Analysis on the clinical advantages and the rules of acupoint selection in treatment of chronic obstructive pulmonary disease with the integration of acupuncture and medication based on data mining.

OBJECTIVES: To explore the clinical advantages and the rules of acupoint selection in treatment of chronic obstructive pulmonary disease (COPD) with the integration of acupuncture and medication by means of frequency statistics and complex network analysis, so as to provide references for the standardized treatment with the integration of acupuncture and medication. METHODS: Searched from PubMed, Web of Science, Embase, Ovid, CNKI, Wanfang, VIP, and SinoMed, the articles of clinical trials for COPD treated with the integration of acupuncture and medication were collected, dated from January 1, 2003 to September 1, 2023. Literature was screened according to the inclusion and exclusion criteria. Using frequency statistics, the clinical advantages of the integration of acupuncture and medication were explored. The database of acupoint prescriptions was established using Microsoft Excel 2019, the complex network model was constructed using SPSS18.0 and Gephi0.10, and the core acupoints and acupoint combinations were screened. RESULTS: In the analysis of the clinical advantages of the combination of acupuncture and herbal medicine for the treatment of COPD, acupuncture alone contributed to the improvement of respiratory system indicators a total of 263 times, accounting for 51.77% of the total number of improved indicators, with the majority being improvements in resting lung function (184 times, 36.22%). In addition, acupuncture alone also showed certain improvement effects on clinical symptoms, cardiac function, and biochemical blood indicators in COPD patients. The combination of acupuncture and traditional Chinese medicine (TCM) contributed to the improvement of respiratory system indicators 90 times, accounting for 42.45% of the total improvement frequency, with the primary focus being on improvements in resting lung function (66 times, 31.13%), followed by improvements in clinical symptoms and biochemical blood indicators. The combination therapy for COPD mainly selected acupoints from the Bladder Meridian of Foot-Taiyang, with the combination of "Shenshu (BL23) + Feishu (BL13)" being the most frequently used acupoint pair. By performing "k-core" analysis and community network partitioning on the complex network diagram, three core acupoint clusters were identified. CONCLUSIONS: This article categorizes the clinical advantages of acupuncture and herbal medicine combination therapy for COPD into two types:the advantages of acupuncture alone and the advantages of acupuncture combined with TCM. Both can improve the function of target organs and enhance patients' lung function. Moreover, for other non-target organ indicators, both also have an improvement effect, demonstrating the comprehensive regulatory capacity of the combination of acupuncture and herbal medicine. In the clinical acupoint selection for the treatment of COPD with the combination of acupuncture and herbal medicine, emphasis was placed on the application of specific acupoints, especially the use of confluent points. The selection is closely related to the pathogenesis of COPD, which is characterized by "fundamental deficiency and marked excess". By combining "predominantly draining" acupoints with "predominantly tonifying" acupoints, the therapy aims to expel pathogenic factors while supporting the body's healthy functions.