Network Meta-analysis Of The Syndrome Types And Syndrome Factors Of Essential Tremor (tremor Syndrome) And TCM Intervention Measure

Research objective: The study consisted of two parts: firstly,the statistical methods such as frequency analysis were used to study the TCM symptom typing and distribution characteristics of idiopathic tremor,which provided a theoretical basis for the identification of TCM evidence of the disease;secondly,the effectiveness of various TCM interventions in the treatment of idiopathic tremor was evaluated by Meta-analysis,and finally,the best TCM interventions were selected based on the reticulated Meta-analysis method and provided a clinical evidence-based reference.Data and Methods:⑴Chinese medical literature involving the identification and typing of idiopathic tremor from 2001 to 2022 was searched through CNKI,VIP and Wanfang databases.The full text was read and the evidence types and frequencies were extracted from them,and the results were recorded in an EXCEL database.The evidence patterns were standardized according to the "Evidence Element Identification",and decomposed into pathological position evidence elements and pathological evidence elements according to the splitting principle in the evidence element identification system,and their distribution patterns were calculated.⑵The database was searched for all published literature on the treatment of idiopathic tremor based on nourishing water and connoting wood and pacifying the liver and calming the wind within the last 20 years.Inclusion and exclusion criteria were established to screen the literature for different TCM interventions for idiopathic tremor in randomized controlled trials(RCTs).The quality of studies in the literature was assessed with reference to the Jadad scale.Meta-analysis was performed using Review Manager 5.4 software and mesh Meta-analysis was performed by ADDIS software.Results:⑴A total of 1,456 cases in 57 relevant papers were included.After normalization,there were 29 types of evidence,and the common types of evidence were liver and kidney yin deficiency and internal movement of liver and wind;5pathological evidence elements were extracted,and the common pathological evidence elements were liver and kidney;12 pathological evidence elements,and the ones with higher frequency were yin deficiency and movement of wind.⑵A total of18 studies were included in the literature,containing 8 TCM interventions.The included studies all referred to randomized groups,9 literature used random number table method and 1 used blinded method.Results of meta-analysis: TCM interventions can improve the efficiency of relieving tremor symptoms;reduce tremor scores;and mitigate the incidence of adverse effects.Results of mesh meta-analysis: The results showed that herbal soup + acupuncture + tui na was the most effective treatment plan.Regarding the incidence of adverse reactions,the incidence of adverse reactions was lowest for acupuncture point embedding + head acupuncture + electroacupuncture.Conclusion:⑴With the help of the evidence element discriminatory analysis,the2 pathogenic and 2 pathogenic evidence elements covered most of the TCM discriminatory information of the disease.This indicates that as long as the pathogenic and pathogenic elements in the current disease lesion can be accurately identified,the key to identification can be recognized,providing new ideas for understanding the disease and guiding clinical treatment.⑵TCM interventions improve the efficiency of medical treatment of idiopathic tremor and the incidence of adverse effects;herbal soup + acupuncture + tui na was the best treatment option,and acupuncture point embedding + head acupuncture + electroacupuncture had the lowest incidence of adverse effects.Because of the poor quality of the included primary literature,the results should be interpreted with caution.