Data Mining And Systematic Review Of Ancient And Modern Literature On Acupuncture Treatment For Stress Urinary Incontinence

Objective:To study and summarize the experience and wisdom of the ancient and present doctors in understanding and treating the disease of stress urinary incontinen-ce(SUI), and systematically evaluate the efficacy and safety of acupuncture treatment of SUI, and to offer reference and guidance for modern acupuncture clinical practice and research activities.Methods:Important ancient and modern acupuncture literature books or database were selected, Words "Niaoshijin""Xiaobian Bujin""Yiniao""Yini" were searched by, inclusion and exclusion criteria was set, and the combined searching methods of the computer and hand were used. The retrieval content was filtered and collected according to certain procedures, and a database was set up, and then data mining technology was used to analyse ancient acupuncture doctors’experience and wisdom on etiology and pathogenesis, therapeutic methods and principle, and on choosing the match meridians and acupoints of stress urinary incontinence. Besides, the efficacy and safety of acupuncture treatment of the disease was systematically evaluated by the method of evidence-based medicine.Results:1.53ancient acupuncture and moxibustion books were chosen in the data mining procedure. The causes of the disease could be summarised as follows:meridians falling ill, or viscera born disease, or injury in pregnancy and production or wrongly needling in hunman body points, one or more of which would sent enuresis; the therapeutic methods and rules could be summerised as follows:dredging meridian, and tonic viscera, and heating up "cell room", and clearing away the heart fire, and banning eliminating dampness and diuresis for which would hurt Yin.2.Results of data mining with prescriptions rules of ancient and modern literature:①Acupoints of Yin meridians are three times the number of acupoints of Yang meridians and the number of Liver Meridian’acupoints are the biggest(for the ancient);②The ancient had paid attention to the Bladder Meridian, for the acupoints of Bladder Meridian had accounted for70%(54/77) in foot Sanyang;③Points on meridian of Ren and bladder, Back-Yu points and rendezvous points were used more often;④Emphasise acupoints on human lower limb and abdomen;⑤The specific acupoints in above all meridians had been selected more often.3.16cases (total1069participants) of modern clinical randomized controlled trials (RCTs) were taken into the evidence-based medicine systematic reviews.①Acupuncture control versus blank or placebo or fake needling:the cure rates was significantly statistically different (P=0.0006), the combined effect odds ratio(OR)=3.23,95%confident interval(CI)[1.65,6.32]; The improvement rates was significantly and statistically different (P<0.00001), the combined effect OR=5.84,95%CI[3.09,11.02]; In reducing urinary incontinence frequency and improving the urethral pressure on the peak, acupuncture therapy was superior to the blank control (P<0.05and P<0.01,respectively).②cupuncture control versus positive interventions such as western medicine etc.:The cure rates was significantly and statistically different (P<0.00001), the combined effect OR=4.17,95%CI[2.47,7.03]; The improvement rates was significantly statistically different(P<0.00001), the combined effect OR=6.83,95%CI[4.44,10.49];③Acupuncture compared with pelvic floor muscle training:In lowering the amount of urinary incontinence, the difference was significant(P=0.002),the combined effect OR=-8.98,95%CI[-14.97,-3.30], but this result is vulnerable for the effect of publication bias, so the conclusion should be treated with caution;④The security of acupuncture treatment for SUI was obviously (P<0.00001,combined effect of OR=-0.73,95%CI[-0.85,-0.61]) higher than western medicine.⑤No significant difference was found (P=0.51>0.05) between effect of traditional chinese herb treatment and acupuncture therapy for SUI. Conclusion:1.The acquaintance about the pathogenesis of the ancient doctors is relatively more comprehensive. The ancient emphasis on regulating liver (QI movement) and heart (mental activities), choosing points such as Dadun(LR1), Taichong(LR3), Shenmen(HT7) etc.; ill of Yin should also be treated by Yin meridian or acupoints on it; Point Zhongji (CV3) was merely used in the treatment of the disease in ancient, which was used often to treat the disease nowadays.2.The present doctors pay more attention to anatomical knowledge of western medicine,and various innovations of modern acupuncture and moxibustion therapy emerge constantly, people today tend to select some important points to regulate the whole body, and take points such as Zusanli(ST36), Sanyinjiao(SP6),Qihai(CV6),Guanyuan(CV4), etc..3.Results of data mining with Prescriptions rules of ancient and modern literature are basically the same hole laws.4.Systematic review of modern literature on acupuncture treatment for SUI:acupuncture is effective in treating the disease; Acupuncture is better than western medicine, pelvic floor muscle exercise and electrical stimulation therapy; Acupuncture is of the same efficacy with chinese herb.