Acupuncture in Medicine最新文献

Background: Metformin (Met) is a first-line pharmacological treatment for type 2 diabetes mellitus (T2DM). The potential effect of combining electroacupuncture (EA) at ST25 (Tianshu) with Met in ameliorating intestinal injury remains largely unexplored.

Methods: We established wild-type (Control) and diabetic model groups that remained untreated (Model), received EA only (EA), received Met treatment only (Met) or received EA combined with Met (EA + Met), and compared markers of intestinal injury and insulin resistance, as well as effects on signal transducer and activator of transcription (STAT) proteins and microRNAs.

Results: EA and Met treatment (alone and in combination) had positive effects on fasting plasma glucose, fasting insulin levels, Homeostatic Model Assessment-insulin resistance (HOMA-IR) indices and stool number, while fecal water content was positively impacted by EA treatment (with or without concurrent Met) but not Met alone. Hematoxylin-eosin staining demonstrated that both EA alone and EA in combination with Met appeared to repair intestinal damage in the jejunum, ileum and colon. In addition, enzyme-linked immunosorbent assay revealed that serum interleukin 10 levels were restored in all treatment groups. Furthermore, quantitative real-time polymerase chain reaction (PCR) analysis revealed that EA at ST25 resulted in the activation of STAT5A in the jejunum, as well as STAT5A, STAT5B and STAT6 in the ileum. Notably, in the EA + Met group, there was a specific enhancement of STAT2, STAT3 and STAT5B in the colon, indicating segment-specific activation within distinct regions of the intestine.

Conclusion: EA at ST25 may ameliorate intestinal injury via the Janus kinase (Jak)/STAT signaling pathway and is closely related to jejunal and ileal segments. These findings provide a theoretical basis for EA combined with medication.

Background: Electroacupuncture (EA) pretreatment can alleviate cerebral ischemia/reperfusion (I/R) injury and mitochondrial impairment. However, the potential protective mechanism associated with mitophagy has not been well elucidated. The aim of this study was to investigate the effect of EA on FUN14 domain-containing protein 1 (FUNDC1) and mitophagy in unc-51 like kinase 1 (ULK1) knockout mice after cerebral I/R injury.

Methods: EA pretreatment was conducted at GV20 and GV26 before ischemia for 30 min over 5 consecutive days in ULK1 knockout mice that underwent modeling of cerebral I/R injury. Neurological function of the mice was assessed using Longa neurological deficit scoring. The area of cerebral infarction was measured by 2,3,5-triphenyltetrazolium (TTC) staining. Mitochondrial structural alterations were observed under transmission electron microscopy, while the mitochondria were stained using MitoTracker Green and the lysosomes were stained with Lyso Tracker Red. Changes in mitochondrial membrane potential were detected by JC-1 staining, and alterations in autophagy-related protein or gene expression were examined using Western blot analysis, qRT-PCR and immunohistochemistry.

Results: EA-pretreated mice exhibited significantly decreased neurological deficit scores, cerebral infarct volumes and edema compared with the untreated I/R group of mice. EA pretreatment also reversed I/R-induced mitochondrial structural abnormalities and loss of mitochondrial membrane potential. Furthermore, EA pretreatment upregulated p-mTORC1 compared with no treatment. Protein and mRNA expression of ULK1, FUNDC1 and mTORC1 did not significantly differ between the groups.

Conclusion: EA pretreatment at GV20 and GV26 alleviated cerebral I/R injury and mitochondrial impairment in ULK1 knockout mice. Knockout of ULK1 did not completely eliminate the regulatory effect of EA.

Introduction: Acupuncturists must treat their patients empathetically, as this influences the outcome of acupuncture treatment. While the Consultation and Relational Empathy (CARE) measure is used globally to assess physician's empathy from the patient's perspective, to our knowledge, it has not been validated as a tool to assess acupuncturists' empathy with general patients.

Objective: To evaluate the validity and reliability of the Japanese version of the CARE measure to assess acupuncturist's empathy from the patient's perspective.

Methods: A total of 22 acupuncturists participated in this study. Face validity was examined by the number of "not applicable" and missing items in the Japanese CARE measure. Construct (convergent) validity was evaluated based on the correlation between the Japanese CARE measure total score and overall treatment satisfaction. Internal consistency was measured using Cronbach's alpha coefficient. Inter-rater reliability was examined based on generalizability theory. Principal component loadings were obtained using principal component analysis.

Results: A total of 669 questionnaires were analyzed (response rate of 80.0%). The number of "not applicable" (0%-1.2%) and missing (0%-0.4%) responses were minimal, confirming face validity. The Japanese CARE measure total score and overall treatment satisfaction showed a strong positive correlation (Spearman's ρ = 0.719, p < 0.001), confirming construct (convergent) validity. The questionnaire demonstrated high internal consistency with a Cronbach's alpha of 0.979, confirming the reliability of internal consistency. To reliably estimate an acupuncturist's empathy, 24 patient ratings per acupuncturist were needed. One principal component was identified.

Conclusion: This study confirms the validity and reliability of the Japanese CARE measure for acupuncturists. It is expected to be utilized in both clinical practice and research.

Introduction: Myofasciitis, a prevalent cause of musculoskeletal pain, is associated with thoracolumbar fascial changes. Acupuncture is effective for pain relief, but its role in fascial repair remains unclear. This study examined the effects of electroacupuncture (EA) at BL23 (Shenshu) and BL40 (Weizhong) on fascial tissue repair in a rat model of thoracolumbar fasciitis (TLF).

Methods: The study involved 42 six-week-old Sprague-Dawley rats divided into control (n = 15) and modeling (n = 27) groups. TLF was induced by injecting complete Freund's adjuvant into the thoracolumbar fascia. Three rats in the control and modeling groups were used for model validation. The remaining 24 modeled rats were split into model and EA groups (n = 12 each). EA was administered at BL23 and BL40 to rats in the EA group for 20 min daily for 9 days. Assessments included skin pain sensitivity, musculoskeletal ultrasound, histological evaluation of fascial thickness, and measurement of inflammatory markers and fibroblast activity.

Results: EA-treated rats showed significant improvements, including reduced mechanical pain sensitivity, decreased fascial thickness and lower expression of pro-inflammatory markers (tumor necrosis factor-α, interleukin 1β) and fibroblast activity markers (proliferating cell nuclear antigen, α-smooth muscle actin, and vimentin). There was also a favorable balance in extracellular matrix components (increased type I/III collagen and matrix metalloproteinase (MMP)-1/tissue inhibitor of MMP (TIMP)-1 ratios), which was linked to reduced activity of the transforming growth factor (TGF)-β1/suppressor of mother against decapentaplegic (Smad)2 pathway.

Conclusion: EA at BL23 and BL40 reduces inflammation, inhibits fibroblast proliferation and activation, and promotes fascial repair, likely via modulation of the TGF-β1/Smad2 pathway. These findings support the therapeutic potential of EA for the treatment of myofasciitis, potentially aiding in chronic musculoskeletal pain management and fascial tissue repair.

Objective: To compare the effects of dry needling (DN) and magnesium sulfate (MgSO4) iontophoresis on pressure pain threshold (PPT), neck disability, pain intensity and muscle activity/amplitude in patients with upper-trapezius active myofascial trigger points (MTrPs) and neck pain.

Methods: Sixty subjects with neck pain and cervical myofascial pain syndrome (MPS) of the upper trapezius muscles were randomly assigned into a DN group that received DN and stretching of all cervical muscles, an iontophoresis group that received MgSO4 iontophoresis and stretching of all cervical muscles or a control group C that received only stretching of all cervical muscles. The subjects received the treatment twice a week for 4 weeks. PPT, Arabic neck disability index (ANDI), pain intensity visual analogue scale (VAS) and cervical muscle amplitude (assessed by electromyography and expressed as a normalized root mean square (RMS)) were measured before and after completion of the treatment.

Results: In the within-group analysis, there were statistically significant differences pre- versus post-treatment in all variables in both experimental groups (p < 0.05) but no significant differences in the control group with the single exception of pain intensity. In the between-group analysis post-treatment, there were statistically significant differences between all three groups. Compared with the iontophoresis group, the DN group showed significant improvements in VAS (mean difference (MD) -2.0, 95% confidence interval (CI) -2.84 to -1.36; p < 0.01), RMS (MD -1.32, 95% CI -1.79 to -0.85; p < 0.001), ANDI (MD -2.60, 95% CI -4.50 to -0.70; p = 0.004) and PPT (MD 1.48, 95% CI 1.01-1.95; p < 0.001).

Conclusion: DN and MgSO4 iontophoresis both had positive effects on PPT, ANDI, VAS and muscle amplitude in the treatment of neck pain subjects with upper-trapezius MTrPs. DN had a superior effect than MgSO4 iontophoresis for all outcomes studied.

Background: The aim of this study was to evaluate the impact of intradermal acupuncture (IA) at PC6 on postoperative nausea and vomiting (PONV) following cerebellopontine angle tumor resection, and to investigate possible mechanisms of action.

Methods: Seventy patients scheduled for elective craniotomy were randomized into IA or sham IA (Sham) groups, with interventions applied 1 h before surgery and continued for 24 h postoperatively. Co-primary outcomes were the incidence of vomiting at 0-6 h and 6-24 h post-surgery. Secondary outcomes included the incidence of nausea and pain intensity. Electrogastrography (EGG) and heart rate variability (HRV) were used to assess gastric activity and autonomic nerve function, respectively. Untargeted metabolomic analysis of serum and cerebrospinal fluid (CSF) was also performed.

Results: The incidence of vomiting at 6-24 h (but not 0-6 h) post-surgery was significantly lower in the IA group (12.1%) compared to the Sham group (36.4%; p = 0.022). IA significantly reduced the incidence of nausea at 0-6 h (48.5% vs 78.8%; p = 0.011) but not 6-24 h. HRV analysis showed a higher HF component in the IA group post-surgery. Metabolomic analyses revealed significant changes in multiple metabolites and pathways in serum and CSF.

Conclusion: IA stimulation at PC6 effectively reduced postoperative vomiting at 6-24 h following cerebellopontine angle tumor resection and may also reduce early nausea (at 0-6 h). The mechanisms of action underlying these effects potentially include modulation of vagus nerve activity and regulation of metabolic pathways.

Trial registration number: ChiCTR2100049992 (Chinese Clinical Trial Registry).

Background: Overactive bladder (OAB) is a common disease in menopausal women that can negatively affect a patient's quality of life and cause high stress levels. Despite several studies of the effects of electroacupuncture (EA) and manual acupuncture (MA) on OAB, to our knowledge, there has been no direct comparison between EA and MA for postmenopausal OAB in a single trial. The object of this study was to evaluate the effectiveness and safety of EA at two frequencies (2 and 16 Hz) and MA for OAB in postmenopausal women.

Methods: In this multicenter, randomized, controlled, parallel clinical trial, 147 participants were allocated randomly to 16 Hz EA, 2 Hz EA or MA groups in a 1:1:1 ratio. All participants received EA or MA twice a week for 6 weeks at CV3, CV4, GV20 and bilateral KI3 and SP6. The EA groups also received electrical stimulation at 2 or 16 Hz at CV3/CV4 and KI3/SP6. A total of 140 participants completed 6 weeks of treatment with 16 Hz EA (n = 48), 2 Hz EA (n = 46) or MA (n = 46) and were followed-up after 4 weeks. The primary outcome measurement was the change in the number of micturitions per 24 hours (averaged over 3 days) from baseline to week 6. Secondary outcome measures included daytime and nocturnal micturitions per 24 h, total number of urinary urgency and urge urinary incontinence (UUI) episodes over 3 days, overactive bladder symptom score (OABSS) and King's Health Questionnaire (KHQ) score.

Results: The primary outcome did not significantly differ between groups (p = 0.160). Of all secondary outcomes, there was a significant difference only in total urinary urgency, which was reduced in 2 Hz EA versus MA groups (-9.9 ± 10.37 vs -4.3 ± 7.21, p = 0.012). Otherwise, there were no significant differences between groups. There were no serious adverse events reported during the treatment period. When symptoms were re-evaluated at week 10 (4 weeks post-treatment), most scores were similar to week 6 but there remained no significant differences between groups.

Conclusion: There were no significant differences between 2 Hz EA, 16 Hz EA and MA for the treatment of OAB-related symptoms in postmenopausal women, except for a tentative finding that 2 Hz EA may reduce the number of urinary urgency episodes compared to MA (secondary outcome without correction for multiple testing).

Trial registration number: KCT0003912 (Clinical Research Information Service).