脳卒中後疲労に対する鍼治療における経穴選択ルールの分析

To analyze the acupoint selection rules of acupuncture for treating post-stroke fatigue (PSF) and provide evidence and insights for clinical acupoint selection in PSF treatment.

Databases including China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), China Science Periodical Database (CSPD), Chinese Core Journal Database (CCD), PubMed, Embase, Web of Science, and Cochrane Library were searched for literature on acupuncture treatment of PSF from their inception to November 1, 2024. Eligible literature was screened strictly in accordance with the inclusion and exclusion criteria, and a database for acupuncture treatment of PSF was established. Excel 2021 was used to analyze the acupoints, meridian attribution, specific acupoints, and acupoint locations in the acupuncture prescriptions. IBM SPSS Modeler 18.0 was employed for association rule analysis, and IBM SPSS Statistics 26.0 for cluster analysis.

A total of 22 articles were included, involving 58 acupoints with a total usage frequency of 231 times. The top 5 acupoints by frequency were Sanyinjiao (SP6), Baihui (GV20), Zusanli (ST36), Neiguan (PC6), and Guanyuan (CV4) & Hegu (LI4, tied for the 5^th place). The top 4 meridians by usage frequency were the Bladder Meridian of Foot-Taiyang, Stomach Meridian of Foot-Yangming, Gallbladder Meridian of Foot-Shaoyang, and Governor Vessel. The commonly used specific acupoints included HE-sea points (of the five SHU points), lower HE-sea points, YUAN-source points, and LUO-connecting points. In terms of location, most acupoints were distributed in the lower limbs, head and face, upper limbs, and chest and abdomen. The core prescription consisted of SP6-ST36-GV20-PC6-LI4, and acupoints could be supplemented based on syndrome differentiation according to individual differences of patients. Intervention methods mainly included filiform needle acupuncture, electroacupuncture, and press tack needle.

The acupoint selection rules for acupuncture in treating PSF are consistent with the therapeutic principles of replenishing qi and blood and dredging meridians. However, the parameters of acupuncture for PSF are not unified at present;therefore, the scientificity and rigor of clinical design schemes related to acupuncture treatment of PSF still need to be improved.