Study On The Rule Of Acupuncture And Moxibustion In The Treatment Of Neurogenic Bladder After Spinal Cord Injury Based On Data Mining Technology And Analysis On The Tutor’s Treatment Ideas

Objective: To provide theoretical support and evidence based reference for the clinical treatment of neurogenic bladder after spinal cord injury,in this study,we searched the clinical literature related to acupuncture and moxibustion treatment of neurogenic bladder after spinal cord injury,then performed statistical processing and data mining on the literature included in the database.The rules of acupoints selection and the compatibility of acupoints of acupuncture and moxibustion treatment of neurogenic bladder after spinal cord injury were summarized and the tutor’s clinical experience in treating this disease was also taken into consideration for comprehensive analysis.Methods: 1.Data retrieval and collection: A combination of computer search and manual search was used to retrieve clinical literature related to acupuncture for neurogenic bladder after spinal cord injury from China Knowledge Network(CNKI),Wan fang Data Knowledge Service Platform,VIP Journal Resource Integration Service Platform(VIP)and China Biomedical Literature Database(CBM).The publication time of the literature is limited to the establishment of the database until June 2020.The composition of the index terms was set as "Neurogenic bladder after spinal cord injury" and("Acupuncture" OR "Acupuncture" OR "Electro-acupuncture" OR "Warm Needle" OR "Moxibustion" OR "Acupuncture Therapy" OR "Acupuncture Therapy" OR "Acupoint" OR "Acupoint Therapy").2.Database establishment: Microsoft Excel 2010 software was used to establish a database named "Literature database of acupuncture and moxibustion for neurogenic bladder after spinal cord injury".The literature that meets the requirements would be input into the database according to the literature screening criteria(inclusion criteria and exclusion criteria).The input information includes the name of the document,the name of the author,the publication time of the document,the name of the selected acupoint,the number of cases,the waveform of electroacupuncture,and the method of supplementing and reducing.In addition,the selection of acupoints,the meridians of acupoints,the location of acupoints,specific acupoints,the use of electroacupuncture and the techniques of reinforcing and reducing acupuncture in the literature were summarized.3.Data normalization: Before the data mining,the literature information included in the database was standardized to ensure the accuracy of the research.The standardized treatment includes three contents:(1)the names of acupoints involved in the literature;(2)the input method;(3)quality control.4.Data mining:(1)Microsoft Excel 2010 software was used to descriptively analyze the frequency of the acupuncture points(names and number of acupoints),the meridians of the acupoints,the location of the acupoints,the specific acupoints,the waveform of electroacupuncture,and the frequency of replenishing and reducing techniques in the acupuncture prescription;(2)IBM SPSS Modeler 14.1 statistical analysis software was used for analysis,the Apriori algorithm was adopted to analyze the association rules of acupuncture points with frequency >10 in the included literature,and calculate the support and confidence of the acupoint set;(3)IBM SPSS Statistics 22.0 statistical analysis software was used for further analysis,the inter-group connection method in the clustering method and the squared Euclidean distance for the distance type was selected,and the cluster analysis was performed on the acupoints with frequency >10 in the included literature.5.Through the analysis of the tutor’s understanding of the etiology of neurogenic bladder after spinal cord injury,the choice of treatment method,and the analysis of the tutor’s treatment ideas for neurogenic bladder after spinal cord injury with typical clinical cases.Results: 1.A total of 153 literatures that met the entry criteria were included through screening and sorting.2.The results of descriptive analysis showed that the literature database of acupuncture treatment of neurogenic bladder after spinal cord injury contains 69 acupoints,and the total frequency of acupoint use is 833 times.The top 20 acupoints with acupuncture treatment frequency of neurogenic bladder after spinal cord injury were Zhongji(CV3),Guanyuan(CV4),Sanyinjiao(SP6),Shenshu(BL23),Bladder shu(BL28),and Baliao,Qihai(CV6),Yinlingquan(SP9),Ciliao(BL32),Zusanli(ST36),Huiyang(BL35),Guilai(ST29),Mingmen(GV4),Shuidao(ST28),Qugu(CV2),Shenque(CV8),Xialian(BL34),Sanjiaoshu(BL22),Taichong(LR3),Tianshu(ST25);The statistical results of the frequency of the meridians of the acupoints showed that the top three meridians were the Zutaiyang Bladder Meridian,Renmai,and the Spleen Meridian of Foot Taiyin,and there were more cases of the use of Yang Meridian points;According to the application frequency of acupoints,the acupoints were ranked from high to low as abdomen,back,lower limbs,head and neck,upper limbs;The statistical results showed that the 69 acupoints in the database include 47 specific acupoints,and the top three specific acupoints were ranked according to the frequency of use of specific acupoints as Mu,Beishu and Wushu;In the application of acupuncture to treat neurogenic bladder after spinal cord injury,replenishing was the main method of use.When combined with electroacupuncture,the waveform was mostly selected as dilatational wave;In clinical treatment,single acupoints or a small number of acupoints were often selected to treat this disease.3.Association rule analysis showed that the most supported acupoint combination was Guanyuan(CV4)-Zhongji(CV3);The acupoint combinations with case number >40,the support >20,and the confidence >70 was Guanyuan(CV4)-Zhongji(CV3),Zhongji(CV3)-Guanyuan(CV4),Zhongji(CV3)-Sanyinjiao(SP6),Zhongji(CV3)-Bladder shu(BL28),Guanyuan(CV4)-Qihai(CV6),Zhongji(CV3)-Qihai(CV6),Zhongji(CV3)-Qihai(CV6)and Guanyuan(CV4).4.The cluster analysis of acupoints with frequency >10 showed that acupoints can be divided into two types: Zhongji(CV3),Guanyuan(CV4)and Qihai(CV6)were the first type,while Baliao,Sanyinjiao(SP6),Huiyang(BL35),Zusanli(ST36),Mingmen(GV4),Taichong(LR3),Shenque(CV8),Tianshu(ST25),Shuidao(ST28),Qugu(CV2),Yinlingquan(SP9),Ciliao(BL32),Guilai(ST29),Xialiao(BL34),Sanjiaoshu(BL22),Shenshu(BL23)and Bladder shu(BL28)were the second type.Conclusions: 1.Data Mining:(1)The commonly used acupoints of acupuncture treatment for neurogenic bladder after spinal cord injury including Zhongji(CV3),Guanyuan(CV4)and Sanyinjiao(SP6),and single acupoint or a small number of acupoints are mostly selected for acupuncture treatment in clinical practice;(2)Acupuncture and moxibustion treatment of neurogenic bladder after spinal cord injury mostly selected points on the Zutaiyang Bladder Meridian,Renmai,and the Spleen Meridian of Foot Taiyin,and usually refer to the Yang Meridian points;(3)Acupuncture and moxibustion treatment of neurogenic bladder after spinal cord injury is mostly based on specific acupoints,most of which are Mu,Backshu and Wushu;(4)The acupuncture and moxibustion treatment of neurogenic bladder after spinal cord injury is based on the selection of acupoints along the meridian,proximal acupoints,and specific acupoints,supplemented by distal acupoint selection;(5)The most commonly used combination of acupuncture points for the treatment of neurogenic bladder after spinal cord injury is Guanyuan(CV4)-Zhongji(CV3),and the compatibility of acupoints has the laws of local acupoints,front and rear acupoints,and far and near acupoints.2.Analysis of the tutor’s thoughts on the treatment of neurogenic bladder after spinal cord injury: The tutor concluded that the impassability of the two channels and the dysfunction of the five internal organs are the root causes of neurogenic bladder after spinal cord injury.Therefore,the treatment should be based on the principle of "passing the governor and ren,reconciling the viscera".In the selection of treatment methods,it emphasizes the combined use of multiple techniques and hybrid treatment;in the process of treatment,emphasis is placed on syndrome differentiation,treatment according to individual conditions,and overall adjustment to achieve the purpose of balancing yin and yang,regulating viscera,and comprehensive treatment.3.When the tutor used acupuncture therapy to treat the neurogenic bladder after spinal cord injury,the rules of acupoints selection and compatibility showed many similarities with the conclusions obtained from data mining.Therefore,the research on acupoint selection rule of acupuncture treatment of neurogenic bladder after spinal cord injury based on data mining has certain guiding significance for clinical practice,which is a topic worthy of further exploration.