Observation on Therapeutic Effect of Lotus Needle Cupping Therapy for Removing Blood Stasis in Zhuang Medicine on PHN and Its Influ-ence on Inflammatory Mediators

[Objectives]To observe the clinical effect of the lotus needle cupping therapy for removing blood stasis in Zhuang medicine in treating PHNand its influence on inflammatory factors.[Methods]96 patients with PHN were randomly divided into three groups:lotus nee-dle cupping therapy group,TCM surrounding acupuncture group and gabapentin group.Venous blood and acupoint blood were collected at 0,21 and 42 d of treatment,and the expression levels of 5-HT,SP and CGRPinflammatory mediators were detected before and after treatment.The changes of VAS scores before,during and after treatment and the clinical efficacy were observed.[Results]The total effective rate of the lotus needle cupping group was 87.50%,which was better than that of the TCM acupuncture group(81.25%)and the gabapentin group(62.50%);after treatment,the VAS scores and the expression of inflammatory mediators in the three groups of patients were lower than those before treatment,and the decrease was more significant in the treatment group(P<0.05).[Conclusions]The lotus needle cupping therapy for removing blood stasis in Zhuang medicine is effective in treating PHN,and its mechanism is to reduce the release of inflammatory media-tors,reduce hyperalgesia,relieve pain and improve the quality of life of patients.

Subconjunctival hemorrhage after wet cupping therapy: a case report

Introduction:Cupping therapy is an integrative and complementary medicine therapy that practiced worldwide by several civilizations for thousands of years.Cupping therapy is reported to be a relatively safe practice especially if performed by qualified therapists.Subconjunctival hemorrhage(SCH)is a common cause of eye redness and can be classified into traumatic and spontaneous.Case presentation:This case report discussed an adverse event related to wet cupping therapy.The patient developed SCH one day after performing cupping therapy.He was completely recovered after 2 weeks.This case report should increase the knowledge of cupping therapists regarding increasing safety of patient when performing wet cupping therapy on specific body parts especially,head,neck and cervical areas.Furthermore,it highlighted the importance of conducting research regarding the mechanical and physiological effects of cupping therapy.Conclusion:Adverse events related to cupping therapy should be reported with every patient.Cupping therapists should be aware of this possible mild adverse event.To the best of our knowledge,this is the first published adult case of SCH related to wet cupping therapy session.More studies are critically needed for evaluation of cupping therapy effects and adverse events especially when performed on head and neck.

Genetic Theory:An Illustration of a Theoretical Mechanism of Acton of Cupping Therapy

Cupping therapy is an ancient natural therapeutic modality which is widely practiced throughout the world.Cupping therapy mechanisms of action are not illustrated by research until now.This article gives a brief illustration of the genetic theory as a possible mechanism of action of cupping therapy.Genetic modulation is also a suggested mechanism of action of acupuncture and massage.

An overview of systematic reviews of clinical evidence for cupping therapy

Background:As a traditional treatment method,cupping therapy is widely used in Asian countries.This overview of systematic reviews (SRs) investigated the effectiveness and safety of cupping therapy through an evidence-based approach.Methods:SRs that assessed the effectiveness of cupping therapy for any type of disease were searched through 6 electronic databases.Target diseases,cupping methods,numbers and types of included studies,quality of included trials,main results (including meta-analysis re sults),and authors' conclusions of SRs were extracted.The Assessment of Multiple Systematic Reviews measurement was used to evaluate methodologic quality of the SRs.Results Eight SRs met the inclusion criteria and effectiveness and safety of cupping therapy for 11 diseases were assessed.All included SRs were of good methodologic quality.However,quality of trials included in the SRs was generally poor.Meta-analysis was performed in 4 studies.Results:showed cupping therapy (alone or combined with other interventions) was better than medications (or other interventions alone) for herpes zoster,acne,facial paralysis,low back pain,or cervical spondylosis.One review reported adverse events,including hematoma,increased pain and tingling following cupping treatment.Conclusions:Cupping therapy may be beneficial for pain-related conditions,acne,and facial paralysis.However,a firm conclusion could not be drawn due to the insufficient number of included reviews and the low quality of the original studies.

Cupping therapy for acute and chronic pain management:a systematic review of randomized clinical trials

Objective:Cupping as a traditional therapy is used to treat a myriad of health conditions,including pain.This systematic review assessed the effectiveness and safety of cupping for different types of pain.Methods:Thirteen databases and four trial registries were searched for randomized clinical trials.Meta-analysis of data was conducted if there was non-significant clinical and statistical heterogeneity(measured by I2 test)among trials.Results:Sixteen trials with 921 participants were eligible and included.Six trials were assessed as low risk of bias,another six trials were of unclear risk of bias,and the remaining four trials were of high risk of bias.Pain was related to three acute and seven chronic diseases.Metaanalysis showed a beneficial effect of cupping compared to wait-list control(visual analogue scale(VAS),MD
1.85 cm,95%CI
2.66 to
1.04)and heat therapy(numerical rating scale,MD
2.05 cm,95%CI
2.93 to
1.17).Cupping combined with acupuncture was superior to acupuncture alone on post-treatment pain intensity(VAS,MD
1.18 cm,95%CI
1.68 to
0.68),however,no difference was found between this comparison based on changes in pain intensity(difference of VAS,MD 0.16 cm,95%CI
0.54 to 0.87).Results from other single studies showed significant benefit of cupping compared with conventional drugs or usual care.Hematoma and pain at the treated site,increasing local pain or tingling were reported as mild adverse effects of cupping.Conclusion:This review suggests a potential positive short-term effect of cupping therapy on reducing pain intensity compared with no treatment,heat therapy,usual care,or conventional drugs.

In vitro evaluation of transdermal permeation effects of Fu’s cupping therapy via six diffusion kinetics models

In this study,six kinetics models of indomethacin hydrophilic gel patch transdermal in vitro release was established,including zero-level,first-order,Higuchi-level,Ritger-Peppas,Weibull and Hixcon-Crowell dynamic equations.The chemical permeation enhancers,including 3%and 5%Azone,and iontophoresis were used as the control.Transdermal diffusion tests were performed in vitro and indomethacin was quantified by high performance liquid chromatography system.The transdermal parameter of the Higuchi and Weibull dynamic equations,indicated that Fu’s cupping therapy(FCT)could significantly improve Higuchi and Weibull kinetic parameters in vitro transdermal,increased transdermal rate and permeability coefficient,reduced lagging time.Additionally,statistical analysis speculated the skin barrier function could be restored after 46 h treatment.Hence,as a new physical transdermal drug delivery technology,transdermal permeation effects produced by FCT are obvious,which has the characteristics of traditional Chinese medicine and has important clinical application value.

The Effects of Cupping Therapy on Skin’s Biomechanical Properties in Wistar Rats

Cupping therapy has been widely used for clinical treatment of soft tissue lesions. The current study investigated the effects of cupping therapy on biomechanical properties of the skin in Wistar rats. 20 rats were divided into two groups: 10 in experimental and 10 in control group. Either the right or the left lower quadrants of the lumbar regions in the experimental group underwent 10 minutes daily cupping therapy for 12 days. The skin stiffness and ultimate tensile strength of all the rats were measured using tensiometer. The skin stiffness and ultimate tensile strength were decreased significantly in cupping side of the experimental group as compared with the non-cupping side and the control group. There were no significant differences between the non-cupping side of the experimental group and the control group. In conclusion, cupping therapy can be useful as a treatment method to reduce the skin stiffness and ultimate tensile strength.

Effects of Medicated Bamboo Cupping Therapy of Zhuang Nationality Medicine on Long-term Efficacy and Quality of Life in the Treatment of Functional Dyspepsia with Stagnation of Liver Qi and Spleen Deficiency Syndrome

Objective:To investigate the effect of medicated bamboo cupping therapy of Zhuang nationality medicine on long-term efficacy and quality of life in the treatment of functional dyspepsia with stagnation of liver Qi and spleen deficiency syndrome,and to provide a new,effective and easy to promote treatment method for functional dyspepsia.Methods:A total of 150 cases of functional dyspepsia treated in our hospital from March 2014 to October 2015 were selected as research subjects,and they were divided into the treatment group(medicated bamboo cupping therapy),the control A group(Omeprazole Enteric-coated Tablets+Domperidone Tablets)and the control B group(acupuncture),50 cases in each group.The clinical efficacy,the gastric electrical index,the recurrence rate and the quality of life were observed and compared.Results:The total effective rate in the treatment group was higher than that in the control A group and the control B group(P<0.05).Compared with before treatment,the main frequency and electrical amplitude in each group was significantly improved,and the rhythm disorder coefficient was significantly reduced(P<0.05).After treatment,compared with the control A group and the control B group,the difference of rhythm disturbance coefficient in the treatment group was statistically significant(P<0.05).The recurrence rate in the treatment group was lower than that in the control A group and the control B group at 1 month,3 months and 6 months after drug discontinuance,with no significant difference(P>0.05).Compared with before treatment,scores of each physiological function after treatment had no significant change(P>0.05),and the scores of physiological function,body pain,general health,vitality,social function,emotional function and mental health were significantly improved(P<0.05).The comparison of scores in each group had no significant difference(P>0.05).Conclusion:The medicated bamboo cupping therapy of Zhuang nationality medicine on functional dyspepsia with stagnation of liver Qi and spleen deficiency syndrome can significantly improve clinical efficiency,and reduce the coefficient of rhythm.The long-term recurrence rate is low,and the quality of life is significantly improved.It is a convenient and effective treatment,which is worthy of promotion.

Dry cupping therapy and the wellness management of health travelers

Objective:Individuals travel locally and internationally in order to find alternative treatments which are less-toxic and more beneficial to their health and wellness.Despite the popularity of the western system of medicine,cupping therapies are gaining enormous attention in Pakistan as a system of traditional and complementary medicine to ensure the quality of life and wellness notions of the people.The present study aims to examine the effectiveness of dry cupping therapy(DCT)on the health,wellness,and quality of life preferences of health-seeking travelers in a sample of Faisalabad.Methods:DCT was performed for 15-20 minutes on subjects by using 3-5 disposable cupping glasses.Study participants filled the questionnaires before and after DCT interventions.Partial least square structural equation modeling technique is used in order to statistically analyze the data.Results:A total of 187 subjects participated in two DCT interventions at Coural Wellness Center Faisalabad and provided their final responses after 30 days from 2nd DCT.Respondents’perceptions of their physical feelings were generally found in a significantly positive and direct relation with DCT and health status(HS),i.e.,body pain(β=0.019),vitality(β=0.138),and bodily movement(β=0.207).This trend was observed in the psychological feelings of respondents as well,i.e.,emotional feelings(β=0.169).DCT significantly mediated the overall phenomenon and variance account for values were found between 20%and 80%for all the study constructs.The scores of all the health and wellness items on the questionnaire were significantly improved in 79.68%of studied participants after 1st and 2nd DCT interventions except for social functioning.Conclusion:Findings of the present study suggest that DCT has an important role in determining the health perceptions and HS of health travelers without potential side-effects.It can improve the health and overall quality of life of the people by positively influencing their physical and psychological health perceptions.It additionally leads to improve travelers’emotion,behavior,and other daily matters.

Key elements that determine the efficacy of cupping therapy:A bibliometric analysis and review of clinical studies

Objective:The aim of this review was to identify the possible mechanisms behind cupping therapy by employing an evidence-based approach,and to explore its possible regional and systemic effects in the human body.Methods:We searched six electronic databases and four online trial registries for articles published up to January 1,2020.Clinical studies on the mechanisms of retained cupping,flashing cupping,moving cupping,and vacuum cupping were considered for this review.The methodological qualities of controlled studies were assessed using the National Institute for Clinical Excellence methodology checklist,the Newcastle-Ottawa Scale,and the Cochrane risk of bias tool.Characteristic statistical description and qualitative summary of results were used for data analysis.Results:Thirty-eight studies(37 full texts and one abstract)were included in this study.Due to the clinical heterogeneity among the studies,we could not conduct a meta-analysis.The results showed that the key factors that contribute to the efficacy of cupping therapy are negative pressure and temperature.Cupping therapy mainly causes local and systemic changes in hemodynamics,immune regulation,metabolism,and pain relief.Conclusion:We identified negative pressure as the key element behind cupping therapy.Cupping therapy may cause redistribution of oxygen at the cupping site and in neighboring tissues,thereby inducing a therapeutic effect by increasing regional blood flow.It may also induce metabolic change,immunomodulation,and neuromodulation.However,additional rigorous clinical research needs to be conducted to further clarify the mechanism behind cupping therapy.

Systematic evaluation and Meta-analysis of acupuncture and collaterals cupping therapy for Knee Osteoarthritis

Objective:In order to obtain the best treatment program for Knee Osteoarthritis(KOA),to alleviate the pain of patients with KOA,and to systematically evaluate the efficacy of acupuncture cupping therapy for KOA.Methods:we used computer to search the databases of CNKI(1989-2018.10),Wanfang(1989-2018.10),VIP(1989-2018.10),PubMed(1966-2018.10),EMbase(1986-2018.10)and Cochrane Library(the 3rd issue of 2018).And the literature quality was evaluated by Jadad scale.Results:A total of 19 eligible RCT studies were included,and a total of 2,088 patients participated in the eligible clinical study.Meta-analysis results showed that the total effective rate OR combination=2.85[OR=3.98,95%CI(2.98,5.32),P<0.00001].The results showed that the curative effect of acupuncture and collaterals cupping in the treatment of KOA was superior to other therapies.Conclusion:Acupuncture and cupping therapy of traditional Chinese medicine is effective and safe in treating KOA.Due to the impact of the original study on Meta-analysis results,more large samples and high-quality clinical trials are still needed to verify.

Active sham cupping therapy technique:identification of limitations and suggesting enhancements

Cupping therapy is an ancient healing modality that has been used for thousands of years.There are two types of sham cupping techniques:passive type which used no suction,and active type which suction was rapidly released through a hole on the top of the cup.This narrative review aimed to identify limitations and suggest enhancements in the current use of active sham cupping therapy technique.Three medical databases were searched for identification of clinical trials that used active sham cupping device.201 published papers were retrieved.195 papers were excluded after applying inclusion/exclusion criteria.Finally,6 clinical trials were selected for this review.This paper identified multiple limitations of the active sham cupping procedure which include failure of blinding,heterogenicity of the characteristics of used devices including heterogenicity in reporting active sham cupping intervention,and the limitation of the sham technique to be used for dry cupping only.The recommended enhancements included using bigger cups holes for release of suction,standardization of characteristics of used sham devices,standardization in reporting,and suggesting recruiting patients without prior experience of cupping for better blindness success in sham cupping clinical trials.This paper suggested reporting criteria for sham cupping clinical trials.In conclusion,this paper identified the limitations of the current sham cupping technique and suggesting enhancements regarding active sham cupping technique.Continues evaluation of the current active sham cupping technique and development of new sham cupping devices and techniques for various types of cupping therapy are highly recommended.

Abul-Qasim Al-Zahrawy’s practice of cupping therapy(Hijama)during the tenth century:a documentation

Abul-Qasim Al-Zahrawy’s(Albucasis)(936-1013 AD)was one of the greatest Andalusian scientists and surgeons.Al-Zahrawy illustrated his pioneering medical and surgical information on his book(“At-Tasrif liman‘Azija‘an at-Ta’lif)or(The method of medicine).He illustrated the cupping therapy practice in the treatise 30 of this book.The aim of this article is to give an anthropological and historical medical information about Al-Zahrawy’s practice of cupping therapy(Hijama in Arabic).This article is a method of documentations of cupping therapy practice during the 10th century.Safety concerns including innovation cup safety design were the most noticed subjects in practicing cupping therapy by Al-Zahrawy.This attitude should be continued.

Clinical application and research progress of cupping therapy

Objective：This article collected,organized,and summarized the medical literatures of cupping therapy from three major Chinese databases including China National Knowledge Infrastructure（CNKI）,Chongqing VIP（VIP）,and Wan Fang,with cupping,moving cupping,flash cupping,pricking cupping,or medicinal cupping as the retrieve title or key words,and the retrieve range was from 1953 to July 15,2015.This article was to give an overall review of cupping therapy from the clinical application and mechanism research based on its application form,indications,and mechanism research progress.The results showed that there are various types of cupping methods;its indications cover multiple subjects such as internal medicine,external medicine,gynecology and pediatrics;and its major action mechanisms include negative pressure suction,increasing pain threshold,promoting dermal blood flow and improving body immunity.

A meta-analysis on the clinical efficacy of fire dragon cupping in the treatment of lumbar disc herniation

Background:The incidence of lumbar disc herniation(LDH)is notably high.Consensus among experts highlights non-surgical treatments as the primary therapeutic approach for LDH.Contemporary medicine frequently employs pharmacotherapy and epidural injections in such treatments,which are associated with numerous adverse effects.Prolonged use can severely impair the liver and kidney functions of patients.Hence,the role of safe and effective traditional Chinese medicine techniques becomes pivotal.Among various traditional Chinese medicine approaches for treating LDH,fire dragon cupping,renowned for its remarkable efficacy,cost-effectiveness,and ease of application,is extensively utilised in clinical settings for managing LDH.Nonetheless,there is a scarcity of systematic and standardised evidence from evidence-based medicine studies.Therefore,conducting a meta-analysis is imperative.Methods:A comprehensive computerised search was conducted in databases including China National Knowledge Infrastructure,WanFang Data,VIP,China Biology Medicine disc,PubMed,EMbase,The Cochrane Library,Web of Science,and CINAHL.The search aimed to gather randomised controlled trials on fire dragon cupping therapy for LDH,spanning from the inception of these databases until December 2023.Two researchers independently screened the literature according to inclusion and exclusion criteria,extracted data,and assessed the methodological quality of the studies included,utilising RevMan 5.3 software for meta-analysis.Results:The results show that the fire dragon cupping therapy group had better clinical effectiveness(relative risk=1.23,95%confidence interval(CI)(1.14,1.33),P<0.00001),less pain(standardized mean difference=–1.33,95%CI(–1.49,–1.16),P<0.00001),and some improvement in lumbar function(Japanese Orthopaedic Association scores:mean difference=3.37,95%CI(2.31,4.43),P<0.00001.Conclusion:The fire dragon cupping therapy significantly alleviates LDH,warranting its extensive application.However,considering the limitations in the number and quality of studies included,the aforementioned conclusion necessitates further validation through more high-quality research.

Observation on clinical effects of acupuncture plus cupping therapy for cervical radiculopathy

Objective：To observe the therapeutic effects of acupuncture plus cupping therapy and Western medication alone for cervical radiculopathy.Methods：A total of 139 patients with cervical radiculopathy were randomly divided based on the random digital table into an acupuncture-cupping group（70 cases） and a Western medication group（69 cases）.In the acupuncture-cupping group,Fengchi（GB 20）（bilateral）,Dazhui（GV 14）,Jianjing（GB 21）（bilateral） and Jiaji（EX-B 2） points of the neck [bilateral,midpoint between Fengchi（GB 20） and Dazhui（GV 14）] were punctured.After the arrival of the needling sensation,bilateral Fengchi（GB 20） and Jianjing（GB 21） were linked with electric stimulation and the rest acupoints were manipulated with the moderate needling technique.In the retaining of the needles,TDP lamp radiation was used.After acupuncture,the cupping therapy was applied to the local area.The treatment was given once every other day,20 d for a course.After one course,the therapeutic effects were observed.The Western medication group was treated by oral administration of Meloxicam（Mobic）,7.5 mg,once a day,with water and liquid after meal.The therapeutic effects were observed after 20 d.Results：The total effective rate was 92.8% in the acupuncture-cupping group and 73.9% in the Western medication group,with a statistical difference between the two groups（P〈0.05）.After treatment,the scores of the clinical symptoms of the two groups were obviously declined（P〈0.01）,and the score of the clinical symptoms of the acupuncture-cupping group was better than that of the Western medication group,with a statistical difference（P〈0.05）.Conclusion：Acupuncture plus cupping therapy was more effective than administration of Meloxicam tablets alone in the treatment of cervical radiculopathy.

Clinical Observation of Acupuncture, Stone Scraping plus Cupping Therapy for Neck-type Cervical Spondylosis

Objective： To investigate the efficacy and safety of a composite treatment with stone scraping, cupping, electroacupuncture and infrared irradiation for neck-type cervical spondylosis Methods： Seventy subjects were randomly allocated into composite treatment group （35 cases） and control group （35 cases）. The composite treatment group was treated by scraping along the Governor Meridian, the Gallbladder Meridian and the Bladder Meridian with Geng＇s multifunctional stone plate, quick cupping with subsequent retention of cups, routine electroacupuncture, and infrared irradiation. The control group was treated by routine electroacupuncture and infrared irradiation. Both groups were treated once very other day, 6 times as a course. The clinical curative effects and adverse responses were evaluated immediately after each treatment and at the completion of one course of treatment in both groups. Results： The total immediate effective rate was 88.6% in the composite treatment group and 80.0% in the control group. The immediate effect was significantly better in the composite treatment group than in the control group （P〈0.05）. The total effective rate at the completion of one course of treatment was 97.1% in the composite treatment group and 94.3% in the control group. The curative effect after one course of treatment was also significantly better in the composite treatment group than in the control group （P〈0.05）. Conclusion： Composite treatment with acupuncture, stone scraping and cupping is safe and effective in treating neck-type cervical spondylosis

Cupping therapy-induced elevated D-dimer

46-year old non-snloking Chinese man was found Laccidently elevated D-dimer during his annual health accidently elevated D-dimer during his annual health checkup on June 10, 2010. The value of his D-dimer was found substantially elevated （6110 ng/ml） （reference range 〈350 ng/ml） by automated latex-enhanced light-scattering immunoassays. Prothrombin time, activated partial thromboplastin time and fibrinogen were within the reference range.

Treatment of 43 Cases of Lateral Femoral Cutaneous Neuritis with Pricking and Cupping Therapy

Lateral femoral cutaneous neuritis, also named asmeralgia paresthetica or Roth syndrome, is markedby cutaneous pain or paresthesia such asformication or numbness in one or both thighs,which can be aggravated by prolonged standing orwalking; it is also characterized by hypoesthesia orskin sensibility without muscular atrophy ordyskinesia. Forty-three cases of lateral femoralcutaneous neuritis have been treated by pricking andcupping therapy since 1996. Now it was reported asfollows.

Observation on Therapeutic Effects of Combined Surrounding Needling, Bloodletting with Cupping Therapy for Localized Scleroderma

Localized Scleroderma, also known as morphea, is a dermal disease manifested by localized edematous skin primarily and progressive thickening and hardening of the skin. It mainly affects the scalp, forehead, lumbar, abdomen and four limbs. The skin lesions are firstly present in single or multiple pink edematous patches in varying sizes, and then change into primrose yellow or beige hardening, being smooth and shiny resembling wax.