基于复杂网络分析的针灸治疗膝骨关节炎选穴规律及证-穴关系研究OA
Study on Acupoint Selection Law and Syndrome-acupoint Relationship in the Acupuncture Treatment for Knee Osteoarthritis Based on Complex Network Analysis
目的 探索针灸治疗膝骨关节炎(KOA)的选穴及配伍规律,为临床应用提供参考.方法 检索2014年9月1日-2025年9月1日中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、中文科技期刊数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Embase、Cochrane Library、Web of Science收录的针灸治疗KOA临床研究文献,根据纳排标准筛选后建立数据库.利用Excel2019对腧穴使用频次、部位、归经及特定穴归属进行统计分析,利用RStudio进行关联规则分析、复杂网络分析、聚类分析及证-穴规律分析.结果 共纳入文献442篇,提取核心腧穴处方443条、证型-腧穴处方111条.使用频次较高的腧穴是犊鼻、阳陵泉、内膝眼、血海、足三里、梁丘、阴陵泉、鹤顶.选穴分布最多的部位为下肢部.腧穴归经以足阳明胃经、足太阴脾经、经外奇穴、足少阳胆经为主.特定穴使用频次最高的是五输穴,其次为下合穴.关联规则分析得出犊鼻、内膝眼、梁丘、血海、阳陵泉、足三里为核心处方.聚类分析得到针灸治疗KOA潜在新处方6首.证-穴规律分析得出临床常见证型为风寒湿痹证、寒湿痹阻证、肝肾亏虚证、阳虚寒凝证、瘀血阻络证.结论 针灸治疗KOA以局部选穴为主,在核心腧穴处方基础上,重视辨证取穴,可为KOA的临床治疗提供参考.
Objective To explore the acupoint selection and compatibility law of acupuncture in the treatment of knee osteoarthritis(KOA);To provide references for clinical application.Methods Clinical research literature about acupuncture for the treatment of KOA was retrieved from CNKI,Wanfang Data,VIP,SinoMed,PubMed,Embase,Cochrane Library,and Web of Science databases from 1st Sep.2014 to 1st Sep.2025.The database was established after screening according to the acceptance criteria.The frequency,location,meridian tropism and specific acupoint attribution of acupoints were statistically analyzed by Excel2019,and the association rule analysis,complex network analysis,clustering analysis and syndrome acupoint rule analysis were performed by RStudio software.Results A total of 442 articles were included,with 443 core acupoint prescriptions and 111 syndrome type-acupoint prescriptions.The acupoints used more frequently were Dubi(ST35),Yanglingquan(GB34),Neixiyan(EX-LE4),Xuehai(SP10),Zusanli(ST36),Liangqiu(ST34),Yinlingquan(SP9)and Heding(EX-LE2).The selected acupoints were distributed most frequently in the lower limbs.The meridian distribution of acupoints primarily involved the stomach meridian,the spleen meridian,the extra-meridian acupoints,and the gallbladder meridian.The most frequently used specific acupoints were the Wushu-acupoints,followed by the Xiahe acupoints.Association rule analysis yielded Dubi(ST35),Neixiyan(EX-LE4),Liangqiu(ST34),Xuehai(SP10),Yanglingquan(GB34),Zusanli(ST36)as the core prescription.Clustering analysis reveals six novel prescription combinations for acupuncture treatment of KOA.Analysis of syndrome-acupoint law revealed the most common clinical patterns to be wind-cold-dampness bi syndrome,cold-dampness obstruction syndrome,liver-kidney deficiency syndrome,yang deficiency with cold stagnation syndrome,and blood stasis obstructing the collaterals syndrome.Conclusion Acupuncture treatment of KOA is mainly based on local acupoint selection.On the basis of core acupoint prescriptions,we should pay attention to acupoint selection based on syndrome differentiation,which can provide references for the clinical treatment of KOA.
姜明尧;李淼;佟键勋;时玉阳;胡芮;罗云红;李绍荣
云南中医药大学,云南 昆明 650500云南中医药大学,云南 昆明 650500云南中医药大学,云南 昆明 650500云南中医药大学,云南 昆明 650500昆明市中医医院,云南 昆明 650599昆明市中医医院,云南 昆明 650599昆明市中医医院,云南 昆明 650599
医药卫生
针灸膝骨关节炎选穴规律证-穴关系复杂网络分析
acupuncture and moxibustionknee osteoarthritisacupoint selection lawsyndrome-acupoint relationshipcomplex network analysis
《中国中医药信息杂志》 2026 (8)
32-40,9
云南省中医药基础研究联合专项面上项目(202501AZ070001-099)
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