Acupuncture and regulation of gastrointestinal function

In China, acupuncture has been considered an effective method for treating gastrointestinal(GI) dysfunction diseases for thousands of years. In fact, acupuncture has gained progressive acceptance from both practitioners and patients worldwide. However, the therapeutic effects and underlying mechanisms in treating GI dysfunction have not yet been established due to a lack of systematic and comprehensive review articles. Therefore, the aim of this review is to discuss the efficacy of acupuncture as a treatment for GI dysfunction and the associated underlying mechanisms. A search of Pub Med was conducted for articles that were published over the past 10 years using the terms "acupuncture", "gastrointestine", and other relevant keywords. In the following review, we describe the effect and underlying mechanisms of acupuncture on GI function from the perspectives of GI motility, visceral sensitivity, the GI barrier, and the brain-gut axis. The dual regulatory effects of acupuncture may manifest by promoting gastric peristalsis in subjects with low initial gastric motility, and suppressing peristalsis in subjects with active initial motility. In addition, the regulation of acupuncture on gastric motility may be intensitydependent. Our findings suggest that further studies are needed to investigate the effects and more systematic mechanisms in treating GI dysfunction, and to promote the application of acupuncture for the treatment of GI diseases.

Influence of Acupuncture on Autonomic Balance in Adult Tinnitus Patients:An Exploratory Study

Acupuncture is an alternative therapy for tinnitus in clinical practice.The mechanism by which acupuncture can alleviate tinnitus is still unknown.Autonomic nervous system was reported to be responsible for tinnitus.The aim of this study was to explore the effect of acupuncture on autonomic balance in adult tinnitus patients.Thirty patients were randomly assigned into either the deep acupuncture(DA)group or the shallow acupuncture(SA)group.Each patient received 6 acupuncture sessions(a-f phase)over three weeks.Measures of heart rate variability and Tinnitus Handicap Inventory(THI)were obtained at baseline and after the sixth acupuncture session in all patients.The results showed that the low frequency/high frequency(LF/HF)pattern was increased at b-f phase until the sixth acupuncture session when compared with that at the first acupuncture session in DA group.However,it continuously increased at b-f phase in SA group even at the sixth acupuncture session,which was not significantly different from that at the first acupuncture session.The decrease in THI in DA group was greater than that in SA group after 3-week treatment(P=0.043).Our preliminary study suggests three-week deep acupuncture can improve tinnitus symptoms in adult tinnitus patients,which may be related to the regulation of autonomic nervous system balance.

针刺临床研究中的安慰剂效应

Placebo control is designed to evaluate the specific effect of one intervention.Relevant studies showed that acupuncture has a considerable placebo effect affected by many factors.In this paper,the relevant articles of acupuncture placebo studies all around the world were reviewed comprehensively to clarify the definition of acupuncture placebo effect and its psychological mechanism.The factors of acupuncture placebo effect were discussed in view of three aspects,i.e.types of sham acupuncture as control,patient-doctor interaction and outcome types.Eventually,the issues encountered in current studies of acupuncture placebo effect were described,e.g.lack of relevant studies especially with systematic and in-depth approaches in this field,inappropriate classification of specific non-needling effect relevant with acupuncture theory,and inaccurate assessment of acupuncture placebo effect due to the dificulty of sham-acupuncture design.In order to drive the future research direction of acupuncture placebo effect,it is suggested that more attention should be paid on the topic,including but not limited to correct recognition of the holistic effect of acupuncture,the appropriate design of sham acupuncture and in-depth research of mechanism of acupuncture placebo effect and its contributing factors.

治疗时长对针刺治疗膝骨关节炎疗效的影响:一项多中心随机对照试验的二次分析

Objective:To explore the influence of acupuncture duration on the effect of acupuncute for patients with knee osteoarthritis(KOA).Methods:This secondary analysis was conducted based on the data of a randomized controlled trial about acupuncture on KOA.A total of 480 patients were recruited at nine centers.Only data from the manual acupuncture(MA)group and electroacupuncture(EA)group were included in this secondary analysis.The needles were retained for 30-min each time and treatment was given three times a week for 8 weeks.The follow-up visit lasted until week 26.Outcomes were numerical rating scale(NRS)on pain,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)function and the response rate.Results:The NRS and WOMAC function at week 8 were lower than those at week 4(P<0.05),and were no significant difference compared with those at week 26 in MA and EA groups(P>0.05).Greater changes were observed in NRS and WOMAC function during 0-4 weeks compared with those during 4-8 weeks(P<0.05)in both groups.The response rate at week 8 was higher than it at week 4(P<0.05),and was no significant difference compared with it at week 26(P>0.05)in both groups.Association was found between BMI and changes of NRS(P<0.05),but not between BMI and WOMAC function(P>0.05)in MA group,while no asscoaition was found between BMI and NRS or WOMAC function in EA group(P>0.05).There was no association found between other factors and NRS or WOMAC function in both groups(P>0.05).Conclusion:For KOA patients,8-week acupuncture was more effective than 4-week acupuncture in relieving pain and improving joint function,but growth rate of the effect slowed down with increasing duration of intervention.It was uncertain whether the long-term effect of 8-week acupuncture was better than that of 4-week acupuncture.Further studies are required to further determine the effect of duration of intervention.

Placebo response of sham acupuncture in patients with primary dysmenorrhea:A meta-analysis

Background The placebo response of sham acupuncture in patients with primary dysmenorrhea is a substantial factor associated with analgesia.However,the magnitude of the placebo response is unclear.Objective This meta-analysis assessed the effects of sham acupuncture in patients with primary dysmenorrhea and the factors contributing to these effects.Search strategy PubMed,Embase,Web of Science,and Cochrane CENTRAL databases were searched from inception up to August 20,2022.Inclusion criteria Randomized controlled trials(RCTs)using sham acupuncture as a control for female patients of reproductive age with primary dysmenorrhea were included.Data extraction and analysis Pain intensity,retrospective symptom scale,and health-related quality of life were outcome measures used in these trials.Placebo response was defined as the change in the outcome of interest from baseline to endpoint.We used standardized mean difference(SMD)to estimate the effect size of the placebo response.Results Thirteen RCTs were included.The pooled placebo response size for pain intensity was the largest(SMD=−0.99;95%confidence interval[CI],−1.31 to−0.68),followed by the retrospective symptom scale(Total frequency rating score:SMD=−0.20;95%CI,−0.80 to−0.39.Average severity score:SMD=−0.35;95%CI,−0.90 to−0.20)and physical component of SF-36(SMD=0.27;95%CI,−0.17 to 0.72).Studies using blunt-tip needles,single-center trials,studies with a low risk of bias,studies in which patients had a longer disease course,studies in which clinicians had<5 years of experience,and trials conducted outside Asia were more likely to have a lower placebo response.Conclusion Strong placebo response and some relative factors were found in patients with primary dysmenorrhea.PROSPERO registration number:CRD42022304215.

Functional connectome of vicarious traumatization:detecting and helping individuals vulnerable to mental illness

COVID-19 has spread globally for more than 2 years,having a tremendous impact on both the physical health of the infected cases and the mental health of the general population(Wu et al.,2021;Shanahan et al.,2022).In addition to psychiatric symptoms such as depression and anxiety,vicarious traumatization(stress resulting from empathic engagement with the trauma of others)is a generic psychological condition during the pandemic,increasing the risk of mental illness(Liu&Liu,2020;Serafim et al.,2020).Certain populations may bemore susceptible to vicarious trauma than others,and it is increasingly important to identify factors that may affect individual susceptibility(de Figueiredo et al.,2021).There is evidence that the prepandemic brain functional connectome can predict individual anxiety induced by the pandemic(He et al.,2021).However,the whole relationship map of the general distress(e.g.depression and anxiety),vicarious traumatization,and functional connectome is unclear.