Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroa...Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.展开更多
Objective:Comorbid pain and depression are common but remain difficult to treat.Electroacupuncture(EA)can effectively improve symptoms of depression and relieve pain,but its neural mechanism remains unclear.Therefore,...Objective:Comorbid pain and depression are common but remain difficult to treat.Electroacupuncture(EA)can effectively improve symptoms of depression and relieve pain,but its neural mechanism remains unclear.Therefore,we used resting-state functional magnetic resonance imaging(rs-fMRI)to detect cerebral changes after initiating a mouse pain model via constriction of the infraorbital nerve(CION)and then treating these animals with EA.Methods:Forty male C57BL/6J mice were divided into 4 groups:control,CION model,EA,and sham acupuncture(without needle insertion).EA was performed on the acupoints Baihui(GV20)and Zusanli(ST36)for 20 min,once a day for 10 consecutive days.The mechanical withdrawal threshold was tested3 days after the surgery and every 3 days after the intervention.The depressive behavior was evaluated with the tail suspension test,open-field test,elevated plus maze(EPM),sucrose preference test,and marble burying test.The rs-fMRI was used to detect the cerebral changes of the functional connectivity(FC)in the mice following EA treatment.Results:Compared with the CION group,the mechanical withdrawal threshold increased in the EA group at the end of the intervention(P<0.05);the immobility time in tail suspension test decreased(P<0.05);and the times of the open arm entry and the open arm time in the EPM increased(both P<0.001).There was no difference in the sucrose preference or marble burying tests(both P>0.05).The fMRI results showed that EA treatment downregulated the amplitude of low-frequency fluctuations and regional homogeneity values,while these indicators were elevated in brain regions including the amygdala,hippocampus and cerebral cortex in the CION model for comorbid pain and depression.Selecting the amygdala as the seed region,we found that the FC was higher in the CION group than in the control group.Meanwhile,EA treatment was able to decrease the FC between the amygdala and other brain regions including the caudate putamen,thalamus,and parts of the cerebral cortex.Conclusion:EA can downregulate the abnormal activation of neurons in the amygdala and improve its FC with other brain regions,thus exerting analgesic and antidepressant effects.Please cite this article as:Yin X,Zeng XL,Lin JJ,Xu WQ,Cui KY,Guo XT,Li W,Xu SF.Brain functional changes following electroacupuncture in a mouse model of comorbid pain and depression:A restingstate functional magnetic resonance imaging study.展开更多
Pain is a subjective and unpleasant sensation that significantly impacts the daily lives of individuals.Chronic pain represents one of the most challenging public health issues,and ensuring effective pain management i...Pain is a subjective and unpleasant sensation that significantly impacts the daily lives of individuals.Chronic pain represents one of the most challenging public health issues,and ensuring effective pain management is a fundamental right of individuals and a sacred duty of healthcare providers.Cannabis,one of the earliest recognized medicinal plants,contains cannabinoids,which are non-opioid substances that modulate nociceptive responses.Electroacupuncture(EA),characterized by its low-risk and well-tolerated nature,is pivotal in pain management.The endocannabinoid system consists of endocannabinoids,cannabinoid receptors,and enzymes involved in endocannabinoid synthesis,degradation,and transport.Recently,the role of the endocannabinoid system in pain development and EA analgesia has attracted considerable research attention.Studies have highlighted the role of the endocannabinoid system in various types of pain,including inflammatory pain,neuropathic pain,and cancer-related pain,as well as in EA analgesia.This study aims to review the mechanisms of endocannabinoid system involvement in pain modulation and EA analgesia to provide insights to inform clinical approaches to pain management.展开更多
OBJECTIVE:To investigate the mechanism of electroacupuncture of sympathetic nerve activity and blood pressure reduction in the hypothalamic paraventricular nucleus(PVN)of spontaneous hypertensive rats(SHRs).METHODS:A ...OBJECTIVE:To investigate the mechanism of electroacupuncture of sympathetic nerve activity and blood pressure reduction in the hypothalamic paraventricular nucleus(PVN)of spontaneous hypertensive rats(SHRs).METHODS:A total of 64 male SHRs were divided into four groups:model,sham-operated(Sham),electroacupuncture(EA),and N-methyl-D-aspartate receptor antagonist and electroacupuncture(NRA+EA).In addition,16 Wistar-Kyoto rats were used as controls.PVN stereotaxic surgery was performed in both the Sham and NRA+EA groups,while the EA and NRA+EA groups received 14 d of electroacupuncture.Blood pressure(BP)and heart rate(HR)were measured the day before the intervention and every other day.After 14 d of intervention,the rats in each group were tested for renal sympathetic nerve activity(RSNA).The associated factor levels were determined using Western blotting,reverse transcription-polymerase chain reaction(RTPCR),enzyme-linked immunosorbent assay(ELISA)and immunofluorescence assays.RESULTS:In comparison to the model group,the EA and NRA+EA groups had significantly lower BP,HR,and RSNA(P<0.01).The expression of N-methyl-Daspartate receptor(NMDAR),angiotensin II(Ang II),angiotensin II type 1(AT1),tumor necrosis factor-α,interleukin-1β,norepinephrine and arginine vasopressin was significantly lower in the EA and NRA+EA groups(P<0.01).Moreover,the antihypertensive effect of NRA+EA group outperformed to the EA group.CONCLUSIONS:Electroacupuncture effectively reduced the BP and sympathetic nerve excitability in SHRs.The mechanism was linked to the inhibition of NMDARmediated Ang II/AT1 and the inflammatory response in PVN.展开更多
Objective:The effectiveness of chemotherapy is affected by tumor heterogeneity and drug resistance mechanisms;however,there are certain limitations.Electroacupuncture can regulate the tumor immune response and restore...Objective:The effectiveness of chemotherapy is affected by tumor heterogeneity and drug resistance mechanisms;however,there are certain limitations.Electroacupuncture can regulate the tumor immune response and restore bone marrow hematopoietic function,which is affected by chemotherapy.This study investigated the efficacy and mechanism of electroacupuncture combined with cisplatin in the treatment of non-small-cell lung cancer mice.Methods:To establish a mouse model of non-small-cell lung cancer,gene sequencing combined with bioinformatics analysis,flow cytometry,and liquid-phase chips was used to observe the expression of immune cells and related factors in the mouse tumor microenvironment.Flow cytometry was used to observe subpopulations of mouse bone marrow hematopoietic stem cells and progenitor cells.PAC1 receptor agonists were used to observe mouse tumor immunity and bone marrow hematopoiesis-related indicators.Results:The combination of electroacupuncture with high-and low-dose chemotherapy had a better tumor-suppressive effect.Electroacupuncture can affect the gene expression profile of immune cells,especially the expression levels of Ccr1,Cxcr5,Zbp1,and CamkIIα,and increases the levels of interferon-γ(IFN-γ)and interleukin(IL)-2 protein,upregulating the levels of cytokines Ccl4,Ccl3,and IL-6 in the tumor tissue.Additionally,electroacupuncture enhanced the infiltration of CD8+T cells,dendritic cells,and M1-type macrophages at the tumor site,and reduced the proportion of Th17 and Treg cells.Furthermore,electroacupuncture remodels the bone marrow hematopoietic microenvironment after chemotherapy by increasing the number of bone marrow hematopoietic stem cell subsets,leukocytes,and subpopulations in the peripheral blood.PAC1 receptor agonists have similar effects to those of electroacupuncture on hematopoietic protection and tumor immunity after chemotherapy.Conclusions:Electroacupuncture may improve chemotherapy-induced bone marrow suppression,reshape the tumor microenvironment immune response affected by chemotherapy,and change the tumor immune microenvironment to an anti-tumor mode by regulating tumor local immune-related cytokines.The PAC1 receptor may be a drug target for the treatment of myelosuppression and immunosuppression in patients with tumors.展开更多
Background:Electroacupuncture(EA)may affect the severity of hot flashes(HFs)associated with natural menopause and provide additional benefits for postmenopausal women.However,the evidence for its effectiveness in the ...Background:Electroacupuncture(EA)may affect the severity of hot flashes(HFs)associated with natural menopause and provide additional benefits for postmenopausal women.However,the evidence for its effectiveness in the management of early postmenopausal HFs remains inadequately understood.Objective:We designed this trial to assess the efficacy and safety of EA for relieving early postmenopausal HFs.Design,setting,participants and interventions:This randomized sham-controlled trial involved 72 women with HFs.The participants were divided equally into the intervention and control groups.The intervention group was treated with EA,while the control group was treated with sham acupuncture.The main acupoints used were Hegu(LI4),Guanyuan(RN4),Sanyinjiao(SP6),Taixi(KI3),Fuliu(KI7)and Shenshu(BL23).All participants received 18 treatment sessions,distributed across a 6-week period.The treatment was administered on three occasions per week,adhering to a fixed weekday schedule(Monday,Wednesday,Friday or Tuesday,Thursday,Saturday)with a minimum interval of one day between sessions.Each patient received a 12-week follow-up.Main outcome measures:The HF score was the primary outcome.Participants documented the frequency and severity of HFs in a 7-day symptom diary,which provided data for calculating the HF score.Secondary outcomes were the Menopause Rating Scale(MRS),Menopause-Specific Quality of Life Questionnaire(MENQOL),Pittsburgh Sleep Quality Index(PSQI)and Traditional Chinese Medicine Syndrome Score Scale(TCMSSS),as well as estradiol(E2),luteinizing hormone(LH)and folliclestimulating hormone(FSH)levels.Results:Both groups demonstrated significant reductions in HF scores after the treatment and during the follow-up(P<0.001).Immediately after completion of the 6-week treatment cycle and at 12 weeks postintervention,the HF scores were similar in both groups.At week 6,the intervention group showed significantly greater improvements in MRS,MENQOL(vasomotor,psychosocial,and physical),PSQI and TCMSSS scores(P<0.05).The improvements in the MENQOL(vasomotor,and psychosocial)and PSQI total scores persisted through the follow-up(P<0.05).However,the results showed no significant inter-or intragroup differences in sexual scores on the MENQOL(P>0.05).EA did not significantly decrease E2,LH or FSH levels compared to placebo.The incidence of adverse events was similar in both groups.Conclusion:EA does not significantly improve HFs in early postmenopausal patients.However,it enhances the quality of sleep and decreases menopausal symptoms across vasomotor,psychosocial and physical domains.Trial registration:Chinese Clinical Trial Registry(http://www.chictr.org.cn);Trial ID:Chi CTR2300072002.Please cite this article as:Wang HX,Yu XT,Hu J,Chen JJ,Mei YT,Chen YF.Electroacupuncture for hot flashes in early menopause:A randomized sham-controlled trial.J Integr Med.2025;23(5):519-527.?2025 Shanghai Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.Published by Elsevier B.V.All rights are reserved,including those for text and data mining,AI training,and similar technologies.展开更多
OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)at scalp motor area for treating post-stroke wrist dyskinesia and its influence on the function of wrist movement-related agonistic muscles.METHODS:A randomi...OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)at scalp motor area for treating post-stroke wrist dyskinesia and its influence on the function of wrist movement-related agonistic muscles.METHODS:A randomized,single-blind,controlled clinical trial was conducted.Sixty-six patients undergoing post-stroke wrist dyskinesia were enrolled and randomized 1:1 to EA or control group.Patients in the control group received manual acupuncture in the scalp motor area(MS 6)on the lesion side.The same acupoint was selected to accept EA stimulation in the EA group.All patients were treated six times a week for three weeks.The primary outcome was the Chinese Stroke Scale(CSS)score.The secondary outcomes included upper limb-related Barthel Index(BI)score,active range of motion(AROM)of the wrist joint,and root mean square(RMS)of the four agonistic muscles associated with wrist motion on the hemiplegic side of patients,i.e.,the extensor carpi radialis longus(ECRL),extensor digitorum(ED),flexor carpi radialis(FCR)and flexor carpi ulnaris(FCU).The above indicators were measured before and after three weeks of treatment.RESULTS:After 3-week treatment,the CSS score and AROM of wrist dorsiflexion of the EA group were better than those in the control group(P=0.038,P=0.047).The differences between the two groups of BI scores and AROM of wrist flexion were not significant(P>0.05).All RMS of the EA group were higher than those in the control group(ECRL:P=0.047,ED:P=0.048,FCR:P=0.049,FCU:P=0.047).The total effective rate in the EA group was 87.50%(28/32),which was higher than that in the control group(77.42%,24/31,P=0.048).CONCLUSION:EA stimulation of the scalp motor area can promote the recovery of the strength and function of the agonistic muscles related to wrist movement and effectively improve post-stroke wrist dyskinesia.展开更多
Background Unsedated colonoscopy is an important method used for diagnosing colorectal cancer,but it can cause discomfort such as pain and bloating,as well as anxiety.At present,the relief is mainly achieved through m...Background Unsedated colonoscopy is an important method used for diagnosing colorectal cancer,but it can cause discomfort such as pain and bloating,as well as anxiety.At present,the relief is mainly achieved through methods such as changing positions and manual pressing,but the efficacy is limited.Hence alternative therapies for sedation and analgesia in unsedated colonoscopy warrant further study.Electroacupuncture(EA)can simplify the procedure of anesthesia and analgesia,while the efficacy of EA on unsedated colonoscopy remains unclear.Therefore,a well-designed randomized controlled trial is needed to demonstrate the potential efficacy of acupuncture in unsedated colonoscopy,particularly for pain relief.Methods In this prospective randomized sham-controlled trial,105 eligible participants will be recruited and randomly assigned to either EA group(n=35),sham EA group(n=35),or control group(n=35)in a 1:1:1 ratio.The EA group will receive acupuncture intervention on bilateral Hegu(LI4),Neiguan(PC6),Zusanli(ST36),and Shenmen(HT7),with LI4 and PC6 on both sides connected to the EA device.The sham EA group will received non transdermal needling on points of no meridian,and deliberately connect the needle to the incorrect output socket of EA device to block the stimulation.The needling will conducted from 30 min before the unsedated colonoscopy to the end of the colonoscopy,the whole retention time would be approximately 40 min.The participants in the control group will not receive any acupuncture intervention.All participants of the three groups will not receive any other treatment.Primary outcomes:Numerical Rating Scale(NRS)reported by participants and Face Pain Scale Revised(FPS-R)evaluated by observers of four areas of the participants during the unsedated colonoscopy.Secondary outcomes:tolerance reported by endoscopists,tolerance reported by participants,satisfaction reported by endoscopists,satisfaction reported by participants,adverse events during the unsedated colonoscopy,postoperative discomfort,unsedated colonoscopy smoothness(cecal insertion time,unwinding time,success rate of one-time intubation).Both intention-to-treat(ITT)and per-protocol(PP)analyses will be performed to assess the efficacy of EA.Discussion The trial will explore the efficacy of relieving pain,improving tolerability,and reducing undesirable adverse events of EA for unsedated colonoscopy.The results of this trial will provide sound evidence for promoting the clinical application of EA for unsedated colonoscopy.Trial registration ClinicalTrials.gov Identifier:ChiCTR2300069903,retrospectively registered on March 16,2023.展开更多
Objective To evaluate the efficacy and safety of electroacupuncture(EA)for postoperative recovery in patients with gastrointestinal(GI)cancers.Methods We retrieved articles from PubMed,Embase,OVID,Cochrane Library,Web...Objective To evaluate the efficacy and safety of electroacupuncture(EA)for postoperative recovery in patients with gastrointestinal(GI)cancers.Methods We retrieved articles from PubMed,Embase,OVID,Cochrane Library,Web of Science,CINAHL,SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang,and Technology Journal Database(VIP)from database inception to November 1,2024.Randomized controlled trials(RCTs)that examine the use of EA to improve GI function,reduce pain,and promote ability ofself-care after GI cancer surgery were included.Based on the type of control interventions,separate meta-analyses were conducted for EA vs postoperative nursing(PN)and EA vs sham acupuncture(SA).The primary outcomes were the time to first flatus(TFF)and the time to first defecation(TFD).The secondary outcomes included the time to recovery of bowel sounds(TRBS),the time to tolerance of liquid diet(TTLD),the time to tolerance of semiliquid diet(TTSD),the time to independent walking(TIW),the length of hospitalization(LH),and visual analog scale(VAS)immediate resting pain scores measured on the first,second and third postoperative days(POD 1–3).Results are reported as mean differences(MDs)with 95%confidence intervals(CIs).RevMan 5.3 was used for meta-analysis,StataSE 15.1 was used for sensitivity analyses and Egger’s tests.This study was registered on PROSPERO(CRD42022314754).Results A total of 19 RCTs involving 1902 participants were included,all of which were conducted in China between 2004 and 2023.When EA compared with PN,the meta-analysis showed EA significantly reduce TFF(n=673,MD=-13.14,95%CI=[-18.97 to-7.31],P<0.00001),TFD(n=598,MD=-19.86,95%CI=[-27.83 to-11.89],P<0.00001),TRBS(n=216,MD=-12.44,95%CI=[-15.00 to-9.87],P<0.00001),TTLD(n=268,MD=-18.14,95%CI=[-24.98 to-11.29],P<0.00001),TTSD(n=141,MD=-20.44,95%CI=[-33.84 to-7.04],P=0.003),VAS on POD 1(n=299,MD=-0.52,95%CI=[-0.92 to-0.11],P=0.01),VAS on POD 2(n=256,MD=-0.91,95%CI=[-1.23 to-0.60],P<0.00001),VAS on POD 3(n=203,MD=-0.57,95%CI=[-0.80 to-0.34],P<0.00001),while no significantly decreasing in the LH(n=322,MD=-1.16,95%CI=[-2.56 to 0.24],P=0.10).As EA compared with SA,EA could significantly reduce TFF(n=782,MD=-15.78,95%CI=[-24.96 to-6.60],P=0.0008),TFD(n=782,MD=-20.42,95%CI=[-36.14 to-4.70],P=0.01),LH(n=782,MD=-1.37,95%CI=[-2.69 to-0.05],P=0.04),TIW(n=743,MD=-0.33,95%CI=[-0.62 to-0.04],P=0.03).13 studies reported that EA reduced the incidence of postoperative complications,and 7 studies reported safety assessments of acupuncture-related adverse events,including hematoma,residual needling,sharp pain,pain,soreness or swelling after needle removal,with no serious adverse events.Conclusion EA can significantly promote the recovery of GI function,reduce postoperative pain,enhance ability of self-care in patients undergoing surgery for GI cancers.展开更多
Objective:Arrhythmia-induced cardiomyopathy(AIC)is a reversible dilated cardiomyopathy induced by rapid or irregular heartbeat.Acupuncture has a long history of use in the treatment of cardiac diseases,and Xinshu(BL15...Objective:Arrhythmia-induced cardiomyopathy(AIC)is a reversible dilated cardiomyopathy induced by rapid or irregular heartbeat.Acupuncture has a long history of use in the treatment of cardiac diseases,and Xinshu(BL15)is a key acupoint.However,the underlying mechanism of acupuncture at BL15 in the treatment of AIC has not yet been elucidated.Methods:AIC was induced in adult male Sprague-Dawley(SD)rats by continuous administration of acetylcholine(ACh)-CaCl2 and treatment with electroacupuncture(EA)at bilateral BL15.Echocardiography was used to evaluate cardiac function;the rotarod test for motor coordination and performance;hematoxylin and eosin(HE)staining for the morphology of ventricles;electrocardiogram for susceptibility,inducibility,and duration of atrial fibrillation(AF);and electrical and optical mapping in isolated rat hearts maintained by the Langendorff perfusion system for electrical conduction and intracellular handling,respectively.Reverse transcription quantitative polymerase chain reaction(RT-qPCR)and Western blotting were used to determine the levels of cardiac conduction and intracellular calcium-handling proteins in the ventricle.Results:The results showed that EA improved the ejection factor and morphological indices on echocardiography,restored motor coordination and performance,and alleviated ventricular dilation and AF onset.EA alleviates atrial conduction disorders,shortens APD80,and decreases calcium handling in rats with AIC.Cx43 was downregulated and CaMKII was upregulated,and both effects were reversed by EA treatment.Conclusion:Our study provides a novel AIC model with abnormal electrical propagation and calcium handling that can be protected by EA at BL15.This potential mechanism may be associated with the modulation of Cx43 and CaMKII expression.展开更多
BACKGROUND Postoperative intestinal paralysis is common in gastrointestinal surgery,and the study of electroacupuncture mechanisms is of great significance.AIM To explore the neuroimmune regulatory mechanism of electr...BACKGROUND Postoperative intestinal paralysis is common in gastrointestinal surgery,and the study of electroacupuncture mechanisms is of great significance.AIM To explore the neuroimmune regulatory mechanism of electroacupuncture at the Zusanli acupoint(ST36)in postoperative intestinal paralysis following gastrointestinal surgery.METHODS A total of 156 patients admitted to the Affiliated Hospital of Jiangnan University between January 2022 and October 2024 for postoperative intestinal paralysis following gastrointestinal surgery were randomly divided into two groups:A control group and an electroacupuncture group,with 75 patients in each.The control group received conventional Western medical treatment,while the electroacupuncture group received electroacupuncture in addition to this,at the bilateral Zusanli acupoints.Both groups received treatment for 7 days.Clinical efficacy,gastrointestinal function recovery,and gastrointestinal hormone[motilin(MTL),gastrin(GAS)],neurotransmitter[vasoactive intestinal peptide(VIP),nitric oxide(NO)],and inflammatory cytokine[tumor necrosis factor-α(TNF-α),serum interleukin-6(IL-6),interleukin-1β(IL-1β)]levels were compared between the two groups before and seven days after treatment.Adverse reactions were also recorded.RESULTS The electroacupuncture group demonstrated a higher overall treatment effectiveness rate and faster recovery of bowel sounds,as well as faster first defecation and first flatus than the control group(P<0.05).After seven days of treatment,MTL and GAS levels were significantly higher and VIP,NO,TNF-α,IL-6 and IL-1βlevels were significantly lower in the electroacupuncture group than in the control group(P<0.05).No adverse reactions were observed in either group during treatment.CONCLUSION Electroacupuncture at the Zusanli acupoint can enhance clinical efficacy,promote the recovery of gastrointestinal function,and regulate the neuroimmune microenvironment in patients with intestinal paralysis after gastrointestinal surgery.This mechanism may involve excitation of the vagus nerve and activation of the cholinergic antiinflammatory pathway through electroacupuncture stimulation of the Zusanli acupoint.展开更多
Objective To evaluate the changes in postoperative plasmaβ-endorphin(β-EP)levels in patients who had received perioperative electroacupuncture(EA)treatment in 10 randomized controlled trials(RCTs)and examine the imp...Objective To evaluate the changes in postoperative plasmaβ-endorphin(β-EP)levels in patients who had received perioperative electroacupuncture(EA)treatment in 10 randomized controlled trials(RCTs)and examine the impact of EA on postoperative pain.Methods This meta-analysis evaluated the changes in plasmaβ-EP levels and visual analog scale(VAS)12,24 and 48 hours after surgery in patients receiving perioperative EA.It also assessed the changes in plasma serotonin(5-hydroxytryptamine,5-HT)and prostaglandin E2(PGE2)levels at 24 hours postsurgery.A comprehensive search was conducted in the China National Knowledge Infrastructure(CNKI),Wanfang,Chongqing VIP database,Chinese Biomedical Database(CBM),Web of Science,and PubMed databases.RCTs on perioperative EA andβ-EP published from the inception of the websites up to July 25,2023,were retrieved.Effect size aggregation,literature quality assessment,and bias analysis were performed using RevMan 5.3 software,and sensitivity analysis was conducted via R 4.3.1.Results A total of 10 RCTs involving 706 patients were included.EA in conjunction with conventional anesthesia significantly increased plasmaβ-EP levels at 12 hours postsurgery[standard mean difference(SMD)=2.79,95%CI(1.85,3.72),Z=5.81,P<0.00001],24 hours postsurgery[SMD=1.87,95%CI(0.9,2.83),Z=3.79,P=0.0001],and 48 hours postsurgery[SMD=2.02,95%CI(1.49,2.54),Z=7.50,P<0.00001].EA reduced plasma PGE2 levels at 24 hours postsurgery and plasma 5-HT levels at 24 hours postsurgery,and the VAS at 12,24 and 48 hours after surgery also decreased.Conclusion These findings suggest that perioperative EA markedly elevates plasmaβ-EP levels,reduces pain-inducing factors in plasma,and effectively alleviates acute postoperative pain.展开更多
BACKGROUND Knee osteoarthritis(KOA)is a chronic condition characterized by joint pain and dysfunction,driven by aging and obesity.Research indicates that the gut microbiota significantly influences KOA,potentially aff...BACKGROUND Knee osteoarthritis(KOA)is a chronic condition characterized by joint pain and dysfunction,driven by aging and obesity.Research indicates that the gut microbiota significantly influences KOA,potentially affecting inflammation and disease progression through the gut-joint axis.Traditional treatments like nonsteroidal anti-inflammatory drugs offer symptom relief but have adverse effects.Emerging therapies like electroacupuncture(EA)and Tuina(TN)have shown promise in alleviating pain and improving joint function by targeting the gut microbiota.AIM To clarify the efficacy of EA with TN in treating KOA and its effect on gut microbiota regulation.METHODS Sixty patients with KOA were allocated to EA or EA+TN(ET)group(n=30 each).Seven acupoints were punctured.The ET group received TN after each EA session.Both groups completed 12 sessions.The visual analog scale(VAS)for assessing pain and the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)for measuring pain intensity,joint stiffness,and functional capacity were employed to assess clinical outcomes.Pre-and post-treatment fecal specimens underwent 16S ribosomal RNA sequencing to analyze the gut microbiota.RESULTS The ET group showed higher rates of“effective”and“markedly effective”outcomes.The VAS score of the ET group remained significantly lower than that of the EA group(P<0.001)immediately after treatment and 1 week post-treatment.The total WOMAC score(P<0.001),pain(P=0.191),stiffness(P=0.015),and function scores(P<0.001)decreased significantly in the ET group post-treatment.The gut microbiota analysis revealed no significant changes in alpha diversity in either group.Beta-diversity analysis indicated distinct patterns in the ET group before and after treatment.Significant changes in microbial abundance were detected in both groups,highlighting variations in Firmicutes,Actinobacteria,Proteobacteria,and Bacteroidetes.CONCLUSION ET outperforms EA alone in improving KOA pain,stiffness,and function,potentially via gut microbiota modulation,intestinal barrier protection,and inflammation reduction.展开更多
Objective:To elucidate the specific mechanisms by which electroacupuncture(EA)alleviates anxiety and fear behaviors associated with posttraumatic stress disorder(PTSD),focusing on the role of lipocalin-2(Lcn2).Methods...Objective:To elucidate the specific mechanisms by which electroacupuncture(EA)alleviates anxiety and fear behaviors associated with posttraumatic stress disorder(PTSD),focusing on the role of lipocalin-2(Lcn2).Methods:The PTSD mouse model was subjected to single prolonged stress and shock(SPS&S),and the animals received 15 min sessions of EA at Shenmen acupoint(HT7).Behavioral tests were used to investigate the effects of EA at HT7 on anxiety and fear.Western blotting and enzyme-linked immunosorbent assay were used to quantify Lcn2 and inflammatory cytokine levels in the prefrontal cortex(PFC).Additionally,the activity of PFC neurons was evaluated by immunofluorescence and in vivo electrophysiology.Results:Mice subjected to SPS&S presented increased anxiety-and fear-like behaviors.Lcn2 expression in the PFC was significantly upregulated following SPS&S,leading to increased expression of the proinflammatory cytokines tumor necrosis factor-a and interleukin-6 and suppression of PFC neuronal activity.However,EA at HT7 inhibited Lcn2 release,reducing neuroinflammation and hypoexcitability in the PFC.Lcn2 overexpression mitigated the effects of EA at HT7,resulting in anxiety-and fear-like behaviors.Conclusion:EA at HT7 can ameliorate PTSD-associated anxiety and fear,and its mechanism of action appears to involve the inhibition of Lcn2-mediated neural activity and inflammation in the PFC.展开更多
BACKGROUND Cervical spondylosis(CS)frequently co-occurs with generalized anxiety disorder(GAD),presenting a complex clinical challenge.Managing CS-related pain in patients with GAD is particularly challenging because ...BACKGROUND Cervical spondylosis(CS)frequently co-occurs with generalized anxiety disorder(GAD),presenting a complex clinical challenge.Managing CS-related pain in patients with GAD is particularly challenging because of the bidirectional relationship between pain and anxiety,necessitating integrated treatment strategies.AIM To evaluate the efficacy of electroacupuncture(EA)in treating CS-related pain and anxiety in patients with GAD.METHODS This retrospective cohort study analyzed data from 83 patients with CS-related pain and GAD who received EA treatment over 2-year period.Pain intensity was assessed using the visual analog scale,and anxiety symptoms were measured using the Hamilton Anxiety Rating Scale.Additionally,neuroinflammatory markers,including interleukin-6,tumor necrosis factor-alpha,and high-sensitivity C-reactive protein,were examined.Outcomes were evaluated at baseline,after 4 weeks,and after 8 weeks of treatment.RESULTS EA treatment significantly reduced CS-related pain(mean visual analog scale reduction:3.24±1.18;P<0.001)and improved anxiety symptoms(mean Hamilton Anxiety Rating Scale reduction:7.83±2.65;P<0.001)after 8 weeks of treatment.Neuroinflammatory markers also showed significant reductions,with interleukin-6 and tumor necrosis factor-alpha levels decreasing by 32.7%and 28.5%,respectively(P<0.01).Pain reduction was significantly correlated with improvements in anxiety symptoms(r=0.68;P<0.001)and a decrease in inflammatory markers(r=0.54;P<0.01).CONCLUSION EA demonstrates significant efficacy in reducing CS-related pain in patients with comorbid GAD,along with concurrent improvements in anxiety symptoms and neuroinflammatory profiles.These findings suggest that EA may offer a valuable integrative approach for managing this complex clinical presentation,potentially addressing both pain and anxiety through the modulation of neuroinflammatory pathways.展开更多
Objective:To investigate whether the presence or absence of improvement in chronic severe functional constipation(CSFC)at the early stage of treatment with electroacupuncture predicts subsequent response or non-respon...Objective:To investigate whether the presence or absence of improvement in chronic severe functional constipation(CSFC)at the early stage of treatment with electroacupuncture predicts subsequent response or non-response,and to determine the optimal treatment duration for assessing subsequent responses to electroacupuncture.Methods:This is a post hoc analysis using data pooled from two large-scale randomized controlled trials.Patients with CSFC were recruited,and those in the electroacupuncture groups were included in the present study.Early improvement was defined as a weekly increase of≥1 complete spontaneous bowel movement(CSBM)compared to baseline.Three treatment response criteria were evaluated:≥3CSBMs per week,overall CSBM response,and sustained CSBM response.Predictive statistics,including sensitivity,specificity,positive predictive value,and negative predictive value,were calculated at weeks1–4.Receiver operating characteristic curves and accuracy rates were used to determine the optimal timepoint for differentiation between responders and non-responders.Results:Cases from a total of 813 participants who received electroacupuncture were analyzed.The proportion of improvers was 40.34%by week 1,increasing to 52.52%by week 4.After 8 weeks of treatment,the response rates were 30.14%,25.83%and 25.58%according to the three aforementioned criteria,respectively.Early improvement was a strong predictor of treatment response,with week 3 demonstrating the highest predictive accuracy.Conclusion:Early improvement with electroacupuncture,especially at week 3,can predict subsequent outcomes.Our findings suggest that acupuncturists may identify non-responders who might require adjustments to therapeutic strategies early in treatment.展开更多
Background:Existing remedial approaches for relieving neuropathic pain(NPP)are challenging and open the way for alternative therapeutic measures such as electroacupuncture(EA).The mechanism underlying the antinocicept...Background:Existing remedial approaches for relieving neuropathic pain(NPP)are challenging and open the way for alternative therapeutic measures such as electroacupuncture(EA).The mechanism underlying the antinociceptive effects of repeated EA sessions,particularly concerning the regulation of the Adora3 receptor and its associated enzymes,has remained elusive.Methods:This study used a mouse model of spared nerve injury(SNI)to explore the cumulative analgesic effects of repeated EA at ST36(Zusanli)and its impact on Adora3 regulation in the spinal cord dorsal horn(SCDH).Forty-eight male mice underwent SNI surgery for induction of neuropathic pain and were randomly assigned to the SNI,SNI+2EA,SNI+4EA,and SNI+7EA groups.Spinal cord(L4-L6)was sampled for immunofluorescence,adenosine(ADO)detection and for molecular investigations following repeated EA treatment.Results:Following spared nerve injury(SNI),there was a significant decrease in mechanical withdrawal thresholds(PWTs)and thermal nociceptive withdrawal latency(TWL)in the ipsilateral hind paw on the third day post-surgery,while the contralateral hind paw PWTs showed no significant changes.On subsequent EA treatments,the SNI+EA groups led to a significant increase in pain thresholds(p<0.05).Repeated EA sessions in SNI mice upregulated Adenosine A3(Adora3)and cluster of differentiation-73(CD73)expression while downregulating adenosine deaminase(ADA)and enhancing neuronal instigation in the SCDH.Colocalization analysis of Neun-treated cells revealed increased Adora3 expression,particularly in the SNI+7EA group.Conclusions:In conclusion,cumulative electroacupuncture treatment reduced neuropathic pain by regulating Adora3 and CD73 expression,inhibiting ADA and most likely increasing neuronal activation in the SCDH.This study offers a promising therapeutic option for managing neuropathic pain,paving the way for further research.展开更多
Background:Obesity represents a major public health issue,closely linked to a range of metabolic and reproductive disorders.Electroacupuncture(EA)has emerged as a potential non-pharmacological intervention that may al...Background:Obesity represents a major public health issue,closely linked to a range of metabolic and reproductive disorders.Electroacupuncture(EA)has emerged as a potential non-pharmacological intervention that may alleviate complications associated with obesity,including reproductive dysfunction.Objectives:This study sought to evaluate the impact of EA on leptin/kisspeptin signaling pathways and hypothalamic inflammation in obese male rats,with the aim of elucidating its potential mechanisms in mitigating reproductive disorders related to obesity.Methods:Forty male Wistar rats were allocated into two groups:a regular diet(RD,n=10)group and a high-fat diet(HFD,n=30)group.Following an 8-week period,23 out of the 30 rats in the HFD group satisfied the criteria for the obesity model,characterized by a body weight surpassing 20%of the average body weight of the RD group.From these 23 obese rats,20 were randomly selected and further subdivided into the Model(n=10)and EA(n=10)groups.The EA group underwent EA treatment at the Zusanli(ST36),Shenshu(BL23),and Sanyinjiao(SP6)acupoints over a duration of 4 weeks.The study assessed parameters including body weight,serum lipid levels,reproductive hormone levels,hypothalamic histology,inflammation markers,and neurotransmitter levels.Results:EA treatment significantly reduced body weight,improved lipid profiles,and restored hormone levels towards those seen in control animals.Histological analysis showed improved neuronal integrity and a shift in microglial polarization towards an anti-inflammatory phenotype in the EA group.EA treatment was associated with improvements in leptin and kisspeptin signaling activity,which may contribute to its beneficial effects on reproductive function in obese male rats.Neurotransmitter profiling and untargeted serum metabolomics revealed significant improvements in metabolic pathways related to amino acid and lipid metabolism,including key pathways associated with dopamine,serotonin,and glutamine.Conclusions:EA significantly alleviated obesity-induced reproductive dysfunction by modulating leptin and kisspeptin signaling,reducing hypothalamic inflammation,and improving neurotransmitter and serum metabolic profiles,suggesting its potential as a therapeutic strategy for reproductive issues related to obesity.Additional research is essential to investigate the molecular pathways of EA and assess its clinical applicability.展开更多
[Objectives]To explore the effects of electroacupuncture combined with rehabilitation training on knee joint function,three-dimensional(3D)gait,and inflammatory markers in patients with knee osteoarthritis(KOA)of cold...[Objectives]To explore the effects of electroacupuncture combined with rehabilitation training on knee joint function,three-dimensional(3D)gait,and inflammatory markers in patients with knee osteoarthritis(KOA)of cold-dampness obstruction syndrome.[Methods]A total of 162 KOA patients admitted to Huadong Hospital Affiliated to Fudan University from January 2021 to May 2023 were enrolled and randomly divided into an electroacupuncture group and a control group,with 81 patients in each group.The control group received routine rehabilitation training,while the electroacupuncture group received electroacupuncture treatment in addition to the same rehabilitation training,both for 4 weeks.The efficacy,syndrome scores,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Lysholm Knee Score(LKS),3D gait parameters,and levels of inflammatory markers were compared between the two groups.[Results]Following treatment,the total effective rate in the electroacupuncture group was 92.59%,which was significantly higher than 77.78%observed in the control group(P<0.05).Additionally,the electroacupuncture group exhibited lower TCM syndrome scores(P<0.05),reduced WOMAC scores,and elevated LKS scores compared to the control group(P<0.05).Gait parameters,including step frequency,step speed,stride length,initial ground contact flexion angle,maximum swing phase extension angle,and support phase extension angle,were all higher in the electroacupuncture group.Additionally,the sagittal plane maximum abduction moment was lower in the electroacupuncture group.Inflammatory markers showed that interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were lower in the electroacupuncture group,while transforming growth factor-β1(TGF-β1)was higher(P<0.05).[Conclusions]Electroacupuncture combined with rehabilitation training effectively enhances clinical efficacy,alleviates symptoms,improves knee joint mobility and walking ability,enhances knee function scores,and reduces inflammatory levels,contributing to the rapid recovery of knee joints in KOA patients.展开更多
Objective To investigate the mechanism of in alleviating colonic mucosal inflammation in ten-eleven translocation(TET)protein 2 gene knockout(TET2^(-/-))mice with ulcerative colitis(UC)by regulating DNA methyltransfer...Objective To investigate the mechanism of in alleviating colonic mucosal inflammation in ten-eleven translocation(TET)protein 2 gene knockout(TET2^(-/-))mice with ulcerative colitis(UC)by regulating DNA methyltransferase(DNMT)and DNA hydroxymethylase.Methods Male specific pathogen-free(SPF)grade C57BL/6J wild-type(WT)mice(n=8)and TET2^(-/-)mice(n=20)were used to establish UC models by freely drinking 3%dextran sulfate sodium solution for 7 d.After UC model validation through histopathological examination in two mice from each type,the remaining mice were divided into four groups(n=6 in each group):WT model(WT+UC),TET2^(-/-)model(TET2^(-/-)+UC),TET2^(-/-)mild moxibustion(TET2^(-/-)+MM),and TET2^(-/-)electroacupuncture(TET2^(-/-)+EA)groups.TET2^(-/-)+MM group received mild moxibustion on Tianshu(ST25)and Qihai(CV6)for 10 min daily for 7 d.The TET2^(-/-)+EA group also applied electroacupuncture(1 mA,2/100 Hz)at the same acupoints for 10 min daily for 7 d.The disease activity index(DAI)scores of each group of mice were accessed daily.The colon lengths of mice in groups were measured following intervention.The pathological changes in the colon tissues were observed with hematoxylin and eosin(HE)staining.The concentrations of interleukin(IL)-6,C-C motif chemokine 17(CCL17),and C-X-C motif chemokine ligand 10(CXCL10)in serum were detected by enzyme-linked immunosorbent assay(ELISA).The expression of DNMT proteins(DNMT1,DNMT3A,and DNMT3B)in the colon tissues was detected by immunohistochemistry.The expression of 5-methylcytosine(5-mC),5-hydroxymethylcytosine(5-hmC),histone deacetylase 2(HDAC2),and DNA hydroxymethylase family proteins(TET 1 and TET3)was detected using immunofluorescence,which also determined the co-localization of TET1 and IL-6 protein.Results Compared with WT+UC group,TET2^(-/-)+UC group exhibited significantly higher DAI scores and shorter colon lengths(P<0.01).Both mild moxibustion and electroacupuncture significantly decreased DAI scores and ameliorated colon shortening in TET2^(-/-)mice(P<0.001).Histopathological scores of TET2^(-/-)+UC mice were significantly higher than those of WT+UC group(P<0.001)and were significantly reduced after both mild moxibustion and electroacupuncture interventions(P<0.001).Serum levels of IL-6,CCL17,and CXCL10 were significantly elevated in TET2^(-/-)+UC group compared with WT+UC group(P<0.001).Mild moxibustion significantly reduced IL-6,CCL17,and CXCL10 levels(P<0.001,P<0.001,and P<0.01,respectively),while electroacupuncture also significantly reduced IL-6,CCL17,and CXCL10 levels(P<0.05,P<0.01,and P<0.01,respectively).TET2^(-/-)+UC mice showed increased expression levels of DNMT1,DNMT3A,DNMT3B,and 5-mC(P<0.05,P<0.01 and P<0.001,respectively),with decreased expression levels of TET1,TET3,5-hmC,and HDAC2(P<0.001).Mild moxibustion significantly reduced DNMT1,DNMT3B,and 5-mC levels(P<0.05,P<0.01,and P<0.001,respectively),while increasing expression levels of TET1,TET3,5-hmC,and HDAC2(P<0.001,P<0.001,P<0.05,and P<0.001,respectively).Electroacupuncture significantly decreased 5-mC and DNMT3B levels(P<0.001 and P<0.01,respectively)and increased 5-hmC and HDAC2 levels(P<0.05 and P<0.001,respectively),but did not significantly affect TET1 and TET3 expression(P>0.05).Compared with TET2^(-/-)+MM group,TET2^(-/-)+EA group showed significantly higher 5-mC expression(P<0.001).TET2^(-/-)+UC group exhibited markedly increased IL-6 expression and higher co-localization of TET1 and IL-6 in mucosal epithelium,whereas minimal IL-6 expression was observed in the other groups.Conclusion Mild moxibustion and electroacupuncture significantly ameliorate colonic inflammation exacerbated by TET2 deficiency in UC mice via epigenetic modulation.Distinct mechanisms exist between the two interventions:mild moxibustion regulates both DNMT and hydroxymethylase,whereas electroacupuncture primarily affects DNMT.展开更多
基金supported by the National Natural Science Foundation of China,Nos.82174496(to NW),82374574(to NW),82302865(to LL)Shanghai Science and Technology Committee Sailing Program,Nos.23YF1403800(to LL),23YF1405200(to YX)Shanghai Hospital Development Center Foundation-Shanghai Municipal Hospital Rehabilitation Medicine Specialty Alliance,No.SHDC22023304(to YW).
文摘Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.
基金supported by National Natural Science Foundation of China(No.82104986 and 82274643)Shanghai“Rising Stars of Medical Talents”Youth Development Program(No.SHWSRS[2023]_062)from Shanghai Municipal Health Commission。
文摘Objective:Comorbid pain and depression are common but remain difficult to treat.Electroacupuncture(EA)can effectively improve symptoms of depression and relieve pain,but its neural mechanism remains unclear.Therefore,we used resting-state functional magnetic resonance imaging(rs-fMRI)to detect cerebral changes after initiating a mouse pain model via constriction of the infraorbital nerve(CION)and then treating these animals with EA.Methods:Forty male C57BL/6J mice were divided into 4 groups:control,CION model,EA,and sham acupuncture(without needle insertion).EA was performed on the acupoints Baihui(GV20)and Zusanli(ST36)for 20 min,once a day for 10 consecutive days.The mechanical withdrawal threshold was tested3 days after the surgery and every 3 days after the intervention.The depressive behavior was evaluated with the tail suspension test,open-field test,elevated plus maze(EPM),sucrose preference test,and marble burying test.The rs-fMRI was used to detect the cerebral changes of the functional connectivity(FC)in the mice following EA treatment.Results:Compared with the CION group,the mechanical withdrawal threshold increased in the EA group at the end of the intervention(P<0.05);the immobility time in tail suspension test decreased(P<0.05);and the times of the open arm entry and the open arm time in the EPM increased(both P<0.001).There was no difference in the sucrose preference or marble burying tests(both P>0.05).The fMRI results showed that EA treatment downregulated the amplitude of low-frequency fluctuations and regional homogeneity values,while these indicators were elevated in brain regions including the amygdala,hippocampus and cerebral cortex in the CION model for comorbid pain and depression.Selecting the amygdala as the seed region,we found that the FC was higher in the CION group than in the control group.Meanwhile,EA treatment was able to decrease the FC between the amygdala and other brain regions including the caudate putamen,thalamus,and parts of the cerebral cortex.Conclusion:EA can downregulate the abnormal activation of neurons in the amygdala and improve its FC with other brain regions,thus exerting analgesic and antidepressant effects.Please cite this article as:Yin X,Zeng XL,Lin JJ,Xu WQ,Cui KY,Guo XT,Li W,Xu SF.Brain functional changes following electroacupuncture in a mouse model of comorbid pain and depression:A restingstate functional magnetic resonance imaging study.
基金supported by the Key Program of the National Natural Science Foundation of China(82130122)the National Natural Science Foundation of China(81973949).
文摘Pain is a subjective and unpleasant sensation that significantly impacts the daily lives of individuals.Chronic pain represents one of the most challenging public health issues,and ensuring effective pain management is a fundamental right of individuals and a sacred duty of healthcare providers.Cannabis,one of the earliest recognized medicinal plants,contains cannabinoids,which are non-opioid substances that modulate nociceptive responses.Electroacupuncture(EA),characterized by its low-risk and well-tolerated nature,is pivotal in pain management.The endocannabinoid system consists of endocannabinoids,cannabinoid receptors,and enzymes involved in endocannabinoid synthesis,degradation,and transport.Recently,the role of the endocannabinoid system in pain development and EA analgesia has attracted considerable research attention.Studies have highlighted the role of the endocannabinoid system in various types of pain,including inflammatory pain,neuropathic pain,and cancer-related pain,as well as in EA analgesia.This study aims to review the mechanisms of endocannabinoid system involvement in pain modulation and EA analgesia to provide insights to inform clinical approaches to pain management.
基金Doctoral Research Fund Project of Qilu Hospital of Shandong University(Qingdao):Mechanistic Study on the Improvement of Vertigo Caused by Posterior Circulation Ischemia by Acupuncture through Regulating Cerebral Blood Flow in Rats with Posterior Circulation Ischemia Vertigo(No.QDKY2023BS19)National Natural Science Foundation of China:From Microrna 9 Regulate P2X7 Receptor of Microglia in Paraventricular Nucleus of Hypothalamus to Explore the Effect of Electroacupuncture on Sympathetic Nerve Excitability in Spontaneously Hypertensive Rats(No.82074553)。
文摘OBJECTIVE:To investigate the mechanism of electroacupuncture of sympathetic nerve activity and blood pressure reduction in the hypothalamic paraventricular nucleus(PVN)of spontaneous hypertensive rats(SHRs).METHODS:A total of 64 male SHRs were divided into four groups:model,sham-operated(Sham),electroacupuncture(EA),and N-methyl-D-aspartate receptor antagonist and electroacupuncture(NRA+EA).In addition,16 Wistar-Kyoto rats were used as controls.PVN stereotaxic surgery was performed in both the Sham and NRA+EA groups,while the EA and NRA+EA groups received 14 d of electroacupuncture.Blood pressure(BP)and heart rate(HR)were measured the day before the intervention and every other day.After 14 d of intervention,the rats in each group were tested for renal sympathetic nerve activity(RSNA).The associated factor levels were determined using Western blotting,reverse transcription-polymerase chain reaction(RTPCR),enzyme-linked immunosorbent assay(ELISA)and immunofluorescence assays.RESULTS:In comparison to the model group,the EA and NRA+EA groups had significantly lower BP,HR,and RSNA(P<0.01).The expression of N-methyl-Daspartate receptor(NMDAR),angiotensin II(Ang II),angiotensin II type 1(AT1),tumor necrosis factor-α,interleukin-1β,norepinephrine and arginine vasopressin was significantly lower in the EA and NRA+EA groups(P<0.01).Moreover,the antihypertensive effect of NRA+EA group outperformed to the EA group.CONCLUSIONS:Electroacupuncture effectively reduced the BP and sympathetic nerve excitability in SHRs.The mechanism was linked to the inhibition of NMDARmediated Ang II/AT1 and the inflammatory response in PVN.
基金supported by the National Key Research and Development Program of China(2022YFC3500404)the Natural Science Foundation of China(NSFC)(81704146,82205310)+1 种基金the Research Program Project of Tianjin Education Commission(2021KJ120)the National College Student Innovation and Entrepreneurship Training Program(202410063009)。
文摘Objective:The effectiveness of chemotherapy is affected by tumor heterogeneity and drug resistance mechanisms;however,there are certain limitations.Electroacupuncture can regulate the tumor immune response and restore bone marrow hematopoietic function,which is affected by chemotherapy.This study investigated the efficacy and mechanism of electroacupuncture combined with cisplatin in the treatment of non-small-cell lung cancer mice.Methods:To establish a mouse model of non-small-cell lung cancer,gene sequencing combined with bioinformatics analysis,flow cytometry,and liquid-phase chips was used to observe the expression of immune cells and related factors in the mouse tumor microenvironment.Flow cytometry was used to observe subpopulations of mouse bone marrow hematopoietic stem cells and progenitor cells.PAC1 receptor agonists were used to observe mouse tumor immunity and bone marrow hematopoiesis-related indicators.Results:The combination of electroacupuncture with high-and low-dose chemotherapy had a better tumor-suppressive effect.Electroacupuncture can affect the gene expression profile of immune cells,especially the expression levels of Ccr1,Cxcr5,Zbp1,and CamkIIα,and increases the levels of interferon-γ(IFN-γ)and interleukin(IL)-2 protein,upregulating the levels of cytokines Ccl4,Ccl3,and IL-6 in the tumor tissue.Additionally,electroacupuncture enhanced the infiltration of CD8+T cells,dendritic cells,and M1-type macrophages at the tumor site,and reduced the proportion of Th17 and Treg cells.Furthermore,electroacupuncture remodels the bone marrow hematopoietic microenvironment after chemotherapy by increasing the number of bone marrow hematopoietic stem cell subsets,leukocytes,and subpopulations in the peripheral blood.PAC1 receptor agonists have similar effects to those of electroacupuncture on hematopoietic protection and tumor immunity after chemotherapy.Conclusions:Electroacupuncture may improve chemotherapy-induced bone marrow suppression,reshape the tumor microenvironment immune response affected by chemotherapy,and change the tumor immune microenvironment to an anti-tumor mode by regulating tumor local immune-related cytokines.The PAC1 receptor may be a drug target for the treatment of myelosuppression and immunosuppression in patients with tumors.
基金supported by Shanghai Clinical Research Center for Acupuncture and Moxibustion(No.20MC1920500)National Administration of Traditional Chinese Medicine High-Level Disciplines Construction Project(No.ZYYZDXK-2023068)Three Year Action Plan for Shanghai to Further Accelerate the Inheritance,Innovation and Development of Traditional Chinese Medicine(2025-2027)(No.1-1-2)。
文摘Background:Electroacupuncture(EA)may affect the severity of hot flashes(HFs)associated with natural menopause and provide additional benefits for postmenopausal women.However,the evidence for its effectiveness in the management of early postmenopausal HFs remains inadequately understood.Objective:We designed this trial to assess the efficacy and safety of EA for relieving early postmenopausal HFs.Design,setting,participants and interventions:This randomized sham-controlled trial involved 72 women with HFs.The participants were divided equally into the intervention and control groups.The intervention group was treated with EA,while the control group was treated with sham acupuncture.The main acupoints used were Hegu(LI4),Guanyuan(RN4),Sanyinjiao(SP6),Taixi(KI3),Fuliu(KI7)and Shenshu(BL23).All participants received 18 treatment sessions,distributed across a 6-week period.The treatment was administered on three occasions per week,adhering to a fixed weekday schedule(Monday,Wednesday,Friday or Tuesday,Thursday,Saturday)with a minimum interval of one day between sessions.Each patient received a 12-week follow-up.Main outcome measures:The HF score was the primary outcome.Participants documented the frequency and severity of HFs in a 7-day symptom diary,which provided data for calculating the HF score.Secondary outcomes were the Menopause Rating Scale(MRS),Menopause-Specific Quality of Life Questionnaire(MENQOL),Pittsburgh Sleep Quality Index(PSQI)and Traditional Chinese Medicine Syndrome Score Scale(TCMSSS),as well as estradiol(E2),luteinizing hormone(LH)and folliclestimulating hormone(FSH)levels.Results:Both groups demonstrated significant reductions in HF scores after the treatment and during the follow-up(P<0.001).Immediately after completion of the 6-week treatment cycle and at 12 weeks postintervention,the HF scores were similar in both groups.At week 6,the intervention group showed significantly greater improvements in MRS,MENQOL(vasomotor,psychosocial,and physical),PSQI and TCMSSS scores(P<0.05).The improvements in the MENQOL(vasomotor,and psychosocial)and PSQI total scores persisted through the follow-up(P<0.05).However,the results showed no significant inter-or intragroup differences in sexual scores on the MENQOL(P>0.05).EA did not significantly decrease E2,LH or FSH levels compared to placebo.The incidence of adverse events was similar in both groups.Conclusion:EA does not significantly improve HFs in early postmenopausal patients.However,it enhances the quality of sleep and decreases menopausal symptoms across vasomotor,psychosocial and physical domains.Trial registration:Chinese Clinical Trial Registry(http://www.chictr.org.cn);Trial ID:Chi CTR2300072002.Please cite this article as:Wang HX,Yu XT,Hu J,Chen JJ,Mei YT,Chen YF.Electroacupuncture for hot flashes in early menopause:A randomized sham-controlled trial.J Integr Med.2025;23(5):519-527.?2025 Shanghai Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.Published by Elsevier B.V.All rights are reserved,including those for text and data mining,AI training,and similar technologies.
基金Supported by the National Natural Science Foundation of China:Exploration of Key Factors and Mechanisms of Modulating Motor Function Reconstruction After Cerebral Infarction Through Multimodal Brain Functional Connectivity Perspective in Procedural Acupoint Electrical Stimulation Research(No.82374601)the Jointly Guided Program of Natural Science Foundation of Heilongjiang Province:Quantitative Study on the Role of Scalp Acupuncture in the Motor Area in Promoting Motor Function Reconstruction after Stroke(No.LH2019H113)+1 种基金the Innovation Team Construction Project of Heilongjiang University of Chinese Medicine:Construction of a Doctoral Research and Innovation Team in Acupuncture Science(No.2017sit01)the Traditional Chinese Medicine Research Project of Heilongjiang Province:Clinical Study on the Promotion of Upper Limb Motor Function Reconstruction in Post-Stroke Patients Using Optimal Limb Positioning with Electroacupuncture(No.ZHY2022-171)。
文摘OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)at scalp motor area for treating post-stroke wrist dyskinesia and its influence on the function of wrist movement-related agonistic muscles.METHODS:A randomized,single-blind,controlled clinical trial was conducted.Sixty-six patients undergoing post-stroke wrist dyskinesia were enrolled and randomized 1:1 to EA or control group.Patients in the control group received manual acupuncture in the scalp motor area(MS 6)on the lesion side.The same acupoint was selected to accept EA stimulation in the EA group.All patients were treated six times a week for three weeks.The primary outcome was the Chinese Stroke Scale(CSS)score.The secondary outcomes included upper limb-related Barthel Index(BI)score,active range of motion(AROM)of the wrist joint,and root mean square(RMS)of the four agonistic muscles associated with wrist motion on the hemiplegic side of patients,i.e.,the extensor carpi radialis longus(ECRL),extensor digitorum(ED),flexor carpi radialis(FCR)and flexor carpi ulnaris(FCU).The above indicators were measured before and after three weeks of treatment.RESULTS:After 3-week treatment,the CSS score and AROM of wrist dorsiflexion of the EA group were better than those in the control group(P=0.038,P=0.047).The differences between the two groups of BI scores and AROM of wrist flexion were not significant(P>0.05).All RMS of the EA group were higher than those in the control group(ECRL:P=0.047,ED:P=0.048,FCR:P=0.049,FCU:P=0.047).The total effective rate in the EA group was 87.50%(28/32),which was higher than that in the control group(77.42%,24/31,P=0.048).CONCLUSION:EA stimulation of the scalp motor area can promote the recovery of the strength and function of the agonistic muscles related to wrist movement and effectively improve post-stroke wrist dyskinesia.
基金Supported by National Basic Evidence-based Capacity Building Project of Traditional Chinese Medicine([2019]130)Natural Science Foundation of Liaoning Province:2024-MS-042+1 种基金Xingliao Talent Program Medical Master Project:YXMJ-QNMZY-10Liaoning University of Traditional Chinese Medicine Key Laboratory of Traditional Chinese Medicine Theory and Application of Ministry of Education open fund project:zyzx2302.
文摘Background Unsedated colonoscopy is an important method used for diagnosing colorectal cancer,but it can cause discomfort such as pain and bloating,as well as anxiety.At present,the relief is mainly achieved through methods such as changing positions and manual pressing,but the efficacy is limited.Hence alternative therapies for sedation and analgesia in unsedated colonoscopy warrant further study.Electroacupuncture(EA)can simplify the procedure of anesthesia and analgesia,while the efficacy of EA on unsedated colonoscopy remains unclear.Therefore,a well-designed randomized controlled trial is needed to demonstrate the potential efficacy of acupuncture in unsedated colonoscopy,particularly for pain relief.Methods In this prospective randomized sham-controlled trial,105 eligible participants will be recruited and randomly assigned to either EA group(n=35),sham EA group(n=35),or control group(n=35)in a 1:1:1 ratio.The EA group will receive acupuncture intervention on bilateral Hegu(LI4),Neiguan(PC6),Zusanli(ST36),and Shenmen(HT7),with LI4 and PC6 on both sides connected to the EA device.The sham EA group will received non transdermal needling on points of no meridian,and deliberately connect the needle to the incorrect output socket of EA device to block the stimulation.The needling will conducted from 30 min before the unsedated colonoscopy to the end of the colonoscopy,the whole retention time would be approximately 40 min.The participants in the control group will not receive any acupuncture intervention.All participants of the three groups will not receive any other treatment.Primary outcomes:Numerical Rating Scale(NRS)reported by participants and Face Pain Scale Revised(FPS-R)evaluated by observers of four areas of the participants during the unsedated colonoscopy.Secondary outcomes:tolerance reported by endoscopists,tolerance reported by participants,satisfaction reported by endoscopists,satisfaction reported by participants,adverse events during the unsedated colonoscopy,postoperative discomfort,unsedated colonoscopy smoothness(cecal insertion time,unwinding time,success rate of one-time intubation).Both intention-to-treat(ITT)and per-protocol(PP)analyses will be performed to assess the efficacy of EA.Discussion The trial will explore the efficacy of relieving pain,improving tolerability,and reducing undesirable adverse events of EA for unsedated colonoscopy.The results of this trial will provide sound evidence for promoting the clinical application of EA for unsedated colonoscopy.Trial registration ClinicalTrials.gov Identifier:ChiCTR2300069903,retrospectively registered on March 16,2023.
基金Supported by the Capital Health Development Research Special Program:2022-4-7016。
文摘Objective To evaluate the efficacy and safety of electroacupuncture(EA)for postoperative recovery in patients with gastrointestinal(GI)cancers.Methods We retrieved articles from PubMed,Embase,OVID,Cochrane Library,Web of Science,CINAHL,SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang,and Technology Journal Database(VIP)from database inception to November 1,2024.Randomized controlled trials(RCTs)that examine the use of EA to improve GI function,reduce pain,and promote ability ofself-care after GI cancer surgery were included.Based on the type of control interventions,separate meta-analyses were conducted for EA vs postoperative nursing(PN)and EA vs sham acupuncture(SA).The primary outcomes were the time to first flatus(TFF)and the time to first defecation(TFD).The secondary outcomes included the time to recovery of bowel sounds(TRBS),the time to tolerance of liquid diet(TTLD),the time to tolerance of semiliquid diet(TTSD),the time to independent walking(TIW),the length of hospitalization(LH),and visual analog scale(VAS)immediate resting pain scores measured on the first,second and third postoperative days(POD 1–3).Results are reported as mean differences(MDs)with 95%confidence intervals(CIs).RevMan 5.3 was used for meta-analysis,StataSE 15.1 was used for sensitivity analyses and Egger’s tests.This study was registered on PROSPERO(CRD42022314754).Results A total of 19 RCTs involving 1902 participants were included,all of which were conducted in China between 2004 and 2023.When EA compared with PN,the meta-analysis showed EA significantly reduce TFF(n=673,MD=-13.14,95%CI=[-18.97 to-7.31],P<0.00001),TFD(n=598,MD=-19.86,95%CI=[-27.83 to-11.89],P<0.00001),TRBS(n=216,MD=-12.44,95%CI=[-15.00 to-9.87],P<0.00001),TTLD(n=268,MD=-18.14,95%CI=[-24.98 to-11.29],P<0.00001),TTSD(n=141,MD=-20.44,95%CI=[-33.84 to-7.04],P=0.003),VAS on POD 1(n=299,MD=-0.52,95%CI=[-0.92 to-0.11],P=0.01),VAS on POD 2(n=256,MD=-0.91,95%CI=[-1.23 to-0.60],P<0.00001),VAS on POD 3(n=203,MD=-0.57,95%CI=[-0.80 to-0.34],P<0.00001),while no significantly decreasing in the LH(n=322,MD=-1.16,95%CI=[-2.56 to 0.24],P=0.10).As EA compared with SA,EA could significantly reduce TFF(n=782,MD=-15.78,95%CI=[-24.96 to-6.60],P=0.0008),TFD(n=782,MD=-20.42,95%CI=[-36.14 to-4.70],P=0.01),LH(n=782,MD=-1.37,95%CI=[-2.69 to-0.05],P=0.04),TIW(n=743,MD=-0.33,95%CI=[-0.62 to-0.04],P=0.03).13 studies reported that EA reduced the incidence of postoperative complications,and 7 studies reported safety assessments of acupuncture-related adverse events,including hematoma,residual needling,sharp pain,pain,soreness or swelling after needle removal,with no serious adverse events.Conclusion EA can significantly promote the recovery of GI function,reduce postoperative pain,enhance ability of self-care in patients undergoing surgery for GI cancers.
基金supported by the National Key R&D Program of China(2022YFC3500405,2019YFC1712105)The National Science Foundation of China(82374075)+1 种基金The National Comprehensive Traditional Chinese Medicine Reform Demonstration Zone Science and Technology Collaborative Development Project(GZY-KJS-SD-2024-046)Taishan Scholar Youth Project of Shandong Province(tsqn202306188).
文摘Objective:Arrhythmia-induced cardiomyopathy(AIC)is a reversible dilated cardiomyopathy induced by rapid or irregular heartbeat.Acupuncture has a long history of use in the treatment of cardiac diseases,and Xinshu(BL15)is a key acupoint.However,the underlying mechanism of acupuncture at BL15 in the treatment of AIC has not yet been elucidated.Methods:AIC was induced in adult male Sprague-Dawley(SD)rats by continuous administration of acetylcholine(ACh)-CaCl2 and treatment with electroacupuncture(EA)at bilateral BL15.Echocardiography was used to evaluate cardiac function;the rotarod test for motor coordination and performance;hematoxylin and eosin(HE)staining for the morphology of ventricles;electrocardiogram for susceptibility,inducibility,and duration of atrial fibrillation(AF);and electrical and optical mapping in isolated rat hearts maintained by the Langendorff perfusion system for electrical conduction and intracellular handling,respectively.Reverse transcription quantitative polymerase chain reaction(RT-qPCR)and Western blotting were used to determine the levels of cardiac conduction and intracellular calcium-handling proteins in the ventricle.Results:The results showed that EA improved the ejection factor and morphological indices on echocardiography,restored motor coordination and performance,and alleviated ventricular dilation and AF onset.EA alleviates atrial conduction disorders,shortens APD80,and decreases calcium handling in rats with AIC.Cx43 was downregulated and CaMKII was upregulated,and both effects were reversed by EA treatment.Conclusion:Our study provides a novel AIC model with abnormal electrical propagation and calcium handling that can be protected by EA at BL15.This potential mechanism may be associated with the modulation of Cx43 and CaMKII expression.
文摘BACKGROUND Postoperative intestinal paralysis is common in gastrointestinal surgery,and the study of electroacupuncture mechanisms is of great significance.AIM To explore the neuroimmune regulatory mechanism of electroacupuncture at the Zusanli acupoint(ST36)in postoperative intestinal paralysis following gastrointestinal surgery.METHODS A total of 156 patients admitted to the Affiliated Hospital of Jiangnan University between January 2022 and October 2024 for postoperative intestinal paralysis following gastrointestinal surgery were randomly divided into two groups:A control group and an electroacupuncture group,with 75 patients in each.The control group received conventional Western medical treatment,while the electroacupuncture group received electroacupuncture in addition to this,at the bilateral Zusanli acupoints.Both groups received treatment for 7 days.Clinical efficacy,gastrointestinal function recovery,and gastrointestinal hormone[motilin(MTL),gastrin(GAS)],neurotransmitter[vasoactive intestinal peptide(VIP),nitric oxide(NO)],and inflammatory cytokine[tumor necrosis factor-α(TNF-α),serum interleukin-6(IL-6),interleukin-1β(IL-1β)]levels were compared between the two groups before and seven days after treatment.Adverse reactions were also recorded.RESULTS The electroacupuncture group demonstrated a higher overall treatment effectiveness rate and faster recovery of bowel sounds,as well as faster first defecation and first flatus than the control group(P<0.05).After seven days of treatment,MTL and GAS levels were significantly higher and VIP,NO,TNF-α,IL-6 and IL-1βlevels were significantly lower in the electroacupuncture group than in the control group(P<0.05).No adverse reactions were observed in either group during treatment.CONCLUSION Electroacupuncture at the Zusanli acupoint can enhance clinical efficacy,promote the recovery of gastrointestinal function,and regulate the neuroimmune microenvironment in patients with intestinal paralysis after gastrointestinal surgery.This mechanism may involve excitation of the vagus nerve and activation of the cholinergic antiinflammatory pathway through electroacupuncture stimulation of the Zusanli acupoint.
基金Supported by Beijing Natural Science Foundation(7232130)Fundamental Research Funds for the Central Universities(2024-JYB-JBZD-024)CZ015-High Level Traditional Chinese Medicine Hospital SM Project(DZMG-LJRC0006)。
文摘Objective To evaluate the changes in postoperative plasmaβ-endorphin(β-EP)levels in patients who had received perioperative electroacupuncture(EA)treatment in 10 randomized controlled trials(RCTs)and examine the impact of EA on postoperative pain.Methods This meta-analysis evaluated the changes in plasmaβ-EP levels and visual analog scale(VAS)12,24 and 48 hours after surgery in patients receiving perioperative EA.It also assessed the changes in plasma serotonin(5-hydroxytryptamine,5-HT)and prostaglandin E2(PGE2)levels at 24 hours postsurgery.A comprehensive search was conducted in the China National Knowledge Infrastructure(CNKI),Wanfang,Chongqing VIP database,Chinese Biomedical Database(CBM),Web of Science,and PubMed databases.RCTs on perioperative EA andβ-EP published from the inception of the websites up to July 25,2023,were retrieved.Effect size aggregation,literature quality assessment,and bias analysis were performed using RevMan 5.3 software,and sensitivity analysis was conducted via R 4.3.1.Results A total of 10 RCTs involving 706 patients were included.EA in conjunction with conventional anesthesia significantly increased plasmaβ-EP levels at 12 hours postsurgery[standard mean difference(SMD)=2.79,95%CI(1.85,3.72),Z=5.81,P<0.00001],24 hours postsurgery[SMD=1.87,95%CI(0.9,2.83),Z=3.79,P=0.0001],and 48 hours postsurgery[SMD=2.02,95%CI(1.49,2.54),Z=7.50,P<0.00001].EA reduced plasma PGE2 levels at 24 hours postsurgery and plasma 5-HT levels at 24 hours postsurgery,and the VAS at 12,24 and 48 hours after surgery also decreased.Conclusion These findings suggest that perioperative EA markedly elevates plasmaβ-EP levels,reduces pain-inducing factors in plasma,and effectively alleviates acute postoperative pain.
基金Supported by Chongqing Municipal Health and Family Planning Commission and Chongqing Municipal Science and Technology Commission Jointly Funded Key Research Projects in Traditional Chinese Medicine,No.ZY201801007。
文摘BACKGROUND Knee osteoarthritis(KOA)is a chronic condition characterized by joint pain and dysfunction,driven by aging and obesity.Research indicates that the gut microbiota significantly influences KOA,potentially affecting inflammation and disease progression through the gut-joint axis.Traditional treatments like nonsteroidal anti-inflammatory drugs offer symptom relief but have adverse effects.Emerging therapies like electroacupuncture(EA)and Tuina(TN)have shown promise in alleviating pain and improving joint function by targeting the gut microbiota.AIM To clarify the efficacy of EA with TN in treating KOA and its effect on gut microbiota regulation.METHODS Sixty patients with KOA were allocated to EA or EA+TN(ET)group(n=30 each).Seven acupoints were punctured.The ET group received TN after each EA session.Both groups completed 12 sessions.The visual analog scale(VAS)for assessing pain and the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)for measuring pain intensity,joint stiffness,and functional capacity were employed to assess clinical outcomes.Pre-and post-treatment fecal specimens underwent 16S ribosomal RNA sequencing to analyze the gut microbiota.RESULTS The ET group showed higher rates of“effective”and“markedly effective”outcomes.The VAS score of the ET group remained significantly lower than that of the EA group(P<0.001)immediately after treatment and 1 week post-treatment.The total WOMAC score(P<0.001),pain(P=0.191),stiffness(P=0.015),and function scores(P<0.001)decreased significantly in the ET group post-treatment.The gut microbiota analysis revealed no significant changes in alpha diversity in either group.Beta-diversity analysis indicated distinct patterns in the ET group before and after treatment.Significant changes in microbial abundance were detected in both groups,highlighting variations in Firmicutes,Actinobacteria,Proteobacteria,and Bacteroidetes.CONCLUSION ET outperforms EA alone in improving KOA pain,stiffness,and function,potentially via gut microbiota modulation,intestinal barrier protection,and inflammation reduction.
基金supported by the Anhui Provincial Department of Education Outstanding Young Teachers Cultivation Key Project(No.YQZD2023046)the Anhui University of Traditional Chinese Medicine School Talent Support Program Project(Nos.DT2400000222 and DT2100000545)。
文摘Objective:To elucidate the specific mechanisms by which electroacupuncture(EA)alleviates anxiety and fear behaviors associated with posttraumatic stress disorder(PTSD),focusing on the role of lipocalin-2(Lcn2).Methods:The PTSD mouse model was subjected to single prolonged stress and shock(SPS&S),and the animals received 15 min sessions of EA at Shenmen acupoint(HT7).Behavioral tests were used to investigate the effects of EA at HT7 on anxiety and fear.Western blotting and enzyme-linked immunosorbent assay were used to quantify Lcn2 and inflammatory cytokine levels in the prefrontal cortex(PFC).Additionally,the activity of PFC neurons was evaluated by immunofluorescence and in vivo electrophysiology.Results:Mice subjected to SPS&S presented increased anxiety-and fear-like behaviors.Lcn2 expression in the PFC was significantly upregulated following SPS&S,leading to increased expression of the proinflammatory cytokines tumor necrosis factor-a and interleukin-6 and suppression of PFC neuronal activity.However,EA at HT7 inhibited Lcn2 release,reducing neuroinflammation and hypoexcitability in the PFC.Lcn2 overexpression mitigated the effects of EA at HT7,resulting in anxiety-and fear-like behaviors.Conclusion:EA at HT7 can ameliorate PTSD-associated anxiety and fear,and its mechanism of action appears to involve the inhibition of Lcn2-mediated neural activity and inflammation in the PFC.
文摘BACKGROUND Cervical spondylosis(CS)frequently co-occurs with generalized anxiety disorder(GAD),presenting a complex clinical challenge.Managing CS-related pain in patients with GAD is particularly challenging because of the bidirectional relationship between pain and anxiety,necessitating integrated treatment strategies.AIM To evaluate the efficacy of electroacupuncture(EA)in treating CS-related pain and anxiety in patients with GAD.METHODS This retrospective cohort study analyzed data from 83 patients with CS-related pain and GAD who received EA treatment over 2-year period.Pain intensity was assessed using the visual analog scale,and anxiety symptoms were measured using the Hamilton Anxiety Rating Scale.Additionally,neuroinflammatory markers,including interleukin-6,tumor necrosis factor-alpha,and high-sensitivity C-reactive protein,were examined.Outcomes were evaluated at baseline,after 4 weeks,and after 8 weeks of treatment.RESULTS EA treatment significantly reduced CS-related pain(mean visual analog scale reduction:3.24±1.18;P<0.001)and improved anxiety symptoms(mean Hamilton Anxiety Rating Scale reduction:7.83±2.65;P<0.001)after 8 weeks of treatment.Neuroinflammatory markers also showed significant reductions,with interleukin-6 and tumor necrosis factor-alpha levels decreasing by 32.7%and 28.5%,respectively(P<0.01).Pain reduction was significantly correlated with improvements in anxiety symptoms(r=0.68;P<0.001)and a decrease in inflammatory markers(r=0.54;P<0.01).CONCLUSION EA demonstrates significant efficacy in reducing CS-related pain in patients with comorbid GAD,along with concurrent improvements in anxiety symptoms and neuroinflammatory profiles.These findings suggest that EA may offer a valuable integrative approach for managing this complex clinical presentation,potentially addressing both pain and anxiety through the modulation of neuroinflammatory pathways.
基金supported by High-Level Chinese Medical Hospital Promotion ProjectHLCMHPP2023089.
文摘Objective:To investigate whether the presence or absence of improvement in chronic severe functional constipation(CSFC)at the early stage of treatment with electroacupuncture predicts subsequent response or non-response,and to determine the optimal treatment duration for assessing subsequent responses to electroacupuncture.Methods:This is a post hoc analysis using data pooled from two large-scale randomized controlled trials.Patients with CSFC were recruited,and those in the electroacupuncture groups were included in the present study.Early improvement was defined as a weekly increase of≥1 complete spontaneous bowel movement(CSBM)compared to baseline.Three treatment response criteria were evaluated:≥3CSBMs per week,overall CSBM response,and sustained CSBM response.Predictive statistics,including sensitivity,specificity,positive predictive value,and negative predictive value,were calculated at weeks1–4.Receiver operating characteristic curves and accuracy rates were used to determine the optimal timepoint for differentiation between responders and non-responders.Results:Cases from a total of 813 participants who received electroacupuncture were analyzed.The proportion of improvers was 40.34%by week 1,increasing to 52.52%by week 4.After 8 weeks of treatment,the response rates were 30.14%,25.83%and 25.58%according to the three aforementioned criteria,respectively.Early improvement was a strong predictor of treatment response,with week 3 demonstrating the highest predictive accuracy.Conclusion:Early improvement with electroacupuncture,especially at week 3,can predict subsequent outcomes.Our findings suggest that acupuncturists may identify non-responders who might require adjustments to therapeutic strategies early in treatment.
基金National Natural Science Foundation of China,Grant/Award Number:32172930。
文摘Background:Existing remedial approaches for relieving neuropathic pain(NPP)are challenging and open the way for alternative therapeutic measures such as electroacupuncture(EA).The mechanism underlying the antinociceptive effects of repeated EA sessions,particularly concerning the regulation of the Adora3 receptor and its associated enzymes,has remained elusive.Methods:This study used a mouse model of spared nerve injury(SNI)to explore the cumulative analgesic effects of repeated EA at ST36(Zusanli)and its impact on Adora3 regulation in the spinal cord dorsal horn(SCDH).Forty-eight male mice underwent SNI surgery for induction of neuropathic pain and were randomly assigned to the SNI,SNI+2EA,SNI+4EA,and SNI+7EA groups.Spinal cord(L4-L6)was sampled for immunofluorescence,adenosine(ADO)detection and for molecular investigations following repeated EA treatment.Results:Following spared nerve injury(SNI),there was a significant decrease in mechanical withdrawal thresholds(PWTs)and thermal nociceptive withdrawal latency(TWL)in the ipsilateral hind paw on the third day post-surgery,while the contralateral hind paw PWTs showed no significant changes.On subsequent EA treatments,the SNI+EA groups led to a significant increase in pain thresholds(p<0.05).Repeated EA sessions in SNI mice upregulated Adenosine A3(Adora3)and cluster of differentiation-73(CD73)expression while downregulating adenosine deaminase(ADA)and enhancing neuronal instigation in the SCDH.Colocalization analysis of Neun-treated cells revealed increased Adora3 expression,particularly in the SNI+7EA group.Conclusions:In conclusion,cumulative electroacupuncture treatment reduced neuropathic pain by regulating Adora3 and CD73 expression,inhibiting ADA and most likely increasing neuronal activation in the SCDH.This study offers a promising therapeutic option for managing neuropathic pain,paving the way for further research.
基金supported by the Natural Science Foundation of Sichuan Province(2023NSFSC1799)the Science and Technology Development Fund of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine(23YY07)National Natural Science Foundation of China(82405413).
文摘Background:Obesity represents a major public health issue,closely linked to a range of metabolic and reproductive disorders.Electroacupuncture(EA)has emerged as a potential non-pharmacological intervention that may alleviate complications associated with obesity,including reproductive dysfunction.Objectives:This study sought to evaluate the impact of EA on leptin/kisspeptin signaling pathways and hypothalamic inflammation in obese male rats,with the aim of elucidating its potential mechanisms in mitigating reproductive disorders related to obesity.Methods:Forty male Wistar rats were allocated into two groups:a regular diet(RD,n=10)group and a high-fat diet(HFD,n=30)group.Following an 8-week period,23 out of the 30 rats in the HFD group satisfied the criteria for the obesity model,characterized by a body weight surpassing 20%of the average body weight of the RD group.From these 23 obese rats,20 were randomly selected and further subdivided into the Model(n=10)and EA(n=10)groups.The EA group underwent EA treatment at the Zusanli(ST36),Shenshu(BL23),and Sanyinjiao(SP6)acupoints over a duration of 4 weeks.The study assessed parameters including body weight,serum lipid levels,reproductive hormone levels,hypothalamic histology,inflammation markers,and neurotransmitter levels.Results:EA treatment significantly reduced body weight,improved lipid profiles,and restored hormone levels towards those seen in control animals.Histological analysis showed improved neuronal integrity and a shift in microglial polarization towards an anti-inflammatory phenotype in the EA group.EA treatment was associated with improvements in leptin and kisspeptin signaling activity,which may contribute to its beneficial effects on reproductive function in obese male rats.Neurotransmitter profiling and untargeted serum metabolomics revealed significant improvements in metabolic pathways related to amino acid and lipid metabolism,including key pathways associated with dopamine,serotonin,and glutamine.Conclusions:EA significantly alleviated obesity-induced reproductive dysfunction by modulating leptin and kisspeptin signaling,reducing hypothalamic inflammation,and improving neurotransmitter and serum metabolic profiles,suggesting its potential as a therapeutic strategy for reproductive issues related to obesity.Additional research is essential to investigate the molecular pathways of EA and assess its clinical applicability.
基金Supported by General Program of the National Natural Science Foundation of China(81973883)Three-Year Action Plan Project for Enhancing Clinical Skills and Clinical Innovation Capabilities of Municipal Hospitals(SHDC2020CR1010A).
文摘[Objectives]To explore the effects of electroacupuncture combined with rehabilitation training on knee joint function,three-dimensional(3D)gait,and inflammatory markers in patients with knee osteoarthritis(KOA)of cold-dampness obstruction syndrome.[Methods]A total of 162 KOA patients admitted to Huadong Hospital Affiliated to Fudan University from January 2021 to May 2023 were enrolled and randomly divided into an electroacupuncture group and a control group,with 81 patients in each group.The control group received routine rehabilitation training,while the electroacupuncture group received electroacupuncture treatment in addition to the same rehabilitation training,both for 4 weeks.The efficacy,syndrome scores,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Lysholm Knee Score(LKS),3D gait parameters,and levels of inflammatory markers were compared between the two groups.[Results]Following treatment,the total effective rate in the electroacupuncture group was 92.59%,which was significantly higher than 77.78%observed in the control group(P<0.05).Additionally,the electroacupuncture group exhibited lower TCM syndrome scores(P<0.05),reduced WOMAC scores,and elevated LKS scores compared to the control group(P<0.05).Gait parameters,including step frequency,step speed,stride length,initial ground contact flexion angle,maximum swing phase extension angle,and support phase extension angle,were all higher in the electroacupuncture group.Additionally,the sagittal plane maximum abduction moment was lower in the electroacupuncture group.Inflammatory markers showed that interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were lower in the electroacupuncture group,while transforming growth factor-β1(TGF-β1)was higher(P<0.05).[Conclusions]Electroacupuncture combined with rehabilitation training effectively enhances clinical efficacy,alleviates symptoms,improves knee joint mobility and walking ability,enhances knee function scores,and reduces inflammatory levels,contributing to the rapid recovery of knee joints in KOA patients.
基金National Natural Science Foundation of China(82274641,81873372,and 82105012).
文摘Objective To investigate the mechanism of in alleviating colonic mucosal inflammation in ten-eleven translocation(TET)protein 2 gene knockout(TET2^(-/-))mice with ulcerative colitis(UC)by regulating DNA methyltransferase(DNMT)and DNA hydroxymethylase.Methods Male specific pathogen-free(SPF)grade C57BL/6J wild-type(WT)mice(n=8)and TET2^(-/-)mice(n=20)were used to establish UC models by freely drinking 3%dextran sulfate sodium solution for 7 d.After UC model validation through histopathological examination in two mice from each type,the remaining mice were divided into four groups(n=6 in each group):WT model(WT+UC),TET2^(-/-)model(TET2^(-/-)+UC),TET2^(-/-)mild moxibustion(TET2^(-/-)+MM),and TET2^(-/-)electroacupuncture(TET2^(-/-)+EA)groups.TET2^(-/-)+MM group received mild moxibustion on Tianshu(ST25)and Qihai(CV6)for 10 min daily for 7 d.The TET2^(-/-)+EA group also applied electroacupuncture(1 mA,2/100 Hz)at the same acupoints for 10 min daily for 7 d.The disease activity index(DAI)scores of each group of mice were accessed daily.The colon lengths of mice in groups were measured following intervention.The pathological changes in the colon tissues were observed with hematoxylin and eosin(HE)staining.The concentrations of interleukin(IL)-6,C-C motif chemokine 17(CCL17),and C-X-C motif chemokine ligand 10(CXCL10)in serum were detected by enzyme-linked immunosorbent assay(ELISA).The expression of DNMT proteins(DNMT1,DNMT3A,and DNMT3B)in the colon tissues was detected by immunohistochemistry.The expression of 5-methylcytosine(5-mC),5-hydroxymethylcytosine(5-hmC),histone deacetylase 2(HDAC2),and DNA hydroxymethylase family proteins(TET 1 and TET3)was detected using immunofluorescence,which also determined the co-localization of TET1 and IL-6 protein.Results Compared with WT+UC group,TET2^(-/-)+UC group exhibited significantly higher DAI scores and shorter colon lengths(P<0.01).Both mild moxibustion and electroacupuncture significantly decreased DAI scores and ameliorated colon shortening in TET2^(-/-)mice(P<0.001).Histopathological scores of TET2^(-/-)+UC mice were significantly higher than those of WT+UC group(P<0.001)and were significantly reduced after both mild moxibustion and electroacupuncture interventions(P<0.001).Serum levels of IL-6,CCL17,and CXCL10 were significantly elevated in TET2^(-/-)+UC group compared with WT+UC group(P<0.001).Mild moxibustion significantly reduced IL-6,CCL17,and CXCL10 levels(P<0.001,P<0.001,and P<0.01,respectively),while electroacupuncture also significantly reduced IL-6,CCL17,and CXCL10 levels(P<0.05,P<0.01,and P<0.01,respectively).TET2^(-/-)+UC mice showed increased expression levels of DNMT1,DNMT3A,DNMT3B,and 5-mC(P<0.05,P<0.01 and P<0.001,respectively),with decreased expression levels of TET1,TET3,5-hmC,and HDAC2(P<0.001).Mild moxibustion significantly reduced DNMT1,DNMT3B,and 5-mC levels(P<0.05,P<0.01,and P<0.001,respectively),while increasing expression levels of TET1,TET3,5-hmC,and HDAC2(P<0.001,P<0.001,P<0.05,and P<0.001,respectively).Electroacupuncture significantly decreased 5-mC and DNMT3B levels(P<0.001 and P<0.01,respectively)and increased 5-hmC and HDAC2 levels(P<0.05 and P<0.001,respectively),but did not significantly affect TET1 and TET3 expression(P>0.05).Compared with TET2^(-/-)+MM group,TET2^(-/-)+EA group showed significantly higher 5-mC expression(P<0.001).TET2^(-/-)+UC group exhibited markedly increased IL-6 expression and higher co-localization of TET1 and IL-6 in mucosal epithelium,whereas minimal IL-6 expression was observed in the other groups.Conclusion Mild moxibustion and electroacupuncture significantly ameliorate colonic inflammation exacerbated by TET2 deficiency in UC mice via epigenetic modulation.Distinct mechanisms exist between the two interventions:mild moxibustion regulates both DNMT and hydroxymethylase,whereas electroacupuncture primarily affects DNMT.
