Early filiform needle acupuncture for poststroke depression: a meta-analysis of 17 randomized controlled clinical trials

OBJECTIVE： To evaluate the effectiveness and safety of filiform needle acupuncture for poststroke depression, and to compare acupuncture with the therapeutic efficacy of antidepressant drugs. DATA RETRIEVAL： We retrieved data from the Chinese National Knowledge Infrastructure （1979-2012）, Wanfang （1980-2012）, VIP （1989-2012）, Chinese Biomedical Literature （1975- 2012）, PubMed （1966-2012）, Ovid Lww （-2012）, and Cochrane Library （-2012） Database using the internet. SELECTION CRITERIA： Randomized controlled trials on filiform needle acupuncture versus antidepressant drugs for treatment of poststroke depression were included. Moreover, the in- cluded articles scored at least 4 points on the Jadad scale. Exclusion criteria： other acupuncture therapies as treatment group, not stroke-induced depression patients, score 〈 4 points, non-ran- domized controlled trials, or animal trials. MAIN OUTCOME MEASURES： These were the Hamilton Depression Scale scores, clinical ef- fective rate, Self-Rating Depression Scale scores, Side Effect Rating Scale scores, and incidence of adverse reaction and events. RESULTS： A total of 17 randomized controlled clinical trials were included. Meta-analysis results displayed that after 4 weeks of treatment, clinical effective rate was better in patients treated with fill- form needle acupuncture than those treated with simple antidepressant drugs [relative risk = 1.11, 95% confidence interval （C/）： 1.03-1.21, P = 0.01]. At 6 weeks, clinical effective rate was similar between filiform needle acupuncture and antidepressant drug groups. At 2 weeks after filiform needle acupuncture, Hamilton Depression Scale （17 items） scores were lower than in the antide- pressant drug group （mean difference = -2.34, 95%CI： -3.46 to -1.22, P 〈 0.000,1）. At 4 weeks, Hamilton Depression Scale （24 items） scores were similar between filiform needle acupuncture and antidepressant drug groups. Self-Rating Depression Scale scores were lower in filiform needle acupuncture group than in the antidepressant drug group. Side Effect Rating Scale was used in only two articles, and no meta-analysis was conducted. Safety evaluation of the 17 arti- cles showed that gastrointestinal tract reactions such as nausea and vomiting were very common in the antidepressant drug group. Incidence of adverse reaction and events was very low in the filiform needle acupuncture group. CONCLUSION： Early filiform needle acupuncture for poststroke depression can perfectly con- trol depression. Filiform needle acupuncture is safe and reliable. Therapeutic effects of filiform needle acupuncture were better than those of antidepressant drugs.

Filiform needle acupuncture for poststroke depression

To the editor, I read with interest the recent report on ＂filiform needle acupuncture for poststroke depression＂ （Zhang et al., 2014）. Zhang et al. （2014） performed a meta-analysis and conclud- ed that ＂early filiform needle acupuncture for poststroke depression can perfectly control depression：＇ In fact, the in- cluded meta-analysis might support the clinical effectiveness of filariform needle acupuncture for poststroke depression. However, there are several concerns. First, the hospital infection due to acupuncture manipulation with filiform is a big topic to be addressed. As Gang et al. （2012） noted, ＂aseptic technic principles aren＇t strictly followed; disinfection and isolation systems are unsound;

Study of Mongolian Warming Needle Acupuncture Therapy

The Mongolian warming needle acupuncture therapy is a Mongolian traditional external treatment method that uses special silver needles to insert specific acupoints on the human body,and then stimulates them with warm acupuncture to achieve the purpose of disease prevention and treatment.This paper reviewed the theoretical basis,acupuncture methods,acupuncture classification,acupuncture tools,acupuncture points,indications,and contraindications of Mongolian acupuncture.Besides,it also summarized the clinical application of the Mongolian warming needle acupuncture therapy.In addition,it elaborated the its principle of regulating cold and heat in the body,leading the disease out,dialectically coordinating the whole,and changing the local part,highlighting its important position in medicine,so as to better promote clinical practice.

Observation on the Curative Effect of"Hand and Foot 12 Needle Acupuncture"on Stroke in Convalescent Period of Phlegm-Dampness Constitution

Objective:To observe the clinical effects of"hand and foot 12 needle acupuncture"on stroke in convalescent period of phlegm-dampness constitution.Methods:The 90 patients were divided into the treatment group(n=45)and the control group(n=45)according to the random number table method.The control group received basic Western medicine treatment+rehabilitation treatment of Western medicine,and the treatment group was additively treated with"hand and foot 12 needle acupuncture"on the basis of the control group.NIHSS score,MRS score and Barthel index(BI)before and after treatment were observed in the two groups,and the clinical efficacy of the two groups was compared.Results:The clinical efficacy of stroke patients in the convalescent period of phlegm-dampness constitution after treatment:the total effective rate of the treatment group was 93.33%,and the total effective rate of the control group was 66.67%.After statistical processing,the clinical efficacy of the treatment group was significantly better than the control group;NIHSS score,MRS score and Barthel index(BI)were better than the control group,and the differences were statistically significant(P<0.05).Conclusion:"Hand and foot 12 needle acupuncture"treatment of phlegm-dampness constitution convalescent stroke clinical effect is remarkable.

Clinical study on fire needle acupuncture treating irregular menstruation with spleen deficiency syndrome

Objective:To observe the clinical efficacy of fire needle acupuncture in treating irregular menstruation with spleen deficiency syndrome.Methods:60 patients with spleen deficiency-irregular menstruation were randomly divided into treatment group and control group of 30 each.In the treatment group,fire needle acupuncture was used to insert into Guanyuan,Qihai,Pishu,Sanyinjiao,Zusanli and Taibai points,while the filiform needle was used to needle the corresponding acupoints in the control group.After 8 weeks of treatment,menstrual cycle,menstrual period,menstrual volume,irregular menstrual symptom score and spleen deficiency symptom score were recorded.Results:Both treatments could effectively improve the menstrual cycle,menstrual period and menstrual volume,but there was no statistical significance between the two groups(P>0.05).Both treatments were effective in regulating the symptoms of menstruation,and fire needle acupuncture was better than filiform needle(P<0.05).Both treatments relieved the symptoms of spleen deficiency,and fire needle acupuncture was better than filiform needle(P<0.05).In terms of overall curative effect,the curative effect of fire needle acupuncture therapy was significantly better than filiform needle therapy,and the difference was statistically significant(P<0.05).Conclusion:Fire needle acupuncture therapy could effectively regulate menstrual volume of patients with irregular menstruation of spleen deficiency syndrome,and relieve the symptoms of traditional Chinese medicine.

Clinical Research Progress of Fire Needle Acupuncture in the Treatment of Alopecia Areata

Alopecia areata is a common disease in dermatology.It is a localized non-inflammatory alopecia that occurs in the head.Its etiology is unclear,but it is thought to be related to a number of factors.At present,there are many methods of treatment with different curative effects.Fire needle acupuncture directly acts on skin lesions,dredges meridians,and regulates Qi and blood.It has a good curative effect.This paper reviews current research progress of fire acupuncture in the treatment of alopecia areata,in order to provide some diagnostic and treatment suggestions for the management of alopecia areata.

Filiform needle acupuncture for allergic rhinitis:A systematic review and meta-analysis

Background:Filiform needle acupuncture(FNA),the most classical and widely applied acupuncture method based on traditional Chinese medicine theory,has shown a promising effect in the treatment of allergic rhinitis(AR).Objective:To evaluate the efficacy,safety,cost-effectiveness,and patient preference of FNA in the treatment of AR by comparing FNA with sham acupuncture,no treatment,and conventional medication.Search strategy:Eight electronic databases were systematically searched from inception to October 14,2021.Additional studies were acquired from clinical trial registration platforms and reference lists.Inclusion criteria:Randomized controlled trials were included if they compared FNA with either sham acupuncture,no treatment or conventional medication for AR.Data extraction and analysis:Two researchers extracted data independently of each other using a predesigned data acquisition form,and results were cross-checked after completion.The primary outcome was symptom score(Total Nasal Symptom Score or Visual Analogue Scale),and the secondary outcomes were the AR control questionnaire,quality of life(QoL)score(Different versions of Rhinoconjunctivitis Quality of Life Questionnaire),medication score(use of rescue medication),mental health score,total IgE,adverse event rate,clinical economic indicators,and patient satisfaction score.Standardized mean difference(SMD)or mean difference(MD)with 95% confidence interval was used to calculate the effect size for continuous data,while risk ratio with 95%CI was used for dichotomous data.Results:Thirty studies were included in this review.Compared with sham acupuncture,FNA significantly reduced the symptom score(SMD:-0.29[-0.43,-0.15]),AR’s impact on QoL(SMD:-0.23[-0.37,-0.08])and medication score(SMD:-0.3[-0.49,-0.11]).Compared with no treatment,FNA dramatically reduced the symptom score(SMD:-0.8[-1.2,-0.39])and AR’s impact on QoL(SMD:-0.82[-1.13,-0.52]).There were no increased rates of adverse events with FNA compared to sham acupuncture and no treatment.FNA increased patient satisfaction and may be cost-effective.Most pieces of evidence from the above two comparisons were of high confidence.Moreover,FNA significantly outperformed conventional medication in reducing the symptom score(SMD:-0.48[-0.85,-0.1])and displayed a lower rate of adverse events,but the quality of evidence was very low.Conclusion:FNA is an effective and safe intervention for AR and can help with symptom relief,QoL improvement,reducing medication usage,and increasing patient satisfaction.Further studies are needed to verify its cost-effectiveness and superiority over conventional medication and the best therapeutic strategies.

Ureteral calculi secondary to a gradually migrated acupuncture needle

We herein presented a case of calculi secondary to a migrated acupuncture needle.A 74-year-old woman with a history of acupuncture therapy for lumbago was referred to our hospital for treatment of ureteral and renal pelvic calculi.Abdominal multi-detector computed tomography scans showed ipsilateral hydronephrosis and two calculi secondary to a migrated acupuncture needle.First,a percutaneous nephrolithotomy was performed to extract two calculi and fine needle fragments from the pelvis.Subsequently,residual needle fragments and calculi in the ureter were then removed by flexible transurethral lithotripsy using a holmium laser.In the present case,the formation of the calculi was caused by a migrated acupuncture needle.Calculi and needle fragments were removed safely endoscopically because the whole calculi and needle fragments were located in the ureteral lumen.ª2021 Editorial Office of Asian Journal of Urology.Production and hosting by Elsevier B.V.This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).

Continuous Separation of Multiple Size Microparticles using Alternating Current Dielectrophoresis in Microfluidic Device with Acupuncture Needle Electrodes

The need to continuously separate multiple microparticles is required for the recent development of lab-on-chip technology. Dielectrophoresis（DEP）-based separation device is extensively used in kinds of microfluidic applications. However, such conventional DEP-based device is relatively complicated and difficult for fabrication. A concise microfluidic device is presented for effective continuous separation of multiple size particle mixtures. A pair of acupuncture needle electrodes are creatively employed and embedded in a PDMS（poly-dimethylsiloxane） hurdle for generating non-uniform electric field thereby achieving a continuous DEP separation. The separation mechanism is that the incoming particle samples with different sizes experience different negative DEP（n DEP） forces and then they can be transported into different downstream outlets. The DEP characterizations of particles are calculated, and their trajectories are numerically predicted by considering the combined action of the incoming laminar flow and the n DEP force field for guiding the separation experiments. The device performance is verified by successfully separating a three-sized particle mixture, including polystyrene microspheres with diameters of 3 μm, 10 μm and 25 μm. The separation purity is below 70% when the flow rate ratio is less than 3.5 or more than 5.1, while the separation purity can be up to more than 90% when the flow rate ratio is between 3.5 and 5.1 and meanwhile ensure the voltage output falls in between 120 V and 150 V. Such simple DEP-based separation device has extensive applications in future microfluidic systems.

The effect of laser acupuncture on hypoxia tolerance and inflammation reaction in mice with optical fiber acupuncture needle intra body

Hypoxia is a disorder in which the tissues are not oxygenated adequately.The lack of oxygen may cause irreversible damage to the major organs such as the brain,heart and lungs.In severe cases,coma,seizures,and death may happen.In addition to the routine medication,acupuncture.treatment has been applied as a complementary treatment to counter hypoxia.In this paper,the optical fiber acupuncture needle was fabricated using the optical fiber imbedding into the metal capillary tube with needle tip,therefore made it easy to insert into the body for the laser treatment.The laser optical fiber needle treatment to the ST36 acupoint conducted with the laser.irradiation intra body.The normobaric hypoxia tolerance test results in mice show that the optical fber needle treatment to the ST36 acupoint with laser acupuncture appears to improve the tolerance to hypoxia.The mice treated with laser acupuncture expressed high level of IL-1βin serum.Our results suggest that laser optical fiber needle acupuncture may serve as a potential treatment for hypoxia.

CHINESE HUAI TANG NINE ACUPUNCTURE NEEDLES: RESEARCH ON THE NEW NINE ACUPUNCTURE NEEDLES THERAPY AND THE NEEDLING INSTRUMENTS (CONTINUED)

PART TWOThe Research on Chinese Huai TangNine Acupuncture Needles TherapyI The theoretical basis of ChineseHuai Tang Nine Needles Therapy.1) The kernel of the theoretical basis ofChinese Huai Tang Nine Needles Therapy.Chinese Huai Tang Nine Needles Therapyis to give full play to the treatment action of thespecifity and entirety of each needle. The speci-fity means that each needle has its own

Practice and Evaluation : Management of Acupuncture Needle Disinfection and Sterilization

Objective： To investigate the necessity and importance of enhancing the sterilization management of acupuncture needles. Methods： Traditionally, acupuncture needles were cleaned manually without thermal disinfection, which often caused needle-stick injuries. To solve the problems, a special cleaning case for acupuncture needles was designed and built to help achieve optimization of the processing flow if the case is used correctly in the process of recycling, cleaning, and package checking. Results： Closed treatment of acupuncture needles reduced the percentage of needle-stick injuries to zero, and centralized management raised patients＇ satisfaction rate from 93% to 98%. Conclusions： Effective sterilization of acupuncture needles is a precondition for the safe treatment of patients. Optimization of the processing flow can ensure the safety of medical personnel and patients; safety is stipulated by relevant regulationsconcerning sterilization and disinfection standards.

Meta-analysis of Clinical Efficacy of Warm Needling Acupuncture in the Treatment of Lumbar Disc Herniation

[Objectives]To evaluate the efficacy of warm needling acupuncture in the treatment of lumbar disc herniation(LDH)by Meta-analysis.[Methods]Randomized controlled trial of warm needling acupuncture in the treatment of lumbar disc herniation published from January 2000 to December 2021 was searched by Cochrane Library,PubMed,VIP,CNKI and Wanfang.After the quality evaluation of the literature,the Meta-analysis of the literature was carried out by using Review Manager 5.3.[Results]A total of 10 studies were included,involving a total of 980 patients.The results of Meta-analysis showed that warm needling acupuncture in the treatment of lumbar disc herniation could improve the total clinical effective rate,OR=5.38,95%CI(3.40,8.49),P<0.00001;decrease the VAS score,MD=-3.33,95%CI[-4.53,-2.12],z=5.42(P<0.00001);increase the JOA score,MD=-5.63,95%CI[-8.12,-3.14];improve the dysfunction,MD=-5.63,95%CI[-8.12,-3.14],z=4.43(P<0.00001);decrease inflammatory factors,MD=-11.09,95%CI[-13.60,-8.58],z=8.65(P<0.00001).And the recurrence rate was low,OR=0.33,95%CI[0.15,0.70],z=2.86(P=0.004).[Conclusions]Warm needling acupuncture could effectively treat lumbar disc herniation and relieve pain symptoms.However,due to the general poorness of literature quality and the low quality of evidence,high-quality randomized controlled trials are still needed.

Clinical Observation of Warm Needling Acupuncture of Mongolian Medicine in the Treatment of Lumbar Disc Herniation

[Objectives]To observe the clinical efficacy of warm needling acupuncture of Mongolian medicine in the treatment of lumbar disc herniation(LDH).[Methods]120 patients with lumbar disc herniation hospitalized in Inner Mongolia International Mongolian Hospital from June 2019 to June 2022 were randomly divided into observation group(n=60)and control group(n=60).The observation group was treated with warm needling acupuncture of Mongolian medicine,and the control group was treated with common acupuncture of Mongolian medicine,with two weeks as a course of treatment.The pain visual analogue scale(VAS)and Japanese orthopaedic association(JOA)score were observed before and after treatment,and the clinical efficacy was evaluated by the changes of clinical symptoms and signs of Mongolian medicine.[Results]The cure rate of the observation group was 71.7%,which was better than that of the control group(53.3%).The difference in the cure rate between the two groups was statistically significant,X 2=4.302,P=0.038.The total markedly effective rate(cured+markedly effective)of the observation group was 90.0%,while that of the control group was 83.3%.There was no significant difference in the total markedly effective rate between the two groups,X 2=1.154,P=0.283.The total effective rate(cured+markedly effective+effective)of the observation group was 100%,while that of the control group was 95.0%.There was no significant difference in the total effective rate between the two groups,and the continuous corrected chi-square value was 1.368 and 0.242.After treatment,the degree of low back pain,lower limb pain and dyskinesia were significantly improved in the two groups,the observation group was better than the control group,and the difference was statistically significant(P<0.05).[Conclusions]The warm needling acupuncture of Mongolian medicine was effective in the treatment of lumbar disc herniation,which is worth popularizing.

Effects of cluster needling of scalp acupuncture on neurofilament protein 200 and signal transducer and activator of transcription 3 in rats with acute cerebral ischemia

Objective:Cluster needling at scalp acupoints has showed satisfying effects with acute cerebral ischemia in clinic whereas the mechanisms are not yet clear completely.This study investigated the influence of cluster needling at scalp acupoints on neurological function,as well as on neurofilament protein 200(NF200)and signal transducer and activator of transcription 3(STAT3)expression,in rats with acute cerebral ischemia.Methods:Fifty-four Sprague-Dawley rats were randomly assigned in equal numbers to the false operation(group F),model(group M),or cluster needling scalp acupuncture(group C)groups.Each group was divided into three subgroups,of six rats each,by acupuncture treatment time(24 h,7 days,and 14 days).The rat local cerebral ischemia model was prepared using a modified suture occlusion method.Group C rats were treated by cluster needling scalp acupuncture,while groups F and M did not receive acupuncture treatment.Neurological effects were evaluated using the Longa score.NF200 and STAT3 expression were measured by western blotting.Results:At 24 h,there were no statistical difference between group C and group M in nerve function(P>.05).On days 7 and 14,nerve function scores in group C were significantly lower than that in group M(respectively were P<.05 and P<.01).In addition,on days 14,expression of NF200 was significantly higher in group C compared with group M(P<.05).Compared with group M,STAT3 expression was also higher in group C on days 7 and 14,although these differences were not statistically significant(both P>.05).Conclusion:Cluster needling scalp acupuncture were efficient in improving nerve function scores in rats with cerebral ischemia,and promoting the recovery of motor function.These improvements were associated with increases in NF200 and STAT3 expression.

Traditional Chinese Medicine Showing Promising Results in Reproductive Medicine

Traditional Chinese Medicine(TCM)treatment including herbal formulas and acupuncture shows promising results in reproductive medicine.Shuguang Hospital’s IVF center is also applying TCM on IVF treatment.We hope that through sharing our publications,more IVF clinics,research institutes,and business companies would collaborate with us to carry TCM-enhanced IVF further.

De-qi,Not Psychological Factors,Determines the Therapeutic Efficacy of Acupuncture Treatment for Primary Dysmenorrhea

Objective： To study the impact of De-qi （得气%, obtaining qi） and psychological factors on the efficacy of acupuncture treatment for primary dysmenorrhea, with an attempt to explore the relationship among De-qi, psychological factors, and clinical efficacy. Methods： The patients with primary dysmenorrhea were randomly assigned to a group of acupuncture with manual manipulation （manipulation group, n=67） and an acupuncture group without manipulation （non-manipulation group, n=64）. Pain intensity and pain duration were used as measures for evaluating the therapeutic efficacy of the acupuncture treatment. De-qi, the sensations a patient experienced during the acupuncture treatment, was scored on a 4-point scale by the subjects. In addition, the psychological factors, including belief in acupuncture, the level of nervousness, anxiety, and depression, were quantitatively assessed. The personality of the subject was assessed using the Eysenck personality questionnaire （EPQ） and 16 personality factor questionnaire （16PF）. Results： Complete data were obtained from 120 patients, 60 patients in each group. There were statistically significant differences in pain intensity （W=2410.0, P〈0.01 ） and pain duration （W=3181.0, P〈0.01） between the two groups. The number of De-qi acupoints （W=1150.5, P〈0.01） and the average intensity of De-qi （W=1141.0, P〈0.01） were significantly higher in the manipulation group as compared with their non-manipulation counterparts. The correlation coefficients between De-qi and therapeutic efficacy of acupuncture were greater than those between psychological factors and therapeutic efficacy. Conclusions： Compared with the psychological factors, De-qi contributed more to the pain-relieving effect of acupuncture in subjects with primary dysmenorrhea. Moreover, manual manipulation is a prerequisite for eliciting and enhancing the De-qi sensations, and De-qi is critical for achieving therapeutic effects.

Evidence and Expert Opinions:Drying Needling versus Acupuncture(Ⅱ)--The American Alliance for Professional Acupuncture Safety(AAPAS)White Paper 2016

In the United States and other Western countries, dry needling has been a topic in academic and legal fields. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by providing the authoritative evidence and expertise regarding critical issues of dry needling and reaching a consensus. We conclude that Dr. Travell, Dr. Gunn, Dr. Baldry and others who have promoted dry needling by simply rebranding（1） acupuncture as dry needling and（2） acupuncture points as trigger points（dry needling points）. Dry needling simply using English biomedical terms（especially using ＂fascia＂ hypothesis） in replace of their equivalent Chinese medical terms. Dry needling is an over-simplified version of acupuncture derived from traditional Chinese acupuncture except for emphasis on biomedical language when treating neuromuscularskeletal pain（dry needling promoters redefined it as ＂myofascial pain＂）. Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy（a surgical procedure） instead of manual therapy. Dr. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture＇s local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients＇ safety, dry needling practitioners should meet standards required for licensed acupuncturists and physicians.