| Research purpose1..The purpose of this study is to conduct a meta-analysis of Randomized Controlled trials(RCTS)of acupuncture combined with drugs in the treatment of phlegm-dampness type Polycystic Ovary Syndrome(PCOS).To evaluate the clinical effect of acupuncture combined with drug therapy compared with drug therapy in the treatment of phlegm-dampness type polycystic ovary syndrome(PCOS),so as to provide reliable evidence-based theoretical basis for clinical practice research.2.The data mining method was used to summarize the high-frequency medication and compatible medication rules of acupuncture and medication in the treatment of phlegm-dampness PCOS,as well as the compatibility rules of high-frequency acupoints and acupoints,the characteristics of prescription and the rules of main acupoint combination,so as to further guide the clinical application of the combination of acupuncture and medication in the treatment of phlegm-dampness PCOS.Research method1.Meta-analysisRandomized controlled trials(RCT)of acupuncture combined with medicine in the treatment of phlegm-dampness polycystic ovary syndrome were comprehensively and systematically searched by computer,and relevant paper journals were searched by manual method.The retrieval time was from January 1,2018 to December 31,2020.According to the inclusion and exclusion criteria,the retrieved literature was strictly screened to determine the final eligible literature.The tool for assessing the risk of bias recommended by the Cochrane Collaboration was used to evaluate the quality of the included studies,and Stata 14.0 software was used for meta-analysis.2.Data miningBy searching the database,the literature on the combination of acupuncture and medicine in the treatment of phlegm-dampness polycystic ovary syndrome that met the inclusion and exclusion criteria was collected.The frequency analysis was carried out by the ancient and modern medical record cloud platform,the association rule analysis was carried out by IBM SPSS Modeler 18.0,and the cluster analysis was carried out by IBM SPSS Statistics 26.Research results1 Meta-analysis of acupuncture combined with medication in the treatment of phlegm-dampness type polycystic ovary syndromeA total of 1210 literatures were retrieved,22 of which were eventually included,with a total of 1732 cases.A total of 12 outcome indicators were reported,including overall efficacy,symptom score,BMI,WHR,sex hormone levels(E2,FSH,LH,T),reproductive hormone levels(AMH,IHNB),ovulation rate and pregnancy rate.The outcome indexes with statistical significance after combined analysis were: overall efficacy,BMI,sex hormone levels(FSH,LH,T),and reproductive hormone levels(AMH,IHNB).There were no statistically significant outcome indicators including symptom score,E2,WHR,pregnancy rate and ovulation rate.The results are as follows:1.1 Overall efficacy index: RR=1.27,95%CI(1.20,1.34)],there was a statistically significant difference in the overall effective rate between the two groups[RR=1.27,95%CI(1.20,1.34)]1.2 TCM symptom score index: The analysis results showed that the TCM symptom score value of the two groups had no statistical significance [WMD=-0.10,95%CI(-2.80,2.60)]1.3 Body mass(BMI)index: The analysis results showed that the changes in BMI values of the two groups were statistically significant [WMD=-1.89,95%CI(-2.57,-1.22)]1.4 Waist-to-hip ratio(WHR)index: There was no statistical significance in body mass BMI between the two groups [WMD=-0.13,95%CI(-0.32,0.07)]1.5 Estradiol(E2)index: Meta-analysis results showed that there was no statistical significance in the change of E2 values between the two groups [WMD=6.99,95%CI(-2.24,16.22)]1.6 Index of follicle stimulating hormone(FSH): Analysis results showed that the value of FSH changed in the two groups,with statistical significance[WMD=-0.42,95%CI(-0.81,0.03)]1.7 Luteinizing hormone(LH)index: Analysis results showed that the change of LH value in the two groups was statistically significant [WMD=-1.89,95%CI(-2.55,-1.22)]1.8 Testosterone(T)index: The analysis results showed that the change of T value in the two groups was statistically significant [WMD=-0.3,95%CI(-0.39,-0.21)]1.9 Anti-Muller’s Tube hormone(AMH)index: The analysis results showed that the change of AMH value in the two groups was statistically significant[WMD=-1.24,95%CI(-1.68,-0.80)]1.10 Statin B(IHNB)index: The analysis results showed that the change of IHNB value in the two groups was statistically significant [WMD=-11.89,95%CI(-14.91,-8.88)]1.11 Ovulation rate index: Analysis results showed no statistical significance in ovulation rate between the two groups [RR=1.13,95%CI(0.96,1.32)]1.12 Pregnancy rate index: Analysis results showed that there was no statistical significance in pregnancy rate between the two groups [RR=0.83,95%CI(0.65,1.05)]2 Data mining results:A total of 106 literatures on the treatment of phlegm-dampness PCOS by acupuncture and moxibustion combined with traditional Chinese medicine were collected.A total of 133 TCM prescriptions were obtained after systematic screening,including 129 TCM prescriptions.108 acupuncture point prescriptions,including 64 points,were analyzed as follows:2.1 Analysis of drug frequency: The top 10 Chinese medicines with the frequency of use were listed as follows: Poria cocos > Xiangfu > Tangerine peel > Pinellia pinellia> atractylodes rhizome > Angelica sinensis > cuscuta > Ligusticum Chuanqin >liquorice > Fructus aurantii.2.2 Drug attribute analysis: The top three of the four qi were warm,flat and slightly cold;The top three are sweet,sweet and bitter;The top four are spleen,liver,lung and kidney channels.In terms of efficacy,the most of them were dryness and dampness,phlegm,menstrual regulation and pain relief,and eye improvement.2.3 Frequency analysis of acupoints: Guanyuan > Sanyinjiao > Zusanli > Uterus >Fenglong > Qi Hai > Shenshu > Tianshu > Zhongwan > Yin Lingquan.2.4 Association rule analysis2.4.1 Analysis of drug association rules: Three association combinations with a 100%confidence percentage had 12 items,Fructus aurantii → atractylodes,Fructus aurantii and pinellia officinalis → Atractylodes,Fructus aurantii and Pinellia officinalis →Fructus officinalis,Fructus aurantii and pinellia officinalis → Tangerina,Fructus officinalis,Fructus aurantii and pinellia officinalis → Tangerina officinalis,Fructus officinalis and pinellia officinalis → Tangerina officinalis,Fructus officinalis and pinellia officinalis → Tangerina officinalis,Fructus officinalis and pinellia officinalis→ Tangerina officinalis,Fructus officinalis and pinellia officinalis.2.4.2 Analysis of acupoint association rules: There are four acupoint combinations with 100% confidence percentage,which are Shenshu and Fenglong → Sanyinjiao,uterus and Fenglong → Sanyinjiao,Qi Hai and Zusanli → Guanyuan,uterus and Fenglong and Guanyuan → Sanyinjiao.2.5 Cluster analysis2.5.1 Drug cluster analysisThrough the cluster analysis of TCM,four groups of potential new TCM prescriptions were obtained,which were as follows:The first category: Divine Qu,ginger,Fructus aurantii,gallinaria,licorice,wolfberry;The second category: Wolfberry,cooked Rehmannia,white peony,amethyst,Spatholoba spatholobi,white Rhizome,codonopsis codonopsis,alisma alisma,Raspberry,alisma alisma,Cornus officinalis,achyranthes bidentata,Epimedium,calamus acorus,Radix saponalis,Radix Astragalus,Yam,salvia miltiorrhiza;The third category: Angelica sinensis,Ligusticum Chuanxiong;The fourth class: dodder,because it appears alone,is invalid cluster;The fifth category: Pinellia pinellia,atractylodes atractylodes,Tangerine peel,Xiangfu,poria cocos2.5.2 Acupoint cluster analysisThrough the cluster analysis of acupoints,five groups of new acupoint prescriptions were obtained as follows:The first category: Taichong,Taixi,Hegu,Ciliao,Dahe,Xiawan,Shuitshui,Daheng,Hui,Belt pulse,moisture,Ganshu,Jiyu,ovary,blood sea,Zhongji;The second category: Shenshu,Pishu;The third category: Tianshu,Yin Lingquan,Zhongwan;The fourth category: Guanyuan,Sanyinjiao,Zusanli,Fenglong;The fifth category: uterus,Qi sea.conclusion1.The combination of acupuncture and medicine in the treatment of phlegm-dampness polycystic ovary syndrome is more effective than the treatment of drug alone.The combination of acupuncture and medicine can effectively improve the overall curative effect,BMI,sex hormones FSH,LH,T levels and reproductive hormones AMH,IHNB levels.2.The traditional Chinese medicine and acupoint selection in the treatment of phlegm-dampness polycystic ovary syndrome combined with acupuncture and medicine were mainly based on strengthening the spleen and kidney,eliminating phlegm and clearing collars.The highest frequency of medication was: poria cocos,and the highest frequency of acupoint was: Guanyuan;The main prescription drugs were added and subtracted with Cangfu Daotum Decoction,Erchen Decoction,kidney-tonifying phlegm decoction and Siwu decoction as the base.Acupoints on the kidney meridian,spleen meridian,liver meridian and lung meridian were taken from the acupoints in the prescription. |
