摘要
目的:运用复杂网络分析技术探索针灸治疗颈源性头痛(CEH)的临床应用特征与规律。方法:系统检索中国期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(SinoMed)、PubMed、EMbase、Cochrane Library从建库起至2024年5月31日发表的针灸治疗CEH的相关文献;应用Microsoft Excel 2019软件建立数据库,对腧穴使用频次、归经、证型分类、治疗方案等进行统计分析并绘制数据透视表;应用SPSS Moderler 18.0软件的Apriori算法对主穴处方进行关联规则分析;应用Cytoscape 3.7.2软件绘制复杂网络共现图谱。结果:共纳入文献311篇,提取针灸处方452条,涉及腧穴146个,总使用频次2349次。使用频次前5的腧穴为风池、天柱、颈夹脊、阿是穴、百会;归经主要为胆经、膀胱经、督脉、三焦经、胃经;常用特定穴为交会穴及五输穴;取穴多集中在头颈部、上肢部及下肢部;针刺补泻以平补平泻法为主;最常采用的单一疗法为毫针、电针,综合疗法中多采用毫针与推拿手法联用;天柱-风池为最高频配伍腧穴,风池、百会、天柱、颈夹脊、阿是穴之间联系紧密,与其他腧穴联通性最强;证型主要分为5种,其中少阳证常取率谷、外关、太阳,肝阳上亢证常取太冲、行间、太溪,风寒证常取大椎、风门、合谷,太阳证常取天柱、风府、后顶,厥阴证常取百会、太冲、四神聪。结论:针灸治疗CEH核心腧穴组合为风池、百会、天柱、颈夹脊、阿是穴,临床多采用近部取穴原则,佐以远部取穴及上下配穴,重视经络辨证,在核心腧穴基础上灵活配穴,以达到最佳治疗效果。
Objective To investigate the clinical application characteristics and rules of acupuncture-moxibustion therapy in treatment of cervicogenic headache(CEH)based on complex network analysis techniques.Methods A comprehensive and systematic literature search was conducted across the China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(W anfang),VIP Chinese Science and Technology Periodical Database(VIP),SinoMed Chinese Biomedical Literature Database,PubMed,EMbase,and Cochrane Library,fromtheir inception to May 31,2024,to retrieve relevant articles on acupuncture-moxibustion treatments for CEH.A database was constructed using Microsoft Excel 2019 to statistically analyze and create comprehensive pivot tables for the frequency of acupoint utilization,meridian attribution,syndrome differentiation,and therapeutic protocols.Furthermore,the Apriori algorithmwithin SPSS Modeler 18.0 was employed to performan association rule analysis on the primary acupoint prescriptions.Cytoscape 3.7.2 software was utilized to visualize the complex network co-occurrence patterns.Results A total of 311 eligible articles were included,yielding 452 acupuncture prescriptions that encompassed 146 acupoints with a cumulative utilization frequency of 2349.The top five most frequently employed acupoints were Fengchi(GB20),Tianzhu(BL10),Jingjiaji(EX-B2),Ashi points,and Baihui(GV20).The predominant meridians targeted were the gallbladder meridian,bladder meridian,governor vessel,triple energizer meridian,and stomach meridian.Specific points,such as confluent points and five-shu points,were frequently utilized.Acupoints selected are mainly distributed on the head,neck,upper extremities,and lower extremities.The even veinforcing-reducing needling technique was dominant in acupuncture manipulation.The most commonly adopted single technique is filiformneedling or electroacupuncture.Regarding the comprehensive therapy,filiformneedling and tuinawas combined.The highest co-occurrence frequency was observed between BL10 and GB20,and the close interconnection was presented among GB20,GV20,BL10,EX-B2 and Ashi(Extra);and these points demonstrated the strongest connectivity to other acupoints.Five syndromes/patterns of traditional Chinese medicine were involved.Shaoyang syndrome was treated with Shuaigu(GB8),W aiguan(TE5),and Taiyang(EX-HN5),liver-yanghyperactivity syndrome was with Taichong(LR3),Xingjian(LR2),and Taixi(KI3);wind-cold syndrome was with Dazhui(GV14),Fengmen(BL12),and Hegu(LI4);Taiyang syndrome was with BL10,Fengfu(GV16),and Houding(EX-HN9);and Jueyin syndrome was with GV20,LR3,and Sishencong(EX-HN1).Conclusion The core acupoint combination of acupuncture and moxibustion for CEH comprises GB20,GV20,BL10,EX-B2 and Ashi points.In clinical practice,the nearby points are principal,combined with the distal points,as well as those selected by the upper-lower combination;and the meridian differentiation is emphasized.On the basis of core acupoints,the supplementary acupoitns are selected accordingly to optimize therapeutic outcomes.
作者
王础桓
谭天阳
张宇帆
高鹏
袁永
李荣俊
王彤
肖京
WANG Chu-huan;TAN Tian-yang;ZHANG Yu-fan;GAO Peng;YUAN Yong;LI Rong-jun;WANG Tong;XIAO Jing(Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091)
出处
《针刺研究》
北大核心
2025年第10期1199-1210,共12页
Acupuncture Research
基金
首都卫生发展科研专项项目(No.首发2022-2-4175)。
关键词
颈源性头痛
针灸
复杂网络
数据挖掘
临床应用
Cervicogenic headache
Acupuncture and moxibustion
Complex network
Data mining
Clinical application
