Acupuncture in Medicine最新文献

Background: Electroacupuncture (EA) has been demonstrated to be efficacious and safe in patients with knee osteoarthritis (KOA), yet the optimal current intensity for pain control in KOA remains unspecified. The present meta-analysis aimed to compare the effects of high-intensity and low-intensity EA in terms of pain relief and functional improvement in KOA.

Methods: A thorough and comprehensive literature search for randomized controlled trials (RCTs), all looking at the intensity of EA for KOA, was carried out in PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science Journal Citation Report (VIP) and Wanfang database, as well as ClinicalTrials.gov. All databases were searched from their inception until April 2022. Study quality was assessed using the Cochrane risk of bias (RoB)2 tool. Finally, a meta-analysis of all eligible RCTs was performed using Review Manager 5.3.

Results: Three studies with 472 individuals were included in the meta-analysis. The pain intensity reductions were significantly different between the high-intensity EA group and low-intensity EA group (mean difference (MD) = -0.22, 95% confidence interval (CI) = -0.26 to -0.18, p < 0.00001). There was no significant difference between the two groups in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores (MD = -3.62, 95% CI = -12.22 to 4.98, p = 0.41). High-intensity EA significantly improved emotional scale (ES) scores compared to low-intensity EA (MD = -0.72, 95% CI = -0.76 to -0.67, p < 0.00001).

Conclusion: The findings of this systematic review and meta-analysis indicated that high-intensity EA provides superior pain relief and has a bigger impact on emotional scale scores in patients with KOA.

Objective: Our aim was to examine the effectiveness of acupuncture in post-stroke depression/anxiety disorders and to determine whether it reduces the need for anxiolytic and sedative drug use.

Methods: This study included 54 stroke patients with depression and/or anxiety disorder. Patients were randomly assigned to the acupuncture treatment group (n = 27) or the control group (n = 27). A conventional rehabilitation program was applied to all patients and acupuncture was performed twice a week for 4 weeks. Patients were evaluated blindly by a psychiatrist at baseline (week 0), week 4 and week 8, using the Hamilton depression rating scale (HAM-D) and Hamilton anxiety rating scale (HAM-A), and drug doses were adjusted when necessary. The HAM-D and HAM-A scores at week 4 were pre-specified as the two primary outcome measures.

Results: Within each group, there was a significant decrease in the mean scores of HAM-D and HAM-A at weeks 4 and 8. No between-group differences in HAM-A or HAM-D scores were seen at 4 weeks but there was a significant decrease in HAM-D scores in favor of the acupuncture group at week 8 (p < 0.025). At week 4, the number of cases whose selective serotonin reuptake inhibitor (SSRI) dose was increased was found to be significantly higher in the control group.

Conclusion: While the study was negative with respect to its primary outcomes, the findings with respect to certain secondary outcomes suggests further research is warranted to determine if acupuncture treatment is an effective/safe treatment to alleviate post-stroke depression/anxiety.

Trial registration number: NCT04283591 (ClinicalTrials.gov).

Objectives: The objectives were to explore the protective effects of electroacupuncture (EA) on senile osteoporosis in aged rats and investigate the underlying mechanisms.

Methods: This study included aged (24-month-old; n = 16) and young (3-month-old; n = 8) male Sprague-Dawley rats. Aged rats were further randomized 1:1 to an aged control group (Aged; n = 8) and an EA treatment group (EA; n = 8). The 3-month-old rats served as young controls (Young). EA rats received EA at ST36, SP6, GB34 and SP10 bilaterally for 30 min a day, 5 days a week, for 8 weeks.

Results: EA significantly increased serum markers of bone formation in Aged rats. There were no significant differences in serum markers of bone resorption between EA and Aged rats. Deterioration of bone mineral density (BMD) and trabecular bone architecture was observed in the Aged group, while EA significantly increased BMD of the left femur and L5 vertebral body in aged rats. Aging-induced deterioration of trabecular bone architecture was partially reversed in EA rats. Runx2 and Osterix mRNA and protein levels were significantly increased and peroxisome proliferator-activated receptor (PPAR)γ was significantly decreased in bone marrow cells in EA compared with Aged groups. The mRNA and protein levels of core constituents of the Wnt/β-catenin signaling pathway (Wnt3a, low-density lipoprotein receptor-related protein (LRP)5 and β-catenin) were significantly increased and Dickkopf 1 was significantly decreased in bone marrow cells in EA compared with Aged groups.

Conclusion: EA may prevent bone loss and deterioration in aged rats by promoting osteogenesis via a mechanism that may involve activation of the Wnt/β-catenin signaling pathway. EA may represent a therapeutic option for senile osteoporosis.

Background: Electrical nerve stimulation is an effective therapeutic tool in the field of rehabilitation for the management of musculoskeletal conditions.

Objective: To analyze the muscle activity of the short head of the biceps femoris (SHBF) and long head of the biceps femoris (LHBF) after the application of percutaneous electrical nerve stimulation to the common fibular versus tibial nerve compartment of the sciatic nerve.

Methods: Thirty-eight healthy subjects received electrical stimulation (asymmetric biphasic rectangular waveforms) through a needle in the sciatic nerve. The sample was divided into two groups in which the technique was applied to the lateral compartment versus medial compartment of the nerve, respectively. The protocol used included 5 s of stimulation at a frequency of 100 Hz and a phase duration of 350 ms, followed by 55 s of rest, for 5 min. The electrical activity of the SHBF and LHBF and the muscle strength of the knee flexors was assessed by surface electromyography during isometric knee flexion in the prone position.

Results: Neither group showed significant changes (p > 0.05) in any variable after the intervention compared with baseline values. Similarly, there were no significant differences in any of the study variables when comparing both groups (p > 0.05).

Conclusion: Selective stimulation of the sciatic nerve by percutaneous electrical nerve stimulation had no measurable effects on muscle activity in the SHBF or LHBF, regardless of the approach applied.

Trial registration number: NCT05549700 (ClinicalTrials.gov).

Background: Considering the importance of cardiac rehabilitation after coronary artery bypass grafting (CABG) and the development of acupuncture over the past few decades, the aim of this study was to evaluate the effects of acupuncture on patients' exercise tolerance, heart rate and blood pressure after CABG.

Methods: Thirty-four patients with a history of recent CABG were recruited between 2019 and 2020 for this clinical trial and randomly divided into two groups receiving acupuncture plus cardiac rehabilitation (group A) and cardiac rehabilitation alone (group B). In both groups, exercise-based rehabilitation exercise was performed. Group A additionally received acupuncture at PC6, PC4, HT7 and GB20 bilaterally. Changes in blood pressure, heart rate and Borg scale score were evaluated before, during and after the course of the treatment.

Results: Heart rate was significantly lower in group A compared to group B after completion of the course of the treatment (P = 0.022). However, there were no statistically significant differences between the two groups in systolic or diastolic blood pressure or Borg scale scores (P > 0.05). Nevertheless, the Borg scale scores showed a significant decrease within each group over time (P < 0.001), reflecting an improvement in the patients' ability to tolerate activity after cardiac rehabilitation with or without acupuncture.

Conclusion: Acupuncture in combination with exercise-based cardiac rehabilitation was more effective at decreasing heart rate than cardiac rehabilitation alone after CABG. Both approaches appeared to be similarly effective at improving exercise tolerance. In this study, the addition of acupuncture at the aforementioned traditional acupuncture point locations to exercise-based cardiac rehabilitation did not affect blood pressure.

Trial registration number: IRCT20171208037793N1 (Iranian Registry of Clinical Trials).

Background: Nosocomephobia, a type of posttraumatic stress disorder (PTSD), is a diagnosis of an extreme fear of hospitals that can hinder current/future medical care. There is little research on how nosocomephobia affects elective surgery or how acupuncture can help patients cope.

Methods: Using the transactional model of stress/coping, this qualitative case study examined the role of acupuncture in nosocomephobia patients' elective surgery appraisal processes. Two patients were interviewed about their nosocomephobia and prior hospital experiences. Six reviewers coded interview transcripts line-by-line using Dedoose software. Reviewers labeled meaningful words, phrases and sentences and produced over 600 codes. Reviewers discussed/identified themes by grouping similar codes and resolving discrepancies. A thematic analysis was then used to develop final themes. Pseudonyms were assigned to protect patient privacy. Sophie had avascular necrosis in both hips and suffered PTSD from a previous traumatic event. Intraoperative acupuncture calmed her hospital anxiety, allowing her to have both hips replaced. Olivia had experienced PTSD and hospital phobia since she was 12 years old. Acupuncture reduced her anxiety surrounding a necessary knee arthrotomy and osteochondral allograft.

Results: Thematic analysis showed how nosocomephobia impacted patients' views of surgery and distinguished between their unique fear rationale. The transactional model of stress/coping illustrated patients' appraisal process from surgery (stressor) to coping (acupuncture) to reappraisal (mental state).

Conclusion: Procedural visits can be stressful due to already heightened anxiety. Although no definitive conclusions can be drawn from this small, uncontrolled case series, acupuncture may represent a safe, noninvasive way for nosocomephobia patients to manage preoperative anxiety.

Objective: To determine the effect of electroacupuncture (EA) on β₁-adrenergic receptor (β₁-AR) and post-receptor protein kinase A (PKA) signaling pathway after acute myocardial ischemia (MI).

Methods: An MI model was established by ligating the left anterior descending coronary artery of wild-type (WT) C57/BL and β₁-AR^+/- mice (heterozygous for β₁-AR gene deletion). EA treatment was administered at HT5-HT7 or LU9-LU8. We evaluated cardiac function by measuring ST segment displacement, ischemic area and serum levels of creatine kinase (CK)-MB and lactate dehydrogenase (LDH). Pathological morphology/apoptosis of myocardial tissue were examined using hematoxylin-eosin and terminal deoxynucleotidyl transferase dUTP nick end labeling staining. Norepinephrine (NE) levels in myocardial tissue were detected by ELISA. Levels of β₁ and post-receptor PKA signaling components were evaluated by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blotting.

Results: EA stimulation at HT7-HT5 could better regulate the level of β₁-AR in myocardial tissue than that at LU9-LU8. Following EA, the ST segment, serum CK-MB/ LDH and area of myocardial infarction were decreased in WT mice, and the degree of myocardial pathology/apoptosis and expression of cleaved caspase-3 were decreased. Myocardial levels of Gs protein (Gs), adenylate cyclase (AC), cyclic adenosine monophosphate (cAMP), phosphorylated protein kinase A (p-PKA), L-type voltage-gated calcium channel α1C (Cav1.2), serine phosphate 16-phospholamban (p-PLB^s16) and sarcoplasmic reticulum Ca²⁺-adenosine triphosphate (ATP)ase 2a (SERCA2a) increased after EA. However, these effects of EA were not replicated in β₁-AR^+/- mice. Interestingly, myocardial NE content decreased after EA in WT and β₁-AR^+/- mice.

Conclusion: EA may enhance cardiac function and reduced MI area/apoptosis by restoring the activity of β₁-AR and post-receptor PKA signaling.

Cocaine is a frequently abused and highly addictive drug that damages brain health and imposes substantial social and economic costs. Acupuncture has been used in the treatment of cocaine addiction and has been shown to improve abnormal mental and motor states. This article mainly focuses on the neurobiological mechanisms involving the central nervous system (CNS) and peripheral nervous system (PNS) that underlie the effects of acupuncture in the treatment of cocaine addiction. The central dopamine system is a key player in acupuncture treatment of cocaine addiction; the ventral tegmental area (VTA)-nucleus accumbens (NAc) signaling pathway, which has a modulatory influence on behavior and psychology after chronic use of cocaine, is a significant target of acupuncture action. Moreover, acupuncture alleviates cocaine-induced seizures or acute psychomotor responses through the paraventricular thalamus and the lateral habenula (LHb)-rostromedial tegmental (RMTg) nucleus circuits. The data suggest that acupuncture can impact various cocaine-induced issues via stimulation of diverse brain areas; nevertheless, the interconnection of these brain regions and the PNS mechanisms involved remain unknown. In this review, we also discuss the effects of specific acupuncture protocols on cocaine addiction and note that variations in needling modalities, current intensities and traditional acupuncture point locations have led to different experimental results. Therefore, standardized acupuncture protocols (with respect to stimulation methods, point locations and number of sessions) may become particularly important in future studies.

Objectives: Osteoporosis is widely regarded as a typical aged-related disease caused by impaired bone remodeling. This research was designed to explore the protective effects of electroacupuncture (EA) on senile osteoporosis in a rat model and investigate the underlying mechanisms.

Methods: Three-month-old rats were randomly selected as the youth group, and 24-month-old rats were randomly assigned to the elderly and EA groups. Rats in the EA group received 30 min of EA at bilateral SP10, ST36, K13 and GB34 daily, 5 days a week for 8 weeks. Bone mineral density (BMD), microstructure of the bone tissue, bone turnover biomarkers and expression level of autophagy-related proteins were detected.

Results: Compared with the elderly group, EA treatment significantly increased BMD of the femur and ameliorated the microstructure. EA treatment increased trabecular bone volume ratio (= bone volume / total volume [BV/TV]) and trabecular number (Tb.N) and decreased trabecular separation (Tb.Sp) in senile osteoporosis rats. Compared with the elderly group, the serum N-terminal telopeptide of type I collagen (NTX1) level in the EA group was lower, and the serum procollagen type I N-terminal propeptide (PINP) concentration was higher. In addition, the expression of Beclin 1, microtubule-associated protein I light chain 3 (LC3B) and P62 was inhibited in the senile osteoporosis rats after EA treatment.

Conclusions: EA can effectively alleviate aging-related bone loss and improve the microstructure of bone tissue in senile osteoporosis rats, and the regulation of autophagy might be one of the important mechanisms.