1 海军军医大学附属长海医院针灸推拿科，上海 200433
2 上海中医药大学基础医学院，上海 201203
目的：运用数据挖掘技术分析总结脑卒中后上肢痉挛性瘫痪的临床针灸局部选穴规律，为临床治疗提供借鉴。方法：从国内外数据库收集2009年1月至6月针灸治疗脑卒中后上肢痉挛性瘫痪的临床文献，建立针灸处方数据库，运用SPSS 21.0、SPSS modeler 18.0软件对腧穴进行统计描述、关联规则和聚类分析。结果：该研究共纳入针灸处方237个，涉及上肢穴位65个，取穴频次1 519次；选穴频次最多的为合谷、肩髃、外关、曲池、手三里，且多互相配伍作为主穴；配穴多为内关、极泉、尺泽、大陵；所取穴位多归手阳明大肠经，手少阳三焦经、手厥阴心包经，且以特定穴为主，其中合穴为多。结论：针灸治疗中风后痉挛性上肢瘫痪总体思路体现了“重取阳明”及“阴可柔痉”的宗旨，取穴上多以特定穴及痉挛侧腧穴为主，对临床有一定的指导作用。
Exploration on prescription compatibility law of local acupoint selection in acupuncture treating upper limb spastic paralysis after stroke based on data mining
CorrespondingAuthor: ZHOU Qinghui
This work was supported by the Medical Guidance (Chinese or Western Medicine) of Science and Technology Support Project of Shanghai, China (17401933900).
Objective: Based on data mining, the prescription compatibility law of local acupoint selection about acupuncture for upper limb spastic paralysis after stroke (ULSPAS) was investigated, as to provide reference for clinical treatment. Methods: The clinical data of acupuncture for ULSPAS from January to June 2019 were collected from Chinese and English database, and acupuncture prescription database was established. Data description, association and cluster rules were analyzed by SPSS 21.0 and SPSS modeler 18.0 software. Results: A total of 237 acupuncture prescriptions are studied, including 65 acupoints of upper limb used for 1 519 times. The most frequently chosen acupoints were Hegu (LI4), Jianyu (LI15), Waiguan (SJ5), Quchi (LI11), Shousanli (LI10), and their multi-compatibility was used as main acupoints. While the core adjunct acupoints were Neiguan (PC6), Jiquan (HT1), Chize (LU5), Daling (PC7). Acupoints belongs to Meridian of Hand-Yangming, Meridian of Hand-Shaoyang and Meridian of Hand-Jueyin were most common, and specific acupoints takes majority, especially He-sea point. Conclusion: The general idea of acupuncture treating ULSPAS follows “Yangming first” and “Yin relieves spasm”, and rules of acupoint selection focus on specific acupoints and acupoints of spasmodic side, which may have a guiding effect on clinical practice.
stroke; upper limb spastic paralysis; acupuncture therapy; acupoints compatibility; data mining