膝骨性关节炎患者下肢结筋病灶点关联规则与聚类分析研究

发布时间：2018-06-12 10:47

本文选题：经筋 + 结筋病灶点　；参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:采用数据挖掘方法分析膝骨性关节炎(KOA)患者下肢筋结点的分布规律和相互联系,初步验证下肢结筋病灶点分布的循经筋特异性,初步探索局部与远端筋结点之间的解剖关系,为经筋针刺治疗KOA临床选点提供理论依据。材料与方法:对122例KOA患者单侧下肢进行筋结点触诊检查,重点检查并记录患肢膝乆部的鹤顶次、髌下、髌内下、髌外下、髌外、髌内、胫骨外髁、胫骨内髁、足三里次、成骨次、成腓间、阳陵次、腓骨小头、毼毼次、膝关次、阴陵上、浮郄次、委中次、委阳次、阴谷次等局部筋结点触发情况,以及髋臀部的承扶次、髂后上棘、环跳次,髋部的中空次、髀枢、健胯次,腹股沟处的气冲次、阴廉次、中空次、五枢次,踝部的解溪次、昆仑次、女膝次、公孙上、照海次等远端筋结点触发情况。采用Microsoft Excel软件对触诊数据进行处理,并导入SPSS Clementine 12.0软件进行数据挖掘处理,分析患者下肢筋结点的频次和频率,采用Apriori算法分析膝(乆)部周围筋结点触诊结果的关联规则,膝(乆)部周围与远端筋结点触诊结果的关联规则;并采用两步聚类算法分析下肢筋结点触诊结果的聚类分组情况。结果:1.局部筋结点出现频次和频率由高到低依次为足阳明经筋筋结点、足太阳经筋筋结点、足少阳经筋筋结点和足三阴经筋筋结点,远端筋结点出现频次和频率由高到低依次为足阳明经筋筋结点、足少阳经筋筋结点、足太阳经筋筋结点和足三阴经筋筋结点。2.关联规则Apriori算法在最小支持度10%,最小置信度80%,提升大于1时确定膝(乆)部周围两点间筋结点出现频率关联规则14条,具有较大关联的有髌内下和鹤顶次(支持度52.46%,置信度87.50%)、委阳次和阴谷次(支持度37.70%,置信度86.96%)、髌内下和髌外下(支持度52.46%,置信度85.94%)、髌内下和髌内(支持度71.31%,置信度85.06%)、委阳次与委中次(支持度58.20%,置信度84.51%)等。在最小支持度15%,最小置信度85%,提升大于1时,确定膝(乆)部周围3筋结点之间关联规则45条,在最小支持度20%,最小置信度90%,提升大于1时,确定4个及以上筋结点关联规则39条。3.关联规则Apriori算法在最小支持度10%,最小置信度60%,提升大于1时确定膝(乆)部周围与臀、髋、腹股沟等部位2个筋结点之间关联规则22条,置信度由高到低分别有承扶次和委中次(支持度58.2%,置信度81.69%)髂后上棘和委中次(支持度58.2%,置信度78.87%)承扶次和阴谷次(支持度37.7%,置信度76.09%)承扶次和委阳次(支持度63.93%,置信度74.36%)髂后上棘和委阳次(支持度63.93%,置信度74.36%)等。在最小支持度10%,最小置信度80%,提升大于1时,确定三点内关联规则21条,在最小支持度15%,最小置信度90%,提升大于1时,确定4个及以上筋结点关联规则40条。4关联规则Apriori算法在最小支持度5%,最小置信度55%,提升大于1时确定膝(乆)部周围与踝关节部位2个筋结点之间关联规则9条,置信度由高到低分别有公孙上和足三里次(支持度44.26%,置信度85.19%)女膝次和阴谷次(支持度37.7%,置信度78.26%)解溪次和髌下(支持度50%,置信度68.85%)解溪次和鹤顶次(支持度52.46%,置信度60.94%)女膝次和委阳次(支持度63.93%,置信度60.26%)等。在最小支持度10%,最小置信度80%,提升大于1时,确定三点内关联规则28条,在最小支持度20%,最小置信度85%,提升大于1时,确定4个及以上筋结点关联规则41条。5采用两步聚类分析将下肢筋结点出现情况在没有先验知识的前提下分为了3组,各种筋结点所属经筋分布差异具有统计学意义(p0.05)。结论:1.KOA患者下肢筋结点出现的关联规则与经筋循行之间存在较强的联系。2.KOA患者下肢筋结点出现的关联规则与筋结点局部肌肉、韧带等软组织解剖结构存在相关性。3.KOA患者下肢筋结点的聚类情况具有经筋分布的特异性。
[Abstract]:Objective: to analyze the distribution and correlation of the lower limb tendons in patients with knee osteoarthritis (KOA) by data mining, and to preliminarily verify the meridian specificity of the distribution of the lesions of the lower extremities and preliminarily explore the anatomical relationship between the local and the distal tendons, and provide a theoretical basis for the clinical selection of KOA. Method: 122 cases of KOA patients with unilateral lower limb muscle touch examination, focus on the examination and record of the leg of the limb of the crane top, patellar, patellar, patellar, patellar, outside patellar, patellar, the tibial condyle, the tibial condyle, the three times of the bone, the fibula, Yang mausoleum, knee, Yin mausoleum, floating cleft times, Yin mausoleum, Yin mausoleum, Yin The triggering of the local gluten nodes of the valley, the buttocks and buttocks, the back of the iliac upper spine, the ring jump, the hip, the hip, the hip, the groin, the inferior, the hollow, the five pivot, the ankle, the Kunlun times, the grand sun, and the other distal tendons, are triggered by the Microsoft Excel software. The palpation data were processed, and the SPSS Clementine 12 software was introduced to data mining to analyze the frequency and frequency of the patients' lower limb tendon nodes. The association rules of the contact results of the tendon of the knee and the distal tendon nodes around the knee were analyzed by Apriori algorithm, and the two step clustering was used to calculate the association rules of the contact results between the knee and the distal tendon. Results: 1. the clustering and grouping of the results of palpation of the joints of the lower limbs were analyzed. Results: the frequency and frequency of the nodes of the local tendons from high to low were the joints of the foot Yang Ming meridian, the joints of the sun meridian tendons, the joints of the foot Shaoyang meridian and the foot of the foot of the foot of three yin meridians, and the frequency and frequency of the distal tendons from the high to the low in the order of the foot Yang Ming meridian. Tendons node, foot Shaoyang meridian node, foot sun tendons node and foot three yin meridian node.2. association rule Apriori algorithm in the minimum support 10%, the minimum confidence 80%, when the elevation is more than 1 to determine the two points of the knee between the two points of the knee joint frequency association rule 14, with a larger correlation of the patellar and crane top (52 support degree) .46%, confidence level 87.50%), committee Yang and Yin Valley Times (support 37.70%, confidence 86.96%), inferior patellar and outside of patellar (support 52.46%, confidence 85.94%), internal and internal patellar (71.31%, confidence 85.06%) in the patellar and patellar (support degree 58.20%, confidence 84.51%), and the minimum support degree 15%, minimum confidence 85%, promotion greater than 1. To determine the 45 association rules between the 3 tendon nodes around the knee, with the minimum support 20%, the minimum confidence 90% and the increase greater than 1, the Apriori algorithm of 39.3. association rules for the association rules of the 4 and above reinforcement nodes is determined by the minimum support 10%, the minimum confidence 60%, and the promotion of the hip, hip, groin and other parts around the knee. 22 association rules between the nodes of the tendon and the confidence degree from high to low, including bearing and supporting and central secondary (support 58.2%, confidence level 81.69%) of the posterior iliac spine and the central secondary (support 58.2%, confidence 78.87%) bearing support and Yin Valley (support degree 37.7%, confidence 76.09%) bearing and support times (support degree 63.93%, confidence 74.36%) and the posterior upper iliac spine (support degree 63.93%, confidence degree 74.36%) and the posterior upper iliac spine, respectively. When the minimum support degree (63.93%, confidence 74.36%), and so on. When the minimum support degree 10%, the minimum confidence 80%, and the lifting greater than 1, the association rule 21 in three points is determined. When the minimum support degree is 15%, the minimum confidence 90% is 90%, and the lifting is greater than 1, the Apriori algorithm of the association rule of the association rule of the.4 is minimum support 5% and minimum. The reliability is 55%, and when the elevation is greater than 1, a rule of 9 association rules between the knee and the ankle joints is determined. The confidence degree is from high to low, with high to low (support 44.26%, confidence 85.19%) in the knee and Yin Valley (support 37.7%, confidence 78.26%) and under patellar (support 50%, confidence 68.85%). Times and crane top times (support degree 52.46%, confidence 60.94%) female knee and committee Yang times (support degree 63.93%, confidence 60.26%), etc.. When minimum support 10%, minimum confidence 80%, and higher than 1, determine the Association Rule 28 in three, minimum support 20%, minimum confidence 85%, increase greater than 1, determine 4 and above association rule 41 association rules 41 A two step cluster analysis was used to divide the appearance of the tendons of the lower extremities into 3 groups without prior knowledge, and the differences in the distribution of the tendons of all kinds of tendons were statistically significant (P0.05). Conclusion: there is a strong association between the association rules of the appearance of the lower limb tendons in 1.KOA patients and the association between the meridians and the tendons of the.2.KOA patients. There is a correlation between the association rules and the local muscle, ligaments and other soft tissue structures of the tendons. The clustering of the lower limbs of the.3.KOA patients has the specificity of the tendons distribution.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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