基于数据挖掘苍龟探穴针法的临床应用研究＊

目的 基于古今医案云平台（V2.2.1）挖掘苍龟探穴针法的临床应用规律及特点,为临床运用提供参考。方法 计算机搜索中国知识资源总库（China Knowledge Resource Database,CNKI）、维普网、中国学术期刊数据库（万方数据）近20年（2000年1月1日-2020年12月31日）收录的苍龟探穴临床相关文献,采用Excel表格建立数据库并录入古今医案云平台（V2.2.1）,采用系统集成的数据挖掘方法如统计分析、关联分析、社团分析、复杂网络分析等对纳入的数据进行分析,总结苍龟探穴针法所治疗的疾病、腧穴选取、操作过程及主治疾病等方面的应用特点及规律,并运用新颖多彩的图表对数据进行直观展示。结果 筛选后,纳入文献150篇,涉及疾病个数65个,腧穴总数103个,总取穴频次435次,针刺手法4种,留针时间总数12种,治疗方式总个数6个,辅助治疗方式总个数37个,总辅助治疗方式频次108次。其中治疗疾病频次前10位为肩关节周围炎、膝关节骨性关节炎、第三腰椎横突综合征、神经根型颈椎病、中风后偏瘫、腰椎间盘突出症、中风后腕手功能障碍、偏头痛、中风后吞咽功能障碍及肱骨外上髁炎。取穴频次最高的穴位为阿是穴,针刺手法频次由高到低排序为未提及、平补平泻、开阖泻法及提插泻法。留针时间频次前3位的为留针30分钟、不留针及留针20分钟,治疗方式频次由高到低排列分别为毫针、穴位注射、针刀、粗针、刃针及皮试针头。辅助治疗方式频次由高到低排列前5位的是中药汤剂、电针、基础治疗、康复治疗及功能锻炼。主治疾病见于肩关节周围炎、膝关节骨性关节炎、第三腰椎横突综合征及神经根型颈椎病等。结论 运用古今医案云平台（V2.2.1）分析数据总结苍龟探穴针法的临床应用规律及特点,并佐以图表进行直观展示,可对临床实践提供借鉴,临床应用仍应结合具体情况,随症加减。

Clinical Application Research of Acupuncturing Method of Dark Tortoise Probing Hole Based on Data Mining

Objective To explore the clinical application rules and characteristics of acupuncturing method of dark tortoise probing hole based on the ancient and modern medical record cloud platform (V2.2.1), and to provide reference for clinical application.Methods Computer search was carried out on the related clinical literature of acupuncturing method of dark tortoise probing hole collected in China Knowledge Resource Database (CNKI), VIP. com and China Academic Journal Database (Wanfang data) in recent 20 years (January 1, 2000 to December 31, 2020). Excel was used to establish the database and enter it into the ancient and modern medical record cloud platform (V2.2.1). Data mining methods integrated by system, such as statistical analysis, association analysis, community analysis and complex network analysis, were used to analyze the included data, and the application characteristics and laws of acupuncturing method of dark tortoise probing hole in treating diseases, selecting acupoints, operating process and dominant diseases were summarized, and the data were displayed visually with novel and colorful charts.Results After screening, 150 papers were included, involving 65 diseases, 103 acupoints, 435 times of acupuncture frequency, 4 acupuncture techniques, 12 kinds of needle retention time, 6 treatment methods, 37 auxiliary treatments and 108 times of auxiliary treatments. Among them, the top 10 diseases for treatment were scapulohumeral periarthritis, knee osteoarthritis, third lumbar transverse process syndrome, cervical spondylotic radiculopathy, hemiplegia after stroke, lumbar disc herniation, wrist dysfunction after stroke, migraine, swallowing dysfunction after stroke, and external humeral epicondylitis. Ashi point was the most frequently selected point, and the order of acupuncture manipulation frequency from high to low was not mentioned, neutral supplementation and draining, open-closed supplementation and draining method, and lifting, lifting-thrusting supplementation and draining method. The top 3 needle retention times were 30 minutes, no needle retention and 20 minutes. The frequency of treatment methods from high to low was filiform needle, acupoint injection, needle knife, thick needle, blade needle and skin test needle. The top five auxiliary treatment methods from high to low were traditional Chinese medicine decoction, electroacupuncture, basic treatment, rehabilitation treatment and functional exercise. The dominant diseases were scapulohumeral periarthritis, knee osteoarthritis, third lumbar transverse process syndrome and cervical spondylotic radiculopathy.Conclusion The ancient and modern medical record cloud platform (V2.2.1) is used to analyze the data, summarize the clinical application rules and characteristics of acupuncturing method of dark tortoise probing hole, and visually display it with charts. It can be used as a reference for clinical practice, and clinical application should still be combined with specific conditions, adding and subtracting according to the symptoms.