[关键词]
[摘要]
目的 基于数据挖掘技术,探析针灸治疗乳腺癌相关淋巴水肿的干预措施和腧穴应用规律。方法 检索中国期刊全文数据库(China National Knowledge Infrastructure, CNKI)、万方数据库(WanFang Data)、维普中文科技期刊全文数据库(Chinese Scientific and Technological Journals, VIP)、PubMed、Embase和the Cochrane Library,检索时间区间为建库至2020年9月9日。依据制定的标准筛查、评估研究设计和提取针灸处方,在WPS 2019软件工作表建立针灸治疗乳腺癌相关淋巴水肿处方数据库,采用频数分析、聚类分析、关联规则分析技术研究针灸治疗乳腺癌相关淋巴水肿取穴规律。结果 共收集到60篇文献,整体研究设计循证评价质量中等,提取出62条处方;干预措施主要为艾灸、针刺和艾灸针刺结合运用;腧穴频次排名前5的为:外关、曲池、足三里、肩髃和合谷;经脉使用频次依次为:手阳明大肠经、手厥阴心包经、任脉、手少阳三焦经和足阳明胃经等;特定穴频次依次为五腧穴、交会穴、络穴、八脉交会穴和原穴等;聚类分析发现7类临床取穴聚类,关联分析发现了以外关为中心关联配伍曲池、肩髃、阴陵泉和水分等强关联穴组。结论 针灸治疗乳腺癌相关淋巴水肿具有一定的规律,临床用穴较为广泛,许多高频腧穴、核心聚类群和关联规则,可直接配伍组成相关针灸处方,为临床应用提供参考和指导。
[Key word]
[Abstract]
Objective To explore the acupoint regularity and interventions of modern acupuncture and moxibustion for breast cancer related lymphedema by using data mining technology.Methods China National Knowledge Infrastructure (CNKI), Chinese Scientific and Technological Journals (VIP), WanFang Database, PubMed, EMBASE and Cochrane were searched. Retrieval time interval was from database establishment to September 9, 2020. Screening, evaluating and extracting prescriptions were performed according to established standards. WPS 2019 Excel software was used to set up the database about acupuncture therapy on breast cancer related lymphedema. Frequency analysis, correlation analysis and cluster analysis were used to analyze the rule of acupuncture for breast cancer related lymphedema.Results A total of 60 papers were collected with 62 prescriptions. The quality of evidence-based evaluation of the overall research design was moderate and the main intervention measures were moxibustion, acupuncture and acupuncture combined with moxibustion. The top 5 acupoints were Waiguan (TE5), Quchi (LI11), Zusanli (ST36), Jianyu (LI15) and Hegu (LI4). The frequency of meridians were as follows: Large Intestine Channel of Hand-Yangming, The Pericardium Channel of Hand-Jueyin, Conception Channel, The Sanjiao Channel of Hand-Shaoyang and The Stomach Channel of Foot-Yangming. The frequency of specific acupoints in turn was five shu points, crossing point, collateral points, eight confluence point and yuan-primary point, and the cluster of main acupoints can be separated for 7 kinds clinical points. The correlation analysis found that there were strong correlations such as Waiguan (TE5) with Quchi (LI11), Jianyu (LI15), Yinlingquan (SP9) or Shuifen (CV9).Conclusion Through data mining technology, it is found that there is a certain rule of acupuncture for breast cancer related lymphedema. The clinical use of acupoints is widespread, but many high-frequency acupoints, core association combination and cluster, which can be directly compatible with the composition of related acupuncture prescriptions for the clinical application of reference and guidance.
[中图分类号]
R245
[基金项目]
国家自然科学基金委员会重大课题(81590951):穴位敏化现象和规律的临床研究,负责人:梁繁荣;国家中医药管理局国家中医药领军人才支持计划(国中医药人教函[2018]284号):国家中医药管理局中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者,负责人:梁繁荣。