Medical Acupuncture最新文献

Background: Although acupuncture points (acupoints) have been used for thousands of years, their exact biological basis remains uncertain. This knowledge gap has hindered both acupuncture research and the integration of acupuncture into clinical care.

Objective: In response to a consensus in the scientific community about the need for an open-access database where researchers can deposit, share, and compare anatomical and physiological data associated with acupoints, the National Center for Complementary and Integrative Health has funded a project to develop such a database, the Topological Atlas and Repository for Acupoint Research (TARA).

Conclusions: TARA will enable researchers to synthesize different types of data to develop a comprehensive understanding of acupoints and help elucidate the mechanisms of acupuncture. For example, one area of research that may benefit from this resource is the developing concept that stimulating points on the surface of the body may have physiological effects through the interstitium-the connective tissue between fascial layers-in addition to effects through pathways within the nervous system.

Objective: Gout arthritis (GA) is a common inflammatory joint disease that is difficult to cure. Moxibustion, as an important alternative therapy, is widely used. However, the criteria for selecting acupuncture point prescriptions and combinations are unclear. Thus, the study aimed to explore the most effective acupoints and combinations in the treatment of GA through data mining techniques.

Methods: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Wanfang, VIP, and China Biomedicine databases were used to screen clinical studies and observations of the efficacy of moxibustion in the treatment of GA. Data on the acupoint prescriptions applied in these studies were collected, and association rule mining analysis and cluster analysis were conducted to summarize the characteristics and patterns of acupoint selection for the treatment of GA with moxibustion.

Results: Sixty-four trials involving 116 groups of prescriptions and 99 acupoints were identified. Zusanli (ST36), Yinlingquan (SP9), Yanglingquan (GB34), Sanyinjiao (SP6), and Xuehai (SP10) were the most commonly used acupoints for GA. The spleen meridian of the foot-taiyin and the stomach meridian of foot-Yangming were the most commonly used meridians. Additionally, most acupoint sites are concentrated in the extremities. Network analysis reveals Gongsun (SP4), Sanyinjiao (SP6), Zusanli (ST36), Yinlingquan (SP9), and Ashi as potentially effective and commonly used acupoints. In the acupoint interconnection network, Ashi and Sanyinjiao (SP6) were potential combinations of acupoints that should be chosen first in GA treatment. Clustering analysis revealed the treatment principle of "invigorating spleen and removing dampness, and relaxing muscles and activating collaterals."

Conclusion: Through data mining analysis of published studies, this study provides valuable information for selecting the most effective acupoints and combinations for clinical moxibustion in the treatment of GA.

Introduction: The nasolabial folds are one of the most recognizable signs of aging in the midface. Acupuncture has been used widely for beauty therapy including facial rejuvenation and is known to be effective and have minimal side effects in reducing wrinkles. The aim of this study was to determine the changes in nasolabial fold after manual acupuncture for facial rejuvenation.

Methods: This study is designed as a quasi-experimental or also called as one group pretest-posttest design involving 25 participants. Eligible patients will receive the same manual acupuncture therapy three times a week for 2 weeks. Manual acupuncture is performed at ST36. At the face, acupuncture is performed using the penetrating needling technique, from the superior edge of the arcus zygomaticus through ST2 toward LI20, on the zygomaticum through ST3 toward the middle of the nasolabial fold, on the inferior edge of the arcus zygomaticum through SI18 toward ST4, ST7 toward ST4, and at ashi point on the scalp along the temporal hairline at the m. temporoparietal. The outcomes are nasolabial length changes measured in millimeters, changes in the wrinkle severity rating scale (WSRS), and changes in the global aesthetic improvement scale (GAIS). The outcome will be evaluated at baseline, posttherapy, 2-week, and 4-week follow-up posttherapy.

Results: The length of the nasolabial fold decreased after therapy with a mean change of 37.34%. There was one level of improvement on the WSRS after therapy. On the GAIS, there was an improvement of two to three levels after therapy.

Conclusion: Nasolabial fold improved after receiving manual acupuncture therapy for facial rejuvenation.

This proceeding summarizes a symposium on multidisciplinary menopause management held on April 13, 2024, as part of the American Academy of Medical Acupuncture's 2024 conference. The workshop featured a presentation that integrated conventional medical perspectives and acupuncture therapy approaches to managing menopause symptoms. Topics included the stages of the menopausal transition, vasomotor symptoms, genitourinary syndrome of menopause, bone and cardiovascular health, and psychological well-being. The presentation also provided traditional Chinese medicine theories, pattern recognition in patient presentation, and evidence from clinical trials on acupuncture efficacy. In this study, we highlight the major points of the presentation.

Background: This study analyzed the research status, hotspots, and trends of acupuncture treatment for insomnia using bibliometrics and scientific knowledge mapping methods.

Methods: We searched for records associated with studies focusing on acupuncture treatment for insomnia collected from the Web of Science Core Collection (WoSCC), from the establishment of the database to December 31, 2022, was retrieved. Visualization analysis was conducted using Excel 2021, CiteSpace 6.2.R5, and VOSviewer 1.6.19 software.

Results: A total of 873 articles were obtained from the WoSCC database. The annual publications showed an overall upward trend, especially from 2018 to 2022, with a rapid increase in publications. Literature output was concentrated in China and the United States, accounting for 43.41% and 22.4% of the total research output, respectively. The highest-yield journal was Medicine and the most cited journal was Sleep. Guangzhou University of Chinese Medicine had the highest publication outputs (51 articles) and the strongest influence (0.18) among institutions. "Fibromyalgia" was the earliest and longest-lasting keyword. "Older adults" was the keyword with the highest burst intensity. The keywords "model," "stroke," "blind," "clinical practice guideline," "risk," "symptoms," "Shenmen (HT7)," and "Neiguan (PC6)" have been continuously trending, indicating that these keywords are current research hotspots and trends. In terms of acupoint selection, "HT7" and "PC6" acupoints are at the frontier of current research. In terms of disease types, poststroke insomnia treated with acupuncture has become a current research frontier. In terms of animal experiments, the mechanism of acupuncture treatment for insomnia through establishing rat models is at the forefront. Attention has been given to controlling bias risk in experiments, becoming a current hotspot and frontier.

Conclusion: This study comprehensively investigated the current status, hotspots, and frontier trends of acupuncture for insomnia. Its research hotspots included acupuncture for poststroke insomnia, and research trends were the mechanism of acupuncture treatment for insomnia through establishing rat models.

Background: Acupuncture enhances the endogenous analgesic system and reduces pain. However, its effect is not constant, and it has been reported that it varies depending on the endogenous analgesic system and spinal cord response. Therefore, we investigated whether there was a difference in the changes in pain thresholds in muscle and skin tissue due to differences in the spinal cord response when electroacupuncture was applied to healthy participants whose endogenous analgesic system works normally.

Methods: We included 29 healthy volunteers who gave consent to participate. The participants underwent psychological evaluations, pain thresholds assessment for muscle and skin tissue, temporal summation of pain (TSP), and conditioned pain modulation (CPM). The participants subsequently received 30 min of acupuncture (scalp + three limbs) as an intervention, and the pain thresholds of muscle and skin tissue were measured before, 30 and 60 min after intervention. Note that participants were grouped by TSP based on high and low spinal cord response.

Results: Analysis of participants grouped by spinal cord response showed no difference in CPM between high and low groups prior to the intervention, indicating that the endogenous analgesic systems were the same for the two groups. However, electroacupuncture intervention affected changes in muscle pain threshold (p = 0.03). A significant difference in pain threshold was noted in the high group, 60 min after intervention (p = 0.04).

Conclusion: When electroacupuncture is applied to healthy participants, those with higher spinal cord response may have higher muscle pain threshold.

Background: Sudden sensorineural hearing loss (SSNHL) is commonly characterized by severe hearing loss of 30 dB or greater over at least three consecutive frequencies occurring within a 72-h period. Current treatments, depending on the cause, include decompression of tumor-related pressure, administration of anti-infection agents, cessation of ototoxic drugs, neuronutrition, administration of prednisone, and hyperbaric oxygen. Some patients may recover spontaneously, usually within 2 weeks of onset. Here, we present a case that the patient's symptoms improved significantly after treatment with electroacupuncture.

Objective: To report a case of SSNHL treated with electroacupuncture (EA) and to discuss its potential effects on hearing recovery of SSNHL.

Design: A single case report.

Setting: Department of Acupuncture and Moxibustion, Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an, China.

Patients: A patient with SSNHL who experienced a significant decrease in left ear hearing.

Intervention: EA treatment on the affected ear of an SSNHL patient; eight acupoints were divided into four groups (SJ21(Ermen)-GB10(Fubai), SJ19(Tinggong)-GB11(Touqiaoyin), GB2(Tinghui)-SJ17(Yifeng), and GV20(Baihui)- EX-HN3 (Yintang), with each group receiving 30 min of electrical stimulation (2 Hz, continuous wave, alternating current, 2 mA). This treatment was administered five times a week for 2 weeks.

Main outcome measures: Pure-Tone Audiometry.

Results: After 2 weeks of EA treatment, the patient's hearing has improved from severe hearing loss to moderate hearing loss, with a significant improvement in daily communication ability.

Conclusions: Electroacupuncture may be a promising complementary treatment for SSNHL.

Registration and funding: The study was not registered, and no funding was received.

With more recent research into the neuromyofascial system, one can begin to surmise how acupuncture may work through modulating nerves, muscles, and fascia. Pain relief from acupuncture is thought to involve the release of endogenous opioids and monoamines. Various different peripheral nerves are stimulated with acupuncture, and there are also specific effects on the brain that can be seen on functional magnetic resonance imaging. Acupuncture has long been used to treat muscular pain from trigger points, and there is now research that can objectively quantify these trigger points. Needling therapies have been shown to improve trigger point status and improve patients' pain and function. Fascia is an often overlooked structure that can contribute to pain and various other symptoms. Fascia is a multilayered structure that interpenetrates and surrounds muscles, bones, nerves, and blood vessels, binding all of these together, and acupuncture has been shown to have specific effects on the fascia. There is evidence for the existence of myofascial meridians that span the body where separate muscles are mechanically linked through the fascia. Structure-based medical acupuncture (SMA) is based on the idea that the targets for acupuncture treatment are actual structures. Some meridians are myofascial meridians such as the Bladder (BL) and Gallbladder (GB) meridian, whereas others may be blood vessels or nerves, such as the Lung (LU) and Pericardium (PC) meridians, respectively. SMA was developed in China but utilizes both ancient and modern, Chinese and Western medicine concepts and understandings of human structure. Principles include that anatomy is foundational, manual manipulation is essential, tools (the needle) are an extension of the hand, and exercise and rehabilitation are the ways to prevent recurrences and maintain efficacy. SMA differs from more traditional TCM acupuncture in that imaging and physical exams are used to guide treatment, immediate pain relief is expected after treatment, and fewer treatment sessions are typically needed.

Background: In the United States, acupuncture education is divided into two primary pathways: medical acupuncture for licensed physicians and traditional acupuncture rooted in Traditional Chinese Medicine (TCM) for nonphysician practitioners. These pathways reflect the distinct educational needs and historical development of acupuncture in the United States.

Objective: To compare medical and traditional acupuncture educational systems, highlighting their strengths, weaknesses, and the potential for integration to enhance patient care.

Methods: This narrative review utilized comprehensive literature searches, analyzing peer-reviewed articles, institutional reports, and accreditation documents. The study focused on programs approved by the American Academy of Medical Acupuncture and accredited by the Accreditation Commission for Acupuncture and Herbal Medicine.

Results: Medical acupuncture programs are shorter and emphasize evidence-based practice, allowing physicians to integrate acupuncture into conventional medical treatment. These programs focus on Western medical terminology and concepts but may lack depth in TCM principles. Traditional acupuncture programs offer extensive training in TCM principles and practices, including herbal medicine, with comprehensive clinical training but may lack emphasis on modern medical science and research-based evidence. There is a significant workforce disparity between licensed traditional acupuncturists and the much smaller number of medical acupuncturists in practice.

Conclusions: Integrating both educational pathways can enhance patient care through comprehensive treatment approaches. Successful integration examples demonstrate improved patient outcomes. Future efforts should focus on developing joint training programs, promoting research collaboration, and increasing hospital-based internships to foster interdisciplinary learning and practice.