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1.中国中医科学院针灸研究所,北京 100700
2.中信银行股份有限公司
✉景向红,研究员。E-mail:jxhtjb@263.net
收稿:2024-09-04,
网络首发:2024-11-28,
纸质出版:2025-02-12
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李素云, 王佳宁, 李中楠, 等. 基于数据挖掘技术探析古代胃脘痛针灸方的选穴治疗规律[J]. 中国针灸, 2025,45(2):253-261.
LI Suyun, WANG Jianing, LI Zhongnan, et al. Rules on acupoint selection and treatment for epigastric pain based on the data mining of ancient acupuncture-moxibustion prescriptions[J]. Chinese Acupuncture & Moxibustion, 2025, 45(2): 253-261.
李素云, 王佳宁, 李中楠, 等. 基于数据挖掘技术探析古代胃脘痛针灸方的选穴治疗规律[J]. 中国针灸, 2025,45(2):253-261. DOI: 10.13703/j.0255-2930.20240904-k0002.
LI Suyun, WANG Jianing, LI Zhongnan, et al. Rules on acupoint selection and treatment for epigastric pain based on the data mining of ancient acupuncture-moxibustion prescriptions[J]. Chinese Acupuncture & Moxibustion, 2025, 45(2): 253-261. DOI: 10.13703/j.0255-2930.20240904-k0002.
收集整理古代胃脘痛针灸方,辨识并基于首见文献挖掘其选穴治疗规律。采用Excel2016软件建立胃脘痛古代针灸处方条文数据库,对病名、病因病机、症状、腧穴术语规范化处理后运用频次统计与关联规则Apriori算法,挖掘其针灸辨治各要素间隐含的多维度关联规律。古代针灸治疗胃脘痛的高频基础穴依次是中脘、上脘、足三里、内关、公孙、脾俞、胃俞,配伍组合以背俞穴两两相配、俞募相配、募原相配、背俞与下合穴相配较常见,任脉、心包经、脾经、胃经、膀胱经腧穴选用频次较高,腹部、足阴、臂阴、腿阳、背部穴较多见。虫、食积、痞块、气滞、胃寒多种病因选穴均与中脘、上脘有关联,病因痞块还与三阴交、大陵有强关联;除伤寒、虫、痞块,其他气滞、胃寒、食积等多种病因导致的胃脘痛,灸法均明显更适用。胃脘痛兼小腹有气上冲者必选气冲、三阴交、天枢、足三里;伴胸满腹胀时必选大都与太白;伴背痛必选中渚;伴噎膈多选足三里,其他兼症则与主症的高频选穴中脘一致。躯干部腧穴胃俞、脾俞、膈俞、中脘、巨阙、气海多选用灸法,但上脘穴例外;四肢肘膝以下足三里多用灸法,但公孙、大陵更常用针刺。
The rules of acupoint selection and treatment were identified and discovered from the collected ancient acupuncture-moxibustion prescriptions recorded the earliest for epigastric pain. The database of ancient acupuncture-moxibustion prescriptions for epigastric pain was set up using Excel2016 software. After the disease term
etiology
pathogenesis
symptoms and acupoints were normalized
the underlying multi-dimensional correlation among the elements of acupuncture-moxibustion was explored
using the frequency statistics and the association rule of Apriori algorithm. In the ancient time
in treatment with acupuncture-moxibustion therapy for epigastric pain
the acupoints of the high use frequency were sequenced as Zhongwan (CV12)
Shangwan (CV13)
Zusanl
i (ST36)
Neiguan (PC6)
Gongsun (SP4)
Pishu (BL20) and Weishu (BL21). The common combinations of acupoints included the pairs of back-
shu
points
the combination of back-
shu
points and front-
mu
points
the combination of front-
mu
points and
yuan
-source points and the combination of back-
shu
points and the lower
he
-sea points. The highly involved acupoints were those from the conception vessel
pericardium meridian
spleen meridian
stomach meridian and bladder meridian; and they were commonly distributed on the abdomen
the
yin
parts of the foot and the arm
the
yang
part of the leg and on the back. Regarding the etiologies such as parasites
food retention
masses
qi
stagnation and stomach cold
Zhongwan (CV12) and Shangwan (CV13) were coordinated; and Sanyinjiao (SP6) and Daling (PC7) were highly associated with masses. Besides cold injury
parasites and masses
for the epigastric pain caused by other factors of etiology (
qi
stagnation
stomach cold and food retention)
moxibustion therapy was greatly applicable. For epigastric pain combined with
qi
reversion in the lower abdominal region
Qichong (ST30)
Sanyinjiao (SP6)
Tianshu (ST25) and Zusanli (ST36) must be selected. Dadu (SP2) and Taibai (SP3) must be used if the distention in the chest and abdomen accompanied; and Zhongzhu (TE3) be used if back pain involved. Zusanli (ST36) was commonly selected for hiccups. For the other accompanied symptoms
Zhongwan (CV12) was used
which is consistent with the acupoint selection of main symptoms. On the trunk
moxibustion was generally used at Weishu (BL21)
Pishu (BL20)
Geshu (BL17)
Zhongwan (CV12)
Juque (CV14) and Qihai (CV6)
except Shangwan (CV13). Among the acupoints below the elbows and knees
moxibustion was commonly applicable at Zusanli (ST36)
and acupuncture was often used at Gongsun (SP4) and Dali
ng (PC7).
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