Abstracts from Society for Acupuncture ResearchPandemics, Pain, & Public Health:Roles and Relevance of Traditional East Asian MedicineJune 14–17, 2021

Abstract

The Journal of Alternative and Complementary MedicineAhead of Print AbstractsFree AccessAbstracts from Society for Acupuncture ResearchPandemics, Pain, & Public Health:Roles and Relevance of Traditional East Asian MedicineJune 14–17, 2021Published Online:8 Oct 2021https://doi.org/10.1089/acm.2021.29097.abstractsAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Featured Poster AbstractsA.32 A SYSTEMATIC REVIEW OF ACUPUNCTURE THERAPIES FOR RECURRENT URINARY TRACT INFECTIONS IN WOMENMeaghan Coyle, RMIT University; Xindong Qin, Guangdong Provincial Hospital of Chinese Medicine; Jueyao Liang, Guangdong Provincial Hospital of Chinese Medicine; Lihong Yang, Guangdong Provincial Hospital of Chinese Medicine; Kaiyi Wang, RMIT University; Xinfeng Guo, Guangdong Provincial Hospital of Chinese Medicine; Anthony Lin Zhang, RMIT University; Wei Mao, Guangdong Provincial Hospital of Chinese Medicine; Chuanjian Lu, Guangdong Provincial Hospital of Chinese Medicine; Charlie C Xue, RMIT University; Xusheng Liu, Guangdong Provincial Hospital of Chinese MedicineIntroduction and Aims: Recurrent urinary tract infections are estimated to affect 30–44% of women. Antibiotics are effective for alleviating the symptoms of acute infections and are recommended to prevent recurrence, but antibiotic resistance remains a global challenge. Acupuncture has been suggested in clinical practice guidelines as an alternative option to prevent recurrent urinary tract infections in women based on the results of two clinical trials. This systematic review determined the efficacy and effectiveness of acupuncture therapies for recurrent urinary tract infections.Methods: Nine English and Chinese databases were searched from inceptions to February 2019. Randomised controlled trials that evaluated acupuncture‐related therapies for the management or prevention of uncomplicated UTI were included. Data were extracted, risk of bias was assessed and adherence to the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines was determined. The primary outcomes were composite cure (defined as a resolution of symptoms and/or negative urine culture) and recurrence. Meta‐analysis used risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with 95% confidence intervals (CI).Results: Five randomised controlled trials were included; three recruited women with acute infections and two tested acupuncture as a preventative treatment. Information relating to STRICTA items ‘details of needling’, ‘treatment regimen’ and ‘control or comparator interventions’ were generally reported well. For women with acute infection, acupuncture therapies increased the chance of a composite cure more than antibiotics (RR 1.92 [95% CI 1.31, 2.81], I2 = 38%). Fewer instances of recurrence were reported with acupuncture compared to sham acupuncture (RR 0.45 [95% CI 0.22, 0.92]) and no treatment (RR 0.39 [95% CI 0.26, 0.58], I2 = 0%).Conclusions: Acupuncture may have a role to play in reducing reliance on antibiotics for women with recurrent urinary tract infections, but more research is needed to guide clinical decision‐making.A.14 ACUPUNCTURE DECREASED THE RISK OF CORONARY HEART DISEASE IN PATIENTS WITH OSTEOARTHRITIS IN TAIWAN: A NATIONWIDE MATCHED COHORT STUDYGil Ton, Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan.; Hung‐Rong Yen, College of Chinese Medicine, Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan; Yu‐Chen Lee, Graduate Institute of Acupuncture Science, China Medical University, Taichung, TaiwanObjectives: Patients with osteoarthritis (OA) are more likely to develop coronary heart disease (CHD) than the general population. Acupuncture is commonly used in OA patients however, the therapeutic effect of acupuncture on the risk of CHD in patients with OA and the association between OA patients and their risk to develop CHD in Taiwan are unknown. We investigated the risk of CHD according to acupuncture use in OA patients and compared it with the general population.Design: Records obtained from Taiwan's National Health Insurance Research Database identified 84773 patients with OA, which were compared with 727,359 patients without OA diagnosis. 5046 of whom met study inclusion criteria, had 1:1 frequency matching and were categorized as OA‐acupuncture cohort (n = 1682) OA non‐acupuncture cohort (n = 1682) and non‐OA cohort (n = 1682). Cox proportional hazards regression analysis determined the risk of CHD, which was defined as the study main outcome. Therapeutic effects of acupuncture and medical expenditure were also analyzed.Results: OA non‐acupuncture cohort had 3.04 higher risk to develop CHD compared with OA‐acupuncture cohort (95% CI 2.54‐3.63 p < 0.001) and non‐OA cohort had 1.88 higher risk to develop CHD compared with OA‐acupuncture cohort (95% CI 1.52‐2.32 p < 0.001). In subgroup analyses, OA patients treated with both acupuncture and oral steroids were at significantly lower risk of CHD compared with those who used neither (aHR; 0.34 95% CI, 0.22‐0.53), and OA patients treated with acupuncture had the lowest medical expenditure in a follow‐up time of 6 months, 3 and 5 years.Conclusion: This is the first large‐scale investigation in Taiwan that shows the association between OA and CHD and the beneficial effects of acupuncture in OA patients and their associated risk to develop CHD. Our results may provide valuable information for health policy decision making. Further randomized controlled trials are needed to confirm these observational findings.A.36 ACUPUNCTURE FOR CHEMOTHERAPY‐ASSOCIATED INSOMNIA IN BREAST CANCER PATIENTS: A PILOT RANDOMIZED CONTROLLED TRIALJialing Zhang, University of Hong Kong; Zongshi Qin, University of Hong Kong; Tsz Him So, University of Hong Kong; Haiyong Chen, University of Hong Kong; Lixing Lao, University of Hong Kong; Zhangjin Zhang, University of Hong KongObjective: Chemotherapy‐associated insomnia is a highly prevalent complaint in breast cancer patients. This study was undertaken to evaluated the feasibility, preliminary efficacy and safety of acupuncture for chemotherapy‐associated insomnia in breast cancer patients. This pilot study would provide useful information for designing a larger clinical trial.Methods: In this randomized, assessor‐blinded, wait‐list controlled trial, 30 breast cancer patients with insomnia under or post chemotherapy were randomly allocated to either the acupuncture group (n = 15) or the wait‐list control group (n = 15). Participants in the acupuncture group received acupuncture treatment (electroacupuncture plus auricular acupressure) twice a week for 6 weeks. Participants from the wait‐list control group received the same regime of acupuncture treatment after the 6‐week of waiting period. The Insomnia Severity Index (ISI) served as the primary outcome measurement. Depression, anxiety, multidimensional health‐related quality of life (QoL) were also evaluated. A linear mixed‐effects models were used for analyses.Results: Twenty‐eight participants completed study (13 in the acupuncture group versus 15 in the wait‐list control group). At week‐6 post‐intervention, ISI score change from baseline showed significant between‐group difference favoring acupuncture group of −2.9 points (95% CI: −5.2 to −0.6, P = 0.014). The acupuncture group showed greater improvements in the total sleep time (P = 0.026), scores of PSQI (P = 0.012), HADS‐depression (P = 0.020), and FACT‐B (P < 0.001) compared with the control group. Improvements were maintained at week‐10 and week‐14 follow‐ups.Conclusions: Acupuncture treatment was a feasible, acceptable, safe and effective intervention for chemotherapy‐associated insomnia in breast cancer patients under or post chemotherapy. A larger sample size randomized clinical trial is warranted to confirm the present findings.Trial registration: Clinicaltrials.gov: NCT03762694.A.51 AURICULAR ACUPRESSURE FOR PATIENTS WITH EMOTIONAL DISTRESS UNDER THE COVID‐19 PANDEMIC: A RANDOMIZED CONTROLLED TRIALPeijing Rong, Institute of Acu.‐Moxi., China Academy of Chinese Medical Sciences; Lei Wang, Institute of Acu.‐Moxi., China Academy of Chinese Medical Sciences; Lingling Yu, Tongji Hospital of Tongji Medical College; Junying Wang, Institute of Acu.‐Moxi., China Academy of Chinese Medical SciencesPurpose: To confirm whether self‐administered AVNA treatment is effective in improving emotional distress under the COVID‐19 pandemic.Methods: A smartphone‐based online, randomized, controlled trial was designed from 26 February 2020 to 28 April 2020 in four study sites, including Wuhan, Beijing, Shenyang, and Guangzhou of China. Local residents who had considerable emotional distress with a score of the Hospital Anxiety and Depression Scale (HADS) ≥9 were recruited. Participants were randomly assigned to three times of AVNA (n = 191) per day, in morning, around noon, and in evening or usual care (UC, n = 215) once daily for 14 days. The primary outcome was the response rate, which was the proportion of participants whose Hospital Anxiety and Depression Scale (HADS) score reduced from baseline by ≥50%. The assessment was conducted at baseline, 3 days, and 14 days.Results: The AVNA group had a markedly higher response rate than the UC group at 3 days (35.6% vs. 24.9%, P = 0.02) and at 14 days (70.7% vs. 60.6%, P = 0.02). The AVNA group showed significantly greater reduction in scores of HADS at the two measurement points and BAI at 3 days (P ≤ 0.03), with average respective effect size of 0.217 and 0.195. Participants with AVNA spent less time falling asleep and rated their sleep quality being remarkably higher than those with UC at endpoint.Conclusion: During COVID‐19 pandemic period, treatment with self‐administrated AVNA was more effective than UC in reducing emotional distress of isolated populations. These findings support self‐administered AVNA as a treatment option for patients with emotional distress under the COVID‐19 pandemic or other emergent events.A.56 COMPARISON BETWEEN VAGAL NERVE STIMULATION AND ELECTROACUPUNCTURE AT ST‐36 FOR TREATING OPIOID‐INDUCED CONSTIPATION IN RATSYiling Zhang, Beijing University of Chinese Medicine; Li Cui, Johns Hopkins University; Xue Lin, Johns Hopkins University; Jiande Chen, University of MichiganAims: Constipation and opioid‐induced constipation (OIC) are high prevalence with limited therapies. We investigated the effects of electroacupuncture (EA) at ST‐36 on OIC in rats and compared its performance with vagal nerve stimulation (VNS).Methods: Acute study: 8 rats implanted with electrodes at the sub‐diaphragmatic vagal nerve for VNS and another 8 rats implanted with electrodes at acupoints ST‐36 for EA. All rats were also implanted with a catheter in the proximal colon for assessing whole colon transit. Chronic study: 30 rats were treated daily with loperamide for 7 days to induce OIC then divided into three groups (N = 10 each) treated with daily EA, VNS and sham‐stimulation for a week, respectively. Feces were collected daily. Whole gut transit time (WGTT) and distal colon transit time (dCTT) were measured.Results: 1) Both VNS and EA at ST‐36 accelerated the whole colon transit (Fig.1) and no difference between the two; 2) Chronic VNS increased the number of daily fecal pellets (39 ± 5 vs. 28 ± 4, P < 0.05, VNS vs. sham‐VNS), wet weight of daily fecal pellets (6.5 ± 0.8 g vs. 4.5 ± 0.4 g, P < 0.05, VNS vs. sham‐VNS), and water content in feces (31.0 ± 2.8 % vs. 20.4 ± 3.6 %, P < 0.05, VNS vs. sham‐VNS). EA at ST‐36 showed similar effects and no difference between the two. 3) Both chronic VNS and EA at ST‐36 shortened WGTT (10.0 ± 1.1 h vs. 12.5 ± 2.3 h, P < 0.05, EA vs. sham‐VNS) and dCTT (17.7 ± 0.7 min vs. 25.0 ± 2.3 min, P < 0.05, EA vs. sham‐VNS); there was no significant difference between the two.Conclusions: EA at ST‐36 improves constipation by enhancing gastrointestinal motility and its effect is as effective as VNS in a rodent model of OIC.A.9 DEVELOPMENT OF A MODEL ACUPUNCTURE RESEARCH CURRICULUM FOR EAM SCHOOLSHeidi Most, Maryland University of Integrative Health; Lisa Conboy, New England School of Acupuncture at MCPHS; Rosaleen Ostrick, Yo San UniversityPurpose: The Society for Acupuncture Research (SAR) is an international group of researchers from major medical and research institutions dedicated to improving the quality and increasing the awareness of research in acupuncture. At the June 2019 SAR conference, a seminar was organized to advance acupuncture research education for EAM students. Out of that conference, SAR participants formed a special interest group on education (SAR SIG‐Edu). Fourteen members from EAM schools across the US and Brazil have been collaboratively contributing to a model curriculum and coordinating through bi‐monthly meetings. One of our goals is to create a model Acupuncture Research curriculum which includes: (1) existing basic science and clinical evidence, its strengths and shortcomings, (2) acupuncture research challenges, and (3) an experiential component to give students a sense of research activities.Methods: We began with a draft syllabus from Dr. Ari Ojeda Ocampo More. Across multiple Zoom meetings and with the help of our members, we iteratively expanded the curriculum and created other resources.Results: This presentation explains our collaborative process and is a venue to share the final curriculum.Conclusion: Creating a detailed curriculum and resources that are available to all EAM schools would improve students' knowledge of the evidence base that exists for acupuncture. An enhanced knowledge base enables them to be valued members of an integrative medicine team as more informed practitioners who incorporate evidence into their treatments. The affiliation with SAR lends legitimacy to the work of SAR SIG‐Edu, which enhances our ability to further develop the curriculum and encourage its adoption. It may also be of interest to international EAM schools.A.39 HERBAL MEDICINE AS A CRITICAL ELEMENT OF INTEGRATIVE CANCER CARE: A RETROSPECTIVE ANALYSIS OF THE HERBAL DISPENSARY PROGRAM AT MEMORIAL SLOAN KETTERING CANCER CENTERYen Nien Hou, MSKCC; Jun Mao, MSKCCObjective: Many cancer patients and survivors use herbs for symptom relief and to prevent disease recurrence. To integrate botanicals used in traditional Chinese medicine (TCM) with proven benefit and safety into cancer care, the Integrative Medicine Service (IMS) along with the Pharmacy division at Memorial Sloan Kettering Cancer Center (MSK) initiated an herbal dispensary. This study aims to analyze data from this program to inform integrative oncology practice and future research.Methods: Patient demographics; herbal prescriptions (type, dose and duration); patient compliance; and pharmacosurveillance data (concomitant drug use and side effects) were documented by IMS physicians and a TCM‐trained pharmacist. The outcomes included prevalence of herbal medicine use; patient characteristics (age, gender, race, cancer type and stage, purpose of use, venue, insurance coverage); the most commonly used herbal formula/single herb and its indication(s), clinical effects, side effects; and concomitant drug use/herb‐drug interactions.Results: Since the program launch in February 2019, 1,172 supplements were dispensed to 736 unique patients. The top indications and corresponding products dispensed were pain/external pain plaster; constipation/Ma Zi Ren Wan; and immunomodulation/turkey tail mushroom.Conclusions: The Integrative Medicine Service at MSK successfully launched an herbal dispensary program – the first of its kind at a National Cancer Institute‐designated cancer center – to integrate herbal therapies into cancer care. The dispensary also helped identify promising supplements for conducting future clinical trials. The data obtained will be used to educate physicians and patients about the safety and efficacy of these products. The findings will also be translated into monographs that will be published on IMS's About Herbs (www.aboutherbs.com) database.A.61 MULTI‐BRAIN FUNCTIONAL CONNECTIVITY DURING ELECTRO‐ACUPUNCTURE IN PATIENT‐CLINICIAN DYADS: AN ELECTROENCEPHALOGRAPHY (EEG) HYPERSCAN APPROACHAlessandra Anzolin, MGH/HMS Athinoula Martinos Center for Biomedical Imaging; Arvina Grahl, MGH/HMS Athinoula Martinos Center for Biomedical Imaging; Kylie Isenburg, Boston University; Jlenia Toppi, Sapienza, University of Rome; Angela Ciaramidaro, University of Modena and Reggio Emilia; Maya Barton Zuckerman, MGH/HMS Athinoula Martinos Center for Biomedical Imaging; Meryem Yucel, Boston University; Dan‐Mikael Ellingsen, University of Oslo; Laura Astolfi, Sapienza, University of Rome; Ted Kaptchuk, Harvard Medical School; Vitaly Napadow, Harvard Medical SchoolIn chronic pain management and treatment, a positive patient‐clinician relationship is associated with higher patient satisfaction and treatment efficacy. In this study, we investigated synchronization of brain activity between patients and clinicians during an experimentally controlled augmented (empathetic) compared to limited (business‐like) clinical interaction context. We recorded EEG simultaneously (hyperscanning, 16 dyads, 64 channels per subject) from low back pain patients and acupuncturists during a task with treatment trials (electro‐acupuncture) and no‐treatment trials in conjunction with evoked cuff pain. EEG data were reconstructed using the algorithm eLORETA on 17 Regions of Interest (ROIs) defined by our previous fMRI study (Ellingsen et al. 2020) and directed statistical connectivity patterns were obtained by comparing Granger Causality‐based estimates for treatment and no‐treatment trials (α = 0.05, FDR corrected). Patients in the augmented group, compared to the limited group, rated therapeutic alliance and clinician warmth significantly higher (Fig.1a, p < 0.01). Low back pain intensity decreased after acupuncture treatment, irrespective of clinical context (Fig.1b, p < 0.01). EEG analysis suggested that in Theta band (linked with empathy for pain in prior EEG studies), inter‐brain network density within social mirroring and pain/sensorimotor brain regions was altered when acupuncturists treated evoked pain. The number of significant inter‐brain clinician‐to‐patient connections was higher in the no‐treatment condition (Fig.1c), while the number of patient‐to‐clinician connections were greater during treatment trials. Also, the density of patient‐to‐clinician inter‐brain connections increased during treatment relative to no‐treatment irrespective of clinical context, yet statistical significance was noted only for the augmented group (Fig.1d, p < 0.01). Both behavioral and simultaneous brain‐to‐brain responses across the patient/clinician dyad reflect clinical interaction context. EEG hyperscanning is an ecologically valid approach to identify inter‐brain networks whose density and directionality within the dyad is altered by electro‐acupuncture and clinical context, highlighting new brain mechanisms linking therapeutic alliance and chronic pain therapy.A.63 NEURAL AND BEHAVIORAL CORRELATES OF PATIENT‐CLINICIAN THERAPEUTIC ALLIANCE IN A LONGITUDINAL ACUPUNCTURE INTERVENTION: AN FMRI HYPER‐SCANNING STUDYArvina Grahl, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Alessandra Anzolin, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Kylie Isenburg, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Jeungchan Lee, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Maya Barton‐Zuckerman, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Dan‐Mikael Ellingsen, Department of Psychology, University of Oslo, Oslo, Norway; Changjin Jung, KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea; Jessica Gerber, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; John Kelley, Endicott College, Beverly, MA, United States; Irving Kirsch, Program in Placebo Studies & Therapeutic Encounter (PiPS), Harvard Medical School, Boston, MA, United States; Ted Kaptchuk, Program in Placebo Studies & Therapeutic Encounter (PiPS), Harvard Medical School, Boston, MA, United States; Vitaly Napadow, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United StatesPrevious research suggests that a warm‐empathic (Augmented) compared to a neutral business‐like (Limited) patient‐clinician relationship can improve clinical outcomes. The clinical relationship is important to acupuncture therapy, which includes multiple sessions allowing for an evolving patient‐clinician relationship. We applied fMRI hyperscanning including a video connection between two scanners and an evoked cuff pressure pain‐treatment paradigm to determine whether behavioral, neural, and clinical variables associated with therapeutic alliance influence clinical outcomes. Eleven women with fibromyalgia (mean age = 38.55, SD = 11.25), randomly assigned to either an Augmented (N = 5) or a Limited (N = 6) patient‐clinician dyad interaction style, were treated with electro‐acupuncture for 6 biweekly sessions, and scanned before and after the acupuncture intervention. Clinical outcomes and the quality of the patient‐clinician relationship were assessed (e.g. pain levels, therapeutic alliance, warmth). As rated by patients, pooled therapeutic alliance and clinicians' warmth in the Augmented group (mean_alliance = 43.17, SD = 2.84; mean_warmth = 4.00, SD = 0.0) were significantly higher than in the Limited group (mean_alliance = 28.84, SD = 9.97; mean_warmth = 3.14, SD = 0.72; t_alliance(9) = 3.04, p = 0.014; t_warmth(9) = 2.65; p = 0.027). Additionally, over all 6 acupuncture treatment sessions, most patients experienced post‐treatment clinical pain relief (p < 0.001) irrespective of group assignment. However, after the 3‐week intervention, patients in the augmented group expected a higher likelihood of fibromyalgia pain relief from future acupuncture and reported a higher probability of continuing to see their assigned acupuncturist for future treatments. Based on results of our previous hyperscan fMRI study (Ellingsen et al., 2020), brain imaging data analysis will focus on social mirroring areas such as the temporo‐parietal junction (TPJ).Our preliminary results from this longitudinal patient‐acupuncturist interaction study highlight the positive influence of the therapeutic relationship on brain processing of nociceptive signaling and clinical outcomes. Moreover, we hope that our results will inform future chronic pain treatment approaches, to harness the positive effects of the patient‐clinician relationship.A.13 SELF‐ADMINISTERED ACUPRESSURE FOR INSOMNIA DISORDER: A RANDOMIZED CONTROLLED TRIALWing Fai YEUNG, School of Nursing, The Hong Kong Polytechnic University; Ka Fai CHUNG, Department of Psychiatry, The University of Hong Kong; Zhang Jin ZHANG, School of Chinese Medicine, The University of Hong Kong; Lixing LAO, School of Chinese Medicine, The University of Hong Kong; Lorna Kwai Ping SUEN, School of Nursing, Tung Wah College; Fiona Yan Yee HO, Department of Psychology, the Chinese University of Hong Kong; Lai Ming HO, School of Public Health, The University of Hong Kong; Branda Yee‐Man YU, School of Nursing, The Hong Kong Polytechnic UniversityObjectives: To evaluate the effects of self‐administered acupressure for insomnia disorder delivered by a training course.Hypothesis: Subjects in the self‐administered acupressure group will have greater improvement in insomnia symptoms and daytime impairment than those in the sleep hygiene education (SHE) group at week4 and 8 week‐8.Design and Methods: A randomized controlled trial with 200 subjects, which were randomized into the self‐administered acupressure group or sleep hygiene education group in a 1:1 ratio. Subjects in the self‐administered acupressure group attended an acupressure training course (2 sessions, 2 hours each) to learn self‐administered acupressure, which were then performed every night for 4 weeks. Subjects in the comparison group received sleep hygiene education (2 sessions, 2 hours each) and be reminded to follow the sleep hygiene practice daily for 4 weeks. The primary outcome was the Insomnia Severity Index (ISI). Other measures included a 7‐day sleep diary and actigraphy, Hospital Anxiety and Depression Scale and Short‐form Six‐Dimension.Results: The subjects in the self‐administered acupressure group had a significantly lower ISI score than the subjects in the sleep hygiene education group at week 4 (d = 0.51, P < 0.001) and 8 (d = 0.67, P < 0.001). Subjects in self‐administered acupressure group had a higher sleep‐diary‐derived TST and SE than those in sleep hygiene education group at week 4 (Cohen's d = 0.32 and 0.32, respectively, all p = 0.03). In addition, self‐administered acupressure showed a greater improvement in HADS‐anxiety (d = 0.35, p = 0.02), HADS depression score (d = 0.28, p = 0.049) and the SF6D (d = 0.32, p = 0.02) at week 4, but not week 8.Conclusions: Self‐administered acupressure taught is a feasible and effective approach to improve sleep and related daytime impairment as well as mood problems in individuals with insomnia disorder.A.44 SHEN LING BAI ZHU SAN FOR CHRONIC DIARRHEA ‐ A SYSTEMATIC REVIEW OF RCTS AND META‐ANALYSISHui Wang, MSKCC; Guang'anmen Hospital, China Academy of Chinese Medical Sciences; Yen‐Nien Hou, MSKCC; Mingxiao Yang, MSKCC; Ye Feng, MSKCC: Peking University Cancer Hospital & Institute; Yi Lily Zhang, MSKCC; Colleen M. Smith, MSKCC; Wei Hou, Guang'anmen Hospital, China Academy of Chinese Medical Sciences; Jun J. Mao, MSKCC; Gary Deng, MSKCCObjective: Many cancer patients experience chronic diarrhea, a debilitating symptom for which effective treatment strategies are lacking. Shen Ling Bai Zhu San (SLBZS) is a botanical formulation used in traditional Chinese medicine to manage diarrhea. This systematic review was conducted to evaluate the available evidence of anti‐diarrheal efficacy of SLBZS.Methods: Both English and Chinese language databases were searched through April 20, 2020 for relevant randomized controlled trials (RCTs). Fourteen RCTs involving 1,158 participants were included. Reported outcomes included stool frequency, stool consistency, patient‐reported satisfaction of chronic diarrhea treatment, and adverse events (AEs). Controls used were prescription drugs and in one study placebo SLBZS.Results: Quality of the studies ranged from low to high risk of bias. One small study reported SLBZ's effects on objective outcomes (no significant reduction in stool frequency but a significant improvement in stool consistency in week 12, when compared to placebo). Meta‐analysis showed that SLBZS with or without conventional medicine was associated with higher patient‐reported satisfaction compared to conventional medicine (RR, 2.15; 95% CI, 1.40 to 3.29; p = 0.0004; I2 = 0%; and RR, 2.34; 95% CI, 1.84 to 2.97; p < 0.00001, I2 = 0). The risk of AEs was not greater with SLBZS (OR, 0.49; 95% CI, 0.28 to 0.84; p = 0.009; I2 = 0%).Conclusions: This systematic review found that treatment with SLBZS significantly improved patient‐reported satisfaction. Well‐designed RCTs with larger sample sizes, lower bias, and strong primary endpoints are needed to further determine the efficacy of SLBZS in reducing stool frequency, and in improving stool consistency for specific gastrointestinal disease.A.79 SPINAL ADIPONECTIN IS INVOLVED IN ELECTROACUPUNCTURE‐PRODUCED ANALGESIC EFFECTSZhipeng Ning, The University of Hong Kong; Haiyong Chen, The University of Hong Kong; Zhangjin Zhang, The University of Hong Kong; Lixing Lao, Virginia University of Integrative MedicinePurpose: To determine whether electroacupuncture (EA)‐produced analgesic effects require the involvement of adiponectin (APN) in the spinal cordMethods: Male C57BL/6J mice, and APN knockout (KO) and wild‐type (WT) mice with a C57BL/6J background were used. Inflammatory pain was induced on hand paw by subcutaneously injection of 0.02 ml complete Freund's adjuvant (CFA). EA of 10 Hz, 2.5 mA and 0.1 ms pulse‐width at acupoint GB30 bilaterally was administrated for 20 min. Sham EA was performed with no‐invasive needle taped on the skin of the point with no electrical current delivered. Recombinant mouse APN protein or vehicle was administrated intrathecally. Paw‐withdrawal latency (PWL) and paw‐withdrawal threshold (PWT) tests were used to measure pain sensitivity. Western blotting (WB) and Immunofluorescence (IF) was used to detect protein expression of spinal APN.Results: Results showed EA reduced 22.87% mechanical allodynia (79.95 ± 1.14% vs 57.08 ± 3.49%, P < 0.001) and 18.17% thermal hyperalgesia (76.00 ± 1.10% vs 57.83 ± 1.65%, P < 0.001) at 5h post‐CFA when compared with sham EA in WT mice, but EA had no significant benefits in mice lacking APN. Moreover, after treatment with 1ng, 10ng, and 100ng recombinant APN. Mechanical allodynia reduced from 82.23 ± 0.78% to 72.34 ± 2.79% (P = 0.0679), 50.69 ± 2.26% (P < 0.001), and 49.99 ± 2.99% (P < 0.001). Thermal hyperalgesia reduced from 80.25 ± 1.43% to 73.19 ± 2.34% (P = 0.3108), 58.42 ± 3.05% (P < 0.001), and 55.17 ± 1.71% (P < 0.001). Furthermore, we confirmed that APN does co‐locate with vascular endothelial marker, not neuronal, microglial, or astrocytic markers in spinal dorsal horn (SDH) and discovered that EA triggers increased APN level on the ipsilateral side of spinal cord at 5h post‐CFA when compares with sham EA group (1.13 ± 0.04 vs 1.42 ± 0.08 in WB examination, P < 0.0