Literature Research And Clinical Trials On Acupuncture Treatment Of Diarrhea-predominant Irritable Bowel Syndrome Based On Data Minin

Objective:To explore the core acupoint prescription and acupoint compatibility rules of acupuncture and moxibustion for IBS-D,the first study analyzed and summarized the relevant literature on IBS-D treated with acupuncture and moxibustion in the past 20 years on the basis of data mining methods and techniques.The second study was to observe the clinical efficacy of this acupoint prescription in the treatment of IBS-D patients and the degree of relief of the quality of life and mental state of the patients.A randomized controlled trial was conducted to combine the Tousanshen acupoint prop osed by Professor Yang Jiasan with the core acupoint prescription,so as to provide new ideas and evidence for the clinical treatment of IBS-D with acupuncture and moxibustion.Method:Chapter 1:This study used a computer to search 8 databases(Pubmed,Cochrane Central Regisrer of Controlled Trials(Central),Embase,Web of Science(SCI),China National Knowledge Internet(CNKI),Wanfang Database,China Science and Technology Jour nal Database(VIP)and China Biology Medicine disc(CBM))for randomized controlled trials of acupuncture and moxibustion in the treatment of diarrhea-predominant irritable bowel syndrome in the past 20 years.We entered the selected literature into the Microsoft Office Excel 2013 software worksheet in order according to the name,source,year of publication,diagnostic criteria,syndrome differentiation,acupoint prescription,in tervention techniques,etc.,and formed the acupuncture and moxibustion treatment IBSD database.In the first step,this study uses Excel 2013 software to analyze the frequency of TCM syndromes,diagnostic criteria,intervention methods,frequency of acupoints,meridians of acupoints,distribution characteristics,and acupoint attributes included in the literature.In the second step,this study uses IBM The Apriori algorithm in the SPSS Modeler 18.0 software was used to analyze the association rules of the high-frequency acupoints,meridians,and distribution characteristics in the acupoint prescriptions,as well as the acupoint prescriptions of each syndrome type;in the third step,this study used the intergroup analysis in the IBM SPSS Statistics 27.0 software.The link method was used to cluster the mathematical prescriptions;finally,this study used Gephi software to analyze the complex network and obtained the core acupoint prescriptions and common acupoint compatibility rules for acupuncture and moxibustion treatment of IBS-D.Chapter 2:In this study,the core acupoint prescriptions mined from the previous data were combined with the "Tousanshen" points proposed by Professor Yang Jiasan to determine the acupuncture treatment plan.This study adopted a randomized controlled clinical trial,and the subjects were all patients who visited the Department of Acupuncture and Moxibustion,Department of Spleen and Gastroenterology,or the inpatient depar tment of Dongfang Hospital of Beijing University of Traditional Chinese Medicine from December 2020 to December 2022.We followed the diagnostic criteria of IBS-D Seventy subjects were screened out and divided into the experimental group(acupuncture group)and the control group(lifestyle intervention group)by random number table method,with 35 cases in each group.During the course of treatment,3 subjects in the test group and 2 subjects in the control group dropped out,and finally 65 subjects who met the diagnostic criteria and inclusion criteria completed the test,including 32 subjects in the test group and 33 subjects in the control group.During the treatment process,the two groups of subjects were given health education and one-on-one nutrition consultation by the competent physician.Patients in the experimental group were treated with continuous acupuncture for 4 weeks(3 times/week,30min/time);patients in the control group were not acupunctured during the treatment period,but they were given free acupuncture treatment for 4 weeks after the treatment period and the followup period.The physician in charge evaluated the IBS Severity Scale Scale(IBS-SSS),average daily defecation times,and Bristol fecal traits classification scores before trea tment,at the end of treatment and at the end of follow-up;In addition,before and after treatment,the competent physician evaluated the IBS-QOL scores,self-rating anxiety scale(SAS),self-rating depression scale(SDS)and safety indicators of the two groups of subjects.Results:Chapter 1:1.A total of 242 papers were included in this literature study,including 197 journal papers and 45 dissertations;a total of 148 papers specified 11 types of evidence,and the most frequent type of evidence was liver-depression and spleen deficiency(69 tim es,46.00%of all evidence);19 diagnostic criteria were mentioned in all papers,and the most frequently used was Rome Ⅲ;the most frequent intervention techniques in the included literature The three categories were acupuncture(98 times)>moxibustion(74 times)>acupuncture point application(52 times);the top three acupuncture points and meridians used in order of frequency were:Tianshu(167 times,69.008%),Zusan li(153 times,63.223%),Shangjuxu(88 times,36.364%),Somach Meridian of Foot Y angming(434 times,34.31%),Ren Meridian(256 times,20.24%),and Bladder Meridi an of Foot Taiyang(211,16.68%);the top three acupoint site frequencies were:lower extremities(461,36.44%),chest and abdomen(457,36.13%),and back(220,17.39%).The top three specific points in order of frequency of distribution were:recruitment points(323,24.10%),five acupuncture points(292,21.79%),and lower healing points(249,18.58%).2.Association rule analysis of 77 valid acupoints prescriptions of acupoints used>10 times,the two,three and four acupoints with the highest correlation obtained are:Tianshu-Zusanli,Shangjuxu-Tianshu-Zusanli,Taichong-Shangjuxu-Tianshu-Zu sanli;and association analysis of acupoints to meridians,the two,three and four meridians with the highest correlation obtained are:Bladder Meridian of Foot Taiyang-Somach Meridian of Foot Yangming,and The highest correlations of the two,three,and four meridians were obtained as follows:Spleen Meridian of Foot Taiyin-Liver Meridian of Foot Jueyin-Stomach Meridian of Foot Yangming,and Du Meridian-Liver Meridian of Foot Jueyin-Stomach Meridian of Foot Yangming-Spleen Meridian of Foot Taiyin.The results showed that the four acupoints with the highest correlation were:Taichong-Shangjuxu-Tianshu-Zusan Li;the four acupoints with the highest correlation were:Guanyuan-Shenshu-Tianshu-Pishu;and the acupoints with the highest correlation were:Pishu-Zhongwan-Zusanli-Tianshu for the weakness of the spleen and stomach.3.Cluster analysis of the 18 acupoints that appeared>20 times in the 77 acupuncture prescriptions yielded 5 valid clusters:the first category was Baihui,Yintang,Taichong,Sanyinjiao,Shangjuxu,Tianshu,and Zusanli;the second category was Neiguan and Yinlingquan;the third category:Guanyuan,Qihai,and Zhongwan;the fourth category:Pishu,Shenshu,Ganshu,Weishu,and Dachangshu;and the fifth category:Shenque.The results of complex network analysis of acupoints showed that the top 12 important acupoints in descending order of degree value were:Tianshu,Zusanli,Zhongwan,Taichong,Guangyuan,Qihai,Pishu,Shangjuxu,Sanyinjiao,Neiguan,Yinlingquan,and Zhangmen.The final core acupoint prescriptions were determined based on acupoint frequency,correlation analysis,cluster analysis,and complex network analysis:Tianshu,Zusanli,Shangjiuxu and Taichong.Chapter 2:1.The differences in general data(age,sex,height,weight,duration of disease),IBS-SSS scale scores,number of bowel movements per day,Bristol stool properties classification scores,IBS-QOL scale scores,SAS and SDS self-assessment scale scores between the two groups of subjects before treatment were not statistically significant(P>0.05),and the data of the two groups were comparable.2.IBS-SSS scale scores:After treatment,the differences were statistically significant when comparing the two groups within and between groups(P<0.05)After the end of follow-up,the differences were statistically significant when comparing the test group with itself before treatment(P<0.05),and compared with the control group;and after treatment and after the end of follow-up,the differences were statistically significant when comparing the test group with itself in terms of improvement in the degree of a bdominal pain and bloating,frequency of abdominal pain,bowel movement The differ ences were statistically significant(P<0.05)in terms of improvement in abdominal pain and bloating,frequency of abdominal pain,bowel movement,and quality of life;compared with the control group,the differences were statistically significant(P<0.05),except for the differences in improving the frequency of abdominal pain,which were not statistically significant(P>0.05).3.Number of bowel movements and patted stool traits:At the end of treatment and at the end of follow-up,the differences in the daily number of bowel movements and patted stool trait scores were statistically significant(P<0.05)when comparing the treatment group before and after itself,and the differences in the patted stool trait scores were statistically significant(P<0.05)when comparing the control group with itself at the same time point;in the control group,the differences in both indicators were statistically significant when comparing the control group with itself at the end of treatment(P<0.05),but the difference was not statistically significant when compared with itself before treatment after follow-up(P>0.05).4.IBS-QOL scale scores:At the end of treatment,the difference in total IBS-QOL scores was statistically significant between the two groups compared with themselves before treatment,but the difference was not statistically significant compared between the two groups(P>0.05),indicating that both groups were able to effectively improve pat ients’ quality of life;and after analyzing the eight dimensions of this scale,it was found that at the end of treatment,the differences between the two groups in mood,behavior,somatic awareness,health Worry and interpersonal relationship scores were statis tically significant(P<0.05)compared to themselves;and the difference in improving mood disorder scores was found to be statistically significant(P<0.05)in the test group compared to the control group at the end of treatment.5.SAS and SDS scale scores:At the end of treatment,the differences in SAS and SDS were statistically different in the treatment group compared with themselves before treatment(P<0.05);in the control group compared with themselves,the differences were not statistically significant(P>0.05).Conclusion:1.The most commonly used acupuncture points are Tianshu,Shu Sanli,Shang Ju Xu,and Tai Chong.2.The combination of acupuncture points(Tianshu,Shangjuxu,Zusanli,Taichong,She nting,Benshen,Sishencong)for the treatment of IBS-D can effectively improve abdominal pain,bloating and bowel traits,improve patients’ quality of life,and have significant advantages in relieving patients’ anxiety,depression and other psychosomatic symptoms.