Investigating Prescriptions and Mechanisms of Acupuncture for Chronic Stable Angina Pectoris: An Association Rule Mining and Network Analysis Study

Abstract

Chronic stable angina pectoris (CSAP) is a worldwide cardiovascular disease that severely affects people’s quality of life and causes serious cardiovascular accidents. Although acupuncture had been confirmed as a potential adjunctive treatment for CSAP, the basic rules and mechanisms of acupoints were little understood. We conducted a systematic search of the China Biology Medicine (CBM), VIP database, Wangfang database, China National Knowledge Infrastructure (CNKI), PubMed, Cochrane Library, Embase, and Web of Science to identify eligible clinical controlled trials (CCTs) and randomized controlled trials (RCTs), from their inception to 18th February 2020. The acupoint prescriptions in the treatment of CSAP were extracted and analyzed based on the association rule mining (ARM) and network analysis. In addition, potential mechanisms of acupuncture for treating CSAP were summarized by data mining. A total of 27 eligible trials were included. Analysis of acupoint prescriptions covered 36 conventional acupoints and 1 experience acupoint, distributing in 10 meridians. The top three frequently used acupoints were PC6, LU9, and ST36. The top three frequently used meridians were the pericardial meridian, lung meridian, and heart meridian. The most frequently used acupoint combinations were LU9 combined with PC6. Besides, network analysis indicated that the core acupoints included PC6, BL15, ST40, and RN17. Moreover, potential mechanisms of acupuncture for treating CSAP involved the regulation of autonomic nerve function, the content of matrix metalloproteinase-9 (MMP-9), volume and the equivalent block of coronary artery calcified plaque (CACP), endothelin (ET), and nitric oxide (NO), neutrophil-lymphocyte ratio (NLR), the content of C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α). In conclusion, our findings concerning acupoint prescriptions and potential mechanisms in the acupuncture treatment of CSAP could provide an optimized acupuncture treatment plan for clinical treatment of CSAP and promote further mechanism research and network research of CSAP.

Artificial intelligence-directed acupuncture: a review

“…Figure 3 shows the flowchart of SVM algorithm for acupuncture efficacy prediction. AI-based acupuncture efficacy prediction has achieved a sufficient accuracy [ 21 , 57 , 58 ]. The work in this field can help us screen patients who may benefit from acupuncture treatment and provide crucial information for clinical personalized acupuncture therapy [ 59 ].…”

“…Furthermore, the well-established TCM databases, warehouses, high-quality electronic TCM records, books, and the medical literature have formed an extensive data system, which provides a platform for TCM data mining. AI-based data mining methods reveal effective acupoint combinations, the laws of acupoints compatibility, and effective acupuncture treatment plans, which have significantly improved the reliability and stability of acupuncture in clinical efficacy [20][21][22][23][24]. Unsupervised machine learning methods, such as association rule and clustering algorithm, are the primary tools being used in those fields [25][26][27][28].…”

“…Currently, most of the stored data on acupoints combination are in Chinese databases, such as China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), Database of Chinese sci-tech periodicals (VIP), and Wanfang Database. Data also exists in English databases, including Science Direct, PubMed, Web of Science, EMBASE, CENTRAL, clinicaltrials.gov., and Cochrane Library [21][22][23]28]. However, the English databases are not the primary data sources for the reason that most of the studies were published in Chinese in this field and they have reached a high academic level.…”

“…Neiguan (PC6), Taiyuan (LU9), and Zusanli (ST36) were the top three frequently used acupoints for chronic stable angina pectoris (CSAP), while the pericardial meridian, lung meridian, and heart meridian were the appropriate meridians. Furthermore, Taiyuan (LU9) combined with Neiguan (PC6) was the most frequently used acupoint combination, whereas Neiguan (PC6), Xinshu (BL15), Fenglong (ST40), and Tanzhong (CV17) were the core acupoints [21]. Furthermore, there still are few acupoints combination studies that performed data mining on TCM books, such as the work of Hou and Hong [20].…”

The Mining Algorithm of Maximum Frequent Itemsets Based on Frequent Pattern Tree

“…Many scholars have joined this research field since Agrawal. R et al published the famous algorithm Apriori in 1994 [ 3 ] and have undertaken lots of research on the association rules' problem and achieved promising research results [ 4 – 6 ]. Literature [ 7 – 9 ] carried out some optimization work based on the Apriori algorithm, such as the introduction of hashing method, the idea of division, and random sampling, to make mine rules more efficient.…”