基于数据挖掘技术探讨针灸治疗脑卒中后痉挛性偏瘫的选穴特点

目的运用数据挖掘技术探讨针灸治疗脑卒中后痉挛性偏瘫的选穴特点。方法检索中国期刊全文数据库(CNKI)、万方数据库、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed上从建库至2020年5月5日的文献,按照纳入和排除标准收集治疗脑卒中后痉挛性偏瘫的针灸处方,利用SPSS 24.0、IBM SPSS Modeler 18软件,对其进行描述性分析、聚类分析和关联规则分析。结果共纳入文献436篇。治疗方法频次最高的是针刺,其次是针刺+康复锻炼。频次应用较高的腧穴:主穴是合谷、三阴交、肩髃等,配穴是丰隆、太溪、太冲等。用穴频次较高的经脉:主穴是手阳明大肠经、足阳明胃经、足太阴脾经经穴等,配穴是足阳明胃经、足少阳胆经、手阳明大肠经经穴等。用穴频次较高的部位:主、配穴均是下肢、上肢、头颈部等。支持度最高的关联群:主穴是合谷-曲池,配穴是太冲-丰隆、太溪-丰隆;置信度最高的关联群:主穴是三阴交-阴陵泉,配穴是地仓-颊车。聚类分析:主穴分为2类,尺泽、极泉、内关、三阴交、阴陵泉、照海、大陵、血海为第一类,合谷、曲池、外关、肩髃、手三里、阳陵泉、足三里为第二类;配穴分为3类,丰隆、太冲、太溪、气海、内庭、血海、风池、足三里为第一类,地仓、颊车、廉泉为第二类,合谷、丘墟、肩髃、曲池为第三类。结论针灸治疗脑卒中后痉挛性偏瘫,以阳经选穴为主,尤其是手、足阳明经,阳经或者阴经取穴大多单独使用,取穴部位多是四肢。主穴多选用特定穴,应用最多的是合穴,其次为交会穴、八脉交会穴、络穴,且多位于拮抗肌(群)肌腹或肌腱之间。配穴多是辨证取穴、随症取穴及按部位取穴,而辨证取穴多从风、痰、虚致病因素考虑。     

基于数据挖掘技术分析针灸治疗血管性认知障碍的选穴规律

[目的]运用数据挖掘技术分析针灸治疗血管性认知障碍的选穴规律,为临床治疗该病提供参考.[方法]通过检索中国知网(CNKI)近20年来针灸治疗血管性认知障碍的文献,建立数据库,对纳入文献的腧穴、归经、分布情况等进行频次分析,进一步对高频腧穴进行关联规则分析和聚类分析.[结果]①最终纳入90篇文献,共涉及85个腧穴,累计出现频次为594次.②使用频次居前6位的腧穴依次为百会、神庭、四神聪、风池、太溪、足三里.③选穴以督脉、足少阳胆经、足阳明胃经腧穴最为常见.④关联规则分析得到10组常用关联组合,其中置信度最高组合为百会-风池、神庭,支持度最高组合为百会-神庭、百会-四神聪.⑤聚类分析总结出5个有效聚类群,分别为百会-命门-风府-大椎,本神-神庭,悬钟-足三里-神门-太溪-肾俞-丰隆,水沟-三阴交-内关,风池-四神聪-印堂-合谷-太冲.[结论]针刺治疗血管性认知障碍时选穴以阳经和头颈部为主,注重局部与远道取穴相结合、补泻兼施,从而达到调补脾肾、化痰行瘀、醒脑开窍的作用.     

基于复杂网络的原发性高血压腧穴配伍规律分析

[目的]探索针刺治疗原发性高血压腧穴配伍规律。[方法]计算机在线检索知网、万方、维普数据库。根据纳入/排除标准选择合格文献,按照设定表格内容提取相关数据建立数据库,利用复杂网络分析方法研究原发性高血压腧穴配伍规律。[结果]纳入161篇文献,提取出221个针灸治疗原发性高血压的处方,复杂网络分析拓扑结构后发现太冲、曲池、足三里、风池、合谷、百会、太溪、三阴交、内关、人迎、丰隆为核心节点,提示头颈部腧穴+四肢部腧穴的配伍方法是临床使用的主要配穴方法。[结论]针刺治疗原发性高血压腧穴配伍复杂网络分析结果与临床基本一致,复杂网络分析可作为腧穴配伍研究的常用方法。     

基于信息可视化数据挖掘隋唐至明清时期针灸治疗中风后半身不遂选穴规律研究

目的运用信息可视化数据挖掘技术研究隋唐至明清时期相关文献针灸治疗中风后半身不遂的选穴规律及穴位配伍意义。方法整理隋唐至明清时期相关文献针灸治疗中风后半身不遂的处方,经筛选后利用信息可视化软件Microsoft Access 2017建立数据库,运用信息可视化软件SPSS 22.0、Modeler 18.0对治疗本病穴位、经络等行统计分析。结果本研究获得隋唐至明清时期治疗中风后半身不遂的针灸处方243条,涉及穴位163个,遍布所有正经及任、督二脉,穴位针刺的总频数为1 872次,其中针刺经穴频数排前3位的经络是手阳明大肠经、足少阳胆经、足阳明胃经;针刺频数排前10位的经穴为:曲池、足三里、昆仑、太溪、百会、阳陵泉、合谷、悬钟、环跳、委中;聚类分析获得5个有效聚类群:风市-足三里-百会、曲池-昆仑-太溪、昆仑-涌泉-太溪、风池-风府、环跳-委中-阳陵泉-风市-悬钟;关联规则分析支持度排前6位的有风市-足三里、合谷-悬钟、悬钟-曲池、合谷-风市、昆仑-太溪、曲池-阳陵泉;特定穴位的针刺频率高达91.29%,其中五腧穴使用频数最多,其次为两脉交会穴及原穴。结论运用信息可视化数据挖掘技术对隋唐至明清时期治疗中风后半身不遂的针灸处方进行规律挖掘,发现其选穴范围较广,常选用四肢部位经穴,注重阳经经穴及特定穴的应用,选取经穴方法多以局部选穴、辨证选穴及循经取穴为主,可为研究中医药古代典籍、针灸治疗中风后半身不遂等提供新思路。     

基于现代文献针刺治疗构音障碍的取穴规律研究

目的:基于现代文献分析针刺治疗构音障碍的取穴规律。方法:检索中国知网、万方数据知识服务平台和维普数据库中收录的关于针刺治疗构音障碍的文献,建立数据库,采用数据挖掘技术,对选穴进行分析。结果:共纳入39篇文献,共选用80个腧穴,总频次为330次,其中使用频次最高的前15位为风池、金津玉液、廉泉、翳风、通里、内关、丰隆、完骨、合谷、三阴交、水沟、哑门、足三里、旁廉泉、百会。经穴涉及以现代经验穴及任脉、足少阳胆经、督脉、经外奇穴腧穴选用最多,归属部位以颈项部最多。关联规则分析显示穴位间相关性较高的组合为风池-完骨。通过聚类分析,得出风池-金津玉液-廉泉、足三里-三阴交-太溪、百会-地仓-舌三针、合谷-通里4个有效聚类群。结论:针刺治疗构音障碍疗效显著,且取穴以颈项部最多,涉及12条经脉、任督二脉以及经外奇穴和现代经验穴。     

基于关联规则、熵层次聚类法探索治疗小儿抽动症选穴规律

目的基于关联规则、熵层次聚类法分析治疗小儿抽动症的选穴规律。方法对中国期刊全文数据库(CNKI)中应用针刺、灸法、穴位注射等方法治疗小儿抽动症的文献进行检索,应用中医传承辅助平台对所有处方的选穴规律进行分析。结果共纳入处方45首,涉及穴位90个,其中,用穴频次≥4次的穴位有27个,其中使用频次排名前5位的穴位分别为太冲(29次)、百会(28次)、风池(28次)、合谷(27次)、三阴交(19次);设置支持度=12,置信度=0.9,得到25对穴位组合,其中,排名前5位的高频穴位组合为合谷-太冲(25次)、百会-太冲(23次)、百会-风池(21次)、百会-合谷(21次)、风池-合谷(21次);得到3个穴位的核心组合24个,4个穴位的核心组合3个。结论针灸治疗小儿抽动症主要通过百会、太冲、合谷、三阴交等穴位起到疏肝解郁、补肾健脾的作用,并为临床发展新型处方提供参考。     

基于数据挖掘技术探究针灸治疗儿童抽动障碍的选穴规律

【目的】采用数据挖掘技术分析针灸治疗儿童抽动障碍的选穴规律。【方法】计算机检索自1992年1月至2022年12月中国期刊全文数据库（CNKI）、万方数据知识服务平台（Wanfang）、维普资讯中文期刊服务平台（VIP）、中国生物医学文献数据库（SinoMed）及PubMed数据库收录的针灸治疗儿童抽动障碍的临床研究文献。通过Excel 2019建立数据库,统计常用治疗方法,并对高频应用方法针刺（高频腧穴、腧穴归经、腧穴关联规则、腧穴聚类）、耳穴压豆（高频耳穴、穴位关联规则）、头穴丛刺高频分区进行分析。【结果】共纳入有效文献190篇,涉及270条针刺处方;其中针刺法腧穴统计184个,应用总频次1 906次,高频应用腧穴依次为百会、太冲、风池、合谷、三阴交、内关、神门、足三里、印堂、四神聪;高频经脉为督脉、足阳明胃经、足少阳胆经、手阳明大肠经、足太阳膀胱经、足厥阴肝经;通过SPSS modeler 18.0及IBM SPSS Statistics26.0软件分析得出3组穴位强关联规则和5个聚类。耳穴压豆穴位29个,应用总频次206次,高频应用耳穴依次为神门、肝、心、皮质下、肾;通过SPSS...     

古代针灸治疗中风穴位处方配伍规律研究

目的：检索从先秦至清代的古代中风针灸处方文献,研究针灸处方的主要配伍规律。方法：选取半身不遂和不省人事2个具代表性的中风症状,用数据挖掘方法分析其治疗中腧穴、经络和特定穴运用规律,总结、提炼针灸处方配伍方式。结果：①半身不遂：使用腧穴频次最多的为曲池、肩髃等手阳明经穴;肩髃、曲池、足三里、百会、风池配伍是最常用处方;多选用足少阳经和手足阳明经穴位。②不省人事：使用腧穴频次最多的为督脉百会穴、心包经中冲穴;风池、百会、曲池配伍或大椎、百会、风池配伍是最常用处方;经脉多选用督脉和足少阳、手阳明等阳经穴位。结论：古代治疗半身不遂和不省人事针灸处方所选腧穴的配穴组方及特定穴运用与现代临床常用处方基本一致。在经络选取上,治疗不省人事针灸处方选用经络与现代临床常用处方基本相同,而治疗半身不遂选用足少阳胆经最多,与现代临床常用足阳明胃经不同,需要进一步思索与研究。     

基于古今医案云平台分析针刺治疗卒中后肢体运动功能障碍选穴规律

【目的】分析针刺治疗卒中后运动功能障碍的选穴规律。【方法】计算机检索中国知网期刊全文数据库（CNKI）、万方学术期刊全文数据库（Wanfang）、维普中文科技期刊数据库（VIP）、中国生物医学数据库（CBM）、美国生物医学信息检索系统（PubMed）、荷兰医学文摘（Embase）、国际循证医学图书馆（Cochrane Library）、科学网（Web of Science）等各大数据库中针刺治疗卒中后运动功能障碍的随机对照研究文献。将符合纳入标准的文献进行内容分析提取并建立处方数据库，使用古今医案云平台对数据进行分析。【结果】最终纳入161篇文献，共涉及腧穴178个，应用频次共1 616次。针刺治疗卒中后运动功能障碍应用频次前5位的腧穴分别是合谷、曲池、肩髃、足三里、外关；最常选用的经脉为手阳明大肠经、足少阳胆经和足阳明胃经；常应用腧穴多分布于四肢部；应用频次前5位的穴对为曲池-合谷、肩髃-合谷、合谷-外关、肩髃-曲池和曲池-外关；关联性最强的穴位组合为曲池-合谷；聚类分析将所有穴位分为5大类，主要核心处方为曲池、合谷、外关、肩髃、手三里、足三里、阳陵泉。【结论】针刺治疗卒中后运动功能...     

基于复杂网络技术探究针灸治疗干燥综合征配穴规律

目的基于复杂网络数据挖掘技术分析针灸治疗干燥综合征的核心穴位和穴位配伍。方法采用Pubmed、知网、维普、万方等数据库作为数据来源,检索国内外针灸治疗干燥综合征近30年的文献资料,建立针灸治疗干燥综合征的处方数据库,利用数据挖掘技术对腧穴节点进行中心性分析以及聚类分析,并运用Gephi 0.9.1软件对复杂网络进行展示。结果针灸治疗干燥综合征的核心腧穴为三阴交、足三里、太溪、廉泉、睛明、攒竹、四白、风池、合谷、液门、迎香、太冲、百会、照海、中极。处方中的特定穴主要分布在头颈部和下肢部位。配伍权重最高的经络依次为足太阳膀胱经、足太阴脾经、任脉、手少阳三焦经、足阳明胃经。配伍结果显示,关联频度最高的配伍为三阴交配太溪,其次是三阴交配合谷、三阴交配太冲,体现了邻近配穴和远道配穴的原则。结论该研究总结出针灸治疗干燥综合征的配穴规律,可为临床上针灸治疗干燥综合征配穴方案提供参考依据。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.