Effect of electroacupuncture at different acupoints in treating rapid gastric emptying:Zusanli(ST36)plus Zhongwan(CV12)versus Zhongwan(CV12)alone

OBJECTIVE:To evaluate the effect of electroacupuncture on rapid gastric emptying by comparing the effectiveness of electroacupuncture at both Zusanli(ST36)and Zhongwan(CV12)(He-Mu acupoints)versus electroacupuncture at Zhongwan(CV12)alone.METHODS:Sixty-five patients were randomly divided into two groups;33 patients in the He-Mu acupoints group received electroacupuncture at both Zusanli(ST36)and Zhongwan(CV12),while 32 patients in the single acupoint group received electroacupuncture only at Zhongwan(CV12).Both groups were treated once daily for 30 min,five times per week for 3 weeks.Before and after the 3-week treatment course,patients underwent gastric emptying scintigraphy and were assessed using the Traditional Chinese Medicine(TCM)symptom scale of gastrointestinal diseases.The two groups were compared regarding the percentages of gastric retention at 30 and 60 min and the TCM symptom scores.RESULTS:After the treatment course,the percentages of gastric retention at 30 and 60 min were significantly improved in both groups compared with the pre-treatment values(P<0.01).The improvement in the gastric retention was significantly better in the He-Mu acupoints group than the single acupoint group at 30 min(P<0.01)and 60 min(P<0.05).The TCM symptom score was significantly decreased after the treatment course in both groups(P<0.01).The improvement in the TCM symptom score was significantly better in the He-Mu acupoints group than the single acupoint group(P<0.01).The total effective rate was 93.55%(29/31)in the He-Mu acupoints group and 77.42%(24/31)in the single acupoint group.The treatment effect was better in the He-Mu acupoints group than the single acupoint group(P<0.05).CONCLUSIONS:Electroacupuncture at both Zusanli(ST36)and Zhongwan(CV12)or at Zhongwan(CV12)alone is effective in treating rapid gastric emptying.Furthermore,electroacupuncture at both Zusanli(ST36)and Zhongwan(CV12)is more effective than electroacupuncture at Zhongwan(CV12)alone.

Effect of scar-producing moxibustion at the acupoints Zusanli(ST 36) and Feishu(BL 13) on neutrophil-to-lymphocyte ratio and quality of life in patients with non-small-cell lung cancer: A randomized,controlled trial

OBJECTIVE: To evaluate the effect of heat stimulation via scar-producing moxibustion at the acupoints Zusanli(ST 36) and Feishu(BL 13) on the neutrophil-to-lymphocyte ratio(NLR) and quality of life in patients with non-small-cell lung cancer(NSCLC).METHODS: Seventy patients with NSCLC were randomly assigned into two groups: group A received scar-producing moxibustion at the acupoints Zusanli(ST 36) and Feishu(BL 13) every day for 6 weeks, while group B received no intervention(control group). Outcome measures were the NLR and the scores from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30). The NLR and the EORTC QLQ-C30 were assessed at baseline and at the end of 6 weeks.RESULTS: Five participants dropped out, leaving afinal total of 65 participants who completed the trial. Groups A and B had a similar mean NLR at baseline. After the treatment course, the NLR in group A was significantly lower than that in group B(P <0.001). Compared with group B, the EORTC QLQ-C30 scores in group A were significantly greater in terms of global health status or quality of life(P < 0.001) and function(P < 0.05), and significantly lower in terms of symptoms(P < 0.05).CONCLUSION: The present study suggests that performing scar-producing moxibustion by heat-stimulating the acupoints Zusanli(ST 36) and Feishu(BL13) effectively decreases the NLR and improves the quality of life in patients with NSCLC.

Effect of dexamethasone injection into Zusanli(ST 36) acupoint on ovalbumin-induced allergic rhinitis

OBJECTIVE:To investigate the effects of acupunc ture with dexamethasone(A.Dex)on allergic rhini tis(AR)by injecting dexamethasone into the Zusan li(ST 36)acupoint.METHODS:Thirty 6-week-old female BALB/c mice were sensitized on days 1,5,and 14 by intraperitoneal injection of 100 pg of ovalbumin(OVA).The mice were then randomly divided into six groups(n =5 in each group).Five groups were sensitized intranasally with 2μL of 1.5 mg of OVA for 10 consecutive days,while one group was sensitized intranasally with PBS in a similar manner as a negative control group.One hour before each administration of intranasal OVA,two groups were orally administered either a control vehicle(distilled water;AR control group)or 200 pg/kg Dex(O.Dex group),while three groups received A.Dex at Zusanli(ST36)with Dex concentrations of 2,20,and 200μg/kg for each group,respectively.AR symptoms were evaluated by measuring the rubbing score,which comprised the number of nose,ear,and eye rubs that occurred in the initial 10 min after OVA intranasal provocation on the 10 th day.We isolated spleen,serum,and nasal mucosal tissue after measuring the rubbing score.Spleen weight was measured using an electronic microbalance.The levels of IgE,thymic stromal lymphopoietin,tumor necrosis factor-a,intercellular adhesion molecule-1,and macrophage-inflammatory protein-2 in serum or nasal mucosal tissue were measured using enzyme-linked immunosorbent assays.The serum histamine levels of OVA-sensitized AR mice were measured using O-phthaldialdehyde spectrofluorometry.Western blot analysis was performed on nasal mucosal tissue extracts.RESULTS:A.Dex significantly reduced the rubbing score,spleen weight,serum IgE,and serum histamine in OVA-sensitized mice.A.Dex significantly decreased the serum levels of inflammatory cytokines(thymic stromal lymphopoietin and tumor necrosis factor-a)in OVA-sensitized mice.A.Dex significantly reduced the nasal mucosal levels of inflammatory markers(intercellular adhesion molecule-land macrophage-inflammatory protein-2)in AR mice.A.Dex effectively attenuated the expression of caspase-1 and receptorinteractingprotein-2 in nasal mucosal tissue.CONCLUSION:A.Dex may be a new and useful therapy for AR.

EXPERIMENTAL STUDY ON MOXIBUSTION AT ZUSANLI(ST 36) AND LIANGMEN (ST 21) INDUCING HEAT SHOCK PROTEIN 70 (HSP70) EXPRESSION TO RESIST OXIDATIVE INJURY OF GASTRIC MUCOSA

To observe effect of moxibustion at Zusanli （足三里 ST 36） and Liangmen （梁门 ST 21 ） on expression of heat shock protein 70 （HSP70） in gastric mucosa of the rat of stress ulcer （SU） to explore the mechanism of moxibustion in resisting oxidative injury of the gastric mucosa. Methods： Sixty SD rats were evenly randomized into 4 groups, a blank group, a model group, an acupoint moxibustion group and a non-acupoint moxibustion group. Water restraint stress （WRS） method was used to make stress gastric ulcer rat model. The ulcerative index （Ul） of gastric mucosa was evaluated by using GUTH method, the gastric mu- cosa blood flux （GMBF） was detected by a laser Doppler bloodflow monitor, and HSP70 expression and malondialdehyde （MDA） content in the gastric mucosa were determined respectively with immunohistochemical and thiobarbiturate methods. Results： Moxibustion at Zusanli （ST 36） and Liangmen （ST 21 ） significantly de- creased Ul, up-regulated HSP70 expression, increased GMBF, and decreased MDA content in the gastric mucosa in the rat of stress gastric ulcer, with significant differences as compared with the model group and the non-acupoint moxibustion group （P 〈 0.05 or P 〈 0.01 ）. Conclusion： Moxibustion at Zusanli （ST 36） and Liangmen （ST 21 ） can induce high expression of HSP70 and decrease MDA content in the gastric mucosa, so as to resist oxidative injury, with relative acupoint specificity.

TREATMENT WITH ACUPUNCTURE AT ZUSANLI (St 36) FOR EPIGASTRIC PAIN IN THE ELDERLY

Acupuncture at a single point is a spe-cial feature in the treatment of acute symp-toms for its simplicity and effectiveness.Theauthor experienced many cases of acuteepigastric pain treated with acupuncture at asingle acupoint with satisfactory results.Pain in the elderly is most often of

Effects of electroacupuncture at Zusanli(ST36) on inflammatory cytokines in a rat model of smokeinduced chronic obstructive pulmonary disease

OBJECTIVE： Improvement in lung function was reported after acupuncture treatment of chronic obstructive pulmonary disease （COPD）, but little is known about the underlying mechanisms. Because an immune response imbalance could be seen in COPD, we hypothesize that electroacupuncture （EA） may play a role in regulating inflammatory cytokines and contribute to lung protection in a rat model of smoke-induced COPD. METHODS： A COPD model using male Sprague-Dawley rats exposed to cigarette smoke was established. The rats were randomly divided into four groups （control, sham, COPD, and COPD plus EA）, and COPD model was evaluated by measuring pulmonary pathological changes and lung function. EA was applied to the acupuncture point Zusanli （ST36） for 30 min/d for 14 d in sham and COPD rats. Bronchoalveolar lavage fluid （BALF） was used to measure levels of tumor necrosis factor-a （TNF-a）, interleukin-113 （IL-113）, and malonaldehyde （MDA）. RESULTS： Compared with the control rats, COPD rats had significant changes in lung resistance （R,） and lung compliance （C,） （both P〈0.01）, bronchi and bronchiole airway obstruction （P〈0.01）, and levels of MDA, TNF-α, and IL-1β（P〈0.01）. There were no significant differences between the control and the sham groups. Compared with the COPD rats, the COPD plus EA rats had decreased R, and increased CL （both P〈0.05）, and reduced bronchi and bronchiole airway obstruction （P〈0.05, P〈0.01, respectively）, while levels of TNF-α, IL-1β, and MDA in BALF were lowered （P〈0.05 and P〈0.01, respectively）. However, TNF-α and IL-1β levels of the EA group rats remained higher than those of the control group （P〈0.05）. CONCLUSION： EA at ST36 can reduce lung injury in a COPD rat model, and beneficial effects may be related to down-regulation of inflammatory cytokines. The anti-inflammatory and antioxidant effects may prolong the clinical benefit of EA.

Electro-acupuncture at Zusanli(ST 36) to improve lower extremity motor function in sensory disturbance patients with cerebral stroke A randomized controlled study of 240 cases

BACKGROUND： Studies have shown that sensory transduction is a way to introduce needle sensation. OBJECTIVE： To observe the influence of electro-acupuncture at the ＂Zusanll＂ （ST 36） point on lower extremity motor function in various sensory disturbance patients with cerebral stroke. DESIGN, TIME AND SETTING： A randomized, controlled, clinical study was performed at the Department of Neurological Rehabilitation, China Rehabilitation Research Centre from September 2006 to June 2008. PARTICIPANTS： Patients with first-time cerebral infarction or hemorrhage, or with a stroke history, but no neurodysfunction （single damage）, were selected for this study. The subjects were right-handed and disease state was stable. A total of 240 inpatients were randomly assigned to the following groups： electro-acupuncture （n = 124） and control （n = 116）. The two groups were further assigned into sub-groups： no sensory disturbance, superficial sensory disturbance, deep sensory disturbance, and deep and superficial sensory disturbance. METHODS： On the basis of routine limb function training, the acupoint Zusanliwas utilized in all patients from the electro-acupuncture group. Perpendicular acupuncture was 3.0-4.0 cm deep. An electric acupuncture instrument was connected when patients developed the needle sensation, deqi. A stimulation pattern consisting of distant and dense waves of 50 Hz was used to elicit slight dorsal foot extension. Acupuncture was administered 5 times per week, 30 minutes per session, for 6 weeks in total. MAIN OUTCOME MEASURES： FugI-Meyer assessment （FMA） was used to evaluate lower extremity motor function; Ver.1.0 gait analysis to estimate gait （step frequency, step speed, and step scope）; lower extremity Composite Spasticity Scale （CSS） to estimate muscle spastic degree. RESULTS： Following treatment, motor function improved in both groups. Compared with the control group, FMA score, step speed, step frequency, and step scope were increased in the electro-acupuncture group, but there was no difference in lower extremity CSS scores between the electro-acupuncture and the control groups （P 〉 0.05）. Compared with the control group, Zusanli （ST 36） electro-acupuncture improved motor function indices as follows： FMA score, step frequency, step speed, and step scope of patients with no sensory disturbance （P 〈 0.05-0.01）, step frequency of patients with superficial sensory disturbance （P 〈 0.05）, and step frequency and step speed of patients with deep sensory disturbance （P 〈 0.05）. CONCLUSION： Zusanfi （ST 36） electro-acupuncture effects on lower extremity motor function in stroke patients were improved with no muscle tone rise. Therefore, this form of treatment can be used in convalescent treatment, Moreover, effects were different according to various sensory disturbance types, which suggested that sensory input influenced acupuncture effects.

Effects of pre-moxibustion at Zusanli (ST36) on heat shock protein 70 expression in rats with gastric mucosal lesions after neurotomy

Studies have shown that pre-moxibustion protects the gastric mucosa by up-regulating the expression of heat shock protein 70. However, the signaling pathway underlying this effect remains unclear. Rats were intragastrically administered absolute alcohol, causing obvious lesion of the gastric mucosa. Following pre-moxibustion at Zusanfi （ST36） for 8 days, the ulcer index decreased to different degrees. The results of an enzyme linked immunosorbent assay and western blotting showed significant upregulation of heat shock protein 70 expression in the gastric mucosa and serum. None out of transection of the spinal cord, damage to the nucleus of the solitary tract, neurotomy of the vagal nerve and neurotomy of the common peroneal nerve affected the decrease in ulcer index or the increase in heat shock protein 70 expression in serum after pre-moxibustion at Zusanfi, and heat shock protein 70 expression was obviously decreased in the gastric mucosa. These findings suggest that pre-moxibustion at Zusanfi can protect the gastric mucosa against lesioning, and that the mechanism underlying this effect involves its induction of heat shock protein 70 expression. Neural pathways participate in the regulatory effects of moxibustion on heat shock protein 70 expression in the gastric mucosa.

Moxibustion at ST36 activates peritoneal macrophages in CTX-induced immunosuppression in mouse model via IFN-γ

Background:To explored whether moxa cone moxibustion can reduce peritoneal inflammation by increasing the content of peritoneal macrophages and B cells via interferon-gamma.Methods:The mice were randomly divided into three groups with six mice in each group:the control group,model group,and moxibustion group,and the model was established in mice using cyclophosphamide.In the moxibustion group,the mice received moxa cone moxibustion at Zusanli(ST36)for 7 days.Analysis of Peritoneal cell were detected by flow cytometry and immunofluorescence,the protein expression level in the peritoneal fluid were measured with mouse cytokine antibody arrays and verified by enzyme linked immuno sorbent assay test,and RNA-Sequencing was used for peritoneal cell RNA analysis.Results:Our results showed that moxa cone moxibustion could reduce the loss of large peritoneal macrophages and B1 cells(P<0.05).With the cytokine array analysis and enzyme linked immuno sorbent assay test of peritoneal fluid,we found that IFN‐γwas up-regulated in moxibustion group(P<0.05).There were 169 genes were down-regulated in the model group and up-regulated in the moxibustion group while 19 genes that were up-regulated in the model group and down-regulated in the moxibustion group via RNA-sequencing.Kyoto Encyclopedia of Genes and Genomes pathway analysis of 188 intersect differentially expressed genes were found that the top 3 pathways with the highest enrichment of up-regulated genes included Hematopoietic cell lineage,Inflammatory bowel disease and Malaria.The differentially expressed genes visualization protein-protein interaction network shows the top 10 genes including Ifng,Grb2,CCR7,CTLA4,CXCR5,Foxp3,kit,PRF1,CD5 and klrg1.Conclusion:These findings showed that moxa cone moxibustion can alleviate chemotherapy-induced diarrhea by reducing the loss of large peritoneal macrophages and B1 cells in the peritoneal cavity,possibly through up-regulating inflammatory bowel disease signaling pathway via interferon-gamma to regulate the survival and function of large peritoneal macrophages and B1 cells.

Comparison of protective effects of electroacupuncture and moxibustion at Zusanli(ST 36)on perinatal nicotine exposure-induced lung phenotype in rat offspring

Objective:To compare the effects of electroacupuncture(EA)and moxibustion at Zusanli(ST 36)on the lung phenotype of rat offspring exposed to nicotine during the perinatal period.Methods:Pregnant Sprague-Dawley rats were randomly divided into 4 groups:the control group(saline only),the model group(nicotine only),the EA group(nicotine+EA at ST 36 acupoints bilaterally),and the moxibustion group(nicotine+moxibustion at ST 36 acupoints bilaterally).n=6 rats per group.On postnatal day 21,the body weight,lung weight,and pulmonary function were determined and lung morphometry was performed.Peroxisome proliferator-activated receptor gamma andβ-catenin levels in the lung tissue of offspring were also determined.Results:Perinatal nicotine exposure(PNE)results in decreased body and lung weights of offspring rats,abnormal lung tissue morphology,and significantly altered pulmonary function,showing an increase in total airway resistance and a decrease in tidal volume,minute ventilation,total airway compliance,and peak expiratory flow.Bilateral EA at ST 36 acupoints could block all of these perinatal nicotine-induced effects.Although moxibustion also had protective effects in nicotine-induced offspring lungs,some of these effects did not reach statistical significance,e.g.,protection against the upregulation ofβ-catenin,the downregulation of PPARγsignaling,and the increase in peak expiratory flow.Conclusion:Maternal EA at ST 36 blocked the PNE-induced changes in key developmental signaling pathways,prevented the PNE-induced changes in lung morphology,and protected pulmonary function.Moxibustion at ST 36 showed similar but weaker protective effects against the PNE-induced changes in the exposed offspring.It is important to note that the mechanism underlying the protective effects of moxibustion at ST 36 may be different from those of EA at ST 36,and further research is needed to understand these differences.

Effect of acupoint injection of Neostigmine on gastrointestinal function after cholecystectomy

Objective： To observe the effect of acupoint injection with Neostigmine Methylsulfate at Zusanli（ST 36） on gastrointestinal function of patients after laparoscopic cholecystectomy.Methods： Totally 120 patients undergone laparoscopic cholecystectomy were randomized into an acupoint injection group, a muscular injection group, and a blank control group at 1：1：1 by random number table, 40 cases in each group. The blank control group was intervened by conventional post-operation treatment, the acupoint injection group was by acupoint injection with Neostigmine Methylsulfate 2 m L at bilateral Zusanli（ST 36） in addition to the treatment given to the blank control group, and the muscular injection group was by muscular injection with Neostigmine Methylsulfate 2 m L in addition to the treatment given to the blank control group. The two injection groups both received injection twice a day, totally for 3 d at most. The restored time of bowel sounds, initial flatulence time, defecation time and clinical efficacy were observed. Results： After treatment, there were significant differences in comparing the restored time of bowel sounds among the three groups（F=17.30, P〈0.05）, the acupoint injection group and muscular injection group were significantly different from the blank control group（P〈0.05）, and there was a significant difference between the acupoint injection group and muscular injection group（P〈0.05）; there were significant differences in comparing the initial flatulence time among the three groups（F=19.12, P〈0.05）, and the acupoint injection group was significantly different from the muscular injection group and the blank control group（P〈0.05）; there were significant differences in comparing the initial defecation time among the three groups（χ^2=21.23, P〈0.05）, while the difference between the acupoint injection group and muscular injection group was statistically insignificant（P〈0.05）. The total effective rate was 87.5% in the acupoint injection group, versus 72.5% in the muscular injection group and 60.0% in the blank control group, and there were significant differences among the three groups（P〉0.05）. Conclusion： Acupoint injection with Neostigmine Methylsulfate at Zusanli（ST 36） can shorten the restored time of bowel sounds and flatulence time in patients undergone laparoscopic cholecystectomy, and the efficacy is more significant compared to muscular injection with Neostigmine Methylsulfate.

Effect of Sanhuangwuji powder,anti-rheumatic drugs,and ginger-partitioned acupoint stimulation on the treatment of rheumatoid arthritis with peptic ulcer:a randomized controlled study

OBjECTIVE:To observe the efficacy and safety of oral Sanhuangwuji powder,anti-rheumatic drugs(ARDs),and ginger-partitioned acupoint stimulation at Zusanli(ST 36) on the treatment of rheumatoid arthritis(RA) complicated by peptic ulcer.METHODS:This prospective randomized controlled study included 180 eligible inpatients and outpatients randomly assigned to an ARD treatment(n = 60),ginger-partitioned stimulation(n =60),or combination treatment(n = 60).Patients assigned to the ARD group were given oral celecoxib,methotrexate,and esomeprazole.Patients assigned to theginger-partitioned stimulation group were given ginger-partitioned acupoint stimulation at Zusanli(ST 36) in addition to the ARDs.Patients in the combination treatment group were given oral Sanhuangwuji powder,ginger-partitioned acupoint stimulation at Zusanli(ST 36),and ARDs.All patients were followed up for 2 months to evaluate clinical effects and safety.The study was registered in the World Health Organization database at the General Hospital of Chengdu Military Area Command Chinese People's Liberation Army(ChiCTR-TCC12002824).RESULTS:The combination treatment group had significantly greater improvements in RA symptoms,laboratory outcomes,and gastrointestinal symptom scores,compared with the other groups(P < 0.05).The peptic ulcer healing rate in the combination treatment group was significantly greater than that in the ARD treatment group(x^2 = 16.875,P < 0.05) and the ginger-partitioned stimulation group(x^2 = 6.171,P<0.05).CONCLUSION:Combination treatment with ginger-partitioned acupoint stimulation at Zusanli(ST36),oral Sanhuangwuji powder,and ARDs had a better clinical effect for RA with complicated peptic ulcer,compared with ARD treatmentalone or in combination with ginger-partitioned acupoint stimulation.

Mechanism study of the transmission of moxibustion heat in human acupoint tissues

Objective: To discuss the topical action characteristics of the biological transmission of moxibustion heat via temperature collection and numerical modeling. Methods: Temperature of moxibustion was measured at multiple points at a distance of 3 cm to obtain the moxibustion temperature field nephograms by the high-accuracy temperature measure array. Finite element analysis was used to imitate the three-dimensional dynamic distribution of temperature in acupoint tissues. Results: Through numerical analysis, the one-dimensional, two-dimensional and three-dimensional distributions of temperature in human acupoint tissues at 5 min of moxibustion were established. The result showed that moxibustion heat mainly tran smitted from the surface of the tissue to the internal, and the in flue nee of moxibusti on heat decreased with the depth of the tissue. The analysis of the nephograms of acupoint tissue temperature at 5,10, 15 and 20 min of moxibustion showed that with the in crease of the moxibusti on time, the temperature in acupoint tissues consta ntly rose, and the transmission depth of moxibustion heat also further expanded inside acupoint. Conclusion: By establishing the three-dimensional dynamic model of heat transmission inside acupoint tissues with the biological parameters of human tissues and the temperature values obtained, this study used finite element analysis software ANSYS 14.0 and discovered the rules in the transmission of heat in body tissues during moxibustion, and the features in moxibustion heat transmission (from the proximal to the distant) and heat penetration (from the surface to the intern al). This study provides theoretical and experime ntal support for the application of moxibusti on in clinical practice.

Effects of needling acupoints at different nerve segments on oxytocin neurons in rat’s hypothalamic paraventricular nucleus and intragastric pressure

Objective:To compare and explore the effects of needling acupoints at different nerve segments on the oxytocin(OT)neurons in the paraventricular nucleus of hypothalamus(PVN)and the intragastric pressure,and discuss the possible mechanisms.Methods:Thirty-two healthy adult Sprague-Dawley(SD)rats were numbered and divided into 4 groups according to the random number table,a Zusanli(ST 36)group,a Neiguan(PC 6)group,a Weishu(BL 21)group and a control group,with 8 rats in each group.Except the control group,rats in the other three groups received acupuncture at the corresponding acupoints.To observe the differences in double-labeled OT neurons and c-fos neurons of the hypothalamic PVN and the intragastric pressure after acupuncture among the three groups of needling acupoints at different nerve segments.Results:Compared with the control group,the numbers of double-labeled cells in the PVN of the Zusanli(ST 36)group and the Neiguan(PC 6)group decreased significantly,while the intragastric pressure increased significantly(all P<0.05),and the inter-group differences were statistically significant(P<0.05).The intragastric pressure in the Weishu(BL 21)group decreased significantly,and the inter-group difference was statistically significant(P<0.05).Compared with the Weishu(BL 21)group,the numbers of OT/c-fos double-labeled cells in PVN of the Zusanli(ST 36)group and the Neiguan(PC 6)group decreased significantly,and the intragastric pressure increased significantly,the inter-group differences were statistically significant(all P<0.01).Conclusion:Acupoints at different nerve segments have different regulation effects on intragastric pressure.The difference may be related to the different nerve conduction pathways by acupoints at different nerve segments in regulating the intragastric pressure.The PVN may be one common integration center for the regulation of gastric function in the three acupoints[Zusanli(ST 36),Neiguan(PC 6)and Weishu(BL 21)]at different nerve segments.

中药内服联合电针对行Halsted疝修补术的老年腹股沟嵌顿疝患者胃肠功能的影响

目的:观察中药内服联合电针对行Halsted疝修补术的老年腹股沟嵌顿疝患者胃肠功能的影响。方法:将64例行Halsted疝修补术的老年腹股沟嵌顿疝患者随机分为治疗组和对照组,每组32例。对照组给予常规治疗,治疗组在对照组治疗的基础上给予中药内服联合电针足三里治疗。观察两组患者肠鸣音恢复时间、肛门排气时间、排便时间、胃肠减压时间及术后围手术期腹胀发生率等。结果:治疗组肠鸣音恢复时间、肛门排气时间、排便时间、胃肠减压时间短于对照组,差异有统计学意义(P<0.05);治疗组腹胀发生率为18.75%,对照组腹胀发生率为53.13%,治疗组腹胀发生率低于对照组,差异有统计学意义(P<0.05)。结论:中药内服联合电针能够促进行Halsted疝修补术的老年腹股沟嵌顿疝患者胃肠功能及早恢复,降低腹胀发生率,减轻腹胀程度。

Adenosine triphosphate mediates the pain tolerance effect of manual acupuncture at Zusanli(ST36) in mice

OBJECTIVE:To investigate the mechanisms behind the effects of acupuncture in Traditional Chinese Medicine,we delved into the adenosine triphosphate/peripheral purinergic P2X receptor 3(ATP/P2X3)receptor signaling system as an indicator of the body's energy state,commonly referred to as"Qi".METHODS:The tail-flick test was utilized to explore the impact of acupuncture on pain tolerance threshold(PTT)in mice,while also assessing adenosine(ADO)levels and adenylate energy charge(EC)at Zusanli(ST36).The study further investigated the dose-dependent effects of acupuncture on PTT and ADO levels at Zusanli(ST36).To shed light on the underlying mechanisms of acupuncture's effects,the study examined the impact of ATP,a P2X3 receptor antagonist,and adenosine disodium on PTT following acupuncture administration.RESULTS:Acupuncture at Zusanli(ST36)led to significant improvements in PTT in mice,with the most effective interventions being twirling for 2 min and needle retention for 28 min.These interventions also resulted in significant increases in ATP levels.The effects of acupuncture were further augmented by administration of different doses of ATP at Zusanli(ST36),and pretreatment with a P2X3 receptor antagonist decreased PTT.Adenylate EC peaked at 30 min after intraperitoneal injection of ATP,and pretreatment with various doses of i.p.ATP 30 min prior to acupuncture increased PTT in a dose-dependent manner.Additionally,pretreatment with an i.p.or intramuscular injection of adenosine disodium enhanced the effects of acupuncture.CONCLUSION:This research provides compelling evidence that ATP is involved in the regulation of PTT through acupuncture,revealing new avenues for achieving enhanced clinical outcomes.

Overview of researches on central action mechanism of needling Zusanli(ST 36)

The contents about the central action mechanisms of needling Zusanli（ST 36） were sorted by summarizing the relevant literatures published in the past 10 years, and it was found that： by comparing acupuncture at Zusanli（ST 36）, other acupoints or sham points, most studies showed that Zusanli（ST 36） had relatively specific characteristics in the brain function response; studies on the central action mechanisms of Zusanli（ST 36） were mainly focused on sequelae of cerebral apoplexy, pain, gastrointestinal diseases, weight loss and drug addiction withdrawal and so on; acupuncture manipulations, stimulation methods, individual differences, stimulation quantity, and stimulation duration, etc. could also induce different brain function responses; acupuncture at Zusanli（ST 36） had an after-working effect, also called long-term effect, but with poor repeatability. So, it was suggested that the future studies should focus on the factors that affect the clinical efficacies and experimental results, including the compatibility effects of the acupoints, reproducibility of research results, sample size, acupuncture methods, long-term effects and disease entities.

Long-term acupuncture treatment has a multitargeting regulation on multiple brain regions in rats with Alzheimer＇s disease：a positron emission tomography study

The acute effect of acupuncture on Alzheimer＇s disease,i.e.,on brain activation during treatment,has been reported.However,the effect of long-term acupuncture on brain activation in Alzheimer＇s disease is unclear.Therefore,in this study,we performed long-term needling at Zusanli（ST36）or a sham point（1.5 mm lateral to ST36）in a rat Alzheimer＇s disease model,for 30 minutes,once per day,for 30 days.The rats underwent 18F-fluorodeoxyglucose positron emission tomography scanning.Positron emission tomography images were processed with SPM2.The brain areas activated after needling at ST36 included the left hippocampus,the left orbital cortex,the left infralimbic cortex,the left olfactory cortex,the left cerebellum and the left pons.In the sham-point group,the activated regions were similar to those in the ST36 group.However,the ST36 group showed greater activation in the cerebellum and pons than the sham-point group.These findings suggest that long-term acupuncture treatment has targeted regulatory effects on multiple brain regions in rats with Alzheimer＇s disease.

Low-frequency fluctuation amplitude analysis of resting-state fMRI for functional brain response differences between acupuncture and moxibustion at Zusanli(ST 36) in patient with functional dyspepsia

Objective： To compare and analyze functional brain response characteristics by applying acupuncture or moxibustion to Zusanli（ST 36） in patients with functional dyspepsia（FD） and investigate the differences of central action mechanism resulting from acupuncture or moxibustion.Methods： A total of eligible 24 FD cases were divided into two blood-oxygen-level dependent（BOLD） sequences for functional magnetic resonance imaging（fMRI） scan. The amplitude of low frequency fluctuation（ALFF） analyses were conducted on the data of location phase, structure phase, resting state before acupuncture/moxibustion, working state during acupuncture/moxibustion and resting state after acupuncture/moxibustion using Data Processing Assistant for Resting-State fMRI（DPARSF） software.Results： Acupuncture and moxibustion produced significant differences in functional brain response. The working state during acupuncture/moxibustion mainly decreased ALFF values in the right supramarginal gyrus, right superior parietal lobule, right frontal gyrus, upper right occipital lobe, right precuneus and right cingulate gyrus. At the same time, it increased ALFF values in the left cerebellum, right caudate nucleus, right cerebellum and left inferior gyrus. The differences during the resting state after acupuncture/moxibustion were significantly smaller than the working state in intensity and size. It mainly resulted in decrease in ALFF values in the right postcentral gyrus and right supramarginal gyrus and increase in ALFF values in the left precuneus, orbital part of inferior frontal gyrus and right cerebellar peduncles.Conclusion： Needling and moxibustion at Zusanli（ST 36） can produce significant differences in immediate functional brain response.

Peripheral Nerve Discharge Elicited by Manual Acupuncture at Zusanli (ST 36) Regulates Blood Pressure in Anesthetized Rats

Objective： To investigate target organ response by recording mean arterial blood pressure （MAP） fluctuation corresponding to nerve-tract discharges from the nerve innervating acupoint of Zusanli （ST 36） in the hind limb evoked by MA in anesthetized rats. Methods： Male SD rats anesthetized with chloral hydrate were randomly divided into 3 groups which were treated with manual acupuncture （MA）, injection of lidocaine followed by MA and injection of normal saline （NS） followed by MA, respectively. The right carotid artery was canulated for persistent measurement of the blood pressure and meanwhile nerve discharges from the nerve-tract were recorded for analysis with amplitude spike counts for every 5 s. Results： The results showed that there were significant nerve discharges recorded from the nerve-tract when applying MA at Zusanli （ST 36） and simultaneous decrease in the MAP, while there was no response when inserting a needle into the Zusanli （ST 36） without manipulation （P〈0.05）. Furthermore, the reduction of MAP during MA could be completely abolished after blockade of peripheral nerve discharges with an injection of lidocaine into the tissue around Zusanli （ST 36） but not with that of normal saline （NS）. Conclusion： These results indicate that MA at Zusanli （ST 36） can elicit the peripheral nerve discharges from the nerve innervating the acupoint; such kind of nerve discharges may contain acupuncture signal regulating blood pressure via somato-cardiovascular reflex.