|
1
|
Gascon-Garcia J, López-Marne S, Dominguez-Rubio R, Martínez de Aragón A, Girabent-Farrés M, Bagur-Calafat C. Efficacy of dry needling with the fascial winding technique in reducing the percentage of surgery in carpal tunnel syndrome: A randomized clinical trial. J Bodyw Mov Ther 2025; 42:408-416. [PMID: 40325700 DOI: 10.1016/j.jbmt.2025.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 12/30/2024] [Accepted: 01/12/2025] [Indexed: 05/07/2025]
Abstract
INTRODUCTION Numerous techniques for the treatment of carpal tunnel syndrome (CTS) have been described. The present study aims to determine the proportion of wrists with CTS in which the application of DN avoids surgery. METHODS An assessor-blind randomized clinical trial clinical trial was performed. Eighty-six wrists with diagnosis of mild or moderate CTS and indication for surgery were recruited from a hospital traumatology service. The intervention group was treated with DN, with a frequency of one session/week over six weeks, while the control group did not follow any specific treatment, remaining on the waiting list for the surgery. The main variable was the recommendation for surgery. Other secondary variables included changes in electromyography and ultrasound; intensity of pain; Boston Carpal Tunnel Syndrome Questionnaire (BCTQ); hand dynamometries; and possible adverse effects. RESULTS The wrists treated by DN had a reduced risk of needing surgery at 12 weeks by 62% compared to the control group (RR = 0.38, 95% CI[0.2-0.72]), with this value being significant (p-value = 0.003). This group also obtained a significant improvement in the intensity of pain (p-value = 0.006), and in the BCTQ-severity of syntoms scale and BCTQ-functional situation scale (p-value = 0.039 and p-value = 0.019 respectively). Statistical significance was not reached in the dynamometries performed, nor in the results of the electromyography and ultrasound studies. Adverse effects were infrequent or unimportant. CONCLUSIONS Application of DN to wrists with mild or moderate CTS reduces the need for surgery, and improves the clinical symptoms and functionality of the hand.
Collapse
Affiliation(s)
- Jordi Gascon-Garcia
- Physical Therapy Department, Universitat Internacional de Catalunya, Sant Cugat Del Vallés, Barcelona, Spain.
| | - Sylvia López-Marne
- Orthopedic and Traumatology Surgery Service, Bellvitge-IDIBELL University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Raul Dominguez-Rubio
- Neurology Service, Bellvitge-IDIBELL University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Alberto Martínez de Aragón
- Orthopedic and Traumatology Surgery Service, Bellvitge-IDIBELL University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Caritat Bagur-Calafat
- Physical Therapy Department, Universitat Internacional de Catalunya, Sant Cugat Del Vallés, Barcelona, Spain
| |
Collapse
|
|
2
|
Kang B, Yoon DE, Ryu Y, Lee IS, Chae Y. Beyond Needling: Integrating a Bayesian Brain Model into Acupuncture Treatment. Brain Sci 2025; 15:192. [PMID: 40002525 PMCID: PMC11852460 DOI: 10.3390/brainsci15020192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2024] [Revised: 02/08/2025] [Accepted: 02/11/2025] [Indexed: 02/27/2025] Open
Abstract
Acupuncture is a medical tool in which a sterile needle is used to penetrate and stimulate a certain body area (acupoint), inducing a series of sensations such as numbness, dullness, or aching, often referred to as de-qi. But is that all? In this article, we adopt a Bayesian perspective to explore the cognitive and affective aspects of acupuncture beyond needling, specifically, how the body integrates bottom-up sensory signals with top-down predictions of acupuncture perception. We propose that the way in which we discern acupuncture treatment is the result of predictive coding, a probabilistic, inferential process of our brain. Active inference from both prior experience and expectations of acupuncture, when integrated with incoming sensory signals, creates a unique, individual internal generative model of our perception of acupuncture. A Bayesian framework and predictive coding may, therefore, aid in elucidating and quantifying the cognitive components of acupuncture and facilitate understanding of their differential interactions in determining individual expectations of treatment. Thus, a perception-based Bayesian model of acupuncture presented in this article may expand on how we perceive acupuncture treatment, from simply inserting needles into our body to one that encompasses a complex healing process supported by belief and hope of regaining health. By exploring how cognitive factors influence individual responsiveness to acupuncture treatment, this review sheds light on why acupuncture treatment is more effective in some individuals than in others.
Collapse
Affiliation(s)
- Beomku Kang
- Department of Meridian and Acupoints, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (B.K.); (D.-E.Y.); (I.-S.L.)
| | - Da-Eun Yoon
- Department of Meridian and Acupoints, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (B.K.); (D.-E.Y.); (I.-S.L.)
| | - Yeonhee Ryu
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea;
| | - In-Seon Lee
- Department of Meridian and Acupoints, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (B.K.); (D.-E.Y.); (I.-S.L.)
| | - Younbyoung Chae
- Department of Meridian and Acupoints, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (B.K.); (D.-E.Y.); (I.-S.L.)
| |
Collapse
|
|
3
|
Xia R, Linde K, Freilinger T, Vickers A, Vertosick EA, Vase L, Fernández-Jané C, Ren Y, Zhao B, Low SL, Fei Y. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev 2025; 2:CD015528. [PMID: 39932102 PMCID: PMC11812084 DOI: 10.1002/14651858.cd015528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2025]
Abstract
OBJECTIVES This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To investigate whether acupuncture is more effective than 'sham' (placebo) acupuncture, no preventative treatment or routine care only, or other interventions, in reducing headache frequency in people with episodic migraine.
Collapse
Affiliation(s)
- Ruyu Xia
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Klaus Linde
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Department of Clinical Medicine, Technical University of Munich, Munich, Germany
| | | | - Andrew Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Emily A Vertosick
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lene Vase
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | | | - Yiming Ren
- School of Qi-Huang Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Bingcong Zhao
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Sara Lk Low
- School of Health Science, Western Sydney University, Campbelltown, Australia
| | - Yutong Fei
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|
|
4
|
Li WX, Wu CQ, Feng W, Zhan YJ, Yang L, Jia HJ, Pei J, Li KP. Acupuncture for rehabilitation after total knee arthroplasty: a systematic review and network meta-analysis. Int J Surg 2025; 111:1373-1385. [PMID: 40053808 PMCID: PMC11745769 DOI: 10.1097/js9.0000000000002006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/26/2024] [Indexed: 03/09/2025]
Abstract
BACKGROUND The increasing interest in acupuncture for promoting postoperative rehabilitation has encouraged its use in rehabilitation after total knee arthroplasty (TKA), but its effectiveness remains controversial. OBJECTIVE This study aims to assess the efficacy of different models of acupuncture-related therapies on pain relief, motor function, inflammation, and overall rehabilitation of the knee after TKA. METHODS Databases PubMed, Embase, Cochrane, Web of Science, Scopus, and Clinicaltrials.gov were searched to screen eligible randomized controlled trials (RCTs). All RCTs that used acupuncture/moxibustion on TKA patients were included by two researchers independently after rigorous quality evaluation, with data extracted. The statistics were performed by using R 4.2.3 and Stata 17. RESULTS The network meta-analysis incorporated 28 RCTs, 21 of which were conducted in mainland China and Taiwan. Evidence of the relation of several common acupuncture/moxibustion treatments was shown by the network meta-analysis (NMA). The results of NMA showed that electroacupuncture was the preferred therapy for soothing pain symptoms (standardized mean difference=0.58, 95% CI=0.36-0.81). Auricular acupressure was the best treatment to improve the knee motor function. Electroacupuncture was superior to special acupuncture in relieving knee joint stiffness and inflammation. CONCLUSION Acupuncture intervention, especially electroacupuncture, can effectively alleviate pain, improve motion, reduce stiffness, and decrease inflammation in post-TKA patients with no serious adverse events.
Collapse
Affiliation(s)
- Wen-Xuan Li
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- The Second Rehabilitation Hospital of Shanghai, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Cai-Qin Wu
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Feng
- The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Yi-Jun Zhan
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Yang
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Heng-Jie Jia
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Pei
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kun-Peng Li
- The Second Rehabilitation Hospital of Shanghai, Shanghai, China
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
|
5
|
Sun MZ, Wang X, Li YC, Liu YH, Yu Y, Ren LJ, Gu W, Yao W. Effects of acupuncture needle modification on acupuncture analgesia. JOURNAL OF INTEGRATIVE MEDICINE 2025; 23:66-78. [PMID: 39675938 DOI: 10.1016/j.joim.2024.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 09/02/2024] [Indexed: 12/17/2024]
Abstract
OBJECTIVE The analgesic effect of acupuncture has been widely accepted. Nevertheless, the mechanism behind its analgesic effect remains elusive, thus impeding the progress of research geared toward enhancing the analgesic effect of acupuncture. This paper investigated the role of acupuncture needle surface textures on acupuncture's analgesic effect by creating four experimental acupuncture needles with different patterns of surface augmentation. METHODS Four types of acupuncture needles with different surface textures (the lined needle, circle needle, sandpaper needle, and threaded needle) were designed. Additionally, the force/torque measurement system used a robot arm and mechanical sensor to measure the force on the needle during insertion and manipulation. To perform acupuncture analgesia experiments, four experimental acupuncture needles and a normal needle were inserted into the Zusanli (ST36) acupoint of rats with inflammatory pain. By comparing the force and torque and the analgesic efficacy of the different acupuncture needles, these experiments tested the role of acupuncture needle body texture on acupuncture analgesia. RESULTS The analgesic effects of different acupuncture needle body textures varied. Specifically, the force required to penetrate the skin with the lined needle was not greater than that for the normal needle; however, the needle with inscribed circles and the sandpaper-roughened needle both required greater force for insertion. Additionally, the torque of the lined needle reached 2 × 10-4 N·m under twisting manipulation, which was four times greater the torque of a normal needle (5 × 10-5 N·m). Furthermore, the lined needle improved pain threshold and mast cell degranulation rate compared to the normal needle. CONCLUSION Optimizing the texture of acupuncture needles can enhance acupuncture analgesia. The texture of our experimental acupuncture needles had a significant impact on the force needed to penetrate the skin and the torque needed to manipulate the needle; it was also linked to variable analgesic effects. This study provides a theoretical basis for enhancing the analgesic efficacy of acupuncture through the modification of needles and promoting the development of acupuncture therapy. Please cite this article as: Sun MZ, Wang X, Li YC, Liu YH, Yu Y, Ren LJ, Gu W, Yao W. Effects of acupuncture needle modification on acupuncture analgesia. J Integr Med. 2025; 23(1): 66-78.
Collapse
Affiliation(s)
- Ming-Zhu Sun
- Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function, Department of Aeronautics and Astronautics, Fudan University, Shanghai 200433, China
| | - Xin Wang
- Department of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China
| | - Ying-Chen Li
- Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function, Department of Aeronautics and Astronautics, Fudan University, Shanghai 200433, China
| | - Yu-Hang Liu
- Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function, Department of Aeronautics and Astronautics, Fudan University, Shanghai 200433, China
| | - Yi Yu
- Medical Instrumentation School, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Liu-Jie Ren
- FPRS Department/ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China
| | - Wei Gu
- Department of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China.
| | - Wei Yao
- Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function, Department of Aeronautics and Astronautics, Fudan University, Shanghai 200433, China.
| |
Collapse
|
|
6
|
Yan Q, Bu H, Xu G, Jia M, Li D. Comparison of the effects of acupuncture methods on the temporomandibular disorder: A network meta-analysis. Oral Dis 2025; 31:12-31. [PMID: 39286939 DOI: 10.1111/odi.15131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 08/11/2024] [Accepted: 08/29/2024] [Indexed: 09/19/2024]
Abstract
OBJECTIVES A network meta-analysis (NMA) was applied to compare the therapeutic effect of different acupuncture methods on temporomandibular disorder (TMD). MATERIALS AND METHODS A computer retrieval was carried out in the English databases of Cochrane, PubMed, Embase and Web of Science, as well as the Chinese databases of CNKI, Wanfang and VIP for randomized controlled trials on the effect of acupuncture on TMD, with a retrieval deadline of January 21, 2024. Data analysis was conducted using R software and Bayesian method. The pain score served as the primary outcome measure, with the mouth opening as the secondary outcome measure. RESULTS Thirty-five articles were included in the analysis, involving 1937 TMD patients. The NMA results suggested that DN-PT had the best effect on relieving pain and improving mouth opening. (Description of all abbreviations in Supplementary Material S3). CONCLUSIONS Based on the available evidence, the results of the NMA suggest that DN-PT is most effective in relieving TMD pain and increasing mouth opening. However, due to the fact that some acupuncture therapies are only reported in a small number of research reports, this may lead to an increase in the randomness of the results and a decrease in the reliability.
Collapse
Affiliation(s)
- Qiuying Yan
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, China
| | - He Bu
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, China
| | - Guixing Xu
- Department of Acupuncture and Moxibustion, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Min Jia
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, China
| | - Dehua Li
- Department of Acupuncture and Moxibustion, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| |
Collapse
|
|
7
|
Zhao L, Sun M, Yin Z, Cui J, Wang R, Ji L, Geng G, Chen J, Cai D, Liu Q, Zheng H, Liang F. Long-Term Effects of Individualized Acupuncture for Chronic Neck Pain : A Randomized Controlled Trial. Ann Intern Med 2024; 177:1330-1338. [PMID: 39222507 DOI: 10.7326/m23-2425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Long-term effects of individualized acupuncture in persons with chronic neck pain (CNP) remain unknown. OBJECTIVE To evaluate the efficacy and safety of pressure pain, sensory-based individualized acupuncture for relieving CNP. DESIGN A 24-week multicenter randomized controlled clinical trial. (ChiCTR1800016371). SETTING Outpatient settings at 4 clinical centers in China from May 2018 to March 2020. PARTICIPANTS 716 participants with CNP. INTERVENTION Participants were randomly assigned to a waiting list (WL) group or to 1 of 3 interventions, which consisted of 10 sessions over 4 weeks: higher sensitive acupoints (HSA), lower sensitive acupoints (LSA), and sham acupoints (SA) acupuncture groups. MEASUREMENTS The primary outcome was the change in the visual analogue scale (VAS) score for neck pain (range, 0 to 100) from baseline to 4 weeks, with a difference of 10 points considered the minimum clinically important threshold. The VAS was also assessed every 4 weeks through 24 weeks. RESULTS The modified intention-to-treat population included 683 participants. The mean baseline VAS was 50.36, 50.10, 49.24, and 49.16 for HSA, LSA, SA, and WL, respectively. Compared with a mean baseline to week 4 change of -12.16 in the HSA group, the mean changes were -10.19 in the LSA group (net difference [ND], -1.97 [95% CI, -5.03 to 1.09]), -6.11 in the SA group (ND, -6.05 [CI, -9.10 to -3.00]), and -2.24 in the WL group (ND, -9.93 [CI, -12.95 to -6.90]). The intervention effects persisted at 24-week follow-up. LIMITATION Lack of complete blinding and limited generalizability. CONCLUSION Individualized acupuncture interventions using high- or low-sensitivity acupuncture points were more effective in reducing CNP than SA and WL control groups sustained through 24 weeks, but the magnitude of relative improvement did not reach a minimal clinically important difference. PRIMARY FUNDING SOURCE National Natural Science Foundation of China.
Collapse
Affiliation(s)
- Ling Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (L.Z., M.S., Z.Y., G.G., J.Chen, D.C., H.Z., F.L.)
| | - Mingsheng Sun
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (L.Z., M.S., Z.Y., G.G., J.Chen, D.C., H.Z., F.L.)
| | - Zihan Yin
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (L.Z., M.S., Z.Y., G.G., J.Chen, D.C., H.Z., F.L.)
| | - Jin Cui
- Acupuncture and Tuina School, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China (J.Cui)
| | - Ruihui Wang
- Acupuncture and Tuina School, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China (R.W., Q.L.)
| | - Laixi Ji
- Acupuncture and Tuina School, Shanxi University of Chinese Medicine, Taiyuan, Shanxi, China (L.J.)
| | - Guoyan Geng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (L.Z., M.S., Z.Y., G.G., J.Chen, D.C., H.Z., F.L.)
| | - Jiao Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (L.Z., M.S., Z.Y., G.G., J.Chen, D.C., H.Z., F.L.)
| | - Dingjun Cai
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (L.Z., M.S., Z.Y., G.G., J.Chen, D.C., H.Z., F.L.)
| | - Qi Liu
- Acupuncture and Tuina School, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China (R.W., Q.L.)
| | - Hui Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (L.Z., M.S., Z.Y., G.G., J.Chen, D.C., H.Z., F.L.)
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (L.Z., M.S., Z.Y., G.G., J.Chen, D.C., H.Z., F.L.)
| |
Collapse
|
|
8
|
Xia Y, Xue M, Sun Y, Wang Y, Huang Z, Huang C. Electroacupuncture inhibits TLR4/NF-κB signaling in the dorsal root ganglion of rats with spared nerve injury. Acupunct Med 2024; 42:275-284. [PMID: 39340148 DOI: 10.1177/09645284241279874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2024]
Abstract
OBJECTIVE Neuropathic pain can be provoked by high mobility group box 1 (HMGB1) activation of toll-like receptor (TLR)4/nuclear factor (NF)-κB signaling in the dorsal root ganglion (DRG). Electroacupuncture (EA) has been reported to effectively alleviate neuropathic pain with few side effects, but its precise mechanism of action remains unknown. The aim of this study was to explore whether 2 Hz EA stimulation suppresses TLR4/NF-κB signaling in the DRG following spared nerve injury (SNI) in a rat model. METHODS In this experiment, SNI rats were given 2 Hz EA once every other day for a total of 21 days. Paw withdrawal threshold (PWT) was measured to assess SNI-induced mechanical hypersensitivity, and western blotting and immunofluorescence staining were used to determine the levels of pain-related signaling molecules and pro-inflammatory mediators in the DRG. RESULTS SNI up-regulated HMGB1, TLR4, myeloid differentiation factor-88 adaptor protein (MyD88) and NF-κB p65 protein expression in the DRG. In addition, immunofluorescence staining demonstrated that SNI induced higher levels of TLR4 and MyD88 in the DRG. We also demonstrated co-localization of TLR4 and MyD88 with both calcitonin gene-related peptide (CGRP) and isolectin GS-IB4 in the DRG of SNI rats, respectively. Meanwhile, 2 Hz EA stimulation effectively reversed the elevations of HMGB1, TLR4, MyD88 and NF-κB p65 induced by SNI in the DRG, which was coupled with amelioration of SNI-induced mechanical hypersensitivity. CONCLUSIONS The results of this study suggested that inhibition of the TLR4/NF-κB signaling pathway in the DRG by 2 Hz EA might be exploited as a therapeutic option for neuropathic pain.
Collapse
Affiliation(s)
- Yangyang Xia
- Department of Physiology, School of Basic Medicine Sciences, Gannan Medical University, Ganzhou, P.R. China
| | - Meng Xue
- Department of Physiology, School of Basic Medicine Sciences, Gannan Medical University, Ganzhou, P.R. China
| | - Yalan Sun
- Department of Physiology, School of Basic Medicine Sciences, Gannan Medical University, Ganzhou, P.R. China
| | - Ying Wang
- Department of Physiology, School of Basic Medicine Sciences, Gannan Medical University, Ganzhou, P.R. China
| | - Zhihua Huang
- Department of Physiology, School of Basic Medicine Sciences, Gannan Medical University, Ganzhou, P.R. China
- Pain Medicine Research Institute, Gannan Medical University, Ganzhou, P.R. China
| | - Cheng Huang
- Department of Physiology, School of Basic Medicine Sciences, Gannan Medical University, Ganzhou, P.R. China
- Pain Medicine Research Institute, Gannan Medical University, Ganzhou, P.R. China
| |
Collapse
|
|
9
|
Karamanlioglu DS, Kaysin MY, Begoglu FA, Akpinar P, Ozkan FU, Aktas I. Effects of acupuncture on pain and function in patients with subacromial impingement syndrome: A randomized sham-controlled trial. Integr Med Res 2024; 13:101049. [PMID: 38948487 PMCID: PMC11214356 DOI: 10.1016/j.imr.2024.101049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 07/02/2024] Open
Abstract
Background Subacromial impingement syndrome (SIS) is the most common cause of shoulder pain. Acupuncture is a traditional medicine that is effective on pain. This study aimed to evaluate the effect of acupuncture treatment on pain, function, range of motion (ROM) and quality of life compared to sham acupuncture in patients diagnosed with SIS. Methods A randomized, prospective, double-blinded, sham-controlled trial was conducted. In acupuncture group 40 participants received acupuncture treatment plus exercise therapy while in control group 40 participants received sham acupuncture plus exercise therapy. Primary outcomes included pain-rest, activity and night pain. Secondary outcomes included function [Shoulder Pain and Disability Index (SPADI) and The Disabilities of the Arm, Shoulder and Hand Score (Quick DASH)], ROM, and quality of life [The Western Ontario Rotator Cuff Index (WORC)] in patients with SIS. Results Both groups had significant improvements for pain-rest, activity night pain scores, SPADI, Quick DASH and WORC after treatment and at the first month follow-up. Significant improvements were recorded in the acupuncture group for all ROM after treatment and at the first month follow-up while in control group only in passive internal rotation. Acupuncture group had better improvements for Quick DASH, WORC and all ROM parameters after the treatment, as well as for all parameters except pain-night and passive flexion at the first month follow-up. Conclusion This study suggest that acupuncture treatment is a safe, effective and non-invasive treatment option in patients with SIS. Trial registration The study protocol is registered at clinicaltrials.gov (NCT05794633).
Collapse
Affiliation(s)
- Duygu Silte Karamanlioglu
- Physical Medicine and Rehabilitation Department, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Meryem Yilmaz Kaysin
- Physical Medicine and Rehabilitation Department, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Feyza Akan Begoglu
- Physical Medicine and Rehabilitation Department, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Pinar Akpinar
- Physical Medicine and Rehabilitation Department, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Physical Medicine and Rehabilitation Department, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Ilknur Aktas
- Physical Medicine and Rehabilitation Department, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
|
10
|
Chien TJ, Huang YS, Liao LL, Chu CC, Pai JH. Head-to-Head Comparison of Electroacupuncture and Laser Acupuncture Effects on Autonomic Regulation and Clinical Effects in Dysmenorrhea: A Randomized Crossover Clinical Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:560-575. [PMID: 38364185 DOI: 10.1089/jicm.2023.0183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Introduction: Electroacupuncture (EA) has been applied in dysmenorrhea and has shown good efficacy. The mechanisms of EA are associated with autonomic nervous system adjustments and neuroendocrine regulation. Laser acupuncture (LA), however, has been widely investigated for its noninvasiveness. However, it remains uncertain whether LA is as effective as EA. This study aimed to compare EA and LA head to head in dysmenorrhea. Methods: A crossover, randomized clinical trial was conducted. EA or LA was applied to selected acupuncture points. Participants were randomized into two sequence treatment groups who received either EA or LA twice per week in luteal phase for 3 months followed by 2-month washout, then shifted to other groups (sequence 1: EA > LA; sequence 2: LA > EA). Outcome measures were heart rate variability (HRV), prostaglandins (PGs), pain, and quality-of-life (QoL) assessment (QoL-SF12). We also compared the effect of EA and LA in low and high LF/HF (low frequency/high frequency) status. Results: Totally, 43 participants completed all treatments. Both EA and LA significantly improved HRV activity and were effective in reducing pain (Visual Analog Scale [VAS]; EA: p < 0.001 and LA: p = 0.010) and improving QoL (SF12: EA: p < 0.001, LA, p = 0.017); although without intergroup difference. EA reduced PGs significantly (p < 0.001; δ p = 0.068). In low LF/HF, EA had stronger effects than LA in increasing parasympathetic tone in respect of percentage of successive RR intervals that differ by more than 50 ms (pNN50; p = 0.053) and very low-frequency band (VLF; p = 0.035). Conclusion: There is no significant difference between EA and LA in improving autonomic nervous system dysfunction, pain, and QoL in dysmenorrhea. EA is prominent in PGs changing and preserving vagus tone in low LF/HF; yet LA is noninvasive for those who have needle phobia. Whether LA is equivalent with EA and the mechanism warrants further study. Clinical trial identification number: NCT04178226.
Collapse
Affiliation(s)
- Tsai-Ju Chien
- Division of Hemato-Oncology, Department of Internal Medicine, Branch of Zhong-Zhou, Taipei City Hospital, Taipei, Taiwan
- Institute of Traditional Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Shuo Huang
- Institute of Traditional Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Department of Traditional Medicine, Branch of Yang-Ming, Taipei City Hospital, Taipei, Taiwan
| | - Li-Lan Liao
- Department of Traditional Medicine, Branch of Kunming, Taipei City Hospital, Taipei, Taiwan
| | - Chi-Chang Chu
- Department of Gynecology and Obstetrics, Branch of Yang-Ming, Taipei City Hospital, Taipei, Taiwan
| | - Juo-Hsiang Pai
- Division of Hemato-Oncology, Department of Internal Medicine, Branch of Zhong-Zhou, Taipei City Hospital, Taipei, Taiwan
| |
Collapse
|
|
11
|
Yu CH, Chiang CP. A survey study for the dental students' satisfaction with the "needling therapies for temporomandibular disorders" lectures. J Dent Sci 2024; 19:1143-1146. [PMID: 38618067 PMCID: PMC11010686 DOI: 10.1016/j.jds.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Dry needling therapy and acupuncture can effectively relieve myofascial pain in temporomandibular disorders (TMDs). This study evaluated dental students' satisfaction with the "needling therapies for TMDs" lectures given in 2022 and 2023. Materials and methods The "needling therapies for TMDs" lectures included mainly a dry needling therapy lecture and an acupuncture lecture which were given to the fifth-year dental students in both 2022 and 2023. An additional needling therapy demonstration lecture was given in 2023 only. Immediately after the lectures, the students were asked to complete an online-based questionnaire with four survey questions regarding their satisfaction with (1) the dry needling therapy, (2) the acupuncture, (3) the overall, and (4) the needling therapy demonstration lectures using 5-point Likert scale ratings. Results Fifty-three (80 %) of 66 and 60 (81 %) of 74 students answered the questions in 2022 and 2023, respectively. The satisfaction rates improved from 70 % in 2022 to 83 % in 2023 for the dry needling therapy lecture, from 64 % in 2022 to 85 % in 2023 for the acupuncture lecture, and from 70 % in 2022 to 88 % in 2023 for the overall lecture. The satisfaction rate was 88 % in 2023 for the needling therapy demonstration lecture. Conclusion The results of this study suggest that inclusion of the needling therapy demonstration lecture in 2023 can results in a marked increase in the satisfaction rates for the lectures. The relatively-lower satisfaction rate for the acupuncture lecture in 2022 may be due to the difficulty in understanding the mechanisms underlying the acupuncture therapy.
Collapse
Affiliation(s)
- Chuan-Hang Yu
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
|
12
|
Liu Z, Huang J, Yan D, Liang S, Zhao S, Zhang M, Li Z, Jiang C, Yin X, Zhang Y, Hou T, Feng M. Effect of "needle sensation" and the real-time changes in autonomic nervous system activity during acupuncture analgesia. Front Neurosci 2024; 18:1349059. [PMID: 38560046 PMCID: PMC10979699 DOI: 10.3389/fnins.2024.1349059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Acupuncture analgesia (AA) is widely used in clinical practice. The autonomic nervous system (ANS) may be an important pathway for acupuncture signal transduction. However, real-time changes in autonomic function during AA and the effect of "needle sensation" remain unclear. Methods We established a human pain model in healthy adults and randomly assigned 128 participants to the model, sham acupuncture, and acupuncture groups in a 1:1:2 ratio. Heart rate variability (HRV), including total power (TP), low-frequency power (LF), high-frequency power (HF), ratio of LF to HF (LF/HF), standard deviation of the normal-normal intervals (SDNN), and root mean square of successive interval differences (RMSSD), were used to assess autonomic function. The visual analog scale (VAS) and efficiency were used to assess the analgesic effect of acupuncture. The Massachusetts General Hospital acupuncture sensation scale (MASS) was used to indicate the intensity of the needle sensation. Anxiety levels were also measured. Finally, the correlation of MASS with HRV, VAS, and anxiety levels was analyzed. Results VAS decreased after 10 min of needling and 5 min after needle withdrawal in the acupuncture group compared with those in the model group (p = 0.038, p = 0.020). The efficacy rates were 82.0, 50.0, and 61.3% in the acupuncture, model, and sham groups, respectively. These represent significant differences between the acupuncture group and the model and sham acupuncture groups (p < 0.001 in each case). No differences were observed between the model and sham acupuncture groups. HF, TP, SDNN, and RMSSD were all increased in the acupuncture group compared with those in the model group (p = 0.045, p = 0.041, p = 0.002, p = 0.006, respectively). No differences were observed in the sham acupuncture group compared to the model group (p = 0.632, p = 0.542, p = 0.093, p = 0.222, respectively). The LF and LF/HF did not differ among all three groups. A positive correlation was observed between MASS and RMSSD2, LF2, RMSSD4, TP4, VAS5, and anxiety levels. Conclusion AA was associated with enhanced vagal activity. The intensity of needle sensation was positively correlated with vagal and sympathetic nerve activities. Acupuncture is an effective means of regulating autonomic function, and needle sensation may be an important modulator.
Collapse
Affiliation(s)
- Zehua Liu
- School of Rehabilitation Medicine and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Jinglei Huang
- School of Rehabilitation Medicine and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Dingshang Yan
- School of Rehabilitation Medicine and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Sha Liang
- School of Rehabilitation Medicine and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Shatong Zhao
- Hunan Provincial Key Laboratory of Dong Medicine, Hunan University of Medicine, Huaihua, China
| | - Mengzhen Zhang
- School of Rehabilitation Medicine and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Zhongwen Li
- School of Rehabilitation Medicine and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Chuliang Jiang
- School of Rehabilitation Medicine and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Xiang Yin
- School of Rehabilitation Medicine and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Yingjun Zhang
- School of Clinical Medicine, Hunan University of Medicine, Huaihua, China
| | - Tianshu Hou
- Department of Preventive Traditional Chinese Medicine, Chengdu Integrated TCM and Western Medical Hospital, Chengdu, China
| | - Min Feng
- School of Rehabilitation Medicine and Healthcare, Hunan University of Medicine, Huaihua, China
| |
Collapse
|
|
13
|
Lee JH, Song JY, Park KS, Lee J, Ha IH, Lee YJ. Long-term follow-up of inpatients with meniscus tears who received integrative Korean medicine treatment: A retrospective analysis and follow-up survey. Medicine (Baltimore) 2024; 103:e36917. [PMID: 38335386 PMCID: PMC10860960 DOI: 10.1097/md.0000000000036917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/22/2023] [Accepted: 12/19/2023] [Indexed: 02/12/2024] Open
Abstract
Evidence regarding the use of Korean medicine (KM) for the conservative treatment of meniscus tears remains lacking. We aimed to evaluate clinical effectiveness and long-term follow-up outcomes in patients undergoing integrative KM treatment for meniscus tears. We analyzed the electronic medical records (EMRs) of 86 patients with meniscus tears and administered a follow-up survey. Patients treated at 1 of 4 KM hospitals between June 1, 2015, and June 30, 2020, were reviewed. KM treatment comprised herbal medicine, acupuncture, pharmacopuncture, bee venom pharmacopuncture, Chuna therapy, and KM physiotherapy. The primary outcome was the numeric rating scale (NRS) score for knee pain; secondary outcomes were the Western Ontario and McMaster Universities Arthritis Index (WOMAC), EuroQol 5-dimension (EQ-5D) score, range of motion, and patient global impression of change. The NRS for knee pain was reduced by an average of 2.49 (95% confidence interval [CI]: 2.03-2.95) at discharge and 1.97 (95% CI: 2.03-2.95) at follow-up. The WOMAC decreased by an average of 15.52 (95% CI: 10.14-20.89) during hospital stay and 30.72 (95% CI: 24.58-36.87) at follow-up. The EQ-5D score increased by an average of 0.06 (95% CI: -0.14 to 0.02) at discharge and 0.19 (95% CI: -0.29 to -0.09) at follow up. KM treatment effectively reduced knee pain, improved knee joint function, and enhanced the quality of life in patients with a meniscus tear for a relatively long period after treatment.
Collapse
Affiliation(s)
- June Haeng Lee
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Jin Young Song
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Kyoung Sun Park
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
| |
Collapse
|
|
14
|
Tanaka F, Mazzardo G, Salm DC, de Oliveira BH, Joaquim L, Machado RS, Cidreira T, Petronilho FC, Bittencourt EB, Bianco G, Bobinski F, Piovezan AP, Srbely JZ, Shah JP, Moré AOO, Mazzardo-Martins L, Martins DF. Peripheral Activation of Formyl Peptide Receptor 2/ALX by Electroacupuncture Alleviates Inflammatory Pain by Increasing Interleukin-10 Levels and Catalase Activity in Mice. Neuroscience 2023; 529:1-15. [PMID: 37572879 DOI: 10.1016/j.neuroscience.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023]
Abstract
In the context of the electroacupuncture (EA) neurobiological mechanisms, we have previously demonstrated the involvement of formyl peptide receptor 2 (FPR2/ALX) in the antihyperalgesic effect of EA. The present study investigated the involvement of peripheral FPR2/ALX in the antihyperalgesic effect of EA on inflammatory cytokines levels, oxidative stress markers and antioxidant enzymes in an animal model of persistent inflammatory pain. Male Swiss mice underwent intraplantar (i.pl.) injection with complete Freund's adjuvant (CFA). Mechanical hyperalgesia was assessed with von Frey monofilaments. Animals were treated with EA (2/10 Hz, ST36-SP6, 20 minutes) for 4 consecutive days. From the first to the fourth day after CFA injection, animals received i.pl. WRW4 (FPR2/ALX antagonist) or saline before EA. Levels of inflammatory cytokines (TNF, IL-6, IL-4 and IL-10), antioxidant enzymes (catalase and superoxide dismutase), oxidative stress markers (TBARS, protein carbonyl, nitrite/nitrate ratio), and myeloperoxidase activity were measured in paw tissue samples. As previously demonstrated, i.pl. injection of the FPR2/ALX antagonist prevented the antihyperalgesic effect induced by EA. Furthermore, animals treated with EA showed higher levels of IL-10 and catalase activity in the inflamed paw, and these effects were prevented by the antagonist WRW4. EA did not change levels of TNF and IL-6, SOD and MPO activity, and oxidative stress markers. Our work demonstrates that the antihyperalgesic effect of EA on CFA-induced inflammatory pain could be partially associated with higher IL-10 levels and catalase activity, and that these effects may be dependent, at least in part, on the activation of peripheral FPR2/ALX.
Collapse
Affiliation(s)
- Fernanda Tanaka
- Postgraduate Program in Neuroscience, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil; Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - Gustavo Mazzardo
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil; Faculty of Medicine, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - Daiana C Salm
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil; Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - Bruna H de Oliveira
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil; Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - Larissa Joaquim
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes (NEUROIMet), Postgraduate Program in Health Science, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Richard S Machado
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes (NEUROIMet), Postgraduate Program in Health Science, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Thaina Cidreira
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes (NEUROIMet), Postgraduate Program in Health Science, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Fabrícia C Petronilho
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes (NEUROIMet), Postgraduate Program in Health Science, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | | | - Gianluca Bianco
- Research Laboratory of Posturology and Neuromodulation RELPON, Department of Human Neuroscience, Sapienza University, Italy; Istituto di Formazione in Agopuntura e Neuromodulazione IFAN, Roma, Italy
| | - Franciane Bobinski
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil; Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - Anna Paula Piovezan
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil; Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - John Z Srbely
- Department of Human Health and Nutritional Science, University of Guelph, Guelph, Ontario, Canada
| | - Jay P Shah
- Rehabilitation Medicine Department, National Institutes of Health, Rockville Pike, Bethesda, MD, USA
| | - Ari O O Moré
- Integrative Medicine and Acupuncture Service, University Hospital, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Leidiane Mazzardo-Martins
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil; Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - Daniel F Martins
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil; Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil.
| |
Collapse
|
|
15
|
Zhang J, Mou Q, Wang Z, Huang J, Zhang Y, Li F. Comparison of efficacy of acupuncture-related therapy in the treatment of herpes zoster: A network meta-analysis of randomized controlled trials. Medicine (Baltimore) 2023; 102:e34920. [PMID: 37773829 PMCID: PMC10545332 DOI: 10.1097/md.0000000000034920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/03/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to evaluate the efficacy and safety of acupuncture-related therapy in the treatment of herpes zoster (HZ) and to provide a reference for the clinical treatment of herpes zoster. METHODS PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, VIP database, Wanfang Database, and SinoMED Chinese and English databases were systematically searched for RCTs on acupuncture-related therapy for HZ until February 2023. Literature screening, data extraction, and risk of bias assessment were performed independently by 2 researchers. R4.2.1 and Stata15.1 software were used for data analysis. RESULTS A total of 26 RCTs involving 1929 HZ patients were included, and the network meta-analysis results showed that acupotomy appeared to be most effective in terms of improving VAS scores and the time of incrustation; SUCRA cumulative probability ranking showed the best efficacy of bloodletting in improving efficiency and the time of ceasing new blisters, acupuncture in improving the time of decrustation, and moxibustion in reducing the incidence of postherpetic neuralgia (PHN). CONCLUSIONS Through a comprehensive comparison of 9 different acupuncture therapies, acupotomy was the optimal treatment to improve VAS pain scores and the time of incrustation; bloodletting, acupuncture, fire needle, and moxibustion could be effective intervention measures to improve the time of ceasing new blisters and decrustation and reduce the incidence of PHN; Western medicine was closely related to adverse reactions. The conclusions need to be further verified due to the limitations of the study.
Collapse
Affiliation(s)
- Jingyu Zhang
- Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Qiujie Mou
- Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Zhuxing Wang
- Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Jinmoni Huang
- Shapingba Hospital, Chongqing University, Chongqing, China
| | - Yixin Zhang
- Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Fuqi Li
- Linyi Hospital of Traditional Chinese Medicine, Linyi, China
| |
Collapse
|
|
16
|
Qi L, Shi H, Zhang Y, Zhang X, Jia H, Tian H. The effect of acupuncture on recovery after colorectal cancer resection: A systematic review meta-analysis of randomized controlled trials. Medicine (Baltimore) 2023; 102:e34678. [PMID: 37657054 PMCID: PMC10476740 DOI: 10.1097/md.0000000000034678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/19/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND To evaluate the efficacy and safety of acupuncture by systematically reviewing the literature on colorectal cancer resection. METHODS Seven electronic databases were searched from inception to February 28, 2023. Randomized controlled trials on acupuncture in patients after CRC resection were included. Two reviewers independently selected relevant trials, extracted data, and assessed the risk of bias. A random-effects meta-analysis model was used to obtain summary effect estimates. The data were pooled and analyzed using RevMan 5.3. The heterogeneity of selected studies was evaluated by evaluating the I-squared (I2) statistics. RESULTS Twenty-two studies with 1878 patients were included. Results of the meta-analysis showed there was a low level evidence that acupuncture may improve early postoperative symptoms, such as time to first flatus (n = 876, MD -0.77h, 95% CI -1.22 to -0.33 h, I2 = 89%), time to first bowel movement (n = 671, MD -1.41h, 95% CI -2.20 to -0.63 h, I2 = 95%), time to first defecation (n = 556, MD -1.03h, 95% CI -1.88 to -0.18 h, I2 = 95%), and nausea/vomiting (n = 1488, RR 0.72, 95% CI 0.59-0.89, I2 = 49%) compared with usual care and sham acupuncture. However, there were no statistically significant differences in postoperative pain (n = 1188, MD-0.21, 95% CI -0.59 to 0.17, I2 = 74%). And there was no sufficient evidence of improving long-term functional outcomes. There was substantial heterogeneity across trials. The adverse events associated with acupuncture stimulation were minor in include studies. CONCLUSION SUBSECTIONS There is currently low-level evidence supporting the use of acupuncture on postoperative symptoms for patients after colorectal cancer resection. More investigations should be established based on the STRICTA statement strictly.
Collapse
Affiliation(s)
- Lin Qi
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hongshuo Shi
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yunsong Zhang
- The First Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | | | - Hongling Jia
- The Second Affiliated Hospital of Shandong University of traditional Chinese Medicine, Jinan, China
| | - Hu Tian
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| |
Collapse
|
|
17
|
Dong P, Wang LF, Zhang LX, Li F, Yin HS, Dou ZX, Huang XJ, Xu R, Zhang WL. Clinical study of acupuncture combined with surface anesthesia using proparacaine in geriatric cataract phacoemulsification. World J Clin Cases 2023; 11:5073-5082. [PMID: 37583853 PMCID: PMC10424011 DOI: 10.12998/wjcc.v11.i21.5073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/28/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND During anesthesia administration for cataract surgery, low pH of proparacaine may induce pain or complications such as corneal damage and poor wound healing, with the use of additional drops intraoperatively increasing the risk of complications. Accordingly, there is a clinical need for adjuncts to local anesthesia needs to improve the efficiency of anesthesia and reduce the required amount of intraoperative proparacaine. AIM To identify a method of anesthesia for geriatric cataract phacoemulsification that provides more efficient analgesia and improves clinical efficacy. METHODS A total of 130 geriatric patients with cataracts who attended Hebei Eye Hospital from December 2020 to December 2022 were included in the present study. Patients were divided into the proparacaine surface anesthesia (SA) group (65 cases) and the compound acupuncture-medicine anesthesia group (CAMA group, 65 cases). Patients in the CAMA group were provided acupuncture analgesia in addition to SA. Preoperative anxiety [Self-Rating Anxiety Scale (SAS) score and state anxiety inventory (SAI) score], intraoperative stress, vital signs, analgesia, and cooperation, as well as postoperative adverse events, were compared between groups. RESULTS More marked reductions in anxiety were observed among patients in the CAMA group, with corresponding reductions in SAS and SAI scores. During the operation, no change in the secretion of E, NE, or Cor group compared to the preoperative period was observed in the CAMA, which was markedly lower than that in the SA group. Heart rate, blood pressure, and respiratory rate were more stable intraoperatively in the CAMA group. In addition, the incidence of intraoperative pain and the number of additional doses of anesthesia required in the CAMA group were markedly lower than in the SA group. Accordingly, patients in the CAMA group were able to avoid eye movements and eyelid closing leading to greater cooperation with surgeons during surgery. Furthermore, marked reductions in intraoperative adverse effects were observed in the CAMA group, indicating greater overall safety. CONCLUSION Proparacaine SA combined with acupuncture as an analgesic provides improved analgesia with greater safety compared to surface anesthesia with proparacaine during geriatric cataract phacoemulsification.
Collapse
Affiliation(s)
- Ping Dong
- Department of Acupuncture and Rehabilitation, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Li-Fang Wang
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Li-Xiang Zhang
- Department of Pediatrics, Hebei General Hospital For Veterans, Xingtai 054000, Hebei Province, China
| | - Fang Li
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Hui-Su Yin
- Department of Science and Education, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Zhi-Xia Dou
- Department of Ocular Trauma, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Xiu-Ju Huang
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Rui Xu
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Wu-Lin Zhang
- Department of Cataract, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| |
Collapse
|
|
18
|
Coelho IA, Cerutti ML, Arruda G, Kraus SI, Lorbiéski JK, Souza RCDE, Pansini M, Valente C. Acupuncture and laserpuncture as a therapeutic approach for nociception and inflammation: An experimental study in mice. AN ACAD BRAS CIENC 2023; 95:e20230104. [PMID: 37466544 DOI: 10.1590/0001-3765202320230104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/23/2023] [Indexed: 07/20/2023] Open
Abstract
Inflammation and pain are consequences of injuries or diseases that affect a large number of people. This study aims to evaluate the effect of acupuncture and laserpuncture on nociception and inflammation in mice compared to the effects of morphine and dexamethasone. 140 male Swiss mice were used. Treatment with acupuncture and laserpuncture were performed at the acupoints LI11, ST36, GB34, and BL60 in mice. To evaluate the effect of acupuncture and laserpuncture on nociception, the hot plate test and intraplantar formalin injection were used. The effect of acupuncture and laserpuncture on the inflammation was evaluated through carrageenan-induced paw edema. Thermographic analysis was also applied to evaluate the anti-inflammatory effects. An antinociceptive effect (≈57%) was observed in treatments with acupuncture and laserpuncture, equivalent to the effect of morphine. Laserpuncture and acupuncture decreased paw edema by ≈25%. Acupuncture had an effect equivalent to dexamethason, basides reducing the neurogenic phase by 35% and the inflammatory phase in formalin-induced nociception by 40%, equivalent to the effects of morphine. In thermographic analysis, acupuncture, laserpuncture, morphine, and negative control had paw temperature of ≈27 °C, while formalin treatment was 31°C. Acupuncture and laserpuncture proved to be effective therapies for the treatment of inflammatory and painful processes.
Collapse
Affiliation(s)
- Iara A Coelho
- Universidade Regional de Blumenau, Departamento de Medicina, Rua Antônio da Veiga 140, 89030-903 Blumenau, SC, Brazil
| | - Murilo Luiz Cerutti
- Universidade Regional de Blumenau, Departamento de Medicina, Rua Antônio da Veiga 140, 89030-903 Blumenau, SC, Brazil
| | - Gisele Arruda
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Universidade Estadual do Oeste do Paraná, Centro de Ciências da Saúde, Rodovia Vitório Traiano Km 2, 85601-970 Francisco Beltrão, PR, Brazil
| | - Scheila I Kraus
- Programa de Pós-Graduação em Neurociência, Universidade Federal de Santa Catarina, Centro de Ciências Biológicas, Rua Engenheiro Agronômico Andrei Cristian Ferreira, s/n, 88040-900 Florianópolis, SC, Brazil
| | - Jhenifer K Lorbiéski
- Universidade Regional de Blumenau, Departamento de Medicina, Rua Antônio da Veiga 140, 89030-903 Blumenau, SC, Brazil
| | - Regina Célia DE Souza
- RCSouza Terapias Orientais, Clínica privada, Rua Dr. Osvaldo Nunes Ribeiro, 80, 82630-147 Curitiba, PR, Brazil
| | - Mário Pansini
- Universidade Regional de Blumenau, Departamento de Medicina, Rua Antônio da Veiga 140, 89030-903 Blumenau, SC, Brazil
| | - Caroline Valente
- Universidade Regional de Blumenau, Departamento de Medicina, Rua Antônio da Veiga 140, 89030-903 Blumenau, SC, Brazil
| |
Collapse
|
|
19
|
Lin KYH, Chang YC, Lu WC, Kotha P, Chen YH, Tu CH. Analgesic Efficacy of Acupuncture on Chronic Pelvic Pain: A Systemic Review and Meta-Analysis Study. Healthcare (Basel) 2023; 11:830. [PMID: 36981487 PMCID: PMC10048458 DOI: 10.3390/healthcare11060830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Chronic pelvic pain (CPP) is the pain occurred in the pelvic region longer than six months. The monotherapy of medicine may not adequate for the pain management of CPP and multidisciplinary approaches have been more recommended. The aim of this study is to evaluate the pain management efficacy of acupuncture compared with a control group on CPP. The articles of randomized controlled trial on CPP in PubMed and Embase databases were screened between January 2011 and September 2022 without language restriction to evaluate the treatment efficacy of acupuncture. The visual analogue scale/numerical rating scale (VAS/NRS) and total pain scores of National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) were served as outcome variables. Post-intervention mean scores were extracted and pooled for meta-analysis. Seventeen studies including 1455 patients were selected for meta-analysis. Both total pain scores of NIH-CPSI and VAS/NAS data revealed significant lower pain level in the acupuncture group than in the control group. Moreover, monotherapy with acupuncture revealed a significantly lower pain level than in the control group in both total pain scores of NIH-CPSI and VAS/NRS. These results indicated that acupuncture may have beneficial effects on pain management for CPP, even when administrated as a monotherapy.
Collapse
Affiliation(s)
- Kent Yu-Hsien Lin
- Department of Gynecology, Ryde Hospital, Northern Sydney Local Health District, Sydney 2122, Australia
| | - Yi-Chuan Chang
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan
- Department of Chinese Medicine, China Medical University Beigang Hospital, Yunlin 651012, Taiwan
| | - Wen-Chi Lu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan
| | - Peddanna Kotha
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan
| | - Yi-Hung Chen
- International Master Program in Acupuncture, China Medical University, Taichung 404333, Taiwan
- Traditional Chinese Medicine Research Center, China Medical University, Taichung 404333, Taiwan
- Department of Photonics and Communication Engineering, Asia University, Taichung 41354, Taiwan
| | - Cheng-Hao Tu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan
| |
Collapse
|
|
20
|
Tian SX, Xu T, Shi RY, Cai YQ, Wu MH, Zhen SJ, Wang W, Zhou Y, Du JY, Fang JF, Shao XM, Liu BY, Jiang YL, He XF, Fang JQ, Liang Y. Analgesic effect of electroacupuncture on bone cancer pain in rat model: the role of peripheral P2X3 receptor. Purinergic Signal 2023; 19:13-27. [PMID: 35478452 PMCID: PMC9984641 DOI: 10.1007/s11302-022-09861-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/28/2022] [Indexed: 11/25/2022] Open
Abstract
Upregulation of P2X3 receptor (P2X3R) has been strongly implicated in nociceptive signaling including bone cancer pain (BCP). The present study, using rat bone cancer model, aimed to explore the role of P2X3R in regulating rat pain behavior under the intervention of electroacupuncture (EA). The BCP model was successfully established by injection with MRMT-1 breast cancer cell into the medullary cavity of left tibia for 3 × 104 cells/3 μL PBS in rats as revealed by obvious bone destruction, decreased paw withdrawal thresholds (PWTs), and reduced paw withdrawal latencies (PWLs). Western blot analyses showed that P2X3R expression was significantly upregulated in ipsilateral lumbar 4-6 (L4-6) dorsal root ganglia (DRG), but the difference not seen in spinal cord dorsal horn (SCDH). With the in-depth study of P2X3R activation, we observed that intrathecal injection of P2X3R agonist α,β-meATP aggravated MRMT-1 induced BCP, while injection of P2X3R inhibitor A-317491 alleviated pain. Subsequently, we demonstrated that BCP induced mechanical allodynia and thermal hyperalgesia were attenuated after EA treatment. Under EA treatment, total P2X3R protein expression in ipsilateral DRGs was decreased, and it is worth mentioning that decreased expression of P2X3R membrane protein, which indicated that both the expression and membrane trafficking of P2X3R were inhibited by EA. The immunofluorescence assay showed that EA stimulation exerted functions by reducing the expression of P2X3R-positive cells in ipsilateral DRGs of BCP rats. Ca2+ imaging analysis revealed that the EA stimulation decreased the percentage of α,β-meATP responsive neurons in DRGs and inhibited calcium influx. Notably, the inhibitory effect of EA on mechanical allodynia and nociceptive flinches was abolished by intrathecal injection of α,β-meATP. These findings demonstrated EA stimulation ameliorated mechanical allodynia and thermal hyperalgesia in rat model of MRMT-1-induced BCP. EA exerts analgesic effect on BCP by reducing the overexpression and functional activity of P2X3R in ipsilateral DRGs of BCP rats. Our work first demonstrates the critical and overall role of P2X3R in EA's analgesia against peripheral sensitization of MRMT-1-induced BCP and further supports EA as a potential therapeutic option for cancer pain in clinic.
Collapse
Affiliation(s)
- Shu-Xin Tian
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Ting Xu
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Ren-Yi Shi
- Department of Acupuncture and Moxibustion, Sanya Traditional Chinese Medicine Hospital, Sanya, 572000, China
| | - Yang-Qian Cai
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Ming-Hui Wu
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Si-Jia Zhen
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Wen Wang
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - You Zhou
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Jun-Ying Du
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Jun-Fan Fang
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Xiao-Mei Shao
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Bo-Yi Liu
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Yong-Liang Jiang
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Xiao-Fen He
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Jian-Qiao Fang
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China.,Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang, Chinese Medical University, Hangzhou, 310005, China
| | - Yi Liang
- Department of Neurobiology and Acupuncture Research, The Third School of Clinical Medicine, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China. .,Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang, Chinese Medical University, Hangzhou, 310005, China.
| |
Collapse
|
|
21
|
Kumar G, Tewari S. Acupuncture for Management of Endodontic Emergencies: a Review. J Acupunct Meridian Stud 2023; 16:1-10. [PMID: 36804816 DOI: 10.51507/j.jams.2023.16.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 05/18/2022] [Accepted: 10/19/2022] [Indexed: 02/22/2023] Open
Abstract
Root canal treatment (RCT) employed for painful endodontic conditions like apical periodontitis and irreversible pulpitis is associated with a high incidence of postoperative pain. Pharmacological management for this purpose is effective, but not entirely free from side effects and in some cases may fail to provide adequate relief. Furthermore, concerns have been raised regarding the transmission of coronavirus disease-2019 (COVID-19) as a result of the aerosols generated and prolonged chair side time required for RCT. Acupuncture is a traditional Chinese therapy commonly employed as an alternative for the treatment of pain. And what's more, the use of acupuncture has been recently reported as treatment for the management of endodontic pain as well as on the anesthetic success in patients with irreversible pulpitis. This review aims to evaluate the current evidence for acupuncture in endodontics and its potential role in emergency pain relief and management for patients. To combat this, a thorough search for literature within the field was performed in five electronic databases. Retrieved studies were screened according to the pre-defined eligibility criteria. After both an electronic and manual search, five studies were selected for review. These studies reported the beneficial effects of acupuncture in reducing the failure of nerve block in patients with irreversible pulpitis and in controlling both intraoperative and postoperative pain following RCT. In addition, it was also reported to reduce anxiety surrounding the dental procedure and minimized the intake of analgesics after the endodontic procedure, which can result in some unwanted side effects. However, more in depth clinical research is required before any recommendation regarding the application of acupuncture in endodontic patients can be made.
Collapse
Affiliation(s)
- Gaurav Kumar
- Department of Conservative, Endodontics and Aesthetic Dentistry, Dental College, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Sanjay Tewari
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| |
Collapse
|
|
22
|
Effect of Traditional Korean Medicine Treatments on the Discoid Meniscus of Knee Joint: Two Clinical Cases. JOURNAL OF ACUPUNCTURE RESEARCH 2023. [DOI: 10.13045/jar.2022.00409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
|
|
23
|
Pooja B, Kamatham R, Anchala K, Avisa P. Effectiveness of low-level laser therapy in reducing pain perception of children during dental local anesthetic administration using laser acupuncture pen on the LI4 point: a randomized clinical trial. Eur Arch Paediatr Dent 2023; 24:219-227. [PMID: 36645646 DOI: 10.1007/s40368-023-00780-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 01/04/2023] [Indexed: 01/17/2023]
Abstract
PURPOSE Laser acupuncture, a non-invasive variant of acupuncture, has been proven effective in the medical and dental fields. Hence, the present study aims to determine the effect of low-level laser therapy on the LI4 point, using a laser acupuncture pen, in reducing children's pain during local anesthetic (LA) administration. METHODS Children in the age range of 8-12 years, in need of LA administration, were randomly assigned to two groups: Group I: laser acupuncture, Group II: control. For all the children, baseline simplified Modified Child Dental Anxiety Scale-Faces version (MCDAS(f)) was recorded, followed by laser acupuncture or standard care. Following the conventional protocol, LA was administered. The procedural pain was assessed using the Faces, Legs, Activity, Cry and Consolability scale (FLACC) and Faces Pain Scale-Revised (FPS-R). All the variations in pulse rate were recorded from baseline to the completion of LA administration. After the procedure, simplified MCDAS(f) was recorded one more time. The data were tabulated and analyzed statistically. RESULTS A significant reduction in anxiety after LA administration, as observed in MCDAS(f) score, was noticed only in the laser acupuncture group. The pain scores, as reported in FPS-R, were low in children randomized to the laser group compared to the control. The FLACC pain scores also showed low values in the experimental group. CONCLUSION Based on the study findings, within the limitations, low-level laser therapy using a laser acupuncture pen can reduce the pain perception of children undergoing LA administration and alleviate dental anxiety.
Collapse
Affiliation(s)
- Bellamkonda Pooja
- Pediatric and Preventive Dentistry, Narayana Dental College, Nellore, 524003, Andhra Pradesh, India
| | - Rekhalakshmi Kamatham
- Pediatric and Preventive Dentistry, Narayana Dental College, Nellore, 524003, Andhra Pradesh, India.
| | - Karthik Anchala
- Pediatric and Preventive Dentistry, Narayana Dental College, Nellore, 524003, Andhra Pradesh, India
| | - Priyanka Avisa
- Pediatric and Preventive Dentistry, Narayana Dental College, Nellore, 524003, Andhra Pradesh, India
| |
Collapse
|
|
24
|
Chen HT, Kuo CF, Hsu CC, Lai LC, Cheng AC, Sun CK, Hung KC. Clinical efficacy of acupuncture for pain relief from renal colic: A meta-analysis and trial sequence analysis. Front Med (Lausanne) 2023; 9:1100014. [PMID: 36698826 PMCID: PMC9868182 DOI: 10.3389/fmed.2022.1100014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Background This meta-analysis aimed at investigating the efficacy of acupuncture for relieving renal colic and reducing the risk of analgesic-related complications. Methods Randomized controlled trials (RCTs) comparing the efficacy of acupuncture (acupuncture group) with conventional interventions (control group) were screened from MEDLINE, EMBASE, Cochrane library databases, China Knowledge Network (CNKI), and Airiti Library till July 15, 2022. The primary outcome was the rate of effective pain relief (response rate), while secondary outcomes included the time of onset of pain relief, visual analog scale (VAS) at 30-60 min and risk of side effects. Results Thirteen eligible studies involving 1,212 participants published between 1992 and 2021 were analyzed. Compared with the control group, patients receiving acupuncture had a higher overall response rate [risk ratio (RR) = 1.12, 95% CI: 1.05-1.19, p = 0.0002, I 2 = 41%, 1,136 patients] (primary outcome) and a faster pain relief [MD = -10.74 min, 95% CI: -12.65 to -8.82, p < 0.00001, I 2 = 87%, 839 patients]. Patients receiving acupuncture had a lower pain score [MD = -0.65, 95% CI: -1.09 to -0.21, p = 0.21, I 2 = 55%, 327 patients] and risk of side effects (RR = 0.11, 95% CI: 0.04-0.26, p < 0.00001, I 2 = 0, 314 patients) compared to those receiving conventional interventions. Results from trial sequence analysis revealed sufficient evidence supporting the beneficial effects of acupuncture on response rate, time to pain relief, and pain score at 30-60 min. Conclusion Compared with conventional analgesic-based interventions, acupuncture can more efficiently relieve renal colic with fewer adverse effects. The limited number and quality of included studies warrant more clinical RCTs to support our findings. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022346714.
Collapse
Affiliation(s)
- Hsiao-Tien Chen
- Department of Chinese Medicine, Chi Mei Medical Center, Tainan City, Taiwan
| | - Cheng-Feng Kuo
- Department of Pharmacy, Chi Mei Medical Center, Tainan City, Taiwan
| | - Chin-Chia Hsu
- Department of Chinese Medicine, Chi Mei Medical Center, Tainan City, Taiwan
| | - Li-Chun Lai
- Department of Nursing, Chi Mei Medical Center, Tainan City, Taiwan
| | - Ai-Chin Cheng
- Division of Respiratory Therapy, Department of Internal Medicine, Chi Mei Medical Center, Tainan City, Taiwan,Department of Medical Sociology and Health Care Bachelor’s Degree Program, College of Health Sciences, Chang Jung Christian University, Tainan City, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan,School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan,*Correspondence: Kuo-Chuan Hung,
| |
Collapse
|
|
25
|
Chen B, Liu D, Li T, Zheng L, Lan L, Yang N, Huang Y. Research Hotspots and Trends on Acupuncture for Anti-Inflammation: A Bibliometric Analysis from 2011 to 2021. J Pain Res 2023; 16:1197-1217. [PMID: 37056280 PMCID: PMC10089150 DOI: 10.2147/jpr.s398393] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/07/2023] [Indexed: 04/15/2023] Open
Abstract
Purpose We here explored the research status, research hotspots, and development trend of acupuncture against inflammation from both quantitative and qualitative aspects through bibliometrics. Methods We used CiteSpace and VOSviewer to analyze the literature about acupuncture against inflammation from 2011 to 2021 in the Web of Science Core Collection database by using a visual knowledge map. Results In total, 1479 articles were included, and the number of articles published each year exhibited an upward trend. The largest number of articles were published in China (661), followed by the United States (287) and South Korea (164). The most productive institution is Beijing University of Chinese Medicine (72), while the most influential institution is the Capital Medical University (0.28). Evidence-based Complementary and Alternative Medicine (131) is the journal that published most articles on the topic. Lin Yiwen is the most prolific author, and Borovikova L is the most influential co-cited author. The keywords that have burst in the last 2 years are inflammation and activation. The keywords with the highest frequency of use are electroacupuncture (EA), inflammation, and expression. Conclusion The number of publications on acupuncture for anti-inflammation research is rapidly increasing. China is a productive country, but the influence of centrality is poor. Research institutions are concentrated in universities, and the whole collaborative network needs to be strengthened. The anti-inflammatory mechanism of acupuncture is the main focus of research in this field. Regulation of immune cell balance by acupuncture may be a hot topic in mechanism research. At present, immune cells, vagus nerve, signal pathway, inflammatory corpuscles, cytokines and neurotransmitters are popular research topics. In the future, the basic research of acupuncture for anti-inflammation transformed into clinical practice may be a trend. EA and bee venom acupuncture may be promising research directions for acupuncture treatment for inflammatory diseases.
Collapse
Affiliation(s)
- Bing Chen
- Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Di Liu
- Traditional Chinese Medicine Orthopedics and Traumatology Department, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Tao Li
- Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Lijiang Zheng
- Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Ling Lan
- Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Niu Yang
- Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Yinlan Huang
- Ningxia Medical University, Yinchuan, People’s Republic of China
- Key Laboratory of Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, People’s Republic of China
- Correspondence: Yinlan Huang, Ningxia Medical University, No. 1160, Shengli Street, Xingqing District, Yinchuan, People’s Republic of China, Tel +86 18209506917, Email
| |
Collapse
|
|
26
|
Lu PH, Chung CH, Chuo HE, Lin IH, Lu PH. Efficacy of acupoint stimulation as a treatment for uremic pruritus: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:1036072. [PMID: 36530891 PMCID: PMC9751623 DOI: 10.3389/fmed.2022.1036072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/14/2022] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Uremic pruritus causes sleep disturbances, poor quality of life, and increased morbidity in patients with chronic kidney disease. Acupuncture has been shown to improve uremic pruritus. There is limited evidence of the efficacy of traditional Chinese therapies. We conducted a systematic review and meta-analysis to evaluate the efficacy of acupoint stimulation therapy in patients with uremic pruritus. METHODS A systematic search of seven databases (up to Sep 2022) was conducted for randomized controlled trials that evaluated the clinical efficacy of acupuncture, acupressure, auricular acupressure, acupoint injection, acupoint thermal therapy, acupoint sticking therapy, or transcutaneous electrical acupoint stimulation in the treatment of patients with uremic pruritus. Two reviewers selected eligible articles for inclusion in the meta-analysis and evaluated the risk of bias via Cochrane Collaboration. The results of pruritus assessments and uremic pruritus-related laboratory parameters were analyzed. RESULTS Forty trials published between 2002 and 2022, including a total of 2,735 participants, were identified for inclusion in the meta-analysis. The effective rates for acupuncture, auricular acupressure, and the combination of acupoint injection and acupoint massage were significantly greater in patients with uremic pruritus compared to the control group. The levels of serum BUN, PTH, and histamine levels were significantly lower vs. control group. CONCLUSIONS Acupuncture, auricular acupressure, and the combination of acupoint injection and acupoint massage seem to be effective in improving uremic pruritus in patients with chronic kidney disease. However, further investigation of these potential treatments is now warranted in larger patient populations and over a longer time frame. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022354585, identifier: PROSPERO CRD42022354585.
Collapse
Affiliation(s)
- Ping-Hsun Lu
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Post-baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | | | - Hui-En Chuo
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan
| | - I-Hsin Lin
- School of Post-baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Po-Hsuan Lu
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| |
Collapse
|
|
27
|
Su SH, Lai PF, Yu HY, Chen KC, Wu K, Huang CK, Tseng WC, Lai CY, Huang CP, Ho TJ. Application of acupuncture in the emergency department for patients with ileus: A pilot prospective cohort clinical study. Medicine (Baltimore) 2022; 101:e31245. [PMID: 36316877 PMCID: PMC9622632 DOI: 10.1097/md.0000000000031245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Acupuncture can be conveniently used for pain control in patients with a variety of conditions, and it has obvious effects on various acute pains. In 2018, we implemented a program for emergency treatment with Chinese medicine to promote the integration of Chinese and Western medicine at the Emergency Department (ED). Ileus is a common cause of abdominal pain among patients in the ED, and it is an indication for emergency treatment with Chinese medicine. This study investigated the efficacy of acupuncture as a traditional Chinese medicine (TCM)-based treatment method for the treatment of patients with ileus in the ED. We analyzed data of patients with ileus, who visited ED between January and December 2019, and compared the length of ED stay between the Western medicine group and the Western medicine plus acupuncture group. Furthermore, pain intensity was measured by a visual analogue scale before and after acupuncture. We found that the length of ED stay was 10.8 hours lesser in the Western medicine plus acupuncture group than in the Western medicine group (P = .04), and the visual analogue scale score decreased by 2.0 on average from before to after acupuncture treatment (P = .02). Acupuncture treatment was effective and rapid in relieving the symptoms and discomfort in patients with ileus and in reducing their length of stay in the ED.
Collapse
Affiliation(s)
- San-Hua Su
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Pei-Fang Lai
- Department of Emergency Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Hsin-Yuan Yu
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Kun-Chuan Chen
- Department of Emergency Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Kari Wu
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Chih-Kai Huang
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Wei-Chun Tseng
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Chun-Yu Lai
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Chun-Ping Huang
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Tsung-Jung Ho
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
- * Correspondence: Tsung-Jung Ho, Department of Chinese Medicine, Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan, ROC Taiwan (e-mail: )
| |
Collapse
|
|
28
|
Ma X, Chen W, Yang NN, Wang L, Hao XW, Tan CX, Li HP, Liu CZ. Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system. Front Neurosci 2022; 16:940343. [PMID: 36203799 PMCID: PMC9530146 DOI: 10.3389/fnins.2022.940343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/29/2022] [Indexed: 12/04/2022] Open
Abstract
Neuropathic pain, caused by a lesion or disease of the somatosensory system, is common and distressing. In view of the high human and economic burden, more effective treatment strategies were urgently needed. Acupuncture has been increasingly used as an adjuvant or complementary therapy for neuropathic pain. Although the therapeutic effects of acupuncture have been demonstrated in various high-quality randomized controlled trials, there is significant heterogeneity in the underlying mechanisms. This review aimed to summarize the potential mechanisms of acupuncture on neuropathic pain based on the somatosensory system, and guided for future both foundational and clinical studies. Here, we argued that acupuncture may have the potential to inhibit neuronal activity caused by neuropathic pain, through reducing the activation of pain-related ion channels and suppressing glial cells (including microglia and astrocytes) to release inflammatory cytokines, chemokines, amongst others. Meanwhile, acupuncture as a non-pharmacologic treatment, may have potential to activate descending pain control system via increasing the level of spinal or brain 5-hydroxytryptamine (5-HT), norepinephrine (NE), and opioid peptides. And the types of endogenously opioid peptides was influenced by electroacupuncture-frequency. The cumulative evidence demonstrated that acupuncture provided an alternative or adjunctive therapy for neuropathic pain.
Collapse
Affiliation(s)
- Xin Ma
- School of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Wen Chen
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Na-Na Yang
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Lu Wang
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Wan Hao
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Chun-Xia Tan
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Hong-Ping Li
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Cun-Zhi Liu
- School of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|
|
29
|
Mechanism of Electroacupuncture Analgesia on Nicotine Withdrawal-Induced Hyperalgesia in a Rat Model. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7975803. [PMID: 36072415 PMCID: PMC9444398 DOI: 10.1155/2022/7975803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/06/2022] [Indexed: 11/18/2022]
Abstract
Purpose This study aimed to investigate the analgesic effect and mechanism of electroacupuncture (EA) in nicotine withdrawal-induced hyperalgesia rats. Methods Behavioral testing was conducted twice a week for 7 weeks during nicotine administration using von Frey filaments. Electroacupuncture at the bilateral “Zusanli” and “Taichong” points was applied daily for 3 days during nicotine withdrawal. Western blot analysis and immunohistology were used to determine expression levels of pain-related factors in the spinal cord and midbrain periaqueductal gray (PAG). Results Behavioral tests showed that electroacupuncture had a significant analgesic effect on nicotine withdrawal-induced hyperalgesic rats. Western blot results demonstrated that, in hyperalgesic rats, the expressions of nicotinic acetylcholine receptors (subunits: nAChR α7, α4, or β2) decreased in the spinal cord, nAChR α7, and β2 decreased in PAG. The proinflammatory factor cyclooxygenase 2 (COX2) and the activated microglia (ionized calcium-binding adaptor molecule 1, Iba1 positive cells) increased in the spinal cord and PAG compared to controls. After electroacupuncture treatment, nAChR α7 and nAChR β2 expressions increased significantly, and COX2 and Iba1 expressions decreased in the spinal cord. Compared with the nonelectroacupuncture nicotine withdrawal group, electroacupuncture stimulation increased the expression of nAChR α7 and nAChR α4 in the PAG of rats with electroacupuncture. Immunohistochemical results confirmed that electroacupuncture reversed nicotine withdrawal-induced changes in nAChR α7 positive neurons and Iba1-positive microglia in the dorsal horn of the spinal cord. Conclusion Electroacupuncture treatment has an analgesic effect on nicotine withdrawal-induced pain in nicotine-dependent rats. The mechanism of analgesia of the electroacupuncture treatment relates to the increased expression of nAChR α7 and nAChR β2 proteins in the spinal cord, nAChR α7 in the PAG, and decreased expression of Iba1 and COX2 protein in the spinal cord.
Collapse
|
|
30
|
Liu K, Cui X, Zhi M, Zhang M, Zhao T, Gao X, Zhu B. Caffeine Attenuates Electroacupuncture Effect on Pressure Pain Threshold and Tolerance in Healthy Individuals: A Randomized Controlled Trial. Front Neurol 2022; 13:859624. [PMID: 35873768 PMCID: PMC9301193 DOI: 10.3389/fneur.2022.859624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The effect of caffeine on acupuncture analgesia in humans is unclear. This study aimed to investigate whether caffeine-containing beverage intake influences the effect of electroacupuncture (EA) on static quantitative sensory testing (QST) and dynamic QST in healthy subjects. Methods A total of 40 healthy subjects were enrolled and randomly assigned to receive coffee containing moderate doses of caffeine (coffee group) or non-caffeinated juice (juice group) for 4 weeks. The primary outcome measures were the pressure pain threshold (PPT), pressure pain tolerance (PPTo), and heat pain threshold (HPT) as static QST parameters. Numerical rating scales (NRS) of heat stimulus and nociceptive flexor reflex (RIII reflex), as parameters of dynamic QST, were also examined. EA stimulation with tolerance intensity was performed at ST36 (Zusanli)-GB34 (Yanglingquan) points at weeks 0, 2, and 4. PPT, PPTo, and HPT were detected pre- and post- EA. The NRS scores were examined pre-, during, and post-EA, and 1 min after EA was completed. The RIII reflex was examined pre- and 1–5 min post-EA. Results At week 0, both groups showed increased PPT and PPTo and decreased NRS scores of heat stimuli and RIII reflex after EA, but HPT was not affected. After 4 weeks, the effects of EA on PPT and PPTo were attenuated in the coffee group compared to the juice group, whereas the effect of EA on the NRS scores and RIII reflex were not influenced. There was no significant difference found at week 2 for these indications. EA also did not affect the HPT in both groups at week 4. Conclusion Moderate caffeine intake reduced the effects of EA on PPT and PPTo in healthy subjects.
Collapse
|
|
31
|
Effect of Korean Medicine Treatments for Fat Pad Syndrome of Knee Joint: A Case Report. JOURNAL OF ACUPUNCTURE RESEARCH 2022. [DOI: 10.13045/jar.2021.00220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Fat pad syndrome is a knee joint condition/disease where acute or chronic inflammation occurs in the fat pad of the knee joint, and it is a cause of anterior knee pain. Fat pad syndrome usually occurs concurrently with other conditions/diseases to collectively cause anterior knee pain. No study to date has reported the treatment of anterior knee pain solely due to fat pad syndrome. Here, we report a case of fat pad syndrome of the knee joint as the sole cause of anterior knee pain in a 49-year-old woman who received integrated Korean medicine treatments (pharmacopuncture, acupuncture, herbal medicine, deep fascial meridian therapy, and chuna). Using patient-reported pain scale scores, the level of the patient’s pain was relieved, and her mobility improved. Integrated Korean medicine treatments could be effective for patients who have fat pad syndrome of the knee joint.
Collapse
|
|
32
|
Acupuncture Treatment Associated with Functional Connectivity Changes in Primary Dysmenorrhea: A Resting State fMRI Study. J Clin Med 2021; 10:jcm10204731. [PMID: 34682857 PMCID: PMC8537009 DOI: 10.3390/jcm10204731] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 11/22/2022] Open
Abstract
Primary dysmenorrhea (PDM) is the most commonly encountered gynecological problem in reproductive-age women. Acupuncture has been suggested as an effective treatment of PDM that may modulate descending pain modulation systems. In the present study, we used resting-state functional magnetic resonance imaging to investigate possible changes in descending pain modulation systems after acupuncture treatment in women with PDM. Thirty-four right-handed adult women with PDM participated in this randomized, single-blinded, sham-controlled study. Each patient was randomly allocated to an 8-week verum or sham acupuncture intervention on the bilateral Sanyinjiao (SP6). Resting-state functional magnetic resonance imaging was conducted before, during, and after the intervention to measure the spontaneous activity in brain. After the 8-week intervention, both verum and sham groups reported decreased menstrual pain. However, the cessation of decreased functional connectivity (FC) between periaqueductal gray matter and the regions associated with affective pain modulation and attention-related pain modulation were found in the verum but not in the sham group after the 8-week intervention. More decreased FC has been found in the region associated with non-specific effects of acupuncture intervention after the early stage of acupuncture intervention. These results indicated that verum acupuncture may intercept the altered FC in descending pain modulation systems in PDM.
Collapse
|
|
33
|
Chen YH, Xie SY, Chen CW, Lu DY. Electroacupuncture improves repeated social defeat stress-elicited social avoidance and anxiety-like behaviors by reducing Lipocalin-2 in the hippocampus. Mol Brain 2021; 14:150. [PMID: 34565419 PMCID: PMC8474847 DOI: 10.1186/s13041-021-00860-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/13/2021] [Indexed: 12/28/2022] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is a trauma-related disorder that is associated with pro-inflammatory activation and neurobiological impairments in the brain and leads to a series of affective-like behaviors. Electroacupuncture (EA) has been proposed as a clinically useful therapy for several brain diseases. However, the potential role of EA treatment in PTSD and its molecular and cellular mechanisms has rarely been investigated. Methods We used an established preclinical social defeat stress mouse model to study whether EA treatment modulates PTSD-like symptoms and understand its underlying mechanisms. To this end, male C57BL/6 mice were subjected to repeated social defeat stress (RSDS) for 6 consecutive days to induce symptoms of PTSD and treated with EA at Baihui (GV 20) and Dazhui (GV 14) acupoints. Results The stimulation of EA, but not needle insertion at Baihui (GV 20) and Dazhui (GV 14) acupoints effectively improved PTSD-like behaviors such as, social avoidance and anxiety-like behaviors. However, EA stimulation at the bilateral Tianzong (SI11) acupoints did not affect the PTSD-like behaviors obtained by RSDS. EA stimulation also markedly inhibited astrocyte activation in both the dorsal and ventral hippocampi of RSDS-treated mice. Using next-generation sequencing analysis, our results showed that EA stimulation attenuated RSDS-enhanced lipocalin 2 expression in the hippocampus. Importantly, using double-staining immunofluorescence, we observed that the increased lipocalin 2 expression in astrocytes by RSDS was also reduced by EA stimulation. In addition, intracerebroventricular injection of mouse recombinant lipocalin 2 protein in the lateral ventricles provoked social avoidance, anxiety-like behaviors, and the activation of astrocytes in the hippocampus. Interestingly, the overexpression of lipocalin 2 in the brain also altered the expression of stress-related genes, including monoamine oxidase A, monoamine oxidase B, mineralocorticoid receptor, and glucocorticoid receptor in the hippocampus. Conclusions This study suggests that the treatment of EA at Baihui (GV 20) and Dazhui (GV 14) acupoints improves RSDS-induced social avoidance, anxiety-like behaviors, astrocyte activation, and lipocalin 2 expression. Furthermore, our findings also indicate that lipocalin 2 expression in the brain may be an important biomarker for the development of PTSD-related symptoms. Supplementary Information The online version contains supplementary material available at 10.1186/s13041-021-00860-0.
Collapse
Affiliation(s)
- Yi-Hung Chen
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
| | - Sheng-Yun Xie
- Department of Pharmacology, School of Medicine, China Medical University, Taichung, Taiwan
| | - Chao-Wei Chen
- Institute of New Drug Development, China Medical University, Taichung, Taiwan
| | - Dah-Yuu Lu
- Department of Pharmacology, School of Medicine, China Medical University, Taichung, Taiwan. .,Department of Photonics and Communication Engineering, Asia University, Taichung, Taiwan.
| |
Collapse
|
|
34
|
Xu M, Fei Y, He Q, Fu J, Zhu J, Tao J, Ni C, Xu C, Zhou Q, Yao M, Ni H. Electroacupuncture Attenuates Cancer-Induced Bone Pain via NF-κB/CXCL12 Signaling in Midbrain Periaqueductal Gray. ACS Chem Neurosci 2021; 12:3323-3334. [PMID: 34460214 DOI: 10.1021/acschemneuro.1c00224] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Electroacupuncture (EA) is effective in various chronic pains. NF-κB and CXCL12 modulate the formation of chronic pain. Herein, we hypothesized that EA alleviates cancer-induced bone pain (CIBP) through NF-κB/CXCL12 axis in midbrain periaqueductal gray (PAG), which participates in "top-down" pain modulatory circuits. In order to filter the optimum EA frequency for CIBP treatment, 2, 100, or 2/100 Hz EA was set up. In addition, ipsilateral, contralateral, and bilateral EA groups were established to affirm the optimal EA scheme. Bilateral 2/100 Hz EA was considered as the optimal therapeutic scheme and was applied in a subsequent experiment. Western blotting along with immunofluorescence illustrated that CIBP induces a rapid and substantial increase in CXCL12 protein level and NF-κB phosphorylation in vlPAG from day 6 to day 12. Anti-CXCL12 neutralizing antibody and pAAV-U6-shRNA(CXCL12)-CMV-EGFP-WPRE in vlPAG remarkably improved the mechanical pain threshold of the hind paw in CIBP model relative to the control. EA inhibited the upregulation of pNF-κB and CXCL12 in vlPAG of CIBP. The recombinant CXCL12 and pAAV-CMV-CXCL12-EF1a-EGFP-3Xflag-WPRE reversed the abirritation of EA in the CIBP rat model. NF-κB phosphorylation mediated-CXCL12 expression contributed to CIBP allodynia, whereas EA suppressed NF-κB phosphorylation in CIBP. According to the above evidence, we conclude that bilateral 2/100 Hz EA is an optimal therapeutic scheme for CIBP. The abirritation mechanism of EA might reduce the expression of CXCL12 by inhibiting the activation of NF-κB, which might lead to the restraint of descending facilitation of CIBP.
Collapse
Affiliation(s)
- Miao Xu
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| | - Yong Fei
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| | - Qiuli He
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| | - Jie Fu
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| | - Jianjun Zhu
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| | - Jiachun Tao
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| | - Chaobo Ni
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| | - Chengfei Xu
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| | - Qinghe Zhou
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| | - Ming Yao
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| | - Huadong Ni
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing 314001, China
| |
Collapse
|
|
35
|
Wang K, Larsen DB, Ambite-Quesada S, Zhang Y, Liu H, Fernández-de-las-Peñas C, Arendt-Nielsen L. Effects of Novel Vibro-Acupuncture on Healthy Subjects and Those with Experimental and Clinical Pain as Assessed by Quantitative Sensory Testing. J Acupunct Meridian Stud 2021; 14:157-166. [DOI: 10.51507/j.jams.2021.14.4.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/20/2021] [Accepted: 06/29/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Kelun Wang
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Dennis Boye Larsen
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Silvia Ambite-Quesada
- Department Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, University Rey Juan Carlos, Alcorcón, Spain
| | - Yuan Zhang
- Department of Oral Anatomy & Physiology, School of Stomatology, The Fourth Military Medical University, Xi'An, P.R. China
| | - Huilin Liu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Capital Medical University, Beijing, P. R. China
| | - César Fernández-de-las-Peñas
- Department Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, University Rey Juan Carlos, Alcorcón, Spain
| | - Lars Arendt-Nielsen
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| |
Collapse
|
|
36
|
Park S, Lyu YR, Park SJ, Oh MS, Jung IC, Lee EJ. Electroacupuncture for post-thoracotomy pain: A systematic review and meta-analysis. PLoS One 2021; 16:e0254093. [PMID: 34234358 PMCID: PMC8263274 DOI: 10.1371/journal.pone.0254093] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 06/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Thoracotomy is an invasive surgical procedure that produces intense postoperative pain. Electroacupuncture has been used to induce analgesia in various situations, including after surgery. The aim of the following systematic review and meta-analysis was to evaluate the effect of electroacupuncture on post-thoracotomy pain. Methods The studies for the systematic review were searched using the following 9 databases: PubMed, Cochrane Library, EMBASE, MEDLINE Complete, Google Scholar, China National Knowledge Infrastructure (CNKI), Korean Medical Database (KMBASE), Koreanstudies Information Service System (KISS), and OASIS, without language restriction. Randomized controlled trials (RCTs) that met the inclusion criteria were selected. The quality assessment was performed using the Cochrane risk-of-bias tool, and RevMan 5.3 was used for meta-analysis. The review protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) as CRD42019142157. Results Eleven randomized controlled trials were included in the systematic review. The meta-analysis was performed for two outcome measures: pain score 24 hours after surgery and total dose of opioid analgesics. A subgroup analysis was performed according to the control group: sham acupuncture and conventional analgesia group. Pain score 24 hours after surgery of electroacupuncture group showed a standard mean difference of -0.98 (95% CI: -1.62 to -0.35) compared to sham acupuncture. The standard mean difference was -0.94 (95% CI: -1.33 to -0.55) compared to conventional analgesia. The total dose of opioid analgesics of electroacupuncture group showed a standard mean difference values of -0.95 (95% CI: -1.42 to -0.47) compared to sham acupuncture. The standard mean difference was -1.96 (95% CI: -2.82 to -1.10) compared to conventional analgesia. Conclusion Current evidence suggests that electroacupuncture might provide useful pain relieving effect on post-thoracotomy patients. However, due to low quality and high heterogeneity of existing data, further rigorously designed studies should be performed to confirm the safety and efficacy.
Collapse
Affiliation(s)
- Sohyeon Park
- College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Yee Ran Lyu
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
- Department of Korean Internal Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - So Jung Park
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
- Department of Korean Internal Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Min Seok Oh
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - In Chul Jung
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
- * E-mail: (ICJ); (E-JL)
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
- * E-mail: (ICJ); (E-JL)
| |
Collapse
|
|
37
|
Ko HF, Chen CH, Dong KR, Wu HC. Effects of Acupuncture on Postoperative Pain After Total Knee Replacement: Systematic Literature Review and Meta-Analysis. PAIN MEDICINE 2021; 22:2117-2127. [PMID: 34152398 DOI: 10.1093/pm/pnab201] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To identify the analgesic effectiveness of acupuncture after total knee replacement by systematic review. METHODS A search of randomized controlled trials was conducted in five English medical electronic databases and five Chinese databases. Two reviewers independently searched in five English medical electronic databases and five Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed with all-time-points meta-analysis. RESULTS A total of seven studies with 891 participants were included. The meta-analysis results indicated that acupuncture had a statistically significant influence on pain relief (standardized mean difference = -0.705, 95% CI -1.027 to -0.382, P = 0.000). The subgroup analysis results showed that acupuncture's effects on analgesia had a statistically significant influence (standardized mean difference= -0.567, 95% CI -0.865 to -0.269, P = 0.000). The main acupuncture points that produced an analgesic effect when they were used after total knee replacement included the Xuehai, Liangqiu, Dubi, Neixiyan, Yanglingquan, and Zusanli points. Electroacupuncture frequency ranged between 2 and 100 Hz. CONCLUSIONS As an adjunct modality, the use of acupuncture is associated with reduced pain and use of analgesic medications in postoperative patients. In particular, ear acupuncture 1 day before surgery could reduce analgesia .
Collapse
Affiliation(s)
- Hsing Fang Ko
- Department of Nursing, Chang Gung Memorial Hospital, Niaosong District, Kaohsiung City, Taiwan
| | - Ching-Hsiu Chen
- Department of Nursing, Fooyin University, Daliao District, Kaohsiung City, Taiwan
| | - Kai-Ren Dong
- Department of Nursing, Chang Gung Memorial Hospital, Niaosong District, Kaohsiung City, Taiwan
| | - Hsien-Chang Wu
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Xindian District, New Taipei City, Taiwan
| |
Collapse
|
|
38
|
Pham T, Ma Q, Agiro A, Bukowiec J, Flannery T. Do acupuncture services reduce subsequent utilization of opioids and surgical interventions compared to noninvasive therapies among patients with pain conditions? PAIN MEDICINE 2021; 22:2754-2762. [PMID: 34129042 PMCID: PMC8633741 DOI: 10.1093/pm/pnab187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare prescribed opioid use and invasive surgical interventions between patients using acupuncture and those using non-steroidal anti-inflammatory drugs (NSAIDs)/Physical Therapy (PT). DESIGN Retrospective observational study of administrative claims. SETTING Large commercial insurance plan. SUBJECTS 52,346 each treated with either acupuncture or NSAIDs/PT. METHODS Users of acupuncture and NSAIDs/PT were identified from January 1, 2014 to December 31, 2017. The first date of each service was defined as the index date. Acupuncture patients were 1:1 propensity score matched to the NSAIDs/PT group on baseline characteristics. Outcomes included opioid use, subsequent invasive surgical procedures, healthcare utilization such as hospitalizations or emergency department (ED) visits, and costs. These were assessed in the 12-month period before index date (baseline) and 12-month period following index date (follow-up) using difference-in-difference (DID) analysis. Results for opioid use were stratified by those with and without baseline opioid use. RESULTS The acupuncture group had fewer patients initiating opioids post-index both among those with (49.2% vs. 56.5%, p < 0.001) and without (15.9% vs. 22.6%, p < 0.001) baseline opioid use. There was a small increase in invasive surgical procedures with acupuncture (3.1% vs. 2.8% p = 0.006). A reduction in ED visits was observed with acupuncture (DID -4.3% for all-cause; -3.3% for pain-related, all p < 0.001). Acupuncture was associated with higher total medical and pharmacy costs (DID +$1,331 per patient, p = 0.006). CONCLUSIONS Acupuncture showed a modest effect in reducing opioid use and ED visits. More research on acupuncture's place in emergency care, pain relief, and comparison to other types of non-opioid treatment is needed.
Collapse
Affiliation(s)
| | - Qinli Ma
- HealthCore, Inc., Wilmington, Delaware
| | | | - Julie Bukowiec
- Office of Medical Policy and Technology Assessment, Anthem, Inc., Latham, New York
| | - Terry Flannery
- Office of Medical Policy and Technology Assessment, Anthem, Inc., Latham, New York
| |
Collapse
|
|
39
|
Kao L, Hui KK, Hui E. A Patient-Centered Integrative Approach Improves Visual Field Defect: A Case Report. Glob Adv Health Med 2021; 10:21649561211021081. [PMID: 34104579 PMCID: PMC8168048 DOI: 10.1177/21649561211021081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 12/02/2022] Open
Abstract
We present a case involving a patient with a complicated visual field defect preventing her from renewing her driver license. It highlights the underappreciated role of chronic stress in the genesis and perpetuation of ill health and the potential of Chinese medicine (CM) to complement biomedicine in the treatment of an intractable visual disorder. The patient experienced impaired vision from age 15, and ophthalmologists considered various diagnoses including optic neuritis and acute zonal occult outer retinopathy (AZOOR)-complex disorder with acute macular neuroretinopathy. She was treated with an integrative East-West medical approach incorporating acupuncture, cupping, trigger point injections, guidance on self-care and lifestyle modification. Although the eye disorder was not cured, there was visual improvement as demonstrated by various objective ophthalmologic tests, and the patient was able to renew her driver license. Visual improvement remained stable upon follow-up examination three years after the treatment intervention. Other concomitant health issues reported by the patient also improved including amelioration of neck pain, a more regular menstrual cycle, and decreased anxiety. This case demonstrates how a patient with an intractable complex eye disorder can have objective visual improvement when treated with an integrative patient-centered approach.
Collapse
Affiliation(s)
- Lan Kao
- UCLA Department of Medicine, UCLA Center for East-West Medicine, University of California Los Angeles, Los Angeles, California
| | - Ka-Kit Hui
- UCLA Department of Medicine, UCLA Center for East-West Medicine, University of California Los Angeles, Los Angeles, California
- UCLA Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Edward Hui
- UCLA Department of Medicine, UCLA Center for East-West Medicine, University of California Los Angeles, Los Angeles, California
- UCLA Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
- Edward Hui, UCLA Department of Medicine, UCLA Center for East-West Medicine, University of California Los Angeles, 1015 Gayley Avenue, Suite 301, Los Angeles, CA 90024, USA.
| |
Collapse
|
|
40
|
Li T, Feng XY, Feng XM, Lv JW, Lv TT, Wang SY. The short-term efficacy of electrical pudendal nerve stimulation versus intravesical instillation for the urethral pain syndrome: a randomized clinical trial. World J Urol 2021; 39:3993-3998. [PMID: 33934208 DOI: 10.1007/s00345-021-03698-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Urethral pain syndrome is a chronic condition characterized by disturbing feeling or server pain sensed at the urethra without specific treatment. This double-center, two-arm controlled trial aimed to explore the efficacy of electrical pudendal nerve stimulation (EPNS) versus intravesical instillation (II) of heparin and alkalinized lidocaine for urethral pain syndrome (UPS). METHODS Eighty eligible patients took three sessions of EPNS, or 1 session of II per week, for 6 consecutive weeks. The primary end point was the change of pelvic pain and urgency/frequency symptom (PUF) score from baseline to week 6. Secondary outcome measures included changes of visual analogue scale (VAS) score and three sub-score extracted from PUF score. RESULTS The enrolled participants were all included in the intention-to-treat analyses, and baseline characteristics between the two groups were well balanced. The post-treatment PUF score decreased by 10.0 (7.00, 16.50) in the EPNS group, and by 7.0 (3.00, 10.00) in the II group. At the closure of treatment, the medians of changes in symptom score, bother score, pain-related score and VAS score were 6.50 (4.25, 10.00), 4.00 (2.00, 6.00), 6.00 (5.00, 8.00),4.50 (2.25, 6.00), respectively, in the EPNS group, and 4.00 (2.00, 7.00), 3.00 (1.00, 3.00), 3.00 (2.00, 6.00), 2.00 (1.00, 4.00), respectively, in the II group. All the between-group differences were statistically significant. CONCLUSION Compared with the II, the EPNS results in superior pain control and better relief of lower urinary tract symptoms, and deserves further attention. TRIAL REGISTRATION ClinicalTrials.gov (NCT03671993).
Collapse
Affiliation(s)
- Tian Li
- Shanghai Pudong Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Xin Y Feng
- Guangming Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Xiao M Feng
- The Clinical Research Section, Shanghai Research Institute of Acupuncture and Meridian, 650 South Wanping Road, Shanghai, China
| | - Jian W Lv
- Department of Urology, Shanghai Jiaotong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Ting T Lv
- Department of Urology, Shanghai Jiaotong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Si Y Wang
- The Clinical Research Section, Shanghai Research Institute of Acupuncture and Meridian, 650 South Wanping Road, Shanghai, China. .,Shanghai University of Traditional Chinese Medicine Yueyang Hospital of Traditional Chinese and Western Medicine, Shanghai, China.
| |
Collapse
|
|
41
|
Wang J, Li Y, Pan D, Han H, Zhang P. Self-assembly of silver nanoparticles on chitosan/polyvinylpyrrolidone modified micro-needle electrode for amperometric detection of nitrate in seawater. Microchem J 2021. [DOI: 10.1016/j.microc.2021.105965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
|
42
|
Lv ZY, Yang YQ, Yin LM. Role of Purinergic Signaling in Acupuncture Therapeutics. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2021; 49:645-659. [PMID: 33641652 DOI: 10.1142/s0192415x21500294] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Acupuncture is a therapeutic treatment that is well recognized in many countries. However, the initiation mechanisms of acupuncture are not well understood. Purinergic signaling has been considered a key signaling pathway in acupuncture in recent years. Acupuncture-induced ATP is mainly produced by mast cells and fibroblasts, and ATP is gradually hydrolyzed into adenosine. ATP and adenosine further participate in the process of acupuncture information transmission to the nervous and immune systems through specific purine receptors. Acupuncture initiates analgesia via the down-regulation of the expression of P2 receptors or up-regulation of the expression of adenosine A1 receptors on nerve fibers. ATP also promotes the proliferation of immune cells through P2 receptors and A3 receptors, causing inflammation. In contrast, adenosine activates A2 receptors, promotes the production and infiltration of immunosuppressive cells, and causes an anti-inflammatory response. In summary, we described the role of purinergic signaling as a general signaling pathway in the initiation of acupuncture and the influence of purinergic signaling on the neuroimmune network to lay the foundation for future systematic research on the mechanisms of acupuncture therapeutics.
Collapse
Affiliation(s)
- Zhi-Ying Lv
- Laboratory of Molecular Biology, Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, P. R. China
| | - Yong-Qing Yang
- Laboratory of Molecular Biology, Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, P. R. China
| | - Lei-Miao Yin
- Laboratory of Molecular Biology, Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, P. R. China.,Shanghai Innovation Center of Traditional Chinese Medicine, Health Service, Shanghai 201203, P. R. China
| |
Collapse
|
|
43
|
Jiang L, Zhang S, Zhang N, Chen JDZ. Optimized Tibial Nerve Stimulation Partially Reduces Visceral Hypersensitivity in Rats Mediated via Autonomic and Opioid Mechanisms. Neuromodulation 2021; 24:1003-1011. [PMID: 33615647 DOI: 10.1111/ner.13378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/24/2021] [Accepted: 02/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the therapeutic effect and possible mechanisms of tibial nerve stimulation (TNS) on visceral hypersensitivity in rats. MATERIALS AND METHODS 1) The effects of TNS with five sets of parameters on visceral sensitivity in normal rats were evaluated by the assessment of abdominal electromyogram (EMG) and abdominal withdrawal reflex (AWR). 2) The effects and mechanisms of TNS with a special set of parameters (14 Hz, 330 μsec, and 40% motor threshold) were evaluated in acute visceral hypersensitivity rats induced by restraint stress and colonic hypersensitized rats induced by acetic acid during the neonatal stage assessed by the EMG, AWR, and the spectral analysis of heart rate variability derived from the electrocardiogram. RESULTS 1) In normal rats, TNS did not show any effect on the visceromotor reflex. 2) In rats with restraint stress-induced hypersensitivity, TNS with the special set of parameters reduced AWR scores and EMG responses to rectal distention at a pressure of 20-60 mmHg (p < 0.05, vs. baseline for both AWR and EMG). Concurrently, TNS increased vagal activity and decreased sympathetic activity (p < 0.03 for both). 3) Similar effects were noted on the EMG (p < 0.05, vs. baseline) and AWR (p < 0.05 vs. baseline) with acute and chronic TNS in rats with chronic colonic hypersensitivity and the effects were blocked by naloxone. CONCLUSIONS TNS with parameters of 14 Hz, 330 μsec, and 40% motor threshold is effective in improving visceral hypersensitivity in rodent models of colonic hypersensitivity via the modulation of autonomic and opioid mechanisms.
Collapse
Affiliation(s)
- Liuqin Jiang
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Shengai Zhang
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nina Zhang
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jiande D Z Chen
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Division of Gastroenterology and Hepatology, University of Michigan School of Medicine, Ann Arbor, MI, USA
| |
Collapse
|
|
44
|
Zhou X, Cao SG, Tan XJ, Liu XD, Li ZQ, Kong LX, Tian YL, Liu D, Shen S, Sun YQ, Jiang HT, Zhou YB. Effects of Transcutaneous Electrical Acupoint Stimulation (TEAS) on Postoperative Recovery in Patients with Gastric Cancer: A Randomized Controlled Trial. Cancer Manag Res 2021; 13:1449-1458. [PMID: 33603487 PMCID: PMC7886100 DOI: 10.2147/cmar.s292325] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/14/2021] [Indexed: 01/18/2023] Open
Abstract
Purpose Transcutaneous electrical acupoint stimulation (TEAS) is an innovative choice for postoperative pain management. However, the safety and effectiveness of this traditional Chinese medicine (TCM) therapy for patients who underwent gastrectomy is largely unknown. So, the purpose of this study is to evaluate the safety and effectiveness of TEAS for patients who underwent gastrectomy. Patients and Methods We recruited 96 patients with gastric cancer from May 2019 to November 2019; 82 patients were enrolled, and 81 patients completed. Patients were randomly assigned to TEAS group (TG) received TEAS on postoperative day (POD) 1–3 or control group (CG) at a 1:1 ratio. The primary outcomes were pain score and consumption of analgesics. The secondary were the time of first postoperative flatus and defecation, frequency of postoperative nausea, vomiting, distention, diarrhea, comfort of semi-fluid diet, Clavien-Dindo grade (C-D grade) and length of postoperative day. We performed hematological analysis to explore the possible mechanisms. Results Overall, 81 patients were enrolled included in the analysis. Compared with CG, pain scores in TG were lower on POD 1–5 (average: 2.55±0.21 vs 3.10±0.42, P<0.001), and the use rate of opioids was lower (43.9 vs 75.0, P=0.004); time of first postoperative flatus (55.63±16.74 vs 72.60±20.92, P<0.001) and defecation (72.20±16.24 vs 95.78±17.75, P<0.001) were shorter; the frequency of nausea were fewer (1.88±1.09 vs 2.58±0.77, P=0.029) and patients were more comfortable with semi-fluid diet (7.63±0.63 vs 6.93±0.69, P<0.001); among the hematologic results, β-endorphin (β-End), interleukin-2 (IL-2), motilin (MTL) on POD 3, POD 5 were lower, 5-hydroxytryptamine (5-HT), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) were higher. And no adverse event was reported. Conclusion TEAS can relieve postoperative pain and promote the recovery of gastrointestinal function. Consequently, it can be an adjunctive therapy to enhance postoperative recovery for patients after gastrectomy.
Collapse
Affiliation(s)
- Xin Zhou
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Shou-Gen Cao
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Xiao-Jie Tan
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Xiao-Dong Liu
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Ze-Qun Li
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Ling-Xin Kong
- Department of Rehabilitation, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Yu-Long Tian
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Dan Liu
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Shuai Shen
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Yu-Qi Sun
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Hai-Tao Jiang
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Yan-Bing Zhou
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| |
Collapse
|
|
45
|
Huang S, Fan Q, Xiong J, Liao K, Hua F, Xiang J, Li C, Jin H. The effectiveness of acupuncture and moxibustion for treating tenosynovitis: A systematic review and meta-analysis protocol. Medicine (Baltimore) 2020; 99:e22372. [PMID: 33285669 PMCID: PMC7717726 DOI: 10.1097/md.0000000000022372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND De Quervain's tenosynovitis is an overuse disease that involves a thickening of the abductor pollicis longus and extensor pollicis brevis tendons. Evidence shows that acupuncture and moxibustion (AM) could remarkably relieve the pain of De Quervain's tenosynovitis patients. The aim of this protocol is to determine the efficacy and safety of AM for treating De Quervain's tenosynovitis. METHODS Several online databases including PubMed, Cochrane Library, Embase, Chinese Biomedical Literatures Database, China National Knowledge Infrastructure, WangFang Database, Chinese Scientific Journal Database will be searched from their establishment to July 1, 2020. We will include all randomized controlled trials using AM as the method for treating De Quervain's tenosynovitis, regardless of blinding or publication types. The selection of studies, data extraction and the assessment of the studies quality will be conducted by 2 reviewers separately. When there is sufficient available data for meta-analysis, we will use the RevMan V.5.3 statistical software for data synthesis. The total effective rate, range of motion of wrist ulnar deviation will be the primary outcomes, and the secondary outcomes contain Visual Analog Scale, Coney Wrist Score and side effects. We will express the result by using Risk ratio for dichotomous data and mean differences with a 95% confidence interval for continuous data. RESULTS The results of this study be presented in corresponding journal or conferences. CONCLUSIONS This study is designed to provide sufficient evidence to assess the exact effectiveness of AM on De Quervain's tenosynovitis. PROSPERO REGISTRATION NUMBER CRD42020158764.
Collapse
Affiliation(s)
- Shouqiang Huang
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Qian Fan
- Changshu Hospital of Traditional Chinese Medicine, Changshu
| | - Jun Xiong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Kai Liao
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Fanghui Hua
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Jie Xiang
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Changsheng Li
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Hangyu Jin
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| |
Collapse
|
|
46
|
Effectiveness of Self-administered Acupressure for Family Caregivers of Advanced Cancer Patients With Insomnia: A Randomized Controlled Trial. Cancer Nurs 2020; 45:E1-E9. [PMID: 32740328 DOI: 10.1097/ncc.0000000000000870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sleep disturbances are common among family caregivers (FCs) of patients with advanced cancer. Self-administered acupressure can combat insomnia, but no study has been conducted to evaluate its efficacy in caregivers of patients with advanced cancer. OBJECTIVE The aim of this study is to investigate whether self-administered acupressure improves sleep quality for FCs of patients with advanced cancer. METHODS Family caregivers of patients with advanced cancer who reported sleep disturbance (Pittsburgh Sleep Quality Index scores >5 in recent months) were recruited. The experimental group self-administered acupressure at the Baihui (GV20), Fengchi (GB20), Neiguan (PC6), and Shenmen (HT7) points over a 12-week period, whereas the comparison group received sleep hygiene education. Sleep quality was assessed subjectively at 4, 8, and 12 weeks after the intervention using the Pittsburgh Sleep Quality Index and objectively using actigraphy measurements. Improvements in sleep quality were analyzed using a generalized estimating equation. RESULTS Compared with the control group, the experimental group demonstrated significantly lower sleep latency (Wald χ2 = 11.49, P = .001) and significantly better sleep efficiency (Wald χ2 = 5.24, P = .02) according to actigraphy measurements, but Pittsburgh Sleep Quality Index scores did not differ significantly between the groups. CONCLUSIONS Self-administered acupressure did not demonstrate favorable effects on subjective sleep quality, but did reduce sleep latency and improve sleep efficiency, according to actigraphy measurements. Self-administered acupressure may help relaxation and sedation and promote sleep in FCs. IMPLICATIONS FOR PRACTICE Healthcare providers may consider advising FCs to apply this self-administered acupressure to improve their sleep latency and sleep efficiency.
Collapse
|
|
47
|
Saraogi M, Geraghty RM, Hameed B, Rob S, Pietropaolo A, Sarica K, Gozen A, Liatsikos E, Somani BK. Role of Complementary Medicine (Music, Acupuncture, Acupressure, TENS and Audio-Visual Distraction) in Shockwave Lithotripsy (SWL): A Systematic Review From EAU Sections of Urolithiasis (EULIS) and Uro-Technology (ESUT). Urology 2020; 145:38-51. [PMID: 32640263 DOI: 10.1016/j.urology.2020.06.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/21/2020] [Indexed: 11/27/2022]
Abstract
We performed a systematic review to look at the role of alternative or complementary medicine such as music, acupressure, acupuncture, transcutaneous electrical nerve stimulation (TENS) and audiovisual distractions to decrease analgesia requirement and alleviate anxiety during SWL. Twenty-three papers(2439 participants) were included: Music (n = 1056.6%), Acupuncture (n = 517.7%), Acupressure (n = 13.8%), TENS (n = 617.2%), and audiovisual distraction (n = 14.6%). Most of the studies showed that complementary therapy, lowered pain, and anxiety with higher patient satisfaction and willingness to undergo the procedure. With its feasibility and convenience, urological guidelines need to endorse it, and more should be done to promote its use in outpatient urological procedures.
Collapse
Affiliation(s)
- M Saraogi
- Faculty of Life and Environmental Sciences, University of Southampton, United Kindom
| | - R M Geraghty
- Department of Urology, University hospital Newcastle, United Kindom
| | - Bmz Hameed
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education (MAHE), Karnataka, India
| | - S Rob
- Department of Urology, University Hospital Southampton NHS Trust, United Kindom
| | - A Pietropaolo
- Department of Urology, University Hospital Southampton NHS Trust, United Kindom
| | - K Sarica
- Department of Urology, Biruni University Medical School, Istanbul, Turkey
| | - A Gozen
- Department of Urology, Klinikum Heilbronn, Heilbronn, Germany
| | - E Liatsikos
- Department of Urology, University of Patras, Patras, Greece
| | - B K Somani
- Department of Urology, University Hospital Southampton NHS Trust, United Kindom.
| |
Collapse
|
|
48
|
Jing Z, Ling Y, Yi F. Multipoint transcutaneous electrical stimulation reduces median effective plasma concentration of propofol: A randomised clinical trial. Indian J Anaesth 2020; 64:483-487. [PMID: 32792712 PMCID: PMC7398017 DOI: 10.4103/ija.ija_775_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/04/2020] [Accepted: 03/12/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND AIMS Previous work shows that transcutaneous electrical stimulation (TES) has analgesic and sedative effects. However, it is unclear whether TES can affect the sedative effect of propofol or not. This study was designed to assess the effect of TES on median effective plasma concentration (Cp50) of propofol and haemodynamic changes before and after tracheal intubation. METHODS 48 patients belonging to ASA I or II posted for thyroidectomy were randomly allocated into control and TES groups. Up-and-down method was used to determine Cp50 of propofol. The average concentration of propofol in each crossover was calculated and the average concentration of those six values was defined as Cp50 of propofol. RESULTS Cp50 of propofol was 3.70 ± 0.28 μg/mL and 3.08 ± 0.31 μg/mL in control and TES groups, respectively (P < 0.05). There were no significant differences in MAP (90.3 ± 12.4 mmHg vs. 97.0 ± 10.8 mmHg, 94.2 ± 18.7 mmHg vs. 98.3 ± 16.6 mmHg and 84.9 ± 14.1 mmHg vs. 91.6 ± 16.2 mmHg) and HR (78.2 ± 11.3 b/min vs. 75.6 ± 9.5 b/min, 90.9 ± 15.4 b/min vs. 90.4 ± 14.9 b/min and 86.7 ± 13.7 b/min vs. 84.0 ± 15.9 b/min) at T0, T1 and T2 between two groups. In TES group, HR changes at T1 and T2 were significantly higher than those at T0. CONCLUSION TES can make an assistant effect on sedation and decrease Cp50 of propofol. But the haemodynamic fluctuations in TES group, especially the HR changes, seem to be more obvious than those in control group.
Collapse
Affiliation(s)
- Zhang Jing
- Department of Anaesthesiology, Peking University People's Hospital (Beijing Cancer Hospital), Beijing, China
| | - Yu Ling
- Department of Anaesthesiology, Peking University People's Hospital (Beijing Cancer Hospital), Beijing, China
| | - Feng Yi
- Department of Anaesthesiology, Peking University People's Hospital (Beijing Cancer Hospital), Beijing, China
| |
Collapse
|
|
49
|
Elahee SF, Mao HJ, Zhao L, Shen XY. Meridian system and mechanism of acupuncture action: A scientific evaluation经络系统与针刺效应机制的科学评价. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2020. [DOI: 10.1016/j.wjam.2020.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
|
50
|
Chen T, Zhang WW, Chu YX, Wang YQ. Acupuncture for Pain Management: Molecular Mechanisms of Action. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2020; 48:793-811. [DOI: 10.1142/s0192415x20500408] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Acupuncture reduces pain by activating specific areas called acupoints on the patient’s body. When these acupoints are fully activated, sensations of soreness, numbness, fullness, or heaviness called De qi or Te qi are felt by clinicians and patients. There are two kinds of acupuncture, manual acupuncture and electroacupuncture (EA). Compared with non-acupoints, acupoints are easily activated on the basis of their special composition of blood vessels, mast cells, and nerve fibers that mediate the acupuncture signals. In the spinal cord, EA can inhibit glial cell activation by down-regulating the chemokine CX3CL1 and increasing the anti-inflammatory cytokine interleukin-10. This inhibits P38 mitogen-activated protein kinase and extracellular signal-regulated kinase pathways, which are associated with microglial activation of the C-Jun N-terminal kinase signaling pathway and subsequent astrocyte activation. The inactivation of spinal microglia and astrocytes mediates the immediate and long-term analgesic effects of EA, respectively. A variety of pain-related substances released by glial cells such as the proinflammatory cytokines tumor necrosis factor [Formula: see text], interleukin-1[Formula: see text], interleukin-6, and prostaglandins such as prostaglandins E2 can also be reduced. The descending pain modulation system in the brain, including the anterior cingulated cortex, the periaqueductal gray, and the rostral ventromedial medulla, plays an important role in EA analgesia. Multiple transmitters and modulators, including endogenous opioids, cholecystokinin octapeptide, 5-hydroxytryptamine, glutamate, noradrenalin, dopamine, [Formula: see text]-aminobutyric acid, acetylcholine, and orexin A, are involved in acupuncture analgesia. Finally, the “Acupuncture [Formula: see text]” strategy is introduced to help clinicians achieve better analgesic effects, and a newly reported acupuncture method called acupoint catgut embedding, which injects sutures made of absorbable materials at acupoints to achieve long-term effects, is discussed.
Collapse
Affiliation(s)
- Teng Chen
- Department of Integrative Medicine and Neurobiology, Institutes of Integrative Medicine School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University Shanghai, P. R. China
| | - Wen Wen Zhang
- Department of Integrative Medicine and Neurobiology, Institutes of Integrative Medicine School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University Shanghai, P. R. China
| | - Yu-Xia Chu
- Department of Integrative Medicine and Neurobiology, Institutes of Integrative Medicine School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University Shanghai, P. R. China
| | - Yan-Qing Wang
- Department of Integrative Medicine and Neurobiology, Institutes of Integrative Medicine School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University Shanghai, P. R. China
| |
Collapse
|