Xiao-Lin Zhang,Cao Di,Long Zhang,Nuo-Xin Pei,Ming-Jun Liu＊

1Changchun University of Chinese Medicine,Changchun 130117,China;2Changchun Hospital of Chinese Medicine,Changchun 130000,China.

Background:Based on the data mining of clinical literature,we analyzed the characteristics of Acupoint Selection and manipulation in the clinical treatment of “simple obesity”,in order to optimize the compatibility of clinical acupoints,simplify the manipulation,and summarize the core prescription of Massage in the treatment of simple obesity.Methods: First we search and screen the clinical literature of Chinese Massage therapy for “simple obesity” by scholars at home and abroad.Then we analyze the Acupoint Selection and manipulation rules of Chinese Massage therapy for “simple obesity” by using data mining technology and traditional Chinese Medicine Inheritance assistant system.Finally we obtain the optimal new prescription based on complex system entropy clustering and unsupervised entropy hierarchical clustering analysis.Results:Fifty-seven prescriptions meeting the inclusion criteria were selected,including TIANSHU (ST25) (36),ZHONGWAN (RN12) (32),GUANYUAN (RN4) (30),ZUSANLI(ST36) (27),QIHAI (RN6) (23),“Stomach Meridians” (10),“Spleen Meridians” (8),Renmai (7),Abdomen (36),Umbilicus (8),Pressing (33),Holding (27),Pressing (26),and get 4 core Prescriptions like ST25-RN12-Renmai-Stomach Meridians-Abdominal Rub-Rubbing-Pushing thumb-Rubbing-Palm Pushing-Thumb Point Acupuncture-Palm Vibration and 4 new prescription of Massage manipulation for the treatment of simple obesity.Conclusion:The results of clinical diagnosis and treatment data are mined and analyzed by traditional Chinese medicine inheritance assistant system.The acupoint compatibility,manipulation rules and core prescriptions obtained can provide statistical basis and references for clinical Massage manipulation in the treatment of simple obesity.

Key words: Simple obesity,Data mining,Manipulation,Aacupoints,Traditional Chinese Medicine Inheritance assistant platform,Compatibility law,Core prescription

Background

“Simple obesity” is one of the most common types of obesity,which refers to poor diet and rest habits,excessive calorie intake and less exercise,or abnormal metabolism.These will lead to excessive accumulation of fat components in the body,resulting in weight gain and causing pathological and physiological changes or latent [1].About 95% of obese people have evenly distributed body fat,and have no endocrine disorder,or no metabolic disorder diseases [2].Chinese Massage in the treatment of simple obesity has the advantages of significant curative effect,high safety,non-toxic side effects,and the curative effect has been confirmed in clinical treatment and literature reports.However,no researcher has explored and analyzed the acupoint compatibility and manipulation selection rules of Massage in the treatment of simple obesity.

For the first time,this paper uses Chinese Medicine Inheritance assistant system (V2.5) to mine data on acupoint compatibility and manipulation selection rules of Massage manipulation in the treatment of simple obesity.According to complex system entropy clustering and unsupervised entropy hierarchical clustering analysis,it obtains the optimal acupoint combination and finds new prescriptions [3],which provides statistical basis for further clinical research and provides theoretical basis for clinical syndrome differentiation and treatment of this disease.Prescription selection also provides data reference for the standardization of Chinese Massage in the treatment of simple obesity.

Data and methods

For the first time,this paper uses Chinese Medicine Inheritance assistant system (V2.5) to mine the data of acupoint compatibility and manipulation selection rules of Massage manipulation in the treatment of Simple obesity.According to complex system entropy clustering and unsupervised entropy hierarchical clustering analysis,it obtains the optimal acupoint combination and finds new prescriptions [3],which provides statistical research basis for further clinical research and provides reference for clinical diagnosis and treatment of the disease.It also provides data reference for the standardization of Chinese Massage in the treatment of Simple obesity.

literature sources and Search strategy

We conduct computer search with the keywords of “Simple obesity”,“Chinese Massage manipulation”,“Chinese Massage”,“Massage manipulation” and “manipulation”,in the main Chinese and English databases such as China knowledge infrastructure database,Wanfang database,VIP database,Cochrane Library,PubMed and EMBASE,supplemented by manual search and other searches.

Inclusion criteria

(1) Clinical research literature on patients with Simple obesity.(2) The diagnostic criteria of Chinese medicine and Western medicine of the observation objects are in line with “Simple obesity”.(3) The intervention measures are mainly Massage manipulation,which can also be combined with other therapies,but the clinical effect is exact.(4) The specific manipulation and acupoints are given clearly.

Exclusion criteria

(1) Literature based on cases.(2) The use of non-Chinese Massage therapy or non-traditional acupoints(Thai Massage,chiropractic Massage,etc.) literature.

Data specification

When inputted,the Massage technique and acupoint words should refer to the 13th five-year-plan textbook “Massage” [4] and the national standard “acupoint name and location” [5].If the expression of Periumbilicus,Umbilical region and Umbilicus is not clear,the corresponding author should be consulted by e-mail.

Data extraction

In order to ensure the authenticity and reliability of the database,only the basic prescriptions are entered;the selected acupoints and manipulations in the literature that meet the inclusion criteria are sorted out [6–62],the relevant data are entered into excel,and the acupoints and manipulations are entered into spss19.0 The standard prescription of Massage was input into the Chinese Medicine Inheritance assistant system (V2.5).

Results

The author searched and sorted out the clinical literatures on the treatment of “simple obesity” by Chinese Massage in the literature database at home and abroad [35–62],and finally included 57 effective literatures,involving 101 acupoints,47 operating lines,47 operating surfaces and 111 kinds of Chinese Massage manipulation.Next,the frequency of Acupoint Selection and Meridians tropism,the frequency of Acupoint Selection,the frequency of Manipulation,the type of Manipulation,the rule of Acupoint composition,and the new Prescription based on Entropy Hierarchical Clustering are analyzed.

Frequency analysis of Acupoint Selection and manipulation

Frequency of Acupoint Selection and analysis of acupoint Meridians tropism.The frequency of Acupoint Selection and acupoint tropism of Chinese Massage for Simple obesity are classified according to Meridianss,as shown in Table 1.

Analysis of frequency of “Big Acupoints” (Operating Line and Operating Surface) and “Meridians Tropism” of Acupoints

The Operation Lines and Operation Surfaces of Chinese Massage for Simple obesity are classified according to Meridianss.See Table 2 for details and Meridians tropism of Acupoints:the Operation line and Operation surface of Chinese Massage for treating Simple obesity are classified according to Meridianss,as shown in Table 2.

Table 2 Frequency of “Big Acupoints” (operating line and operating surface) and “Meridians Tropism” of Acupoints of Simple obesity treated by Chinese Massagewqbc

Frequency analysis of acupoints selected by different Meridianss in treating simple obesity with Chinese Massage (See Figure 1 for details).

Manipulation Frequency Analysis of Chinese Massage in the treatment of simple obesity.See Figure 2 for details.

The statistical analysis of the Types of Manipulations is shown in Figure 3.

Figure 1 Frequency analysis of selected acupoints of Simple obesity treated by Chinese Massage

Figure 2 Manipulation frequency analysis of Chinese Massage in the treatment of Simple Obesity

Analysis of association rules based group rules

Analysis of the rules of acupoint prescription.Set “Number of Supports” to 23 and “Degree of Confidence” to 0.9 to get 2 groups of common acupoints,ST25-RN12(24) and RN12-RN4 (23).According to the rules of operation line group,set “Number of Supports” to 6 and “Degree of Confidence” to 0.9 to get 2 groups of common acupoints,Renmai-Stomach Meridians (7) and Spleen Meridians-Stomach Meridians (6).According to the rules of operation surface group,set “Number of Supports” to 6 and “Degree of Confidence” to 0.9 to get 3 groups of common acupoint combinations,namely,Abdomen-Umbilical (7),Abdomen-Rib (6) and Abdomen-Both Lower Extremities (6).According to the rules of manipulation group,set “Number of Supports” to 7 and “Degree of Confidence” to 0.9 to get 3 groups of common manipulation combinations,namely,Press Knead;-Rub(9),Push-Press Knead;(7) and Push-Rub(7).See Figure 4 for details.

Figure 4 Analysis of the rules of acupoint prescription

Analysis of new prescriptions based on entropy hhierarchical clustering.The core combination analysis of acupoints based on entropy clustering of complex system is based on the results of correlation analysis between acupoints of improved mutual information method,using unsupervised entropy layer clustering algorithm.In the hierarchical cluster analysis of the new prescription of operation point (acupoint),the “Correlation Degree” was set to 5,and the “Punishment Degree” was set to 2.The core combination was obtained by extraction and analysis.After further clustering,the new prescription was obtained:ST21-RN12-ST22-Huaroumen.Hierarchical cluster analysis of the new prescription of operation line,set “Correlation Degree” as 6,and “Punishment Degree” as 2,extract the combination,analyze the core combination,and further cluster to get the new prescription:Stomach Meridians-Spleen Meridians-Abdomen Stomach Meridians-Spine-Renmai.In the new hierarchical cluster analysis of the operation surface,the “Correlation Degree” is set to 5,and the “Punishment Degree” is set to 2.The core combination obtained by the analysis is:Double Lower Limbs-Upper Limbs-Waist-Umbilicus.Hierarchical cluster analysis of the new operation method,set the “Correlation Degree” as 5,the “Punishment Degreet” as 2,extract the combination,analysis to obtain the core combination:Rub-Press and Knead-push-Thumb Press and Knead-Palm push-Thumb digital-acuPoint Pressing-Palm vibration.See Figure 5 for details.

Figure 5 New method of entropy hierarchical clustering

Discussion

Traditional Chinese Medicine Inheritance assistant system,using data mining,network association,artificial intelligence and other discipline technology,based on association rule analysis,improved mutual information,complex system Entropy Clustering,unsupervised entropy hierarchical clustering and other methods,can achieve quantitative description of the correlation between research objectives,core combination evolution and extraction,discovery of new prescriptions and other research objectives,and provide reference for researchers.It provides a feasible scheme for the mining and discovery of invisible experience.At the same time,the modern literature database has been gradually improved,forming a large number of research data with high reliability,which has laid a good research foundation for data mining of traditional Chinese medicine.With the continuous change of living environment,the relationship between symptoms of the same disease in different times and the application of Massage techniques and acupoints pose challenges to the research.At present,most researchers at home and abroad study the law of Acupoint Selection in acupuncture treatment.As a widely used,green and efficient external treatment,the law of Acupoint Selection in Massage is rarely studied.At the same time,there is no precedent to analyze the manipulation and the law of Acupoint Selection in clinical Massage treatment.The author thinks that Acupoint Selection in Massage is not only the simple compatibility of acupoints,but also the inevitable connection with manipulation.

Starting from this idea,the author innovates the data mining function of traditional Chinese Medicine Inheritance auxiliary system,analyzes and summarizes the acupoint compatibility and manipulation selection rules of Massage manipulation in the treatment of simple obesity,so as to provide reliable data reference for the treatment of Simple obesity by traditional Chinese medicine Massage manipulation.The specific analysis is as follows:

Frequency of acupoints

Chinese Massage is based on the theory of Meridianss and collaterals,but because it mainly takes the operator’s hand as the main treatment carrier,it can not achieve the ideal effect of acupuncture precise stimulation of acupoints.It is mainly reflected in the local treatment surface centered on acupoints,which is still not separated from the basis of acupoint treatment.Therefore,the operation point,operation line and operation surface of Chinese Massage can be classified as “acupoints”.Domain analysis shows that 195 “Acupoints” are involved in 57 Massage prescriptions(including 101 acupoints,47 operating lines and 47 operating surfaces).Through association algorithm analysis,the high-frequency “acupoints” for treating Simple obesity are:ST25 (36),RN12 (32),RN4 (30),Stomach Meridians (10),Spleen Meridians (8),Renmai(7),Abdomen (36) and Umbilicus Department (8).ST25 point,as a large intestine raising point,is produced by Yangming pulse Qi,which is mainly used to regulate bowel and Fu organs,regulate qi circulation stagnation,and eliminate food.Massage has significant effect on improving bowel and Fu functions.RN12 point is the Stomach raising point,Fu meeting point,and also the club of hand Taiyin,Shaoyang,Foot Yangming,and Ren pulse.Therefore,Massage,as well as Abdominal Ren pulse and navel,has the effect of dispersing and promoting the Qi mechanism of middle Jiao,tonifying the middle Qi,and regulating the middle Qi.It can promote gastrointestinal peristalsis and accelerate metabolism;the Stomach Meridians is the sea of water-grain,and the sea of five Zang-six Fu organs,which can activate Qi-blood and nourish the exterior-interior.Therefore,Massage the Stomach Meridians and spleen Meridians of the Abdomen can help activate Qi-blood,strengthen the function of five Zang-six Fu organs,promote toxin metabolism and regulate fat storage.

Meridianss and types of Acupoints

Yang Jizhou’s book “Acupuncture and Moxibustion DachengVolume 2” in Ming dynasty recorded that “it’s better to lose one’s acupoints than lose one’s Meridianss”.In the treatment of Chinese Massage manipulation,the selection of Meridianss,tendons,Meridians divergence and skin parts is particularly emphasized,because the literature has not yet formed such a concept.This study mainly analyzes the rules of Meridianss,involving 14 Meridianss in the 14 regular Meridianss.It is mainly located in Stomach Meridians of Foot Yangming (23.87%,37.05%),Ren Meridians(24.73%,11.61%),Bladder of foot Taiyang (25.59%,11.61%),Spleen Meridians of foot Taiyin (11.82%,8.93%).Stomach and spleen are the source of Qi-blood biochemistry and the center of metabolism.Massage of Stomach and Spleen Meridians of Abdomen can regulate metabolism and improve fat conversion.Ren Meridians is described in “sixty six difficulties of dysmenorrhea”.It can regulate the Qi of Du,Ren and Chong to balance the movement of the whole body Meridianss and Qi.the bladder Meridians of foot Taiyang is the location of the back Shu Points of the five zang-six Fu organs,and Massage the back bladder Meridians can act on the back Shu Points of the five Zang-six Fu organs,regulate the function of the Zang-Fu organs,promote the normal metabolism of the body,help to evenly distribute the volume of lipids,and regulate the transformation of fat and sugar.

Frequency and type of manipulation

Based on the analysis of association rules,among 57 Massage prescriptions,there are 111 kinds of Chinese Massage manipulations,which are frequently used,such as Press and Knead (33),NA Massage (27),Point Pressing (26),and Rub (25),mainly including three kinds of manipulations:Extrusion (217,59.62%),Friction (63,17.31%),and Swing (56,15.38%).Kneading method is gentle,and it can be used to warm Meridianss,regulate qi,disperse blood stasis and relieve pain.The book of “The Essentials of the Method of Setting the Bones and Strengthening the Mind” :shows that pressing helps to relieve depression of Meridianss and collaterals,and moxibustion has the effect of Supplementing Qi,warming Yang,activating blood circulation and dispelling wind.The combination of the 3 kinds of manipulations is helpful to dredge the depressed Meridianss,regulate the movement of Meridianss,enhance the transformation of carbohydrate protein fat,reduce the storage of lipids,and inhibit the inflammatory reaction of fat mast cells by squeezing,so as to effectively reduce obesity.

To sum up,57 effective prescriptions were included in this study,involving 101 acupoints,47 operating lines,47 operating surfaces and 111 Chinese Massage manipulations.By association algorithm analysis,the high-frequency “acupoints” for the treatment of Simple obesity were ST25 (36),RN12 (32),RN4 (30),ST36(27),RN6(23),Stomach Meridians (10),Spleen Meridians (8),Renmai (7),Abdomen (36) and Umbilicus (8).The commonly used manipulations were Pressing and Kneading (33).The combination of high frequency “Acupoints” was ST25-RN12-Renmai-Stomach Meridians-Abdomin-Umbilicus (7),RN12-RN4-Renmai-Stomach Meridians-Abdomin-Umbilicus(8),RN12-RN4 Spleen Meridians Stomach Meridians abdominUmbilicus (6),ST25-RN12-Spleen Meridians-Stomach Meridians-AbdominUmbilicus (7),and the combination of high frequency manipulations was Press and Knead-Rub (9) and Push-Press and Knead (7),Push-Rub (7).Through further evolution,using unsupervised entropy layer clustering algorithm,the core new prescription is obtained:ST25-RN12-Renmai-Stomach Meridians-Abdomen-Rub-Press and Knead-push-Thumb Press and knead-Palm Push-Thumb Tip Acupoint -Palm Vibration.

Manipulation is the main means of Massage therapy,and acupoint nature is the basic element of acupoint compatibility.The combination of Massage manipulation and acupoint nature is the basis of Massage prescription.The core prescription from data analysis is based on the Chinese Massage theory of Professor Liu Mingjun “Meridians and viscera related theory” -stimulation of external Meridianss and acupoints can adjust the function of internal viscera as the direction.The summarized Massage methods of moving Abdomen and dredging Meridianss are similar.Big data analysis and traditional theory are consistent and support each other.Under the guidance of the overall concept of traditional Chinese medicine and the principle of syndrome differentiation and treatment,the combination of Acupoint Selection based on syndrome differentiation and symptomatic manipulation can enhance the clinical efficacy of Massage in the treatment of Simple obesity.

Conclusion

By analyzing and refining the rules of Acupoint Selection,manipulation application and prescription composition of Chinese Medicine Inheritance auxiliary system,the obtained acupoint manipulation combination and core new prescription can provide reference scheme for modern clinical treatment of Simple obesity,provide ideas for the formation of optimal scheme of acupoint Massage,and also provide ideas for the excavation and analysis of acupoint Massage for the treatment of other diseases.