Acupuncture for ischemic stroke:where are we now?

Acupuncture is an effective treatment for ischemic stroke(IS)and plays a key role in neurological rehabilitation after IS.Acupuncture can improve the clinical symptoms of various complications after IS,including motor dysfunction,swallowing disorders,speech disorders,cognitive impairment,depression,insomnia,and fatigue.However,the mechanisms underlying the effects of acupuncture in IS remain unclear.Available evidence suggests that acupuncture may exert neuroprotective effects through neuroplasticity(neurogenesis and synaptogenesis),angiogenesis,cell proliferation and apoptosis,and regulation of oxidative stress,inflammation,and immunity.Further studies should be conducted to improve the high-quality evidence-based system of acupuncture intervention for IS,by focusing on the clinical and basic research design,increasing the sample size,standardizing and quantifying the standards of acupuncture operations,using multidisciplinary techniques and methods to systematically explore the key targets of acupuncture intervention for IS,and reveal the efficacy and mechanism of acupuncture in the treatment of IS.

How to conduct an acupuncture dose–effect relationship study? A discussion based on study methodology

Acupuncture therapy is widely used in the clinic,and its therapeutic effects have been proven by numerous studies.The dose–effect relationship of acupuncture is a fundamental aspect of the acupuncture research system.Recent studies found that different acupuncture dosages altered study results directly,indicating the importance of screening the optimal stimulation dosage.However,the system for studying the acupuncture dose–effect relationship is still in its infancy,and the methodology of the system needs to be improved.This review aimed to define the factors impacting acupuncture“dosage”and“effect,”and to improve the methodological system for research on the dose–effect relationship of acupuncture.By summarizing the current findings of acupuncture dose–effect studies,we discussed the vital acupuncture parameters and methodological problems that influence the relationship between acupuncture dosage and its effects.These factors consist of specific influencing factors(acupoint selection,acupuncture manipulation parameters,de qi response)and nonspecific influencing factors(comparison selection,blinding procedure,patient expectancy).Our perspectives offer suggestions for the design of acupuncture dosage–effect trials.Further studies need to be conducted to establish the methodological system and provide systematic evidence of the acupuncture dose–effect relationship.

Moxibustion for COVID-19:a systematic scoping review

Objective:Moxibustion has been widely used in the prevention and treatment of COVID-19.However,there is no systematic review of current topics and clinical findings on moxibustion for COVID-19.We conducted this scoping review to systematically summarize and analyze the themes and findings of published articles,and to provide an overview of current knowledge and practice of moxibustion for COVID-19.Methods:PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,SinoMed,Wan Fang Data,and VIP databases were searched from inception until April 2022.The relevant data were presented through bar graphs,structured tables,and figures along with descriptive statistics and analysis.This scoping review was conducted based on the PRISMA-ScR Checklist.Results:A total of 76 articles were reviewed:47 reviews,19 clinical research studies,seven systematic reviews(all were protocols),and three guidelines.All the studies were conducted by Chinese researchers and published from January 1,2020 to March 14,2022.The feasibility of moxibustion in the prevention and treatment of mild or moderate COVID-19 is based on the consensus of therapeutic mechanisms and effectiveness.The most adopted approach was the suspended and gentle moxibustion,and the most frequently applied or recommended acupoints were found to be ST36,CV8,CV6,CV4,CV12,GV14,BL13,LI4,ST25,and LR3.Conclusions:As a convenient and safe traditional Chinese medicine(TCM)therapy with its specific feature,moxibustion has been significantly effective at ameliorating mild or moderate symptoms among COVID-19 patients.Further large-scale,welldesigned research and international cooperation are still warranted in clinical evaluations of moxibustion.