Acupuncture in Medicine最新文献

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.

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).

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.

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.