[基于古针灸方剂数据挖掘的胸痹心痛组成原理]。

中国针灸 Pub Date : 2025-10-12 Epub Date: 2025-07-25 DOI:10.13703/j.0255-2930.20250408-k0004
Jianing Wang, Xianghong Jing, Suyu Li
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引用次数: 0

摘要

目的:检索整理胸痹心痛古代针灸方剂中最早记载的文献,探讨其穴位构成原理。方法:采用Excel 2016软件建立胸闷心痛针灸方剂古籍记录数据集。在对病因、病机、伴随症状、腧穴、治疗方法等相关术语进行统一后,运用频次统计分析和关联规则算法,从多维度分析古方剂中辨证、选治、选穴各要素之间的隐性关联模式。结果:古代针灸治疗胸闷心痛的高频基础穴为大岭穴(PC7)、内关穴(PC6)、太溪穴(KI3)、太中穴(LR3)、上脘穴(CV13)、涌泉穴(KI1)、心枢穴(BL15)。方剂以元源穴为主。此外,五枢穴二、五枢穴与络连穴、元源穴与络连穴的组合也很常见。高频点来自手觉阴心包经、胎脉、足少阴肾经、足觉阴肝经、足太阳膀胱经,一般分布在手臂阴部、腹部、足阴部、背部、腿部阴部。治疗胸闷心绞痛,以直沟(TE6)、足三里(ST36)、百会(GV20)、九胃(CV15)及特定穴位组合为主。艾灸多适用于气势逆寒、气滞引起的胸闷心痛。伴有手颤者一律选择Shaohai (HT3);选择中冲(PC9)联合大灵(PC7)是专门针对手掌发热的感觉。艾灸专施于上脘(CV13),常灸刺激太西(KI3)。在内关(PC6)和大岭(PC7),艾灸配合针刺(针刺置信度高)。结论:古代针灸治疗胸痹心痛,以手觉阴心包经穴位为主,与足觉阴肝经、足少阴肾经、胎脉、足太阳膀胱经等穴位相配合。它遵循取穴原则,“心包代心”,“以调气为主”,“元源穴与络连穴相结合”,“沿患处经络就近取穴”。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Composition principles for chest obstruction and heart pain based on data mining of ancient acupuncture-moxibustion prescriptions].

Objective: To retrieve and collate the earliest recorded texts in ancient acupuncture-moxibustion prescriptions for chest obstruction and heart pain, and explore the acupoint composition principles.

Methods: The Excel 2016 software was used to build a data set of ancient textual records on acupuncture-moxibustion prescriptions for chest obstruction and heart pain. After the terminology related to etiology, pathogenesis, accompanying symptoms, acupoints, and treatment methods unified, the frequency statistical analysis and association rule algorithms were applied to analyze the implicit association patterns among various elements of syndrome differentiation, treatment selection, and acupoint selection in ancient prescriptions from multiple dimensions.

Results: The basic acupoints of high frequency in ancient acupuncture-moxibustion treatment for chest obstruction and heart pain were Daling (PC7), Neiguan (PC6), Taixi (KI3), Taichong (LR3), Shangwan (CV13), Yongquan (KI1), and Xinshu (BL15). The prescription was mostly composed of yuan-source points. Besides, the combinations of two of five-shu points, five-shu points with luo-connecting points, and yuan-source points with luo-connecting points were common. The high-frequency points were from the pericardium meridian of hand-jueyin, conception vessel, kidney meridian of foot-shaoyin, liver meridian of foot-jueyin, and bladder meridian of foot-taiyang, generally distributed on the yin part of the arm, abdominal region, the yin part of foot, the back, and the yin part of the leg. Zhigou (TE6), Zusanli (ST36), Baihui (GV20), and Jiuwei (CV15), as well as the specific acupoint combinations, were used for chest obstruction and heart pain due to qi stagnation. Moxibustion was more suitable for chest obstruction and heart pain caused by qi reversion, cold and qi stagnation. Shaohai (HT3) was invariably selected when hand tremor was accompanied; Zhongchong (PC9) combined with Daling (PC7) was selected specially for feverish sensation in the palms. Moxibustion was exclusively applied to Shangwan (CV13), and Taixi (KI3) was often stimulated with moxibustion. At Neiguan (PC6) and Daling (PC7), moxibustion was delivered in combination with acupuncture (high confidence was presented in acupuncture).

Conclusion: In ancient acupuncture-moxibustion treatment for chest obstruction and heart pain, the points of the pericardium meridian of hand-jueyin are predominant, coordinated with those of the liver meridian of foot-jueyin, kidney meridian of foot-shaoyin, conception vessel, and bladder meridian of foot-taiyang. It follows the principles of acupoint selection, "the pericardium acting on behalf of the heart", "regulating qi as the priority", "combination of yuan-source points with luo-connecting points", and "selecting nearby points along the affected meridians".

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来源期刊
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期刊介绍: Chinese Acupuncture and Moxibustion (founded in 1981, monthly) is an authoritative academic journal of acupuncture and moxibustion under the supervision of China Association for Science and Technology and co-sponsored by Chinese Acupuncture and Moxibustion Society and Institute of Acupuncture and Moxibustion of China Academy of Traditional Chinese Medicine. It is recognised as a core journal of Chinese science and technology, a core journal of Chinese language, and is included in the core journals of China Science Citation Database, as well as being included in MEDLINE and other international well-known medical index databases. The journal adheres to the tenet of ‘improving, taking into account the popularity, colourful and realistic’, and provides valuable learning and communication opportunities for the majority of acupuncture and moxibustion clinical and scientific research workers, and plays an important role in the domestic and international publicity and promotion of acupuncture and moxibustion disciplines.
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