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基于数据挖掘的针药结合治疗慢性阻塞性肺疾病临床优势及选穴规律分析

[Analysis on the clinical advantages and the rules of acupoint selection in treatment of chronic obstructive pulmonary disease with the integration of acupuncture and medication based on data mining].

作者信息

Zhang Chao-Yang, Yang Yuan-Zhen, Luo Yu, Gao Fei-Fei, Guo Yi, Zhao Tian-Yi, Li Shan-Shan, Xu Zhi-Fang

机构信息

Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.

College of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617.

出版信息

Zhen Ci Yan Jiu. 2025 Feb 25;50(2):232-242. doi: 10.13702/j.1000-0607.20231122.

DOI:10.13702/j.1000-0607.20231122
PMID:40059059
Abstract

OBJECTIVES

To explore the clinical advantages and the rules of acupoint selection in treatment of chronic obstructive pulmonary disease (COPD) with the integration of acupuncture and medication by means of frequency statistics and complex network analysis, so as to provide references for the standardized treatment with the integration of acupuncture and medication.

METHODS

Searched from PubMed, Web of Science, Embase, Ovid, CNKI, Wanfang, VIP, and SinoMed, the articles of clinical trials for COPD treated with the integration of acupuncture and medication were collected, dated from January 1, 2003 to September 1, 2023. Literature was screened according to the inclusion and exclusion criteria. Using frequency statistics, the clinical advantages of the integration of acupuncture and medication were explored. The database of acupoint prescriptions was established using Microsoft Excel 2019, the complex network model was constructed using SPSS18.0 and Gephi0.10, and the core acupoints and acupoint combinations were screened.

RESULTS

In the analysis of the clinical advantages of the combination of acupuncture and herbal medicine for the treatment of COPD, acupuncture alone contributed to the improvement of respiratory system indicators a total of 263 times, accounting for 51.77% of the total number of improved indicators, with the majority being improvements in resting lung function (184 times, 36.22%). In addition, acupuncture alone also showed certain improvement effects on clinical symptoms, cardiac function, and biochemical blood indicators in COPD patients. The combination of acupuncture and traditional Chinese medicine (TCM) contributed to the improvement of respiratory system indicators 90 times, accounting for 42.45% of the total improvement frequency, with the primary focus being on improvements in resting lung function (66 times, 31.13%), followed by improvements in clinical symptoms and biochemical blood indicators. The combination therapy for COPD mainly selected acupoints from the Bladder Meridian of Foot-Taiyang, with the combination of "Shenshu (BL23) + Feishu (BL13)" being the most frequently used acupoint pair. By performing "k-core" analysis and community network partitioning on the complex network diagram, three core acupoint clusters were identified.

CONCLUSIONS

This article categorizes the clinical advantages of acupuncture and herbal medicine combination therapy for COPD into two types:the advantages of acupuncture alone and the advantages of acupuncture combined with TCM. Both can improve the function of target organs and enhance patients' lung function. Moreover, for other non-target organ indicators, both also have an improvement effect, demonstrating the comprehensive regulatory capacity of the combination of acupuncture and herbal medicine. In the clinical acupoint selection for the treatment of COPD with the combination of acupuncture and herbal medicine, emphasis was placed on the application of specific acupoints, especially the use of confluent points. The selection is closely related to the pathogenesis of COPD, which is characterized by "fundamental deficiency and marked excess". By combining "predominantly draining" acupoints with "predominantly tonifying" acupoints, the therapy aims to expel pathogenic factors while supporting the body's healthy functions.

摘要

目的

运用频次统计和复杂网络分析方法,探讨针药结合治疗慢性阻塞性肺疾病(COPD)的临床优势及选穴规律,为针药结合规范化治疗提供参考。

方法

通过检索PubMed、Web of Science、Embase、Ovid、CNKI、万方、维普、中国生物医学文献数据库,收集2003年1月1日至2023年9月1日期间针药结合治疗COPD的临床试验文献。依据纳入与排除标准进行文献筛选。运用频次统计方法,探讨针药结合的临床优势。使用Microsoft Excel 2019建立穴位处方数据库,运用SPSS18.0和Gephi0.10构建复杂网络模型,筛选核心穴位及穴位配伍。

结果

在针药结合治疗COPD临床优势分析中,单纯针刺对呼吸系统指标改善共计263次,占改善指标总数的51.77%,其中以静息肺功能改善次数最多(184次,占36.22%)。此外,单纯针刺对COPD患者临床症状、心功能及血液生化指标也有一定改善作用。针药结合对呼吸系统指标改善90次,占总改善频次的42.45%,主要集中在静息肺功能改善(66次,占31.13%),其次为临床症状及血液生化指标改善。COPD联合治疗主要选取足太阳膀胱经穴位,其中“肾俞(BL23)+肺俞(BL13)”为最常用穴位配伍。通过对复杂网络图进行“k-核”分析和社区网络划分,确定了3个核心穴位簇。

结论

本文将针药结合治疗COPD的临床优势分为两类:单纯针刺优势和针药结合优势。二者均能改善靶器官功能,增强患者肺功能。此外,对于其他非靶器官指标,二者也有改善作用,体现了针药结合的综合调节能力。在针药结合治疗COPD的临床选穴中,注重特定穴位的应用,尤其是交会穴的使用。选穴与COPD“本虚标实”的病机特点密切相关,通过“泻多补少”穴位配伍,达到祛邪扶正的治疗目的。

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