Acupuncture in Medicine最新文献

Background: Electroacupuncture (EA) accelerates repair of peripheral nerve injury. The aim of this study was to explore how EA regulates energy metabolism by examining its effects on glucose transport and mitochondrial dynamic balance in a rat model of sciatic nerve injury.

Methods: In experiment 1, expression of glucose transporter (GLUT)4 was measured in n = 16 rats at 1, 3, 5 and 7 days following EA to identify the optimal glucose uptake time. In experiment 2, n = 32 rats were randomly divided into the following four groups: Normal, Injury, EA and ES (electrical stimulation). Three days after sciatic nerve injury modeling, micro-positron emission tomography/computed tomography (PET/CT) was performed to observe glucose uptake in the sciatic nerve and surrounding tissues. After 1 week, we measured nerve conduction velocity and expression of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), mitofusin (Mfn)1/2 and dynamin-related protein (Drp)1 in the sciatic nerve (by Western blotting) and observed pathological changes in the sciatic nerve and gastrocnemius.

Results: Protein expression levels of GLUT4, Mfn1/2 and Drp1 were significantly higher in the EA group, and histopathological changes were improved, compared with other groups. Glucose uptake by micro-PET/CT in the target area in the EA group was significantly higher than that in the other groups. Furthermore, nerve conduction velocity and NGF/BDNF expression was significantly higher in the EA group compared with the other three groups.

Conclusion: EA accelerated the repair and regeneration of the injured sciatic nerve, activated glucose transport and improved mitochondrial dynamic balance, in a rat model.

Objective: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common elective surgical procedures that are often associated with significant post-operative pain, commonly leading to opioid use. Acupuncture has been studied as a non-invasive approach to alleviate post-operative pain and reduce opioid consumption. Our aim was to review the literature to assess the efficacy of pre-operative and intra-operative acupuncture as an analgesic adjunct for arthroplasty patients.

Methods: This systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement guidelines. A comprehensive search was conducted in multiple databases to identify studies that utilized acupuncture in primary THA and TKA patients from their inception to June 2023. Inclusion criteria included full-text availability and publication in the English language.

Results: Eight studies were included in the final analysis, comprising seven randomized controlled trials and one prospective cohort study. Meta-analysis was not feasible due to the heterogeneity of study design and outcome measures. Acupuncture use led to a significant reduction in total intra-operative fentanyl and post-operative patient-controlled analgesia (PCA) use in THA and TKA patients. Patients who received acupuncture reported fewer analgesic-related side effects. However, patient-reported outcome measures (PROMs) varied among studies, with no consistent trend observed.

Conclusion: The incorporation of pre- and intra-operative acupuncture into arthroplasty protocols may help reduce opioid usage and minimize analgesia-related side effects. It appears, based on the available literature, that acupuncture has the potential to improve pain management in arthroplasty patients. Although the number of studies remains limited, the cost-effectiveness and ease of implementation of acupuncture suggest that it could be an advantageous adjunct in the peri-operative setting. Further research is needed to establish best practices and guide healthcare professionals on the use of acupuncture in arthroplasty patients.

Objective: To investigate the effect of manual acupuncture (MA) in a rat model of diabetic neurogenic bladder (DNB) based on protein and mRNA expression of nuclear factor erythroid 2-related factor 2 (Nrf2), nicotinamide adenine dinucleotide phosphate quinone oxidoreductase-1 (NQO1) and glutathione peroxidase (GSH-Px) in bladder tissue.

Methods: A DNB rat model was established via intraperitoneal injection of streptozotocin (STZ). The rats were randomly divided into a control group, a model group and an MA group (n = 10 per group). In the MA group, MA was applied after modeling. Body weight, fasting blood glucose (FBG) and bladder wet weight were measured, and urodynamics and bladder histomorphology were performed to verify whether the DNB model had been successfully established. Protein and mRNA expression levels of Nrf2, NQO1 and GSH-Px in the bladder tissue were determined by Western blotting and real-time polymerase chain reaction (PCR) analysis.

Results: Bladder wet weight, urodynamic parameters and bladder histomorphology in the MA group were significantly improved compared to the untreated DNB group; however, MA had no significant effect on body weight or blood glucose. In addition, protein and mRNA expression of Nrf2, NQO1 and GSH-Px in the bladder tissues of rats in the MA group was significantly increased.

Conclusions: Our findings suggest that MA improved bladder dysfunction and that this may be related to upregulation of mRNA and protein expression of Nrf2, NQO1 and GSH-Px, which may reduce oxidative stress and protect bladder smooth muscle.

Objective: To evaluate the effects of electroacupuncture (EA) on myocardial insulin resistance (IR) in Zucker diabetic fatty (ZDF) rats, an established model for type 2 diabetes mellitus (T2DM).

Methods: Twenty-four ZDF-Lepr^fa/fa rats were randomized to: (1) ZDF group (n = 8); (2) ZDF + PIO (pioglitazone) group (n = 8); and (3) ZDF + EA group (n = 8). An additional control group of eight healthy ZDF^+/fa rats was included (Lean group). We examined protein and mRNA expression levels of critical insulin signaling pathway intermediates including insulin receptor substrate (IRS)-1, phosphoinositide 3-kinase (PI3K), protein kinase B (Akt), adenosine monophosphate (AMP)-activated protein kinase (AMPK), ribosomal protein S6 kinase (p70S6K), glycogen synthase kinase 3β (GSK3β) and glucose transporter type 4 (GLUT4), as well as serum levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α and C-reactive protein. Echocardiography and cardiac histology were performed.

Results: Significant improvements in glucose metabolism, reflected in reduced fasting insulin levels and fasting blood glucose levels, were demonstrated after EA and PIO treatment. EA treatment also led to a notable decrease in inflammatory cytokine levels. In addition, there were marked improvements in myocardial structural integrity, as evidenced by histological analyses. Moreover, increased GLUT4 expression in myocardial tissue suggested improved insulin signaling, further supported by reductions in markers of myocardial injury such as serum troponin T type 2 (TNNT2) and B-type natriuretic peptide (BNP).

Conclusion: EA ameliorated myocardial IR in a rat model of T2DM and positively impacted TNNT2 and BNP levels, as well as phosphorylation status and mRNA expression of several genes involved in the insulin signaling pathway. Our findings underscore the potential of EA to modulate multiple therapeutic targets in the treatment of myocardial IR. If these effects can be replicated clinically, EA may represent a promising non-pharmacological option for the management of cardiometabolic risks associated with diabetes.

Introduction: There has been limited research comparing the different types of needles used for auricular battlefield acupuncture (BFA). The aim of this exploratory study was to determine the feasibility of examining whether there are differences in needle tolerance and/or pain reduction between different needle types.

Methods: We conducted an unblinded, exploratory, randomized controlled trial in human subjects with complaints of acute or chronic pain. We randomized 30 patients to receive BFA with ASP needles, disposable needles of 15 mm length or Pyonex needles (n = 10 per group). Differences in Defense and Veteran Pain Rating Scale (DVPRS) scores and needle tolerance questionnaire responses by treatment group and follow-up time point (baseline, 10 min, 24 h and 1 week) were assessed using random effects regression and ordinal logistics models.

Results: A difference in needle tolerance by treatment group was observed for pain at the site(s) of needling (p = 0.002), which was lower for 15-mm needles (odds ratio (OR) = 0.12, p = 0.005) than for ASP needles, but not significantly different for Pyonex versus ASP (OR = 1.45, p = 0.525). There were no difference in overall patient satisfaction, dizziness, bruising, fatigue or headaches between the three BFA needle groups (p = 0.190). No statistically significant associations were observed between treatment group and clinical characteristics (all p > 0.05). DVPRS scores significantly declined after treatment (interaction beta coefficient (β) = -1.40, p < 0.001) across all treatment groups. Declines were also observed post treatment for DVPRS questions 1 (β = -1.23, p = 0.003), 3 (β = -1.23, p < 0.002) and 4 (β = -1.10, p = 0.002). A decline over time after treatment was also observed for DVPRS question 1 (β = -0.15, p = 0.014), 3 (β = -0.12, 0.049) and 4 (β = -0.13, p = 0.016) but was not DVPRS overall score. No significant interactions by treatment group were observed.

Conclusion: Testing BFA needle types against each other was feasible and the interventions were acceptable to subjects. Through a post hoc power calculation, this study provides a greater understanding of the number of patients that would be needed to more definitively assess for potential differences in effectiveness (pain reduction) between various types of needles in BFA.

Trial registration number: NCT04464954 (ClinicalTrials.gov).

Background: Acupuncture was shown to be efficacious for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in a prior randomized controlled trial (RCT). The purpose of this secondary analysis was to evaluate the efficacy of acupuncture in the subgroup of CP/CPPS patients with a sedentary lifestyle and to compare outcomes between sedentary and non-sedentary participants in the group receiving acupuncture.

Methods: In the original RCT, 440 patients with moderate to severe CP/CPPS received 20 sessions of acupuncture or sham acupuncture (SA) over 8 weeks and were followed up for 24 weeks after the treatment was completed. The primary outcome was the proportion of sustained responders, defined as those with a reduction of at least six points in the National Institute of Health-chronic prostatitis symptom index (NIH-CPSI) total score at weeks 8, 20 and 32. In this secondary analysis, we compared n = 147 participants in the acupuncture group with a sedentary lifestyle group: (1) n = 148 participants with a sedentary lifestyle in the SA group ; and (2) n = 62 participants with a non-sedentary lifestyle in the acupuncture group.

Results: Among those with a sedentary lifestyle, the proportion of sustained responders was 38.3% in the acupuncture group versus 20.1% in the SA group (odds ratio (OR) 2.52 [95% confidence interval (CI) 1.45-4.10]; P = 0.001). However, among those receiving verum acupuncture, response rates were higher in non-sedentary compared with sedentary participants at 56.9% vs 38.3% (OR 1.32 [95% CI 1.19- 3.49]; P = 0.044).

Conclusion: Acupuncture appears to be an efficacious for the treatment of CP/CPPS patients with a sedentary lifestyle. However, compared with a non-sedentary population, sedentary patients are less likely to achieve a significant/sustained treatment response following acupuncture.

Objective: The aim of this study was to determine whether electroacupuncture (EA) modulates the phospholipase C-inositol-1,4,5-trisphosphate (PLC-IP3) pathway and platelet-derived growth factor receptor (PDGFR)α⁺ cells in a rat model of functional dyspepsia (FD) characterized by gastrointestinal (GI) motor dysfunction.

Methods: Forty Sprague-Dawley (SD) rats were allocated into five groups: control, model, EA, U73122 and U73122 + EA groups (n = 8 each). All groups except the control group underwent a multifactorial method to induce FD. The EA group received EA, the U73122 group received the PLC inhibitor U73122, and the U73122 + EA group received U73122 prior to EA. The control and model groups received no interventions. After 10 days of treatment, behavioral and GI motility tests were conducted. Gastric antrum tissues were analyzed post-euthanasia to determine PDGFRα, PLC, phosphorylated (P)-PLC, and IP3 expression and co-localization using Western blotting, RT-qPCR and immunofluorescence. Electron microscopy was used to examine gastric antrum gap junctions (GJs) and PDGFRα⁺ cells.

Results: The FD model rats displayed reduced activity, weight gain and food intake, with altered GI motility, widened gastric antrum GJs and decreased mRNA/protein expression of PDGFRα, PLC, P-PLC and IP3. Post-EA, rats showed improved weight gain, food intake, GI motility and mRNA/protein expression, as well as normal GJs. The U73122 group failed to demonstrate significant improvements in motility or PDGFRα⁺ cell morphology, with lower protein/mRNA expression of key pathway intermediates than the EA group.

Conclusion: EA enhances GI function in FD rats by activating the PDGFRα⁺ cell-associated PLC-IP3 pathway, demonstrating potential as a therapeutic target for FD.

Background: The quality of life (QoL) of individuals with cervical spondylosis (CS) can be impaired due to both physical discomfort and psychological harm. Acupuncture is known to be an effective treatment approach for CS; however, the relevant factors affecting QoL in this patient population remain unclear.

Objective: The purpose of this study was to assess QoL and investigate related factors among patients with CS undergoing acupuncture.

Methods: A predictive correlational study was conducted among 265 participants with CS undergoing acupuncture as part of routine clinical care. The following questionnaires were used to collect data on QoL and related factors: healthy lifestyle questionnaire (HLQ), Pittsburgh sleep quality index (PSQI), Chinese version of the perceptual stress scale (CPSS), self-rated abilities for health practices scale (SRAHP), social support rating scale (SSRS), cervical spine disease health knowledge awareness questionnaire and 12-item short form survey (SF-12). Standard multiple linear regression analysis was applied to determine the predictors of QoL in this patient population.

Results: The mean total score of the QoL scale was 37.8 ± 10.57 (mean ± SD), indicating moderate QoL levels among patients with CS undergoing acupuncture. Based on multiple regression, lifestyle (β = 0.25, p < 0.01), health behavior (β = 0.379, p < 0.01), social support (β = 0.098, p < 0.01), knowledge about CS (β = 0.107, p < 0.01) and PSQI scores (β = -0.196, p < 0.001) explained 71% of the variance of QoL.

Conclusion: Lifestyle, health behavior, social support and knowledge about CS significantly and positively predict the level of QoL, while PSQI scores negatively predicted QoL.