy treatment in the past two decades through data mining techniques. Methods: We searched the CNKI, PubMed, SinoMed, VIP, and WanFang from January 1, 2000, to December 12, 2023, to find out the clinical efficacy of acupuncture in the treatment of epilepsy observation type of literature, the data imported into Microsoft Excel 2021 software to establish a database, the use of IBM SPSS Statistics 27.0 for descriptive analysis, statistical inclusion of the frequency of use of acupoints, frequency, attributed to the meridian, the distribution, and the production of intuitive diagrams, and at the same time, high-frequency acupoints for the Exploratory factor analysis, systematic cluster analysis. IBM SPSS Modeler 18.0 software was used to draw the network diagram of association rules and analyze the association rules of high-frequency acupoints according to the Apriori algorithm. Gephi 0.10.1 software was used to draw the co-occurrence network diagram of high-frequency acupoints. Results: A total of 54 papers were included, with 116 acupuncture prescriptions involving 89 acupoints and a total frequency of 882 times. A total of 2847 patients were included in the study. The top 5 high-frequency acupoints used in acupuncture for epilepsy were Baihui (GV 20) (78 times), Fenglong (ST 40) (52 times), Shuigou (GV 26) (44 times), Dazhui (GV 14) (43 times), Neiguan (PC 6) (43 times), Jiuwei (CV 15) (40 times), and Taichong (LR 3) (40 times); the top 3 selected meridians were the Du Vessel, the bladder meridian of foot greater yang, and the stomach meridian of foot yang brightness; the acupoints used were located in the largest number of parts of the human body, namely, head, face, neck and neck; the top 5 acupoints used were the specific acupoints. The top three frequencies were five acupuncture points, Luo points, and original points; the frequency of acupuncture points attributed to the thirteen needles of the Ghost Gate was 12.36%. After association rule analysis, the highly supported acupoint pairs for acupuncture treatment of epilepsy were Baihui-Taichong, Baihui-Taichong-Jiuwei, Baihui-Shenmen, and Baihui-Neiguan-Taichong, respectively. The six metrics extracted by exploratory factor analysis were the commonly used acupoint combinations for acupuncture for epilepsy. Conclusion: Acupuncture treatment for epilepsy mostly takes acupoints in the head, neck and neck collar to regulate yang Qi and then to tranquilize, nourish and guard the spirit; the core acupoints are Baihui (GV 20), Neiguan (PC 6), Taichong (LR 3), Fenglong (ST 40) and Shenmen (HT 7), and according to the state-target identification, the treatment is discriminated according to the state and the target is added or subtracted according to the target, and the axial developmental law of epilepsy is extracted for the idiopathic, secondary, and co-morbid phenomena, which can provide the reference basis for the clinic to carry out the multi-channel, multi-circuit, multi-target treatments.