Reticular Meta-analysis And Research On Acupoint Selection Rule Of Acupuncture And Moxibustion In The Treatment Of Dry Eye

Objective:Using the network Meta analysis method based on Bayesian theory,the efficacy and safety of acupuncture in the treatment of dry eye disease were evaluated,and the efficacy of various interventions was ranked according to the relevant results,providing the following evidencebased clinical practice The basis.At the same time,based on the Chinese Medicine Genetic Computing Platform(V3.0),it conducts data mining on related clinical studies,analyzes the acupoint selection method to treat dry eye disease,summarizes the core prescriptions,and provides guidance for optimizing prescriptions.Methods:Computer search of PubMed,Embase,Cochrane Library,Web of Science,CBM,CNKI,Wanfang and VIP databases,comprehensive collection of randomized controlled trials(RCT)on acupuncture and its combination therapy for dry eye disease,search time limit From the establishment of the database to November 25,2020.Two reviewers independently screened the literature,extracted data,and used the Risk of Bias Tool(RoB)recommended by the Cochrane Collaboration to evaluate the risk bias of the included studies.Using Stata 14.0 and R 4.0.3 software for data analysis,and drawing related Figure.Select acupuncture and moxibustion treatment of dry eye disease related clinical research,use the traditional Chinese medicine inheritance computing platform(V3.0)to conduct data mining on the acupoint prescriptions involved in the research,from acupoint frequency,acupoint meridian attribution,acupoint location,acupoint combination,acupoint clustering,etc.select the laws of acupuncture points on the treatment of dry eye disease research aspects.Results:A total of 71 studies involving 5536 dry eye disease patients were included in the network Meta-analysis,involving simple acupuncture,acupuncture+artificial tears,acupuncture +traditional Chinese medicine,acupuncture+traditional Chinese medicine+artificial tears,simple moxibustion,moxibustion+artificial tears,Moxibustion+traditional Chinese medicine+artificial tears,acupuncture+moxibustion,acupuncture+moxibustion+artificial tears,acupuncture+moxibustion+traditional Chinese medicine,artificial tears,a total of 11 interventions.Among them,58 articles reported the total effective rate,61 articles reported the BUT,62 articles reported the SIT and 6 articles reported the occurrence of adverse events.Network Meta analysis results show:in terms of total effective rate,simple acupuncture,acupuncture+artificial tears,acupuncture+traditional Chinese medicine,acupuncture+traditional Chinese medicine+artificial tears,moxibustion,moxibustion+traditional Chinese medicine+artificial tears,acupuncture+moxa Moxibustion,acupuncture+moxibustion+artificial tears are better than artificial tears;acupuncture+traditional Chinese medicine,acupuncture+traditional Chinese medicine+artificial tears are better than acupuncture;acupuncture+traditional Chinese medicine+artificial tears are better than acupuncture+artificial tears.Moxibustion+artificial tears have statistically significant differences in curative effect.The top 3 interventions in SUCRA are:acupuncture+traditional Chinese medicine+artificial tears(0.95),acupuncture+traditional Chinese medicine(0.70),simple moxibustion(0.64);in terms of tear film rupture time,simple acupuncture,acupuncture+Artificial tears,acupuncture+traditional Chinese medicine,acupuncture+traditional Chinese medicine+artificial tears,moxibustion,acupuncture+moxibustion is better than artificial tears;acupuncture+traditional Chinese medicine is better than acupuncture,the difference in efficacy is statistically significant.The top 3 interventions in SUCRA are:acupuncture+traditional Chinese medicine+artificial tears(0.79),acupuncture+traditional Chinese medicine(0.78),acupuncture+moxibustion+traditional Chinese medicine(0.69);in terms of tear secretion,simple acupuncture,Acupuncture+artificial tears,acupuncture+traditional Chinese medicine,acupuncture+traditional Chinese medicine+artificial tears,acupuncture+moxibustion is better than artificial tears;acupuncture+traditional Chinese medicine,acupuncture+traditional Chinese medicine+artificial tears are better than acupuncture,and there are statistical differences in efficacy Learn meaning.The top 3 interventions in SUCRA were:acupuncture+traditional Chinese medicine+artificial tears(0.92),acupuncture+traditional Chinese medicine(0.78),and simple moxibustion(0.6).2.In order to study the law of acupoint selection,a total of 118 clinical literatures were included,including 157 acupuncture prescriptions,involving 89 related acupoints.The frequency of acupoint application in descending order is BL2(129),BL 1(122),EX-HN5(92),SP6(85),LI4(82),ST2(83),GB20(71),SJ23(67),ST(56),ST36(52);the top five points for the number of meridians are:The Stomach Meridian of Foot-yangming(12),The Bladder Meridian of Foot-Taiyang(10),The Gallbladder Meridian of Foot-Shaoyang(7),Ren Vessel(7),The Spleen Meridian of Foot-Taiyin(6),;the frequency of use of acupuncture points in each part is from high to low;head and face 843 times,lower limbs 281 Times,147 times on upper limbs,61 times on waist and back,51 times on chest and abdomen;in terms of prescription rules,the core acupoint combination with confidence of 0.8 and support of 50%includes three acupoints:BL2,BL1,and EX-HN4,including four associations rule.The acupoint combinations with 30%support include 8 acupoints:BL2,BL1,EX-HN4,ST2,SJ23,LI4,SP6 and GB20.;4 basic acupoint selection combinations were obtained through cluster analysis.Conclusions:1.The combination of acupuncture and moxibustion therapy can increase the clinical benefit of dry eye disease compared to the single application of artificial tears.In which the curative effect of acupuncture combined Chinese medicine in the treatment of dry eye disease is better than the combination of traditional Chinese medicine acupuncture and moxibustion therapy,acupuncture combination therapy is better than that of acupuncture and moxibustion therapy alone,the best combination is triple therapy of acupuncture,traditional Chinese medicine(TCM),artificial tears.2.Acupuncture and moxibustion treatment of dry eye disease is mainly based on local acupoints on the head and face,and attention is paid to the application of Zusanyang meridian acupoints and meridian external odd acupoints.The commonly used points in clinical practice include BL2,BL1,EX-HN4,ST2,SJ23,LI4,SP6 and GB20.It is suggested to make reasonable selection according to the clinical situation and TCM syndrome differentiation.