Efficacy of acupoint injection in the treatment of chronic eczema and its influence on peripheral blood T cells

BACKGROUND Chronic eczema significantly impacts daily life,social interactions,and quality of life;however,no curative treatment has been identified.AIM To determine the clinical efficacy of acupoint injection for chronic eczema and its influence on peripheral blood T cells.METHODS Eighty patients with chronic eczema treated at our hospital between June 2022 and March 2023 were randomly assigned to a control group(n=40),which received conventional Western medicine treatment,or an observation group(n=40),which received routine Western medicine treatment plus acupoint injection of triamcinolone acetonide.Response and adverse reaction rates,as well as differences in the levels of serum cytokines IFN-γ,IL-2,IL-4,and IL-10 before and after treatment were investigated.RESULTS No difference in overall response rates were found between the observation and control groups(100%vs 90%,respectively;P>0.05);however,the observation group had a higher marked response rate than the control group(87.5%vs 52.5%;P<0.05).Both groups had decreased Eczema Area and Severity Index scores and increased pruritus after treatment(P<0.05),particularly in the observation group(P<0.05).The observation group had an adverse reaction rate of 2.5%(1/40),which did not differ significantly from that of the control group(P>0.05).The observation group exhibited higher post-treatment INF-γand IL-2 but lower IL-4 levels than the control group(P<0.05);however,no significant inter-group difference was observed in post-treatment IL-10 levels(P>0.05).CONCLUSION Acupoint injection of triamcinolone acetonide is safe and effective in treating chronic eczema.Its therapeutic mechanism is related to the regulation of peripheral blood T cell levels,inhibition of inflammatory reactions,and mitigation of immune imbalance.

Mechanism of acupoint penetration acupuncture therapy regulating chondrocyte autophagy via the PI3K/Akt-mTOR pathway in KOA rats

Objective To investigate whether acupoint penetration acupuncture(APA)could regulate chondrocyte autophagy and apoptosis via the PI3K/Akt-mTOR signaling pathway to reduce cartilage degeneration in knee osteoarthritis(KOA)rats.Methods KOA was induced in rats via intra-articular injection of sodium iodoacetate resolution.Forty male Sprague-Dawley rats were randomly assigned to blank control,model,APA,electro-acupuncture(EA),and sham model groups(n=8)and those in the APA and EA groups received their respective therapies.Following completion of the treatment course,histological examinations of cartilage and muscle were conducted.Levels of apoptosis-and autophagy-related factors,including Bax,Bcl-2,mTOR,ULK-1,and Beclin-1 protein,and mRNAs were assessed.Additionally,β-endorphin(β-EP)concentrations in the brain and serum were measured.Results Histological analysis revealed that APA alleviated cartilage and muscle damage compared with the model group.APA inhibited cartilage degeneration by modulating the expression of apoptosis-and autophagy-related proteins and mRNA,thus preventing chondrocyte apoptosis.In the APA group,Bax and mTOR protein levels were significantly lower than those in the model group(both P=.024).Conversely,the Bcl-2 expression level was significantly higher than that in the EA group(P=.035).Additionally,ULK-1 expression was significantly lower than that in the EA group(P=.045).The mRNA level of Bax was significantly higher than that in the blank control group(P<.001).However,Beclin-1 levels were significantly higher than those in both the model and EA groups(both P<.001).ELISA results showed a significant decrease in the concentration ofβ-EP in the brains of the rats in the APA group compared with those in the model group(P=.032).Conclusions APA reduced osteoarthritis-related pain and alleviated cartilage damage by upregulating chondrocyte autophagy and down-regulating apoptosis via signaling pathways involving PI3K/Akt-mTOR in KOA rats.

Analysis of acupoint massage combined with touch on relieving anxiety and pain in patients with oral implant surgery

BACKGROUND Oral implant surgery is an effective procedure for artificial implants in missing tooth areas under local anesthesia.Because patients under local anesthesia are conscious during this procedure,compared with general anesthesia-related operations,they are more likely to experience negative emotions,such as anxiety and tension.These emotional reactions result in shivering and chills in the limbs,leading to poor doctor-patient cooperation and even avoidance of treatment.In traditional Chinese medicine,it is believed that acupoint massage regulates blood and Qi,dredge menstruation,and relieve pain,which is beneficial for patients’emotional adjustment;however,there are few related clinical studies.AIM To observe the changes in anxiety and pain in patients with oral implant after acupoint massage combined with touch therapy.METHODS One hundred patients undergoing oral implantation in our hospital between May 2020 and May 2023 were randomly divided into control and study groups,according to a random number table,with 50 patients in each group.The control group received routine intervention,and the study group received acupoint massage combined with touch on the basis of the control group.Anxiety[assessed using the Modified Dental Anxiety Scale(MDAS)],pain severity,blood pressure,heart rate,and satisfaction were compared between the two groups.RESULTS Before intervention,the difference in MDAS score between the two groups was not significant(P>0.05),while after the intervention,the MDAS scores decreased in both groups compared with those before the intervention(P<0.05);the MDAS score of the study group was lower than that of the control group,with a statistically significant difference(P<0.05).The degree of pain in the intervention group was significantly lower than that in the control group(P<0.05).Before the intervention,there were no significant differences in systolic and diastolic blood pressures or heart rate between the two groups(P>0.05).The systolic and diastolic blood pressures and heart rate in the intervention group,during and after the intervention,were significantly lower than those in the control group(P<0.05).The total degree of satisfaction in the study group was significantly higher than that in the control group(P<0.05).CONCLUSION Acupoint massage combined with touch better relieves anxiety and pain in patients undergoing dental implant surgery,improving the perioperative comfort of these patients and ensuring safety and a smooth operation.

Acupoint catgut-embedding therapy ameliorates DNCB-induced atopic dermatitis in BALB/c mice by regulating Th2 type immune response and reducing infiltration of CD4^(+)and CD8^(+)cells

Background:This study aimed to assess how acupoint catgut-embedding therapy influences Th2-type immune response and the infiltration of CD4^(+)and CD8^(+)cells in DNCB-induced atopic dermatitis in BALB/c mice.It also conducted an initial examination of the underlying molecular mechanisms.Methods:Seventy-two mice were randomly divided into four groups:normal control,DNCB-induced atopic dermatitis model(AD),AD with acupoint catgut-embedding treatment(ADA),and AD with sham-acupoint catgut-embedding treatment.After DNCB challenge to induce AD,the ADA group received acupoint catgut-embedding therapy treatment at Zusanli(ST 36)and Quchi(LI 11)acupoints every other week from day 8.Mice in the AD with sham-acupoint catgut-embedding treatment group underwent the same procedure as the ADA group but without catgut implantation.Severity was assessed using SCORAD on treatment days 1,10,and 20.On day 18,nine mice per group were euthanized,and the remaining on day 28.Histopathological changes were observed using hematoxylin-eosin and immunohistochemistry staining.TNF-α,IL-4,IL-6,and IL-13 levels were analyzed by ELISA,and GATA3 and STAT6 protein levels by western blot.Results:After 20 days of acupoint catgut-embedding therapy treatment,mice showed reduced dermatitis scores compared to DNCB-induced AD-like mice.Significant decreases occurred in serum IL-4,IL-6,IL-13,and TNF-αlevels.Skin analysis revealed marked reductions in CD4^(+)and CD8^(+)cell infiltration,as well as GATA3 and STAT6 protein levels.Conclusion:Acupoint catgut-embedding therapy may effectively alleviate atopic dermatitis by suppressing Th2 immune responses via the STAT6-GATA3 pathway and reducing CD4^(+)and CD8^(+)T cell infiltration in skin lesions.

Exploring the mechanism of electroacupuncture at different acupoints on acute colitis rats based on JAK2/STAT3/SOCS1 signaling pathway

Objective:To investigate the mechanism of JAK2/STAT3/SOCS1 signaling pathway in electroacupuncture of different acupoints on acute colitis rats.Methods:36 SPF SD rats were randomly divided into 6 groups,with 6 rats in each group.The rat model of acute colitis was prepared by enema with glacial acetic acid solution.After the model was established,electroacupuncture was given to each acupoint group,with density wave,frequency 2Hz-50 Hz,intensity 2 mA,muscle tremor as the degree 20 min/time,1 time/day,for 3 consecutive days.Observe the general condition of rats;the pathological changes of colonic mucosa in rats were observed by HE method.The contents of serum interleukin-4(IL-4)and interleukin-8(IL-8)were detected by ELISA.Western blot and RT-PCR were used to detect the expression of JAK2,STAT3,SOCS1 protein and mRNA in rat colon tissue.Results:In contrast to the normal group,the overall condition of the model group was worse,the colonic mucosa was severely damaged,even necrotic,and the ulcer surface was obvious.The content of IL-4 in serum was obviously reduced,and the content of IL-8 was obviously go up(P<0.01).The protein content of JAK2,STAT3 and the expression of JAK2,STAT3 mRNA in colon tissue of rats were obviously go up,while the protein content of SOCS1 and the expression of SOCS1 mRNA were obviously reduced(P<0.01).In contrast to the model group,the general condition of rats in each acupoint group was significantly improved,the damage and necrosis of colonic mucosa and ulcer surface were obviously alleviated,the content of IL-4 in serum was obviously go up,and the content of IL-8 was significantly decreased(P<0.01).The protein content of JAK2,STAT3 and the expression of JAK2,STAT3 mRNA in colon tissue of rats were obviously reduced,while the protein content of SOCS1 and the expression of SOCS1 mRNA were obviously go up(P<0.05,P<0.01).Comparison of different acupoint groups,the colonic mucosal injury in the Zusanli group was significantly reduced,the content of serum IL-4 was significantly increased,and the content of IL-8 was significantly decreased(P<0.05,P<0.01).The protein content and mRNA expression of JAK2 and STAT3 in colon tissue were significantly down-regulated,while the protein content and mRNA expression of SOCS1 were significantly go up(P<0.05,P<0.01).Conclusion:Electroacupuncture at each acupoint can improve the damage of colonic mucosa and reduce the inflammatory response.The therapeutic effect of Zusanli(ST36)is better than that of Tianshu(ST25),Dachangshu(BL25)and Shangjuxu(ST37).The mechanism may be related to the regulation of JAK2/STAT3/SOCS1 signaling pathway related proteins and inflammatory cytokines IL-4 and IL-8.

Clinical Study on the Therapeutic Effect of Combined Traditional Chinese Medicine with Acupoint Injection and Herbal Paste Application in Treating Ovulatory Dysfunction in Polycystic Ovary Syndrome (PCOS)

Objective: To observe the therapeutic effect of combined traditional Chinese medicine (TCM) therapy with acupoint injection and herbal patch application on patients with ovulatory dysfunction associated with polycystic ovary syndrome (PCOS). Methods: A total of 80 PCOS patients who received treatment at the First Affiliated Hospital of Guangxi University of Chinese Medicine between October 2022 and March 2024 were enrolled in this study. They were randomly divided into a control group (n = 40) and an observation group (n = 40). The control group received conventional Western medical treatments, while the observation group was administered TCM combined with acupoint injection and herbal patch application. Pre- and post-treatment conditions were compared between the two groups. Results: After treatment, the overall effective rate was significantly higher in the observation group compared to the control group (P 0.05). Following treatment, both ovulation and pregnancy rates increased in both groups, but the increase was more evident in the observation group, showing a statistically significant difference (P < 0.01). Conclusion: For patients with oligoovulation or anovulation due to PCOS, the combined use of TCM, acupoint injection, and herbal patch application appears to be effective in improving systemic symptoms and achieving notable clinical outcomes.

Effect of Head Meridian Massage Combined with Auricular Acupoint Plaster on Patients with Insomnia

Objective:To study the effect of head meridian massage combined with auricular acupoint plasters on patients with insomnia.Methods:The sample consisted of 50 cases,and all of them were admitted to Yixing Hospital of Traditional Chinese Medicine from January 2022 to December 2023.The patients were divided into an observation group and a control group,with 25 cases in each group.The observation group was treated with a combination of head meridian massage and auricular acupoint plaster while the control group underwent conventional nursing care.The improvement of sleep quality and nursing effect were used as evaluation criteria to compare the clinical effects of the nursing programs.Results:After nursing intervention,the Pittsburgh sleep quality index(PSQI)score of the observation group,which was 7.17±1.41 points was lower than that of the control group(9.04±1.96 points),(t=3.8724,P<0.05).The total efficacy was 96.00%for the observation group and 76.00%for the control group(2=4.1528,P<0.05).Conclusion:Head meridian massage combined with auricular acupoint can improve the sleep quality of patients with insomnia.

Clinical Analysis of Acupuncture Combined with Acupoint Injection for the Treatment of Chronic Nonbacterial Prostatitis

Objective:To evaluate the therapeutic effect of acupuncture combined with acupoint injection on chronic nonbacterial prostatitis(CNP).Methods:A total of 72 CNP patients admitted between March 2022 and October 2023 were selected.The patients were randomly divided into two groups using a random number table.The combined treatment group(36 cases)received acupuncture combined with acupoint injection therapy,while the control group(36 cases)received conventional Western medicine treatment.The overall efficacy rate,symptom severity,prostatic fluid indicators,incidence of adverse reactions,and recurrence rates were compared.Results:The overall efficacy rate of the combined treatment group was higher than that of the control group(P<0.05).After 10 days of treatment,the symptom severity score of the combined treatment group was higher than that of the control group,and the prostatic fluid indicators were lower than those of the control group(P<0.05).The incidence of adverse reactions in the combined treatment group was lower than in the control group(P<0.05).During the follow-up period of 1-6 months,the recurrence rate in the combined treatment group was lower than that in the control group(P<0.05).Conclusion:Acupuncture combined with acupoint injection can alleviate CNP disease symptoms,improve prostate function,and prevent post-treatment adverse reactions.It also has a lower recurrence risk and demonstrates excellent efficacy.

Analysis of the Effect of Transcutaneous Electrical Stimulation of Acupoints Combined with Rehabilitation Training in The Treatment of Upper Limb Dysfunction After Stroke

Objective:To analyze the effect of combining transcutaneous electrical acupoint stimulation(TEAS)with rehabilitation training in patients with upper limb dysfunction after stroke(ULDAS).Methods:A total of 130 ULDAS patients who were hospitalized and rehabilitated in Wuxi Xinwu District Rehabilitation Hospital from May 2021 to May 2023 were selected and randomly divided into Group A(65 cases,rehabilitation training)and Group B(65 cases,rehabilitation training+TEAS).The effects of the two groups were compared.Results:After treatment,the upper limb functional indexes of Group B were better than those of Group A(P<0.05).The rate of muscle tone grades 0-4 in Group B was higher than those of Group A(P<0.05).Conclusion:The function of upper limbs and muscle strength of ULDAS patients improved by combining TEAS with rehabilitation training.

Evaluation of the Efficacy of Auricular Acupoint Pressure Patch Combined with Modified Huangqi Decoction in Treating Diabetic Nephropathy

Objective:To explore the efficacy of auricular acupoint pressure patch combined with modified Huangqi Decoction in treating diabetic nephropathy.Methods:60 patients with diabetic nephropathy treated in our hospital from January 2021 to December 2022 were selected for this study.The patients were randomly divided into two groups using the random number table method,with 30 patients in each group.Among them,the control group was treated with conventional Western medicine,while the experimental group was treated with auricular acupoint pressure patches combined with modified Huangqi Decoction.The patients’fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),glycated hemoglobin(HbA1c),urinary protein quantification,urea nitrogen(BUN),serum creatinine(SCr),and other indicators were detected and recorded before and after treatment.Results:Before treatment,there was no statistically significant difference in the FPG,the 2hPG,and the HbA1c between the two groups of patients(P>0.05);after treatment,the FPG,the 2hPG,and the HbA1c of the patients in the experimental group were significantly lower than those in the control group(P<0.05).Before treatment,there was no statistically significant difference in the urinary protein quantification,the BUN,and the SCr between the two groups of patients(P>0.05);after treatment,the urinary protein quantification,BUN,and SCr of the patients in the experimental group were significantly lower than those in the control group(P<0.05).The experimental group showed better improvement in symptoms such as fatigue,backache,and frequency of nocturia(P<0.05).Conclusion:Auricular acupoint pressure patch combined with modified Huangqi Decoction effectively treats diabetic nephropathy and it helps control blood sugar and renal function indicators and improve clinical symptoms,therefore improving the patients’quality of life.

Analysis of the Effect of Traditional Chinese Medicine Nursing Intervention Combined with Acupoint Application in The Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective:To study the effect of Traditional Chinese medicine(TCM)nursing intervention combined with acupoint patch in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods:A total of 60 patients with acute exacerbation of COPD admitted between September 2022 and September 2023 were selected and randomly grouped into a control group(conventional care and treatment)and an observation group(joint interventions:traditional Chinese medicine nursing interventions,acupoint compresses),with 30 patients each.The arterial blood gas indexes of the two groups,hospitalization time,pulmonary function indexes,and TCM symptom scores were analyzed and compared between the two groups.Results:The arterial oxygen pressure(PaO_(2))(9.52±1.02 kPa)and partial pressure of carbon dioxide(PaCO_(2))(5.01±1.02 kPa)of the observation group were better than those of the control group after the intervention(P<0.05).The forced expiratory volume(FEV1)(3.38±0.15%),the FEV1% prediction value(72.52±2.25),and the FEV1/forced vital capacity(FVC)(79.52±1.41%)were higher than those of the control group(P<0.05).The hospitalization time(12.16±1.02 d)and TCM symptom score(4.12±1.26)of the observation group were better than those of the control group(P<0.05).Conclusion:Significant nursing effects were achieved by carrying out combined interventions(Chinese medicine nursing intervention and acupoint application)during the acute exacerbation of COPD.

Research on the Different Frequencies of Transcutaneous Electrical Acupoint Stimulation for Postpartum Pelvic Girdle Pain

Objective:To observe the clinical effect of different frequencies of transcutaneous electrical acupoint stimulation in treating postpartum pelvic girdle pain and promoting postpartum rehabilitation.Methods:From January to September 2022,300 patients with pelvic girdle pain after spontaneous delivery in a hospital in Shaanxi Province were selected and randomly divided into three groups,low frequency,high frequency,and alternating frequency,with 100 cases in each group.In addition to routine postpartum care and psychological counseling,the three groups received transcutaneous electrical acupoint stimulation at low-frequency(2 Hz,)high-frequency(100 Hz),and alternating frequency(2/100 Hz),respectively.The differences in initial pain,pain scores before and after treatment,satisfaction with analgesic effect,and postpartum rehabilitation effect were evaluated among the three groups of patients.Results:There was a significant correlation between maternal age and postpartum pelvic girdle pain(P<0.001),but no correlation was observed between newborn birth weight and postpartum pelvic girdle pain(P>0.05).After 1d/2d of treatment,the pain scores and rehabilitation effect of patients in the alternating-frequency group and low-frequency group were significantly better than those in the high-frequency group,and the postpartum curative effect of patients in the alternating-frequency group was the best,followed by the low-frequency group,and the high-frequency group;the differences were statistically significant(P<0.001).Among the three groups,the alternating-frequency group had the highest satisfaction with the analgesic effect and the highest rate of selecting the same analgesic regimen the next time;the differences were statistically significant(P<0.001).Conclusion:Transcutaneous electrical acupoint stimulation at different frequencies is safe and effective in treating postpartum pelvic girdle pain and beneficial to postpartum rehabilitation.Sparse-dense wave stimulation is effective in treating postpartum pelvic girdle pain.It has the best effect in promoting postpartum rehabilitation and the highest patient satisfaction.Therefore,its application in clinical practice is highly recommended.

Mechanism of Scalp Acupuncture Combined with Distal Acupoint Selection in the Treatment of Vascular Headache Caused by Hyperactivity of Liver-Yang

The clinical effect of acupuncture on vascular headache caused by hyperactivity of liver-yang has been shown, but the specific mechanism is not yet clear. This paper is intended to discuss the etiology and pathogenesis of vascular headache caused by hyperactivity of liver-yang and the mechanism of acupuncture, so as to provide a certain reference for clinical diagnosis and treatment of scalp acupuncture treatment of vascular headache caused by hyperactivity of liver-yang.

New therapy for oral ulcer:Evodia rutaecarpa patch combined with acupoint application

Background:Oral ulcer is the most common and easily recurrent disease in stomatology,which influence the patients’communication,normal dietary,and sleep.Evodia rutaecarpa(ER)is a traditional Chinese herbal medicine recorded in ancient Chinese medical books,which has a medicinal history of more than 2,000 years.Clinically,the application of ER at plantar Yongquan point(KI1)is effective in the treatment of oral ulcer.The purpose of this study was to combine the modern transdermal drug delivery system with traditional Chinese medicine to develop the transdermal absorption patch of ER and apply it to the treatment of oral ulcer at Yongquan point of plantar.Methods:Firstly,the medicinal materials of ER were extracted and the extracted materials were prepared into dispersed ER patch.The formulation and preparation process were screened by orthogonal design method and single factor investigation method.The adhesive and transdermal properties of the patch were used as the evaluation index of the preparation.Secondly,Wistar rats were used as experimental animals to establish a rat model of mouth ulcers.Wistar rats were randomly divided into normal group,model group(A),model group(B),low dose group,medium dose group and high dose group.the efficacy of ER on rat’s oral ulcer model was evaluated through three aspect such as apparent index,pathological index and biochemical index.Results:The patch had suitable adhesion and good skin penetration,which was an effective treatment for oral ulcer.In vivo pharmacodynamic studies,compared with the normal group,the body mass and food intake of rats in each group after modeling decreased,the amount of drinking water increased,the tissue structure of oral mucosa was damaged,and the levels of inflammatory factors(TNF-α,IL-6)and malondialdehyde increased,the levels of anti-inflammatory factors(IL-10),cell growth factor(epidermal growth factor,TGF-β_(1))and superoxide dismutase decreased.Compared with the model group,the body weight and food intake of each dosing group increased,water consumption decreased,the oral mucosal tissue structure was more complete,the levels of TNF-α,IL-6 and malondialdehyde decreased,the levels of IL-10,epidermal growth factor,TGF-β1 and superoxide dismutase increased,and the changes of various indexes were dose-related.Conclusion:ER patch can inhibit inflammatory reaction,enhance the antioxidant defense ability of the body,and promote the repair of damaged oral mucosa,so as to play an effective role in the treatment of oral ulcer.

Effect of acupuncture on acupoint "Yingxiang-Hegu" on Th1, Th2 cytokines and T-bet/GATA-3 of allergic rhinitis rats

Objective:To explore the effect of"Yingxiang-Hegu"on Th1,Th2-related cytokines and[2]transcription factors T-bet and GATA-3 in rats with allergic rhinitis.Methods:Rats were randomly divided into three groups:blank group,model group and acupoint group.The rat model of ovalbumin(OVA)AR was established,and the general condition of the rats was observed and scored.Acupuncture intervention was performed on the acupoint group on the second day after successful modeling,once per day for 20 min for 10 d.After intervention,the general behavior,behavioral score and histomorphological changes of nasal mucosa were observed.Eosinophils(EOS)were counted under microscope after nasal lavage smear staining,and the contents of total IgE,IFN-γ,IL-12,IL-4 and IL-5 in serum were detected by ELISA.Westernblot and IHC were used to detect the protein level and positive protein expression of specific transcription factors T-bet and GATA-3 in rat nasal mucosa.Results:After the establishment of the model,except for the blank group,the behavioral observation scores of rats in the model group and acupoint group were more than 5 points,indicating that the model was successful.After acupuncture intervention on acupoint"Yingxiang-Hegu",the behavioral score of rats in the acupoint group and western medicine group was significantly lower than that in the model group(P<0.05).Microscopic examination showed that the structure of nasal mucosa in the model group was obviously damaged,cilia were arranged discontinuously,uneven,local congestion and swelling,a large number of epithelial cells exfoliated and necrotic,goblet cell proliferation,obvious inflammatory cell infiltration.The pathological degree of nasal mucosa in the pair point group was significantly less than that in the model group.Compared with the model group,the levels of IFN-γ,IL-2 and IL-12 in serum were significantly increased,while IgE,IL-4,IL-5 and IL-6 were significantly decreased,GATA-3 protein and positive expression in nasal mucosa were significantly decreased and T-bet was significantly increased after acupuncture.Conclusion:Acupuncture at"Yingxiang-Hegu"can effectively improve the nasal sensitive symptoms and control nasal inflammation in AR rats.The mechanism may be that acupuncture at Yingxiang-Hegu can up-regulate the expression of T-bet,decrease the level of GATA-3,promote the production of Th1 cytokines and inhibit the synthesis and secretion of Th2 cells,thus restoring the immune balance of Th1 and Th2.

Transcutaneous electrical acupoint stimulation in adult patients receiving gastrectomy/colorectal resection:A randomized controlled trial

BACKGROUND Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery.The effects of transcutaneous electrical acupoint stimulation(TEAS)remain unclear.AIM To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection.METHODS Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive:(1)TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery,plus two 30-min daily sessions for 3 consecutive days after surgery(perioperative TEAS group);(2)Preoperative and intraoperative TEAS only;(3)Preoperative and postoperative TEAS only;or(4)Sham stimulation.The primary outcome was the time from the end of surgery to the first bowel sound.RESULTS In total,441 patients were randomized;405 patients(58.4±10.2 years of age;247 males)received the planned surgery.The time to the first bowel sounds did not differ among the four groups(P=0.90;log-rank test).On postoperative day 1,the rest pain scores differed significantly among the four groups(P=0.04;Kruskal–Wallis test).Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group(1.4±1.2)than in the sham sti-mulation group(1.7±1.1;P=0.04).Surgical complications did not differ among the four groups.CONCLUSION TEAS provided analgesic effects in adult patients undergoing major abdominal surgery,and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.

Meta-analysis of the acupoint application therapy for stable chronic obstructive pulmonary disease

Objective:To systematically evaluate the clinical efficacy and safety of acupoint application in the treatment of stable chronic obstructive pulmonary disease.Methods:A comprehensive search of domestic and international databases,the search time is limited to nearly ten years,collecting traditional Chinese medicine acupoint application in the treatment of chronic obstructive pulmonary disease in stable phase of randomized controlled trials.Literature screening,information extraction and literature quality evaluation were carried out independently by two researchers,and Meta analysis was carried out by Revman software.Results:A total of 42 RCTs with a total of 4192 patients were included.The results of Meta analysis showed that:Compared with the routine treatment of western medicine,the addition of acupoint application therapy can significantly increase the effective rate[RR=1.23,95%CI(1.19,1.27),P<0.00001]and FEV1/FVC[MD=4.46,95%CI(3.17,5.76),P<0.00001].Significantly improved BODE index[MD=-0.63,95%CI(-0.87,-0.40),P<0.00001],SGRQ score[MD=-6.77,95%CI(-9.81,-3.72),P<0.00001],CAT score[MD=-3.33,95%CI(-3.87,-2.79),P<0.00001]and TCM syndrome integral[MD=-3.51,95%CI(-3.96,-3.06),P<0.00001].The differences is statistically significant and the safety profile is good.Conclusion:On the basis of routine treatment of COPD western medicine,acupoint application therapy can significantly improve the clinical symptoms of patients with less adverse reactions.However,due to the limitations of the research,high-quality research is still needed to provide further evidence.

基于γ-氨基丁酸抑制性神经通路探讨“长强”配“太溪”穴电针治疗自闭症神经发育障碍的作用机制

目的:探讨“长强”配“太溪”穴电针治疗自闭症神经发育障碍仔鼠的靶向调控机制。方法:选取已成功受孕SD大鼠10只,分为造模组和非造模组,每组5只,造模组大鼠给予丙戊酸钠600 mg/kg灌胃造模,非造模组给予等量生理盐水灌胃。将造模组大鼠所产36只仔鼠随机分为电针穴位组、电针非经非穴组和模型组,每组12只,随机选取非造模组仔鼠所产的仔鼠12只作为对照组。电针穴位组仔鼠在出生第24天即开始电针长强和太溪穴位。电针非经非穴组避开经络和穴位针刺。分别于干预前后对所有仔鼠行旷场实验和Morris水迷宫测试。并取仔鼠腹主动脉血检测血清谷氨酸(Glu)、γ-氨基丁酸(GABA)水平。断头处死留取海马组织,通过实时荧光定量聚合酶链式反应(RT-PCR)测定仔鼠海马组织γ-氨基丁酸A型受体(GABAAR)m RNA相对表达水平,采用蛋白免疫印迹法(Western Blot)测定仔鼠海马组织糖原合酶激酶-3β(GSK-3β)、β-catenin和微白蛋白(PV)相对表达水平。结果:旷场实验结果表明,经干预后,电针穴位组水平得分和垂直得分高于模型组和电针非经非穴组,低于对照组,差异有统计学意义(P<0.05)。Morris水迷宫测试结果表明,经干预后,与模型组和电针非经非穴组比较,电针穴位组逃避潜伏期缩短,而穿越次数增加,平台停留时间延长,差异有统计学意义(P<0.05)。与模型组比较,电针穴位组仔鼠Glu、GABA、海马GABAAR m RNA、β-catenin和PV相对表达水平降低,而GSK-3β蛋白相对表达水平上调,差异有统计学意义(P<0.05)。结论:针刺长强和太溪穴可有效改善自闭症仔鼠的空间学习和记忆能力,靶向调控自闭症神经发育障碍,其具体机制可能与通过促进GABA神经通路的兴奋-抑制平衡,同时作用于Wnt/β-catenin信号通路中的重要调节因子有关。

耳穴揿针联合栀黄散穴位贴敷在胆石症患者中的应用研究

目的观察耳穴揿针联合栀黄散穴位贴敷对胆石症患者的应用效果。方法将120例患者随机分为A组:耳穴揿针组(40例),B组:穴位贴敷组(40例),C组:联合治疗组(40例)。A组患者在常规西医治疗的基础上加用耳穴揿针治疗,按压4~6次/d,1~3 min/次,5 d 1个疗程,双耳交替操作。B组患者在常规西医治疗的基础上加用栀黄散穴位贴敷,贴敷于双侧胆俞穴、双侧肝俞穴、右侧期门穴、双侧阳陵泉穴,贴敷时间为4~6 h,2次/d,5 d 1个疗程。C组患者在常规西医治疗的基础上联合使用耳穴揿针和栀黄散穴位贴敷治疗。通过疼痛数值评分量表(NRS)比较3组患者治疗后0.5、1、2、24、48 h疼痛评分;治疗前后3组患者C反应蛋白(C-reactive protein,CRP)、胆红素、肝功能(ALT)变化情况;通过B超检查治疗前后胆囊收缩功能、胆囊壁厚度。结果干预后3组患者疼痛评分时间效应值、CRP、胆红素、ALT数值、胆囊壁厚度均低于干预前,胆囊收缩功能较干预前增加,差异具有统计学意义(P<0.05),A组、B组两组患者干预后疼痛评分时间效应值、CRP、胆红素、ALT数值、胆囊壁厚度、胆囊收缩功能比较,差异无统计学意义(P>0.05)。C组患者干预后疼痛评分时间效应值、CRP、胆红素、ALT数值、胆囊壁厚度均低于A、B两组,胆囊收缩功能高于A、B两组,差异具有统计学意义(P<0.05)。结论耳穴揿针和栀黄散穴位贴敷应用于胆石症患者,均可减轻患者的疼痛反应,降低炎症作用,促进肝功能恢复,增强胆囊收缩功能。将两者联合应用,临床疗效更加显著,能够加速患者康复,值得临床推广。

A study of acupoint specificity and mechanism of electroacupuncture intervention on chronic colitis in rats based on PI3K/AKT/mTOR signaling pathway

Objective:This study aimed to elucidate the differences in effects and mechanisms of action of electric-needle therapy at Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)and Shang Ju Xu(ST37)acupoints on chronic experimental colitis in rats through the PI3K/AKT/mTOR signaling pathway.Methods:Sixty pathogen-free SD rats were randomly assigned to six groups:the normal,model,Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)and Shang Ju Xu(ST37)groups,each with 10 rats.Chronic colitis was induced in rats by combining immunization and local stimulation.After model establishment,electrical needle intervention combined with dispersing wave of 2 Hz/50 Hz with a current intensity of 2 mA once daily for 20 min was applied on acupoints of each group.Subsequently,the inflammation of colonic mucosa and serum levels of inflammatory factors(IL-23,IL-17,IL-10)were observed;ELISA was used to detect mRNA expressions of PI3K,Akt and mTOR in colitic tissues by RT-PCR as well as protein content of p-PI3k/PI3K,p-Akt/Akt,and p-mTOR/mTOR in colitic tissues by Western blotting.Result:Compared with the normal group,the model rats showed a poor general condition,serious damage to the colonic mucosa with a large number of inflammatory cells infiltration.The serum IL-23 and IL-17 expressions were significantly increased(P<0.01),while the serum IL-10 expression was significantly decreased(P<0.01);the mRNA and protein expressions of PI3K,Akt,mTOR and p-PI3K,p-Akt and p-mTOR were significantly increased(P<0.05,P<0.01).Compared with the model group,the pathological slices of rats in each acupoints intervention group showed obvious improvement of colitis inflammatory reaction and tissue damage;the serological levels of IL-23 and IL-17 were significantly reduced(P<0.01),while the serology level of IL-10 was significantly increased(P<0.01);the expressions of PI3K,Akt,mTOR mRNA and p-PI3K,p-Akt,p-mTOR proteins were significantly decreased(P<0.05,P<0.01).Compared with Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)groups,the recovery degree of mucosa layers in Shang Ju Xu(ST37)group was closer to that of normal group,and the curative effect was relatively the best;in terms of serological levels of IL-23 and IL-17,the Shang Ju Xu(ST37)group was significantly lower(P<0.05),while the level of IL-10 was significantly higher(P<0.01);the expressions of PI3K,Akt,mTOR mRNA and p-PI3K,p-Akt,p-mTOR proteins were significantly decreased(P<0.05,P<0.01).Conclusion:Results indicate that electrical acupuncture at Tian Shu(ST25),Da Chang Shu(BL25),Zu San Li(ST36)and Shang Ju Xu(ST37)show similar effects in relieving the colitis-induced damage in the mucosa of chronic colitis rats,as well as inflammatory response.Among them,Shang Ju Xu(ST25)has a superior overall effect in treating chronic colitis compared to Tian Shu(ST25),Da Chang Shu(BL25)and Zu San Li(ST36).The mechanism may be related to inhibition of PI3K/Akt/mTOR signaling pathway.