A Preliminary Study On The Law Of Acupoint Selection In The Treatment Of Type 2 Diabetes By Acupuncture Based On Complex Network Technology

Objective:By using China National Knowledge Infrastructure(CNKI),Wanfang(WanFang),China Biomedical Literature Database(CBMdisc),and Pubmed database to conduct literature search,the randomized controlled trial(RCT)clinical research on the use of acupuncture and moxibustion in the treatment of type 2 diabetes was obtained.Literature and experimental research literature.Data mining of acupuncture and moxibustion prescriptions used in the RCT literature was conducted to extract and summarize the core acupoints of modern Chinese medicine for the treatment of type 2 diabetes.Screening experimental research literature on core acupoints in acupoint prescriptions,and analyzing the mechanism of action and biological effectsMethods:In the database,the subject headings such as "acupuncture,acupuncture,electro-acupuncture" were used,and the subject headings such as "type 2 diabetes mellitus,diabetes mellitus,diabetes mellitus" were used in combination with diseases.The Chinese documents were obtained from CNKI,Wanfang(WanFang),China Biomedical Literature Database(CBMdisc),the English literature is mainly from Pubmed,and the clinical randomized controlled trial(RCT)of acupuncture in the treatment of type 2 diabetes mellitus has been obtained since the establishment of the database until December 31,2021.The research literature was screened according to the inclusion and exclusion criteria,the acupuncture prescriptions used in the screened literature were entered into Excel,a database of acupuncture and moxibustion treatment of type 2 diabetes prescriptions was established and standardized,and the standardized data files were imported into the ancient and modern medical record cloud platform for Data mining,through association rule analysis,cluster analysis,complex network analysis and other methods to explore the rules of acupoint selection and compatibility from multiple perspectives.Using "acupuncture,acupuncture,electroacupuncture"+"type 2 diabetes,diabetes,diabetes mellitus" "Type 2 Diabetes Mellitus"+"acupuncture,electroacupuncture,acupuncture therapy" as the subject and keywords to search for experimental research literature,and screened out The acupoint prescriptions include experimental research literature on core acupoints.The screened literatures are sorted by article number,title,author,source,year,research type,acupoint prescription(core acupoints),and target order.Enter Excel to establish prescription acupoint targets point database.Using the UniProt KB protein information library to query and compare,standardize the target name,screen human gene targets,and establish a standardized target gene library.The standardized target gene library data were imported into the Metascape database,and GO enrichment analysis and KEGG enrichment analysis were performed.The visual map of acupoint-target-pathway network was drawn using Cytoscape software.Results:A total of 55 RCT literatures were screened according to the criteria of intake and excretion,with a total of 69 prescriptions,involving 75 acupoints,including 4 extra-meridian acupoints(Weixiashu,Sishencong,Jinjin,Yuye),and 3 experience points(Upper rheumatic point,lower rheumatic point,gas side).The commonly used high-frequency acupoints for acupuncture treatment of type 2 diabetes are mainly Sanyinjiao,Zusanli,Pishu,Shenshu,Weiwanxiashu;the most frequently used meridians are the bladder meridian of Foot Taiyang,Stomach Meridian of Foot Yangming,and Ren meridian.,Foot Taiyin Spleen Meridian,Foot Shaoyin Kidney Meridian,etc.The results of acupoint compatibility correlation analysis showed that the strongly correlated acupoints screened with support ≥50%and confidence ≥80%were:Shenshu-Pishu,Sanyinjiao-Zusanli,Pishu-Sany injiao,Pishu-Zusanli,Shenshu Yu-Sanyinjiao.Cluster analysis was carried out on 15 main acupoints with acupoint selection frequency ≥10 times,and finally 4 groups of commonly used high-frequency acupoint combinations were obtained:the first group:Sanyinjiao,Zusanli;the second group:Weishu,Pishu,Shenshu,Weiwanxiashu,Feishu;the third group:Fenglong,Hegu,Quchi;the fourth group:Zhongwan,Guanyuan,Qihai,Tianshu.Through complex network analysis of acupoints prescribed for acupuncture treatment of type 2 diabetes mellitus,when K value=19,the K-core network of this study is obtained,including a total of 20 core acupoints:Shenshu,Pishu,Ganshu,Feishu,Weishu,Geshu,Sanjiaoshu,Guanyuan,Qihai,Zhongwan,Quchi,Hegu,Sanyinjiao,Xuehai,Zusanli,Taixi,Neiguan,Yanglingquan,Weiwanxiashu.They belong to the Bladder Meridian of Foot Taiyang,Ren Meridian,Large Intestine Meridian of Hand Yangming,Spleen Meridian of Foot Taiyin,Stomach Meridian of Foot Yangming,Kidney Meridian of Foot Shaoyin,Pericardial Meridian of Hand Jueyin,Gallbladder Meridian of Foot Shaoyang.A total of 41 experimental literatures that met the inclusion and exclusion criteria were searched and screened,involving 12 core K acupoints mentioned above.According to the frequency of use,they were:Zusanli,Weiwanxiashu,Sanyinjiao,Pishu,Shenshu,Xuehai,Hegu,Quchi,Zhongwan,Qihai,Feishu,Geshu.The main targets are:IRS-1,TNFA,GLUT4,IL-6,GLP-1R,Bcl-2,PDX-1,PI3K,AMPK,INS.In GO analysis,GO CC enrichment mainly concentrated in:transferase complex/transfer phosphorus-containing groups,mitochondrial outer membrane,neuronal cell body,intercellular junction,and cell edge;GO MF enrichment results showed that the molecular functions of target genes Main effects:phosphotransferase activity with alcohol group as receptor,cytokine receptor binding,cysteine endopeptidase activity involved in apoptosis process,insulin-like growth factor receptor binding,protein kinase binding;GO BP Mainly enriched in response to hormones,apoptosis signaling pathway,regulation of neuronal death,positive regulation of protein transport,and regulation of kinase activity.The KEGG enrichment results showed that target genes involved in signaling pathways were mainly enriched in non-alcoholic fatty liver disease,lipids and atherosclerosis,adipocytokine signaling pathways,neurodegeneration pathways in various diseases,and growth hormone synthesis.secretion and action.The study found that the quality of clinical research literature on acupuncture and moxibustion treatment of type 2 diabetes RCTs was mixed,and the quality of Chinese literature was generally lower than that of English literature.Although subject to the treatment of literature,the results of this part can basically reflect the acupoint selection and compatibility rules of acupuncture and moxibustion in the treatment of type 2 diabetes in modern Chinese medicine.And summed up the commonly used 20 core acupoints(including Shenshu,Pishu,Ganshu,Feishu,Weishu,Geshu,Sanjiaoshu,Guanyuan,Qihai,Zhongwan,Quchi,Hegu,Sanyinjiao,Xuehai.,Zusanli,Taixi,Neiguan,Yanglingquan,Weiwanxiayu).Conclusion:The biological effects and mechanism of action of the core acupoints were analyzed,and the results of GO enrichment were combined with the corresponding experimental results.It can promote the translocation of GLUT4,inhibit the phosphorylation of serine threonine,and promote insulin signaling.It can increase the proportion of Bcl-2 protein and down-regulate the proportion of bax protein,inhibit caspase activation,prevent cell apoptosis,and improve islet function.Combining the KEGG enrichment results with the GO biological process results,it was found that the combination of acupuncture and moxibustion core acupoints can improve insulin resistance in type 2 diabetes through multiple pathways,including improving insulin signaling,reducing islet β-cell apoptosis,and reducing inflammatory factors.,regulate lipid metabolism,etc.,and achieve through a variety of signaling pathways through different biological functions of different target genes.