Optimization and principles of acupoint selection and coordination in the treatment of adult abdominal obesity using acupuncture and moxibustion over the past decade: A data mining

基于数据挖掘技术探析近十年针灸治疗成人中心性肥胖的腧穴优选与配伍规律

Jia-xin SHEN (沈佳欣)^a, Tian-yun HUANG (黄天韵)^a, Zhou HAO (郝舟)^a,b, Guang-bin PENG (彭广彬)^a,b, Yue-ying MA (马玥樱)^a, Huan-gan WU (吴焕淦)^a,b, Chun-hui BAO (包春辉)^a,b

^aYueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China (上海中医药大学附属岳阳中西医结合医院, 上海200437, 中国)

^bShanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China (上海市针灸经络研究所,上海200030, 中国)

Abstract

Objective: To explore the optimization and principles of acupoint selection and coordination in the treatment of adult abdominal obesity using acupuncture and moxibustion over the past decade using data mining.

Methods: Clinical studies of abdominal obesity treated with acupuncture and moxibustion, collected in the past 10 years, were searched from China Biology Medicine disc(CBMdisc), China National knowledge infrastructure (CNKI), Wanfang, China Science and Technology Journal Database(VIP), Pubmed, Embase, Google Scholar, Web of Science, (The Cumulative Index to Nursing and Allied Health Literature)CINAHL, Psyclnfo and Scopus, dated from March 1, 2013 to March 31, 2023. Using IBM SPSS Modeler 18.0 and other software, the frequency analysis, association-rules analysis and cluster analysis were conducted on interventions, traditional Chinese medicine(TCM) patterns, use frequency of acupoint, meridian attribution of acupoint, acupoint location, etc.

Results: A total of 55 articles were included, with 102 prescriptions and 71 acupoints involved. The top 3 interventions were acupoint embedding method, simple electroacupuncture and simple filiform needling. Seventeen patterns/syndromes of TCM differentiation were collected, dominated by spleen deficiency and damp blockage, spleen and kidney yang deficiency and heat accumulation in stomach and intestines. The acupoints in clinical practice were mostly at the foot-yangming stomach meridian, the conception vessel and the foot-taiyin spleen meridian, and located at the abdominal region. The top 5 acupoints of high frequency were Tianshu (ST25), Zhongwan (CV12), Daheng (SP15), Zusanli (ST36), Huaroumen (ST24) and Daimai (GB26). The specific points of the high frequency were the crossing points and front-mu points, of which, ST25 and CV12 were the most prominent. After association-rules analysis on the high-frequency acupoints, 20 groups of associated acupoints were obtained, in which, the core acupoints included ST25, CV12, SP15 and ST36.

Conclusion: In recent 10 years, abdominal obesity is treated by the acupoints of foot-yangming stomach meridian, the conception vessel and the foot-taiyin spleen meridian. Compared with the regimen for simple obesity, the acupoints at the abdominal region are specially selected in treatment of abdominal obesity, such as ST25, CV12, SP15 and ST36. Supplementary acupoints are selected based on syndrome differentiation to simultaneously address both the disease manifestations and root causes.

【摘要】

目的：利用数据挖掘技术探析近十年针灸治疗成人中心性肥胖的临床选穴配伍规律。

方法：检索中国生物医学文献数据库、中国知网、Pubmed等11个中英文数据库过去十年收录的针灸治疗中心性肥胖的临床研究文献，运用IBM SPSS Modeler 18.0等软件进行干预方法、证型、腧穴频次、腧穴归经、腧穴部位等方面的频次分析、关联规则分析以及聚类分析。

结果：共纳入55篇文献，收集处方102条，涉及穴位71个。干预方法中排名前三位分别是穴位埋线、单纯电针和单纯毫针。涉及证型17种，以脾虚湿阻、脾肾阳虚与胃肠腑热居多。临床选穴主要集中在足阳明胃经、任脉和足太阴脾经，多位于腹部。穴位使用频次排名前5的依次是天枢、中脘、大横、足三里、滑肉门和带脉。特定穴中使用频次最多的为交会穴与募穴，以天枢和中脘最为突出。高频穴位关联规则分析后得出关联腧穴组合20组，核心穴位为天枢、中脘、大横和足三里。

结论：近十年来针灸治疗中心性肥胖选穴以足阳明胃经、任脉及足太阴脾经为主，较单纯性肥胖的治疗更加强调腹部腧穴的选取，核心穴位为天枢、中脘、大横和足三里。临证应辨证配穴以达到病证结合、标本兼治的作用。