摘要
目的:分析推拿治疗腰椎管狭窄症的手法及选穴规律。方法:检索中国知网(CNKI)、万方数据知识服务平台(万方数据)、中国生物医学文献数据库(CBM)及PubMed等数据库建库至2023年9月29日有关推拿治疗腰椎管狭窄症的临床研究文献。经过查重及筛选后建立推拿处方数据库。采用R4.2.3软件对数据进行描述性分析、关联规则分析及聚类分析。结果:纳入106篇推拿治疗腰椎管狭窄症的临床研究文献,涉及46种推拿手法,应用频数为522,其中应用频数最高的手法为㨰法。提取出腧穴处方78份,涉及65个腧穴,腧穴使用频数为614,应用频数最高的腧穴为环跳。腧穴主要集中在足太阳膀胱经、足少阳胆经、督脉、足阳明胃经和经外奇穴。在手法和腧穴的配伍方面,点按法、环跳配伍其他手法、腧穴最为常见。关联规则网络分析显示环跳、委中、阳陵泉、承山关联性较强;点按法、斜扳法、弹拨法、擦法、拿捏法关联性较强。聚类分析结果显示,腧穴与手法各形成5个有效的聚类群。结论:推拿治疗腰椎管狭窄症以松筋和正骨手法为主,强调“筋骨并重”原则,注重局部和循经取穴法,发挥了手法与腧穴的协同作用。
Objective:To analyze the manipulation and point selection rules of massage therapy for lumbar spinal stenosis.Methods:The clinical research literature on the treatment of lumbar spinal stenosis with tuina in China Knowledge Information Network(CNKI),Wanfang Data Knowledge Service Platform(Wanfang Data),China Biomedical Literature Database(CBM),and PubMed until September 29,2023 were searched.The database of tuina prescription was established after checking and screening.R4.2.3 software was used to perform descriptive analysis,association rule analysis,and cluster analysis on the data.Results:A total of 106 clinical research papers on the treatment of lumbar spinal stenosis with tuina were included,involving 46 tuina techniques with a frequency of 522 applications,of which the technique with the highest frequency of application was the Gun method.A total of 78 prescriptions foracupoints were extracted,involving 65 acupoints with a frequency of 614,and the acupoint with the highest frequency of application was Huantiao(GB30).The acupoints were mainly concentrated in the bladder meridian,gallbladder meridian,governor vessel,stomach meridian,and extraordinary points.In terms of the compatibility of techniques and acupoints,the most common methods are the combination of point pressing and Huantiao(GB30)with other techniques and acupoints.The network analysis of association rules showed that there were strong associations between Huantiao(GB30),Weizhong(BL40),Yanglingquan(GB34),and Chengshan(BL57),and strong associations between point-pressing,diagonal wrenching,flicking,rubbing,and pinching.Cluster analysis showed that each of the acupoints and maneuvers formed five effective clusters.Conclusion:Tuina therapy for lumbar spinal stenosis is mainly based on tendon loosening and bone-setting techniques,emphasizing the principle of"equal emphasis on tendons and bones",focusing on local and meridian-based acupoints,and giving full play to the synergistic effect of the manipulation techniques and acupoints.
作者
吴双
吕智桢
周星辰
陈龙豪
利涛
陈耀棋
洪泽
孙佳雨
吕立江
WU Shuang;LYU Zhizhen;ZHOU Xingchen;CHEN Longhao;LI Tao;CHEN Yaoqi;HONG Ze;SUN Jiayu;LYU Lijiang(The Third Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou Zhejiang 310053,China)
出处
《中医药导报》
2024年第6期119-124,共6页
Guiding Journal of Traditional Chinese Medicine and Pharmacy
基金
浙江省“尖兵”“领雁”重大研发攻关项目(2022C03123)
国家自然科学基金项目(82274672)
浙江省吕立江名老中医专家传承工作室建设项目(GZS2021026)
国家中医药管理局高水平中医药重点学科项目(GJXK2023-85)。
关键词
腰椎管狭窄症
推拿手法
腧穴
R语言
数据挖掘
可视化分析
lumbar spinal stenosis
manipulation of massage
acupoints
R language
data mining
visual analysis
