Effects of pestle needle on nerve conduction velocity and inflammatory injury in patients with diabetic peripheral neuropathy

Background:Diabetic peripheral neuropathy(DPN)is one of the most common complications of diabetes mellitus.Impaired neurological function is one of the main characteristics of DPN and is strongly associated with the inflammatory response.Our previous studies have confirmed that pestle needle can improve the nerve function of patients with DPN.But the mechanism of pestle needle treatment of DPN is still unclear.Methods:A total of 70 DPN patients who met the inclusion criteria were randomly divided into two groups.Control group(CG)(n=35)received DPN conventional treatment and the pestle needle group(PNG)(n=35)received pestle needle therapy at Zhiyang(DU09)eight array,Mingmen(DU04)eight array and Heche Road(from Mingmen(DU04)to Changqiang(DU01)),Zusanli(ST36),Sanyinjiao(SP06),Taixi(KI03)and Yongquan(KI01).Patients in the PNG group were required to take this treatment for 4 weeks,5 times a week.Examination indexes were collected before and after treatment,respectively.Nerve function was examined using the Toronto clinical scoring system and nerve conduction velocity detection.Serum inflammatory factors were measured by enzyme linked immunosorbent assay.Results:The Toronto clinical scoring system was significantly reduced in the PNG compared with the CG after treatment.The sensory nerve conduction velocity and motor nerve conduction velocity of the right peroneal and median nerves were significantly faster in the PNG than those in the CG(P<0.05).After treatment,serum interleukin-1 beta,interleukin-6 and tumor necrosis factor-alpha levels decreased in both groups,and the improvement of PNG was better than CG(P<0.05).Conclusion:The pestle needle can significantly improve the symptoms and nerve conduction velocity of DPN,and its mechanism may be related to the reduction of inflammatory factors.

Efficacy study on pestle needle combined with Chinese herbal fumigation for cervical spondylosis

Objective：To observe the clinical effect of pestle needle combined with Chinese herbal fumigation on cervical spondylosis and provide a safe effective therapy for this condition.Methods：A total of 54 cases were randomly allocated into two groups（27 cases in each group） according to their sequence of consultation.Patients in both groups were treated with the same Chinese herbal fumigation.Patients in the treatment group were additionally treated with pestle needle therapy on a unique set of Ba Zhen points around Dazhui（GV 14）,Fengfu（GV 16） and the distance between Naohu（GV 17） and Dazhui（GV 14） along the He Che pathway,whereas patients in the control group were additionally treated with routine acupuncture therapy.Then the short-term and long-term efficacies were observed and compared after treatment using the visual analog scale（VAS） and pain rating index（PRI）.Results：At the end of treatment,VAS scores were significantly decreased in both groups,and the VAS score in the treatment group was lower than that in the control group（P〈0.05）.The intra-group differences were statistically significant in VAS scores 1 month,3 and 6 months after treatment（all P〈0.05）.At the end of treatment,the sensory and total PRI scores in the treatment group were significantly lower than those in the control group,showing statistically significant differences（both P〈0.01）;and there was no significant between-group difference（P〈0.05） in the affective PRI score.At the end of treatment,the total effective rate was 85.2% in the treatment group,versus 65.4% in the control group,showing a statistical significance（P〈0.05）.The follow-up six months later showed that the total effective rate was 92.6% in the treatment group,versus 76.9% in the control group,showing a statistical significance（P〈0.05）.Conclusion：Pestle needle therapy is a stable and positive therapy for cervical spondylosis.

Effects of the pestle needle therapy,a type of acupoint stimulation,on post-hemorrhoidectomy pain:A randomized controlled trial

Background:Hemorrhoids are one of the most common conditions that lead to surgery,and until now surgical hemorrhoidectomy has been the major effective treatment.Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation.Objective:This study evaluates the clinical efficacy of the pestle needle therapy,an acupoint stimulation method,for relief of post-hemorrhoidectomy pain.Design,setting,participants and interventions:This was a single-center,patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery.Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1:1.The treatment group received the pestle needle therapy,with manual stimulation at Yaoshu(DU2),Mingmen(DU4),Changqiang(DU1),Chengshan(BL57),Erbai(EX-UE2)and the perianal points(1,3,5,7,9,and 11 o’clock around the lesion);while the control group received a sham treatment with very light pressure.Three sessions of treatment were performed at 30 min,4 h and 12 h after the surgery,and each lasted for 15 min.Main outcome measures:The primary outcome was post-operative pain measured with the visual analogue scale(VAS)at 12 h after surgery.The secondary outcomes included the VAS scores measured at0.5,2,4,6,8,24 and 48 h after surgery,the analgesic dose,the time and the VAS score of the patients’first defecation after surgery,as well as the Hamilton Rating Scale for Anxiety(HAMA)evaluated before discharge.Results:The mean pain score of the treatment group was significantly lower than that of the control group(3.10±1.27 vs 4.82±1.29;P<0.001)at 12 h after surgery.Compared with the control group,patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery(P=0.002);and their HAMA scores before discharge were lower(4.07±2.40 vs 5.10±2.45,P=0.009).Compared to the treatment group,patients in the control group had a greater time to the first defecation after surgery([52.34±15.72]h vs[27.08±13.68]h;P<0.001),but there was no difference in their VAS scores at the first defecation(P=0.092).Conclusion:The pestle needle therapy was effective for relieving pain,reducing anxiety and improving bowel function after hemorrhoidectomy,and it is worthy of clinical application.

Effect of pestle intervention in type 2 diabetic peripheral neuropathy on Keap1/Nrf2/ARE pathway and the relationship with oxidative stress

Objective:To investigate the effect of pestle needle treatment on Nrf2 pathway and the relationship with oxidative stress in diabetic peripheral neuropathy.Methods:Patients with DPN who met the inclusion criteria were randomly divided into control and test groups with 30 patients in each group in a 1:1 allocation ratio.Both groups were given basic treatment,and the pestle group was treated with needle pestle therapy 5 times a week for a total of 4 weeks of intervention.Serum SOD and GSH PX levels were examined by colorimetry before and after intervention;Serum Keap1/Nrf2/ARE signaling pathway related factors expression levels were measured by ELISA;Keap1 and Nrf2 mRNA expression was determined by RT-PCR.Results:Compared with the control group,SOD and GSH-Px in the test group were significantly increased,Keap1 expression was decreased,Nrf2 expression was increased,Keap1 mRNA expression was significantly decreased,and Nrf2 mRNA expression was significantly increased.Conclusions:the pestle needle may enhance the body's antioxidant capacity by modulating the Keap1/Nrf2/ARE signaling pathway to enhance the production of its downstream antioxidant enzymes SOD and GSH Px,thereby protecting and repairing the damaged peripheral nerves in DPN patients.

Pestle needling at Yāoyángguān-Bāzhèn points for intractable lumbodynia after lumbar disc herniation surgery: A randomized controlled trial

Objective:To observe the differences of clinical efficacy of intractable lumbodynia after lumbar disc herniation surgery treated by pestle needling at Yāoyángguān Bāzhèn points,electroacupuncture and western medication.Methods:A total of 210 patients with intractable lumbodynia after lumbar disc herniation were randomly divided into pestle needle group,electroacupuncture group and western medication group,with 70 cases in each group.The pestle needle group was treated with pestle needle poking Yāoyángguān-Bāzhèn(GV3-Bāzhèn)points.The electroacupuncture group was treated with conventional electroacupuncture,and the western medication group was treated with oral diclofenac sodium dual release enteric-coated capsules(Difene).The pestle needle group and the electroacupuncture group were treated once a day,and there was 1 day of rest after 6 days of treatment,and a course of treatment included 7 days,and a total of 3 courses of treatment were performed.The western medication group took 1 Difene capsule(75 mg)at a time,with once a day continuing for 21 days.Visual Analog Scale(VAS),Pain Rating Index(PRI)and Present Pain Intensity(PPI)were used to observe the improvement of pain before and after treatment,and the waist muscle tone was examined and the clinical efficacy was observed.Results:The post-treatment VAS,PRI,and PPI scores of the three groups were all lower than pretreatment,and the differences were statistically significant(all P<0.05).There were no statistically significant differences in VAS,PRI and PPI scores between pestle needle group and western medication group(all P>0.05).Meanwhile,they were all lower than the electroacupuncture group,and the differences were statistically significant(both P<0.05).After treatment,the waist muscle tone of the three groups was higher than that pre-treatment,and the differences were statistically significant(all P<0.05).After treatment,the waist muscle tone of the pestle needle group was higher than the electroacupuncture group,and the electroacupuncture group was higher than the western medication group,and the differences were statistically significant(both P<0.05).The total effective rate was 88.57%in the pestle needle group,80%in the electroacupuncture group,and 77.14%in the western medication group,and there were no statistically significant differences among the groups(P>0.05).Conclusions:Pestle needle poking GV3-Bāzhèn points can effectively relieve intractable lumbodynia after lumbar disc herniation surgery,decrease VAS,PRI,PPI scores and relieve waist muscle tone,and the effect was remarkable.