MULTI-CENTER RANDOMIZED CONTROLLED TRIALS OF COMBINED TREATMENT OF VERTEBRAL ARTERY TYPE CERVICAL SPONDYLOSIS WITH ACUPUNCTURE AND MASSAGE

Objective.To evaluate the clinical value of synthetical therapy of acupuncture and massage for treating vertebral artery type cervical spondylosis （VACS）. Methods： In the present study, triple-center, single-blind, randomized and control methods were adopted. Qualified subjects were randomly assigned to three groups： acupuncture-massage （acu-mas） group, acupuncture group, and massage group （60 subjects in each group）. Bilateral Fengchi （风池 GB 20）, Jiaji （夹脊 EX-B 2, C4-7） and Baihui （百会 GV 20） ware punctured in combination with massage at the neck-shoulder and back region. The treatment was conducted once daily, 14 times altogether. Results. After treatment, of the 60 cases in each of acu-mas, acupuncture and massage groups, 28, 11 and 13 were cured, 13, 20 and 17 markedly effective, 12, 14 and 16 effective, and 7, 15 and 14 ineffective, with the total effective rates being 88.3%, 75.0% and 76.7% respectively. The therapeutic effect of acu-mas group was significantly superior to that of simple acupuncture and massage groups （P〈 0.05）. The scores of clinical symptoms and signs in 3 groups all declined significantly after treatment （ P〈 0.01 ）, and the score of symptoms of acu-mas was markedly lower than those of acupuncture and massage groups （P〈 0.05）. No significant differences were found among 3 groups in the score of clinical signs and between acupuncture and massage groups in the score of clinical symptoms （P〉0.05）. The time for producing therapeutic effects in acu-mas group was significantly shorter than those of acupuncture and massage groups （P〈0.01, 0.05）, meanng a faster of aou-mas group in producing clinical effect. No adverse events ware found in all the 3 groups. Conclusion： Acupuncture and massage are effective and safe in the treatment of VACS, and the therapeutic effect of acupuncture combined with massage is superior to that of simple acupuncture and simple massage therapy.

Electro-acupuncture regulates the cholinergic anti-inflammatory pathway in a rat model of chronic obstructive pulmonary disease

Objective： Acupuncture has a definite therapeutic effect on chronic obstructive pulmonary disease （COPD）, and the cholinergic anti-inflammatory pathway （CAP） has been shown to be involved in regula- tion of inflammation. In this study, we investigated whether electro-acupuncture （EA） affects the CAP in COPD,Methods： Sprague-Dawley rats were induced into COPD through exposure to cigarette smoke combined with lipopolysaccharide. EA treatment was applied at Zusanli （ST36） and Feishu （BL13） points for 30 min/d for 7 d. Seventy-two rats were randomly divided into six study groups, including normal, normal ＋ EA, normal ＋ α-bungarotoxin （α-BGT） （the antagonist of the nicotinic acetylcholine receptor α7 subunit （α7nAChR）） ＋ EA, COPD, COPD ＋ EA, and COPD ＋ α-BGT ＋ EA. Lung function, pathology and vagus nerve discharge were tested. The levels of acetylcholine （ACh）, acetylcholinesterase （ACHE）, interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-ct） in bronchoalveolar lavage fluid （BALF） and lung tissue were measured by enzyme-linked immunosorbent assay. The mRNA and protein expression and immunoreac- tivity of α7nAChR and its postreceptor inflammation signal pathway, including janus kinase 2 （JAK2）, sig- nal transducers and activators of transcription 3 （STAT3）, nuclear factor-KB （NF-KB）, were observed by quantitative reverse transcription-polymerase chain reaction, Western blot and immunohistochemistry. Results： Compared with normal rats, there were a significant decline in lung function and discharge of the vagus nerve （P 〈 0.01）, a marked sign of lung inflammation and an increase of ACh, ACHE, IL-6 and TNF-α level in BALF or lung tissue （P 〈 0.05, P 〈 0.01 ） and higher expression of 0t7nAChR, JAK2, STAT3 and NF-αB （P 〈 0.05, P 〈 0.01） in the COPD rats. In rats receiving EA, the lung function and vagal discharge were enhanced （P 〈 0.01 ）, lung inflammation was improved and the levels of ACh, ACHE, IL-6 and TNF-α were decreased （P 〈 0.01）. Further, the expression of α7nAChR, JAK2, STAT3 and NF-κB was downregulated （P 〈 0.05, P 〈 0.01 ）. However, the above effects of EA were blocked in rats injected with α-BCT （P 〈 0.01 ）. Conclusion： EA treatment can reduce the lung inflammatory response and improve lung function in COPD, which may be related to its involvement in the regulation of CAP.

Effect of electroacupuncture on expressions of acetylcholine and mucin 5AC in the lungs of rats with chronic obstructive pulmonary disease

Objective： To observe the effect of electroacupuncture （EA） on the expressions of acetylcholine （ACh） and mucin 5AC （MUC5AC） in the lungs of rats with chronic obstructive pulmonary disease （COPD）, and explore the mechanism of EA in treating COPD. Methods： Thirty Sprague-Dawley （SD） rats were randomly divided into a control group, a COPD group, and an EA group, with 10 rats in each group. The control group was a group of normal rats. The COPD rat model was induced by cigarette smoke combined with lipopolysaccharide （LPS）. The COPD rats were treated with EA at bilateral Feishu （BL 13） and Zusanli （ST 36） in the EA group, 30 rain each time, once a day, successively for 14 d. The lung function was tested. The contents of ACh and MUC5AC in lungs and bronchoalveolar lavage fluid （BALF） were detected by enzyme-linked immunosorbent assay （ELISA）. Pearson method was used to analyze the correlation between pulmonary function and the content of MUC5AC in lungs. The mRNA and protein expressions of MUC5AC in lung tissues were detected by real-time polymerase chain reaction （RT-PCR） and Western blot （WB）, respectively. The immune response of MUC5AC was observed by immunohistochemistry. Results： Eight rats were left in each group, and the other two died. Compared with the control group, the total airway resistance （Raw） increased significantly and dynamic compliance （Cdyn） decreased significantly in the COPD group （P〈0.01）; compared with the COPD group, the Raw level declined significantly and Cdyn increased significantly in the EA group （P〈0.01）. The contents of ACh and MUC5AC in the lungs and BALF were remarkably higher in the COPD group compared with those in the control group （P〈0.01, P〈0.001）; compared with the COPD group, the contents of ACh and MUC5AC were significantly lower in the EA group （P〈0.05, P〈0.001）. There was a negative correlation between MUC5AC content and lung function （P〈0.001）. The mRNA and protein expressions of MUC5AC in the lungs were significantly higher in the COPD group than in the control group （P〈0.001）; compared with the COPD group, the expressions were significantly lower in the EA group （P〈0.01）. Compared with the control group, the immune response of MUC5AC in the airway epithelium significantly increased in the COPD group （P〈0.001）; the immune response of MUC5AC was significantly lower in the EA group compared with that in the COPD group （P〈0.001）. Conclusion： EA treatment can improve the lung function of COPD rats, which may be related to its effect in the down-regulation of ACh and MUC5AC contents in the lungs as well as the inhibition of mucus hypersecretion.