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Title: [Study on the rule of acupoint selection in treatment of acute exacerbation of chronic obstructive pulmonary disease].
Author: Zhang D, Zhang HL, Feng ZZ, Li XL, Wang L, Li JS.
Journal: Zhongguo Zhen Jiu; 2021 Dec 12; 41(12):1399-403. PubMed ID: 34936282.
Abstract:
OBJECTIVE: To explore the characteristics and rule of clinical acupoint selection in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: The clinical articles of acupuncture in treatment of AECOPD were retrieved from the databases of PubMed, EMbase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP and SinoMed, from the date of establishment to July 15, 2020. The articles were screened in accordance with the inclusion and exclusion criteria, the prescriptions of acupuncture and the relevant information of the acupoints and meridians were extracted to establish the database. The data mining methods i.e. Apriori association rule analysis and cluster analysis were used to analyse the using frequency, involving meridians, acupoint distributions, association rules and cluster of selected acupoints. RESULTS: A total of 54 articles were included, 67 acupuncture prescriptions were extracted, 69 acupoints were involved and the total using frequency was 475 times. The top 5 acupoints in frequency were Danzhong (CV 17), Feishu (BL 13), Zusanli (ST 36), Fenglong (ST 40) and Dingchuan (EX-B1). The main involved meridians were bladder meridian of foot-taiyang, conception vessel, stomach meridian of foot-yangming and lung meridian of hand-taiyin. The acupoints were mainly distributed in chest and abdomen, waist and dorsum. The mainly selected special points were five-shu points, front-mu points, convergent points and back-shu points. Twenty strong association rules were summarized by association rule analysis, including Fenglong (ST 40)Þ Zusanli (ST 36), Fengmen (BL 12)Þ Danzhong (CV 17), Tianshu (ST 25)Þ Zhongwan (CV 12), Dingchuan (EX-B1)+ Feishu (BL 13) Þ Danzhong (CV 17), Fenglong (ST 40)+ Feishu (BL 13) Þ Zusanli (ST 36), etc. Five cluster groups were summarized by cluster analysis, i.e. ①Feishu (BL 13), ② Dingchuan (EX-B1) and Danzhong (CV 17), ③ Chize (LU 5), Lieque (LU 7) and Fengmen (BL 12), ④Zusanli (ST 36) and Fenglong (ST 40), ⑤Tianshu (ST 25), Guanyuan (CV 4) and Zhongwan (CV 12). CONCLUSION: The local acupoints and acupoints along meridians are the main acupuncture prescriptions for AECOPD, and the special points are the predominated selection. The acupoint compatibility embodies the therapeutic principle of "strengthening vital qi to eliminate pathogenic factors and considering both the root cause and symptoms". 目的：探索针刺治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床选穴特点和规律。方法：检索PubMed、EMbase、Cochrane Library、Web of Science、中国期刊全文数据库（CNKI）、万方数据知识服务平台（Wanfang）、维普中文期刊服务平台（VIP）、中国生物医学文献服务系统（SinoMed）建库至2020年7月15日收录的针刺治疗AECOPD的临床研究文献，按纳入、排除标准筛选文献，提取针刺处方及腧穴归经等信息建立数据库，采用Apriori关联规则分析、系统聚类分析等数据挖掘方法对针刺选穴进行频次、归经、分布及关联规则、聚类分析。结果：共纳入文献54篇，提取针刺处方67条，涉及腧穴69个，累计频次475次。使用频次前5的腧穴依次为膻中、肺俞、足三里、丰隆、定喘；所属经脉主要有足太阳膀胱经、任脉、足阳明胃经和手太阴肺经；选穴部位多涉及胸腹、腰背部；特定穴选用以五输穴、募穴、八会穴、背俞穴为多。关联规则分析共得到强关联规则20条，包括丰隆Þ足三里、风门Þ膻中、天枢Þ中脘、定喘＋肺俞Þ膻中、丰隆＋肺俞Þ足三里等；聚类分析得到5个聚类群，分别为：①肺俞；②定喘、膻中；③尺泽、列缺、风门；④足三里、丰隆；⑤天枢、关元、中脘。结论：针刺治疗AECOPD以局部选穴、循经选穴为主，特定穴的选用是针刺组方的重要组成部分，腧穴配伍体现了中医“扶正祛邪、标本兼顾”的治疗原则。.

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