| ObjectiveNowadays,with the development of modern society,the pace of life is rapid and the pressure of life is increasing,which is more important for peri-menopausal women to bear both physical and psychological pressure.Therefore,it is particularly important to explore effective and safe methods for the treatment of peri-menopausal depression.At present,the disease is mainly treated by estrogen replacement therapy,sequential therapy of estrogen and progesterone and the choice of antidepressants,which can achieve obvious curative effect in a short time,but the clinic is often limited by the tolerance,side effects and potential carcinogenicity of these drugs.Traditional Chinese medicine treatment happens to make up for such defects and is favored by many clinical doctors.In particular,the research on acupuncture and moxibustion on PDD is gradually increasing,which has attracted great attention from the medical circles at home and abroad because of its obvious curative effect and little side effects.At present,there is not much literature research on the acupoint selection and application rules of acupuncture and moxibustion in the treatment of PDD,most of which start with acupuncture in the treatment of primary depression and post-stroke depression.There is still some research space on the acupoint selection and application rules of acupuncture and moxibustion in the treatment of PDD,and the research method of data mining can be further improved.The purpose of this study is to summarize and explore the specific application and hidden rules of acupuncture and moxibustion in the treatment of PDD through the input,arrangement and analysis of several literature databases,such as the combination of acupoints or meridians commonly used in acupuncture treatment of PDD,specific acupoints and the relationship between acupoints selection,etc.,and explore the relationship among syndrome types,secondary symptoms and acupoints of acupuncture and moxibustion in the treatment of PDD.And then the overall analysis of acupuncture treatment of PDD treatment ideas and concepts,in order to further expand its clinical application to give objective data support,summed up the clinical acupuncture treatment of PDD meridians and acupoints selection ideas,for its clinical treatment plays a certain guiding significance.MethodsThrough searching and sorting out the literatures related to acupuncture treatment PDD from 1988 to now in China Journal full-text Database(CNKI),Wanfang data knowledge Service platform(WF),VIP Journal full-text Database(VIP),Pubmed and other databases,the types include RCT test,clinical efficacy observation,famous doctor experience and case reports,and the treatment and acupoint selection have achieved definite results.Build a database,including:basic information of literature,diagnosis of traditional Chinese and western medicine,syndrome types,symptoms,tongue and pulse,acupuncture prescriptions,treatment methods,acupoints meridian,location,specific acupoints and other information.Standardize the data and unify the names of acupoints with the same name,such as "Juegu" as "Xuanzhong","Renzhong " as "Shuigou" and so on.The specific steps are as follows:(1)using SPSS Statistics 25.0 software to analyze the general information,syndrome type,symptoms,acupuncture prescription,treatment method,acupoint meridian tropism.specific acupoints of the patients with PDD,in order to understand the general situation of the included literature and grasp the overall situation of acupuncture and moxibustion treatment of patients with Acupuncture and moxibustion.(2)using SPSS Statistics 25.0 software to make a simple correspondence analysis of the relationship between syndrome types and meridian tropism in all the literatures of acupuncture and moxibustion treatment of PDD.so as to provide a certain reference value for clinical syndrome differentiation and selection of acupoints.(3)the acupoints selected in all the literatures were clustered and analyzed by SPSS Statistics 25.0 software,and the clustering tree diagram was generated,and the grouping of acupuncture acupoints was observed.(4)using SPSS Modeler 18.0 software to analyze the association rules of acupuncture acupoints,by setting the parameters such as confidence and credibility,to observe the correlation between acupoints.(5)the syndrome types,secondary symptoms and acupoint selection of PDD patients in the collected literature were analyzed by using Gephi 0.9.2 software,and the complex network was constructed by ForceAtlas 2 layout algorithm to form the regularity table of acupuncture treatment PDD acupoint selection.ResultsIn this study,a total of 197 articles on acupuncture-related therapy of PDD were collected,including 117 articles from China Journal full-text database(CNKI),43 articles from Wanfang data knowledge service platform(WF),22 articles from Pubmed database.15 articles from VIP Chinese journal service platform(VIP).The types of literatures are divided into three categories:121articles of RCT trial,8 clinical records and 1 famous doctor’s experience.The year range of them is from 1988 to 2020.and the proportion of literature in the past decade is larger than that in the previous decade,showing an increasing trend as a whole.According to the frequency statistics,there are many kinds of acupuncture treatment methods for PDD,among which there are 11 single treatment methods,including acupuncture,electroacupuncture,auricular pressure,moxibustion,scraping,etc.,and 15 combined treatment methods,including acupuncture+traditional Chinese medicine,acupuncture+moxibustion,acupuncture+western medicine,electroacupuncture+traditional Chinese medicine,water acupuncture+acupuncture,etc.,among which acupuncture,acupuncture+traditional Chinese medicine and electroacupuncture are the most frequently used.There are 16 TCM syndrome types,including syndrome of liver depression and qi stagnation,liver-kidney yin deficiency syndrome,syndrome of kidney deficiency and liver depression,spleen-kidney yang deficiency pattern,etc.A total of 47 symptoms are described,including insomnia and dreaminess,depression and anxiety,hypochondriac pain,hot sweating,anorexia,irritability,chest tightness and chest pain,etc.There are 96 acupoints,including 85 main acupoints and 47 matching acupoints;the total frequency of acupoints is 1048,including 906 main acupoints and 142 matching acupoints.The main acupoints are Sanyinjiao,Baihui,Shenshu,Taichong,Neiguan,Ganshu,Xinshu,Guanyuan,Shenmen,Zusanli,Sishencong,Hegu,Yintang,etc.,and the matching acupoints from high to low are Shenmen,Taichong,Fenglong,Zusanli,Pishu,Luzhong,Xingjian,Daling,Neiguan,etc.According to the statistics of the specific acupoints and meridian tropism of all acupoints,the specific point are in the order of source point,stream point,transport point,alarm point and confluence points of the eight vessels according to the frequency from high to low.Meridian meridians from high to low are bladder meridian,governor vessel,conception vessel,spleen meridian,ear point,extra point,stomach meridian,liver meridian and so on.From the simple correspondence analysis,it is concluded that the relationship between syndrome type and meridian tropism of acupuncture and moxibustion treatment of PDD are as follows:syndrome of heart-liver fire depression,syndrome of loss of nourishment of heart and spirit-heart meridian,liver meridian and pericardial meridian;syndrome of internal disturbance of phlegm-heat,syndrome of liver depression of phlegm-heat,syndrome of stagnation of phlegm-qi-gallbladder meridian,stomach meridian;syndrome of yin deficiency with fire effulgence-ear point;using cluster analysis,the main acupoints of acupuncture and moxibustion for PDD are classified into five categories:C1:①liver.spleen,sympathetic,heart,endocrine,kidney;②Zhaohai,Yongquan,Fenglong,Zhongwan;③uterus,Tianshu;C2:Feishu,Geshu,Pishu;C3:Qihai,Zhongji;C4:Shenting,Benshen;C5:Xinshu,Ganshu,Shenshu.By using the association rules,it is found that the commonly used main acupoint pairs are:①Back-Shu point pair:Ganshu-Shenshu-Pishu-Xinshu;②Tiaoshen point pair:Benshen-Shenting,Benshen-Sishencong,Yintang-Baihui:③Taixi-Sanyinjiao;④Hegu and Taichong.By using complex network analysis,the syndrome types,secondary symptoms and acupoint selection of acupuncture and moxibustion treatment of PDD were divided into several groups:insomnia,dreaminess-Zhaohai,Shenmai,hypnotic point,mental dysphoria syndrome-Shenting,Shaohai,night sweating-Yinxi,hypochondriac pain-Danzhong,Qimen,Waiguan,irritability-liver,heart deficiency and timidity syndrome-liver and kidney,gallbladder Shu,chest tightness and chest pain-Daling,Shenmen.Heart-kidney syndrome-palpitation,mouth dryness-Xinshu,Shenshu,subcortical,constipation-Zhigou,heart-liver fire depression syndrome-tinnitus,irritability and easy to cry-Taichong,Taiyuan,Neiguan,liver depression fire syndrome-Xingjian,Xiaxi,Zuqiaoyin,five heart upset heat-Laogong.Yongquan,abdominal distension-Tianshu,spleen,syndrome of dual deficiency of the heart and spleen,spleen-kidney yang deficiency syndrome-weakness,anorexia,cold limbs,less qi lazy speech-Zusanli,Sanyinjiao.Guanyuan,Pishu,Liver depression and phlegm-heat syndrome,phlegm-heat internal disturbance syndrome-stomachache-Zhongwan,Fenglong,Yinlingquan,Yanglingquan,blood stagnation syndrome-skin itching-Geshu,Quchi,Xuehai,dizziness-Fengchi,Sishen Cong,liver-kidney yin deficiency syndrome-Ligou,Taixi.ConclusionWith the help of data mining technology,this study explored the clinical acupoint selection and application rules of acupuncture and moxibustion in the treatment of peri-menopausal depression,and obtained the following conclusions:(1)there are many kinds of acupuncture and moxibustion therapy for PDD,and the curative effect of combined therapy is more significant than that of single therapy.(2)the two internal organs of liver and kidney are closely related to the pathogenesis and progression of PDD,so in the selection of acupoints,attention should be paid to the nourishment of kidney water,supplemented by the method of soothing the liver and relieving depression.Represented by three groups of acupoints:Zhaohai and Yongquan,Taixi and Sanyinjiao,Hegu and Taichong.(3)in the process of acupuncture and moxibustion treatment of patients with PDD.we should also pay attention to the recuperation of Rendu Ermai point,recuperate Ren pulse and protect vitality,dredge Du pulse and regulate the mind.The acupoints of Tiaoshen are represented by Ben Shen and Shen Ting,Ben Shen and Si Shen Cong,Yintang and Baihui.(4)the disease development of PDD is often accompanied by the production of phlegm-damp qi.Acupuncture treatment should pay attention to invigorating the spleen and strengthening the stomach,resolving phlegm and regulate the mind,and select more acupoints on the stomach meridian of foot Yangming,represented by Fenglong and Zhongwan.(5)many results of data mining show the importance of back-Shu point in acupuncture treatment of PDD.By stimulating back-Shu point,we can regulate and promote the operation of Five Zang-Organs’ qi,so as to improve the function of viscera and mental symptoms in patients with PDD.Through many results of data mining,it shows the importance of source point and transport point in acupuncture treatment of PDD.Through the stimulation of source point and transport point,it can regulate Zang-fu essence and promote the operation of five Zang-organs qi,so as to improve the function of Zang-fu organs and improve mental symptoms in patients with PDD.(6)the choice of acupoints for acupuncture and moxibustion treatment of PDD can be achieved through the grasp of syndrome types and corresponding symptoms,so as to achieve syndrome differentiation and treatment,select acupoints according to symptoms,alleviate all kinds of secondary symptoms as far as possible,and improve patients’ quality of life and sense of self-comfort. |
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