Early filiform needle acupuncture for poststroke depression: a meta-analysis of 17 randomized controlled clinical trials

OBJECTIVE： To evaluate the effectiveness and safety of filiform needle acupuncture for poststroke depression, and to compare acupuncture with the therapeutic efficacy of antidepressant drugs. DATA RETRIEVAL： We retrieved data from the Chinese National Knowledge Infrastructure （1979-2012）, Wanfang （1980-2012）, VIP （1989-2012）, Chinese Biomedical Literature （1975- 2012）, PubMed （1966-2012）, Ovid Lww （-2012）, and Cochrane Library （-2012） Database using the internet. SELECTION CRITERIA： Randomized controlled trials on filiform needle acupuncture versus antidepressant drugs for treatment of poststroke depression were included. Moreover, the in- cluded articles scored at least 4 points on the Jadad scale. Exclusion criteria： other acupuncture therapies as treatment group, not stroke-induced depression patients, score 〈 4 points, non-ran- domized controlled trials, or animal trials. MAIN OUTCOME MEASURES： These were the Hamilton Depression Scale scores, clinical ef- fective rate, Self-Rating Depression Scale scores, Side Effect Rating Scale scores, and incidence of adverse reaction and events. RESULTS： A total of 17 randomized controlled clinical trials were included. Meta-analysis results displayed that after 4 weeks of treatment, clinical effective rate was better in patients treated with fill- form needle acupuncture than those treated with simple antidepressant drugs [relative risk = 1.11, 95% confidence interval （C/）： 1.03-1.21, P = 0.01]. At 6 weeks, clinical effective rate was similar between filiform needle acupuncture and antidepressant drug groups. At 2 weeks after filiform needle acupuncture, Hamilton Depression Scale （17 items） scores were lower than in the antide- pressant drug group （mean difference = -2.34, 95%CI： -3.46 to -1.22, P 〈 0.000,1）. At 4 weeks, Hamilton Depression Scale （24 items） scores were similar between filiform needle acupuncture and antidepressant drug groups. Self-Rating Depression Scale scores were lower in filiform needle acupuncture group than in the antidepressant drug group. Side Effect Rating Scale was used in only two articles, and no meta-analysis was conducted. Safety evaluation of the 17 arti- cles showed that gastrointestinal tract reactions such as nausea and vomiting were very common in the antidepressant drug group. Incidence of adverse reaction and events was very low in the filiform needle acupuncture group. CONCLUSION： Early filiform needle acupuncture for poststroke depression can perfectly con- trol depression. Filiform needle acupuncture is safe and reliable. Therapeutic effects of filiform needle acupuncture were better than those of antidepressant drugs.

Antidepressant effect of electroacupuncture regulates signal targeting in the brain and increases brain- derived neurotrophic factor levels

Electroacupuncture improves depressive behavior faster and with fewer adverse effects than antidepressant medication. However, the antidepressant mechanism of electroacupuncture remains poorly understood. Here, we established a rat model of chronic unpredicted mild stress, and then treated these rats with electroacupuncture at Yintang （EX-HN3） and Baihui （DU20） with sparse waves at 2 Hz and 0.6 mA for 30 minutes, once a day. We found increased horizontal and vertical activity, and decreased immobility time, at 2 and 4 weeks after treatment. Moreover, levels of neurotransmitters （5-hydroxytryptamine, glutamate, and y-aminobutyric acid） and protein levels of brain-derived neurotrophic factor and brain-derived neurotrophic factor-related proteins （TrkB, protein kinase A, and phosphorylation of cyclic adenosine monophosphate response element binding protein） were increased in the hippocampus. Similarly, protein kinase A and TrkB mRNA levels were increased, and calcium-calmodulin-dependent protein kinase lI levels decreased. These findings suggest that electroacupuncture increases phosphorylation of cyclic adenosine monophosphate response element binding protein and brain-derived neurotrophic factor levels by regulating multiple targets in the cyclic adenosine rnonophosphate response element binding protein signal- ing pathway, thereby promoting nerve regeneration, and exerting an antidepressive effect.

Electroacupuncture-regulated neurotrophic factor mRNA expression in the substantia nigra of Parkinson's disease rats

Acupuncture for the treatment of Parkinson＇s disease has a precise clinical outcome. This study investigated the effect of electroacupuncture at Fengfu （GV16） and Taichong （LR3） acupoints in rat models of Parkinson＇s disease induced by subcutaneous injection of rotenone into rat neck and back. Reverse transcription-PCR demonstrated that brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor mRNA expression was significantly increased in the substantia nigra of rat models of Parkinson＇s disease, and that abnormal behavior of rats was significantly improved following electroacupuncture treatment. These results indicated that electroacupuncture treatment upregulated brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor mRNA expression in the substantia nigra of rat models of Parkinson＇s disease. Thus, electroacupuncture may be useful in the treatment of Parkinson＇s disease.

Effects of Acupuncture on Hemorheology, Blood Lipid Content and Nail Fold Microcirculation in Multiple Infarct Dementia Patients

Forty-six cases of multiple infarct dementia (MID) in the treatment group were treated by acupuncture with the principle of supplementing the inferiority to clear the superiority and regulating spirit to invigorate intelligence. Changes of the blood lipid content, hemorheological indexes and nail fold microcirculation in the treatment group were compared with those in the randomly assigned control group.The data collected showed that the changes in the treatment group were remarkable, and part of them were superior to their counterparts obtained in the control group by statistical analysis. It is indicated that acupuncture can effectively regulate the affected hemodynamic state in MID.

TREATMENT OF PERIPHERAL FACIAL PARALYSIS WITH PICK-PRICK AND CONNECTING-ACUPUNCTURE

Peripheral facial paralysis may occur inall ages,but particularly in the young.Thedisease is characterized by a wry mouth andinability to close the eyes.For many years,the author used pick-prick andconnecting-acupuncture in treatment of thismalady with good therapeutic results,as re-ported in the following.

TREATMENT OF FACIAL SPASM BY PLUM-BLOSSOM NEEDLE TAPPING AND CUPPING THERAPY

Facial spasm is a frequently seen dis-ease characterized by unilateral involuntaryirregular twitching of the facial muscles.This disorder may be induced by intoxica-tion,infection,trauma and long-term facialparalysis which was not properly treated.

Moxibustion inhibits interleukin-12 and tumor necrosis factor alpha and modulates intestinal flora in rat with ulcerative colitis

AIM: To investigate the effect of moxibustion on intestinal flora and release of interleukin-12 (IL-12) and tumor necrosis factor-α (TNF-α) from the colon in rat with ulcerative colitis (UC). METHODS: A rat model of UC was established by local stimulation of the intestine with supernatant from colonic contents harvested from human UC patients. A total of 40 male Sprague-Dawley rats were randomly divided into the following groups: normal (sham), model (UC), herb-partition moxibustion (HPM-treated), and positive control sulfasalazine (SA-treated). Rats treated with HPM received HPM at acupuncture points ST25 and RN6, once a day for 15 min, for a total of 8 d. Rats in the SA group were perfused with SA twice a day for 8 d. The colonic histopathology was observed by hematoxylin-eosin. The levels of intestinal flora, including Bifidobacterium, Lactobacillus, Escherichia coli (E. coli), and Bacteroides fragilis (B. fragilis), were tested by real-time quantitative polymerase chain reaction to detect bacterial 16S rRNA/DNA in order to determine DNA copy numbers of each specific species. Immunohistochemical assays were used to observe the expression of TNF-α and IL-12 in the rat colons. RESULTS: HPM treatment inhibited immunopathology in colonic tissues of UC rats; the general morphological score and the immunopathological score were significantly decreased in the HPM and SA groups compared with the model group [3.5 (2.0-4.0), 3.0 (1.5-3.5) vs 6.0 (5.5-7.0), P < 0.05 for the general morphological score, and 3.00 (2.00-3.50), 3.00 (2.50-3.50) vs 5.00 (4.50-5.50), P < 0.01 for the immunopathological score]. As measured by DNA copy number, we found that Bifidobacterium and Lactobacillus, which are associated with a healthy colon, were significantly higher in the HPM and SA groups than in the model group (1.395 ± 1.339, 1.461 ± 1.152 vs 0.045 ± 0.036, P < 0.01 for Bifidobacterium, and 0.395 ± 0.325, 0.851 ± 0.651 vs 0.0015 ± 0.0014, P < 0.01 for Lactobacillus). On the other hand, E. coli and B. fragilis, which are associated with an inflamed colon, were significantly lower in the HPM and SA groups than in the model group (0.244 ± 0.107, 0.628 ± 0.257 vs 1.691 ± 0.683, P < 0.01 for E. coli, and 0.351 ± 0.181, 0.416 ± 0.329 vs 1.285 ± 1.039, P < 0.01 for B. fragilis). The expression of TNF-α and IL-12 was decreased after HPM and SA treatment as compared to UC model alone (4970.81 ± 959.78, 6635.45 ± 1135.16 vs 12333.81 ± 680.79, P < 0.01 for TNF-α, and 5528.75 ± 1245.72, 7477.38 ± 1259.16 vs 12550.29 ± 1973.30, P < 0.01 for IL-12). CONCLUSION: HPM treatment can regulate intestinal flora and inhibit the expression of TNF-α and IL-12 in the colon tissues of UC rats, indicating that HPM can improve colonic immune response.

OBSERVATION ON THE THERAPEUTIC EFFECT OF NEEDLING IN COMBINATION WITH HERBAL MEDICINES FOR THE TREATMENT OF RHEUMATOID ARTHRITIS

Objective: To discover the effective therapy for the treatment of rheumatoid arthritis. Methods: A total of 62 patients were randomly divided into treatment group (30 cases) and control group (32 cases). The treatment group were punctured with filiform needle Dazhui (大椎 GV 14), Zhiyang (至阳 GV 9), Mingmen (命门 GV 4), Shenting (神庭 GV 24), Hegu (合谷 LI 4) and Zusanli (足三里 ST 36) were used as main points in combination with oral taking herbal medicines, and the control group only took herbal medicines, and the clinical effects of two groups were observed. Result: At the end of the first course of treatment, the total effective rate between treatment group (93.3%) and control group (87.5%) was obvious significant ( P<0.05 ). At the end of the second course of treatment, the total effective rate between treatment group(96.73%) and control group (90.6%) was obvious significant (P≤0.01). Conclusion: The effect of needling in combination with herbal medicine for the treatment of rheumatoid arthritis is definite, and it is better than using herbal medicines only. Besides, the longer the course is, the more remarkable the effect is.

A FLUID MECHANICS MODEL OF TISSUE FLUID FLOW IN LIMB CONNECTIVE TISSUE——A MECHANISM OF ACUPUNCTURE SIGNAL TRANSMISSION

This article explores the mechanisms of acupuncture meridians by determining characteristics of the tissue fluid flow in the connective tissue along meridians. Based on deep dissection of acupoints on the upper and lower limbs of the human body and micro and macro observation and measurement, a mathematical model of the flow of tissue fluid in interosseous membranes is constructed. It is shown that the signal transmission along acupuncture meridians may be determined by unique anatomical and physiological factors that govern the flow of tissue fluid in the connective tissue and involve mast cell degranulation. Our results provide a preliminary explanation of the phenomenon of the ＂de qi＂ sensation and the mechanism of acupuncture signal transmission along acupuncture meridians.

Effects of TAT-SOD at Acupoints on Essential Hypertension by Monitoring Meridians Electrical Potential

Objectives:To investigate the effect on essential hypertension of the topical application of TAT-Cu,Zn-superoxide dismutase(TAT-SOD)at left acupoint Zusanli(ST 36),and to observe whether the change of electrical potential difference(EPD)can be related to the change of blood pressure.Methods:Sixteen patients with essential hypertension and 16 healthy subjects were included in the study.EPD between the left acupoints of Yanglingquan(GB 34)and Qiuxu(GB 40)was firstly screened out for the EPD detection.An intracellular superoxide quenching enzyme,TAT-SOD,was topically applied to the acupoint ST 36 within an area of 1 cm^2 once a day,and the influence on EPD was investigated.The dosage applied to TAT-SOD group(n=8)was 0.2 mL of 3000 U/mL TAT-SOD cream prepared by adding purified TAT-SOD to a vehicle cream,while placebo group(n=8)used the vehicle cream instead.The left acupoints of Yanglingquan(GB 34)and Qiuxu(GB 40)were selected for EPD measurement after comparing EPD readings between 5 acupoints on each of all 12 meridians.Results:EPDs between the left acupoints of GB 34 and GB 40 for 16 patients of essential hypertension and 16 healthy subjects were 44.9±6.4 and 5.6±0.9 mV,respectively.Daily application of TAT-SOD for 15 days at ST 36 of essential hypertension patients significantly decreased systolic blood pressure(SBP)and diastolic blood pressure(DBP)of 179.6 and 81.5 mm Hg to 153.1 and 74.1 mm Hg,respectively.Responding to the change in blood pressure,EPD between the left acupoints of GB 34 and GB 40 also declined from 44.4 to 22.8 mV with the same trend.No change was observed with SBP,DBP and EPD between the left acupoints of GB 34 and GB 40 with the daily application of the placebo cream.Conclusion:Enzymatic scavenging of the intracellular superoxide at ST 36 proved to be effective in decreasing SBP and DBP.The results reconfirm the involvement of superoxide anions and its transportation along the meridians,and demonstrate that EPD between acupoints may be an indicator to reflect its functioning status.Moreover,prellmlnary results suggest a close correlatlon between EPD and blood pressure readings,implying a possibility of using EPD as a sensitive parameter for blood pressure and to monitor the effect of antihypertensive treatment.

Inhibitory Effect of the Extract of Phellodendron amurense Ruprecht Root on Collagen-Induced Arthritis in Mice

Objective： To investigate whether the dried root of Phellodendron amurense Ruprecht（Phellodendri cortex; PC） extract improves arthritic symptoms through anti-inflammatory and immune-modulatory effects in collagen-induced arthritis in mice. Methods： Rheumatoid arthritis（RA） was induced in male DBA/1 mice by immunization with type Ⅱ collagen（ColⅡ）. CIA mice were divided into 5 groups（n=10 per a group） with normal, CIA control, PC extract（50 mg/kg and 100 mg/kg）-treated, and meloxicam（50 mg/kg）-treated as the reference drug. The PC extract or meloxicam were administered orally in CIA mice once a day for 14 days after arthritis induction. Arthritic score, levels of anti-ColⅡ IgG2a antibody, prostaglandin E2（PGE2）, tumor necrosis factor（TNF）-α, and interleukin（IL）-17 in the sera of CIA mice were measured. Histopathological changes in the ankle joints of CIA mice were also analyzed by staining with hematoxylin and eosin（H and E）, safranin-O and immunohistochemistry using anti-TNF-α and anti-IL-17 antibodies. Results： The arthritic score was increased in CIA mice in a time-dependent manner, as were the serum levels of anti-ColⅡ IgG2a antibody, PGE2, TNF-α, and IL-17. However, the oral administration of PC extract at 50 and 100 mg/kg in CIA mice significantly decreased the arthritic scores, and the serum levels of anti-ColⅡ IgG2a, PGE2, TNF-α, and IL-17 compared with those in the CIA group（P〈0.05 or P〈0.01）. Furthermore, histopathological improvement of the joint architecture in CIA mice was observed after administration of PC extract. PC extract also significantly inhibited the expression of TNF-α and IL-17 in the joints of CIA mice by suppressing the expression of their m RNA and proteins. Conclusion： PC extract may improve the pathological progression of RA through the inhibition of joint destruction by synovial inflammation and immune-stimulation, therefore, it would be a potential anti-arthritic agent in RA.

Successfully treated recalcitrant atopic eczema with acupoint autohemotherapy:A case report and hypothesized mechanism of the therapy

Acupoint autohemotherapy at bilateral Zusanli(ST36)and Xuehai(SP10)was used to treat a 26-year-old female patient who had suffered from recalcitrant atopic eczema(AE)for five years.The treatment was applied at a frequency of once per week for the first month,followed by a three-month period of once every other week.At the end of treatment,the patient’s AE symptoms were entirely resolved,and by the end of a six-month follow-up her immunoglobulin E level had returned to the normal range.Further,there was no relapse of AE symptoms during the six-month follow-up.Therefore,we hypothesized that after the repeated treatments the local inflammatory reaction induced by autologous blood injection triggered a local immune response,followed by a systemic immune response after the repeated treatment,finally leading to the anti-inflammation and immunomodulation effects.This case suggests that acupoint autohemotherapy could be used as an effective complementary treatment for recalcitrant AE,especially in cases where other treatments have failed.Further comparative studies are needed to corroborate the value and mechanisms of this therapy.

Research Status and Perspective on Correlation between Stomach Meridian Points and Stomach

This article expounds the action mechanism on correlation between stomach meridians points and stomach as well as its perspective from myriad ancient and modem literature.

Introduction to Quick and Surround Needling Method for Nodular Goiter

Clinically guided by the holistic concept of traditional Chinese medicine and in combination with four diagnostic methods and pattern identification, quick and surround puncture is used for treating nodular goiter, fully displaying the practical application value of the special acupuncture therapy.