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.

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.

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.

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.

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.

Application of five-element music therapy in pain coping skills training in patients with knee osteoarthritis

Objective:The objective of this study is to assess the application effect of five elements music therapy introduced in the pain coping skills training of knee osteoarthritis(KOA).Materials and Methods:Totally,80 patients with KOA were selected and randomly divided into the experimental group(39 cases)and the control group(41 cases).The control group was only given routine nursing measures,and the experimental group was additionally treated with five-element music therapy on the basis of the control group,twice a day,28 days in total.The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)was used to evaluate the functional status of the knee joint of the two groups.The clinical efficacy of the two groups was evaluated by Guiding Principles for Clinical Research of New Chinese Medicine in the Treatment of Osteoarthritis.Results:WOMAC score statistically significantly decreased in the experimental group(35.92±9.48 vs.16.17±5.43,P<0.01)and the control group(36.73±6.42 vs.22.53±7.51,P<0.01)after 28 days of intervention when compared with that before intervention;WOMAC score in the experimental group was lower than that of the control group after 28 days of intervention(16.17±5.43 vs.22.53±7.51,P<0.01).The total effective rate of the experimental group was statistically higher than that of the control group(82.0%vs.51.2%,χ2=11.97,P=0.003).Conclusion:The combination of five-element music therapy and routine nursing measures has better effect in relieving pain and bad emotions of patients with KOA when compared with routine nursing measures alone.

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.

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.

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.

Effects of Medicated Bamboo Cupping Therapy of Zhuang Nationality Medicine on Long-term Efficacy and Quality of Life in the Treatment of Functional Dyspepsia with Stagnation of Liver Qi and Spleen Deficiency Syndrome

Objective:To investigate the effect of medicated bamboo cupping therapy of Zhuang nationality medicine on long-term efficacy and quality of life in the treatment of functional dyspepsia with stagnation of liver Qi and spleen deficiency syndrome,and to provide a new,effective and easy to promote treatment method for functional dyspepsia.Methods:A total of 150 cases of functional dyspepsia treated in our hospital from March 2014 to October 2015 were selected as research subjects,and they were divided into the treatment group(medicated bamboo cupping therapy),the control A group(Omeprazole Enteric-coated Tablets+Domperidone Tablets)and the control B group(acupuncture),50 cases in each group.The clinical efficacy,the gastric electrical index,the recurrence rate and the quality of life were observed and compared.Results:The total effective rate in the treatment group was higher than that in the control A group and the control B group(P<0.05).Compared with before treatment,the main frequency and electrical amplitude in each group was significantly improved,and the rhythm disorder coefficient was significantly reduced(P<0.05).After treatment,compared with the control A group and the control B group,the difference of rhythm disturbance coefficient in the treatment group was statistically significant(P<0.05).The recurrence rate in the treatment group was lower than that in the control A group and the control B group at 1 month,3 months and 6 months after drug discontinuance,with no significant difference(P>0.05).Compared with before treatment,scores of each physiological function after treatment had no significant change(P>0.05),and the scores of physiological function,body pain,general health,vitality,social function,emotional function and mental health were significantly improved(P<0.05).The comparison of scores in each group had no significant difference(P>0.05).Conclusion:The medicated bamboo cupping therapy of Zhuang nationality medicine on functional dyspepsia with stagnation of liver Qi and spleen deficiency syndrome can significantly improve clinical efficiency,and reduce the coefficient of rhythm.The long-term recurrence rate is low,and the quality of life is significantly improved.It is a convenient and effective treatment,which is worthy of promotion.

TREATMENT OF 102 CASES OF ACUTE ABDOMEN BY BLOODLETTING PUNCTURE AND CUPPING THERAPY

102 cases of the acute abdominal disease were treated with the blood-lettingpuncture and cupping. 56 cases were cured, 22 markedly effective, 17 improved and 7 ineffective.Total effective rate was 93.1%.

Three-step acupuncture and cupping therapy:an effective approach to treat cervicogenic headache

As early as 1983,Sjaastad proposed the concept of cervicogenic headache(CH)in the World Headache Conference,that is,the pain from upper cervical joints and muscles can be referred to the head.CH is a group of syndromes mainly caused by dysfunction of the upper cervical spine and its component muscles,ligaments,bony,vertebral arteries and/or soft tissue elements,usually not accompanied by neck pain.Therefore,the treatment strategy of CH focuses on pain relief and repair cervical lesions.Patients with painful disorders of upper cervical zygapophysial joints showed significant headache relief after directly treated at disordered cervical joints[1].

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

本研究建立吲哚美辛亲水凝胶贴剂的体外经皮渗透的6种动力学模型:零级、一级、Higuchi级、Ritger-Peppas级、Weibull级与Hixcon-Crowell级动力方程Q1/3=kt+b,评价付罐疗法(FCT)体外经皮促渗作用与特点。3%氮酮和5%氮酮化学促渗剂与离子导入为参比,用HPLC-工作曲线对吲哚美辛(IM)定量,进行体外透皮扩散,结果进行回归建模。结果表明:FCT促渗处理组能明显提高吲哚美辛的透皮效果,改善体外透皮的Higuchi级与Weibull级动力学参数,提高透皮速率与渗透系数,减低时滞。FCT作为新的物理经皮给药促渗新技术,效果明显,具有中医特色和重要的临床应用价值。

Key elements that determine the efficacy of cupping therapy:A bibliometric analysis and review of clinical studies

Objective:The aim of this review was to identify the possible mechanisms behind cupping therapy by employing an evidence-based approach,and to explore its possible regional and systemic effects in the human body.Methods:We searched six electronic databases and four online trial registries for articles published up to January 1,2020.Clinical studies on the mechanisms of retained cupping,flashing cupping,moving cupping,and vacuum cupping were considered for this review.The methodological qualities of controlled studies were assessed using the National Institute for Clinical Excellence methodology checklist,the Newcastle-Ottawa Scale,and the Cochrane risk of bias tool.Characteristic statistical description and qualitative summary of results were used for data analysis.Results:Thirty-eight studies(37 full texts and one abstract)were included in this study.Due to the clinical heterogeneity among the studies,we could not conduct a meta-analysis.The results showed that the key factors that contribute to the efficacy of cupping therapy are negative pressure and temperature.Cupping therapy mainly causes local and systemic changes in hemodynamics,immune regulation,metabolism,and pain relief.Conclusion:We identified negative pressure as the key element behind cupping therapy.Cupping therapy may cause redistribution of oxygen at the cupping site and in neighboring tissues,thereby inducing a therapeutic effect by increasing regional blood flow.It may also induce metabolic change,immunomodulation,and neuromodulation.However,additional rigorous clinical research needs to be conducted to further clarify the mechanism behind cupping therapy.

Brief introduction to the historical development and therapeutic effects of cupping therapy in traditional Chinese medicine

Cupping therapy (CT) is an ancient traditional and complementary medicine practice. Recently, there has been a growing evidence of its potential benefits in the treatment of various diseases. The CT has been constantly developing with the emergence of various modern and improved cupping devices. It is now evident that cupping could adjust the Qi, blood, Yin and Yang, dredge the meridian, as well as relieve the effect of illness, achieve fitness and relative equilibrium of Yin-Yang. It exerts its effects through the negative pressure suction via the mechanical and thermal stimulations, and the negative pressure effects induced by cupping. This article gives an overview of CT practice, its historical development, as well as its therapeutic effects and mechanism. Furthermore, a new and updated classification of CT was briefly introduced.

Integrating cupping therapy in the management of tinnitus and dizziness:a pilot study

Background:Cupping therapy is one of integrative medicine modalities which is used by several nations.Its mechanism of action is not well known but there are several theories explained how it can play a rule in the treatment of diseases.In recent years,huge advances have taken place in understanding of inner ear pathophysiology causing sensorineural hearing loss,tinnitus,and vertigo.Research articles providing evidence of acupuncture treating dizziness and vertigo but no studies of cupping therapy.The aim of this pilot study was to evaluate the safety and efficacy of integrating wet cupping therapy in the management of tinnitus and dizziness associated with ear pathologies.Methods:This is a prospective interventional pilot study in which pre and post intervention outcomes(tinnitus handicap inventory and dizziness handicap inventory)were assessed and compared.27 patients diagnosed with Ménière's disease and idiopathic tinnitus or tinnitus secondary to inner ear pathology were included in this study and received usual medical treatment and wet cupping therapy.Results:There was a significant improvement after 6 sessions of cupping in tinnitus handicap inventory and dizziness handicap inventory but not in patient’s hearing.No adverse events were reported in this study.Conclusion:Wet cupping therapy demonstrates a promising effectiveness in reducing discomforts of both dizziness and tinnitus.A large scale randomized controlled trial is recommended.

Dry cupping therapy and the wellness management of health travelers

目的:个人通过在本地和国际旅行来寻找毒性更低、更有益于他们的健康的替代疗法。尽管西方医学体系很受欢迎,但拔火罐治疗作为传统医学和补充医学体系中的一种疗法在巴基斯坦获得了极大的关注,它可以提高人民的生活质量和健康观念。本研究旨在探讨干罐疗法(DCT)对费萨拉巴德寻求健康的旅行者的健康和生活质量的影响。方法:用3~5个一次性玻璃罐对受试者进行15~20分钟的拔罐治疗。参与者在接受拔罐前后填写问卷。采用偏最小二乘结构方程建模技术对数据进行统计分析。结果:共有187名受试者参加了费萨拉巴德法院健康中心进行的两次DCT干预,并在第二次DCT后30天内提供最终反馈。DCT干预后,参与者对身心感受的认知与健康状况呈显著正相关,如在身体疼痛(β=0.019)、活力(β=0.138)和身体运动(β=0.207)。在被访者的心理感受(如情绪感受β=0.169)中也观察到了这一趋势。DCT显著地介导了整体现象。除社会功能外,在第一和第二次DCT干预后,79.68%的研究参与者在问卷中所有健康项目的得分均显著提高。结论:本研究结果提示,DCT在确保健康旅行者的健康认知和健康状况方面具有重要作用,而没有潜在的副作用。它能够通过积极影响人们的身心健康感知来提高人们的健康和总体生活质量。它还可以改善旅行者的情绪、行为和其他日常活动。

Active sham cupping therapy technique:identification of limitations and suggesting enhancements

Cupping therapy is an ancient healing modality that has been used for thousands of years.There are two types of sham cupping techniques:passive type which used no suction,and active type which suction was rapidly released through a hole on the top of the cup.This narrative review aimed to identify limitations and suggest enhancements in the current use of active sham cupping therapy technique.Three medical databases were searched for identification of clinical trials that used active sham cupping device.201 published papers were retrieved.195 papers were excluded after applying inclusion/exclusion criteria.Finally,6 clinical trials were selected for this review.This paper identified multiple limitations of the active sham cupping procedure which include failure of blinding,heterogenicity of the characteristics of used devices including heterogenicity in reporting active sham cupping intervention,and the limitation of the sham technique to be used for dry cupping only.The recommended enhancements included using bigger cups holes for release of suction,standardization of characteristics of used sham devices,standardization in reporting,and suggesting recruiting patients without prior experience of cupping for better blindness success in sham cupping clinical trials.This paper suggested reporting criteria for sham cupping clinical trials.In conclusion,this paper identified the limitations of the current sham cupping technique and suggesting enhancements regarding active sham cupping technique.Continues evaluation of the current active sham cupping technique and development of new sham cupping devices and techniques for various types of cupping therapy are highly recommended.

Abul-Qasim Al-Zahrawy’s practice of cupping therapy(Hijama)during the tenth century:a documentation

Abul-Qasim Al-Zahrawy’s(Albucasis)(936-1013 AD)was one of the greatest Andalusian scientists and surgeons.Al-Zahrawy illustrated his pioneering medical and surgical information on his book(“At-Tasrif liman‘Azija‘an at-Ta’lif)or(The method of medicine).He illustrated the cupping therapy practice in the treatise 30 of this book.The aim of this article is to give an anthropological and historical medical information about Al-Zahrawy’s practice of cupping therapy(Hijama in Arabic).This article is a method of documentations of cupping therapy practice during the 10th century.Safety concerns including innovation cup safety design were the most noticed subjects in practicing cupping therapy by Al-Zahrawy.This attitude should be continued.