Electroacupuncture at Fengchi(GB20) inhibits calcitonin gene-related peptide expression in the trigeminovascular system of a rat model of migraine

Most migraine patients suffer from cutaneous allodynia; however, the underlying mechanisms are unclear. Calcitonin gene-related peptide（CGRP） plays an important role in the pathophysiology of migraine, and it is therefore, a potential therapeutic target for treating the pain. In the present study, a rat model of conscious migraine, induced by repeated electrical stimulation of the superior sagittal sinus, was established and treated with electroacupuncture at Fengchi（GB20）（depth of 2–3 mm, frequency of 2/15 Hz, intensity of 0.5–1.0 m A, 15 minutes/day, for 7 consecutive days）. Electroacupuncture at GB20 significantly alleviated the decrease in hind paw and facial withdrawal thresholds and significantly lessened the increase in the levels of CGRP in the trigeminal ganglion, trigeminal nucleus caudalis and ventroposterior medial thalamic nucleus in rats with migraine. No CGRP-positive cells were detected in the trigeminal nucleus caudalis or ventroposterior medial thalamic nucleus by immunofluorescence. Our findings suggest that electroacupuncture treatment ameliorates migraine pain and associated cutaneous allodynia by modulating the trigeminovascular system ascending pathway, at least in part by inhibiting CGRP expression in the trigeminal ganglion.

针灸优势病种:头痛

In 1920s,pain medicine involving many disciplines started to develop increasingly,promoting clinical practice and mechanism research of pain worldwide ever since.The research on pain of the head and face,especially primary pain is thereby enhanced.In 1988,International Headache Society released International classification of headache disorder(the first edition)[1].Thirty years later,International classification of headache disorder(the third edition)(ICHD-3)was issued in 2018[2].In China,Diagnosis and treatment protocol for headache(migraine)was released by“The 11th Five-Year”Key Speciality Collaborative Group,National Administration of Traditional Chinese Medicine in 2017[3];and in 2022,The updated guidelines on diagnosis and treatment of migraine in China was issued by Chinese Medical Association[4].

Acupuncture for chronic nonspecific low back pain in middle-aged and older patients:A randomized controlled trial

Objective:To observe the specific effects of acupuncture in middle-aged and older patients with chronic nonspecific low back pain(CNSLBP).Methods:Sixty-six patients with CNSLBP were randomized into the acupuncture or sham acupuncture groups(n=33).In the acupuncture group,penetrating acupuncture with a long needle was delivered at Ashi points(painful/sensitive points),and the needles were manipulated by rotating technique after deqi till patients felt distending pain.The needles were retained in place for 30 min.Acupuncture was given three times per week for 4 weeks.In the sham acupuncture group,shallow needling was performed at non-meridian,non-acupoint,non-painful,and non-sensitive points.The needle retention and duration of treatment were the same as those of the acupuncture group before treatment,after the first intervention,after the whole treatment,and in follow-up visit(4 weeks after the whole treatment).The scores of the visual analog scale(VAS)for pain,range of movement(ROM)of the spine,and simplified Oswestry Dysfunction Index(ODI)were observed separately.Results:Compared to the outcomes before treatment,the VAS score,spinal ROM,and simplified ODI score were lower after the first intervention,after treatment,and in follow-up visits in the acupuncture group,indicating the statistical significance(P<0.05).When compared with the sham acupuncture group,the VAS score,spinal ROM,and simplified ODI score were significantly lower in the acupuncture group after the first intervention,after treatment,and in follow-up visit(P<0.05).The total effective rate was 90.9%in the acupuncture group,which was significantly higher than that(75.76%)in the sham acupuncturegroup(P<0.05).Conclusion:Acupuncture has a specific effect on CNSLBP in middle-aged and older patients and a superior effect on immediate analgesia.