Objective: To analyze the regularities of combination of acupoints in the existing clinical trial literature by using complex network technique, so as to provide reliable evidence for selecting appropriate acupoint recipes in the treatment of knee osteoarthritis with acupuncture and moxibustion therapies.
Methods: Clinical papers about acupuncture treatment of knee osteoarthritis published from January of 2000 to April of 2020 were searched from Chinese and English databases including CNKI, Wanfang, VIP, Pubmed and ScienceDirect by using keywords of “acupuncture”, “moxibustion” and “knee osteoarthritis”. According to the inclusive and exclusive criteria, the collected papers were screened out to set up a database.
SPSS Modeler18.0 software was used to analyze the association rules of acupoints (including the core acupoint nodes and compatibility relationship), and Gephi0.9.2 software was employed to conduct a complex network analysis about the compatibility rules of acupoints and their application characteristics of moxibustion and needling methods in the treatment of knee osteoarthritis (shown by a complex network schematic diagram).
Results: A total of 444 acupuncture prescriptions were extracted, including 6 single-acupoint prescriptions (1.35%) and 438 multiple-acupoint prescriptions (98.65%). A total of 112 acupoints were involved, with the application frequency of 3 389. Among them, the application frequency of the Neixiyan (EX-LE4)is the highest (354 times, 10.45%), followed by Dubi (ST35), Xuehai (SP 10), Yanglingquan (GB 34), Liangqiu (ST 34), Zusanli(ST36), etc. The mainly involved meridians are the Stomach Meridian of Foot-Yangming and the Spleen Meridian of Foot-Taiyin. The involved specific acupoints are the Five-shu (stream) acupoints, being the most commonly used, followed by the crossing points, and lower confluent (sea) acupoints.
Conclusion: In the treatment of knee osteoarthritis with acupuncture and moxibustion, the regularities and characteristics of acupoint combinations (acupoint prescriptions) are: 1) often selecting local acupoints at the lower limbs, 2) frequently applying the Five-shu acupoints (specific acupoints), and 3) matching the acupoints of the outside meridians and inside meridians, especially those of the Spleen Meridian and Stomach Meridian.