Abstract
Acupuncture has been used as an alternative and complementary therapy, however the selection of acupoints combination for a specific disease (or symptoms) highly depends on the experience of acupuncturists. The current study aimed to develop a reliable and quantifiable method for selection of acupoints combinations, which may improve treatment efficiency and reproducibility among acupuncturists. In the current study, a number of acupuncture prescriptions for treatment of acute or chronic gastritis had been collected and organized from public databases and literatures. Three types of associations, acupoints-symptoms associations (ASA), acupoints-acupoints associations (AAA), and symptoms-symptoms associations (SSA) were defined to delineate their connections. The network constructed by AAA was used to study the synergistic effects among acupoints combination whereas SSA network was used to examine coexistence of symptoms. On the other hand, ASA characterized the empirical association between acupoints and symptoms in the prescription database which may be considered as the mathematical representation of acupoints selection for a particular prescription. Then a novel method namely mutual information screening (MIS) was proposed for screening acupoints combinations based on pseudo mutual information maximization. The selected acupoints combinations of MIS method were verified to be in accordance with the rules of acupoints compatibility based on the theory of acupuncture. Validation of MIS through conditional entropy and significance test of the clinical records suggested the method to be reliable and robust. Furthermore, a ten-fold cross validation were carried out to evaluate the performance of MIS compared with artificial neural network (ANN)-based method. The F1-score of MIS was found to be 0.67, higher than that of the ANN-based method (0.58). The current results provided a reliable and practical tool for symptom-specific acupoints selection, which may help to develop a scientific basis for clinical acupuncture therapy.
Highlights
Acupuncture, an important constituent in traditional Chinese medicine (TCM), has been widely used as a complementary and alternative therapy [1, 2] for diseases such as migraines [3], hyperlipemia [4], arthritis [5], and gastritis [6]
ST36 has been widely used in clinical acupuncture for treating a variety of medical conditions especially gastrointestinal disorders [23]
This study applied network analysis to explore the interconnectedness of acupoints and acupoints, symptoms and symptoms which were present in 220 prescriptions of acupuncture treatment of gastritis
Summary
Acupuncture, an important constituent in traditional Chinese medicine (TCM), has been widely used as a complementary and alternative therapy [1, 2] for diseases such as migraines [3], hyperlipemia [4], arthritis [5], and gastritis [6]. Therapeutic effect of clinical acupuncture is rarely achieved through treatment on a specific acupoint. Instead, it is normally obtained through acupuncture on a combination of acupoints. It was found that combination of different acupoints may trigger either synergistic therapeutic or antagonistic effects that inhibit the effectiveness of acupuncture treatment [7]. The selection of acupoints combinations is carried out based on experience of acupuncturists and classical ancient TCM references [8]. In practice, there may be large variation in the selection of acupoints combination for a particular disease, which may probably lead to inconsistency in therapeutic effects and excessive acupoints selection. A reliable and quantifiable evidence-based method for selection of acupoints combination is essential to achieve a better efficacy and reproducibility of acupuncture treatment among different acupuncturists
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