Supplementary Material for: An Association Rule Analysis of Combined Acupoints for the Treatment of Patients with Dry Eye Disease

Background: Dry eye disease (DED) has a higher incidence in old age and is seen predominantly in females worldwide. Neurosensory abnormalities, ocular surface inflammation and damage, film instability, and hyperosmolarity are major and proven pathologies responsible for a poor quality of life. Tear breakup time and Schirmer’s I test are predominantly used for the evaluation of primary outcomes in patients undergoing conventional treatment. A previous meta-analysis of some relevant studies proved that combination of acupoints could be more effective than single acupoint treatment. Objectives: The present study aimed to undertake association rule mining and examined the potential kernel acupoint combination in DED treatment constructed from the extracted randomized controlled trials (RCTs) based on a previous meta-analysis. Methods: We summarized 32 acupoints as binary data from the 12 eligible RCTs and analyzed them based on the Apriori algorithm. Results: TE23, BL2, ST2, ST1, EX-HN5, BL1, LI4, ST36, SP6, and KI3 were the 10 most frequently selected acupoints. The major associated rules in combination of acupoints were {TE23, LI4} ≥ {ST1} and {TE23, ST1} ≥ {LI4}, as inferred from 23 association rules. Conclusions: For acupuncture treatment of DED, combined TE23, LI4, and ST1 acupoints could be settled as the kernel of acupoint combination.

背景：干眼症（Dry eye disease, DED）在老年人群中发病率更高，且在全球范围内女性患者占比更高。神经感觉异常、眼表炎症与损伤、泪膜不稳定以及泪液高渗状态是导致患者生活质量下降的主要且已被证实的病理机制。泪膜破裂时间（Tear breakup time）与施墨I试验（Schirmer’s I test）是常规治疗患者中评估主要结局指标的常用手段。既往一项针对相关研究的荟萃分析显示，穴位联合疗法相较于单穴位治疗更为有效。
研究目的：本研究旨在开展关联规则挖掘，基于既往荟萃分析中提取的随机对照试验（randomized controlled trials, RCTs），探究干眼症治疗中潜在的核心穴位配伍方案。
研究方法：本研究从12项符合纳入标准的随机对照试验中提取了32个穴位的二分类数据，并采用Apriori算法进行分析。
研究结果：位列使用频次前十的穴位分别为TE23、BL2、ST2、ST1、EX-HN5、BL1、LI4、ST36、SP6及KI3。基于23条关联规则推导得到的核心穴位配伍关联规则为{TE23, LI4} ≥ {ST1}与{TE23, ST1} ≥ {LI4}。
研究结论：在干眼症的针灸治疗中，TE23、LI4与ST1的联合配伍可作为穴位配伍方案的核心组方。