Zhang Yi-Qing, Wen Jing, Li Ya-Nan, Liu Ran-Ran, Zhang Xuan-Ping, Zhang Xin, Jia Chun-Sheng
Institute of Acupuncture-Moxibustion and Tuina of Hebei University of CM, Shijiazhuang 050200, China.
Zhongguo Zhen Jiu. 2022 Nov 12;42(11):1311-6. doi: 10.13703/j.0255-2930.20211111-k0002.
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 syndrome, wandering syndrome, fixed syndrome and syndrome due to wind, damp and heat. Regarding the core combination of acupoints, painful syndrome: Guanyuan (CV 4) and Shenshu (BL 23); fixed syndrome: Yinlingquan (SP 9), Sanyinjiao (SP 6), Zusanli (ST 36), Pishu (BL 20) and Fenglong (ST 40); wandering syndrome: Fengchi (GB 20), Geshu (BL 17), Fengmen (BL 12), Xuehai (SP 10) and Waiguan (TE 5); 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.
运用复杂网络技术，分析类风湿关节炎（RA）核心穴位处方特点及针灸技术应用，为针灸治疗RA的选穴及治疗方法提供依据。整理并录入近20年针灸治疗RA的文献，建立穴位处方数据库。运用Cytoscape 3.9.2软件，将处方中的穴位进行可视化处理，进行共现网络分析。运用IBM SPSS Modeler 18.0软件进行关联规则分析，运用Gephi 0.9.2软件进行复杂网络分析。共筛选出798篇文献，提取出3258首处方，涉及253个穴位。从辨证、穴位部位及主穴、治疗方法等方面进行选穴分析。结果显示，RA最常见的中医证型包括痛痹、行痹、着痹、风湿热痹。痛痹的核心穴位组合为：关元（CV4）、肾俞（BL23）；着痹的核心穴位组合为：阴陵泉（SP9）、三阴交（SP6）、足三里（ST36）、脾俞（BL20）、丰隆（ST40）；行痹的核心穴位组合为：风池（GB20）、膈俞（BL17）、风门（BL12）、血海（SP10）、外关（TE5）；风湿热痹的核心穴位组合为：大椎（GV14）、曲池（LI11）、合谷（LI4）。从穴位部位来看，上肢、下肢及脊柱部位的穴位被普遍选用。曲池（LI11）是处方中使用频次最高的主穴之一。足三里（ST36）与肾俞（BL23）共现强度最高，足三里（ST36）与曲池（LI11）相关性最高。针灸治疗RA一般遵循“主穴、局部病变部位配穴及辨证配穴相结合”的原则。温针灸及针药结合是RA最常用的治疗方法。
