[Study on the rules of clinical application of acupuncture for prevention and treatment of perioperative neurocognitive disorder in elderly patients based on data mining].

OBJECTIVES

To analyze the rules of clinical application of acupuncture in the prevention and treatment of perioperative neurocognitive disorder (PND) by using data mining method.

METHODS

Randomized controlled trials on acupuncture for preventing and treating PND from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Database, and Wanfang Database were retrieved, with the retrieval time ranging from the establishment of each database to July 16, 2024. A relevant database was established to statistically analyze the application of acupuncture methods, selected acupoints, timing of acupuncture intervention, acupuncture stimulation parameters, and stimulation intensity. Additionally, association rules and cluster analysis of acupoints were carried out.

RESULTS

A total of 69 articles were included, with 69 acupuncture prescriptions extracted, involving 40 acupoints. The top 5 acupoints in terms of usage frequency were Neiguan (PC6), Baihui (GV20), Zusanli (ST36), Hegu (LI4), and Sanyinjiao (SP6). The top 3 meridians by usage frequency were the Pericardium Meridian of Hand-Jueyin (49 times, 21.68%), Governor Vessel (44 times, 19.47%), and Stomach Meridian of Foot-Yangming (30 times, 13.27%). The top 3 specific acupoints in terms of usage frequency were the crossing acupoints (66 times, 29.20%), confluence points of the eight vessels (50 times, 22.12%), and luo-connecting acupoints (49 times, 21.68%). Regarding acupoints compatibility, the top 3 high-frequency acupoint pairs were PC6-ST36, PC6-GV20, and PC6-LI4. The high-frequency acupoints could be classified into 4 categories:Category 1 includes PC6, ST36, GV20, SP6, and LI4;Category 2 includes Shenmen (HT7) and Yintang (GV24+);Category 3 includes Benshen (GB13), Taichong (LR3), Sishencong (EX-HN1), and Shenting (GV24);Category 4 is Fengchi (GB20). The top 2 acupuncture treatment methods by usage frequency and times were transcutaneous electrical acupoint stimulation (TEAS) and electroacupuncture (EA). The intervention timing was mostly selected during and before surgery. For EA stimulation, sparse-dense waves were commonly used, with a frequency of 2 Hz/100 Hz, adjusted to the patient's tolerance.

CONCLUSIONS

PC6, GV20, ST36, LI4 and SP6 are the core acupoints for the prevention and treatment of PND, and TEAS or EA is usually performed during or before the operation.