针刺研究最新文献

Objectives: To observe the clinical efficacy of acupotomy at trigger points combined with meridian sinew manipulation in treatment of early and mid-term knee osteoarthritis (KOA), and investigate whether its therapeutic mechanism is related to the regulation of inflammatory response.

Methods: Seventy-four patients with early and mid-term KOA were randomly divided into the control group (37 cases, with 2 cases dropouts) and the observation group (37 cases, with 1 case dropout). The control group was treated with meridian sinew manipulation for 30 min each time, 5 times a week, for 4 consecutive weeks. The observation group was given acupotomy at trigger points on the basis of the treatment of control group, once a week, for 4 consecutive weeks. Western Ontario and McMaster University osteoarthritis index (WOMAC) scores, short-form McGill pain questionnaire (SF-MPQ) scores, the medical outcome 36-item short form health survey (SF-36) scores, serum inflammatory factors content before and after treatment were compared between the two groups. The clinical efficacy were assessed after the treatment.

Results: Compared with those before treatment, the total scores and the scores of pain, stiffness and activity impairment of WOMAC, the pain rating index (PRI), visual analog scale (VAS) and present pain intensity (PPI) scores of SF-MPQ, and the contents of serum tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 in both groups were significantly decreased after treatment (P<0.05), while the scores of the physical component summary (PCS) and the mental component summary (MCS) of SF-36 were significantly increased (P<0.05). Compared with the control group, the total scores, scores of pain, stiffness and activity impairment of WOMAC, the PRI, VAS and PPI scores of SF-MPQ, and the contents of serum TNF-α, IL-6 and IL-10 in the observation group were significantly decreased after treatment (P<0.05), while the scores of PCS and MCS of SF-36 were significantly increased (P<0.05). The total effective rate of the observation group was 94.4% (34/36) after treatment, which was significantly higher than that of the control group (74.3%, 26/35, P<0.05).

Conclusions: Acupotomy at trigger points combined with meridian sinew manipulation can significantly improve the clinical symptoms such as joint pain, stiffness and limited activity in patients with KOA, improve the quality of life, and its mechanism may be related to reducing the inflammatory response.

Objectives: To explore the underlying mechanism of "Tongdu Qishen" acupuncture (dredging the Govern Vessel and normalizing mental activities) in treating SAMP8 mice from the perspective of pyroptosis.

Methods: Six-month-old male SAMP8 mice were randomly divided into model and "Tongdu Qishen" acupuncture (EA) groups, with 12 mice in each group. SAMR1 mice of the same age (n=12) were used as the normal group. In the EA group, EA (2 Hz/50 Hz, 20 min) was applied to "Baihui" (GV20) and "Yintang" (GV24⁺), and pricking bleeding was applied to "Shuigou" (GV26). The treatment was performed once a day, for a total of 28 days. Morris water maze test was used to evaluate the learning and memory ability of mice, and HE staining was used to observe the morphology of cells in the hippocampus and cortex. Nissl staining was used to observe the number of neurons in the hippocampus and cortex. Immunohistochemistry was used to observe the expressions of Aβ_1-40, interleukin (IL)-1β and IL-18 in the hippocampus and cortex. The co-staining of TUNEL and Caspase-1 was detected by immunofluorescence. Western blot and real-time quantitative PCR were used to observe the protein and mRNA expression levels of Nod-like receptor 3 (NLRP3), Caspase-1 and Gasdermin D (GSDMD) in the hippocampus and cortex, respectively.

Results: Behavioral results showed that compared with the normal group, the escape latency was prolonged (P<0.001), the dwell time in the original platform quadrant and the times of crossing the original platform were considerably decreased (P<0.001) in the model group. In comparison with the model group, the escape latency was shortened (P<0.05, P<0.001, P<0.01), and the dwell time in the original platform quadrant was significantly increased (P<0.01) in the EA group. Following modeling, the number of neurons was decreased (P<0.001), the positive expression of Aβ_1-40, IL-1β and IL-18 in the hippocampus and cortex, the co-expression of TUNEL and Caspase-1, and the protein and mRNA expression levels of NLRP3, Caspase-1, GSDMD were all increased (P<0.001) in the model group relevant to the normal group. After EA intervention, modeling induced increase and decrease of indexes mentioned above were completely reversed (P<0.01, P<0.05, P<0.001).

Conclusions: "Tongdu Qishen" acupuncture may improve the cognitive function of SAMP8 mice by regulating the NLRP3/Caspase-1/GSDMD pathway, relieving the release of inflammatory factors and reducing the content of Aβ_1-40.

Objectives: To observe the effect of acupuncture at "Zusanli" (ST36) on the expression of Mer receptor tyrosine kinase (MerTK)-related efferocytosis regulatory molecules in mice with adjuvant arthritis induced by complete Freund's adjuvant (CFA), so as to explore the potential mechanism of acupuncture on efferocytosis in adjuvant arthritis.

Methods: C57BL/6J mice were randomly divided into a saline group, a model group, and an acupuncture group (10 mice/group). The right hind footpad of mice in the saline group was injected with 0.9% sodium chloride solution, while those in the model group and the acupuncture group were injected with CFA (50 μL) to establish the model of adjuvant arthritis. Mice in the acupuncture group received acupuncture at bilateral ST36 once a day for a total of 7 times, and mice in the saline group and the model group were fixed in the same way. During the experiment, paw swelling degree and the paw withdrawal thermal latency (PWTL) of mice were measured before modeling, on the day of modeling (D0) and on the 1^st, 3^rd, 5^th and 7^th day of acupuncture (D1, D3, D5, D7) to evaluate paw swelling and pain conditions. The mRNA expressions of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β in spinal cord tissue were detected by real-time quantitative PCR. The protein expressions of MerTK, phosphorylated (p)-signal transducer and activator of transcription 3 (STAT3), STAT3, and programmed death-ligand 1 (PD-L1) in footpad and spinal cord tissue were detected by Western blot.

Results: After modeling, compared with the saline group, the PWTL on D0-D7, the protein expression of PD-L1 in spinal cord and protein expressions of MerTK and PD-L1 in footpad, the phosphorylation level of STAT3 in spinal cord and footpad were decreased (P<0.01) in the model group, while the degree of paw swelling, mRNA expressions of TNF-α, IL-6, and IL-1β in spinal cord tissue were increased (P<0.01, P<0.05). Compared with the model group, the PWTL on D1-D7, the protein expressions of MerTK, PD-L1 and phosphorylation level of STAT3 in spinal cord and footpad were increased (P<0.01) in the acupuncture group after acupuncture intervention, while the degree of paw swelling on D7, the mRNA expressions of TNF-α, IL-6, and IL-1β in spinal cord tissue were significantly decreased(P<0.01, P<0.05).

Conclusions: Acupuncture can improve the symptoms of mice with adjuvant arthritis, which may be related to promoting MerTK-mediated efferocytosis and thus exerting an anti-inflammatory effect.

Objectives: To observe the effect of electroacupuncture (EA) on the excitatory/inhibitory (E/I) balance of prefrontal cortex and hippocampal pyramidal neurons in anxiety-like mice induced by chronic unpredictable mild stress (CUMS).

Methods: Forty-eight male C57BL/6 mice were randomly divided into control, control+EA (CE), model, and model+EA (ME) groups, with 12 mice in each group. The anxiety model was established by using CUMS (restraint, day-night reversal, forced swimming in warm water, food/water deprivation for 24 h, rearing in a humid environment, and shaking the cage) for 21 consecutive days. EA (2 Hz, 1 mA) was applied to "Baihui" (GV20) and "Yintang" (GV24⁺) for 30 min, once daily for 10 consecutive days. The anxiety-like behaviors of mice were evaluated by open field test and elevated plus maze (EPM) test. The E/I balance of the prefrontal cortex and hippocampal pyramidal neurons of the mice were observed by whole-cell recording.

Results: After modeling, the exploration time in the central area of open field test, the times of entries and residence time in the open arm of EPM test were significantly reduced (P<0.01) in the model group, while the spontaneous excitatory postsynaptic current (sEPSC) frequency, capacitance and E/I ratio of sEPSC in the dorsolateral prefrontal cortex (dlPFC), medial prefrontal cortex (mPFC) and ventral hippocampal CA1 (vCA1) were increased significantly (P<0.01). Compared with the model group, the exploration time in the central area of the open field, the times of entries and residence time in the open arm of EPM test were significantly increased (P<0.05, P<0.01), while the frequency, capacitance and E/I ratio of sEPSC in the dlPFC, mPFC and vCA1 were significantly decreased (P<0.01, P<0.05) in the ME group. In comparison with the CE group, the exploration time in the central area of the open field, the times of entries and residence time in the open arm of EPM test were significantly reduced (P<0.01), while the frequency, capacitance and E/I ratio of sEPSC in the dlPFC, mPFC and vCA1 were significantly increased (P<0.01, P<0.05) in the ME group.

Conclusions: Chronic stress may induce anxiety in mice by increasing the E/I of pyramidal neurons in dlPFC, mPFC and vCA1. EA may improve anxiety-like behaviors in mice by regulating the E/I balance of the above brain regions.

Objectives: To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) at the bilateral acupoints Neiguan (PC6) and Jianshi (PC5) on heart rate variability (HRV) and inflammatory factors in frail elderly patients undergoing laparoscopic colorectal cancer surgery under general anesthesia.

Methods: A total of 78 frail elderly patients undergoing elective laparoscopic colorectal cancer surgery were randomized into the TEAS group (39 patients, with 2 patients dropping out) and the control group (39 patients, with 1 patient dropping out). In the TEAS group, TEAS was applied to the bilateral PC6 and PC5 from 30 min before anesthesia induction until the end of the surgery. The control group was connected to an electronic acupuncture instrument at the same acupoints but did not receive electrical stimulation. A short-term Holter electrocardiogram was used to collect HRV parameters in the frequency domain, including low-frequency power (LF), high-frequency power (HF), and the LF/HF ratio. Serum concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) were measured using ELISA. The Quality of Recovery-15 (Qor-15) score was recorded, along with adverse reactions such as postoperative nausea and vomiting (PONV), palpitations, chest tightness, and chest pain.

Results: Compared with 1 d before surgery, LF and HF were significantly decreased (P<0.05), and the LF/HF ratio significantly increased (P<0.05) at 1, 2, and 3 d after surgery in the control group. In the TEAS group, both LF and the LF/HF ratio were significantly decreased (P<0.05) at 1, 2, and 3 d after surgery. Compared with the control group, LF and HF levels were significantly increased (P<0.05), and the LF/HF ratio was significantly decreased (P<0.05) in the TEAS group at 1, 2, and 3 d after surgery. Both groups exhibited increased levels of CRP and IL-6 at 1, 3, and 5 d after surgery compared to 1 d before surgery (P<0.05), with the TEAS group showing lower CRP and IL-6 levels than the control group (P<0.05). Compared to baseline before surgery, the Qor-15 scores of both groups were decreased at 1, 2, and 3 d after surgery (P<0.05), with the TEAS group showing significantly higher Qor-15 scores than those in the control group (P<0.05). The incidence of PONV, palpitations, chest tightness, and chest pain in the TEAS group was lower than that in the control group (P<0.05).

Conclusions: TEAS at the PC6 and PC5 can regulate autonomic nervous function, reduce the early postoperative sympathetic nerve excitation, maintain parasympathetic nerve tension, reduce inflammatory responses, improve the quality of postoperative recovery, and decrease the incidence of postoperative adverse reactions in frail elderly patients after laparoscopic colorectal cancer surgery.

Objectives: To investigate the effect of moxibustion on the cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway in the synovial tissue of knee joints in rheumatoid arthritis (RA) model rats, and to explore the mechanism by which moxibustion alleviates synovial inflammatory injury.

Methods: Forty male SD rats were randomly divided into 4 groups (10 rats in each group):blank, model, moxibustion, and triptolide groups. The RA model was induced by injecting complete Freund's adjuvant into the right hind toe combined with exposure to wind, cold, and damp environments. The moxibustion group received daily 20 min treatment at "Zusanli" (ST36) or "Shenshu" (BL23) for 15 d;the triptolide group was administered triptolide suspension (8 mg/kg) via gavage for 15 d. The joint swelling degree of right hind toe was measured by water displacement;the synovial morphology was assessed via HE staining;the mitochondrial ultrastructure was observed by transmission electron microscopy;the synovial protein expression levels of cGAS, STING, TANK-binding kinase 1 (TBK1), phosphorylated interferon regulatory factor 3 (p-IRF3) and phosphorylated nuclear factor-kappa B p65(p-NF-κB p65) were detected by Western blot;serum contents of interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1), C-X-C motif chemokine ligand 10 (CXCL10), and interferon-β (IFN-β) were measured by ELISA.

Results: Compared with the blank group, the model group showed increased joint swelling degree (P<0.01), irregular synovial lining cell distribution, marked hyperplasia, and inflammatory cell infiltration;synovial cGAS, STING, TBK1, p-IRF3, and p-NF-κB p65 protein expression levels and serum IL-6, ICAM-1, CXCL10, and IFN-β contents were significantly elevated (P<0.01). Compared with the model group, both moxibustion and triptolide interventions reduced joint swelling degree (P<0.01), improved synovial histopathology, and down regulated the aforementioned proteins and cytokines (P<0.01). No significant differences were observed between the moxibustion and triptolide groups.

Conclusions: Moxibustion attenuates joint swelling, inflammatory cytokine release, and synovial injury in RA model rats, potentially via suppression of the cGAS/STING pathway.

Pain-related emotions refer to the negative emotions such as depression and anxiety triggered by pain, which seriously impact patients' physical and mental health as well as the quality of life. The gamma-aminobutyric acid (GABA) ergic system is the primary inhibitory neurotransmitter system in the brain and plays a significant role in the onset and development of pain-related emotions. Acupuncture can effectively ameliorate the negative emotions such as depression and anxiety caused by pain. Its mechanism is closely related to the regulatory effect of acupuncture on GABAergic system. Acupuncture is active in modulating GABAergic neurons, up-regulating the expression of GABAergic neuron subtype parvalbumin neurons and down-regulating the expression of GABAergic neuron subtype neuropeptide Y; up-regulating the mRNA expression of GABAA receptor (GABAAR) and the protein expression of GABAB2 in the amygdala, and down-regulating the protein expression of GABAAR in the anteiror cingulate cortex. Besides, acupuncture can regulate the expressions of the key factors such as gutamate decarboxylase and gama-amino-butyrate transporter that affect the GABAergic system, thereby relieve pain-related emotions. These findings provide the references for the mechanism research and clinical application of acupuncture in treatment of pain-related emotions.