Study On The Clinical Effect Of Extracorporeal Shock Wave Acupoint Shock Therapy On Hemiplegic Shoulder Pain Based On Acupoint Prescription Mining

Objective:The data mining technology is used to mine the acupoint prescription and acupoint selection rules,and based on this,the clinical effect of extracorporeal shock wave acupoint shock therapy on hemiplegic shoulder pain(HSP)is discussed.Methods:1.Search CNKI,Wan Fang,VIP,Sino Med,Pub Med,Embase,Cochrane,Web of Science to collect the clinical literature on the treatment of hemiplegic shoulder pain by acupuncture and moxibustion combined with rehabilitation published from the establishment of the database to December 1,2021,and establish the acupoint prescription database.Then,using Excel 2019 to descriptive analyze the frequency,meridian,specific acupoints and distribution position,using SPSS Modeler 18.0Apriori algorithm to analyze the association rules of acupoints and draw complex network diagram,using SPSS 25.0 clustering analysis was carried out on the acupuncture point.2.Fifty-four patients with HSP were randomly divided into control group(n=18),extracorporeal shock wave pain point treatment group(n=18)and extracorporeal shock wave acupoint treatment group(n=18).All the patients received basic therapy and routine rehabilitation therapy.The patients in the treatment group received conventional Extracorporeal shock wave therapy(ESWT)on the basis of the control group,the extracorporeal shock wave acupoint treatment group received extracorporeal shock wave acupoint shock treatment on the basis of the extracorporeal shock wave acupoint treatment group.ESWT was given twice a week for two weeks,four times in total.The visual analogue scale(VAS),shoulder flexion,abduction,external rotation pain-free passive joint range of motion(PROM)and upper fugl-meyer motor function assessment(U-FMA)score before treatment,after treatment and follow-up(two weeks after course of treatment)were assessed.Results:1.Data mining results: Totally 101 articles were included,106 acupoint prescriptions were extracted,involving 82 acupoints,with a total frequency of 870 times.The most highly supported acupoint combinations were Jianyu + Quchi and Jianyu + Hegu + Quchi,which focused on the upper extremity and hand-sanyang meridians,the Hand Yangming large intestine meridian have the most selected points;five Shu points in the point,eight-vessel intersection point for the most use of specific points.2.After treatment and during follow-up,the VAS scores of three groups were lower than before(P < 0.05);pain-free PROM of flexion,abduction and external rotation and U-FMA scores were higher than before(P < 0.05).After treatment,the VAS scores of observation group A and observation group B were lower than control group(P<0.05);and painfree PROM of flexion in observation group A and pain-free PROM of flexion and abduction in observation group B were higher than control group(P<0.05).During follow-up,the VAS scores of observation group A and observation group B were lower than control group(P<0.05),and the VAS scores of observation group B were lower than observation group A(P<0.05);pain-free PROM of flexion and abduction in observation group A and observation group B were higher than control group(P<0.05),pain-free PROM of flexion,abduction and external rotation in observation group B was higher than observation group A(P < 0.05);the U-FMA scores in observation group A and observation group B was higher than control group(P<0.05).Conclusion:1.The main therapeutic principle of acupuncture and moxibustion combined with rehabilitation for HSP is to promoting qi and blood circulation,unblocking collaterals and relieving pain;the most core acupoints are the shoulder,Quchi,and Hegu acupoints;the main method of acupoint selection is to differentiate and select acupoints and local acupoint selection based on the condition of the lesion;“treating impotence by taking yangming alone” and “the channels pass by and the main points reach” are the important thoughts of selecting acupoints;and the selection of specific acupoints has received sufficient attention.2.Both traditional ESWT and extracorporeal shock wave acupoint shock therapy can effectively improve pain,PROM and upper limb motor function in patients with HSP,extracorporeal shock wave acupoint shock therapy is more effective than traditional ESWT in the treatment of HSP,and it is worth popularizing in clinic.