The research on rule of Acupoints and Massage Manipulations selection for Postischemic Stroke Constipation based on association rule and entropy clustering analysis

Long Zhang ,Xiao-Lin Zhang ,A-Ru Sun ,Di Cao ,Zheng-Ri Cong ,Ming-Jun Liu*

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

Abstract Constipation is a common complication of stroke,and it is increasing year by year,which is worthy of attention.In fact,as an effective treatment for Post-ischemic Stroke Constipation,massage has been recognized by doctors at home and abroad.However,In the known research reports,massage prescriptions are complicated,therefore,a simple and effective massage prescription is urgently needed to effectively guide the clinic and promote it.In this study,we used association rule and entropy clustering analysis methods to mine clinical literature on Post-ischemic Stroke Constipation in 7 databases,and combined with data analysis,traditional chinese massage theory and clinical practice,a core new prescription is summarized.The core new prescription of massage in treating Post-ischemic Stroke Constipation take tonifying spleen,nourishing Qi and generating Body Fluid,promoting Qi,invigorating the circulation of blood and eliminating phlegm as the principle of treatment,which is accord with the pathogenesis of this disease,can better guide the clinical practice and facilitate the popularization and application of massage therapy.

Key words:Stroke,Constipation,Association rule,Entropy clustering,Massage,Rule of acupoint selection

Background

Post-stroke Constipation is a disease that after a stroke,patients experience difficulty in defecation or defecation disorders,which can cause a series of clinical symptoms such as loss of appetite,headache,dizziness,etc [1].In addition,long-term constipation may increase the risk of colon malignant tumors in the elderly [2].In general,stroke patients are mostly the elderly.Constipation will increase abdominal pressure for a long time,reduce the amount of return blood,and make intracranial pressure increase continuously,which can easily lead to cerebral hemorrhage,cerebral thrombosis,myocardial infarction and other cardiovascular diseases,and increase the mortality of patients [3].At the same time,when stroke patients suffer from constipation,excessive defecation will cause the intracranial pressure to increase,make the original symptoms aggravate suddenly or protracted,and can again induce complications such as stroke and myocardial infarction.SO,stroke and constipation form a vicious circle [4].According to the latest research,the incidence of Poststroke Constipation is 51% [5],the disease with such a high incidence brings a heavy economic burden to individuals,families and the Public Health and Medical Service System [6].At present,clinical treatment mainly focuses on promoting intestinal peristalsis and restoring effective defecation [7].Stool softeners,prokinetics,osmotic and irritating laxatives are used,but these drugs usually have side effects such as abdominal distension,nausea,vomiting and diarrhea[8],long-term application is easy to be dependent,and even induces cancerous and other adverse reactions [9].Massage has the advantages of simple and effective treatment without side effects,which has been recognized by the majority of medical workers and patients [10].This study sorted out the clinical literature related to massage for Post-ischemic Stroke Constipation in many domestic and foreign databases,and used data mining methods to conduct research,in order to obtain the optimal Massage Prescriptions for Post-ischemic Stroke Constipation,so as to provide more valuable clinical reference scheme for massage treatment of Post-ischemic Stroke Constipation.

Objection

The objective of this study was to obtain the simple and effective Massage Prescriptions for Post-ischemic Stroke Constipation through data mining and analysis.

Materials and methods

Literature sources and retrieva

The search terms used were as follows:“Massage”(MeSH) or “Tuina” or “Massotherapy”,“Stroke”(MeSH) or “Ischemic Stroke” or “Apoplexy” or“Cerebral Stroke” or “Cerebralvascular Accident”,“Constipation” (MeSH) or “Astriction”,“Clinical Experiment” or “Clinical Observation” searched the Cochrane Library,PubMed,EMBASE,and Web of Science,CNKI,VIP and Wanfang database.The retrieval time is before March 21,2021.There are no language restrictions on document retrieval.Take the EMBASE database as an example,the search conditions are shown in Figure 1.

Figure 1 Retrieval condition graph based on EMBASE database

Figure 2 The Acupoints of using frequency ≥ 10 times in treating Post-ischemic Stroke Constipation by massage

Literature inclusion criteria

(1) The research objects described in the literature were patients with Ischemic Stroke.

(2) The research object described in the literature is Constipation after Stroke,which has nothing to do with gastrointestinal organic diseases.

(3) There are complete clinical prescriptions of massage in the literature.

(4) The literature shows that massage has definite effect in treating Post-ischemic Stroke Constipation.

Literature exclusion criteria

(1) Literature on the prevention of Post-ischemic Stroke Constipation by massage therapy.

(2) Literature on the treatment of Post-ischemic Stroke Constipation by anal massage or rectal massage.

(3) The literature of unclear or incomplete Massage Manipulation.

(4) Literature on the treatment of Post-ischemic Stroke Constipation by auricular point pressing bean massage.(5) Review literature or meta-analysis.

Data collation and software analysis

The articles meeting the inclusion criteria and exclusion criteria were entered into excel by two researchers according to the publication time,The entered entries involve 5 items,including "Author","Title","Acupoint","Part" and " Massage Manipulation ".The"Part" is subdivided into " Surfaces " and " Threads ",and refer to teaching material of “Science of Tuina” and"JINGLUO SHUXUEXUE " to standardize the names of Massage Manipulation,Parts,Meridians and Acupoints.In order to ensure the accuracy of data entry,two researchers simultaneously entered the standardized and collated data into the TCMISS V2.5.And used TCMISS V2.5 software to obtain the frequency of Acupoints and Massage Manipulation,used Apriori algorithm in the software to obtain strong association rules of Acupoints,Parts,Massage Manipulation in treating Post-ischemic Stroke Constipation by massage,entropy clustering algorithm was used to obtain the candidate new Massage Prescriptions for Post-ischemic Stroke Constipation.

Results

Results of literature retrieva and inclusion

According to the literature search conditions,8 articles were retrieved from EMBASE,9 articles from Web of Science,14 articles from Cochrane Library,0 article from PubMed,239 articles from CNKI,82 articles from VIP database and 140 articles from Wanfang database.According to the literature screening criteria,and finally 146 effective literatures were included,of which 5 were foreign literature [11-14].A total of 121 Acupoint Prescriptions,66 Parts (surfaces) Prescriptions,17 Parts(threads) Prescriptions,146 Massage Manipulation Prescriptions and 146 comprehensive data prescriptions were collected.

Analysis of Frequency of Acupoints and Massage Manipulations

Frequency and meridians classification of Acupoints.A total of 121 Acupoint Prescriptions were included in this study,involving 63 Acupoints,and 16 Acupoints were used ≥ 10 times.See Figure 2 for details.The analysis of the meridians classification of 63 Acupoints is carried out,see Table 1 for details.

Table 1 Statistics of total frequency of meridians and number of Acupoints in treating Post-ischemic Stroke Constipation by massage

Frequency of massage manipulations

In this study,146 Massage Manipulation Prescriptions were included,involving 45 Massage Manipulations,and 7 were used ≥ 10 times.See Figure 3 for details.

Constipation based on association rule

Association rule are used to mine information about the connections of valuable things in massive data,and the setting of support degree and confidence degree can measure the strength of association [15].In this study,based on the Apriori algorithm,the number of support degree for 121 Acupoint Prescriptions was set to 24,the confidence degree was set to 0.6,and 10 strong association rules of common Acupoint Combinations were obtained,of which there were 2 with confidence ≥0.9.see Table 2 for details.The number of support degree for 66 parts (surfaces) and 17 parts (threads)Prescriptions was set to 2,the confidence degree was set to 0.6,and 2 strong association rules of common Parts(surfaces) and Parts (threads) Combinations were obtained.See Table 3 and Table 4 for details.The number of support degree for 146 Massage Manipulation Prescriptions was set to 5,the confidence degree was set to 0.6,and 4 strong association rules of common Massage Manipulation Combinations were obtained.See Table 5 for details.The network structure diagram of strong association rules is shown in Figure 4.In this study,146 effective literatures were collected,and each literature was regarded as a prescription,each prescription included Acupoints,Parts (surfaces),Parts(threads),Massage Manipulations.Based on Apriori algorithm,the number of support degree was set to 20,and the confidence degree was set to 9.The strong association rules for comprehensive data were obtained.See Table 6 for details.The network structure diagram of the comprehensive data strong association rules is shown in Figure 5.

Table 2 Association rule of Acupoints in treating Post-ischemic Stroke Constipation by massage (Confidence≥ 6)

Table 3 Association rule of Parts (surfaces) in treating Post-ischemic Stroke Constipation by massage(Confidence ≥ 6)

Table 4 Association rule of Parts (threads) in treating Post-ischemic Stroke Constipation by massage(Confidence ≥ 6)

Table 5 Association rule of Massage Manipulation in treating Post-ischemic Stroke Constipation by massage(Confidence ≥ 6)

Table 6 Association rule of comprehensive data in treating Post-ischemic Stroke Constipation by massage(Confidence ≥ 9)

New prescriptions analysis based on entropy clustering algorithm

The Cluster analysis method is based on the analysis results of the mutual information method,and divides the data set into several sub-data sets according to the correlation coefficient and penalty coefficient constraints,so that the objects in the corresponding data set are similar in some characteristics [16].In this study,121 Acupoint Prescriptions were analyzed by entropy clustering algorithm,and the correlation degree was set to 8,the penalty degree was set to 2,the core Acupoint Combination was obtained by clustering,and then 3 candidate new Acupoint Prescriptions were obtained by Entropy Hierarchical Clustering.66 Parts (surfaces) and 17 Parts (threads) Prescriptions were analyzed by entropy clustering algorithm,and the correlation degree was set to 6,the penalty degree was set to 2,the core Parts (surfaces) and Parts (threads) Combination was obtained by clustering,and then 1 candidate new Parts(surfaces) and Parts (threads) Prescriptions were obtained by Entropy Hierarchical Clustering.146 Massage Manipulation Prescriptions were analyzed by entropy clustering algorithm,and the correlation degree was set to 4,the penalty degree was set to 2,the core Massage Manipulation Combination was obtained by clustering,and then 1 candidate new Massage Manipulation Prescriptions were obtained by Entropy Hierarchical Clustering.See Figure 6 for details.

In this study,each of the 146 effective literatures was regarded as a prescription,and each prescription included Acupoints,Parts (surfaces),Parts (threads) and Massage Manipulations.entropy clustering algorithm was used to analyze,set the correlation degree to 5 and the penalty degree to 2,The core Massage Prescription Combination was obtained by clustering,and further using Entropy Hierarchical Clustering to obtain 2 new Massage Prescriptions for the treatment of Constipation after Ischemic Stroke.See Figure 7 for details.

Figure 5 Network structure diagram of comprehensive data strong association rules in treating Post-ischemic Stroke Constipation by massage（support ≥ 13.70%）

Figure 6 Network structure diagram of new Prescriptions in treating Post-ischemic Stroke Constipation by massage on entropy clustering algorithm. A,New Acupoint Prescriptions.B,New Parts (surfaces) Prescriptions.C,New Parts (threads) Prescriptions.D,New Massage Manipulation Prescriptions.

Figure 7 Network structure diagram of comprehensive data new Massage Prescriptions in treating Postischemic Stroke Constipation by massage

Discussion

The pathogenesis of Post-ischemic Stroke Constipation

Studies have shown that after a stroke,the Central Nervous System (CNS),Sympathetic Nerve and Parasympathetic Nerve signal feedback of the patient’s brain are severely affected,which leads to the destruction of the functional coordination between the pelvis and anal sphincter [17],while the infarcted focus of ischemic stroke will lead to the damage of the CNS,affecting the normal physiological function of ascending conduction fibers.So that the rectal sensory center lost its conduction function,and eventually leads to defecation disorders [18].Not only that,the abnormal function of the CNS can also lead to the disorder of the secretion of gastrointestinal hormones,which causes the endocrine metabolic dysfunction result in abnormal gastrointestinal function,leading to constipation.Modern studies have found that the abnormal function of the Brain-gut Axis is closely related to the onset of Post-stroke Constipation [19-20].The Brain-gut Axis is the connection channel between the gastrointestinal neuroendocrine and CNS.The function of the gastrointestinal is regulated by the autonomic nervous system (ANS),CNS and enteric nervous system (ENS).The physiological and pathological changes of brain are closely related to the physiological and pathological changes of the gastrointestinal tract,the gastrointestinal tract and the brain have a closer and complex"interaction"[21].As an important regulatory substance in the Brain-gut Axis,Brain-gut peptides participate in the signal transmission between brain and intestine as neurotransmitter,and participate in the regulation of gastrointestinal sensory and motor functions in the form of gastrointestinal hormones [22].

Traditional Chinese Medicine (TCM) believes that the pathogenesis of Post-ischemic Stroke Constipation is deficiency of Qi and Blood in liver and kidney,inability to promote the movement of stool,or Qi deficiency and dyskinesia,Qi stagnation for a long time turns into fire,Combination of phlegm and blood stasis in the gastrointestinal tract,resulting in Qi obstruction of viscera,resulting in constipation [23].Academician Shi Xuemin pointed out that the pathogenesis of stroke is " Brain orifice occlusion,mind hidden,and the spirit does not guide the Qi." It is considered that Post-stroke Constipation is the viscera disease of the Qi obstruction of viscera after the brain and mind occlusion [24].

Significance of data mining on Massage Prescriptions of Post-ischemic Stroke Constipation

In recent years,the clinical research of Post-stroke Constipation has gradually become a hot topic.There are more and more reports in the literature on the treatment of Post-ischemic Stroke Constipation with TCM internal treatment,Acupoint Application,Ear Pressing Beans,Acupuncture and Massage therapy.The curative effect of massage in the treatment of this disease is significant,but the number of literature is not large and the quality is uneven,In some literatures,the treatment of massage is complicated,or do not give a specific massage program,which cannot effectively guide clinical treatment.Based on the above problems,this study used the TCMISS V2.5 software to analyze all the clinical research literatures about massage intervention in domestic and foreign databases,to explore the valuable massage intervention information hidden in big data,and to explore the rule of Acupoint selection,Massage Manipulation selection and Massage Prescriptions based on association rule and complex entropy clustering algorithm of Post-ischemic Stroke Constipation.In order to provide a comprehensive and effective massage treatment scheme for clinical,which popularize massage therapy beneficially.At the same time,it provides easy-to-follow home massage treatments for patients with Post-ischemic Stroke Constipation but not seeking medical attention,which greatly reduces the family economic burden of patients,saves medical resources,and reduces the burden of Public Health and Medical System in the New Coronavirus Pneumonia environment,resulting in greater economic and social benefits.

Analysis of frequency of Acupoints and Massage Manipulations

In this study,121 Acupoint Prescriptions were included,involving 63 Acupoints.The commonly used Acupoints are:ST 25,CV 12,ST 36,CV 4,SP 15,CV 6.The rule of Acupoint selection is shown as:①Pay attention to Specific Points,especially to take Front-Mu Points and Rendezvous Points.②Take more abdominal Acupoints.ST 25 is a large intestine Front-Mu Point,derived from the Yangming meridian Qi.It is mainly used to regulate intestines,regulates Qi and promotes stagnation,digest food.CV 12 is a stomach Front-Mu Point,“Fuhui” of the Eight-convergent Points,is also Rendezvous Points of the Conception Vessel,Hand-Taiyang and Foot-Yangming Meridians.It has the effect of dredge the functional activity of Qi of Zhongjiao,tonifying Zhongqi,and can promote the peristalsis of intestines and stomach.ST 36 is a stomach Xiahe Points,it is not only the Key Point for tonifying Qi and Blood,but also the Effective Point for Expelling Phlegm,Inducing Resuscitation,and regulating the spleen and stomach.Modern research shows that ST 36 has immunomodulatory effects [25].CV 4 is a small intestine Front-Mu Points,the Rendezvous Points of the Conception Vessel,Foot-Taiyin,Foot-Shaoyin,Foot-Jueyin Meridians.It has the effect of “Pei Yuan Gu ben”,tonifying Xiajiao.SP 15 is the Rendezvous Points of Foot-Taiyin,Yinwei Meridian.It has the effect of harmonizing spleen and stomach,tonifying spleen and Relieve Dampness,regulating the viscera of intestines.CV 6 has the effect of tonifying the kidney,nourishing Qi and Blood.“The Qi interlinked in the Yin and Yang and Meridians,connected in the viscera and abdomen and back” said Hua Boren in the “NANJING BENYI”.It shows that the Qi of the viscera is related to the Front-Mu Points,and the Front-Mu Points are mostly used for diseases of the viscera.The pathogenesis of Postischemic Stroke Constipation is more complicated,and it is not a meridian that can be treated,so the Rendezvous Points are often used to regulate the overall meridian.ST 25,CV 12,CV 4,SP 15,CV 6 are all located in the abdomen.The Acupoints on the abdomen are adjacent to the stomach and intestine,which can treat stomach and intestine diseases,and embody the rule of acupoint indications of "the meridians pass,and the main treatment is"[26]

According to Table 1,Acupoints are mostly belong to Stomach Meridian of Foot-Yangming,Conception Vessel,Bladder Meridian of Foot-Taiyang,Spleen Meridian of Foot-Taiyin;Large Intestine Meridian of Hand-Yangming,Governor Vessel,Sanjiao Meridian of Hand-Shaoyang,Kidney Meridian of Foot-Shaoyin corresponding a small proportion.Conception Vessel is the sea of “Yin Mai”.Its collaterals are scattered in the abdomen from CV 15,forming a network that communicates the internal and external viscera of the abdomen.A large number of Front-Mu Points and Rendezvous Points are scattered here,which has the functions of “Pei Yuan Gu ben”,tonifying the spleen and stomach,regulating Qi and harmonizing intestines[27].Therefore,Conception Vessel with accumulation of viscera Qi is often used for the treatment of this disease.Bladder Meridian is the place where all Yang converge.It runs on the most superficial back of the human body,so it is known as the "fence of the human body".It has the function of resisting the invasion of external pathogens and has the most “Yang Qi”.Therefore,the deficiency of Qi and Blood and the combination of phlegm and blood stasis all start from the Foot-Taiyang Meridian helping Yang to transform Yin.Stomach Meridian is the sea of water and cereal essence,the sea of viscera,which has the function of generate Qi and Blood,nourishing the human body.Spleen Meridian and Stomach Meridian are mutually exterior and interior,communicating with each other,and jointly regulating the generate and transportion of Qi and Blood.The spleen and stomach is the hub of Qi and regulating the rise and fall of Qi.Therefore,the diseases caused by Qi stagnation and blood stasis and deficiency of Qi and Blood are treated from the spleen and stomach meridian.

In this study,146 Massage Manipulation Prescriptions were included,involving 45 Massage Manipulations,The commonly used Massage Manipulations are:Pressing and Kneading,Palm rubbing,One Finger Zen Push.The kneading is gentle and more tonic,mainly to warming meridians,regulating Qi and dispersing blood stasis and relieving pain."Yi Zong Jin Jian" pointed out:" Pressing the meridians can dredge the stagnant Qi." Explain that Point-pressing can dredge the meridians.Circular kneading has the effect of tonifying Qi,warming Yang,activating blood circulation and dispelling wind.One Finger Zen Push belongs to Pushing method,which has the function of dredging meridians and harmonizing Yin and Yang [28].

In summary,the high-frequency Acupoints used in massage to treat Post-ischemic Stroke Constipation are Specific Acupoints,and focus on Front-Mu Points and Rendezvous Points.The high-frequency Meridians are Stomach Meridian,Conception Vessel,Bladder Meridian,Spleen Meridian.The high-frequency Massage Manipulations are Pressing and Kneading,Palm rubbing,One Finger Zen Push.The combination of Massage Manipulations and Meridian and Acupoints can harmonize Qi and Blood,harmonize spleen and stomach,and dredge the functional activity of Qi of Zhongjiao.

Association rule and entropy clustering analysis

Based on the Apriori algorithm,2 common Acupoint Combinations were obtained:CV 12-ST 25,ST 25-SP 15;3 common Parts (surfaces) Combinations were obtained:Abdomen-Navel,Navel-Lateral Abdomen,Abdomen-Along the ascending colon,transverse colon,descending colon,sigmoid colon;1 common Parts(threads) Combinations were obtained:Abdominal Conception Vessel-Abdominal Stomach Meridian-Abdominal Spleen Meridian-Abdominal Kidney Meridian;3 common Massage Manipulations Combinations were obtained:Pressing and Kneading-Palm rubbing,Pressing and Kneading-One Finger Zen Push,Palm rubbing-One Finger Zen Push;1 preferred Massage Prescription was obtained by comprehensive data analysis:Palm rubbing-Abdomen-Pressing and Kneading-One Finger Zen Push-CV 12-ST 25-CV 4-CV 6-SP 15-ST 36.According to the analysis of strong association rule,the commonly used combinations of Acupoints,Parts,and Massage Manipulations are paired together to tonifying Qi and Blood,dredging Meridians,regulating Qi and promoting blood circulation to remove blood stasis dredging,which are the first prescriptions choice of Acupoints,Parts,Massage Manipulations for treating Post-ischemic Stroke Constipation.

Based on the analysis of entropy clustering algorithm,3 candidate new Acupoint Prescriptions were obtained:CV 12-SP 6-TE 6-CV 4,SP 15-BL 23-GV 1-CV 6,ST 36-LI 4-SP 6-TE 6-CV 6.1 candidate new Parts(surfaces) Prescriptions were obtained:Around the navel -Along ascending colon,transverse colon and descending colonl-Lateral Abdomen–Nave-Along the anatomical position of the colon-Along the ascending colon,transverse colon,descending colon,sigmoid colon.1 candidate new Parts (threads) Prescriptions were obtained:Abdominal Stomach Meridian-Abdominal Kidney Meridian-Large Intestine Meridian-From LI 15 to LI 1 along the path of Large Intestine Meridian of Hand-Yangming.1 candidate new Massage Manipulations Prescriptions were obtained:Linear rubbing Grasping-Pushing-Acupressure.2 candidate new Massage Prescriptions was obtained by comprehensive data analysis:Pressing and Kneading-BL 21-BL 20-LI 4-ST 36,Pushing and Kneadingabdomen-Along the corresponding to the skin of sigmoid colon-from the proximal end of the sigmoid colon to the distal end.From the perspective of new prescriptions combination,the treatment idea of dredging meridians,tonifying Qi and Blood has not changed,and potential Acupoints and Massage Manipulation have been excavated,such as newly added Acupoints:SP 6 is the Rendezvous Points of Foot-Taiyin,Foot-Shaoyin,Foot-Jueyin Meridians.It has the effect of tonifying spleen and relieve dampness.

SP 15 is the Rendezvous Points of Foot-Taiyin,Yinwei Meridian.It has the effect of harmonizing spleen and stomach,tonifying spleen and relieve dampness,regulating the viscera of intestines,mind easing&menstruation normalizing.It has a good therapeutic effect on gastrointestinal dysfunction caused by spleen deficiency.TE 6 is the Jing Points of Five-Shu Acupoints in The Sanjiao Meridian.It has the effect of soothing the liver and regulating Qi,invigorate the circulation of blood and relieving pain,nourishing Yin and generating Body Fluid.It is an Experience Point for treating constipation.BL 23 is the Back-shu Points of kidney.It has the effect of Invigorate Kidney and Yang,tonifying essence and marrow,tonifying vitality,diuresis and diminution of swelling.LI 4 is the Yuan Points of the Large Intestine Meridian of Hand-Yangming.It has a good effect on diseases of large intestine dysfunction.The pathogenesis of constipation is related to the deficiency of Qi,Blood,Yin,Body Fluid and can not smooth the bowel movement,Therefore,SP 6 and TE 6 are newly added to nourish Yin and promote Qi.The newly added Linear-rubbing method and Grasping method can generate heat when applied to the local area,and have the function of invigorate the circulation of blood and warming meridians.Combined with the Pushing method,they play the role of warming meridians and tonifying Yang,promoting Qi and invigorate the circulation of blood.Potential new prescriptions contain potential therapeutic rules,which are worthy of further clinical verification.

Conclusion

Massage Manipulation is the main method of massage therapy,Acupoints and Parts are the basic elements of massage therapy.The combination of each other is the basis of Massage Prescription.The data of Massage Prescriptions obtained by association rule and entropy clustering analysis are connected with Professor Liu Mingjun's “Yunfu Tongjing” massage based on traditional chinese massage theory,and combined with actual clinical practice,and summarized the core new prescriptions:Palm rubbing-Grasping-Abdomen-Pushing and Kneading-Along the ascending colon,transverse colon,descending colon,sigmoid colon-Pushing-Abdominal Conception Vessel-Abdominal Stomach Meridian-Abdominal Spleen Meridian-Abdominal Kidney Meridian-From LI 15 to LI 1 along the path of Large Intestine Meridian of Hand-Yangming-Pressing and Kneading-CV 12-ST 25-CV 4-CV 6-SP 15-ST 36-SP 6-TE 6-BL 23-LI 4.

In the core new prescription,Palm rubbing the abdomen can not only relax patients,but also have the effect of Tonifying Qi and Blood;Grasping the abdomen and Pushing and Kneading along the ascending colon,transverse colon,descending colon,sigmoid colon can enhance intestinal activity and improve visceral activity.Pushing along the Abdominal Conception Vessel,Abdominal Stomach Meridian,Abdominal Spleen Meridian,Abdominal Kidney Meridian and Pushing from Jianyu(LI 15) to Shangyang(LI 1) along the path of The Large Intestine Meridian of Hand-Yangming to dredge the meridians mainly.It has the effect of promoting Qi and invigorating the circulation of blood.Pressing and Kneading the CV 12,ST 25,CV 4,CV 6,SP 15,ST 36,SP 6,TE 6,BL 23,LI 4 can regulate the body's Viscera,Qi,Blood,Yin and Yang as a whole.The combination of Acupoints,Parts and Massage Manipulations reflects the main treatment ideas of tonifying spleen,nourishing Qi and generating Body Fluid,promoting Qi,invigorating the circulation of blood and eliminating phlegm,which is accord with the pathogenesis of this disease.