Based On Data Mining And Delphi Method,the Acupoint Scheme Of Auricular Acupoint Sticking In The Intervention Of Perioperative Anxiety During Cholecystectomy And Its Effect Evaluation Were Constructed

Objective: Based on data mining technology,the acupoint selection rule of auricular acupoint sticking in the intervention of perioperative patients’ anxiety was explored.The Delphi method was used to construct the acupoint optimization scheme of auricular acupoint sticking in the intervention of perioperative patients’ anxiety during cholecystectomy,and clinical trials were carried out to evaluate the effect of the auricular acupoint sticking optimization scheme.Methods:1.Systematically search the RCTS related to aural-point compression intervention for perioperative anxiety in CNki.com,Wanfang Database,Chinese biomedical literature Database,VIP,Web of Science,Cochrane Library,Em Base and Pub Med,and import the retrieved literatures into Endnote X9.The literature was screened independently by two researchers according to the inclusion criteria,and was evaluated using Cochrane recommended RCT quality evaluation criteria.Meta-analysis was performed by Rev Man5.3software.2.Relevant studies on auricular point sticking intervention in perioperative anxiety of general surgery patients were systematically searched,and data mining technology was used to explore the acupoint association rules,high-frequency stimulation frequency,pressing duration and intervention duration of auricular point sticking intervention in perioperative anxiety of general surgery patients.A 15-member expert letter consultation group was established.Based on the data mining results,the Delphi method was comprehensively applied to construct the acupoint optimization scheme of auricular acupoint sticking in the intervention of perioperative anxiety of patients undergoing laparoscopic cholecystectomy.3.In a quasi-experimental study,80 cases of patients undergoing laparoscopic cholecystectomy who met the natrol standard were randomly divided into the experimental group and the control group.The control group implemented the nursing routine,and the experimental group implemented the constructed auricular acupoint sticking optimization scheme based on the control group,and the intervention time was 7 days.The effect of clinical intervention was evaluated by SAS score,PSQI score and heart rate before,12 h before and 7d after intervention.Result:1 meta analysis: A total of 15 studies were included,including 1559 patients with perioperative anxiety.Auricular application pressure intervention in patients with perioperative anxiety[SMD=-1.05,95%CI(-1.36,-0.74),P<0.001],reduce heart rate [MD=-3.87,95%CI(-6.38,-1.37),P=0.002],improved sleep [MD=-1.48,95%CI(-2.62,-0.34),P=0.01].2 Scheme construction: A total of 51 literatures were included,including 36 auricular acupoints.The most frequently used acupoints were Shenmen acupoints(18%),corticoxia acupoints(15%)and Xin acupoints(12%).The top five association rules of acupoint compatibility ranked by degree of improvement were: Sheneman-sympathetic,Shenemanrenal-sympathetic,Sheneman-Renal-subcortical,Sheneman-cardio-sympathetic,Shenemansympathetic and Sheneman-sympathetic subcortical.Two rounds of Delphi method were used to construct the optimization plan of auricular acupoint sticking.The main acupoints were Shenmen,subcortical and sympathetic.Acupoint matching is,pressing frequency is 3 ～ 5times/day;Pressing time is 30 ～ 60 seconds/point;The intervention lasted for 7 days.3 Effect evaluation:(1)SAS: The results of the between-group study showed no statistically significant differences in anxiety scores among patients undergoing translaparoscopic cholecystectomy12 hours prior to surgery(P>0.05),but on the 7th day,the difference was statistically significant(P<0.05).The results of intra-group study showed that anxiety of experimental group patients had statistical significance before intervention and 12 h before surgery,before intervention and 7d,12 h before surgery and 7d(P<0.05).Repeated measurement variance results showed that anxiety scores of both groups were statistically significant in terms of time effects,between-group effects,and interaction effects(P<0.05).(2)PSQI: The results of the between-group study showed statistically significant sleep scores in patients undergoing translaparoscopic cholecystectomy at 12 h and 7d before surgery(P<0.05).The results of intra-group study showed that sleep scores of experimental groups were statistically significant compared with 12 h before intervention,7d before intervention,and 12 h before surgery(P<0.05).The results of the between-group comparison of sleep factor scores at different time points showed statistically significant differences between the two groups in terms of sleep quality,sleep duration,sleep time,sleep efficiency,sleep disturbance and daytime function in the 12 h preoperative period(P<0.05).On the 7th day,statistically significant differences were found between the 2 groups in sleep quality,sleep efficiency,sleep disturbance and daytime functional scores(P<0.05).Repeated measurement variance results showed that sleep scores of both groups were statistically significant in terms of time effects,between-group effects,and interaction effects(P<0.05).(3)Heart rate: The results of the between-group study showed no statistically significant(P>0.05)heart rate in patients undergoing transabdominal cholecystectomy at 12 h and 7 d before surgery;the results of the within-group study showed no statistically significant(P>0.05)heart rate in both groups at 12 h before and 7 d before the intervention,before and 7d before the intervention,and 12 h and 7 d before surgery.Repeated measures of variance showed no significant differences in time effects,between-group effects and interaction effects between the two groups(P>0.05).Conclusion:1 meta analysis: Ear acupressure can effectively relieve anxiety,improve sleep,and stabilize heart rate in perioperative patients.2 Scheme construction: Patients undergoing hepatobiliary surgery are the common auricular point sticking group for perioperative anxiety.Shenmen point,cortical point and heart point are the high-frequency acupoints for auricular point sticking intervention for perioperative anxiety of patients.Based on data mining and Delphi method,the acupoint optimization scheme of auricular acupoint sticking intervention for patients with anxiety during perioperative period of laparoscopic cholecystectomy is scientific and reliable.3 Effect evaluation: Clinical trials were carried out to evaluate the effect of the constructed acupoint pressure optimization scheme.The research results showed that auricular point pressure could shorten the anxiety and improve the sleep disorders of patients during the perioperative period of laparoscopic cholecystectomy,but had no significant effect on heart rate.