Objectives: To observe the differences in the effects of different dosages of grain-sized moxibustion on uterine artery blood flow in patients with cold and dampness primary dysmenorrhea (PD).
Methods: A total of 60 patients with PD were randomly divided into 3 groups with 20 cases in each group. Acupoints Sanyinjiao (SP6), Diji (SP8) and Xuehai (SP10) were selected in all the 3 groups, and different dosages of grain-sized moxibustion were used (3 moxa cones, 6 moxa cones, 9 moxa cones) respectively. Treatment started 7 days before menstruation for 3 times, lasting for a total of 3 menstrual cycles. The values of uterine artery blood flow parameters including pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio (S/D) were recorded before and after treatment. The visual analog scale (VAS) score and cox menstrual symptom scale (CMSS) score (including severity ［CMSS-S］ and time of duration ［CMSS-T］) were evaluated before treatment, at the end of each menstrual cycle, and one menstrual cycle after treatment.
Results: The values of uterine artery blood flow parameters (PI, RI, S/D) after treatment in the 9 moxa cones group were lower than those before treatment, as well as lower than those in the 3 and 6 moxa cones groups after treatment (P<0.05). The VAS scores of the 3 moxa cones group were lower than those before treatment in the first and second cycle (P<0.05). The VAS scores of the 6 and 9 moxa cones groups were lower than those before treatment at each observation point (P<0.05), and were lower than those of the 3 moxa cones group in the third cycle of treatment and follow-up period (P<0.05). And the VAS score of the 9 moxa cones group was lower than that of the 6 moxa cones group during the follow-up period (P<0.05). Compared with the scores before treatment, the CMSS-T scores at each observation point after treatment were lower in the 9 moxa cones group (P<0.05)；the CMSS-T scores in the second and third cycle after treatment, and follow-up period were lower in the 6 moxa cones group (P<0.05), with the CMSS-S scores in the second and third cycle after treatment, and follow-up period lower in the 6 and 9 moxa cones groups (P<0.05). The CMSS-T and CMSS-S scores of the 6 and 9 moxa cones groups were lower than those of the 3 moxa cones group in the third cycle and follow-up period (P<0.05). The CMSS-T and CMSS-S scores of the 9 moxa cones group were lower than those of the 6 moxa cones group during the follow-up period (P<0.05).
Conclusions: Grain-Sized moxibustion has dose-effect relationship in the treatment of PD. Compared with 3 and 6 moxa cones groups, 9 moxa cones group has advantages in improving uterine artery blood flow parameters and alleviating dysmenorrhea symptoms in PD patients.
Objectives: To compare the difference in the clinical efficacy on piriformis syndrome between trigger-point (TrP) acupuncture and glucocorticoid injection.
Methods: Sixty patients with piriformis syndrome were randomly allocated to an acupuncture group (30 cases, treated with TrP acupuncture) and a control group (30 cases, treated with glucocorticoid injection). In the two groups, the intervention was delivered once weekly and 2 treatments were required. Before treatment and 1 week, 1 month, 2 months and 3 months after treatment, the scores of the numerical rating scale (NRS) and Oswestry dysfunction index questionnaire (ODI), and the passive hip range of motion (PROM) were collected separately；the score of the 36-item short form of health survey (SF-36) was observed 3 months after treatment；and the administration of analgesic medication and the occurrence of adverse effects were recorded in the patients of 2 groups.
Results: The scores of NRS and ODI were decreased, and PROM was increased at each time point compared with the baseline (before treatment) in both groups (P<0.05). In comparison with the control group, the scores of NRS and ODI were decreased (P<0.01, P<0.05) and the range of hip internal rotation (HIR) was increased in the acupuncture group 2 and 3 months after treatment (P<0.01). Three months after treatment, the scores for physiological function, body pain, and vitality of SF-36 in the acupuncture group were higher than those of the control group (P<0.05). The number of patients with analgesic drugs was less (P<0.05) in the acupuncture group than that in the control group in 2 and 3 months after treatment. During treatment and in follow-up stage, no serious adverse reactions occurred in the patients of 2 groups.
Conclusions: The clinical effect of TrP acupuncture is similar to that of glucocorticoid injection on piriformis syndrome in 1 month after treatment. In 2 months after treatment, TrP acupuncture is markedly effective for attenuating pain and the functional impairment of the lower limbs, improving the quality of life and reducing the use of analgesic drugs in comparison with glucocorticoid injection.
Objectives: To explore the relationship between sensitization points of the body surface and the expression of pituitary adenylate cyclase activating polypeptides (PACAP) in myocardial ischemia (MI) mice, so as to reveal the underlying mechanisms of acupoint sensitization from the perspective of molecular biology.
Methods: Male C57BL/6J mice were randomly divided into control and model groups (28 mice/group). The MI-induced visceral pain model was established by intraperitoneal injection of isoprenaline (ISO, 160 mg/kg). The mice of the control group received intraperitoneal injection of the same dose of normal saline. Six days after modeling, the Evans blue (EB) dye was injected into the tail vein of mice to observe the distribution and quantity of the plasma extravasated EB points at the body surface. Meanwhile, the mechanical pain threshold (MPT) was measured to evaluate the level of pain sensitivity in the activated area on their body surface and left forelimb and hindlimb, respectively. Hematoxylin-eosin (H.E.) staining was used to evaluate the morphologic and pathological changes of the heart tissue in the two groups. Then, the expressions of PACAP in the thoracic (T)1-T5 dorsal root ganglia (DRGs), spinal cord and skin in the dominant area of body surface were detected by Western blot and immunofluorescence staining, respectively.
Results: Compared with the control group, the heart tissue of the model group was hypertrophic and the myocardial tissue showed obvious inflammatory cell infiltration and fibrosis. In addition to these pathologic changes, the number of EB exudation points on the body surface was significantly increased (P<0.01), and was mainly distributed in the innervated region of T1-T5 segments of the spinal cord, and the MPT of these EB exudation points was lower than that of non-exudation points (P<0.01). At the same time, the MPTs of left forelimb and hindlimb were significantly decreased in the model group (P<0.001). More importantly, the level of protein and positive expression of PACAP were significantly higher in the model group than those in the control group, which was observed in the innervated body surface, spinal cord and its DRG neurons of T1-T5 segments (P<0.01, P<0.001, P<0.05).
Conclusions: ISO injection resulted in histological lesions and cardiogenic referred pain on the body surface after the formation of MI in mice. The expression of PACAP in the body surface of the sensitization points, the corresponding T1-T5 segments of spinal cord and DRG neurons were significantly increased, which may partly explain the reason for acupoint sensitization in the animal model of visceral pain.
Objectives: To observe the effect of electroacupuncture(EA) on adenosine 5'-monophosphate-activated protein kinase (AMPK)/Kruppel-like factor 2 (KLF2) signaling pathway in ischemic myocardial tissues of rats, so as to explore the underlying mechanism of EA in attenuating myocardial ischemia-reperfusion injury (MIRI) through mediating angiogenesis.
Methods: Male SD rats were randomly divided into sham operation group, model group and EA group, with 10 rats in each group. The MIRI model was established by ligation of the anterior descending branch of the left coronary artery. Twenty-four hours after modeling, the rats in the EA group were given EA (2 Hz/100 Hz, 2 mA) at "Neiguan" (PC6) for 20 min each time, once a day for 5 consecutive days. Echocardiography was used to detect cardiac ejection fraction (EF) to evaluate cardiac function. HE staining was used to observe the morphological changes in rat myocardial tissue. Immunohistochemistry was used to detect the density of neovascularization in rat ischemic myocardium. Western blot and ELISA were used to detect the phosphorylated(p)-AMPK, AMPK, KLF2, vascular endothelial growth factor (VEGF) protein expression levels, and VEGF receptor 2 (VEGFR2) content in rat ischemic myocardial tissue, respectively.
Results: After modeling, compared with the sham operation group, rats in the model group had decreased EF(P<0.01), significant myocardial fiber damage with inflammatory cell infiltration, increased neovascular density (P<0.05), increased p-AMPK, AMPK, VEGF protein expression levels and VEGFR2 content in myocardial ischemic tissues(P<0.05, P<0.01), and decreased protein expression level of KLF2 (P<0.05). After EA intervention, compared with the model group, rats in the EA group had elevated EF(P<0.01), significantly reduced myocardial fiber damage, reduced inflammatory cell infiltration, increased neovascular density(P<0.01), and elevated p-AMPK, AMPK, KLF2, and VEGF protein expression levels and VEGFR2 content in the myocardial ischemic tissue (P<0.01).
Conclusions: EA may promote angiogenesis, attenuate myocardial injury, and achieve cardioprotective effects in MIRI rats by regulating the expression of AMPK/KLF2 signaling pathway in myocardial tissues.
A large number of studies have confirmed the anti-inflammatory effects of acupuncture, and some of the mechanisms and pathways regulating inflammatory response have been revealed. However, most of these researches focused on the effect of acupuncture on systemic anti-inflammation, and there is no consensus about the effect characteristics of different acupoints on regulating inflammatory response. It is noteworthy that increasing attention and exploration have been paid to the neuro-immune interactions and regulation of immune-inflammatory homeostasis. Importantly, the understanding of local neuroimmune regulation of non-immune organs has been deepening, which was known as the regional immunity. This new concept lays a scientific foundation for elucidating the characteristics of acupoints on the inflammation, especially the modulation of target visceral organs by the relevant acupoint stimulation. In this paper, the local effects (e.g. activating regional nerve components to induce local neuroimmuno-inflammatory regulation, etc), target visceral organ effects (e.g. regulating activities of visceral resident immune cells to initiate regional immunity regulation mediated by locally resident lymphocytes to promote inflammatory response degradation and to restore the homeostasis of regional immunity in the internal organs, via somato-visceral neuro-segmental connection, etc.) and systemic anti-inflammatory effects (e.g. regulating cholinergic anti-inflammatory pathway, including activating the vagus nerve to exert systemic anti-inflammatory effects through neuroimmune regulatory network, etc.) of acupoint stimulation were analyzed from different levels of neuroimmunological regulation, so as to provide new insights for clarifying the role of acupoints in improving inflammatory diseases.
Parkinson's disease (PD) is a neurodegenerative disease commonly seen in middle-aged and elderly people. The incidence of PD is increasing year by year, which seriously affects the patients' quality of life. Oxidative stress (OS) is one of the pathogeneses of PD. In recent years, with the deepening of research, it has been found that OS is closely related to other PD-related pathogenesis, such as the susceptibility of substantia nigra, mitochondrial dysfunction, abnormal folding of α -synuclein (α -Syn), nitric oxide (NO) increasing, endoplasmic reticulum stress (ERS), decreased antioxidant capacity, etc., which is considered to be the central link of the complex convergence of various pathogenesis. A large number of studies also have shown that acupuncture has great potential in regulating OS and treatment of PD. In the present article, we reviewed the role of OS in PD pathology and the mechanism of acupuncture in the treatment of PD by improving OS in recent years： 1) acupuncture acts on Parkinson's disease by increasing antioxidant enzyme levels, 2) acupuncture works in Parkinson's disease by improving pathways related to OS (Nrf2/ARE, PI3K/Akt), 3) acupuncture acts on Parkinson's disease by improving OS-related neuroinflammation, and 4) acupuncture acts on Parkinson's disease by improving the cerebral-intestinal axis associated oxidative stress.
Objectives: To observe the effect of acupuncture on gut microbiota in mice with rheumatoid arthritis (RA), so as to explore its mechanisms underlying improvement of RA.
Methods: Eighteen male C57BL/6J mice were randomly divided into saline, model and acupuncture groups, with 6 mice in each group. The RA model was established by injection of complete Freund's adjuvant (CFA, 50 μL) into the right hind paw. Acupuncture group received manual acupuncture stimulation of the bilateral "Zusanli" (ST36) for 30 min, once daily for 7 days. The paw withdrawal thermal latency (PWTL) was detected by using a thermal pain detector. After the last intervention, the mice's feces were collected for extracting the feces DNA, and 16S RNA sequencing was used to detect and analyze the diversity and structural composition of intestinal flora.
Results: Compared with the saline group, the PWTL from day 0 to 7 after administration of CFA was significantly decreased (P<0.01), and the paw swelling volume from day 0 to 7 significantly increased in the model group (P<0.01). In comparison with the model group, the PWTL from day 1 to 7 was significantly increased (P<0.01), and the paw swelling volume on day 7 was strikingly decreased (P<0.01) in the acupuncture group. The Alpha diversity analysis of intestinal flora showed that the Chao1 index was markedly decreased in the model group compared with the saline group (P<0.05), and markedly increased in the acupuncture group compared with the model group (P<0.05). Beta diversity principal coordinate analysis (PCoA) displayed that the intestinal microbiota community structure of each group was different, and there were some overlapping areas, but they could be distinguished (P<0.01), suggesting that the species richness and diversity of RA mice were changed after acupuncture treatment. Compared with the saline group, the relative abundance of Bacteroidota was decreased (P<0.05), and that of Desulfobacterota and Escherichia-Shigella significantly increased (P<0.05) in the model group. In comparison with the model group, the relative abundance of Actinobacteria and Lactobacillus was considerably increased (P<0.05, P<0.01), while that of Escherichia-Shigella and Faecalibacterium strikingly decreased (P<0.05) in the acupuncture group.
Conclusions: Acupuncture treatment can significantly alleviate joint inflammation in RA mice, which may be related to its function in regulating the diversity and composition of gut microbiota.
Objectives: To observe the therapeutic effect of intranasal acupuncture combined with Tiaoshen (spirit-regulation) acupuncture for patients with moderate-to-severe persistent allergic rhinitis (AR), and to explore its mechanism of anti-inflammation.
Methods: 135 patients with persistent AR were randomly divided into western medicine group, intranasal acupuncture group, and combination group, with 45 cases in each group. The western medicine group was treated with budesonide nasal spray, 1 press (32 μg/press) in each nostril, once a day. Patients in the intranasal acupuncture group were treated with intranasal acupuncture at the Neiyingxiang (EX-HN9) and Biqiu (nasal hillock) for 20 min. Patients in the combination group were treated with intranasal acupuncture combined with spirit-regulation acupuncture at Baihui (GV20), Sishencong (EX-HN1), Daling (PC7), Shenmen (HT7), Yintang (GV24+), Shenting (GV24), Anmian, and Yingxiang (LI20) for 20 min. Each group was treated once daily for 2 weeks. Total nasal symptom score (TNSS), total non-nasal symptom score (TNNSS), rhinoconjunctivitis quality of life questionnaire (RQLQ), self-assessment scale of anxiety (SAS), and self-assessment scale of depression (SDS) were observed before and after treatment respectively. Serum total immunoglobulin E (IgE), substance P (SP), neuropeptide Y (NPY), and vasoactive intestinal peptide (VIP) levels were detected before and after treatment using ELISA. The number of eosinophil (EOS) in peripheral venous blood was detected using a blood analyzer. The clincial efficacy of the 3 groups was evaluated.
Results: Compared with those before treatment, TNSS, TNNSS, RQLQ, SAS, SDS scores, EOS number and serum IgE, SP and VIP contents were decreased (P<0.05), and serum NPY content was increased (P<0.05) after treatment in the 3 groups. After treatment, the observation indexes in the intranasal acupuncture group were significantly improved (P<0.05) than those in the western medication group. The observation indexes of the combination group were better (P<0.05) than those of the other 2 groups. The total effective rate of the combination group (40/45, 88.89%) was higher (P<0.05) than that of the intranasal acupuncture group (35/45, 77.78%) and higher (P<0.05) than that of the western medication group (33/45, 73.33%).
Conclusions: Intranasal acupuncture combined with spirit-regulation acupuncture can improve the nasal clinical symptoms and accompanying symptoms of AR patients, reduce EOS and IgE, as well as regulate the secretion of neuropeptide and relieve the negative emotions of anxiety and depression.
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