Research progress on insomnia treated by traditional Chinese medicine and acupuncture based on microbial-gut-brain axis theory

Insomnia,as one of the emotional diseases,has been increasing in recent years,which has a great impact on people's life and work.Therefore,researchers are eager to find a more perfect treatment.The microbiome-gut-brain axis is a new theory that has gradually become popular abroad in recent years and has a profound impact in the field of insomnia.In recent years,traditional Chinese medicine(TCM)has played an increasingly important role in the treatment of insomnia,especially acupuncture and Chinese herbal medicine.It is the main method of TCM in the treatment of insomnia.This paper mainly reviews the combination degree of"microorganism-gut-brain axis"theory with TCM and acupuncture under the system of TCM.To explore the mechanism of TCM and acupuncture in the treatment of insomnia under the guidance of"microorganismgut-brain axis"theory,in order to provide a new idea for the diagnosis and treatment of insomnia.

Guidance on home rehabilitation in Chinese and Western medicine to prevent the relapse of novel coronavirus disease-19 pneumonia after recovery

Patients with novel coronavirus disease-19(COVID-19)pneumonia continue to have problems with respiratory function,physical and psychological function,the ability to perform activities of daily living,and social participation after discharge from the hospital.As such,strengthening rehabilitation treatments for discharged patients and relapse prevention after recovery are important aspects of the prevention and control of COVID-19.This paper combined the principles and practices of in Chinese and Western medicine and compiled the recommendations of both for home rehabilitation in the post-COVID-19 epidemic stage.The purpose of this paper is to facilitate the self-rehabilitation of patients with COVID-19 and to promote the prevention and control of COVID-19 at this current stage.

Analgesic effects of different acupuncture therapies on postherpetic neuralgia:a Bayes⁃ian network meta-analysis

OBJECTIVE To assess the effi⁃cacy and safety of acupuncture-related treat⁃ments for postherpetic neuralgia(PHN),identify the most effective acupuncture and related treat⁃ments.METHODS PubMed,Cochrane Central Register of Controlled Trials,Embase,Web of Science,and four Chinese databases,a clinical research registration platform,and grey literature were searched.We evaluated the risk of bias and quality in the included studies and per⁃formed a Bayesian multiple network meta-analysis.RESULTS We included 29 randomized controlled trials comprising 1973 patients,of which approximately 17.24%showed a high risk of bias.According to the Jadad scale,2,16,and 11 studies were high,medium,and low quality,respectively.The pairwise meta-analysis results revealed that the efficacy of all acupuncture-related treatments for pain relief related to PHN showed the difference was statistically significant com⁃pared with that of antiepileptics.The network meta-analysis results showed that pricking and cupping plus antiepileptics were the most effective,followed by electroacupuncture(EA)plus antiepileptics for pain relief in patients with PHN.EA plus antiepileptics ranked the best regarding reduced Pittsburgh Sleep Quality Index and Self-Rating Depression Scale scores in patients with PHN.No results were found regarding total response rate or quality of life among this study.Acupuncture-related treatments showed a lower incidence of adverse events than that of antiepi⁃leptics-related treatments.CONCLUSION Acu⁃puncture-related therapies may be potential treat⁃ment options for PHN and are relatively safe.Pricking and cupping plus antiepileptics are the most effective techniques for pain relief.EA plus antiepileptics is the best approach for improving insomnia and depression symptoms of PHN.

Efficacy of acupuncture on acute tonsillitis:a systematic review and meta-analysis

OBJECTIVE To systematically assess the efficacy and safety of acupuncture in treating acute tonsillitis,providing a reference for clinical decision-making.METHODS We searched PubMed,CENTRAL,Embase,Web of Science,China National Knowledge Infrastruc⁃ture,China Biomedical,clinical research registra⁃tion platforms,grey literature,and the reference lists of the selected studies from inception to Oct.30,2022.The risk of bias assessment used Rev⁃Man.Meta-analysis was performed using STATA with Hedges′g value.In addition,we performed subgroup analysis,meta-regression,and publica⁃tion bias detection with Harbord′s and Egger′s tests.RESULTS We included 19 randomized controlled trials comprising 1701 patients,of which 1 study was assessed high risk of bias.The primary outcome,the response rate,revealed that acupuncture was more effective than antibi⁃otics.The secondary outcomes showed that the difference in the reduction of the VAS scores,sore throat time,and white blood cell counts was statistically significant with acupuncture compared to antibiotics.However,the difference in modulat⁃ing neutrophil percentage and C-reactive protein was not statistically significant.Besides,acupuncture treatments showed a lower incidence of adverse events than antibiotics.CONCLUSION Acupuncture therapy on acute tonsillitis is safe,and the response rate is superior to antibiotics.For alleviating sore throat symptoms,shortening sore throat time,and improving immune in fl am mation index,acupuncture has positive signi fi cance.Nevertheless,because of the limitations of this study,our conclusions should be inter⁃preted with caution.Future efforts still need more high-quality trials to improve the methodology and reporting quality.

Effect of Yuchang suppository on PPAR γ/NF-KB signaling pathway in rats with ulcerative colitis

Objective: To investigate the therapeutic effect of Yuchang suppository on experimental ulcerative colitis rats and the effect of PPARγ/NF-KB signaling pathway. Methods: The UC rat model was replicated by 2.4.6-trinitrobenzenesulfonic acid (TNBS)/ethanol method and randomly divided into normal control group, model group, high-dose group of Yuchang suppository, middle dose group , Low-dose group and sulfasalazine group, 8 rats in each group. After 14 days of treatment, the general condition of the rats was observed and the disease activity index was scored. The changes of serum TNF-α, IL-1β and IL-6 levels were detected by ELISA. The colonic mucosal injury index (CMDI) score and colon were observed by colon specimens. Histopathological changes;RT-PCR and Western blot were used to detect the expression of PPARγ and NF-KB genes and proteins in colon tissue. Results: Compared with the normal control group, the DAI and CMDI scores in the model group and the levels of serum TNF-α, IL-1β, IL-6, NF-κB p65 mRNA and protein in colon tissue were significantly increased, PPAR. - γ mRNA and protein expression levels were significantly reduced. The levels of IL-1β, IL-6, TNF-α and the expression of NF-κB p65 mRNA and protein in colon tissue were lower than those in the model group, and the expression levels of PPARγ mRNA and protein were high. In the model group. In the improvement of NF-κBp65 and PPAR-γ gene and protein expression in rat colonic mucosa, the high-dose group and the middle-dose group were significantly better than the low-dose group. Conclusion:Yuchang suppository can significantly improve the symptoms and histopathology of UC model rats. The mechanism may be through activation of PPARγ, blocking the activation of NF-κB signaling pathway, and down-regulating inflammatory factors such as TNF-α and IL-1β. The expression is such that the inflammatory response is alleviated or eliminated, thereby achieving the therapeutic effect of UC.

Effect of acupuncture on cerebral hematoma volume and HO-1 expression in rats with acute cerebral hemorrhage

Objective:To explore the effect of acupuncture on the expression of heme oxygenase-1 in rats with acute cerebral hemorrhage.Methods:108 Wistar male rats were randomly divided into sham operation group,model group,and acupuncture combined with model group(referred to as acupuncture group).Each group was divided into 3 subgroups according to 1d,3d and 7d,with 6 rats in each subgroup.The rat model of cerebral hemorrhage was established by autologous blood injection.Acupuncture was given at Baihui(GU20)and Qubin(GB7).Separately,at the 1st,3rd and 7th day,modified neurological severity score was used to evaluate the neurological function of rats,HE staining was used to measure the volume of cerebral hematoma and western blot was used to detect the expression of heme oxygenase-1 protein in cerebral hematoma tissue.Results:Compared with the model group,at each time point,the modified neurological severity score of the acupuncture group was significantly reduced(P<0.01);at the two time points of 3rd and 7th day,the cerebral hematoma volume of the acupuncture group was significantly reduced(P<0.05)and the expression of heme oxygenase-1 protein in brain tissue was significantly increased(P<0.05).Conclusion:Acupuncture may promote the expression of heme oxygenase-1 protein,reduce the volume of hematoma and the score of neurological deficit in rats with intracerebral hemorrhage,improve the performance of neurological deficit,and play a role in brain protection.

Effect of Shengsui Jiangu capsule on TNF-α, TGF-β1, and empty bone lacuna in rats with alcoholic osteoporosis

TGF-Objective:To investigate the effect of postgraduate Shengsui Jiangu Capsule on tumor necrosis factors TNF-α,transforming growth factor TGF-β1 and empty bone lacuna in rats with alcoholic osteoporosis.Method:120 SD rats were randomly divided into 4 groups,30 rats in each group:blank group,model group,western medicine control group and traditional Chinese medicine intervention group.Liquor gavage was used to model the disease,except for the blank group.The western medicine control group was gavaged with a suspension of calcium carbonate and afad3,while the Chinese medicine intervention group was gavaged with a suspension of Shengsui Jiangu capsules combined with 0.9%saline solution injection.The values of TNF-αand TGF-β1 in femora were measured after 8,12,and 16 weeks of intervention.After dissecting out the femoral head using the HE(hematoxylin-eosin staining)staining method,the bone lacunae were observed under a light microscope,and the empty bone lacunae rate was calculated for intergroup comparison.Results:Compared with the blank group,the model group had a significantly higher percentage of TNF-αand empty bone lacunae,and a significantly lower percentage of TGF-β1(P<0.01).Compared with the model group,the rates of TNF-αand empty bone lacunae in the western medicine control group and the Chinese medicine intervention group were significantly decreased,and TGF-β1 was significantly increased(P<0.01).The traditional Chinese medicine intervention group was more effective than the western medicine control group(P<0.05).Conclusion:Shengsui Jiangu capsule attenuates the expression of TNF-α,enhances the expression of TGF-β1,decreases the rate of empty bone lacunae,and achieves a protective effect against alcoholic osteoporosis in rats with alcoholic osteoporosis.

Research progress of acupuncture in the treatment of Parkinson's disease

Parkinson's disease(PD)is a common degenerative disease of the central nervous system.The basic and clinical research of acupuncture therapy has witnessed several advances in the treatment of PD.The purpose of this study is to provide some ideas for clinical acupuncture therapy in the treatment of PD.The authors attempt to achieve this objective by systematically organizing the clinical efficacy studies of several acupuncture therapies for PD and elaborating the mechanisms of action in terms of secretion of substantia nigra dopaminergic neurons,level of oxidative stress,inflammatory response,excitotoxicity,and mitochondrial dysfunction.

Efficacy and Safety of Mulberry Twig Alkaloids Tablet for Treatment of Type 2 Diabetes:A Randomized,Double-Blind,Placebo-Controlled Multicenter Clinical Study

Objective:To assess the efficacy and safety of mulberry twig alkaloids(Sangzhi alkaloids,SZ-A)for treatment of type 2 diabetes in a randomized,double-blind,placebo-controlled multicenter clinical trial.Methods:A total of 200 patients were randomized to receive SZ-A(n=100)or placebo(n=100)for 16 weeks.The data analysis system for electronic data capture clinical trial central randomization system was used for randomization and dispensing of drugs.The primary outcome was the change in glycosylated hemoglobin(Hb A1c)level.The secondary outcome included the proportions of cases with Hb A1c<7.0%and Hb A1c<6.5%,fasting blood glucose(FBG),postprandial blood glucose(PBG),area under curve for the PBG(AUC_(0-2h)),body weight,and body mass index(BMI).Adverse events(AEs),severe adverse events(SAEs),treatment-related adverse events(TAEs),gastrointestinal disorders(GDs),blood pressure,routine blood tests,and liver and kidney function were monitored.Results:Compared with baseline,the change of Hb A1c at week 16 was-0.80%(95%CI:-0.98%to-0.62%)and-0.09%(95%CI:-0.27%to 0.09%)in SZ-A group and placebo group,respectively.The proportion of patients with Hb A1c<7%and<6.5%was higher in the SZ-A group than in the placebo group(46.8%vs.21.6%and 29.9%vs.10.8%).The observed values and changes in FBG,1 h-PBG,2 h-PBG,and AUC_(0-2h) differed significantly between groups(P<0.001),but differences were not significant in body weight and BMI(P>0.05).The incidence rates of AEs,TAEs,and GDs differed significantly between groups(P=0.010,P=0.005,and P=0.006,respectively),whereas the incidence rates of SAEs showed no significant differences between groups(P=1.000).Conclusion:SZ-A are effective and safe for treatment of type 2 diabetes.

Effect of Combined Acupuncture and Shen Zao An Shen Tang on Sleep Quality of Insomnia Patients Due to Deficiency of the Heart and Spleen

Objective: To observe the clinical efficacy of acupuncture combined with Shen Zao An Shen Tang for insomnia due to deficiency of the heart and spleen, investigate the law of treating insomnia based on syndrome differentiation, and thus provide evidence for treatment based on differentiation of insomnia in traditional Chinese medicine. Methods: A total of 62 cases with insomnia due to deficiency of the heart and spleen were randomized into a combined acupuncture and Chinese herbal formula group and a Western medication group, 31 cases in each group. Acupuncture and self-made Shen Zao An Shen Tang were employed in the former, while Estazolam was used in the latter. After a 28-day treatment, the clinical efficacy, sleep efficiency, sleep dysfunction rating scale(SDRS) and adverse reactions in the two groups were observed and compared. Results: The total effective rate in the combined acupuncture and Chinese herb formula group was 96.8%, versus 74.2% in the Western medication group, showing a statistically significant difference(P<0.05). After treatment, the sleep efficiency ratios in both groups were significantly increased(P<0.01, P<0.05), and there was a between-group statistically significant difference(P<0.05). Also, the SDRS scores in both groups were decreased(P<0.01, P<0.01) and there was a between-group statistically significant difference(P<0.01). In addition, the adverse reaction rate in the combined acupuncture and Chinese herb formula group was significantly lower than that in the Western medication group(P<0.05). Conclusion: Combining acupuncture and Chinese herb formula can obtain a substantial clinical efficacy for insomnia due to deficiency of the heart and spleen and improve the patients' sleep quality. Compared with Estazolam, it is better in effect and less in adverse reactions.

Warm-needle acupuncture for limb spasticity post-stroke:a systematic review

Background:Warm acupuncture,or warm-needle acupuncture,is a traditional external treatment widely used in China for thousands of years.However,the effects of different treatment times on limb spasticity post-stroke have not been evaluated.Methods:We searched PubMed,Embase,the Cochrane Library,the Web of Science,the China National Knowledge Infrastructure,the Chinese Scientific and Journal Database,the Wanfang database,and the Chinese Biomedical Literature Database from inception to May 21st,2020,to seek information regarding randomized controlled trials studying warm-needle acupuncture for limb spasticity post-stroke.Two authors selected 24 studies fitting the eligibility criteria and developed this systematic review and meta-analysis.Results:Warm-needle acupuncture is shown to be more effective than other treatments used in the control groups(odds ratio(OR)=3.61,95%confidence intervals(CI)(2.51,5.19),P<0.001).This treatment decreased limb spasticity as assessed with the Modified Ashworth Scale(mean differences(MD)=−0.78,95%CI(−1.00,−0.56),P<0.001)and the Clinic Spasticity Index(MD=1.06,95%CI(0.51,1.60),P=0.0002),improved sensorimotor impairments according to the Fugl-Meyer Assessment(MD=9.51,95%CI(6.99,12.03),P<0.001),and improved activities of daily living according to the Barthel Index(MD=9.70,95%CI(6.27,13.12),P<0.001).Subgroup analysis based on the length of the treatment using the Modified Ashworth Scale,Fugl-Meyer Assessment,and Barthel Index showed better outcomes for patients who received more than 20 days of treatments(P<0.001).Conclusion:Warm-needle acupuncture is an effective treatment for limb spasticity post-stroke.A treatment frequency of more than 20 days appears to have better effectiveness than that of less than 20 days.

腹部电针治疗脑卒中后便秘:一项随机对照试验

目的:观察腹部电针治疗对脑卒中后便秘患者肠道功能的影响。方法:将100例脑卒中后便秘患者根据随机数字表法随机分为观察组和对照组,每组50例。对照组口服乳果糖,每次10 mL,每日3次,连续治疗2周。观察组在口服乳果糖基础上加电针腹部天枢、府舍及大横,每次留针30 min,每日针刺1次,连续治疗2周。比较两组患者治疗后总有效率、便秘症状评分、便秘患者生存质量量表(PAC-QOL)评分、血清胃动素(MTL)水平及简易智力状态评价量表(MMSE)评分的差异。结果:治疗2周后,观察组总有效率为93.5%,对照组总有效率为76.1%,差异具有统计学意义(P<0.05)。两组治疗前后便秘症状评分、PAC-QOL和MMSE评分及MLT水平比较,差异具有统计学意义(P<0.05);观察组治疗后便秘症状评分及PAC-QOL评分低于对照组,MMSE评分及MLT水平高于对照组,差异具有统计学意义(P<0.05)。结论:在口服乳果糖基础上加用电针腹部穴位可以明显改善脑卒中患者肠道功能,同时可改善患者认知功能。

Electroacupuncture attenuates chronic salpingitis via transforming growth factor-β1/p38 mitogen-activated protein kinase signaling pathway

OBJECTIVE:To explore the effect of electroacupuncture(EA)on rats with chronic fallopian tube inflammation and its potential mechanisms.METHODS:Thirty-six female Sprague-Dawley rats were divided into Control,Model and EA groups.The pathological morphology of the fallopian tubes was observed by hematoxylin-eosin(HE)and Masson staining.The results of transforming growth factor-β1(TGF-β1),P38 mitogen-activated protein kinase(MAPK),phosphorylation(p)-p38MAPK in rat oviduct tissues were detected by immunohistochemistry.Results of P38MAPK,p-P38MAPK and TGF-β1 in rat oviduct tissues were detected by immunofluorescence.The expression level of p38MAPK,p-P38MAPK,TGF-β1 protein in rats was detected by Western blot.Quantitative real-time polymerase chain reaction(RT-q PCR)was used to detect m RNA expression levels of TGF-β1.RESULTS:It found that collagen fibers counts decreased significantly in EA group compared to Model group.The phosphorylation of P38MAPK in EA group was significantly reduced compared to Model group.The serum TGF-β1 expressions in EA group increased decreased significantly.CONCLUSION:Electroacupuncture was able to attenuate chronic salpingitis through down-regulating TGF-β1/MAPK signaling pathway.

针药并用治疗老年阿尔茨海默病患者的临床研究

目的:观察调神针法配合多奈哌齐对老年性阿尔茨海默病(AD)患者认知能力、平均脑血流速度、事件相关电位P300以及日常生活能力(ADL)的影响.方法:按照随机分配信封法将60例老年性AD患者分为治疗组和对照组,每组30例.在常规内科治疗的基础上,对照组口服多奈哌齐治疗;治疗组在对照组的基础上加用调神针刺法.两组均治疗4周后评价简易智力状态评价量表(MMSE)、阿尔茨海默病评估量表认知部分(ADAS-Cog)及ADL评分,观察P300和平均脑血流速度的变化.结果:治疗前两组患者MMSE、ADAS-Cog及ADL评分比较,差异无统计学意义(P>0.05).治疗后两组患者MMSE评分均高于治疗前,且治疗组MMSE评分显著高于对照组,组内及组间差异有统计学意义(P<0.05).治疗后两组患者ADAS-Cog及ADL评分均降低,且治疗组评分明显低于对照组,组内及组间差异有统计学意义(P<0.05).与同组治疗前比较,两组患者治疗后P300潜伏期均缩短,波幅均延长,差异有统计学意义(P<0.05);治疗组患者治疗后潜伏期小于对照组,波幅高于对照组,组间差异有统计学意义(P<0.05).治疗后两组血管平均血流速度均较治疗前升高,差异有统计学意义(P<0.05),且治疗组改善情况优于对照组(P<0.05).结论:调神针法联合多奈哌齐可以调节P300的潜伏期及波幅,提高患者的脑血流量,同时改善老年性AD患者的学习记忆能力.

Modified Gexiazhuyu decoction(膈下逐瘀汤加减方)alleviates chronic salpingitis via p38 signaling pathway

OBJECTIVE:To investigate pharmacodynamic effects of modified Gexiazhuyu decoction(MGXZYD)and explore the underlying mechanism in the treatment of chronic salpingitis METHODS:Chronic salpingitis model rats were firstly constructed and the blood was collected to detect the whole blood viscosity and plasma viscosity.Rat oviduct were collected to evaluate the macroscopic damage and the pathological injury and fibrosis of oviduct by hematoxylin-eosin(HE)and Masson staining.Elisa assay was to detect the production interleukin-1β(IL-1β)in serum and collagen I(COL-1),matrix metalloprotein 9(MMP-9),tissue inhibitor of metalloproteinases 1(TIMP-1)in oviduct tissue.And immunohistochemical staining with MMP-9 and TIMP-1 in oviduct tissue were examined.Western blot was used to detect the expressions of p38 mitogen-activated protein kinases(p38MAPK),phosphop38MPAK(p-p38MPAK),transforming growth factor-β1(TGF-β1)in oviduct.The expression ofα-smooth muscle actin(α-SMA),p-p38MPAK,in oviduct tissue were detected by immunofluorescence method.The m RNA of p-p38MAPK,α-SMA,COL-1,MMP-9,TIMP-1 was measured by reverse transcription-polymerase chain reaction.RESULTS:Rats administrated with MGXZYD demonstrated decreased the whole blood viscosity and plasma viscosity.MGXZYD obviously improved the tubal wall thickening,swelling and pelvic adhesion.And HE and Masson staining showed MGXZYD improved the pathological injury and fibrosis of oviduct.The results of MTT assay and flow cytometry indicated that MGXZYD could decreased the NIN-3T3 cells viability and improved the apoptosis.Besides,MGXZYD inhibited the protein and/or m RNA of TGF-β1,IL-1β,COL-1,α-SMA,pp38MAPK expressions and increased the production of MMP-9/TIMP-1.CONCLUSION:MGXZYD could prevent the progression of chronic salpingitis by inhibited the fibrocyte and inflammation which via inhibited the p38 MAPK signaling pathway.