CLINICAL REPORT ON MULTI-CENTER RANDOMIZED CONTROLLED TRIAL OF TREATMENT OF MIGRAINE BY ELECTRO-ACUPUNCTURE AT QI■X■(丘墟GB40)

Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center （3 First-Class hospitals） study was adopted, and the involved 3 hospitals did clinical observation according to the requirements of the project. The methods are as follows. All cases were randomized into treatment group and control group according to their sequence. QIǖXǖ（丘墟GB40） was selected in treatment group, while Tiānshū （天枢 ST25） was selected in control group. Both groups were performed electro acupuncture, and syndromes indexes of migraine and 5-HT were observed before and after treatment. All data were analyzed by statistic software SPSS11.5. Results There was significant difference of VAS margin between two groups in each center and the combined center （u= -3. 362, P=0. 001 ）. There was significant difference of therapeutic effect of 4-week treatment between two groups in each clinical center and the combined center. The therapeutic effect of 3-month treatment between two groups in No. 1 and No. 3 hospitals, showed significant difference, the treatment group was better; while that of No. 2 hospital had no obvious difference. The therapeutic effect of 6-month treatment between two groups in each center and the combined center had significant difference, the treatment group was better. Conclusion The therapy of electro acupuncture at QIǖXǖ（丘墟GB40） is effective for migraine.

EVIDENCE-BASED MEDICINE AND THE CLINICAL STUDY ON ACUPUNCTURE AND MOXIBUSTION

In this article, the authors hold that the evidence based medicine(EBM) is a new medical action produced at the historic moment in clinical practice, which is promoting development of the medicine and even the whole life science in a fully new train of thought and method. Further the briefly introduced contents are the effect of EBM, the difficulty of utilizing in the acupuncture clinical practice and how to resolve them. It is highly recommended that the doctors of the acupuncture science field should study EBM and its effect and difficulties in practice as earlier as possible, insistently assimilate new knowledge and keep abreast of the times’ progress to facilitate the further development of acupunctology.

Clinical Observation on Scalp Acupuncture Treatment in 50 Cases of Headache

Headache is frequently encountered in clinic, including vascular headache, cervical headache, traumatic cerebral headache, and tonic headache, which may be seenin many acute or chronic diseases. During the period from Aug. 1996 - Apr. 2000, the author had treated 50 cases of headache by scalp acupuncture therapy and got quite satisfactory therapeutic results as reported in the following. ……

SUMMARY OF CLINICAL STUDY ON ACUPUNCTURE COMBINED WITH EPIDURAL ANESTHESIA FOR CHOLECYSTECTOMY

Objective: TO study clinical effect and anesthetic method of acupuncture anesthesia combined with epidural administration of small dose of anesthetic for cholecystectomy. Methods: A total of 194 cases of cholecystectomy patients were randomly divided into acupuncture combined with epidural anesthesia group (group A, n = 66), acupoint-skin electrical stimulation combined with epidural anesthesia group (group B, n = 63) and simple epidural anesthesia group (group C, n=65). Observations were conducted using single-bland method. Bilateral Neiguan (PC 6) and Zusanli (ST 36) were punctured and stimulated electrically in group A and only stimulated electrically via cutaneous electrodes in group B. Epidural anesthetic used was 1.5% Lidocaine and the anesthetic level was controlled to reach T4-11 . Results: The class-I (excellent) rates of group A, B and C were 75.76%, 60.32% and 13.85% respectively, showing significant differences between group A and C and group B and C (P <0.001). The initial dose, doses of every hour and every case of group A and B were lower than those of group C. The dose of every hour of group C was 36.23% and 3. 75% higher then group A and B respectively (P < 0. 001), suggesting that acupuncture or acupoint-skin electrical stimulation could strengthen anesthetic effect and reduce the dose of epidural anesthetic. During operation, indexes of the life signs as HR, MAP, RR, TV, MV, SpO2 and ECG kept basically stable and all patients in group A passed surgical operation safely. Conclusion: Acupuncture or acupoint-skin electrical stimulation combined with epidural anesthesia can be used as one of the anesthetic methods for cholecystectomy.

ISSUES AND MEASURES ON ASSISTED REPRODUCTION BY ACUPUNCTURE ABROAD

As the application of acupuncture has been increased year by year in the field of overseas reproduction, it has become crucial to give a scientific and objective evaluation of the safety and efficacy of acupuncture in the field of assisted reproduction, which attaches great importance to the sustainable development of acupuncture in the field of reproduction. This article aims to introduce the current situation of overseas clinical study in the field of assisted reproduction, analyze the existing issues profoundly and put forward measures to solve them, in order to enhance the level of international clinical study of acupuncture.

Exploration of Stratified Evidence Scoring Method of Acupuncture Clinical Practice Guidelines

Due to its own internal laws of development,Chinese medicine(CM)seems more inclined to empirical medicine in a relatively long historical period.It is considered to be lacking objective and unified clinical practice guidelines(CPGs),and the difficulties in diagnosis and therapeutic effect evaluation comes with it,have restricted its further inheritance,development and international communication.Over the years,our research group has been committed to improving the standardization theory and methodology of CM,also perfecting relative techniques for further application,which are all based on the stratified evidence scoring method.We have already applied this method to 45 issued guidelines,including 5 national guidelines,3 industrial guidelines,and 37 formulation/revision social organization guidelines.The stratified evidence scoring method has been recognized and used widely.It helps scholars and applicators to study,formulate,publish and popularize the acupuncture therapy clinical practice guidelines better,thus further promotes the development of acupuncture therapy.

Recommendations for Acupuncture in Clinical Practice Guidelines of the National Guideline Clearinghouse

Objective： To organize the clinical practice guidelines（CPGs） related to acupuncture included in the National Guideline Clearinghouse（NGC） to systematically summarize the diseases and disorders most commonly treated with acupuncture, the strength of recommendations for acupuncture and the quality of evidence. Methods： The NGC database was systematically searched for guidelines that included acupuncture as an intervention. Two independent reviewers studied the summaries and the full texts of the guidelines and included guidelines based on the inclusion and exclusion criteria. Thirty-nine guidelines were collected with 80 recommendations. The Appraisal of Guidelines for Research and Evaluation（AGREE） Ⅱ instrument was used to assess the quality of these guidelines. Results： Of the 80 recommendations on acupuncture, 49 recommendations were clearly for acupuncture, 25 recommendations were against acupuncture and 6 recommendations did not indicate any clear recommendations, 37 recommendations were for painful diseases/disorders, and 12 recommendations were for non-painful diseases/disorders. Locomotor system disorders were the most common in the painful diseases/disorders category. Out of all the recommendations for acupuncture, most recommendations（87.76%） were weak in strength, and most of the evidence（40.84%） was of low quality. Conclusion： In the National Guideline Clearinghouse, the recommendations for acupuncture focus on painful diseases/disorders. The recommendations in the guidelines are not high in strength, and most of the evidence is moderate or low in quality.

Clinical Practice Guideline of Acupuncture for Herpes Zoster

BACKGROUND Herpes zoster （HZ）, also called shingles, zona and zoster, is a painful skin rash. It is a distinctive syndrome caused by reactivation of varicella zoster virus （VZV）. The reaction occurs when immunity to VZV declines because of aging or immunosuppression.~1） At this time the virus infects nerves （namely, the dorsal root ganglia） where it remains latent for years. It occurs in about one million people in the United States annually.（2） In China, few studies reported the prevalence of HZ and one article has mentioned the number was 1.4%0-4.8%.

Pivotal Factors Concerned in Design of Acupuncture Clinical Research:From Two Articles in JAMA

Two randomized controlled trials of acupuncture concerning polycystic ovary syndrome（PCOS） and stress urinary incontinence（SUI） were published simultaneously in the 24 th issue, 2017 of The Journal of the American Medical Association（JAMA）. A trial involving PCOS indicated that active acupuncture did not increase live birth compared with sham acupuncture; meanwhile, another trial referring to SUI showed that electroacupuncture resulted in less urine leakage compared with sham electroacupuncture. With an eye to the negative and positive results of acupuncture, three pivotal factors should be contemplated：（1） proper illness for acupuncture, that is, a problem need to be solved in current medical science, and acupuncture may really work for it;（2） proper pre-studied primary outcome, which is better be objective and repeatedly measurable to reveal the therapeutic effect of acupuncture truly and objectively;（3） proper sham control, which can blind the patients to the upmost extent with minimal biological effects. Through the publication of clinical trials of acupuncture in high-impact journals in recent years, researchers should have confidence in their clinical trials by pondering over these three pivotal factors.

Curative effect of acupuncture and moxibustion on insomnia: a randomized clinical trial

OBJECTIVE: To observe the effect of acupuncture and moxibustion on insomnia and explore its mechanism. METHODS: One hundred and twenty patients were randomly divided into an experiment group and a control group. Sixty patients in the experiment group were treated once a day with acupuncture at Baihui (GV 20), Sishencong (EX-HN 1), Shenmai (BL 62), and Zhaohai (KI 6) and with moxibustion at Baihui (GV 20) and Sishencong (EX-HN 1). Sixty patients in the control group were acupunctured once a day at Shenmen (HT 7), Neiguan (PC 6), and Sanyinjiao (SP 6).The Pittsburgh Sleep Quality Index (PSQI) was used to compare sleep improvement between the two groups. RESULTS: The total effective rate was 87.7% in the experiment group and 76.3% in the control group. The PSQI scores and the total score were lower after treatment than before treatment in bothgroups. However, the reduction in the experiment group was greater than that in the control group in sleeping quality, time to fall asleep, sleeping disorder, and daytime function (P<0.05). CONCLUSION: Acupuncture and moxibustion at Baihui (GV 20), Sishencong (EX-HN 1), Shenmai (BL 62), and Zhaohai (KI 6) significantly improved insomnia symptoms in the experiment group compared with the control group.

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]

Thinking on Clinical Research of Acupuncture

In its thousands of years of development, acupuncture, with its peculiar theoretical system and distinct clinical efficacy, has been quite active in medical history. At present, acupuncture is being used in 160 odd nations/areas, and has become an important constituent of medical sciences in the world. So it is of great significance as to how to further deepen its clinical research and raise its clinical efficacy in China, the mother country of acupuncture science, to acclimatize the ancient and full-of- vitality discipline with the modern social tide and to serve the health of human beings better.