Core Acupoint Prescription Patterns for Primary Dysmenorrhea: Data Mining and Network-Based Analysis

To identify core acupoint prescription patterns for primary dysmenorrhea (PD) using data mining and to generate hypothesis-level mechanistic insight through network-based analysis.

Nine Chinese and English databases were searched from inception to 18 January 2025. Clinical studies of body acupuncture for PD were screened, and acupoint prescriptions were extracted and standardized. Frequency analysis and Apriori association rule mining identified commonly used acupoints and stable cooccurring combinations. Through the use of a network pharmacology-based, hypothesis-generating inference framework, putative bioactive compounds and molecular targets related to the core acupoint combination were derived using STITCH and SwissTargetPrediction, after which a protein-protein interaction (PPI) network was constructed and GO/KEGG enrichment analyses performed to explore the underlying mechanism.

A total of 5993 records were collected; after screening, 177 PD-related articles that produced 291 prescriptions were identified, with 124 unique effective prescriptions involving 66 acupoints included for data analysis. The most frequently used acupoints were Sanyinjiao (SP6), Guanyuan (CV4), and Diji (SP8). Association rule mining supported SP6-CV4-SP8 as a consistent core combination. Network analysis linked this core to 29 active compounds and 640 potential targets, with 94 PD-related targets overlapping. PPI analysis revealed 10 core targets. Enrichment analyses indicated involvement of inflammation, hormone, and pain pathways, especially the PI3K-Akt, cAMP, and AGE-RAGE signaling pathways.

Acupuncture prescriptions for PD showed consistent core acupoint patterns centered on SP6-CV4-SP8. Network-based analyses generated hypothesis-level mechanistic insights, highlighting dominant biological themes related to inflammation, hormonal regulation, and neuroendocrine-immune signaling, with multitarget and multipathway involvement. Interpretations should be made with caution due to heterogeneity in the included studies and the exploratory nature of target/pathway prediction. These findings may help prioritize candidate targets/pathways for experimental verification and inform future trial design and evidence-based optimization of acupuncture prescriptions for PD.