Acupuncture in Medicine最新文献

Objective: The objective of the study is to evaluate the effectiveness and safety of one session of electroacupuncture (EA) in the immediate postoperative period for the recovery of gastrointestinal function after laparoscopic cholecystectomy (LC).

Methods: A randomized, assessor-blinded controlled trial was conducted from October 2022 to March 2023 with 1:1 allocation to the intervention group and the control group. Eighty-four patients with benign gallbladder disease based on conventional diagnostic criteria were randomly assigned to one of the two different groups. The intervention group received a 30 min EA treatment at LI4, PC6, ST36 and LR3 (2/100 Hz frequency, 1 mA average intensity) that was given immediately after surgery. All patients received standard perioperative management based on an enhanced recovery after surgery (ERAS) protocol. Time to first flatus was the primary outcome. Secondary outcomes included time to first defecation and first normal bowel sound, as well as evaluation of abdominal distension/pain and postoperative nausea and vomiting (PONV).

Results: The intervention group had a shorter time to first flatus and time to first normal bowel sound. They also had a lower overall incidence of postoperative abdominal distension, pain and PONV over the first 24 h. The degree/grading of abdominal distension was also lower at 12 h and that of abdominal pain and PONV was lower at both 12 and 24 h postoperatively.

Conclusion: One session of EA immediately after surgery may reduce the incidence and severity of postoperative gastrointestinal dysfunction (POGD).

Trial registration number: ChiCTR2200064748 (Chinese Clinical Trial Registry).

Background: Electroacupuncture (EA) has been shown to be effective in the treatment of knee osteoarthritis (KOA); however, its underlying mechanism remains unclear.

Methods: 40 KOA model rats were divided into control, untreated model, EA-treated model and celecoxib-treated model groups (n=10 each). Articular cartilage of the knee joint was stained with hematoxylin and eosin (HE), periodic acid-Schiff (PAS) and Alcian blue (AB)-PAS, and Moran/Mankin scores were used to evaluate articular cartilage injury across groups. Moreover, toll-like receptor (TLR)4/nuclear factor (NF)-κB pathway (TN-P)-related protein levels in the articular cartilage were detected using Western blotting. Oxidative stress and inflammatory biomarkers in the synovial fluid were measured by enzyme-linked immunosorbent assay (ELISA). MicroRNA (miRNA/miR) expression was measured by quantitative real-time polymerase chain reaction (qRT-PCR).

Results: Compared with the control group, Moran scores increased and Mankin scores decreased in the KOA model rats. In addition, compared with those in the control group, levels of superoxide dismutase (SOD), glutathione peroxidase (GSHPx) and interleukin (IL)-10 were significantly decreased, while levels of IL-1β, IL-6, tumor necrosis factor (TNF)-α, malondialdehyde (MDA) and nitric oxide (NO) were significantly increased, in the synovial fluid of the KOA model group. Protein levels of TLR4, anti-myeloid differentiation primary response protein 88 (MyD88) and p65 NF-κB phosphorylation were significantly increased in the articular cartilage of the KOA model group. EA and celecoxib treatment reversed the trends of these protein levels. Moreover, expression of miR-15a/127/140/146a/216a-5p and miR-27a-3p in the articular cartilage were markedly increased in KOA rats, while EA and celecoxib treatment reduced their expression.

Conclusions: EA reduces inflammation, oxidative stress and cartilage damage in KOA model rats, likely through regulation of the miRNA/TLR4/NF-κB pathway.

Objective: To investigate the influence of acupuncture expectancy on fertility outcomes in infertile women with polycystic ovary syndrome (PCOS) receiving active or control acupuncture with or without clomiphene.

Methods: This study was a secondary analysis of PolyCystic Ovary Syndrome Acupuncture plus Clomiphene Trial (PCOSAct), which was randomized controlled trial that recruited 1000 infertile patients with PCOS and randomly allocated them to receive active acupuncture or control acupuncture with or without clomiphene. Acupuncture expectancy data (measured on a scale from 4 to 20 points) were available in 827 women, who were subdivided into low expectancy and high expectancy groups (with scores <16 or ⩾16 points, respectively) after the third session of active or control acupuncture treatment. Anthropometric and endocrine parameters and fertility outcomes were compared. Kaplan-Meier curves were employed to evaluate the time to ovulation and live birth and a Cox regression model was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs), adjusting by body mass index (BMI) and treatment group allocation in PCOSAct.

Results: 373 and 454 patients were identified as having low and high expectancy, respectively. Compared with the low expectancy group, patients with high expectancy had been attempting to conceive for a shorter period (18 vs 24 months) and were more likely to have a prior history of acupuncture treatment (16.7% vs 10.7%). They also had an earlier menarche (13 vs 14 years), a higher BMI (23.8 vs 23.5 kg/m²) and a lower estradiol level (194.5 vs 206.9 pmol/L). There was no interaction between acupuncture and acupuncture expectancy in terms of fertility outcomes. High expectancy was significantly associated with a shorter time to ovulation (35.0 vs 49.0 days) and higher chances of ovulation during the study period (HR: 1.3, 95% CI: 1.1-1.5). After adjusting for confounders, there were no significant between-group differences in any other outcomes, including conception, clinical pregnancy and live birth.

Conclusion: High acupuncture expectancy was associated with a shorter time to ovulation and higher chances of ovulation in infertile patients with PCOS receiving active or control acupuncture in the PCOSAct trial.

Trial registration number: NCT01573858 (ClinicalTrial.gov) and ChiCTR-TRC-12002081 (Chinese Clinical Trial Registry).

Objective: To investigate the effects of different frequencies of electroacupuncture (EA) stimulation on the electroencephalogram (EEG) and intracranial levels of adenosine (Ad) and prostaglandin D₂ (PGD₂) in rats anesthetized using propofol.

Methods: Thirty-six rats were divided into the manual acupuncture (MA), high-frequency EA (HF-EA) and low-frequency EA (LF-EA) groups (n = 12/group). After intravenous anesthesia with propofol, an EEG was recorded before and after stimulation at bilateral ST36 and PC6 using 50-Hz stimulation (HF-EA group) or 2/15-Hz stimulation (LF-EA group) versus no electrical stimulation (MA group). The brains were collected after the experiment to determine cortical and subcortical Ad and PGD₂ levels. The ventrolateral preoptic nucleus (VLPO) was collected for Ad immunohistochemistry.

Results: There were changes in the δ wave in the LF-EA group and in the α, β and θ waves in the HF-EA group. Compared with the MA group, subcortical Ad levels were higher in the LF-EA group (0.96 ± 0.035 vs 0.93 ± 0.034 pmol/mL, p < 0.05). Cortical PGD₂ levels were higher in the LF-EA group than in the MA group (13.49 ± 0.440 vs 12.95 ± 0.436 pmol/mL, p < 0.05). VLPO Ad levels were significantly increased in the LF-EA group compared to both the HF-EA group (0.210 ± 0.0066 vs 0.201 ± 0.0065, p < 0.05) and the MA group (0.210 ± 0.0066 vs 0.199 ± 0.0095, p < 0.01).

Conclusion: LF-EA at bilateral ST36 and PC6 may increase the depth of anesthesia and sedation, possibly through increased intracranial PGD₂ and Ad levels. However, such an effect was not found with HF-EA.

Background: Acupuncture is a traditional Chinese medicine technique that involves the insertion of filiform needles into the body. Currently, various brands of acupuncture needles are available for purchase and product quality control is intended to ensure the safety of both the patient and the acupuncturist.

Objective: The purpose of this study was to assess the quality of acupuncture needles using physical-chemical and mechanical tests according to International Organization for Standardization (ISO) standard 17218:2014.

Methods: We evaluated nine different brands of 0.25 mm × 30 mm acupuncture needles. The needles were characterized using scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS) techniques for morphological and compositional evaluation at 300× magnification. Mechanical tests were used to determine puncture performance, intensity and needle tip sharpness according to ISO 17218:2014 using an Instron 4411 with controlled needle displacement. Puncture force was measured in Newtons, and a stereomicroscope was used to evaluate structural changes after the intensity test.

Results: SEM-EDS analyses indicated deformations, scratches and imperfections in various brands of needle, particularly Açomed and Complementar. Following the intensity test, all brands exhibited deformations at the needle tips. The Uniqmed brand had the lowest puncture performance test force (median = 0.033 N, 95% confidence interval (CI) = 0.030-0.035 N), while Açomed had the highest (0.117 N, 95% CI = 0.109-0.132 N). The Dragon brand had the lowest sharpness test force (0.026 N, 95% CI = 0.025-0.029 N), while Complementar had the highest (0.060 N, 95% CI = 0.056-0.064 N).

Conclusion: Despite statistically significant disparities, no group exceeded the limits set by ISO 17218:2014. Although there are a few research studies on this topic, some authors have opted not to reveal brand names, which makes direct comparisons problematic. As a result, we anticipate that the findings from this study may be used in future meta-analyses and ISO 17218:2014 revisions.

Objective: This study aimed to explore the effects of electroacupuncture (EA) in a rat model of type 2 diabetes mellitus (T2DM) by examining the hypothalamic miRNA-29a-3p, insulin receptor substrate (IRS)-1 / phosphatidylinositol 3-kinase (PI3K) / protein kinase B (AKT) / signal transducer and activator of transcription (STAT)3 pathway, as well as metabolic molecules including proopiomelanocortin (POMC), neuropeptide Y (NPY) and agouti-related protein (AgRP), with the goal of revealing the molecular mechanisms by which EA mitigates T2DM.

Methods: T2DM was induced by high-fat diet exposure followed by streptozotocin (STZ) injection, and LY294002 (a PI3K inhibitor) was administered to evaluate whether the effects of EA were mediated through the hypothalamic IRS-1/PI3K/AKT pathway. T2DM was induced in 36 rats that were assigned to model, EA and EA + LY294002 groups (n = 12 each). An additional 12 rats formed a healthy control group. Food intake, body weight and serum levels of fasting blood glucose (FBG), insulin, total cholesterol (TC), triglyceride (TG) and low-density lipoprotein (LDL) were measured. Hypothalamic micro (mi)RNA-29a-3p expression was detected by quantitative polymerase chain reaction (qPCR), while insulin receptor signaling pathway intermediates and metabolic molecules were analyzed using Western blotting, qPCR and immunohistochemistry.

Results: After the EA intervention, T2DM rats showed a significant decrease in both food intake and body weight. In addition, there were reductions in serum concentrations of FBG, insulin, TC, TG and LDL. The homeostatic model assessment of insulin resistance (HOMA-IR) index also significantly declined. EA significantly decreased hypothalamic miRNA-29a-3p expression and enhanced IRS-1/PI3K/AKT/STAT3 pathway activity, while regulating POMC, NPY and AgRP expression. These effects of EA were at least partially reversed by LY294002 administration, which supports our hypothesis that EA mitigates T2DM via the hypothalamic IRS-1/PI3K/AKT pathway.

Conclusion: EA may improve hypothalamic IR by activating the IRS-1/PI3K/AKT/STAT3 pathway and regulating POMC, NPY and AgRP, thereby reducing food intake, correcting metabolic imbalance and mitigating T2DM. The effect of EA on the IRS-1/PI3K/AKT pathway may involve miRNA-29a-3p downregulation.

Background: Parkinson's disease (PD) is a neurodegenerative disorder that is characterized by a substantial loss of dopaminergic cells in the substantia nigra (SN) and the formation of intracellular Lewy bodies, which are mainly composed of α-synuclein (α-syn). Acupuncture has been used to improve the symptoms of PD in humans and exhibits a neuroprotective effect against Parkinsonism in animal models. We further investigated the neuroprotective effect of acupuncture via its effect on α-syn levels, dopaminergic cell death and serping1 expression in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced mouse model of chronic PD.

Methods: Mice were divided into a control group receiving phosphate-buffered saline (CTL) and three model groups receiving MPTP that either remained untreated (MPTP) received verum acupuncture at GB34 and LR3 (MPTP_A) or received control acupuncture at sites not corresponding to any traditional acupuncture point location (MPTP_NA). The signal intensity of serping1 gene expression was assessed using microarray, and α-syn level and dopaminergic cell death were measured by Western blotting, immunohistochemistry and immunofluorescence. To further investigate the relationship between expression of serping1 and α-syn, a cell culture experiment was carried out in a 1-methyl-4-phenylpyridinium (MPP+) treated neuroblastoma cell line (SH-SY5Y) with and without serping1 knockdown using short interfering (si)RNA.

Results: Acupuncture at GB34 and LR3 attenuated the MPTP-induced decrease in tyrosine hydroxylase (TH) levels and increase in α-syn levels in the SN. Furthermore, verum acupuncture prevented the increase in serping1 level induced by MPTP. In SH-SY5Y cells, MPP+ treatment increased α-syn and decreased both TH expression and cell viability; however, these effects were mitigated by serping1 knockdown.

Conclusions: Our results suggest that an MPTP-induced reduction in serping1 level leads to decreased TH and increased α-syn expression, and that these effects can be attenuated/blocked by acupuncture at GB34 and LR3. Our findings provide new evidence for the neuroprotective effects of acupuncture on dopaminergic cells, which may be mediated by control of serping1 expression.

Objective: Dry needling (DN) has recently been investigated as an alternative strategy to reduce muscle spasticity and improve mobility in people with multiple sclerosis (pwMS). The aim of the present review was to identify any available literature on the potential benefits of DN in pwMS.

Methods: A systematic literature search was conducted in the PubMed, Scopus, ScienceDirect, Embase/Ovid, CINAHL, CENTRAL, Web of Science and PEDro databases and at ClinicalTrials.gov. The search results were limited to studies published between 2000 and 2023 without language restrictions. All articles reporting on the application of DN (defined as the use of a needle to target myofascial trigger point(s) without injection) in pwMS were included. Studies related to traditional medicine were excluded. Two reviewers independently investigated the quality of reporting based on Joanna Briggs Institute critical appraisal tools. Data on the effects of DN on muscle spasticity, pain intensity, mobility and other reported outcomes in pwMS were extracted and analyzed.

Results: Four original articles (two case reports and two case series) and one conference paper reporting the findings of a randomized controlled trial randomized controlled trial (RCT) were included. The RCT was small (n = 16 participants) and sham-controlled with no significant differences between groups. In all four case reports/series, reduced spasticity was observed following DN treatment in pwMS. Findings with respect to other outcomes (including pain intensity, mobility, quality of life, manual dexterity and disability reduction) were mixed.

Conclusion: Although no firm conclusions can be drawn from these uncontrolled case reports/series, DN for pwMS appears feasible and (based on limited clinical observation) may have potential as an adjunct therapeutic method to address spasticity in pwMS. However, the quantity and quality of available data are extremely limited. There is a need for high-quality studies of DN (ideally adequately sized RCTs with a low risk of bias) to further explore its effectiveness in the MS population.