基于隐结构和频繁项集挖掘腰椎间盘突出症针刺辨证选穴规律OA
Exploring the Pattern of Syndrome Differentiation and Acupoint Selection in Acupuncture for Lumbar Disc Herniation Based on Latent Structure and Frequent Itemset Mining
[目的]探索针刺治疗腰椎间盘突出症(LDH)的辨证选穴规律,为临床治疗腰椎间盘突出症提供参考.[方法]计算机检索中国知网期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、中国生物医学数据库(CBM)等各大数据库,检索时间为各数据库自建库以来至2025年6月;检索有关针刺辨证选穴治疗LDH的相关文献.提取症状、证型、选穴信息并建立数据库.采用Lantern 5.0、Weka 3.9.6以及SPSS statistics 27.0等软件,对辨证选穴规律进行隐结构模型分析、聚类分析、关联规则分析和频繁项集分析.[结果]共计纳入文献174篇,涉及患者7 554例,包含症状或体征171个.其中,高频症状(频次≥1 000次)有18项,包括活动受限、舌有瘀斑、痛有定处等.证型分布共有9种中医证型.高频腧穴(频次≥1 000次)有15个,包括委中、肾俞、大肠俞、环跳等.隐结构分析共得到11个隐变量,将其聚类分析成3类证型,包括气滞血瘀、寒湿阻络、肝肾亏虚.关联规则分析得到委中、大肠俞、环跳、肾俞等穴位间关联度最强."症状-腧穴"组合频繁项集共2项."证型-症状-腧穴"频繁项集共2项.[结论]腰椎间盘突出症以气滞血瘀及寒湿阻络为常见证型,针刺选穴多以委中、肾俞、大肠俞、环跳、腰夹脊等为主穴,临床辨证配穴.
Objective To explore the pattern of syndrome differentiation and acupoint selection in acupuncture treatment for lumbar disc herniation(LDH),providing a reference for its clinical management.Methods A computerized search was conducted across databases including the China National Knowledge Infrastructure(CNKI)Journal Full-text Database,Wanfang Academic Journal Full-Text Database,VIP Chinese Science and Technology Journal Database(VIP),and the Chinese Biomedical Literature Database(CBM).The search period spanned from the inception of each database to June 2025,focusing on literature related to acupuncture treatment for LDH based on syndrome differentiation and acupoint selection.Information on symptoms,syndrome patterns,and selected acupoints was extracted to establish a database.Software including Lantern 5.0,Weka 3.9.6,and SPSS Statistics 27.0 were used to analyze the patterns of syndrome differentiation and acupoint selection through latent structure modeling,cluster analysis,association rule analysis,and frequent itemset mining.Results A total of 174 articles were included,involving 7 554 patients and 171 symptoms or signs.Among these,18 were high-frequency symptoms(frequency≥1 000),including limited mobility,petechiae on the tongue,and fixed location of pain.The syndrome distribution comprised 9 TCM syndrome types.There were 15 high-frequency acupoints(frequency≥1 000),including Weizhong(BL40),Shenshu(BL23),Dachangshu(BL25),and Huantiao(GB30).Latent structure analysis identified 11 latent variables,which were clustered into 3 categories through cluster analysis:qi stagnation and blood stasis syndrome,cold-dampness obstructing the collaterals syndrome,and liver-kidney deficiency syndrome.Association rule analysis revealed the strongest associations among acupoints such as Weizhong,Dachangshu,Huantiao,and Shenshu.A total of 2"symptom-acupoint"frequent itemsets and 2"syndrome-symptom-acupoint"frequent itemsets were identified.Conclusion Lumbar disc herniation is commonly characterized by the syndrome patterns of qi stagnation and blood stasis and cold-dampness obstructing the collaterals.In acupuncture treatment,acupoints such as Weizhong(BL40),Shenshu(BL23),Dachangshu(BL25),Huantiao(GB30),and lumbar Jiaji points are frequently selected as the main points,with supplementary points added based on clinical syndrome differentiation.
颜文定;田天照;王金媛;李欢;杜鹏;蔡迎峰
广州中医药大学附属广州中医医院,广东 广州 510130广州医科大学附属中医医院,广东 广州 510130广州中医药大学附属广州中医医院,广东 广州 510130广州中医药大学附属广州中医医院,广东 广州 510130广州中医药大学附属广州中医医院,广东 广州 510130广州医科大学附属中医医院,广东 广州 510130
医药卫生
隐结构模型频繁项集腰椎间盘突出症针刺辨证选穴规律气滞血瘀寒湿阻络委中肾俞大肠俞环跳
《广州中医药大学学报》 2026 (4)
995-1002,8
广州市科技计划项目(编号:2023A03J0320)广东省中医药局蔡迎峰省名中医传承工作室建设项目(编号:440100240000000059076)
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