World Journal of Acupuncture-Moxibustion最新文献

This article reported the application of wrist-ankle acupuncture with the ultrasound-guided interfascial plane block (Transversus abdominis plane block,TAPB; Rectus sheath block, RSB; Rhomboid intercostal and sub–serratus block, RISSB) in two emergency laparotomy in elderly frail patients. These cases were successfully completed with only a small dosage of narcotic analgesics, and the patient's spontaneous breathing was preserved and the vital signs of the patients were stable with the Visual Analogue Scale (VAS) of 2 points and the oxygen saturation level over 95%. Both patients recovered soon after the surgery. The combination of wrist-ankle acupuncture and interfascial plane block to preserve spontaneous breathing during laparotomy in elderly frail patients in China had not been previously reported.

Crohn's disease (CD) is an inflammatory bowel disease whose pathogenesis remains unclear. In this paper, we reviewed the basic research of acupuncture and moxibustion in treating CD by regulating intestinal intrinsic immunity, and summarized in more detail that acupuncture and moxibustion can regulate the intestinal intrinsic immune system through the intestinal epithelial cell barrier, monocytes/macrophages, natural killer cells (NK cells), dendritic cells (DC), and neutrophils. Specifically, acupuncture and moxibustion can reduce the expression of inflammatory factors in the intestinal mucosa, alleviate intestinal fibrosis to repair the mechanical barrier of the intestinal mucosa, inhibit the expression of molecules of the MAPK, TLR/NF-κB signaling pathway and inflammatory factors, block the NK cell-mediated cytotoxicity pathway, and prevent the overactivation of neutrophils to control inflammatory responses, repairing the damaged intestinal tract and alleviating CD symptoms. This paper illustrated the characteristics of acupuncture and moxibustion for CD, which involves multi targets and pathways, aiming to provide guidance for the clinical application and basic research of acupuncture and moxibustion for CD. It also pointed out the current drawbacks of acupuncture and moxibustion therapy, and finally proposing the shortcomings of the current research, including the insufficient number of studies on acupuncture and moxibustion in the treatment of CD through the modulation of NK cells and neutrophils, the lack of standardization in acupuncture point selection, duration and treatment course, and the geographical limitations of the research locations for acupuncture and moxibustion in treating CD.

Microglia (MG) activation and its mediated neuroinflammation are closely related to the occurrence and deterioration of Alzheimer's disease (AD). Acupuncture is one of the effective approach for AD, which can relieve the symptoms and slow the deterioration of AD. Based on the role of MG activation and its induced pro-inflammatory and anti-inflammatory phenotypes in neuroinflammation, this paper reviews the related literature on the mechanism of acupuncture in regulating MG activation and relieving neuroinflammation in AD. It is found that acupuncture can inhibit abnormal MG activation by regulating the release of MG surface immune receptors and pro-inflammatory/ anti-inflammatory cytokines. It can also modulate the activity of signaling pathways associated with MG polarization, downregulate the expression of M1, and promote MG polarization towards the M2 phenotype. Additionally, it adjusts the imbalance between M1 and M2 phenotypes of MG, thereby relieving the neuroinflammatory pathological procession of and repairing the neuronal damage so as to achieve its therapeutic effect.

Objective

To assess the effect and safety of acupuncture on the base of rehabilitation for knee function after total knee arthroplasty.

Methods

Relevant articles were collected from CNKI, Sinomed, Wanfang, VIP, Cochrane Library, Medline and Embase. The search was conducted by using a combination of subject terms and free words. The data were analyzed by Revman 5.4 software, and the included studies were evaluated in compliance with the Cochrane Collaboration's tool for assessing risk of bias in randomized trials.

Results

A total of 10 studies of randomized controlled trial (RCT) were included, with 785 participants involved, of which, 393 cases in experiment group and 392 cases in control group. The interventions were electroacupuncture in 4 RCTs, filiform needling in 4 RCTs and transcutaneous electrical acupoint stimulation in 2 RCTs. Meta-analysis results showed that, compared with rehabilitation alone, acupuncture combined with rehabilitation improved the score of Hospital for Special Surgery (HSS) (MD=4.27, 95% CI=[2.77, 5.78], Z=5.58, P<0.00001), increased the range of motion (ROM) of the knee (MD=3.09, 95% CI=[1.47,4.70], Z=3.75, P<0.001), and decreased the postoperative score of visual analogue scale (VAS) (MD=-0.53, 95%CI=[-0.74, -0.33], Z=5.04, P<0.00001), but the difference in VAS score between groups only indicated statistical significance, without clinical importance. The sensitivity analysis showed the results were stable. In subgroup analysis, the stability of VAS score was relatively poorer in electroacupuncture group and filiform needle group, which may be associated with the differences in waveform of electroacupuncture and trial setting.

Conclusion

Compared with rehabilitation alone, acupuncture in combination with rehabilitation could effectively improve the knee function for the patients after total knee arthroplasty.

Acupoints on the different parts of the body surface vary in regulating the autonomic nervous system (ANS), exhibiting differences in the acupoint specificity in terms of the distributing directions of sympathetic and parasympathetic branches. The paper introduces the rules of acupoints on the corresponding body surfaces in modulating ANS based on their location at four limbs, abdomen, sacrum, head and face, suboccipital and lateral cervical region and auricle (concha). The fundamental rule of acupoint heterogeneity in ANS regulation is that: all acupoints can induce somatic-sympathetic reflex. The regional heterogeneity of acupoints in ANS is shown: by the fact that stimulation beyond a certain intensity can induce systemic autonomic effects. The acupoints on the abdomen act on the sympathetic nervous system, those at concha on the vagal system and those on the sacral region on the sacral parasymathetic system. The heterogeneity of acupoints in regulating ANS refers to co-effects of acupoints specific effect (within segments) and its systemic effect (whole body), which embodies the specificity of acupoints structure. The acupoints on the same body surface regions display the homogeneity of modulation. Mastering the heterogeneous characteristics of acupoints in modulating ANS is particularly conductive to constructing the theoretical basis of acupoints in clinical acupuncture treatment for systemic diseases.

Background

The aim of the study was to explore the regularity of acupoints combination in the treatment of functional dyspepsia (FD) by means of data mining technology.

Methods

We conducted a systematic search of nine databases from their inception to December 2022 to identify eligible randomized controlled trials (RCTs). The acupoints prescriptions in the treatment of FD were extracted and analyzed based on association rule mining and network analysis. Furthermore, the acupoints prescribed for irritability symptom of FD were quantified by forward inference, reverse inference and Bayes factor (BF) correction.

Results

A total of 45 RCTs on 30 acupoints were included, involving 172 times the total application frequency. Analysis of acupoints prescriptions covered 29 meridian acupoints and one extra-ordinary point, disturbing in 10 meridians. The top three acupoints in application frequency were Zusanli (ST36, 19.77%), Neiguan (PC6, 16.86%), Zhongwan (CV12, 12.21%). The most involved meridian was the foot yangming stomach meridian (34 times). The most frequently used acupoints combinations were PC6 and ST36. The core prescriptions were ST36, PC6, Tianshu(ST25), CV12. The specificities of acupoints selection for FD with dysphoria as follows: using the forward inference, PC6, Taichong(LR3), Qimen(LR14), CV12, Danzhong(CV17), ST25, ST36 were selected. Using the reverse inference and BF correction, PC6, CV12, CV17, Sanyinjiao(SP6), ST25, ST36 were selected.

Conclusion

ST36, PC6, ST25, CV12 could be used as the main prescriptions in treating FD. For FD with dysphoria the acupoints prescription is PC6, CV12, CV17, ST25 and ST36.

One case of acute Bell's palsy was reported and treated with Fu's subcutaneous needling(FSN). Present symptoms: facial muscle stiffness on the right side, ptosis of labial angle, failure to frown the right eyebrow, the eyeball exposed about 2 mm when gently closing the eyes, air leaking when bulging the cheeks, drooling when brushing the teeth and gargling, and food retained in the cheek when eating. Western medicine diagnosis: peripheral facial palsy. Traditional Chinese medicine diagnosis: facial paralysis. The subcutaneous swaying movement and reperfusion action of FSN were adopted on the affected muscles and achieved the remarkably effects on incomplete closure of eyes and drooping of the mouth. The patient was recovered quickly. Before and after treatment, the laser speckle contrast imaging was used to observe the improvement of blood flow on the face, which provides the idea for the research and clinical practice of Fu's subcutaneous needling in treatment of Bell's palsy.

Objective

To summarize the rules of acupoint selection in treatment of cancer with moxibustion by analyzing the articles of relevant clinical trials in recent years in China, so as to provide the references for acupoint selection of moxibustion for cancer.

Methods

The articles of clinical trials for treatment of cancer with moxibustion were retrieved from China National knowledge Infrastructure (CNKI), VIP Chinese Journal Service Platform (VIP) and Wanfang Data Knowledge Service Platform (Wanfang) from 1st January 2015 to 30th June 2021. Using EpiData software, the data were extracted and exported in Excel. The analysis was performed with IBM SPSS Statistics 23 software.

Results

A total of 516 articles were collected, including 533 prescriptions with 164 acupoints involved. The high-frequency acupoints were similar among 7 types of cancers and these acupoints mostly acted on supporting the antipathogenic qi, replenishing qi and regulating the spleen and stomach. Regarding meridian tropism, the acupoints from the conception vessel, the governor vessel and bladder meridian were dominant in treatment of cancer with moxibustion. In terms of location distribution, the selected acupoints were generally distributed on the chest, abdomen, lumbar region and the upper back of the body. Based on cancer related symtomes in different systems, the use frequency of Zusanli (ST36) was the highest for the symptoms of the immune, digestive, circulatory and motor systems; that of Feishu (BL13) was the highest for the respiratory system symptoms and that of Guanyuan (CV4) was the highest for the urinary system symptoms. The cluster analysis of high-frequency acupoints showed that the acupoints of moxibustion for cancer generally work on cultivating yang, supporting the antipathogenic qi, strengthening the spleen and harmonizing the stomach, and were selected in association with the clinical symptoms of different cancers.

Conclusion

In treatment of cancer with moxibustion, the acupoints of the conception vessel and the governor vessel, as well as the back-shu points of the bladder meridian were dominated. All of these acupoints acted on supporting the antipathogenic qi, replenishing qi and regulating the spleen and stomach. It emphasized the etiology of “the deficiency in the root” of cancer, and the characteristics of acupoint selection based on syndrome differentiation in treatment with moxibustion.

This article introduces the clinical experience of Professor Jian-qiao FANG in treatment of postherpetic neuralgia (PHN) with acupuncture and moxibustion. Jian-qiao FANG believes that PHN is characterized by “stagnation” and “deficiency” in pathogenesis and it is treated by “resolving stasis” and “replenishing for deficiency”. Electroacupuncture is predominated in treatment and the combined regimen of various techniques of acupuncture and moxibustion is adopted in therapeutic strategy. According to the pain characteristics of patients, the acupuncture and moxibustion prescription is drafted for resolving stasis and masses, replenishing for deficiency and regulating the mind. The acupoints include Ashi points, Jiaji (EX-B2), Hegu (LI4), Waiguan (TE5), Zusanli (ST36), Sanyinjiao (SP6), Shenting (GV24), Baihui (GV20) and Sishencong (EX-HN1). In treatment with electroacupuncture, the stimulation parameters are selected flexibly according to different pain characteristics. The frequency of 2/100 Hz is the first option, 100 Hz is used for the acute seizure and 2 Hz is for mild pain. After electric stimulation, the treatment with roller type of dermal needle and moxibustion can be applied to ensure clinical efficacy.