Study On The Rule Of Acupoints And Medications And Systematic Evaluation In The Treatment Of Hiccup With External Therapy Of Traditional Chinese Medicine

Objective:1.Systematically sort out ancient and modern chinese and foreign literature on the external treatment of hiccups in Traditional Chinese Medicine,and deeply excavate the rules of its acupoints and herbs,to provide a basis for clinical application and further use and promotion.2.In strict accordance with the PICO principle,conduct a systematic evaluation of the part of modern randomized clinical controlled trials to evaluate the effectiveness of external chinese medicine treatments for hiccups.Method:1.Systematic collection of the Encyclopedia of Traditional Chinese Medicine,National Press Index,CNKI,Wanfang Data,VIP,Web of Science,Pub Med,and Cochrane Library databases until the end of December 2020 related literature,for the main external treatment of Traditional Chinese Medicine acupoints and herbs,using IBM SPSS 18 and Modeler 18 software for association rules and cluster analysis,to explore the law of acupoint selection and medication,and analyze the theoretical basis of Traditional Chinese Medicine.2.Use Rev Man 5.4 software to group and merge the collected clinical controlled research literature in strict accordance with the PICO principle,and evaluate the scores of hiccup symptoms,diet,sleep,and mental symptoms and effectiveness.Result:1.First,we sorted out the source of the ancient names of hiccups and provided a basis for the inclusion and exclusion of the ancient provisions.It was discovered that Yue was one of the ancient names,and in the Tang Dynasty began to change from hiccup to vomiting.Ke-Ni has always been referred to as cough,but in the song,Jin and Yuan Dynasties,it appeared to refer to hiccup,until the Ming and Qing Dynasties,this phenomenon gradually disappeared.E until the Yuan Dynasty appeared,E and Eni referred to hiccups in the Ming and Qing Dynasties,and they have been used today.2.After inclusion,exclusion,and exclusion of repetition,a total of 1,249articles and 13 documents were included in the ancient part.After the identification of disease names,460 articles related to acupoints,144articles related to herbs,69 acupoints and parts were included,among which ST 18 and LR 14 were the most commonly used,mainly moxibustion;71 herbs were involved,including Olibanum,Sulfur,Realgar and Wine,mainly olfactory method.The modern literature includes a total of 2818 articles,63 in English,3590 articles on acupuncture points,and 936 articles on herbs.Involving 375acupuncture points and parts,the most common among RN 12,ST 36,PC 6,BL17,and RN 17;involving 118 kinds of herbs,37 kinds of western medicines,chinese medicines are commonly used such as Caryophylli Flos,Zingiberis Rhizoma Recens,Evodiae Fructus,and anisodamine,metoclopramide and chlorpromazine are the most commonly used western medicine.3.After inclusion,exclusion,and PICO grouping,a total of two groups of post-stroke hiccup acupuncture vs chlorpromazine and refractory hiccup acupuncture vs anisodamine were included in 5 studies,involving a total of614 patients.After the merger,the heterogeneity of hiccup symptom score,diet,sleep and mental score and the effective rate was small(I~2=0%),and there were statistical differences between the groups(P<0.05).However,GRADE evidence grade scores are between Low and Moderate,and the included literature bias risk is mostly unknown risk and high risk in terms of allocation hiding,participant blinding,third-party data processing,result hiding,and other biases.Conclusions:1.The external treatment of hiccup in Traditional Chinese Medicine,ancient and modern herb,is mainly composed of multiherb groups,all of which are mainly Pungent and Warm herbs,and the channel tropism is mainly spleen,stomach,liver,and lung.Use warm and pungent herb to Dredging Meridian and Striae,and match with warming and regulating qi,tonifying Middle-Jiao and Dissipate Cold herb.The emphasis is different in ancient and modern times.In ancient times,herbs for promoting blood circulation and removing blood stasis,and promoting qi were mainly used,while in modern times,herbs for Inner-Warming were mainly used.The western medicine part is dominated by single-herb prescriptions.In ancient times,the olfactory method was the main method,but not dialectical.According to hiccup,the prescription is matched with Realgar-Wine,Olibanum-Sulfur-Folium Artemisiae Argyi.Modern acupoint injections are also not dialectical prescriptions for disease differentiation.The drugs are mainly anisodamine,metoclopramide,and chlorpromazine,while the external application is mostly syndrome differentiation formula.The main prescriptions are Caryophylli Flos-Kaki Calyx and Evodiae Fructus-Vinegar,Arecae Semen-Aurantii Fructus-Magnoliae Officinalis Cortex-Amomi Fructus-Pinelliae Rhizoma,and Zingiberis Rhizoma Recens-Citri Reticulatae Pericarpium and Caryophylli Flos-Kaki Calyx match,respectively suitable for intractable hiccups caused by stagnation of cold in the stomach and external pathogenic cold.Aquilariae Lignum Resinatum and Evodiae Fructus-Vinegar is matched,and Tie KI 1 can be used in conjunction with hiccups accompanied by kidney qi or kidney yang deficiency,and when there is no root for qi.2.The ancient and modern acupoint selection methods for hiccups in Traditional Chinese Medicine are mainly based on Ren Meridian acupoints and Mu-Acupoints.However,in ancient times,acupoint selection was mainly based on partial selection,and acupuncture points were mostly used alone.The focus was mainly on soothing the liver,regulating qi and lowering stomach qi,and at the same time replenishing qi and solidifying the middle energy.Most of them were not dialectical.Acupoints were mainly selected from ST 18,LR 14,RN 4,RN 6,and RN 17.Modern acupoints are mainly selected from the remote points of limbs,and the acupoints are composed of multiple acupoints,with the emphasis on tonifying qi and consolidating the middle of the stomach and Qi regulating acupoints as the auxiliary.The selection of acupoints is based on syndrome differentiation.Mainly,PC 6-ST 36-RN 12-BL 17 is the main prescription,and it matches the inner court on the stomach fire;when the spleen and stomach are weak,add BL 21-BL 20;when the stomach is cold and the kidney-yang is insufficient,add RN 6-RN 4-SP 6;LI 4-LR 3 or RN 17-RN 22 points can be used when Qi stagnation occurs.3.The pathogenesis of hiccup is the disease of Qi ascending.The route of Traditional Chinese Medicine coincides with the route of water and grain transportation and the starting route of twelve meridians.The pathogenesis of hiccup is related to the Ge-Guan of“Four Gates”.Acupoint selection and medication are based on the theory of“Circumfluence at a Stretch”of Traditional Chinese Medicine.4.In the part of the systematic review,we discussed in groups strictly according to the principle of PICO and determined that the external treatment of Traditional Chinese Medicine has advantages in the aspects of hiccup symptom score,diet,sleep and spirit score,and effective rate in the control of chlorpromazine in patients with hiccup after stroke,and anisodamine in patients with an intractable hiccup.However,due to the poor quality of literature and the small number of studies,the corresponding conclusions should be treated with caution.After the strict design,large sample,and multicenter research,it still needs to be further carried out in the treatment of hiccup by external treatment of Traditional Chinese Medicine.