Acupuncture in Medicine最新文献

Objective: The aim of this study was to evaluate the therapeutic effect of electroacupuncture (EA) in a rat model of stress urinary incontinence (SUI) induced by vaginal distension (VD). The potential mechanisms underlying this process were also explored.

Methods: Virgin Sprague-Dawley rats underwent VD (to model SUI) or a sham operation, followed by EA or no treatment. Cystometry and leak point pressure (LPP) testing were employed to demonstrate the impact of EA on the micturition reflex and urethral closure function. mRNA expression of α_1A and α_1D adrenoceptors and 5-hydroxytryptamine (5-HT)_2C and 5-HT_2A receptors were examined in spinal segments using real-time qRT-PCR, Western blotting and immunohistochemistry (IHC). The individual role of 5-HT_2A and 5-HT_2C receptors were distinguished with selective antagonists (MDL 100907 and SB 242084, respectively).

Results: EA treatment successfully reversed the decrease of LPP induced by VD without any significant effect on the micturition reflex in this rat model of SUI. VD did not change bladder basic pressure (BP), voided volume or bladder contraction. Multiple approaches including qRT-PCR, Western blotting and IHC revealed over-expression of 5-HT_2C and 5-HT_2A receptors but not α_1A or α_1D adrenoceptors in the L6-S2 spinal cord of these rats. Administration of the 5-HT_2C antagonist (SB 242084) largely eliminated EA-mediated mitigation of the decrease in LLP caused by VD, while the 5-HT_2A antagonist (MDL 100907) had no effect under these conditions.

Conclusion: EA improves impaired urethral closure capacity induced by VD in female rats, and it appears that the 5-HT_2C receptor plays a critical role in this effect. It is reasonable to speculate that EA represents a promising treatment for SUI caused by childbirth trauma.

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).

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.

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: 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.

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.