Evaluating the clinical application and effect of acupuncture therapy in anal function rehabilitation after low-tension rectal cancer surgery

BACKGROUND According to the indexes of serum and anal function,acupuncture therapy was applied to patients with low rectal cancer in order to avoid the occurrence of anal incontinence and reduce complications.AIM To explore the clinical application and evaluate the effect of acupuncture therapy for anal function rehabilitation after low-tension rectal cancer surgery.METHODS From the anorectal surgery cases,we selected 120 patients who underwent colorectal cancer surgery between January 2020 and December 2022 and randomly divided them into a control group(n=60),observation group(n=60),and control group after surgery for lifestyle intervention(including smoking cessation and exercise),dietary factor adjustment,anal movement,and oral loperamide treatment.The serum levels of motilin,5-hydroxytryptamine,and vasoactive intestinal peptide(VIP),Wexner score for anal incontinence,and incidence of complications were compared between groups.RESULTS After treatment,the VIP and 5-hydroxytryptamine levels in the observation group were lower than those in the control group(P<0.05).The motilin level was higher than that in the control group(P<0.05).Postoperative anal incontinence was better in the observation group than in the control group(P<0.05).The incidence of complications in the observation group was 6.67%,which was significantly lower than that in the control group(21.67%;P<0.05).CONCLUSION Acupuncture therapy has a positive effect on the rehabilitation of anal function after low-tension rectal cancer surgery;it can effectively help to improve the serum indices of patients,avoid the occurrence of anal incontinence,and reduce the incidence of complications.Popularizing and applying it will be valuable.

Advances in Acupuncture and its Associated Therapies for the Prevention and Treatment of Obesity Type 2 Diabetes Mellitus

Obesity type 2 diabetes mellitus is a common metabolic disease in clinical practice,and its prevalence is increasing rapidly with the aging of the population and changes in lifestyle.Acupuncture,as a distinctive therapy,has its unique advantages in the treatment of obesity type 2 diabetes and has an irreplaceable role in a variety of treatment methods.The author organized the literature on acupuncture and its related therapies to prevent and treat obesity type 2 diabetes in recent years and found that acupuncture and its associated therapies to prevent and treat obesity type 2 diabetes mainly include:simple acupuncture,electroacupuncture,acupoint catgut embedding therapy,auricular-plaster therapy and other treatments,all of which can safely and effectively improve clinical symptoms,acupuncture and its related therapies to treat obesity type 2 diabetes has a broad prospect,worthy of further clinical promotion.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE THERAPY FOR SIMPLE OBESITY COMPLICATED WITH PREMENSTRUAL TENSION SYNDROME

Objective: To observe the therapeutic effect of acupuncture therapy in the treatment of simple obesity complicated with premenstrual tension syndrome. Methods: A total of 39 cases of simple obesity complicated with premenstrual tension were treated by combination of body acupuncture and otoacupuncture based on syndrome-differentiation of traditional Chinese medicine (TCM). Symptoms, physical signs, obesity indexes and cumulative scores of clinical disease-syndrome before and after treatment were analyzed and compared. Results: After one, two and three courses of treatment, the effective rates were 69.23%, 79.49% and 87.18% respectively. Conclusion: Acupuncture therapy works well in the treatment of simple obesity with concurrent premenstrual tension syndrome.

Study of wrist-ankle acupuncture therapy for optimizing anaesthesia scheme of painless gastroscopy and improving painless gastroscopy related complications

BACKGROUND Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical work,adverse drug reactions of anaesthesia schemes are often one of the important areas of concern for doctors and patients.With the increase in propofol dosage,the risk of serious adverse drug reactions,such as respiratory depression and hypotension,increases significantly;the use of opioids often causes gastrointestinal reactions in patients after examination,such as nausea,vomiting,delayed recovery of gastrointestinal function and other complications,which seriously affect their quality of life.AIM To observe the effect of wrist-ankle acupuncture therapy on the anaesthesia regimen and anaesthesia-related complications during and after painless gastroscopy examination.METHODS Two hundred patients were selected and randomly divided into a treatment group(n=100)and a control group(n=100).Both groups were routinely anaesthetized with the nalbuphine and propofol regimen,gastroscopy began after the patient lost consciousness,and given supportive treatment and vital sign monitoring.If the patient interrupted the surgery due to intraoperative torsion,intravenous propofol was used to relieve his or her discomfort.The treatment group received wrist-ankle acupuncture on this basis.RESULTS The general data before treatment,American Society of Anesthesiologist(ASA)grade and operation time between the two groups was no significant difference.The Wakeup time,and the Selfambulation time in the treatment group was significantly faster than that in the control group(P<0.05).The total dose of propofol in the treatment group was 109±8.17 mg,significantly lower than that in the control group(P<0.05).The incidence of respiratory depression and hypotension was not significantly different,but the incidence of hiccups was significantly lower than that in the control group(P<0.05).After the examination,the incidence of nausea,vomiting,abdominal distension,and abdominal pain was 11%,8%,6%,and 5%,respectively,which was significantly lower than that in the control group(P<0.05).In addition,both the operators and the patients were more satisfied with this examination,with no significant difference between the groups(P>0.05).CONCLUSION Wrist-ankle acupuncture treatment can optimize the painless gastroscopy and anaesthesia scheme,reduces propofol total dose;shortens patient Wakeup time and Self-ambulation time,improves patient compliance and tolerance,is beneficial to clinical application.

Management of male obesity-related secondary hypogonadism:A clinical update

The global obesity pandemic has resulted in a rise in the prevalence of male obesity-related secondary hypogonadism(MOSH)with emerging evidence on the role of testosterone therapy.We aim to provide an updated and practical approach towards its management.We did a comprehensive literature search across MEDLINE(via PubMed),Scopus,and Google Scholar databases using the keywords“MOSH”OR“Obesity-related hypogonadism”OR“Testosterone replacement therapy”OR“Selective estrogen receptor modulator”OR“SERM”OR“Guidelines on male hypogonadism”as well as a manual search of references within the articles.A narrative review based on available evidence,recommendations and their practical implications was done.Although weight loss is the ideal therapeutic strategy for patients with MOSH,achievement of significant weight reduction is usually difficult with lifestyle changes alone in real-world practice.Therefore,androgen administration is often necessary in the management of hypogonadism in patients with MOSH which also improves many other comorbidities related to obesity.However,there is conflicting evidence for the appropriate use of testosterone replacement therapy(TRT),and it can also be associated with complications.This evidence-based review updates the available evidence including the very recently published results of the TRAVERSE trial and provides comprehensive clinical practice pearls for the management of patients with MOSH.Before starting testosterone replacement in functional hypogonadism of obesity,it would be desirable to initiate lifestyle modification to ensure weight reduction.TRT should be coupled with the management of other comorbidities related to obesity in MOSH patients.Balancing the risks and benefits of TRT should be considered in every patient before and during longterm management.

Effect of Acupressure Therapy on Anti-inflammatory Mechanism in Obesity-induced IR Rats

[Objectives] To study the effect of "acupressure therapy" on anti-inflammatory mechanism in obesity-induced IR rats. [Methods] 10 rats were randomly selected and fed with normal diet as blank group, and the remaining 30 rats were fed with high-fat diet for 8 weeks. The obesity-induced IR model was induced and divided into two groups: model group and acupressure group. The acupressure group was treated by "acupressure therapy" three times a week for 6 weeks;the model group was taken 3 times at the same time every week, and the supine binding experiment lasted for 10 min for 6 weeks. Morphological observation was carried out before and after the experiment, mainly observing the general conditions and body weight. After the last intervention, the animals were killed and samples were collected. Western Blot method was used to detect the expression of TNF-α and IL-6 protein in adipose tissue of the three groups. [Results] Compared with the blank group, the expression of TNF-α and IL-6 protein in adipose tissue of the model group increased significantly ( P <0.01);compared with the model group, the expression of TNF-α and IL-6 protein in adipose tissue of the acupressure group decreased significantly ( P <0.01). [Conclusions] After intervening in the obesity-induced IR rats with acupressure method, the status of insulin resistance in obese rats was improved by inhibiting the expression of inflammatory factors.

Acupuncture therapies in combination with conservative treatments for postoperative ileus:a systematic review and network meta-analysis

Background:Although acupuncture therapies have been widely used in combination with conservative treatments(CT)for postoperative ileus(POI),evidence of their safety and efficacy remains scarce.To evaluate and rank the efficacy of different acupuncture therapies combined with CT for POI.Methods:A comprehensive search was carried out in several databases(Embase,PubMed,Cochrane Library,Chinese National Knowledge Infrastructure,Wanfang Data,VIP Chinese Science and Technology Periodical Database and China Biology Medicine disc)for relevant randomized controlled trials(RCTs)investigating different acupuncture therapies for POI from inception to February 17,2023.The Cochrane risk of bias tool was used to determine the risks of bias of the included RCTs.The primary outcomes included the time to first defecation,time to first flatus,and time to first bowel movement;and the secondary outcome was the response rate.Pairwise meta-analysis was performed by Review Manager 5.3 software,and network meta-analysis was carried out by Stata v.15.0 software.The cumulative ranking curve was obtained with Stata v.15.0 and was utilized to rank the included treatments.Results:29 studies with 2,600 participants were included in this systematic review.This meta-analysis demonstrated that all acupuncture therapies combined with CT were superior to conservative treatments alone in time to first defecation,time to first flatus,time to first bowel movement,and response rate.Among 10 evaluated methods,auricular needle with CT was the most effective treatment to reduce the time to first defecation.Furthermore,moxibustion with CT was the most effective in reducing the time to first flatus,and warm needling with CT most markedly reduced the time to first bowel movement among 9 interventions.Moreover,manual acupuncture with CT showed the largest improvement in response rate.Conclusion:This meta-analysis revealed that all acupuncture therapies are effective and safe for POI,with warm needling+CT being the most effective way to relieve symptoms.These results indicated that acupuncture therapies combined with CT should be considered for POI patients.However,most of the included trials were ranked as moderate quality,and further large-scale,high-quality RCTs are required to confirm the optimal interventions for POI patients.

Electroacupuncture regulates glucose-inhibited neurons in treatment of simple obesity

The glucose-inhibited neurons present in the lateral hypothalamic area are regarded as glucose detectors. This structure is involved in the regulation of food intake through extracellular blood glucose concentrations, and plays a crucial role in obesity onset. In the present study, obesity models established with high fat feeding were treated with electroacupuncture at Zusanli （ST36）/ tnner Court （ST44） on the left side and Tianshu （ST25） bilaterally. We found that electroacupuncture could effectively reduce body weight and the fat-weight ratio, and decrease serum leptin, resistin, tumor necrosis factor alpha, and neuropeptide Y levels, while increase serum adiponectin and cholecystokinin-8 levels. This treatment altered the electrical activity of glucose-inhibited neurons in the lateral hypothalamic area, with electroacupuncture at Zusanli/Inner Court exerting an inhibitory effect, while electroacupuncture at bilateral Tianshu exerting an excitatory effect. These data suggest that electroacupuncture at the lower limbs and abdominal cavity is an effective means for regulating the activity of glucose-inhibited neurons in the lateral hypothalamic area and for improving the secretory function of adipose tissue.

PROPHYLACTIC AND THERAPEUTIC EFFECTS OF ACUPUNCTURE ON SIMPLE OBESITY COMPLICATED BY CARDIOVASCULAR DISEASES

In order to understand the prophylactic-therapeutic effects of acupuncture and moxibustion insimple obesity complicated by cardiovascular diseases,we have observed in 102 cases the changesof pathogenetic and hazardous factors and the regulating function of vegetative nerves oncardiovascular activities.The results showed that the therapeutic effect of acupuncture andmoxibustion was good with a total effective rate of 88.24%.At the same time,acupuncture andmoxibustion were found to have a benign conversion effect on the loin hip ratio(the pathogeneticfactor),the arteriosclerotic index(the hazardous factor),and the vegetative nerve function ofregulating the heart and blood vessels(the equilibrium indices of the vegetative nervous system).All this suggests that acupuncture is a treatment of choice for obesity and an important methodof preventing and treating complicating cardiovascular diseases.

SIMPLE OBESITY AND OBESITY HYPERLIPEMIA TREATED WITH OTOACUPOINT PELLET PRESSURE AND BODY ACUPUNCTURE

161 cases of simple obesity with or without hyperlipemia were treated by pellet pressure onauricular acupoints plus body acupuncture for 3 months in a single-blind experiment.Pa-tients on Capsulae Oiei Oenothera Erythrosepalae were taken as positive controls.Bodyweight,circumference of chest,abdomen,arms and legs,the appetite,sleep,bowelmovement,blood TC,TG and HDL-C were recorded for comparison.The results indicatedthat treatment in the auricular and body acupoint group was superior to treatment in thecontrol group.In the acupoint group body weight dropped by an average of 5.04 kg in84.55% of the patients,who also showed decreased appetite,blood TC and TG.

Observation on the Therapeutic Effects of Acupuncture for 60 Cases of Simple Obesity

Simple obesity refers to a disease characterized by body overweight due to excessive calorie intake and over accumulation of adipose tissue in the body. With the improvement of life conditions, obesity has become a factor that impairs the health of the people. From 1997 to 1998, the author had treated 60 cases of simple obesity with acupuncture and obtained satisfactory results. The results of treatment are reported as follows.

Screening of acupuncture treatment for simple obesity

Objective:Observe the advantages and characteristics of Acupuncture therapy and Point Thread Embedding therapy in the treatment of simple obesity and to select the superior treatment schemes.Methods:on the basis of syndrome differentiation,acupuncture and Point Thread Embedding therapy were adopted respectively for 3 courses of treatment.Observe the changes of body weight and abdomen/waist/hip circumference in different stages of treatment and evaluate the curative effect.Results:Both acupuncture and Point Thread Embedding could lessen the weight and the abdomen/waist/hip circumference of simple obesity.Acupuncture and Point Thread Embedding can not only reduce body weight,but also improve clinical symptoms of simple obesity.The effect rate of clinical symptoms is better than that of weight(P<0.05);The efficiency of Point Thread Embedding group is better than that of Acupuncture group(P<0.05).There was no significant weight loss from the second course of treatment especially in acupuncture group(P>0.05).Conclusion:Acupuncture and Point Thread Embedding in the treatment of simple obesity focus more on the adjustment of body shape and constitution of obese patients;Compare with acupuncture treatment,point thread embedding group had a slower onset time and a longer duration of curative effect while acupuncture group had a faster onset time but a shorter duration.When the body weight is reduced to 5kg,the plateau stage occurs.Point Thread Embedding therapy is easier to be popularized and applied in clinic Because of its convenient and stable therapeutic effect.

INFLUENCE OF ACUPUNCTURE ON INSULIN RESISTANCE IN PATIENTS WITH SIMPLE OBESITY

Objective To investigate clinical therapeutic effect and regulative function of acupuncture on insulin resistance in patients with simple obesity. Methods Acupuncture was applied at the eight points surrounding the umbilicus: bilateral Tianshu (天枢ST 25), Huaroumen (滑肉门ST 24) and Wailing (外陵ST 26), Yinjiao (阴交CV 7) and Shuifen (水分CV 9), and also Guanyuan (关元CV 4) and Zusanli (足三里ST 36), and the ear embedding method was used in combination in 50 cases of simple obesity. The changes in FBG, INS, ISI, TC, TG, LDL-C and HDL-C after the treatment were observed. The changes in waistline (WL) and hip circumference (HC), their ratio (WL/HC), body weight (BW) and body mass index (BMI) after the treatment were also observed, and the therapeutic effects were compared between the patients with obesity in Grade Ⅰ and Grade Ⅱ. The aforementioned values were compared with those in the control group comprised of 30 normal subjects. Results Hyperinsulinemia (HI) appeared in the patients with simple obesity, and the value of ISI was obviously decreased, compared with that in normal subjects ( P<0.01 ). After the treatment, the values of WL, HC, WL/HC, BW and BMI were all obviously decreases ( P<0.05 ), and those of FBG, INS, TC, TG and LDL-C also reduced ( P<0.01 ), but those of ISI and HDL-C obviously increased ( P<0.05 ). Conclusion Acupuncture can not only efficiently improve the parameters in body fat in the patients with simple obesity, but also regulate their abnormal lipid metabolism and improve the situation of insulin resistance.

RECENT RESEARCHES ON THE TREATMENT OF OBESITY WITH ACUPUNCTURE AND MOXIBUSTION

The paper reviews the treatment of obesity with ear acupuncture and bodyacupuncture as well as the two methods combined since 1987. From the influence of acupuncture oncarbohydrate metabolism, fat metabolism, regulation of hormone, function of autonomic nerve, en-docrine, digestive and renal functions, etc., the mechanism is also explored.

CLINICAL EXPERIENCE IN ACUPUNCTURE TREATMENT OF OBESITY

Obesity manifests itself as derangement of qi and blood with disorder of the defensive qi inparticular to be a causative factor of primary importance,meanwhile,deficiency of theprimary qi in Sanjiao may also contribute to it.Fundamentally,its pathological changesare also related to dysfunction of the spleen and stomach.According to syndromedifferentiation,obesity can be classified into three types,namely,heat in the stomach andintestine,spleen and stomach qi deficiency,and deficiency of primary qi.The mainmethods of treatment include clearing and reducing heat in the stomach and intestine;regulating qi in the fu organs and promoting water metabolism;balancing and regulatingqi and blood,yin and yang,and removing stagnation of defensive qi.

75 CASES OF SIMPLE OBESITY TREATED WITH AURICULAR AND BODY ACUPUNCTURE

The author adopted auricular and body acupuncture in the treatment of obesity with satisfactory results as reported in the following: Clinical Data The series of 75 cases were diagnosed simple obesity for lack of evidence of any primary disease; age range was 17-65 years,

COMPARISON OF THE THERAPEUTIC EFFECT OF AURICULAR ACUPUNCTURE, BODY ACUPUNCTURE AND COMBINATION OF AURICULAR PLUS BODY ACUPUNCTURE FOR TREATMENT OF SIMPLE OBESITY

Objective: To observe the therapeutic effect of auricular acupuncture (AA), body acupuncture (BA) and AA + BA for treatment of simple obesity. Methods: A total of 195 cases of obesity patients including 8 males and 187 females were randomly divided into AA group (n=55), BA group (n=64) and AA+ BA group (n=76). Acupuncture treatment was given to the patient once every other day, with 12 sessions being a therapeutic course. Results: Af ter one course of treatment, ofthe55 cases in AA group, 1 case (1.8%) was cured, 15(27.3%) had marked improvement, 11(20.0%) had improvement and 28 (50.9%) failed in treatment, with the total effective rate being 49.9%.In BA group, of the 64 cases, 11(17.2%) were cured, 23 (35.9%) had striking improvement, 18 (28. 1%) had improvement and 12 (18.8%) failed in treatment, with an effective rate of 81.2%. In AA+ BA group, of the 76 cases, 16 (21. 1%) were cured, 35 (46. 1%) had significant amelioration, 20 (26.3%) had amelioration and 5 (6. 6%) failed in treatment, with the effective rate being 93.4%. Statistical analysis showed that the therapeutic effect of BA and AA+ BA groups was significantly superior to that of AA group (P< 0.05); and that of AA+ BA group was higher than that of BA group. Conclusion: The therapeutic effect of BA and AA+ BA was superior to that of AA in treatment of simple obesity.

Traditional Chinese manual acupuncture for management of obesity: A systematic review

AIM： To evaluate the effectiveness and safety ofacupuncture for the treatment of obesity by reviewing currently available randomised controlled trials.METHODS： This review followed the Cochrane Hand-book for Systematic Reviews of Interventions. Fifteen English and three Chinese databases were searched from their respective inceptions until July 2014. Key words used in the search consisted of acupuncture, needles, obesity, overweight, randomised trial and their synonyms. The risk of bias of included studies was assessed. The differences in effect size between acupuncture and control （including sham, no treatment, western medicine and dietary therapy/exercise） groups were compared using Cochrane Collaboration’s RevMan5.3 software.RESULTS： Two thousand six hundred and twenty-one records were identifed; after full-text articles assessed for eligibility, 9 of them met inclusion criteria. Majority of included studies had unclear or high risk of bias across all domains. All included studies had high or unclear risk of bias in randomisation, blinding and outcome data. Meta-analysis showed that acupuncture was more effective for reducing body weight and body mass index than no treatment group. Manual acupuncture was also superior to dietary therapy alone for decreasingbody weight. With dietary therapy as co-intervention, combined acupuncture group achieved lower body mass index than combined sham acupuncture group or dietary therapy alone group at the end of treatment period. No severe adverse events from acupuncture group were reported from all included studies.CONCLUSION： Due to the poor quality of included studies the effectiveness of acupuncture cannot be concluded. Better-designed, large-scale, randomised, sham-controlled clinical trials with long-term follow-up are needed.

EFFECT OF ACUPUNCTURE ON HYPERLEPTINAEMIA AND HYPERINSULINEMIA IN OBESITY RATS

Objective: To observe the effect of acupuncture on hyperleptinaemia and hyperinsulinemia for studying its underlying mechanism about anti-obesity and reducing blood lipid in obesity rats. Methods: A total of 80 SD rats were randomized into normal control, model, acupuncture and medication groups, with 20 cases in each group. Hypothalamic obesity model was established by subcutaneous injection of 15% sodium glutamate (0.2 mL/10 g body weight), once daily and continuously for 5 days. “Zusanli” (足三里 ST 36), “Sanyinjiao”(三阴交 SP 6), “Guanyuan”(关元 CV 4) and “Zhongwan”(中脘 CV 12) were punctured and stimulated electrically (100 Hz, dense-sparse waves, and a suitable strength inducing local muscular tremor) for 15 min, once daily. In medication group, rats were fed with Sibutramine 4 mg/kg, once daily. After 4 weeks’ treatment, Lee’s index was detected, and serum leptin and insulin contents were determined by radioimmunoassay (RIA). Results: Compared with normal control group, Lee’s index, serum leptin and insulin contents of model group increased significantly (P<0.01). Comparison between acupuncture and model groups, Lee’s index and serum leptin of acupuncture group decreased significantly (P<0.01), and serum insulin level also lowered. In comparison with model group, Lee’s index, serum leptin and insulin levels of medication group also lowered. Comparison between acupuncture and medication groups showed that Lee’s index and serum leptin level of acupuncture group were significantly lower than those of the later group (P<0.01), displaying that the therapeutic effect of acupuncture is better than that of Sibutramine in lowering Lee’s index and serum leptin. No significant differences were found between acupuncture and medication groups in body weight and length and serum insulin(P>0.05). Conclusion: Acupuncture can effectively reduce Lee’s index, serum leptin and insulin contents in fasting obese rats, which may contribute to its effect in anti-obesity.

EFFECT OF ACUPUNCTURE TREATMENT ON CELLULAR HEMORHEOLOGY, CHOLESTEROL AND TRIGLYCERIDE OF SIMPLE OBESITY PATIENTS

Objective: To observe the effect of acupuncture on simple obesity and cellular hemorheology. Methods: Thirty-two cases of simple obesity patients were enrolled into this study. Acupoints of the Stomach Meridian and Spleen Meridian as Zhongwan (中脘 CV 12), Liangmen (梁门 ST 21), Tianshu (天枢 ST 25), Guayuan (关元 CV 4), etc. were punctured, once daily in the first 5 days, and once every other day afterwards, with 10 sessions being a therapeutic course. Before treatment and after 3 courses of treatment, the body weight, waistline, weight index, seam cholesterol (CH), triglyceride and aggregation index of red blood cell (RBC) were detected. Results: After acupuncture treatment, all the indexes of body weight, waistline, weight index, serum CH, triglyceride and aggregation index of RBC decreased significantly in comparison with those of pre-treatment(P< 0.05). Conclusion: Acupuncture can apparently improve cellular hemorheology, reduce body weight, serum cholesterol and TG levels in simple obesity patients.