Data Mining And Systematic Review Of Modern Acupuncture Treatment For Menstrual Migraine

Objective:using data mining technology to summarize and analyze acupoints selection rules of acupuncture therapy for menstrual migraine in the modern literature from January 1990 to December 2015, and with the systematic review on its effectiveness and safety, so as to provide reference for the evaluation of the clinical curative effect and mechanism research in the future.Methods:collecting the relative literature of acupuncture therapy for menstrual migraine through CNKI by electronic and network retrieval method, establishing the corresponding access database, then using the data mining software to analyze and summarize the acupoints selection rules including the meridians and specific acupoints. On the basis, according to the Cochrane Handbook, formulating inclusion and exclusion criteria strictly, screening out the RCTs and extracting the data by two reviewers, and evaluating their methodology quality with "bias risk assessment tool". Then inputing the data to Revman5.3 to make meta-analysis, and classificating the results according to the GRADE standards.Results:Data mining results:the acupoints such as Fengchi, Taichong, Baihui, Shuaigu, Hegu, Sanyinjiao, Touwei, Taiyang, Zusanli are frequently used, and the acupoints which are often used unites usually. Besides that, most acupoints lie on the head, face, neck and lower limb. And the gall bladder and liver meridian get mostly applied, the same to the main intersection point and five transport points that belong to the particular acupoints. The course of the treatment is 3 months in 17,4 months in 4,2 months in 2, and 6 months in 1 of all researches. As for each course of treatment time,19 studies initiated the treatment from the 3-7 days before the menstrual,4 studies from the 10 days before the menstrual, and 5 studies from the onset of pain, and 10 studies terminated the therapy at the end of the menstrual period,9 studies ended the treatment when the menses start, and 3 studies chose to treat the patients throughout the menstrual cycle. For the treatment frequency, daily treatment was carried in 22 researches, every day or two for a time was carried in 1 study, and 2-3 times a week was for one study, and for Pricking Bloodletting therapy, one time in every 5-7 days was selected. In all tests, patients were followed up among 3 months in 10, half of the year in 9, and one year in 3. Systematic review results:included 15 RCTs are divided into 5 groups,8 for the simple acupuncture vs Western medicine,2 for acupuncture combined with auricular point vs Western medicine,3 for acupuncture combined with traditional Chinese medicine vs Western medicine,1 for electroacupuncture vs Western medicine and 1 for the pricking blood therapy vs traditional Chinese medicine. The methodological quality evaluation:8 for B,7 for C. The results of meta analysis:(1) the efficiency:the simple acupuncture, acupuncture combined with auricular acupuncture, and electroacupuncture are superior to Western medicine; it still can not prove that acupuncture combined with traditional Chinese medicine is superior to Western medicine; pricking blood therapy is superior to traditional Chinese medicine. (2) the pain index:the simple acupuncture is superior to Western medicine. (3) the pain degree and time:the simple acupuncture is superior to Western medicine, and the the pricking blood therapy is superior to the traditional Chinese medicine. (4) symptom score:the simple acupuncture is superior to Western medicine on improvement of headache and accompanying symptoms; but there is no proof that it is superior to Western medicine on the accompanying symptoms improvement; headache symptoms improvement of acupuncture combined with auricular point is better than that of Western medicine. (5) serum biochemical indicators:on the P-EP and vascular pressure,there is no proof that acupuncture combined with auricular point is better than Western medicine; however on the PGF2? and ET-1, it is. (6) safety:it can't prompt that acupuncture therapy is safer than Western medicine. The evaluation on all the evidence is between low to very low.Conclusion:Modern acupuncture treatment for menstrual migraine is based on the principle of the following meridian acupoint selection, and the main choices of acupoints are close to the head. It also pays much attention to the specific acupoints on the gall bladder and liver meridian, the spleen and stomach meridian, and the kidney and bladder merdian, and their compatibility. The principle and specific acupoints on the main meridians are strongly recommended. Its meta analysis confirms the effectiveness of acupuncture therapy on the disease. But with the limited researches, their low methodology quality, the GRADE evidence qualities mostly turn out to be very low, the evaluation of the outcomes are unreliable. As to the The therapeutic mechanism, with the slight amount of the researches and their many problems within, more and better studies are expected, and with the combination of the EBM future progress, it will provide reliable foundation and references for the evaluation of the effectiveness and safety of the acupuncture therapy for menstrual migraine, the same as its therapeutic mechanism such as the influence on specific symptoms, serum biochemical indicators and the brain function. Beyond that, we look forward to the progress and intergration of the Traditional Chinese Medicine, the data mining and evidence-based medicine technology to make more contribution to its international recognition.