Topical halometasone cream combined with fire needle pretreatment for treatment of primary cutaneous amyloidosis:Two case reports

BACKGROUND Primary cutaneous amyloidosis(PCA)is a chronic metabolic skin disease that has a detrimental impact on physical and mental health.It appears as mossy papules and severe itching,which is long-term and recurrent.Traditional treatments are unsatisfactory,especially for refractory cases.Fire needle therapy,which is widely used in China,has shown good clinical efficacy,as well as advantages concerning safety and cost.Clinical reports about fire needle treatment of this disease are few at present.CASE SUMMARY We report two older men who had developed maculopapules with itchiness on the trunk and arms for more than 10-15 years.Due to the dermatopathological findings,PCA was our primary consideration.They received topical halometasone cream and pretreatment with fire needle for 8-16 wk.Both patients showed significant improvement of lesions.Neither patient had recurrence with a minimum of 2 years of follow-up.CONCLUSION Topical halometasone cream and pretreatment with fire needle could be a fast,safe,and economic treatment for PCA.

Effectiveness of fire needle combining with moist healing dressing to promote the growth of granulation tissue in chronic wounds:A case report

In this case study,we analyzed the wound-healing process of a patient with a chronic wound who underwent fire needle treatment,and we tracked the coverage of granulation tissue and decrease of slough and exudate.An 85-year-old man had repeated right shoulder and back pain,itching,and skin festering for more than 1.5 years.A fire needle was administered combined with moist dressing once every 5 days to promote wound healing.After six rounds of fire needle treatment,granulation tissue formed over the surface of the wound base,the depth of the wound had become shallow,and the wound area was reduced.No complications occurred during the intervention.Fire needle therapy combined with a moist wound-healing dressing can be an effective alternative approach in managing chronic wounds.

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 up-regulates the expression of ERK1/2 in neural stem cells

Objective:To explore the effect of fire needle on the expression of ERK1/2 of neural stem cells(NSCs)obtained from rats with spinal cord injury(SCI).Methods:Sixty SD female rats were randomly divided into 5 groups,including 5 in the blank group,5 in the sham operation group,25 in the model group,and 25 in the fire needle treated group.Rats in the model group and the fire needle treated group were further divided into the 1d group,the 3d group,the 7d group,the 10d group and the 14d group,respectively.Modified Allen's method was applied to build SCI model,and serum in the abdominal aorta was collected at the indicated time and placed into NSCs culture dishes for 72h.RT-PCR was applied to detect the expression of ERK1/2.Results:According to the Basso,Beattie&Bresnahan scale(BBB scale),rats in the model group and the fire needle treated group scored 0 at first day,suggesting a success of modeling after treatment.The scores of the fire needle group were significantly higher than those in the model group(P<0.05).Compared with sham operation group,the expression of ERK1 and ERK 2 in model group and fire needle group were significantly decreased at day 1(P<0.05),and lasted for 3d(P<0.05).At day 7 and day 10,the expressions of ERK1 and ERK2 in the fire needle group were significantly higher than those in the model group(both P<0.05).Conclusion:Fire needle could up-regulate the expression of ERK1 and ERK2 of NSCs from SCI rats.

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.

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.

Surgical use of fire needle for connective tissue external hemorrhoids：a case report

Objective： To report a patient with connective tissue external hemorrhoids who showed beneficial efficacy after fire needle was used for cutting off the connective tissue. Methods： Burn the front end of needle on the alcohol lamp until red and cut off the connective tissue external hemorrhoids quickly and accurately. Results： The connective tissue external hemorrhoid was totally removed and the patient showed a complete recovery after one and a half-year follow up. Conclusion： Fire needle can quickly eliminate perianal connective tissue, improve pain and bleeding, promote tissue regeneration and shorten the wound healing time, which may provide us a new idea for the surgical treatment of external hemorrhoids.

Clinical study on fire needle acupuncture treating irregular menstruation with spleen deficiency syndrome

Objective:To observe the clinical efficacy of fire needle acupuncture in treating irregular menstruation with spleen deficiency syndrome.Methods:60 patients with spleen deficiency-irregular menstruation were randomly divided into treatment group and control group of 30 each.In the treatment group,fire needle acupuncture was used to insert into Guanyuan,Qihai,Pishu,Sanyinjiao,Zusanli and Taibai points,while the filiform needle was used to needle the corresponding acupoints in the control group.After 8 weeks of treatment,menstrual cycle,menstrual period,menstrual volume,irregular menstrual symptom score and spleen deficiency symptom score were recorded.Results:Both treatments could effectively improve the menstrual cycle,menstrual period and menstrual volume,but there was no statistical significance between the two groups(P>0.05).Both treatments were effective in regulating the symptoms of menstruation,and fire needle acupuncture was better than filiform needle(P<0.05).Both treatments relieved the symptoms of spleen deficiency,and fire needle acupuncture was better than filiform needle(P<0.05).In terms of overall curative effect,the curative effect of fire needle acupuncture therapy was significantly better than filiform needle therapy,and the difference was statistically significant(P<0.05).Conclusion:Fire needle acupuncture therapy could effectively regulate menstrual volume of patients with irregular menstruation of spleen deficiency syndrome,and relieve the symptoms of traditional Chinese medicine.

Clinical Research Progress of Fire Needle Acupuncture in the Treatment of Alopecia Areata

Alopecia areata is a common disease in dermatology.It is a localized non-inflammatory alopecia that occurs in the head.Its etiology is unclear,but it is thought to be related to a number of factors.At present,there are many methods of treatment with different curative effects.Fire needle acupuncture directly acts on skin lesions,dredges meridians,and regulates Qi and blood.It has a good curative effect.This paper reviews current research progress of fire acupuncture in the treatment of alopecia areata,in order to provide some diagnostic and treatment suggestions for the management of alopecia areata.

Observation on the effect of fire needle combined with Linggui Bafa for post-herpetic neuralgia

Objective To observe the clinical effect of fire needle combined with Linggui Bafa for post-herpetic neuralgia （PHN）. Methods One hundred and twenty patients were randomly divided into an observation group and a control group with 60 cases each. For observation group, fire needle was applied to prick Zusanli （足三里 ST 36）, Yanglingquan （阳陵泉 GB 34）, Taichong （太冲 LR 3）, Sanyinjiao （三阴交 SP 6） and partial Ashi points around the lesion, and Linggui Bafa was combined to perform acupuncture therapy, once every other day, 10 times as a course of treatment; for the control group, only fire needle was applied. After 2 courses of treatment, the comparison of the value of visual analogue scale （VAS） and the total effective rate for the two groups were carried out. Results The VAS value of the observation group after treatment was obviously lower than that before treatment （2.28±2.08 vs 6.12±1.96） and that of the control group （2.28±2.08 vs 3.62±2.90）, there were significant differences （all P〈0.01）. The total effective rate of the observation group was obviously higher than that of the control group [93.3% （56/60） vs 76.7% （46/60）], the difference between the two groups was statistically significant （P〈0.05）. Conclusion The effect of fire needle combined with Linggui Ba.fa for PHN is obviously superior to that of single fire needle therapy.

Efficacy of fire needle on acute gouty arthritis induced by monosodium urate in rats

OBJECTIVE:To explore the therapeutic effect and inflammatory mechanism of fire needles on gouty arthritis.METHODS:Sixty male Sprague-Dawley rats were divided into four groups,that is,control group,the model group,the colchicine group,and the fire needle treatment group.Acute gouty arthritis was prepared by injection of monosodium urate in the ankle joint.The inflammation-related protein[toll-like receptor 4(TLR4),pyrin domain-containing protein 3(NLRP3),interleukin(IL)-1β,myeloid differentiation factor 88(My D88),nuclear factorkappa B(NF-κB),phosphorylated NF-κB(p-NF-κB),caspase-1,and p-caspase-1]in swollen tissues,the inflammation-related m RNAs indicators(TLR4,NLRP3,NF-κB,and caspase-1)and the inflammatory factors[IL-1β,IL-6,IL-8,tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP)]in the serum were detected by Western blot,real-time quantitative polymerase chain reaction,and enzyme-linked immunosorbent assay,respectively.RESULTS:The fire needle treatment could reduce joint swelling,increase mechanical pain threshold and decrease the inflammation index score in the fire needle treatment group.It could also significantly decreased the protein expression of IL-1β,TLR4,My D88,p-NF-κB and NLRP3 in joint tissue,markedly downregulated the m RNA levels of TLR4 and NLRP3 in joint tissue,and significantly reduce serum levels of IL-1β,IL-6,IL-8,TNF-α,and CRP.CONCLUSION:The fire needle treatment had positive effect of treating gouty arthritis,and its underlying mechanism might be associated with NF-κB activation and related inflammatory response.

Is fire needle superior to Western medication for herpes zoster?A systematic review and meta-analysis

Objective:To compare the effectiveness of fire needle versus Western medicine in the treatment of herpes zoster.Methods:Randomized controlled trials comparing fire needle with Western medicine in the treatment of herpes zoster were identified using 8 databases.A meta-analysis was performed using RevMan 5.3 software.Results:Eight trials involving 569 patients were included in this meta-analysis,and the results showed that fire needle was superior to Western medicine comparing the effective rate[risk ratio(RR)=1.13,95%confidence interval(Cl):1.06 to 1.20;P=0.0002],the visual analog scale(VAS)score[mean difference(MD)=-7.95;95%Cl:-10.71 to-5.20;P<0.00001],time of pain disappearance(MD=-7.61;95%CI:-9.38 to-5.84;P<0.00001),time of blister-stop(MD=-1.34,95%CI:-1.51 to-1.18;P<0.00001),time of crusted scab(MD=-2.92,95%CI:-3.62 to-2.23;P<0.00001);and time of scab off(MD=-4.64,95%CI:-5.83 to-3.46;P<0.00001).In addition,a significantly lower incidence of postherpetic neuralgia was found in the fire needle group in 30 d(RR=0.23,95%CI:0.11 to 0.51;P=0.0002)and 60 d(RR=0.33,95%CI:0.12 to 0.91;P=0.03)after treatment.Conclusion:Fire needle has a favorable effect in increasing the effective rate,relieving pain,recovering skin lesions and decreasing incidence of postherpetic neuralgia in the treatment of herpes zoster.However,considering the limitations in this study,the findings should be interpreted cautiously.

Lateral Epicondylitis Successfully Treated with Fire Needle Therapy:A Case Report

Lateral epicondylitis （LE） is a common musculoskeletal problem. The incidence is estimated to be 0.4%-0.7% per year in general practice, and between 1% and 3% per year in the adult general populationJ2） LE results from repetitive micro-trauma by overuse of the wrist extensor musculature, which ultimately leads to failure of the common extensor tendon,

Acupotomy combined with fire needle for sacral nerve dysfunction syndrome:A randomized,single-blind clinical trial

Objective： To provide the clinical evidence to evaluate the feasibility and refine the protocol for acupotomy combined with fire needle and pudendal nerve block therapy in treatment of sacral nerve dysfunction syndrome（SNDS）. Methods： Seventy-five patients with SNDS were randomized into the treatment group（acupotomy and fire needle and pudendal nerve block therapy） and the control group（pudendal nerve block therapy）. After a course of treatment, Visual Analogue Scales（VAS） of anorectal pain, defecation disorders, anal incontinence, VAS of lumbar pain or soreness, VAS of abdominal distension and pain were compared before and after the treatment. Result： Scores of defecation disorders, including defecation interval time index, defecation time index, fecal property index and defecation difficulty index, of patients with SNDS in the two groups were statistically different before and after the treatment in the same group（all P〈0.05）, but the differences of those indexes between two groups were not statistically significant（all P〈0.05） after the treatment,. Scores of anal incontinence, VAS scores of lumbar pain or soreness, VAS scores of abdominal pain and distension in the two groups were statistically different before and after the treatment（all P〈0.05）. However, after treatment, the differences between two groups were not statistically significant（all P〈0.05）. VAS scores of anorectal pain in the two groups were statistically different before and after the treatment（both P〈0.05）, and that of the treatment group was statistically lower than control group after the treatment（1.61 ± 0.95 vs. 3.04 ± 1.81, P〈0.01）, the total effective rate of the treatment group was higher than that of the control group, and the difference was statistically significant（94.74% vs. 81.08%, P〈0.01）, there was no difference in self-evaluation between the two groups（P〈0.05）. Conclusion： In treating SNDS, acupotomy combined with fire needle and pudendal nerve block therapy can more effectively alleviate anorectal pain and improve the total effective rate.

Characteristics and key to manipulation of fire needle

To explore the characteristics and key to manipulation and of traditional fire needle in China. Fire needle refers to a therapy with red-hot needle inserting into the skin. Special requirements are proposed in terms of selected acupoints, to burn needle body, fire needle manipulation, needle withdrawal disposal and other aspects. The therapy is characterized by ＂paying equal attention to needling and scorching, and laying emphasis on warming and unblocking＂, ＂rapid needle insertion and withdrawal with coherent manipulations＂, and ＂performing needling based on pattern differentiation＂. In the process of applying red-hot needling with fire needles, normalized and unified manipulations, accurate point selection and safe stimulus should be emphasized, and the performer should be dedicated and scrupulous, and keep the manipulations coherent in order to achieve the ＂stable, accurate and rapid＂ effect. The popularization and application of red-hot needling with fire needles in TCM clinical practice can further enrich the acupuncture therapy, so that this ancient and traditional needling method can give play to its role renewedly.

Systematic review of the therapeutic effect of fire acupuncture on psoriasis vulgaris based on"releasing stagnated fire"theory

Background:To systematically evaluate the clinical efficacy of fire acupuncture(or needle)in the treatment of psoriasis vulgaris.Methods:The following electronic databases were retrieved by calculator:PubMed,Embase,Cochrane Library,CNKI,Wanfang Academic Journal Database,VIP Chinese Journal Database,etc.All the randomized controlled trials using fire needles in the treatment of psoriasis vulgaris from the self-established database to August 2021 were included,and the qualified literatures were included.Review manager 5.3 software was used for the combined analysis of the included literatures,TSA v0.9 Beta for sequential analysis,and GRADE pro V3.6 for evidence quality evaluation.Results:A total of 14 studies with 1,440 patients were included in this study.Meta analysis results showed:effective rate[RR=1.15,95%CI(1.10,1.19),P<0.00001,very low quality evidence];Psoriasis Area and Severity Index[PASI score,WMD=-2.15,95%CI(-2.40,-1.90),P<0.00001,evidence of low quality],Dermatology Life Quality Index scale[DLQI score,WMD=-3.56,95%CI(-4.86,-2.26),P<0.00001,very low quality evidence],the experimental group was better than the control group(P<0.05).Sequential analysis further showed that the use of fire needle as the primary treatment could significantly reduce PASI score.The adverse reactions rate of the experimental group was 6%,and that of the control group was 11%,P<0.05.Conclusion:Fire acupuncture as the main treatment can reduce PASI and QLDI scores of patients with psoriasis vulgaris,improve the treatment efficiency,and fewer adverse reactions.

Intensive and deep needling method of fire-needle for 47 cases of chronic impairment on gluteus medius

Objective To observe the therapeutic effect of intensive and deep needling method of fire-needle for chronic gluteus medius impairment. Methods The tenderness of anterior superior iliac spine which was the starting point of gluteus medius was taken as the center, i cm around it, 4-8 needle insertion points were fixed. Fire-needle with intensive and deep needling method was applied deeply on the surface of the bone then immediately taken out. The treatment was given once every 3 days, 3 times as a course. Results After 2 courses, 22 cases were fully recovered, 22 cases with remarkable effect, 4 cases without effect, and the total effective rate was 92.5%. Conclusion Fire- needle with intensive and deep needling method has remarkable therapeutic effect.

Clinical Experience in the Treatment of Vitiligo by the Method of Invigorating Qi,Promoting Blood Circulation and Detoxification

Studies have shown that traditional Chinese medicines have clear curative effects in the treatment of vitiligo with few side effects.Through literature research and clinical observation,the study summarized the etiology and pathogenesis of vitiligo in traditional Chinese medicine as"deficiency,toxin,and stasis",formulated the method of invigorating qi,promoting blood circulation and detoxification,and prescribed Fuse Hexue Jiawei Decoction for the treatment of vitiligo.

Meta-analysis and trial sequential analysis on blood uric acid and joint function in gouty arthritis treated with fire needling therapy in comparison with western medication

Objective:To conduct the meta-analysis and trial sequential analysis(TSA) on clinical trials of fire needling therapy in treatment of gouty arthritis and review systematically the clinical therapeutic effect of fire needling therapy on gouty arthritis so as to provide the medical evidences of the extensive application of this therapy in treatment of gouty arthritis.Methods:The relevant clinical trials of fire needling therapy for treatment of gouty arthritis were searched from China National knowledge Infrastructure,Wanfang Data Knowledge Service Platform,Chinese Science and Technology Journal Database,American Medical Online,Dutch Medical Literature Database and International Evidence-Based Medical library.Using Review Manager 5.3 software,the quality of the included trials was assessed and meta-analysis was performed.With TSA v0.9 software,the trial sequential analysis was conduced on the appropriate outcomes.Results:A total of 10 trials were included with 775 patients involved.The analysis results showed that compared with the western medication,the total effective rate(RR=1.14’95%CI [1.09,1.20]),the curative rate(RR=1.59’95%CI [1.33,1.89]),the reduced VAS score(MD=-1.44’ 95%CI [-1.93,-0.951]) and the reduced incidence of adverse reaction(RR=0.27’ 95% CI [0.09,0.76]) of the fire needling therapy were different significantly(all P <0.05).Regarding the reduction of blood uric acid(MD=-40.47’ 95%CI [-80.21,-0.72]) and the score of symptoms and physical signs(MD=-1.38’95% CI [-3.71,0.95]),the effect of fire needling therapy was similar to that of western medication group(both P≥0.05).The trial sequential analysis suggested that the result was reliable,in which,the total effective rate of fire needling therapy was much higher than the western medication.But,it was potentially a false-positive finding,in which,fire needling therapy was much more advantageous at reducing blood uric acid as compared with the western medication.Conclusion:Based on the analytic results,it can be determined that fire needling therapy,as an effective approach to the treatment of gouty arthritis,has a certain advantage as compared with western medication.Given the low overall quality of trials,it still needs high-quality clinical trial to verify the findings of this study results.

Professor LIU Huilin’s experience in treating cluster headache with acupuncture-moxibustion

This paper introduces chief physician LIU Huilin’s empirical characteristics in treating cluster headache based on holism and pattern-identification-based treatment,with spirit-regulating filiform needling,filiform fire needle pricking,and collateral-pricking for bloodletting sequential therapy,which inherits the academic thoughts of“acupuncture-moxibustion for treating spirit”from Professor ZHOU De’an and“three-unblocking acupuncture therapy”from HE Puren,thus providing a reference for treating cluster headache with acupuncture-moxibustion therapy.