| ObjectiveIn recent years,more and more patients have eye disease,according to the latest statistics from WHO,about 314 million people worldwide suffer from visual impairment due to eye disease.Among 45 million blind people in China,10 million blind people in china.Eye disease can damage people’ s vision and seriously affect the physical and mental health and quality of people’s life.In 2009 WHO made blinding eye disease as the third damage and affect the quality of life of human diseases which is after tumor,cardiovascular disease.Therefore,the treatment of eye disease has become an urgent problem for some medicine.It is difficult to Modern medicine to find a affecitive treatment for the refractory eye diseases,such as optic nerve,retina.While acupuncture has received a certain curative effect in clinic and attracts more and more attention of the clinicians in nation and abroad.But how to apply to acupuncture to improve the clinical curative effect of eye,especially for refractory ocular fundus disease which blindness rate is high,how to effectively improve the visual function to improve the quality of life of patients,is necessary to do the further research.Ancient physicians for acupuncture treatment of eye diseases has accumulated rich experience,provides an important guidance to the future development of clinical ophthalmology of tcm.Unfortunately,there are few studies on the ancient literature of acupuncture treatment of eye disease.On the other hand,the Chinese ancient medical literatures also exist some problems:①.The names of oculopathy is not standardized.For example,some oculopathys should have had one name but have many names,while many different eye diseases have one name of oculopathy.That makes the situation mass and easily to cause confusion;②The contents of treatment to eye diseases in acupuncture are scattered and not systematic.Some content is replicated from the fomal medicians works generation by generation;③Same oculopathys have different acupuncture therapy treatments but are lack of systemic summarize,which leads to;④The acupuncture records for some ophthalmopathy disease etiology description is not detailed enough which leads to contradiction of the treatments.For example,same symptom like eyes can’ t see with pains,it recorded with moxibustion in book "Treasure Way of Improving Eyesight",while in other medicine is considered as "eye pain all belongs to the heat caused by the irritation of gas with the fire" and should take blooding way to spill out the fire heat.If you do not do the further study and identify it,it will easily to cause confusion and miTaiYangderstanding.⑤Although the ancient physicians has been summed up a lot of good points for oculopathy,but the theories for the acupuncture and moxibustion,blooding,plaster,acupuncture points selecting and combination are less.It is not clear that which Chinese medicine theory is applied and the acupuncture dialectical ideasf is not clear.⑥ The current research on ancient literature of treatments to oculopathy is less.These problems is disadvantaged to inheritate the ancient medical experices of treating oculopathys in acupunture objiectively and completely.Therefore,TCM theory of acupuncture in eye disease treatments is worth of in-depth studying.Studying the ancient medical acupuncture treatment of eye fundus diseases especially in the treatment of traditional Chinese medicine theory and clinical application of combination of the characteristics and rules of eye acupuncture treatment combined with the past literature,find relevant results has guiding value for the clinical,helps to guide the modern clinical acupuncture the diagnosis and treatment of ocular fundus diseases,improve the clinical efficacy of acupuncture in the treatment of ocular fundus diseases.Because the scope of the oculopathy is too large,this study only aims at the ocular fundus disease.Review and summary of the ancient and modern literature of ocular fundus diseases in acupuncture,in order to obtain the ancient and modern acupuncture treatments of ocular fundus diseases,charactors of acupoints choose,prescription rules.According to compare with two periods medical methods,analysis their similarities and differences in acupuncture,to provide a better reference for improving clinical efficacy of acupuncture in the treatment of ocular fundus diseases with the basic theory of traditional Chinese medicine.Methods1 retrieval strategies(1)Part of the ancient literature①The part of ancient literature retrieval:"Chinese medical classics" Fifth Edition includes ancient literature database of ancient acupuncture treatment of eye diseases.②Retrieval methods:the combination of computer retrieval and manual retrieval.③Key words:t the names of diseases(symptoms)in ancient books reference to "Chinese Dictionary","Chinese TCM terminology integration-Chinese Literature".Key words includes:ocular connectors,night blindness,glaucoma,optic sudden blindness,ShiZhan,distorted vision,dark eyes.as the eye not hyperopia is unknown,and a visual content is two times,see one as two,such as the present unknown keyword retrieval.(2)the part of modern literature①The search scope:Chinese Technology Journal Full-text Database(VIP),China Journal Full-text Database(CNKI,CNKI,Dissertations Database),Wanfang Data Resource System(digital periodical database,database of degree papers,conference papers database),from 1979 to December 2015,published nearly 36 years of clinical research on acupuncture and moxibustion fundus disease literature.②Retrieval methods:the combination of computer retrieval and manual retrieval.③Key words:a variety of diseases of the ocular fundus disease"name + acupuncture"," acupuncture","acupuncture medicine","Chinese medicine","traditional Chinese medicine and Western medicine" ect.as the key words.2 The establishment of database and data specification(1)part of the ancient literature①Establishment of databaseThis database of this study is built with Access Software by two professional inputters.It shoud comform to the standards of Inclusion criteria and exclusion standard does not include provisions.according to sources,the original,eye disease(disease),acupoint name,specific acupoints of meridian points,classification,treatment of a total of 7 entry,establishment of database.②.The standardization of dataSearch results for "Chinese medical classics".If there is the archaic word appears blank vacant,I should combine with manual retrieval of paper version of the original book to check one by one with hands.The name of the points reference standard "acupoint acupuncture and moxibustion hole international standard manual" and " Chinese acupoints dictions";disease(disease)reference to "Chinese dictionary".Before statistics and analysis,the data should be standardized,so that the influence of various factors on the analysis of the data can be excluded.③ Classification of dataThe original name of disease according to disease classification,such as glaucoma,night blindness,blindness,ocular fundus disease no standard disease name refer to the "dictionary of Chinese medicine".According to the symptoms described as the most similar eye symptoms,such as "the county","bird blind" and "blind chicken" to "night blindness";other description of blurred vision in the name,such as"faint eyes" and "dark eyes"," hyperopia weak "ect.For the special eye literature more provisions,separate classification studies,such as "ShiChan"," hyperopia weak" and "blind".(2)the part of modern literature①Establishment of databaseUsing Access database entry standards in line with the study of literature,according to western medicine eye disease classification,and record the following indicators according to each eye disease:Literature title and first author,literature sources,literature published time,methods of treatment,acupuncture acupoint,acupoint injection,auricular acupoint selection consists of 7 parts,the establishment of the database.The database adopts the literature title and first author of "field name as the primary key,repeat entry can greatly reduce the literature,and by professionals with literature manuscript contents repeatedly check to avoid duplicate entry.②The data on the point name specification:normative reference"acupuncture","acupuncture and moxibustion hole international standard manual" and "mirror" China acupoints.③Classification of the data:according to the classification of diseases of the eye diseases of the eye diseases of Western medicine,the modern literature in the name of traditional Chinese medicine is classified according to the western medicine in the literature.3 data statistics:(1)part of the ancient literature① Because most of the ancient literature retrieval data recorded single point for treatment,association rules analysis credibility is low,so a single eye disease only do statistical research on the frequency,frequency and selection of acupoint acupuncture meridians.This study uses the statistics of the meridians corresponding acupoints through the meridians to,with a selection of acupoints frequency,also shows that the corresponding meridian selection frequency,to be together.Correlation analysis of the whole fundus disease to do the whole sequence association rules analysis,in order to explore the ancient acupuncture treatment of ocular fundus disease associated with a high degree of combination of acupuncture points.②The whole fundus disease to do the whole sequence association rule analysis,using Sequence algorithm,and the parameter setting minimum support degree is 30%,the minimum confidence is 40%.(2)the part of modern literatureAccording to statistics:eye disease classification,respectively for each acupuncture prescription of fundus diseases do acupoint and meridian frequency statistics,association rules analysis of single eye points,using Apriori algorithm,a minimum support of 20%,minimum confidence 80%.All of the modern fundus disease do sequence correlation analysis,using Sequence algorithm,the minimum support degree is set to 30%,the minimum set reliability is set to 40%.Modern literature of eye diseases whose number is less than 8 only for point frequency statistics,do not do the analysis of association rules.4 Statistical software:Analysis of association rules are taken with Spss Modeler 15.0.of Windows7.Research results1.Part of ancient literatureThis study involves a total of 39 acupuncture books.the ancient literature in line with the inclusion and exclusion criteria of a total of 1092 provisions of the literature,acupuncture points a total of 2458,a total of 146 points,the average of 16.8 times per point,(1)The overall situations of ocular fundus diseases treated with acupuncture and moxibustion in ancient.① Meridian choose of ancient acupuncture treatment of fundus diseasesThe meridians of most high numbers of times selected by ancient TCM doctors is the bladder meridians with 731 times.Among them,7 meridians have been chosen more than one hundred times.according to the frequency from high to low ranking are:bladder meridian(731),gall bladder meridian(353),Du meridian(243),Stomach meridian(225),and large intestine meridian(221),Kidney meridian(169),Sanjiao meridian(121).The top three of the bladder meridian acupoints are liver Shu,JingMing,Cuanzhu acupoint;TongZi Liao,Muchuang,Fengchi are the points that have been chosen most often;ShangXing,MingMen,HouDing are the points most chosed in Du meridian.(2)The situation of acupoint selectionFrom the point view of all the frequency point,frequency from ancient literature on acupuncture and moxibustion for treatment of ocular fundus diseases from the top 10 of the points are Ganshu(141 times),Jingming(103),Cuanzhu(76),Tong Zi Liao(65 times),Juliao(68).Fuliu(63),MuChuang(62),ShuiQuan(58),Hegu(58),Chengqi(54 times).From the application of specific points of view,the specific points of ancient literature on acupuncture and moxibustion for treatment of ocular fundus diseases is selected in the five acupoints,acupuncture frequency from more to less specific points of the first 10 are Ganshu(Beishu),Fuliu(Jing point),SuiQuan(Xi point),Hegu(the original point),Shenshu(Beishu),Valley(spring point),Pianli(Luo point),YangLao(points),Shang Yang(wells points),Ququan(acupoints).From the point of view of the distribution of points,the ancient literature of acupuncture and moxibustion treatment of ocular fundus disease selected points according to the total frequency of sorting,the main points of the frequency of the main distribution in the head,accounting for 48.94%,followed by the limbs accounted for 38.12%.(3)acupoint prescriptionThe ancient point sequence association analysis,results are consistent with the strong association rules and relevance of the highest three point combination is:LinQi,Baihui,Jingming"combination,support was 50%,100%confidence.2.modern acupuncture treatment of the overall situation of ocular fundus disease(1)Meridian choose of cupuncture treatment of fundus diseases in morden time.The acupuncture treatment of fundus diseases with meridians is the largest bladder,followed by gallbladder and stomach.The meridian frequency of the top 5 are:bladder,gall bladder,stomach,large intestine,spleen.The number of selected points from each of the meridians,acupoints most bladder meridians are selected,31 points.The second is the gallbladder,with 23 points;third is the stomach,with 17 points.(2)the situation of acupoint selectionModern acupuncture and moxibustion in the treatment of ocular fundus disease point prescription to multi hole square for more,rarely use single point.Which is the most used point Jingming(377 times),the frequency of the top 10 ranked by multi points at least is in turn:Jingming(377 times),TaiYang(373),QiuHou(368 times),Fengchi(255),Hegu(279),Cuanzhu(250 time),Chengqi(239 times),ZuShanLi(238 times),GuangMing(181),Sanyinjiao(169).The heard is still the main point distribution.Specific five-shu points,followed by the original network points.The frequency from high to low in the top 5 specific points are:Hegu(original point),Zusanli(He,lower He point),GuangMing(connect point),Shenshu(Beishu),Taichong(lthe original point).(3)acupoint prescriptionAccording to fundus disease sequence association rule of modern acupuncture treatment,with stronggest association rules and four point combination:Fengchi-YuYao-Shenshu-GuangMing;with strong association rules and the degree of the strongest five sets of acupoint combination:TaiYang-GuangMIng-Yuyao-SiBai-Chengqi,support is 40%,confidence is 100%.Research results1.From the selection of meridians,ancient acupuncture treatment of fundus diseases reuse bladder,gall bladder,and du.Modern acupuncture reuse bladder,gallbladder and stomach.The difference lies in the Du Meridian and the stomach meridian.Du Meridian is the sea of Yang Meridians circulation,not only in the middle of the head,but also into the brain,and the brain is the sea of marrow,"eyes",also known as the eye department,is connected to the brain choroid of eyeball,pathway is equivalent to the optic nerve and optic nerve in the brain,and also so Du have a greater relationship.The reuse of the ancients attention from Du Yang,replenishing tonifying myeloid sea treating eye diseases.The modern people that modern people attach importance to the reuse of the stomach,acquired from the original Qi and blood,thus realizing the organs of the essence of the supply,treatment of fundus diseases.2.From points frequency sequence,the points of the most number include:GanShu,Jingming,zanzhu,Tong Zi liao.To show the relationship between the liver and the purpose of the ancients.In addition,foot Jue Yin liver Yu Shigan by the Department of acupuncture,Jingming is bladder meridian of foot Taiyang standard,cuanzhu is small intestine meridian standard,to dredge the channel qi of the viscera function is strong,also reflected the importance of using standard of meridian treating ocular fundus disease.The pupil Liao in canthus meridians in the eye,is the most densely populated areas,pupils can reflect the importance of reuse "clear to the eye meridians dense meridians.Therefore,from the acupoints frequency sort of view,in addition to pay attention to the ancients from Beishu on liver qi and blood tonic,but also pay attention to the eye especially dense dredge meridians canthus conditioning,help meridians open into the eye.The modern medicine points the most is:Jingming,Taiyang,QiuHou,Fengchi.It reflects that the modern acupuncture and moxibustion is more important than selecting the points of the eye socket,the eye of the eye can be more directly effect on the eye and the corresponding blood vessels and nerves,especially the fundus.Fengchi can clear the inner and outer wind,promote head meridians unobstructed reflect modern physicians focus on clearing the channels inside and outside of the wind,and the meridians of ocular fundus diseases by the evil,deficiency of Qi and blood,viscera deficiency can be caused by pathogenic wind invasion meridians corresponding pathogenesis.3.From distribution o fpoints,in addition to the focus on eye acupoints,head acupoints are also many,tspecific point,is the most distal acupoints meridian is GanShu of bladder and Fuliu of kidney meridians.It reflecst the importance to clear the meridian Qi of head and eye by using points in ancient,and embodies the thought and coherent by Tonifying the liver and kidney.Modern doctors pay more attention to the eye acupuncture acupoint,acupuncture frequency than ancient times less head,distal acupoints also use specific acupoints of distal acupoints with acupuncture Zusanli and Sanyinjiao is the most.Embody the modern attention effects on the spleen and stomach,spleen,stomach,relationship between liver and kidney and to a point,Sanyinjiao homology embodies the use of points of the spleen and kidney to streamline the modern medicine.4.As for the prescription rules,ancient acupuncture treatment of ocular fundus diseases in single point for many.Through the ancient all acupuncture treatment of fundus diseases in the literature of acupuncture points to do sequence correlation analysis of three sets of results show that the eye acupuncture points with the head acupuncture points,acupuncture points with the head and the four limbs of the strong combination of acupuncture points.The combination of the three highest point is a combination of "LintQi-Baihui-Jingming",support was 50%,100%confidence.The modern acupuncture prescription commonly compose with many points.All fundus diseases acupoint sequence association rules show that the acupoints to the eye,the head,the combination of the three part of the distal limbs acupoint combination association points more,strong correlation.And the four point combination degree of the strongest strong association rules in line with the overall correlation analysis:Fengchi-YuYao-Shenshu-light;Jingming-Yuyaot-Shenshu-Cuanzhu;Jingming-Yuyao-Shenshu-light;JingMing-Yuyao-Sanyinjiao cuanzhu;the eye-sizhukong-light-Chengqi;with strong association rules and the degree of the strongest five sets of acupoint combination:Taiyang-SiBai-YuYao-Chengqi,support was 40%,100%confidence.The eye that local acupoints combined with distal acupoints combined with acupuncture point with hyperopia is more suitable method.Point correlation analysis result of modern acupuncture treatment by fundus diseases,but also to the local acupoints prescription eye acupuncture combined with distal acupoints and acupoints is associated with higher strength acupoints,distal acupoints Zusanli,Hegu and Sanyinjiao mainly,Shenshu,Ganshu,bright.5.As for the treatment and acupuncture and moxibustion,ancient acupuncture treatment of ocular fundus diseases mainly include acupuncture,moxibustion and bloodletting therapy.Which is the most widely used in the treatment of moxibustion by the Shang Yang hole(24)and the treatment of night blindness hand fingernails after 1 inch 1 low horizontal head white skin;bloodletting therapy is mainly used in the emergency eye syndrome,such as sudden blindness.Modern acupuncture treatment of ocular fundus disease simple acupuncture therapy alone accounted for 24.73%,compared to the ancient,modern acupuncture treatment of ocular fundus disease more attention to two or more than two kinds of traditional Chinese medicine therapy,accounting for 75.27%.The combination of acupuncture and medicine accounted for 42.08%,plus points injection accounted for 28.83%,the proportion of the largest.The modern medicine combined with western medicine and more eye knowledge,new medical devices,the invention of new acupuncture therapy of traditional Chinese medicine,combined Chinese and Western medicine.Dialectical thinking,not only in accordance with the Overall Dialectics of traditional Chinese medicine dialectical,but also reference to the fundus disease in western medicine to the dialectical point,the development of governance,reflecting the modern acupuncture treatment of ocular fundus disease. |
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