Zhang Dong, Zhang Hai-Long, Feng Zhen-Zhen, Li Xuan-Lin, Wang Lu, Li Jian-Sheng
Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province and Education Ministry of P.R. China, Henan Key Laboratory of Chinese Medicine for Respiratory Disease, First Clinical Medical College of Henan University of CM, Zhengzhou 450046, China.
Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province and Education Ministry of P.R. China, Henan Key Laboratory of Chinese Medicine for Respiratory Disease, First Clinical Medical College of Henan University of CM, Zhengzhou 450046, China; Department of Respiration, First Affiliated Hospital of Henan University of CM, Zhengzhou 450003.
Zhongguo Zhen Jiu. 2021 Dec 12;41(12):1399-403. doi: 10.13703/j.0255-2930.20201021-k0005.
To explore the characteristics and rule of clinical acupoint selection in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
The clinical articles of acupuncture in treatment of AECOPD were retrieved from the databases of PubMed, EMbase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP and SinoMed, from the date of establishment to July 15, 2020. The articles were screened in accordance with the inclusion and exclusion criteria, the prescriptions of acupuncture and the relevant information of the acupoints and meridians were extracted to establish the database. The data mining methods i.e. Apriori association rule analysis and cluster analysis were used to analyse the using frequency, involving meridians, acupoint distributions, association rules and cluster of selected acupoints.
A total of 54 articles were included, 67 acupuncture prescriptions were extracted, 69 acupoints were involved and the total using frequency was 475 times. The top 5 acupoints in frequency were Danzhong (CV 17), Feishu (BL 13), Zusanli (ST 36), Fenglong (ST 40) and Dingchuan (EX-B1). The main involved meridians were bladder meridian of foot-, conception vessel, stomach meridian of foot- and lung meridian of hand- The acupoints were mainly distributed in chest and abdomen, waist and dorsum. The mainly selected special points were five- points, front- points, convergent points and back- points. Twenty strong association rules were summarized by association rule analysis, including Fenglong (ST 40)Þ Zusanli (ST 36), Fengmen (BL 12)Þ Danzhong (CV 17), Tianshu (ST 25)Þ Zhongwan (CV 12), Dingchuan (EX-B1)+ Feishu (BL 13) Þ Danzhong (CV 17), Fenglong (ST 40)+ Feishu (BL 13) Þ Zusanli (ST 36), etc. Five cluster groups were summarized by cluster analysis, i.e. ①Feishu (BL 13), ② Dingchuan (EX-B1) and Danzhong (CV 17), ③ Chize (LU 5), Lieque (LU 7) and Fengmen (BL 12), ④Zusanli (ST 36) and Fenglong (ST 40), ⑤Tianshu (ST 25), Guanyuan (CV 4) and Zhongwan (CV 12).
The local acupoints and acupoints along meridians are the main acupuncture prescriptions for AECOPD, and the special points are the predominated selection. The acupoint compatibility embodies the therapeutic principle of "strengthening vital to eliminate pathogenic factors and considering both the root cause and symptoms".
探讨针刺治疗慢性阻塞性肺疾病急性加重期（AECOPD）临床选穴特点及规律。
检索PubMed、EMbase、Cochrane Library、Web of Science、CNKI、万方、维普、中国生物医学文献数据库中自建库至2020年7月15日针刺治疗AECOPD的临床研究文献，按照纳入与排除标准进行筛选，提取针刺处方及穴位、经络相关信息建立数据库，采用Apriori关联规则分析和聚类分析等数据挖掘方法，分析选穴的使用频次、涉及经络、穴位分布、关联规则及聚类情况。
共纳入54篇文献，提取针刺处方67首，涉及穴位69个，总使用频次475次。使用频次前5位的穴位依次为膻中（CV17）、肺俞（BL13）、足三里（ST36）、丰隆（ST40）、定喘（EX-B1）。主要涉及的经络为足太阳膀胱经、任脉、足阳明胃经、手太阴肺经。穴位主要分布于胸腹部、腰背部。主要选用的特定穴为五输穴、募穴、交会穴、背俞穴。通过关联规则分析总结出20条强关联规则，包括丰隆（ST40）→足三里（ST36）、风门（BL12）→膻中（CV17）、天枢（ST25）→中脘（CV12）、定喘（EX-B1）+肺俞（BL13）→膻中（CV17）、丰隆（ST40）+肺俞（BL13）→足三里（ST36）等。通过聚类分析总结出5个聚类组，即①肺俞（BL13）；②定喘（EX-B1）、膻中（CV17）；③尺泽（LU5）、列缺（LU7）、风门（BL12）；④足三里（ST36）、丰隆（ST40）；⑤天枢（ST25）、关元（CV4）、中脘（CV12）。
局部穴位及循经取穴是AECOPD针刺治疗的主要选穴处方，特定穴为主要选用对象。穴位配伍体现了“扶正祛邪、标本兼治”的治疗原则。
