针刺研究最新文献

Objectives: To observe the clinical effect of acupuncture on abducens nerve palsy (ANP) guided by Biaoben Genjie theory (referring to the distribution, connection and gathering of meridian qi in the body).

Methods: A total of 60 patients with ANP were randomly assigned to an observation group (30 cases) and a control group (30 cases). The conventional treatment with western medicine was used in the two groups. Additionally, in the observation group, based on Biaoben Genjie theory, acupuncture therapy was delivered at the sites of Biao, Ben, Gen and Jie of Shaoyang Meridians of hand and foot, meaning at Sizhukong (TE23), Zhongzhu (TE3), Zuqiaoyin (GB44) and Tongziliao (GB1), combined with Fengchi (GB20), Taiyang (EX-HN5), Qiuhou (EX-HN7) and Guangming (GB37). In the control group, the routine acupuncture therapy was operated. In either group, the intervention was given once daily, and 6 interventions a week as 1 course of treatment;6 courses were required, with a 1- day interval after every 6 interventions. Before and after treatment, diplopia degree, strabismus degree, the score for eye position, and the score for main symptoms of traditional Chinese medicine (TCM) were recorded and the clinical effect was evaluated in the two groups.

Results: After treatment completion, diplopia degree, strabismus degree, the score for eye position, and the score for main symptoms of TCM were reduced in both of the two groups compared with those before treatment (P<0.05), and the results in the observation group were better than those of the control group (P<0.05). The effective rate was 96.67% (29/30) in the observation group, and it was 86.67% (26/30) in the control group. The effective rate in the observation group was superior to that in the control group (P<0.05).

Conclusions: Under the guidance of Biaoben Genjie theory, acupuncture therapy can effectively ameliorate diplopia degree, strabismus degree, eye position score and the main symptoms of TCM;and it can promote the functional reconstruction in ANP to a certain extent.

Objectives: To observe the clinical efficacy of heat-sensitive moxibustion in reducing toxicity and enhancing efficacy in cancer patients undergoing chemotherapy, and to provide a scientific basis for its application and promotion in cancer rehabilitation.

Methods: A total of 150 malignant tumor patients were selected and randomly divided into a control group (75 cases, with 25 dropouts) and an experimental group (75 cases, with 21 dropouts). The control group received conventional chemotherapy and pharmacological treatment, while the experimental group received additional heat-sensitive moxibustion treatment, which administered once daily for 1 week before and after each chemotherapy session, for 4 consecutive chemotherapy cycles. Evaluation indicators included the incidence of adverse reactions, anorexia/cachexia scale (A/CS-12), nausea and vomiting grading, white blood cell count, platelet count, hemoglobin level, bone marrow suppression grade, and response evaluation criteria in solid tumors (RECIST 1.1). Data were collected before and after each chemotherapy session and statistically analyzed.

Results: Compared with pre-chemotherapy levels, as the number of chemotherapy sessions was increased, A/CS-12 scores were decreased in both groups (P<0.01), while the incidence of nausea and vomiting increased (P<0.01), the white blood cell count, platelet count, and hemoglobin levels were also decreased (P<0.01). Intergroup comparisons showed that the experimental group had a lower incidence of adverse reactions after each chemotherapy session (P<0.05, P<0.01), higher A/CS-12 scores (P<0.01), and lower rates of nausea and vomiting and bone marrow suppression (P<0.05, P<0.01) than the control group. Hematological analysis indicated that the experimental group had higher white blood cell counts and hemoglobin levels before the 2^nd to 4^th chemotherapy sessions (P<0.05, P<0.01), and higher platelet counts before the 3^rd and 4^th sessions (P<0.01). RECIST evolution result showed that the experimental group had an efficacy rate of 50.00%(27/54), which was higher (P<0.05) than that(28.00%[14/50]) of the control group.

Conclusions: Heat-sensitive moxibustion can reduce the incidence of chemotherapy-induced adverse reactions, alleviate gastrointestinal discomfort and bone marrow suppression, improve chemotherapy efficacy. It is worthy of clinical promotion and application.

Objectives: To summarize and evaluate the existing evidence on acupuncture-assisted in vitro fertilization-embryo transfer (IVF-ET), to survey clinicians and patients regarding gaps between the evidence and clinical concerns, and to identify directions for future clinical research.

Methods: Randomized controlled trials (RCTs) of acupuncture-assisted IVF-ET were retrieved from CNKI, SinoMed, VIP, WanFang, PubMed, Embase, and Cochrane Library from inception through December 31, 2024. Two researchers independently screened the literature and extracted data. The methodological quality of the included studies was assessed using the Risk of Bias (ROB) 1.0 tool. Questionnaires, developed based on prior research and expert discussions, were distributed to clinicians and patients. Discrepancies between the evidence and clinical priorities were analyzed across the population, intervention, comparison and outcome dimensions.

Results: A total of 143 RCTs with potential risks of bias were included. Questionnaires were completed by 103 clinicians and 108 patients. Comparisons reveal that elderly patients (>35 years old), patients with long-standing infertility (>5 years), and patients undergoing frozen embryo transfer are more focused on by clinicians, but the evidence supporting these concerns is limited. In acupuncture modalities, filiform needles have strong evidence and high recognition;moxibustion and ear acupuncture attract patients' attention but have limited evidence, while transcutaneous electrical acupoint stimulation shows the opposite pattern. Regarding acupuncture timing and frequency, doctors focus on the pre-oocyte retrieval, the retrieval-to-transfer, and post-embryo transfer periods, with low evidence in some periods. High-evidence scenarios (≥3 pre-oocyte retrieval, 1 post-embryo transfer) receive moderate-to-low doctors' attention. For control measures, comparisons with Western and Chinese medicine attract doctors' attention but with limited evidence;blank controls show the opposite trend. In terms of outcomes, live birth rate attracts attention but has limited evidence. Mental health outcomes have little evidence and show substantial disparities between doctor and patient priorities. Complications have weak evidence yet high doctors' focus. Clinical pregnancy rate aligns more closely with doctor-patient attention.

Conclusions: Future studies should enhance the quality of RCTs, broaden the range of included samples, and perform stratified analyses. High-quality trials are needed to evaluate the efficacy and safety of different interventions, determine the optimal acupuncture timing and frequency, and design clinically relevant control groups. Outcome measures should be expanded, and long-term follow-up should be emphasized to advance acupuncture's value in assisted reproduction.

Objectives: To evaluate the efficacy and safety of intranasal acupuncture for allergic rhinitis (AR).

Methods: Randomized controlled trials on intranasal acupuncture for AR were searched in China National Knowledge Infrastructure, Wanfang Data Knowledge Service platform, VIP Database, PubMed, Web of Science, Embase, and The Cochrane Library from their inception to October 2024. The basic information, evaluation of the therapeutic efficacy, related scales, and laboratory indexes were screened and extracted by 2 independent reviewers. The scales included the Total Nasal Symptom Score (TNSS), the Total Nasal Symptom and Sneezing Score (TNNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Laboratory indicators focused on serum total IgE and serum interleukin-4 (IL-4) contents. Meta-analysis was conducted using RevMan software and Stata software.

Results: A total of 19 randomized controlled trials involving 1 482 participants were included. The Meta-analysis indicated that, compared with conventional western medicines and nasal-external acupuncture, the intranasal acupuncture group achieved greater reductions in TNSS [MD=-1.67, 95% CI (-2.30, -1.04), P<0.000 01], RQLQ score [MD=-3.14, 95% CI(-4.16, -2.12), P<0.000 01], and TNNSS [MD=-0.52, 95% CI (-0.67, -0.36), P<0.000 01] from baseline to post-treatment, and greater decreases in serum IgE [SMD=-1.17, 95% CI (-1.46, -0.87), P=0.000 01] and IL-4 [SMD=-1.14, 95% CI (-1.80, -0.49), P=0.000 6] levels. Adverse events were mainly mild epistaxis and localized pain.

Conclusions: Intranasal acupuncture appears superior to nasal-external acupuncture and western medicines in reducing nasal symptom severity and improving life quality in AR, with no obvious adverse events reported. However, because the existing studies generally have small sample sizes, limited methodological rigor in randomized designs, and substantial heterogeneity across studies, the reliability of the findings is limited. Therefore, large-sample, multicenter, randomized controlled clinical trials are needed to improve the quality level of the evidence.

Objectives: To observe the effect of electroacupuncture (EA) at "Gongsun" (SP4) on tumor suppressor protein 53 (P53)/cyclin-dependent inhibitor 21 (P21) pathway in rats with premature ovarian insufficiency (POI), so as to investigate its underlying mechanism in alleviating ovarian granulosa cell senescence.

Methods: Forty female SD rats were randomly divided into control, model, EA and medication groups, with 10 rats in each group. The POI model was established by intraperitoneal injection of cyclophosphamide (50 mg·kg^-1·d^-1 on the 1^st day and 8 mg·kg^-1·d^-1 from the 2^nd to 15^th day, for a total of 15 days). After successful modeling, EA (0.1-1 mA, 2 Hz) was applied at bilateral SP4 for 20 min, once a day for 14 d. Rats of the medication group were treated by gavage of solution of estradiol valerate tablets (0.01 mg/mL, 1 mL/0.1 kg) once a day for 14 d. The changes in the estrous cycle, pregnancy rate and embryo number were observed. The senescence status of ovarian granulosa cells was observed by β-galactosidase staining. The contents of follicle-stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH), anti-Müllerian hormone (AMH), transforming growth factor β1 (TGF-β1), interleukin (IL)-6, and IL-1β in serum were detected by ELISA. The protein and mRNA expression levels of P53, P21, cyclin-dependent kinase inhibitor 2A (P16), and phosphorylated H2AX (γH2AX) in ovarian tissues were detected by Western blot and qPCR, respectively.

Results: After modeling, the rats' estrus cycles were disordered, mostly stagnated in proestrus and diestrus. Compared with the control group, the pregnancy rate, the number of embryos, and the contents of E2 and AMH were decreased (P<0.01) in the model group, while the contents of serum FSH, LH, IL-6, IL-1β and TGF-β1, the expression of P16, P21, P53 and γH2AX protein and mRNA in ovarian tissue were increased (P<0.01), with wild SAβ-gal blue staining in ovary. Compared with the model group, the pregnancy rate, the number of embryos, the contents of E2 and AMH were increased (P<0.01) in both EA and medication groups, while the contents of FSH, LH, IL-6, IL-1β and TGF-β1, the protein and mRNA expressions of P53, P21, P16 and γH2AX were significantly decreased (P<0.01, P<0.05), with reduced SAβ-gal blue staining in ovary.

Conclusions: EA of SP4 can regulate the level of serum sex hormones, slow down the aging process of ovarian granulosa cells, improve the ovarian reserve function and fertility of POI rats, which may be related to its function in regulating P53/P21 signaling pathway.

The root cause of the lagging evidence level in clinical trials of acupuncture lies in the complex system characteristics of acupuncture intervention. Process evaluation can solve the above difficulties through systematically monitoring the implemention of fidelity, verifying causal mechanism, analyzing situational factors and other approaches. In view of the complexity of operation, this study proposes a framework for process evaluation, i.e., constructing "fidelity index" can enable quantitative measurement of differences in technical schools, and can develop "total stimulus dose" to standardize intervention dosage; using "capability matrix" can model the dynamic interaction between clinicians and patients, so as to cope with the uncertainty, and applying "therapeutic alliance scale" to capture the variation of human factors; for background effect visualization, a "resource heatmap" can be created to integrate macro-variables such as medical insurance policy coverage and cultural acceptance; and using the "latent category growth model" can identify heterogeneous trajectories and establish a closed loop of monitoring, optimization and feedback in terms of dynamic tracking of efficacy. By the fidelity index, capability matrix, resource heatmap, and dynamic trajectory model, this framework can transform the abstract complexity into the intervention target, which can significantly improve the validity and extensibility of the experiment. Process evaluation can drive the leap from empirical inheritance to evidence-based medicine in acupuncture research, which will not only provide methodological support for the modernization of traditional medicine, but also can enhance the internationalization trend of acupuncture by optimizing localization adaptation strategies and policy evidence transformation paths.

Objectives: To observe the effect of Tongdu Xingshen (unblocking the Governor Vessel and refreshing the spirit) needling on hypoxia-induced factor-1α/pyruvate dehydrogenase kinase 1 (HIF-1α/PDK1) pathway and hippocampal glycolysis level in rats with cerebral ischemia-reperfusion injury (CIRI), so as to explore its mechanisms underlying improvement of learning and memory ability.

Methods: SD rats were randomly divided into sham operation, model, acupuncture and acupuncture + inhibitor groups (n=12 in each group). The CIRI model was established by middle cerebral artery occlusion/reperfusion (MCAO/R). EA (1 Hz/20 Hz) was applied to "Shenting" (GV24) and "Baihui" (GV20) for 30 min, once daily for 14 consecutive days. In the acupuncture + inhibitor group, 2ME2 (5 mg/kg) was injected intraperitoneally 30 min before modeling. Learning and memory ability were evaluated by using open field test and new object recognition experiment. TTC staining was used to detect cerebral infarction volume. The pathological changes of hippocampus were observed by HE staining. The contents of lactic acid and ATP in hippocampal tissue were detected by colorimetric assay kit. The protein and mRNA expression levels of HIF-1α, PDK1, hexokinase 2 (HK2), phosphofructokinase 1 (PFK1) and pyruvate kinase M2 (PKM2) in hippocampal tissues on the ischemic side were detected by Western blot and qPCR, respectively.

Results: Compared with the sham operation group, the rats in the model group had a significant decrease in the proportion of central distance, the number of crossing platform and the new object preference index (P<0.01), and a significant increase in percentage of cerebral infarction volume (P<0.01). The content of lactic acid in hippocampus, the protein and mRNA expression of HIF-1α, PDK1, HK2, PFK1 and PKM2 were increased significantly (P<0.01), while the content of ATP was decreased (P<0.01) in the model group compared with those in the sham operation group. Following the interventions, modeling induced increase and decrease of the indexes mentioned above were all reversed in the acupuncture group (P<0.01), and the therapeutic effects of acupuncture + inhibitor were better than those of acupuncture alone (P<0.01, P<0.05). H.E. staining showed disordered cell arrangement, abnormal morphology, and evident nuclear rupture and nuclear pyknosis in the hippocampus tissue in the model group, which was relatively milder in the two intervention groups.

Conclusions: Tongdu Xingshen needling can improve the learning and memory function of CIRI rats, which may be associated with its function in down-regulating the expression of HIF-1α/PDK1 signaling pathway, inhibiting anaerobic glycolysis in the hippocampus, reducing lactic acid accumulation and increasing ATP production.