【摘要】：目的:以針灸有效病癥胃脘痛為切入點(diǎn),全面收集和整理針灸治療胃脘痛的古代文獻(xiàn)、醫(yī)案、醫(yī)話和現(xiàn)代針灸醫(yī)學(xué)著作等針灸處方,利用數(shù)據(jù)挖掘技術(shù)分析腧穴優(yōu)選和配伍優(yōu)選的規(guī)律,明確單穴與腧穴配伍,不同腧穴配伍之間的聯(lián)系,揭示腧穴配伍效應(yīng)規(guī)律,進(jìn)而探討取穴的分布特點(diǎn),分析胃脘痛的針灸處方,建立腧穴優(yōu)選及配伍優(yōu)選規(guī)律譜,從而為臨床穴位優(yōu)選及配伍優(yōu)選提供有效依據(jù)。方法:研究采集的古代著作類以《中華醫(yī)典》(第五版)為基礎(chǔ),收錄了民國(guó)以前中國(guó)醫(yī)家(朝鮮和日本醫(yī)家所著的書不在收集范圍之內(nèi))所著的針灸專著、綜合性醫(yī)籍、醫(yī)經(jīng)、方書和臨床各科著作類,現(xiàn)代著作類通過(guò)校圖書館以及網(wǎng)絡(luò)收集1949-2013年國(guó)內(nèi)公開(kāi)發(fā)行的中醫(yī)針灸著作類。將檢索到有關(guān)胃脘痛針灸著作類作為研究對(duì)象,將各條針灸處方數(shù)據(jù)輸入access數(shù)據(jù)庫(kù),然后對(duì)這些數(shù)據(jù)進(jìn)行預(yù)處理,運(yùn)用數(shù)據(jù)挖掘技術(shù)中的關(guān)聯(lián)規(guī)則和中醫(yī)傳承輔助平臺(tái)軟件分析針灸處方的腧穴運(yùn)用頻次、歸經(jīng)、屬性、分布以及主要配伍方法來(lái)挖掘出針灸治療胃脘痛的腧穴優(yōu)選及配伍優(yōu)選規(guī)律。結(jié)果:1.腧穴頻次運(yùn)用結(jié)果:在針灸治療胃脘痛的992條針灸處方中,應(yīng)用腧穴為121個(gè),總運(yùn)用的頻次為4206次。其中以足三里、中脘、內(nèi)關(guān)、胃俞、脾俞、公孫、太沖、三陰交、天樞、內(nèi)庭居多,經(jīng)脈關(guān)聯(lián)分析結(jié)果:以足陽(yáng)明胃經(jīng)和任脈為主;部位關(guān)聯(lián)分析結(jié)果:選穴主要集中在四肢、胸腹和背部,以四肢部居多。特定穴運(yùn)用結(jié)果:特定穴使用頻次中,五輸穴居于首位,其中五腧穴中合穴頻次最多,其次為交會(huì)穴,再次為募穴。2.腧穴配伍頻次運(yùn)用結(jié)果:2對(duì)腧穴組合頻次最高為(中脘,足三里),3對(duì)腧穴組合頻次最高為(中脘,內(nèi)關(guān),足三里),4對(duì)腧穴組合頻次最高為(胃俞,內(nèi)關(guān),中脘,足三里)。腧穴配伍關(guān)聯(lián)規(guī)則運(yùn)用結(jié)果:中脘分別在公孫、(足三里,公孫)、(內(nèi)關(guān),足三里,公孫)出現(xiàn)的時(shí)候概率最高,足三里分別在太沖、(胃俞,中脘)、(脾俞,內(nèi)關(guān),中脘)出現(xiàn)的時(shí)候概率最高,內(nèi)關(guān)分別在公孫、(中脘,公孫)、(中脘,足三里,公孫)出現(xiàn)的時(shí)候概率最高。結(jié)論:1.循經(jīng)取穴:胃脘痛多取足陽(yáng)明胃經(jīng)的腧穴,其次為任脈、手厥陰心包經(jīng)、足太陽(yáng)膀胱經(jīng)、足太陰脾經(jīng)等。主要以局部選穴和循經(jīng)遠(yuǎn)端選穴為主。2.選穴部位:多選用四肢部位,其次為胸腹部,頭頸部不常用。四肢部多選用五輸穴,五輸穴中合穴應(yīng)用最多,其次為經(jīng)脈間的交會(huì)穴。特定穴在針灸治療胃脘痛的處方中有著大的比重。3.配伍方法:針灸治療胃脘痛大多數(shù)采用俞募配伍法和合募配伍法,并且八脈交會(huì)穴配伍應(yīng)用的也相當(dāng)廣泛,其次有陰經(jīng)與陰經(jīng)配穴法、陰經(jīng)與陽(yáng)經(jīng)配穴法、局遠(yuǎn)配穴法、上下配穴法、前后配穴法、絡(luò)穴與下合穴配伍法、絡(luò)穴與募穴配伍法、背俞穴與下合穴配伍法、原穴與下合穴配伍法、絡(luò)穴與原穴配伍法等。
[Abstract]:Objective: to collect and sort out the ancient literature, medical records, medical words and modern acupuncture and moxibustion prescriptions for the treatment of epigastric pain with effective acupuncture and moxibustion as a starting point. Using data mining technology to analyze the law of optimal selection and compatibility of acupoints, to make clear the relationship between single point and acupoint compatibility, to reveal the law of acupoint compatibility effect, and to discuss the distribution characteristics of acupoints. The acupuncture and moxibustion prescription of epigastric pain was analyzed, and the regular spectrum of acupoint selection and compatibility selection was established, which provided an effective basis for clinical acupoint selection and compatibility selection. Methods: the ancient works were collected on the basis of the Chinese Medical Code (Fifth Edition), which included acupuncture monographs, comprehensive medical books, and medical classics by Chinese physicians before the Republic of China (the books by Korean and Japanese physicians were not included in the collection). Fangshu and clinical works, modern works through the school library and network collection of Chinese medicine published from 1949 to 2013, acupuncture and moxibustion works. The data of acupuncture and moxibustion related to epigastric pain were retrieved, and the data of acupuncture and moxibustion prescription were entered into access database, and the data were preprocessed. Using the association rules in data mining technology and the software of Chinese medicine inheritance support platform to analyze the frequency of acupoint application, the return to the meridian, and the attributes of acupuncture prescriptions. The distribution and main compatibility methods were used to find out the optimal selection of acupoints and compatibility of acupuncture and moxibustion in the treatment of epigastric pain. The result is 1: 1. Results: among the 992 acupuncture and moxibustion prescriptions for the treatment of epigastric pain 121 acupoints were used and the total frequency was 4206. Among them, Zusanli, Zhongwan, Neiguan, Weishu, Peshu, Gongsun, Taichong, Sanyinjiao, Tianshu, Inner atrium, the results of correlation analysis of meridians: the main results were as follows: the results of part correlation analysis: the acupoints were mainly concentrated on the limbs, Chest, abdomen and back, most of the limbs. The result of specific acupoint application: among the specific acupoints, Wuyou acupoint was the first one, among which the most frequent was the joint acupoint, the second was rendezvous point, and the second was the common acupoint. The results showed that the highest frequency of combination of acupoints (Zhongwan, Zusanli) and 3 pairs of acupoints (Zhongwan, Neiguan, Zusanli) was the highest frequency of combination of acupoints (Weishu, Neiguan, Zhongwan, Zusanli) of 4 pairs of acupoints (Weishu, Neiguan, Zhongwan, Zusanli). The results of application of association rules of acupoints compatibility: Zhongwan appeared in Gongsun, (Zusanli, Gongsun), (, Zusanli, Gongsun), and Zusanli was in Taichong, (Weishu, Zhongwan), (Peshu, Neiguan). The probability of appearing in Zhongwan is the highest, and that in Gongsun (Zhongwan,), (, Zusanli, Gongsun) is the highest. Conclusion 1. Acupoints along meridian: epigastric pain takes acupoints of foot Yangming stomach Meridian, followed by Ren pulse, hand Jueyin pericardial Meridian, foot Sun bladder Meridian, foot Taiyin spleen Meridian and so on. The main points were local selection and distal acupoint selection along meridian. Selection of points: more parts of the limbs, followed by the chest and abdomen, head and neck is not commonly used. In extremities, five points were selected, and the points of meridian intersection were used most frequently. Specific points have a large proportion in the prescription of acupuncture and moxibustion for epigastric pain. Methods of compatibility: most of acupuncture and moxibustion treatment of epigastric pain were done by combination of Yu and Hu, and the compatibility of the eight meridians was also widely used, followed by the combination of yin meridian and yin meridian, yin meridian and yang meridian, bureau far point matching method, and the method of combining acupoints with yin meridian and yin meridian. Methods of combination of points from the upper and lower, from the front and back, from the collaterals to the lower points, from the back to the lower points, from the original points to the lower points, from the collaterals to the original points, and from the collaterals to the original points.
【學(xué)位授予單位】：長(zhǎng)春中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.1

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