Visual Analysis Of Traditional Chinese Medicine in The Treatment Of Primary Dysmenorrhea Based On Citespace Knowledge Map Ⅱ

2.3 Keyword analysis

2.3.1 Research hotspot analysis

The depth of the color in the co-occurrence graph indicates the order of publication time. The lighter the color, the closer the publication time of the document is. The size of the node represents the frequency of keyword occurrence. The larger the node, the higher the frequency of occurrence. The dark purple circle outside the node represents the high betweenness centrality of the document. Through the analysis of the co-occurrence graph of keywords, we can get the research hotspots of TCM treatment of primary dysmenorrhea from 2013 to 2022. CiteSpace generated a total of 306 nodes and 318 links. The top 5 keywords in terms of frequency are dysmenorrhea, traditional Chinese medicine, clinical efficacy, acupuncture, and acupuncture treatment. The top 5 keywords in terms of betweenness centrality are Guanyuan, dysmenorrhea, qi stagnation and blood stasis, etiology and pathogenesis, and irregular pain. The most popular TCM therapy in the field is acupuncture, and the treatment type is mainly qi stagnation and blood stasis. The most used acupoint for treatment is Guanyuan. The research direction mainly focuses on the treatment effect and etiology and pathogenesis of acupuncture. See Figure 3, Table 1.

Through keyword analysis and literature reading, it can be seen that the combination of acupuncture and medicine has also attracted more and more attention from scholars. For example, Zhang Xiaochun [12] used acupuncture at Guanyuan, Hegu, Sanyinjiao and other acupoints in combination with Chinese medicine such as Cyperus rotundus and Cistanche to treat primary dysmenorrhea of blood stasis type in clinical practice, and achieved good clinical efficacy. Cyperus rotundus belongs to the category of Qi-regulating medicine, and Angelica sinensis has the effects of nourishing blood and activating blood circulation, regulating menstruation and relieving pain. The combination of these medicines with acupuncture therapy can significantly reduce the pain caused by Qi stagnation and blood stasis in patients. In addition, Guanyuan and Baliao are two commonly used acupoints for the treatment of primary dysmenorrhea. The treatment methods for Guanyuan are mainly acupuncture and moxibustion, which is mostly related to the effect of Guanyuan in regulating the Chong and Ren meridians and promoting Qi and blood circulation [13]. The etiology and mechanism of primary dysmenorrhea in Western medicine have not yet been fully clarified. At present, the generally accepted view is that this may be closely related to prostaglandins, oxytocin, vasopressin, sex hormones, etc. [14]. Studies have shown that acupuncture treatment can effectively reduce the level of prostate metabolites in serum, reduce the secretion level of inflammatory factors (TNF-α, IL-1β, etc.), and inhibit uterine smooth muscle, thereby alleviating the symptoms of primary dysmenorrhea to a certain extent [15].

Figure 3 Co-occurrence of high-frequency keywords in the field of TCM treatment of primary dysmenorrhea from 2013 to 2022

2.3.2 Keyword clustering analysis

Keyword clustering is an analysis function that comes with CiteSpace software. It uses scientific calculation methods to summarize and conclude keywords. Average profile value (S value), it is generally believed that clusters with S > 0.5 are reasonable, and S > 0.7 means that the cluster is trustworthy and can be adopted. Average year refers to the average year of key appearance in the cluster. Keyword clustering generated a total of 15 tags, and the S values of all 15 tags are above 0.7, indicating that each cluster is trustworthy and can be used as a reference.

NEW HERBAL FORMULATION FOR  TCM TREATMENT OF PRIMARY DYSMENORRHEA 

There are 27 keywords in the No. 0 tag, indicating that since 2013, research in the field of TCM treatment of primary dysmenorrhea has been gradually developing and improving, and more and more TCM treatment methods have been used to treat primary dysmenorrhea, and acupuncture and massage are commonly used methods of TCM treatment of primary pain. The keyword "adverse reactions" in label No. 7 indicates that the field has begun to pay attention to some problems that may arise in the application of traditional Chinese medicine treatment. This is a very important direction in the application process, indicating that the research on the field is becoming more and more comprehensive, and the knowledge system of the field is gradually improving, which provides important support for clinical treatment. Label No. 8 contains the word "holographic therapy". Holographic therapy is based on the theory of meridians in traditional Chinese medicine and the biological holographic law proposed by Professor Zhang Yingqing. It uses holographic acupoints, different combinations of meridians and different combinations to treat diseases [16]. Among them, ear holographic therapy includes ear acupoint pressing in label No. 1. Studies have shown that ear acupoint pressing with fenugreek seeds has a significant effect on relieving pain caused by primary dysmenorrhea in patients [17]. This shows that holographic therapy has attracted the attention of researchers in the field and is of great help to clinical efficacy. It is predicted that holographic therapy will become a new research direction. See Table 2.

2.3.4 Analysis of research directions

Keyword emergence refers to a significant increase in the frequency of keyword use in a relatively short period of time. By analyzing keyword emergence, we can understand the research hot spots in a certain field over a period of time and predict the future development of the research hot spots in this field. Analysis[18].

The evolution of keyword emergence from 2013 to 2022 can be divided into 3 stages. From 2013 to 2016, the research direction was mainly Chinese medicine hot compress and Chinese medicine nursing, indicating that the research on the field of Chinese medicine treatment of primary dysmenorrhea is still relatively general, and No detailed field-specific research has been conducted. From 2017 to 2019, the emerging words in the field include moxibustion, Shenque, massage, etiology and pathogenesis, herb-partitioned moxibustion, and therapeutic effect, indicating that research in the field has become more refined and more comprehensive.

Many researchers have begun to pay attention to the study of the causes of primary dysmenorrhea. At the same time, the clinical efficacy of moxibustion, massage and herb-partitioned moxibustion on primary dysmenorrhea has become a new hot topic. From 2020 to 2021, emerging words in the field include cold coagulation and blood stasis, heat-sensitive moxibustion, medication rules, and menstrual abdominal pain, indicating that at this time, researchers' research direction has changed from studying the etiology and pathogenesis of primary dysmenorrhea to studying primary dysmenorrhea. Treatment options for dysmenorrhea. Heat-sensitive moxibustion has replaced herb-partitioned moxibustion as a new research hotspot, which shows that acupuncture has always been a research hotspot in the field. The combination of acupuncture and medicine is one of the core contents of the traditional Chinese medicine treatment system. In recent years, it has been used more and more frequently in the field. For example, heat-sensitive moxibustion, as a type of acupuncture alternative therapy, is often used clinically with traditional Chinese medicine decoction. It can relieve lower abdominal pain caused by primary dysmenorrhea of cold coagulation and blood stasis type, and has achieved good clinical therapeutic effects [19].

It is predicted that the clinical application of acupuncture and medicine in the treatment of primary dysmenorrhea with traditional Chinese medicine will become the main research direction. The treatment, etiology and pathogenesis of primary dysmenorrhea of cold coagulation and blood stasis type, and combined treatment with other therapies will become the research direction of heat-sensitive moxibustion. See Figure 4.

Figure 4 Keyword emergence in the field of TCM treatment of primary dysmenorrhea from 2013 to 2022

3 Summary and Outlook

This study included the literature on TCM treatment of primary dysmenorrhea from January 1, 2013 to December 31, 2022 in CNKI, and used CiteSpace software to create a map. The analysis was conducted from multiple aspects such as the number of articles, research institutions, and keywords, and the following conclusions were drawn: ① The use of TCM to treat primary dysmenorrhea has attracted more and more attention; ② Research institutions in the field show a relatively obvious regional distribution, and the cooperation between research institutions is mainly in the same province or region, with less cross-regional cooperation, and there are significantly more research institutions in the north than in the south; ③ Acupuncture and acupuncture treatment are still the more commonly used TCM treatments for primary dysmenorrhea. At present, more and more treatment methods are being used to treat primary dysmenorrhea, such as acupuncture-drug combination and holographic therapy, which are predicted to become new research hotspots; ④ The current research hotspot is the clinical efficacy of thermosensitive moxibustion on primary dysmenorrhea. The next step is to study the mechanism of action of thermosensitive moxibustion more deeply, and combined treatment will become the research direction of thermosensitive moxibustion.

This study also has certain limitations. For example, the CNKI database used cannot ensure that all literature in this field is included, and there is also the possibility of misscreening and missing in the process of manual screening of literature; only Chinese literature in the field is used, and English literature is not included, and there is a lack of comparison of domestic and foreign research in this field. In subsequent in-depth research, more detailed analysis can be conducted on more different treatment methods to provide reference ideas for studying different methods. I believe that with the continuous development of science and technology, the update of big data analysis software, and the further improvement of bibliometric methods, in-depth research in the field of TCM treatment of primary dysmenorrhea will be further promoted.

References

[1] Xiao Zengdong. Traditional Chinese medicine treatment of primary dysmenorrhea[J]. Medical Information, 2023, 36 (2): 184-188.

[2] Ou Junzhao, Ke Ke, Wu Fanwei, et al. Clinical observation on low-energy extracorporeal shock wave combined with "Three Yuan Qi and Blood Acupuncture" acupuncture in the treatment of primary dysmenorrhea with qi stagnation and blood stasis syndrome[J]. Guangzhou Traditional Chinese Medicine

Journal of Pharmaceutical University, 2022, 39(9): 2084-2093.

[3] Chai Meiling. Xuefu Zhuyu Capsule on uterine artery blood flow in patients with primary dysmenorrhea due to qi stagnation and blood stasis syndrome

The influence of resistance［D］. Shenyang: Liaoning University of Traditional Chinese Medicine, 2022.

[4] Lu Yan, Huang Xuchun, Cao Xiaojing, et al. The network pharmacological mechanism of Wenjing Decoction in treating primary dysmenorrhea[J]. World Science and Technology⁃Modernization of Traditional Chinese Medicine, 2021, 23 (10): 3519⁃3527.

[5] Liang Renmin. Clinical observation on Qijiao moxibustion in the treatment of primary dysmenorrhea[D]. Guangzhou: Guangzhou University of Traditional Chinese Medicine, 2021.

[ 6 ] Zhu Sumei, Qin Shina, Qin Miao, etc. Metrological analysis of domestic and foreign research literature on quality markers of traditional Chinese medicine from 2016 to 2021 based on CiteSpace [J]. Chinese Herbal Medicine, 2021, 52(9): 2575-2588.

[7] Liu Siqi. Clinical observation of Xuefu Zhuyu Capsule in the treatment of primary dysmenorrhea accompanied by anxiety and depression due to qi stagnation and blood stasis [D]. Shenyang: Liaoning University of Traditional Chinese Medicine, 2022.

[8] Yang Huangshan, Zhang Xiaodong. Zhang Xiaodong's experience in treating primary dysmenorrhea[J]. Chinese Folk Therapy, 2021, 29(9): 37⁃39.

[9] Zhang Yu. Time-effective efficacy of herb-partitioned moxibustion in the treatment of primary dysmenorrhea (qi stagnation and blood stasis syndrome)

Check [D]. Shenyang: Liaoning University of Traditional Chinese Medicine, 2020.

[10] Liu Xuehong. Research on Professor Liu Ruifen's medication usage rules for treating primary dysmenorrhea based on data mining [D]. Jinan: Shandong University of Traditional Chinese Medicine, 2021.

[11] Hao Cangcang, Wang Xin. Observation on the efficacy of acupuncture in treating primary dysmenorrhea of cold coagulation and blood stasis type [J]. Chinese Journal of Traditional Chinese Medicine, 2018, 36(3): 659-662.