Xingnao Kaiqiao needling method for acute ischemic stroke： a meta-analysis of safety and efficacy

OBJECTIVE： To evaluate the effectiveness and safety of the Xingnao Kaiqiao needling method for treating acute ischemic stroke.DATA SOURCES： We retrieved relevant randomized controlled trials involving Xingnao Kaiqiao acupuncture for treatment of acute ischemic stroke. The China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and Pub Med were searched from June 2006 to March 2016.DATA SELECTION： We analyzed randomized and semi-randomized clinical controlled trials that compared Xingnao Kaiqiao acupuncture with various control treatments, such as conventional drugs or other acupuncture therapies, for treatment of acute ischemic stroke. The quality of articles was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions（Version 5.1）, and the study was carried out using Cochrane system assessment methods. Rev Man 5.2 was used for the meta-analysis of the included studies.OUTCOME MEASURES： The mortality rate, disability rate, activities of daily living（Barthel Index）, and clinical efficacy were observed.RESULTS： Twelve studies met the inclusion criteria for this review. The meta-analysis showed that between Xingnao Kaiqiao acupuncture and the control treatment, Xingnao Kaiqiao acupuncture reduced the disability rate [risk ratio（RR） = 0.51, 95% confidence interval（CI） = 0.27-0.98, z = 2.03, P 〈 0.05], elevated the activities of daily living（weighted mean difference = 12.23, 95% CI： 3.66-20.08, z = 2.80, P 〈 0.005）, and had greater clinical efficacy（RR = 1.61, 95% CI： 1.23-2.09, z = 3.53, P 〈 0.0004）. However, there was no significant difference in mortality rate（RR = 0.61, 95% CI： 0.15-2.45, z = 0.70, P 〉 0.05）. CONCLUSION： The Xingnao Kaiqiao needling method is effective and safe for acute ischemic stroke. However, there was selective bias in this study, and the likelihood of measurement bias is high. Thus, more high-quality randomized controlled trials are needed to provide reliable evidence of the efficacy and safety of Xingnao Kaiqiao acupuncture in the treatment of acute ischemic stroke.

Systematic review of long-term Xingnao Kaiqiao needling efficacy in ischemic stroke treatment

OBJeCTIve：To systematically evaluate the long-term effect and safety ofXingnao Kaiqiao nee-dling method in ischemic stroke treatment. DATA ReTRIevAL： We retrieved relevant random and semi-random controlled trials that used theXingnao Kaiqiao needling method to treat ischemic stroke compared with various control treatments such as conventional drugs or other acupuncture therapies. Searched databases included China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and PubMed, from May 2006 to July 2014. SeLeCTION CRITeRIA： Two authors independently conducted literature screening, quality evaluation, and data extraction. The quality of articles was evaluated according to the Cochrane Reviewers’ Handbook 5.1, and the study was carried out using Cochrane system assessment methods. RevMan 5.2 was used for meta-analysis of the included studies. MAIN OUTCOMe MeASUReS： Mortality rate, recurrence rate, and disability rate were observed. ReSULTS：Nine randomized and semi-randomized controlled trials treating 931 cases of ischemic stroke were included in this review. Meta-analysis results showed that there were no sig-niifcant differences in mortality reduction （risk ratio （RR） = 0.58, 95% conifdence interval （CI）： 0.17–1.93,Z = 0.89,P = 0.37） or recurrence rate （RR = 0.55, 95%CI： 0.18–1.70,Z = 1.04,P = 0.30） of ischemic stroke patients between theXingnao Kaiqiao needling and control treatment groups. However, theXingnao Kaiqiao needling method had a tendency towards higher efifcacy in mor-tality reduction and recurrence rates. TheXingnao Kaiqiao needling method was signiifcantly better than that of the control treatment in reducing disability rate （RR = 0.51, 95%CI： 0.27–0.98, Z = 2.03,P 〈 0.05）. CONCLUSION：TheXingnao Kaiqiao needling method has a better effect than control treatment in reducing disability rate. The long-term effect ofXingnao Kaiqiao needling against ischemic stroke is better than that of control treatment. However, the limitations of this study limit the strength of the conclusions. Randomized controlled trials with a strict, reasonable design, and multi-center, large-scale samples and follow-up are necessary to draw conclusions aboutXingnao Kaiqiao needling.

Conducting qi and regulating the spirit needling method for insomnia: A randomized controlled trial

Objective:To evaluate the clinical effect differences between conducting qi and regulating the spirit needling method and regular needling method.Methods:Sixty-nine patients of insomnia were randomly divided into an observation group(35 cases)and a control group(34 cases).Bǎihuì(百会GV20),Sìshéncōng(四神聪EX-HN1),Hégǔ(合谷LI4),Tàichōng(太冲LR3),Zúsānlǐ(足三里ST36)and Sānyīnjiāo(三阴交SP6)were selected in the two groups.The patients in the observation group were treated with needling method for conducting qi and regulating the spirit.The patients in the control group were treated with the regular needling method.The treatment was given once every other day,both groups were treated for 12 times.Pittsburgh Sleep Quality Index(PSQI)and Epworth Sleepiness Scale(ESS)were observed before and after the treatment and the clinical effect was evaluated.Results:After treatment,the total score and the score of each item of PSQI as well as the result of ESS were all improved after the treatment in the two groups(all P<0.05).The improvements in the total score of PSQI and the result of ESS in the observation group were better than the control group(both P<0.05).The total effective rate was 88.57%(31/35)in the observation group,significantly superior to 76.47%(26/34)in the control group(P<0.05).Conclusion:The conducting qi and regulating the spirit needling method achieves a better effect on insomnia as compared with the regular needling method.This method achieves a remarkable improvement in sleep latency,sleep quality and daytime sleepiness.

动痛穴阻力针法治疗粘连期难治性肩凝症的随机对照观察

Objective:To objectively evaluate the clinical effect of resisting method of acupuncture at movementpainful points on treating the refractory cases of frozen shoulder during adhesion period,and to compare with that of the conventional acupuncture method.Methods:According to the random grouping principle,90 patients with frozen shoulder during adhesion period were divided into"resisting method acupuncture group,general acupuncture group,and physiotherapy group",30 patients in each.In the resisting method acupuncture group,the resisting method of needling was applied at the"movement-painful points",and during acupuncture the patient was asked to do shoulder movements.In the general acupuncture group,the conventional needling method of acupuncture was applied at the conventional three shoulder-acupoints.In the physiotherapy group,the patients were treated with shock wave at the affected shoulder.All groups were treated once a day,5 times a week,a total of 2 weeks as a course of treatment.After one course of treatment,the clinical effect of the three groups was evaluated.The shoulder pain and shoulder function scale(Constant-Murley),Rating Scale of the American Shoulder and Elbow Surgeons(ASES),and infrared thermal imaging temperature change score were observed.Results:After treatment,the shoulder pain was relieved and movement improved in all three groups,whilst the cured and remarkably effective rate of the resisting method acupuncture group was 96.7%(29/30),better than those of the general acupuncture group 86.2%(25/29)and the physiotherapy group 73.3%(22/30),with a statistically significant difference(P<0.05);the VAS score of the resisting method acupuncture group was significantly lower than those of the other two groups(P<0.05),the ConstantMurley score and the ASES score were significantly lower than those of the other two groups(all P<0.05),and the infrared thermal imaging temperature change score was significantly improved in comparing with those of the other two groups,with a statistically significant difference(both P<0.05).Conclusion:The resisting method of needling has an obvious analgesic effect and is able to restore the joint movement function in the treatment of refractory frozen shoulder during adhesion period.

刺卫法临床应用举隅

In the paper,two medical cases,i.e.carpal tunnel syndrome and acute chest soft tissue contusion,are treated and reported with acupuncture kinesitherapy,in which the needles are inserted shallowly and no sensation of deqi is required in the guidance of subcutaneous shallow puncture and"pain point as the acupoint".The mechanism of needling wei method is summarized.