| Background:Lumbar disc herniation is an all-encompassing symptom with radicular pain in the waist and hip and lower extremities or numbness as the primary presentation.Acupuncture is a common clinical disease in the lives of patients with elderly.Most choose conservative therapy among which,acupuncture therapy is one of the most commonly used methods.In this setting,is it effective in the treatment of lumbar disc herniation with acupuncture ? If proven to be effective,what are the high-frequency acupoints selected for different types of TCM syndrome in the clinical management of lumbar disc herniation? Both of these questions are of great research interest.Objective:1.Compare the efficacy and side effects of acupuncture alone and western medicine in the treatment of lumbar disc herniation through systematic evaluation and Meta-analysis,and evaluate the safety and effectiveness of acupuncture in the treatment of lumbar disc herniation;2.Which uses data mining technology to explore the frequency and consistency of acupuncture and moxibustion in the treatment of lumbar disc herniations with different types of TCMs,in order to provide an objective basis for clinical treatment of lumbar disc herniation using acupuncture.Method:The search of the Chinese and English literature databases revealed that the Chinese database took "lumbar disc herniation" and "acupuncture" as the topic words,and the scope of the database included CNKI,Wanfang Medical and Weipu Medical Chinese databases,the English database,"acupuncture" and "lumbar disc herniation" are the theme words,and the database scope includes Pubmed,Medline,Cochrane Library English database.The search period spanned almost 20 years,from January 2002 through December 2022.1.We will retrieve collation from the literature for nearly 20 years of acupuncture for lumbar disc herniations.Based on the inclusion and exclusion criteria of the literature,the required papers were eliminated,the information required for the study was extracted,and the data were then subjected to Meta-analysis by Revman5.4 software.2.Inducing and cleaning up almost 20 years of acupuncture treatment literature on lumbar disc herniation,a summary of acupoint prescriptions in the literature that met the inclusion criteria was presented according to different categories(1Wind cold and dampness type 2damp heat phlegm resistance type 3qi stagnation and blood stasis type4 liver and kidney deficiency type)of TCM.In order to calculate the frequency of acupoints used in the clinical treatment of each type of syndrome.The Apriori correlation analysis was carried out on the most frequent acupoints with the software SPSS Modeler 18.0.Frequently used acupoints were routinely clustered using the SPSS 26.0 software package.1.Results:1.The results of the Meta-based analysis of the clinical effectiveness of acupuncture treatment compared to western medicine treatment of lumbar disc herniation showed that in the comparison of the acupuncture group and the western medicine group,P <0.05,the difference is statistically significant.This finding has shown acupuncture to be effective in the treatment of lumbar disc herniation.A meta-analysis of adverse events in the treatment between the acupuncture group and the western medicine group found that in the overall adverse events,there was a statistically significant difference of P <0.05 between the acupuncture group and the western medicine group.This finding showed that the safety of acupuncture in the treatment of lumbar disc herniation was superior to that of medicine in the West.1.When analyzing the data on the frequency of acupuncture for the treatment of lumbar disc herniation,1In 104 articles,the "principal acupoint" was mentioned,the top 7 of the major acupoints were Weizhong(79),Huantiao(65),Yanglingquan(62),Yaojiaji(60),Shenshu(53),Ashixue(47),and Dachangshu(47).Yaoyangguan(67),Mingmen(31),and Yinlingquan(29)were among the top three most frequently used items in 117 items involving the dialectical "wind,cold,and wet bi type".In the 37 papers involving the dialectical "wet and moist type of phlegm resistance",yinlingquan(22),Sanyinjiao(15),and Quchi(5)were among the top three in terms of the frequency of acupoint usage.In133 articles involving the dialectical "qi stagnation and blood stasis type",geshu(73),Weizhong(46)and Xue Hai(36)were among the top three in terms of the frequency of acupoint use.The top three frequencies of acupoint use in 100 papers involving the dialectical "type of liver and kidney impairment" were those of Taixi(51),Shenyu(44)and Mingmen(37).The eight most important acupoints(main acupoint + acupoint)are Weizhong(154),Shenshu(140),Huantiao(120),Yanglingquan(115),Yaojiaji(108),Yaoyangguan(105),Dachangshu(88),and Ashixue(82),among others.2Acupoint-meridian in the correlation analysis: Across the 180 included publications,the prescription of acupuncture for lumbar disc herniation acupuncture involved 14 canals and collaterals,and the 4 upper canals and collaterals were as follows: The bladder canal of Foot-Taiyang(850),The gall bladder channel of Foot-Shaoyang(361),The Du channel(236),The spleen channel of Foot-Taiyin(138).3Acupoint-specific point correlation analysis: In the statistics of frequency use of all specific points,Wushuxue(566),Xiahexue(319),Beishuxue(246),Bahuixue(239),Yuanxue(109),Bamaijiaohuixue(37),Muxue(19),Luoxue(18).4Acupoint-body part correlation analysis: lower extremities are most commonly used(986),the lumbar spine is the second(827),the head and neck(54)are the same as the upper extremities(54),and the thorax and abdomen(27)are the least affected.5Through cluster analysis,we obtained two types of acupoints.In the first category,Zhibian,Kunlun,Chengshan,Xuanzhong,Huantiao,Yanglingquan,Weizhong,Zusanli,Yaojiaji are mostly "palliative" in nature;the second category is Yinlingquan,Sanyinjiao,Taixi,Xuehai,Shenshu,Dachangshu,Yaoyangguan,Mingmen,Geshu,A Shi Xue,which are primarily concerned with "filling in the deficiency and reducing the excess".6 With respect to the support,the top three in the strength of the correlation are Weizhong-Shenshu,Huantiao-Shenshu,Huantiao-Weizhong.2.Conclusion:1.In clinical treatment evaluation: acupuncture on lumbar disc herniation has obvious efficacy and high safety.2.In the analysis of acupoint selection for acupuncture therapy:(1)In the treatment of lumbar disc herniation,the treatment of acupuncture in the main selection of Weizhong,Huantiao,Yanglingquan,Yaojiaji,Shenshu,Ashuxue,Dachangshu patients;Based on this,depending on different TCM syndrome type add acupoint,cold and wet bi type of wind with Yaoyangguan,Mingmen and Yinlingquan;warm and moist type of sputum block with Yinlingquan,Sanyinjiao,and Qu chi;Qi stagnation and blood stasis types with Geshu,Weizhong and Xuehai;liver and kidney deficiency types with Taixi,Shenshu and Mingmen.(2)To pay attention to the therapeutic effect of Yang-Meridian acupuncture in lumbar disc herniations,and the vesical canal of Foot-Taiyang is most marked;(3)The use of a specific acupoint in the treatment of lumbar disc herniation can not be overlooked;(4)In treatment,greater attention should be paid to "the meridian crossings,the main treatment,and the scope," and local selection and distal collection should be combined to enhance clinical effectiveness.(5)In clinical treatment,according to the patient’s condition,"filling deficiency and reducing excess" and "treating symptoms" are combined to achieve the purpose of treating symptoms and root causes.(6)The therapeutic effect of highly correlated acupoints should be emphasized. |
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