Acupuncture & Moxibustion
Background
Functional constipation (FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Numerous systematic reviews (SRs) examining the use of acupuncture to treat FC have reported inconsistent results, and the quality of these studies has not been fully evaluated.
Objective
In this overview, we evaluated and summarized clinical evidence on the effectiveness and safety of acupuncture for treating FC and evaluated the quality and bias of the SRs we reviewed.
Search strategy
The search strategy was structured by medical subject headings and search terms such as “acupuncture therapy” and “functional constipation.” Electronic searches were conducted in eight databases from their inception to September 2020.
Inclusion criteria
SRs that investigated the effectiveness and safety of acupuncture for managing FC were included.
Data extraction and analysis
Two authors independently extracted information and appraised the methodology, reporting accuracy, quality of evidence, and risk of bias using the following critical appraisal tools: (1) A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2); (2) Risk of Bias in Systematic Reviews (ROBIS); (3) Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A); and (4) the Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A κ index was used to score the level of agreement between the 2 reviewers.
Results
Thirteen SRs that examined the clinical utility of acupuncture for treating FC were identified. Using the AMSTAR 2 tool, we rated 92.3% (12/13) of the SRs as “critically low” confidence and one study as “low” confidence. Using the ROBIS criteria, 38.5% (5/13) of the SRs were considered to have “low risk” of bias. Based on PRISMA-A, 76.9% (10/13) of the SRs had over 70% compliance with reporting standards. The inter-rater agreement was good for AMSTAR 2, ROBIS, and PRISMA-A. Using the GRADE tool, we classified 22.5% (9/40) of the measured outcomes as “moderate” quality, 57.5% (23/40) as “low” quality, and 20.0% (8/40) as “very low” quality. The inter-rater agreement was moderate when using GRADE. Descriptive analyses indicated that acupuncture was more efficacious than sham acupuncture for improving weekly complete spontaneous bowel movements (CSBMs) and for raising the Bristol Stool Form Scale (BSFS) score. Acupuncture appeared to be superior to anti-constipation drugs for improving weekly spontaneous bowel movements, the total effective rate, and the Patient Assessment of Constipation Quality of Life score. Although ten SRs mentioned the occurrence of adverse events, serious adverse events were not associated with acupuncture treatment.
Conclusion
Acupuncture may be more efficacious than sham acupuncture for improving CSBMs and BSFS scores and may be superior to anti-constipation drugs for improving bowel movement frequency, as well as quality of life. Limitations to current studies and inconsistent evidence suggest a need for more rigorous and methodologically sound SRs to draw definitive conclusions.
Systematic review registration
PROSPERO CRD42020189173.
目的：建立大鼠胫骨癌痛模型,观察电针和西乐葆对大鼠胫骨癌痛的缓解作用。方法：采用经皮穿刺技术将大鼠乳腺癌细胞Walker 256接种至雌性Wistar大鼠胫骨骨髓腔内,建立大鼠胫骨癌痛模型。大鼠造模后,采用电针和西乐葆灌胃治疗,观察其对大鼠骨肿瘤引起的机械性痛觉超敏的影响。结果：模型组大鼠后肢逐渐产生机械性痛觉超敏,接种后第16天胫骨近心端可见显著的肿瘤生长。单用电针或西乐葆5 mg/(kg·d)治疗大鼠,与模型组相比其机械性疼痛阈值差异无统计学意义;治疗后第22天和第26天,西乐葆10 mg/(kg·d)组大鼠后肢机械性疼痛阈值较溶剂对照组提高（P<0.05）;治疗后第10、18和23天,电针合用西乐葆5 mg/(kg·d)组大鼠机械性疼痛阈值高于模型组,差异有统计学意义（P<0.05）。结论：电针与小剂量西乐葆具有协同作用,合用可以增强对大鼠胫骨癌痛的镇痛效果。
目的：探索个体针刺疗法作为常规治疗的辅助手段在精神分裂症患者中的效果;采用探索性病例研究的方法,使用定量和定性评价工具,以便能够对针刺治疗此类患者的确切疗效作出科学评价,并对未来采用针刺治疗此类患者的试验设计提供方法学建议。方法：共纳入11例精神分裂症患者,在予以10周的针刺治疗前,治疗过程中及治疗后分别采用多种有效的定量和定性评价工具对患者进行多方面的评价。这些评价手段包括对针刺治疗、全科医生及精神科医生病历的整理回顾。分析定性资料以评价受试者向研究者及其临床医生和护理人员报告的内容的可靠性。结果：11名受试者中共有8名完成了1个疗程的针刺治疗,全部11名受试者都报告了针刺治疗的积极作用,包括精神分裂症症状的改善,缓解药物的副作用,对精力、内在动机、睡眠、成瘾症状及其他身体机能的促进作用。但是,受试者向研究者和针刺医生报告的信息在不同治疗阶段有一定差别,且往往不一致;在研究结束后,受试者向研究者报告了更多的信息。结论：本研究表明,在常规疗法之外辅以针刺治疗能够给精神分裂症病人带来一定益处。对数据的三角测量表明了受试者报告内容的某些不一致性,而这些可以通过多种研究方法的混合使用得以克服。通过对数据的比较,推荐在将来的研究设计中使用阳性与阴性症状量表、针刺临床试验干预措施报告标准以及在问卷中增加对药物副作用、运动、睡眠以及日常作息的调查。在将来的研究中还应充分考虑到,恢复期患者容易复发,应该让他们可以方便地获得帮助。
This study investigated the acceptability and effectiveness of acupuncture for persistent musculoskeletal pain in the elderly and assessed the conditions for a future controlled trial.
Methods
A total of 60 patients, hospitalized in a geriatric hospital were enrolled. The intervention consisted of eight acupuncture sessions. The main outcome was the patient’s participation rate. Regarding pain, the evaluation was based on pre- and post-treatment variations. As a high proportion of the patients had cognitive impairment, the behavioral pain scale DOLOPLUS-2 was chosen although self evaluation was used wherever possible.
The mean age of the patients was 83 years. The acceptance rate was very high (89.6%) and 90% of the patients completed the entire course of treatment. After five weeks, the mean DOLOPLUS score had decreased significantly (P<0.01). The patients reported improved sleep quality and a reduction in their anxiety symptoms. Furthermore, caregivers noticed a decrease in patient aggressiveness making care easier.
Our results suggest that acupuncture is highly acceptable and could be very useful in the management of chronic pain when performed in very old frail people with chronic physical and mental disability.
Trial Registration Identifier
NCT01043692 ClinicalTrials.gov.
Improvement in lung function was reported after acupuncture treatment of chronic obstructive pulmonary disease (COPD), but little is known about the underlying mechanisms. Because an immune response imbalance could be seen in COPD, we hypothesize that electroacupuncture (EA) may play a role in regulating inflammatory cytokines and contribute to lung protection in a rat model of smoke-induced COPD.
A COPD model using male Sprague-Dawley rats exposed to cigarette smoke was established. The rats were randomly divided into four groups (control, sham, COPD, and COPD plus EA), and COPD model was evaluated by measuring pulmonary pathological changes and lung function. EA was applied to the acupuncture point Zusanli (ST36) for 30 min/d for 14 d in sham and COPD rats. Bronchoalveolar lavage fluid (BALF) was used to measure levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and malonaldehyde (MDA).
Compared with the control rats, COPD rats had significant changes in lung resistance (RL) and lung compliance (CL) (both P<0.01), bronchi and bronchiole airway obstruction (P<0.01), and levels of MDA, TNF-α, and IL-1β (P<0.01). There were no significant differences between the control and the sham groups. Compared with the COPD rats, the COPD plus EA rats had decreased RL and increased CL (both P<0.05), and reduced bronchi and bronchiole airway obstruction (P<0.05, P<0.01, respectively), while levels of TNF-α, IL-1β, and MDA in BALF were lowered (P<0.05 and P<0.01, respectively). However, TNF-α and IL-1β levels of the EA group rats remained higher than those of the control group (P<0.05).
EA at ST36 can reduce lung injury in a COPD rat model, and beneficial effects may be related to down-regulation of inflammatory cytokines. The anti-inflammatory and antioxidant effects may prolong the clinical benefit of EA.
A pragmatic clinical trial design was used. The study was conducted in a psychiatric clinic. Fifty patients with depression and 50 with schizophrenia were randomly divided into an experimental and a waiting-list group. Additionally, 25 healthy control participants were included. Twelve weeks of individualized acupuncture treatment was used as the clinical intervention.
All patients were tested before (T1) and after (T2) acupuncture treatment on a mood scale (Beck Depression Inventory-II, BDI-II), a simple working memory task (digit span), and a complex working memory task (letter-number sequencing); the healthy controls were tested at T1 only.
Patients with depression scored worse than the others on the BDI-II, and patients with schizophrenia scored worse than the healthy controls. On the digit span, patients with schizophrenia did not differ from healthy controls whereas they scored worse of all on the letter-number sequencing. With respect to the acupuncture findings, first, the present study showed that the use of acupuncture to treat patients with schizophrenia was both practical and safe. Moreover, acupuncture had a positive effect on the BDI-II for the depression group, but acupuncture had no effect on the digit span and on the letter-number sequencing performance for the two clinical groups.
The clinical improvement in patients with depression after acupuncture treatment was not accompanied by any significant change in a simple working memory task or in a more complex working memory task; the same was true for the patients with schizophrenia.
目的
观察针刺对佐剂性关节炎大鼠滑膜组织病理改变、滑膜肥大细胞脱颗粒及类胰蛋白酶表达的影响,探讨肥大细胞功能与针刺治疗大鼠佐剂性关节炎的关系。 方法
46只雄性Wistar大鼠随机分为正常对照组（n=16）、模型组（n=15）和针刺组（n=15）。除正常对照组外,其余大鼠通过足垫部注射0.1 mL弗氏完全佐剂建立佐剂性关节炎模型。针刺组隔天针刺双侧足三里、悬钟、肾俞穴,每次15 min,共8次。治疗期间,正常对照组和模型组除不予针刺外,其余处理均同针刺组。设造模当天为实验第0天,之后每3天对大鼠的体质量和足跖体积进行测量并记录。治疗结束后,取所有大鼠右后踝关节滑膜组织,HE染色后根据滑膜病理5级评分法评价滑膜组织病理改变,甲苯胺蓝染色法观察滑膜肥大细胞数量及其脱颗粒情况,免疫组织化学法检测类胰蛋白酶在滑膜组织中的表达情况。 结果
与模型组比较,针刺组大鼠治疗后体质量明显增加（P<0.05）,足跖体积明显减小（P<0.01）。HE染色显示,针刺可显著减轻佐剂性关节炎大鼠滑膜组织中的炎细胞浸润、滑膜细胞增生和滑膜纤维组织增生等病理表现（P<0.05）;甲苯胺蓝染色显示,与正常对照组比较,模型组大鼠滑膜肥大细胞数量和脱颗粒率均明显增加（P<0.01）,而针刺组大鼠滑膜肥大细胞数量和脱颗粒率的上升得到有效抑制,与模型组比较差异有统计学意义（P<0.01）;免疫组织化学检测显示,针刺可显著抑制佐剂性关节炎大鼠滑膜组织中上调的类胰蛋白酶表达（P<0.01）。相关分析显示,滑膜肥大细胞数量及脱颗粒率均与滑膜组织病理改变总评分呈明显的正相关（P<0.01）。 结论
针刺具有治疗大鼠早期佐剂性关节炎和调节滑膜肥大细胞功能的作用,由于两者间存在明显的正相关性,因此针刺可能通过抑制滑膜肥大细胞功能,对佐剂性关节炎大鼠起治疗作用。
目的：探讨电针天枢穴对牛黄胆酸钠诱导的重症急性胰腺炎(severe acute pancreatitis, SAP)大鼠血清促炎和抗炎因子的影响。方法：将66只SD雄性大鼠随机分为假手术组、模型组、电针组,每组22只。通过胆胰管注射3.5%牛黄胆酸钠制作SAP模型。电针组分别在模型制作成功后和处死前给予电针天枢穴治疗各30 min (2/100 Hz,2 mA)。各组大鼠分别于术后3、6和12 h分批处死,留取血液及胰腺组织标本,酶联免疫吸附法检测各组血清中肿瘤坏死因子α(tumor necrosis factor-α, TNF-α)、白细胞介素6(interleukin-6, IL-6)和白细胞介素10(interleukin-10, IL-10)的浓度,苏木精和伊红染色观察各组胰腺组织病理变化并进行评分。结果：在术后3、6和12 h时模型组血清TNF-α、IL-6浓度和3、6 h时的IL-10浓度均高于假手术组(P<0.05)。术后6和12 h时,电针组血清TNF-α、IL-6浓度较模型组明显降低,IL-10浓度、IL-10/TNF-α浓度比值较模型组升高(P<0.05),胰腺组织病理学评分较模型组明显降低(P<0.05)。结论：电针天枢穴可以减轻SAP大鼠胰腺病理损伤,其作用机制可能是通过下调TNF-α、IL-6等促炎细胞因子的释放,并一定程度提高抗炎细胞因子IL-10水平,重建促炎和抗炎细胞因子的平衡,减轻SAP炎症的进一步发展。
Functional magnetic resonance imaging (fMRI) is a novel method for studying the changes of brain networks due to acupuncture treatment. In recent years, more and more studies have focused on the brain functional connectivity network of acupuncture stimulation.
To offer an overview of the different influences of acupuncture on the brain functional connectivity network from studies using resting-state fMRI.
The authors performed a systematic search according to PRISMA guidelines. The database PubMed was searched from January 1, 2006 to December 31, 2016 with restriction to human studies in English language.
目的 采用针刺手法参数实时采集及教学演示系统实现针刺手法的数据化处理和分析,以满足针灸教学和科研的需要。方法 通过研制针刺传感器,对针刺手法操作过程中参数的变化进行实时采集和观察。结果 在作针刺提插手法时,针体作匀变速运动,得气时作用力依然存在;在作捻转手法时,捻转次数和弧度的改变可引起阻力矩的变化,且与机体反应有关;在作摇摆手法时,针刺的摆动幅度与作用力、作用点及方向等因素有关。结论 该系统为针刺手法的量化研究以及教学提供了新的手段。
本文从中医腧穴学出发,结合西医解剖学、神经学理论,探讨穴位深度与针刺靶点问题,分析了一直以来针刺和选穴操作不规范的原因及针刺神经节、神经孔的理论依据;以原发性三叉神经痛为例,提出将下关、攒竹、四白、夹承浆定位于蝶腭神经节及相应神经孔（眶上孔、眶下孔及颏孔）的针刺方法;认为规范穴位针刺靶点,既符合针刺临床试验干预措施报告标准对针刺细节的国际化要求,也有利于针灸技术的规范化研究,对于临床规避风险、提高针刺疗效具有现实意义。
Methods/design
Discussion
Trial Registration:
Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by functional disability and pain. Although acupuncture is widely used, until now Western acupuncture studies on RA have not shown conclusive positive results. Acupuncture is regarded as a reflex therapy that has effects on the human autonomic nervous system. By establishing a traditional Chinese medicine (TCM) diagnosis first, the practitioner is able to choose acupoints according to the state of each individual patient.
Methods/Design
We are interested if acupuncture, using a classical diagnostic procedure to allocate acupoints to the patient according to the Shang Han Lun theory, can be effective in relieving pain, improving hand function and increasing health-related quality of life in RA. The authors intend to harmonize TCM diagnosis according to clinical and genetic profiles. Patients with the TCM diagnosis of a so-called Turning Point syndrome will be followed up in a randomized, prospective, double-blind, placebo-controlled, multicenter and three-armed parallel-group study with a standardized treatment in order to optimize potential therapeutic effects of acupuncture on pain, strength and muscle function of patients with RA as well as the influence on inflammation and quality of life.
The findings of this study will provide important clinical information about the feasibility and efficacy of acupuncture treatment for RA patients. In addition, it will explore the feasibility of further acupuncture research.
Trial Registration Number
ClinicalTrials.gov Identifier NCT02553005.
探讨头针治疗脑缺血的可能作用机制。 方法
采用线栓法制备大脑中动脉闭塞（middle cerebral artery occlusion,MCAO）再灌注模型。60只MCAO再灌注模型大鼠分为模型组和头针组,再根据缺血再灌注时间（24、48、72 h）的不同,将模型组和头针组各随机分为3个亚组。另选10只大鼠行假手术作为假手术组。采用头针治疗,接穴位神经刺激仪,疏密波,频率2 Hz/100 Hz,强度2 mA,每次30 min,每天1次。应用神经功能缺损评分（neurological severity score,NSS）、苏木精和伊红（hematoxylin and eosin, HE）染色、聚合酶链反应及酶联免疫吸附测定法观察急性脑缺血再灌注后头针治疗对模型大鼠神经功能缺损,缺血脑组织环氧化酶2（cyclooxygenase-2,COX-2）、核因子κB（nuclear factor-kappa B,NF-κB）、转化生长因子β1（transforming growth factor-beta1,TGF-β1）mRNA及蛋白含量的影响。 结果
头针组各时相的NSS与模型组比较,差异均有统计学意义（P<0.05,P<0.01）,以脑缺血再灌注72 h后较明显。HE染色提示,头针组各时相脑组织白细胞浸润较模型组减轻,以脑缺血再灌注72 h后最为明显。头针治疗组COX-2和NF-κB含量在24、48、72 h均低于模型组（P<0.01,P<0.05）,而头针治疗组TGF-β1含量在24、48、72 h均显著高于模型组（P<0.01）。 结论
头针有利于脑缺血大鼠神经功能的恢复,可减轻急性脑缺血再灌注后神经元的损害,并在一定范围内降低损伤脑组织中COX-2和NF-κB的表达,增强TGF-β1的表达,从而减缓免疫炎症反应,减轻脑缺血再灌注损伤。
目的:研究在短时间之内使普通人进入前气功状态的方法。
方法:健康的试验参与者以不随机的方式纳入本次研究。使用多通道生理记录仪检测试验参与者是否有进入前气功状态。参与者在针刺合谷穴的时候获得酸（得气）的感觉,同时暗示参与者丹田处有热及放松的感觉,由此让参与者进入一个松、静、自然的前气功状态。
结果:本研究中,72.2%没有习练气功经历的参与者成功进入前气功状态。参与者进入气功状态后,大部分生理指标与基线指标相比有显著差异。
结论:使用针刺引起酸的感觉可以让试验参与者快速进入前气功状态。因此气功的研究不再限制在特定的人才可以实行,本研究方法可以应用到每个人身上。
Effective pain management among hospitalized patients is an important aspect of providing quality care and achieving optimal clinical outcomes and patient satisfaction. Common pharmacologic approaches for pain, though effective, have serious side effects and are not appropriate for all inpatients. Findings from randomized controlled trials (RCTs) support the efficacy of acupuncture for many symptoms relevant to inpatients including postoperative pain, cancer-related pain, nausea and vomiting, and withdrawal from narcotic use. However, the extent to which findings from RCTs translate to real-world implementation of acupuncture in typical hospital settings is unknown.
In partnership with the launch of a clinical program offering acupuncture services to inpatients at the University of California San Francisco's Mount Zion Hospital, we are conducting a pilot study using a hybrid effectiveness-implementation design to: (1) assess the effectiveness of acupuncture to manage pain and other symptoms and improve patient satisfaction; and (2) evaluate the barriers and facilitators to implementing an on-going acupuncture service for inpatients. During a two-month pre-randomization phase, we evaluated and adapted clinical scheduling and treatment protocols with acupuncturists and hospital providers and pretested study procedures including enrollment, consent, and data collection. During a six-month randomization phase, we used a two-tiered consent process in which inpatients were first consented into a study of symptom management, randomized to be offered acupuncture, and consented for acupuncture if they accepted. We are also conducting in-depth interviews and focus groups to assess evidence, context, and facilitators of key provider and hospital administration stakeholders.
Effectiveness research in “real-world” practice settings is needed to inform clinical decision-making and guide implementation of evidence-based acupuncture practices. To successfully provide clinical acupuncture services and maintain a rigorous research design, practice-based trials of acupuncture require careful planning and attention to setting-specific, contextual factors.
Trial Registration
This trial has been registered in ClinicalTrials.gov. The identifier is NCT01988194, registered on November 5, 2013.
The aim of this study was to examine the changes in natural killer (NK) cell activity, pulse rate, and pain intensity among older adults before and after acupuncture treatment.
Fifty-six individuals (16 males and 40 females), aged 60 to 82 years (mean age 72.4 ± 5.0), who were experiencing pain in the shoulder, low back, or knee, participated in the study. NK cell activity, leukocyte differentiation (granulocytes and lymphocytes), pulse rate, and blood pressure values were obtained. Pain intensity was evaluated by using the visual analog scale (VAS). The Wilcoxon test was used to analyze NK cell activity, leukocytes (granulocyte counts and granulocyte-to-lymphocyte ratio), and the VAS score in accordance with the location of pain complaints before and after acupuncture treatment.
NK cell activity decreased after acupuncture treatment for pain in the shoulder-pain and knee-pain groups. Further, the lymphocyte and granulocyte counts increased after acupuncture treatment for the shoulder-pain group. Pulse rate decreased for the shoulder-pain, low-back-pain, and knee-pain groups after acupuncture treatment. The VAS score decreased after acupuncture treatment for the shoulder-pain, low-back-pain, and knee-pain groups.
This study showed that in older adults, acupuncture treatment decreases pulse rate, relieves pain in the shoulder, low back, and knee, and reduces NK-cell activity.
This study evaluated the effectiveness of acupuncture point injection (API) with placental extract on pain reduction and joint function in patients with knee osteoarthritis (OA).
Fifty-two patients with knee OA, with an average age of 64, and having a symptom duration of more than 3 months were studied in this report. Placental extract was injected weekly into acupuncture point ST35, BL23, BL24 and BL25 for 5 weeks; 8 mL of placental extract into ST35 on the affected side, and 1 mL of placental extract to BL23, BL24 and BL25 bilaterally.
After a five-week treatment of API with placental extract, pain was substantially decreased in patients of all Kellgren-Lawrence (KL) grades. Improvement of knee joint swelling was also apparent. Decrease of pain and joint swelling improved daily working productive time among patients of all KL grades.
Study results imply that API with placental extract is a potentially useful therapy to control pain and maintain joint functions in knee OA patients.
目的 研究电针与饮食调整对营养性肥胖大鼠胰岛素抵抗（insulin resistance, IR）的影响,阐明针刺、饮食调整在减肥中的作用。方法 采用高脂饮食建立营养性肥胖大鼠模型。造模成功的肥胖大鼠再随机分为高脂饮食组、普食组、高脂饮食加电针组、普食加电针组,另设正常对照组,各组分别处理15 d。实验结束后检测大鼠肥胖指标、血脂水平,血清肿瘤坏死因子-α（tumor necrosis factor α, TNF-α）及血清空腹胰岛素（fasting insulin, FINS）水平。结果 与高脂饮食组比较,高脂饮食加电针组和普食加电针组大鼠摄食量、体质量以及内脏脂肪质量均明显减少（P＜0.05）;普食加电针组血清总胆固醇（total cholesterol, TC）、游离脂肪酸（free fatty acid, FFA）含量及IR指数均显著降低（P＜0.01）,TNF-α和FINS水平亦显著降低（P＜0.05）。结论 电针结合饮食调整能降低肥胖大鼠异常升高的血清TNF-α、FINS,改善胰岛素抵抗状态。
目的：探讨头针对脑梗死（cerebral infarction, CI）所致血管性痴呆（vascular dementia, VaD）患者智能障碍的影响。方法：将108例CI所致VaD患者随机分为头针治疗组和西药治疗组进行观察,对比分析治疗前后患者简易智力状态检查（Mini-Mental State Examination, MMSE）、Blesse痴呆量表（Blesse Dementia Scale, BDS）、长谷川痴呆量表（Hasegawa Dementia Scale, HDS）、日常生活能力量表（Ability of Daily Life, ADL）评分的变化。结果：92例患者完成观察,治疗后两组患者MMSE、BDS、HDS得分均明显上升,ADL得分明显下降（P<0.05）,但两组治疗前后HDS、ADL、BDS、MMSE量表评分差值及治疗后总有效率比较,差异无统计学意义（P>0.05）。结论：头针能在一定程度上改善CI所致VaD患者的临床智能状况。
目的:探讨电针（electro-acupuncture, EA）丰隆穴对高脂血症（hyperlipidemia, HLP）大鼠血脂、一氧化氮（nitric oxide, NO）及内皮素（endothelin, ET）含量的影响。
方法:将80只Wistar大鼠随机分为4组：正常对照组（饲喂基础饲料）、模型组（饲喂高脂饲料）、电针治疗组（饲喂高脂饲料+电针丰隆治疗）、普伐他汀治疗组（饲喂高脂饲料+普伐他汀钠灌胃）。各组20只。30 d后称取各组大鼠体质量,以改良大鼠心脏穿刺采血方法采血,检测血脂、NO以及ET含量。
结果:与正常对照组比较,模型组大鼠体质量、总胆固醇（total cholesterol, TC）、甘油三酯（triacylglycerol, TG）、低密度脂蛋白胆固醇（low density lipoprotein-cholesterol, LDL-C）和ET水平显著升高（P<0.05,P<0.01）;高密度脂蛋白胆固醇（high density lipoprotein-cholesterol, HDL-C）、NO水平显著降低（P<0.05）。与模型组比较,普伐他汀治疗组、电针治疗组大鼠体质量、TC、TG、LDL-C水平明显降低（P<0.01）,NO水平显著升高。普伐他汀治疗组HDL-C水平显著升高,而电针治疗组升高不明显,两组之间差异有统计学意义（P<0.01）。普伐他汀治疗组ET水平降低（P<0.05）,电针治疗组ET水平降低不明显（P>0.05）。
结论:电针治疗和西药治疗均对HLP大鼠血脂具有良性调节作用,且能在一定程度上纠正高脂状态下NO和ET水平的失衡。西药对HLP大鼠HDL-C有较好的良性调节作用,而电针对HLP大鼠HDL-C的调节作用有限。
目的：很多有关补充替代医学（complementary and alternative medicine, CAM）的研究表明,CAM的使用情况与患者的社会文化背景、性别、年龄及基础疾病等因素有关。本研究旨在调查分析拥有医疗保险的德国老年人对特定的CAM疗法的使用情况。方法：在一次匿名的德国保险受益人的横断面调查中,对5 830名老年人过去5年里通过医生或非医疗工作者使用CAM的情况的调查数据进行分析。结果：德国老年人最广泛使用的CAM疗法分别为针刺/中医（21%）、顺势疗法（21%）、运动疗法/锻炼（19%）、整骨疗法/脊椎指压疗法（12%）、草药/植物疗法（7%）、节食/特殊食谱（6%）及足底反射疗法（5%）。人智学疗法只被很少数的人使用。针刺与顺势疗法的使用者倾向于同时使用多种CAM疗法,特别是同时使用针刺与顺势疗法。男性患者与女性患者在CAM疗法的使用上有显著的不同。结论：针刺与顺势疗法的使用人数近似,而顺势疗法是源于西欧的一种CAM疗法,这说明针刺这一来自东方的疗法在德国也有其立足之地。很多患者同时使用多种CAM疗法,特别是针刺与顺势疗法同时使用者居多。此外,对于一些将并非CAM疗法的治疗方法纳入其研究之中而得出的结论,应该持谨慎态度。
目的 评价传统针刺治疗香港地区慢性疲劳综合征（chronic fatigue syndrome, CFS）的临床疗效。 方法 采用单盲、随机、对照研究方法,将99例合格受试者按1∶1比例随机分成治疗组50例和对照组49例。治疗组以传统针刺法,选取百会、足三里、三阴交穴治疗;对照组以平针按穴法（针不刺入皮肤),选穴同治疗组。疗程共4周,每周治疗2次。按照英国Trudie Chalder等制定的疲劳量表和美国疾病控制中心1994年制定的CFS诊断标准及SF-12生活质量量表,建立效应评价表,评价疗效及安全性。结果 治疗后两组临床症状得到改善,在身体疲劳、精神疲劳及SF-12生活质量方面,治疗组优于对照组（P＜0.01或P＜0.05）;受试者未发现不良反应。 结论 针刺治疗CFS安全有效。
背景
手术后胃轻瘫综合征是腹部手术后常见的并发症,外科医生往往无有效的治疗手段。 目的
探讨针刺治疗腹部肿瘤外科术后胃轻瘫患者的效果。 设计、场所、对象和干预措施
选择东方肝胆外科医院63例腹部肿瘤外科手术术后呃逆的患者,随机分成针刺组32例和胃复安组31例。针刺组采用针刺足三里等穴位治疗,1次/d;胃复安组肌肉注射胃复安20 mg,3次/d。 主要结局指标
观察治疗后胃液引流量及治疗次数和痊愈率。 结果
针刺和胃复安均可显著减少胃液引流量。针刺组痊愈率为90.6%,平均治疗（6.58±4.26）次;胃复安组痊愈率为32.3%,平均治疗（10.13±3.60）次。两组胃液引流量、临床痊愈率和治疗频次比较,差异有统计学意义（P<0.05,P<0.01）。 结论
针刺可有效治疗腹部肿瘤外科术后胃轻瘫,具有治疗次数少、治愈率高、奏效快等优点。
背景：考前紧张综合征在考前学生中常见,直接影响他们的考试成绩和生活状态。腕踝针被认为在精神紧张相关病症的治疗中有效。 目的：评价腕踝针对考前紧张综合征的缓解作用。 设计、场所、对象和干预措施：将符合纳入标准的上海某高校60名考前紧张综合征学员随机分为观察组和对照组,每组30例。观察组采用腕踝针疗法,针刺双侧上1针刺点;对照组用不刺入皮肤的假针刺法。两组均分别于考试前1周开始接受治疗,每次留针30 min,隔日1次,共治疗3次。 主要结局指标：比较两组疗效,观察治疗前后Sarason考试焦虑量表(Test Anxiety Scale, TAS)以及预期和治疗信任度问卷(Expectation and Treatment Credibility Scale,ETCS)的评分变化情况。 结果：腕踝针针刺治疗组患者的疗效优于假针刺对照组患者（P<0.05)。两组治疗前TAS和ETCS评分比较,差异无统计学意义。与治疗前相比,治疗组和对照组治疗后的TAS评分下降(P<0.05,P<0.01);治疗组TAS绝对差值和相对差值高于对照组（P=0.008,P=0.02）。治疗后与对照组比较,治疗组ETCS各项的评分较高(P<0.05,P<0.01)。两组均未出现不良反应。 结论：腕踝针能显著缓解考前紧张综合征症状,该疗法具有很高的安全性。
Acupuncture is a complex intervention consisting of specific and non-specific components. Acupuncture studies more frequently focus on collecting data from the patients’ perspective and response, but the acupuncturist’s role remains relatively unclear. In order to investigate potential non-mechanical active factors originating from the acupuncturist and transmitted to the patient during treatment, two novel devices for basic research in acupuncture were designed. The Acuplicator allows the researcher to insert needles without touching the needles themselves, while the Veliusator locks the needle in its place so that no mechanical movement can be transferred.
The Acuplicator was used to insert needles at Neiguan (PC6) on the right forearm of 23 volunteers. The insertion depth was measured using a depth gauge. The transfer of mechanical movements from the handle to the tip was detected with a precision length gauge with a motoric-tactile sensor.
The mean insertion depth was (12.3 ± 1.5) mm (range 9.5 to 15.0 mm). Even with intense manipulation of the needle handle, no movements within ± 1 μm could be detected at the tip when the needle was locked.
With these two devices it will be possible to investigate the influence of non-mechanical components such as therapeutic qi in acupuncture.
近年来,针刺与辅助生殖技术（assisted reproductive technology, ART）结合运用提高ART成功率的研究,正在被越来越多的人所关注。本文分析自2002年以来发表的针刺与ART结合的临床随机对照研究报告,对研究设计特别是针刺介入时机进行评价。过去5年多的相关研究初步显示胚胎移植（embryo transfer, ET）前后针刺有可能提高辅助生殖的孕育率,但缺乏大规模、高质量的临床研究以证实该结论;不同刺激方式效果可能存在差异;在体外受精-胚胎移植（in vitro fertilization-embryo transfer, IVF-ET）周期的不同时间点针刺,对孕育率的影响尚未得出较一致的看法。针刺的效应因女性内分泌周期性变化而有所不同,如果能够选择体外受精（in vitro fertilization, IVF）周期的关键时间点进行针刺并配合药物治疗,有可能在提高辅助生殖技术的孕育率上实现更大的突破。
目的 观察电针治疗对大鼠不稳定膀胱模型下尿路组织氮能神经递质的影响。方法 制作大鼠不稳定膀胱模型,电针会阳、中膂俞7 d后,采用免疫组织化学法检测大鼠膀胱逼尿肌、膀胱颈平滑肌神经源性一氧化氮合酶（neuronal nitric oxide synthase, nNOS）、内皮型一氧化氮合酶（endothelial nitric oxide synthase, eNOS）和诱导型一氧化氮合酶（inducible nitric oxide synthase, iNOS）阳性细胞并计数。结果 不稳定膀胱模型其膀胱逼尿肌、膀胱颈平滑肌中氮能神经递质明显下降,而电针治疗则可促进氮能神经递质的生成和分泌。结论 电针促进膀胱组织中氮能神经递质的生成和分泌可能是电针治疗改善不稳定膀胱功能的主要机制之一。
目的 研究电针、补阳还五汤对大鼠坐骨神经损伤后的再生作用。方法 采用手术造成大鼠坐骨神经损伤模型,电针、补阳还五汤治疗,进行神经电生理和HRP追踪观察。结果 电针组、补阳还五汤组的神经传导速度和诱发动作电位振幅恢复率高、脊髓前角和脊神经节标记细胞数多,与西药组、空白组比较有显著性差异,其中电针组优于补阳还五汤组。结论 电针、补阳还五汤均能更好地促进神经早期的功能恢复,是一种促进周围神经损伤后神经再生的有效手段。
