Journal of Acupuncture and Meridian Studies最新文献

Importance: Labor pain presents significant challenges during childbirth, necessitating effective pain management strategies. Auriculotherapy, a non-pharmacological intervention targeting specific ear points, has been explored as a potential solution for alleviating labor pain.

Objective: This systematic review and meta-analysis aimed to evaluate the efficacy of auriculotherapy in reducing labor pain intensity and improving maternal satisfaction.

Data resources: The electronic databases PubMed, Scopus, ScienceDirect, and Cochrane Library were searched from inception until December 2023 for randomized controlled trials (RCTs) investigating auriculotherapy as an intervention for labor pain management.

Study selection: Two authors independently conducted literature selection based on predefined criteria (i.e., RCTs assessing auriculotherapy for labor pain management).

Data extraction and synthesis: Data extraction was performed independently by two authors, and a random-effects model was used for meta-analysis. The pooled mean difference (MD), with a 95% confidence interval (CI), was calculated to estimate the effect size.

Main outcome(s) and measure(s): The primary outcome was labor pain intensity measured on the visual analog scale.

Results: Meta-analysis of five RCTs involving 451 patients revealed a significant reduction in labor pain following auriculotherapy compared with no treatment (MD, -1.78; 95% CI, -2.62 to -0.93). However, significant heterogeneity was observed among the included studies (I², 87%; p < 0.01).

Conclusions and relevance: Despite the observed heterogeneity, this meta-analysis suggests that auriculotherapy holds promise as a non-pharmacological intervention for alleviating labor pain. Further investigation is warranted to refine auriculotherapy protocols and assess its long-term effects, thereby enhancing its potential as a viable option for labor pain management.

Importance: Acupoint autohemotherapy (AA), a therapeutic technique involving the subcutaneous injection of autologous blood into acupoints, has been empirically validated as safe and effective for treating asthma by alleviating symptoms and decreasing acute attacks, though its mechanism is not well understood.

Objective: The role of heme oxygenase-1 (HO-1) in AA-induced suppression of asthmatic airway inflammation is examined.

Methods: Twenty rats were assigned randomly to four groups, namely the Control, OVA, OVA + AA, and (OVA + Snpp) + AA. Rats in the OVA + AA and (OVA + Snpp) + AA received autologous blood injections into acupoints (BL13 and BL23) following OVA challenge. Rats in the (OVA + Snpp) + AA were concurrently subjected to intraperitoneal injections of Snpp, a inhibitor of HO-1. Airway inflammation was evaluated through HE staining, while the concentrations of cytokines in BALF were quantified using ELISA. The mRNA and protein levels of RORγt (Th17-specific transcription factor), Foxp3 (Treg-specific transcription factor), and HO-1 in lung tissue were assessed through qRT-PCR and WB.

Results: HE staining indicated that airway inflammation was alleviated in the OVA + AA. The OVA + AA displayed significantly lower counts of total cells and eosinophils in the BALF compared to both the OVA and (OVA + Snpp) + AA. The ELISA demonstrated a significant decrease in levels of pro-inflamatory cytokines (IL-4, IL-17A), and an increase in levels of anti-inflamatory cytokines (IFN-γ, IL-10), in the OVA + AA when compared to both OVA and (OVA + Snpp) + AA. The qRT-PCR and WB analyses revealed an upregulation of HO-1 and Foxp3 expression, and a downregulation of RORγt expression, in the OVA + AA when compared to OVA and (OVA + Snpp) + AA.

Conclusions and relevance: The involvement of HO-1 in the underlying mechanism responsible for the anti-inflammatory effects of AA is evident.

Importance: Stroke is a leading cause of disability worldwide and is often accompanied by complications such as spasticity. Static stretching (SS) is a common physiotherapy intervention for reducing spasticity, whereas dry needling (DN) is a novel approach. However, the combined effects of DN and SS on spasticity have not been thoroughly investigated. Given the pivotal effect of spasticity on daily activities, mitigating spasticity can significantly contribute to restoring patient independence.

Objective: This study will explore the impact of DN plus SS on spasticity, alpha motor neuron excitability, overall function, and quality of life in patients with chronic stroke.

Design, setting, and population: A double-blind, randomized, sham-controlled trial will be conducted in patients with post-stroke spasticity in the plantar flexor muscles. Twentyeight participants will be randomly assigned to either an intervention or control group. The intervention group will receive DN (60s × 3 days/week; 1 week) plus SS (20 min × 5 days/ week; 1 week). The control group will undergo sham DN (60s × 3 days/week; 1 week) and SS (20 min × 5 days/week; 1 week).

Exposures: DN plus SS or sham DN plus SS.

Main outcomes and measures: Both groups will be assessed at baseline, immediately post-treatment, and after 1 week of follow-up. Outcome measures will include the Modified Modified Ashworth Scale, H-reflex latency, Hmax/Mmax ratio, active and passive ankle dorsiflexion range of motion, timed up and go test, and the EuroQol questionnaire.

Results: Results from this randomized, sham-controlled study will provide evidence for the effectiveness of DN in combination with SS for spasticity.

Conclusions and relevance: The additional impact of DN in conjunction with SS, a widely used method for reducing muscle tone, remains unclear and warrants investigation. This study, with a high level of evidence, aims to address this knowledge gap.

Importance: We compile and analyze ancient literature related to Baihui (GV20) moxibustion and summarize the development of its ancient clinical application.

Observations: The Chinese Medical Classic (5th edition) was used as the search source to screen and organize articles related to Baihui moxibustion to establish a database. We created indexing norms according to study characteristics and indexed books, dynasties, literary styles, disease key words, matching acupoints, combinations, moxibustion amounts, and moxa cone sizes. SPSS version 24.0 software was used to calculate the index results. A total of 320 articles that met the requirements were finally included and were attributed to 99 ancient books, spanning from the Western Han Dynasty to the Qing Dynasty. A total of 45 keywords were used for disease evidence: the most frequent occurrences were internal medicine (primary category), limb meridians (secondary category), and head diseases (specific patterns).

Conclusions and relevance: Baihui moxibustion has been updated and developed in the literature over the ages, and the method of Baihui moxibustion is diverse. The main treatment rule of Baihui moxibustion considers the whole body and close treatment of partial diseases. Baihui moxibustion also has the rule of following meridian indications, with treatment based on syndrome differentiation and compatible application. Baihui moxibustion alone has a relatively strong effect of raising yang and lifting the sunken, which can treat the sinking of qi and deficiency.

Importance: The Yi Shen Juan Bi (YSJB) pill has been used to treat rheumatoid arthritis (RA), with several studies reporting its anti-inflammatory effects and ability to prevent bone destruction. However, the lack of evidence regarding the effectiveness and toxicity of individual components of YSJB limits its widespread use.

Objective: This protocol outlines a systematic review and/or meta-analysis to evaluate the effectiveness and safety of YSJB.

Data resources: We will search worldwide electronic databases, including MEDLINE, Cochrane Library, China National Knowledge Infrastructure, Wanfang, CiNii, J-STAGE, KoreaMed, Korean Medical Database, Korean Studies Information Service System, National Digital Science Library, Korea Institute of Science and Technology Information, and Oriental Medicine Advanced Searching Integrated System. In addition, we will conduct manual searches, and, if necessary, contact authors directly. The search will cover publications until June 2024.

Study selection: We will select randomized controlled trials (RCTs) that compare the use of YSJB for the treatment of RA against other treatments.

Study extraction and synthesis: Data from the selected RCTs will be extracted, including sample size, patient characteristics, intervention details, and outcome measures. We will perform a meta-analysis using Review Manager software.

Main outcome(s) and measure(s): The primary outcome measures will include disease activity scores such as effective rate, swollen joint count, tender joint count, and morning stiffness. Secondary outcome measures will include blood test results and adverse events.

Results: The results will reveal the effectiveness and safety of YSJB for the treatment of RA.

Conclusions: and Relevance: The findings will provide an evidence-based review of the use of YSJB for RA.S.

Importance: Choledocholithiasis, or bile duct gallstones, is effectively treated with surgery, which does not prevent relapse. A common adjuvant therapy is the stimulation of the Yanglingquan point (GB34). Acupoint catgut embedding (ACE), an acupoint stimulation therapy, may be a better treatment for choledocholithiasis.

Objectives: To investigate the effect of ACE in stimulating GB34 on bile metabolism and its possible mechanism via metabonomics.

Methods: In this study, we used ultrahigh performance liquid chromatographyquadrupole time-of-flight mass spectrometry (UHPLC-MS/MS) to analyze the changes in bile metabolites, metabolic pathways, and liver function indicators in 16 patients with choledocholithiasis before and after ACE stimulation.

Results: We identified 10 metabolites that exhibited significant differences in the bile before and after ACE, six of which significantly increased and four that significantly decreased. Moreover, six liver function indicators showed a downward trend. We identified related metabolic pathways as glycerophospholipid metabolism, steroid biosynthesis, and the citrate cycle (TCA cycle).

Conclusions and relevance: This study shows that ACE stimulation of GB34 can effectively help treat choledocholithiasis, which may be clinically applicable to ACE.

Recently, several previously undiscussed concerns in acupuncture research have been brought to light. Among these, the core issue stems from the ambiguity surrounding the identity of acupoints. Hence, the question "What is the identity of acupoints?" remains of particular importance in acupuncture research. To answer this question, we reviewed the original concept of acupoints explained in Oriental medicine, from which acupuncture treatment originated, and examined scientific research on acupuncture and acupoints. We then proposed a perspective on the identity of acupoints and speculated about a possible reason for their elusive nature: qi, which congregates at and flows in and out of acupoints, might be bioelectricity, making these points inherently difficult to measure anatomically or histologically. Consequently, acupoints are suggested to be spaces where bioelectricity congregates, thus inevitably exhibiting electrical characteristics.

Importance: Neuromodulation may be one of the underlying mechanisms of dry needling (DN); however, the mechanism has not yet been fully clarified.

Objective: This randomized controlled trial is designed to evaluate DN stimulation of the tibialis anterior and peroneus longus muscles in chronic ankle instability (CAI) and healthy subjects, employing functional magnetic resonance imaging (fMRI).

Design: Clinical study protocol, SPIRIT compliant.

Setting: Brain Mapping Laboratory.

Population: A total of thirty participants aged between 18 and 40 years old will be included in this study. Twenty healthy participants will be randomized into 2 groups (real DN and sham DN). Ten patients with CAI will also be recruited to the third group and receive only real DN for comparison.

Exposures: Real and sham DN.

Main outcomes and measures: The voxel count, coordinates of peak activation, and peak intensity will be obtained as primary outcomes to report brain map activation. Measurements will be taken before, during, and after DN treatment. The strength of the ankle dorsiflexors, active dorsiflexion range of motion, and McGill pain questionnaire short-form will be used as secondary outcome measures.

Results: The results from this study will be published in peer-reviewed journals and disseminated as presentations at national and international congresses.

Conclusion: This trial will explore brain responses to real and sham DN in healthy participants and to real DN in CAI patients. Overall, our results will provide preliminary evidence of the neural mechanism of DN.

There is no clear evidence that acupuncture points and meridians are separate organs or specific tissues. However, in traditional Chinese medicine, the mechanism of acupuncture action is associated with the vital energy concept. To identify the body's energy source and the material basis of its transmission, transformation, and use, it is necessary to consider it as an energy-generating object, with all its components. By abstracting from the body's usual structural view, we found that it is an autonomous energy-generating object. The human body generates energy through the lungs and digestive tract, which are electrochemical generator organs. Because the generated energy must be transferred to the consumer, the body has wire and transformer analogs. It bears an obvious resemblance with an electronic circuit, where cellular structures, tissues, and their combinations act as electrical and radioelements. The heart, brain, and muscles, which have well-known electrical parameters, as well as acupuncture points, offer information about the state of these electronic circuits. This article describes an extra-organ approach for systematizing body structures. It also attempts to represent the meridians and acupuncture points system as integral electro-radioelements, as well as the local circuit components of the whole body's electronic scheme.

Importance: Post-stroke sialorrhea (PSS) refers to excessive saliva flowing out the lip border after a stroke. PSS negatively affects patient self-image and social communication and may lead to depression. Limited evidence supports the link between excessive salivation and PSS. No large-scale, strictly controlled randomized controlled trials have shown the effectiveness of acupuncture in treating PSS patients.

Objective: We aim to compare the effects of intraoral and sham acupuncture in PSS patients and explore relationships among salivation and drooling severity and frequency and swallowing function in stroke patients.

Design: Clinical study protocol, SPIRIT compliant.

Setting: Prospective, single-center, randomized, and sham-controlled trial.

Population: We will recruit 106 PSS patients to receive 4-week intraoral or sham acupuncture. Additionally, 53 stroke patients without PSS will undergo a conventional 4-week treatment program to compare salivation between PSS and non-PSS patients.

Exposures: Intraoral or sham acupuncture.

Main outcomes and measures: The main evaluation index will be the 3-minute saliva weight (3MSW), comparing changes in 3MSW from baseline to weeks 4 and 8. Secondary assessment indices will include the “Drooling Severity and Frequency Scale” and “Functional Oral Intake Scale.”

Results: The results from this study will be published in peer-reviewed journals.

Conclusion: Comparing effects of intraoral and sham acupuncture in PSS patients, this study may contribute important evidence for future PSS treatment and provide valuable insights into whether salivation issues in stroke patients are attributed to heightened salivary secretion or dysphagia.