1.北京中医药大学针灸推拿学院(北京 100029)
郭亭廷,女,硕士研究生,主要从事针灸作用规律与机制研究工作
嵇波,主任医师,博士研究生导师; E-mail:jibo@bucm.edu.cn
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郭亭廷,嵇波,刘翼天,等.基于数据挖掘的电针及经颅电刺激治疗痴呆刺激参数应用规律研究[J].上海中医药杂志,2023,57(4):65-71.
GUO Tingting,JI Bo,LIU Yitian,et al.Data mining⁃based study on application rules of stimulation parameters of electroacupuncture and transcranial electrical stimulation for dementia[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(4):65-71.
郭亭廷,嵇波,刘翼天,等.基于数据挖掘的电针及经颅电刺激治疗痴呆刺激参数应用规律研究[J].上海中医药杂志,2023,57(4):65-71. DOI: 10.16305/j.1007-1334.2023.2206085.
GUO Tingting,JI Bo,LIU Yitian,et al.Data mining⁃based study on application rules of stimulation parameters of electroacupuncture and transcranial electrical stimulation for dementia[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(4):65-71. DOI: 10.16305/j.1007-1334.2023.2206085.
目的,2,借助数据挖掘技术,探讨电针及经颅电刺激治疗痴呆的刺激参数应用规律。,方法,2,检索中国知网(CNKI)、维普中文期刊服务平台(VIP)、万方数据知识服务平台(WanFang Data)、中国生物医学文献服务平台(CBM)、PubMed、Web of Science、Embase、Cochrane Library、Medline等中英文数据库中电针及经颅电刺激治疗痴呆的临床研究文献,文献发表时间为建库至2022年5月。采用Cochrane 5.4偏倚风险评估工具对纳入文献中的随机对照试验进行质量评价。建立电刺激参数数据库,并采用描述性分析、关联规则分析及聚类分析进行数据挖掘。,结果,2,①最终纳入文献175篇,其中143篇为随机对照试验,包含数据179组。②总体而言,电针及经颅电刺激治疗痴呆时,常用的脉冲波形为连续波(57次,50.44%)和疏密波(44次,38.94%),电刺激频率为300~500次/min(即5.00~8.33 Hz)。电针疗法电刺激强度常以患者耐受为度,单次治疗时间以30 min多见;经颅电刺激疗法电刺激强度则多为2 mA,单次治疗时间常选择20 min。③电针及经颅电刺激治疗血管性痴呆(VaD)时,常用的刺激参数与文献总体情况一致。治疗阿尔茨海默病(AD)时的刺激参数则有所差异:常用的脉冲波形为连续波,电刺激频率为10/50 Hz,电针疗法电刺激强度常以患者耐受为度,经颅电刺激疗法电刺激强度则多为2 mA,在单次治疗时间的选择方面,电针及经颅电刺激均常选择30 min。④电刺激选用频次最多的腧穴为百会、四神聪、风池、神庭、本神,经穴归属频次最高的经脉为督脉、胆经及胃经。⑤关联规则分析结果显示,电针治疗痴呆最常用的双穴配伍为百会-神庭,3穴配伍为四神聪-风池-百会,4穴配伍为百会-神庭-风池-四神聪;聚类分析亦发现,常用穴位所形成的聚类群中,风池与四神聪、百会与神庭各占一类。,结论,2,电针及经颅电刺激治疗痴呆时常选用连续波,频率为300~500次/min(即5.00~8.33 Hz);电针刺激强度常以患者耐受为度,单次治疗时间常为30 min,经颅电刺激强度常为2 mA,单次治疗时间则为20 min。百会、四神聪、神庭和风池是电针及经颅电刺激治疗痴呆的常用穴位,上述穴位配伍关系密切。
Objective,2,To study the application rules of stimulation parameters of electroacupuncture and transcranial electrical stimulation (TES) for dementia with data mining techniques.,Methods,2,Both Chinese databases including Chinese National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP), WanFang Data, China Biology Medicine (CBM) and English databases including PubMed, Web of Science, Embase, and Cochrane Library were systematically searched for clinical research literature related to electroacupuncture and TES for dementia which were published from the establishment of databases up to May 2022. The quality of randomized controlled trials in the included literature was assessed using the Cochrane 5.4 risk of bias tool. A database of electrical stimulation parameters was established and data mined using descriptive analysis, association rules, and cluster analysis.,Results,2,①Finally, 175 articles were included, of which 143 were randomized controlled trials, containing data from 179 groups. ②Overall, the frequently used pulse waveforms were continuous wave (57 times, 50.44%) and disperse-dense wave (44 times, 38.94%), and electrical stimulation frequency was 300 to 500 times/min (5.00-8.33 Hz) when using electroacupuncture and TES for dementia. The electrical stimulation intensity of electroacupuncture therapy was often determined by patient tolerance, and a single treatment session was 30 min. The stimulation intensity of TES therapy was 2 mA, and a single treatment session was 20 min. ③The commonly used stimulation parameters of electroacupuncture and TES for vascular dementia (VaD) were consistent with literature data in general, while those for Alzheimer’s disease (AD) were different from literature data: the frequently used pulse waveform was continuous wave, and the electrical stimulation frequency was 10/50 Hz. The electrical stimulation intensity was determined by patient tolerance for electroacupuncture, while that of TES was 2 mA, and a single treatment session often lasted 30 min for both electroacupuncture and TES. ④The most frequently selected acupoints were Baihui (DU20), Sishencong (Ex-HN01), Fengchi (GB20), Shenting (DU24), and Benshen (GB13), and the most frequently selected meridians were Du meridian, gallbladder meridian and stomach meridian. ⑤According to the association rule analysis, for electroacupuncture treatment of dementia, the most frequently used acupoint-pair was Baihui (DU20)-Shenting (DU24), 3-acupoint-combination was Sishencong (Ex-HN01)-Fengchi (GB20)-Baihui (DU20), and 4-acupoint-combination was Baihui (DU20)- Shenting (DU24)- Fengchi (GB20)- Sishencong (Ex-HN01). The cluster analysis also revealed that among the clusters formed by common acupoints, the pair of Fengchi (GB20) and Sishencong (Ex-HN01), and that of Baihui (DU20) and Shenting (DU24) were in two separate clusters.,Conclusions,2,Continuous waves are commonly used at a frequency of 300 to 500 times/min (5.00-8.33 Hz) for electroacupuncture and TES for dementia. The electrical stimulation intensity of electroacupuncture is often determined by the patient tolerance, and a single treatment session lasts 30 min. The electrical stimulation intensity of TES therapy is 2 mA, and a single treatment session is 20 min. The frequently used acupoints for electroacupuncture and TES for dementia are Baihui (DU20), Sishencong (Ex-HN01), Shenting (DU24), and Fengchi (GB20), which were closely compatible with each other.
痴呆阿尔茨海默病电针经颅电刺激刺激参数中医药疗法
dementiaAlzheimer’s diseaseelectroacupuncturetranscranial electrical stimulationstimulation parametertraditional Chinese medicine therapy
中国痴呆与认知障碍指南写作组. 2018中国痴呆与认知障碍诊治指南(一):痴呆及其分类诊断标准[J]. 中华医学杂志,2018, 98(13): 965-970.
中华医学会老年医学分会老年神经病学组,老年人认知障碍诊断专家共识撰写组. 中国老年人认知障碍诊治流程专家建议[J]. 中华老年医学杂志,2014, 33(8): 817-825.
吴玉莲,杨晋如,程桂荣,等. 中国居民对阿尔茨海默病临床表现及危害识别[J]. 中国老年学杂志,2019, 39(8): 1992-1996.
王琼,周帅,侯芳芳,等. 痴呆症的流行病学及预防措施[J]. 中国临床保健杂志,2021, 24(6): 747-751.
Alzheimer’s Disease International(ADI). World Alzheimer Report 2018. The state of the art of dementia research: new frontiers[R/OL]. (2018-09-21)[2022-06-20]. https://www.alz.co.uk/news/world-alzheimer-report-2018-state-of-art-of-dementia-research- new-frontierhttps://www.alz.co.uk/news/world-alzheimer-report-2018-state-of-art-of-dementia-research-new-frontier.
刘言言,楚海波. 中西医治疗阿尔茨海默病的研究现状[J]. 中医临床研究,2017, 9(13): 146-148.
刘珂,缪林清,蒋鹭莲,等. 针刺对比西药改善阿尔茨海默病患者认知功能障碍和精神行为症状的临床研究现状与分析[J]. 世界科学技术-中医药现代化,2021, 23(6): 2105-2115.
SONG Y Y, XU W T, ZHANG X C, et al. Mechanisms of electroacupuncture on Alzheimer’s disease: a review of animal studies[J]. Chin J Integr Med, 2020, 26(6): 473-480.
YU T W, LANE H Y, LIN C H. Novel therapeutic approaches for Alzheimer’s disease: an updated review[J]. Int J Mol Sci, 2021, 22(15): 8208.
刘智斌,牛文民,杨晓航,等. 嗅三针对老年痴呆大鼠学习记忆功能及海马胆碱乙酰化酶、乙酰胆碱酯酶活性的影响[J]. 针刺研究,2009, 34(1): 48-51.
望庐山,周丽莎. 电针治疗对阿尔茨海默病大鼠Ach、ChAT、AchE的影响[J]. 针灸临床杂志,2009, 25(6): 40-42,54.
薛卫国,葛桂玲,张忠,等. 电针对转基因阿尔茨海默病小鼠海马CA1区超微结构的影响[J]. 针刺研究,2009, 34(5): 309-314.
马骏,王彦春,王述菊,等. 电针对阿尔茨海默病模型大鼠海马区神经营养因子及其受体表达的影响[J]. 针灸临床杂志,2010, 26(7): 63-66.
张晓东,刘洋,王吉锡,等. 电针对阿尔茨海默病大鼠学习记忆及NOS、CaMKⅡ表达的影响[J]. 针灸临床杂志,2011, 27(6): 70-74.
朱书秀,孙国杰. 电针对阿尔茨海默病模型大鼠学习记忆能力及海马区胶质细胞的影响[J]. 中国针灸,2009, 29(2): 133-136.
蒋希成,姜国华,于洋. 针刺对老年性痴呆大鼠脑组织中tau蛋白表达的影响[J]. 针灸临床杂志,2008, 24(11): 38-39.
MOREIRA P I, SANTOS R X, ZHU X, et al. Autophagy in Alzheimer’s disease[J]. Expert Rev Neurother, 2010, 10(7) : 1209-1218.
王东岩,董旭,王斌. 电针促进中风后腕手功能重建的量效关系研究[J]. 时珍国医国药,2019, 30(8): 1914-1915.
褚婷婷,高明,杨华元,等. 电针仪波形参数的研究进展[C]//世界针灸学会联合会. “中医针灸”申遗十周年特别活动暨世界针灸学会联合会2020国际针灸学术研讨会论文集. 海口:海南省卫生健康委员会,2020: 122-123.
褚婷婷,高明,刘堂义,等. 电针仪波形参数设计研发的现状分析与思考[J]. 生物医学工程与临床,2022, 26(2): 234-242.
孙迎春. 电针不同波形、频率、刺激强度、时间对大鼠坐骨神经损伤修复的实验研究[D]. 哈尔滨:黑龙江中医药大学,2005.
HAN J S. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies[J]. Trends Neurosci, 2003, 26(1): 17-22.
王颖,孔立红,李威,等. 不同频率电针对阿尔茨海默病大鼠学习记忆能力效应及部分作用机制探讨[J]. 中国针灸,2017, 37(6): 629-636.
张世能,刘晓红,张会珍,等. 电针不同频率对VD小鼠学习记忆能力的影响[J]. 河北中医药学报,2011, 26(3): 34-35.
端木程琳,王晓宇,张晓宁,等. 不同强度电针和经皮穴位电刺激对肌肉炎性痛大鼠的镇痛效应[J]. 针刺研究,2020, 45(11): 902-907.
熊繁,黎诗琪,王颖,等. 不同强度电针刺激上巨虚穴脑功能磁共振成像的比较[J]. 时珍国医国药,2020, 31(3): 749-752.
熊繁,黎诗琪,吴笑,等. 不同强度电针刺激上巨虚后续效应磁共振成像比较[J]. 中国中医药信息杂志,2019, 26(12): 26-30.
陈少宗. 针刺时机作用规律的研究及其临床意义[J]. 针灸临床杂志,2010, 26(11): 6-9.
陈少宗. 针刺作用时效关系研究的临床意义[J]. 针灸临床杂志,2008, 24(6): 1-3.
黄泳,赖新生,陈静,等. 针刺百会穴前后血管性痴呆患者不同脑区的脑葡萄糖代谢[J]. 中国临床康复,2005, 9(36): 68-70.
张虹,赵凌,何成奇,等. 头电针治疗血管性痴呆的临床多中心随机对照研究[J]. 中国针灸,2008, 28(11): 783-787.
张平,倪兰枝. 风池、风府穴在中风后遗症中的应用研究[J]. 中国针灸,1998, 17(12): 39-40.
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