RANDOMIZED CONTROL STUDY ON DEPRESSION INDUCED BY CHRONIC PAIN TREATED WITH ACUPUNCTURE

Objective To study and verify the efficacy of acupuncture on depression caused by chronic pain and to further analyze the advantages of acupuncture. Methods According to random number table, the cases were randomized into experimental group and western medicine group, treated with acupuncture and antidepression drug （deanxit） respectively. Hamilton Depressive Scale （HAMD） and Visual Analogue Scale （VAS） were adopted for the evaluation before treatment and in the 1, 2 and 4 weeks after treatment in two groups successively. Results ① Very significant differences had been achieved on the comparisons of HAMD, VAS and HAMD reducing rate before and after treatment in experimental group （P 〈 0.01）. Very significant differences had been achieved in the comparisons of HAMD, VAS and HAMD reducing rate before and after treatment in western medicine group （P 〈 0.01 ）. ③Significant differences in HAMD reducing rate^＊ and VAS score^＊ ＊ had been achieved in the comparison between experiment group and western medicine group 1 week after treatment （^＊ P〈0.01, ^＊ ＊ P〈0.05）. ④ The significant differences had not been received in HAMD, VAS score and HAMD reducing rate in 2 and 4 weeks after treatment in the comparison between experimental group and western medicine group （P 〉0.05）. ⑤ No any harmful effect happened in experimental group after treatment, but it happened in western medicine group. Conclusion Both acupuncture and deanxit have achieved the definite therapeutic effects on depression caused by chronic pain, with similar efficacy. But the effects of acupuncture are obtained more quickly. In comparison of western medicine, acupuncture has no side and harmful effect. Additionally, acupuncture applies the multi-targeting and holistic modulation to the whole body.

Acupuncture and moxibustion for visceral pain

Totally three articles focusing on"analgesic action of suspended moxibustion effect in visceral hypersensitivity rats with irritable bowel syndrome,and changes in prokineticin 1 and prokineticin receptor 1 expression in the spinal cord,enkephalins in the spinal cord and prokineticin-1 and prokineticin receptor-1 in the colon tissue during the analgesic progress"were

Acupuncture Treatment of Abdominal Pain

Case History Mr. Li, a university student aged 23 years, paid his first visit on July 16, 2001, with the chief complaint of abdominal pain for one day. The patient stated that one day before when it happened to be the weekend, he got abdominal pain after supper, which went worse gradually and caused him to roll all over in bed. The pain was slightly alleviated half an hour later after he had taken some pain killers. Upon inquiry, the patient said that because of their newly graduation from the university, he and his classmates were so excited that they went to have a sumptuous lunch with alcoholic drinks. And in the evening he ate again a delicious supper cooked for him by his mother, after which he continued to have some fruit and dessert.

THE ROLE OF CONNEXIN 43 GENE IN ACUPUNCTURE ANALGESIA

Objective To and connexin 43. Methods investigate the possible relationship between the analgesic effect of acupuncture Connexin 43 gene knock-out mice were randomly divided into 4 groups： a wide type （WT） control group, a WT acupuncture group, a heterozygous （HT） control group and HT acupuncture group. Hot-plate test and writhing response induced by acetic acid were used for investigating the different analgesic effect of acupuncture on HT and WT mice. Results There was no significant difference in the basic pain threshold value between HT and WT mice （P 〉0.05）. Acupuncture could significantly increase the pain threshold value, prolong the latency period of writhing body and decrease the number of writhing body as compared with pre-acupuncture in WT and HT mice （P 〈 0.01 or P 〈 0.05）. The pain threshold, latency period of writhing and number of writhing body in HT mice were less than WT mice post-acupuncture （P〈0.05）. Conclusion Connexin 43 gene knock-out might partially inhibit the analgesic effect of acupuncture, suggesting that connexin 43 is possibly related with meridians and the effect of acupuncture.

RELATIONSHIP BETWEEN ACUPUNCTURE ANALGESIA AND MET-ENKEPHALIN OR DYNORPHIN

subjective: The effect of 4～5 Hz electroacupuncture (EA) on alterations of both met enkephalin (MEK) and dynorphin (Dyn) in the patient plasma or mouse spinal cord and its relation with analgesic effect were studied.Methods: In acupuncture clinic 10 patients with acute pain were treated with 4 Hz EA at Zusanli(ST 36) and/or Hegu(LI 4) acupoints for 30 min. 20 BALB/C mice were randomly divided into 2 groups: a. EA group(n=10), treated with 4～5 Hz EA at bilateral “Zusanli"(ST 36) for 15 min; b. control group(n=10) treated with no EA, but also restrained for 15 min. Before and after EA or restraining acupoints, the pain threshold of the patients or mice was detected. 10 μl of the patient plasma before and after EA and each mouse spinal cord suspension, of the 2 groups were blotted onto nitrocellulose membrane (NCM) respectively. The protein dot blot signals were detected by immunoreactivity (IR) and using Shimadu TLC Scanner and analyzed statistically. Results: The results showed that an increase in patient plasma MEK IR or Dyn IR and a decrease in mouse spinal MEK IR or Dyn IR could be detected, and the alteration of plasma or spinal MEK IR was more significant than that of plasma or spinal Dyn IR. There was a positive correlation in alteration between plasma or spinal MEK IR and plasma or spinal Dyn IR with respective parallel levels in individuals. The increased plasma MEK IR or the decreased spinal MEK IR was positively or negatively correlated with the analgesic effect, while the correlation between plasma or spinal Dyn IR and analgesic effect was insignificant. Conclusion: The results suggest that under lower frequency EA the met enkephalin may play an important role in analgesia.

Clinical efficacy observation of thalamic pain treated with acupuncture under the guidance of evidence-based medicine

Objective To study the feasibility of the crossover trial design and the minimal imbalance index random distribution method in the clinical small-sample-size randomized controlled trial（RCT） research of thalamic pain treated with acupuncture under the guidance of evidence-based medicine（EBM）.Methods The crossover trial design was adopted.Eleven cases with the definite diagnosis were randomized into a program-I group（6 cases,treated with acupuncture before western medicine） and a program-II group（5 cases,treated with western medicine before acupuncture） according to the minimal imbalance index method.In the statistical analysis,the groups were named as an acupuncture group and a western medicine group separately,11 cases in each one.Acupuncture was applied to Xìmén（郄门 PC 4）,Yīnxì（阴郄 HT 6）,Xuèhǎi（血海 SP 10）,etc.In the control treatment,Carbamazepine was prescribed for oral administration.Either the duration of treatment or the wash-out period was 10 days.The visual analogue scale（VAS） was adopted for the efficacy assessment.Results The total effective was 100.0%（11/11） after treatment in either group.The remarkably effective rates were 63.6%（7/11） and 36.4%（4/11） in the acupuncture group and the western medicine group separately,without statistically significant difference in comparison.Conclusion The crossover trial design and the minimal imbalance index distribution method can accomplish RCT of the clinical acupuncture and moxibustion research with the small sample size involved.They can provide the high-quality evidences for clinical acupuncture research.Acupuncture therapy can achieve the same therapeutic effect as Carbamazepine,the common western medicine,and the efficacy of it is potentially superior to that of western medicine.

Effectiveness of bee venom acupuncture in alleviating post-stroke shoulder pain: a systematic review and meta-analysis

BACKGROUND：Shoulder pain is a common complication of stroke.Bee venom acupuncture（BVA）is increasingly used in the treatment of post-stroke shoulder pain.OBJECTIVE：To summarize and evaluate evidence on the effectiveness of BVA in relieving shoulder pain after stroke.SEARCH STRATEGY：Nine databases,namely MEDLINE,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure（CNKI）,the Japan Science and Technology Information Aggregator,Electronic（J-STAGE）,and four Korean medical databases,namely,the National Assembly Library,the Research Information Service System,the National Discovery for Science Leaders,and OASIS,were searched from their inception through August 2014 without language restrictions.INCLUSION CRITERIA：Randomized controlled trials（RCTs）were included if BVA was used at acupoints as the sole treatment,or as an adjunct to other treatments,for shoulder pain after stroke.DATA EXTRACTION AND ANALYSIS：Two review authors independently selected trials for inclusion,assessed methodological quality and extracted data.RESULTS：A total of 138 potentially relevant articles were identifi ed,4 of which were RCTs that met our inclusion criteria.The quality of studies included was generally low,and a preponderance of positive results was demonstrated.All four trials reported favorable effects of BVA on shoulder pain after stroke.Two RCTs assessing the effects of BVA on post-stroke shoulder pain,as opposed to saline injections,were included in the meta-analysis.Pain was signifi cantly lower for BVA than for saline injections（standardized mean difference on 10-cm visual analog scale：1.46 cm,95%CI=0.30–2.62,P=0.02,n=86）CONCLUSION：This review provided evidence suggesting that BVA is effective in relieving shoulder pain after stroke.However,further studies are needed to confi rm the role of BVA in alleviating post-stroke shoulder pain.Future studies should be conducted with large samples and rigorous study designs.

Clinical Study on Extracorporeal Shock Wave Therapy plus Electroacupuncture for Myofascial Pain Syndrome

Objective: To observe the clinical effect of extracorporeal shock wave plus electroacupuncture(EA) on myofascial pain syndrome(MPS) and to investigate its treatment mechanism. Methods: Ninety cases who met the inclusion criteria were randomly allocated into an EA group, an extracorporeal shock wave therapy(ESWT) group and a combined therapy group, 30 in each group. EA was employed in the EA group, extracorporeal shock wave therapy in the ESWT group and EA plus extracorporeal shock wave therapy in the combined therapy group. The VAS, tenderness threshold and therapeutic efficacy were evaluated after three months of treatment. Results: After 2 weeks, 4 weeks and 3 months of treatment, the VAS scores in all three groups were significantly reduced and the tenderness threshold significantly elevated. The recovery rate and total effective rate were 23.3% and 83.3% respectively in the EA group, versus 40.0% and 90.0% in the ESWT group and 63.3% and 96.7% in the combined therapy group, showing statistical differences(P<0.05). Conclusion: EA combined with EWST works remarkably well for MPS.

Acupuncture in Preterm Babies during Minor Painful Procedures

Objective: To evaluate analgesic effects of acupuncture in preterm neonates during minor painful procedures. Methods: Ten preterm neonates requiring heel prick for blood gas analysis were enrolled in the study, which had a crossover design. Oxygen saturation, systolic and diastolic blood pressure, respiratory rate, heart rate, and crying duration were recorded before and after heel prick. Babies were given expressed breast milk before each procedure. Patients were randomly assigned to receive acupuncture or not, and the groups were crossed over on the following day, so that patients who had received acupuncture received only breast milk, and the previous breast milk only group received both acupuncture and breast milk. The neonatal infant pain scale (NIPS) was used for pain evaluation. Results: Crying duration and NIPS pain scores during heel prick were lower in the neonates who had received acupuncture. Conclusion: Acupuncture is an effective method for the treatment of pain in neonates.

DESIGNING A FEASIBILITY STUDY ON THE USE OF ACUPUNCTURE FOR PHANTOM LIMB PAIN

People with diabetes are 30 times more likely to undergo amputation than the general population.A total of 3.2million people in the UK have been diagnosed with diabetes and by 2025 this number is estimated to be 5million.One potential complication post amputation is phantom limb pain(PLP),a prevalent and often chronic condition which is difficult to treat.To inform a

The methodology flaws in Hinman's acupuncture clinical trial, Part Ⅲ: Sample size calculation

In the October 2014 publication of JAMA,Dr.Hinman and colleagues published the study＂Acupuncture for Chronic Knee Pain：A Randomized Clinical Trial,＂in which the authors concluded that＂in patients older than50 years with moderate or severe chronic knee pain,neither laser nor needle acupuncture conferred benefi t over sham for pain or function.Our fi ndings do not support acupuncture[1]

Acupuncture Treatment for Idiopathic Trigeminal Neuralgia:A Longitudinal Case-Control Double Blinded Study

Objective： To evaluate the treatment effect of acupuncture on patients with idiopathic trigeminal neuralgia（ITN） by case-control longitudinal blinded study. Methods： Sixty ITN patients and 30 healthy subjects were included. The ITN patients were randomly assigned to acupuncture group（15 cases）, sham-acupuncture group（15 cases） and carbamazepine group（30 cases）, respectively. Clinical orofacial evaluation（including pain intensity and medication doses）, research diagnostic criteria for temporomandibular disorders（RDC/TMD） and Helkimo indexes（for functional evaluation of the masticatory system）, and quantitative sensory testing for sensory thresholds（gustative, olfactory, cold, warm, touch, vibration and superficial and deep pain） were evaluated before treatment, immediately after treatment, and 6 months after treatment. Results： The mean pain intensity by the Visual Analogue Scale only decreased in the acupuncture group at the last evaluation（P=0.012）. Patients in the sham-acupuncture group had an increase in carbamazepine doses according to the prescriptions（P〈0.01）. There was a reduction in secondary myofascial pain and mandibular limitations at the acupuncture and sham-acupuncture groups, however only the acupuncture group kept the changes after 6 months（P〈0.01, P=0.023）. There was a decrease in mechanical thresholds in the acupuncture group（tactile, P〈0.01; vibration, P=0.027） and an increase in deep pain thresholds in both acupuncture and sham-acupuncture groups（P=0.013）. Conclusion： Acupuncture can be an option in the treatment of ITN due to its analgesic effect in both ITN and secondary myofascial pain associated with it.

Therapeutic Observation of Point-towards-point Electroacupuncture for Cervical Spondylotic Radiculopathy

Objective: To compare the therapeutic efficacies of point-towards-point electroacupuncture(EA), EA with Jiaji points(EX-B 2), and Jing Fu Kang in treating cervical spondylotic radiculopathy(CSR), and to explore the optimal treatment protocol. Methods: Totally 160 patients with CSR were randomized into three groups: a point-towards-point group(n=60) treated with EA with point-towards-point method; a Jiaji group(n=60) treated with EA at cervical Jiaji(EX-B 2) points; a medicine group(n=40) treated with oral administration of Jing Fu Kang alone. The clinical efficacies were compared afterwards. Results: After treatment, the recovery rate and total effective rate of the point-towards-point group were significantly better than that of the Jiaji group and medicine group(both P<0.01). After 1-week treatment, the symptom and function score of the point-towards-point group was significantly better than that of the Jiaji group and medicine group(both P<0.01); the point-towards-point group and Jiaji group both achieved significant improvements in the symptom and function score(P<0.01, P<0.05). After 2-week treatment, the three groups all achieved marked improvements in the symptom and function score(P<0.01). At the end of treatment, in comparing the symptom and function score, the point-towards-point group was significantly different from the medicine group(P<0.01) and Jiaji group(P<0.05); the difference between the Jiaji group and medicine group was also statistically significant(P<0.05). Conclusion: Point-towards-point EA can rapidly improve the symptoms and function of CSR patients, and it's superior to EA at Jiaji(EX-B 2) and oral administration of Jing Fu Kang in comparing the clinical efficacy.

Clinical Study on Treatment of Cervical Spondylotic Radiculopathy by Electroacupuncture plus Tuina

Objective: To observe the clinical effects of electroacupuncture(EA) plus tuina for cervical spondylotic radiculopathy. Methods: One hundred and twenty cases with cervical spondylotic radiculopathy were divided randomly by the digital table into the observation group and control group. The patients in an observation group were treated by EA plus tuina techniques. The patients in the control group were treated by simple tuina techniques. Results: The total effective rate was 91.7% in the observation group and 78.3% in the control group. The effective rates in the two groups were statistically different(P<0.05). Conclusion: EA plus tuina therapy is better than simple tuina therapy in the treatment of cervical spondylotic radiculopathy.

Effect of Electroacupuncture Combined with Tuina on Lumbar Muscle Tone in Patients with Acute Lumbar Sprain

Objective: To observe the clinical effect of electroacupuncture(EA)combined with tuina on acute lumbar sprain and lumbar muscle tone before and after treatment. Methods: A total of 130 acute lumbar sprain cases were randomly allocated into an observation group and a control group, 65 in each group. Cases in the observation group were treated with EA combined with tuina, whereas cases in the control group were treated with Diclofenac Sodium Dual Release Enteric-coated capsules. The muscle tones in two groups were tested before and after treatment. Results: The recovery rate and overall response rate in the observation group were 66.2% and 93.8% respectively, versus 56.9% and 87.7% in the control group, showing no between-group statistical significances(P>0.05). After treatment, the force-displacement area under curve(AUC) in both groups showed a significance difference(P<0.05). Conclusion: Both EA combined with tuina and aforementioned oral medication have remarkable effects for acute lumbar sprain, and the former can better improve the lumbar muscle tone in patients with acute lumbar sprain.

Contralateral Needling Method and Its Applications in Treating Upper-limb Pain

Contralateral Needling is an ancient needling method recorded in Nei Jing （Inner Canon）. It said in the Guan Zhen chapter of Ling Shu （chapter of needling technique of Spiritual Pivot） that contralateral needling is to needle the points on contralateral side to the affected side of the body.

Curative effect of scraping therapies on lumbar muscle strain

OBJECTIVE:To explore factors influencing the curative effect of scraping therapies (at acupoints or along channels) and to determine the relationship of scraping site and strength to curative effect. METHODS: Two hundred and ten patients with lumbar muscle strain were divided into five groups with 42 patients each.The "scraping therapy at acupoint until appearance of skin eruptions" and "scraping therapy along channel until appearance of skin eruptions" groups were treated with a 4-daycourse. The "scraping therapy at acupoint without appearance of skin eruptions", "scraping therapy along channel without appearance of skin eruptions", and acupuncture groups were treated with a 2-day course.The five groups were treated with seven courses. The visual analog scale (VAS), oswestry disability index (ODI), and lumbago scores were recorded in the five groups before treatment, after each treatment, and in follow-up visits one month and three months after treatment. RESULTS: VAS, ODI, and lumbago scores after treatment improved in the five groups (P<0.01). There was a statistical difference (P<0.01) in the change of VAS scores by appearance of skin eruptions and scraping site. CONCLUSION: Scraping therapy can effectively alleviate lumbago symptoms. The appearance of skin eruptions and scraping therapy along channels can enhance the curative effect of scraping therapy.