李平平 周鸿飞

【摘 要】 目的：探索周围性面瘫急性期针刺选穴规律。方法：通过检索近十年公开发表在各大数据库中有关周围性面瘫急性期针刺治疗的临床文献，运用Excel软件建立穴位处方数据库，设计提取程序对穴位信息进行提取、综合，选用数据挖掘关联规则的Apriori算法和聚类分析，总结针刺选穴的特征及规律。结果：纳入处方82条，涉及穴位33个，穴位总使用频次649，其中使用频次最高的穴位、归经、部位分别是合谷（73次）、足阳明胃经（223次）、头面部（480次）。关联分析结果显示置信度最高的穴位组合为合谷—太冲，支持度最高的穴位组合是地仓—颊车，聚类分析结果显示存在有效聚类群。结论：周围性面瘫急性期针刺选穴特点局部取穴结合远端取穴，核心穴位为地仓、颊车、阳白、翳风、合谷、太冲，并结合不同的临床症状辨证施治。

【关键词】 周围性面瘫;急性期;数据挖掘;针刺;穴位

【中图分类号】R246   【文献标志码】 A    【文章编号】1007-8517（2021）11-0019-05

Abstract：Objective To explore the law of acupuncture point selection in acute stage of peripheral facial paralysis. Methods By searching the clinical literature published in major databases in recent ten years about acupuncture treatment of peripheral facial paralysis in acute stage， Excel software was used to establish the database of acupuncture prescription， and the extraction program was designed to extract and synthesize the information of acupuncture points. Apriori algorithm and cluster analysis of data mining association rules were selected to summarize the characteristics and laws of acupuncture selection. Results Eighty-two prescriptions were included， involving 33 acupoints， with a total use frequency of 649. Among them， the most frequently used acupoints， meridian tropism and location were Hegu （73 times）， Foot Yangming Stomach Meridian （223 times） and Head and Face （480 times）. The results of association analysis show that the highest confidence point combination is Hegu-Taichong， and the highest support point combination is Dicang-Buccal Car. The cluster analysis results show that there are effective clusters. Conclusion The characteristics of acupuncture point selection in acute stage of peripheral facial paralysis are local point selection combined with remote point selection. The core points are Dicang， Buccal Vehicle， Yangbai， Fufeng， Hegu and Taichong， which are treated according to different clinical symptoms.

Keywords：Peripheral Facial Paralysis; Acute Phase; Data Mining;Acupuncture; Acupuncture Point

周圍性面瘫又被称为Bell麻痹，是茎乳孔内面神经非特异性炎症所致常见病、多发病[1]。在临床上，周围性面瘫的患者症状呈现的很严重，对患者的工作和生活困扰极大[2]，同时也会引发相应的焦虑、抑郁等心理问题[3]。针灸治疗周围性面瘫效果显著，可以有效的改善患者面部神经功能，有助于患者的康复[4]，但目前对于针刺介入治疗的时机仍有较大争议[5-8]，且在急性期针灸选穴缺乏明确统一的使用标准，有学者[9]经临床试验得出针灸在周围性面瘫急性期介入可以显著提高治愈率，缩短疗程。……