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.
Objective: To establish a proper experimental model of bone cancer pain in rat for acupuncture research, and observe the pain-relieving effect of electroacupuncture (EA) and/or Celebrex on bone cancer pain in rats.Methods: The rat model of bone cancer pain was established by percutaneous direct puncture technique and inoculating the rat mammary gland carcinoma cells Walker 256 into tibial medullary cavity directly, and evaluated by detecting the bone tumor growth and mechanical allodynia. The effects of daily EA treatment and/or Celebrex treatment on the rat mechanical allodynia after intratibial Walker 256 inoculation was observed in this study.Results: Significant mechanical allodynia in ipsilateral hind paw and tumor growth in proximal end of tibial bone of rats in the untreated group were observed after intratibial Walker 256 inoculation. The mechanical allodynia thresholds in rats that received EA or 5 mg/(kg·d) Celebrex treatment showed no significant difference as compared with that of rats in the untreated group. However, the mechanical allodynia thresholds of rats in 10 mg/(kg·d) Celebrex group showed significant increase after 22- and 26-day treatment as compared with that in the methyl cellulose (MC) group. There was significant difference between rats with EA combined with 5 mg/(kg·d) Celebrex treatment and rats in the untreated group after 10-, 18- and 23-day treatment.Conclusion: EA and 5 mg/(kg·d) Celebrex have synergistic effect on pain relieving and their combined use may enhance the analgesic effect on bone cancer pain.
Objective: This study explored the effects of individualized acupuncture when used alongside routine care for patients diagnosed with schizophrenia in order to assess the possibility and nature of potential benefits for this patient group. This study used an exploratory case study approach that included both quantitative and qualitative research tools, in order to generate a hypothesis questioning the possible benefits of acupuncture and develop future study designs. Methods: Eleven patients diagnosed with schizophrenia were given multiple validated quantitative and qualitative assessments before, during and after a 10-week acupuncture intervention. A range of qualitative and quantitative assessments were employed including review of acupuncture, general practitioner and mental health clinical case notes. Qualitative data were interrogated to explore the reliability of participants’ reports to researchers, their clinicians and their carers while acting as informants in the study. Results: Eight out of eleven participants completed a course of acupuncture treatment and all eleven reported positive benefits as a result of acupuncture, including improvements in the symptoms of schizophrenia, side effects of medication, energy, motivation, sleep, addictions and other associated physical problems. However, participants’ reports to the researcher and the acupuncturists varied at times and were often inconsistent between treatments, with participants revealing more information to the team towards the end of the study. Conclusion: The study indicates that patients diagnosed with schizophrenia would benefit from acupuncture treatment alongside conventional treatment. Triangulation of the data highlights some inconsistencies in reporting from participants, but also that this can be overcome through the use of mixed research methods. Comparison of data also shows that future studies would benefit from using a Positive and Negative Syndrome Scale, the Standards for Reporting Interventions in Controlled Trials of Acupuncture and an enhanced questionnaire regarding side effects of medication, exercise, sleep and daily routine. It is also worth noting that future studies of this nature must maintain consideration for the vulnerability of participants as they recover and make support easily accessible.
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.
Although acupuncture theory is a fundamental part of the Huangdi Neijing, the clinical application of the needle therapy in ancient China was always a limited one. From early times there have been warnings that acupuncture might do harm. In books like Zhang Zhongjing’s Shanghanlun it plays only a marginal role. Among the 400 emperors in Chinese history, acupuncture was hardly ever applied. After Xu Dachun called acupuncture a “lost tradition” in 1757, the abolition of acupuncture and moxibustion from the Imperial Medical Academy in 1822 was a radical, but consequent act. When traditional Chinese medicine was revived after 1954, the “New Acupuncture” was completely different from what it had been in ancient China. The conclusion, however, is a positive one: The best time acupuncture ever had was not the Song dynasty or Yuan dynasty, but is now - and the future of acupuncture does not lie in old scripts, but in ourselves.
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.
Background In patients with depression, as well as in patients with schizophrenia, both mood and working memory performance are often impaired. Both issues can only be addressed and improved with medication to some extent. Objective This study investigates the mood and the working memory performance in patients with depression or schizophrenia and whether acupuncture can improve these. Design, setting, participants and interventions
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.
Objective: To observe the effects of electroacupuncture (EA) at Tianshu (ST25) on pro- and anti-inflammatory cytokines in sodium taurocholate-induced severe acute pancreatitis (SAP) in rats.Methods: Sixty-six male Sprague-Dawley rats were randomly divided into three groups: sham-operation group, SAP group and EA group. An SAP model was established by injecting 3.5% sodium taurocholate at a dose of 1 mL/kg through puncturing the pancreatic duct. In the EA group, EA at ST25 was performed with sparse-dense wave (2/100 Hz, 2 mA for 30 min) immediately after sodium taurocholate injection and 30 min before sacrifice. Rats were sacrificed at 3 (n=7), 6 (n=7) and 12 h (n=8) after operation. Levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-10 in serum were estimated by enzyme-linked immunosorbent assay. Pathological changes of pancreatic tissues were examined by hematoxylin and eosin staining and observed under a microscope and also scored.Results: The levels of serum TNF-α and IL-6 of SAP rats were significantly higher than those of sham-operation rats at 3, 6 and 12 h. The level of IL-10 in serum of SAP rats was significantly higher than that of sham-operation rats at 3 and 6 h (P<0.05). EA at ST25 down-regulated the levels of TNF-α and IL-6 in serum and up-regulated the level of IL-10 and the ratio of IL-10/TNF-α, also attenuated the morphological damages at 6 and 12 h (P<0.05) in rats with SAP. The pathological scores of pancreatic tissues in the EA group were significantly less than those in the SAP group at 6 and 12 h (P<0.05).Conclusion: EA at ST25 may have a therapeutic effect on rats with SAP by down-regulating the levels of TNF-α and IL-6 and up-regulating the level of IL-10 to re-establish the balance of pro- and anti-inflammatory cytokines, and to ameliorate the inflammatory response of SAP.
To observe the effects of acupuncture on synovial pathology, synovial mast cell degranulation and tryptase expression and to investigate the relationship between the functions of mast cells and effects of acupuncture on early adjuvant arthritis in rats. Methods
Forty-six male Wistar rats were randomly divided into normal control group (n=16), untreated group (n=15) and acupuncture group (n=15). Adjuvant arthritis was induced by injection of 0.1 mL Freund’s complete adjuvant in right hind limb footpad. Normal control group and untreated group received no acupuncture treatment, while rats in the acupuncture group were treated with sterilized disposable stainless steel needles inserted perpendicularly as deep as 2 to 3 mm at Xuanzhong (GB39), 6 mm at Shenshu (BL23) and 7 mm at Zusanli (ST36) for eight times (15 min each time) every two days. Setting the modeling day as the 0 day of the experiment, the body weight and paw volume of the rats were measured every three days from the 0 day. In the end, synovial tissues of the right hind ankles were sampled and made into paraffin sections. Then they were firstly stained with hematoxylin-eosin for observing synovial pathology to evaluate the effects of acupuncture on adjuvant arthritis, then stained with toluidine blue for observing the number and degranulation ratio of synovial mast cells and finally detected by immunohistochemical staining method to investigate the expression of tryptase in synovium. Results
Compared with the untreated group, the body weight of rats in the acpuncture group was increased significantly (P<0.05), while the paw volume decreased obviously (P<0.01). Hematoxylin-eosin staining showed that acupuncture significantly inhibited inflammatory cell infiltration, synovial cell hyperplasia, and synovial fibroplasia in synovium of rats with adjuvant arthritis as compared with the untreated group (P<0.05). Toluidine blue staining showed that acupuncture could significantly diminish the numbers of total and degranulated mast cells in rats with adjuvant arthritis (P<0.01), which were significantly higher in the untreated group than in the normal control group (P<0.01). Showing by immunohistochemical staining, the expression of tryptase in synovium in the acupuncture group was decreased as compared with the untreated group (P<0.01). Analyzed by Spearman’s bivariate correlation, the number of mast cells and degranulation ratio of mast cells were positively correlated with the pathological scores (r=0.837, P<0.01; r=0.634, P<0.01). Conclusion
Acupuncture can improve pathological condition of inflammatory synovium in rats with early adjuvant arthritis by inhibiting the function of synovial mast cells, which may play an important underlying role in the immunoregulation of acupuncture on adjuvant arthritis.
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.
In this paper, issues of acupuncture using target points and depth of needling were discussed based on the theory of traditional Chinese medicine acupoints and combined with anatomical and neurological research of Western medicine. The theoretical evidence of acupuncture on nerve foramen and ganglion and the reasons for being nonstandard operating on acupoints were analyzed. This study summarized the method of using acupuncture at Xiaguan (ST7), Cuanzhu (BL2), Sibai (ST2) and Jiachengjiang acupoints to align with the spheno-palatine ganglion and additional nerve foramen (supraorbital, infraorbital and mental foramina) to treat primary trigeminal neuralgia. This study adhered to the Standards for Reporting Interventions in Clinical Trials of Acupuncture and helped in development of study standardization for acupuncture processes. The authors hoped that should help in significantly diminishing risk and improving therapeutic efficacy in clinic.
To apply the real-time data collection and demonstration system for acupuncture manipulation to quantitative analysis of acupuncture manipulation for acupuncture teaching and research.
The real-time observation and analysis of parameter changes of acupuncture manipulation were implemented by this system.
During the course of lifting and thrusting manipulation, the needle body moved in a uniform variable motion, and the action force was still kept while the arrival of Qi was achieved. During the course of twirling manipulation, the variations of twirling number and radian caused the changes of resistance moment, and this reaction was related to the body response. During the course of rotating and shaking manipulation, the radius for rotating and shaking was related to such factors as the force, the action point and the direction.
The real-time data collection and demonstration system for acupuncture manipulation can provide a new experimental method for quantitative data analysis, standardized research and teaching demonstration of acupuncture.
To explore the mechanisms of scalp acupuncture in treating cerebral ischemia in rats.
Sixty SD rats with middle cerebral artery occlusion (MCAO) were randomly divided into untreated group and scalp acupuncture group. The scalp acupuncture was performed by inserting needles from Baihui (GV20) to Qubin (GB7), and the scalp was stabbed through 0.5 to 0.8 cun with a 30 degree angle. After a Han’s Electro-Acupuncture Apparatus was connected, we selected “disperse-dense” wave and alternated frequency of 2 Hz and 100 Hz at an intensity level of 2 mA, 30 min once daily. Another 10 SD rats without artery occlusion were taken as sham-operated control. Neurological severity score (NSS), hematoxylin and eosin (HE) staining, polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) were applied to observing the changes of neurofunctional defect, the inflammatory infiltration in cerebral tissue and the contents of cyclooxygenase-2 (COX-2), nuclear factor-kappa B (NF-κB) and transforming growth factor-beta1 (TGF-β1) in brain tissues after 24-, 48- and 72-hour reperfusion. Results
There were significant differences in NSS between the scalp acupuncture group and the untreated group (P<0.05, P<0.01) after 24-, 48- and 72-hour reperfusion, especially after 72-hour reperfusion. HE staining results of ischemic cerebral tissues showed an apparent reduction of inflamed lesions in the scalp acupuncture group as compared with the untreated group, especially after 72-hour reperfusion. The contents of COX-2 and NF-κB after reperfusion in the scalp acupuncture group were significantly lower than those in the untreated group in 24, 48 and 72 h (P<0.01, P<0.05), and the contents of TGF-β1 in scalp acupuncture group were significantly higher than those in the untreated group after 24-, 48- and 72-hour reperfusion (P<0.01). Conclusion
Scalp acupuncture can attenuate cerebral ischemia-reperfusion injury, improve neurofunctional rehabilitation and suppress leukocyte infiltration in rats by decreasing the contents of COX-2 and NF-κB and enhancing TGF-β1 expression in brain tissues.
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.
Objective: The purpose of the study was to find out how to enter the preliminary Qigong simulation state in a short period of time.
Methods: This is a non-randomized, human experiment with healthy participants. A multi-channel digital physiological data recorder was used to detect whether the participants had entered the Qigong state. Participants were assisted to enter the Qigong state (relaxation, tranquility and naturalness) by being given the sore (sour) feeling produced by acupuncturing Hegu (LI4), and suggestions (repeating words “relax” and “heat” from the hypogastrium).
Results: About 72.2% of the participants who had no Qigong experience were found entering the preliminary Qigong simulation state. Most of the physiological parameters measured after the participants entering the Qigong state showed significant changes compared with the baseline data.
Conclusion: This study revealed that acupuncture-made sore feeling is able to induce the participants to quickly enter the preliminary Qigong simulation state; hence this can be seen as no longer a limited phenomenon, but can be commonly applied to everybody.
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.
Objective: To study the effects of electroacupuncture and diet adjusting on insulin resistance in rats with nutrition obesity, and the role of electroacupuncture and diet adjusting in the treatment of obesity.Methods: Obesity was induced in rats by high-fat diet. Rats with nutrition obesity were randomly divided into high-fat diet (HD) group, high-fat diet plus electroacupuncture (HA) group, normal diet (ND) group and normal diet plus electroacupuncture (NA) group, with another group of SD rats as normal control (NC). After 15 days, all the rats' body weight and length were measured, the Lee's index was calculated, and the levels of total cholesterol (TC), triglycerides (TG), free fatty acid (FFA), fasting plasma glucose (FPG), fasting insulin (FINS) and tumor necrosis factor-α (TNF-α) were detected.Results: Compared with the HD group, food intake, body weight and viscera fat weight of the rats with nutrition obesity in the HA group and the NA group were markedly reduced (P<0.05). The levels of blood serum TC, FFA and IR index in the NA group were obviously lower than those in the HD group (P<0.01). The levels of TNF-α and FINS in the NA group were lower than those in the HD group (P<0.05).Conclusion: Electroacupuncture plus diet adjusting can decrease the levels of serum TNF-α and FINS of the obesity rats, and improve the state of insulin resistance.
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.
Objective: To investigate the effects of scalp-acupuncture on intelligence in patients with vascular dementia (VaD).Methods: A total of 108 VaD patients were randomly divided into two groups: scalp-acupuncture group and Western medicine group. The scores of Mini-Mental State Examination (MMSE), Blesse Dementia Scale (BDS), Hasegawa Dementia Scale (HDS), Ability of Daily Life (ADL) before and after treatment in the two groups were detected.Results: A total of 92 patients completed the treatment. The scores of MMSE, BDS and HDS in the two groups were significantly increased, and the ADL scores significantly declined (P<0.05). There was no difference in the scores of MMSE, BDS, HDS and ADL between the two groups before and after the treatment. There was no difference in the total effectiveness between the two groups (P>0.05).Conclusion: Scalp-acupuncture therapy could improve the clinical intelligence level of VaD patients.
Objective: To evaluate the efficacy of acupuncture in treating chronic fatigue syndrome (CFS) in Hong Kong.Methods: A single-blinded, randomized controlled trial design was adopted. Participants meeting inclusion criteria were randomly assigned to a treatment and a control group according to 1∶1 ratio, resulting in an effective sample size of 99, with 50 and 49 patients in treatment and control group respectively. The same set of acupuncture points, which were selected according to traditional Chinese medicine theories, was applied in both groups, while conventional needle acupuncture was applied in treatment group and sham acupuncture (without skin penetration) was applied in control group. Schedule of treatment was the same in both groups, i.e. twice a week for 4 weeks. Key outcome measures were Chalder's Fatigue Scale, diagnostic criteria for CFS of the US's Centre for Disease Control and SF-12 health-related quality of life (HQOL) questionnaire. Adverse events, if any, were recorded.Results: Improvements in physical and mental fatigue and HQOL in both groups were observed, but the improvements in treatment group were significantly bigger than in control group (P<0.01 or P<0.05). No adverse events occurred.Conclusion: Acupuncture is a safe, effective treatment for CFS.
Objective:To investigate the effect of electro-acupuncture (EA) at Fenglong (GV 16) on body weight, blood lipids, nitric oxide (NO) and endothelin (ET) in rats with hyperlipidemia (HLP).
Methods:Eighty Wistar rats were randomly divided into normal control group (fed normal diet), untreated group (fed a high-fat diet), EA-treated group (fed a high-fat diet plus EA therapy) and pravastatin-treated group (fed a high-fat diet plus pravastatin tablet). There were 20 rats in each group. The body weight and the blood content of total cholesterol (TC), triacylglycerol (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), NO the and ET of the rats in different groups were measured before experiment and after 30-day treatment. A modified method of cardiac puncture for blood sampling was used for blood collection.
Results:Compared with the normal control group, the body weight and the levels of TC, TG, LDL-C and ET in the untreated group were significantly elevated (P<0.01, P<0.05), while the levels of HDL-C and NO were obviously decreased (P<0.05). The body weight and the levels of TC, TG, LDL-C demonstrated significant reduction in pravastatin-treated group and EA-treated group as compared with the untreated group (P<0.01), and the NO content in pravastatin-treated group and EA-treated group was higher than that in the untreated group (P<0.01). Compared with the untreated group, HDL-C level was elevated significantly in pravastatin-treated group, while HDL-C level in EA-treated group was not changed significantly, and there was significant difference in the HDL-C level between pravastatin-treated group and EA-treated group (P<0.01). The level of ET was decreased obviously in pravastatin-treated group (P<0.05), while the level of ET in EA-treated group was not changed significantly (P>0.05).
Conclusions:Both EA therapy and pravastatin have efficient regulation of body weight and the content of TC, TG, LDL-C and NO in HLP rats. To some extent, they are able to regulate the imbalance between ET and NO content under the condition of HLP. Western medicine such as pravastatin can regulate the HDL-C level in HLP rats, while the effect of EA therapy on regulation of the HDL-C level is limited.
Objective: The manifold studies on the usage of complementary and alternative medicine (CAM) indicate that its utilization differs with respect to socio-cultural background, gender, age and underlying disease. This study intended to analyze the usage of specific CAM practices among a population of older German adults with health insurance coverage. Methods: Data of 5 830 older individuals who participated in an anonymous cross sectional survey among German insurance beneficiaries were analyzed with respect to usage of CAM treatments applied by medical doctors or non-medical practitioners within the last 5 years. Results: The most frequently used approaches were acupuncture/traditional Chinese medicine (21%), homeopathy (21%), movement therapies/physical exercises (19%), osteopathy/chiropractic (12%), herbs/phytotherapy (7%), diets/specific food recommendations (6%) and foot reflexology (5%). Anthroposophic medicine was used only to a minor degree. Acupuncture and homeopathy users were likely to choose more than one CAM treatment simultaneously, particularly the combination of homeopathy and acupuncture. Moreover, this study can confirm significant differences between women and men in the use of the main relevant CAM interventions. Conclusion: The relative proportion of acupuncture usage was similar to homeopathy, which is an alternative whole medical system originating from Western Europe. This means that an Eastern alternative system is established also in Germany. In several cases not only one CAM treatment was used but distinct combinations existed (particularly homeopathy and acupuncture); thus one should be cautious to draw predictive conclusions from studies with broad and unspecific CAM categories, for among them there are several therapies which should not be regarded as CAM.
Postoperative gastroparesis syndrome (PGS) is a common complication after abdominal surgery in patients with primary liver cancer. However, surgeons usually do not have effective treatment for them. Objective
To explore the effects of acupuncture applied to Zusanli and other acupoints on PGS in patients after abdominal surgery. Design, setting, participants and interventions
Sixty-three PGS patients of abdominal surgery, from Eastern Hepatobiliary Surgical Hospital, were randomized into acupuncture group (32 cases) and metoclopramide group (31 cases). The patients in acupuncture group were treated with acupuncture applied to Zusanli and other acupoints once a day, while the patients in metoclopramide group were intramuscularly injected 20 mg metoclopramide three times a day. Main outcome measures
Volume of gastric drainage, number of treatment and cure rate in the two groups were measured and evaluated. Results
Acupuncture and metoclopramide could significantly reduce gastric drainage volume. In acupuncture group, the cure rate was 90.6% and the number of treatment was 6.58±4.26, while in metoclopramide group, the cure rate and the number of treatment were 32.3% and 10.13±3.60 respectively. There were significant differences in gastric drainage volume, cure rate and number of treatment between the two groups (P<0.05, P<0.01). Conclusion
Acupuncture is a good treatment for PGS, with fewer treatments, high cure rate and rapid effect.
Background: Pre-exam anxiety syndrome is a common condition occurring in pre-exam students and directly affects their examination performance and physical state. Wrist-ankle acupuncture has significant therapeutic effects in treating mental disorders and may also relieve the symptoms of pre-exam anxiety syndrome.Objective: To assess the therapeutic effect of wrist-ankle acupuncture on pre-exam anxiety syndrome.Design, setting, participants and interventions: A total of 60 students who met the inclusion criteria of pre-exam anxiety syndrome were enrolled from a university in Shanghai and they were randomly divided into treatment group and control group. There were 30 cases in each group, and no case failed to follow-up. In the treatment group, wrist-ankle acupuncture was adopted to point upper 1 bilaterally (impression between flexor carpi ulnaris tendon and ulnar margin), and there was no requirement for Deqi (arrival of qi). In the control group, sham acupuncture was adopted. The treatment was applied 3 times totally in both groups one week before the exam, once every other day, each time with the needles retained for 30 min.Main outcome measures: The therapeutic effects were compared between two groups. Before and after 3 treatments, Sarason Test Anxiety Scale (TAS) and Expectation and Treatment Credibility Scale (ETCS) were measured and evaluated.Results: The therapeutic effect experienced by the treatment group was better than that of the control group (P<0.05). There were no statistically significant differences in TAS and ETCS before treatment between the two groups. The scores of TAS after treatment in two groups were higher than those before treatment (P<0.05, P<0.01). There were statistical differences in TAS absolute difference and TAS relative difference between the two groups and the treatment group had better results (P<0.05, P<0.01). After treatment, patients in the treatment group had higher scores in ETCS than those in the control group (P<0.05, P<0.01). No adverse reaction was reported.Conclusion: Wrist-ankle acupuncture can relieve the symptoms of pre-exam anxiety syndrome significantly, and this therapy is highly safe.
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.
To observe the effects of electroacupuncture treatment on nitrergic neurotransmitter in bladder neck and detrusor of rats with unstable bladder.
Rat models of unstable bladder were established by operation to induce urethral obstruction. Electroacupuncture treatment was given by acupuncturing Huiyang and Zhonglüshu points for a week. Then the neuronal nitric oxide synthase (nNOS)-, endothelial nitric oxide synthase (eNOS)- and inducible nitric oxide synthase (iNOS)-positive cells in bladder neck and detrusor of the rats were observed.
The nitrergic neurotransmitter in bladder neck and detrusor were obviously decreased in rats with unstable bladder. The electroacupuncture treatment could significantly increase the contains of NOS in bladder tissue.
To promote the synthesis and secretion of nitrergic neurotransmitter in bladder tissue may be one of the mechanisms of acupuncture in adjusting bladder function.
Recently the combination of acupuncture with assisted reproductive technology (ART) to increase the outcomes of ART is being widely studied. In this article, the literatures concerning random controlled clinical trials since 2002 are reviewed and the designs of the trials, especially the timing of acupuncture, are evaluated. Over the past 5 years, the related clinical trials have primarily showed that acupuncture done immediately before and after embryo transfer might increase the assisted reproduction rates, but still requiring further high quality trials with large samples; in addition, different stimulation modes could produce different result, and so far there has not been a consensus as to the optimal time-point for the acupuncture intervention during the in vitro fertilization-embryo transfer (IVF-ET) course. Since the effects of acupuncture change with women's endocrine cycles, it is important and possible to make a breakthrough in ART outcomes if acupuncture is performed at a suitable time point during the cycle of IVF/ET combined with ART.
To study the effect of the electroacupuncture and Buyang Huanwu Decoction (BYHWD) on the regeneration of the rat's injured sciatic nerve.
Rat's sciatic nerve injury model was made by operation. The rats were treated with electroacupuncture or BYHWD and their nerve electro-physiological indices and histological changes tested by HRP were observed.
It was demonstrated that the recovery ratios of nerve conduction velocity and muscle evoked action potential of the group treated with electroacupuncture and the group treated with BYHWD were higher than those of the group treated with western medicine or the group without treatment. The differences were significant. The labeling cells in anterior horn of spinal marrow and spinal ganglion of the group treated with electroacupuncture and the group treated with BYHWD were more abundant than those of the group treated with western medicine or the group without treatment. The differences were significant. The effect of electroacupuncture was better than that of the BYHWD.
It suggests that both electroacupuncture therapy and BYHWD can promote the recovery of the function in early stage of injured nerve, and they are effective methods for promoting the regeneration of injured peripheral nerve.
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