穴位按摩治疗失眠的辩证选穴规律分析

doi:10.3761/j.issn.0254-1769.2021.03.015

摘要/Abstract

摘要：

目的利用数据挖掘技术,了解穴位按摩治疗失眠的主要辩证分型及选穴配伍规律,为失眠患者的穴位按摩提供参考依据。方法计算机检索PubMed、Web of Science、中国知网、万方数据知识服务平台、中国生物医学文献数据库中有关穴位按摩治疗失眠的文献,检索时限为建库至2020年11月15日。使用Excel建立穴位按摩治疗失眠的腧穴数据库,并利用SPSS 25.0对数据库中的腧穴进行频次、频数统计,通过SPSS Modeler 18.0所提供的Apriori版块进行关联规则分析,描述各腧穴之间的配伍关联规律。结果最终纳入文献137篇,共含腧穴97个,多数腧穴分布在头面部,其中最常用腧穴依次为百会、太阳、神门、印堂,经络以足太阳膀胱经（18.5%）和督脉（14.8%）为主。失眠辩证分型以虚证为主,其中以心脾两虚为主要证型,其次为心肾不交。穴位按摩治疗失眠的常用配伍腧穴为太阳-印堂和太阳-印堂-百会。结论数据挖掘可有效分析穴位按摩治疗失眠的常用腧穴、主要证型及腧穴配伍规律,为临床护理人员选穴提供可靠依据。配伍腧穴符合中医“以循经为主,证因标本相结合”的配穴规律,其治疗失眠效果更佳。

关键词: 失眠, 穴位按摩, 数据挖掘, 选穴规律, 中医护理学

Abstract:

Objective To explore the dialectical classification of insomnia and the potential laws of points selection in the treatment of insomnia by using data mining.Methods The literature on acupoint massage therapy for insomnia in PubMed,Web of science,CNKI,Wan Fang Data,CBM were searched by computer,and it was ranged from the time of the estabilishment of databases to November 15,2020. Excel was used to establish acupoint database of acupoint massage for insomnia;the Apriori section provided by SPSS Modeler18.0 is used to analyze and describe the association rules among various acupoints. Results Totally 137 documents,involving 97 acupuncture points,were included;most points are distributed on the head and face. The most common points were Point Baihui,Point Taiyang,Point Shenmen,Point Yintang. Most of the points are distributed in the urinary bladder channel of Foot-Taiyang（18.5%） and Governor Vessel（14.8%）. In the dialectical classification of insomnia treated by acupoint massage,deficiency syndrome is the main syndrome;heart-spleen deficiency is the main syndrome type,followed by heart-kidney imbalance. In the treatment of insomnia,the most common combination of acupoints is Point Taiyang - Point Yintang and Point Taiyang - Point Yintang - Point Baihui. Conclusion Data mining can effectively explore the common acupoints,main syndrome types and compatibility rules of acupoints in acupoint massage treatment of insomnia,and provide reliable bases for clinical nurses to select acupoints.Compatibility of acupoints conforms to the law of acupoints matching of traditional Chinese medicine,which is mainly based on meridian circulation and combined with syndrome samples,and has a better effect in treating insomnia.

Key words: Insomnia, Acupoint Massage, Data Mining, Law of Selecting Acupoints, Nursing（TCM）

黄瑞盈, 马小琴, 颜新凌. 穴位按摩治疗失眠的辩证选穴规律分析[J]. 中华护理杂志, 2021, 56(3): 404-408.

HUANG Ruiying, MA Xiaoqin, YAN Xinling. Analysis of dialectical acupoint selection rules of acupoint massage in treatment of insomnia[J]. Chinese Journal of Nursing, 2021, 56(3): 404-408.

图/表 4

Table 1 Main syndromes of insomnia treated by acupoint massage,the number of literatures involved and the main points used

Table 2 Statistical table of acupoint locations with use frequency≥5 times

Table 3 Meridian statistics of acupoint massage for insomnia

Table 4 Strong association rules of acupoint massage for insomnia

参考文献 16

[1]	中华医学会神经病学分会, 中华医学会神经病学分会睡眠障碍学组. 中国成人失眠诊断与治疗指南(2017版)[J]. 中华神经科杂志, 2018,51(5):324-335.
	Chinese Society of Neurology, Sleep disorders Group, Neurology Branch, Chinese Medical Association . Guidelines for diagnosis and treatment of insomnia in Chinese adults(2017 edition)[J]. Chin J Neurol, 2018,51(5):324-335.
[2]	窦海伟, 赵晓东, 吴江昀 , 等. 浅谈中医对不寐病因病机的认识[J]. 中华中医药杂志, 2015,30(11):4169-4170.
	Dou HW, Zhao XD, Wu JY , et al. Understanding of insomnia in traditional Chinese medicine[J]. China J Tradit Chin Med Pharm, 2015,30(11):4169-4170.
[3]	Ito E, Inoue Y . The international classification of sleep disorders,third edition. American academy of sleep medicine. Includes bibliographies and index[J]. Nihon rinsho, 2015,73(6):916-923.
[4]	Cunnington D, Junge MF, Fernando AT . Insomnia:prevalence,con-sequences and effective treatment[J]. Med J Aust, 2013,199(8):S36-S40.
[5]	中国睡眠研究会. 中国失眠症诊断和治疗指南[J]. 中华医学杂志, 2017,97(24):1844-1856.
	The China Sleep Research Society. Chinese guidelines for diagnosis and treatment of insomnia[J]. Natl Med J China, 2017,97(24):1844-1856.
[6]	Kay-Stacey M, Attarian H . Advances in the management of chro-nic insomnia[J]. BMJ, 2016,354:i2123.
[7]	陈丽坚, 萧鲲, 肖明月 , 等. 基于数据挖掘的便秘患者选穴规律分析[J]. 中华护理杂志, 2018,53(4):457-461.
	Chen LJ, Xiao K, Xiao MY , et al. Analysis on the laws of selecting points to treat constipation based on data mining[J]. Chin J Nurs, 2018,53(4):457-461.
[8]	刘雅丽, 张军鹏, 王恩杰 . 五行音乐配合穴位按摩在冠心病失眠患者中的应用效果[J]. 中华护理杂志, 2017,52(7):849-853.
	Liu YL, Zhang JP, Wang EJ . Effects of application of five elements music combined with acupoint massage on insomnia in patients with coronary heart disease[J]. Chin J Nurs, 2017,52(7):849-853.
[9]	丁宇坤, 高雅, 郭建波 , 等. 11640例失眠症证候要素及靶位分析[J]. 北京中医药, 2017,36(12):1095-1097.
	Ding YK, Gao Y, Guo JB , et al. Analysis of syndrome elements and targets in 11,640 cases of insomnia[J]. Beijing J Tradit Chin Med, 2017,36(12):1095-1097.
[10]	袁拯忠, 叶人, 项祖闯 , 等. 913例失眠患者中医证型分布规律[J]. 中华中医药学刊, 2011,29(7):1508-1510.
	Yuan ZZ, Ye R, Xiang ZC , et al. Analysis on the distribution law of TCM pattern identification of 913 insomnia cases[J]. Chin Arch Tradit Chin Med, 2011,29(7):1508-1510.
[11]	储小红, 康群, 杭燕 . 足部穴位按摩在脑卒中后病人睡眠障碍中的应用[J]. 护理研究, 2015,29(32):4041-4043.
	Chu XH, Kang Q, Hang Y . Application of foot acupoint massage in sleep disorders in patients with cerebral apoplexy[J]. Chin Nurs Res, 2015,29(32):4041-4043.
[12]	曲润波, 马淑丽, 杨莉霞 . 推拿疗法治疗失眠的临床研究进展[J]. 山西中医学院学报, 2019,20(1):73-75.
	Qu RB, Ma SL, Yang LX . Clinical research progress on massage therapy in the treatment of insomnia[J]. J Shanxi Coll Tradit Chin Med, 2019,20(1):73-75.
[13]	马冉, 孔立红, 齐凤军 , 等. 百会穴对脑的作用之古今研究探析[J]. 辽宁中医杂志, 2019,46(2):425-428.
	Ma R, Kong LH, Qi FJ , et al. Ancient and modern research on role of Baihui to brain[J]. Liaoning J Tradit Chin Med, 2019,46(2):425-428.
[14]	梁晶, 陈军, 王俊杰 , 等. 推拿按揉法治疗心脾两虚型失眠症的临床疗效观察[J]. 针灸临床杂志, 2015,31(5):52-54.
	Liang J, Chen J, Wang JJ , et al. Clinical effect of massage kneading method on insomnia with heart and spleen deficiency type[J]. J Clin Acupunct Moxibustion, 2015,31(5):52-54.
[15]	左晓琳, 杨琳, 李琦 , 等. 穴位按摩治疗失眠效果的系统评价[J]. 护理学报, 2016,23(12):33-39.
	Zuo XL, Yang L, Li Q , et al. A systematic review on effect of acupressure on insomnia[J]. J NursChina, 2016,23(12):33-39.
[16]	张国雪, 刘昊, 王富春 . 论腧穴配伍与针灸处方[J]. 中国针灸, 2014,34(10):987-990.
	Zhang GX, Liu H, Wang FC . Acupoint combination and acu-puncture-moxibustion prescription[J]. Chin Acupunct Moxibu-stion 2014,34(10):987-990.