[1]张亮,刘桐序,付昕怡,等.基于数据挖掘技术探讨针刀治疗膝骨关节炎的施术规律[J].中医正骨,2026,38(07):19-22.
　ZHANG Liang,LIU Tongxu,FU Xinyi,et al.Exploring the operational rules of acupotomy for knee osteoarthritis based on data mining technology[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2026,38(07):19-22.
点击复制

基于数据挖掘技术探讨针刀治疗膝骨关节炎的施术规律()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第38卷
期数:
2026年07期
页码:
19-22
栏目:
文献研究
出版日期:
2026-07-20

文章信息/Info

Title:
Exploring the operational rules of acupotomy for knee osteoarthritis based on data mining technology
作者:
张亮1; 刘桐序1; 付昕怡1; 姜恩周2; 梁朝1; 闫立1; 秦伟凯1
1.中国中医科学院望京医院,北京 100102; 2.贵州中医药大学第二附属医院,贵州 贵阳 550003
Author(s):
ZHANG Liang1; LIU Tongxu1; FU Xinyi1; JIANG Enzhou2; LIANG Chao1; YAN Li1; QIN Weikai1
1.Wangjing Hospital of CACMS,Beijing 100102,China; 2.The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550003,Guizhou,China
关键词:
骨关节炎; 膝;  针刀疗法;  数据挖掘;  施术规律;  频繁项集;  聚类分析
Keywords:
osteoarthritis; knee;  acupotomy therapy;  data mining;  operational regularity;  frequent itemsets;  cluster analysis
摘要:
目的:探讨针刀治疗膝骨关节炎(knee osteoarthritis,KOA)的施术规律。方法:应用计算机检索中国知网、维普网、万方数据库、PubMed、Embase、Cochrane Library中关于针刀治疗KOA的临床研究,检索时限均为2014年12月1日至2024年12月31日。2名研究人员分别独立进行文献筛选、数据提取和规范处理。统计施术解剖点、施术手法、联合疗法的使用频次和使用频率,采用SPSS19.0软件对施术解剖点进行聚类分析,采用SPSS Modeler18.0软件对施术手法进行频繁项集分析。结果:共检索到1 685篇文献,通过逐层筛选最终纳入217篇文献。涉及施术解剖点23个,累计使用频次677。施术解剖点按照使用频次由高到低排序位于前5位的依次是膝关节外侧副韧带、膝关节内侧副韧带、髌下脂肪垫、髌韧带、髌内侧支持带。最优聚类结果为2个施术解剖点组合,组合1包括膝关节外侧副韧带和内侧副韧带; 组合2包括髌下脂肪垫、髌韧带、髌内侧支持带、髌外侧支持带、鹅足囊。涉及针刀施术手法5种,累计使用频次582。施术手法按照使用频次由高到低排序依次为纵行疏通剥离法、横行剥离法、十字切开法、通透剥离法、铲磨削平法。施术手法频繁项集按照置信度由高到低排序位于前5位的依次为纵行疏通剥离法-横行剥离法、纵行疏通剥离法-横行剥离法-十字切开法、横行剥离法-十字切开法、纵行疏通剥离法-通透剥离法、十字切开法-铲磨削平法。针刀联合治疗文献86篇,涉及联合疗法5种,按照使用频次由高到低排序依次为针刺、推拿疗法、运动疗法、中药外治、中药内服。结论:针刀闭合松解术治疗KOA,以膝关节内外侧副韧带为核心施术解剖点,以纵行疏通剥离法和横行剥离法联合使用为核心施术手法,以针刺、推拿疗法为主要联合疗法。
Abstract:
Objective:To investigate the operational rules of acupotomy in the treatment of knee osteoarthritis(KOA).Methods:All the clinical study articles on acupotomy for KOA included from December 1,2014 to December 31,2024 were retrieved from the China National Knowledge Infrastructure,Vip Database,Wanfang Database,PubMed,Embase,and Cochrane Library through computer.The pertinent articles were screened,the information was extracted and normalized independently by two researchers.The usage frequency and percentage of anatomical sites,manipulation techniques,and combined therapies in the included articles were calculated,then the cluster analysis was performed on the anatomical sites using SPSS 19.0 software,and the frequent itemset analysis on the manipulation techniques was conducted using SPSS Modeler18.0 software.Results:A total of 1 685 articles were identified,and 217 ones were included in the final analysis after stepwise screening,involving 23 anatomical sites and 5 manipulation techniques,with the cumulative usage frequency of 677 and 582,respectively.The top five anatomical sites were ranked by the usage frequency in a descending order as follows:the lateral collateral ligament of the knee joint,medial collateral ligament of the knee joint,infrapatellar fat pad,patellar ligament,and medial patellar retinaculum.The optimal clustering resulted in two anatomical site combinations:combination 1 included the lateral and medial collateral ligaments of the knee joint; combination 2 comprised the infrapatellar fat pad,patellar ligament,medial and lateral patellar retinacula,and pes anserine bursa.The five manipulation techniques were ranked by the usage frequency in a descending order as follows:the longitudinal unblocking and stripping method,transverse stripping method,cross-shaped incision method,cut-through stripping method,and scraping-grinding and leveling method.The top five frequent itemsets for manipulation techniques were ranked by the confidence in a descending order were longitudinal unblocking and stripping method-transverse stripping method,longitudinal unblocking and stripping method-transverse stripping method-cross-shaped incision method,transverse stripping method-cross-shaped incision method,longitudinal unblocking and stripping method-cut-through stripping method,and cross-shaped incision method-scraping-grinding and leveling method.The acupotomy combined therapies were reported in 86 articles,involving five types,ranked by usage frequency from highest to lowest were acupuncture,Tui Na therapy,exercise therapy,external Chinese herbal medicine,and oral Chinese herbal medicine.Conclusion:Acupotomy closed release targets the medial and lateral collateral ligaments of the knee joint as the core anatomical sites,employs the combination of longitudinal unblocking and stripping method with transverse stripping method as the core manipulation techniques,and adopts acupuncture and Tui Na therapy as the primary combination therapies in the treatment of KOA.

参考文献/References:

[1] 中国中西医结合学会骨伤科专业委员会.膝骨关节炎中西医结合诊疗指南[J].中华医学杂志,2018,98(45):3653-3658.
[2] ZOU Z,LUO X,CHEN Z,et al.Emerging microfluidics-en-abled platforms for osteoarthritis management:from benchtop to bedside[J].Theranostics,2022,12(2):891-909.
[3] 邵欣欣,李鑫茹,潘丽婕,等.基于Piezo1/p38MAPK/ERK5力敏感通路探讨针刀干预膝关节骨关节炎兔膝关节软骨退化的作用机制[J].中国针灸,2026,46(1):75-84.
[4] 唐永秀,陈明,唐忠银,等.针刀技术联合富血小板血浆技术治疗膝骨关节炎的作用机制及对修复功能的影响[J].针灸临床杂志,2022,38(6):30-34.
[5] 柏树令.系统解剖学[M].5版.北京:人民卫生出版社,2001:21-25.
[6] 庞继光.针刀医学基础与临床骨关节疾病分册[M].北京:人民卫生出版社,2019:51-56.
[7] VINCENT T L,ALLISTON T,KAPOOR M,et al.Osteoarthritis pathophysiology:therapeutic target discovery may require a multifaceted approach[J].Clin Geriatr Med,2022,38(2):193-219.
[8] 张全,吴立友,翁建峰,等.MTrPs针刀精准干预对KOA患者疼痛程度及关节功能影响的临床观察[J].中国中医药科技,2026,33(2):178-181.
[9] 曾振明,陆嘉欣,潘兆丰,等.超声引导针刀松解膝结筋病灶对膝骨关节炎的临床研究[J].针灸临床杂志,2026,42(2):42-48.
[10] 尹侃,夏晟宁,王玥.基于经筋理论肌骨超声引导下针刀治疗膝骨关节炎疗效及相关机制初步探讨[J].针灸临床杂志,2025,41(10):32-38.
[11] 修忠标,张春霞,刘洪,等.针刀治疗膝骨性关节炎临床观察及机制探讨[J].辽宁中医药大学学报,2018,20(1):15-18.
[12] 唐占英,肖静,李唯薇,等.针刀松解联合Mulligan手法治疗中期膝骨关节炎临床观察[J].世界中医药,2024,19(1):47-51.
[13] 王黄栋,王华禹,杨礼跃,等.针刀松解激痛点联合经筋推拿治疗膝关节骨关节炎:随机对照试验[J].针刺研究,2025,50(7):822-828.
[14] 张雨晴,夏敏,侯逸敏,等.针刀松解合阳内调控中重度膝骨关节炎患者膝周肌电信号的临床研究[J].针灸临床杂志,2025,41(10):23-31.
[15] 张雨晴,侯逸敏,夏敏,等.针刀松解合阳内调控膝周肌力改善KOA患者膝关节功能的研究[J].世界科学技术-中医药现代化,2024,26(12):3180-3186.
[16] 赵汉卿,尚祥,孟德鸿,等.基于生物力学特性超声引导下针刀联合针刺治疗膝骨关节炎临床观察[J].中医药临床杂志,2025,37(5):987-993.
[17] 唐昊,曾庆云,孙刚毅.针刀联合推拿治疗膝骨关节炎临床疗效的Meta分析[J].云南中医中药杂志,2022,43(2):61-67.
[18] 梁杰,张炘武,蔡芷珊,等.基于经筋理论的针刀联合康复训练治疗膝关节骨性关节炎临床研究[J].实用中西医结合临床,2026,26(9):5-8.
[19] 王庆,冯文昌,庄迪,等.消瘀散贴膏联合针刀治疗膝骨关节炎的疗效及对炎症因子的影响[J].辽宁中医杂志,2020,47(10):155-159.

相似文献/References:

[1]樊庆阳,任凯晶.定制3D打印切模辅助全膝关节置换术治疗 膝骨关节炎合并股骨干骨折畸形愈合[J].中医正骨,2015,27(11):37.
[2]刘晓雅,孙永强,刘国杰.主动快速康复锻炼对全膝关节置换术后关节活动度的影响[J].中医正骨,2015,27(09):73.
[3]郑春松,叶蕻芝,李西海,等.透骨消痛胶囊中补肾柔肝药和活血祛风药治疗 骨关节炎作用方式的计算机模拟比较[J].中医正骨,2015,27(07):6.
　ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Comparison of the mode of action of Bushen Rougan(补肾柔肝)drugs versus Huoxue Qufeng(活血祛风)drugs contained in Tougu Xiaotong Jiaonang(透骨消痛胶囊)for the treatment of osteoarthritis:A computer simulation study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):6.
[4]宋兵华,孙俊英,倪增良,等.全膝关节置换术前CT测量股骨后髁角的临床意义[J].中医正骨,2015,27(07):38.
[5]郑春松,叶蕻芝,李西海,等.独活寄生汤含药血清对白细胞介素1β诱导的 退变关节软骨细胞中基质金属蛋白酶 和环氧化酶2表达的影响[J].中医正骨,2015,27(12):1.
　ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Impact of Duhuo Jisheng Tang(独活寄生汤)medicated serum on expression of matrix metalloproteinase and cyclooxygenase 2 in degenerative articular chondrocytes induced by interleukin-1 beta[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):1.
[6]王金良,孙京涛,李玲,等.骨水泥联合螺钉修复全膝关节置换术中 胫骨平台内侧骨缺损[J].中医正骨,2015,27(12):55.
[7]冯荣,王平,李炳奇,等.铍针刺络拔罐结合中药口服治疗膝骨关节炎合并 原发性血小板增多症1例[J].中医正骨,2015,27(12):73.
[8]蔡云仙.围手术期耳穴按压联合平衡针疗法 在全膝关节置换术后镇痛中的应用[J].中医正骨,2015,27(06):41.
[9]张荣,王健.人工全膝关节置换术的围手术期心理护理[J].中医正骨,2015,27(05):77.
[10]喻长纯,杨明路,王战朝.不同手术方式治疗胫骨平台骨折畸形愈合的体会[J].中医正骨,2015,27(03):37.
[11]孟维娜,明立功,王新德,等.关节镜下清理联合腓骨近1/3段截骨治疗膝骨关节炎[J].中医正骨,2015,27(11):40.
[12]明立功,孟维娜,王新德,等.腓骨近端截骨治疗内侧间室膝骨关节炎的近期疗效观察[J].中医正骨,2015,27(10):25.
[13]张杰,王人彦,张玉柱.膝骨关节炎的治疗进展[J].中医正骨,2015,27(10):68.
[14]梁朝,蔡静怡,闫立,等.针刀疗法改善膝骨关节炎早期疼痛症状的疗效评价[J].中医正骨,2015,27(09):9.
　LIANG Zhao,CAI Jingyi,YAN Li,et al.Evaluation of the curative effect of needle-knife therapy for relieving knee pain in patients with early knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):9.
[15]王建武,党建军,李强,等.四联疗法治疗膝骨关节炎[J].中医正骨,2015,27(08):44.
[16]刘红娟,郭会利,郭树农.云克联合中药治疗膝骨关节炎的护理[J].中医正骨,2015,27(08):75.
[17]陈卫衡.探索建立系统的膝骨关节炎中医临床科研范式 和理论体系[J].中医正骨,2015,27(07):1.
[18]帅波,沈霖,杨艳萍,等.加味青娥丸治疗膝骨关节炎的作用机制研究[J].中医正骨,2015,27(07):15.
　SHUAI Bo,SHEN Lin,YANG Yanping,et al.Study on the mechanism of action of Jiawei Qing'e Wan(加味青娥丸)for the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):15.
[19]梅其杰,袁长深,段戡,等.壮药骨痹方烫熨联合运动疗法治疗膝骨关节炎的临床研究[J].中医正骨,2015,27(07):27.
　MEI Qijie,YUAN Changshen,DUAN Kan,et al.Clinical study of the curative effect of hot compressing and rubbing with packet of Gubi Fang(骨痹方)combined with exercise therapy in the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):27.
[20]王丹辉,张燕,刘丽娟,等.重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白 关节腔注射联合中药薰洗治疗膝骨关节炎的临床研究[J].中医正骨,2015,27(07):31.
　WANG Danhui,ZHANG Yan,LIU Lijuan,et al.Clinical study on intra-articular injection of TypeⅡrecombinant human tumor necrosis factor receptor-Fc fusion protein combined with Chinese herbal steaming and washing therapy for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):31.

备注/Memo

备注/Memo:
通信作者:秦伟凯 E-mail:qinvkai@163.com
(收稿日期:2025-11-30 本文编辑:吕宁)
更新日期/Last Update: 2026-07-20