Acupoint catgut-embedding therapy ameliorates DNCB-induced atopic dermatitis in BALB/c mice by regulating Th2 type immune response and reducing infiltration of CD4^(+)and CD8^(+)cells

Background:This study aimed to assess how acupoint catgut-embedding therapy influences Th2-type immune response and the infiltration of CD4^(+)and CD8^(+)cells in DNCB-induced atopic dermatitis in BALB/c mice.It also conducted an initial examination of the underlying molecular mechanisms.Methods:Seventy-two mice were randomly divided into four groups:normal control,DNCB-induced atopic dermatitis model(AD),AD with acupoint catgut-embedding treatment(ADA),and AD with sham-acupoint catgut-embedding treatment.After DNCB challenge to induce AD,the ADA group received acupoint catgut-embedding therapy treatment at Zusanli(ST 36)and Quchi(LI 11)acupoints every other week from day 8.Mice in the AD with sham-acupoint catgut-embedding treatment group underwent the same procedure as the ADA group but without catgut implantation.Severity was assessed using SCORAD on treatment days 1,10,and 20.On day 18,nine mice per group were euthanized,and the remaining on day 28.Histopathological changes were observed using hematoxylin-eosin and immunohistochemistry staining.TNF-α,IL-4,IL-6,and IL-13 levels were analyzed by ELISA,and GATA3 and STAT6 protein levels by western blot.Results:After 20 days of acupoint catgut-embedding therapy treatment,mice showed reduced dermatitis scores compared to DNCB-induced AD-like mice.Significant decreases occurred in serum IL-4,IL-6,IL-13,and TNF-αlevels.Skin analysis revealed marked reductions in CD4^(+)and CD8^(+)cell infiltration,as well as GATA3 and STAT6 protein levels.Conclusion:Acupoint catgut-embedding therapy may effectively alleviate atopic dermatitis by suppressing Th2 immune responses via the STAT6-GATA3 pathway and reducing CD4^(+)and CD8^(+)T cell infiltration in skin lesions.

Meta-analysis of the acupoint application therapy for stable chronic obstructive pulmonary disease

Objective:To systematically evaluate the clinical efficacy and safety of acupoint application in the treatment of stable chronic obstructive pulmonary disease.Methods:A comprehensive search of domestic and international databases,the search time is limited to nearly ten years,collecting traditional Chinese medicine acupoint application in the treatment of chronic obstructive pulmonary disease in stable phase of randomized controlled trials.Literature screening,information extraction and literature quality evaluation were carried out independently by two researchers,and Meta analysis was carried out by Revman software.Results:A total of 42 RCTs with a total of 4192 patients were included.The results of Meta analysis showed that:Compared with the routine treatment of western medicine,the addition of acupoint application therapy can significantly increase the effective rate[RR=1.23,95%CI(1.19,1.27),P<0.00001]and FEV1/FVC[MD=4.46,95%CI(3.17,5.76),P<0.00001].Significantly improved BODE index[MD=-0.63,95%CI(-0.87,-0.40),P<0.00001],SGRQ score[MD=-6.77,95%CI(-9.81,-3.72),P<0.00001],CAT score[MD=-3.33,95%CI(-3.87,-2.79),P<0.00001]and TCM syndrome integral[MD=-3.51,95%CI(-3.96,-3.06),P<0.00001].The differences is statistically significant and the safety profile is good.Conclusion:On the basis of routine treatment of COPD western medicine,acupoint application therapy can significantly improve the clinical symptoms of patients with less adverse reactions.However,due to the limitations of the research,high-quality research is still needed to provide further evidence.

Analysis of the prescription of auricular acupoint therapy for simple obesity based on complex network techniques

Objective： To explore the core acupoints and combination rules of auricular acupoint therapy for simple obesity, and to further analyze the characteristics of the prescription of auricular acupoint therapy for simple obesity.Methods： Relevant clinical study literature in recent 30 years in PubMed, China Biology Medicine disc（CBM）, China National Knowledge Infrastructure（CNKI）, Wan Fang Database. VIP Database and TCM Online Database was retrieved, and eligible articles were selected in order to build a prescription database of auricular acupoint therapy for simple obesity. On the basis of complex network techniques, the core acupoints and combination rules of auricular acupoint therapy for simple obesity were analyzed, and the characteristics of auricular acupoint therapy for simple obesity were analyzed comprehensively.Results： There were 46 network nodes of auricular acupoint. The top 16 core acupoints for auricular acupoint therapy for simple obesity included Nèifēnmì（内分泌CO18）, Pí（脾CO13）, Wèi（胃CO4）, Sānjiāo（三焦CO17）, Jīdiǎn（饥点）.Shénmén（神门TF4）. Dàcháng（大肠CO7）. Pízhìxià（皮质下AT4）. Fèi（肺CO14）. Shèn（肾CO10）. Jiāogǎn（交感AH6 a）, Kǒu（口CO1）,Gān（肝CO12）. Xiǎocháng（小肠CO6） and Nǎo（脑）. The combination of auricular acupoints was mainly based on the main indications of acupoints. The analysis of auricular acupoints combination indicated that the combination of CO4 with CO18 was applied most frequently, which was followed by the combinations of CO13 with CO18 and CO13 with C04. According to the analysis of auricular acupoint stimulation methods, ear point taping and pressing with Wángbùliúxíng（王不留行,Semen Vaccariae） seeds was used frequently, which was followed by magnetic beads taping and pressing and pyonex therapy. Auricular acupoint therapy combined with acupuncture for simple obesity was used most commonly, which was followed by auricular acupoint therapy combined with catgut embedment in acupoint and simple auricular acupoint therapy.Conclusion： In this study, the core acupoints and combinations of auricular acupoint therapy for simple obesity were explored effectively, and the pressing materials and major combined intervention methods were summarized and analyzed, thus providing references and treatment thoughts in terms of the point and prescription selection of auricular acupoint therapy for simple obesity.

Effect of acupoint therapy combined with spine pinching in patients with menopausal syndrome: a randomized controlled trial

OBJECTIVE:To assess the efficacy of acupoint therapy combined with spine pinching in patients with menopausal syndrome.METHODS:This is a parallel,randomized,controlled,investigator-blinded trial.A total of 132 participants were randomly assigned to receive either acupoint therapy combined with spine pinching(intervention group)or tibolone therapy alone(control group).The intervention group received acupoint therapy combined with spine pinching three times per week for 4 weeks.The control group received 2.5 mg of tibolone once daily for 4 weeks.The primary outcome was the improved Kupperman score.The WHO quality of life scale was also used.The secondary aim was to identify those who would benefit from acupoint therapy combined with spine pinching based on the levels of follicle stimulating hormone(FSH)and luteinizing hormone(LH).RESULTS:In the intervention group,the improved Kupperman score was significantly decreased after treatment compared with before treatment.However,there were no differences between the intervention and control groups for any outcome.Changes in the physiology score presented negative outcomes in patients with a low FSH level with increasing body mass index(BMI)(P=0.0).In contrast,changes in the physiology score presented positive outcomes in patients with a moderate LH level with increasing BMI(P=0.0).The mean change in the physiology score of patients with a low FSH level and a BMI of≥25.7 kg/m2 was-7.17(range-10.94 to-3.40)after adjustments for age and disease duration.CONCLUSION:Acupoint therapy combined with spine pinching is effective in treating menopausal syndrome,especially in women with a moderate LH level.However,patients with a low FSH level had a negative outcome after acupoint therapy combined with spine pinching.In addition,patients with a BMI of>25.7 kg/m2 had a negative outcome after the intervention,regardless of hormone levels.

CLINICAL OBSERVATION ON TREATMENT OF ALLERGIC BRONCHIAL ASTHMA WITH ACUPOINT APPLICATION THERAPY

In the present paper, the therapeutic effect of acupoint application of Chinese Materia Medica in the treatment of allergic asthma was observed. The results revealed that topical application of drug paste [mixture of powder of Mahuang (Herba Ephedrae), Xixin (Herba Asari), Baijiezi (Semen Sinapis Albae), etc.] at the acupuncture points could improve symptoms and signs of allergic asthma patients, with the total effective rate being 69.57% (16/23) for the short term effect, and 52.17%(12/23) for the long term effect. In medication (Aminophylline) group, of the 25 cases of allergic asthma, 16 (64.0%) were effective after 4 weeks of treatment, while 6 (24.0%) were still effective that was shown by 6 months’ follow up. The therapeutic effect of acupoint application group was significantly better than that of medication group in the long term effect. Results also showed that no obvious interrelation between the short term therapeutic effect and the duration or the severity of the disease. Results also display that acupoint application therapy is an effective, safe and handy method with fewer side effects for asthma.

CLINICAL OBSERVATION ON THE ACUPOINT INTRADERMAL EMBEDDING OF RINGHEADED THUMBTACK-NEEDLE THERAPY FOR HYPERPLASIA OF MAMMARY GLANDS

In the present paper, the author used acupoint intradermal embedding of ringheaded thumbtack-needle therapy combined with herbal medicine therapy to treat 110 cases of hyperplasia of mammary glands, and compared its therapeutic effect with that of herbal therapy alone. The observed indexes of the treatment were pain relief degree, the size of hyperplasic glands and the time of occurrence of marked effect. Following 3 courses of treatment,the results showed the therapeutic effect of the ringheaded thumbtack-needle needle plus herbal medicine therapy was superior to that of herbal medicine therapy alone in the above-mentioned 3 indexes (P ＜ 0.01 ).

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPOINT APPLICATION OF FAR-INFRARED ASTHMA-RELIEVING PLASTER FOR ASTHMA

Objective To observe the clinical effect of acupoint application of Yuanhongwai Xiaochuankang Plaster （Far-infrared Asthma-relieving Plaster, FIRARP） for prevention and treatment of asthma. Methods Three hundred and sixty-six cases of bronchial asthma were randomly divided into treatment group （n = 185） and control group （n = 181 ）. Patients of treatment group were treated with FIRARP and those of control group treated with external application of traditional ＂Sonfu （Dog-days） moxibustion＂ （herbal-paste-cake separated moxibustion） and acupoints used were Dazhui（大椎 GV14）, Feishu（肺俞BL13）, Tiantu （天突 CV22）, etc. which were given to the patients. Forced expiratory volume in 1 second （FEV1） and peak expiratory flow （PEF） of the pulmonary function were determined and the changes of main symptoms and signs were observed before and after the treatment. Results The pulmonary functions were effectively improved, the symptoms were controlled, and the asthma attack was reduced in the two groups with no significant difference between the two groups （P 〉0.05）. Conclusion There is no significant difference between Yuanhongwai Xiaochuonkong Plaster and traditional ＂Sanfu moxibustion＂ on bronchial asthma. It may substitute for traditional ＂Sonfu moxibustion＂.

THEORY OF OPPOSITE ACUPOINTS AND ITS CLINICAL APPLICATION

In the light of the position character, acupoints situating on the corresponding medial and lateral sides of the limbs or in the front and back parts of the body trunk are called as “opposite acupoints”. In the present paper, the author expounds its theoretical basis from yin-yang theory, investigates its origin from the location of acupoints and ancient clinical application, and introduces its current application in clinical practice. In addition, the author lists 4 typical cases about treatment of hysteric convulsion, pregnant hypertension, child bed-wetting and leucorrhagia with opposite acupoints. Clinical practice demonstrates that opposite acupoints therapy is fewer in taking acupoints for one session of treatment, simple in operation, and good in the therapeutic effect for treatment of various diseases of different systems in the human body.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPOINT INJECTION FOR TREATMENT OF GOUTY ARTHRITIS

In the present paper, 60 cases of gouty arthritis patients were randomly divided into acupuncture group (n=30) and acupoint injection group (n=30). In these two groups, the tender point was used as the main acupoint, combined with Taichong (LR 3), Yinbai (SP 1), Sanyinjiao (SP 6), Juegu (GB 39), Xuehai (SP 10), etc. 10% Chishao (Radix Paeoniae Rubra) Injection and dexamethasone were used for acupoint injection. Results indicated that in acupoint injection and acupuncture groups, 15 (50.0%) and 9 (30.0%) cases had marked improvement, 12 (40.0%) and 10 (33.3%) were effective, and 3 (10.0%) and 11(36.7%) failed in treatment, with the total effective rats being 90.0% and 63.3% respectively. Statistical analysis shows that acupoint injection is significantly superior to simple acupuncture in the therapeutic effect (P<0.05).

A randomized placebo-controlled trial of Chinese medicine acupoint application on gastrointestinal dysfunction after appendectomy

Background:Gastrointestinal dysfunction is one of the common complications of appendectomy,which seriously affects the postoperative recovery and clinical prognosis.Through traditional Chinese medicine acupoint application is suggested for managing postoperative gastrointestinal dysfunction,supporting evidence is weak.Here,the prospective randomized placebo-controlled study was designed to provide high-level evidence regarding whether traditional Chinese medicine acupoint application is effective on the gastrointestinal dysfunction after appendectomy.Methods:A total of 60 patients who underwent appendectomy in Dongfang Hospital Beijing University of Chinese Medicine(Beijing,China)from November 2016 to December 2017 were selected as study objects and randomly divided into control group(n=30)and observation group(n=30).Based on routine postoperative care,the acupoints Zusanli(ST36)and Yongquan(KI1)were selected.The control group was given acupoint application of traditional Chinese medicine placebo and the observation group was given acupoint application of clinical empirical Chinese medicine called Wentongliqi prescription.The course of treatment was performed on the 1st,2nd,and 3rd days after appendectomy,once a day and 4 hours each time.The primary outcome includes the time until the recovery time of bowel sounds(h),the first postoperative flatus(h)and first bowel movement time(h)on the 1st,2nd,and 3rd days after appendectomy.The secondary outcome includes clinical symptom score,life ability score and adverse reactions were observed and recorded on the 1st,2nd,and 3rd days after appendectomy.Results:After treatment,the recovery time of intestinal sound in the observation group was earlier than that in the control group(P<0.05).However,there were no significant difference between the two groups in first anal exhaust time and first bowel movement time,clinical symptom scores and life ability scores between the two groups before and after treatment(P>0.05).Conclusion:Acupoint application therapy has limited effect on the recovery of gastrointestinal dysfunction after appendectomy.Further study with large sample size is needed to confirm its therapeutic effects.

THERMOLYTIC EFFECT OF MOXIBUSTION AND ITS RELATION TO ACUPOINT RECEPTORS

In the present paper, the effect of moxibustion stimulation (by using a computer automaticallycontrolled condensed light) of Dazhui (GV 14) etc. on auricular temperature changes was observed in the rabbit after intravenous injection of endotoxin. Changes of rabbit’s auricular temperature were sampled and recorded by using a thermistorthermometer (connected with a computer) before and after moxibustion stimulation. Results indicated that moxibustion making the skin temperature reach to 48℃ could inhibit the endotoxininduced lowering reaction of auricular temperature, while moxibustion making the skin temperature of 40℃ had no this effect. It revealed that higherskintemperature moxibustion had a thermolytic effect on bodyfever, which had a close relation mainly with polymodal receptors rather than with temperature receptor. It also demonstrated that endotoxininduced changes of auricular temperature could be used as an index for evaluating the thermolytic effect of moxibustion.

CLINICAL OBSERVATION ON TREATMENT OF HICCUP BY ACUPOINT DIGITAL-PRESSING AND MASSAGE

In the present paper, 32 cases of hiccup are treated with acupoint digital pressing and massage. According to syndrome differentiation, hiccup is divided into 5 types including stomach-cold, reversed rising of the stomach-fire, adverse flow of qi and phlegm obstruction, deficiency of both spleen-yang and kidney-yang and insufficiency of the stomach-yin. Acupoints used are Zusanli (ST 36), Neiguan (PC 6), Zhongfu (LU 1), etc. and pressed with fingers repeatedly. Then, massage manipulations are performed by tapping the patient's back repeatedly for 5 - 6 times; tapping Jiuwei (CV 15) area, and pressing the tender-point beside the left side of T3_4 spinous processes and Geshu (BL 17). After treatment, of the 32 cases of hiccup, 23 cases are cured, 6 have remarkable improvement and 3 are failed in treatment, with the effective rate being 90.6% .

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACU-MOXIBUSTION OF DIFFERENT ACUPOINT GROUPS IN STROKE PATIENTS IN CONVALESCENCE STAGE

Objective: To observe and compare clinical therapeutic effect of acupuncture and moxibustion at different acupoint groups in stroke patients in the convalescence stage. Methods: Sixty stroke patients were evenly randomized into yin-meridian group and yang-meridian group. On the basis of the treatment with Chinese and Western medicines, these stroke patients of two groups were treated mainly by acupuncture of acupoints of yin meridians such as Jiquan (极泉HT 1), Tongli (通里HT 5), Neiguan (内关PC 6), etc., and those of yang meridians as Jianyu (NFDA1 LI 15), Quchi (曲池 LI 11), Shousanli (手三里LI 10), etc. respectively. After 30 days’ treatment, the therapeutic effect was evaluated by using American National Institutes of Health Stroke Scale (NIHSS), Hamilton Depression (HAMD) Rating Scale, Mini-Mental State Examination (MMSE), Barthel Index and Activities of Daily Living (ADL) Scale. Results: Following treatment, the therapeutic effect of yin-meridian group was significantly superior to that of yang-meridian group in improving stroke patients’ neurological deficits [Level B: 50% (15/30) vs 20% (6/30)] and ADL [Level Ⅱ: 40% (12/30) vs 13.3% (4/30)]. No significant difference was found between two groups in the neurological impairment domains. Conclusion: Acu-moxibustion of acupoints of yin meridians is superior to acupoints of yang meridians in improving stroke patients’ neurological impairment and daily living activities.

COMMENTS ON THE STUDY OF ACUPOINT COMBINATION AND REMEDIES FOR TREATMENT OF DIABETES MELLITUS WITH ACUPUNCTURE AND MOXIBUSTION

In the present paper, the author reviews the progresses in the study on acumoxi (acupuncture-moxi-bustion) treatment of diabetes mellitus (DM) from Chinese ancient classical works, Chinese and foreign journals. The therapeutic results reveal that acupuncture treatment of DM is effective in improving DM patients' symptoms via vagal-nerve reflex, regulation of neuroendocrine and immune functions. The author holds that ① correct selection of acupoints in accordance with syndrome differentiation and the related meridians and combined application of acupuncture and Chinese herbal medicines (for oral administration) are the key points for raising the therapeutic effect; and ② acupoint combination and curative methods need to be researched further.

Acupoint magnetic therapy in the treatment of spasmodic torticollis

Objective To observe the clinical efficacy of acupoint magnetic therapy for spasmodic torticollis. Methods Twenty patients with spasmodic torticollis were treated by acupoint magnetic therapy at Fengchi （风池 GB 20）, Dazhui （大椎 GV 24） and Shenzhu （身柱 GV 12）. Once a day, ten days as a course of treatment, 24 treatments were given. Results Six cases were cured and 9 cases were markedly effective, 3 cases were effective and 2 cases were ineffective with the cured rate of 30% and the effective rate of 90%. Conclusion Acupoint magnetic therapy has sound effect in the treatment of spasmodic torticollis.

Effects of acupoint thread-embedding therapy on serum apelin and GLP-1 in type 2 diabetes mellitus patients with obesity due to dampness-heat encumbering spleen

Objective:To observe the effects of acupoint thread-embedding therapy on serum apelin and glucagon-like peptide-1(GLP-1)in type 2 diabetes mellitus patients with obesity due to dampness-heat encumbering spleen.Methods:Sixty-six patients were randomly divided into a control group and an observation group according to the random number table method,with 33 cases in each group.Patients in the control group were treated with exenatide and metformin,while patients in the observation group were treated with additional acupoint thread-embedding.After 12-week treatment,the obesity-related indicators,including body mass index(BMI),waist circumference and body fat rate,the glycometabolism indicators,including fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin,and the lipid metabolism indicators,including total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C),as well as serum apelin and GLP-1 levels were observed in patients of the two groups.Results:After treatment,the BMI,waist circumference and body fat rate of patients in the two groups were all reduced(all P<0.05),and were lower in the observation group than in the control group(all P<0.05);the fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin levels of patients in both groups were all decreased(all P<0.05),and were significantly lower in the observation group than in the control group(all P<0.05);the TC level was decreased(P<0.05),while the TG and LDL-C levels did not change significantly in the control group(both P>0.05);the TC,TG and LDL-C levels were all significantly reduced in the observation group(all P<0.05),lower than those in the control group(all P<0.05);the serum apelin level was decreased(P<0.05)and the serum GLP-1 level was increased(P<0.05)in the observation group,statistically different from those in the control group(both P<0.05).Conclusion:Combined with the conventional medication,acupoint thread-embedding therapy can significantly improve the obesity-related indicators,glycometabolism and lipid metabolism in type 2 diabetes mellitus patients with obesity due to dampness-heat encumbering spleen.This may be achieved by regulating the serum apelin and GLP-1 levels.

Treatment of acne vulgaris with auricular acupoint pricking-bloodletting plus auricular point sticking therapy: a randomized controlled study

Objective: To observe the clinical efficacy of auricular point pricking-bloodletting plus auricular point sticking therapy for acne vulgaris. Methods: A total of 66 patients with acne vulgaris were randomized into an observation group and a control group by the random number table, with 33 cases in each group. The observation group was treated with auricular point pricking-bloodletting plus auricular point sticking therapy, and the control group was treated only with auricular point sticking therapy. The treatments of both groups were performed twice a week, 4 weeks as a course of treatment, for 3 courses in total. The scores of skin lesions and dermatology life quality index (DLQI) scores were recorded before and after treatment to assess the clinical efficacy. Results: During the trial, there were 3 cases of drop-out both in the observation group and the control group. After 3 courses of treatment, the total effective rate of the observation group was 96.7%, while that of the control group was 76.7%. The difference between the two groups was statistically significant (P<0.05). The intra-group comparison showed that the scores of skin lesion and DLQI were both decreased with the increase of treatment times, that was, the scores were lower than those at the previous time point (allP<0.05). After 1, 2, and 3 courses of treatment, the scores of skin lesion and DLQI of both groups were statistically different from those of the same group before treatment (allP<0.05). At every time point during the treatment, the scores of skin lesion and DLQI of the observation group were lower than those of the control group, and the differences between the two groups were statistically significant (all P<0.05). Conclusion: Auricular point pricking-bloodletting plus auricular point sticking has a better curative effect than auricular point sticking therapy alone in the treatment of acne vulgaris, and has a time-effect correlation.

Exploration to the disease spectrum of acupoint catgut-embedding therapy

Objective To explore the clinically indicated diseases of acupoint catgut-embedding therapy, and summarize and analyze the disease spectrum of acupoint catgut-embedding therapy. Methods By literature research and data mining technique, the clinical study papers relevant to acupoint catgut-embedding therapy published from 1971 to June 2011 were selected, entered and verified, then the effective information were extracted, and finally, the disease spectrum were summarized. Results Acupoint catgut-embedding therapy is indicated for 103 diseases, involving 6 departments, of which there are 50 internal diseases, which is the most, accounting to 48.54%, and 15 surgical diseases, 12 ENT diseases, 11 gynecological diseases and 11 dermatological diseases, and 4 pediatric diseases, which is the least. Meanwhile, according to the rule of ＂Efficacy acupuncture grading disease spectrum＂, the diseases treated with this therapy were graded preliminarily into grade Ⅰ with 26 diseases, grade Ⅱ with 30 diseases, and grade Ⅲ with 8 diseases. Conclusion Acupoint catgut-embedding therapy can be used widely in clinical treatment with much broader disease spectrum, and it is worthy of being spread and applied.

Acupoint catgut-embedding therapy as promising treatment for non-alcoholic fatty liver disease

Objective:To investigate the effect of acupoint catgut-embedding therapy on non-alcoholic fatty liver disease(NAFLD).Methods:Twenty-three participants were subjected to acupoint catgut-embedding therapy for 3 sessions.The second session was performed one month after the first session and the third session two months after the second session.Three months after the third session of catgut-embedding therapy,the patients were subjected to fibroscan analysis.A total of 20 acupoints were selected in three sessions.Same acupoints were selected for all the patients at the same session but different points were selected at different sessions.Results:Of the 23 participants,5 cases showed significant improvement and 8 cases showed moderate improvement as the steatosis stage was reduced by 1 or 2 degrees.The whole group showed significant improvements in terms of patient score,fat percentage,NAFLD steatosis stage,weight loss and abdominal circumference reduction after acupoint catgut-embedding therapy(all P<0.05).Conclusion:The acupoint catgut-embedding therapy can significantly improve the important factors in patients with NAFLD.

Systematic evaluation on the clinical efficacy of acupoint stimulation therapy for treatment of premature ovarian insufficiency on the basis of network Meta-analysis

Objective To systematically evaluate the effectiveness and safety of acupoint stimulation therapy for treatment of premature ovarian insufficiency（POI）. Methods Computer retrieval was carried out in such databases as Pub Med, Embase, Cochrane Library, web of science, Chinese biomedicine database（CBM）, China National Knowledge Infrastructure（CNKI）, Wan Fang and VIP in order to collect the randomized controlled trials（RCT） concerning acupoint stimulation therapy for treatment of POI. Software R 3.40 and stata 14.0 were used for Meta-analysis and network Meta-analysis, and Rev Man 5.3 was used for plotting the risk bias diagrams. Results Fortythree RCTs were included in total, involving 3046 POI patients and 18 acupoint stimulation therapies and comprehensive therapies. Metaanalysis showed：（1） The curative effects of acupoint stimulation therapy（RR=1.25, 95%CI [1.07,1.45]）, acupoint stimulation therapy＋Chinese herbal medicine（RR=1.25, 95%CI [1.18,1.32]） and acupoint stimulation therapy＋ hormone replacement therapy（HRT）（RR=1.20, 95%CI [1.12,1.29]） were all superior to that of HRT, indicating that the differences were statistically significant（Z=2.90, P=0.04; Z=7.56, P〈0.000 01; Z=4.06, P〈0.000 01）.（2） Compared with HRT, the occurrence rate of adverse effect of acupoint stimulation therapy was lower, and the safety was superior to that of HRT（RR=0.18, 95%CI [0.08,0.41]）, indicating that the differences were statistically significant（Z=4.08, P〈0.000 1）. Forty-two direct comparisons and 110 indirect comparisons were generated according to network Meta-analysis, among which, 38 comparisons were statistically significant. Network Metaanalysis results with HRT as control showed： the therapeutic measures ranking top 3 according to the curative effect sequence were catgut embedment in acupoint, moxibustion and warming-needle moxibustion, successively, and all the 3 measures were monotherapies without reflecting the advantages of comprehensive therapy. HRT ranked 17 th among the 18 included therapeutic measures. Conclusion On the basis of current evidences, acupoint stimulation therapy has a better clinical efficacy and safety for treatment of POI when compared with HRT. The acupoint stimulation therapies ranking the top 3 have more significant curative effects, but the long-term efficacy and the effect on the ovarian function still need to be further explored. In addition, the conclusion of this study still needs to be verified through a large number of RCTs with reasonable designs and appropriate methods.