Early filiform needle acupuncture for poststroke depression: a meta-analysis of 17 randomized controlled clinical trials

OBJECTIVE： To evaluate the effectiveness and safety of filiform needle acupuncture for poststroke depression, and to compare acupuncture with the therapeutic efficacy of antidepressant drugs. DATA RETRIEVAL： We retrieved data from the Chinese National Knowledge Infrastructure （1979-2012）, Wanfang （1980-2012）, VIP （1989-2012）, Chinese Biomedical Literature （1975- 2012）, PubMed （1966-2012）, Ovid Lww （-2012）, and Cochrane Library （-2012） Database using the internet. SELECTION CRITERIA： Randomized controlled trials on filiform needle acupuncture versus antidepressant drugs for treatment of poststroke depression were included. Moreover, the in- cluded articles scored at least 4 points on the Jadad scale. Exclusion criteria： other acupuncture therapies as treatment group, not stroke-induced depression patients, score 〈 4 points, non-ran- domized controlled trials, or animal trials. MAIN OUTCOME MEASURES： These were the Hamilton Depression Scale scores, clinical ef- fective rate, Self-Rating Depression Scale scores, Side Effect Rating Scale scores, and incidence of adverse reaction and events. RESULTS： A total of 17 randomized controlled clinical trials were included. Meta-analysis results displayed that after 4 weeks of treatment, clinical effective rate was better in patients treated with fill- form needle acupuncture than those treated with simple antidepressant drugs [relative risk = 1.11, 95% confidence interval （C/）： 1.03-1.21, P = 0.01]. At 6 weeks, clinical effective rate was similar between filiform needle acupuncture and antidepressant drug groups. At 2 weeks after filiform needle acupuncture, Hamilton Depression Scale （17 items） scores were lower than in the antide- pressant drug group （mean difference = -2.34, 95%CI： -3.46 to -1.22, P 〈 0.000,1）. At 4 weeks, Hamilton Depression Scale （24 items） scores were similar between filiform needle acupuncture and antidepressant drug groups. Self-Rating Depression Scale scores were lower in filiform needle acupuncture group than in the antidepressant drug group. Side Effect Rating Scale was used in only two articles, and no meta-analysis was conducted. Safety evaluation of the 17 arti- cles showed that gastrointestinal tract reactions such as nausea and vomiting were very common in the antidepressant drug group. Incidence of adverse reaction and events was very low in the filiform needle acupuncture group. CONCLUSION： Early filiform needle acupuncture for poststroke depression can perfectly con- trol depression. Filiform needle acupuncture is safe and reliable. Therapeutic effects of filiform needle acupuncture were better than those of antidepressant drugs.

Filiform needle acupuncture for poststroke depression

To the editor, I read with interest the recent report on ＂filiform needle acupuncture for poststroke depression＂ （Zhang et al., 2014）. Zhang et al. （2014） performed a meta-analysis and conclud- ed that ＂early filiform needle acupuncture for poststroke depression can perfectly control depression：＇ In fact, the in- cluded meta-analysis might support the clinical effectiveness of filariform needle acupuncture for poststroke depression. However, there are several concerns. First, the hospital infection due to acupuncture manipulation with filiform is a big topic to be addressed. As Gang et al. （2012） noted, ＂aseptic technic principles aren＇t strictly followed; disinfection and isolation systems are unsound;

Surrounding Needling with Fire Needle and Filiform Needle Plus Moxibustion in the Treatment of Lower Limb Herpes Zoster:One Case Report

Introduction Herpes zoster is a skin disease caused by activation of the varicella zoster virus,which is latent in neurons.It can be accompanied by severe neuralgia.Some herpes zoster patients may have pain allergy,general discomfort,loss of appetite and other prodromal symptoms,typical clinical manifestation as a cluster of blisters distribution along unilateral peripheral nerve,often accompanied by obvious neuralgia[1].

Fire needle combined with filiform needle therapy for hemifacial spasm： a case report

Objective： Hemifacial spasm （HFS） is characterized by involuntary unilateral contractions of the muscles, usually starting around the eyes before progressing inferiorly to the cheek, mouth, and neck. Here we described the use of fire needle combined with filiform needle for a patient with HFS on the left face. Methods： The fire needle was inserted into the points of Du meridian and the first lateral line of bladder meridian, combined with the points of the Ashi points around the left eye, Guanyuan （CV 4）, Qihai （CV 6）, Xiawan （CV 10）, Zhongwan （CV 12）, Tianshu （ST 25）, Guilai （ST 29） and Daheng （SP 15）. The filiform needle was used to acupuncture the points located on the left side of face including Cuanzhu （BL 2）, Tongziliao （GB 1）, Yangbai （GB 14）, Fengchi （GB 20）, Sizhukong （TE 23） and Sibai （ST 2）. Results： The patient received the combined therapy of fire needle and filiform needle for 9 times in 5 weeks. After that, the symptoms of dull sensation in the left facial area and the twitching of the muscles of the left eye were improved remarkably. Conclusions： The fire needle combined with filiform needle therapy has the potential to cure HFS.

World Federation of Acupuncture-Moxibustion Societies(WFAS)Technical Benchmark of Acupuncture and Moxibustion:Filiform Needle

On December 31,2023,World Federation of Acupuncture-Moxibustion Societies(WFAS)officially issued Technical Benchmark of Acupuncture and Moxibustion:Filiform Needle.This technical benchmark clarifies terms and definitions,operating procedures and requirements,safety requirements,etc.The promulgation and implementation of this technical benchmark would provide a standard for acupuncture practitioners to apply filiform needle in clinical practice,and may play a positive role in the safe use and promotion of filiform needle.

Filiform needle acupuncture for allergic rhinitis:A systematic review and meta-analysis

Background:Filiform needle acupuncture(FNA),the most classical and widely applied acupuncture method based on traditional Chinese medicine theory,has shown a promising effect in the treatment of allergic rhinitis(AR).Objective:To evaluate the efficacy,safety,cost-effectiveness,and patient preference of FNA in the treatment of AR by comparing FNA with sham acupuncture,no treatment,and conventional medication.Search strategy:Eight electronic databases were systematically searched from inception to October 14,2021.Additional studies were acquired from clinical trial registration platforms and reference lists.Inclusion criteria:Randomized controlled trials were included if they compared FNA with either sham acupuncture,no treatment or conventional medication for AR.Data extraction and analysis:Two researchers extracted data independently of each other using a predesigned data acquisition form,and results were cross-checked after completion.The primary outcome was symptom score(Total Nasal Symptom Score or Visual Analogue Scale),and the secondary outcomes were the AR control questionnaire,quality of life(QoL)score(Different versions of Rhinoconjunctivitis Quality of Life Questionnaire),medication score(use of rescue medication),mental health score,total IgE,adverse event rate,clinical economic indicators,and patient satisfaction score.Standardized mean difference(SMD)or mean difference(MD)with 95% confidence interval was used to calculate the effect size for continuous data,while risk ratio with 95%CI was used for dichotomous data.Results:Thirty studies were included in this review.Compared with sham acupuncture,FNA significantly reduced the symptom score(SMD:-0.29[-0.43,-0.15]),AR’s impact on QoL(SMD:-0.23[-0.37,-0.08])and medication score(SMD:-0.3[-0.49,-0.11]).Compared with no treatment,FNA dramatically reduced the symptom score(SMD:-0.8[-1.2,-0.39])and AR’s impact on QoL(SMD:-0.82[-1.13,-0.52]).There were no increased rates of adverse events with FNA compared to sham acupuncture and no treatment.FNA increased patient satisfaction and may be cost-effective.Most pieces of evidence from the above two comparisons were of high confidence.Moreover,FNA significantly outperformed conventional medication in reducing the symptom score(SMD:-0.48[-0.85,-0.1])and displayed a lower rate of adverse events,but the quality of evidence was very low.Conclusion:FNA is an effective and safe intervention for AR and can help with symptom relief,QoL improvement,reducing medication usage,and increasing patient satisfaction.Further studies are needed to verify its cost-effectiveness and superiority over conventional medication and the best therapeutic strategies.

Fire needle combined with blood-letting therapy for a case of 20-year trigeminal neuralgia

Background： Trigeminal neuralgia （TN） is a neuropathic pain syndrome. It is the most frequent cranial neuralgia and defined as sudden, usually unilateral and lightning-like, knife-like or burning-like recurrent episodes of pain within the distribution area of one or more divisions of the trigeminal nerve. Here we reported that an 81-year-old woman with TN who complained of severe pain on her right face showed a complete clinical relief after comprehensive therapy containing fire needle, filiform needle and blood-letting therapy. Methods： The patient was applied fire needle combined with filiform needle therapy （3 times / week for 4 months） and three consecutive fire needle combined with blood-letting therapy （3 times / week for one week）. Fire needle was inserted into the back points of Du meridian, the first lateral line of bladder meridian, the right spreading area of the trigeminal nerve and the points around the pain radiation site. The filiform needle acupuncture was applied to the points on the right face including Yuyao （EX-HN4）, Yangbai （GB14）, Toulinqi （GB15）, et al; points on the abdomen including Xiawan （RN10）, Qihai （RN16）, Guanyuan （RN14） and the bilateral points including Tianshu （ST25）, Daheng （SP15）, Zusanli （ST36）, et al. Finally, the three-edged fire needle punctured the points of Yangbai （GB41）, Shangguan （GB3）, Jiache （ST6） on the right face accompanied by the cupping method on the bleeding points. Results： The patient reported the complete disappearance of pain and could open mouth and eat normally. The face was normal and no triggering pain recurred after one-month follow-up. Conclusions： The fire needle combined with blood-letting therapy can cure the TN and might provide an alternative non-drug therapy for those patients who still suffered from TN after other medical treatments or whom that refused surgical treatment.

Observation on the Curative Effect of"Hand and Foot 12 Needle Acupuncture"on Stroke in Convalescent Period of Phlegm-Dampness Constitution

Objective:To observe the clinical effects of"hand and foot 12 needle acupuncture"on stroke in convalescent period of phlegm-dampness constitution.Methods:The 90 patients were divided into the treatment group(n=45)and the control group(n=45)according to the random number table method.The control group received basic Western medicine treatment+rehabilitation treatment of Western medicine,and the treatment group was additively treated with"hand and foot 12 needle acupuncture"on the basis of the control group.NIHSS score,MRS score and Barthel index(BI)before and after treatment were observed in the two groups,and the clinical efficacy of the two groups was compared.Results:The clinical efficacy of stroke patients in the convalescent period of phlegm-dampness constitution after treatment:the total effective rate of the treatment group was 93.33%,and the total effective rate of the control group was 66.67%.After statistical processing,the clinical efficacy of the treatment group was significantly better than the control group;NIHSS score,MRS score and Barthel index(BI)were better than the control group,and the differences were statistically significant(P<0.05).Conclusion:"Hand and foot 12 needle acupuncture"treatment of phlegm-dampness constitution convalescent stroke clinical effect is remarkable.

PUSHING-PLUCKING STIMULATION OF ACUPOINTS WITH OX-HORN-MADE STICK NEEDLE FOR TREATMENT OF APOPLECTIC HEMIPLEGIA

The present series of treatment were made up of 103 cases of apoplectic hemiplegia patients. 55 cases of them formed stick needle group and were treated by using pushing plucking manipulation with stick needle and 48 cases formed filiform needle group and were treated with routine filiform needle. After 4 courses of treatment, results showed that the effective rates of stick needle group and filiform needle group were 54.5% and 52.08% respectively. Statistical analysis indicated that there was no significant difference between these two groups. Thus, stick needle is useful in convalescence medicine.

A COMPARATIVE STUDY ON HYPOTHALAMIC MECHANISMS OF ANALGESIA INDUCED BY FOUR KINDS OF ACUPUNCTURE THERAPIES IN ADJUVANT ARTHRITIS RATS

Objective.. To compare the mechanisms of analgesia induced by four kinds of acupunture therapies at the trypothalamic level in adjuvant arthritic rats. Methods： Forty-eight SD rats were randomized into normal, model, electroacupuncture （EA）, filiform needle （FN）, pricking blood-letting （BL） and point injection （PI） groups, with 8 cases in each. EA （20-100 Hz, 2-4 V and duration of 20 min）, FN, BL PI were respectively applied to “Kunlun” （昆仑 BL 60）. Arthritis model was established by injecting complete Freund＇s adjuvant （0.1 mL） into the rat＇s right foot pad. Behavioral reactions, pain threshold （latancy of tail flick to heat stimulation） and local swelling severity （foot volurne） were detected; the cordents of β-endorphin （β-EP） and α- drenocortiootropin （ACTH） were assayed with radioimmunoassay; and the expression of pro-opi-omelanocortin （POMC） mRNA in hypot were determined with hybridization method. Results： The pain threshold was significantly enhanced by all the four kinds of acupuncture therapies, and the effects of EA and PI were more obvious （P〈0.05, P〈0.01）. The severity of local swelling was markedly alleviated by all the four kinds of acupuncture therapies （ P〈 0.01 ） without significant differences among them （P 〉 0.05）. The content of β-EP in the hypothalamus was obviously elevated by EA and FN （P〈 0.05, P 〈 0.01 ）, and the effect of EA was more obvious, but no marked effect of BL or PI on β-EP was found （ P 〉0.05）. The content of ACTH in hypothalamus was considerably elevated by PI （P〈0.05）, but not by the other three therapies. The expression of PCMCmRNA in hypothalamus was significantly strengthened by EA and FN （P〈0. 01）, but not by the other two therapies. Conclusion：EA, flliform needle, blood-letting and point-injection all can produce analgesic effect in adjuvant arthritis rats, the effect of EA and filiform needie may be related to their resultant increase of hypothalamic β-EP, and that of point-injectiON related to the increase of hypothalamic ACTH level.

Effects of different acupuncture-moxibustion methods on the plasma SP content and expression of colonic SP mRNA of rats with functional constipation

Objective To explore the effects of different acupuncture-moxibustion methods on the plasma substance P（SP） content,and the expression of colonic SP m RNA of the rats with functional constipation.Methods Sixty healthy male SD rats were divided into six groups according to the random number table,including blank control group（group B,n=8）,model group（group M,n=11）,drug control group（group D,n=8）,filiform needle group（group F,n=11）,electroacupuncture group（group E,n=11） and moxibustion group（group MB,n=11）.The rats in group B and group M accepted no intervention,gavage with cisapride suspension was conducted in group D,and electroacupuncture,filiform needling and moxibustion therapies were carried out in group E,group F and group MB for 6 days.After treatment,the stool quantity and fecal moisture content during 24 h of the rats were observed in each group,colon tissue structure and the acidic mucus in mucosa layer were observed,plasma SP content was detected and the expression of colonic SP m RNA was detected.Results compared with group B,the stool quantity and fecal moisture content during 24 h of the rats in group M decreased significantly（P0.01）;compared with group M,the stool quantity during 24 h of the rats in each group increased（P0.05 or 0.01）,and the fecal moisture content during 24 h of the rats in each group also increased significantly except group MB（P0.01）;compared with group D,the fecal moisture content during 24 h of the rats in group MB decreased（P0.01）;according to the comparison among the groups with different acupuncture-moxibustion methods,there was no difference in the stool quantity during 24 h of the rats in each group（P0.05）,the fecal moisture contents during 24 h of the rats in group F and group E were higher than that of group MB（P0.01）,and there was no difference between group F and group E（P0.05）.HE staining of colon tissue of rats showed that the structure was normal and complete,and there was no difference among each group.PAS staining showed that the acidic mucus level of the rats in group M decreased significantly when compared with group B;compared with group M,the acidic mucus level of the rats in group D,fgroup F,group E and group MB increased in varying degrees.Compared with group B,the plasma SP content of the rats in group M decreased（P0.05）;compared with group M,the plasma SP contents of the rats in group F and group MB increased（P0.01）;the plasma SP contents of the rats in group F,group MB and group E were higher than that of group D（P0.05 or 0.01）;according to the comparison among the groups with different acupuncture-moxibustion methods,the plasma SP content of the rats in group F was higher than that of group MB and electro-acupuncture group（P0.05）,and there was no difference between group MB and group E.Compared with group B,the expression level of colonic SP m RNA of the rats in group M elevated（P0.05）;compared with group M,the expression level of colonic SP m RNA of the rats in the four intervention groups declined（P0.05）;compared with drug group D,there was no difference among group F,group E and group MB（P0.1）;according to the comparison among the groups with different intervention methods,the expression level of colonic SP m RNA of the rats in group MB was lower than that of group F（P0.05）.Conclusion The different efficacy of different acupuncture-moxibustion methods in treatment of functional constipation may be related with the mechanism of regulation of plasma SP content and the expression level of colonic SP m RNA.