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      Analysis of Acupoint Selection and Combinations in Acupuncture Treatment of Piriformis Syndrome: A Protocol for Data Mining

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          Abstract

          Background

          Piriformis syndrome (PS) is a neuromuscular condition characterized by discomfort in the gluteal region. The efficacy of acupuncture as a treatment modality for PS has been substantiated through a multitude of clinical trials. However, certain queries persist, such as the optimal approach for identifying the most efficacious acupoints. The objective of this study is to perform an initial data mining analysis aimed at identifying the optimal acupoint selection and combinations for the treatment of PS.

          Methods

          We will search 7 electronic bibliographic databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database and Chongqing VIP Database) from inception to June 2023. We will select clinical trials that evaluate the efficacy of acupuncture therapy in the management of PS. Exclusions will be made for reviews, protocols, animal trials, case reports, systematic reviews, and meta-analyses. The primary outcome measure will be clinical outcomes associated with PS. Descriptive statistics will be performed in Excel 2019. Association rule analysis will be performed in SPSS Modeler 18.0. Exploratory factor analysis and cluster analysis will be performed in SPSS Statistics 26.0.

          Results

          This study will investigate the most effective acupoint selection and combinations for patients with PS.

          Conclusion

          Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupoint application for patients with PS, helping clinicians and patients make a more informed decision together.

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          Most cited references42

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          RoB 2: a revised tool for assessing risk of bias in randomised trials

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            Acupuncture: theory, efficacy, and practice.

            Traditionally, acupuncture is embedded in naturalistic theories that are compatible with Confucianism and Taoism. Such ideas as yin-yang, qi, dampness, and wind represent East Asian conceptual frameworks that emphasize the reliability of ordinary, human sensory awareness. Many physicians who practice acupuncture reject such prescientific notions. Numerous randomized, controlled trials and more than 25 systematic reviews and meta-analyses have evaluated the clinical efficacy of acupuncture. Evidence from these trials indicates that acupuncture is effective for emesis developing after surgery or chemotherapy in adults and for nausea associated with pregnancy. Good evidence exists that acupuncture is also effective for relieving dental pain. For such conditions as chronic pain, back pain, and headache, the data are equivocal or contradictory. Clinical research on acupuncture poses unique methodologic challenges. Properly performed acupuncture seems to be a safe procedure. Basic-science research provides evidence that begins to offer plausible mechanisms for the presumed physiologic effects of acupuncture. Multiple research approaches have shown that acupuncture activates endogenous opioid mechanisms. Recent data, obtained by using functional magnetic resonance imaging, suggest that acupuncture has regionally specific, quantifiable effects on relevant brain structures. Acupuncture may stimulate gene expression of neuropeptides. The training and provision of acupuncture care in the United States are rapidly expanding.
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              Acupuncture needling sensation: the neural correlates of deqi using fMRI.

              The needling sensation of deqi is considered by most acupuncturists to be an important component of acupuncture, yet neuroimaging research that investigates this needle sensation has been limited. In this study we have investigated the effect of deqi and acute pain needling sensations upon brain fMRI blood oxygen level-dependent (BOLD) signals. Seventeen right-handed participants who received acupuncture at the right LI-4 (Hegu) acupoint were imaged in a 3T MRI scanner. fMRI datasets were classified, on the basis of psychophysical participants' reports of needling scores, into those that were associated with predominantly deqi sensations versus those with predominantly acute pain sensations. Brain areas showing changes in BOLD signal increases (activations) and decreases (deactivations) were identified. Differences were demonstrated in the pattern of activations and deactivations between groupings of scans associated with deqi versus pain sensations. For the deqi grouping, significant deactivations occurred, whereas significant activations did not. In contrast, the predominantly acute pain grouping was associated with a mixture of activations and deactivations. For the comparison between the predominately deqi sensation grouping and the acute pain sensation grouping (deqi>pain contrast), only negative Z value voxels resulted (mainly from deactivations in the deqi grouping and activations in the pain grouping) in the limbic/sub-cortical structures and the cerebellum regions of interest. Our results show the importance of collecting and accounting for needle sensation data in neuroimaging studies of acupuncture. 2009 Elsevier B.V. All rights reserved.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                jpr
                Journal of Pain Research
                Dove
                1178-7090
                28 September 2023
                2023
                : 16
                : 3265-3272
                Affiliations
                [1 ]Faculty of Acupuncture, Moxibustion and Tui Na, Guangxi University of Chinese Medicine , Nanning, People’s Republic of China
                [2 ]Graduate School, Guangxi University of Chinese Medicine , Nanning, People’s Republic of China
                Author notes
                Correspondence: Furui Miao; Yushan Fan, Faculty of Acupuncture, Moxibustion and Tui Na, Guangxi University of Chinese Medicine , 179 Mingxiu East Road, Xi Xiang Tang District, Nanning City, People’s Republic of China, Email snowymiao@163.com; doctorfanyushan@163.com
                Author information
                http://orcid.org/0000-0002-2713-6106
                Article
                422857
                10.2147/JPR.S422857
                10544196
                37790189
                6afcb438-49bc-4b9d-aa02-e96ad7446989
                © 2023 He et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 17 June 2023
                : 22 July 2023
                Page count
                Figures: 1, Tables: 2, References: 42, Pages: 8
                Funding
                Funded by: Innovation Project of Guangxi Graduate Education;
                Funded by: The Special Project of TCM Talent Team Construction of Guangxi Administration of Traditional Chinese Medicine—Prof. Yushan Fan Guangxi Famous TCM Inheritance Studio;
                Funded by: National Natural Science Foundation of China, open-funder-registry 10.13039/501100001809;
                This study is supported by Innovation Project of Guangxi Graduate Education (No. YCBZ2023149, No. YCSW2022351, No. YCSZ2022009); The Special Project of TCM Talent Team Construction of Guangxi Administration of Traditional Chinese Medicine—Prof. Yushan Fan Guangxi Famous TCM Inheritance Studio (No. 2023017-05-07); National Natural Science Foundation of China (No. 82260983).
                Categories
                Study Protocol

                Anesthesiology & Pain management
                piriformis syndrome,acupuncture,data mining
                Anesthesiology & Pain management
                piriformis syndrome, acupuncture, data mining

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