Study On The Correlation Between Meridians And Viscera Syndrome Differentiation Of Chloasm

Purpose:1.To systematically evaluate the clinical efficacy of acupuncture in the treatment of melasma,to provide a reliable evidence-based basis for the clinical application of acupuncture in the treatment of melasma,and to provide a reasonable scientific basis for the study of meridian identification and organ identification of melasma and their correlation.2.Through the identification and typing of meridians and viscera of melasma patients,the core symptoms and main symptoms of different meridians were analyzed and discussed to discover the pattern of clinical meridian identification,which provides scientific basis for improving the accuracy of clinical acupuncture therapy in identifying meridians and selecting acupuncture points,and at the same time,the patients were typed according to the theory of viscera identification,and then the correlation between viscera identification and meridian identification was discussed.Materials and methods:Paper I:Computer searches of Pub Med,Cochrane Library,Web of science,Embase,China Knowledge Network(CNKI),China Scientific Journal Database(VIP)and Wanfang database were conducted.Randomized controlled trials(RCTs)on acupuncture for melasma published from the establishment of the database to May 2021 were collected,and those meeting the inclusion criteria were extracted and evaluated for quality,and Meta-analysis was performed using Rev Man 5.3 statistical software.Paper II:Among the patients with melasma attending the outpatient clinic of the Department of Dermatology of the Affiliated Hospital of Liaoning University of Chinese Medicine,120 patients with melasma who met the inclusion criteria were selected,and their information such as age,menstrual history,disease duration,symptoms and signs were collected,and based on the collected information,the patients were identified by meridians and viscera,and a database was established,and statistical methods were used to analyze the study,to obtain the preliminary patterns of meridian identification and core symptoms of melasma,and to explore the correlation between the results of meridian identification and viscera identification.Results:Paper I:1.Literature search results: 15 RCTs were finally included,with a total of 1429 patients with melasma.2.Data analysis results: Meta-analysis results showed that:(1)The treatment group was better than the control group in terms of improving the overall effective rate(OR = 3.68,95%CI(2.65,5.11),Z=7.78,P<0.00001),melasma lesion area score [MD =-0.31,95% CI(-0.56,-0.05),Z=2.35,P=0.02],melasma lesion color scores [MD =-0.36,95% CI(-0.56,-0.07),Z=3.60,P=0.02] were better than those of the control group.(2)Adverse effects: only five studies mentioned adverse effects.Paper II:1.A total of 120 patients with melasma were included in this study,and according to the above-mentioned meridian identification and typing,35 cases of the stomach meridian type,39 cases of the kidney meridian type,20 cases of the bile meridian type,and 26 cases of the liver meridian type were investigated.Statistical analysis of the symptoms of each meridian of melasma showed that the core symptoms of the stomach meridian type were dry throat,stomach distension and fullness,and its main symptoms included stomach cold,diarrhea when eating cold,abdominal distension,belching,heart trouble,pain in shoulder,neck and back,sweating and bad wind;the core symptoms of the kidney meridian type were hot mouth,dry tongue and heart trouble,and its main symptoms included abdominal distension,mouth pain,pain in shoulder,neck and back,constipation,back pain and dizziness;the core symptoms of the bile meridian type were bitterness in the mouth,joyful The core symptoms of the bile meridian type are bitterness in the mouth,sighing,pain in the heart,chest and ribs,and easy to eat;the core symptoms of the liver meridian type are fullness in the chest and ribs and pain in the ribs,and the main symptoms include distress in the heart,pain in the back,dryness in the throat,pain in the shoulders,neck and back,heat in the mouth,dryness in the tongue,and loose stools.2.According to the above syndrome differentiation of zang-fu organs,the syndrome differentiation of liver stagnation and spleen deficiency in all samples was mainly liver stagnation and spleen deficiency.The results of correlation analysis showed that the patients with chloasma stomach meridian type were related to the syndrome of spleen deficiency and dampness accumulation,liver stagnation and spleen deficiency and spleen and kidney Yang deficiency.The kidney meridian type of chloasma is related to spleen and kidney Yang deficiency syndrome,liver stagnation and spleen deficiency syndrome,spleen deficiency dampness accumulation syndrome,liver and kidney Yin deficiency syndrome.The gallbladder type of chloasma is related to the damp-heat syndrome of liver and gallbladder and the syndrome of liver stagnation and qi stagnation.Liver meridian type of chloasma is related to liver stagnation and spleen deficiency syndrome,damp-heat syndrome of liver and gallbladder,liver stagnation and qi stagnation syndrome.Conclusion:Paper I: In this study,Meta-analysis of the RCT of acupuncture treatment for melasma proved that clinical acupuncture treatment is effective for melasma and superior to other therapies(western medicine,traditional Chinese medicine and physical therapy),indicating the effectiveness of acupuncture treatment for melasma and providing a reliable basis for the detailed study of meridian identification in the second part.Paper II:This study uses the theory of meridian identification and statistical method to analyze the core symptoms and main symptoms of each meridian represented by stomach meridian,kidney meridian,gall bladder meridian and liver meridian in clinical melasma,to explore the connection between meridian identification and internal organs identification,to provide theoretical support for guiding the treatment of meridian and internal organs identification in clinical melasma,and to provide scientific basis for improving the accuracy of meridian identification and point selection in clinical acupuncture treatment.It also provides scientific basis for improving the accuracy of meridian identification and selection of acupuncture points.