Study of the clinical distinctions of acupuncture-moxibustion treatment of acute gouty arthritis based on complex networks

To discuss the point-selection and point-grouping patterns and therapeutic application features in acupuncture-moxibustion treatment of acute gouty arthritis (AGA) based on complex networks and to provide references for treating AGA with acupuncture-moxibustion therapy.

Articles related to acupuncture-moxibustion treatment of AGA were searched across the China National Knowledge Infrastructure (CNKI), Chongqing VIP Database (CQVIP), Wanfang Data Knowledge Service Platform (Wanfang), Chinese Biomedical Literature Service System (SinoMed), PubMed, Web of Science (WOS), and Excerpta Medica Database (EMBASE) from their inception till March 31, 2023. An acupuncture-moxibustion prescription database was established after the articles were screened according to the inclusion and exclusion criteria. The association rule and complex network analyses of points were conducted using SPSS Modeler 18.1 and Gephi 0.9.7.

A total of 145 articles were collected, contributing 382 pieces of acupuncture-moxibustion prescriptions involving 104 points with a total frequency of 1 288. Ashi points contributed the highest frequency. The Spleen Meridian of Foot-Taiyin and the Stomach Meridian of Foot-Yangming were more commonly selected. Filiform-needle acupuncture and bloodletting therapy were more frequently used. The association rule analysis revealed that the highest degree of support belonged to “Ashi point-Zusanli (ST36)” and “Sanyinjiao (SP6)-Zusanli (ST36)”, which reflected the rules of point combination of distal and proximal areas and point combination of the coupled meridians. The complex network analysis of the major points discovered a core point prescription mainly consisting of Ahi point, Zusanli (ST36), Sanyinjiao (SP6), Yinlingquan (SP9), and Taichong (LR3). Pattern differentiation and region differentiation were used in selecting adjunct points, stressing the improvements of patterns and joint-related symptoms.

Acupuncture-moxibustion treatment of AGA follows the principle of combining major points with adjunct points selected based on pattern or region differentiation; the selection of major points focuses on regulating the deficient Zang-Fu organs, and the selection of adjunct points emphasizes improving patterns and symptoms. The specificity of therapeutic effects is also stressed.