作者
Yiqing Zhang,Jing Wen,Yanan Li,Ranran Liu,Shouxin Zhang,Shouxin Zhang,Chun‐Sheng Jia
摘要
Using the complex network technology, the characteristics of the core acupoint prescriptions and the application of acupuncture-moxibustion techniques were analyzed in treatment of rheumatoid arthritis (RA) so as to provide the evidences for acupoint selection and therapeutic methods for RA treated with acupuncture and moxibustion. The articles of acupuncture and moxibustion for treatment of RA in recent 20 years were collated and imported, and the database of the acupoint prescriptions was developed. Using Cytoscape 3.9.2 software, the acupoints in the prescriptions were visualized for the common occurrence network analysis. The association rule analysis was performed with IBM SPSS Modeler 18.0 software and the complex network analysis was by Gephi 0.9.2 software. A total of 798 articles were screened, in which, 3 258 prescriptions were extracted with 253 acupoints involved. The analysis of acupoint selection was conducted in terms of syndrome/pattern differentiation, acupoint locations and main acupoints, and therapeutic methods. The results showed that the most common TCM syndromes of RA included painful bi syndrome, wandering bi syndrome, fixed bi syndrome and bi syndrome due to wind, damp and heat. Regarding the core combination of acupoints, painful bi syndrome: Guanyuan (CV 4) and Shenshu (BL 23); fixed bi syndrome: Yinlingquan (SP 9), Sanyinjiao (SP 6), Zusanli (ST 36), Pishu (BL 20) and Fenglong (ST 40); wandering bi syndrome: Fengchi (GB 20), Geshu (BL 17), Fengmen (BL 12), Xuehai (SP 10) and Waiguan (TE 5); bi syndrome due to wind, damp and heat: Dazhui (GV 14), Quchi (LI 11) and Hegu (LI 4). Regarding the acupoint locations, the acupoints located in the upper limbs, lower limbs and spinal region were generally selected. Quchi (LI 11) was one of the main acupoints in prescriptions with the highest use frequency. Zusanli (ST 36) and Shenshu (BL 23) presented the highest co-occurrence intensity, while Zusanli (ST 36) and Quchi (LI 11) indicated the highest correlation. The treatment of acupuncture-moxibustion for RA is generally complied with the principle as "the synthesis of main acupoints, supplementary acupoints in local affected area and those based on syndrome differentiation". Warm needling and the combination of acupuncture and herbal medication are the most common therapeutic methods for RA.利用复杂网络技术分析针灸治疗类风湿关节炎的核心腧穴处方以及刺灸法应用特点,为临床针灸治疗类风湿关节炎提供选穴、治法依据。对近20年针灸治疗类风湿关节炎的文献进行收集、整理、录入,建立针灸处方数据库,对处方中的腧穴运用Cytoscape3.9.0进行共现网络可视化、运用IBM SPSS Modeler 18.0进行关联规则分析、利用Gephi0.9.2软件进行复杂网络分析。共筛选出798篇文献,提取3 258条针灸处方,涉及253个腧穴,主要从辨证分型选穴、分部选穴、主穴处方及疗法进行分析。结果表明最常见的中医证型为痛痹、行痹、着痹及风湿热痹;辨证选穴核心腧穴组合为痛痹:关元、肾俞;着痹:阴陵泉、三阴交、足三里、脾俞、丰隆;行痹:风池、膈俞、风门、血海、外关;风湿热痹:大椎、曲池、合谷。分部选穴以上肢部、下肢部、脊柱部腧穴多见。曲池在主穴处方中使用频次最高,足三里-肾俞的共现强度最高;相关性最高的腧穴组合为足三里-曲池。针灸治疗类风湿关节炎选穴多遵循“主穴-局部配穴-辨证配穴”的原则,温针灸及针药联合为最常用的施治方法。.