High-quality clinical evidence is the basis of evidence-based medical practice.Acupuncture is the most widely used complementary and alternative medicine in the world.However,the improvement in the quality of acupunct...High-quality clinical evidence is the basis of evidence-based medical practice.Acupuncture is the most widely used complementary and alternative medicine in the world.However,the improvement in the quality of acupuncture clinical research does not match the rapid increase in the number of acupuncture clinical research in recent years.At present,the number of high-quality acupuncture clinical research in the world remains low.Taking the trial of acupuncture for chronic spontaneous urticaria published in Annals of Internal Medicine as an example,this paper discusses the factors that contribute to producing high-quality clinical evidence for acupuncture from the aspects of selecting the topic of study,formulating the study method,designing the study plan,controlling the study process,writing the study report,and selecting the journal in the process of before,during,and after the research.It emphasizes the necessity to start from the benefit of global people's health,take practical clinical problems as guidance,cleverly choose the research entry point,and conduct high-quality research with clinical value.After the accomplishment of the study,the results must be faithfully described,the scientific conclusions accurately sublimated,and appropriate scientific journals selected for publication.展开更多
Objective:Growing evidence suggests a strong link between gut microbiota and the pathogenesis of urticaria,positioning the gut-skin axis as a novel therapeutic target.Despite the efficacy of acupuncture in alleviating...Objective:Growing evidence suggests a strong link between gut microbiota and the pathogenesis of urticaria,positioning the gut-skin axis as a novel therapeutic target.Despite the efficacy of acupuncture in alleviating urticaria symptoms,the underlying mechanisms remain poorly understood.We investigated the effects of electroacupuncture on gut microbiota in a rat model of urticaria.Methods:Sprague-Dawley rats were randomly divided into three groups:control,model,and electroacupuncture.An urticaria model was established by combining active systemic and passive cutaneous allergic reactions.Electroacupuncture treatment was administered for 7 days,during which the number of scratches,the diameter of skin sensitization blue spots,and degranulation rate of mast cells were recorded.Inflammation in the sensitized skin was assessed using hematoxylin and eosin staining,and the composition of the gut microbiota was analyzed using 16S rRNA gene sequencing.Results:Electroacupuncture significantly reduced the frequency of scratching,the diameter of sensitized blue spots,and the degranulation rate of mast cells in rats.The staining results revealed that electroacupuncture decreased inflammatory cell infiltration and fibrous tissue proliferation in the sensitized skin.The 16S rRNA gene sequencing demonstrated that electroacupuncture adjusted the ratio of Firmicutes to Bacteroidetes.Receiver operating characteristic(ROC)curve analysis identified Parabacteroides johnsonii as a potential biomarker for diagnosing urticaria(AUC=0.8516,where AUC stands for the area under the curve)and Lactobacillus reuteri and Limosilactobacillus as potential biomarkers for predicting the effectiveness of acupuncture treatment(AUC=0.8281).Conclusion:Electroacupuncture may alleviate urticaria symptoms by modulating the gut microbiota,providing new theoretical and practical directions for acupuncture treatment of urticaria.展开更多
Objective:To explore the association between acupuncture during controlled ovarian hyperstimulation(COH)and the live birth rate(LBR)using different propensity score methods.Methods:In this retrospective cohort study,e...Objective:To explore the association between acupuncture during controlled ovarian hyperstimulation(COH)and the live birth rate(LBR)using different propensity score methods.Methods:In this retrospective cohort study,eligible women who underwent a COH were divided into acupuncture and non-acupuncture groups.The primary outcome was LBR,as determined by propensity score matching(PSM).LBR was defined as the delivery of one or more living infants that reached a gestational age over 28 weeks after embryo transfer.The propensity score model encompassed 16 confounding variables.To validate the results,sensitivity analyses were conducted using three additional propensity score methods:propensity score adjustment,inverse probability weighting(IPW),and IPW with a"doubly robust”estimator.Results:The primary cohort encompassed 9751 patients(1830[18.76%]in the acupuncture group and7921[81.23%]in the non-acupuncture group).Following 1:1 PSM,a higher LBR was found in the acupuncture cohort(41.4%[755/1824]vs 36.4%[664/1824],with an odds ratio of 1.23[95%confidence interval,1.08-1.41]).Three additional propensity score methods produced essentially similar results.The risk of serious adverse events did not significantly differ between the two groups.Conclusion:This retrospective study revealed an association between acupuncture and an increased LBR among patients undergoing COH,and that acupuncture is a safe and valuable treatment option.展开更多
Background:The use of inserted sham acupuncture as a placebo in randomized controlled trials(RCTs)is controversial,because it may produce specific effects that cause an underestimation of the effect of acupuncture tre...Background:The use of inserted sham acupuncture as a placebo in randomized controlled trials(RCTs)is controversial,because it may produce specific effects that cause an underestimation of the effect of acupuncture treatment.Objective:This systematic survey investigates the magnitude of insert-specific effects of sham acupuncture and whether they affect the estimation of acupuncture treatment effects.Search strategy:PubMed,Embase and Cochrane Central Register of Controlled Trials were searched to identify acupuncture RCTs from their inception until December 2022.Inclusion criteria:RCTs that evaluated the effects of acupuncture compared to sham acupuncture and no treatment.Data extraction and analysis:The total effect measured for an acupuncture treatment group in RCTs were divided into three components,including the natural history and/or regression to the mean effect(controlled for no-treatment group),the placebo effect,and the specific effect of acupuncture.The first two constituted the contextual effect of acupuncture,which is mimicked by a sham acupuncture treatment group.The proportion of acupuncture total effect size was considered to be 1.The proportion of natural history and/or regression to the mean effect(PNE)and proportional contextual effect(PCE)of included RCTs were pooled using meta-analyses with a random-effect model.The proportion of acupuncture placebo effect was the difference between PCE and PNE in RCTs with non-inserted sham acupuncture.The proportion of insert-specific effect of sham acupuncture(PIES)was obtained by subtracting the proportion of acupuncture placebo effect and PNE from PCE in RCTs with inserted sham acupuncture.The impact of PIES on the estimation of acupuncture's treatment effect was evaluated by quantifying the percentage of RCTs that the effect of outcome changed from no statistical difference to statistical difference after removing PIES in the included studies,and the impact of PIES was externally validated in other acupuncture RCTs with an inserted sham acupuncture group that were not used to calculate PIES.Results:This analysis included 32 studies with 5492 patients.The overall PNE was 0.335(95%confidence interval[CI],0.255-0.415)and the PCE of acupuncture was 0.639(95%CI,0.567-0.710)of acupuncture's total effect.The proportional contribution of the placebo effect to acupuncture's total effect was 0.191,and the PIES was 0.189.When we modeled the exclusion of the insert-specific effect of sham acupuncture,the acupuncture treatment effect changed from no difference to a significant difference in 45.45%of the included RCTs,and in 40.91%of the external validated RCTs.Conclusion:The insert-specific effect of sham acupuncture in RCTs represents 18.90%of acupuncture's total effect and significantly affects the evaluation of the acupuncture treatment effect.More than 40%of RCTs that used inserted sham acupuncture would draw different conclusions if the PIES had been controlled for.Considering the impact of the insert-specific effect of sham acupuncture,caution should be taken when using inserted sham acupuncture placebos in RCTs.展开更多
Background: Insomnia is a common complaint that is closely related to gastrointestinal symptoms, which is consistent with the traditional Chinese medicine classical theory of ‘‘stomach disharmony leading to restless...Background: Insomnia is a common complaint that is closely related to gastrointestinal symptoms, which is consistent with the traditional Chinese medicine classical theory of ‘‘stomach disharmony leading to restless sleep." Acupuncture is an effective complementary and alternative medicine therapy to improve gastrointestinal function and restore the normal sleep-wake cycle. However, studies on the effectiveness of acupuncture for insomnia due to spleen-stomach disharmony syndrome are limited to case reports and few randomized controlled trials; deeper research on its mechanism is still lacking. This randomized controlled trial aims to assess the treatment efficacy of ‘‘harmonizing stomach to tranquilize mind"acupuncture for insomnia and its influence on the intestinal microbiome.Methods/design: This is a randomized, single-blind, parallel-group study. Sixty eligible patients with insomnia due to spleen-stomach disharmony syndrome will be randomly divided into two groups(1:1 allocation ratio). The intervention group will use ‘‘harmonizing stomach to tranquilize mind"acupuncture, and the control group will receive sham acupuncture. Participants will receive 5 acupuncture treatment sessions per week for 4 consecutive weeks. The Pittsburgh Sleep Quality Index will be used to evaluate the clinical efficacy of acupuncture treatment by making assessments at baseline, the end of treatment and the end of the follow-up. High-throughput 16 S ribosomal ribonucleic acid gene sequencing will be performed to detect changes in the intestinal microbial composition before and after treatment.Discussion: The results of this trial are expected to confirm that ‘‘harmonizing stomach to tranquilize mind" acupuncture can effectively relieve insomnia and alter the intestinal microbiome.展开更多
Acupuncture at Baihui （GV20） and Dazhui （GV14） reduces neuronal loss and attenuates ultra- structural damage in cerebral ischemic rats. However, whether acupuncture can treat addiction and prevent readdiction thro...Acupuncture at Baihui （GV20） and Dazhui （GV14） reduces neuronal loss and attenuates ultra- structural damage in cerebral ischemic rats. However, whether acupuncture can treat addiction and prevent readdiction through changes to brain cell ultrastructure remains unknown. In this study, cell apoptosis was observed in the hippocampus and frontal lobe of heroin readdicted rats by electron microscopy. Immunohistochemical staining displayed a reduction in Bcl-2 ex- pression and an increase in Bax expression in the hippocampus and frontal lobe. After rats were given acupuncture at Baihui and Dazhui, the pathological damage in the hippocampus and frontal lobe was significantly reduced, Bcl-2 expression was upregulated and Bax expression was downregulated. Acupuncture exerted a similar effect with methadone, a commonly used drug for clinical treatment of drug addiction. Experimental findings suggest that acupuncture at Dazhui and Baihui can prevent brain cell apoptosis in heroin readdicted rats.展开更多
OBJECTIVE:To assess the effectiveness and safety of acupuncture for post-stroke fatigue(PSF).METHODS:Eight online databases were searched to collect relevant trials of acupuncture for PSF published before April 2021.M...OBJECTIVE:To assess the effectiveness and safety of acupuncture for post-stroke fatigue(PSF).METHODS:Eight online databases were searched to collect relevant trials of acupuncture for PSF published before April 2021.Meta-analysis was performed by using RevMan 5.4 software.The Grading of Recommendations,Assessment,Development and Evaluation system was used to assess the certainty of evidence.RESULTS:Four randomized controlled trials involving 289 PSF patients were identified and included in the systematic review.The results of the Meta-analysis revealed that acupuncture group was significantly better than routine treatment group in improving the effective rate[risk ratio(RR)=1.15,95%CI(1.01,1.33),P=0.04],reducing the FSS score[mean difference(MD)=-4.71,95%CI(-6.22,-3.20),P<0.00001]and FMA score[MD=15.60,95%CI(11.96,19.23),P<0.00001].Side effects of acupuncture were mild and rarely reported.The certainty of evidence of the outcomes based on the four trials was assessed as low.CONCLUSIONS:The existing evidence suggests acupuncture as an adjunct to routine treatment may benefit in managing fatigue in stroke patients.However,high-quality RCTs are needed to further confirm these findings.展开更多
Background: Some depressed patients receive acupuncture as an adjunct to their conventional medications.Objective: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness ...Background: Some depressed patients receive acupuncture as an adjunct to their conventional medications.Objective: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategy: English and Chinese databases were searched for randomized controlled trials(RCTs)published until December 1, 2021.Inclusion criteria: RCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysis: Meta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose.The Grading of Recommendations Assessment, Development and Evaluation(GRADE) framework was used to evaluate the overall quality of evidence in the included studies.Results: This review included 16 studies(with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17(HAMD-17) scores(standard mean difference [SMD]-0.44, 95% confidence interval [CI]-0.55 to-0.33, P < 0.01;I^(2)= 14%), Self-rating Depression Scale(SDS) scores(SMD-0.53, 95% CI-0.84 to-0.23, P < 0.01;I^(2)= 79%), and the Side Effect Rating Scale(SERS) scores(SMD-1.11, 95% CI-1.56 to-0.66, P < 0.01;I^(2)= 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores(SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01;I^(2)= 15%), decreased the number of participants who increased their antidepressant dosages(relative risk[RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01;I^(2)= 0%), and resulted in significantly higher remission rates(RR1.52, 95% CI 1.26 to 1.83, P < 0.01;I^(2)= 0%) and treatment responses(RR 1.35, 95% CI 1.24 to 1.47, P < 0.01;I^(2)= 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.Conclusion: Acupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.展开更多
Objective:To clarify altered whole brain functional connectivity of the anterior cingulate cortex(ACC)in functional dyspepsia(FD)patients,and then to explore cerebral influence of acupuncture with deqi treating for FD...Objective:To clarify altered whole brain functional connectivity of the anterior cingulate cortex(ACC)in functional dyspepsia(FD)patients,and then to explore cerebral influence of acupuncture with deqi treating for FD.Methods:Thirty-two FD patients and 35 healthy subjects(HS)were firstly scanned by the resting-state blood oxygenation level-dependent functional magnetic resonance imaging(BOLD-fMRI)to compare differences of ACC-based functional connectivity(FC).Then 32 FD patients were randomized to receive 20 sessions’acupuncture treatment with(n=16)and without deqi(n=16),as well as underwent functional magnetic resonance imaging(fMRI)scans after treatment.After group re-division according to deqi response,changes of ACC subregions-based resting-state FC(rsFC)were compared between the actual with and without deqi group.Two seeds with bilateral of each were selected as regions of interest(ROIs)of the ACC,including two from the dorsal ACC:S2(BA24)(x=±5,y=2,z=46,r=3.5 mm)and two from the pregenual ACC:17(BA24)(x=±5,y=38,z=6,r=3.5 mm).The clinical changes of the Nepean Dyspepsia Index(NDI)that measuring symptoms and quality of life(QOL)were also used to further assess the correlation with ACC subregions rsFC in FD patients.Results:Compared to HS,FD patients showed significantly increased ACC subregions rsFC with left fusiform gyrus,temporal cortex,hippocampus(HIPP)/amygdala,temporal pole,and right INS,superior occipital gyrus,and bilateral precuneus,superior parietal lobule(SPL),and decreased rsFC with left postcentral/precentral gyrus(PoG/PrG),supplementary motor area(SMA)and right cerebellum.32 FD patients which were then re-divided into the actual deqi group(n=16)and actual without deqi group(n=16).The decrease of the NDI symptom score(pre-pos)in the actual deqi group was significantly greater than that in the actual without deqi group(P<0.05).Among the two groups,the actual deqi group showed increased ACC subregions rsFC with right SMA and bilateral PrG/PoG,and decreased rsFC with right precuneus,middle occipital gyrus,bilateral posterior cingulate cortex(PCC),HIPP/paraHIPP,angular gyrus and SPL after treatment.In addition,the changed NDI QOL scores(pre-post)of the actual deqi group was significantly positively correlated with their Fisher’s transformed Z value of the altered ACC subregion(left I7)rsFC with right SPL(r=-0.597,P=0.04<0.05,FDR corrected P>0.05).Conclusion:The results tested the hypothesis that the advantage of deqi on efficacy is related to affecting the ACC subregions rsFC.It suggested that deqi might participate in the adaptive modulation of disrupted relationship between the ACC subregions and the default mode network(DMN).展开更多
Background: Functional constipation(FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Num...Background: Functional constipation(FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Numerous systematic reviews(SRs) examining the use of acupuncture to treat FC have reported inconsistent results, and the quality of these studies has not been fully evaluated.Objective: In this overview, we evaluated and summarized clinical evidence on the effectiveness and safety of acupuncture for treating FC and evaluated the quality and bias of the SRs we reviewed.Search strategy: The search strategy was structured by medical subject headings and search terms such as‘‘acupuncture therapy" and ‘‘functional constipation." Electronic searches were conducted in eight databases from their inception to September 2020.Inclusion criteria: SRs that investigated the effectiveness and safety of acupuncture for managing FC were included.Data extraction and analysis: Two authors independently extracted information and appraised the methodology, reporting accuracy, quality of evidence, and risk of bias using the following critical appraisal tools:(1) A Measurement Tool to Assess Systematic Reviews 2(AMSTAR 2);(2) Risk of Bias in Systematic Reviews(ROBIS);(3) Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture(PRISMA-A);and(4) the Grading of Recommendations, Assessment, Development and Evaluations(GRADE). A j index was used to score the level of agreement between the 2 reviewers.Results: Thirteen SRs that examined the clinical utility of acupuncture for treating FC were identified.Using the AMSTAR 2 tool, we rated 92.3%(12/13) of the SRs as ‘‘critically low" confidence and one study as ‘‘low" confidence. Using the ROBIS criteria, 38.5%(5/13) of the SRs were considered to have ‘‘low risk"of bias. Based on PRISMA-A, 76.9%(10/13) of the SRs had over 70% compliance with reporting standards.The inter-rater agreement was good for AMSTAR 2, ROBIS, and PRISMA-A. Using the GRADE tool, we classified 22.5%(9/40) of the measured outcomes as ‘‘moderate" quality, 57.5%(23/40) as ‘‘low" quality, and 20.0%(8/40) as ‘‘very low" quality. The inter-rater agreement was moderate when using GRADE.Descriptive analyses indicated that acupuncture was more efficacious than sham acupuncture for improving weekly complete spontaneous bowel movements(CSBMs) and for raising the Bristol Stool Form Scale(BSFS) score. Acupuncture appeared to be superior to anti-constipation drugs for improving weekly spontaneous bowel movements, the total effective rate, and the Patient Assessment of Constipation Quality of Life score. Although ten SRs mentioned the occurrence of adverse events, serious adverse events were not associated with acupuncture treatment.Conclusion: Acupuncture may be more efficacious than sham acupuncture for improving CSBMs and BSFS scores and may be superior to anti-constipation drugs for improving bowel movement frequency, as well as quality of life. Limitations to current studies and inconsistent evidence suggest a need for more rigorous and methodologically sound SRs to draw definitive conclusions.展开更多
Background:Polycystic ovary syndrome(PCOS)is the primary cause of anovulatory infertility,bringing serious harm to women’s physical and mental health.Acupuncture may be an effective treatment for PCOS.However,systema...Background:Polycystic ovary syndrome(PCOS)is the primary cause of anovulatory infertility,bringing serious harm to women’s physical and mental health.Acupuncture may be an effective treatment for PCOS.However,systematic reviews(SRs)on the efficacy and safety of acupuncture for PCOS have reported inconsistent results,and the quality of these studies has not been adequately assessed.Objective:To summarize and evaluate the current evidence on the efficacy and safety of acupuncture for PCOS,as well as to assess the quality and risks of bias of the available SRs.Search strategy:Nine electronic databases(Cochrane Library,MEDLINE,Embase,PsycINFO,CINAHL,Chinese National Knowledge Infrastructure,Wanfang Data,Chongqing VIP Chinese Science and Technology Periodical Database,and China Biology Medicine disc)were searched from their establishment to July 27,2022.Based on the principle of combining subject words with text words,the search strategy was constructed around search terms for“acupuncture,”“polycystic ovary syndrome,”and“systematic review.”Inclusion criteria:SRs of randomized controlled trials that explored the efficacy and(or)safety of acupuncture for treating patients with PCOS were included.Data extraction and analysis:Two authors independently extracted study data according to a predesigned form.Tools for evaluating the methodological quality,risk of bias,reporting quality,and confidence in study outcomes,including A Measurement Tool to Assess Systematic Reviews 2(AMSTAR 2),Risk of Bias in Systematic Reviews(ROBIS),Preferred Reporting Items for Systematic Reviews and Metaanalyses for Acupuncture(PRISMA-A),and the Grading of Recommendations Assessment,Development and Evaluation(GRADE),were used to score the included SRs.Results:A total of 885 studies were retrieved,and 11 eligible SRs were finally included in this review.The methodological quality of 2 SRs(18.18%)was low,while the other 9 SRs(81.82%)were scored as extremely low.Four SRs(36.36%)were considered to be of low risk of bias.As for reporting quality,the reporting completeness of 9 SRs(81.82%)was more than 70%.Concerning the confidence in study results,2study results were considered to have a high quality of evidence(3.13%),14(21.88%)a“moderate”quality,28(43.75%)a“low”quality,and 20(31.24%)considered a“very low”quality.Descriptive analyses suggested that combining acupuncture with other medicines can effectively improve the clinical pregnancy rate(CPR)and ovulation rate,and reduce luteinizing hormone/follicle-stimulating hormone ratio,homeostasis model assessment of insulin resistance,and body mass index(BMI).When compared with medicine alone,acupuncture alone also can improve CPR.Further,when compared with no intervention,acupuncture had a better effect in promoting the recovery of menstrual cycle and reducing BMI.Acupuncture was reported to cause no adverse events or some adverse events without serious harm.Conclusion:The efficacy and safety of acupuncture for PCOS remains uncertain due to the limitations and inconsistencies of current evidence.More high-quality studies are needed to support the use of acupuncture in PCOS.展开更多
Objective:To explore the core acupoints and combination rules of acupuncture therapy for postoperative urinary retention after hemorrhoidectomy,and,further to analyze the characteristics of the prescription of acupunc...Objective:To explore the core acupoints and combination rules of acupuncture therapy for postoperative urinary retention after hemorrhoidectomy,and,further to analyze the characteristics of the prescription of acupuncture therapy for postoperative urinary retention after hemorrhoidectomy.Methods:Relevant clinical studies in seven databases were searched systematically from database inception to 1 st October 2020.Based on data mining techniques,the core acupoints,characteristics and combination rules of acupuncture therapy for postoperative urinary retention after hemorrhoidectomy were analyzed comprehensively.Statistics collected and analysis of acupoint selection included the frequency of usage of acupoints,the meridian of acupoints,the location of acupoints and the combination of acupoints.Cluster and association analysis were performed utilizing Excel 13.0 and SPSS 26.0.Results:In the 36 studies included,the most frequently adopted acupoint was Sānyīnjiāo(三阴交 SP6);the most frequently adopted meridian was the foot-taiyin spleen meridian;the most frequently involved location was the lower limbs;and the most frequently adopted combination of acupoints was SP6 and Zhōngjí(中极CV 3).Cluster analysis showed that the acupoints could be divided into three categories:the first group comprised SP6 alone;the second group included CV3,Guānyuán(关元CV4),Yīnlíngquán(阴陵泉SP9) and Zúsānlǐ(足三里ST36);and the third group included Pángguāngshū(膀胱俞BL28),Chéngshān(承山BL57),Tàichōng(太冲LR3),Zhìbiān(秩边 BL54),Tàixī(太溪KI6),Hégǔ(合谷 LI4),Xuèhǎi(血海SP10),Qìhǎi(气海CV6) and Shǔidào(水道ST28).Conclusion:It was found that acupuncture therapy for postoperative urinary retention after hemorrhoidectomy mainly follows the four characteristic rules:the selection of acupoints following the meridian,selection of acupoints at local points,selection of acupoints at distal points and selection of acupoints according to special symptoms.展开更多
OBJECTIVE： To evaluate the efficacy and safety of acupuncture for optic atrophy. DATA SOURCES： A computer-based online search was conducted in Medline （1966-2008）, Embase （1986-2008）, the Cochrane Library （up t...OBJECTIVE： To evaluate the efficacy and safety of acupuncture for optic atrophy. DATA SOURCES： A computer-based online search was conducted in Medline （1966-2008）, Embase （1986-2008）, the Cochrane Library （up to 2008）, Chinese Biomedical Literature Database （1975-2008）, China National Knowledge Infrastructure （1994-2008）, VIP Database （1989-2008）, Wanfang Database （1980-2008） and the National Research Register for ongoing trials. DATA SELECTION： Randomized, controlled trials addressing acupuncture treatment for patients with optic atrophy were included in this review. Inclusion criteria evaluated all forms of acupuncture therapy, such as filiform needle, electro-acupuncture, laser-acupuncture, acupressure, and auricular-acupuncture. Comparisons between acupuncture therapy and no treatment （blank） or placebo or Chinese medicine or Western medicine, as well as between acupuncture as an adjuvant and other treatments, were included. Exclusion criteria included studies comparing different forms of acupuncture therapy, different manipulations of acupuncture, and different acupuncture prescriptions, as well as non-randomized, controlled trials and animal studies. The domain-based evaluation criteria recommended by the guidelines in Chapter 8 of the Cochrane Handbook for Systematic Reviews of Interventions 5.0.1 was used to assess quality of the included studies. According to the type of outcome index, measurement data as assessed by weighted mean difference or standardized mean difference and 95% confidence interval; numeration data was estimated by relative risk and 95% confidence interval. Heterogeneity was analyzed by Meta-analysis using RevMan 5.0 software. MAIN OUTCOME MEASURES： Improved visual acuity and visual field was sought between treatment and control groups in the included articles. RESULTS： Seven randomized, controlled trials were included after screening and application of inclusion and exclusion criteria. However, the studies were of low methodological quality and lacked comparisons between acupuncture and no treatment or placebo. Applying visual acuity as the outcome index, meta-analysis indicated： the effect of medicine combined with acupuncture was superior to the medicine alone （relative risk = 1.41, 95% confidence interval 1.14-1.70, P 〈 0.01 ）, the efficacy of acupuncture was better than medicine alone （relative risk =1.42, 95% confidence interval 1.14-1.77, P 〈 0.01 ）. Using visual field as the other outcome index, meta-analysis revealed： effectiveness of acupuncture or acupuncture in combination with medicine was superior to medicine alone （relative risk = 1.47, 95% confidence interval 1.27-1.69, P 〈 0.01 ）. The 7 included articles were incorporated in a sensitivity analysis, and the overall effect showed a significant difference （relative risk = 1.35, 95% confidence interval 1.16-1.56, P 〈 0.01）. Acupuncture was not associated with any adverse events in any of the studies. CONCLUSION： Acupuncture therapy was determined to be superior to medicine in terms of improved visual acuity and visual field. However, well-designed, randomized, controlled trials with adequate controls and scientific rigor are urgently needed.展开更多
Chronic respiratory diseases(CRDs)are among the most common noncommunicable diseases globally,with high morbidity and mortality rates.Acupuncture,a treatment method derived from Traditional Chinese Medicine,has been s...Chronic respiratory diseases(CRDs)are among the most common noncommunicable diseases globally,with high morbidity and mortality rates.Acupuncture,a treatment method derived from Traditional Chinese Medicine,has been shown to be effective at treating CRDs,with little risk of adverse effects.Scientific research on the mechanisms underlying the effects of acupuncture,especially,its immune regulatory function,has rapidly advanced in recent years.Herein,the diverse immune regulatory mechanisms underlying the beneficial effects of acupuncture are summarized from the perspectives of innate immunity,adaptive immunity,and neuroimmunity.A better understanding of these mechanisms will ultimately provide a scientific basis for the clinical use of acupuncture for the treatment of CRDs.展开更多
OBJECTIVES: To study the expression of inflammatory signal in local prostate tissue of chronic pelvic pain syndrome(CPPS) rats by electroacupuncture(EA) of Guanyuan(CV4), Zhongji(CV3), Huiyang(BL35) and Sanyinjiao(SP6...OBJECTIVES: To study the expression of inflammatory signal in local prostate tissue of chronic pelvic pain syndrome(CPPS) rats by electroacupuncture(EA) of Guanyuan(CV4), Zhongji(CV3), Huiyang(BL35) and Sanyinjiao(SP6), and to explore the possible mechanism of anti-inflammatory and analgesic effects of EA. METHODS : A total of 36 Sprague-Dawley male rats were randomly divided into three groups: control, model and EA(n=12 rats/group). The CPPS model was made by injection of CFA into ventral lobes of the prostate(0.1 m L). Electric acupuncture apparatus was applied to stimulate Guanyuan(CV4), Zhongji(CV3), bilateral Huiyang(BL35) and Sanyinjiao(SP6) acupoints in EA group. The general condition of rats was observed and the prostate index(PI) was calculated. The thermal pain threshold was collected after each therapeutic course. Histopathological changes of the prostate tissue were examined by hematoxylin-eosin staining method. The expression levels of tumor necrosis factor α(TNF-α), interleukin-1β(IL-1β) and prostaglandin E2(PGE2) in prostatic homogenates were measured by enzyme linked immunosorbent assay(ELISA). Moreover, the expression levels of purinergic 2X7 receptor(P2X7R), NOD-like receptor pyrin domain-containing 3(NLRP3), caspase-1 and interleukin-18(IL-18) m RNA were quantified by quantitative real-time polymerase chain reaction. RESULTS: Compared with control group, the PI of rats increased, and the thermal pain threshold decreased significantly in model group. The morphological structure of prostate tissues of rats in model group was severely damaged with a large number of inflammatory cells infiltration. Additionally, the levels of TNF-α, IL-1β and PGE2 were higher, and the expressions of P2X7R, NLRP3, caspase-1 and IL-18 m RNA were higher than those in control group. After EA treatment, the PI was significantly decreased, the thermal pain threshold was significantly increased, and the tissue damage was significantly improved. The expressions of inflammatory cytokines were lower in EA group, and expression of P2X7R/NLRP3 pathway was down-regulated. CONCLUSION: The effect of EA at Guanyuan(CV4), Zhongji(CV3), Huiyang(BL35) and Sanyinjiao(SP6) can improve inflammation and pain symptoms of CPPS rats induced by Complete Freund’s adjuvant(CFA). This suggests that EA at Guanyuan(CV4), Zhongji(CV3), Huiyang(BL35) and Sanyinjiao(SP6) can produce antiinflammatory analgesia effect by preventing the activation of P2X7R/NLRP3 signal pathway, inhibit the release of inflammatory cytokines in CPPS rats, which may provide a putative novel target for the treatment of CPPS.展开更多
OBJECTIVE:The aim of this study was to investigate the protective effects of Tuina(a traditional Chinese massage therapy)on intervertebral disc(IVD)degeneration and the regulatory mechanisms of the transforming growth...OBJECTIVE:The aim of this study was to investigate the protective effects of Tuina(a traditional Chinese massage therapy)on intervertebral disc(IVD)degeneration and the regulatory mechanisms of the transforming growth factor-β1(TGF-β1)/small mothers against decapentaplegic(Smad)signaling pathway.METHODS:Thirty New Zealand white rabbits were randomized into five groups:the control group,model group,model+Tuina group(Tuina group),model+TGF-β1 group(TGF-β1 group),and model+TGF-β1 inhibitor SB431542 group(SB431542 group).The model was established by posterolateral annulus fibrosus puncturing(AFP).Recombinant TGF-β1 and inhibitor SB431542 was injected into the TGF-β1 group and SB431542 group with a microsyringe,respectively.The rabbits in the Tuina group received Tuina treatment along the bladder meridian for 4 weeks.Magnetic resonance imaging(MRI)was performed on rabbits before AFP and after 4 weeks of intervention.Lumbar IVDs(L2-L3 to L4-L5)were harvested after intervention.Histopathological changes in the IVDs were measured by hematoxylin and eosin(HE)staining.Type I collagen was analyzed by immunohistochemistry detection.The expression level of matrix metalloproteinase-3(MMP3)was determined by enzyme-linked immunosorbent assay.Cell apoptosis was evaluated by terminal deoxynucleotidyl transferasemediated nick end labeling and Western blotting.Realtime polymerase chain reaction and Western blotting were used to analyze the expression of TGF-β1 and Smad2/3/4 and a disintegrin and metalloproteinase with thrombospondin motifs 5.RESULTS:Posterolateral AFP induced IVD degeneration in rabbits with histopathological damage and noticeable changes in MRI images.Tuina alleviated histopathological changes and reversed the expression of extracellular matrix degeneration-related molecules and apoptosis-related proteins.Furthermore,AFP induced the activation of TGF-β1 and Smad2/3/4,whereas Tuina therapy markedly reduced the protein expression of Smad2/3 and the gene expression of TGF-β1 and Smad2/3/4.Additionally,the TGF-β1/Smad signaling pathway was activated in the TGF-β1 group,while the TGF-β1/Smad signaling pathway was inhibited in the SB431542 group.CONCLUSION:Posterolateral AFP induced disc degeneration as determined by MRI assessment and histological analysis.Tuina alleviated disc degeneration,possibly by inhibiting the fibrotic response mediated by the TGF-β1/Smad pathway,thus alleviating extracellular matrix degeneration and reducing cell apoptosis.展开更多
Objective:To investigate the effect of acupuncture on advanced cancer patients by meta-analysis.Methods:Nine databases(the Cochrane Central Register of Controlled Trials,MEDLINE,Web of Science,Embase,China National Kn...Objective:To investigate the effect of acupuncture on advanced cancer patients by meta-analysis.Methods:Nine databases(the Cochrane Central Register of Controlled Trials,MEDLINE,Web of Science,Embase,China National Knowledge Infrastructure,the Cumulative Index to Nursing and Allied Health Literature,Chinese Biomedical Literature Database,China Science and Technology Journal Database,and Wan Fang Data)were searched for randomized controlled trials(RCTs)on acupuncture in advanced cancer patients published from inception to February 13,2023 and updated to June 1,2023.Primary outcomes were quality of life(QOL),while secondary outcomes were pain,fatigue,and adverse events(side effects).Data synthesis was performed using RevMan V.5.3 to calculate pooled effect sizes.RoB-2 was used for the risk of bias,and the quality of evidence was assessed using the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)tool.Results:Totally 17 RCTs involving 1,178 participants were included,15 of which were pooled for meta-analysis.Most studies demonstrated some concern for the overall risk of bias.The pooled data indicated that acupuncture was associated with improved QOL[mean difference(MD)=6.67,95%confidence interval(CI):5.09 to 8.26],pain(MD=–1.18,95%CI–2.28 to–0.08),and adverse events(risk ratio=0.30,95%CI:0.26to 0.57)compared with control groups.Fatigue outcome was not included.Heterogeneity was substantial,and GRADE evidence was very low for both QOL and pain.Conclusions:Acupuncture could benefit patients with advanced cancer and is considered safe compared with usual care.However,the evidence regarding QOL and pain outcomes requires further validation.It is crucial to encourage the development of high-quality studies to strengthen this evidence.(Registry No.CRD42023423539).展开更多
Cold tumors,defined by insufficient immune cell infiltration and a highly immunosuppressive tumor microenvironment(TME),exhibit limited responsiveness to conventional immunotherapies.This reviewsystematically summariz...Cold tumors,defined by insufficient immune cell infiltration and a highly immunosuppressive tumor microenvironment(TME),exhibit limited responsiveness to conventional immunotherapies.This reviewsystematically summarizes the mechanisms of immune evasion and the therapeutic strategies for cold tumors as revealed by multiomics technologies.By integrating genomic,transcriptomic,proteomic,metabolomic,and spatialmulti-omics data,the review elucidates key immune evasionmechanisms,including activation of the WNT/β-catenin pathway,transforming growth factor-β(TGF-β)–mediated immunosuppression,metabolic reprogramming(e.g.,lactate accumulation),and aberrant expression of immune checkpoint molecules.Furthermore,this review proposes multi-dimensional therapeutic strategies,such as targeting immunosuppressive pathways(e.g.,programmed death-1(PD-1)/programmed death-ligand 1(PD-L1)inhibitors combined with TGF-βblockade),reshaping the TME through chemokine-based therapies,oncolytic viruses,and vascular normalization,and metabolic interventions(e.g.,inhibition of lactate dehydrogenase A(LDHA)or glutaminase(GLS)).In addition,personalized neoantigen vaccines and engineered cell therapies(e.g.,T cell receptor-engineered T(TCR-T)and natural killer(NK)cells)show promising potential.Emerging evidence also highlights the role of epigenetic regulation(e.g.,histone deacetylase(HDAC)inhibitors)and N6-Methyladenosine(m6A)RNA modifications in reversing immune evasion.Despite the promising insights offered by multi-omics integration in guiding precision immunotherapy,challenges remain in clinical translation,including data heterogeneity,target-specific toxicity,and limitations in preclinical models.Future efforts should focus on coupling dynamic multi-omics technologies with intelligent therapeutic design to convert cold tumors into immunologically active(“hot”)microenvironments,ultimately facilitating breakthroughs in personalized immunotherapy.展开更多
Under the background of Artificial Intelligence(AI)and medical data informationization,intelligent Traditional Chinese Medicine(TCM)emerges as a new medical model.In this study,we introduce Affective Computing into th...Under the background of Artificial Intelligence(AI)and medical data informationization,intelligent Traditional Chinese Medicine(TCM)emerges as a new medical model.In this study,we introduce Affective Computing into the diagnosis and treatment process of TCM FiveTone Therapy.And proposes an intelligent diagnosis and treatment system including Five-tone diagnosis,monitoring and treatment,to achieve intelligent music matching.This system based on sound-image database for standardized collection and diagnosis of the Five-tone.The assessment and monitoring process are then visually presented,and an emotion analysis model is established by using affective computing.On the other hand,the system employs virtual reality(VR)visual media music and somatosensory music to play and intelligently match the Five-tone,solving issues in the clinical treatment of Five-tone therapy,such as the difficulties of quantifying emotional data,limited ability for generalization feature extraction,and relatively insufficient research on the intelligence of Five-tone therapy.This study can promote the integration of technology in the fields of healthcare,information,and music,thereby enhancing the accuracy of diagnosis and treatment.It holds significant importance in advancing the intelligent development of Traditional Chinese Medicine diagnosis and treatment.展开更多
Acupuncture is widely used to treat functional dyspepsia with satisfactory outcomes. Combination of the He and Mu acupoints is commonly used and has a synergistic effect on functional dyspepsia; however, its underlyin...Acupuncture is widely used to treat functional dyspepsia with satisfactory outcomes. Combination of the He and Mu acupoints is commonly used and has a synergistic effect on functional dyspepsia; however, its underlying mechanisms remain unclear. Therefore, a randomized controlled parallel clinical trial is currently underway at Chengdu University of Traditional Chinese Medicine, China. This trial is designed to explore the efficacy of and central responses to the He-Mu point combination in patients with functional dyspepsia using functional magnetic resonance imaging. A total of 105 patients with functional dyspepsia will be allocated into 3 groups： the low-He point group（puncturing at Zusanli（ST36））, Mu point group（puncturing at Zhongwan（CV12））, and He-Mu point combination group（puncturing at ST36 and CV12）. Every participant will receive 20 sessions of manual acupuncture for 4 weeks. The needles will be inserted perpendicularly to a depth of 1 to 2 cun. The angle of rotation and twisting will range from 90 to 180 degrees, while lifting and thrusting will range from 0.3 to 0.5 cm. The various manipulations will be performed 60 to 90 times per minute. The needles will remain in place for 30 minutes, during which manipulation will be applied every 10 minutes. Magnetic resonance imaging will be performed before and after 20 sessions of acupuncture. The primary outcome is symptom improvement according to the Chinese version of the Nepean Dyspepsia Index. Secondary outcomes include the Leeds dyspepsia questionnaire, Self-Rating Anxiety Scale, Self-Rating Depression Scale, Beck Anxiety Inventory, Beck Depression Inventory, and visual analogue scale scores before and after 10 and 20 sessions of acupuncture. Needle sensation and adverse events will be used to assess the therapeutic effects. This study will promote more widespread awareness of the benefits of acupoint combination in the clinical setting and provide a further explanation of the neuromechanism by which acupuncture at the He-Mu point combination for functional dyspepsia. Registration： Chinese Clinical Trial Registry, Chi CTR-IOR-15006402.展开更多
基金Supported by Sichuan Province science and technology education joint fund project:2024NSFSC1976Science and Technology Research Project of Sichuan Ad-ministration of Traditional Chinese Medicine:2021MS320.
文摘High-quality clinical evidence is the basis of evidence-based medical practice.Acupuncture is the most widely used complementary and alternative medicine in the world.However,the improvement in the quality of acupuncture clinical research does not match the rapid increase in the number of acupuncture clinical research in recent years.At present,the number of high-quality acupuncture clinical research in the world remains low.Taking the trial of acupuncture for chronic spontaneous urticaria published in Annals of Internal Medicine as an example,this paper discusses the factors that contribute to producing high-quality clinical evidence for acupuncture from the aspects of selecting the topic of study,formulating the study method,designing the study plan,controlling the study process,writing the study report,and selecting the journal in the process of before,during,and after the research.It emphasizes the necessity to start from the benefit of global people's health,take practical clinical problems as guidance,cleverly choose the research entry point,and conduct high-quality research with clinical value.After the accomplishment of the study,the results must be faithfully described,the scientific conclusions accurately sublimated,and appropriate scientific journals selected for publication.
基金supported by grants from the National Natural Science Foundation of China(82205283)the Natural Science Foundation of Sichuan Provincial Department of Science and Technology(24NSFSC1549)+1 种基金the China Postdoctoral Science Foundation(2022MD723719)Chengdu University of Traditional Chinese Medicine’s 2024 Undergraduate Innovation and Entrepreneurship Training Program Project(202410633015).
文摘Objective:Growing evidence suggests a strong link between gut microbiota and the pathogenesis of urticaria,positioning the gut-skin axis as a novel therapeutic target.Despite the efficacy of acupuncture in alleviating urticaria symptoms,the underlying mechanisms remain poorly understood.We investigated the effects of electroacupuncture on gut microbiota in a rat model of urticaria.Methods:Sprague-Dawley rats were randomly divided into three groups:control,model,and electroacupuncture.An urticaria model was established by combining active systemic and passive cutaneous allergic reactions.Electroacupuncture treatment was administered for 7 days,during which the number of scratches,the diameter of skin sensitization blue spots,and degranulation rate of mast cells were recorded.Inflammation in the sensitized skin was assessed using hematoxylin and eosin staining,and the composition of the gut microbiota was analyzed using 16S rRNA gene sequencing.Results:Electroacupuncture significantly reduced the frequency of scratching,the diameter of sensitized blue spots,and the degranulation rate of mast cells in rats.The staining results revealed that electroacupuncture decreased inflammatory cell infiltration and fibrous tissue proliferation in the sensitized skin.The 16S rRNA gene sequencing demonstrated that electroacupuncture adjusted the ratio of Firmicutes to Bacteroidetes.Receiver operating characteristic(ROC)curve analysis identified Parabacteroides johnsonii as a potential biomarker for diagnosing urticaria(AUC=0.8516,where AUC stands for the area under the curve)and Lactobacillus reuteri and Limosilactobacillus as potential biomarkers for predicting the effectiveness of acupuncture treatment(AUC=0.8281).Conclusion:Electroacupuncture may alleviate urticaria symptoms by modulating the gut microbiota,providing new theoretical and practical directions for acupuncture treatment of urticaria.
基金funded by the National Natural Science Foundation of China(No.81973966)。
文摘Objective:To explore the association between acupuncture during controlled ovarian hyperstimulation(COH)and the live birth rate(LBR)using different propensity score methods.Methods:In this retrospective cohort study,eligible women who underwent a COH were divided into acupuncture and non-acupuncture groups.The primary outcome was LBR,as determined by propensity score matching(PSM).LBR was defined as the delivery of one or more living infants that reached a gestational age over 28 weeks after embryo transfer.The propensity score model encompassed 16 confounding variables.To validate the results,sensitivity analyses were conducted using three additional propensity score methods:propensity score adjustment,inverse probability weighting(IPW),and IPW with a"doubly robust”estimator.Results:The primary cohort encompassed 9751 patients(1830[18.76%]in the acupuncture group and7921[81.23%]in the non-acupuncture group).Following 1:1 PSM,a higher LBR was found in the acupuncture cohort(41.4%[755/1824]vs 36.4%[664/1824],with an odds ratio of 1.23[95%confidence interval,1.08-1.41]).Three additional propensity score methods produced essentially similar results.The risk of serious adverse events did not significantly differ between the two groups.Conclusion:This retrospective study revealed an association between acupuncture and an increased LBR among patients undergoing COH,and that acupuncture is a safe and valuable treatment option.
基金the National Key R&D Program of China(No.2023YFC3503300 and No.2023YFC3503304)National Natural Science Foundation of China for Distinguished Young Scholars(No.82225049)and Youths(No.82305045)Fundamental Research Funds for the Central Public Welfare Research Institutes(No.2020YJSZX-3)。
文摘Background:The use of inserted sham acupuncture as a placebo in randomized controlled trials(RCTs)is controversial,because it may produce specific effects that cause an underestimation of the effect of acupuncture treatment.Objective:This systematic survey investigates the magnitude of insert-specific effects of sham acupuncture and whether they affect the estimation of acupuncture treatment effects.Search strategy:PubMed,Embase and Cochrane Central Register of Controlled Trials were searched to identify acupuncture RCTs from their inception until December 2022.Inclusion criteria:RCTs that evaluated the effects of acupuncture compared to sham acupuncture and no treatment.Data extraction and analysis:The total effect measured for an acupuncture treatment group in RCTs were divided into three components,including the natural history and/or regression to the mean effect(controlled for no-treatment group),the placebo effect,and the specific effect of acupuncture.The first two constituted the contextual effect of acupuncture,which is mimicked by a sham acupuncture treatment group.The proportion of acupuncture total effect size was considered to be 1.The proportion of natural history and/or regression to the mean effect(PNE)and proportional contextual effect(PCE)of included RCTs were pooled using meta-analyses with a random-effect model.The proportion of acupuncture placebo effect was the difference between PCE and PNE in RCTs with non-inserted sham acupuncture.The proportion of insert-specific effect of sham acupuncture(PIES)was obtained by subtracting the proportion of acupuncture placebo effect and PNE from PCE in RCTs with inserted sham acupuncture.The impact of PIES on the estimation of acupuncture's treatment effect was evaluated by quantifying the percentage of RCTs that the effect of outcome changed from no statistical difference to statistical difference after removing PIES in the included studies,and the impact of PIES was externally validated in other acupuncture RCTs with an inserted sham acupuncture group that were not used to calculate PIES.Results:This analysis included 32 studies with 5492 patients.The overall PNE was 0.335(95%confidence interval[CI],0.255-0.415)and the PCE of acupuncture was 0.639(95%CI,0.567-0.710)of acupuncture's total effect.The proportional contribution of the placebo effect to acupuncture's total effect was 0.191,and the PIES was 0.189.When we modeled the exclusion of the insert-specific effect of sham acupuncture,the acupuncture treatment effect changed from no difference to a significant difference in 45.45%of the included RCTs,and in 40.91%of the external validated RCTs.Conclusion:The insert-specific effect of sham acupuncture in RCTs represents 18.90%of acupuncture's total effect and significantly affects the evaluation of the acupuncture treatment effect.More than 40%of RCTs that used inserted sham acupuncture would draw different conclusions if the PIES had been controlled for.Considering the impact of the insert-specific effect of sham acupuncture,caution should be taken when using inserted sham acupuncture placebos in RCTs.
基金supported by a grant from the Science and Technology Planned Project of Sichuan Province,China (No.18YYJC0949)
文摘Background: Insomnia is a common complaint that is closely related to gastrointestinal symptoms, which is consistent with the traditional Chinese medicine classical theory of ‘‘stomach disharmony leading to restless sleep." Acupuncture is an effective complementary and alternative medicine therapy to improve gastrointestinal function and restore the normal sleep-wake cycle. However, studies on the effectiveness of acupuncture for insomnia due to spleen-stomach disharmony syndrome are limited to case reports and few randomized controlled trials; deeper research on its mechanism is still lacking. This randomized controlled trial aims to assess the treatment efficacy of ‘‘harmonizing stomach to tranquilize mind"acupuncture for insomnia and its influence on the intestinal microbiome.Methods/design: This is a randomized, single-blind, parallel-group study. Sixty eligible patients with insomnia due to spleen-stomach disharmony syndrome will be randomly divided into two groups(1:1 allocation ratio). The intervention group will use ‘‘harmonizing stomach to tranquilize mind"acupuncture, and the control group will receive sham acupuncture. Participants will receive 5 acupuncture treatment sessions per week for 4 consecutive weeks. The Pittsburgh Sleep Quality Index will be used to evaluate the clinical efficacy of acupuncture treatment by making assessments at baseline, the end of treatment and the end of the follow-up. High-throughput 16 S ribosomal ribonucleic acid gene sequencing will be performed to detect changes in the intestinal microbial composition before and after treatment.Discussion: The results of this trial are expected to confirm that ‘‘harmonizing stomach to tranquilize mind" acupuncture can effectively relieve insomnia and alter the intestinal microbiome.
基金financially sponsored by the Foundation for Excellent Young Talents in Universities of Anhui Province in China,No.2010SQRL105the National Natural Science Foundation of China,No.81173325
文摘Acupuncture at Baihui （GV20） and Dazhui （GV14） reduces neuronal loss and attenuates ultra- structural damage in cerebral ischemic rats. However, whether acupuncture can treat addiction and prevent readdiction through changes to brain cell ultrastructure remains unknown. In this study, cell apoptosis was observed in the hippocampus and frontal lobe of heroin readdicted rats by electron microscopy. Immunohistochemical staining displayed a reduction in Bcl-2 ex- pression and an increase in Bax expression in the hippocampus and frontal lobe. After rats were given acupuncture at Baihui and Dazhui, the pathological damage in the hippocampus and frontal lobe was significantly reduced, Bcl-2 expression was upregulated and Bax expression was downregulated. Acupuncture exerted a similar effect with methadone, a commonly used drug for clinical treatment of drug addiction. Experimental findings suggest that acupuncture at Dazhui and Baihui can prevent brain cell apoptosis in heroin readdicted rats.
基金Supported by National Key Basic Research and Development Program(No.2015CB554503)Collaborative Innovation Center for Moxibustion Therapy Research and Clinical Translation(No.5241400202)+1 种基金Jiangxi University of Chinese Medicine School-level Science and Technology Innovation Team Development Program(No.CXTD22010)Jiangxi University of Chinese Medicine Innovation Special Project(No.JZYC21B03)。
文摘OBJECTIVE:To assess the effectiveness and safety of acupuncture for post-stroke fatigue(PSF).METHODS:Eight online databases were searched to collect relevant trials of acupuncture for PSF published before April 2021.Meta-analysis was performed by using RevMan 5.4 software.The Grading of Recommendations,Assessment,Development and Evaluation system was used to assess the certainty of evidence.RESULTS:Four randomized controlled trials involving 289 PSF patients were identified and included in the systematic review.The results of the Meta-analysis revealed that acupuncture group was significantly better than routine treatment group in improving the effective rate[risk ratio(RR)=1.15,95%CI(1.01,1.33),P=0.04],reducing the FSS score[mean difference(MD)=-4.71,95%CI(-6.22,-3.20),P<0.00001]and FMA score[MD=15.60,95%CI(11.96,19.23),P<0.00001].Side effects of acupuncture were mild and rarely reported.The certainty of evidence of the outcomes based on the four trials was assessed as low.CONCLUSIONS:The existing evidence suggests acupuncture as an adjunct to routine treatment may benefit in managing fatigue in stroke patients.However,high-quality RCTs are needed to further confirm these findings.
基金supported by a grant from National Natural Science Foundation of China (grant number 82104983)Scientific Research Program by Traditional Chinese Medicine Bureau of Guangdong Province,China (grant number 20201103)Fundamental Research Funds for the Central Universities,China (grant number 21620362)。
文摘Background: Some depressed patients receive acupuncture as an adjunct to their conventional medications.Objective: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategy: English and Chinese databases were searched for randomized controlled trials(RCTs)published until December 1, 2021.Inclusion criteria: RCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysis: Meta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose.The Grading of Recommendations Assessment, Development and Evaluation(GRADE) framework was used to evaluate the overall quality of evidence in the included studies.Results: This review included 16 studies(with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17(HAMD-17) scores(standard mean difference [SMD]-0.44, 95% confidence interval [CI]-0.55 to-0.33, P < 0.01;I^(2)= 14%), Self-rating Depression Scale(SDS) scores(SMD-0.53, 95% CI-0.84 to-0.23, P < 0.01;I^(2)= 79%), and the Side Effect Rating Scale(SERS) scores(SMD-1.11, 95% CI-1.56 to-0.66, P < 0.01;I^(2)= 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores(SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01;I^(2)= 15%), decreased the number of participants who increased their antidepressant dosages(relative risk[RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01;I^(2)= 0%), and resulted in significantly higher remission rates(RR1.52, 95% CI 1.26 to 1.83, P < 0.01;I^(2)= 0%) and treatment responses(RR 1.35, 95% CI 1.24 to 1.47, P < 0.01;I^(2)= 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.Conclusion: Acupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.
基金grants from the National Natural Science Foundation of Outstanding Youth Fund in China:81622052National Natural Science Foundation of China:81473602+2 种基金the major program of the National Natural Science Foundation of China:81590950the Ten Thousand Talent Program:W02020595Youth Science and Technology Innovative Team of Sichuan Province:2019JDTD0011。
文摘Objective:To clarify altered whole brain functional connectivity of the anterior cingulate cortex(ACC)in functional dyspepsia(FD)patients,and then to explore cerebral influence of acupuncture with deqi treating for FD.Methods:Thirty-two FD patients and 35 healthy subjects(HS)were firstly scanned by the resting-state blood oxygenation level-dependent functional magnetic resonance imaging(BOLD-fMRI)to compare differences of ACC-based functional connectivity(FC).Then 32 FD patients were randomized to receive 20 sessions’acupuncture treatment with(n=16)and without deqi(n=16),as well as underwent functional magnetic resonance imaging(fMRI)scans after treatment.After group re-division according to deqi response,changes of ACC subregions-based resting-state FC(rsFC)were compared between the actual with and without deqi group.Two seeds with bilateral of each were selected as regions of interest(ROIs)of the ACC,including two from the dorsal ACC:S2(BA24)(x=±5,y=2,z=46,r=3.5 mm)and two from the pregenual ACC:17(BA24)(x=±5,y=38,z=6,r=3.5 mm).The clinical changes of the Nepean Dyspepsia Index(NDI)that measuring symptoms and quality of life(QOL)were also used to further assess the correlation with ACC subregions rsFC in FD patients.Results:Compared to HS,FD patients showed significantly increased ACC subregions rsFC with left fusiform gyrus,temporal cortex,hippocampus(HIPP)/amygdala,temporal pole,and right INS,superior occipital gyrus,and bilateral precuneus,superior parietal lobule(SPL),and decreased rsFC with left postcentral/precentral gyrus(PoG/PrG),supplementary motor area(SMA)and right cerebellum.32 FD patients which were then re-divided into the actual deqi group(n=16)and actual without deqi group(n=16).The decrease of the NDI symptom score(pre-pos)in the actual deqi group was significantly greater than that in the actual without deqi group(P<0.05).Among the two groups,the actual deqi group showed increased ACC subregions rsFC with right SMA and bilateral PrG/PoG,and decreased rsFC with right precuneus,middle occipital gyrus,bilateral posterior cingulate cortex(PCC),HIPP/paraHIPP,angular gyrus and SPL after treatment.In addition,the changed NDI QOL scores(pre-post)of the actual deqi group was significantly positively correlated with their Fisher’s transformed Z value of the altered ACC subregion(left I7)rsFC with right SPL(r=-0.597,P=0.04<0.05,FDR corrected P>0.05).Conclusion:The results tested the hypothesis that the advantage of deqi on efficacy is related to affecting the ACC subregions rsFC.It suggested that deqi might participate in the adaptive modulation of disrupted relationship between the ACC subregions and the default mode network(DMN).
基金supported by grants from the National Natural Science Foundation of China(No.8207455481774430)the Foundation of the Science and Technology Department of Sichuan Province,China(No.2021YJ0197)。
文摘Background: Functional constipation(FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Numerous systematic reviews(SRs) examining the use of acupuncture to treat FC have reported inconsistent results, and the quality of these studies has not been fully evaluated.Objective: In this overview, we evaluated and summarized clinical evidence on the effectiveness and safety of acupuncture for treating FC and evaluated the quality and bias of the SRs we reviewed.Search strategy: The search strategy was structured by medical subject headings and search terms such as‘‘acupuncture therapy" and ‘‘functional constipation." Electronic searches were conducted in eight databases from their inception to September 2020.Inclusion criteria: SRs that investigated the effectiveness and safety of acupuncture for managing FC were included.Data extraction and analysis: Two authors independently extracted information and appraised the methodology, reporting accuracy, quality of evidence, and risk of bias using the following critical appraisal tools:(1) A Measurement Tool to Assess Systematic Reviews 2(AMSTAR 2);(2) Risk of Bias in Systematic Reviews(ROBIS);(3) Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture(PRISMA-A);and(4) the Grading of Recommendations, Assessment, Development and Evaluations(GRADE). A j index was used to score the level of agreement between the 2 reviewers.Results: Thirteen SRs that examined the clinical utility of acupuncture for treating FC were identified.Using the AMSTAR 2 tool, we rated 92.3%(12/13) of the SRs as ‘‘critically low" confidence and one study as ‘‘low" confidence. Using the ROBIS criteria, 38.5%(5/13) of the SRs were considered to have ‘‘low risk"of bias. Based on PRISMA-A, 76.9%(10/13) of the SRs had over 70% compliance with reporting standards.The inter-rater agreement was good for AMSTAR 2, ROBIS, and PRISMA-A. Using the GRADE tool, we classified 22.5%(9/40) of the measured outcomes as ‘‘moderate" quality, 57.5%(23/40) as ‘‘low" quality, and 20.0%(8/40) as ‘‘very low" quality. The inter-rater agreement was moderate when using GRADE.Descriptive analyses indicated that acupuncture was more efficacious than sham acupuncture for improving weekly complete spontaneous bowel movements(CSBMs) and for raising the Bristol Stool Form Scale(BSFS) score. Acupuncture appeared to be superior to anti-constipation drugs for improving weekly spontaneous bowel movements, the total effective rate, and the Patient Assessment of Constipation Quality of Life score. Although ten SRs mentioned the occurrence of adverse events, serious adverse events were not associated with acupuncture treatment.Conclusion: Acupuncture may be more efficacious than sham acupuncture for improving CSBMs and BSFS scores and may be superior to anti-constipation drugs for improving bowel movement frequency, as well as quality of life. Limitations to current studies and inconsistent evidence suggest a need for more rigorous and methodologically sound SRs to draw definitive conclusions.
基金supported by grants from the National Natural Science Foundation of China (No. 82174517)
文摘Background:Polycystic ovary syndrome(PCOS)is the primary cause of anovulatory infertility,bringing serious harm to women’s physical and mental health.Acupuncture may be an effective treatment for PCOS.However,systematic reviews(SRs)on the efficacy and safety of acupuncture for PCOS have reported inconsistent results,and the quality of these studies has not been adequately assessed.Objective:To summarize and evaluate the current evidence on the efficacy and safety of acupuncture for PCOS,as well as to assess the quality and risks of bias of the available SRs.Search strategy:Nine electronic databases(Cochrane Library,MEDLINE,Embase,PsycINFO,CINAHL,Chinese National Knowledge Infrastructure,Wanfang Data,Chongqing VIP Chinese Science and Technology Periodical Database,and China Biology Medicine disc)were searched from their establishment to July 27,2022.Based on the principle of combining subject words with text words,the search strategy was constructed around search terms for“acupuncture,”“polycystic ovary syndrome,”and“systematic review.”Inclusion criteria:SRs of randomized controlled trials that explored the efficacy and(or)safety of acupuncture for treating patients with PCOS were included.Data extraction and analysis:Two authors independently extracted study data according to a predesigned form.Tools for evaluating the methodological quality,risk of bias,reporting quality,and confidence in study outcomes,including A Measurement Tool to Assess Systematic Reviews 2(AMSTAR 2),Risk of Bias in Systematic Reviews(ROBIS),Preferred Reporting Items for Systematic Reviews and Metaanalyses for Acupuncture(PRISMA-A),and the Grading of Recommendations Assessment,Development and Evaluation(GRADE),were used to score the included SRs.Results:A total of 885 studies were retrieved,and 11 eligible SRs were finally included in this review.The methodological quality of 2 SRs(18.18%)was low,while the other 9 SRs(81.82%)were scored as extremely low.Four SRs(36.36%)were considered to be of low risk of bias.As for reporting quality,the reporting completeness of 9 SRs(81.82%)was more than 70%.Concerning the confidence in study results,2study results were considered to have a high quality of evidence(3.13%),14(21.88%)a“moderate”quality,28(43.75%)a“low”quality,and 20(31.24%)considered a“very low”quality.Descriptive analyses suggested that combining acupuncture with other medicines can effectively improve the clinical pregnancy rate(CPR)and ovulation rate,and reduce luteinizing hormone/follicle-stimulating hormone ratio,homeostasis model assessment of insulin resistance,and body mass index(BMI).When compared with medicine alone,acupuncture alone also can improve CPR.Further,when compared with no intervention,acupuncture had a better effect in promoting the recovery of menstrual cycle and reducing BMI.Acupuncture was reported to cause no adverse events or some adverse events without serious harm.Conclusion:The efficacy and safety of acupuncture for PCOS remains uncertain due to the limitations and inconsistencies of current evidence.More high-quality studies are needed to support the use of acupuncture in PCOS.
文摘Objective:To explore the core acupoints and combination rules of acupuncture therapy for postoperative urinary retention after hemorrhoidectomy,and,further to analyze the characteristics of the prescription of acupuncture therapy for postoperative urinary retention after hemorrhoidectomy.Methods:Relevant clinical studies in seven databases were searched systematically from database inception to 1 st October 2020.Based on data mining techniques,the core acupoints,characteristics and combination rules of acupuncture therapy for postoperative urinary retention after hemorrhoidectomy were analyzed comprehensively.Statistics collected and analysis of acupoint selection included the frequency of usage of acupoints,the meridian of acupoints,the location of acupoints and the combination of acupoints.Cluster and association analysis were performed utilizing Excel 13.0 and SPSS 26.0.Results:In the 36 studies included,the most frequently adopted acupoint was Sānyīnjiāo(三阴交 SP6);the most frequently adopted meridian was the foot-taiyin spleen meridian;the most frequently involved location was the lower limbs;and the most frequently adopted combination of acupoints was SP6 and Zhōngjí(中极CV 3).Cluster analysis showed that the acupoints could be divided into three categories:the first group comprised SP6 alone;the second group included CV3,Guānyuán(关元CV4),Yīnlíngquán(阴陵泉SP9) and Zúsānlǐ(足三里ST36);and the third group included Pángguāngshū(膀胱俞BL28),Chéngshān(承山BL57),Tàichōng(太冲LR3),Zhìbiān(秩边 BL54),Tàixī(太溪KI6),Hégǔ(合谷 LI4),Xuèhǎi(血海SP10),Qìhǎi(气海CV6) and Shǔidào(水道ST28).Conclusion:It was found that acupuncture therapy for postoperative urinary retention after hemorrhoidectomy mainly follows the four characteristic rules:the selection of acupoints following the meridian,selection of acupoints at local points,selection of acupoints at distal points and selection of acupoints according to special symptoms.
基金Supported by: the National Key Basic ResearchDevelopment Plan Program of China, No. 2006CB504501
文摘OBJECTIVE： To evaluate the efficacy and safety of acupuncture for optic atrophy. DATA SOURCES： A computer-based online search was conducted in Medline （1966-2008）, Embase （1986-2008）, the Cochrane Library （up to 2008）, Chinese Biomedical Literature Database （1975-2008）, China National Knowledge Infrastructure （1994-2008）, VIP Database （1989-2008）, Wanfang Database （1980-2008） and the National Research Register for ongoing trials. DATA SELECTION： Randomized, controlled trials addressing acupuncture treatment for patients with optic atrophy were included in this review. Inclusion criteria evaluated all forms of acupuncture therapy, such as filiform needle, electro-acupuncture, laser-acupuncture, acupressure, and auricular-acupuncture. Comparisons between acupuncture therapy and no treatment （blank） or placebo or Chinese medicine or Western medicine, as well as between acupuncture as an adjuvant and other treatments, were included. Exclusion criteria included studies comparing different forms of acupuncture therapy, different manipulations of acupuncture, and different acupuncture prescriptions, as well as non-randomized, controlled trials and animal studies. The domain-based evaluation criteria recommended by the guidelines in Chapter 8 of the Cochrane Handbook for Systematic Reviews of Interventions 5.0.1 was used to assess quality of the included studies. According to the type of outcome index, measurement data as assessed by weighted mean difference or standardized mean difference and 95% confidence interval; numeration data was estimated by relative risk and 95% confidence interval. Heterogeneity was analyzed by Meta-analysis using RevMan 5.0 software. MAIN OUTCOME MEASURES： Improved visual acuity and visual field was sought between treatment and control groups in the included articles. RESULTS： Seven randomized, controlled trials were included after screening and application of inclusion and exclusion criteria. However, the studies were of low methodological quality and lacked comparisons between acupuncture and no treatment or placebo. Applying visual acuity as the outcome index, meta-analysis indicated： the effect of medicine combined with acupuncture was superior to the medicine alone （relative risk = 1.41, 95% confidence interval 1.14-1.70, P 〈 0.01 ）, the efficacy of acupuncture was better than medicine alone （relative risk =1.42, 95% confidence interval 1.14-1.77, P 〈 0.01 ）. Using visual field as the other outcome index, meta-analysis revealed： effectiveness of acupuncture or acupuncture in combination with medicine was superior to medicine alone （relative risk = 1.47, 95% confidence interval 1.27-1.69, P 〈 0.01 ）. The 7 included articles were incorporated in a sensitivity analysis, and the overall effect showed a significant difference （relative risk = 1.35, 95% confidence interval 1.16-1.56, P 〈 0.01）. Acupuncture was not associated with any adverse events in any of the studies. CONCLUSION： Acupuncture therapy was determined to be superior to medicine in terms of improved visual acuity and visual field. However, well-designed, randomized, controlled trials with adequate controls and scientific rigor are urgently needed.
基金Supported by the Sichuan Science and Technology Application Foundation Plan(No.2021YFS0039)the Project of Sichuan Provincial Administration of Traditional Chinese Medicine(No.2020LC0031)the foundation of Chengdu University of Traditional Chinese Medicine(No.YYZX2019039 and YYZX2019038)。
文摘Chronic respiratory diseases(CRDs)are among the most common noncommunicable diseases globally,with high morbidity and mortality rates.Acupuncture,a treatment method derived from Traditional Chinese Medicine,has been shown to be effective at treating CRDs,with little risk of adverse effects.Scientific research on the mechanisms underlying the effects of acupuncture,especially,its immune regulatory function,has rapidly advanced in recent years.Herein,the diverse immune regulatory mechanisms underlying the beneficial effects of acupuncture are summarized from the perspectives of innate immunity,adaptive immunity,and neuroimmunity.A better understanding of these mechanisms will ultimately provide a scientific basis for the clinical use of acupuncture for the treatment of CRDs.
基金Supported by Fundamental Research Funds for the Central Universities Project:RNA Sequencing Technology Screening the Mechanism of Acupuncture on Pain in Chronic Pelvic Pain Syndrome Rats (2020-JYB-XJSJJ-018)。
文摘OBJECTIVES: To study the expression of inflammatory signal in local prostate tissue of chronic pelvic pain syndrome(CPPS) rats by electroacupuncture(EA) of Guanyuan(CV4), Zhongji(CV3), Huiyang(BL35) and Sanyinjiao(SP6), and to explore the possible mechanism of anti-inflammatory and analgesic effects of EA. METHODS : A total of 36 Sprague-Dawley male rats were randomly divided into three groups: control, model and EA(n=12 rats/group). The CPPS model was made by injection of CFA into ventral lobes of the prostate(0.1 m L). Electric acupuncture apparatus was applied to stimulate Guanyuan(CV4), Zhongji(CV3), bilateral Huiyang(BL35) and Sanyinjiao(SP6) acupoints in EA group. The general condition of rats was observed and the prostate index(PI) was calculated. The thermal pain threshold was collected after each therapeutic course. Histopathological changes of the prostate tissue were examined by hematoxylin-eosin staining method. The expression levels of tumor necrosis factor α(TNF-α), interleukin-1β(IL-1β) and prostaglandin E2(PGE2) in prostatic homogenates were measured by enzyme linked immunosorbent assay(ELISA). Moreover, the expression levels of purinergic 2X7 receptor(P2X7R), NOD-like receptor pyrin domain-containing 3(NLRP3), caspase-1 and interleukin-18(IL-18) m RNA were quantified by quantitative real-time polymerase chain reaction. RESULTS: Compared with control group, the PI of rats increased, and the thermal pain threshold decreased significantly in model group. The morphological structure of prostate tissues of rats in model group was severely damaged with a large number of inflammatory cells infiltration. Additionally, the levels of TNF-α, IL-1β and PGE2 were higher, and the expressions of P2X7R, NLRP3, caspase-1 and IL-18 m RNA were higher than those in control group. After EA treatment, the PI was significantly decreased, the thermal pain threshold was significantly increased, and the tissue damage was significantly improved. The expressions of inflammatory cytokines were lower in EA group, and expression of P2X7R/NLRP3 pathway was down-regulated. CONCLUSION: The effect of EA at Guanyuan(CV4), Zhongji(CV3), Huiyang(BL35) and Sanyinjiao(SP6) can improve inflammation and pain symptoms of CPPS rats induced by Complete Freund’s adjuvant(CFA). This suggests that EA at Guanyuan(CV4), Zhongji(CV3), Huiyang(BL35) and Sanyinjiao(SP6) can produce antiinflammatory analgesia effect by preventing the activation of P2X7R/NLRP3 signal pathway, inhibit the release of inflammatory cytokines in CPPS rats, which may provide a putative novel target for the treatment of CPPS.
基金National Natural Science Foundation of China:Based on TGF-β1/Smads Signaling Pathway to Study the Effect Mechanism of Tuina along the Bladder Meridian on Intervertebral Disc Degeneration(82004497)China Postdoctoral Science Foundation:Based on TGF-β1/RhoA/JNK Signaling Pathway to Study the Effect Mechanism of Tuina along the Bladder Meridian on Intervertebral Disc Degeneration(No.2021M693788)。
文摘OBJECTIVE:The aim of this study was to investigate the protective effects of Tuina(a traditional Chinese massage therapy)on intervertebral disc(IVD)degeneration and the regulatory mechanisms of the transforming growth factor-β1(TGF-β1)/small mothers against decapentaplegic(Smad)signaling pathway.METHODS:Thirty New Zealand white rabbits were randomized into five groups:the control group,model group,model+Tuina group(Tuina group),model+TGF-β1 group(TGF-β1 group),and model+TGF-β1 inhibitor SB431542 group(SB431542 group).The model was established by posterolateral annulus fibrosus puncturing(AFP).Recombinant TGF-β1 and inhibitor SB431542 was injected into the TGF-β1 group and SB431542 group with a microsyringe,respectively.The rabbits in the Tuina group received Tuina treatment along the bladder meridian for 4 weeks.Magnetic resonance imaging(MRI)was performed on rabbits before AFP and after 4 weeks of intervention.Lumbar IVDs(L2-L3 to L4-L5)were harvested after intervention.Histopathological changes in the IVDs were measured by hematoxylin and eosin(HE)staining.Type I collagen was analyzed by immunohistochemistry detection.The expression level of matrix metalloproteinase-3(MMP3)was determined by enzyme-linked immunosorbent assay.Cell apoptosis was evaluated by terminal deoxynucleotidyl transferasemediated nick end labeling and Western blotting.Realtime polymerase chain reaction and Western blotting were used to analyze the expression of TGF-β1 and Smad2/3/4 and a disintegrin and metalloproteinase with thrombospondin motifs 5.RESULTS:Posterolateral AFP induced IVD degeneration in rabbits with histopathological damage and noticeable changes in MRI images.Tuina alleviated histopathological changes and reversed the expression of extracellular matrix degeneration-related molecules and apoptosis-related proteins.Furthermore,AFP induced the activation of TGF-β1 and Smad2/3/4,whereas Tuina therapy markedly reduced the protein expression of Smad2/3 and the gene expression of TGF-β1 and Smad2/3/4.Additionally,the TGF-β1/Smad signaling pathway was activated in the TGF-β1 group,while the TGF-β1/Smad signaling pathway was inhibited in the SB431542 group.CONCLUSION:Posterolateral AFP induced disc degeneration as determined by MRI assessment and histological analysis.Tuina alleviated disc degeneration,possibly by inhibiting the fibrotic response mediated by the TGF-β1/Smad pathway,thus alleviating extracellular matrix degeneration and reducing cell apoptosis.
基金Supported by the National Natural Science Foundation of China (Nos. 82004487 and 82230127)Central Guidance for Local Projects of Sichuan Province (No. 2022ZYD0101)。
文摘Objective:To investigate the effect of acupuncture on advanced cancer patients by meta-analysis.Methods:Nine databases(the Cochrane Central Register of Controlled Trials,MEDLINE,Web of Science,Embase,China National Knowledge Infrastructure,the Cumulative Index to Nursing and Allied Health Literature,Chinese Biomedical Literature Database,China Science and Technology Journal Database,and Wan Fang Data)were searched for randomized controlled trials(RCTs)on acupuncture in advanced cancer patients published from inception to February 13,2023 and updated to June 1,2023.Primary outcomes were quality of life(QOL),while secondary outcomes were pain,fatigue,and adverse events(side effects).Data synthesis was performed using RevMan V.5.3 to calculate pooled effect sizes.RoB-2 was used for the risk of bias,and the quality of evidence was assessed using the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)tool.Results:Totally 17 RCTs involving 1,178 participants were included,15 of which were pooled for meta-analysis.Most studies demonstrated some concern for the overall risk of bias.The pooled data indicated that acupuncture was associated with improved QOL[mean difference(MD)=6.67,95%confidence interval(CI):5.09 to 8.26],pain(MD=–1.18,95%CI–2.28 to–0.08),and adverse events(risk ratio=0.30,95%CI:0.26to 0.57)compared with control groups.Fatigue outcome was not included.Heterogeneity was substantial,and GRADE evidence was very low for both QOL and pain.Conclusions:Acupuncture could benefit patients with advanced cancer and is considered safe compared with usual care.However,the evidence regarding QOL and pain outcomes requires further validation.It is crucial to encourage the development of high-quality studies to strengthen this evidence.(Registry No.CRD42023423539).
基金The 75th Batch of China Postdoctoral Science Foundation projects(No.2024M754279)Natural Science Foundation of Jiangsu Province(No.BK20240738)+2 种基金Basic Science(Natural Science)Research Project in Universities of Jiangsu Province(No.24KJB360004)Jiangsu Province Chinese Medicine Science and Technology Development Plan Youth Talent Project(No.QN202206)Nanjing University of ChineseMedicine Luo Linxiu Teacher Development Fund Project(No.LLX202310).
文摘Cold tumors,defined by insufficient immune cell infiltration and a highly immunosuppressive tumor microenvironment(TME),exhibit limited responsiveness to conventional immunotherapies.This reviewsystematically summarizes the mechanisms of immune evasion and the therapeutic strategies for cold tumors as revealed by multiomics technologies.By integrating genomic,transcriptomic,proteomic,metabolomic,and spatialmulti-omics data,the review elucidates key immune evasionmechanisms,including activation of the WNT/β-catenin pathway,transforming growth factor-β(TGF-β)–mediated immunosuppression,metabolic reprogramming(e.g.,lactate accumulation),and aberrant expression of immune checkpoint molecules.Furthermore,this review proposes multi-dimensional therapeutic strategies,such as targeting immunosuppressive pathways(e.g.,programmed death-1(PD-1)/programmed death-ligand 1(PD-L1)inhibitors combined with TGF-βblockade),reshaping the TME through chemokine-based therapies,oncolytic viruses,and vascular normalization,and metabolic interventions(e.g.,inhibition of lactate dehydrogenase A(LDHA)or glutaminase(GLS)).In addition,personalized neoantigen vaccines and engineered cell therapies(e.g.,T cell receptor-engineered T(TCR-T)and natural killer(NK)cells)show promising potential.Emerging evidence also highlights the role of epigenetic regulation(e.g.,histone deacetylase(HDAC)inhibitors)and N6-Methyladenosine(m6A)RNA modifications in reversing immune evasion.Despite the promising insights offered by multi-omics integration in guiding precision immunotherapy,challenges remain in clinical translation,including data heterogeneity,target-specific toxicity,and limitations in preclinical models.Future efforts should focus on coupling dynamic multi-omics technologies with intelligent therapeutic design to convert cold tumors into immunologically active(“hot”)microenvironments,ultimately facilitating breakthroughs in personalized immunotherapy.
基金Project of Jiangsu Province Technology Engineering Research Center of Traditional Chinese Medicine Health PreservationScientists Fund of the Natural Science Foundation of Nanjing University of Chinese Medicine:to Study the Mechanism of Five Elements Music in the Treatment of Post-stroke Depression based on Metabolomics-based Study(NZY81804161)Major Project of Philosophy and Social Sciences Fund for Universities in Jiangsu Province:Research on Ancient Chinese Music Therapy Thought(2024SJZD150)。
文摘Under the background of Artificial Intelligence(AI)and medical data informationization,intelligent Traditional Chinese Medicine(TCM)emerges as a new medical model.In this study,we introduce Affective Computing into the diagnosis and treatment process of TCM FiveTone Therapy.And proposes an intelligent diagnosis and treatment system including Five-tone diagnosis,monitoring and treatment,to achieve intelligent music matching.This system based on sound-image database for standardized collection and diagnosis of the Five-tone.The assessment and monitoring process are then visually presented,and an emotion analysis model is established by using affective computing.On the other hand,the system employs virtual reality(VR)visual media music and somatosensory music to play and intelligently match the Five-tone,solving issues in the clinical treatment of Five-tone therapy,such as the difficulties of quantifying emotional data,limited ability for generalization feature extraction,and relatively insufficient research on the intelligence of Five-tone therapy.This study can promote the integration of technology in the fields of healthcare,information,and music,thereby enhancing the accuracy of diagnosis and treatment.It holds significant importance in advancing the intelligent development of Traditional Chinese Medicine diagnosis and treatment.
基金supported by the National Scientific Foundation Committee in China,No.81473602the Education Ministry’s New Century Excellent Talents Supporting Plan in China+3 种基金the Foundation for the Author of National Excellent Doctoral Dissertation of China,No.201486the Youth Foundation of Science and Technology Department of Sichuan Province in China,No.15QNJJ0008the National Natural Science Foundation-Excellent Youth Foundation in China,No.81622052the 2011 Co-Innovation Center of Sichuan Province named Acupoint Effects of Acupuncture Co-Innovation Center
文摘Acupuncture is widely used to treat functional dyspepsia with satisfactory outcomes. Combination of the He and Mu acupoints is commonly used and has a synergistic effect on functional dyspepsia; however, its underlying mechanisms remain unclear. Therefore, a randomized controlled parallel clinical trial is currently underway at Chengdu University of Traditional Chinese Medicine, China. This trial is designed to explore the efficacy of and central responses to the He-Mu point combination in patients with functional dyspepsia using functional magnetic resonance imaging. A total of 105 patients with functional dyspepsia will be allocated into 3 groups： the low-He point group（puncturing at Zusanli（ST36））, Mu point group（puncturing at Zhongwan（CV12））, and He-Mu point combination group（puncturing at ST36 and CV12）. Every participant will receive 20 sessions of manual acupuncture for 4 weeks. The needles will be inserted perpendicularly to a depth of 1 to 2 cun. The angle of rotation and twisting will range from 90 to 180 degrees, while lifting and thrusting will range from 0.3 to 0.5 cm. The various manipulations will be performed 60 to 90 times per minute. The needles will remain in place for 30 minutes, during which manipulation will be applied every 10 minutes. Magnetic resonance imaging will be performed before and after 20 sessions of acupuncture. The primary outcome is symptom improvement according to the Chinese version of the Nepean Dyspepsia Index. Secondary outcomes include the Leeds dyspepsia questionnaire, Self-Rating Anxiety Scale, Self-Rating Depression Scale, Beck Anxiety Inventory, Beck Depression Inventory, and visual analogue scale scores before and after 10 and 20 sessions of acupuncture. Needle sensation and adverse events will be used to assess the therapeutic effects. This study will promote more widespread awareness of the benefits of acupoint combination in the clinical setting and provide a further explanation of the neuromechanism by which acupuncture at the He-Mu point combination for functional dyspepsia. Registration： Chinese Clinical Trial Registry, Chi CTR-IOR-15006402.
