Clinical Practice Of Acupuncture Research Articles

Investigation of international demand for Clinical Practice Guidelines of Acupuncture and moxibustion: A cross-sectional study

This study aims to get the medical management of acupuncture and moxibustion in the countries and regions where the society members of World Federation of Acupuncture-Moxibustion Societies (WFAS) are located, including the educational background of acupuncture and moxibustion practitioners and the local clinical practice of acupuncture and moxibustion, and the demands of the content and evidence types of Clinical Practice Guidelines (CPGs) of acupuncture and moxibustion in accordance with WFAS standards, so as to provide requirements and reference principles for the development of CPGs of acupuncture and moxibustion in accordance with WFAS standards. The convenient sampling method was used to collect the questionnaires, and the WFAS secretariat distributed the questionnaires to 294 contacts of society members from 70 countries and regions in the form of Questionnaire Star four times in April 2020, July 2020, March 2021, and April 2021 respectively. They were then distributed to individual members of acupuncture-moxibustion societies by the contacts. The study content involved the basic information of respondents, including their nationality, occupation, educational background of acupuncture and moxibustion, their local clinical practice and medical management of acupuncture and moxibustion, as well as their demand for CPGs of acupuncture and moxibustion, etc. After the questionnaires were collected, the data were analyzed and described by quantitative research method. In all, 302 respondents from 37 countries of six continents responded. The 302 respondents were members of the WFAS society members. (1) Basic information of respondents. They all had acupuncture and moxibustion learning experience, among which, 76.5% (231/302) had the education background of acupuncture and moxibustion professional college training, and 88.4% (267/302) had experience of acupuncture and moxibustion clinical practice. Acupuncturists or traditional Chinese medicine doctors accounted for 63.9% (193/302), western medicine doctors, nurses, and pharmacists accounted for 18.2% (55/302), and researchers and teachers accounted for 6.3% (19/302). (2) Local clinical practice and medical management of acupuncture and moxibustion. The level of clinical practice of acupuncture and moxibustion varies greatly among the regions where the WFAS society members lived. Among them, more countries in Europe have not included acupuncture and moxibustion in medical insurance than those in other continents (x2=26.049, P < 0.01), and more countries have not included acupuncture and moxibustion in public hospital treatment system than those in other continents (x2=113.488, P < 0.01). (3) Demand for CPGs of acupuncture and moxibustion. A total of 93.0% (281/302) respondents believed that WFAS CPGs of acupuncture and moxibustion would be helpful for their local practice. The order of their demand and concern for WFAS CPGs was: acupuncture manipulation > latest progress of acupuncture treatment > choice of acupuncture therapies > safety of acupuncture and moxibustion > combination of acupuncture and other programs. A total of 87.4% (264/302) respondents believed that ancient classics could guide clinical practice, and the ancient literature should be used as evidence for the development of guidelines. The respondents are those future practitioners of CPGs of acupuncture and moxibustion conforming to WFAS standards. Commonly they have clinical practice experience and professional education background. They believe that guidelines will be of help to the clinical practice of acupuncture and moxibustion, hope that WFAS CPGs would recommend effective guidelines for acupuncture manipulation and provide the latest progress in acupuncture treatment and so on, and they believe that classical ancient books can guide their clinical practice. It indicates the necessity and feasibility of formulating the WFAS CPGs of acupuncture and moxibustion. In view of the results of this study, it is suggested that the formulation process of WFAS CPGs of acupuncture and moxibustion should take into account the clinical practice level of acupuncture and moxibustion in each region, as well as its legislation and management situation of acupuncture and moxibustion, so as to meet the needs of users as much as possible.

A Protocol of a Guideline to Establish the Evidence Ecosystem of Acupuncture.

This is a protocol for developing a guideline to establish the evidence ecosystem of acupuncture. It describes all steps that will be followed in line with the World Health Organization Handbook for Guideline Development and the Reporting Items for practice Guidelines in Healthcare (RIGHT). The key steps included guideline protocol development, guideline registration, systematic review of acupuncture evidence issues, systematic review of methods for establishing evidence ecosystem, survey of acupuncture stakeholders regarding potential acupuncture evidence issues, development of potential items for guidelines, Delphi method for guideline item development, consensus meeting, drafting guideline, peer review, approval, and publishing. This future guideline will help to establish evidence ecosystem of acupuncture, which will facilitate the application of acupuncture in clinical practice.

The effects of acupuncture on psychological symptoms in patients with insomnia: study protocol for a randomized controlled trial

BackgroundInsomnia is a common sleep-related condition that includes dissatisfaction with sleep quality, difficulty in initiating or maintaining sleep, and early morning waking. Insomnia can affect daytime functioning by causing fatigue, depression, and anxiety. Medications are the most common method for the management of insomnia but can cause adverse effects, including psychological and physical dependence, residual daytime sedation, and cognitive impairment. Acupuncture is a common traditional Chinese therapy. It has been used in the treatment of insomnia, depression, and anxiety in China. However, there are no high-quality studies focusing on acupuncture for insomnia, especially for depression and anxiety due to insomnia. Therefore, we have designed a randomized controlled trial (RCT) involving a placebo control to ensure blinding of participants to investigate the effects of acupuncture on insomnia in improving sleep quality and psychosocial symptoms.MethodsWe have designed a single-center, parallel-group, single-blinded RCT. A total of 252 participants who meet the eligibility criteria will be randomly allocated into a manual acupuncture group or sham acupuncture group in a 1:1 ratio. All participants will receive 24 sessions of acupuncture (30 min per session, three sessions per week for 8 weeks). Participants will be assessed using the Pittsburgh Sleep Quality Index score, self-assessment anxiety scale, self-assessment depression scale, and Medical Outcomes Study 36-Item Short-Form Health Survey at baseline and 8 weeks. All analyses will be based on an intention-to-treat principle. The results will be published in an international peer-reviewed journal.DiscussionThe results of this study are expected to clarify the effects of acupuncture on sleep quality and psychosocial symptoms in patients with insomnia. This will contribute to the clinical practice of acupuncture in the management of insomnia.Trial registrationChinese Clinical Trail Registry ChiCTR2100049172. Registered on 24 July 2021.

Problems in randomized controlled trial on acupuncture and moxibustion for migraine in the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine

Regarding the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine, the existing problems of the design and methodology of randomized controlled trial (RCT) on acupuncture and moxibustion for migraine were summarized in views of participant, intervention, control, outcome and study design. Four directions need to be further explored, (1) research of adolescent migraine, special subtype of migraine and migraine in a special population; (2) research of the immediate analgesic effect of acupuncture and moxibuation at the attack stage of migraine and the therapeutic effect of migraine at each stage; (3) research on safety and health economics; (4) clinical trial registration of acupuncture and moxibustion. In study, the target population should be further determined and specialized, the diagnosis criteria of western medicine and traditional Chinese medicine be generalized and concentrated, the staging and type division of disease be accurate, the intervention procedure be integrated, the control design be rationalized, the outcomes be validated, and the description of randomization and blinding be clarified.

Analysis of Acupoint Selection and Combinations in Acupuncture Treatment of Asthma Based on Data Mining

Objective: Asthma is a highly prevalent respiratory disease that remains difficult to control. Acupuncture, as an important alternative therapeutic modality in preventing and treating asthma, is widely used in the world due to its promising efficacy and safety. Although acupoint selection and combinations are critical to therapeutic effects of acupuncture, its fundamental rules for asthma have not been fully understood. Thus, using data mining, the present study aimed to discover the most effective acupoints and combinations in the acupuncture treatment of asthma. Methods: Controlled clinical trials (CCTs) of acupuncture treatment for asthma were searched and retrieved from databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang, and PubMed. Data regarding the main acupoints prescribed in these clinical trials was collected and quantified. A network analysis was performed to uncover the interconnections between the acupoints. Additionally, hierarchical clustering analysis and association rule mining were conducted to discover the potential acupoint combinations. Results: A total of 183 CCTs were retrieved. Feishu (BL13), Dingchuan (EX-B1), Dazhui (GV14), Shengshu (BL23), Pishu (BL20), and Fengmen (BL12) appeared to be the most frequently used acupoints for asthma. While the Bladder Meridian of Foot Taiyang, the Governor Vessel, and the Conception Vessel, compared to other meridians, were found to be the more commonly selected meridians. In the acupoint interconnection network, Feishu (BL13), Fengmen (BL12), Dingchuan (EX-B1), and Dazhui (GV14) were defined as key node acupoints. Moreover, acupoint clustering analysis revealed the treatment principle of “facilitating the flow of the lung Qi, tonifying spleen and kidney, and treating both the symptoms and root causes.” Association rule mining analysis demonstrated that the combination of Pishu, Shenshu, Feishu, and Dingchuan, as well as that of Feishu, Dazhui, and Fengmen were potential acupoint combinations that should be selected with priority in asthma treatment. Conclusion: Based on a data mining analysis of published CCTs, this study provides valuable information regarding the selection of the most effective acupoints and combinations for clinical acupuncture practice and experimental study aimed at the prevention and treatment of asthma.

A “4D” systemic view on meridian essence: Substantial, functional, chronological and cultural attributes

The term Jingluo, translated as meridian or channel, is a core component of traditional Chinese medicine (TCM) and has played a fundamental role in guiding the clinical practice of acupuncture for thousands of years. However, the essence of the meridian remains elusive and is a source of both confusion and debate for researchers. In this study, a “4D” systemic view on the essence of the meridian, namely substantial, functional, chronological, and cultural dimensions, was proposed based on a review of the ancient medical classics, recent research developments, and results from clinical practice. Previous studies have primarily focused on the substantial dimension of the meridian system, with scant interpretation about its functional domain. Neither systemic data nor evaluations have been adequately documented. Additionally, a limited but increasing number of studies have focused on the chronological and cultural dimensions. More investigations that embody the holistic concept of TCM and integrate the systemic modes and advanced techniques with dominant diseases of TCM need to be performed to obtain a more comprehensive understanding of the essence of meridians. The goal of this study is to yield useful information in understanding the essence of meridians and provide a reference and perspective for further research.

Tracing origin and development of "Fenglong (ST 40) for phlegm": examination and verification

From the perspective of academic history, the background and evolution of "Fenglong (ST 40) for phlegm" were systematically summarized. As a result, it was found that in the early period, Fenglong (ST 40) was used for "tangible phlegm" of respiratory tract, but in the later generations, due to the comprehensive effects of various factors, the phlegm treated by Fenglong (ST 40) was generalized. In modern clinical practice of acupuncture and moxibustion, Fenglong (ST 40) is widely used for phlegm-related diseases. In addition, the knowledge content represented by "Fenglong (ST 40) for phlegm" showed evolution and change in academic heritage of previous dynasties. It is necessary for modern acupuncture researchers to systematically sort out, test and discriminate the habitual knowledge in combination with the background of traditional Chinese medicine, so as to promote the contemporary inheritance and application of traditional acupuncture theory and knowledge.

Great physician with absolute sincerity and carrying forward acupuncture and moxibustion: commemorating the 100th anniversary of the birth of academician CHENG Xin-nong, master of traditional Chinese medicine

The academician CHENG Xin-nong's academic thoughts and his contributions to the acupuncture and moxibustion of traditional Chinese medicine are summarized. Academician CHENG emphasizes the importance of meridian theory to acupuncture and moxibustion. He has hosted the National Climbing Program "Meridian Research", and put forward the symptom differentiation along the running course of channel and symptom differentiation based on meridian tropism. He values the guiding role of TCM theory on clinical practice of acupuncture and moxibustion, and advocates that acupoints have the same properties as traditional Chinese herb. He has established the acupuncture and moxibustion treatment based on syndrome differentiation, which includes principle, method, prescription, acupoint and technique. He is good at summarizing the acupuncture and moxibustion treatment rules of dominant diseases of TCM, and has formed his own unique acupuncture method in clinical practice: San-Cai acupuncturing method. In addition, he is one of the important founders of acupuncture and moxibustion education in the New China by pioneering early education of acupuncture and moxibustion and compiling textbooks. He is also the pioneer of international communication of acupuncture and moxibustion, carrying out international training of acupuncture and moxibustion, and spreading knowledge of acupuncture and moxibustion. He has the qualities of a great physician, dedicated to clinical practice and very kind to patients.

Modernization of Anatomy and Graduate Medical Education from the Past to the Present

In the recent decade, there have been many technological innovations and improvements in the pedagogy of medical and graduate education. We have applied some of these developments to one of the most important and most fundamental elements in modern medical and graduate education, while combining traditional and innovative approaches. Gross anatomy is a core course for first year medical and some graduate students from time immemorial, since Nicholaes Tulp was first depicted by Rembrandt in the now classic painting “The Anatomy Lesson of Dr Tulp”. In the now famous Rembrandt, Dr Tulp is shown dissecting an unembalmed cadaver, while paid onlookers viewed the dissection of the cadaver with great interest. At USAT and EWCNM, the anatomy dissection begins with didactic lectures, much along the traditional lines, but with the exception that the discussion is orientated toward a clinical setting for each phase of the lectures. This is followed by lectures in Organ Systems Pathophysiology with the added incorporation of the Anatomage® virtual and 3-D technology. Medical Biophysics, Medians, Acupuncture points, and finally by Introduction to the dissection laboratory. As in the distant past all dissections utilize fresh, unembalmed cadavers, but in modern times all cadavers at the USAT-EWCNM laboratory are safety tested for hazards or pre-existing infectious diseases before the start of the dissection, which takes place in a modern state-of-the-art facility. Prior to the dissection, important sensitivity instruction is given, including acceptable respect, clinical attire [scrubs and surgical gowns], proper and expected personal demeanor during the dissection. During the dissections, which last for several days on each cadaver, key surgical and medical procedures that are likely to be needed during PGY-I and in acupuncture clinical practice are demonstrated on each cadaver, including insertion of chest tubes, spinal taps, Intubation, topical and cosmetic suturing, endoscopy, 3-D imaging, surgical technique, needling placement, and others. The culmination of the dissection ends with each student being able to demonstrate the above procedures to standard, and with a complete functional dissection of the cadaver. At the conclusion of the lab body parts are reconnected and prepared for disposal and the ashes returned to the family that donated the cadaver. As an outcome, USAT-EWCNM anatomy lab has become one of the most sought-after courses in the first-year curriculum, with many students requesting to retake it 2 or more times, and performance on post laboratory examination exercises indicative of long term functional retention of anatomic principles upon entry to clinical and post graduate years.

Problems and countermeasures in clinical studies on acupuncture and moxibustion in course of developing Guideline for Clinical Practice of Acupuncture and Moxibustion: Insomnia

To explore the problems and countermeasures existing in acupuncture and moxibustion clinical studies, in the perspective of the key steps of Guideline for Clinical Practice of Acupuncture and Moxibustion: Insomnia. The problems include: confusion of disease names and disunity of diagnostic criteria, inadequate refined clinical problems that need to be addressed, lack of targeted analysis of efficacy evaluation index, lack of adequate research on common acupuncture, difficulty to balance innovation and universality, lack of emphasis on the importance of timing for acupuncture, lack of attention to healthy lifestyles and self-care. We suggests that the disease name and diagnostic criteria should refer to the authoritative standards; the clinical study design should based on the realistic clinical problems; the efficacy evaluation index should based on the clinical needs and be analyzed targetedly; further research on common acupuncture or therapy should be carried out.

Instructive significance of "treatment in accordance with time factor" for the idea of clinical diagnosis and treatment with acupuncture and moxibustion

"Treatment in accordance with time factor" is one of the key principles of acupuncture and moxibustion treatment. In clinical practice of acupuncture and moxibustion, the connotation of "timing/time factor" should be fully understood and the temporal rule on physiology and pathology affected by the changes of four seasons and day and night be grasped. Based on the change law of qi, blood, yin and yang and the rise and fall rules of pathogens and antipathogenic qi, the intervention is exerted timely. The dynamic law of acupoints should be associated with the changes in pathogenesis and illness location, thus, the acupoint selection, needle manipulation and needle withdrawal can be operated precisely. The idea of time factor should be considered in the whole process of clinical diagnosis and treatment with acupuncture and moxibustion so as to provide some guidance for clinical analysis and practice.

Effects of Stimulating Local and Distal Acupoints on Diabetic Gastroparesis: A New Insight in Revealing Acupuncture Therapeutics.

One of the most important aspects of clinical acupuncture practice, like diabetic gastroparesis, is the selection of suitable acupoints. Furthermore, it is critical to examine the therapeutic impact differences between distal and local acupoints, as well as the prescription of their combination. In this study, diabetic gastroparesis rats were treated by needling Zhongwan (CV12) and Zusanli (ST36), and then used Single Photon Emission Computed Tomography-CT (SPECT-CT) technology to assess the effects of promoting gastric motility. In addition, morphological observation, immunohistochemical examination, and biomarker assays, such as determination of growth factor 1, motilin, and ghrelin contents in serum samples, were performed to better understand the impact of certain various acupuncture treatments. All of the therapies improved the symptoms of diabetic gastroparesis rats, according to the findings. Stimulating these acupoints, on the other hand, can have a different therapeutic effect. In addition, needling local and distal acupoints together can have an antagonistic or synergistic impact on specific physiological and biochemical indexes such as gastric motility, ghrelin, gastrin, and growth factor 1, among others. Our findings demonstrated the benefits of acupoints and acupuncture in the management of diabetic gastroparesis, as well as a new insight into acupuncture therapeutics.

Acupoint specificity in acupuncture clinical practice for chronic low back pain and migraine : a systematic review and meta-analysis

Acupoint specificity in acupuncture clinical practice for chronic low back pain and migraine : a systematic review and meta-analysis

Acupuncture Therapy for Cognitive Impairment: A Delphi Expert Consensus Survey.

BackgroundCurrent research evidence challenges clinical decision-making when acupuncture is taken into consideration in the treatment of cognitive impairment (CI). Aiming to provide some viable recommendations for acupuncture practitioners in dealing with actual clinic issues, an expert consensus study was conducted.MethodsA clinical question investigation among 47 acupuncturists yielded 24 initial items. Subsequently, systematic reviews on acupuncture for CI were searched within three online databases. A panel of 30 authoritative experts were requested to respond with agreement, neutrality, or disagreement for each item. Consensus establishment was defined as the percentage of agreement on a given item >80%.ResultsFollowing a 2-round Delphi survey, there were 21 items reaching consensus and three items resulting in no consensus; of which 10 items reached 90∼100% agreement, and 80∼90% expert agreement was achieved for 11 items. These items could be roughly categorized into six domains: (1) therapeutic effects of acupuncture, (2) therapeutic principles, (3) acupoint selection and combination, (4) acupuncture parameters, (5) considerable combined therapies, and (6) possible adverse events.ConclusionWithout ready-made guidelines, this expert consensus may be conducive to guide acupuncturists in implementing clinical acupuncture practice for CI. Moreover, given the lack of high-quality research evidence and plenty of unresolved clinical issues in this field, it is of necessity to carry out more studies to better clarify the treatment algorithm.

Transformation of the domestic standard (Guideline for Clinical Practice of Acupuncture-Moxibustion: Migraine) to international standard: in the perspective of the differences in clinical questions

Through analyzing the differences in the clinical questions of Guideline for Clinical Practice of Acupuncture- Moxibustion: Migraine (Guideline) between the domestic standard and international standard (under development), the specific issues are determined in the transformation from domestic standard to international one. Taking acupuncture practitioners as investigation object, by means of the survey, the basic information and clinical questions were investigated. The survey results show that the following aspects should be supplemented in terms of the international requirements during the development of this international Guideline: suitable patient population, applicable types of disease, the optimal intervention time of acupuncture for migraine, common methods in treatment as well as the other involved health problems. Moreover, it needs to update the key clinical questions, recommended regimens for the newly supplemented types of disease, as well as the more specified assessment on therapeutic effect. The ultimate solution of these questions relies on the quality of clinical evidence.

A review of time-effect research on acupuncture in experimental rats/mice in the recent 10 years

To summarize the influence patterns of related time factors on acupuncture effectiveness in different disease model rats/mice, and to provide reference for acupuncture clinical practice. Retrieved the relevant literatures on time-effect experimental studies of acupuncture in rats/mice in the recent 10 years. The correlations between the key time factors (such as different intervention timings of acupuncture, acupuncture moments, operation durations, needle-retaining times, intervals and treatment courses) and the acupuncture effect were analyzed and summarized. From the mainstream perspective of quantification, the earlier the acupuncture intervention, the better. The proper time to implement acupuncture varied depending on disease models and points. The best operation time varied widely between different diseases. The most frequently needle-retaining time was 20–30 min. The frequency of acupuncture was usually 1 time/day; the length of the treatment course was determined according to practitioners’ experience. Throughout the time-effect studies of acupuncture intervention in experimental rats/mice, conclusions are inconsistent, especially the lack of quantitative research on acupuncture operation time, acupuncture frequency, acupuncture treatment duration, and optimal stimulation amount. Future research should explore and determine the best time-quantity parameters that affect the effectiveness of acupuncture intervention, which is the key and goal of the acupuncture time-effect research. Independent intervention-time experiments throughout the entire course of a single disease (dominant disease) need to be done to guide clinical and disciplinary development.

Clinical characteristics of ZHU Dan-xi's acupuncture and moxibustion

The clinical characteristics of ZHU Dan-xi 's acupuncture and moxibustion in the aspects of syndrome differentiation based on meridian and collateral and the techniques of acupuncture and moxibustion were explored by analyzing and summarizing ZHU Dan-xi's clinical experience in acupuncture and moxibustion practice. ZHU Dan-xi pointed out a compound symptoms with the three yin and three yang of hand and foot meridians, which enriches the connotation of the diagnosis and treatment on base of the meridian-collateral theory. In clinical practice, the therapeutic method with acupuncture and moxibustion is combined with herbal medicine. He believed that acupuncture is mostly used for reducing rather than reinforcing purpose. Hence, the bloodletting technique of acupuncture is commonly used. The moxibustion therapy is applicable for all of the conditions of deficiency, excess, cold and heat. In clinical practice, moxibustion is used for heat syndrome and acute syndrome by reducing heat, removing toxin and regaining consciousness. The timing of moxibustion should be considered specifically in the treatment for tonifying yang, generating yin, reducing heat and removing toxin. The unique characteristics of ZHU Dan-xi 's experience provide the reference for the clinical practice of acupuncture and moxibustion in the later generations.

Apprenticeship system of American NCCAOM Certification of acupuncture and oriental medicine

The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is the only national institution for the accreditation of clinical practice of acupuncture and Oriental (Chinese) Medicine in the United States. Its qualification certificate or examination certificate is a mandatory document for 47 states and Washington, D.C. to issue the practice license. According to the latest information of the NCCAOM official website, this paper introduced the preceptor qualifications of the apprenticeship, studying hours, quality control, and the evaluation at the end of apprenticeship. The paper also discussed the enlightening and referential effects of the American system to apprenticeship policy in China.

Discussion on the enlightenment of heat-sensitive moxibustion technology to acupuncture clinic: dynamically grasping the state of acupoints, on-demand treatment are the key to achieving clinical efficacy

The enlightenment of heat-sensitive moxibustion technology on acupuncture clinical practice was discussed from the perspective of heat-sensitive moxibustion technology on the requirements of moxibustion acupuncture points, exploration and stimulation, and strict matching of acupoint sensitization types.The heat-sensitive moxibustion technology pays attention to the selection of acupoint status, and accurately locates the heat-sensitive acupoints by moxibustion. According to the needs of the body, the heat-sensitive acupoints are stimulated by heat, so the curative effect is remarkable. From the above discussion, it is known that the dynamic grasp of the state of the acupoints and the treatment according to the objectiveneeds of the body are the key to achieving clinical efficacy.

Acupoint combinations used for treatment of Alzheimer's disease: A data mining analysis

OBJECTIVETo identify the acupoint combinations used in the treatment of Alzheimer's disease (AD). METHODSThe clinical literature regarding acupuncture and moxibustion for AD was searched and collected from databases including Chinese Biomedical Medicine, China National Knowledge Infrastructure, Wanfang Database and PubMed. The database of acupuncture and moxibustion prescriptions for AD was established by using Excel software so as to conduct the descriptive analysis, association analysis on the data. RESULTSBaihui (GV 20), Sishencong (EX-HN 1), Shenmen (HT 7), Zusanli (ST 36), Neiguan (PC 6), Fengchi (GB 20), Taixi (KI 3), Dazhui (GV 14), Shenshu (BL 23), Sanyinjiao (SP 6), Shenting (GV 24), Fenglong (ST 40), Xuanzhong (GB 39), Shuigou (GV 26) and Taichong (LR 3) were of higher frequency in the treatment of AD with acupnucture and moxibustion. Most acupoints were selected from the Governor Vessel. The commonly used acupoints were located on the head, face, neck and lower limbs. The combination of the local acupoints with the distal ones was predominated. The crossing points among the specific points presented the advantage in the treatment. The association analysis indicated that the correlation among Fengchi (GB 20)-Baihui (GV 20) was the strongest, followed by combinations of Dazhui (GV 14)-Baihui (GV 20), Shenshu (BL 23)- Baihui (GV 20) and Neiguan (PC 6)- Baihui (GV 20) and indicated the common rules of the clinical acupoint selection and combination for AD. CONCLUSIONOur findings provide a reference for acupoints selection and combination for AD in clinical acupuncture practice.