| Objective:To use data mining methods and techniques to explore the dialectical rule of meridian selection of acupuncture in the treatmentof incomplete spinal cord injury,determine the treatment plan,design and implement clinical randomized controlled trials,to evaluate the function of acupuncture in the treatment of incomplete spinal cord injury The clinical efficacy of obstacles.Method:The first part uses computer and manual methods to retrieve the modern literature research on acupuncture treatment of incomplete spinal cord injury dysfunction,collecting 20 years of domestic and foreign acupuncture treatment of incomplete spinal cord injury dysfunction(including lower extremity dyskinesia,lower limb sensory disturbance,urination Obstacles,defecation disorders)randomized controlled trials report literature,through the Note express software,the selected points,locations,meridians and other content are entered into the Microsoft Office Excel worksheet to build a database.Use Excle 2010 software for acupuncture and moxibustion Perform descriptive analysis on the statistical results of acupoints,acupoints to meridians,and acupoint positioning in the prescription;then use SPSS 18.0 statistical analysis software to analyze the association rules of acupuncture prescription selection in the selected literature,and calculate the support and confidence of the acupoint set Degree;then use SPSS 22.0 statistical software,select the inter-group connection method in the clustering method,and perform cluster analysis on the acupoints included in the literature.Frequency analysis,correlation analysis and cluster analysis methods were used to summarize and summarize,and the rule of point selection for acupuncture treatment of incomplete spinal cord injury dysfunction was obtained.The second part is based on the data mining results of the first part to determine the treatment plan of the clinical trial and evaluate the clinical efficacy.A total of 40 subjects were included in the trial,including 20 in the treatment group and 20 in the control group.Acupuncture and rehabilitation were used to observe the curative effect.The two groups of patients were treated once per day,30 minutes per time,each 6 times a week,continuous treatment for 8 weeks,and before treatment,treatment 4w,8 w to evaluate the efficacy.Lower limb motor dysfunction is evaluated by Asia motor score and motor evoked potential(latency,amplitude),lower limb sensory dysfunction is evaluated by Asia sensory score,somatosensory evoked potential(latency,amplitude),and voiding dysfunction is evaluated by urination diary(The number of times,average daily urine output,maximum daily urine output),urodynamics(maximum bladder volume,residual urine volume,bladder voiding pressure,detrusor pressure)are evaluated for curative effect.Defecation dysfunction is evaluated by the severity of chronic constipation and the self-consciousness of patients with constipation.The curative effect was evaluated by the scale,and the ability of daily living was evaluated by the spinal cord injury independence scale and the modified Barthel index,which confirmed the clinical curative effect of acupuncture in the treatment of incomplete spinal cord injury dysfunction.Result:This study included a total of 164 acupuncture and moxibustion prescriptions with a total frequency of 1930.The acupoints and meridians with the highest frequency of use were:Zusanli(116 times,accounting for 6.01%of the total frequency of use),Foot Yangming stomach meridian(3 87 times,accounting for The total frequency of use is 20.05%),among which Jiaji is the only acupoint that these four parts have been used together,and the frequency cited is all in the top five(110 times,accounting for 5.70%of the total frequency of use),so acupuncture treatment is incomplete The main point for dysfunction of spinal cord injury is Jiaji point.The specific content of each part is as follows:1.A total of 58 effective acupuncture prescriptions for lower limb motor dysfunction were included,84 acupoints were used,and the frequency of use was 806.The most frequently used acupoints and meridians were Zusanli(50 times,6.20%of the total frequency of use)and Foot Yang Ming Stomach Meridian(191 times,accounting for 23.70%of the total frequency of use);According to the analysis of the two-point and three-point association rules,the most supportive points are:Zusanli-S anyinjiao,Zusanli-S anyinjiao-Jiaji points;frequency of use ? After 20 times of hierarchical cluster analysis of 19 acupoints,two effective clusters were formed:Jiaji point-Tiaoguan-Zusanli-S anyi njiao,Zusanli-S anyinjiao-Xuehai-Tiugu an.The final treatment plan is:Zusanli,Sanyinjiao,Tiaoguan,and Xuehai.2.A total of 39 effective acupuncture prescriptions for lower limb sensory dysfunction were included,with a total frequency of 43 2 times.The most frequently used acupoints and meridians were Zusanli(26 times,accounting for 6.02%of the total frequency of use),Foot Yangming stomach meridian(88 times).According to the analysis of the two-point and three-point association rules,the most supportive points are:Baihui-Dazhui,Baihui-Dazhui-Jiaji:19 points that will be used more than 10 times Hierarchical cluster analysis of acupoints formed two effective clusters:Baihui-Dazhui-Zusanli-Jiaji,Zusanli-Sanyinjiao-Yanglingquan-Fengshi.The final treatment plan is:Baihui,Dazhui,Yanglingquan,Fengshi.3.A total of 50 effective acupuncture prescriptions for urinary dysfunction were included.The total frequency of use was 490 times.The most frequently used acupoints and meridians were Guanyuan(34 times,accounting for 6.94%of the total frequency of use),and the full sun bladder meridian(126 times,(Accounting for 25.71%of the total frequency of use);According to the analysis of the two-point and three-point association rules,the highest support points are:Guanyuan-Zhongji,Guanyuan-Zhongji-Jiaji points;18 points that will be used more than 20 times Hierarchical cluster analysis of acupoint forms three effectiveclusters:Guanyuan-Zhongji-Water-Shuidao,Point-Guanyuan-Shuidao-Water,Jiaji Point-Bladder Shu-Shuidao-Shuiquan.The final treatment plan is:Guan Yuan,Zhongji,Water,Waterway.4.A total of 17 effective acupuncture prescriptions for defecation dysfunction were included,with a total frequency of 202 times.The most frequently used acupoints and meridians were:Shenshu(14 times,accounting for 6.93%of the total frequency of use),Renmai(46 times,accounting for The total frequency of use is 22.77%);according to the analysis of the two-point and three-point association rules,the most supportive points are:Tianshu-Zhong wan,Tianshu-Zhongwan-Jiaji points;15 points with frequency?10 times will be used Carry out hierarchical cluster analysis to form 2 effective clusters:Jiaji point-Tianshu-Zhong wan-Guanyuan,Shenshu-Dachangshu-Huiyang-Zhigou.The final treatment plan is:Tianshu,Zhongwan.Clinical trials were conducted according to the treatment plan.After 8 weeks of continuous treatment,the total effective rate in the treatment group was 85.0%,and the total effective rate in the control group was 65.0%.Before treatment,there was no statisticaldifference between the two groups of patients in gender,age,time of onset,severity,and location of injury(P>0.05),and they were comparable.After 4w and 8w treatments,the two groups of patients werecompared with those before treatment.Neurological function assessment(motor,sensory),urination diary(number of urination,averagedailyurination,maximum daily urination),severity of chronic constipation,and self-evaluation of patients with constipation in Asia Scale,spinal cord injury independence scale,modified Barthel index,urodynamics(maximum total bladder,residual urinevolumebladdervoidingpressure,detrusor pressure),motor evoked potential(latency amplitude),somatosensory evoked potential(In terms of incubation period and amplitude),the statistical difference was significant(P<0.05),indicating that the two treatment methods were effective,and the treatment group was better than the control group.According to the comparison of different onset times,the two groups of patients had a definite effect within 6 months of onset,with statistical differences(P<0.05).Among them,the onset of onset within 1 month had the best therapeutic effect.The curative effect was not significant at 7-12 months after onset,and the statistical difference was not significant(P>0.05).Conclusion:1.Through the analysis of data mining technology,acupuncture incomplete spinal cord injury has obvious acupoint selection along the meridians,most of which are the stomach meridian of foot yangming,the bladder meridian of foot sun,and the ren meridian.2.Determine the final treatment plan through data mining technology:the main point is Jiaji point,lower limb motor dysfunction plus Zusanli,Sanyinjiao,Tiaoguan,and Xuehai;lower limb sensory disorder plus Baihui,Dazhui,Yanglingquan,Fengshi;Urinary disorders add Guanyuan,Zhongji,water,and waterways;defecation disorders add Tianshu and Zhongwan.3.Clinical treatment is performed according to the final treatment plan.After 8 weeks of acupuncture treatment,neurological function assessment(motor,sensory),urination diary(average daily urination,daily maximum urination,number of urinations),severity of chronic constipation,and patients with constipation in Asia Self-rating scale,urodynamics(maximum bladder volume,residual urine volume,bladder voiding pressure,detrusor pressure),motor evoked potential(latency,amplitude),somatosensory evoked potential(latency,amplitude),spinal cord injury Both the table and the modified B arthel index have been significantly improved,confirming that acupuncture is safe and effective in treating incomplete spinal cord injury dysfunction. |
PDF Full Text Request