基于数据挖掘技术探讨针刀治疗膝骨关节炎的施术规律OA

Objective:To investigate the operational rules of acupotomy in the treatment of knee osteoarthritis(KOA).Methods:All the clinical study articles on acupotomy for KOA included from December 1,2014 to December 31,2024 were retrieved from the China National Knowledge Infrastructure,Vip Database,Wanfang Database,PubMed,Embase,and Cochrane Library through computer.The pertinent arti-cles were screened,the information was extracted and normalized independently by two researchers.The usage frequency and percentage of anatomical sites,manipulation techniques,and combined therapies in the included articles were calculated,then the cluster analysis was per-formed on the anatomical sites using SPSS 19.0 software,and the frequent itemset analysis on the manipulation techniques was conducted using SPSS Modeler18.0 software.Results:A total of 1 685 articles were identified,and 217 ones were included in the final analysis after stepwise screening,involving 23 anatomical sites and 5 manipulation techniques,with the cumulative usage frequency of 677 and 582,re-spectively.The top five anatomical sites were ranked by the usage frequency in a descending order as follows:the lateral collateral ligament of the knee joint,medial collateral ligament of the knee joint,infrapatellar fat pad,patellar ligament,and medial patellar retinaculum.The optimal clustering resulted in two anatomical site combinations:combination 1 included the lateral and medial collateral ligaments of the knee joint;combination 2 comprised the infrapatellar fat pad,patellar ligament,medial and lateral patellar retinacula,and pes anserine bur-sa.The five manipulation techniques were ranked by the usage frequency in a descending order as follows:the longitudinal unblocking and stripping method,transverse stripping method,cross-shaped incision method,cut-through stripping method,and scraping-grinding and leveling method.The top five frequent itemsets for manipulation techniques were ranked by the confidence in a descending order were longitudinal unblocking and stripping method-transverse stripping method,longitudinal unblocking and stripping method-transverse stripping method-cross-shaped incision method,transverse stripping method-cross-shaped incision method,longitudinal unblocking and stripping method-cut-through stripping method,and cross-shaped incision method-scraping-grinding and leveling method.The acupotomy combined therapies were reported in 86 articles,involving five types,ranked by usage frequency from highest to lowest were acupuncture,Tui Na therapy,exercise therapy,external Chinese herbal medicine,and oral Chinese herbal medicine.Conclusion:Acupotomy closed release targets the medial and lateral collateral ligaments of the knee joint as the core anatomical sites,employs the combination of longitudinal unblocking and stripping method with transverse stripping method as the core manipulation techniques,and adopts acupuncture and Tui Na therapy as the primary combination therapies in the treatment of KOA.