Subconjunctival hemorrhage after wet cupping therapy: a case report

Introduction:Cupping therapy is an integrative and complementary medicine therapy that practiced worldwide by several civilizations for thousands of years.Cupping therapy is reported to be a relatively safe practice especially if performed by qualified therapists.Subconjunctival hemorrhage(SCH)is a common cause of eye redness and can be classified into traumatic and spontaneous.Case presentation:This case report discussed an adverse event related to wet cupping therapy.The patient developed SCH one day after performing cupping therapy.He was completely recovered after 2 weeks.This case report should increase the knowledge of cupping therapists regarding increasing safety of patient when performing wet cupping therapy on specific body parts especially,head,neck and cervical areas.Furthermore,it highlighted the importance of conducting research regarding the mechanical and physiological effects of cupping therapy.Conclusion:Adverse events related to cupping therapy should be reported with every patient.Cupping therapists should be aware of this possible mild adverse event.To the best of our knowledge,this is the first published adult case of SCH related to wet cupping therapy session.More studies are critically needed for evaluation of cupping therapy effects and adverse events especially when performed on head and neck.

A meta-analysis on the clinical efficacy of fire dragon cupping in the treatment of lumbar disc herniation

Background:The incidence of lumbar disc herniation(LDH)is notably high.Consensus among experts highlights non-surgical treatments as the primary therapeutic approach for LDH.Contemporary medicine frequently employs pharmacotherapy and epidural injections in such treatments,which are associated with numerous adverse effects.Prolonged use can severely impair the liver and kidney functions of patients.Hence,the role of safe and effective traditional Chinese medicine techniques becomes pivotal.Among various traditional Chinese medicine approaches for treating LDH,fire dragon cupping,renowned for its remarkable efficacy,cost-effectiveness,and ease of application,is extensively utilised in clinical settings for managing LDH.Nonetheless,there is a scarcity of systematic and standardised evidence from evidence-based medicine studies.Therefore,conducting a meta-analysis is imperative.Methods:A comprehensive computerised search was conducted in databases including China National Knowledge Infrastructure,WanFang Data,VIP,China Biology Medicine disc,PubMed,EMbase,The Cochrane Library,Web of Science,and CINAHL.The search aimed to gather randomised controlled trials on fire dragon cupping therapy for LDH,spanning from the inception of these databases until December 2023.Two researchers independently screened the literature according to inclusion and exclusion criteria,extracted data,and assessed the methodological quality of the studies included,utilising RevMan 5.3 software for meta-analysis.Results:The results show that the fire dragon cupping therapy group had better clinical effectiveness(relative risk=1.23,95%confidence interval(CI)(1.14,1.33),P<0.00001),less pain(standardized mean difference=–1.33,95%CI(–1.49,–1.16),P<0.00001),and some improvement in lumbar function(Japanese Orthopaedic Association scores:mean difference=3.37,95%CI(2.31,4.43),P<0.00001.Conclusion:The fire dragon cupping therapy significantly alleviates LDH,warranting its extensive application.However,considering the limitations in the number and quality of studies included,the aforementioned conclusion necessitates further validation through more high-quality research.

Observation on Therapeutic Effect of Lotus Needle Cupping Therapy for Removing Blood Stasis in Zhuang Medicine on PHN and Its Influ-ence on Inflammatory Mediators

[Objectives]To observe the clinical effect of the lotus needle cupping therapy for removing blood stasis in Zhuang medicine in treating PHNand its influence on inflammatory factors.[Methods]96 patients with PHN were randomly divided into three groups:lotus nee-dle cupping therapy group,TCM surrounding acupuncture group and gabapentin group.Venous blood and acupoint blood were collected at 0,21 and 42 d of treatment,and the expression levels of 5-HT,SP and CGRPinflammatory mediators were detected before and after treatment.The changes of VAS scores before,during and after treatment and the clinical efficacy were observed.[Results]The total effective rate of the lotus needle cupping group was 87.50%,which was better than that of the TCM acupuncture group(81.25%)and the gabapentin group(62.50%);after treatment,the VAS scores and the expression of inflammatory mediators in the three groups of patients were lower than those before treatment,and the decrease was more significant in the treatment group(P<0.05).[Conclusions]The lotus needle cupping therapy for removing blood stasis in Zhuang medicine is effective in treating PHN,and its mechanism is to reduce the release of inflammatory media-tors,reduce hyperalgesia,relieve pain and improve the quality of life of patients.

Technical operation specification for pricking-cupping therapy

Pricking-cupping therapy is a Traditional Chinese Medicine(TCM)nursing technology that can adjust the viscera of the human body,make the meridians smooth,and Yin and Yang balanced mainly by means of relieving heat and detoxification,harmonizing Qi and blood,promoting blood circulation and removing blood stasis,dredging meridians and activating collaterals,reducing swelling and pain,purging heat and calming shock,clearing heat,and opening orifices.Pricking-cupping therapy has a long history and wide application.After thousands of years of development,it has made great progress.They are widely used to treat lumbar disc herniation,herpes zoster,acute arthritis,migraine,and other diseases in China.Through the clinical practice and theoretical exploration of physicians of past dynasties,the therapeutic mechanism and application scope of pricking-cupping therapy have been greatly enriched.Modern TCM practitioners have conducted in-depth researches on the operation norms of the therapy on the basis of the ancients,hoping to grasp the essence of the disease more accurately and make the rational use of the operation technology of the therapy.

Technical operation specification for cupping therapy

Cupping,as one of the characteristic therapies of traditional Chinese medicine,has been applied for more than 2000 years and has a unique curative effect in clinic.With the evolution of the times,the types and operation techniques of cupping method are also iterating.In the process of its inheritance and development,cupping technology is also known by more and more people.Starting from the development and efficacy of cupping method,this paper introduces the clinical operation steps and precautions of cupping method in detail,and lists the representative diseases such as lumbar muscle strain,herpes zoster,and ankylosing spondylitis,to provide reference for clinical application.

Wet cupping(Al-hijamah)as a strange cause of ear trauma:A case report

BACKGROUND Cupping therapy is used across the globe since ancient Egypt.It is used as a complementary or alternative to daily clinical practice.Cupping therapy could be dry or wet(Al-hijamah)type.It is considered a relatively safe procedure for a variety of clinical problems like lower backache,shoulder pain,neck pain,headache,and migraine.Application of cupping therapy over body orifices is contraindicated.CASE SUMMARY A 27-year-old gentleman presented with sudden left-sided hearing loss and tinnitus for 7 d.He gave a history of upper respiratory tract infection 14 d before his complaints.He received Al-hijamah over his left ear 3 d before seeking advice from the Otolaryngology clinic,but without benefit.Physical examination showed a dull-looking left ear drum,hemotympanum in the posterior part of the tympanic cavity,two blood clots over the eardrum,and multiple bleeding points over the external ear canal and tympanic membrane.A pure tone audiogram and tympanogram confirmed the diagnosis of middle ear effusion.Conservative treatment(avoidance of water entry,antibiotics,and local and systemic decongestants)was given for 5 d.The presenting symptoms as well as ear injuries resolved completely two weeks after the follow-up.CONCLUSION We do not recommend using Al-hijamah directly over the ear as a treatment option for hearing loss to avoid unwanted ear trauma as well as there is no benefit from this kind of treatment.

Genetic Theory:An Illustration of a Theoretical Mechanism of Acton of Cupping Therapy

Cupping therapy is an ancient natural therapeutic modality which is widely practiced throughout the world.Cupping therapy mechanisms of action are not illustrated by research until now.This article gives a brief illustration of the genetic theory as a possible mechanism of action of cupping therapy.Genetic modulation is also a suggested mechanism of action of acupuncture and massage.

Extreme venous letting and cupping resulting in life-threatening anemia and acute myocardial infarction:A case report

BACKGROUND Wet cupping (WC) is a traditional therapy of skin suction-assisted bloodlettingthat is widely used in modern alternative medicine in Asia and the Middle East.Herein, we report the case of a male who presented with ST-elevation myocardialinfarction (STEMI) and life-threatening anemia and underwent excessive WC.CASE SUMMARY A 55-year-old male presented with chest pain (30 min) and dyspnea (3 wk). Hisinitial electrocardiogram suggested STEMI in the anterior wall. Furthermore, hislaboratory results showed severe anemia with a hemoglobin level of 4.1 g/dL. Ofnote, the patient underwent regular WC therapy for chronic back pain, which hehad recently intensified. His WC practice resulted in life-threatening anemia andeventually STEMI. Percutaneous coronary intervention in the left anteriordescending artery was performed to treat the STEMI. His dyspnea dramaticallyimproved after the transfusion, and his hemoglobin level returned to 14.8 g/dLwithin 2 mo after discharge. He has been uneventful for the last seven years offollow-up.CONCLUSION The current case demonstrates that excessive WC without adequate medicalmonitoring can result in severe anemia, which can further develop into STEMI.

Preliminary studies on the mechanism of blistering cupping therapy

Blistering cupping therapy, as a new type of cupping therapy, has attracted more and more attention of clinical doctor and scholars in home and abroad. Blistering cupping therapy achieves better effects through the formation of blistering fluid after suction. However, it is still controversial whether cupping induced blisters are beneficial to recovery of diseases, and the mechanism is still not completely clear. Here on the basis of the traditional cupping method, we aimed to identify the mechanism of blistering cupping from the levels of biomechanics and molecular biology. The negative pressure attraction induced by cupping suck should be of value in increasing pain threshold and relieving pain as well as improving the blood circulation and metabolism. Furthermore, the blistering fluid induced by cupping was the inflammatory substance actually that discharged through the superficial lymphatic vessels, including immunoglobulin, lysozyme, erythrocytes, etc. which could cause the autogenetic inflammatory reaction of selected cupping area, and further activated certain immune pathways including anti-oxidation, anti-apoptosis, tissue repairing and metabolic regulation. Besides, the formation of scar induced by blistering cupping was not only the result of excessive inflammatory response, but also involved in mobilizing the immune response.

An overview of systematic reviews of clinical evidence for cupping therapy

Background:As a traditional treatment method,cupping therapy is widely used in Asian countries.This overview of systematic reviews (SRs) investigated the effectiveness and safety of cupping therapy through an evidence-based approach.Methods:SRs that assessed the effectiveness of cupping therapy for any type of disease were searched through 6 electronic databases.Target diseases,cupping methods,numbers and types of included studies,quality of included trials,main results (including meta-analysis re sults),and authors' conclusions of SRs were extracted.The Assessment of Multiple Systematic Reviews measurement was used to evaluate methodologic quality of the SRs.Results Eight SRs met the inclusion criteria and effectiveness and safety of cupping therapy for 11 diseases were assessed.All included SRs were of good methodologic quality.However,quality of trials included in the SRs was generally poor.Meta-analysis was performed in 4 studies.Results:showed cupping therapy (alone or combined with other interventions) was better than medications (or other interventions alone) for herpes zoster,acne,facial paralysis,low back pain,or cervical spondylosis.One review reported adverse events,including hematoma,increased pain and tingling following cupping treatment.Conclusions:Cupping therapy may be beneficial for pain-related conditions,acne,and facial paralysis.However,a firm conclusion could not be drawn due to the insufficient number of included reviews and the low quality of the original studies.

Cupping therapy for acute and chronic pain management:a systematic review of randomized clinical trials

Objective:Cupping as a traditional therapy is used to treat a myriad of health conditions,including pain.This systematic review assessed the effectiveness and safety of cupping for different types of pain.Methods:Thirteen databases and four trial registries were searched for randomized clinical trials.Meta-analysis of data was conducted if there was non-significant clinical and statistical heterogeneity(measured by I2 test)among trials.Results:Sixteen trials with 921 participants were eligible and included.Six trials were assessed as low risk of bias,another six trials were of unclear risk of bias,and the remaining four trials were of high risk of bias.Pain was related to three acute and seven chronic diseases.Metaanalysis showed a beneficial effect of cupping compared to wait-list control(visual analogue scale(VAS),MD
1.85 cm,95%CI
2.66 to
1.04)and heat therapy(numerical rating scale,MD
2.05 cm,95%CI
2.93 to
1.17).Cupping combined with acupuncture was superior to acupuncture alone on post-treatment pain intensity(VAS,MD
1.18 cm,95%CI
1.68 to
0.68),however,no difference was found between this comparison based on changes in pain intensity(difference of VAS,MD 0.16 cm,95%CI
0.54 to 0.87).Results from other single studies showed significant benefit of cupping compared with conventional drugs or usual care.Hematoma and pain at the treated site,increasing local pain or tingling were reported as mild adverse effects of cupping.Conclusion:This review suggests a potential positive short-term effect of cupping therapy on reducing pain intensity compared with no treatment,heat therapy,usual care,or conventional drugs.

A clinical study on medical cupping for metabolic syndrome with abdominal obesity

Objective:To observe the clinical effects of medical cupping for metabolic syndrome(MetS)with abdominal obesity.Methods:In total,75 patients with MetS with abdominal obesity were randomly divided into three groups:medical cupping,acupuncture,and waiting.Patients in the medical cupping group received smearing of Chinese medicine and cupping twice a week for 8 weeks.Patients in the acupuncture group received acupuncture on regulating the Dai meridian three times a week for 8 weeks.The waiting group was observed without any intervention.Changes in metabolic indices,including waist circumference(WC),blood pressure,fasting triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),2-h blood glucose(2hBG),and subcutaneous fat thickness were observed and compared before and after treatment among the three groups.Results:After the treatment,the WC,TG,FBG,and 2hBG in the medical cupping and acupuncture groups were lower than those in the waiting group.No difference was observed between the medical cupping and acupuncture groups.The subcutaneous fat thickness at the upper umbilicus,right side of the umbilicus,and waist in the medical cupping and acupuncture groups were lower than those in the waiting group.The subcutaneous fat thickness at the upper umbilicus and waist in the medical cupping group was lower than that in the acupuncture group.The MetS prevalence in the medical cupping and acupuncture groups was lower than that in the waiting group.Conclusion:medical cupping treatment can effectively alleviate metabolic indices and subcutaneous fat thickness at the abdomen in patients with MetS and abdominal obesity and decrease the MetS prevalence.Its efficacy was better than that of waiting and similar to that of acupuncture.The frequency of medical cupping is lower than that of the acupuncture.Meanwhile,it circumvents some patients’fear of acupuncture.medical cupping should be clinically promoted.

A REPORT OF 300 CASES OF MIGRAINE TREATED WITH ACUPUNCTURE PLUS BLOOD-LETTING PUNCTURING AND CUPPING

Acupuncture combined with blood-letting puncturing and cupping Is quite effectivein treatment of migraine.The total effective rate of 300 cases is 95.7％.Combined treatment ofacupuncture and cupping can supplement each other in strengthening the therapeutic effect and is agood way for relieving headache.

The effect of hot intermittent cupping on pain,stiffness and disability of patients with knee osteoarthritis

Objective:The aim of this study was to investigate the effect of hot intermittent cupping on pain,stiffness and inability of patients with knee osteoarthritis(KO).Methods:The present study was a clinical trial,which was performed on 38 patients with KO referring to Gonabad Rheumatology Specialty Clinic.Based on permutation block method,the research units were divided into cupping therapy and control groups.For the cupping therapy group,four sessions of cupping therapy were performed every four days.To collect data,the form of demographic information,Visual Analogue Scale(VAS)and the Western Ontario and McMaster(WOMAC)osteoarthritis scale were used,and the data were analyzed by SPSS software v.16 using descriptive statistics and independent t-test,paired t-test,Chi-square test and Fishers exact test with a significance level of P<0.05.Results:Findings showed that there was no significant difference between the cupping therapy and control groups in terms of demographic characteristics and they were homogeneous.Findings indicated that,based on VAS,the mean pain intensity in the left(P<0.001)and the right knees(P<0.001),as well as based on WOMAC,stiffness(P=0.006),pain intensity(P<0.001)and disability(P<0.001)in the cupping therapy group significantly decreased compared to the control group.Conclusion:Findings showed that hot intermittent cupping therapy reduced the pain intensity,stiffness and disability in patients with KO.

In vitro evaluation of transdermal permeation effects of Fu’s cupping therapy via six diffusion kinetics models

In this study,six kinetics models of indomethacin hydrophilic gel patch transdermal in vitro release was established,including zero-level,first-order,Higuchi-level,Ritger-Peppas,Weibull and Hixcon-Crowell dynamic equations.The chemical permeation enhancers,including 3%and 5%Azone,and iontophoresis were used as the control.Transdermal diffusion tests were performed in vitro and indomethacin was quantified by high performance liquid chromatography system.The transdermal parameter of the Higuchi and Weibull dynamic equations,indicated that Fu’s cupping therapy(FCT)could significantly improve Higuchi and Weibull kinetic parameters in vitro transdermal,increased transdermal rate and permeability coefficient,reduced lagging time.Additionally,statistical analysis speculated the skin barrier function could be restored after 46 h treatment.Hence,as a new physical transdermal drug delivery technology,transdermal permeation effects produced by FCT are obvious,which has the characteristics of traditional Chinese medicine and has important clinical application value.

Comparative pilot study on the effects of pulsating and static cupping on non-specific neck pain and local skin blood perfusion

Objective:To compare the effects of pulsating and static cupping on non-specific neck pain and local skin microcirculation blood perfusion,which is a pilot study.Methods:Seventy participants with non-specific neck pain were randomized to the following groups:low-frequency pulsating cupping(LF,n=20);high-frequency pulsating cupping(HF,n=20);static cupping(SC,n=20),or waiting list(WL,n=10).The LF,HF,and SC received a bilateral 10-minute cupping treatment at Jianzhongshu(SI 15).Outcomes were pain intensity(visual analog scale,VAS),functional status(Neck Disability Index,NDI),and skin blood perfusion at the SI 15,Dazhui(GV 14),and Shenzhu(GV 12)acupoint areas,measured using Laser Speckle Contrast Analysis technology.Results:Both LF and HF groups showed a significant reduction in VAS scores compared with the SC group(9.00,95%Cl 1.05-16.95,P=.027;8.75,95%CI 0.80-16.70,P=.031).There was no significant difference in VAS scores between the LF and HF groups(P>.05)and between NDI scores measured 3 days after intervention among the four groups(P>.05).In the SI 15 area,blood perfusion in the three treatment groups was higher than that in WL group(P<.01),and the perfusion unit(PU)of the HF pulsating group at 5 minutes after intervention was significantly higher compared with the SC group(P<.05).In the GV 14 area,blood perfusion in the two pulsating cupping groups was higher compared with the WL and SC groups after cupping(P<.05).In the GV 12 area,the PU of the LF group was higher compared with the other three groups only at the time of cup removal(P<.05).Conclusion:This study showed that pulsating cupping may have more favorable analgesic effects on non-specific neck pain compared with static cupping,which may be related to its better effect on improving the local skin blood perfusion.

Bloodletting puncture and cupping as an adjuvant therapy for breast cancer-related lymphedema in female adults: A non-randomized controlled pragmatic trial

Objective:To evaluate the effectiveness of bloodletting puncture and cupping in relieving breast cancer-related lymphedema.Methods:We conducted a non-randomized controlled study at the Galactophore Department of the 3rd Affiliated Hospital of Beijing University of Chinese Medicine from March 2013 to December 2014.Seventy-five patients undergoing treatment for breast cancer-related lymphedema were divided into two groups in accordance with the patients' treatment choices:the treatment group (n =50) underwent bloodletting puncture and cupping every 5 days for 15 min/session (one session per day) combined with exercise training once a day for 30 minutes;the control group (n =25) underwent the same exercise training alone.Evaluation indexes were measured before and after treatment;these included arm circumference (at the wrist crease,10 cm distal to the wrist crease,the elbow crease,and 10 cm distal to the elbow crease)and visual analogue scale (VAS) score for pain.The safety of the treatment was also evaluated.Results:The treatment period was 50 days for all 75 patients.At the end of the treatment period,the mean reduction in arm circumference was 1.21 (0.65) cm the treatment group,and 0.58 (0.78) cm in the control group.Compared with the control group,the treatment group had a significantly greater reduction in arm circumference (P =.03) and a significantly lower VAS score for pain (P =.01).No patient in either group experienced any adverse events.Conclusion:Bloodletting puncture and cupping effectively reduces arm circumference and relieves upper limb pain in patients with breast cancer-related lymphedema.Our results provide sufficient basis for exploring cupping as long-term therapy for managing breast cancer-related lymphedema.

Bloodletting Cupping Therapy for postherpetic neuralgia:a systematic review and meta-analysis

Objective:To evaluate the clinical effects of bloodletting cupping therapy(BCT)for patients with postherpetic neuralgia.Methods:We comprehensively searched four Chinese databases(Wanfang,China National Knowledge Infrastructure,VIP Database for Chinese Technical Periodicals,China Biology Medicine disc)and foreign databases(Pubmed,Cochrane Library).The retrieval time was from the build-up time to May 2018.RevMan 5.3 software was used for statistical analysis.Results:We finally obtained 18 eligible studies.Compared with routine western medicine,BCT can significantly improve PHN(OR=7.45,95%CI,3.36-16.51,Z=4.95,P<0.01).BCT plus other methods of acupuncture with fire needle and filiform needle has significant therapeutic effect(OR=5.54,95%CI,3.01-10.19,P<0.01),BCT plus routine western medicine has significant therapeutic effect(OR=4.99,95%CI,2.73-9.11,P<0.00001).Conclusion:It showed that the therapeutic effects of BCT,BCT plus other acupuncture methods with fire needle and filiform needle,and BCT combined with western medicine are better than those treated with single western medicine.It is effective to treat postherpetic neuralgia with Bloodletting Cupping Therapy.

Effects of Acupoint Massage Combined with Cupping Therapy on Postpartum Lactation and Mastitis in Puerpera

OBJECTIVE: To explore the effects of acupoint massage combined with cupping therapy on postpartum lactation and mastitis. METHODS: A total of 360 women who had breastfeeding needs after hospitalization in the Second People's Hospital of Hefei were selected from August to December in 2018. A total of 180 women who had no contraindications and were willing to cooperate were included in the observation group, and 180 women who were unwilling to participate in the intervention were the control group. Routine postpartum care was performed on both groups of pregnant women, and acupoint massage and cupping therapy were performed on the maternal women in the observation group. During the hospitalization period, the starting time of lactation in the 2 groups, and the lactation volume at 1 day, 2 days, and 3 days after delivery, and the incidence of mastitis and cracked nipple, and the situation of exclusive breastfeeding were recorded and analyzed. Comparative analysis of the effects of acupoint massage combined with cupping therapy on postpartum lactation and mastitis in primipara were made. RESULTS: In the observation group, 145 women had a moderate amount of lactation 1 day after delivery, and the lactation amount of remaining 35 cases were small. There were 22 women with a high amount of lactation 2 days after delivery, and 132 women had a moderate amount of lactation, and the lactation amount of the remaining 26 cases were small. 138 women had a high amount of lactation 3 days after delivery, and 37 women had a moderate amount of lactation, and the lactation amount of the remaining 5 cases were small. All the women in the observation group did not have cracked nipple or mastitis, and the postpartum effect was significantly better than that of the control group(P < 0.05). CONCLUSION: Acupoint massage combined with cupping therapy can promote early lactation, increase breastfeeding rate, and reduce the incidence of mastitis.

The Effects of Cupping Therapy on Skin’s Biomechanical Properties in Wistar Rats

Cupping therapy has been widely used for clinical treatment of soft tissue lesions. The current study investigated the effects of cupping therapy on biomechanical properties of the skin in Wistar rats. 20 rats were divided into two groups: 10 in experimental and 10 in control group. Either the right or the left lower quadrants of the lumbar regions in the experimental group underwent 10 minutes daily cupping therapy for 12 days. The skin stiffness and ultimate tensile strength of all the rats were measured using tensiometer. The skin stiffness and ultimate tensile strength were decreased significantly in cupping side of the experimental group as compared with the non-cupping side and the control group. There were no significant differences between the non-cupping side of the experimental group and the control group. In conclusion, cupping therapy can be useful as a treatment method to reduce the skin stiffness and ultimate tensile strength.