COMMENTS ON THE STUDY OF ACUPOINT COMBINATION AND REMEDIES FOR TREATMENT OF DIABETES MELLITUS WITH ACUPUNCTURE AND MOXIBUSTION

In the present paper, the author reviews the progresses in the study on acumoxi (acupuncture-moxi-bustion) treatment of diabetes mellitus (DM) from Chinese ancient classical works, Chinese and foreign journals. The therapeutic results reveal that acupuncture treatment of DM is effective in improving DM patients' symptoms via vagal-nerve reflex, regulation of neuroendocrine and immune functions. The author holds that ① correct selection of acupoints in accordance with syndrome differentiation and the related meridians and combined application of acupuncture and Chinese herbal medicines (for oral administration) are the key points for raising the therapeutic effect; and ② acupoint combination and curative methods need to be researched further.

DEVELOPMENT ON CLINICAL TREATMENT OF CONSTIPATION WITH ACUPUNCTURE AND MOXIBUSTION

In the present paper, the authors review recent developmarrt of clinical treatment of constipation with acupunctire and moxibustion from ① body acupuncture therapy including special needling manipulations, as Ziwu Daojiu Needling, etc. and acupoint combination,②electrcacupunture therapy, ③ scalp-acupuncture therapy, ④ auricular acupuncture therapy, ⑤ needleembedding and acupoint-catgut-embedding therapies, ⑥ acupoint-application therapy, ⑦ combinged acupuncture aud medication therapy, ⑧ other therapies such as cupping therapy and holo-therapy, and ⑨ considerations about the action of acupuncture in the treatmnt of constipation and its prospect. Up to now, researches on the effect of acupuncture in treating constipation are seldom seen, thus, much attention should be paid about this by clinical and experimental researchers.

Clinical observation of acupuncture combined with medication for mild-to-moderate depression

Objective:To discuss the clinical efficacy and plausible mechanism of Tiao Yang Qu Xie(regulating Yang to eliminate pathogenic factors)needling method plus paroxetine in treating mild-to-moderate depression.Methods:Sixty-six patients with mild-to-moderate depression were divided into an observation group and a control group using the random number table method,each consisting of 33 cases.Another 25 healthy subjects were recruited as a healthy group.The control group took oral paroxetine tablets for treatment,and the observation group received additional acupuncture treatment 3 times weekly.Both groups underwent 4-week treatment.Before treatment,after 2-week and 4-week treatment,and 2 weeks after treatment(follow-up),the patients were assessed using the Hamilton depression scale-17-item(HAMD-17),self-rating depression scale(SDS),self-rating anxiety scale(SAS),and traditional Chinese medicine(TCM)pattern element identification scale for depression.The two groups each randomly contributed 25 cases to detect the protein content of brain-derived neurotrophic factor(BDNF)before treatment and after 4-week treatment,and compared with the healthy group.Results:After 2-week treatment,the markedly effective and total effective rates were significantly higher in the observation group than in the control group(P<0.05);after 4-week treatment,the observation group significantly surpassed the control group in comparing the markedly effective rate(P<0.05).After 2 and 4 weeks of treatment and at the follow-up,the HAMD-17 total score and sleep disorder factor score were lower in the observation group than in the control group(P<0.05);the anxiety-somatic score was lower in the observation group than in the control group after 2-week treatment(P<0.05).After 2 and 4 weeks of treatment and at the follow-up,the observation group was lower than the control group in comparing the scores of SDS,SAS,and TCM pattern element identification scale for depression(P<0.05).After 4-week treatment,the observation group had an increased serum BDNF protein content,higher than that in the control group(P<0.05)and had no significant difference compared to the healthy group(P>0.05).Conclusion:Compared to the use of oral paroxetine alone,acupuncture plus paroxetine can produce more significant efficacy in treating mild-to-moderate depression and act faster in improving sleep disorder and anxiety-somatic symptoms;increasing the serum BDNF protein content may be a part of the mechanism underlying its antidepressant actions.

Two cases of corona virus disease 2019(COVID-19)treated with the combination of acupuncture and medication in bedridden patients

The paper reports the experiences in treatment of two cases of corona virus disease 2019(COVID-19)with the combination of acupuncture and medication in bedridden patients confirmed in C7 Inpatient Ward,Wuhan Leishenshan Hospital,China.The combined treatment of acupuncture with the oral administration of"Shanghai leishen No.1 formula"was given every day.The prescription was modified weekly according the symptoms of the patients.Besides,the antivirus,anti-infectious and symptomatic treatment of western medicine was combined.Both of the two cases were improved and discharged.It is anticipated that the treatment experiences in these two cases may provide the instruction and enlightenment for the prevention and treatment of COVID-19.

Clinical Observation on Combination of Acupuncture and Medication in Treating Breast Hyperplasia

Objective: To observe the clinical efficacy of acupuncture combined with medication in treating breast hyperplasia. Methods: One hundred patients with breast hyperplasia who met the inclusion criteria were randomly divided into an acupuncture combined with traditional Chinese medicine(A&TCM) group and a traditional Chinese medicine(TCM) group, 50 cases in each group. The A&TCM group received acupuncture combined with oral TCM; the TCM group only received oral TCM. After two courses of treatment, the efficacy was observed. Results: During the two treatment courses, the recovery rates had been increasing in both groups. The recovery rate of the A&TCM group was 40.0% and the total effective rate was 98.0%. While the recovery rate of the TCM group was 18.0% and the total effective rate was 80.0%. According to statistical analysis, the differences of recovery rate and total effective rate between the two groups were statistically significant(P<0.01). Conclusion: Combination of acupuncture and TCM is more effective than simple oral TCM.

Clinical Study on Treatment of Knee Osteoarthritis with Combined Acupuncture and Medication

Objective： To observe the effect of treatment for proliferative knee osteoarthritis （KOA） using combined acupuncture and medicated compression. Method： All 328 cases were randomized into an observation and control group, 164 cases in each. Combined acupuncture and medicated compression were adopted in the observation group, while oral administration of Zhui Feng Tou Gu Wan （Wind-removing and Bone-penetrating Pills） were adopted in the control group. The clinical effects in the two groups were evaluated 40 days after the treatment. Result： There were significant differences in both marked and total effective rates （P〈0.05）. Conclusion Combined acupuncture and medicated compression can obtain better effect for KOA than oral administration of the Wind-Removing and Bone-Penetrating pills.

Treatment of 65 Cases of Cervical Vertigo Treated by Acupuncture plus Medication

Objective： To investigate the efficacy of acupuncture plus puerarin and glucose injection for treating cervical vertigo. Method： 110 cases of cervical vertigo were divided into the treatment group and control group. 65 cases in the treatment group were treated by acupuncture plus puerarin and glucose injection and 45 cases in the control group were treated with Western medications. Results： In the treatment group, the results showed cure in 33 cases, effect in 29 cases and failure in 3 cases, and the total effective rate in 95.38%. In the control group, the results showed cure in 12 cases, effect in 23 cases and failure in 10 cases, and the total effective rate in 77.87%. In comparison of the total effective rate between the two groups, the treatment group was better than the control group （P〈0.01）. Conclusion： The therapeutic effect is better in the treatment of cervical vertigo by acupuncture plus herbal medicine.than that by Western medications.

Therapeutic effect observation on acupuncture plus medication for post-stroke depression

Objective: To observe the clinical efficacy of acupuncture with medication for post-stroke depression. Methods: A total of 96 patients with post-stroke depression were randomized into an observation group and a control group, with 48 cases in each group. The control group was treated with oral fluoxetine hydrochloride capsules, and the observati on group was treated with acup un cture on the basis of the treatme nt of the con trol group. After 6 mon ths of treatment, the traditional Chinese medicine (TCM) symptom scores, and Hamilton depression scale (HAMD) component scores and total scores of the two groups before and after treatment were observed, and the clinical efficacy and adverse reaction rate were compared between the two groups. Results: The total effective rate was 95.8% in the observation group and 83.3% in the control group, and the differenee between the two groups was statistically significant (Pv0.05). After treatment, the intra-group differences in TCM symptom scores and HAMD score of both groups were statistically significant (all P<0.01). In the observation group, the scores of in differe nt expressi on, emoti onal restlessness, and sen time ntality in the TCM symptoms were statistically differe nt from those in the control group (all P<0.01). The scores of desperate factor and sleep disorder factor and total score in HAMD in the observation group were significantly different from those in the control group (all P<0.01). The incidenee of adverse reactions was 6.3% in the observation group and 4.2% in the control group, and the differenee was not significant between the two groups (P>0.05). Conclusion: Acupuncture plus medication is an effective method for post-stroke depression, and it can further improve the patient's bad mood.

Observation on Therapeutic Effect of Acupuncture and Medication for 30 Cases of Post-Stroke Depression

Objective： To investigate the therapeutic effects and adverse reaction of acupuncture plus medication and single medication for post-stroke depression（PSD）. Methods： In an open control study, 93 cases of the patients with depression were randomly allocated to three groups： 30 cases in the acupuncture-medication group （AM）, 30 cases in Prozac Group A （A）, and 33 cases in Prozac Group B （B）. The acupuncture-medication group was treated by oral administration of Prozac 20 mg/d plus acupuncture. Prozac Group A was treated by oral administration of Prozac 20 mg/d. Prozac Group B was treated by oral administration of Prozac 20-40 mg/d. All three groups were treated for 6 weeks. The therapeutic effects and adverse reaction were evaluated by Hamilton Depression Scale （HAMD） and Treatment Emergent Symptom Scale （TESS） respectively in the three groups. Results： The effective rate was 86.7% in the acupuncture-medication group, 63.3% in Prozac Group A and 87.9% in Prozac Group B. The therapeutic effect was better in the acupuncture-medication group than in Prozac Group A, and there was no significant difference in comparisonwith Prozac Group B （P〉0.05）. But the occurrence rate of drug adverse reaction was higher in Prozac Group B than in the acupuncture-medication group. Conclusion： Simultaneous application of acupuncture and medication is a therapeutic method with affirmative effect and less side effect for post-stroke depression.

Clinical Observation of Combined Acupuncture ＆ Medications in Treating Dysspermia Infertility

Objective： To observe the curative effect of combined acupuncture and medication on infertility due to seminal abnormality. Method： Thirty-eight patients with seminal abnormality were separately treated by acupuncture and traditional Chinese medications （“Erxian Decoction”） plus Clomiphene. Results and Conclusion： The total effective rate was 96.0% in the acupuncture plus traditional Chinese medication group （26 cases） and 66.7% in the acupuncture and western medication groups （12 cases）. Statistical analysis showed a significant difference （P〈0.05）. The cure rate and the pregnancy rate were 38.5% and 30.8% respectively in the acupuncture and traditional Chinese medication group. Both of them were higher than 8.3% and 8.3% in the acupuncture and western medication group respectively, but there were no statistically significant differences. In the two groups of patients, seminal volume, liquefaction time and viscosity and spermatozoal density, death rate and one-hour survival rate took a significant turn for the better after treatment as compared with before treatment （P〈 0.05）. In the acupuncture and traditional Chinese medication groups of patients, symptoms markedly improved after treatment as compared with before treatment.

Therapeutic Effect Analysis on Combined Acupuncture and Medication for Peripheral Facial Paralysis

Objective： To investigate the therapeutic efficacy of combined acupuncture and medication for peripheral facial paralysis. Methods： Sixty-six cases with peripheral facial paralysis were randomly allocated into a treatment group and a control group, 33 cases in each group. The cases in the treatment group were treated with combined electroacupuncture and Chinese medicine formula, while the cases in the control group were treated by electroacupuncture alone. Results： The recovery rate in the treatment group was significantly higher than the control group （P〈0.05）. In addition, the time length for recovery in the treatment group tended to be shorter than the control group. Conclusion： Combined acupuncture and medication can obtain better effect than electroacupuncmre alone for peripheral facial paralysis.

Clinical Observation on Combined Acupuncture and Medication for Osteoporosis in Postmenopausal Women

Objective： To observe the clinical effect of combined acupuncture and medication for osteoporosis in postmenopausal women. Methods： A total of 100 cases with postmenopausal osteoporosis were randomly allocated into a treatment group and a control group, 50 in each group. The cases in the treatment group were treated with electroacupuncture coupled with Calcitriol soft capsules, while the cases in the control group were treated with electroacupuncture alone. Results： There were significant differences in treatment effects between the treatment group and control group （P〈0.05）. Conclusion： Combined acupuncture and medication can obtain a marked effect for postmenopausal osteoporosis.

Therapeutic Effect Observation on Combined Acupuncture and Medication for Ovulation

Objective：To observe the curative effect of acupuncture plus medicine in treating ovulatory dysfunctional infertility.Method：All 36 cases with anovulatory infertility were randomly allocated into a control group （19 cases） and an observation group （17 cases）.The cases in the control group were treated with 50 mg of oral administration Clomiphene once a day for 5 d,and 50 menstrual cycles were observed.The cases in the observation group were treated with combined acupuncture and the same medication as those in the control group and 45 menstrual cycles were observed.During the treatment sessions,the follicular development,ovulation,thickness of the endometrium,cervical mucus and pelvic fluid were observed and recorded.Results：The cases in the observation group showed significantly higher ovulation and pregnancy rates,along with thickening of the endometrium.In addition,no luteinized unruptured follicle syndrome （LUFS） occurred in the observation group.Conclusion：Acupuncture coupled with oral administration Clomiphene can obtain higher ovulation and conception rates than oral Clomiphene alone.

Clinical Study on Acupuncture plus Medication for Chronic Atrophic Gastritis Due to Spleen-stomach Deficiency

Objective: To observe the clinical efficacy of combining acupuncture and medication in treating chronic atrophic gastritis(CAG) due to spleen-stomach deficiency. Methods: Totally 176 patients with CAG were randomized into two groups by the random number table. The 91 subjects in the treatment group were intervened by acupuncture and oral Chinese patent medication; the other 85 subjects were by oral Chinese patent medication alone. The clinical efficacies were compared at the end of intervention. Results: After a treatment course, the total effective rate was 87.9% in the treatment group versus 75.3% in the control group; according to the gastroscopy and pathological biopsy examinations, the total effective rate was 85.7% in the treatment group versus 74.1% in the control group. There were significant differences in comparing the clinical efficacy, gastroscopy and pathological examinations between the two groups(P<0.05). Conclusion: Combining acupuncture and medication can produce a better therapeutic efficacy than medication alone in treating CAG due to spleen-stomach deficiency.

Therapeutic Efficacy Observation on Acupuncture plus Medication for Rheumatoid Arthritis

Objective： To observe the clinical efficacy of acupuncture plus medication for rheumatic arthritis （RA）. Methods： A total of 80 RA cases were randomized into an observation group and a control group, 40 in each group. Cases in the observation group received antirheumatic agents and acupuncture therapy, whereas cases in the control group received antirheumatic agents alone. The therapeutic efficacies were observed after 3 sessions of treatment. Results： After the treatment, patients in the observation group had significant improvement in their morning stiffness time, average grip of both hands, joint tenderness and joint swelling, showing statistical significances （P〈0.01）; symptoms of patients in the control group were also remarkably improved （P〈0.01, P〈0.05）. Compared with the control group, the improvements in joint tenderness and average grip of both hands in the observation group were more significant （P〈0.05）. After treatment, the Health Assessment Questionnaire （HAQ） points were significantly improved in both groups, erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） in both groups were remarkably reduced （P〈0.01, P〈0.05）; however, compared with the control group, the CRP decrease in the observation group was more significant （P〈0.05）. Conclusion： Acupuncture plus antirheumatic agents can effectively increase the RA patients＇ activities of daily living （ADL） and thus improve their quality of life.

Therapeutic Observation on Combined Acupuncture and Medication for Recurrent Facial Dermatitis

Objective: To observe the clinical efficacy of acupoint injection plus medication in treating recurrent facial dermatitis(RFD). Methods: Fifty-eight patients with RFD were randomized into a treatment group and a control group, 29 in each. The treatment group was intervened by acupoint injection with BCG-PSN plus oral administration of Fexofenadine Hydrochloride, and the control group was by Fexofenadine Hydrochloride only. The clinical efficacies were compared between the two groups, and a follow-up study was conducted to investigate the recurrence rate. Results: The total effective rate was 96.6% in the treatment group versus 65.5% in the control group, and the difference was statistically significant(P<0.01). Of the cured and improved patients in the treatment group, the recurrence rates were 10.7%, 25.0%, and 32.1% respectively 3 months, 6 months, and 12 months after treatment, versus 31.6%, 36.8%, and 73.7% in the control group, and the differences were statistically significant(P<0.05). Conclusion: Acupoint injection plus medication is an effective method in treating RFD.

Effects of acupuncture plus medication on hippocampus SIRT1 and FOXO3a expression,MDA content,and SOD activity of rats with Alzheimer disease

Objective To observe the effect of the acupuncture plus medication on the expression of silent information regulator of transcription 1(SIRT1)and transcription factor forkhead box protein O3a(FOXO3a)in the hippocampus,the malondialdehyde(MDA)content,and the superoxide dismutase(SOD)activity of rats with Alzheimer disease(AD),and to explore the possible mechanism of combining acupuncture and medication in improving AD-related neurological symptoms.Methods Sixty male Sprague-Dawley rats were divided into a normal group,a model group,an electroacupuncture(EA)group,a drug group,and an acupuncture-medication combined group by the random number table method,with 12 rats in each group.The model was established by micro-injection of streptozotocin into the bilateral lateral ventricles.After successful modeling,rats in the EA group received EA at Zusanli(ST36)and Dazhui(GV14),those in the drug group received intragastric administration of resveratrol at a dose of 44 mg/(kg·bw),and those in the acupuncture-medication combined group received the combined intervention of EA and resveratrol.Rats in each group received intervention once a day for 4 consecutive weeks.Morris water maze was used to detect the rat behavioral changes.Nissl staining method was used to observe the cell morphology and changes in the number of rat hippocampal neurons.Western blotting and immunohistochemical staining methods were used to observe the expression changes of SIRT1 and FOXO3a.The thiobarbituric acid method was used to detect the MDA content.SOD activity was determined by the hydroxylamine method.Results Compared with the normal group,the escape latency was significantly prolonged(P<0.05);the percentage of stay in the target quadrant was reduced(P<0.05),the hippocampal neuronal cells were shrunken,nucleoli were unclear,and cell number was reduced(P<0.05);the SIRT1 expression and SIRT1 positive cell number were decreased,while the FOXO3a expression and FOXO3a positive cell number were increased significantly(P<0.05);the MDA content was increased significantly,and the SOD activity was decreased significantly(P<0.05)in the model group.Compared with the model group,the escape latency was shortened(P<0.05);the percentage of stay in the target quadrant was increased(P<0.05);the shape and number of hippocampal neurons tended to be normal(P<0.05);the SIRT1 protein expression and the SIRT1 positive cell numbers were increased,the FOXO3a protein expression and the FOXO3a positive cell number were decreased(P<0.05);the MDA content was significantly decreased,and the SOD activity was significantly increased(P<0.05)in the EA group,the drug group,and the acupuncture-medication combined group.The changes in the acupuncture-medication combined group were more obvious(P<0.05).Conclusion Both EA and resveratrol improve the learning and memory ability of AD rats by regulating the expression of SIRT1 and FOXO3a and improving the levels of MDA and SOD in the hippocampus and protect the hippocampal neurons,while the combined use of EA and medication is more effective than EA or resveratrol alone,suggesting that this combined treatment is more effective in AD treatment.

Acupuncture combined with medication for postherpetic neuralgia affecting the head and face:a randomized controlled trial

Objective:To observe the efficacy of needling the Xi-Cleft points of yang meridians plus topical surrounding needling and pregabalin in treating postherpetic neuralgia(PHN)affecting the head and face and its influence on quality of life(QOL).Methods:Eighty patients with PHN affecting the head and face were randomized into an acupuncture-medication group and a Western medication group by their visiting sequence,with 40 cases in each group.The Western medication group took pregabalin capsules orally,75 mg each time,twice a day.The dosage could increase to 150 mg each time and twice a day within 1 week based on the efficacy and tolerance.The treatment lasted for 5 weeks.The acupuncture-medication group was given additional surrounding needling at the herpes zoster on the head and face,and Xi-Cleft points of yang meridians were chosen according to the affected area for acupuncture,once every other day,for 5 weeks in total.Results:Prior to treatment,there were no significant differences in the visual analog scale(VAS)and QOL scores between the two groups(both P>O,05).After treatment,VAS and QOL scores dropped significantly in both groups(all P<0.01),and were significantly lower in the acupuncture-medication group than in the Western medication group(both P<0.01).The total effective rate was 67.5%in the Western medication group,versus 92.5%in the acupuncture-medication group,and the b etwee n-group difference was statistically significant(P<0.05).Conclusion:Based on oral administration of pregabalin,needling the Xi-Cleft points of yang meridians and topical surrounding needling can reduce PHN,notably improve patients'QOL,and produce more significant efficacy than oral administration of pregabalin alone。

Clinical study of acupuncture combined with medication for the elderly with Alzheimer disease

Objective:To observe the impact of mind-regulating acupuncture plus donepezil on the cognitive ability,mean cerebral blood flow velocity,event-related potential P300,and activities of daily living(ADL)in the aged patients with Alzheimer disease(AD).Methods:Sixty senile AD patients were divided into a treatment group and a control group following the envelope method for random allocation,with 30 cases in each group.Based on the conventional treatment of the internal medicine,the control group received oral donepezil,and the treatment group received oral donepezil plus mind-regulating acupuncture.After 4-week treatment,the two groups were evaluated by the mini-mental state examination(MMSE),Alzheimer disease assessment scale-cognitive part(ADAS-Cog),and ADL;changes in P300 and the mean cerebral blood flow velocity were also observed.Results:Before treatment,there were no significant differences in the scores of MMSE,ADAS-Cog,or ADL between the two groups(P>0.05).The MMSE score increased after treatment in both groups and was notably higher in the treatment group than in the control group,showing intra-group and inter-group statistical significance(P<0.05).After treatment,the ADAS-Cog and ADL scores dropped in both groups and were markedly lower in the treatment group than in the control group,also showing intra-group and inter-group statistical significance(P<0.05).Compared with the same group before treatment,the latency of P300 was shortened and the amplitude was extended in both groups,all with statistical significance(P<0.05);the latency was shorter and the amplitude was larger in the treatment group than in the control group after treatment,presenting significant between-group differences(P<0.05).The mean blood flow velocity accelerated after the intervention in both groups,and the differences were statistically significant(P<0.05);the improvement in the treatment group was more notable than that in the control group(P<0.05).Conclusion:Mind-regulating acupuncture plus donepezil can regulate the latency and amplitude of P300,increase cerebral blood flow,and improve the learning and memory abilities of AD patients.

Effect of Combined Acupuncture and Medication for Hypertension due to Type 2 Diabetes Mellitus and Plasma Neuropeptide Y

Objective： To observe the effect of combined acupuncture and medication for hypertension due to type 2 diabetes and plasma Neuropeptide Y （NPY）. Methods： Sixty cases with hypertension due to type 2 diabetes were randomized into two groups. Thirty cases in the treatment group were treated with acupuncture and oral extended release nifedipine tablets, while 30 cases in the control group were treated with oral extended release nifedipine tablets alone. After 15 d of treatment, the blood pressure and NPY contents in two groups were observed. Results： The blood pressure and NPY contents in the two groups were remarkably reduced （P〈0.01） and the effect in the treatment group was superior to the control group （P〈0.01）. Conclusion： Combined acupuncture and medication can significantly reduce blood pressure and the NPY contents.