Study on the rule of acupoint selection in treatment of acute exacerbation of chronic obstructive pulmonary disease

Abstract

To explore the characteristics and rule of clinical acupoint selection in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The clinical articles of acupuncture in treatment of AECOPD were retrieved from the databases of PubMed, EMbase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP and SinoMed, from the date of establishment to July 15, 2020. The articles were screened in accordance with the inclusion and exclusion criteria, the prescriptions of acupuncture and the relevant information of the acupoints and meridians were extracted to establish the database. The data mining methods i.e. Apriori association rule analysis and cluster analysis were used to analyse the using frequency, involving meridians, acupoint distributions, association rules and cluster of selected acupoints. A total of 54 articles were included, 67 acupuncture prescriptions were extracted, 69 acupoints were involved and the total using frequency was 475 times. The top 5 acupoints in frequency were Danzhong (CV 17), Feishu (BL 13), Zusanli (ST 36), Fenglong (ST 40) and Dingchuan (EX-B1). The main involved meridians were bladder meridian of foot-taiyang, conception vessel, stomach meridian of foot-yangming and lung meridian of hand-taiyin. The acupoints were mainly distributed in chest and abdomen, waist and dorsum. The mainly selected special points were five-shu points, front-mu points, convergent points and back-shu points. Twenty strong association rules were summarized by association rule analysis, including Fenglong (ST 40)Þ Zusanli (ST 36), Fengmen (BL 12)Þ Danzhong (CV 17), Tianshu (ST 25)Þ Zhongwan (CV 12), Dingchuan (EX-B1)+ Feishu (BL 13) Þ Danzhong (CV 17), Fenglong (ST 40)+ Feishu (BL 13) Þ Zusanli (ST 36), etc. Five cluster groups were summarized by cluster analysis, i.e. ①Feishu (BL 13), ② Dingchuan (EX-B1) and Danzhong (CV 17), ③ Chize (LU 5), Lieque (LU 7) and Fengmen (BL 12), ④Zusanli (ST 36) and Fenglong (ST 40), ⑤Tianshu (ST 25), Guanyuan (CV 4) and Zhongwan (CV 12). The local acupoints and acupoints along meridians are the main acupuncture prescriptions for AECOPD, and the special points are the predominated selection. The acupoint compatibility embodies the therapeutic principle of "strengthening vital qi to eliminate pathogenic factors and considering both the root cause and symptoms".