Acupuncture For Myopia:A System Review And A Selection Rules Of Acupuncture Point

Objective:In this study,the efficacy and safety of acupuncture and moxibustion in the treatment of myopia were studied by systematic evaluation method.To investigate the improvement of visual acuity,intraocular pressure and other related indexes of myopia patients after acupuncture treatment.In order to provide evidence-based medicine for the clinical efficacy of acupuncture and moxibustion in the treatment of myopia,so as to better serve for clinical treatment.A database of acupoints used in the treatment of myopia by acupuncture and moxibustion was established to collect,screen and analyze the standard acupoints selected for the treatment of myopia by acupuncture and moxibustion.Data mining technology based on partial order structure was used to analyze the rules of acupoints in the included literatures,in order to provide further reference for the clinical treatment of myopia by acupuncture and moxibustion.Methods:[1]System ReviewIn this study,a systematic review method was used to collect all clinical RCT that met the requirements.After data collection,the literature was rigorously evaluated for quality.Scientific analysis and comprehensive conclusion are obtained after data analysis.The specific steps are as follows:(1)Literature search method:According to the standard and unified search strategy,literature search on acupuncture and moxibustion for myopia was conducted through the network database.The retrieval databases were CNKI,VIP,Wanfang,Pub Med,Embase and Web Of Science in Chinese and English.Literature retrieval time:literature from the establishment of each major database to 2021.The search terms include subject and free words.The retrieval was conducted by "disease type:myopia+pseudomyopia+refractive error","intervention measures:acupuncture+needle+acupuncture+electroacupuncture+ear acupuncture+ear acupuncture+abdominal ne edle+plum needle+eye needle+head needle",and "research method:random+random control+random allocation+RCT".The English search terms were"Myopia OR degenerative myopia OR high myopia OR Acupuncture OR Pharmacopuncture OR randomized controlled trial OR Randomized OR placebo".(2)Noteexpress software was used to de-screen the obtained literatures,and the randomized controlled literatures(RCTs)that met the inclusion and exclusion criteria were screened by reading the titles,abstracts and full texts;(3)The quality of the included literatures was evaluated according to the Cochrane evaluation manual and the modified Jadad scale,and meta-analysis was performed using Review5.3.[2]Selection rules of acupuncture point(1)Literature retrieval method:according to the retrieval strategy and literature collection method developed in this study,the search was carried out in China Journal Full-text Database(CNKI)and other databases.(2)Clinical RCT literature on acupuncture therapy for myopia was collected according to the inclusion criteria,and Excel 2019 was used to establish a database of acupuncture points for myopia treatment.The acupoints selected in the literature should meet the national standard of the names of the 14 meridian points.The variable names in the database are composed of:number,author,publication year,selected acupoints,etc.(3)According to the acupoint database of acupuncture and moxibustion therapy for myopia as the object,and with the help of knowledge discovery method based on partial order structure of big data,the partial order structure map of attributes can be generated to reflect the selected acupoint,acupoint-meridian return,acupoint-location and myopia classification of acupuncture therapy at multiple levels and factors.On this basis,interpret the results and draw a conclusion.Results:[1]System ReviewAccording to the retrieval strategies and literature collection methods developed in this study,190 literatures were retrieved from CNKI,121 literatures were retrieved from VIP,442 literatures were retrieved from Wanfang Database,8 literatures were retrieved from Pub Med,10 literatures were retrieved from Embase and 12 literatures were retrieved from Web Of Science.The relevant literatures retrieved from the major database cases were imported into the NoteExpress management software,and the final included literatures were 71.Among them,there were 17 literatures with high quality(2 literatures with 5 marks,15 literatures with 4 marks),and 55 literatures with low quality(55 literatures with 3 marks).There were 17 high-quality literatures and 54 low-quality literatures.Of the 71 studies included in this systematic evaluation,a total of 8285 myopia patients were included,including 4031 cases in the control group and 4254 cases in the experimental group.In this study,the experimental group was treated with simple acupuncture or acupuncture combined with other therapies,while the control group was treated with conventional treatment.Into the experimental group in the study of 71,there are 37 research includes acupuncture treatment of myopia,nine studies include acupuncture combined therapy with Chinese medicine embalm eye myopia,has 39 research contains myopia treated auricular application pressure,there are two research include abdominal needle treatment myopia,there are two research include joint acupuncture moxibustion treatment of myopia,there are two research include joint plum needle acupuncture treatment of myopia,Thirteen studies included acupuncture combined with massage for myopia,and four included acupuncture combined with internal administration of traditional Chinese medicine for myopia.In terms of primary outcome measures,the primary outcome of this systematic study was overall response rate,and the effectiveness of acupuncture in the treatment of myopia was reported in all 71 included studies.In terms of secondary outcome indicators,the secondary outcome of this systematic study was the changes in parameters of naked visual acuity,ocular axis and intraocular pressure before and after treatment.Of the 71 studies included,28 studies reported naked visual acuity before and after treatment,2 studies reported axial values before and after treatment,and 3 studies reported intraocular pressure values before and after treatment.Safety summary:Two of the 71 studies reported a total of 10 cases of lost follow-up or abscission.Adverse effects were reported in 3 studies:(1)Needle sickness was reported in 1 study;(2)One study reported 5 cases of dry mouth,4 cases of eye catching skin itching,2 cases of abnormal eyelid secretion,and 4 cases of facial hot flushes.(3)One study reported 2 cases of peripheral eye redness and swelling with mild pain,3 cases of mild ear pain and 3 cases of auricular skin ulceration.Results of Meta analysis:(1)Influence of acupuncture and moxibustion therapy on total effective rate score compared with conventional treatmentAll 71 studies used total response rate as a measure to evaluate the efficacy of myopia treatment.Meta-analysis was performed on the total effective rate after treatment,and the results showed that acupuncture treatment could better improve the total effective rate than the control group.According to different types of acupuncture and moxibustion group analysis,the results showed that simple acupuncture treatment for myopia,auricular point sticking pressure treatment for myopia,abdominal acupuncture treatment for myopia,acupuncture combined with traditional Chinese medicine fumigation,acupuncture combined with plum needle can better improve the total effective rate compared with conventional treatment.Only 2 studies reported the treatment of myopia by acupuncture combined with moxibustion,and the results showed that this study did not have statistical significance,but its RR value was greater than 1,showing a certain trend.More evidence is needed to verify the effectiveness of this therapy in the future.(2)The effect of acupuncture therapy on naked visual acuity of patients compared with conventional treatmentOf the 71 studies,29 reported patients' naked eye visual acuity before and after treatment.Meta-analysis was conducted on patients' naked eye visual acuity before and after treatment.The results showed that acupuncture therapy could better improve patients'naked eye visual acuity than conventional treatment.(3)The effect of acupuncture and moxibustion therapy on intraocular pressure and ocular axis compared with conventional treatmentThree of the 71 studies reported IOP before and after treatment.Meta-analysis of IOP before and after treatment showed that acupuncture therapy could better improve IOP compared with conventional treatment.A total of 2 studies reported the patients' axial values before and after treatment.Meta-analysis of the patients' axial values before and after treatment showed that this study was not statistically significant,and more evidence was needed for verification in the future.[2]Selection rules of acupuncture pointA total of 53 studies met the inclusion criteria,52 kinds of acupoints were included in all the literatures,and a total of 394 acupoints were recorded into the database.The selected acupoints,meridians of acupoints,location of acupoints and myopia classification in the included literatures were analyzed and studied.(1)Select acupointsIn the treatment of myopia in this study,the authors used Cuanzhu acupoint 37 times,Jingming acupoint 33 times,Sibai acupoint 32 times,Temple acupoint 29 times,Sizhu acupoint 25 times,Fengchi acupoint 24 times,Yuyao acupoint 22 times,Guangming acupoint 17 times and so on.Researchers have used acupuncture to treat myopia,and the most commonly used acupoints are:Cuanzhu,Jingming,Sibai,Temple,Sizhu.Fengchi and Yuyao.[Cuanzhu-Jingming-Sibai-Taiyang-Yuyao],[Cuanzhu-Jingming-Sibai-Taiyang-Sizhu kong],[Cuanzhu-Jingming-Sibai-Yuyao],[Cuanzhu-Jingming-Taiyang],[Jingming-Sibai],[Sibai-Taiyang]and so on are the matching points often used by doctors to treat myopia with acupuncture and moxibustion.Cuanzhu is the most commonly used acupoint,is the main acupoint for the treatment of myopia.(2)Acupoint returnThe meridians and meridians most commonly used in the treatment of myopia by acupuncture and moxibustion are "foot sun bladder meridian and foot yangming stomach meridian".[Bladder meridian-stomach meridian-outer point],[Bladder meridian-stomach meridian],[Bladder meridian-gallbladder meridian],[Bladder meridian-outer point]are the meridian pairs often used by doctors to treat myopia with acupuncture and moxibustion.Foot sun bladder meridians for the most commonly used meridians,is the main treatment of myopia meridians.(3)Acupoint locationIn the literature on myopia treatment in this study,50 times of acupoints around the eyes,50 times of acupoints on the head and face,35 times of limbs,3 times of chest and abdomen,and 10 times of back were used.The most commonly used acupoints used by researchers to treat myopia were around the eyes and the head and face.(4)Classification of myopia In the literature of myopia treatment in this study,53 times of myopia were used,including 27 times of adolescent myopia,7 times of children myopia,and 11 times of pseudo-myopia.The most commonly used acupoints in the study were classified as "adolescent myopia,childhood myopia,and pseudo-myopia".Conclusion:1.Acupuncture and moxibustion therapy is effective in the treatment of myopia.In the treatment of acupuncture and moxibustion,the efficacy of simple acupuncture,auricular point sticking,abdominal acupuncture,acupuncture combined with plum needle,acupuncture combined with traditional Chinese medicine fumigation and other acupuncture and moxibustion therapy is better than that of conventional treatment group.Acupuncture was also superior to conventional treatment in improving naked vision and intraocular pressure.2.The commonly used acupuncture points in the treatment of myopia are:Cuanzhu,Jingming,Sibai,Taiyang,Sizhukong and Fengchi,among which Cuanzhu is the most commonly used acupoint.[Cuanzhu-Jingming-Sibai-Taiyang-Yuyao],[Cuanzhu-Jingming-Sibai-Taiyang-Sizhukong],[Cuanzhu-Jingming-Sibai-Yuyao],[Cuanzhu-Jingming-Taiyang],[Jingming-Sibai],[Sibai-Taiyang]are the acupoints often used by doctors to treat myopia with acupuncture.3.Acupuncture and moxibustion are commonly used in the treatment of myopia:around the eyes,head and face;4.The categories of myopia commonly used by doctors in the treatment of myopia with acupuncture are:pseudo-myopia,childhood myopia and adolescent myopia.5.The foot sun bladder meridian and foot Yang Ming stomach meridian are the most commonly used meridians and collateralchannels in the treatment of myopia by acupuncture and moxibustion.[bladder meridian-stomach meridian-external point].[bladder meridian-stomach meridian],[bladder meridian-gallbladder meridian]and[bladder meridian-external point]are the most commonly used meridian pairs in the treatment of myopia by acupuncture and moxibustion.Acupuncture is effective in the treatment of myopia,but the quality of clinical trial methods is poor,and this conclusion should be treated with caution.