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Blinding effect of sham Fu's subcutaneous needling in a healthy population: 假浮针在健康受试者中的盲法效应

ObjectiveFu's subcutaneous needling (FSN) has been shown potential positive effectiveness in clinical practice. However, its specific effects are still not clear. This study aims to evaluate the blinding effect of a non-penetrating sham FSN needle, developed for the first time by the authors' research team in healthy participants. Furthermore, to provide a reliable control tool to assess the specific effects of FSN. MethodsWe conducted a randomized, sham-controlled trial in 60 healthy participants divided into FSN group and sham FSN group in a 1:1 ratio. The participants were assessed according to blinding index (BI), pain intensity, sensation type and acceptability of needling. ResultsThe James' BI was (0.56, 95 %CI [0.45, 0.67]) for two groups. The Bang's BI was (0.50, 95 % CI [0.24, 0.76]) in the FSN group and (−0.36, 95 % CI [−0.67, −0.07]) in the sham FSN group. There was no significant difference between needling pain intensity (P > 0.05) and type of needling sensation. A total of 96.6 % participants who received sham FSN and 86.6 % participants who received FSN considered the needling acceptable or better. ConclusionThis study confirmed the effective blinding capability of the sham FSN needles in healthy participants, indicating that the novel non-penetrating sham FSN needle can be served as eligible control to evaluate the specific effects of FSN.

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“Scapular heat penetration” technique of acupuncture in treatment of scapulohumeral periarthritis: Exploratory research: “穿胛热”针法治疗肩周炎-探索性研究

ObjectiveTo observe the clinical effect of “scapular heat penetration” technique of acupuncture in treatment of scapulohumeral periarthritis. DesignIt was a single-central randomized controlled trial, the participants, outcome assessors and statisticians were blinded. SettingThe trial was undertaken in Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, from June 2021 to January 2022. ParticipantsSixty-seven patients with scalpulohumeral periarthritis were participated. InterventionsIn the control group, the routine acupuncture was given, while in the trial group, the “scapular heat penetration” technique of acupuncture was adopted. The intervention was delivered once every two days, 3 treatments a week; and one course included 9 treatments. Before the 1st treatment and after the 9th treatment, the symptoms and physical signs were observed and recorded in each group. OutcomesPrimary outcome: the score of visual analogy scale (VAS) before treatment and after treatment completion. Secondary outcomes: the range of movement (ROM) of shoulder joint, the score of Japanese Orthopaedic Association (JOA) of shoulder joint and the infrared thermal imaging temperature around the shoulder. ResultsA total of 102 cases were collected, 72 cases of them were eligible and 5 cases were withdrawn. Sixty-seven cases were included in analysis. In the within-group comparison, VAS score, ROM and JOA score as well as the shoulder temperature were all ameliorated after 9 treatments in either the trial group or the control group, compared with those before treatment (P < 0.05). In the comparison between two groups, after 9 treatments, VAS score in the trial group was lower than that of the control group (P < 0.05); and the improvements in ROM and shoulder temperature in the trial group were better than those of the control group (P < 0.05). No adverse reactions were found in the two groups. ConclusionBoth the “scapular heat penetration” technique of acupuncture and the conventional acupuncture are effective on scapulohumeral periarthritis. But, regarding the improvements in pain, ROM of shoulder joint, the activity of daily life and shoulder temperature, the “scapular heat penetration” technique of acupuncture is superior to the conventional acupuncture. Registration numberChiCTR1900025505

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Acupuncture for chronic nonspecific low back pain in middle-aged and older patients: A randomized controlled trial: 针刺治疗中老年慢性非特异性下腰痛:一项随机对照临床试验

ObjectiveTo observe the specific effects of acupuncture in middle-aged and older patients with chronic nonspecific low back pain (CNSLBP). MethodsSixty-six patients with CNSLBP were randomized into the acupuncture or sham acupuncture groups (n = 33). In the acupuncture group, penetrating acupuncture with a long needle was delivered at Ashi points (painful/sensitive points), and the needles were manipulated by rotating technique after deqi till patients felt distending pain. The needles were retained in place for 30 min. Acupuncture was given three times per week for 4 weeks. In the sham acupuncture group, shallow needling was performed at non-meridian, non-acupoint, non-painful, and non-sensitive points. The needle retention and duration of treatment were the same as those of the acupuncture group before treatment, after the first intervention, after the whole treatment, and in follow-up visit (4 weeks after the whole treatment). The scores of the visual analog scale(VAS) for pain, range of movement (ROM) of the spine, and simplified Oswestry Dysfunction Index (ODI) were observed separately. ResultsCompared to the outcomes before treatment, the VAS score, spinal ROM, and simplified ODI score were lower after the first intervention, after treatment, and in follow-up visits in the acupuncture group, indicating the statistical significance (P < 0.05). When compared with the sham acupuncture group, the VAS score, spinal ROM, and simplified ODI score were significantly lower in the acupuncture group after the first intervention, after treatment, and in follow-up visit (P < 0.05). The total effective rate was 90.9% in the acupuncture group, which was significantly higher than that (75.76 %) in the sham acupuncture group (P < 0.05). ConclusionAcupuncture has a specific effect on CNSLBP in middle-aged and older patients and a superior effect on immediate analgesia.

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Moxibustion versus non-moxibustion for immune reconstitution inflammatory syndrome in patients with HIV: A 48-week prospective cohort study: 艾灸V.S.非艾灸治疗HIV感染者免疫重建炎性综合征:一项48周的前瞻性队列研究

ObjectiveTo assess the effects of moxibustion on immune reconstitution inflammatory syndrome (IRIS) in patients with acquired immune deficiency syndrome (AIDS) by tracking T-cell subsets over a 48-week prospective cohort study. MethodsPatients with AIDS who had low viral loads and weakened immune systems were divided into a moxibustion group and a non-moxibustion group. The non-moxibustion group received standard western treatment, including 48 weeks of antiretroviral therapy (ART). The moxibustion group received ART combined with moxibusion therapy, administered three times weekly. Each treatment lasted 10 weeks, with four courses completed over 48 weeks, separated by 2-week breaks. At different time points, plasma levels of CD4+, CD8+, CD45RA+, CD45RO+, CD4+CD28+, CD8+CD38+, and CD4+CD38+ were compared between the two groups. ResultsA total of 200 eligible patients were included and divided into two groups, with 100 in the non-moxibustion group and 100 in the moxibustion group. At Week 24, the CD4+T cell count was (180.71 ± 79.62) cells/μL in the non-moxibustion group and (218.22 ± 82.02) cells/μL in the moxibustion group. By Week 36, the counts were (204.83 ± 96.78) cells/μL and (239.35±81.90) cells/μL, respectively. At Weeks 24 and 48, the CD8+ T cell and CD45RO+ counts were higher in the moxibustion group than in the non-moxibustion group (P < 0.05). By Week 48, the CD45RA+ count was also higher in the moxibustion group (P < 0.05). At Week 24, the CD4+CD25+ count was lower in the moxibustion group than in the non-moxibustion group (P < 0.05). ConclusionMoxibustion enhances immune function in patients with AIDS and IRIS by regulating T-HIVcell subsets and increasing CD4+ and CD8+ T lymphocyte counts.

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Effects of acupuncture on iron metabolism in the hippocampus of the rats with cerebral ischemia-reperfusion injury based on the imbalance of iron homeostasis: 基于铁稳态的失衡探讨针刺对脑缺血再灌注损伤大鼠海马区铁代谢的影响

ObjectiveThis study aimed to observe the effects of acupuncture on iron metabolism in the hippocampus of rats with cerebral ischemia-reperfusion injury (CIRI) and to explore the mechanism of acupuncture on neural repair in CIRI rats. MethodsAfter general feeding for 3 days, 16 of 48 healthy Sprague–Dawley rats were selected according to a random number table to form a sham-occlusion group, and the models were prepared in the remaining rats. After successful modeling, the rats were randomized into model and acupuncture groups, with 16 rats in each group. The CIRI models were prepared using the modified Zea Longa suture-occlusion method. In the acupuncture group, the rats were fixed and acupuncture was delivered at “Shuigou” (GV26), “Dazhui” (GV14), and “Baihui” (GV20), and the needles were manipulated once every 15 min. In the sham-occlusion and model groups, rats were fixed without acupuncture. The intervention was performed for 30 min in each group, once every 12 h, seven times. The degree of neurological impairment was assessed by using the modified Garcia score. Cerebral blood flow (CBF) was monitored using a laser speckle blood flow imaging system. The cerebral infarction area ratio was measured using triphenyltetrazolium chloride staining. Ferric ion aggregation in brain tissue was noted using Prussian blue staining. The ferric ion and glutathione (GSH) contents of the hippocampal tissue on the ischemic side were detected using ferric ion and GSH kits. The protein expression of transferrin receptor 1 (TFR1), iron regulatory protein 2 (IRP2), and ferroportin (FPN) was detected via western blotting. Results(1) Before intervention, compared with the sham-occlusion group, the Garcia neurological score was significantly reduced in the model and acupuncture groups (both P < 0.01). After the intervention, compared with the sham-occlusion group, the Garcia neurological score in the model group decreased significantly (P < 0.01), and the score in the acupuncture group was elevated compared with the model group (P < 0.05). Compared to before the intervention, the Garcia neurological score increased after the intervention in the acupuncture group (P < 0.05). (2) Compared with the sham-occlusion group, in the model group, CBF was reduced, the infarct area was significantly enlarged, ferric ion aggregation increased in the hippocampus, the content of ferric ion increased, and that of GSH decreased significantly (both P < 0.01), while the protein expression of TFR1 and IRP2 was upregulated and that of FPN was downregulated (both P < 0.05). When compared with the model group, in the acupuncture group, CBF was increased, the infarct area was reduced (P < 0.01), the ferric ion aggregation was reduced in the hippocampus, the content of ferric ion decreased, and that of GSH increased significantly (P < 0.05, P < 0.01); the protein expression of TFR1 and IRP2 was downregulated and that of FPN was upregulated (both P < 0.05). ConclusionAcupuncture can alleviate CIRI, which may be related to the regulation of iron homeostasis-associated transferrin in the hippocampus, attenuation of ferric ion aggregation in hippocampal tissue, reduction of lipid peroxidation, and inhibition of ferroptosis.

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Meta-analysis of the efficacy of acupuncture and moxibustion in the treatment of polycystic ovary syndrome: 针灸治疗多囊卵巢综合征的 Meta 分析

Objective: To systematically evaluate the effectiveness of acupuncture and moxibustion as a complementary treatment for polycystic ovary syndrome(PCOS) and provide evidence for clinical treatment. Methods: The following seven databases were searched from the date of database creation to October 29, 2023: PubMed, Embase, the Cochrane Library, China Biology Medicine (CBM), Chinese National Knowledge Infrastructure (CNKI), WanFang, and VIP. The literature was screened according to the inclusion and exclusion criteria, data were extracted, quality was evaluated using the Cochrane Risk of Bias Assessment Tool, and a meta-analysis of the outcomes was performed using Review Manager 5.4 software. Results: A total of 20 researches were included and the test group was treated with modern medicine, acupuncture, electroacupuncture, warm needling, and thunder-fire moxibustion. The control group was treated with modern medicine, including clomiphene, Diane-35, letrozole, metformin, and progesterone. The meta-analysis showed that acupuncture and moxibustion as a complementary therapy for PCOS improved the ovulation and pregnancy rates and reduced the body mass index (BMI), luteinizing hormone (LH) levels, the LH/follicle-stimulating hormone (FSH) ratio, and ovarian volume; however, due to high heterogeneity, the differences regarding improvements in FSH, estradiol(E2), testosterone (T) and progesterone (P) levels could not draw a definite conclusion when compared with modern first-line drugs alone. Conclusion: Acupuncture and moxibustion as a complementary treatment for PCOS has good clinical efficacy; however, because of the relatively low quality of the included studies, the results may be biased. More high-quality clinical studies are needed to verify the results. The Prospero Registration number is CRD42022368304.

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A global review of acupuncture and moxibustion recommendations in guidelines/expert consensus for chemotherapy- and/or radiotherapy-induced nausea and/or vomiting: 放化疗所致恶心呕吐临床实践指南/专家共识中针灸推荐意见:一项全球综述

ObjectiveTo summarize and analyze the recommendations of acupuncture and moxibustion in the global guidelines/expert consensus of chemotherapy- and/or radiotherapy-induced nausea and/or vomiting, providing a basis for the development of clinical practice guidelines on acupuncture and moxibustion for chemotherapy- and/or radiotherapy-induced nausea and/or vomiting. MethodsWe systematically searched 7 comprehensive databases, 7 guideline libraries and 4 websites of societies/associations. The retrieval period was from the inception to April 1, 2023. Two researchers independently screened the literature, extracted data, and used the Scientific, Transparent, and Applicable Rankings (STAR) tool to evaluate the quality of guidelines/expert consensus that contained acupuncture and moxibustion recommendations, and analyzed acupuncture and moxibustion recommendations in guidelines/expert consensus and their evidence base. ResultsA total of 56 guidelines/expert consensus related to the prevention and treatment of chemotherapy- and/or radiotherapy-induced nausea and/or vomiting were included, and 22 guidelines/expert consensus contained acupuncture and moxibustion recommendations, with a total of 34 recommendations on acupuncture and moxibustion (27 supports, 4 neutrals, 3 objections). The STAR evaluation (excluding 1 patient version of guideline) showed that none of the guidelines/expert consensus was with high quality, 95.24% (20/21) with medium quality, and 4.76% (1/21) with low quality. Although there were many recommendations of acupuncture and moxibustion in the existing guidelines/expert consensus, there was great heterogeneity among the acupuncture and moxibustion treatment regimens. Moreover, most of the guidelines/expert consensus did not describe the details of acupuncture and moxibustion treatment regimens, such as acupuncture and moxibustion manipulation, acupoint selection, course and timing of treatment, which is difficult to guide the clinical practice of acupuncture and moxibustion. ConclusionDeveloping clinical practice guidelines of acupuncture and moxibustion for chemotherapy- and/or radiotherapy-induced nausea and/or vomiting according to the items of the STAR tool was urgent, so as to clarify the details of acupuncture and moxibustion regimens and provide standardized treatment regimens to guide the clinical practice of acupuncture and moxibustion.

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