【目的】 探讨针灸治疗全膝关节置换术后疼痛的选穴规律。【方法】 计算机检索中国期刊全文数据库（CNKI）、万方数据 知识服务平台（Wanfang）、维普中文科技期刊数据库（VIP）、中国生物医学数据库（CBM）、美国生物医学信息检索系统 （PubMed）、国际循证医学图书馆（Cochrane Library）等各大数据库中有关针灸治疗全膝关节置换术后疼痛的文献。检索时间 为各数据库自建库以来至2024年11月。采用Microsoft Excel 2024 软件建立数据库，统计腧穴、归经、部位、治法的频次以 及治法-选穴关系，并应用 SPSS Modeler 18.0 软件中的 Apriori 算法进行关联规则分析；应用 SPSS Statistics 27.0 软件对高频 腧穴实现层次聚类分析并绘制树状图；应用Gephi 0.10.1软件进行k-core复杂网络分析并可视化。【结果】 共纳入254篇文献， 提取处方305条，包含腧穴163个，总频次达1 424次。总使用频次前5位的腧穴为足三里、阳陵泉、血海、梁丘、阴陵泉； 腧穴归经以胃经、脾经、胆经以及膀胱经为主，下肢部以及耳部腧穴占比较高；足三里-阳陵泉、足三里-梁丘、血海-梁丘 以及足三里-阳陵泉-血海为高频腧穴配伍。全方共涉及13个核心腧穴。前29位高频腧穴可分为4个有效聚类群。耳穴压豆 最常选用的穴位为耳神门、皮质下、膝、交感、肾；电针最常选用的穴位为足三里、阳陵泉、血海、阴陵泉、梁丘；普通 针刺最常选用的穴位为阳陵泉、血海、梁丘、足三里、阴陵泉；推拿最常选用的穴位为足三里、三阴交、阳陵泉、阴陵泉、 承山；灸法最常选用的穴位为足三里、梁丘、犊鼻、三阴交、膝眼；经皮穴位电刺激最常选用的穴位为血海、足三里、阴 陵泉、梁丘、阳陵泉。【结论】 针灸治疗TKA术后疼痛主要在于调和气血，遵循局部选穴、循经选穴原则，核心处方包括血 海、梁丘、阴陵泉、阳陵泉、足三里、三阴交，治法主要涉及普通针刺、电针、推拿、灸法以及经皮穴位电刺激。

Objective To explore the acupoint selection patterns in acupuncture and moxibustion for treating pain after total knee arthroplasty （TKA）. Methods Computerized searches were conducted in databases including China National Knowledge Infrastructure （CNKI），Wanfang Data Knowledge Service Platform，VIP Chinese Sci-Tech Journal Database， China Biology Medicine disc （CBM）， PubMed， and Cochrane Library for literature on acupuncture and moxibustion treatment for post-TKA pain. The search period spanned from the inception of each database to November 2024. A database was established using Microsoft Excel 2024 to statistically analyze the frequency of acupoints，meridiantropism，locations，treatment methods，and the relationship between treatment methods and acupoint selection. Association rule analysis was performed using the Apriori algorithm in SPSS Modeler 18.0. Hierarchical cluster analysis of high-frequency acupoints was conducted using SPSS Statistics 27.0， and a dendrogram was generated. k-core complex network analysis and visualization were performed using Gephi 0.10.1. Results A total of 254 articles were included，yielding 305 prescriptions involving 163 acupoints with a total frequency of 1 424 occurrences. The top five acupoints by total usage frequency were Zusanli（ST36）， Yanglingquan （GB34）， Xuehai （SP10）， Liangqiu （ST34）， and Yinlingquan （SP9）. Acupoints primarily belonged to the stomach meridian，spleen meridian，gallbladder meridian，and bladder meridian，with a high proportion located in the lower limbs and ear. High-frequency acupoint combinations included ZusanliYanglingquan， Zusanli-Liangqiu， Xuehai-Liangqiu， and Zusanli-Yanglingquan-Xuehai. The complete set of prescriptions involved 13 core acupoints. The top 29 high-frequency acupoints could be divided into four effective clusters. The most commonly selected auricular points for auricular plaster therapy were Shenmen， subcortex， knee， sympathetic， and kidney. The most frequently used acupoints for electroacupuncture were Zusanli， Yanglingquan，Xuehai，Yinlingquan，and Liangqiu. For conventional acupuncture，the most common acupoints were Yanglingquan，Xuehai，Liangqiu，Zusanli，and Yinlingquan. The primary acupoints for tuina therapy were Zusanli，Sanyinjiao，Yanglingquan，Yinlingquan，and Chengshan（BL57）. For moxibustion，the most selected acupoints were Zusanli，Liangqiu，Dubi （ST35），Sanyinjiao，and Xiyan（EX-LE5）. The predominant acupoints for transcutaneous electrical acupoint stimulation were Xuehai， Zusanli， Yinlingquan， Liangqiu， and Yanglingquan. Conclusion Acupuncture and moxibustion for post-TKA pain primarily aim to regulate qi and blood， following the principles of local acupoint selection and meridian-based selection. The core prescription includes Xuehai， Liangqiu， Yinlingquan， Yanglingquan， Zusanli， and Sanyinjiao. The main treatment methods involve conventional acupuncture， electroacupuncture， tuina， moxibustion， and transcutaneous electrical acupoint stimulation.

R246.9

国家自然科学基金资助项目（编号：82374484）