Functional dyspepsia (FD), affects more than 20% of the general population [1] and is one of the most common medical gastrointestinal conditions in the absence of an organic cause [2]. FD is characterized by the presence of one or more of the specific symptoms: epigastric pain, epigastric burning, postprandial fullness, and early satiation [3]. It has been reported that approximately 10% to 15% of patients with FD worldwide report symptoms of anxiety or depression, leading to worse quality of life, although FD is not associated with increased mortality [4].

Because of the complex pathophysiology, the exact mechanism of FD is still not well understood. Several related mechanisms are thought to contribute to this condition. Some of them include delayed gastric emptying, gastroesophageal reflux, and visceral hypersensitivity alterations in the nervous system. Others included gastroduodenal inflammation, altered sensitivity to duodenal acid or lipids, and impaired barrier function [5]. Currently, FD treatments for symptom management include H2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), prokinetic agents, and even antidepressants [6]. However, the effectiveness and safety of these drugs remain controversial [7], Food and Drug Administration (FDA) have issued a warning about the cardiac safety of domperidone, uncommon adverse effects include rebound acid hypersecretion syndrome, fragility fractures, interstitial nephritis, electrolyte derangements, pneumonia, enteric infection and vitamin B12 deficiency.

Acupuncture, a traditional Chinese therapy, effectively improved the recovery of FD related symptoms with fewer side effects, as reported by several systematic reviews [8], [9], [10], [11]. Ho RST, et al. concluded that manual acupuncture combined with clebopride has the highest probability of being the most effective treatment for FD related symptoms. Patients who are contraindicated for prokinetics may use manual acupuncture or moxibustion as alternatives [12]. Zhang J, et al. concluded that manual acupuncture alone was the most effective therapy for FD [13]. Acupoints are one of the factors determining the effectiveness of acupuncture therapy in clinical practice [14], and it is essential to identify which acupoints are specifically associated with the curative effect on FD. However, there is still a lack of analyses of the specificity of prescribed acupoints for FD, especially a lack of analyses of the specificities of acupoints selection based on specific symptoms for FD such as dysphoria.

Therefore, this study aimed to identify the specificities of acupoint selection and acupoints combination of FD especially the FD with dysphoria, by using association ruling mining, network analysis, forward inference, reverse inference and Bayes factor (BF) correction to optimize the acupoints combination and improve the therapeutic effect of acupuncture for treating FD.