The Developments Of Disease Spectrum And Standardized Manipulation Of Jing-well Points Collateral Pricking And Bloodletting Therapy-based On The Pattern Of Multi-dimensional Evidence

ObjectiveTo clarify clinical applicable diseases of jing-well points collateral pricking and bloodletting therapy,i.e.,the spectrum of diseases,and to screen the dominant systems/dominant diseases,as well as to standardize the technical manipulation of the jing-well points collateral pricking and bloodletting therapy,and to promote a wider application of this therapy.Methods1 Development of disease spectrum and screening of dominant systems/dominant diseases of jing-well points collateral pricking and bloodletting therapy1 A systematic data collection of the diseases treated by jing-well points collateral pricking and bloodletting therapy was done.Physicians who have applied jing-well points collateral pricking and bloodletting therapy were selected and a questionnaire was developed to conduct the research of them.Databases of each type were established,the above evidence was extracted and summarized by entry,and the data were processed and analyzed according to the steps of correspondence and transformation of the original diseases and coded disease,classification of the diseases,and frequency statistics.The completed disease spectrum was supplemented with each other by combining similar items and accumulating frequencies.The4 parts of the evidence were organically integrated to develop the disease spectrum of jing-well points collateral pricking and bloodletting therapy based on the "multi-dimensional body of evidence" model.(2)Based on the disease spectrum,the top 3 disease systems in each category were selected as the dominant systems.At the same time,the guiding ideology of screening dominant diseases was “documented in ancient literature,handed down by generations of medical practitioners,and applied by modern medical practitioners”,diseases documented in all 4 parts of the evidence in ancient literature,journal papers,modern books,and questionnaire survey or in 3 parts were selected as the dominant diseases to recommend for clinical application.2 Development of Standardized manipulation of jing-well points collateral pricking and bloodletting therapyEvidence were collected and integrated based on the "multi-dimensional body of evidence" model.The literature describing clinical manipulation of jing-well points collateral pricking and bloodletting were selected from the established literature databases in Study 1and supplemented accordingly to the databases of ancient literature,journal papers and modern books.3 parts of the original text was extracted and combined to form a general literature database for clinical manipulation of jing-well points collateral pricking and bloodletting.Guided by the general rules of the Specification of manipulations of acupuncture and moxibustion-General rules for the drafting(GB/T 33416-2016)and combined with basic manipulation steps of this therapy and the contents of the incorporated literature,the entries were divided into pools of original entries of jing-well points collateral pricking and bloodletting clinical manipulation.Valid information in each literature was divided and summarized according to the entries,and the degree of different options selected were counted.Afterward,an operability test was conducted on college students who had not been exposed to this therapy to verify the practical applicability of this specification.Results1 The disease spectrum,dominant systems/dominant diseases of jing-well points collateral pricking and bloodletting therapyA total of 2463 articles of ancient documents,659 modern journal papers(654 in Chinese and 5 in English),25 relevant textbooks(9 textbooks of various versions of Science of acupuncture and moxibustion,7 textbooks of Subject of meridian,collateral and point,7textbooks of Subject of acupuncture and moxibustion therapy,2 textbooks of Subject of acupuncture and moxibustion prescription),4 relevant standards(1 standard of World Federation of Chinese Medicine Societies,1 Chinese national standard,4 Chinese industry and group standards),11 relevant works of acupuncture masters were included,and 97 valid questionnaires were collected.The four parts of evidence from ancient literature,journal papers,modern books and questionnaire survey were combined to form a spectrum of jing-well points collateral pricking and bloodletting therapy diseases.A total of 11048 cases were obtained from the 15 categories of jing-well points application,involving 18 disease systems.In addition to selection by the lesion site,the remaining 14 categories of jing-well points collateral pricking and bloodletting application screened 125 dominant diseases in total.2 The formation of Standardized manipulation of jing-well points collateral pricking and bloodletting therapy(draft)A total of 110 ancient documents,866 modern journal papers(861 in Chinese and 5 in English),and more than 10 modern books were included.An original pool consisting of 20 items in 4 dimensions was formed,which was then adjusted to 22 entries according to the actual situation.130 questionnaires were collected to obtain the application experience of this therapy from modern medical practitioners.Comparative analysis found some controversial issues such as the terminology,needle tools,the number of pushing and squeezing methods,the amount of bleeding,needling depth and the unit.A consistent recommendation was formed through three consensus argumentation,according to which the draft of Standardized manipulation of jing-well points collateral pricking and bloodletting therapy was completed.Conclusions1 The characteristic of diseases treated by collateral pricking and bloodletting at each jing-well point is individuality in commonness.It can cure the diseases of meridians in which it is located or associated.Jing-well points collateral pricking and bloodletting therapy can treat various of systemic diseases,mainly with the nervous system,respiratory system,digestive system,circulatory system,mental and behavioural disorders,genitourinary system,and ear or mastoid conditions.The dominant diseases of collateral pricking and bloodletting at each jing-well point are consistent with the national standard Indications of acupuncture points(GB/T 30233-2013)and the latest edition of the textbook Science of acupuncture and moxibustion,as well as the indications of the meridian where this jing-well point is located.The overall preference is for the treatment of heat and actual symptoms,but it also involves mixed deficiency,deficiency,and cold symptoms.2 The Standardized manipulation of jing-well points collateral pricking and bloodletting therapy(draft)has been initially verified to have strong operability.3 With the guidance of multi-dimensional evidence,the collection and integration of evidence specific to traditional Chinese medicine characteristic evidence,which is conducive to improving the scientific validity and applicability of research results and can be used in a variety of scenarios requiring evidence integration in traditional Chinese medicine.