| Objective:(1)The clinical efficacy of acupuncture in the treatment of Chronic Fatigue syndrome(CFS)was evaluated by meta-analysis,in order to provide evidence-based medical evidence for clinical treatment of CFS.(2)Data mining technology was used to analyze the application rules of acupoints selection in treatment of CFS with acupuncture therapy,in order to provide reference for the selection of acupoints and prescription for clinical treatment of CFS.Methods:(1)Meta Analysis: Randomized controlled trials(RCT)for acupuncture treatment of CFS published from the inception of database to December 31,2021 were searched from CNKI,Wanfang,VIP,Embase,Pub Med and The Cochrane Library Database.Data extraction and quality evaluation were carried out for the literatures that met the inclusion and exclusion criteria,and meta-analysis was performed on the relevant outcome index data by Revman5.3 software.(2)Data mining section: Randomized controlled trials(RCT)and quasi-randomized controlled trials(q RCT)for acupuncture treatment of CFS published from the inception of database to December 31,2021 were searched from CNKI,Wanfang and VIP Database.The CFS prescription database was established by Microsoft Excel software and descriptive analysis was carried out.IBM SPSS Modeler 14.1 was used to analyze association rules and draw the network diagram of co-occurrence of acupoints.IBM SPSS Statistics 21.0was used for cluster analysis of high-frequency acupoints.Results:(1)Meta-analysis: A total of 30 RCT literatures were included in this study,involving 2041 CFS patients(1027 in the treatment group and 1014 in the control group).Meta-analysis results showed that:(1)total effective rate:The total effective rate of CFS treated by acupuncture was better than that treated by non-acupuncture(RR=1.20,95%CI=[1.15,1.26],P<0.00001).Subgroup analysis showed that the total effective rate of the acupuncture group(RR=1.23,95%CI=[1.15,1.33],P<0.00001)and the moxibustion group(RR=1.18,95%CI=[1.10,1.26],P<0.0001)were better than that of control group.The acupoint catgut embedding group(RR = 1.04,95% CI = [0.86,1.25],P = 0.69),the electric acupuncture group(RR = 1.30,95% CI = [0.97,1.74],P = 0.08),the auricular-plaster therapy group(RR = 1.23,95% CI =[0.96,1.57],P=0.10)compared with the control group,there was no statistical significance in the total effective rate.(2)FS-14 score: Acupuncture treatment of CFS was superior to non-acupuncture treatment in reducing FS-14 score(SMD=-1.49,95%CI=[-1.96,-1.02],P<0.00001).Subgroup analysis showed that: Acupuncture group(SMD = 1.79,95% CI = [2.66,0.93],P < 0.0001),the moxibustion group(SMD = 1.27,95% CI = [1.67,0.87],P < 0.00001),the acupoint catgut embedding group(SMD = 0.66,95% CI = [1.00,0.32],P =0.0002),the auricular-plaster therapy group(SMD = 1.75,95% CI = [2.35,1.15],P < 0.00001)were better than control group in reducing FS-14 score.(3)FAI score: Acupuncture treatment of CFS was superior to non-acupuncture treatment in reducing FAI score(SMD=-0.73,95%CI=[-0.98,-0.4],P<0.00001).(4)PSQI score: Acupuncture treatment of CFS was superior to non-acupuncture treatment in reducing PSQI score(MD=-4.07,95%CI=[-4.87,-3.27],P<0.00001).(5)SF-36 score: Acupuncture treatment of CFS was superior to non-acupuncture treatment in improving SF-36 score(MD=129.17,95%CI=[57.44,200.90],P=0.0004).(6)SDS score: Acupuncture treatment of CFS was superior to non-acupuncture treatment in reducing SDS score(MD=-6.73,95%CI=[-8.61,-4.86],P<0.00001).(7)SAS score:Acupuncture treatment of CFS was superior to non-acupuncture treatment in reducing SAS score(MD=-5.90,95%CI=[-7.40,-4.40],P<0.00001).(8)WHOQOL-BREF score: There was no statistically significant difference between acupuncture treatment and non-acupuncture treatment in improving WHOQOL-BREF score of CFS(MD=9.47,95%CI=[0.80,19.73],P=0.07).(2)Data mining:(1)A total of 108 articles were included,with 171 acupoint prescriptions and 85 acupoints extracted.The total frequency of acupoints was 1101 times.(2)Frequency statistics: The top five acupoints with frequency ≥20 were Zusanli(ST 36),Pishu(BL 20),Sanyinjiao(SP 6),Baihui(GV 20)and Shenshu(BL 16).The top five in the frequencies of use of the meridians to which the acupoints belong were the foot-taiyang bladder meridian,the Ren meridian,the Du meridian,the foot-Yangming stomach meridian and the foot-Taiyin spleen meridian.The top three points in the frequency of using specific points were Crossing point,Back-shu point and Five-shu point.The top three most frequencies used parts of the body where acupoint were located were lower back,lower limbs,chest and abdomen.(3)Association rule analysis: Set support ≥20% and confidence ≥80% to obtain 19 association rules in total.The acupoint combination with the highest confidence referred to“Baihui(GV 20)、Sanyinjiao(SP 6)→Zusanli(ST 36)(94.64%)”,the acupoint combination with the highest support and frequency was “Sanyinjiao(SP 6)→Zusanli(ST 36)(44.44%)”.Common combinations of acupoints include Baihui(GV 20)、 Sanyinjiao(SP6)→Zusanli(ST 36),Taichong(LR 3)、Sanyinjiao(SP 6)→Zusanli(ST 36),Guanyuan(CV 4)、Sanyinjiao(GV 20)→Zusanli(ST 36),etc.(4)Clustering analysis of high-frequency acupoints: The acupoints whose usage frequencies is greater than or equal to 25 times can be divided into four categories: The first category includes Sanyinjiao(SP 6),Baihui(GV 20),Taichong(LR 3)and Zusanli(ST 36);The second category includes Shenmen(HT 7)and Neiguan(PC 6);The third category includes Guanyuan(CV 4),Qihai(CV 6)and Zhongwan(CV 12).The fourth category includes Shenshu(BL 23),Feishu(BL 13),Pishu(BL 20),Ganshu(BL 18)and Xinshu(BL 15).Conclusion:(1)The following conclusions can be drawn from the meta-analysis results:(1)Acupuncture treatment of CFS was superior to non-acupuncture treatment in reducing SF-14,FAI,SAS and SDS scores,improving SF-36 score and total effective rate.(2)Acupuncture treatment of CFS showed no significant advantage in improving WHOQOL-BREF score.(2)The following conclusions can be drawn from the data mining research results:(1)Acupoints for acupuncture treatment of CFS are mainly selected at specific acupoints with beneficial effects,such as Zusanli(ST 36),Pishu(BL 20),Sanyinjiao(BL 20),Baihui(GV 20),Shenshu(BL 16),etc;The selected acupoints are mainly concentrated in the meridian of the foot-taiyang bladder meridian,the Ren meridian,the Du meridian,etc.Acupoints are mostly distributed in the back,lower limbs,chest and abdomen.(2)Common acupuncture point groups for CFS treatment include Baihui(GV20)-Sanyinjiao(GV 20)-Zusanli(ST 36),Taichong(LR 3)-Sanyinjiao(GV20)-Zusanli(ST 36),Guanyuan(CV 4)-Sanyinjiao(GV 20)-Zusanli(ST 36),etc.Commonly used acupoint groups are: Sanyinjiao(GV 20)-Baihui(GV20)-Taichong(LR 3)-Zusanli(ST 36),Shenmen(HT 7)-Neiguan(PC 6),Guanyuan(CV 4)-Qihai(CV 6)-Zhongwan(CV 12),Shenshu(BL 23)-Feishu(BL 13)-Pishu(BL 20)-Ganshu(BL 18)-Xinshu(BL 15). |
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