基于数据挖掘探究针灸治疗冠心病 血瘀证的选穴与配伍规律

于子璇 陈伶利 李金香 张书萌 刘佳 江雨洁 李杰

〔摘要〕 目的 通過数据挖掘技术，探究针灸治疗冠心病血瘀证的临床选穴与配伍规律。方法 运用计算机检索中英文数据库中的相关文献，筛选符合标准的针灸处方，建立数据库，并对选穴与配伍规律进行频数与关联分析。结果 纳入文献88篇，涉及腧穴62个。其中，高频腧穴代表为内关、膻中和心俞，经络代表为足太阳膀胱经，运用频次最高的特定穴是背俞穴;核心穴对为膻中-内关，核心主穴为膻中、内关、心俞，核心配穴为足三里、膈俞、血海、厥阴俞、三阴交、郄门。不同血瘀证常用的配穴是气海、中脘（气虚血瘀证）;神门、阴郄（心血瘀阻证）;肾俞（肾虚血瘀证）;丰隆（痰浊血瘀证）;巨阙（阳虚血瘀证）;中脘、脾俞（脾虚血瘀证）。结论 本研究发现针灸治疗冠心病血瘀证的取穴多为局部取穴、循经取穴，特定穴多取背俞穴，配伍多为俞募配穴和远近配穴方法，且随证选穴特点明显，可为临床应用提供客观依据和借鉴。

〔关键词〕 针灸;冠心病;血瘀证;临床选穴;配伍规律;数据挖掘

〔中图分类号〕R245;R541       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.05.011

Acupoint Selection and Compatibility of Acupuncture and Moxibustion in Treating Blood

Stasis Syndrome of Coronary Heart Disease： A Data Mining Analysis

YU Zixuan1， CHEN Lingli1*， LI Jinxiang2， ZHANG Shumeng1， LIU Jia1， JIANG Yujie1， LI Jie1*

（1.Hunan University of Chinese Medicine， Changsha， Hunan 410208， China; 2. The First Hospital of Hunan

University of Chinese Medicine， Changsha， Hunan 410007， China）

〔Abstract〕 Objective To explore the clinical acupoint selection and compatibility rules of acupuncture and moxibustion in the treatment of blood stasis syndrome of coronary heart disease by data mining technology. Methods The relevant literatures in Chinese and English databases were searched by computer to screen the acupuncture prescription and establish the database， and the frequency and correlation analysis of acupoint selection and compatibility rules were carried out. Results 88 references were included， and 62 acupoints were involved， among which the high-frequency acupoints were Neiguan （PC6）， Danzhong （RN17） and Xinshu （BL15）， the meridians and channels were bladder meridian of foot Taiyang， and the most frequently used specific acupoint is back-Shu points. The core point pair was Danzhong （RN17）-Neiguan （PC6）， the core main point was Danzhong （RN17）， Neiguan （PC6）， Xinshu （BL15）， the core matching point was Zusanli （ST36）， Geshu （BL17）， Xuehai （SP10）， Jueyinshu （BL14）， Sanyinjiao （SP6）， Ximen （PC4）. The commonly used acupoints for different blood stasis syndrome were Qihai （RN6） and Zhongwan （RN12） （Qi deficiency and blood stasis syndrome）; Shenmen （HT7）， Yinxi （HT6） （heart blood stasis syndrome）; Shenshu （BL23） （kidney deficiency and blood stasis syndrome）; Fenglong （ST40） （phlegm turbidities and blood stasis syndrome）; Juque （RN14） （Yang deficiency and blood stasis syndrome）; Zhongwan （RN12）， Pishu （BL20） （spleen deficiency and blood stasis syndrome）. Conclusion In this study， it is found that the acupoints of acupuncture and moxibustion in the treatment of coronary heart disease with blood stasis syndrome are mostly local acupoints， meridian selection， specific acupoint is mostly back-Shu point， and the compatibility of Shu-Mu and far and near acupoints， etc. It can provide objective basis and reference for clinical application with evidence.

〔Keywords〕 coronary heart disease; blood stasis syndrome; acupuncture and moxibustion; clinical acupoint selection; compatibility law; data mining

冠状动脉粥样硬化性心脏病（coronary heart

disease， CHD），简称冠心病，是一种因冠状动脉管腔狭窄或堵塞而导致心肌缺血坏死的疾病[1]，其越来越高的发病率和致死率严重危害着人类的健康[2]。中医学认为冠心病属于“胸痹”范畴，多因气血阴阳亏虚而致血瘀、寒凝、痰浊、气滞等实邪阻滞心脉[3]，故而血瘀证是其最重要的证型之一[4]。目前，西医常用的治疗方案为口服抗血小板聚集、抗凝以及硝酸酯类等药物，同时控制血压、血糖等多项指标。……