古代针灸治疗冠状动脉粥样硬化性心脏病的选穴规律*

作者：刘 超，田安哲，郭 城，肖孟霞，刘红华，欧阳里知，刘迈兰

单位：湖南中医药大学，湖南 长沙 410208

引用：引用：刘超，田安哲，郭城，肖孟霞，刘红华，欧阳里知，刘迈兰.古代针灸治疗冠状动脉粥样硬化性心脏病的选穴规律[J].中医药导报,2025,31(10):152-158,194.

DOI：10.13862/j.cn43-1446/r.2025.10.026

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摘要：

目的：采用多元数据挖掘技术梳理中医古籍文献中针灸治疗冠状动脉粥样硬化性心脏病的选穴规律。方法：以《博览医书中医古籍文献数据库》为数据来源，对先秦至清末（公元前221年至公元1912年）的针灸推拿学古籍进行检索，纳入针灸治疗“胸痹”“真心痛”“厥心痛”等可归属于西医学“冠状动脉粥样硬化性心脏病”的相关条文，对穴位处方中腧穴使用频数、腧穴归经及特定穴的使用情况进行统计分析，并对组穴进行关联规则分析及复杂网络分析。结果：共纳入古籍条文379条，源自29部古籍，其中涉及单穴的条文336条、涉及组穴的条文43条，共包含104个腧穴，使用总频数498次。使用频数前5位的腧穴为中脘（18次）、巨阙（18次）、然谷（16次）、上脘（16次）、神门（13次）；腧穴分布涉及十二正经及任脉、督脉、经外奇穴，其中排名前5位的经脉依次为任脉（79次）、足太阳膀胱经（68次）、足少阴肾经（57次）、手厥阴心包经（56次）和手少阴心经（51次）；特定穴使用频数最高的为五输穴（235次），其次为交会穴（94次）、原穴（80次）。关联规则分析及共现网络图显示，“京骨-昆仑-然谷”、“大都-太白-中脘”为常用腧穴组合；复杂网络分析显示，“支沟-间使-少冲-膈俞”“太冲-内关-独阴”“然谷-太溪-大都-太白-行间-建里-神门-中脘-涌泉”“昆仑-京骨”为核心腧穴组合。结论：古籍中针灸治疗冠状动脉粥样硬化性心脏病常选用巨阙、期门、上脘、中脘、然谷、神门等阴经腧穴，选穴符合益气活血、扶正祛邪的治疗原则，并注重五输穴及交会穴的使用。

关键词：冠状动脉粥样硬化性心脏病；针灸；选穴规律；中医古籍；数据挖掘

Abstract：

Objective: To analyze the rules of acupoint selection for treating coronary atherosclerotic heart disease (CHD) in ancient Chinese medical literature using multivariate data mining techniques. Methods: Relevant passages on acupuncture and moxibustion treatment for conditions such as "chest obstruction", "true heart pain", and "syncopal heart pain", which can be classified under CHD in Western medicine, were retrieved from the "Expo Medical Books-Database of Ancient Chinese Medicine Books", covering texts from the pre-Qin period to the end of the Qing Dynasty (221 BC to 1912 AD). The frequency of acupoint use, meridian distribution, and application of specific points were statistically analyzed. Association rule analysis and complex network analysis were performed on acupoint combinations. Results: A total of 379 relevant passages from 29 ancient texts were included, comprising 336 single-acupoint entries and 43 combination entries, involving 104 acupoints with a total usage frequency of 498. The top five most frequently used acupoints were Zhongwan (RN12) and Juque (RN14) (18 times each), Rangu (KI2) and Shangwan (RN13) (16 times each), and Shenmen (HT7) (13 times). Acupoints belonged to the twelve regular meridians, the Conception Vessel (Ren Mai), the Governor Vessel (Du Mai), and extraordinary points. The top five meridians by usage frequency were the Conception Vessel (79 times), Bladder Meridian of Foot-Taiyang (68 times), Kidney Meridian of Foot-Shaoyin (57 times), Pericardium Meridian of Hand-Jueyin (56 times), and Heart Meridian of Hand-Shaoyin (51 times). Among specific points, the five-shu points were used most frequently (235 times), followed by crossing points (94 times) and yuan-primary points (80 times). Association rule analysis and co-occurrence network diagrams revealed commonly used acupoint combinations such as Jinggu (BL64)-Kunlun (BL60)-Rangu (KI2) and Dadu (SP2)-Taibai (SP3)-Zhongwan (RN12). Complex network analysis identified core combinations including "Zhigou (SJ6)-Jianshi (PC5)-Shaochong (HT9)-Geshu (BL17)", "Taichong (LR3)-Neiguan (PC6)-Duyin (EX-LE11)", "Rangu (KI2)-Taixi (KI3)-Dadu (SP2)-Taibai (SP3)-Xingjian (LR2)-Jianli (RN11)-Shenmen (HT7)-Zhongwan (RN12)-Yongquan (KI1)", and "Kunlun (BL60)-Jinggu (BL64)". Conclusion: Ancient texts on acupuncture treatment for CHD frequently selected acupoints from Yin meridians, such as Juque (RN14), Qimen (LR14), Shangwan (RN13), Zhongwan (RN12), Rangu (KI2), and Shenmen (HT7). The selection principles aligned with the therapeutic aims of boosting Qi, activating Blood, reinforcing healthy Qi, and eliminating pathogens, emphasizing the use of five-shu points and crossing points.

Key words：coronary atherosclerotic heart disease; acupuncture and moxibustion; acupoint selection rules; ancient chinese medical texts; data mining

发布时间：2026-01-08

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