Efficacy of acupuncture on cardiovascular complications in patients with diabetes mellitus in Korea:A nationwide retrospective cohort

Objective The main aim of this study is to investigate whether acupuncture could be an effective complementary treatment for reducing the risk of macrovascular complications in diabetic patients currently taking antidiabetic medications using a nationwide population-based database.Methods We conducted a retrospective cohort study to assess the efficacy of acupuncture on cardiovascular complications in diabetic patients using data from patients between 40 and 79 years of age,newly diagnosed with diabetes between 2003 and 2006,found in the National Health Insurance Service-National Sample Cohort(NHIS-NSC)in Korea.From the data,we identified 21,232 diabetic patients who were taking antidiabetic medication between 2003 and 2006.The selected patients were divided into two groups-those who received acupuncture at least three times and those who received no acupuncture(non-acupuncture)in the year following their diagnosis of diabetes.After 1:1 propensity score matching(PSM),each group had 3350 patients,and the observation ceased at the occurrence of a major adverse cardiovascular event(MACE),which was defined as either myocardial infarction,stroke,or death due to cardiovascular cause.Results After PSM,the acupuncture group had a lower incidence of MACE(hazard ratio[HR]:0.87;95%confidence interval[CI]:0.81-0.94;P=0.0003)and all-cause mortality(HR:0.77;95%CI:0.70-0.84;P<0.0001)than the non-acupuncture group;the HRs for stroke-related mortality(HR:0.75;95%CI:0.56-1.00;P=0.0485),ischemic heart disease mortality(HR:0.53;95%CI:0.34-0.84;P=0.006)and circulatory system disease mortality(HR:0.67;95%CI:0.55-0.82;P<0.0001)were lower in the acupuncture group than in the non-acupuncture group in the secondary analysis.Conclusion Our results indicate that diabetic patients receiving acupuncture treatment might have a lower risk of MACE,all-cause mortality and cardiovascular mortality.This population-based retrospective study suggests beneficial effects of acupuncture in preventing macrovascular complications associated with diabetes.These findings call for further prospective cohort or experimental studies on acupuncture treatment for cardiovascular complications of diabetes.

Moutan Cortex Radicis inhibits the nigrostriatal damage in a 6-OHDA-induced Parkinson's disease model

The traditionally used oriental herbal medicine Moutan Cortex Radicis [MCR; Paeonia Suffruticosa Andrews(Paeoniaceae)] exerts anti-inflammatory, anti-spasmodic, and analgesic effects. In the present study, we investigated the therapeutic effects of differently fractioned MCR extracts in a 6-hydroxydopamine(OHDA)-induced Parkinson's disease model and neuro-blastoma B65 cells. Ethanol-extracted MCR was fractionated by n-hexane, butanol, and distilled water. Adult Sprague-Dawley rats were treated first with 20 μg of 6-OHDA, followed by three MCR extract fractions(100 or 200 mg·kg^(-1)) for 14 consecutive days. In the behavioral rotation experiment, the MCR extract-treated groups showed significantly decreased number of net turns compared with the 6-OHDA control group. The three fractions also significantly inhibited the reduction in tyrosine hydroxylase-positive cells in the substantia nigra pars compacta following 6-OHDA neurotoxicity. Western blotting analysis revealed significantly reduced tyrosine hydroxylase expression in the substantia nigra pars compacta in the 6-OHDA-treated group, which was significantly inhibited by the n-hexane or distilled water fractions of MCR. B65 cells were exposed to the extract fractions for 24 h prior to addition of 6-OHDA for 30 min; treatment with n-hexane or distilled water fractions of MCR reduced apoptotic cell death induced by 6-OHDA neurotoxicity and inhibited nitric oxide production and neuronal nitric oxide synthase expression. These results showed that n-hexane-and distilled water-fractioned MCR extracts inhibited 6-OHDA-induced neurotoxicity by suppressing nitric oxide production and neuronal nitric oxide synthase activity, suggesting that MCR extracts could serve as a novel candidate treatment for the patients with Parkinson's disease.

The effect of acupuncture on mood and working memory in patients with depression and schizophrenia

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. MAIN OUTCOME MEASURES： 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. RESULTS： 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. CONCLUSION： 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.

Traditional Chinese medicine in psychiatry： the fruit-basket-problem

Traditional Chinese medicine （TCM） is gaining popularity in the treatment of psychiatric disorders that can be described and treated from either an Eastern or a Western perspective. In Eastern medicine, the disorders are described according to five diagnostic methods that are used in TCM： inspection, auscultation, olfaction, inquiry, and palpation, including tongue and pulse diagnosis.

Acupuncture treatment of a male patient suffering from long-term schizophrenia and sleep disorders

OBJECTIVE: To investigate the effectiveness of acupuncture in the treatment of chronic schizophrenia and co-morbid sleep disorders.METHODS: A 42-year-old German male outpatient,suffering from long-term schizophrenia and sleep disorders, entered the study. Acupuncture was used as a non-pharmacological intervention. In addition to his ongoing Western Medicine(pharmacological) treatment, the patient received 12 weekly(non-standardized) acupuncture treatments in the clinic. The Traditional Chinese Medicine(TCM) diagnosis, the psychological assessment and the actiwatch data were compared before and after the acupuncture treatment.RESULTS: The TCM diagnosis revealed a Liver Fire pattern before the acupuncture treatment, which was still present, although to a lesser degree, after the treatment. The psychological assessment revealed no change in the positive symptoms, but a small decrease in the negative symptoms and the general psychopathology of the patient. This was further illustrated by the small decrease in the number of depressive symptoms. The subjective sleep disorders improved markedly after acupuncture treatment, but the daytime sleepiness did not. The actiwatch results showed that after acupuncture treatment, the patient was moving less during sleep, but no significant results were found for the other sleep parameters.CONCLUSION: Acupuncture was found to be an effective non-pharmacological add-on method for treating subjective sleep disorders, and, to a lesser degree, objective sleep disorders and the negative symptoms of chronic schizophrenia. Future larger clinical trials with follow-up measurements are needed in order to replicate the present preliminary beneficial acupuncture findings and in order to determine whether the observed effects can be sustained.

Transcranial magnetic stimulation for schizophrenia: potential and risks

Recently, transcranial magnetic stimulation (TMS) has increasingly been used to investigate the neurobiology of schizophrenia. In those studies, researchers applied TMS in combination with motor evoked potentials (TMS/MEPs) and high density electroencephalograms (TMS/hd-EEG)[1].

Schizophrenia and comorbid sleep disorders

Schizophrenia is a severe psychiatric disorder that has a worldwide prevalence of 0.5%^([1])and poses a high cost to society.^([2])The disorder is characterized by positive symptoms,such as hallucinations and delusions,^([3])negative symptoms,such as impaired emotional functioning and behavioral disruptions(e.g.flat affect,difficulty in starting activities and completing them,etc.),^([4])and cognitive symptoms,such as deficits in executive functioning,impaired working memory,and attention problems.