基于信息挖掘技术分析针刺治疗颈性眩晕的选穴组方规律及文献质量
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摘要
目的采用信息挖掘技术探析针刺治疗颈性眩晕的选穴组方规律及文献质量。方法检索中国知网(CNKI)1990—2017年针刺治疗颈性眩晕的临床研究文献,采用Microsoft Excel以及SPSS Clementine软件中Apriori算法进行信息挖掘。结果统计发现纳入的458篇文献中针刺治疗颈性眩晕的腧穴涉及129个穴位,其归经涉及十二正经、督脉、任脉、经外奇穴;使用频次前3位的腧穴依次是风池、颈夹脊、百会;穴位频次前3位的经脉依次是胆经、督脉、经外奇穴;在穴位关联度分析中,作为主要穴位的风池、颈夹脊、百会的穴位组合支持度为31.66%。经Jadad评分分析统计,仅1.53%为高质量文献,其中采用随机对照的文献占72.05%,有明确诊断标准的文献占79.48%,明确提出疗效判定标准的文献占92.58%。结论针刺治疗颈性眩晕在选穴、组方方面有一定的规律可循,但高质量文献所占比例仍较低。
Objective To explore and analyze the regularities in acupoint selection and literature quality for acupuncture treatment of cervical vertigo by using data mining techniques. Method Clinical research papers on acupuncture treatment of cervical vertigo were retrieved from China National Knowledge Infrastructure (CNKI) (1990 to 2017). Microsoft Excel and Apriori algorithm in SPSS Clementine software were applied in data mining. Result According to statistical analysis, the recruited 458 papers on acupuncture treatment of cervical vertigo involved 129 acupoints, which were from the twelve ordinary meridians, Governor Vessel, Conception Vessel and extra acupoint. The top three most frequently used acupoints were Fengchi (GB20), Cervical Jiaji (EX-B2) and Baihui (GV 20). The top three meridians on the acupoint frequency list were Gallbladder Meridian, the Governor Vessel and extra acupoint. The association analysis showed that the support for the combination of Fengchi (GB20), Cervical Jiaji (EX-B2) and Baihui (GV 20) was 31.66%. Jadad analysis showed that only 1.53% of the papers were of high quality, of which, randomized controlled papers accounted for 72.05%, papers with definite diagnostic criteria accounted for 79.48%, and papers with criteria for efficacy evaluation accounted for 92.58%. Conclusion There are certain rules in acupoint selection and prescription for acupuncture treatment of cervical vertigo. However, the proportion of high-quality paper is low.
Objective To explore and analyze the regularities in acupoint selection and literature quality for acupuncture treatment of cervical vertigo by using data mining techniques. Method Clinical research papers on acupuncture treatment of cervical vertigo were retrieved from China National Knowledge Infrastructure (CNKI) (1990 to 2017). Microsoft Excel and Apriori algorithm in SPSS Clementine software were applied in data mining. Result According to statistical analysis, the recruited 458 papers on acupuncture treatment of cervical vertigo involved 129 acupoints, which were from the twelve ordinary meridians, Governor Vessel, Conception Vessel and extra acupoint. The top three most frequently used acupoints were Fengchi (GB20), Cervical Jiaji (EX-B2) and Baihui (GV 20). The top three meridians on the acupoint frequency list were Gallbladder Meridian, the Governor Vessel and extra acupoint. The association analysis showed that the support for the combination of Fengchi (GB20), Cervical Jiaji (EX-B2) and Baihui (GV 20) was 31.66%. Jadad analysis showed that only 1.53% of the papers were of high quality, of which, randomized controlled papers accounted for 72.05%, papers with definite diagnostic criteria accounted for 79.48%, and papers with criteria for efficacy evaluation accounted for 92.58%. Conclusion There are certain rules in acupoint selection and prescription for acupuncture treatment of cervical vertigo. However, the proportion of high-quality paper is low.
引文
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[19]赵森,刘执玉,毕玉顺,等.椎动脉椎前部的形态特点及临床意义[J].中国临床解剖学杂志,2002,20(1):51-53.
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[23]王霭平.针灸治疗颈性眩晕的研究进展[J].中医外治杂志,2003,12(5):35-37.
[24]詹倩,陈华德.用关联规则方法探索眩晕的针灸处方配伍规律[J].上海针灸杂志,2015,34(5):468-471.
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[26]青雪梅,房繁恭,刘保延,等.实用性随机对照试验及其方法学特征思考[J].北京中医药大学学报,2008,31(1):14-18.
[27]Schulz KF,Altman DG,Moher D,et al.CONSORT 2010statement:updated guidelines for reporting parallel group randomised trials[J].BMJ,2010,340:c332.
[28]郭新峰,温泽淮,老膺荣,等.临床试验质量评价工具及其应用[J].中国循证医学杂志,2004,4(7):484-487,502.
[29]李斌.龙氏正骨手法结合针灸治疗颈性眩晕的临床研究[D].广州中医药大学,2009:15-16,21.
[30]郭剑华,马善治,刘渝松,等.颈性眩晕中医诊疗康复一体化方案临床治疗评估[J].中国中医急症,2015,24(3):402-405.
[31]刘麒麟.针刺四神聪穴为主治疗颈性眩晕的临床研究[D].湖北中医药大学,2013:3,5,7.
[32]逯艳丽.人迎穴为主治疗颈性眩晕与常规取穴的对照观察[D].北京中医药大学,2015:30,38.
[33]张东岩.针刺晕听区配合颈夹脊穴治疗颈性眩晕的临床研究[D].黑龙江中医药大学,2016:15,18.
[34]张永焕.滋肾调神法治疗颈性眩晕的临床疗效评价[D].山东中医药大学,2013:3.
[35]闫世艳,何丽云,刘保延.如何保持中医盲法临床试验的盲态[J].世界科学技术:中医药现代化,2014,16(12):2527-2530.
[36]李静.随机分配方案的隐藏[J].中国循证医学杂志,2004,4(10):714-715.
[37]姜布平,赵爱英.毫针刃针治疗颈性眩晕1000例[J].陕西中医,2013,33(12):1660-1661.
[38]侯燕鸣,郑建国.针刺加百会灸及督脉走罐治疗颈性眩晕30例[J].中国现代医生,2007,45(10):83.
[39]陈华德,白鹤.百会长留针法为主治疗颈性眩晕80例观察[J].浙江中医杂志,2010,45(5):354-355.
[40]任秀梅.针刺对颈性眩晕患者椎动脉血流动力学紊乱影响的临床观察[J].针灸临床杂志,2004,20(8):15-17.
[41]赵延红.颈性眩晕的针灸与养血清脑颗粒治疗[J].中国基层医药,2006,13(11):1808-1809.
[42]李长吉.针刺颈夹脊穴为主配合TDP治疗肝阳上亢型颈性眩晕的临床研究[D].黑龙江中医药大学,2014:24.
[43]张俊,贾秀丽.养心氏联合针刺治疗颈性眩晕的临床观察[J].中西医结合心脑血管病杂志,2012,10(2):187-188.
[44]屠健如.论针灸随机对照试验设计的若干基本要则[J].中国针灸,2011,31(8):755-758.
[45]任亚峰.加味温胆汤配合针刺治疗颈性眩晕65例[J].河南中医,2005,25(6):63-64.
[46]张旭霞.针药并用治疗颈性眩晕65例[J].上海针灸杂志,2005,24(11):9-10.
[47]闫世艳.临床研究中常用随机化方法的比较[D].第四军医大学,2006:27.
[48]张训浩.基于现代临床文献的单穴针灸治疗颈性眩晕的研究[J].云南中医中药杂志,2017,38(4):94-95.
[2]Hou Z,Xu S,Li Q,et al.The Efficacy of Acupuncture for the Treatment of Cervical Vertigo:A Systematic Review and Meta-Analysis[J].Evid Based Complement Alternat Med,2017:7597363.
[3]Brandt T,Huppert D.A new type of cervical vertigo:Head motion-induced spells in acute neck pain[J].Neurology,2016,86(10):974-975.
[4]Peng B.Cervical Vertigo:Historical Reviews and Advances[J].World Neurosurg,2018,(109):347-350.
[5]Brandt T,Bronstein AM.Cervical vertigo[J].J Neurol Neurosurg Psychiatry,2001,71:8-12.
[6]Wrisley DM,Sparto PJ,Whitney SL,et al.Cervicogenic dizziness:a review of diagnosis and treatment[J].JOrthop Sports Phys Ther,2000,30(12):755-766.
[7]Yacovino DA,Hain TC.Clinical characteristics of cervicogenic-related dizziness and vertigo[J].Semin Neurol,2013,33(3):244-255.
[8]Ryan GM,Cope S.Cervical vertigo[J].Lancet,1955,269(6905):1355-1358.
[9]Zuo J,Han J,Qiu S,et al.Neural reflex pathway between cervical spinal and sympathetic ganglia in rabbits:implication for pathogenesis of cervical vertigo[J].Spine J,2014,14(6):1005-1009.
[10]Li J,Gu T,Yang H,et al.Sympathetic nerve innervation in cervical posterior longitudinal ligament as a potential causative factor in cervical spondylosis with sympathetic symptoms and preliminary evidence[J].Med Hypotheses,2014,82(5):631-635.
[11]Hong L,Kawaguchi Y.Anterior cervical discectomy and fusion to treat cervical spondylosis with sympathetic symptoms[J].J Spinal Disord Tech,2011,24(1):11-14.
[12]Wang Z,Wang X,Yuan W,et al.Degenerative pathological irritations to cervical PLL may play a role in presenting sympathetic symptoms[J].Med Hypotheses,2011,77(5):921-923.
[13]Hahn T,Halatsch ME,Wirtz C,et al.Response to Cervical Medial Branch Blocks In Patients with Cervicogenic Vertigo[J].Pain Physician,2018,21(3):285-294.
[14]Sun Y,Muheremu A,Tian W.Atypical symptoms in patients with cervical spondylosis:Comparison of the treatment effect of different surgical approaches[J].Medicine(Baltimore),2018,97(20):e10731.
[15]Magliulo G,Iannella G,Manno A,et al.Chronic inflammatory demyelinating polyneuropathy:evaluation of the vestibular system with cervical and ocular vestibular evoked myogenic potentials[J].Eur Arch Otorhinolaryngol,2018,275(6):1507-1512.
[16]魏德芝,霍清萍.颈性眩晕的发病机制及其研究进展[J].现代中西医结合杂志,2012,21(22):2501-2503.
[17]瞿东滨,金大地,钟世镇.椎动脉V2段与周围结构关系的解剖学观察[J].颈腰痛杂志,2001,22(2):98-100.
[18]沈亚琴,吴艳华,刘燕青.水针联合温胆汤治疗风痰瘀阻型颈性眩晕临床观察[J].上海针灸杂志,2018,37(2):213-216.
[19]赵森,刘执玉,毕玉顺,等.椎动脉椎前部的形态特点及临床意义[J].中国临床解剖学杂志,2002,20(1):51-53.
[20]刘文英,于广莹,金鸿宾.颈性眩晕的诊治国内进展[J].中国矫形外科杂志,2014,22(1):55-58.
[21]李云峰.丹红注射液治疗颈性眩晕疗效观察[J].辽宁中医药大学学报,2012,14(8):194-195.
[22]申鹏飞,孔莉,石学敏.醒脑开窍针法治疗卒中后抑郁症临床研究[J].中国针灸,2005,25(1):11-13.
[23]王霭平.针灸治疗颈性眩晕的研究进展[J].中医外治杂志,2003,12(5):35-37.
[24]詹倩,陈华德.用关联规则方法探索眩晕的针灸处方配伍规律[J].上海针灸杂志,2015,34(5):468-471.
[25]Byar DP,Simon RM,Friedewald WT,et al.Randomized clinical trials perspectives on some recent ideas[J].NEngl J Med,1976,295(5):74-80.
[26]青雪梅,房繁恭,刘保延,等.实用性随机对照试验及其方法学特征思考[J].北京中医药大学学报,2008,31(1):14-18.
[27]Schulz KF,Altman DG,Moher D,et al.CONSORT 2010statement:updated guidelines for reporting parallel group randomised trials[J].BMJ,2010,340:c332.
[28]郭新峰,温泽淮,老膺荣,等.临床试验质量评价工具及其应用[J].中国循证医学杂志,2004,4(7):484-487,502.
[29]李斌.龙氏正骨手法结合针灸治疗颈性眩晕的临床研究[D].广州中医药大学,2009:15-16,21.
[30]郭剑华,马善治,刘渝松,等.颈性眩晕中医诊疗康复一体化方案临床治疗评估[J].中国中医急症,2015,24(3):402-405.
[31]刘麒麟.针刺四神聪穴为主治疗颈性眩晕的临床研究[D].湖北中医药大学,2013:3,5,7.
[32]逯艳丽.人迎穴为主治疗颈性眩晕与常规取穴的对照观察[D].北京中医药大学,2015:30,38.
[33]张东岩.针刺晕听区配合颈夹脊穴治疗颈性眩晕的临床研究[D].黑龙江中医药大学,2016:15,18.
[34]张永焕.滋肾调神法治疗颈性眩晕的临床疗效评价[D].山东中医药大学,2013:3.
[35]闫世艳,何丽云,刘保延.如何保持中医盲法临床试验的盲态[J].世界科学技术:中医药现代化,2014,16(12):2527-2530.
[36]李静.随机分配方案的隐藏[J].中国循证医学杂志,2004,4(10):714-715.
[37]姜布平,赵爱英.毫针刃针治疗颈性眩晕1000例[J].陕西中医,2013,33(12):1660-1661.
[38]侯燕鸣,郑建国.针刺加百会灸及督脉走罐治疗颈性眩晕30例[J].中国现代医生,2007,45(10):83.
[39]陈华德,白鹤.百会长留针法为主治疗颈性眩晕80例观察[J].浙江中医杂志,2010,45(5):354-355.
[40]任秀梅.针刺对颈性眩晕患者椎动脉血流动力学紊乱影响的临床观察[J].针灸临床杂志,2004,20(8):15-17.
[41]赵延红.颈性眩晕的针灸与养血清脑颗粒治疗[J].中国基层医药,2006,13(11):1808-1809.
[42]李长吉.针刺颈夹脊穴为主配合TDP治疗肝阳上亢型颈性眩晕的临床研究[D].黑龙江中医药大学,2014:24.
[43]张俊,贾秀丽.养心氏联合针刺治疗颈性眩晕的临床观察[J].中西医结合心脑血管病杂志,2012,10(2):187-188.
[44]屠健如.论针灸随机对照试验设计的若干基本要则[J].中国针灸,2011,31(8):755-758.
[45]任亚峰.加味温胆汤配合针刺治疗颈性眩晕65例[J].河南中医,2005,25(6):63-64.
[46]张旭霞.针药并用治疗颈性眩晕65例[J].上海针灸杂志,2005,24(11):9-10.
[47]闫世艳.临床研究中常用随机化方法的比较[D].第四军医大学,2006:27.
[48]张训浩.基于现代临床文献的单穴针灸治疗颈性眩晕的研究[J].云南中医中药杂志,2017,38(4):94-95.