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  • Title: Exploration of the methods and rules of syndrome/pattern differentiation and treatment of headache from the acupuncture-moxibustion prescriptions of ancient literature based on the data mining technology.
    Author: Li S, Wang J.
    Journal: Zhongguo Zhen Jiu; 2024 Feb 12; 44(2):224-230. PubMed ID: 38373772.
    Abstract:
    The study aims to identifying and exploring the methods and rules of the syndrome/pattern differentiation and treatment of headache through collating acupuncture-moxibustion prescriptions recorded earliest in ancient literature. Using Excel2016 software, the structural data table was prepared with "name of disease", "location of disease", "etiology and pathogenesis", "complicated symptoms", "sites for acupuncture and moxibustion" and "techniques of acupuncture and moxibustion" included. The normative approach was conduced on "name of disease", "etiology and pathogenesis", "complicated symptoms" and "nomenclature of acupoint". Using conventional literature statistical method, combined with Apriori algorithm of association rule, the implicit multi-dimensional correlation rules were explored among various elements of syndrome/pattern differentiation of headache and corresponding therapeutic methods. Based on the findings of the study, the regularity was distinct regarding the treatment at "distal acupoints along the affected meridian and the local acupoints at the affected area" after identifying the location of headache; the strong association was presented between "etiology and pathogenesis" and "acupoint selection", and between "etiology and pathogenesis" and "therapeutic methods", including 9 and 12 rules, respectively. Guanyuan (CV 4) selected in treatment of headache was associated with kidney deficiency, the combination of Zhongwan (CV 12) and Zusanli (ST 36) was with phlegm, Fengfu (GV 16), Fengchi (GB 20), Xinghui (GV 22) and Baihui (GV 20) was with wind, and Hegu (LI 4) was with cold. Moxibustion was dominant in treatment if headache was caused by pathogenic cold or related to deficiency syndrome; acupuncture was used specially for the case caused by phlegm, or interaction of wind and phlegm or wind and heat. For heat syndrome, either acupuncture or moxibustion was applicable, in general, acupuncture was more commonly used in comparison with moxibustion for headache. There were 6 association rules regarding the acupoint selection and the techniques of acupuncture and moxibustion. Moxibustion was generally applied to Xinghui (GV 22), Shangxing (GV 23) and Baihui (GV 20) ; and acupuncture was to Fengfu (GV 16), Hegu (LI 4) and Zusanli (ST 36). There were few association rules between the complicated symptoms and acupoint selection. Among nearly 100 complications, there were only 3 feature associations. Zhongwan (CV 12) was selected for the case with poor appetite, Chengjiang (CV 24) was with neck stiffness, and Fengchic (GB 20) combined with Fenglong (ST 40) or Jiexi (ST 41) was used if vertigo was present. In the ancient time, regarding the treatment of headache, acupuncture and moxibustion are delivered based on the three aspects, i.e. the location of illness, the etiology and pathogenesis, and the complicated symptoms. For acupoint selection, in line with the courses of affected meridians, the adjacent and distal acupoints are combined according to the location of headache. The acupoint prescription is composed in terms of the etiology and pathogenesis. The techniques of acupuncture and moxibustion are optimized in consideration of the sites where acupuncture and moxibustion are operated. 收集整理古代头痛针灸处方,辨识并基于首见文献挖掘其辨治方法与规律。采用Excel2016软件构建病名-病位-病因病机-兼症-刺灸处-刺灸法的结构化数据表,并对病名、病因病机、兼症、腧穴术语进行规范化处理。运用传统文献统计结合关联规则Apriori算法,挖掘头痛针灸辨证论治各要素间隐含的多维度关联规律。结果表明头痛辨病位时的循经远取和局部近取的规律性明显,病因病机与选穴、病因病机与治法的强关联较多,分别有9条与12条规则:选取关元的头痛均为肾虚证,选取中脘与足三里配伍者均因于痰,选取风府、风池、囟会、百会的病因多为风,选取合谷治疗时病因多为寒;头痛因感受寒邪或虚证所致均以灸法为主,病因为痰多用针刺,风兼痰或风兼热亦多用针刺,热证针灸均适用,但针刺比灸法多见;选穴与刺灸法的关联规则有6条,囟会与上星、百会多采用艾灸,风府、合谷、足三里多采用针刺;兼症与选穴的关联规则较少,约100种兼症只有3个症状与选穴有特征性关联:头痛伴不进饮食时选取中脘、头痛兼项强时选取承浆、头痛伴有目眩选取风池配丰隆或解溪。古代针灸治疗头痛的辨治方法主要体现在辨头痛部位、辨病因病机、辨兼症3个方面,根据病变所在经脉循经选穴、视病位不同近取与远取结合,以及根据病因病机选穴治疗、不同刺灸处选用更适宜的刺灸操作是其辨治规律。.
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