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基于古代针灸处方数据挖掘的胃脘痛选穴与治疗规律研究

[Rules on acupoint selection and treatment for epigastric pain based on the data mining of ancient acupuncture-moxibustion prescriptions].

作者信息

Li Suyun, Wang Jianing, Li Zhongnan, Chai Qingyang, Jing Xianghong

机构信息

Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.

China CITIC Bank Corporation Limited.

出版信息

Zhongguo Zhen Jiu. 2025 Feb 12;45(2):253-61. doi: 10.13703/j.0255-2930.20240904-k0002.

Abstract

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), Zusanli (ST36), Neiguan (PC6), Gongsun (SP4), Pishu (BL20) and Weishu (BL21). The common combinations of acupoints included the pairs of back- points, the combination of back- points and front- points, the combination of front- points and -source points and the combination of back- points and the lower -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 parts of the foot and the arm, the part of the leg and on the back. Regarding the etiologies such as parasites, food retention, masses, 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 ( stagnation, stomach cold and food retention), moxibustion therapy was greatly applicable. For epigastric pain combined with 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 Daling (PC7).

摘要

穴位选择和治疗规律是从收集到的最早记载胃脘痛的古代针灸处方中识别和发现的。使用Excel2016软件建立了胃脘痛古代针灸处方数据库。对疾病名称、病因、病机、症状和穴位进行规范化处理后,运用频率统计和Apriori算法的关联规则,探索针灸各要素之间潜在的多维相关性。古代胃脘痛针灸治疗中,高频使用穴位依次为中脘(CV12)、上脘(CV13)、足三里(ST36)、内关(PC6)、公孙(SP4)、脾俞(BL20)、胃俞(BL21)。常见穴位组合包括背俞穴配伍、背俞穴与募穴配伍、募穴与原穴配伍、背俞穴与下合穴配伍。高频涉及的经脉为任脉、心包经、脾经、胃经和膀胱经;穴位多分布于腹部、足部、手臂、小腿及背部。对于寄生虫、食积、肿块、气滞、胃寒等病因,常配伍中脘(CV12)和上脘(CV13);三阴交(SP6)和大陵(PC7)与肿块高度相关。除寒邪、寄生虫、肿块外,对于其他病因(气滞、胃寒、食积)所致胃脘痛,艾灸疗法应用广泛。胃脘痛伴少腹上逆者,必选气冲(ST30)、三阴交(SP6)、天枢(ST25)、足三里(ST36)。伴有胸腹满闷者,必用大都(SP2)和太白(SP3);伴有背痛者,选用中渚(TE3)。呃逆者常选足三里(ST36)。对于其他伴随症状,选用中脘(CV12),与主症选穴一致。躯干部,除上脘(CV13)外,一般艾灸胃俞(BL21)、脾俞(BL20)、膈俞(BL17)、中脘(CV12)、巨阙(CV14)、气海(CV6)。肘膝关节以下穴位,艾灸常选足三里(ST36),针刺常用公孙(SP4)和大陵(PC7)。

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