Clinical Efficacy Evaluation Of Acupoint Treatment In Functional Constipation

ObjectiveBased on the analyze the acupoints regularity of acupuncture and moxibustion in treating constipation,this randomized controlled study was conducted to evaluate the difference in the curative effect between acupoint and sham acupoint on patients with Functional Constipation(FC),to provide part of research evidences for the specific theory of acupoint and the clinical application of acupuncture in the treatment of FC.Methods1.Acupoint prescriptions used in the treatment of constipation were retrieved from China National Knowledge Infrastructure(CNKI),Chongqing VIP,Wan Fang database from January2002 to April 2021.Citespace,R Language and Apriori algorithm association rule mining were used to carry out data mining in terms of analysis of acupoint frequency,meridian frequency,acupoint combinations and core point group,to provide reference for acupoint selection in clinical efficacy evaluation of acupuncture treatment of FC.2.In this study,76 FC patients who met the inclusion criteria were divided into two groups: the acupoint group(38 cases)and the shame-acupoint group(38 cases)by the method of randomization and control.Both groups were treated with acupuncture once a day,5 days as a course of treatment,with 2 days’ rest in between.There were 2 courses of treatment in total.Before and after treatment,the Spontaneous Bowel Movements(SBMS),the Bristol stool form scale score,defecation difficulty score,the Cleveland Constipation Score(CCS)and the Patient Assessment of Constipation Symptom Scale(PAC-SYM)were used to evaluate the clinical efficacy of the two treatments in FC patients;the Patient Assessment of Constipation Quality of Life Questionnaire(PAC-QOL)was used to evaluate the influence of the two treatments on the quality of life of FC patients.Results1.Literature research results:(1)A total of 271 clinical studies on acupuncture and moxibustion for constipation were included.(2)A total of 87 acupoints and 13 meridians were involved,Tianshu(162),Shangjuxu(120)and Zusanli(99)are the most frequently used acupoints for the treatment of constipation;The Stomach Meridian of Foot-Yangming(409)is the most commonly selected meridian for acupuncture treatment of constipation.2.Clinical study results:(1)66 FC patients had completed the trial,including 34 cases in the acupoint group and32 cases in the sham-acupoint group.(2)Baseline results: Demographic data and baseline disease data were compared between the two groups,and there was no statistical difference(p>0.05).(3)Results of intra-group comparison after treatment: After treatment,SBMS,the Bristol stool form scale score,CCS score,PAC-SYM total score,PAC-SYM rectal symptom score,PAC-SYM abdominal symptom score,PAC-QOL total score and scores of all dimensions of FC patients in acupoint group were significantly improved compared with those before treatment,with statistical differences(p<0.01).After treatment,SBMS,the Bristol stool form scale score,CCS score,PAC-SYM score,PAC-SYM rectal symptom score,PAC-QOL total score and scores of various dimensions in FC patients of sham-acupoint group were significantly improved(p<0.01).(4)Comparison results between groups after treatment: There were significant statistical differences between the two groups in the total score of PAC-SYM and the improvement value of PAC-SYM rectal symptom score before and after treatment(p< 0.05),the effect of acupoint group was better than the sham-acupoint group.Conclusion1.The Stomach Meridian of Foot-Yangming is the most commonly selected meridian for acupuncture treatment of constipation,and Tianshu(ST-25),Shangjuxu(ST-37)and Zusanli(ST-36)are the most frequently used acupoints for the treatment of constipation.2.acupoint and sham-acupoint can both improve the clinical symptoms and quality of life of FC patients,acupoint can improve the subjective symptoms of FC patients better than that sham-acupoint.