| ObjectiveEpilepsy is one of the most common chronic neurological disorders.It occurs to people of all ages,regions,and races.The disease threatens about one percent of the world’ s population.In recent years,the incidence of the disease has gradually increased.The pathological basis of epilepsy is the abnormal discharge of neurons in the brain which occurs repeatedly,however,the exact pathogenesis is not clear.Epilepsy belongs to the category of“Xian Zheng”in traditional Chinese medicine.There’ s a variety of clinical manifestations of epileptic seizures,disorders of sensory impairment,motor disorders,neurological dysfunction,mental disorders,emotional disorders,memory disorders,cognitive and behavioral issues.Seizures have the characteristics of sudden onset,transient and self-limiting.The epilepsy has a long course of illness and repeated episodes,which seriously endangers the physical and mental health of patients and has serious negative effects on individuals,families and society.The risk of death in people with epilepsy is two to three times higher than that in the general population.Currently,the primary treatment for epilespy is oral antiepileptic medication,and there are also surgical treatments and progesterone treatments.In our country,Traditional Chinese Medicine(TCM)therapy method has been active in the treatment of epilepsy,and more and more researches show that acupuncture method can increase curative effect either alone or in combination with medicine.Furthermore,under the guidance of the precautionary theory,TCM can participate in the treatment of the diseases earlier than western medicine with fewer side effects.Ancient books on TCM recorded a large number of methods to treat epilepsy,which is valuable to treat epilepsy in clinic.To explore the pattern and characteristics of ancient acupuncture treatment of epilepsy can be beneficial to modern clinical practice.MethodsThis research is mainly based on literature review,combined with five parts.The first part summarizes the research progress of acupuncture therapy on epilepsy.The second part systematically sorts out ancient books of acupuncture related to epilepsy and explores the academic origins.To select representative ancient medical books by referring to the catalogue and brief introduction recorded in The summary of Chinese acupuncture and moxibustion literature.To explore the theoretical development of acupuncture therapy for epilepsy through reading and organizing relevant literature.The third part is to collect the acupoint prescriptions for epilepsy in ancient literature and explore the acupoint selection rules in epilepsy therapy of ancient acupuncturists by data mining methods.The fourth part is the data mining of related modern literature on the acupuncture treatment of epilepsy.All the clinical modern literature on acupuncture and moxibustion treatment for epilepsy in WanFang Data,CNKI,CBM and VIP database since the database was built were collected through computer retrieval method.Retrieval type as“epilepsy”AND "’ acupuncture and moxibustion ’ or ’ acupuncture ’ or’electroacupuncture’ or ’ acupoint embedding’ or ’acupoint injection’ or’ moxibustion ’ or pricking blood therapy’ or ’fire needle’”.Establish the database after establishing inclusion and exclusion criteria.Make a statistical analysis through data mining method after completing the standardization of data processing.The software Spss statistics 22.0 was used to conduct frequency and clustering analysis and the software Spss Modeler 18.0 was used to analyze association rules for the acupuncture points included.In the fifth part,the characteristics of ancient and modern acupuncture treatment of epilepsy were compared to study the inheritance relationship.ResultsFirstly,the research results of ancient literature.1.The origin and development of the name and type classification of epilepsy.①The name of epilepsy appeared in The fifty-two Cases as Chinese characters "间" and "瘨" and it is also recorded in Inner Canon of Huangdi as Chinese characters "巅疾" in the pre-Qin period,these both refers to epilepsy.The book Inner Canon of Huangdi initially proposed the cause of epilepsy,one is congenital deficiency and the other is the viscera dysfunction.The distinction between epilepsy and madness is presented in Nanjing.In the literature of this period,"Dian" and "Xian" usually refers to epilepsy,while "Kuang" refers to manic psychosis.In the pre-Qin period,doctors had a preliminary understanding of epilepsy,but the observation of epilepsy symptoms was not specific enough,and the cognition of etiology and pathogenesis of epilepsy was also relatively general.②The understanding of epilepsy was further developed in the Sui and Tang dynasties,while the literature of this period still makes no distinction between "Dian" and"Xian".It is believed in The Pulse Classic that both "Dian" and "Xian" are related to governor meridian.Doctor Xu Sibo put forward that adult "Dian”and child "Xian" was actually the same kind of disease.The etiology and nosology of epilepsy has been greatly developed.According to Etiology of Various Diseases,epilepsy can be divided into three types according to etiology:epilepsy caused by wind pathogens,epilepsy caused by shock and epilepsy due to eating disorders.And also epilepsy can be divided into Yin epilepsy and Yang epilepsy according to the pulse condition and symptoms.Important Formulas Worth a Thousand Gold Pieces for Emergency suggested to divide epilepsy into"epilepsy of the five internal organs" and"epilepsy of six animals" according to the symptoms of seizures.③Doctors in Song,Jin and Yuan dynasties enriched and developed the academic theories of epilepsy in TCM.YAN’s Jishengfang turned the epilepsy of six animals into five kinds of epilepsy,corresponding to the epilepsy of the five internal organs respectively.According to the book Bian Que Xin Shu,epilepsy is divided into“Tai Xian”and“Qi Xian”,which suggests that epilepsy is associated with congenital and emotional factors.Taiping Shenghui Fang first mentioned the name“Re Xian”,which refers to epilepsy caused by heat evil.Shengji Zonglu proposed that Yin epilepsy meant chronic infantile convulsion and Yang epilepsy meant acute infantile convulsion.④In the Ming and Qing dynasties,doctors differentiated the implications of "Dian","Kuang" and "Xian".According to Puji Fang,the symptoms of Dian and Xian are quite different,they are not the same disease while the causes of both are related to frightened.Introduction to Medicine made a detailed distinction between epilepsy and manic psychosis.Doctor Wang Kentang identified "Dian","Kuang" and "Xian" in his book Gynecological Standards for Diagnosis and Treatment.Unti1 Qing dynasty the distinction between "Dian","Kuang" and Xian is very close to that of modern Chinese medicine according to doctor He Mengyao ’ s book Yi Bian.2.The application history of acupuncture therapy for epilepsy.①The theory of acupuncture therapy for epilepsy originated in the pre-Qin period.The clinical symptoms of epilepsy are preliminarily described in Inner Canon of Nuangdi,which suggested that epilepsy was related to the kidney meridian and the bladder meridian and proposed five meridians and tianzhu acupoints for the treatment of epilepsy by acupuncture.It is the first time to propose the blood-letting therapy for’ epilepsy in Inner Canon of Huangdi.According to Nan jingy the pathological characteristics of epilepsy is "yin excess causes epilepsy".②As the development of acupoint theory in the Han dynasty,some single-acupoint prescriptions for acupuncture therapy of epilepsy appeared,and the existing literature is mainly contained in The Yellow Emperor ’s Mingtang Classic.Theoretical research on acupuncture and moxibustion for the treatment of epilepsy in the Jin dynasty was further developed.The theory of combination of pulse and needle" was put forward in the book The Pulse Classic,which associated the meridians and pulse and suggested that the selection of acupoints should refer to pulse characteristics.It is suggested according to The Pulse Classic that the meridians related to epilepsy are governor meridian,yangqiao meridian,yinqiao meridian,yangwei meridian,yinwei meridian,kidney meridian and bladder meridian.A-B Classic of Acupuncture and Moxibustion set up separate chapters on epilepsy related content,and the method of treating epilepsy according to symptoms was put forward.There are seven moxibustion prescriptions for treating epilepsy in Zhouhou Beiji Fang,which reflects doctor Ge’ s good use of moxibustion through the the extraordinary points.④In the Sui and Tang Dynasties,doctors began to recognize epilepsy from the perspective of etiology.The Etiology of Various Diseases proposed six causes of epilepsy such as pre-acupuncture,congenital factors,heat evil,pathogenic wind and improper diet.On this basis,Sun Simiao proposed 20 pieces of foreboding symptoms of epilepsy and proposed the principle of moxibustion for the treatment of pediatric epilepsy,that is,the deficiency syndrome can be treated with moxibustion while the excessive syndrome shouldn t.In addition,Sun also proposed the correlation between the onset time of epilepsy and the sick meridian of the disease.He also summed up and carried forward the“thirteen ghost points”,which became commonly used for the treatment of mental illness.Waitai Miyao focused on moxibustion alone and further enriched the application theory of moxibustion treatment of epilepsy.Taiping Shenghui Fang proposed that the pathogenesis of epilepsy mainly lies in the accumulation of heat in the organs,and a more detailed description of the moxibustion method of epilepsy was recorded.Shengji Zonglu expatiated on the taboos of using relevant acupoints for epilepsy and the treatment methods after wrong operation.Zhenjiu Shenshu forward reducing technique at jiuwei point for the treatment of epilepsy.Zhenjiu Zishengjing emphasized,the application of"location of disease" in the treatment of diseases,which is futher development of pain-point needling theory and ashi acupoints theory.⑥Only few books on acupuncture and moxibustion in Yuan dynasty spread until now,but there are still some innovative ideas on epilepsy.Xifangzi Mingtang Jiujing focused on moxibustion and the moxibustion treatment of epilepsy theory was further improved.The Guidance to Acupuncture advocated the eight acupoints coordinated with the eight extra meridians,in which houxi and shenmai acupoints were used for epilepsy.Willful Intercept of Acupuncture put forward zusanli with shangwan to treat epilepsy,which showed the emergence of acupoint compatibility theory.⑦During the Ming and Qing dynasties,a large number of books on acupuncture and moxibustion appeared,especially the research on the collation of medical books on acupuncture and moxibustion reached its peak.Fuji Fang cited Zhang Yuansu’ s viewpoint and put forward that moxibustion at shenmai point is used to treat daytime seizures and moxibustion at zhaohai point is used to treat seizures that occur especially at night.A complete collection of Acupuncture and Moxibustion advocated the application of the neiguan point of the eight acupoints coordinated with the eight extra meridians to treat epilepsy.Yang Jingzhai Acupuncture Book recorded acupuncture prescriptions in the form of pictures of people.Compendium of Acupuncture and Moxibustion collected the essence of acupuncture medical records in various eras,which contained a large number of multi-point prescriptions for epilepsy and epilepsy related content in acupuncture songs.The book hold a view that epilepsy is due to phlegm and fire-evil,emphasizing the means of acupuncture and moxibustion combined with TCM therapy for the treatment of epilepsy.3.Ancient literature data mining.In this study,a total of 282 prescriptions for epilepsy were included,which contains 193 records on single acupoint treatment accounting for 48.58%and 62 records on multiple points.A total of 168 acupoints were involved in this study and the cumulative application frequency was 700 times,Among them,the high-frequency acupoints with application frequency of more than 17 times were baihui(34 times),jiuwei(20 times),xinshu(18 times)and shenting(17 times).The cephalic acupoints were the most commonly used points in the selection of epilepsy,of which the application frequency was 215 times,accounting for 31.71%of the total usage frequency.Acupoints of lower limbs were used 172 times and points of upper limbs 164 times.The total application frequency of acupoints in the limbs was 50%,and the application of acupoints on the waist back was the least,accounting for only 9.71%of the total application frequency.From the point of view of meridians,the prescription acupoints involve all the twelve meridians,du and ren channel,among which the acupoints of du-meridian were most frequently used and the cumulative application frequency was 154 times,followed by 127 times of bladder meridian and 70 times of ren-meridian.The cumulative frequency of acupoints of du-meridian,bladder meridian and ren-meridian was up to 50%.The application frequency of specific points in the prescriptions was 544 times,and the ratio of specific points to non-specific points was 3.49.Among specific points,the most frequently used point was the eight confluent points,which was used 208 times,accounting for 25.15%.In five shu-points the most frequently used was jing-river acupoint,which was used 54 times with the frequency of 6.53%.Secondly,modern literature research results;the results of data mining are basically consistent with modern clinical.According to the screening criteria of the literature,294 articles were finally included,and 765 prescriptions were included,involving 177 acupoints,with a total frequency of 4858 times,among which there are 388 prescriptions for acupuncture therapy,343 for acupoint catgut embedding,16 for moxibustion,10 for acupoint blood-letting therapy,7 for acupoint injection,and 1 for needle knife.①Rules of acupoints selection for epilepsy based on data mining technology:The top five acupoints with the highest frequency are dazhui,baihui,fenglong,yao qi and zusanli.According to the classification of body parts,the most frequently used acupoints are those on the lower back,followed by those on the lower limbs.According to the classification of the meridians,the three most commonly used meridians are the governor meridian,the bladder meridian and the stomach meridian.For the selection of specific acupoints,the three types of acupoints with the highest application frequency are the eight confluent acupoints,luo-connecting points and the back shu-points.The yuan-source points are the most commonly used in the five shu-points.According to analysis of association rules,it is found that some acupoints are highly correlated:yaoqi,dazhui;jiuwei,dazhui;baihui,taichong;jinsuo,dazhui and so on.Eight effective groups were obtained by cluster analysis such as xinshu,ganshu,shenshu,pishu;dazhui,jinsuo,jiuwei,changqiang,yaoqi,dianxia n;shenzhu,zhiyang;shenmai,zhaohai;fengchi,fengfu;jianshi,quchi,fenglong;s anyinjiao,shenmen,baihui,shuigou,neiguan,hegu,taichong,zusanli;shenting,y anglingquan.According to the icicle chart,eleven pairs of core points are obtained such as xinshu,ganshu;xinshu,ganshu,shenshu;jinsuo,yaoqi;shenzhu,zhiyang;fengchi,fengfu;jianshi,quchi;sanyinjiao,shenmen;hegu,taichong;nei guan,zusanli.②The rules of acupoints selection for epilepsy by embedding therapy.There are 94 acupoints in the embedding prescriptions,among which the top five acupoints of frequency are dazhui,yaoqi,jiuwei,fenglong,xinshu.According to the classification of the body parts,the most commonly used points are the points on the lower back,followed by the lower limb points.In terms of meridians,the top three are in turn governor meridian,bladder meridian and ren channel.The top three most frequently used specific acupoints are confluent acupoints,back-shu points and luo-connecting points and the most commonly used specific acupoints in five-shu point are he-sea points.According to the results of association rules analysis,some acupoints are highly correlated as:dazhui,jiuwei;dazhui,jinsuo;yaoqi,dianxian;dazhui,jinsuo,yaoqi;dazhui,jinsuo,jiuwei.Eleven clusters were obtained by cluster analysis as yaoshu,qihai;fengchi,fengfu,baihui;sanyinjiao,geshu;hegu,neiguan;suzanli,pishu;danshu,jueyinshu,ganshu,xinsh u,yanglingquan,shenshu;fenglong,jianshi;yaoqi,dianxain,dazhui,jinsuo,jiuw ei,changqiang;shenmai;zhaohai.Core pairs are shown on the icicle chart as qihai,yaoshu;zhiyang,jizhong;dazhui,jinsuo;dianxian,yaoqi;xinshu,ganshu;f engchi,fengfu;jianshi,fenglong;danshu,jueyinshu;pishu,zusanli.③149 acupoints were involved in the treatment of epilepsy by needling therapy,among which the top five high frequency acupoints were baihui,fenglong,taichong,dazhui,neiguan.According t.o the division of the human body,the highest application frequency is the lower extremity acupoints,followed by the head and the lower back.In terms of meridians,the top three high-frequency meridians are the governor meridian,the stomach and the bladder meridian.The top three types of specific points with the highest frequency are the confluent acupoints,the yuan-Source acupoints and the luo-connecting points.According to the results of association rules analysis,some acupoints are highly correlated as:baihui,taichong;baihui,dazhui;baihui,shuigou;baihui,dazhui,taichong.Seven clusters were obtained by cluster analysis as baihui,hegu,taichong,shuigou;dazhui,fenglong,jianshi,jinsuo,jiuwei,yaoqi,changqiang;pishu,shenshu,ganshu,xinshu,shenmen,taixi;neiguan,sanyinjiao,z usanli;sishencong,shenting,yintang,quchi;fengchi,fengfu;guanyuan,juque,da nzhong.Core pairs are shown on the icicle chart as shenshu,ganshu;jianshi,jiuwei;jinsuo,yaoqi;guanyuan,juque;sanyinjiao,zusanli;hegu,taicho ng;fengchi,fengfu;shenmai,zhaohai.④Moxibustion treatment of epilepsy involves 50 acupoints,of which the five highest frequencies are baihui,jinsuo,dazhui,jiuwei and shenzhu.According to the division of the human body,the acupoints of the highest application frequency are on the lower back,followed by the head and abdmen-thorax.In terms of meridians,the top three most frequently used meridians are governor meridian,ren channel and bladder meridian.The type of specific acupoints of the first three application frequencies are confluent acupoints,he-sea point and the Mu-front acupoints.According to the results of association rules analysis,some acupoints are highly correlated as baihui,shenzhu;shenzhu,dazhui;jinsuo,dazhui and so on.Cluster analysis divides all acupoints into two categories.The first category is baihui and jinsuo,while the other acupoints fall into the second category.The second group of acupoints can be divided into two categories,jiuwei,shenzhu and dazhui fall into the first category and the others fall into the second category.Core acupoint combination as shendao,zhongshu;jizhong,mingmen;shenzhu,jiuwei;jinsuo,baihui.⑤Acupoint injection therapy involves 11 points,and the first three points with the highest application frequency are dazhui,yaoqi and fengchi.Bloodletting therapy involves 21 acupoints,among which the top three most frequently used are taiyang,chize and quchi.Conclusion1.In chronological order,this paper has sorted out the theoretical origin of acupuncture and moxibustion in the treatment of epilepsy,and summarized as follows;The earliest record of epilepsy can be found in The fifty-two Cases,and the book Inner Canon of Huangdi first proposed acupuncture and bloodletting therapy for epilepsy.There were many single acupoint prescriptions of acupuncture therapy for epilepsy appeared in The Yellow Emperor ’s Mingtang Classic.The Pulse Classic put forward the theory of"combination of pulse and needle" for acupuncture clinical.The prescriptions in A-B Classic of Acupuncture and Moxibustion changed from single to multiple acupoints.From jin dynasty to yuan dynasty,moxibustion theory developed and flourished gradually,many prescriptions for the treatment of epilepsy using extraordinary points are provided in Zhouhou Beiji Fang.The Etiology of Various Diseases began to recognize epilepsy from the perspective of etiology.Important Formulas Worth a Thousand Gold Pieces for Emergency proposed 20 pieces of foreboding symptoms of epilepsy and proposed the principle of moxibustion for the treatment of pediatric epilepsy.Waitai Miyao further enriched the application theory of moxibustion treatment of epilepsy.Taiping Shenghui proposed that the pathogenesis of epilepsy mainly lies in the accumulation of heat in the organs,and a more detailed description of the moxibustion method of epilepsy was recorded.Shengji Zonglu expatiated on the taboos of using relevant acupoints for epilepsy and the treatment methods after wrong operation.Zhenjiu Shenshuput forward reducing technique at jiuwei point for the treatment of epilepsy.Zhenjiu Zishengjing emphasized the application of "location of disease" in the treatment of epilepsy.The moxibustion treatment theory of epilepsy was further improved in Xifangzi Mingtang Jiujing.The Guidance to Acupuncture advocated the eight acupoints coordinated with the eight extra meridians,in which houxi and shenmai acupoints were used for epilepsy.Willful Intercept of Acupuncture put forward Zusanli with Shangwan to treat epilepsy.During the Ming and qing dynasties,the research on the collation of medical books on acupuncture and moxibustion reached its peak.Fuji Fang cited Zhang Yuansu’ s viewpoint and put forward that moxibustion at shenmai point is used to treat daytime seizures and moxibustion at zhaohai point is used to treat seizures that occur especially at night.The complete collection of Acupuncture and Moxibustion advocated the application of the neiguan point of the eight acupoints coordinated with the eight extra meridians to treat epilepsy.Yang Jingzhai Acupuncture Book recorded acupuncture prescriptions in the form of pictures of people.Compendium of Acupuncture and Moxibustion hold a view that epilepsy is due to phlegm and fire-evil and contained a large number of multi-point prescriptions for epilepsy.At this point,the theory of acupuncture treatment of epilepsy gradually mature.2.Research on the inheritance relationship between ancient and modern acupuncture treatment for epilepsy:(DIn the application of acupuncture and moxibustion method,needle therapy is one of the main treatment methods,in ancient and modern times,moxibustion was emphasized in ancient treatment of epilepsy while modern clinical treatment methods are more abundant,acupoint embedding therapy is more commonly used and the application of moxibustion is relatively uncommon.②In the use of meridians,both of them pay attention to the application of acupoints of du meridian and bladder meridian,in addition,ancient medical doctors valued the application of acupoints of ren meridian while modern modern medical doctors attach more importance to stomach meridians.③As to the distribution of the human body in the selected acupoints,more emphasis was placed on the choice of acupuncture points on the head,and there were fewer applications in the lower back acupoints,while modern clinics pay more attention to the application of acupuncture points on the lower back at the same time.④Both ancient and modern clinics are flexible in the treatment of epilepsy with external acupoints,but the ancient doctors are not standardized on the naming of the external acupoints while modern medical doctors have a relatively systematic understanding of the naming,positioning,and attending of the external acupoints.⑤In the aspect of specific acupionts application,ancient and modern doctors both often use confluent acupoints to treat epilepsy,and the back-shu points of xinshu and ganshu are usually used in common.In terms of five-shu points,the ancient doctors used the the application frequency of jing-river acupoints,he-sea acupoints,shu-stream acupoint and yuan-primary points are quite in ancient times,while modern doctors pay more attention to the application of the yuan-original point,in addition to the application of luo-connecting points.⑥In ancient and modern times,the acupoint selection process of doctors all reflected the theory of cooperation among acupoints,but the related records of ancient times are scattered while the method is is widely used in modern clinical practice.Modern doctors have summarized and developed the theory on the basis of predecessors.⑦In the way of acupuncture treatment based on syndrome differentiation,both ancient and modern doctors treat patients from the perspectives of symptoms,discrete category,the pathological viscera,the onset time and the pathogenesis.Based on this,Modern doctors are able to treat epilepsy from a more comprehensive perspective,such as according to the western medicine classification of epilepsy and disease staging. |
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