OBJECTIVE:To evaluate the effectiveness and safety of multiple acupuncture therapies in the treatment of allergic rhinitis(AR)using a network Meta-analysis.METHODS:This network Meta-analysis adhered to the PRISMA-NMA ...OBJECTIVE:To evaluate the effectiveness and safety of multiple acupuncture therapies in the treatment of allergic rhinitis(AR)using a network Meta-analysis.METHODS:This network Meta-analysis adhered to the PRISMA-NMA guideline.Eight databases were systematically searched from inception to December 31,2023,and retrieved references were managed using End Note 20.The risk of bias in individual studies was assessed with the Cochrane Ro B 2.0 tool(ROB 2.0).Data analysis was performed using R 4.2.1 and STATA 15.1.RESULTS:A total of 56 studies that had enrolled 4859 patients with AR were included.Hand acupuncture(HA)combined with acupoint catgut embedding(AE),hand acupuncture with heat sensitive moxibustion(HA+HSM),and acupoint application were the most effective in attaining the clinical effective rate.HA+AE,hand acupuncture with indirect moxibustion(HA+IM),and electroacupuncture(EA)with AE ranked the highest with respect to the Rhinoconjunctivitis Quality of Life Questionnaire Score.HA+IM,HA,and HA+EA yielded the best Total Nasal Symptom Score,whereas HA+AE,EA+AE,and HA had the best results for the Total NonNasal Symptom Score.However,subgroup analyses of clinical efficacy revealed that HA+HSM had the best therapeutic effects in the short term,whereas HA+AE was the most effective in the medium to long term.CONCLUSION:Combined acupuncture and moxibustion therapy may be a safe and effective intervention for patients with AR.HA+IM and HA+AE exhibited the most desirable therapeutic effects compared with other acupuncture and moxibustion therapies.展开更多
Objective:Comorbid pain and depression are common but remain difficult to treat.Electroacupuncture(EA)can effectively improve symptoms of depression and relieve pain,but its neural mechanism remains unclear.Therefore,...Objective:Comorbid pain and depression are common but remain difficult to treat.Electroacupuncture(EA)can effectively improve symptoms of depression and relieve pain,but its neural mechanism remains unclear.Therefore,we used resting-state functional magnetic resonance imaging(rs-fMRI)to detect cerebral changes after initiating a mouse pain model via constriction of the infraorbital nerve(CION)and then treating these animals with EA.Methods:Forty male C57BL/6J mice were divided into 4 groups:control,CION model,EA,and sham acupuncture(without needle insertion).EA was performed on the acupoints Baihui(GV20)and Zusanli(ST36)for 20 min,once a day for 10 consecutive days.The mechanical withdrawal threshold was tested3 days after the surgery and every 3 days after the intervention.The depressive behavior was evaluated with the tail suspension test,open-field test,elevated plus maze(EPM),sucrose preference test,and marble burying test.The rs-fMRI was used to detect the cerebral changes of the functional connectivity(FC)in the mice following EA treatment.Results:Compared with the CION group,the mechanical withdrawal threshold increased in the EA group at the end of the intervention(P<0.05);the immobility time in tail suspension test decreased(P<0.05);and the times of the open arm entry and the open arm time in the EPM increased(both P<0.001).There was no difference in the sucrose preference or marble burying tests(both P>0.05).The fMRI results showed that EA treatment downregulated the amplitude of low-frequency fluctuations and regional homogeneity values,while these indicators were elevated in brain regions including the amygdala,hippocampus and cerebral cortex in the CION model for comorbid pain and depression.Selecting the amygdala as the seed region,we found that the FC was higher in the CION group than in the control group.Meanwhile,EA treatment was able to decrease the FC between the amygdala and other brain regions including the caudate putamen,thalamus,and parts of the cerebral cortex.Conclusion:EA can downregulate the abnormal activation of neurons in the amygdala and improve its FC with other brain regions,thus exerting analgesic and antidepressant effects.Please cite this article as:Yin X,Zeng XL,Lin JJ,Xu WQ,Cui KY,Guo XT,Li W,Xu SF.Brain functional changes following electroacupuncture in a mouse model of comorbid pain and depression:A restingstate functional magnetic resonance imaging study.展开更多
BACKGROUND Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis,a common acute abdominal condition.Despite surgical advances,postoperative gastrointestinal dysfunction and delayed recover...BACKGROUND Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis,a common acute abdominal condition.Despite surgical advances,postoperative gastrointestinal dysfunction and delayed recovery continue to negatively impact rehabilitation outcomes and patient quality of life.Laser acupuncture represents a promising emerging complementary therapy with potential benefits for promoting functional recovery.AIM To evaluate the clinical efficacy of laser acupuncture in enhancing gastrointestinal function recovery following laparoscopic appendectomy and to investigate its potential applications in postoperative rehabilitation.METHODS This retrospective controlled clinical study selected 120 acute appendicitis patients who underwent laparoscopic appendectomy from January 2022 to December 2023 at a tertiary hospital.Patients were randomly divided into two groups:Routine treatment group(n=60)and laser acupuncture intervention group(n=60).There were no significant statistical differences in baseline characteristics(age,gender,body mass index,appendicitis severity)between the two groups.The routine treatment group received standard postoperative care,while the laser acupuncture intervention group received additional laser acupuncture treatment on top of standard care.Key observation indicators included time to first exhaust,time to first bowel movement,time to gastrointestinal function recovery,and postoperative complication rates.RESULTS Patients in the laser acupuncture intervention group showed significantly faster gastrointestinal function recovery compared to the routine treatment group.Specifically,time to first exhaust was significantly shortened(intervention group:12.5±2.3 hours vs control group:18.7±3.1 hours,P<0.05),time to first bowel movement was earlier(intervention group:36.4±4.6 hours vs control group:48.2±5.7 hours,P<0.05),postoperative complication rate was significantly reduced(intervention group:8.3%vs control group:20.0%,P<0.05),postoperative pain score was significantly lower(intervention group:3.2±1.1 vs control group:4.7±1.5,P<0.05),and intestinal motility recovery was faster and more effective.CONCLUSION Laser acupuncture,as an auxiliary treatment method,can significantly promote gastrointestinal function recovery in patients after laparoscopic appendectomy,reduce complications,and improve postoperative comfort.This technique has advantages such as minimal invasiveness,rapid recovery,and few side effects,making it worthy of further clinical promotion and application.展开更多
OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)at scalp motor area for treating post-stroke wrist dyskinesia and its influence on the function of wrist movement-related agonistic muscles.METHODS:A randomi...OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)at scalp motor area for treating post-stroke wrist dyskinesia and its influence on the function of wrist movement-related agonistic muscles.METHODS:A randomized,single-blind,controlled clinical trial was conducted.Sixty-six patients undergoing post-stroke wrist dyskinesia were enrolled and randomized 1:1 to EA or control group.Patients in the control group received manual acupuncture in the scalp motor area(MS 6)on the lesion side.The same acupoint was selected to accept EA stimulation in the EA group.All patients were treated six times a week for three weeks.The primary outcome was the Chinese Stroke Scale(CSS)score.The secondary outcomes included upper limb-related Barthel Index(BI)score,active range of motion(AROM)of the wrist joint,and root mean square(RMS)of the four agonistic muscles associated with wrist motion on the hemiplegic side of patients,i.e.,the extensor carpi radialis longus(ECRL),extensor digitorum(ED),flexor carpi radialis(FCR)and flexor carpi ulnaris(FCU).The above indicators were measured before and after three weeks of treatment.RESULTS:After 3-week treatment,the CSS score and AROM of wrist dorsiflexion of the EA group were better than those in the control group(P=0.038,P=0.047).The differences between the two groups of BI scores and AROM of wrist flexion were not significant(P>0.05).All RMS of the EA group were higher than those in the control group(ECRL:P=0.047,ED:P=0.048,FCR:P=0.049,FCU:P=0.047).The total effective rate in the EA group was 87.50%(28/32),which was higher than that in the control group(77.42%,24/31,P=0.048).CONCLUSION:EA stimulation of the scalp motor area can promote the recovery of the strength and function of the agonistic muscles related to wrist movement and effectively improve post-stroke wrist dyskinesia.展开更多
Objective:This study aimed to explore the clinical effect of acupuncture therapy for menstruation regu-lation and pregnancy promotion on thin endometrium in the real world.Design:This study is a single-center pragmati...Objective:This study aimed to explore the clinical effect of acupuncture therapy for menstruation regu-lation and pregnancy promotion on thin endometrium in the real world.Design:This study is a single-center pragmatic randomized controlled trial blinded to the statisticians.Using the“blockrand”software package,based on the age(≥35,<35),37 patients were randomized into an intervention group(19 cases)and a control group(18 cases).After reassignment regarding patient preference,21 patients were included in the intervention group and 16 in the control group.Setting:The trial was executed in the Specialty Outpatient Clinic,Acupuncture-Moxibustion Hospital of China Academy of Chinese Medical Sciences,from March 1,2019,to September 30,2020.Participants:The study included 37 patients with thin endometrium and without previous acupuncture treatment.Intervention:The intervention group was administered acupuncture for menstruation regulation and pregnancy promotion and a small-dose of progynova(2 mg daily),while the control group was adminis-tered a large-dose of progynova(4 mg daily).Interventions started from Day 5 of menstruation until the end of ovulation under B-ultrasound monitoring.The intervention lasted for three menstrual cycles.Measurements:Primary outcomes were changes in endometrial thickness between baseline and after intervention completion and the difference between the two groups after intervention.The secondary outcomes were endometrial and subendometrial blood flow,serum estradiol levels,menstrual conditions,and adverse reactions.Results:(1)Comparison of each indicator before and after intervention completion in the two groups:in the intervention group,the differences were significant in endometrial thickness,menstrual score,estra-diol(E2)level in ovulatory period,the pulsatility index(PI)and resistance index(RI)of uterine artery,the ratio of peak systolic velocity to end-diastolic velocity(S/D),the endometrial vascular index(VI),flow index(FI),and vascular flow index(VFI)and volume(P<0.01).In the control group,significant changes were observed in endometrial thickness,menstrual score,and E2 before and after the interven-tion(P<0.05),and no differences were observed in uterine artery PI,RI,S/D and endometrial VI,FI,VFI,and volume(P>0.05).Compared with the control group,the intervention group showed significant differences in endometrial thickness,menstrual score,E2,uterine artery PI,RI,S/D,and endometrial VI,FI,VFI,and volume after intervention(P<0.01).No adverse reactions were reported in the intervention group.In contrast,the control group had two cases of nausea and gastrointestinal discomfort after med-ication,eight cases of breast distention during medication,and one case of breast nodules enlarged by 1 cm after trial completion.展开更多
OBJECTIVE:To explore the efficacy and safety of acupuncture combined with atlantoaxial joint bone-setting therapy for the treatment of Tourette syndrome.METHODS:We randomly divided 600 patients at a ratio of 1∶1∶1 i...OBJECTIVE:To explore the efficacy and safety of acupuncture combined with atlantoaxial joint bone-setting therapy for the treatment of Tourette syndrome.METHODS:We randomly divided 600 patients at a ratio of 1∶1∶1 into three groups:group A(acupuncture combined with atlantoaxial joint bone setting therapy group),group B(acupuncture group),and group C(tiapride group).After two months of treatment,the Yale global tic severity scale(YGTSS)score reduction,improvement in social function impairment,clinical efficacy,and long-term efficacy in the three groups were compared.RESULTS:After treatment,in the analysis of YGTSS score reduction,social function impairment improvement,the clinical control rate,and long-term efficacy,the results were all Group A>Group B>Group C,with a statistically significant difference(P<0.05).However,the total clinical efficacy of treatment in group A(94.9%)was not significantly different from that in group B(91.8%).Adverse reactions did not occur in groups A and B,and several adverse reactions occurred in 29%(n=58)of the group C patients.CONCLUSION:Compared with traditional drug therapy,acupuncture combined with atlantoaxial joint bone setting therapy has better clinical and long-term efficacy.This treatment strategy can improve the social function of children and prevent adverse reactions to drugs.展开更多
Objective The present study evaluated the effects of deep acupuncture at Weizhong acupoint(BL40)on bladder function and brain activity in a rat model of overactive bladder(OAB),and investigated the possible mechanisms...Objective The present study evaluated the effects of deep acupuncture at Weizhong acupoint(BL40)on bladder function and brain activity in a rat model of overactive bladder(OAB),and investigated the possible mechanisms around the acupuncture area that initiate the effects of acupuncture.Methods Adult female Sprague-Dawley rats were randomly divided into six groups,comprising a control group,model group,group treated with deep acupuncture at BL40,group treated with shallow acupuncture at BL40,group treated with acupuncture at non-acupoint next to BL40,and group treated with acupuncture at Xuanzhong(GB39).Urodynamic evaluation was used to observe the urination,and functional magnetic resonance imaging was used to observe the brain activation.The mechanism of acupuncture at BL40 in regulating bladder function was explored by toluidine blue staining and enzyme-linked immunosorbent assay,and the mechanism was verified by stabilizing mast cells(MCs)or blocking tibial nerve.Results Deep acupuncture at BL40 significantly increased the intercontraction interval in OAB rats and enhanced the mean amplitude of low frequency fluctuation of primary motor cortex(M1),periaquaductal gray matter(PAG),and pontine micturition center(PMC).It also increased the zero-lag functional connectivity between M1 and PAG and between PAG and PMC.Shallow acupuncture at BL40 and acupuncture at non-acupoint or GB39 had no effect on these indexes.Further studies suggested that deep acupuncture at BL40 increased the number and degranulation rate of MCs as well as the contents of 5-hydroxytryptamine,substance P,and histamine in the tissues around BL40.Blocking the tibial nerve by lidocaine injection or inhibiting MC degranulation by sodium cromoglycate injection obstructed the effects of acupuncture on restoring urinary function and modulating brain activation in OAB rats.Conclusion Deep acupuncture at BL40 may be more effective for inhibiting OAB by promoting degranulation of MCs around the acupoint and stimulating tibial nerve,thereby regulating the activation of the brain area that controls the lower urinary tract.展开更多
OBJECTIVE:To explore the correlation between acupuncture treatment for allergic rhinitis(AR) and hypothalamic-pituitary-adrenal(HPA) axis regulation by investigating changes in serum immune factors,HPA axis-associated...OBJECTIVE:To explore the correlation between acupuncture treatment for allergic rhinitis(AR) and hypothalamic-pituitary-adrenal(HPA) axis regulation by investigating changes in serum immune factors,HPA axis-associated hormone levels,activation levels of paraventricular nucleus(PVN) neurons,and the severity of nasal mucosal lesions,in rats with AR before and after acupuncture treatment.METHODS:After establishing the AR rat model,ovalbumin was administered via nasal drip to all groups except the blank control.Each group received continuous treatment for 14 d:the acupuncture,acupuncture + RU-486(mifepristone),and RU-486 groups received acupuncture only,RU486 intraperitoneal injection and acupuncture,and RU-486 intraperitoneal injection only,respectively.Following the intervention period,behavioral scoring was performed on all AR rats,and peripheral blood,nasal mucosa samples,and brains tissue(containing PVN region) were obtained following euthanization.Interleukin(IL-4,IL-5,IL-13),interferon gamma(IFN-γ),corticosterone(CORT),and corticotrophin-releasing hormone(CRH) levels were evaluated in peripheral blood samples.Adrenocorticotropic hormone(ACTH) levels were determined using an enzyme-linked immunoassay assay,and hematoxylin and eosin staining was performed on the nasal mucosa samples.The expression levels of c-Fos in PVN neurons following acupuncture treatment were evaluated by immunofluorescent staining.RESULTS:Following the intervention period,the behavioral scores for the blank control group were lower than those of other groups(P < 0.05),while the acupuncture group scores were lower than those in the model control,acupuncture + RU486,and RU486 groups(P < 0.05).The blank control group had lower serum IL-4,IL-5,and IL-13 levels than those in the other groups(P < 0.05).The acupuncture group had lower serum IL-4,IL-5,and IL-13 levels than those in the model control,acupuncture + RU486,and RU486 groups(P < 0.05).The blank control group had the highest serum IFN-γ levels among all groups,followed by the acupuncture group.The serum CORT,CRH,and ACTH levels in the blank control group were lower than those in the remaining groups(P < 0.05).These biomarker levels were also lower in the acupuncture group than those in the model control,acupuncture + RU486,and RU486 groups(P < 0.05).Compared with model,rats in the acupuncture group exhibited an increased c-Fos expression in PVN neurons.CONCLUSION:Acupuncture can alleviate AR symptoms and regulate serum inflammatory factor levels and HPA axis-related hormones in AR rats.Moreover,these effects are inhibited by glucocorticoid antagonists,suggesting that acupuncture may regulate AR symptoms through HPA axis regulation.展开更多
OBJECTIVE:To investigate the anti-inflammatory effect of electroacupuncture in rats with bupivacaine-induced lumbar multifidus injury and its underlying regulatory mechanism on macrophage polarization.METHODS:A total ...OBJECTIVE:To investigate the anti-inflammatory effect of electroacupuncture in rats with bupivacaine-induced lumbar multifidus injury and its underlying regulatory mechanism on macrophage polarization.METHODS:A total of seventy-two Sprague-Dawley male rats were randomly divided into control,model,and electroacupuncture groups.Forty-eight rats categorized in model groups were injected 0.5% bupivacaine(BPVC) into the lumbar multifidus at the L4-L5 segment.Rats in the electroacupuncture groups received the intervention for 1,2,3 and 5 d,respectively.The degree of macrophage infiltration and change of M1/M2 polarization were observed based on hematoxylin and eosin staining,immunohistochemistry and immunofluorescence to evaluate the anti-inflammatory effect of electroacupuncture.Meanwhile,exosomal miRNAsequencing and bioinformatics analysis predicted the pathways and biological processes related to inflammatory response and macrophage polarization regulated by electroacupuncture intervention.RESULTS:BPVC injection induced the infiltration of local macrophages at the L4-L5 segment of lumbar multifidus.Comparison of mean IOD values with 2 d and 5 d post injury revealed the highest expression of CD68+ macrophages on day 3 post injury by immunohistochemistry.(P < 0.001,P < 0.001,respectively).Compared with the model group,the cell counts of iNOs+ CD68+ M1-macrophages were lower in the electroacupuncture group,while the positive percent of CD163+ CD206+ M2-macrophages was higher in the electroacupuncture group,on day 3 after BPVC injection(P < 0.001,P < 0.001,respectively).Moreover,the results of sequencing and bioinformatic analysis suggested that exosomal miRNAs were involved in the EA regulating macrophage polarization.CONCLUSIONS:Electroacupuncture can promote macrophage polarization to reduce inflammation following lumbar multifidus muscular injury.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 Postoperative intestinal paralysis is common in gastrointestinal surgery,and the study of electroacupuncture mechanisms is of great significance.AIM To explore the neuroimmune regulatory mechanism of electr...BACKGROUND Postoperative intestinal paralysis is common in gastrointestinal surgery,and the study of electroacupuncture mechanisms is of great significance.AIM To explore the neuroimmune regulatory mechanism of electroacupuncture at the Zusanli acupoint(ST36)in postoperative intestinal paralysis following gastrointestinal surgery.METHODS A total of 156 patients admitted to the Affiliated Hospital of Jiangnan University between January 2022 and October 2024 for postoperative intestinal paralysis following gastrointestinal surgery were randomly divided into two groups:A control group and an electroacupuncture group,with 75 patients in each.The control group received conventional Western medical treatment,while the electroacupuncture group received electroacupuncture in addition to this,at the bilateral Zusanli acupoints.Both groups received treatment for 7 days.Clinical efficacy,gastrointestinal function recovery,and gastrointestinal hormone[motilin(MTL),gastrin(GAS)],neurotransmitter[vasoactive intestinal peptide(VIP),nitric oxide(NO)],and inflammatory cytokine[tumor necrosis factor-α(TNF-α),serum interleukin-6(IL-6),interleukin-1β(IL-1β)]levels were compared between the two groups before and seven days after treatment.Adverse reactions were also recorded.RESULTS The electroacupuncture group demonstrated a higher overall treatment effectiveness rate and faster recovery of bowel sounds,as well as faster first defecation and first flatus than the control group(P<0.05).After seven days of treatment,MTL and GAS levels were significantly higher and VIP,NO,TNF-α,IL-6 and IL-1βlevels were significantly lower in the electroacupuncture group than in the control group(P<0.05).No adverse reactions were observed in either group during treatment.CONCLUSION Electroacupuncture at the Zusanli acupoint can enhance clinical efficacy,promote the recovery of gastrointestinal function,and regulate the neuroimmune microenvironment in patients with intestinal paralysis after gastrointestinal surgery.This mechanism may involve excitation of the vagus nerve and activation of the cholinergic antiinflammatory pathway through electroacupuncture stimulation of the Zusanli acupoint.展开更多
Background:Diabetic peripheral neuropathy(DPN)is a prevalent and debilitating complication of diabetes mellitus,lacking effective treatment options.Despite unclear underlying mechanisms,electroacupuncture(EA)shows pro...Background:Diabetic peripheral neuropathy(DPN)is a prevalent and debilitating complication of diabetes mellitus,lacking effective treatment options.Despite unclear underlying mechanisms,electroacupuncture(EA)shows promise in relieving DPN symptoms.Neurotransmitter dysregulation is central to DPN pathophysiology.This study aimed to investigate EA’s effects on DPN via targeted neurotransmitter metabolomics.Methods:A streptozotocin-induced mouse model of DPN was developed,and EA treatment was administered for two weeks to assess the therapeutic potential of EA.Following the collection of sciatic nerve samples,LC-MS-based targeted metabolomics analyses investigations were performed to examine alterations in DPN-associated neurotransmitter metabolism brought on by EA therapy.Multivariate statistical analyses were employed to assess metabolite expression patterns,using cluster heatmaps to display neurotransmitter expression results.KEGG pathway analyses were also used to explore the functional classifications of these neurotransmitters and associated metabolic pathways.Results:Targeted neurotransmitter-focused metabolomics analyses led to the identification of 34 putative biomarkers associated with EA treatment,of which 5 showed significant changes,such as beta-alanine(increased by 80.37%,P=0.0004)and kynurenine(decreased by 29.36%,P=0.0163).KEGG pathway analysis indicated that changes in the abundance of these metabolites were associated with the cAMP signaling pathway,neuroactive ligand-receptor interactions,the synaptic vesicle cycle,and other pathways.Conclusion:The results indicate that EA can efficiently regulate neurotransmitter metabolism and restore peripheral nerve function,suggesting a feasible non-pharmacological strategy for DPN treatment and warranting clinical translation.展开更多
BACKGROUND Post-operative nausea and vomiting(PONV)after cholecystectomy occurs in 40%-75%of patients,significantly affecting recovery and satisfaction.AIM To evaluate the effectiveness and safety of acupuncture at He...BACKGROUND Post-operative nausea and vomiting(PONV)after cholecystectomy occurs in 40%-75%of patients,significantly affecting recovery and satisfaction.AIM To evaluate the effectiveness and safety of acupuncture at Hegu(LI4)and Zusanli(ST36)acupoints in preventing PONV in patients undergoing cholecystectomy.METHODS This retrospective study included 240 patients undergoing cholecystectomy(January 2022 to December 2023),randomized to acupuncture(n=120)or control groups(n=120).The acupuncture group received bilateral LI4 and ST36 acupuncture immediately post-surgery and 6 hours later;controls received routine care.Primary outcomes included PONV incidence,severity(visual analogue scale score),and time to first occurrence.RESULTS The total PONV incidence in the acupuncture group was significantly lower than in the control group(28.3%vs 47.5%,P<0.01).Stratified analysis showed that in the laparoscopic group,the acupuncture group’s PONV incidence was 26.7%,significantly lower than the control group’s 45.6%(P<0.01);in the open surgery group,the acupuncture group was 33.3%,lower than the control group’s 53.3%(P<0.05).The acupuncture group showed significantly reduced symptom severity(visual analogue scale score 2.7±1.4 vs 4.5±1.8,P<0.01),delayed time to first occurrence(8.4±2.1 hours vs 4.2±1.5 hours,P<0.01),with the symptom-free period extended by 4.2 hours.The acupuncture group had a higher proportion of mild symptoms(76.5%vs 35.1%)and a significantly increased proportion of symptom-free patients within 6 hours post-surgery(67.6%vs 28.1%,P<0.01).Rescue antiemetic medication usage was significantly reduced in the acupuncture group(18.3%vs 35.8%,P<0.01).Patient satisfaction scores in the acupuncture group were significantly better than the control group(4.6±0.7 vs 3.8±0.9,P<0.01),with hospital stay shortened by 0.5 days(2.1±0.8 days vs 2.6±1.1 days,P<0.05).Subgroup analysis showed that acupuncture was more effective in patients≤45 years(incidence reduction 23.5%vs>45 years group 16.8%),with significant efficacy in high-risk patients(Apfel score≥3)(36.2%vs 62.2%,P<0.01).Safety analysis showed only 7 cases(5.8%)of mild adverse reactions in the acupuncture group,all self-resolved with no serious adverse events.CONCLUSION Acupuncture at LI4 and ST36 acupoints significantly reduces PONV incidence and severity after cholecystectomy,with an excellent safety profile.This non-pharmacological intervention offers particular value for high-risk patients and those with medication contraindications.展开更多
Objective:To explore the effect of combining Duhuo Jisheng decoction with warm acupuncture and moxibustion in the treatment of patients with lumbar disc herniation.Methods:Using a random number table method,a total of...Objective:To explore the effect of combining Duhuo Jisheng decoction with warm acupuncture and moxibustion in the treatment of patients with lumbar disc herniation.Methods:Using a random number table method,a total of 100 patients with lumbar disc herniation treated at Xianning Matang Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were divided into a control group of 50 patients treated with Duhuo Jisheng decoction and a study group of 50 patients treated with Duhuo Jisheng decoction combined with warm acupuncture and moxibustion.The TCM syndrome scores,lumbar function,lumbar pain,and lumbar activity were compared between the two groups.Results:After intervention,the TCM syndrome scores,ODI,and VAS scores of both groups showed a decreasing trend compared to before intervention,and the decreasing trend was more significant in the study group(P<0.05).After intervention,the JOA and lumbar activity indicators of both groups showed an increasing trend compared to before intervention,and the increasing trend was more significant in the study group(P<0.05).Conclusion:Duhuo Jisheng decoction combined with warm acupuncture and moxibustion is an effective and safe treatment method for lumbar disc herniation,which can improve lumbar function and activity.展开更多
OBJECTIVE:To investigate the possible mechanisms by which acupuncture improves post-stroke limb spasticity using single-cell sequencing technology.METHODS:Thirty-two rats were randomly assigned to four groups:Control,...OBJECTIVE:To investigate the possible mechanisms by which acupuncture improves post-stroke limb spasticity using single-cell sequencing technology.METHODS:Thirty-two rats were randomly assigned to four groups:Control,Sham,Model,and Acupuncture.The middle cerebral artery occlusion(MCAO)model was established,and the acupuncture groups received acupuncture treatment.After treatment,brain morphological changes and the degree of neurological impairment were assessed.The effect of acupuncture on the proportion of brain cell types in the ischemic penumbra of MCAO rats was analyzed using single-cell transcriptomics,and the expression and enrichment of differentially expressed genes were examined.Finally,selected differential genes were validated by Western blot and quantitative real-time polymerase chain reaction.RESULTS:Triphenyltetrazolium chloride staining showed that the infarct area in MCAO rats was significantly reduced after acupuncture.Garcia scoring,hematoxylin-eosin staining,Nissl staining,and terminal deoxynucleotidyl transferase d UTP nick end labeling demonstrated that acupuncture reduced brain damage.Enzyme-linked immunosorbent assay results showed that acupuncture significantly decreased serum inflammatory factors,including interleukin-1 beta(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-alpha(TNF-α).Single-cell transcriptome analysis revealed marked changes in cell type proportions between the Acupuncture and Model groups.A total of 207 differential genes were identified,including 157 upregulated and 50 downregulated genes.Analysis of macrophage-specific differential genes in the ischemic penumbra showed enrichment in Gene Ontology terms such as Ras protein signal transduction and regulation of GTPase activity,and Kyoto Encyclopedia of Genes and Genomes pathways including lysosome,axon guidance,and mitogenactivated protein kinase signaling.S100a8 and leukocyte specific transcript 1(LST1)were identified as key differential genes.CONCLUSION:These findings suggest that the key differential genes S100a8 and LST1 may alleviate poststroke limb spasticity by regulating the inflammatory response in the ischemic penumbra.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
Background Temporomandibular disorders(TMD)are the leading cause of chronic orofacial pain,which significantly affects patients’quality of life.However,the efficacy of acupuncture in the management of TMD remains unc...Background Temporomandibular disorders(TMD)are the leading cause of chronic orofacial pain,which significantly affects patients’quality of life.However,the efficacy of acupuncture in the management of TMD remains unclear.Objective This systematic review aimed to conduct a PRISMA-compliant review to critically assess the therapeutic efficacy of acupuncture as an intervention for patients with TMD.Methods We searched nine electronic databases for randomized controlled trials on acupuncture for TMD published up to February 4,2025.Eligible studies included adults diagnosed with TMD and compared acupuncture(manual,electroacupuncture,warm,auricular,thread-embedding,or laser)with conservative treatment(positive control)or sham acupuncture(negative control).Outcomes included pain intensity,mouth opening,pressure pain threshold,and adverse events.Risk of bias was assessed using ROB 2,and certainty of evidence was evaluated using GRADE.All outcome data were analyzed using RevMan 5.4 software.Low heterogeneity was defined as I^(2)≤50% and P≥0.1,in which case a fixed-effects model was applied.High heterogeneity(I^(2)>50% or P<0.1)prompted further analysis to identify its source.After excluding the influence of evident heterogeneity,a random-effects model was used for the meta-analysis.Results Of the 2664 screened records,14 randomized controlled trials involving 476 participants met the inclusion criteria.Acupuncture significantly reduced pain intensity compared with that of negative controls(MD=-1.75,95%confidence interval[CI]-2.47 to-1.03;P<0.00001;I^(2)=60%)but showed no difference compared with that of positive controls(MD=-0.06,95%CI-0.62 to 0.50;P=0.83;I^(2)=0%).No significant differences were observed in pain-free jaw opening,whereas acupuncture improved maximum mouth opening relative to negative controls(MD=1.80,95%CI 1.62 to 1.97;P<0.00001;I^(2)=0%).For pressure pain threshold,two small studies suggested greater increases with acupuncture.Safety data were limited,with only one trial reporting mild adverse events in the acupuncture group.Conclusion Based on limited evidence,acupuncture appears superior to negative controls in relieving pain associated with TMD but shows no significant advantage over positive controls.The certainty of the evidence for all outcomes,as assessed by GRADE,was low or very low.Therefore,these findings should be interpreted with caution.Future high-quality randomized controlled trials are warranted to further evaluate the role of acupuncture in the management of patients with TMD.展开更多
OBJECTIVE:To evaluate the clinical efficacy and safety of acupuncture for postpartum depression group.METHODS:A total of 84 participants were allocated into the acupuncture(n=59)and blank control(BC;n=25)groups.Partic...OBJECTIVE:To evaluate the clinical efficacy and safety of acupuncture for postpartum depression group.METHODS:A total of 84 participants were allocated into the acupuncture(n=59)and blank control(BC;n=25)groups.Participants in the acupuncture group received acupuncture therapy twice a week for 16 sessions in total,while participants in the BC group received no medical intervention.The primary outcomes were the response and elimination rates.The secondary outcome measures were the scores of the 17-item Hamilton Depression Rating Scale(HDRS17)and the factor analysis of the HDRS17.RESULTS:Compared to the BC group,the acupuncture group showed significant improvement in response and elimination rates(both P<0.05).A significant difference at week 8 was found in the between-group HDRS17 score alterations[RR=-3.04,95%CI(-5.16,-0.92),P<0.05].In addition,the reduction in depression and insomnia in the acupuncture group was greater than that in the BC group[between-group difference,depression:RR=1.20,95%CI(0.14,2.26),P<0.05;insomnia:RR=0.89,95%CI(0.16,1.62),P<0.05].There were no severe adverse events in our study.CONCLUSION:Acupuncture alleviated the severity of postpartum depressive symptoms compared to the control condition,and no serious adverse events occurred during the treatment.展开更多
BACKGROUND Cervical spondylosis(CS)frequently co-occurs with generalized anxiety disorder(GAD),presenting a complex clinical challenge.Managing CS-related pain in patients with GAD is particularly challenging because ...BACKGROUND Cervical spondylosis(CS)frequently co-occurs with generalized anxiety disorder(GAD),presenting a complex clinical challenge.Managing CS-related pain in patients with GAD is particularly challenging because of the bidirectional relationship between pain and anxiety,necessitating integrated treatment strategies.AIM To evaluate the efficacy of electroacupuncture(EA)in treating CS-related pain and anxiety in patients with GAD.METHODS This retrospective cohort study analyzed data from 83 patients with CS-related pain and GAD who received EA treatment over 2-year period.Pain intensity was assessed using the visual analog scale,and anxiety symptoms were measured using the Hamilton Anxiety Rating Scale.Additionally,neuroinflammatory markers,including interleukin-6,tumor necrosis factor-alpha,and high-sensitivity C-reactive protein,were examined.Outcomes were evaluated at baseline,after 4 weeks,and after 8 weeks of treatment.RESULTS EA treatment significantly reduced CS-related pain(mean visual analog scale reduction:3.24±1.18;P<0.001)and improved anxiety symptoms(mean Hamilton Anxiety Rating Scale reduction:7.83±2.65;P<0.001)after 8 weeks of treatment.Neuroinflammatory markers also showed significant reductions,with interleukin-6 and tumor necrosis factor-alpha levels decreasing by 32.7%and 28.5%,respectively(P<0.01).Pain reduction was significantly correlated with improvements in anxiety symptoms(r=0.68;P<0.001)and a decrease in inflammatory markers(r=0.54;P<0.01).CONCLUSION EA demonstrates significant efficacy in reducing CS-related pain in patients with comorbid GAD,along with concurrent improvements in anxiety symptoms and neuroinflammatory profiles.These findings suggest that EA may offer a valuable integrative approach for managing this complex clinical presentation,potentially addressing both pain and anxiety through the modulation of neuroinflammatory pathways.展开更多
OBJECTIVE:To investigate the mechanism of electroacupuncture of sympathetic nerve activity and blood pressure reduction in the hypothalamic paraventricular nucleus(PVN)of spontaneous hypertensive rats(SHRs).METHODS:A ...OBJECTIVE:To investigate the mechanism of electroacupuncture of sympathetic nerve activity and blood pressure reduction in the hypothalamic paraventricular nucleus(PVN)of spontaneous hypertensive rats(SHRs).METHODS:A total of 64 male SHRs were divided into four groups:model,sham-operated(Sham),electroacupuncture(EA),and N-methyl-D-aspartate receptor antagonist and electroacupuncture(NRA+EA).In addition,16 Wistar-Kyoto rats were used as controls.PVN stereotaxic surgery was performed in both the Sham and NRA+EA groups,while the EA and NRA+EA groups received 14 d of electroacupuncture.Blood pressure(BP)and heart rate(HR)were measured the day before the intervention and every other day.After 14 d of intervention,the rats in each group were tested for renal sympathetic nerve activity(RSNA).The associated factor levels were determined using Western blotting,reverse transcription-polymerase chain reaction(RTPCR),enzyme-linked immunosorbent assay(ELISA)and immunofluorescence assays.RESULTS:In comparison to the model group,the EA and NRA+EA groups had significantly lower BP,HR,and RSNA(P<0.01).The expression of N-methyl-Daspartate receptor(NMDAR),angiotensin II(Ang II),angiotensin II type 1(AT1),tumor necrosis factor-α,interleukin-1β,norepinephrine and arginine vasopressin was significantly lower in the EA and NRA+EA groups(P<0.01).Moreover,the antihypertensive effect of NRA+EA group outperformed to the EA group.CONCLUSIONS:Electroacupuncture effectively reduced the BP and sympathetic nerve excitability in SHRs.The mechanism was linked to the inhibition of NMDARmediated Ang II/AT1 and the inflammatory response in PVN.展开更多
基金Supported by Guangxi Administration of Traditional Chinese Medicine High-Level Key Discipline in Traditional Chinese Medicine-Acupuncture and Moxibustion Project(No.2025013-03-05)Guangxi University of Chinese Medicine Guangxi School Apricot Grove Top Talents Project(No.2022C017)。
文摘OBJECTIVE:To evaluate the effectiveness and safety of multiple acupuncture therapies in the treatment of allergic rhinitis(AR)using a network Meta-analysis.METHODS:This network Meta-analysis adhered to the PRISMA-NMA guideline.Eight databases were systematically searched from inception to December 31,2023,and retrieved references were managed using End Note 20.The risk of bias in individual studies was assessed with the Cochrane Ro B 2.0 tool(ROB 2.0).Data analysis was performed using R 4.2.1 and STATA 15.1.RESULTS:A total of 56 studies that had enrolled 4859 patients with AR were included.Hand acupuncture(HA)combined with acupoint catgut embedding(AE),hand acupuncture with heat sensitive moxibustion(HA+HSM),and acupoint application were the most effective in attaining the clinical effective rate.HA+AE,hand acupuncture with indirect moxibustion(HA+IM),and electroacupuncture(EA)with AE ranked the highest with respect to the Rhinoconjunctivitis Quality of Life Questionnaire Score.HA+IM,HA,and HA+EA yielded the best Total Nasal Symptom Score,whereas HA+AE,EA+AE,and HA had the best results for the Total NonNasal Symptom Score.However,subgroup analyses of clinical efficacy revealed that HA+HSM had the best therapeutic effects in the short term,whereas HA+AE was the most effective in the medium to long term.CONCLUSION:Combined acupuncture and moxibustion therapy may be a safe and effective intervention for patients with AR.HA+IM and HA+AE exhibited the most desirable therapeutic effects compared with other acupuncture and moxibustion therapies.
基金supported by National Natural Science Foundation of China(No.82104986 and 82274643)Shanghai“Rising Stars of Medical Talents”Youth Development Program(No.SHWSRS[2023]_062)from Shanghai Municipal Health Commission。
文摘Objective:Comorbid pain and depression are common but remain difficult to treat.Electroacupuncture(EA)can effectively improve symptoms of depression and relieve pain,but its neural mechanism remains unclear.Therefore,we used resting-state functional magnetic resonance imaging(rs-fMRI)to detect cerebral changes after initiating a mouse pain model via constriction of the infraorbital nerve(CION)and then treating these animals with EA.Methods:Forty male C57BL/6J mice were divided into 4 groups:control,CION model,EA,and sham acupuncture(without needle insertion).EA was performed on the acupoints Baihui(GV20)and Zusanli(ST36)for 20 min,once a day for 10 consecutive days.The mechanical withdrawal threshold was tested3 days after the surgery and every 3 days after the intervention.The depressive behavior was evaluated with the tail suspension test,open-field test,elevated plus maze(EPM),sucrose preference test,and marble burying test.The rs-fMRI was used to detect the cerebral changes of the functional connectivity(FC)in the mice following EA treatment.Results:Compared with the CION group,the mechanical withdrawal threshold increased in the EA group at the end of the intervention(P<0.05);the immobility time in tail suspension test decreased(P<0.05);and the times of the open arm entry and the open arm time in the EPM increased(both P<0.001).There was no difference in the sucrose preference or marble burying tests(both P>0.05).The fMRI results showed that EA treatment downregulated the amplitude of low-frequency fluctuations and regional homogeneity values,while these indicators were elevated in brain regions including the amygdala,hippocampus and cerebral cortex in the CION model for comorbid pain and depression.Selecting the amygdala as the seed region,we found that the FC was higher in the CION group than in the control group.Meanwhile,EA treatment was able to decrease the FC between the amygdala and other brain regions including the caudate putamen,thalamus,and parts of the cerebral cortex.Conclusion:EA can downregulate the abnormal activation of neurons in the amygdala and improve its FC with other brain regions,thus exerting analgesic and antidepressant effects.Please cite this article as:Yin X,Zeng XL,Lin JJ,Xu WQ,Cui KY,Guo XT,Li W,Xu SF.Brain functional changes following electroacupuncture in a mouse model of comorbid pain and depression:A restingstate functional magnetic resonance imaging study.
文摘BACKGROUND Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis,a common acute abdominal condition.Despite surgical advances,postoperative gastrointestinal dysfunction and delayed recovery continue to negatively impact rehabilitation outcomes and patient quality of life.Laser acupuncture represents a promising emerging complementary therapy with potential benefits for promoting functional recovery.AIM To evaluate the clinical efficacy of laser acupuncture in enhancing gastrointestinal function recovery following laparoscopic appendectomy and to investigate its potential applications in postoperative rehabilitation.METHODS This retrospective controlled clinical study selected 120 acute appendicitis patients who underwent laparoscopic appendectomy from January 2022 to December 2023 at a tertiary hospital.Patients were randomly divided into two groups:Routine treatment group(n=60)and laser acupuncture intervention group(n=60).There were no significant statistical differences in baseline characteristics(age,gender,body mass index,appendicitis severity)between the two groups.The routine treatment group received standard postoperative care,while the laser acupuncture intervention group received additional laser acupuncture treatment on top of standard care.Key observation indicators included time to first exhaust,time to first bowel movement,time to gastrointestinal function recovery,and postoperative complication rates.RESULTS Patients in the laser acupuncture intervention group showed significantly faster gastrointestinal function recovery compared to the routine treatment group.Specifically,time to first exhaust was significantly shortened(intervention group:12.5±2.3 hours vs control group:18.7±3.1 hours,P<0.05),time to first bowel movement was earlier(intervention group:36.4±4.6 hours vs control group:48.2±5.7 hours,P<0.05),postoperative complication rate was significantly reduced(intervention group:8.3%vs control group:20.0%,P<0.05),postoperative pain score was significantly lower(intervention group:3.2±1.1 vs control group:4.7±1.5,P<0.05),and intestinal motility recovery was faster and more effective.CONCLUSION Laser acupuncture,as an auxiliary treatment method,can significantly promote gastrointestinal function recovery in patients after laparoscopic appendectomy,reduce complications,and improve postoperative comfort.This technique has advantages such as minimal invasiveness,rapid recovery,and few side effects,making it worthy of further clinical promotion and application.
基金Supported by the National Natural Science Foundation of China:Exploration of Key Factors and Mechanisms of Modulating Motor Function Reconstruction After Cerebral Infarction Through Multimodal Brain Functional Connectivity Perspective in Procedural Acupoint Electrical Stimulation Research(No.82374601)the Jointly Guided Program of Natural Science Foundation of Heilongjiang Province:Quantitative Study on the Role of Scalp Acupuncture in the Motor Area in Promoting Motor Function Reconstruction after Stroke(No.LH2019H113)+1 种基金the Innovation Team Construction Project of Heilongjiang University of Chinese Medicine:Construction of a Doctoral Research and Innovation Team in Acupuncture Science(No.2017sit01)the Traditional Chinese Medicine Research Project of Heilongjiang Province:Clinical Study on the Promotion of Upper Limb Motor Function Reconstruction in Post-Stroke Patients Using Optimal Limb Positioning with Electroacupuncture(No.ZHY2022-171)。
文摘OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)at scalp motor area for treating post-stroke wrist dyskinesia and its influence on the function of wrist movement-related agonistic muscles.METHODS:A randomized,single-blind,controlled clinical trial was conducted.Sixty-six patients undergoing post-stroke wrist dyskinesia were enrolled and randomized 1:1 to EA or control group.Patients in the control group received manual acupuncture in the scalp motor area(MS 6)on the lesion side.The same acupoint was selected to accept EA stimulation in the EA group.All patients were treated six times a week for three weeks.The primary outcome was the Chinese Stroke Scale(CSS)score.The secondary outcomes included upper limb-related Barthel Index(BI)score,active range of motion(AROM)of the wrist joint,and root mean square(RMS)of the four agonistic muscles associated with wrist motion on the hemiplegic side of patients,i.e.,the extensor carpi radialis longus(ECRL),extensor digitorum(ED),flexor carpi radialis(FCR)and flexor carpi ulnaris(FCU).The above indicators were measured before and after three weeks of treatment.RESULTS:After 3-week treatment,the CSS score and AROM of wrist dorsiflexion of the EA group were better than those in the control group(P=0.038,P=0.047).The differences between the two groups of BI scores and AROM of wrist flexion were not significant(P>0.05).All RMS of the EA group were higher than those in the control group(ECRL:P=0.047,ED:P=0.048,FCR:P=0.049,FCU:P=0.047).The total effective rate in the EA group was 87.50%(28/32),which was higher than that in the control group(77.42%,24/31,P=0.048).CONCLUSION:EA stimulation of the scalp motor area can promote the recovery of the strength and function of the agonistic muscles related to wrist movement and effectively improve post-stroke wrist dyskinesia.
基金Supported by Special Funds for Basic Scientific Research of Central Public Welfare Research Institutes:201814006。
文摘Objective:This study aimed to explore the clinical effect of acupuncture therapy for menstruation regu-lation and pregnancy promotion on thin endometrium in the real world.Design:This study is a single-center pragmatic randomized controlled trial blinded to the statisticians.Using the“blockrand”software package,based on the age(≥35,<35),37 patients were randomized into an intervention group(19 cases)and a control group(18 cases).After reassignment regarding patient preference,21 patients were included in the intervention group and 16 in the control group.Setting:The trial was executed in the Specialty Outpatient Clinic,Acupuncture-Moxibustion Hospital of China Academy of Chinese Medical Sciences,from March 1,2019,to September 30,2020.Participants:The study included 37 patients with thin endometrium and without previous acupuncture treatment.Intervention:The intervention group was administered acupuncture for menstruation regulation and pregnancy promotion and a small-dose of progynova(2 mg daily),while the control group was adminis-tered a large-dose of progynova(4 mg daily).Interventions started from Day 5 of menstruation until the end of ovulation under B-ultrasound monitoring.The intervention lasted for three menstrual cycles.Measurements:Primary outcomes were changes in endometrial thickness between baseline and after intervention completion and the difference between the two groups after intervention.The secondary outcomes were endometrial and subendometrial blood flow,serum estradiol levels,menstrual conditions,and adverse reactions.Results:(1)Comparison of each indicator before and after intervention completion in the two groups:in the intervention group,the differences were significant in endometrial thickness,menstrual score,estra-diol(E2)level in ovulatory period,the pulsatility index(PI)and resistance index(RI)of uterine artery,the ratio of peak systolic velocity to end-diastolic velocity(S/D),the endometrial vascular index(VI),flow index(FI),and vascular flow index(VFI)and volume(P<0.01).In the control group,significant changes were observed in endometrial thickness,menstrual score,and E2 before and after the interven-tion(P<0.05),and no differences were observed in uterine artery PI,RI,S/D and endometrial VI,FI,VFI,and volume(P>0.05).Compared with the control group,the intervention group showed significant differences in endometrial thickness,menstrual score,E2,uterine artery PI,RI,S/D,and endometrial VI,FI,VFI,and volume after intervention(P<0.01).No adverse reactions were reported in the intervention group.In contrast,the control group had two cases of nausea and gastrointestinal discomfort after med-ication,eight cases of breast distention during medication,and one case of breast nodules enlarged by 1 cm after trial completion.
基金Supported by Traditional Chinese medicine foundation of Zhejiang province:Clinical Study on the Correlation Between Tourette Syndrome and Anatomical Changes in the Atlantoaxial Joint(2010ZB162)Medical Health Science and Technology Project of Zhejiang Provincial Health Commission:Study on Protein Fingerprinting of Tourette Syndrome(2011KYB142)+1 种基金Renowned Traditional Chinese Medicine Expert Inheritance Studio Construction Project of Zhejiang province(No.GZS2020049)Key Disciplines of Traditional Chinese Medicine Foundation of Zhejiang Province(2012-XK-D20)。
文摘OBJECTIVE:To explore the efficacy and safety of acupuncture combined with atlantoaxial joint bone-setting therapy for the treatment of Tourette syndrome.METHODS:We randomly divided 600 patients at a ratio of 1∶1∶1 into three groups:group A(acupuncture combined with atlantoaxial joint bone setting therapy group),group B(acupuncture group),and group C(tiapride group).After two months of treatment,the Yale global tic severity scale(YGTSS)score reduction,improvement in social function impairment,clinical efficacy,and long-term efficacy in the three groups were compared.RESULTS:After treatment,in the analysis of YGTSS score reduction,social function impairment improvement,the clinical control rate,and long-term efficacy,the results were all Group A>Group B>Group C,with a statistically significant difference(P<0.05).However,the total clinical efficacy of treatment in group A(94.9%)was not significantly different from that in group B(91.8%).Adverse reactions did not occur in groups A and B,and several adverse reactions occurred in 29%(n=58)of the group C patients.CONCLUSION:Compared with traditional drug therapy,acupuncture combined with atlantoaxial joint bone setting therapy has better clinical and long-term efficacy.This treatment strategy can improve the social function of children and prevent adverse reactions to drugs.
基金supported by grants from the Shanghai Science and Technology Commission(No.21ZR1461000)Shanghai Municipal Health Commission(No.ZY[2021–2023]−0204).
文摘Objective The present study evaluated the effects of deep acupuncture at Weizhong acupoint(BL40)on bladder function and brain activity in a rat model of overactive bladder(OAB),and investigated the possible mechanisms around the acupuncture area that initiate the effects of acupuncture.Methods Adult female Sprague-Dawley rats were randomly divided into six groups,comprising a control group,model group,group treated with deep acupuncture at BL40,group treated with shallow acupuncture at BL40,group treated with acupuncture at non-acupoint next to BL40,and group treated with acupuncture at Xuanzhong(GB39).Urodynamic evaluation was used to observe the urination,and functional magnetic resonance imaging was used to observe the brain activation.The mechanism of acupuncture at BL40 in regulating bladder function was explored by toluidine blue staining and enzyme-linked immunosorbent assay,and the mechanism was verified by stabilizing mast cells(MCs)or blocking tibial nerve.Results Deep acupuncture at BL40 significantly increased the intercontraction interval in OAB rats and enhanced the mean amplitude of low frequency fluctuation of primary motor cortex(M1),periaquaductal gray matter(PAG),and pontine micturition center(PMC).It also increased the zero-lag functional connectivity between M1 and PAG and between PAG and PMC.Shallow acupuncture at BL40 and acupuncture at non-acupoint or GB39 had no effect on these indexes.Further studies suggested that deep acupuncture at BL40 increased the number and degranulation rate of MCs as well as the contents of 5-hydroxytryptamine,substance P,and histamine in the tissues around BL40.Blocking the tibial nerve by lidocaine injection or inhibiting MC degranulation by sodium cromoglycate injection obstructed the effects of acupuncture on restoring urinary function and modulating brain activation in OAB rats.Conclusion Deep acupuncture at BL40 may be more effective for inhibiting OAB by promoting degranulation of MCs around the acupoint and stimulating tibial nerve,thereby regulating the activation of the brain area that controls the lower urinary tract.
基金the National Natural Science Foundation of China:to Explore the Mechanism of Acupuncture Treatment on Rats with Allergic Rhinitis from the Hypothalamic-Pituitary-Adrenal (HPA) Axis and Serum Immune Factor Levels (No.82004455)。
文摘OBJECTIVE:To explore the correlation between acupuncture treatment for allergic rhinitis(AR) and hypothalamic-pituitary-adrenal(HPA) axis regulation by investigating changes in serum immune factors,HPA axis-associated hormone levels,activation levels of paraventricular nucleus(PVN) neurons,and the severity of nasal mucosal lesions,in rats with AR before and after acupuncture treatment.METHODS:After establishing the AR rat model,ovalbumin was administered via nasal drip to all groups except the blank control.Each group received continuous treatment for 14 d:the acupuncture,acupuncture + RU-486(mifepristone),and RU-486 groups received acupuncture only,RU486 intraperitoneal injection and acupuncture,and RU-486 intraperitoneal injection only,respectively.Following the intervention period,behavioral scoring was performed on all AR rats,and peripheral blood,nasal mucosa samples,and brains tissue(containing PVN region) were obtained following euthanization.Interleukin(IL-4,IL-5,IL-13),interferon gamma(IFN-γ),corticosterone(CORT),and corticotrophin-releasing hormone(CRH) levels were evaluated in peripheral blood samples.Adrenocorticotropic hormone(ACTH) levels were determined using an enzyme-linked immunoassay assay,and hematoxylin and eosin staining was performed on the nasal mucosa samples.The expression levels of c-Fos in PVN neurons following acupuncture treatment were evaluated by immunofluorescent staining.RESULTS:Following the intervention period,the behavioral scores for the blank control group were lower than those of other groups(P < 0.05),while the acupuncture group scores were lower than those in the model control,acupuncture + RU486,and RU486 groups(P < 0.05).The blank control group had lower serum IL-4,IL-5,and IL-13 levels than those in the other groups(P < 0.05).The acupuncture group had lower serum IL-4,IL-5,and IL-13 levels than those in the model control,acupuncture + RU486,and RU486 groups(P < 0.05).The blank control group had the highest serum IFN-γ levels among all groups,followed by the acupuncture group.The serum CORT,CRH,and ACTH levels in the blank control group were lower than those in the remaining groups(P < 0.05).These biomarker levels were also lower in the acupuncture group than those in the model control,acupuncture + RU486,and RU486 groups(P < 0.05).Compared with model,rats in the acupuncture group exhibited an increased c-Fos expression in PVN neurons.CONCLUSION:Acupuncture can alleviate AR symptoms and regulate serum inflammatory factor levels and HPA axis-related hormones in AR rats.Moreover,these effects are inhibited by glucocorticoid antagonists,suggesting that acupuncture may regulate AR symptoms through HPA axis regulation.
基金Natural Science Foundation-funded Project:Regulation of Autophagy by Electroacupuncture at Weizhong Point on the Proliferation of Multifidus Muscle Satellite Cells (No.81574052) and Exosomes Arounding Acupoints Deliver miR-206 to Mediate Insulin-like Growth Factor 1/Phosphatidylinositol 3-Kinase/Protein Kinase B Pathway and Regulate Muscle Satellite Cell Differentiation:Mechanism of Electroacupuncture in Promoting Rehabilization of Lumbar Multifidus Muscles Injury in Model Rats (No.82174482)Major Program of Foundation of Inner Mongolia Autonomous Region:Study on the Eeffect of Pediatric Tuina Combined with Acupuncture on the Intestinal Microflora Structure in Children with Provisional Tic Disorder and its Therapeutic Mechanism (201802127)。
文摘OBJECTIVE:To investigate the anti-inflammatory effect of electroacupuncture in rats with bupivacaine-induced lumbar multifidus injury and its underlying regulatory mechanism on macrophage polarization.METHODS:A total of seventy-two Sprague-Dawley male rats were randomly divided into control,model,and electroacupuncture groups.Forty-eight rats categorized in model groups were injected 0.5% bupivacaine(BPVC) into the lumbar multifidus at the L4-L5 segment.Rats in the electroacupuncture groups received the intervention for 1,2,3 and 5 d,respectively.The degree of macrophage infiltration and change of M1/M2 polarization were observed based on hematoxylin and eosin staining,immunohistochemistry and immunofluorescence to evaluate the anti-inflammatory effect of electroacupuncture.Meanwhile,exosomal miRNAsequencing and bioinformatics analysis predicted the pathways and biological processes related to inflammatory response and macrophage polarization regulated by electroacupuncture intervention.RESULTS:BPVC injection induced the infiltration of local macrophages at the L4-L5 segment of lumbar multifidus.Comparison of mean IOD values with 2 d and 5 d post injury revealed the highest expression of CD68+ macrophages on day 3 post injury by immunohistochemistry.(P < 0.001,P < 0.001,respectively).Compared with the model group,the cell counts of iNOs+ CD68+ M1-macrophages were lower in the electroacupuncture group,while the positive percent of CD163+ CD206+ M2-macrophages was higher in the electroacupuncture group,on day 3 after BPVC injection(P < 0.001,P < 0.001,respectively).Moreover,the results of sequencing and bioinformatic analysis suggested that exosomal miRNAs were involved in the EA regulating macrophage polarization.CONCLUSIONS:Electroacupuncture can promote macrophage polarization to reduce inflammation following lumbar multifidus muscular injury.
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.
文摘BACKGROUND Postoperative intestinal paralysis is common in gastrointestinal surgery,and the study of electroacupuncture mechanisms is of great significance.AIM To explore the neuroimmune regulatory mechanism of electroacupuncture at the Zusanli acupoint(ST36)in postoperative intestinal paralysis following gastrointestinal surgery.METHODS A total of 156 patients admitted to the Affiliated Hospital of Jiangnan University between January 2022 and October 2024 for postoperative intestinal paralysis following gastrointestinal surgery were randomly divided into two groups:A control group and an electroacupuncture group,with 75 patients in each.The control group received conventional Western medical treatment,while the electroacupuncture group received electroacupuncture in addition to this,at the bilateral Zusanli acupoints.Both groups received treatment for 7 days.Clinical efficacy,gastrointestinal function recovery,and gastrointestinal hormone[motilin(MTL),gastrin(GAS)],neurotransmitter[vasoactive intestinal peptide(VIP),nitric oxide(NO)],and inflammatory cytokine[tumor necrosis factor-α(TNF-α),serum interleukin-6(IL-6),interleukin-1β(IL-1β)]levels were compared between the two groups before and seven days after treatment.Adverse reactions were also recorded.RESULTS The electroacupuncture group demonstrated a higher overall treatment effectiveness rate and faster recovery of bowel sounds,as well as faster first defecation and first flatus than the control group(P<0.05).After seven days of treatment,MTL and GAS levels were significantly higher and VIP,NO,TNF-α,IL-6 and IL-1βlevels were significantly lower in the electroacupuncture group than in the control group(P<0.05).No adverse reactions were observed in either group during treatment.CONCLUSION Electroacupuncture at the Zusanli acupoint can enhance clinical efficacy,promote the recovery of gastrointestinal function,and regulate the neuroimmune microenvironment in patients with intestinal paralysis after gastrointestinal surgery.This mechanism may involve excitation of the vagus nerve and activation of the cholinergic antiinflammatory pathway through electroacupuncture stimulation of the Zusanli acupoint.
基金supported by Pudong New Area Science and Technology Development Fund Special Research Project on the Livelihood of Institutions(No.PKJ2023-Y03)Pudong New Area Chinese Medicine Senior Teacher Training Program(No.PDZY-2023-0801)Talents Training Program of the Seventh People’s Hospital,Shanghai University of Traditional Chinese Medicine(No.JY2024-08).
文摘Background:Diabetic peripheral neuropathy(DPN)is a prevalent and debilitating complication of diabetes mellitus,lacking effective treatment options.Despite unclear underlying mechanisms,electroacupuncture(EA)shows promise in relieving DPN symptoms.Neurotransmitter dysregulation is central to DPN pathophysiology.This study aimed to investigate EA’s effects on DPN via targeted neurotransmitter metabolomics.Methods:A streptozotocin-induced mouse model of DPN was developed,and EA treatment was administered for two weeks to assess the therapeutic potential of EA.Following the collection of sciatic nerve samples,LC-MS-based targeted metabolomics analyses investigations were performed to examine alterations in DPN-associated neurotransmitter metabolism brought on by EA therapy.Multivariate statistical analyses were employed to assess metabolite expression patterns,using cluster heatmaps to display neurotransmitter expression results.KEGG pathway analyses were also used to explore the functional classifications of these neurotransmitters and associated metabolic pathways.Results:Targeted neurotransmitter-focused metabolomics analyses led to the identification of 34 putative biomarkers associated with EA treatment,of which 5 showed significant changes,such as beta-alanine(increased by 80.37%,P=0.0004)and kynurenine(decreased by 29.36%,P=0.0163).KEGG pathway analysis indicated that changes in the abundance of these metabolites were associated with the cAMP signaling pathway,neuroactive ligand-receptor interactions,the synaptic vesicle cycle,and other pathways.Conclusion:The results indicate that EA can efficiently regulate neurotransmitter metabolism and restore peripheral nerve function,suggesting a feasible non-pharmacological strategy for DPN treatment and warranting clinical translation.
文摘BACKGROUND Post-operative nausea and vomiting(PONV)after cholecystectomy occurs in 40%-75%of patients,significantly affecting recovery and satisfaction.AIM To evaluate the effectiveness and safety of acupuncture at Hegu(LI4)and Zusanli(ST36)acupoints in preventing PONV in patients undergoing cholecystectomy.METHODS This retrospective study included 240 patients undergoing cholecystectomy(January 2022 to December 2023),randomized to acupuncture(n=120)or control groups(n=120).The acupuncture group received bilateral LI4 and ST36 acupuncture immediately post-surgery and 6 hours later;controls received routine care.Primary outcomes included PONV incidence,severity(visual analogue scale score),and time to first occurrence.RESULTS The total PONV incidence in the acupuncture group was significantly lower than in the control group(28.3%vs 47.5%,P<0.01).Stratified analysis showed that in the laparoscopic group,the acupuncture group’s PONV incidence was 26.7%,significantly lower than the control group’s 45.6%(P<0.01);in the open surgery group,the acupuncture group was 33.3%,lower than the control group’s 53.3%(P<0.05).The acupuncture group showed significantly reduced symptom severity(visual analogue scale score 2.7±1.4 vs 4.5±1.8,P<0.01),delayed time to first occurrence(8.4±2.1 hours vs 4.2±1.5 hours,P<0.01),with the symptom-free period extended by 4.2 hours.The acupuncture group had a higher proportion of mild symptoms(76.5%vs 35.1%)and a significantly increased proportion of symptom-free patients within 6 hours post-surgery(67.6%vs 28.1%,P<0.01).Rescue antiemetic medication usage was significantly reduced in the acupuncture group(18.3%vs 35.8%,P<0.01).Patient satisfaction scores in the acupuncture group were significantly better than the control group(4.6±0.7 vs 3.8±0.9,P<0.01),with hospital stay shortened by 0.5 days(2.1±0.8 days vs 2.6±1.1 days,P<0.05).Subgroup analysis showed that acupuncture was more effective in patients≤45 years(incidence reduction 23.5%vs>45 years group 16.8%),with significant efficacy in high-risk patients(Apfel score≥3)(36.2%vs 62.2%,P<0.01).Safety analysis showed only 7 cases(5.8%)of mild adverse reactions in the acupuncture group,all self-resolved with no serious adverse events.CONCLUSION Acupuncture at LI4 and ST36 acupoints significantly reduces PONV incidence and severity after cholecystectomy,with an excellent safety profile.This non-pharmacological intervention offers particular value for high-risk patients and those with medication contraindications.
文摘Objective:To explore the effect of combining Duhuo Jisheng decoction with warm acupuncture and moxibustion in the treatment of patients with lumbar disc herniation.Methods:Using a random number table method,a total of 100 patients with lumbar disc herniation treated at Xianning Matang Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were divided into a control group of 50 patients treated with Duhuo Jisheng decoction and a study group of 50 patients treated with Duhuo Jisheng decoction combined with warm acupuncture and moxibustion.The TCM syndrome scores,lumbar function,lumbar pain,and lumbar activity were compared between the two groups.Results:After intervention,the TCM syndrome scores,ODI,and VAS scores of both groups showed a decreasing trend compared to before intervention,and the decreasing trend was more significant in the study group(P<0.05).After intervention,the JOA and lumbar activity indicators of both groups showed an increasing trend compared to before intervention,and the increasing trend was more significant in the study group(P<0.05).Conclusion:Duhuo Jisheng decoction combined with warm acupuncture and moxibustion is an effective and safe treatment method for lumbar disc herniation,which can improve lumbar function and activity.
基金the Medical Technologies R&D Program of Henan Province:Clinical Efficacy and Mechanism of Action of Intermittent Oro-esophageal Tube Feeding in the Treatment of Post-Stroke Dysphagia(No.LHGJ20220348)Natural Science Foundation of Henan Province:Mechanism of Acupuncture in Preventing and Treating Limb Spasticity after Stroke Based on Mechanistic Target of Rapamycin Lactylation and Mitophagy(No.232300420256)。
文摘OBJECTIVE:To investigate the possible mechanisms by which acupuncture improves post-stroke limb spasticity using single-cell sequencing technology.METHODS:Thirty-two rats were randomly assigned to four groups:Control,Sham,Model,and Acupuncture.The middle cerebral artery occlusion(MCAO)model was established,and the acupuncture groups received acupuncture treatment.After treatment,brain morphological changes and the degree of neurological impairment were assessed.The effect of acupuncture on the proportion of brain cell types in the ischemic penumbra of MCAO rats was analyzed using single-cell transcriptomics,and the expression and enrichment of differentially expressed genes were examined.Finally,selected differential genes were validated by Western blot and quantitative real-time polymerase chain reaction.RESULTS:Triphenyltetrazolium chloride staining showed that the infarct area in MCAO rats was significantly reduced after acupuncture.Garcia scoring,hematoxylin-eosin staining,Nissl staining,and terminal deoxynucleotidyl transferase d UTP nick end labeling demonstrated that acupuncture reduced brain damage.Enzyme-linked immunosorbent assay results showed that acupuncture significantly decreased serum inflammatory factors,including interleukin-1 beta(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-alpha(TNF-α).Single-cell transcriptome analysis revealed marked changes in cell type proportions between the Acupuncture and Model groups.A total of 207 differential genes were identified,including 157 upregulated and 50 downregulated genes.Analysis of macrophage-specific differential genes in the ischemic penumbra showed enrichment in Gene Ontology terms such as Ras protein signal transduction and regulation of GTPase activity,and Kyoto Encyclopedia of Genes and Genomes pathways including lysosome,axon guidance,and mitogenactivated protein kinase signaling.S100a8 and leukocyte specific transcript 1(LST1)were identified as key differential genes.CONCLUSION:These findings suggest that the key differential genes S100a8 and LST1 may alleviate poststroke limb spasticity by regulating the inflammatory response in the ischemic penumbra.
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.
文摘Background Temporomandibular disorders(TMD)are the leading cause of chronic orofacial pain,which significantly affects patients’quality of life.However,the efficacy of acupuncture in the management of TMD remains unclear.Objective This systematic review aimed to conduct a PRISMA-compliant review to critically assess the therapeutic efficacy of acupuncture as an intervention for patients with TMD.Methods We searched nine electronic databases for randomized controlled trials on acupuncture for TMD published up to February 4,2025.Eligible studies included adults diagnosed with TMD and compared acupuncture(manual,electroacupuncture,warm,auricular,thread-embedding,or laser)with conservative treatment(positive control)or sham acupuncture(negative control).Outcomes included pain intensity,mouth opening,pressure pain threshold,and adverse events.Risk of bias was assessed using ROB 2,and certainty of evidence was evaluated using GRADE.All outcome data were analyzed using RevMan 5.4 software.Low heterogeneity was defined as I^(2)≤50% and P≥0.1,in which case a fixed-effects model was applied.High heterogeneity(I^(2)>50% or P<0.1)prompted further analysis to identify its source.After excluding the influence of evident heterogeneity,a random-effects model was used for the meta-analysis.Results Of the 2664 screened records,14 randomized controlled trials involving 476 participants met the inclusion criteria.Acupuncture significantly reduced pain intensity compared with that of negative controls(MD=-1.75,95%confidence interval[CI]-2.47 to-1.03;P<0.00001;I^(2)=60%)but showed no difference compared with that of positive controls(MD=-0.06,95%CI-0.62 to 0.50;P=0.83;I^(2)=0%).No significant differences were observed in pain-free jaw opening,whereas acupuncture improved maximum mouth opening relative to negative controls(MD=1.80,95%CI 1.62 to 1.97;P<0.00001;I^(2)=0%).For pressure pain threshold,two small studies suggested greater increases with acupuncture.Safety data were limited,with only one trial reporting mild adverse events in the acupuncture group.Conclusion Based on limited evidence,acupuncture appears superior to negative controls in relieving pain associated with TMD but shows no significant advantage over positive controls.The certainty of the evidence for all outcomes,as assessed by GRADE,was low or very low.Therefore,these findings should be interpreted with caution.Future high-quality randomized controlled trials are warranted to further evaluate the role of acupuncture in the management of patients with TMD.
基金the National Natural Science Foundation of China(No.82004470):Study on the Mechanism of Acupuncture in Treating Depression by Regulating Host Toll-like receptor 4/Nuclear Factor Kappa-B Signaling Pathway via Gut Microbiotathe Shenzhen Traditional Chinese Medicine Hospital"3030 Program",Chinese Medicine Clinical Research Project(No.G3030202119):Study on the Mechanism of Acupuncture in Treating Postpartum Depressive Disorder and Brain-Gut Response Characteristics Based on the"Gut Microbiota-Habenular Nucleus Neural Circuit"Pathway+1 种基金the Medical Research Foundation of Guangdong Province(No.B2023099):Study on Epidemiological Investigation of Postpartum Depression in Shenzhen Based on Internet Terminals and Evaluation of Intervention Effect of"Internet+"Peer Educationthe National Veteran Chinese Medicine Expert Inheritance Studio Construction Project[No.(2022)75]。
文摘OBJECTIVE:To evaluate the clinical efficacy and safety of acupuncture for postpartum depression group.METHODS:A total of 84 participants were allocated into the acupuncture(n=59)and blank control(BC;n=25)groups.Participants in the acupuncture group received acupuncture therapy twice a week for 16 sessions in total,while participants in the BC group received no medical intervention.The primary outcomes were the response and elimination rates.The secondary outcome measures were the scores of the 17-item Hamilton Depression Rating Scale(HDRS17)and the factor analysis of the HDRS17.RESULTS:Compared to the BC group,the acupuncture group showed significant improvement in response and elimination rates(both P<0.05).A significant difference at week 8 was found in the between-group HDRS17 score alterations[RR=-3.04,95%CI(-5.16,-0.92),P<0.05].In addition,the reduction in depression and insomnia in the acupuncture group was greater than that in the BC group[between-group difference,depression:RR=1.20,95%CI(0.14,2.26),P<0.05;insomnia:RR=0.89,95%CI(0.16,1.62),P<0.05].There were no severe adverse events in our study.CONCLUSION:Acupuncture alleviated the severity of postpartum depressive symptoms compared to the control condition,and no serious adverse events occurred during the treatment.
文摘BACKGROUND Cervical spondylosis(CS)frequently co-occurs with generalized anxiety disorder(GAD),presenting a complex clinical challenge.Managing CS-related pain in patients with GAD is particularly challenging because of the bidirectional relationship between pain and anxiety,necessitating integrated treatment strategies.AIM To evaluate the efficacy of electroacupuncture(EA)in treating CS-related pain and anxiety in patients with GAD.METHODS This retrospective cohort study analyzed data from 83 patients with CS-related pain and GAD who received EA treatment over 2-year period.Pain intensity was assessed using the visual analog scale,and anxiety symptoms were measured using the Hamilton Anxiety Rating Scale.Additionally,neuroinflammatory markers,including interleukin-6,tumor necrosis factor-alpha,and high-sensitivity C-reactive protein,were examined.Outcomes were evaluated at baseline,after 4 weeks,and after 8 weeks of treatment.RESULTS EA treatment significantly reduced CS-related pain(mean visual analog scale reduction:3.24±1.18;P<0.001)and improved anxiety symptoms(mean Hamilton Anxiety Rating Scale reduction:7.83±2.65;P<0.001)after 8 weeks of treatment.Neuroinflammatory markers also showed significant reductions,with interleukin-6 and tumor necrosis factor-alpha levels decreasing by 32.7%and 28.5%,respectively(P<0.01).Pain reduction was significantly correlated with improvements in anxiety symptoms(r=0.68;P<0.001)and a decrease in inflammatory markers(r=0.54;P<0.01).CONCLUSION EA demonstrates significant efficacy in reducing CS-related pain in patients with comorbid GAD,along with concurrent improvements in anxiety symptoms and neuroinflammatory profiles.These findings suggest that EA may offer a valuable integrative approach for managing this complex clinical presentation,potentially addressing both pain and anxiety through the modulation of neuroinflammatory pathways.
基金Doctoral Research Fund Project of Qilu Hospital of Shandong University(Qingdao):Mechanistic Study on the Improvement of Vertigo Caused by Posterior Circulation Ischemia by Acupuncture through Regulating Cerebral Blood Flow in Rats with Posterior Circulation Ischemia Vertigo(No.QDKY2023BS19)National Natural Science Foundation of China:From Microrna 9 Regulate P2X7 Receptor of Microglia in Paraventricular Nucleus of Hypothalamus to Explore the Effect of Electroacupuncture on Sympathetic Nerve Excitability in Spontaneously Hypertensive Rats(No.82074553)。
文摘OBJECTIVE:To investigate the mechanism of electroacupuncture of sympathetic nerve activity and blood pressure reduction in the hypothalamic paraventricular nucleus(PVN)of spontaneous hypertensive rats(SHRs).METHODS:A total of 64 male SHRs were divided into four groups:model,sham-operated(Sham),electroacupuncture(EA),and N-methyl-D-aspartate receptor antagonist and electroacupuncture(NRA+EA).In addition,16 Wistar-Kyoto rats were used as controls.PVN stereotaxic surgery was performed in both the Sham and NRA+EA groups,while the EA and NRA+EA groups received 14 d of electroacupuncture.Blood pressure(BP)and heart rate(HR)were measured the day before the intervention and every other day.After 14 d of intervention,the rats in each group were tested for renal sympathetic nerve activity(RSNA).The associated factor levels were determined using Western blotting,reverse transcription-polymerase chain reaction(RTPCR),enzyme-linked immunosorbent assay(ELISA)and immunofluorescence assays.RESULTS:In comparison to the model group,the EA and NRA+EA groups had significantly lower BP,HR,and RSNA(P<0.01).The expression of N-methyl-Daspartate receptor(NMDAR),angiotensin II(Ang II),angiotensin II type 1(AT1),tumor necrosis factor-α,interleukin-1β,norepinephrine and arginine vasopressin was significantly lower in the EA and NRA+EA groups(P<0.01).Moreover,the antihypertensive effect of NRA+EA group outperformed to the EA group.CONCLUSIONS:Electroacupuncture effectively reduced the BP and sympathetic nerve excitability in SHRs.The mechanism was linked to the inhibition of NMDARmediated Ang II/AT1 and the inflammatory response in PVN.
