Acupoint Injection Group Research Articles

Acupoint injection ameliorates Th1/Th2 imbalance through Toll-like receptor 4/activator protein-1 signal pathway and improves inflammatory response in rats with allergic rhinitis

To observe the effect of acupoint injection on serum T helper (Th)1/Th2 related cytokines, and the expression levels of Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88) and activator protein-1 (AP-1) of nasal mucosa in allergic rhinitis (AR) rats, so as to explore its mechanism underlying improvement of AR. Thirty-two SD rats were randomly divided into normal, model, non-acupoint injection and acupoint injection groups (n=8 in each group). The AR model was established by ovalbumin sensitization. In the acupoint injection group, "Yintang" (GV24+) and bilateral "Yingxiang" (LI20) were selected for injection of mixture solution of dexamethasone and lidocaine (0.05 mL/acupoint), once every 4 days for a total of 4 times. The non-acupoints, located at the midpoint between the "Houhai" and "Huantiao" (GB30) on the bilateral hips and the sites 5 cm inferior to the axillary were injected with the same dose of mixture solution as that in the acupoint injection group. The AR severity was assessed by cumulative quantification scoring methods (including the numbers of nose-catching and sneezes, and the amount of nasal secretions in 30 min). The pathological changes of nasal mucosa were observed by HE staining. The contents of immunoglobulin E (IgE), interleukin (IL)-4 and interferon (IFN)-γ in serum were detected by ELISA. The expressions of TLR4 and MyD88 in nasal mucosa was detected by immunofluorescence. The expression of AP-1 in nasal mucosa was detected by Western blot. Following modeling, the AR symptom score, serum IgE and IL-4 contents and expression of TLR4, MyD88 and AP-1 of nasal mucosa were significantly increased in the model group than those in the normal group (P<0.01), while the serum IFN-γ content was significantly decreased (P<0.01). Compared with the model group and non-acupoint injection group, the AR symptom score, the serum contents of IgE and IL-4 and the expressions of TLR4, MyD88 and AP-1 in nasal mucosa were significantly decreased in the acupoint injection group (P<0.01, P<0.05), while the serum IFN-γ content was significantly increased (P<0.01). H.E. staining of the nasal mucosa showed that most of the epithelium fell off, the lamina propria vessels expanded, the glands proliferated, and eosinophils and lymphocytes infiltrated in the model and non-acupoint injection groups, and those were significantly improved in the acupoint injection group. Acupoint injection can effectively improve allergic inflammation of the nose in AR rats, which may be related with its function in inhibiting the abnormal activation of TLR4/AP-1 signaling pathway and regulating the imbalance of Th1/Th2.

Effect and mechanism of acupoint injection on influenza A virus induced pneumonia in mice

To investigate the effect and mechanism of acupoint injection with 0.1% vitamin C+vitamin B complex solution (VC+VBCo) at "Tiantu" (CV 22), "Quchi" (LI 11) and "Zusanli" (ST 36) in mouse model of pneumonia induced by influenza A virus (A/PR/8/34 [H1N1], PR8). Sixty male ICR mice were randomized into 6 groups, i.e. control group, model group, acupoint injection group, intraperitoneal injection group, non-target point group and ribavirin group, 10 mice in each one. Except the control group, the pneumonia models were induced by slow nasal dripping PR8 virus in the other groups. On the 2nd day of experiment, VC+VBCo solution, 40 μL was injected at "Tiantu" (CV 22), "Quchi" (LI 11, left) and "Zusanli" (ST 36, left) in the acupoint injection group; VC+VBCo solution, 120 μL was injected intraperitoneally in the intraperitoneal injection group; VC+VBCo solution, 40 μL was injected at non-target acupoints (0.5 cm away from "Tiantu" [CV 22] to the left side, "Quchi" [LI 11, left] and "Zusanli" [ST 36, left]) in the non-target point group; and ribavirin solution, 120 μL was injected intraperitoneally in the ribavirin group. The intervention was delivered once daily, for consecutive 7 days. Three parallel experiments were undertaken. The mean death rate and survival time were assessed in each group, the body mass and lung index were compared among groups. Using HE staining, the morphology of lung tissue was observed; and with real-time fluorescence quantitative PCR, viral load in lung tissue was detected. The concentrations of inflammatory factors (tumor necrosis factor α [TNF-α], interleukin [IL]-1β, IL-10) were detected in lung tissue of each group using ELISA; and those of oxidative stress markers (superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], malondialdehyde [MDA]) were detected with chemiluminescence method. Compared with the control group, the body mass was decreased and lung index was increased in the model group (P<0.01). In comparison with the model group, body mass was increased in the acupoint injection group (P<0.05), lung index was reduced in the acupoint injection group the and ribavirin group (P<0.05); the mean death rate was decreased and the mean survival time prolonged in the mice of the acupoint injection group (P<0.01, P<0.05); and the mean death rate was reduced in the mice of the ribavirin group (P<0.05). In the model group, the alveolar structure was not integral, the alveolar septum was thickened, inflammatory cells were infiltrated and red blood cells exudated seriously (P<0.01). Compared with the model group, in the acupoint injection group and the ribavirin group, the alveolar structure was integral, the thickened alveolar septum was alleviated; and the infiltration of inflammatory cells and the exudation of red blood cells were reduced remarkably. The viral load was reduced in the mice of the ribavirin group when compared with the model group (P<0.01). Compared with the control group, the concentrations of TNF-α, IL-1β and MDA in lung tissue were increased and those of IL-10, SOD and GSH-Px were reduced in the model group (P<0.01). In the acupoint injection group and the ribavirin group, the concentrations of TNF-α, IL-1β and MDA were reduced in lung tissue and those of IL-10, SOD and GSH-Px were increased (P<0.05, P<0.01) when compared with the model group. Acupoint injection with VC+VBCo solution may alleviate inflammatory responses and oxidative stress in lung tissue of the PR8-induced pneumonia mice, improve survival rate and prolong the survival time in the case of no effect of the viral load.

Diffusion Tensor Imaging Evaluates Effects of Acupoint Injection at Zusanli (ST36) for Type 2 Diabetic Peripheral Neuropathy.

BackgroundAcupoint injection is a therapeutic method that combines acupuncture and Western medicine and shows good curative effects for neuropathies. This study aimed to explore the efficacy of acupoint injection for treating diabetic peripheral neuropathy (DPN) by magnetic resonance neuroimaging (MRN).Material/MethodsForty patients with DPN were randomly divided into an acupoint injection group (AI; n=20) and intramuscular injection group (MI; n=20). The AI group received an acupoint injection of mecobalamin at acupoint Zusanli (S36); the MI group received intramuscular injection of mecobalamin. The curative effect was evaluated by the Toronto Clinical Neuropathy Score and diffusion tensor imaging (DTI).ResultThe neuropathy scores of both groups decreased from baseline (AI 9.31±2.36; MI 9.34±2.54) to after the 2-week treatment (AI 7.12±1.87; MI 7.86±2.11); the differences were not significant. The fractional anisotropy (FA) value showed significant differences on the common peroneal nerve (AI 0.36±0.04; MI 0.31±0.05; P<0.05) and tibial nerve (AI 0.38±0.07; MI 0.34±0.06; P<0.05) after treatment. Likewise, apparent diffusion coefficient (ADC) values between groups showed significant differences for the common peroneal nerve (AI 1.44±0.17×10−3 mm2/s; MI 1.61±0.20×10−3 mm2/s; P<0.05) and tibial nerve (AI 1.54±0.22×10−3 mm2/s; MI 1.60±0.17 10−3 mm2/s; P<0.05).ConclusionsPatients with DPN showed lower nerve FA and higher ADC in DTI-MRN. The acupoint injection of mecobalamin could treat DPN and repair the damaged nerves, which was shown by elevated FA and lowered ADC. Our study provides clinical evidence for the application of acupoint injection therapy and the evaluation of DPN by MRN.

Synergistic effect of acupoint injection and moxibustion or catgut embedding or acupuncture on symptoms and expression of Th1/Th2 related cytokines in nasal mucosa of rats with allergic rhinitis

To observe the effect of moxibustion, catgut embedding and acupuncture on allergic symptoms and expression of interferon-γ (IFN-γ) and interleukin-4 (IL-4) of nasal mucosa in rats with allergic rhinitis (AR) based on acupoint injection, so as to explore their synergistic effect and related mechanism in relieving AR. SD rats (half male half female) were randomly divided into normal control, model, acupoint injection (AI), AI+moxibustion, AI+catgut embedding and AI+acupuncture groups, with 8 rats in each group. The AR model was established by intraperitoneal injection of ovalbumin suspension (once every other day for 7 times), and intranasal drop of 0.5% ovalbumin solution (once daily for 7 days). After successful modeling, rats of the AI group received injection of a mixture solution of equal proportion of 1% lidocaine, dexamethasone and transfer factor into "Yingxiang" (LI20) and "Yintang" (EX-HN3) once every 4 days, 4 times altogether. Mild moxibustion or catgut embedment or manual acupuncture was applied to bilateral "Feishu" (BL13) and "Zusanli" (ST36). Both moxibustion (20 min every time) and acupuncture (with the needles retained for 30 min every time) were conducted once daily for 14 times, and catgut embedding was conducted once a week, twice altogether based on acupoint injection. The rats' nasal allergic reaction score (symptom score, 1-3 points) was given according to the times of nose scratching and sneezing, and the running nose state in 30 min, and histopathological changes of nasal mucosa were observed by H.E. staining. The expression levels of IFN-γ and IL-4 in the nasal mucosa were detected by immunohistochemistry and Western blot, separately. Compared with the normal group, the symptom score and the expression of IL-4 positive cells and protein in nasal mucosa were significantly increased (P<0.05), while the expression of IFN-γ positive cells and protein were considerably decreased in the model group (P<0.05). In comparison with the model group, the symptom score and the expression of IL-4 positive cells and protein were obviously decreased (P<0.05), while the expression of IFN-γ positive cells and protein were remarkably increased in the 4 treatment groups (P<0.05). The effects of AI+moxibustion, AI+catgut embedment, AI+acupuncture were signi-ficantly superior to those of simple AI in up-regulating the expression of IFN-γ positive cells and protein and in down-regulating the expression of IL-4 positive cells and protein (P<0.05). Both the symptom score and the expression of IL-4 were notably lower in the AI+moxibustion group than in the AI+catgut embedment and AI+acupuncture groups (P<0.05), whereas the expression of IFN-γ was apparently higher in the AI+moxibustion group than in the other 3 treatment groups (P<0.05). No significant differences were found between the AI+catgut embedment and AI+acupuncture groups in the levels of symptom score, IFN-γ and IL-4 expressions (P>0.05). Moxibustion or catgut embedment or acupuncture and AI have a synergistic effect in relieving symptoms of AR rats, which may be related to their function in regulating the expression levels of nasal IFN-γ and IL-4 proteins. The therapeutic effect of moxibustion is obviously superior to those of both acupuncture and catgut embedment.

Acupoint injection combined with Vitalstim electrical stimulation for post-stroke dysphagia:a randomized controlled trial

To observe the clinical efficacy of acupoint injection combined with Vitalstim electrical stimulation for post-stroke dysphagia. A total of 98 patients with dysphagia after first stroke were randomized into an acupoint injection group (35 cases, 2 cases dropped off), an electrical stimulation group (31 cases, 3 cases dropped off) and a combination group (32 cases, 3 cases dropped off). Injection of mecobalamin into Tunyan point, Vitalstim electrical stimulation and the combination of injection of mecobalamin into Tunyan point and Vitalstim electrical stimulation were applied respectively in the 3 groups, once a day, 10 times as one course, 2 courses were required. Before and after treatment, the tongue muscle thickness and video fluoroscopic swallowing study (VFSS) score were observed in the 3 groups. After treatment, the tongue muscle thickness was decreased (P<0.05), the VFSS scores were increased (P<0.05) compared with before treatment in the 3 groups, and the variation of tongue muscle thickness and VFSS score in the combination group was greater than the acupoint injection group and the electrical stimulation group (P<0.05). Both acupoint injection of mecobalamin and Vitalstim electrical stimulation have therapeutic effect on dysphagia after stroke, and the two have synergistic effect.

A systematic review and meta-analysis of neostigmine for urinary retention after surgeries.

BackgroundThe aim of this research is to analyze the efficacy of neostigmine in the treatment of postoperative urinary retention (POUR).MethodsIn this research, we screened multiple databases including PubMed, EMBASE, Web of Science, and Chinese National Knowledge Infrastructure (CNKI). After a systematic search process, data extraction was conducted. Review Manager 5.2 was adopted for meta-analysis, sensitivity analysis, and bias analysis.ResultsAfter searching for articles, 20 eligible trials including 1,850 patients after surgery were extracted. Our results suggested that the neostigmine group had a higher effective rate for urinary retention than the Chinese traditional and physical therapy group (OR =7.47, 95% CI: 4.10–13.59, overall effect P<0.001). Further subgroup analysis showed that neostigmine acupoint injection was better than neostigmine intramuscular injection. Time to first voiding in the neostigmine acupoint injection group was shorter than that in the neostigmine intramuscular injection group (MD =–81.92, 95% CI: –130.13 to –33.70, overall P<0.001, I2=99% with random effects model). Furthermore, neostigmine acupoint injection improved urine excretion (MD =243.40, 95% CI: 201.62–285.18, overall P<0.0001) and reduced the residual urine volume (MD =–41.31, 95% CI: –58.05 to –24.58, overall P<0.001, I2=75% with random effects model). The results of the sensitivity analysis and publication bias showed that this research was robust and had little publication bias.DiscussionOur meta-analysis results suggest that neostigmine can effectively improve the symptoms of POUR and neostigmine acupoint injection may achieve a better therapeutic effect.

Combined spinal-epidural anesthesia with acupoint injection for labor anesthesia reduces IL-1β/IL-10 ratio in maternal peripheral blood, umbilical cord blood and improves the labor outcomes: A prospective randomized controlled trial

BackgroundThis study aimed to investigate the effects of combined spinal-epidural anesthesia (CSEA) with acupoint injection (AI) on the maternal-fetal expression of interleukin-1β (IL-1β), interleukin-10 (IL-10), analgesia effect, and labor outcomes. MethodsA total of 360 healthy primiparas were randomized into the CSEA+AI group, the CSEA group, the AI group, and the control group (n = 90, each group) according to the labor analgesia methods. ResultsCompared to the CSEA group, the CSEA+AI group had significantly lower visual analog scale (VAS) scores, adverse events, dose of ropivacaine/sufentanil, and shorter labor durations. The IL-1β/IL-10 ratio in maternal peripheral blood and umbilical cord blood was reduced in the CSEA+AI group compared with the CSEA group. ConclusionThe combination of CSEA and AI can reduce the ratio of IL-1β/ IL-10 in maternal peripheral blood and umbilical cord blood, which can effectively relieve labor pain.

Clinical observation on treatment of functional dyspepsia by injection of vitamin B1 into Zusanli (ST36) and Hegu (LI4)

To observe the effect and safety of injection of vitamin B1 into Zusanli (ST36) and Hegu (LI4) in the treatment of functional dyspepsia (FD). A total of 100 FD patients were equally divided into medication group and acupoint injection group (n=50/group) according to a random number table. Patients in the medication group were ordered to take mosapride citrate tablets (5 mg) orally 30 min before each of the three meals, while those in the acupoint injection group received injection of vitamin B1 into ST36 and LI4, once every other day, three times a week. One week later, the clinical symptom scores, total effective rates, serum gastrin (GAS) and plasma motilin (MTL) contents, and gastric emptying rates between the two groups were compared, followed by the observation of adverse reactions. Two weeks' follow-up survey was conducted after the end of treatment, and the clinical symptom scores and total effective rates of the two groups were further compared. Compared with the data before treatment in the same one group, the clinical symptom scores and serum GAS contents of post-treatment as well as the follow-up symptom scores were all significantly decreased (P<0.05，P<0.01), while the plasma MTL levels and gastric emptying rates were obviously increased in both groups (P<0.01). Comparison between the two groups showed that the clinical symptom score, serum GAS content after the treatment and follow-up symptom score were considerably lower (P<0.01), but the total effective rate, plasma MTL, gastric emptying rate after the treatment and total effective rate of follow-up notably higher in the acupoint injection group than those in the medication group (P<0.01,P<0.05). Injection of vitamin B1 into ST36 and LI4 is effective in improving symptoms of PD patients, which may be related to its functions in regulating the levels of GAS and MTL in blood, and facilitating gastrointestinal motility.

Efficacy of Ropivacaine injection at acupoints for labor analgesia and its effect on breastfeeding and serum prolactin

To investigate the efficacy of acupoint injection of Ropivacaine for labor analgesia and its effect on breastfeeding and prolactin secretion. A total of 80 primipara who asked to receive labor analgesia were randomized into epidural analgesia group (n＝35) and acupoint injection group (n＝36), and other 36 primipara who refused to receive labor analgesia were subjected to the control group. The labor analgesia began to be performed when the puerpera's uterine orifice opened about ≥3 cm (the first stage of labor), including puerpera controlled epidural analgesia (PCEA, Sufentainil ＋ 0.1% Ropivacaine hydrochloride, 5 µg/mL at L3-L4 interspace, till the birth of fetus) or acupoint injection of Ropivacaine (0.2%, 1 mL/acupoint) at bilateral Hegu (LI4) and Sanyinjiao (SP6). The delivery situations such as the duration of labor, and number of cases who used oxytocin, obstetric-forceps-aided delivery, cesarean delivery were recorded. The serum prolactin concentration was assayed by using ELISA. The visual analogue scale (VAS) scores at the time points of T0 (about 3 cm widening of the orifice of uterus and before performing analgesia), T1 (30 min after labor analgesia), T2(about 10 cm widening of the orifice of uterus) and T3(coming out of fetal head). The duration of labor, ratio of use of oxytocin, onset time of breastfeeding, and times of breastfeeding within 24 postpartum hours were recorded accordingly. The VAS scores at time-points of T1, T2 and T3 were significantly lower in both epidural analgesia and acupoint injection groups in comparison with their own T0 and the control group (P<0.05), and were also considerably higher in the acupoint injection group than in the epidural analgesia group (P<0.05). The duration of the 2nd stage of labor (from complete opening of the uterus orifice to complete birth of the fetus) was significantly longer, (P<0.05) and the number of oxytocin-using puerpera was obviously bigger in the epidural analgesia group than in the control group (P<0.05). After partum, the 1st breastfeeding time was obviously earlier and the frequency of breastfeeding notably increased in both epidural analgesia and acupoint injection groups than in the control group (P<0.05), the serum prolactin content was remarkably higher in the acupoint injection group than in the epidural analgesia group (P<0.05). No significant differences were found between the acupoint injection and the control groups in the duration of the 1st and 2nd stages of labor, and in the numbers of oxytocin-using puerpera, obstetric forceps-aided birth and cesarean delivery (P>0.05), and between the epidural analgesia group and control group in the serum prolactin levels (P>0.05)．. Injection of Ropivacaine at LI4 and SP6 is effective for labor analgesia and raising prolactin level, and favorable to breastfeeding in the early postpartum period.

Clinical observation on acupoint injection of Chuankezhi injection plus acupoint sticking in treating bronchial asthma

To observe the clinical efficacy of acupoint injection of Chuankezhi plus acupoint sticking treatment for bronchial asthma, and provide clinical evidence for the synergy of the two therapies, and explore their synergistic mechanism. A total of 70 patients were randomized into an acupoint injection plus sticking group and an acupiont sticking group by the random number table, with 35 cases in each group. The treatment took place in July and August. The acupoint injection plus sticking group was treated with acupoint injection and acupiont sticking, while the acupiont sticking group was treated only with acupiont sticking therapy. The treatment course was 4 weeks. After the treatment, the scores of symptom scale in the two groups before treatment, 3 months and 6 months after the treatment were observed. During the treatment, there were 5 dropouts in the acupoint injection plus sticking group with 30 cases remained, and 4 dropouts in the acupiont sticking group with 31 cases remained. Before the treatment, there was no significant difference in the total scores of symptom scale between the two groups. Three months after the treatment, the total scores of symptom scale of both groups were lower than those before treatment, and the intra-group differences were statistically significant (both P 0.05). Six months after the treatment, the total scores of symptom scale in both groups were lower than those before treatment, and the intra-group differences were statistically significant (both P<0.05), so were the differences in the difference values of the scores before treatment and 6 months after treatment (both P<0.05). Acupoint injection of Chuankezhi plus acupoint sticking or acupoint sticking alone both can improve the symptoms of patients with bronchial asthma. Acupoint injection of Chuankezhi plus acupoint sticking has a higher total effective rate than single acupoint sticking therapy.

Acupoint injection improves allergic rhinitis by balancing Th17/Treg in allergic rhinitis rats

To observe the effect of acupoint injection on expression of fork head/winged helix protein 3 (Foxp3), retinoic acid-related orphan receptor γt (RORγt) in nasal mucosa and serum interleukin-17 (IL-17) level in allergic rhinitis (AR) rats, so as to explore its mechanism underlying improvement of AR in terms of balancing Th17/Treg. Thirty-two SD rats (half male and half female) were randomized into normal control, AR model, acupoint injection and non-acupoint injection groups (n＝8 in each group). The AR model was established by ovalbumin sensitization. In the acupoint injection group, "Yintang" (EX-HN3) and bilateral "Yingxiang"(LI20) were selected for injection of mixture solution of dexamethasone (DEX) and transfer factor and lidocaine (0.1 mL/acupoint), once every 3 days for a total of 4 times. The non-acupoints, located at the mid-point between the "Houhai" (GV1) and "Huantiao"(GB30) on the bilateral hips and the sites 5 cm inferior to the axillary were injected with the same dose of mixture solution as that in the acupoint injection. The AR severity was assessed by cumulative quantification scoring methods (including the numbers of nose-catching and sneezes, and the amount of nasal secretions in 30 min). The expressions of Foxp3 and RORγt in the nasal mucosa were detected by immunohistochemistry. The serum IL-17 content was detected by enzyme linked immunosorbent assay (ELISA)．. The AR symptom score and serum IL-17 content were significantly higher in the AR model group than those in the normal control group (P<0.05), and significantly down-regulated in the acupoint injection group (not in the non-acupoint group) relevant to the AR model group (P<0.05). Following modeling, the expression levels of nasal Foxp3 protein was significantly down-regulated while that of RORγt protein markedly up-regulated in the AR model group relevant to the normal control group (P<0.05), indicating an imbalance between Foxp3 and RORγt activity(P<0.05). After EA intervention, the increased expression of Foxp3 and the down-regulated expression of RORγt were revised in the acupoint injection group (P<0.05) but not in the non-acupoint group (P>0.05). The percentage of the Foxp3 positive cells and the ratio of Foxp3/RORγt were negatively correlated with the AR symptom score(P<0.05), the expression of RORγt and the content of IL-17 were positively correlated with the symptom score (P<0.05)．. Acupoint injection is able to improve symptoms of RA rats, which may be related with its function in up-regulating the level of nasal mucosal Foxp3 and suppressing the levels of nasal RORγt and serum IL-17 to correct the imbalance of Th17/Treg.

Neuroprotective effect of surround needling combined with acupoint injection on acute herpetic neuralgia

To explore the effect and mechanism of surround needling combined with acupoint injection on acute herpetic neuralgia (AHN). Ninety-nine patients with T6-T10 segment AHN were randomly divided into 3 groups, 33 cases in each group, including 2 cases dropped off in the surround needling group, 4 cases dropped off in the acupoint injection group, and 3 cases dropped off in the combined group. Oral valacyclovir was given in each group, 0.3 g each time, 2 times a day for 10 days. Oblique insertion of needle used at ashi points around the herpes in the surround needling group, and continuous wave was stimulated to tolerance for 20 min; the same acupoints were selected as the surround needling group, stimulated with the mixture injection of mecobalamin and lidocaine in the acupoint injection group; After the surround needling, acupoint injection was performed in the combined group. The treatment was given once a day, 14 times for a course, and one course was needed in all groups. The skin healing conditions (blistering, crusting, and dislocation time) of each group were compared after treatment. The pain scores, pain area and quality of life scores in each group were observed before and after treatment. The levels of neuron specific enolase (NSE), substance P (SP) and calcitonin gene-related peptide (CGRP) in the local blister fluid were measured before and after treatment in all groups. The blistering, crusting and dislocation time in the combined group were earlier than the other two groups (all P<0.05). The pain score and pain area in the each group were significantly lower than those before treatment, and the quality of life score was significantly higher than that before treatment (all P<0.05). The improvements of pain score and quality of life score in the combined group were more obvious than the other two groups (all P<0.05). After treatment, the levels of NSE, SP and CGRP in the local blister fluid in each groups were significantly lower than those before treatment (all P<0.05). The indexes in the combined group were significantly lower than those in the other two groups (all P<0.05). Both surround needling and acupoint injection have an adjuvant effect on AHN. The combination of the two is better, the skin is healed quickly, the analgesia is significant, and the contents of local NSE, SP and CGRP are significantly decreased. The mechanism of action is to exert neuroprotective effects.

Short-term and long-term therapeutic effects of internal heat-type acupuncture needle therapy combined with acupoint injection of O3 for post-stroke shoulder pain

To observe the short-term and long-term therapeutic effects of internal heat-type acupuncture needle (IHTAN) therapy combined with acupoint injection of O3for post-stroke shoulder pain in apopletic patients. Patients with post-stroke shoulder pain were divided into warm needle moxibustion ＋ acupoint injection group (29 cases), acupoint injection group (30 cases) and IHTAN＋acupoint injection group (29 cases) according to the random number table. For acupoint injection, O3 solution (3 mL, 30 µg/mL) was injected into Jianyu (LI15), Jianliao (SJ14), Jianzhen (LI9), Binao (LI14) and Ashi points (4-6 acupoints every time) on the affected side, once every other day for 4 weeks. For warm needle moxibustion, the above mentioned acupoints were stimulated with filiform needles attached with an ignited moxa-stick, once every other day for 4 weeks. For IHTAN, the internal warmth controllable acupuncture needles were inserted into the above mentioned acupoints on the affected side, and then connected to an internal heat acupuncture apparatus for stimulating the acupoints at 42 ℃， 20 min every time, once a week, for 4 weeks. The severity of shoulder pain was assessed by using visual analogue scale (VAS, 0-10 points), the upper limb joint motion function evaluated using Fugl-Meyer assessment scale (FMA, 0－66 points), and the ability of daily living activities (ADL) evaluated using Barthel index (0－100 points) at the ends of the 2nd and 4th week as well as the 6th month after the treatment. If the shoulder pain disappeared or basically disappeared, it was considered to be healed. If the pain was relieved, it was considered to be effective. Otherwise, it was considered to be ineffective. At the ends of the 2nd and 4th week as well as the 6th month after the treatment, the VAS scores of the IHTAN＋acupoint injection group were significantly lower than those of the warm needle moxibustion＋acupoint injection and acupoint injection groups (P<0.05), and the FMA and ADL scores were significantly higher in the IHTAN＋acupoint injection group than in the other two groups (P<0.05). No significant differences were found between the warm needle moxibustion＋acupoint injection and the acupoint injection groups in the scores of VAS, FMA and ADL (P>0.05). Of the 29, 30 and 29 cases in the warm needle moxibustion＋acupoint injection, acupoint injection and IHTNA＋acupoint injection groups, 1, 0 and 7 cases at the 2nd week, 3, 2 and 12 cases at the 4th week, 4, 2 and 15 cases at the 6th month were cured; 15, 14 and 16 cases at the 2nd week, 17, 17 and 13 cases at the 4th week, and 18, 18 and 12 cases at the 6th month experienced marked improvement; 13, 16 and 6 cases at the 2nd week, 9, 11 and 4 cases at the 4th week, 7, 10 and 2 cases at the 6th month had no apparent changes in their shoulder pain severity, with the total effective rates at the 4th week and 6th month being 68.97% and 75.86%, 63.33% and 66.60%, and 86.21% and 93.10%, respectively. The internal heat-type acupuncture needle therapy combined with O3 acupoint injection has obvious short-term and long-term therapeutic effects for post-stroke shoulder pain and is obviously superior to warm needle moxibustion＋ acupoint injection and simple acupoint injection in relieving shoulder pain and improving upper limb motion function.

Clinical effect of acupoint injection of salmon calcitonin in the treatment of senile osteoporosis

Objective To observe the clinical effect of acupoint injection of salmon calcitonin in the treatment of senile osteoporosis. Methods From February 2016 to July 2017, 136 elderly patients with osteoporosis admitted to Wenzhou Hospital of Traditional Chinese Medicine were included.The patients were randomly divided into two groups, with 68 cases in each group.The acupoint-injection group was given 50IU salmon calcitonin on day 1, day 2 100IU, one time per day, continuously used for 15 days for a course of treatment, and with an interval of 90 days, and repeat the course of treatment.The patients were given 0.9% sodium chloride diluted to 2mL, inject 0.5mL into bilateral Shenshu and Zusanli these two points.The intramuscular injection group was given the same dose of salmon calcitonin gluteus maximus injected intramuscularly.At the same time, both two groups were given calcium Erqi D tablets one tablet a day, alendronate once a week, each time 70mg fasting taken orally.The type Ⅰ collagen β-CTx, PINP, NBAP, femoral neck, femur trochanter, lumbar (L1-L4) lumbar BMD and osteoporosis symptom score before and after treatment were compared. Results After treatment, the NBAP and BMD of the two groups were significantly higher than those before treatment (all P<0.05), and the β-CTx, PINP and symptoms scores were lower than before treatment (P<0.05). After treatment, NBAP in the acupoint injection group was (32.36±3.03)μg/L, which was higher than (29.66±3.20)μg/L in the intramuscular injection group(t=10.477, P<0.05). The β-CTx and PINP in the acupoint injection group were decreased to (0.10±0.05)μg/L and (28.78±5.23)μg/L, which were significantly lower than those in the intramuscular injection group[β-CTx(0.20±0.05)μg/L, PINP(35.77±6.49)μg/L(t=5.983, 2.662, all P<0.05)]. After treatment, the BMD of the femoral neck, femur trochanter and lumbar vertebra (L1-L4) in the acupoint injection group were (0.690±0.032)g/m2, (0.620±0.010)g/m2 and (0.822±0.012)g/m2, respectively, which were higher than those in the intramuscular injection group[(0.652±0.012)g/m2, (0.572±0.022)g/m2 and (0.801±0.011)g/m2(t=5.055, 6.133, 1.956, all P<0.05)]. After treatment, the improvements of TCM syndromes such as weakness in the waist and knees, tinnitus and deafness, loss of appetite, release of teeth, relaxation of two feet, weak tongue, weak pulse in the acupoint injection group were better than those in the intramuscular injection group (all P<0.05). Conclusion The acupoint injection of salmon calcitonin at Zusanli and Shenshu points is more effective than the intramuscular injection in the treatment of senile osteoporosis.It can significantly increase the serum NBAP, decrease the serum β-CTx, PINP, improve the BMD and improve the patients' clinical symptoms, which means acupoint injection is a safe and effective way to treat senile osteoporosis. Key words: Osteoporosis; Acupuncture points; Shenshu; Tsusanli; Injections, intramuscular; Salmon calcitonin; Aged; Comparative study

Acupoint injection of BMSCs combined with Chinese herbs for capillary density in ischemic hind limb of diabetes mellitus rats

To observe the effect of acupoint injection of bone mesenchymal stem cells (BMSCs) combined with Chinese herbs of benefiting qi for activating blood circulation for capillary density and arterioles density in skeletal muscle in ischemic hind limb of diabetes mellitus (DM) rats. A total of 80 rats were randomized into a normal sham operation group (10 rats) and a model group (70 rats). Disposable intraperitoneal injection of streptozotocin (STZ, 50.0 mg/kg) was used to establish DM model, and the rats in the model group were randomized into 7 subgroups, 10 rats in each one. The subgroups were the DM sham operation group, DM ischemic group, Chinese herb group (intragastric herbs of benefiting qi for activating blood circulation), local injection group (BMSCs local injection), local injection + Chinese herb group (BMSCs local injection combined with intragastric herbs of benefiting qi for activating blood circulation), acupoint injection group (BMSCs acupoint injection), acupoint injection + Chinese herb group (BMSCs acupoint injection combined with intragastric herbs of benefiting qi for activating blood circulation). The local injection was phosphate buffer (PBS) injection at the equidistant 5 points along the line between the ischemic tissue and the normal tissue a time. The acupoints were "Sanyinjiao" (SP 6), "Zhaohai" (KI 6), "Huantiao" (GB 30), "Housanli" (ST 36) and "Yanglingquan" (GB 34). 100 μL BMSCs with 1×107/mL was totally injected at the above acupoints for one rat, 20 μL an acupoint. 1.5 kg/L Chinese herbs were applied by intragastric administration, including 120 g Radix Astragali, 120 g Codonopsis, 48 g Radix Glycyrrhiza, 120 g Angelica sinensis, 120 g Blood Rattan, 48 g Achyranthes bidentata. Intragastric distilled water was used in the other non-Chinese herb groups. The expressions of α-smooth muscle actin (α-actin), latelet endothelial cell adhesion molecule (CD31) and von willebrand factor (vWF) in the skeletal muscle were detected with immunohistochemical SP two-step method. Twenty-one days after intervention, the expressions of α-actin and CD31 on the operation hind limb were higher than those on the healthy hind limb in all the groups, except the Chinese herb group (P<0.05，P<0.01). The vWF expressions on the operation side were lower than those on the healthy side in the Chinese herb group, the local injection group, the local injection + Chinese herb group and the acupoint injection + Chinese herb group (P<0.05, P<0.01). The α-actin expression on the operation side in the acupoint injection + Chinese herb group was higher than those in the normal sham operation group, DM sham operation group, the DM ischemic group and the local injection group (P<0.05, P<0.01). The CD31 expressions in the acupoint injection group, the acupoint injection + Chinese herb group, local injection + Chinese herb group were higher than those in the normal sham operation group, DM sham operation group and DM ischemic group (P<0.05, P<0.01). The CD31 expression in the acupoint injection + Chinese herb group was higher than those in the Chinese herb group and the local injection group (both P<0.05). The vWF expressions in the local injection + Chinese herb group, the acupoint injection group and the acupoint injection + Chinese herb group lower than those in the DM sham operation group and the DM ischemic group (P<0.05, P<0.01). schemia increases the expressions of the vascular density related factors of α-actin and CD31. It is more obvious for the increasing expressions of α-actin and CD31, and decreasing expression of vWF with the interventions of simple BMSCs injection and simple Chinese herbs of benefiting qi for activating blood circulation, especially with the combination of the above tow methods. It is indicated that acupoint injection of BMSCs combined with Chinese herbs of benefiting qi for activating blood circulation can improve the angiogenesis of ischemic tissue.

Acupoint Injection at "Yingxiang"(LI 20) and "Yintang"(GV 29) May Relieve Nasal Allergic Symptoms Possibly by Down-regulating Expression of Histamine Receptor H 1 and H 4 in Nasal Mucosa of Allergic Rhinitis Rats

To observe the effect of acupoint injection at "Yingxiang"(LI 20) and "Yintang"(GV 29) on nasal allergic reactions and the expression of histamine receptor H 1 and H 4 in nasal mucosa of allergic rhinitis (AR) rats, so as to reveal its mechanism underlying improvement of AR. SD rats were randomized into normal, model, non-acupoint injection and acupoint injection groups (n=8 in each). The AR model was established by intraperitoneal (i.p.) injection of mixture of ovalbumin, aluminium hydroxide gel and normal saline (once every other day, for 7 times), and nasal drip of ovalbumin (on the following day of i.p.for 7 days). The mixture solution of lidocaine, dexamethasone (DXM) and transfer factor (0.1 mL/acupoint or non-acupoint) was injected into bilateral LI 20 and GV 29 in the acupoint injection group, or into the non-acupoints (about 5 cm below the armpit on both sides, and the middle point between the left "Houhai"[GV 1] and "Huantiao"[GB 30]), on the 1st , 5th, 9th, and 13th day after modeling. Symptoms of sneezing, nasal discharge, nose-rubbing, etc. were scored after the treatment. The expression levels of H1 R and H4 R proteins and genes in the nasal mucosa tissue were determined using immunohistochemistry and quantitative real-time PCR, respectively. Compared with the normal group, the symptom score and the expression levels of H1 R, H4 R proteins and genes in nasal mucosa were significantly increased in the model group (P<0.05). After acupoint injection for 4 times, the symptom score and the expression levels of H1 R, H4 R proteins and mRNAs were significantly down-regulated in the acupoint injection group relevant to the model group (P<0.05). There were no significant differences between the non-acupoint and the model groups in the abovementioned indexes (P>0.05), suggesting a specificity of the effect of acupoint injection. Acupoint injection can relieve the allergic symptoms of AR rats, which may be related to its effects in down-regulating the over expression of H1 R and H4 R proteins and genes in the nasal mucosa.

Zusanli (ST36) Acupoint Injection with Neostigmine for Paralytic Postoperative Ileus following Radical Gastrectomy for Gastric Cancer: a Randomized Clinical Trial.

Background: The Zusanli (ST36) acupoint has been associated with treatment of various gastrointestinal conditions. There have been no studies of acupuncture therapy for paralytic postoperative ileus (PPOI).Materials and methods: Patients with PPOI following gastrectomy for gastric cancer were randomized to receive ST36 acupoint injection with neostigmine, gluteal intramuscular injection with 1.0 mg neostigmine, ST36 acupuncture alone, or standard therapy. The main outcome was the effectiveness rate for recovery of peristalsis. Secondary outcomes were time to bowel sound recovery, time to first flatus, and time to first defecation. Tertiary outcomes were drug-related adverse events, including abdominal pain, diarrhea, nausea, vomiting, tearing, delirium, seizure, and anxiety.Results: ST36 acupoint injection with neostigmine and gluteal intramuscular injection of neostigmine gave a higher rate of peristalsis recovery, and the ST36 acupoint injection group showed significantly higher total effectiveness rate than that of the intramuscular injection group. These interventions gave significantly shorter times to bowel sound recovery, shorter times to first flatus and first defecation compared with ST36 acupuncture and standard post-operative therapy (P < 0.01). ST36 acupoint injection group gave shorter time to bowel sound recovery, shorter time to first flatus and first defecation than those of the intramuscular injection group (P < 0.01). Drug-related adverse events in the intramuscular injection group were more serious than in the ST36 acupoint injection group (P < 0.05).Conclusion: ST36 acupoint injection with neostigmine is safe and effective for treatment of PPOI.

Effect of moxibustion combined with autohemotherapy of acupoint injection for life quality of allergic rhinitis with qi deficiency of lung and spleen:a randomized controlled trial

To observe the effects of moxibustion combined with autohemotherapy of acupoint injection and simple moxibustion for allergic rhinitis(AR) with qi deficiency of lung and spleen and to explore its mechanism. By random number table,75 patients who matched the criteria were assigned into a moxibustion combined with autohemotherapy of acupoint injection group(a combination group,37 cases) and a moxibustion group(38 cases). In the combination group,moxibustion was used at bilateral Yingxiang(LI 20) and injection bila-teral Feishu(BL 13),Pishu(BL 20) and Zusanli(ST 36). In the moxibustion group,moxibustion was applied bilaterally at all the above acupoints. Acupoint injection was given twice a week,and moxibustion once a day,seven days as a course. The patients were observed for four courses and followed up half a year after treatment. Rhinoconjunctivitis quality of life questionnaire(RQLQ) was compared before and after treatment and at follow-up. The short-term and long-term effects as well as the changes of interferon-γ(IFN-γ),interleukin-4(IL-4) and immunoglobulin E(IgE) were observed in the two group. After treatment,the obviously effective rate of the combination group was 75.68%(28/37),which was higher than 52.63%(20/38) of the moxibustion group(P<0.05). But at follow-up, the obviously effective rate of the moxibustion group was 47.37%(18/38),which was better than 24.32%(9/37) of the combination group(P<0.05). Life quality of the two group in all aspects after treatment and at follow-up were apparently improved compared with the baseline(P<0.01,P<0.05). After treatment,the life quality,sleep condition,non nasal-eye symptoms,behavior issue of the combination group were superior to those of the moxibustion group(all P<0.05),and at follow-up,the above outcomes,the eye and nasal symptoms as well as emotional response of the mo-xibustion group were better(all P<0.05). There was statistical significance in the two group about serum IFN-γ,IgE,IL-4 before and after treatment(P<0.01,P<0.05),and significance existed between the two groups(P<0.05). Moxibustion combined with autohemotherapy of acupoint injection can effectively improve the short-term quality of life of AR with qi deficiency of lung and spleen. The mechanism may be related to balancing the immune response of Th1 and Th2.

Postmenopausal osteoporosis treated with acupoint injection of salmon calcitonin:a randomized controlled trial

To verify the clinical efficacy on postmenopausal osteoporosis treated with acupoint injection of salmon calcitonin. Ninety patients of postmenopausal osteoporosis were randomized into three groups, 30 cases in each one. In the acupoint injection group, Shenshu (BL 23) and Zusanli (ST 36) were selected bilaterally. The injection 4 mL was prepared with salmon calcitonin 100 U (1 mL) and 0.9% sodium chloride injection. Each acupoint was stimulated with the injection, 1 mL. In the blank group, 0.9% sodium chloride injection was applied to bilateral Shenshu (BL 23) and Zusanli (ST 36), 1 mL at each acupoint. In the intramuscular injection group, salmon calcitonin 100 U was injected at gluteus maximus. The treatment was given once every two days in the patients of the three groups and lasted for 2 months. The levels of bone mineral density (BMD), bone alkaline phosphatase (NBAP), C-terminal telopeptides of typeⅠcollagen (CTX), urine calcium/creatinine (Ca/Cr) and the symptom score of osteoporosis were detected in the patients of the three groups before and after treatment. In the patients of the three groups, NBAP and BMD in lumbar vertebra after treatment were higher than those before treatment (all P<0.05); CTX, Ca/Cr and symptom score were lower than those before treatment (all P<0.05). After treatment, NBAP was (32.7±2.5) μg/L in the acupoint injection group, higher than those in the blank group and the intramuscular injection group (both P<0.05). In the acupoint injection group, CTX was reduced to (239.7±63.6) μmmol/L and Ca/Cr was reduced to 0.525±0.274, apparently lower than those in the blank group and intramuscular injection group (both P<0.05). After treatment, in the acupoint injection group, BMD of lumbar vertebra was (0.731±0.062) g/m2, higher than the level of the rest two groups (both P<0.05). After treatment, the symptom score was 5.2±0.6 in the acupoint injection group, lower than those in the blank group and intramuscular injection group (both P<0.05). Salmon calcitonin injec-tion at Zusanli (ST 36) and Shenshu (BL 23) achieves significant efficacy on postmenopausal osteoporosis, stimulating osteoblast activity and inhibiting bone absorption of osteoclast.

Clinical efficacy of acupoint injection for chemotherapy-induced peripheral neuropathy of patients with breast cancer

ObjectiveTo observe the clinical efficacy of acupoint injection for chemotherapy-induced peripheral neuropathy (CIPN). MethodsNinety CIPN patients with breast cancer conforming to inclusive criteria were randomly divided into an acupuncture group (group A), a mecobalamin group (group B) and an acupoint injection group (group C) according to random number table, with 30 cases in each group. In group A, acupuncture was conducted at bilateral Qāchí (▪ LI 11), Hégu (▪ LI 4), Zúsānli (▪ ST 36), Sānyīnjiāo (▪ SP 6) and Xuèhai (▪ SP 10); in group B, intramuscular injection with 1 mL of mecobalamin injection was conducted; and in group C, acupoint selection was the same as group A, and 0.1 mL of mecobalamin injection was injected into each acupoint, respectively. The treatment was conducted once every three days in each group, and the changes of clinical efficacy, nerve electrophysiology and hemorrheology indicators after treatment for 10 times were observed. ResultThe total effective rate of group C was 93.1% (27/29), which was higher than 78.6% (22/28) in group A and 83.3% (25/30) in group B, and the differences among three groups were statistically significant (all P<0.01); conduction velocity of lesion nerves was improved in group B and group C, the improvement in group C was obviously superior to the other two groups (all P<0.01), hemorrheology indicator was improved in group A and group C (both P<0.05). ConclusionThe efficacy of acupoint injection with mecobalamin for breast cancer CIPN was significant, which can not only improve the nerve conduction velocity, but also improve the hemorrheology indicator.