Network analysis of acupuncture points used in the treatment of low back pain

Background. The appropriate selection of acupoints is fundamental to obtain a therapeutic effect from clinical acupuncture. Objective. Using a network analysis method, we investigated the acupoints that are combined to treat low back pain (LBP). Methods. To analyze the patterns of the combinations of acupoints, we used acupoint information from clinical trials to calculate the modified mutual information (MI) value, integrated these data, and visualized the network. Results. Based on the highest MI values, we found two different types of acupoint pairs used in the treatment of LBP: pairs of distant acupoints and pairs of local acupoints. Using modular analysis, we found that three acupoint modules were applied in the treatment of LBP: local acupoints, distant acupoints along the meridian, and distant acupoints based on the symptom differentiations. Conclusion. Using the modified MI technique, we provide a systematic framework for the acupoint combination network, and reveal how the technique of acupoint combination is used in the treatment of LBP. Application of this knowledge in acupuncture research may help clarify the mechanisms underlying acupuncture treatment at the systems level, bridging the gap between traditional medicine and modern science.