Core Acupoints and Acupoint Combination Patterns for Acupuncture Treatment of Discogenic Low Back Pain: A Data Mining Study.

BACKGROUND

Discogenic low back pain (DLBP) is a distinct subtype of chronic low back pain arising from intradiscal degeneration in the absence of nerve root compression. Previous data-mining studies on acupuncture have focused largely on lumbar disc herniation (LDH), creating a gap in evidence for DLBP-specific acupoint selection.

OBJECTIVE

To systematically identify acupuncture prescription rules for DLBP using data-mining techniques.

METHODS

Eight databases were searched for clinical studies on acupuncture for DLBP (2016-2025). We analyzed acupoint frequency, association rules, and hierarchical clustering to identify core prescription patterns.

RESULTS

A total of 57 studies involving 41 acupoints were included in the analysis. The five most frequently utilized acupoints were BL40 (Weizhong), BL25 (Dachangshu), Ashi points, EX-B2 (Jiaji), and BL23 (Shenshu). Standard treatment protocols typically involved needle retention for 30 minutes per session, administered once daily. Warm-needle acupuncture or moxibustion was incorporated in approximately 32% of the treatment regimens. Data mining identified two principal association patterns: (1) intra‑meridian pairings within the Governor Vessel (Du Meridian), and (2) synergistic combinations targeting lower‑limb acupoints. Hierarchical clustering further yielded three clinically meaningful acupoint clusters: (i) distal points for systemic meridian regulation, (ii) local lumbar points for segmental symptom control, and (iii) syndrome‑specific points guided by Traditional Chinese Medicine pattern differentiation. Notably, compared with prescriptions for lumbar disc herniation (LDH), those for discogenic low back pain (DLBP) demonstrated a stronger emphasis on local and warming interventions particularly warm‑needle acupuncture and moxibustion and less reliance on distal Gallbladder meridian points.

CONCLUSION

This first dedicated data-mining study for DLBP reveals a distinct acupoint selection paradigm of "warming and dispersing cold, local precision", differing from the LDH pattern of "activating blood and unblocking meridians distally". These findings provide a quantitative evidence base for developing diagnosis-specific acupuncture protocols.