Objectives: To investigate the repair effects of He's qiangtong method of acupuncture (involved bloodletting technique with strong action of unblocking) on the neurovascular unit of the patients with acute ischemic stroke (AIS) in terms of serological indicators so as to provide new ideas for the treatment of AIS.
Methods: Seventy subjects with AIS were randomly divided into an observation group (35 cases, 1 case dropped out) and a control group (35 cases , 4 cases dropped out). Patients in the control group were treated with conventional regimen. In the observation group, the bloodletting was operated, combined with the conventional treatment. Bloodletting was performed at Baihui (GV20), Sishencong (EX-HN1) and bilateral Erjian (EX-HN6), using He's qiangtong method of acupuncture, 3 times a week and for 2 weeks. Before and after treatment, the scores of the national institute of health stroke scale (NIHSS), the modified Rankin scale (MRS), and the Barthel index were evaluated；and the serological levels of the serum brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE) and blood-brain barrier permeability-associated protein (S100β protein) were detected in the two groups.
Results: After treatment, NIHSS score and MRS score were decreased (P<0.01), and Barthel score was increased (P<0.01) in both groups. NIHSS score of the observation group was lower than that of the control group (P<0.01). Compared with those before treatment, the content of BDNF in both groups increased (P<0.05), and VEGF content was elevated in the observation group (P<0.05) after treatment. The total effective rate was 100% (34/34) in the observation group, higher than that (67.74%, 21/31) in the control group (P<0.01).
Conclusions: He's qiangtong method of acupuncture can promote the recovery of neurological deficits in AIS patients and effectively improve their motor function and the activity of daily living, which may be related to the reconstruction of neurovascular unit in the brain of AIS patients by increasing the levels of serological repair factors.
Objectives: To explore the effects of cluster needling at scalp points with needle retaining combined with the training of the upper-limb intelligent rehabilitation robot on shoulder function in stroke patients during convalescence.
Methods: Ninety stroke patients during convalescence were collected and randomized into scalp point group, robot training group and combined intervention group, with 30 cases each. In the scalp point group, the cluster needling was delivered at scalp points with the needles retained. In the robot training group, the patients were trained with the upper-limb intelligent rehabilitation robot. In the combined intervention group, the patients received both the cluster needling and the training of the upper-limb intelligent rehabilitation robot. In each group, the treatment was given once daily, 5 treatments a week with 2 days rest, for consecutive 4 weeks. Separately, before and after treatment, the score of Fugl-Meyer assessment upper extremity scale (FMA-UE) and the score of activity of daily living (ADL) were evaluated. Using the in-built assessment system of the upper-limb intelligent rehabilitation robot, the range of motion (ROM) of forward flexion, horizontal abduction and horizontal adduction of the affected shoulder joint were evaluated. With surface electromyogram (sEMG), the sEMG value of the deltoid muscle and the pectoralis major on the affected side were detected.
Results: Compared with the values before treatment, ADL score and FMA-UA score increased in patients of the three groups (P<0.05), and ROM of forward flexion, horizontal abduction and horizontal adduction of the affected shoulder joint was larger (P<0.05), the sEMG value of the fasciculi pectoralis major anterior of patients in the combined intervention group was reduced (P<0.05), and the sEMG of anterior deltoid tract was elevated in the three groups (P<0.05). When compared with the scalp point group and the robot group, in the combined intervention group, after treatment, ADL score and FMA-UA score were higher (P<0.05), ROM of forward flexion, horizontal abduction and horizontal adduction of the affected shoulder joint elevated (P<0.05) and sEMG value of the fasciculi pectoralis major anterior reduced (P<0.05), while which of the anterior deltoid tract was elevated (P<0.05).
Conclusions: The cluster needling at scalp points with needle retaining, combined with the training of the upper-limb intelligent rehabilitation robot, improves the upper limb motor function and the range of motion of the shoulder joint in stroke patients during convalescence.
Objectives: To compare the clinical efficacy between trigger-point (TrP) electroacupuncture and transversus abdominis plane (TAP) block in treatment of chronic abdominal wall pain (CAWP).
Methods: A total of 62 CAWP patients were randomly divided into a TrP electroacupuncture group (31 cases, 1 case dropped off) and a TAP block group (31 cases, 1 case dropped off). Electroacupuncture at trigger points was delivered in the TrP electroacupuncture group, and TAP block was administered under ultrasonic guidance in the TAP block group. Separately, the score of the numerical pain rating scale (NRS) was observed before treatment and in 1 week, 1 month and 3 months after treatment；the scores of the self-rating anxiety scale (SAS) and the self-rating depressive scale (SDS) observed before treatment and in 1 week and 3 months after treatment；and the score of the short form 36 questionnaire (SF-36) was observed before treatment and in 3 months after treatment. The utilization rate of remedial drugs was recorded during follow-up visit. The clinical efficacy was compared.
Results: At each time point after treatment, NRS score decreased in comparison with that before treatment (P<0.05), the scores of SAS and SDS 1 week and 3 months after treatment were reduced (P<0.05) and the each item score of SF-36 increased (P<0.05) 3 months after treatment of each group. Compared with the outcomes in the TAP block group, NRS scores were reduced 1 month and 3 months after treatment respectively (P<0.05), the scores of SAS and SDS decreased (P<0.05) and SF-36 score was elevated (P<0.05) 3 months after treatment in the TrP electroacupuncture group. There was no significant difference in the utilization rate of remedial drugs between the two groups. The clinical efficacy of the TrP electroacupuncture group (96.7%) was superior to that of the TAP block group (83.3%, P<0.05).
Conclusions: Both TrP electroacupuncture and TAP block can markedly relieve pain, attenuate the emotional symptoms of anxiety and depression and improve the quality of life in the patients with chronic abdominal wall pain. The clinical efficacy of TrP electroacupuncture is better than that of TAP block 3 months after treatment.
Objectives: To investigate the selection rules of acupoints for promoting gastrointestinal function recovery after colorectal cancer surgery using complex network technology.
Methods: Relevant literatures on acupuncture and moxibustion for promoting gastrointestinal function recovery after colorectal cancer surgery were searched from databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Chinese Journal Service Platform, and SinoMed from retrieved to May 9, 2023. Literatures were selected based on inclusion and exclusion criteria, and a database of acupuncture and moxibustion for promoting gastrointestinal function recovery after intestinal cancer surgery was established. Association rule analysis was performed using IBM SPSS Modeler 18.0. Clustering analysis was performed using IBM SPSS Statistics 26.0. Complex network analysis was conducted using Gephi0.9.2.
Results: A total of 255 articles were included, covering 113 acupoints, with a total usage frequency of 1 080 times. The top 5 frequently used acupoints were Zusanli (ST36), Shangjuxu (ST37), Tianshu (ST25), Zhongwan (CV12), and Neiguan (PC6). The meridians predominantly used were the Stomach Meridian, Conception Vessel, and Spleen Meridian. Commonly used specific acupoints included lower he-sea points, five shu acupoints, crossing points, and mu-front acupoints. Association rule analysis showed that the acupoint combination with the highest support degree was ST36-ST37 (33.82%), followed by ST36-ST25 (23.53%), ST36-CV12 (23.53%), and ST36-PC6 (22.43%). Clustering analysis identified 3 effective clusters. Complex network analysis revealed two core groups of acupoints：the back-lower limb prone position group and the abdomen-limb supine position group. Intervention measures primarily involved filiform needle acupuncture and electroacupuncture. Uniform reinforcing-reducing method was mostly used techniques, with strongly associated acupoints being ST37 and ST36；lifting-thrusting and twisting reducing method came secondly, with strongly associated acupoints being ST25 and CV12. Overall, reducing technique was used more frequently than reinforcing technique.
Conclusions: Acupuncture and moxibustion for promoting gastrointestinal function recovery after intestinal cancer surgery focuses on strengthening and harmonizing the spleen and stomach, cultivating the body's foundation, and regulating qi flow. The specific acupoints on the Stomach Meridian, Conception Vessel, and Spleen Meridian were mainly selected, and filiform needle acupuncture and uniform reinforcing-reducing technique were mainly used to realize the bidirectional regulation characteristics and advantages of acupuncture.
Objectives: To explore the efficacy of electroacupuncture (EA) based on the "ascending lucidity and descending turbidity" theory in patients with diabetic gastrointestinal dysfunction and its regulatory effect on gut microbiota.
Methods: A total of 48 patients with diabetic gastrointestinal dysfunction were randomly divided into the EA group (24 cases, 3 cases dropped-off) and the control group (24 cases, no dropped off). Both groups received blood glucose control and basic symptomatic treatment. EA (15 Hz/100 Hz) was applied to Zhongwan (CV12), Tianshu (ST25), Zhongfu (LU1), bilateral Zhangmen (LR13), bilateral Taibai (SP3), bilateral Taiyuan (LU9), bilateral Zusanli (ST36), and bilateral Shangjuxu (ST37) in the EA group. Sham EA was applied to corresponding non-acupoints without electric stimulation in the control group. Both groups received treatment for 30 min per time, once daily, for a total of 5 treatments followed by a 2-day break, over a consecutive period of 2 weeks. Symptoms were evaluated by gastrointestinal symptom rating scale (GSRS) and gastroparesis cardinal symptom index (GCSI) before and after treatment, and 4 weeks after treatment. During the treatment period, fasting blood glucose levels were monitored daily. Stool samples were collected before and after treatment for 16S rDNA sequencing analysis to examine changes in gut microbiota.
Results: Compared with the control group, GSRS and GCSI scores in the EA group were significantly decreased (P<0.001) after treatment and at follow-up at the same time point, and compared with those before treatment, GSRS and GCSI scores in the EA group were significantly decreased after treatment and at follow-up (P<0.001). After treatment, the 16S rDNA sequencing showed that at the phylum level, the ratio of Proteobacteria in the EA group was higher than that in the control group (FDR<0.05). At the genus level, a total of 18 different gut microbiota were identified between the two groups. Compared to the control group, patients in the EA group showed a significant decrease in the abundance of Pseudomonas and Alkalibacter (FDR<0.05), while the abundance of the remaining 16 gut microbiota was significantly increased (FDR<0.05). Compared to the baseline, the EA group showed a significant up-regulation of Olsenella (FDR<0.05) and a significant down-regulation of Pseudomonas (FDR<0.05) after treatment.
Conclusions: EA based on the "ascending lucidity and descending turbidity" theory can effectively improve the symptoms of patients with diabetic gastrointestinal dysfunction. EA can also affect the distribution of gut microbiota by up-regulating the levels of certain beneficial bacteria and suppressing pathogenic bacteria .
Objectives: To observe the effect of moxibustion at "Zusanli "(ST36) on the plasma amino acid metabolism in rats with knee osteoarthritis (KOA), and to explore the amino acid metabolism mechanism of moxibustion in repairing cartilage injury in KOA.
Methods: A total of 30 SD rats were randomly divided into normal, model and moxibustion groups, with 10 rats in each group. Rats in the model and moxibustion groups were injected with the mixture of L-cysteine and papain into bilateral knee joint cavity to make the KOA model. The moxibustion group received moxibustion at bilateral ST36 for 30 min, once daily for 30 days. At the end of the experiment, the swelling degree of knee joint was calculated, the mechanical pain threshold was measured by the Von Frey filament, the cartilage tissue injury was observed by HE staining, the matrix metalloproteinase-13 (MMP-13) content in the synovial tissue was detected by enzyme-linked immunosorbent assay (ELISA), and the differential amino acid metabolites in plasma were detected and screened by liquid chromatography-mass spectrometry (LC-MS).
Results: Compared with the normal group, the model group showed irregular cartilage surface, decreased number of chondrocytes, uneven distribution, and local clusters of chondrocytes；the contour of the tide line was blurred. The degree of joint swelling in the model group was higher than that in the normal group (P<0.01), the mechanical pain threshold was lower (P<0.01), and the content of MMP-13 in synovial tissue was higher (P<0.01). The contents of proline and tryptophan in the model group were down-regulated (P<0.01, P<0.05). Compared with the model group, the cartilage tissue damage and knee joint swelling were decreased(P<0.05), mechanical pain threshold was increased(P<0.05), MMP-13 content in synovial tissue and levels of glutamate and histidine expression were decreased (P<0.01, P<0.05).
Conclusions: Moxibustion at ST36 significantly alleviated arthritis-related swelling and pain in KOA model rats, attenuated cartilage damage, and regulated levels of certain plasma amino acid metabolites. Moxibustion may regulate KOA cartilage synthesis and degradation through amino acid metabolic pathways such as proline, tryptophan, glutamate and histidine, exerting anti-inflammatory, analgesic, and protection of cartilage injury effects.
The active role of "Shen" (mind) in the process of disease treatment has always been valued by scholars of traditional Chinese medicine (TCM). "Tiaoshen" (mind-regulating) is regarded as the fundamental component of TCM therapy. "Mind-regulating" acupuncture and moxibustion therapy, as a treatment method for both body and mind, is consistent with the present bio-psycho-social medical model. In recent years, a large number of clinical studies have confirmed the exact efficacy of "mind-regulating" acupuncture and moxibustion therapy. This article reviewed the clinical applications of that in psychosomatic diseases, neurological diseases, and digestive diseases over the last decade. This article also summarized the research progress of various "mind-regulating" acupuncture and moxibustion methods, investigated the theoretical connotations of "Tongdu Tiaoshen" (dredging Governor Vessel and regulating mind) acupuncture, "Shugan Tiaoshen" (soothing liver and regulating mind) acupuncture, and the "Tiaoshen needling technique" (mind-regulating needling technique), and generalized the main acupoint selection rules. Lastly, future development directions were provided for the theoretical basis of clinical application of "mind-regulating" acupuncture and moxibustion therapy for further improvement.
The animal experiment is an important form of acupuncture research, which is of great significance for revealing the regularities and mechanisms of acupuncture effects. The ethical principle of animal welfare is the important guarantee of animal rights and experimental scientificity in the process of research. Starting from the "3R principle" and "five welfare" rules, and the specific operation process of acupuncture animal experiments, we, in this paper, proposed the implementation methods of animal ethics in acupuncture experiments, including ethical execution before acupuncture experiments, and ethical requirements during the experimental stage (such as animal fixation method that meets the needling needs, selection of acupuncture apparatus, acupuncture manipulations, acupuncture stimulation intensity, and sampling of animal tissues). These proposed methods may provide some appropriate references for the guarantee of animal ethics in acupuncture research, and provide ideas for establishing a new paradigm of animal welfare ethics in acupuncture animal experiments, and finally promote the standardization and scientificity process of the implementation of animal welfare ethics in acupuncture animal experiments.
Alzheimer's disease (AD) is a neurodegenerative disease with high incidence in the elderly population, and the synaptic changes in central neurons are the key pathological feature. The clinical effect of acupuncture and moxibustion in the treatment of AD is positive, and the research on the mechanism of acupuncture intervention of AD from the perspective of central synaptic plasticity regulation has been conducted uninterruptedly. In the present paper, we made a summation about the relevant experimental studies in recent years, and analyzed its mechanisms underlying improvement of AD by regulating synaptic plasticity from 1) repairing synaptic structure (synaptic contact area ［total number of synapses, synaptic surface density, synaptic number density］, postsynaptic dense zone thickness, synaptic gap width, and interface curvature), 2) improving synaptic transmission efficiency (regulating long-term potentiation and long-term depression), 3) promoting the expression of synapse related proteins (synaptophysin, postsynaptic density protein 95, growth associated protein 43), 4) regulating the expression of neurotransmitters (acetylcholine, monoamines, amino acids, etc.) and receptors (α7 nicotinic acetylcholine receptor, glutaminergic receptor, etc.), and 5) improving the level of neurotrophic factors (brain derived neurotrophic factor, BDNF) and BDNF/SYN/microtubule-associated protein 2 signaling, etc., hoping to provide a reference for future studies.
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