Randomized controlled trial: Moxibustion and acupuncture for the treatment of Crohn's disease

AIM: To evaluate the clinical efficacy and safety of acupuncture and moxibustion for the treatment of active Crohn's disease(CD).METHODS: Ninety-two patients were equally and randomly divided into the treatment group and received herb-partitioned moxibustion combined with acupuncture, and the control group received wheat bran-partitioned moxibustion combined with superficial acupuncture. The patients received three treatment sessions per week for 12 wk and were followed up for 24 wk. The main outcome was evaluated using the CD Activity Index(CDAI) score, and the secondary outcomes were evaluated using laboratory indicators such as hemoglobin(HGB), C-reactive protein(CRP), erythrocyte sedimentation rate, quality-of-life, endoscopic ratings, and intestinal histology scores.RESULTS: The CDAI scores of both the treatment and control groups were significantly reduced after treatment compared with those measured before treatment. However, the degree of improvement in the treatment group was significantly greater than that of the control group. The improvement in symptoms in patients of the treatment group was sustained at follow-up, whereas that of the control group was not. The overall efficacy of the treatment was significantly greater than that of the control. Both groups demonstrated significant improvements in quality-of-life ratings after treatment, but the improvement was significantly greater in the treatment group than in the control group. In addition, the patients in the treatment group showed significantly increased HGB and significantly decreasedCRP levels and histopathological scores at the end of treatment, whereas the control group did not exhibit significant changes.CONCLUSION: Moxibustion with acupuncture provided significant therapeutic benefits in patients with active CD beyond the placebo effect and is therefore an effective and safe treatment for active CD.

Effects of different acupuncture manipulations on protein expression in the parietal cortex of spontaneously hypertensive rats

Objective: To analyze the effects of twirling reinforcing and reducing manipulations on protein expression in parietal cortex of spontaneously hypertensive rats(SHRs), and elucidate the main mechanisms and differences between two manipulations in hypertension treatment.Methods: Rats were randomly divided into the control, model, twirling reinforcing manipulation(TRFM),and twirling reducing manipulation(TRDM) groups. The control and model groups received catch and fixation stimulations once a day for 14 days. The TRFM and TRDM groups were intervened once a day for 20 min for 14 days. On days 0, 2, 6, 10, and 14 after acupuncture, rat systolic blood pressures(SBPs) were measured. Differential protein(DP) expression in the rat parietal cortices was detected. Thereafter, GO functional significance and KEGG pathway enrichment analyses were performed.Results: Compared with the model group, SBP of rats in the TRDM and TRFM groups decreased on days 6 and 10 of acupuncture, respectively(P=.009;P <.001). Moreover, SBP of the TRDM group was significantly lower than that of the TRFM group on days 10 and 14 of acupuncture(P=.015;P=.013).Compared with control group, 601 and 1040 DPs were up-and downregulated, respectively, in the model group. Compared with model group, 44 and 28 up-and downregulated DPs were expressed, respectively,in the TRFM group. Compared with model group, expression of 616 and 427 up-and downregulated DPs,respectively, was found in the TRDM group. After combining the results of GO and KEGG enrichment analyses, five and one pathways were found to be related to the central antihypertensive mechanism of the parietal cortex during twirling reducing and reinforcing manipulations, respectively.Conclusion: TRDM showed a more effective antihypertensive effect on SHRs than TRFM;this antihypertensive effect was related to the regulation of different proteins and their biological functions.

Research Progress and Analysis of Moxibustion in Prevention and Treatment of Acute Infectious Diseases

To introduce and evaluate current research progress of moxibustion in the prevention and treatment of acute infectious diseases,related literature in CNKI,Wanfang Data,and SinoMed was retrieved and analyzed by the present study.Results showed abundant studies on the mechanism of action of moxibustion in the prevention and treatment of acute infectious diseases with remarkable clinical efficacy.The present study also summarizes the commonly-occurring problems and found out the deficiencies in existing studies in hope of providing more reference for further research.

Research Progress and Analysis of Moxibustion in Prevention and Treatment of Acute Infectious Diseases

To introduce and evaluate current research progress of moxibustion in the prevention and treatment of acute infectious diseases,related literature in CNKI,Wanfang Data,and SinoMed was retrieved and analyzed by the present study.Results showed abundant studies on the mechanism of action of moxibustion in the prevention and treatment of acute infectious diseases with remarkable clinical efficacy.The present study also summarizes the commonly-occurring problems and found out the deficiencies in existing studies in hope of providing more reference for further research.

Protective mechanisms of Tuina therapy against lipopolysaccharide-induced fever in young rabbits based on untargeted metabolomics analysis

OBJECTIVE:To investigate the effect of Tuina on the plasma metabolites of lipopolysaccharide-induced febrile in infant rabbits.METHODS:Twenty-four infant New Zealand rabbits were selected and randomly divided into three groups:saline,model,and Tuina.The fever model was established by injecting LPS intravenously through the ear margin vein in the model group and Tuina group,respectively.The modeling was considered successful when the anal temperature increased by 0.5℃or above within 1 h.In the Tuina group,six Tuina techniques(i.e.,opening Tianmen/the heaven gate,pushing Kangong/the superciliary arch,kneading Taiyang and the prominent bone behind the ears,clearing Tianheshui,spine pinching)that alleviate fever were performed on the young rabbits 1 h after the modeling,whereas the model and saline groups were not given Tuina treatment,with the real-time anal temperature monitored during the experiment.The plasma was taken 3 h after the modeling for liquid chromatography-mass spectrometry(LC-MS)untargeted metabolomics study.RESULTS:Our results showed a fever-reducing effects of Tuina therapy on lipopolysaccharide-induced fever in young rabbits,as indicated by a significantly lower anal temperature,maximum rise in body temperature,and body response index at 2 and 3 h after modeling in the Tuina group compared to the model group,with reductions in the PGE2 expression observed in the blood and hypothalamus.The differential metabolites including riboflavin,nicotinamide N-oxide,porphobilinogen,5-hydroxyindoleacetic acid,gamma-aminobutyric acid,and lysoPC(16:1(9Z)/0:0)were found following the Tuina intervention.Tuina primarily involves glycine-serinethreonine,arginine-proline,porphyrin-chlorophyll,pyrimidine,primary bile acid biosynthesis,and cyanoamino acid metabolic pathways.CONCLUSION:Tuina therapy has proven to be effective in reducing body temperature and down-regulating PGE2 expression in LPS-induced febrile young rabbits,with its mechanism of fever-reducing action possibly associated with the changes in plasma metabolites and metabolic pathways.

Acupuncture and moxibustion for malignant tumor patients with psychological symptoms of insomnia,anxiety and depression:a systematic review and Meta-analysis

OBJECTIVE:To evaluate the efficacy and safety of acupuncture and moxibustion therapy(AMT) for cancerrelated psychological symptoms(CRPS) of insomnia,depression and anxiety.METHODS:Seven databases were searched for randomized controlled trials(RCT) comparing AMT to routine care or conventional drug for alleviating CRPS of insomnia,depression,and anxiety before April 2020.Two independent reviewers performed the data extraction and assessed the risk of bias.RESULTS:A total of 30 RCTs involving 2483 cancer patients were enrolled.The pooled analysis indicated that the treatment group was significantly better than the control group in improving the depression effective rate [RR = 1.29,95% CI(1.12,1.49),P = 0.0004],the quality of life(QOL) [MD = 1.11,95% CI(0.80,1.42),P < 0.000 01],and reducing Self-rating Anxiety Scale(SAS) [MD =﹣7.75,95% CI(﹣10.44,﹣5.05),P < 0.000 01].But there was no statistically significant difference between two groups in improving the insomnia effective rate [RR = 1.18,95% CI(0.93,1.51),P = 0.18].The subgroup analysis showed the effectiveness of different intervention on CRPS.Compared with routine care,AMT helps relieve CRPS better evaluated by Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Scale(HAMD),and Self-rating Depression Scale(SDS),and depression effective rate.Compared with conventional drug,AMT performs better evaluated by SDS,depression effective rate and QOL.Moreover,the conventional drug showed higher treatment efficacy on improving insomnia effective rate compared with AMT.Compared to conventional drug,AMT plus conventional drug resulted in a significant reduction on CRPS such as PSQI,HAMD,SDS,and SAS,and also had a meaningful improvement on insomnia effective rate,depression effective rate and QOL.Fewer published reports were found on the adverse events of AMT than the conventional drug.CONCLUSION:The results suggested that AMT might be effective in improving CPRI;however,a definite conclusion could not be drawn because the quality of trials are low.Further large-scale and high-quality RCTs to verify the efficacy and safety of AMT on CRPS are still warranted.

Electroacupuncture stimulating Zhongji(CV3),Guanyuan(CV4),and bilateral Dahe(KI12)attenuates inflammation in rats with chronic nonbacterial prostatitis induced by estradiol through inhibiting toll-like receptor 4 pathway

OBJECTIVE:To investigate the anti-inflammatory effect of electroacupuncture(EA)on chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS),also known as chronic nonbacterial prostatitis(CNP),and explore its underlying mechanism.METHODS:A CNP rat was established by surgical castration combined with 17-βestradiol injection in male Sprague-Dawley rats for thirty consecutive days.The CNP rats received EA treatment once a day for eight days.Chronic pelvic pain was evaluated by mechanical withdrawal threshold measurement.The histological change was assessed by hematoxylin-eosin staining.The inflammatory cytokines in prostates were determined by enzyme-linked immunosorbent assays.The expressions of toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),inhibitors of kappa-B alpha(IκBα),and nuclear factor-kappa B(NF-κB)were detected by Western blotting.The nuclear translocation of NF-κB and the location of TLR4 were observed with immunofluorescence staining.RESULTS:The results showed that EA decreased the prostate index,upregulated the mechanical withdrawal threshold,restored the histomorphology of the prostate,reduced the inflammatory factor levels,inhibited NF-κB p65 nuclear translocation,and downregulated the expression levels of critical proteins involved in the TLR4/NF-κB signaling pathway in prostates.CONCLUSIONS:Our findings suggested that EA could relieve pelvic pain and attenuate prostatic inflammation in estradiol-induced CNP rats.The underlying mechanism may be related to the inhibition of the TLR4/NF-κB signaling pathway.

Mechanism Research of Electroacupuncture Stimulation at Baihui and Zusanli in Cerebral Ischemia-reperfusion Injury Using RNA-Sequencing

Background:Electroacupuncture(EA)therapy,as a combination of electric stimulation and traditional acupunc-ture technology,is currently an important mean for treatment of ischemic stroke and post-stroke rehabilitation in China.Because of its remarkable therapeutic effect,it has been widely used in hospitals and clinic,however,the detailed mechanism remains unclear.Objective:This research aims to comprehensively and systematically elucidate the mechanisms of EA treatment at the acupoints of Zusanli(ST36)and Baihui(GV20)on ischemic stroke.Methods:In this study,EA was performed twice at onset of reperfusion and 20 h after reperfusion following cerebral ischemia-reperfusion(I/R)in middle cerebral artery occlusion(MCAO)rats,and transcriptomic changes of various molecules in ischemic hippocampal neurons of rats in Sham,I/R and EA groups were detected by RNA-Sequencing(RNA-Seq).Results:Thus,we detected 18 significantly different genes related to atherosclerosis(AS),with their functions associated with lipid metabolism,thrombosis,monocytes and vascular smooth muscle cells.And,we detected 10 significantly different genes related to oxidative stress and apoptosis and 10 significantly different genes related to calcium overload and excitatory amino acids release.Also,we detected 19 significantly different genes related to blood-brain barrier(BBB)and 22 significantly different genes related to inflammatory response.Conclusion:In conclusion,EA can play a role in treating ischemic stroke through a variety of mechanisms,affecting atherosclerosis,oxidative stress,apoptosis,calcium overload,excitatory amino acids release,blood-brain barrier(BBB)and inflammatory response.

Efficacy of Electroacupuncture in the Treatment of Functional Constipation:A Randomized Controlled Pilot Trial

Objective:To evaluate the efficacy and safety of eiectroacupuncture at Tianshu(ST25) for patients with functional constipation(FC).Methods:Ninety-six patients with FC were randomized to receive deep needling on bilateral ST25(group A,48 cases) or shallow needling on bilateral ST25(group B,48 cases) with eiectroacupuncture once daily for 4 weeks.The proportion of patients with four or more complete spontaneous bowel movements(CSBMs) per week,and scores of constipation symptoms and satisfaction with treatment were compared between two groups.Safety was also assessed.Results:The proportion of patients with four or more CSBMs per week was 52.1%in group A,significantly higher than 25.0%in group B during the 4-week treatment(P<0.05).The constipation symptom score of patients were significantly improved in group A as compared with group B at week 2-4(P<0.05).Patients in group A were more satisfied with their treatment compared with those in group B at week 1-4(P<0.05).Five patients in group A felt significant pain and discomfort.No other adverse reaction was observed in both groups.Conclusion:Using eiectroacupuncture at ST25 to treat patients with FC is effectively,and deep needling had more stable effect than shallow needling.

Effectiveness and safety of heat-sensitive moxibustion on bronchial asthma:a Meta-analysis of randomized control trials

OBJECTIVE: To systematically evaluate the effectiveness and safety of heat-sensitive moxibustion(HSM)onasthma.METHODS: Large databases in China and overseas were searched by electronic and manual means to collect information on randomized controlled trials(RCTs).Two evaluators independently extracted data and evaluated the quality of RCTs according to Cochrane Review Handbook v5.0. RevMan v5.0.20 was used for statisticalanalyses.RESULTS: Fourteen RCTs involving 637 patients were collected.Thirteen RCTs compared the effects of HSM and Western Medicine. After 3-month treatment and after 6-month follow-up, there was no significant difference in effective rate [relative risk(RR)=1.01, 95% CI(0.92, 1.12), and 1.12,(0.93, 1.36),respectively], in the asthma control test score of asthma symptoms [weighted mean difference(WMD)=﹣1.54, 95% CI(﹣3.54, 0.47), and 1.41,(﹣0.48, 3.29), respectively] and in the forced expiratory volumein 1 second(FEV1)and peak expiratory flow(PEF). One RCT compared the effect of HSM with warm-suspended moxibustion. After 6-month follow-up, there was a significant difference in FEV1 and PEF [WMD=0.51, 95% CI(0.10, 0.92), and 1.78,(1.06, 2.50), respectively]. After 3-month treatment,there was no significant difference between the two groups. One RCT compared the effect of HSM with acupoint application. After 3-month treatment, there was no significant difference in the effectiverate[RR=0.68,95%CI(0.42,1.12)].CONCLUSION: HSM did not show superiority to conventional Western Medicine and acupoint application in terms of curative effects, and may be superior to warm-suspended moxibustion with regard to long-term curative effects. Because of low quality of the included RCTs, this conclusion must be bolstered with higher-quality RCTs.

Effect of miniscalpel-needle on relieving the pain of myofascial pain syndrome: a systematic review

OBJECTIVE: To evaluate the effect and safety of miniscalpel-needle(MSN) on reducing the pain of myofascial pain syndrome(MPS).METHODS: We reviewed the available literatures inception up to February 2014 using Pubmed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure Database, Chinese Biomedical Database and Wanfang Database.RESULTS: Eight randomized controlled trials were finally identified. The main controls involved acupuncture, medications, injection, massage and cupping. We found that all of the studies agreed on the potential benefit of MSN as a strategy for MPS and the superiority compared to the controls, however,randomized methods applied in most of the trials could be criticized for their high or unclear risk of bias. Further research is also needed to clarify questions around the appropriate frequency and number of treatment sessions of MSN.CONCLUSION: This review shows that MSN might have the effect on MPS, even though there were some limitations in the studies included in the review. Studies with robust methodology are warranted to further test its pain-relieving effect on MPS.

Effects of nape acupuncture combined with swallowing rehabilitation on dysphagia in pseudobulbar palsy

OBJECTIVE: To evaluate the therapeutic effects of nape acupuncture combined with rehabilitative swallowing training for dysphagia caused by pseudobulbar palsy, and to compare it with rehabilitative swallowing training alone, and to observe the improvement in quality of life after the therapy.METHODS: One hundred patients were randomly divided into two groups: the rehabilitative swallowing training group(control group, n = 50) and the nape acupuncture combined with rehabilitative swallowing training group(experimental group,n = 50). Each group had 8 weeks' therapy, 5 times a week. Patients in the control group received rehabilitative swallowing training, while those in the experimental group received nape acupuncture therapy based on swallowing rehabilitation. The out-comes were assessed by the repetitive saliva-swallowing test(RSST), water swallow test(WST), standardized swallowing assessment(SSA), and a swallow quality-of-life questionnaire(SWAL-QOL). Correlations of onset age, onset frequency and lesion location with the efficacy of the acupuncture treatment were also observed.RESULTS: The scores for RSST, WST, and SSA in both groups were lower than before the therapy(P <0.001), although the changes were more marked in the experimental group than in the control group(RSST and WST, P < 0.005; SSA, P < 0.001). Both groups recorded changes in SWAL-QOL index after the therapy(P < 0.001); and the experimental group scored higher than the control group(P < 0.001). The efficacy of acupuncture was not correlated with location(P > 0.05), but was related to onset age(P < 0.05) and onset frequency(P < 0.01).CONCLUSION: Nape acupuncture combined with rehabilitative swallowing training has an effect on dysphagia caused by pseudobulbar palsy and improves quality of life.

灸法通过促进血管性痴呆大鼠海马神经血管新生改善延迟回忆

目的:观察灸法治疗后血管性痴呆(VD)大鼠延迟记忆的改变及其与神经血管新生的关系。方法:共200只SPF级Wistar大鼠进行实验。随机选择36只作为假手术组。除假手术组外的大鼠均通过双侧颈总动脉闭塞(BCCAo)法制作VD模型。造模后,108只存活大鼠被随机分为模型组、神经干细胞(NSCs)加内皮祖细胞(EPCs)艾灸组和NSCs艾灸组,每组36只。将共植体移植入NSCs加EPCs艾灸组,NSCs组仅移植NSCs。NSCs加EPCs艾灸组和NSCs艾灸组使用悬灸百会、大椎和神庭治疗(每组根据疗程分为3个亚组,分别治疗1、2和3个疗程)。各组在治疗3个疗程结束后用Morris水迷宫测量评估延迟记忆;分别在治疗1、2和3个疗程1 d后心脏灌注4%多聚甲醛,然后取脑。通过激光共聚焦显微镜检测标记蛋白表达,分析神经发生和血管生成与艾灸的关系。结果:Morris水迷宫试验显示缺血损伤后3 d,VD大鼠延迟回忆障碍。NSCs加EPCs艾灸组和NSCs艾灸组大鼠在3个疗程艾灸治疗后,VD诱导的延迟回忆缺陷得到改善。两个治疗组大鼠的巢蛋白(Nestin),双皮质素(DCX)和CD34的表达在1、2和3个疗程治疗后均显著增加(均PV0.05),这可能有助于海马的神经新生和血管生成。此外,与移植NSCs的大鼠相比,艾灸显著增加NSCs加EPCs艾灸组的Nestin>DCX和CD34表达(均PV0.05)。结论:灸法可以减轻VD诱导的延迟记忆障碍,这可能与促进神经新生和血管生成有关。

Effect of electroacupuncture at different acupoints in treating rapid gastric emptying:Zusanli(ST36)plus Zhongwan(CV12)versus Zhongwan(CV12)alone

OBJECTIVE:To evaluate the effect of electroacupuncture on rapid gastric emptying by comparing the effectiveness of electroacupuncture at both Zusanli(ST36)and Zhongwan(CV12)(He-Mu acupoints)versus electroacupuncture at Zhongwan(CV12)alone.METHODS:Sixty-five patients were randomly divided into two groups;33 patients in the He-Mu acupoints group received electroacupuncture at both Zusanli(ST36)and Zhongwan(CV12),while 32 patients in the single acupoint group received electroacupuncture only at Zhongwan(CV12).Both groups were treated once daily for 30 min,five times per week for 3 weeks.Before and after the 3-week treatment course,patients underwent gastric emptying scintigraphy and were assessed using the Traditional Chinese Medicine(TCM)symptom scale of gastrointestinal diseases.The two groups were compared regarding the percentages of gastric retention at 30 and 60 min and the TCM symptom scores.RESULTS:After the treatment course,the percentages of gastric retention at 30 and 60 min were significantly improved in both groups compared with the pre-treatment values(P<0.01).The improvement in the gastric retention was significantly better in the He-Mu acupoints group than the single acupoint group at 30 min(P<0.01)and 60 min(P<0.05).The TCM symptom score was significantly decreased after the treatment course in both groups(P<0.01).The improvement in the TCM symptom score was significantly better in the He-Mu acupoints group than the single acupoint group(P<0.01).The total effective rate was 93.55%(29/31)in the He-Mu acupoints group and 77.42%(24/31)in the single acupoint group.The treatment effect was better in the He-Mu acupoints group than the single acupoint group(P<0.05).CONCLUSIONS:Electroacupuncture at both Zusanli(ST36)and Zhongwan(CV12)or at Zhongwan(CV12)alone is effective in treating rapid gastric emptying.Furthermore,electroacupuncture at both Zusanli(ST36)and Zhongwan(CV12)is more effective than electroacupuncture at Zhongwan(CV12)alone.

调神针法配合心理疏导治疗网络依赖38例(英文)

Internet addiction disorder (IAD) refers to impulsive internet use, which does not involve using any addictive drugs. It includes psychiatric symptoms such as substance withdrawal symptoms, emotional disorders and loss of social relationship,as well as a group of

穴位贴敷加电针治疗周围性面瘫临床观察

目的:观察面瘫膏穴位贴敷加电针对周围性面瘫患者面神经功能、面部残疾及临床症状与体征的影响.方法:共纳入周围性面瘫患者96例,按简单随机化方法分为观察组、药物组和电针组,每组32例.药物组予以口服甲钴胺与醋酸泼尼松治疗,电针组于此基础上加用电针治疗,观察组予以面瘫膏穴位贴敷加电针治疗.比较三组患者治疗4周后的临床疗效,观察不良反应,以及治疗前后House-Brackmann(H-B)面神经功能分级量表评分、疼痛视觉模拟量表(VAS)评分、临床症状与体征评分,以及面部残疾指数评分(FDI)情况.结果:治疗4周后,观察组的总有效率96.9%,高于药物组的68.7%和电针组的75.0%(均P<0.05).治疗4周后,3组的H-B分级评分、VAS评分及临床症状与体征评分均较治疗前下降,且观察组评分均低于药物组和电针组(均P<0.05).治疗4周后,3组FDI评分中躯体功能评分(FDIP)较治疗前提高,且观察组高于药物组和电针组(均P<0.05);社会生活功能评分(FDIS)较治疗前降低,且观察组低于药物组和电针组(均P<0.05);而药物组与电针组的以上各项评分差异均无统计学意义(均P>0.05).三组不良反应发生率差异无统计学意义(P>0.05).结论:面瘫膏穴位贴敷加电针治疗周围性面瘫,能降低H-B分级,减轻疼痛程度,改善临床症状与体征以及面部残疾状况,疗效优于口服药物及药物加电针治疗.