针刺研究最新文献

Objectives: To investigate the efficacy of "Tongdu Tiaoshen" needling (draging the Governor Vessel and normalizing mental activities) in the treatment of insomnia in the clinical real world and to explore the influencing factors of clinical efficacy.

Methods: A total of 227 patients with insomnia were given "Tongdu Tiaoshen" (freeing the Governor Vessel and regulating the spirit) needling, with electroacupuncture (EA) applied at Baihui (GV20), Yintang (GV24+), bilateral Shenmen (HT7), and bilateral Sanyinjiao (SP6) for 30 min each time. Based on the number of treatments, the patients were divided into 2 cohorts:the < 6 times group (227 cases) and the≥6 times group (74 cases). Then, propensity score matching was used to balance the confounding factors between the cohorts. Patients with < 6 treatments within 4 weeks were included in the low-frequency group (37 cases), and patients with≥6 treatments were included in the high-frequency group (37 cases). Propensity score matching was used to balance the confounding factors between the cohorts. Before and after treatment, the Pittsburgh sleep quality index (PSQI), fatigue severity scale (FSS), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) scores of the patients were evaluated. The therapeutic effect was assessed.

Results: Following the treatment, the PSQI and FSS scores of the high-frequency treatment group and the low-frequency treatment group were all decreased (P<0.05), while the FSS score of the high-frequency treatment group was lower than that of the low-frequency treatment group (P<0.05). There were no significant differences in SDS scores between the two groups. The high-frequency treatment group showed a significant decrease (P<0.05) in SAS scores after treatment than that before treatment, whereas no significant difference was observed in the low-frequency group, additionally, the high-frequency treatment group was lower than the low-frequency treatment group (P<0.05).

Conclusions: "Tongdu Tiaoshen" needling can effectively treat insomnia, relieve fatigue and anxiety in patients with insomnia. The number of treatment significantly affects the clinical efficacy in treating insomnia.

Objectives: To observe the clinical efficacy of transcranial repeated acupuncture at Baihui (GV20) and the lower 1/5 of the healthy-side motor area in treating idiopathic facial paralysis (IFP) during the recovery phase.

Methods: A total of 72 IFP patients in the recovery phase were randomly divided into control group (36 cases, 3 dropped off) and treatment group (36 cases, 2 dropped off). Both groups received basic western medical treatment, including neurotrophic drugs, until the end of the treatment course. The control group underwent conventional electroacupuncture (EA) for 30 min, followed by an additional 10 min of needle retention, totaling 40 min per session. The treatment group received the same 30 min EA as the control group, with the addition of transcranial repeated acupuncture involving manual twisting of needles at GV20 and the lower 1/5 of the healthy-side motor area for 5 min each, also totaling 40 min per session. Both groups were treated once daily, with 6 sessions constituting 1 treatment course. After each course, a 1-day break was taken, and treatment continued for 4 consecutive courses. Before and after treatment, efficacy was evaluated using the House-Brackmann (H-B) facial nerve grading scale, facial disability index (FDI) scale (including physical function [FDIP] and social function [FDIS] subscales), and a traditional Chinese medicine (TCM) symptom efficacy scoring scale. Clinical outcomes were compared between the 2 groups.

Results: Compared with pre-treatment levels, both groups showed improvement in H-B grading (P<0.05, P<0.01), increased FDIP scores (P<0.05), and decreased FDIS and TCM symptom scores (P<0.05) after treatment. Post-treatment, the treatment group exhibited significantly greater improvement in H-B grading (P<0.05), higher FDIP scores (P<0.05), and lower FDIS and TCM symptom scores (P<0.05) compared to the control group. The total effective rate was 94.12% (32/34) in the treatment group and 87.88% (29/33) in the control group, with the treatment group demonstrating statistically superior efficacy (P<0.05).

Conclusions: Combining transcranial repeated acupuncture at GV20 and the lower 1/5 of the healthy-side motor area with conventional EA enhances clinical efficacy, significantly improves facial muscle paralysis and related symptoms such as facial deviation, food retention, and taste dysfunction in IFP patients during the recovery phase.

Objectives: To establish a predictive model of acupuncture treatment of insomnia and to create a profile of suitable populations for acupuncture schemes, so as to help improve clinical efficacy.

Methods: The data was sourced from a prospective clinical study on acupuncture treatment of insomnia by "Tongdu Tiaowei" acupoint prescription (Baihui [GV20], Yintang [EX-HN3], bilateral Shenmai [BL62] and bilateral Zhaohai [KI6]). Data from 113 insomnia patients were included in the analysis of the present study, with the reduction rate of the Pittsburgh Sleep Quality Index (PSQI) served as the overall clinical efficacy evaluation. First, the feature selection was performed using univariate logistic regression and Boruta algorithm, and the prediction accuracy of the three boosting algorithms - adaptive boosting, gradient boosting, and extreme gradient boosting (XGBoost) - was compared for selecting the best algorithm. The grid search and ten-fold cross-validation were used to optimize the hyperparameters of the best algorithm. The optimal dataset partitioning method was selected using stratified random partitioning, and the best cut-off value was determined based on the Youden index. The predictive model for the therapeutic efficacy was constructed and its performance was evaluated. Finally, SHAP (shapley additive explanation) analysis was used to visually interpret the model.

Results: The features included in the model were the proportion of stage N1 to total sleep duration, the proportion of stage N2 to total sleep duration, R latency from lights out, stage N2 latency from lights out, the awake time after sleep onset, PSQI sleep efficiency score, and the presence of an old tongue (a tongue picture of a dry, rough texture and an old body). XGBoost was identified as the best algorithm, with the optimal probability threshold of 0.76, a corresponding precision of 0.91, a recall of 0.91, a F1 score of 0.91, an accuracy of 0.91, and an area under curve (AUC) of 0.82. Patients who meet the following conditions are more likely to respond to "Tongdu Tiaowei" acuoint stimulation:the proportion of N1 phase was about 6%-70% of the total sleep duration, N2 phase latency was less than about 40 min from the time when the lights were off, the wakefulness time was less than about 75 min or 100-300 min after falling asleep, the R phase latency was more than about 75 min from the time when the lights were off. The N2 phase were about 20%-50% of the total sleep duration, PSQI sleep efficiency score was 2 or 3, and there was no appearance of "old tongue".

Conclusions: The predictive model of the efficacy of acupuncture treatment for insomnia established using XGBoost, along with the preliminary profile of the suitable population constructed using SHAP, provides a reliable auxiliary decision-making tool for acupuncture treatment of insomnia.

Objectives: This study aims to investigate the intervention effects of electroacupuncture on neuropathic pain and anxiety-like behavior, and to explore the underlying mechanisms of the DRN^5-HT-BLA (dorsal raphe nucleus serotoninergic - basolateral amygdala) neural circuit.

Methods: Male C57BL/6J mice were selected, and a neuropathic pain model was established through spared nerve injury (SNI) surgery. Electroacupuncture (100 Hz, 0.3 mA, 30 min) was applied to bilateral "Zusanli" (ST36) and "Sanyinjiao"(SP6). Anxiety-like behavior was assessed using the elevated plus maze (EPM) and open field (OF) tests, while mechanical allodynia was evaluated using the Von-Frey test. Viral tracing was used to confirm the anatomical connection between DRN^5-HT and BLA. Immunofluorescence was used to assess the activity of 5-HT neurons in the DRN. Chemogenetic and calcium imaging techniques were employed to observe changes in the activity of 5-HT neurons in the DRN of DRN^5-HT-BLA. Chemogenetics were used to observe the effect of inhibiting DRN^5-HT-BLA on electroacupuncture.

Results: SNI model mice showed a significant decrease in mechanical pain threshold (P<0.000 1) and exhibited marked anxiety-like behavior in both the EPM and OF tests (P<0.01, P<0.05). Compared to the model group, electroacupuncture significantly increased the mechanical pain threshold in the electroacupuncture group (P<0.000 1). The EPM and OF results indicated that electroacupuncture significantly reduced anxiety-like behavior (P<0.05, P<0.001) without affecting spontaneous activity. Virus tracing results confirmed the anatomical connection between 5-HT neurons in the DRN and the BLA. Immunofluorescence results showed that the activity of 5-HT neurons in the DRN was significantly reduced (P<0.000 1) in SNI model mice, which was significantly reversed by electroacupuncture (P<0.01). Calcium imaging revealed that in SNI model mice, the excitability of 5-HT neurons in the DRN^5-HT-BLA circuit was decreased, and electroacupuncture treatment restored their excitability. After chemogenetic inhibition of the DRN^5-HT-BLA circuit, electroacupuncture failed to improve mechanical allodynia and anxiety-like behavior in the SNI model mice (P<0.05, P<0.001, P<0.01).

Conclusions: 5-HT neurons in the DRN^5-HT-BLA circuit play a crucial role in the mechanical allodynia and associated anxiety-like behavior in neuropathic pain. Electroacupuncture activates this circuit, enhancing the activity of 5-HT neurons in the DRN, thereby alleviating mechanical allodynia and anxiety-like behavior in SNI model mice.

Objectives: To observe the differential analgesic effects of electroacupuncture (EA) at different intensities on calcium activity in dorsal root ganglia (DRG) neurons induced by mechanical, thermal, and cold stimuli in a state of muscular inflammatory pain, so as to preliminarily reveal the peripheral integration characteristics of acupuncture analgesia mechanisms.

Methods: The inflammatory muscle pain model was established by injection of complete Freund's adjuvant (CFA) into the right tibialis anterior muscle. EA (0.5 mA or 1 mA, 2 Hz) was applied to "Zusanli" (ST36) on the right side for 10 min. Before and after the EA, mice were given body surface stimulation of brush, clamp and different temperature, while simultaneously recording DRG neuron calcium activity during stimulation. The effects of different stimulation methods before and after EA on the change in fluorescence intensity (ΔF/F0) and the percentage of activated DRG neurons were compared.

Results: In the clamp hind paw stimulation, both 0.5 mA and 1 mA EA could reduce the fluorescence intensity of neurons, and the effect of 1 mA was better than that of 0.5 mA (P<0.001). Specifically, 0.5 mA EA decreased the percentage of medium and large neurons (P<0.05), while 1 mA EA decreased the percentage of small, medium, and large neurons (P<0.05, P<0.01), and the effect of 1 mA was better than that of 0.5 mA in reducing the percentage of small and medium neurons (P<0.01). In the stimulation of clamping tibialis anterior muscle, both EA intensities could reduce the fluorescence intensity of neurons (P<0.05, P<0.000 1), and the effect of 1 mA was better than that of 0.5 mA (P<0.000 1), and 1 mA EA could reduce the percentage of small and medium neurons (P<0.05). In the brush stimulation, both EA intensities could reduce the fluorescence intensity of neurons (P<0.000 1), and the effect of 1 mA was better than that of 0.5 mA (P<0.000 1), and 0.5 mA EA decreased the percentage of medium and large neurons (P<0.05), while 1 mA EA decreased the percentage of small, medium and large neurons (P<0.05, P<0.01). However, in the temperature stimulation (43, 51, 4 ℃), there were no obvious changes in the fluorescence intensity and the percentage of activated neurons in different intensities of EA.

Conclusions: Both 0.5 mA and 1 mA EA intervention at ST36 can inhibit the reactivity of DRG neurons to mechanical stimulation, with higher intensity EA showing more significant effects.

Objectives: To observe the effect of electroacupuncture (EA) of bilateral "Tianshu" (ST25) on ulcerative colitis (UC) in mice, and further investigate its related neural circuits including colonic-associated sympathetic and sacral parasympathetic postganglionic components.

Methods: Thirty C57BL/6J male mice were randomly divided into normal control, model and EA groups, with 10 mice in each group. The UC model was established by free access to 3% dextran sulfate sodium (DSS) solution for 7 consecutive days. Under isoflurane inhalation anesthesia on day 1, 3, 5, and 7 of modeling, mice of the EA group received EA stimulation of bilateral ST25 (2 mA, 10 Hz) for 30 min each time. The colonic histopathological changes were assessed by HE staining, and the body weight of mice was recorded. The relative abundance values of acetylcholine (ACh) and norepinephrine (NE) in the distal colon tissues were detected by using high performance liquid chromatography-mass spectrometry. In addition, six male C57BL/6J mice were randomly and equally divided into model and EA groups. On the fifth day of modeling, mice in the EA group received once EA stimulation with the same operations above, while mice in the model group were only anesthestized without EA. Immunofluorescence staining was used to examine the expression of c-Fos protein of the tyrosine hydroxylase-positive (TH⁺) neurons in the superior mesenteric ganglion (SMG), inferior mesenteric ganglion (IMG), and vesicular acetylcholine transporter-positive (VAChT⁺) neurons in the pelvic ganglion (PG).

Results: From day 7 to 9 of DSS modeling, the model group showed significant decrease of body weight compared to the normal control group (P<0.001), and the EA group showed a significantly lower reduction in body weight in contrast to the model group (P<0.01, P<0.05). The histopathological score (thickening of the colon wall, injury of the lamina propria structure, submucosal edema, and inflammatory cell infiltration) was significantly increased after modeling (P<0.000 1) and obviously improved after EA (P<0.001). Compared with the normal group, the relative abundance of ACh in the distal colon of the model group decreased significantly (P<0.05), which increased significantly in the EA group (P<0.05) when compared with the model group. No significant differences were found among the 3 groups in the relative abundance value of NE in the distal colonic tissues. Results of immunofluorescence staining showed that, compared with the model group, there were no statistically significant differences in the expression of c-Fos in TH⁺ neurons of SMG and IMG (sympathetic postganglionic component innervating the colon tissue) in the EA group. However, compared with the model group, the number of VAChT⁺ neurons that express c-Fos in PG of the EA group increased significant

Objectives: To analyze the characteristics of point prescriptions for acute and chronic urticaria treated with acupuncture using complex network and data mining, so as to provide the basis for acupoint selection and the approaches to clinical treatment of acute and chronic urticaria.

Methods: The clinical trials of acupuncture in treatment of urticaria were systematically searched from China National Knowledge Infrastructure (CNKI), VIP database (VIP), Wanfang database (WanFang), SinoMed and PubMed. According to the screening criteria, the "database of acupuncture for acute and chronic urticaria" was established. IBM SPSS Modeler18.0, Cytoscape3.9.0, Origin2021, Gephi0.9.2 and other softwares were used for frequency analysis, association rule analysis and cluster analysis.

Results: A total of 352 articles were included, and 158 acupuncture prescriptions were extracted, involving 76 points. The analysis focused on main acupoints, and the laws of acupoint selection and medications based on syndrome differentiation. The results showed that the meridian with the highest use frequency of acupuncture was the bladder meridian of foot-taiyang. The top 6 acupoints with the highest use frequency included Quchi (LI11), Xuehai (SP10), Zusanli (ST36), Sanyinjiao (SP6), Geshu (BL17) and Feishu (BL13). Acupuncture was delivered for urticaria in terms of "syndrome differentiation and treatment" to determine the principle, and acupuncture was combined with medication as the main regimen. Among reinforcing and reducing techniques, the neutral supplementation and drainage method is the most frequently used. In the acupoint and herbal prescriptions for combined acupuncture-medication therapy of chronic urticaria:the 3 strongest acupoint pairings were Quchi (LI11) and Xuehai (SP10), Quchi (LI11) and Zusanli (ST36), and Xuehai (SP10) and Sanyinjiao (SP6). The 3 strongest herb pairs were Jingjie (Schizonepeta) and Fangfeng (Saposhnikovia), Gancao (Licorice) and Fangfeng (Saposhnikovia), and Danggui (Angelica sinensis) and Fangfeng (Saposhnikovia). The three strongest herb-acupoint associations were Xuehai (SP10) and Fangfeng (Saposhnikovia), Quchi (LI11) and Fangfeng (Saposhnikovia), and Zusanli (ST36) and Fangfeng (Saposhnikovia).

Conclusions: Acupuncture is commonly combined with medication in treatment of acute and chronic urticaria. The combined therapy can solve the insufficiency presented in treatment with either simple delivery of acupuncture or Chinese herbal medicine, give a full play to the advantages of acupuncture and Chinese medicine, and advance the therapeutic effect.

An increasing number of studies indicate that the modulation effect of acupuncture on intracerebral neural circuits is a crucial pathway through which acupuncture exerts its therapeutic effects. Among these, brain region activation, functional connectivity, and synaptic transmission collectively form the three dimensions of acupuncture modulation of neural circuits. Brain region activation reflects the activity state of key nodes in neural circuits, functional connectivity focuses on the intensity and patterns of information exchange within neural circuits, and snaptic transmission examines molecular-level changes during signal projection in neural circuits. To systematically elucidate the mechanisms of acupuncture, this paper first analyzed the impact of acupuncture on these three dimensions using commonly used points such as Quchi (LI11) as examples. Then, it explored the multi-dimensional regulatory effects of acupuncture on neural circuits related to clinically advantageous conditions like pain, mood disorders, and gastrointestinal dysfunction. Finally, it proposed issues and potential solutions for the multi-dimensional analysis of acupuncture-related neural circuits, aiming to provide insights for advancing research on acupuncture mechanisms and guiding further precision treatment.