Acupoints LI4 Research Articles

Electroacupuncture remodels gut microbiota and metabolites in mice with perioperative neurocognitive impairment

Gut microbiota and metabolites are considered key factors in the pathogenesis of perioperative neurocognitive disorders (PND), and the brain-gut axis may be a promising target for PND treatment. Electroacupuncture has been shown to improve a wide range of neurological disorders and to restore function to the gastrointestinal tract. Thus, we hypothesized whether electroacupuncture could remodel gut microbiota and neuroinflammation induced by anesthesia/surgery. First, we observed electroacupuncture at acupoints GV20, LI4 and PC6 significantly improved memory in behavioral tests. Next, we found electroacupuncture decreased the levels of inflammatory factors (NSE, S-100β, IL-6, etc.) in the hippocampus, indicating that nerve inflammation was blocked by electroacupuncture. Furthermore, via 16S rRNA sequence analysis and LC-MS analysis, the gut microbiota and its metabolites were appropriately restored after electroacupuncture treatment. Additionally, we further confirmed the restorative effect of electroacupuncture on PND by fecal transplantation. In conclusion, the role of electroacupuncture in improving cognitive function and protecting neurons may be related to the modulation of gut microbiota and their metabolite dysregulation, thereby inhibiting neuroinflammation in PND mice.

Effect of Low-level Laser on LI4 Acupoint in Pain Reduction during Local Anesthesia in Children.

BackgroundPain is a multidimensional construct that involves sensory, emotional, and cognitive processes. It is an essential component of child behavior guidance. The injection of a local anesthetic agent during pediatric dental treatment is one of the most painful and distressing procedures performed, stimulation of acupoint LI4 provides an analgesic effect in the orofacial region, thus decreasing the pain during injection.Aims and objectivesTo compare and evaluate the effect of low-level laser on LI4 acupoint and surface-acting 20% benzocaine gel during local anesthesia.Materials and methodsChildren of age-group between 5 years and 9 years receiving bilateral local anesthesia were scheduled for dental treatment. Split-mouth cross-over study was planned and was divided into two groups, receiving low-level laser acupuncture on LI4 acupoint with placebo as a moist cotton swab in the first visit and 20% benzocaine gel with placebo as low-level laser acupuncture off mode in second visit and vice versa. Pain intensity was evaluated using the sound eye motor scale as subjective scale, Wong–Bakers pain rating scale. Pulse rate was measured before, during, and after the procedure using a pulse oximeter.ResultsThe average heart rate, Wong–Bakers pain rating scale, and Sound Eye Motor scale were significantly lower in the group having low-level laser when compared with the group having placebo low-level laser therapy.ConclusionThe low-level laser can be used to control pain during local anesthesia in children.How to cite this articleSandhyarani B, Pawar RR, Patil AT, et al. Effect of Low-level Laser on LI4 Acupoint in Pain Reduction during Local Anesthesia in Children. Int J Clin Pediatr Dent 2021;14(4):462–466.

Electroacupuncture prevents cocaine-induced conditioned place preference reinstatement and attenuates \u0394FosB and GluR2 expression

Acupuncture has been used for treating drug addiction since the 1970s, but little is known about the mechanisms by which acupuncture affects drug cue-induced relapse. The transcription factor delta-FosB (ΔFosB) plays a critical role in behavior and pathology after chronic use of cocaine. ΔFosB regulates glutamate receptor signaling and dendritic spine morphology in animal models. This experimental study compared the effects of electroacupuncture (EA) at acupoints LI4 and LI11 with those of another potentially beneficial intervention, gabapentin (GBP), alone or in combination, on reinstatement of cocaine-induced conditioned place preference (CPP) and levels of ΔFosB and glutamate receptor subunit 2 (GluR2) expression in the nucleus accumbens (NAc). EA at LI4 and LI11 significantly prevented cue-induced cocaine CPP reinstatement, whereas needle insertion without electrical stimulation at these acupoints had no such effect. EA also significantly attenuated cocaine-induced increases in ΔFosB and GluR2 expression in the NAc. Unexpectedly, these effects were reversed when GBP was combined with EA. Treatment with EA at LI4 and LI11 prevented cocaine-induced increases in dendritic spine density in the NAc core and shell. Our results suggest that EA at LI4 and LI11 may prevent cocaine relapse by modulating ΔFosB and GluR2 expression, as well as dendritic spine density.

Manual Acupuncture Effect on Vertigo and Tinnitus in Patient with Labyrinthitis: A Case Report

Labyrinthitis is an inflammatory disease of the inner ear perilymphatic cavity and the most common cause of prolonged spontaneous vertigo. Other symptoms are tinnitus and sensorineural hearing loss. Acupuncture is one of the non-pharmacological therapeutic modalities to improve symptoms of labyrinthitis. A 54-year-old woman complained of vertigo that is preceded by tinnitus in both ears since the last 6 months. She was diagnosed with labyrinthitis. Had taken amoxicillin and decadryl for 5 days, betaserc and dimenhydrinate when she felt dizzy, and amlodipine as a routine drug for her hypertension. Physical examination showed vital signs within normal limits, grade 2 obesity, positive Romberg test, and THI score 18. Manual acupuncture was performed at acupoints GV20, GB20, TE17, TE21, SI19, GB2, GB8, TE5, LI4, KI3, PC6 and LR3 with 20 minutes retention. After the first therapy, vertigo complaints disappeared and after 12 treatments (twice a week), frequency and intensity of tinnitus became less, with THI score of 6. Therefore, acupuncture can relieve vertigo and improve tinnitus which can be seen by a decrease of THI score.
 Keywords: acupuncture, labyrinthitis, tinnitus, vertigo

Potential Acupoint Prescriptions and Outcome Reporting for Acupuncture in Atopic Eczema: A Scoping Review.

Background Acupuncture is considered a complementary therapy for atopic eczema. The aim of this scoping review is to identify, examine, and summarize the potential acupoint prescriptions and outcome reporting regarding the clinical trials of acupuncture for eczema. Methods We searched different databases from inception to September 30, 2020. The data were screened and extracted to identify the potential acupuncture prescription and examine the variation in outcome reporting, outcome measurement instruments (OMIs), and measurement time points in clinical trials of acupuncture. Results A total of 116 clinical studies were included. The acupoint combination of LI11 and SP10 was used frequently. The core acupoint association networks were acupoints LI11, SP10, ST36, SP6, and LI4. For clinical trials of acupuncture, a total of 6 outcome distinct domains were identified in the 32 outcome measurements. The most frequently reported outcome was the eczema area, which was reported 97 times (83.6%, 97/116). Immune system outcomes were assessed in 15 outcome measurements, which totally reported 37 times. Adverse events were reported 51 times. TCM syndrome, which could reflect the characteristics of TCM, was reported 4 times. 29 outcomes (90.6%, 29/32) were provided definitions or OMIs. Among these outcomes, the outcome measurement times ranged from 0 to 34. Conclusions This scoping review provides potential knowledge that should be considered as priority in future research of acupuncture for eczema.

A Randomized, Blinded, Controlled, Clinical Trial Investigating the Mitigation Effect of Acupuncture Points PC-6, ST-36 and LI-4 on Morphine Induced Nausea and Vomiting in Healthy Dogs

The use of antiemetic agents preoperatively can help reduce the discomfort and postoperative complications experienced by canine surgery patients. The goal of this randomized blinded controlled clinical trial was to determine if dry needle stimulation at acupoints PC-6, ST-36 and LI-4 could reduce the incidence of nausea and vomiting in healthy dogs receiving an acepromazine and morphine injection prior to elective surgical procedures. Twenty-nine clinically healthy dogs were randomly divided into two groups. Ten minutes prior to receiving an acepromazine maleate and morphine sulphate injection, the Test Group received dry needle acupuncture stimulation at LI-4, PC-6 and ST-36 and the Control Group received sham acupuncture at LU-5, BL-36 and BL-40. The outcomes measured included the presence or absence of lip-licking, nausea or vomiting occurring within 10 minutes after receiving acepromazine/morphine premedication. Twelve out of 15 (80%) subjects in the Control Group exhibited vomiting after receiving acepromazine/morphine injection, whereas only 3 out of 14 (21.4%) subjects in the Test Group exhibited vomiting (p = 0.0028). To a lesser degree, and not achieving statistical significance under the sample size of this study, a 15% trend toward nausea reduction (11/14 test versus 14/15 control) was exhibited in the Test Group. The study concluded there was a statistically significant anti-emetic effect of presurgical acupuncture treatment at PC-6, ST-36 and LI-4 . These findings support the use of these acupoints by clinicians to reduce vomiting induced by acepromazine/morphine injection in healthy dogs undergoing an elective surgical procedure.

A brief discussion on theoretical basis and clinical application of "treatment of orofacial diseases by using Hegu(LI4)"

In traditional Chinese medicine, the well-known saying that "in the treatment of disorders of the orofacial region, Hegu(LI4)is usually taken" is a highly summary of functions of acupoint LI4, the Yuan-primary point of the Large Intestine Meridian of Hand Yangming. By consulting the related literature and viewing from the angle of differentiation of meridians, the present paper expounded the characteristics of location, the attributed meridian and clinical functions of LI4, and summarized its underlying mechanisms in the treatment of some orofacial disorders revealed by experimental researches. In addition, some examples of clinical application of LI4 were listed, including peripheral facial palsy, oral diseases, problems of the nose and headache.

Effectiveness of Laser Acupuncture and Battlefield Acupuncture Therapy for Pain Management in Juvenile Idiopathic Arthritis : A Case Report

<p><strong>Introduction : </strong>Juvenile Idiopathic Arthritis (JIA) is a comprehensive chronic condition of a joint inflammatory autoimmune process, resulting a decrease of function in a long period characterized by fever and pain, which is include all form of unknown etiology that begin before 16 years old. Here we reported effectiveness of Laser Acupuncture and Battlefield Acupuncture Therapy for pain management in JIA case.<strong></strong></p><p><strong>Case report :</strong> A 10-year-old girl diagnosed with JIA was admitted to the pediatric department in Dr. Cipto Mangunkusumo Hospital, and treated by clinical multidisiplinary team from pediatrict, orthopedist, nutritionist, physiotherapist, and medical acupuncture doctor. She was referred to the Medical Acupuncture Department due to complaining of prolonged continous pain throughout her joints, and swelling in her right knee joint. The patient received laser acupuncture therapy in acupoints LI4 Hegu, LI11 Quchi, ST36 Zusanli, SP9 Yinliquan, and EX-LE5 Xiyan. Battlefield Acupuncture Points method (ears) of Omega2, Shenmen, Gyrus Cingulate, Thalamus, and Point Zero. The Therapy was given every day for two weeks and showed a significant improvement on patient’s Visual Analog Score.</p><p><strong>Conclusion :</strong> The combination regimen was effective in relieving pain and swelling, and caused a significant Visual Analog Score and Range of Motion improvement in our case.</p><p> </p>

Commonality and Specificity of Acupuncture Point Selections.

Objective Because individual acupoints have a wide variety of indications, it is difficult to accurately identify the associations between acupoints and specific diseases. Thus, the present study aimed at revealing the commonality and specificity of acupoint selections using virtual medical diagnoses based on several cases. Methods Eighty currently practicing Korean Medicine doctors were asked to prescribe acupoints for virtual acupuncture treatment after being presented with medical information extracted from 10 case reports. The acupoints prescribed for each case were quantified; the data were normalised and compared among the 10 cases using z-scores. A hierarchical cluster analysis was conducted to categorise diseases treated based on the acupoint prescription patterns. Additionally, network analyses were performed on the acupoint prescriptions, at the individual case and cluster level. Results Acupoints ST36, LI4, and LR3 were most commonly prescribed across all diseases. Regarding the specific acupoints prescribed in each cluster, acupoints around the disease site (knee and lower back) were frequently used in cluster A (musculoskeletal symptoms), acupoints LI4, LR3, PC6, and KI3 were frequently used in cluster B (psychiatric symptoms), and acupoints ST36, LI4, LR3, PC6, CV12, and SP6 were frequently used in cluster C (several symptoms of diseases of internal medicine). Conclusions The present study identified the commonality and specificity of acupoint selections based on virtual acupuncture treatments prescribed by practicing clinicians. Acupoint selection patterns, which were defined using a top-down approach in previous studies and classical medical texts, may be further elucidated using a bottom-up approach based on patient medical records.

Three Acupoints of Acupressure Improve the Anxiety Level in Cancer Patients based on Types of Cancer Therapy

Background: Cancer and its therapeutic management trigger the multiorgans physical disorders, that can cause the patient to worry and become anxious about the condition. Three acupoints of acupressure therapy stimulates relaxation of the body and can reduce anxiety. The purpose was to determine the influence of three acupoints of acupressure therapy to improve the anxiety level in cancer patients based on types of cancer therapy.Methods: This was an interventional study using pre-experiment pre-test post-test design. Samples were 30 cancer patients living at the Indonesian Cancer Foundation East Java Branch Surabaya Indonesia, taken by purposive technique sampling based on inclusion criteria. The instrument was Beck Anxiety Inventory that it was valid and reliable based on the test. Ethical feasibility tests has been carried out. Acupressure therapy is given on acupoint St36, Li4 and Li11. It conducted 2 times per week for 4 weeks. Wilcoxon Signed Rank Test was applied to analyze this result with p < 0.05.Results: There was a significant effect of acupressure for improving anxiety levels in both groups with p value in the chemotherapy group 0.001 and in the chemoradiotherapy group 0.002. But a greater influence occurred in the chemotherapy group compared to chemoradiotherapy group.Conclusions: Acupressure therapy in three acupoints can stimulate relaxation condition, it can decrease the anxiety level for cancer patients with all types of cancer therapy.

Electroacupuncture increases immunoexpression of CB1 and CB2 receptors in experimental model of inflammatory bone loss.

This study evaluated the participation of CB1 and CB2 receptors in the antiresorptive effect of electroacupuncture (EA) on an experimental model of inflammatory bone loss in rats. 30 rats were divided into five groups: C (control); EP (experimental periodontitis); EA (C+ EA); EP-EA (EP+ EA in the acupoints LI4, LG11, ST36, ST44); EP - EA-sham (EP+ EA in sham acupoints). For the EP groups, a ligature was placed around the right mandibular first molars at day 1. Sessions of EA or EA-sham were assigned every other day. Animals were euthanized at day 11. Histometric analysis was performed to evaluate the percentage of bone area in the furcation area. Immunolabeling patterns in the periodontal tissues and immunofluorescent staining in the trigeminal ganglia and in the trigeminal spinal tract for CB1 and CB2 receptors were performed. It was observed increased bone loss in the furcation in the EP and EP-EA-sham groups, in comparison to the other groups (p < 0.05). Enhanced CB2 immunolabeling was observed in the periodontal tissues in the EP-EA group, when compared to the EP and EP-EA-sham groups (p < 0.05). Increased CB1 immunofluorescent staining was observed in the neural tissues in the EA treated group in comparison with the other groups (p < 0.05), while no expression of CB2 was observed in those regions. Our study showed that in the presence of inflammatory bone disease, EA treatment reduced bone erosion and increased the immunoexpression of CB1 in the neural tissues and CB2 in the periodontal tissues.

Neuropeptide Initiated Mast Cell Activation by Transcutaneous Electrical Acupoint Stimulation of Acupoint LI4 in Rats

Transcutaneous electrical acupoint stimulation (TEAS) has been consistently used clinically for its ease of operation, non-invasiveness and painlessness, in contrast to the characteristics of inserted needles. However, the mechanism remains unknown. The aim of this study was to investigate the local response of TEAS at Hegu acupoint (LI4). Immunohistochemistry was used to measure the expression of tryptase-positive mast cells, neuropeptides of the calcitonin gene-related peptide (CGRP) and substance P (SP) in LI4. Mast cells were also labelled with serotonin (5-HT), neurokinin-1 receptor (NK-1R) and toluidine blue. The results showed that cutaneous CGRP and SP immune-positive (CGRP-IP or SP-IP) nerve fibres in LI4 were more highly expressed. There were high degrees of mast cell aggregation and degranulation with release of 5-HT near the CGRP-IP or SP-IP nerve fibres and blood vessels after TEAS. The degranulation of mast cells (MCs) was accompanied by expression of NK-1R after TEAS. Either mast cell membrane stabilizer (Disodium cromoglycate) or NK-1R antagonist (RP 67580) diminished the accumulation and degranulation of MCs induced by TEAS. Taken together, the findings demonstrated that TEAS induced sensory nerve fibres to express CGRP and SP, which then bound to the NK-1R on MCs, after which MCs degranulated and released 5-HT, resulting in TEAS-initiated acupuncture-like signals.

Interaction of acupuncture treatment and manipulation laterality modulated by the default mode network.

Appropriate selection of ipsilateral or contralateral electroacupuncture (corresponding to the pain site) plays an important role in reaching its better curative effect; however, the involving brain mechanism still remains unclear. Compared with the heat pain model generally established in previous study, capsaicin pain model induces reversible cutaneous allodynia and is proved to be better simulating aspects of clinical nociceptive and neuropathic pain. In the current study, 24 subjects were randomly divided into two groups with a 2 × 2 factorial design: laterality (ipsi- or contralateral side, inter-subject) × treatment with counter-balanced at an interval of one week (verum and placebo electroacupuncture, within-subject). We observed subjective pain intensity and brain activations changes induced by capsaicin allodynia pain stimuli before and after electroacupuncture treatment at acupoint LI4 for 30 min. Analysis of variance results indicated that ipsilateral electroacupuncture treatment produced significant pain relief and wide brain signal suppressions in pain-related brain areas compared with contralateral electroacupuncture. We also found that verum electroacupuncture at either ipsi- or contralateral side to the pain site exhibited comparable significant magnitudes of analgesic effect. By contrast, placebo electroacupuncture elicited significant pain reductions only on the ipsilateral rather than contralateral side. It was inferred that placebo analgesia maybe attenuated on the region of the body (opposite to pain site) where attention was less focused, suggesting that analgesic effect of placebo electroacupuncture mainly rely on the motivation of its spatial-specific placebo responses via attention mechanism. This inference can be further supported by the evidence that the significant interaction effect of manipulation laterality and treatment was exclusively located within the default mode network, including the bilateral superior parietal lobule, inferior parietal lobule, precuneus, and left posterior cingulate cortex. It is also proved that disruptions of the default mode network may account for the cognitive and behavioral impairments in chronic pain patients. Our findings further suggested that default mode network participates in the modulation of spatial-oriented attention on placebo analgesia as a mechanism underlying the degree to which treatment side corresponding to the pain.

Acupuncture Reduces Pain and Autonomic Distress During Injection of Local Anesthetic in Children: A Pragmatic Crossover Investigation.

Stimulation of acupoint LI4 has been shown to result in analgesic effects in patients experiencing acute pain. We aimed to study the effectiveness of LI4 stimulation for pain relief in children receiving an injection of a local anesthetic (LA). Children scheduled for dental treatment using LA received bilateral acupuncture at LI4 using indwelling fixed needles. During the treatment, the parents of the patients stimulated the needles by massage. Two different treatment regimes were compared: a standardized LA injection given 5 minutes after acupuncture, and an LA injection without acupuncture. The order of treatment was randomized, with the 2 treatments performed in a crossover manner on different days. Pain intensity during LA injection, assessed by the patient with the Verbal Rating Scale or Faces Pain Scale (0 to 10), was used as the primary endpoint. Parent-assessed and dentist-assessed pain intensity and agitation, heart rate, and the patients' satisfaction with the therapy were also recorded. Data were obtained from 49 patients (22 female; mean age 10 y). Patients reported less pain when acupuncture was used: mean 2.3 (95% confidence interval, 1.5-3.1) versus 3.9 (95% confidence interval, 3.0-4.7); P<0.001. The patients' heart rate remained low throughout the dental treatment after LI4 stimulation, when compared with treatment without acupuncture (P<0.05). LI4 stimulation was safe and increased satisfaction levels in both the patients and their parents, when compared with LA injection alone (P<0.05). Stimulation of acupoint LI4 reduces pain and autonomic distress in children during LA injection in dental procedures.

Local cutaneous nerve terminal and mast cell responses to manual acupuncture in acupoint LI4 area of the rats

Previous studies have shown that the effects of manual acupuncture (MA) are contributed by collagen fibers and mast cells in local acupoints, at which acupuncture stimulation causes various afferent fiber groups to be excited. However what happens in local nerve fibers and mast cells after MA remains unclear. The aim of this study was to examine the response of cutaneous nerve fibers and mast cells to MA stimulation in acupoint Hegu (LI4). The contralateral LI4 of the same rat was used as a non-stimulated control. Immnohistochemistry analysis were carried out to observe the expression of histamine (HA), serotonin (5-HT) and nociceptive neuropeptides, calcitonin gene-related peptide (CGRP) and substance P (SP), in the LI4 area. Mast cells were labeled with anti-mast cell tryptase antibody and simultaneously with HA or 5-HT primary antibodies to observe their co-expression. Our results showed that SP and CGRP were expressed more highly on the cutaneous nerve fibers of LI4 after MA stimulation than that of the control. Mast cells aggregated in close proximity to the blood vessels in intra-epidermis and dermis and some of them with degranulation in the lower dermis and subcutaneous tissue of LI4. Both mast cells and their granules appeared with HA (+) and 5-HT (+) expression at stimulated L14 sites, while a few intact mast cells with a little expression of 5-HT and HA were distributed in areas of non-stimulated L14. The results indicated that local cutaneous nerve terminals and mast cells responded to MA with higher expression of SP and CGRP in nerve fibers, as well as with aggregation and degranulation of mast cells with HA and 5-HT granules at acupoint LI4. These neuroactive substances may convey signals to certain pathways that contribute to the effects of acupuncture.

Effect of blinding with a new pragmatic placebo needle: a randomized controlled crossover study.

Placebo control is a useful method for determining the efficacy of a therapy. In acupuncture researches, the preferred method for placebo control is acupuncture using a placebo needle that has a blunt tip and achieves no skin penetration.We performed a crossover study to validate the blinding effect of a new type of placebo needle. Sixty volunteers were randomized to receive acupuncture using 2 types of needles with different sequences: sequence AB, involving first the pragmatic placebo needle and then the real needle, and sequence BA, in a reverse order. Placebo acupuncture was performed by administering the placebo needle through an adhesive pad without skin penetration on the acupoints LI4, RN12, BL25, and BL36. Real acupuncture was performed by needling through the pad and penetrating the skin to 15 mm using a real needle on the same acupoints. The acupuncture was administered every other day with 3 sessions for 1 type of needle. The primary outcome was the perception of needle penetration. Besides degree of acupuncture pain, type, and degree of needle sensation, needle acceptability and factors influencing the subject blinding effect were assessed.Needle penetration was felt by 100%, 90% (54/60), 88.3% (53/60), and 95% (57/60) of volunteers receiving placebo acupuncture and 98.3% (59/60), 96.7% (58/60), 95% (57/60), and 95% (57/60) of volunteers receiving real acupuncture on LI4, RN12, BL25, and BL36, respectively. Differences of the volunteers’ perception of needle penetration between the placebo needle and real needle were not significant for the 4 acupoints (all P > 0.05). Volunteers experienced fewer distension sensations (P = 0.01), a lower degree of needle sensation (P = 0.007), and less pain (P = 0.006) during placebo acupuncture than during real acupuncture. The placebo needle was more easily accepted than the real needle (OR = 1.63, 95% CI, 1.01–2.64). The influences of age, sex, educational level, acupuncture experience, needle sensation, acupuncture pain, and needle acceptability on volunteers’ perception of needle penetration were not significant.The pragmatic placebo needle is a valid control for acupuncture research. It produces a good subject blinding effect with a similar appearance to conventional acupuncture needles and no skin penetration when applied.

Electrical acupoint stimulation of the affected arm in acute stroke: a placebo-controlled randomized clinical trial

Objectives: To determine whether adding electrical stimulation of upper limb acupoints to conventional rehabilitation during acute stroke could produce greater and longer lasting motor improvements of the arm. Design: Double-blind, randomized, placebo-controlled trial. Setting: Acute stroke wards, followed by rehabilitation hospitals and subjects’ residences. Participants: Seventy-three patients ≤ 46 hours post stroke onset with moderate to severe weakness in the arm contralateral to the side of stroke. Intervention: All subjects received conventional rehabilitation. Twenty-nine received additional electrical stimulation, 21 received additional placebo-electrical stimulation and 23 received conventional rehabilitation only, as control. Electrical stimulation or placebo-electrical stimulation was applied to acupoints GB20, LI15, LI11, LI10 and LI4, 60 minutes a day, five days a week, for four weeks. Measurements: Primary outcome measures were hand grip and pinch strength, with Action Research Arm Test (ARAT) as secondary outcome measure. These were assessed on the affected arm at recruitment, then 4 (W4), 12 (W12) and 24 weeks (W24) afterwards. Results: Post-hoc analysis showed that the electrical stimulation group had greater improvements than the control group in hand grip (P = 0.015) and pinch strength (P = 0.007) at W4, with the gains maintained at W12 and W24. In contrast, the placebo-electrical stimulation group did not differ from either the control or the electrical stimulation group. Between-group improvements in ARAT scores from baseline to W24 (by 16.8 in control, 27.6 in placebo-electrical stimulation group and 26.3 in electrical stimulation group) were not significant. Conclusions: Adding four weeks of electrical stimulation during acute stroke appears to produce greater and longer lasting hand grip and pinch strength improvements than administering conventional rehabilitation alone.

Acupuncture in 21st Century Anesthesia

Acupuncture in 21st Century Anesthesia

Laser acupuncture in patients with temporomandibular dysfunction: a randomized controlled trial

A prospective, double-blind, randomized, and placebo-controlled trial was conducted in patients with chronic temporomandibular disorder (TMD) to check the analgesic efficacy of infrared low-power GaAlAs diode laser applied to acupuncture points. Forty female subjects, ranging in age from 20 to 40 years, with diagnoses of chronic myofascial pain and arthralgia were randomly allocated to two groups: an experimental group (EG) who received the laser acupuncture as adjunct to reversible occlusal splint therapy and a control group (CG) who received a placebo laser associated with occlusal splint therapy. Both approaches were applied once a week for 3 months. Laser acupuncture was defined by the following parameters: 50-mW continuous radiation for 90 s to acupoints ST6, SI19, GB20, GB43, LI4, LR3, NT3, and EX-HN3; defining 4.5-J energy; 1250-W/cm(2) density point; and 112.5-J/cm(2) total density. The outcome measurements included a symptom evolution assessment carried out by checking spontaneous and palpation pain intensity, which was indicated on a visual analog scale (VAS). All evaluations were made by an assessor who was blind to the treatment. The symptom reduction was significant in both groups (EG: VAS = 0, n = 20; CG: VAS between 2 and 4, n = 18). The measurements showed significantly faster and lower pain intensity values in the EG (p ≤ 0.002), where there was a higher proportion of patients with remission of symptoms related to the action of laser acupuncture. For patients in whom conservative treatment was adopted, the laser acupuncture is a secure, noninvasive, and effective treatment modality because it improves the chronic pain associated with TMD and has no side effects.

P01.54. Electrical potential of acupuncture points: use of a Scanning Kelvin Probe

Purpose According to conventional wisdom within the acupuncture community, acupuncture points are distinguishable by their electrical properties. However, confounders arising from skin-to-electrode contact (such as electrode pressure and skin moisture) have contributed to controversies over this claim. Because the Scanning Kelvin Probe relies on capacitive coupling and thus measures electrical potential without actually touching the skin, it is ideal for assessing the electrical characteristics of acupuncture points. In this study, we evaluate the electrical potential profiles of acupoint LI-4 and PC-6 and their adjacent controls. We hypothesize that acupoints are associated with a potential maximum, while adjacent controls are not.