Acupuncture Research Research Articles

Innervated Properties of Acupuncture Points LI 4 and LR 3 in the Rat: Neural Pathway Tracing with Cholera Toxin Subunit B.

Objective: Increasing evidence from acupuncture research suggests that the nervous system corresponds closely with classical acupuncture points. The aim of this research was to provide neuroanatomical evidence for revealing the innervated properties of different acupuncture points through comparing the sensory and motor pathways associated with Hegu (LI 4) and Taichong (LR 3) in rat extremities. Materials and Methods: Cholera toxin subunit B (CTB) was injected into LI 4 and LR 3 in different rats, and CTB neural labeling was examined using fluorescent immunohistochemistry and observed under fluorescent microscopy in the corresponding areas from the peripheral nervous system to the central nervous system, including the dorsal root ganglia (DRG), spinal cord, and brainstem. Results: When LI 4 was injected with CTB, CTB-labeled sensory neurons ranged from C-5 to T-1 DRG, and their transganglionic axons terminated in the C-5 to C-8 spinal dorsal horn as far as the cuneate nucleus, while labeled motor neurons were located in the C-7 to T-1 spinal ventral horn. In contrast, similar neural labeling was observed for LR 3 CTB injection, with an orderly arrangement in the L-3 to L-5 DRG, L-3 to L-5 spinal dorsal horn, gracile nucleus, and L-4 to L-6 spinal ventral horn. Conclusions: The present results provide further evidence to aid understanding of the differential innervation of acupuncture points LI 4 and LR 3. This innervation establishes its connection with the nervous system in a distinct segmental and regional pattern through the spinal sensory and motor pathways.

Clinical research of acupuncture combined with metformin or the treatment of diabetes at the early stage

Objective To investigate the clinical application of acupuncture combined with metformin or the treatment of diabetes at the early stage. Methods According to the random table method, 123 patients with diabetes at the early stage were divided into control group (n=61) and the treatment group (n=62). The patients in the control group were treated with metformin, while the patients in the treatment group were treated with acupuncture combined with metformin. Two groups of patients were treated for 12 weeks. The clinical total effective rate of two groups of patients after treatment was counted. The FPG, HbA1c, FINS, FCP, TG, TC, LDL-C, HDL-C, LEP, GLP-1, RETN, HOMA-IR and ISI of the two groups before and after treatment were compared. Results The total effective rate of treatment group was 91.9% (57/62), while the control group was 65.6% (40/61), and the difference between two groups was statistically significant (χ2=12.818, P<0.01). After treatment, the FPG, HbA1c, FINS. FCP, HOMA-IR, ISI, TG, TC, LDL-C, LEP, RETN of treatment group were significantly lower than those of the control group (t were 14.149, 14.301, 4.254, 7.552, 9.470, 11.032, 9.993, 12.000, 11.802, 5.385, 9.121, P<0.01), while the HDL-C, GLP-1 of treatment group were significantly higher than those of the control group (t were 3.402, 14.680, P<0.01). Conclusions Acupuncture combined with metformin or the treatment of diabetes at the early stage has a good efficacy, can correct the disorder of glucose and lipid, improve the insulin resistance. Key words: Prediabetic state; Acupuncture therapy; Metformin; Integrated Chinese traditional and western medicine therapy

A bibliometric analysis of acupuncture research in Taiwan from 1988 to 2017.

Since Taiwan's national health insurance system provides residents with easy and affordable access to clinical acupuncture treatment, this study sought to analyze trends in the publication of acupuncture-related research in Taiwan from 1988 to 2017, using a bibliometric method. Data on the scholarly literature from 1988 to 2017 were retrieved through Web of Science searches for the keywords acupunct*, acupoint*, electroacupunct*, electro-acupunct*, acupre*, auricular acupunc*, and auricular needle* in study titles. A total of 539 acupuncture-related articles published from 1988 to 2017 were identified and analyzed. The articles had an h-index of 38 and were cited in subsequent studies 7250 times, meaning that Taiwan ranked sixth in the production of such publications among countries/regions globally. Among those articles, 99 (18.4%) had no subsequent citations, six (1.1%) were highly cited (over 100 citations), and 141 (26.1%) were cited 4 to 10 times. The highly cited articles discussed the possible pathways of acupuncture stimulation and efficacy, and received 1103 (15.2%) of the citations. The China Medical University in Taichung, Taiwan, was the most active educational institution in Taiwan in terms of acupuncture-related research. Professor Lin Jaung-Geng was the leading acupuncture-related researcher, having the most publications, citations, and the highest h-index value. These results provided a context for analyzing the strengths of the existing research and informing prospective strategies for further studies.

Acupuncture for Chronic Low Back Pain: Recommendations to Medicare/Medicaid from the Society for Acupuncture Research.

Editor's Note: This column takes our series from the Society for Acupuncture Research (SAR) in a new direction. Recently, the U.S. government's Center for Medicare and Medicaid Services (CMS) issued a call for public comment related to the government's exploration of inclusion of acupuncture and licensed acupuncturists in federal payment schemes. The decision of SAR's research leaders to engage with policymakers is forward thinking, especially as much dialogue and many research needs related to acupuncture and other integrative health practices and practitioners are shifting toward implementation concerns. SAR's engagement in this arena is also reflected in the organization's 2019 conference June 27–29, 2019 in Burlington, Vermont: “Acupuncture Research, Health Care Policy, & Community Health…Closing the Loop.” The author team includes the entire SAR Board, led by president-elect Jun J. Mao, MD, and current copresidents Robert T. Davis, MS, LAc, and Richard Harris, PhD. This is also a moment to congratulate Harris on his selection to the U.S. National Institutes of Health National Advisory Council on Complementary and Integrative Health.—John Weeks, Editor-in-Chief

Evidence based methods in tobacco dependence treatment

Smoking is the leading cause of preventable death. Every year, more than 71600 of Poles and 36600 Romanians are killed by tobacco-caused disease. In whole European Union 1 400 000 people die due to tobacco smoking. Tobacco smoking causes many diseases like cardiovascular diseases, pulmonary diseases, cancer and others, however tobacco dependence is a disease itself. Tobacco dependence syndrome (F 17.2.- ICD X revision) is a chronic disease caused by nicotine dependence. The criteria to diagnose tobacco dependence are very similar to those recognized in drug and alcohol addiction. Tobacco dependence is a chronic condition that is treatable, however due to its nature often requires repeated intervention for success and good plan for treatment provided by specialist (doctor, nurse, health counsellor, therapist etc). The effective treatment exists and include pharmacotherapy and behavioural support. Both methods are effective itself but according to Cochrane library reviews the most effective is combing both medicines and psychological support. Evidence-based guidelines recommend nicotine replacement therapy, bupropion SR, and varenicline as effective in smoking cessation therapy, especially when combined with behavioral interventions. There is as well effective and safe herbal drug - cytisine, however not available in all European countries. The success rate is at least doubled by using evidence based methods in tobacco dependence treatment. The effects of alternative methods like hypnotherapy in smoking cessation in uncontrolled studies were not confirmed by analysis of randomized controlled trials. Electrostimulation is not effective for smoking cessation. Well‐designed research of acupuncture, acupressure and laser stimulation could be needed since these are very popular among smokers, though these interventions alone are likely to be less effective than evidence‐based interventions. There is an evidence from few trials that electronic cigarettes effectiveness in smoking cessation may be equal to nicotine patches or higher, when both products were accompanied by behavioral support.

From molecular pharmacy to electroceuticals: SPARC program and acupuncture research

The NIH-funded "Stimulating Peripheral Activity to Relieve Conditions (SPARC)" program has been initiated in Octomber 2016, aiming at developing high resolution neural circuit maps and next generation neural modulation devices. This program has brought great stimulus to acupuncturists and acupuncture researchers both at home and abroad. Is the SPARC program a driving force or a challenge of acupuncture research? In the present study, we introduced the SPARC program and compared it with current acupuncture research. The first step of SPARC is to better map neural circuits associated with disease on the anatomical level so as to identify the best points for intervention, and to decode the neural language at these intervention points for developing a dictionary of patterns associated with health and disease states on the signaling level. Similarly, our acupuncture research also focuses on revealing the neural encoding of acupuncture stimulation and its effect on visceral function, seeking suitable stimulation parameters to regulate the abnormal visceral activity precisely. Therefore, the common point of SPARC program and acupuncture research is the scientific basis of peripheral somatic neuronal regulation, and their difference is that acupuncture regulates the visceral function through multiple neural circuits and neural feedbacks by stimulating the sensitized points or acupoints, achieving homeostasis at last. Acupuncture-induced regulation effect is limited and the therapy is safe. Whereas, "stimulating periphe-ral activity (SPA)" can regulate the visceral organs precisely but without neural feedback. Inevitably, SPA will produce tolerance or side effects. Therefore, there is still much work to be done in terms of the initiation of trigger stimulation and the feedback inhibition of target organ effects. The SPARC program is definitely a powerful force in revealing the mechanisms by which acupuncture works.

Acupuncture for symptoms management in Korean breast cancer survivors: a prospective pilot study.

There is an unmet need for effective treatment of the various treatment-related symptoms experienced by breast cancer survivors. These symptoms could be alleviated by acupuncture. Although several lines of evidence in Western countries suggest that acupuncture has a beneficial effect on symptoms in breast cancer survivors, few relevant studies have been conducted in Korean patients. This pilot study assessed the feasibility of acupuncture for a variety of treatment-related symptoms in Korean breast cancer survivors. From October 2015 to March 2016, we recruited patients who had undergone treatment for breast cancer and subsequently reported symptoms, including aromatase inhibitor-related knee pain, vasomotor symptoms, insomnia, sexual dysfunction and post-mastectomy pain in the chest wall or shoulder. The women received 4 weeks of symptom-specific acupuncture followed by a further 4 weeks of follow-up to evaluate the feasibility of acupuncture for this indication, and its impact on common and symptom-specific outcome variables. Eight study participants were recruited over a period of 6 months, six of whom completed the planned acupuncture treatment and follow-up assessments. A total of 78 acupuncture sessions were performed. We found that acupuncture was feasible, with only six minor self-limiting acupuncture-related adverse events. Most of the women felt that they had benefitted from participation in the study. The preliminary analysis indicated improvement in common symptom-specific outcomes. Our findings suggest that acupuncture is feasible, but low recruitment rates should be considered when considering future acupuncture research in Korean breast cancer survivors. Rigorous evaluation of this symptomatic treatment strategy is now needed in the Korean population.

Progress of the application of PET technology in acupuncture research

To further investigate the application of positron emission tomography (PET) technology in acupuncture research field, with "PET" and "acupuncture" as keywords, the related literature published from 1997 to 2018 was searched in PubMed, CNKI and WANFANG database; then the literature was classified and analyzed. The results showed that in clinical and experimental studies, whether in physiological or pathological conditions, PET technology has verified the specificity of acupoints, bidirectional regulation of acupoints, and the clinical effect of qi-arrival from the level of brain functional activity. It has deeply revealed the central mechanism underlying that acupuncture has multi-target, multi-channel and multi-level overall effects. The purpose of this study is to provide objective scientific basis for acupuncture research, and then potentially guide the clinical practice.

The reporting quality of acupuncture for neurogenesis in experimental ischemic stroke study.

There is increasing evidence demonstrating the highly inadequate reporting of preclinical research in multiple scientific publications. The purpose of this study is to systematically investigate the reporting quality of acupuncture for neurogenesis in animal models of acute ischemic stroke. We searched eight databases, including PubMed, EMBASE, CINAHL, AMED, Chinese National Knowledge Infrastructure, VIP information database, Wanfang data Information Site, and Chinese Biomedical Literature Database. The methodological quality of included studies was assessed by using the CAMARADES 10-item checklist. The STRICTA statement was modified to gear to animal acupuncture research. The reporting quality was assessed according to the ARRIVE guidelines and the modified STRICTA statement. Data were analyzed with descriptive statistics. Ultimately, 44 studies containing 2,411 subjects were identified. The overall compliance with the CAMARADES 10-item checklist has a mean of 4.3. The reporting quality indicated that the overall compliance with ARRIVE guidelines has a mean of 59.9% and with the modified STRICTA statement a mean of 71.8%. The findings suggest that the reporting quality of acupuncture for preclinical stroke was generally poor. Full compliance with ARRIVE guidelines and/or modified STRICTA statement in designing, conducting and reporting preclinical acupuncture research is urgently needed in the future.

Impact of different anesthetic states on acupuncture-mediated modulation of autonomic nervous system in animal studies

Acupuncture therapy has a positive role in the prevention and treatment of some related diseases by regulating autonomic nervous function. But it has been found in experimental researches that the modulatory effects of acupuncture on autonomic nervous system are not always consistent with each other. Because in the animal studies on the mechanism of acupuncture intervention, the anesthetic agent has to be used and definitely affects the activities of the autonomic nervous system while playing its pharmacological effects. Hence, it is very significant to explore the rational application of anesthetic agents and minimize their unfavorable impacts on the research outcomes. In the present paper, we make a retrospective analysis on (1) the effect of acupuncture intervention on activities of the autonomic nerve in animal models of myocardial ischemia, gastrointestinal mobility, and urinary system; (2) the effect of anesthetics as isoflurane, urethane, pentobarbital sodium, ketamine, α-chloralose, propofolum, etc. on activities of the autonomic nerve system. In terms of different anesthetic modes and various depths of anesthesia by using isoflurane inhalation, mixed solution of urethane and chloralose, etc., some approaches for assessing the state of anesthesia in accordance with the pupillary reflex, righting reflex, footboard reflex, swallowing reflex, heart rate, blood pressure, body temperature, respiration frequency, ventilation volume, oxygen saturation, partial pressure of carbon dioxide, neuromuscular blo-ckade, etc. in combination with the indexes directly and indirectly reflecting functions of the sympathetic and vagus nerves are proposed to analyze the impact of different anesthetic states on the therapeutic effect of acupuncture in various models of dysfunction of the autonomic nerve system. Under the circumstances, it is possible to provide a reference for rational use of anesthetic agents and dosages in the acupuncture research of autonomic nerve regulation.

A Guideline for Randomized Controlled Trials of Acupuncture.

Guidelines for clinical trials of acupuncture are scarce, particularly in their guidance on choosing an adequate control in an acupuncture trial. This guideline was developed to address the research methodology for clinical research in acupuncture which contains the essential elements to be considered in the design, preparation and reporting of an acupuncture RCT. Particularly, investigators focused on the control design because of the unique feature of acupuncture. As one size does not fit all, one single design cannot answer all research questions. Therefore, we recommend that the clinical questions be answered in different stages of trials by choosing the appropriate control or comparator. This concept is adapted from classical drug trials developed by the Food and Drug Administration (FDA) of USA in which trials are staged in four phages in order to address different research questions. From the points listed above, this guideline offers the specific recommendations in an acupuncture RCT.

The research of acupuncture on the treatment of alcohol dependence: hope and challenge

The research of acupuncture on the treatment of alcohol dependence: hope and challenge

Improving Acupuncture Research Dissemination to Impact Policy Implementation: An Invitation to the June 2019 Conference of the Society for Acupuncture Research

Improving Acupuncture Research Dissemination to Impact Policy Implementation: An Invitation to the June 2019 Conference of the Society for Acupuncture Research

Comparison of 3 assessment modes of acupuncture effect on patients with chronic prostatitis/chronic pelvic pain syndrome: A study protocol for a randomized controlled trial.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder. Some studies have indicated that acupuncture may ameliorate the symptoms of CP/CPPS. However, results are varied and range widely, perhaps due to different modes of assessment including timepoints, places of assessment, and especially subjective scales. We propose to determine the efficacy of acupuncture relative to sham acupuncture for patients with CP/CPPS, and compare different modes of assessment regarding the therapeutic effects of acupuncture. Sixty patients with CP/CPPS will be randomly assigned to receive either acupuncture or sham-acupuncture (30 patients, each). Treatment will be conducted 3 times/week, for 4 weeks. The coprimary outcomes will each be the change from baseline of the total NIH (National Institutes of Health) CPSI (Chronic Prostatitis Symptom Index) score associated with 3 modes of assessment: Mode 1, the scale recorded at the hospital within 10 minutes after the last session of 4 weeks of acupuncture treatment, in the company of the outcome assessors; Mode 2, the scale recorded the same day, but not at the hospital; and Mode 3, the scale recorded at the hospital 1 to 3 days after the last acupuncture session. The 3 key secondary outcomes include will be the 3 modes assessment of the changes from baseline of the NIH-CPSI total scores in the acupuncture group at week 4 after treatment. Analysis was by intention-to-treat, and multiplicity was controlled for with a step-down closed-testing procedure. To our knowledge, previous studies did not include the details of assessment scales when determining the efficacy of acupuncture in CP/CPPS. Furthermore, it is not clear which mode was used to assess the effect. The answers provided by the proposed study may improve the reproducibility of acupuncture research and the reliability of results.

Application of Laser Scanning Confocal Microscope to Morphologic Research of Acupuncture and Moxibustion

Laser scanning confocal microscope (LSCM) has been used in the field of morphological research of acupuncture and moxibustion for more than 20 years. It is one of the important tools for revealing the structure of acupoints and the effect of acupuncture from histological perspective. With the help of technical advantages of LSCM, the quality of morphological research of acupuncture and moxibustion has been greatly improved, helping us gain a deeper understanding about the structure of acupoints and meridians as well as histochemical changes induced by acupuncture/moxibustion intervention. In order to promote the application of LSCM in acupuncture and moxibustion, we simply reviewed some recent studies in this field and combined them with our experience, trying to provide some technical suggestions. We expect that the technique of LSCM could be integrated into more experiments in acupuncture medicine to provide more powerful morphological evidence for exploring the underlying mechanisms of acupuncture and moxibution therapies.

The patterns analysis of clinical application of acupuncture for ophthalmopathy

Based on the data from the Information Library of Acupuncture-Moxibustion of TCM, the bibliometric analysis was applied to analyze and evaluate the literature regarding clinical research of acupuncture for ophthalmopathy published between 1954 to 2016, hoping to objectively reflect the disease spectrum and indication of acupuncture for ophthalmopathy. The results showed that the disease spectrum of acupuncture for ophthalmopathy involved 47 specific diseases in 13 types of diseases. The total number of cases was 176 469, and the number of effective cases was 160 662, and the effective rate was 91.0%. The indication of acupuncture for ophthalmopathy included myopia, blepharoptosis and conjunctivitis. The commonly used indications were strabismus, dry eye and ophthalmoplegia, and the secondary indications were optic atrophy, blepharoptosis, oculomotor paralysis, blepharospasm, amblyopia. The most commonly used acupuncture points for ophthalmopathy were Cuanzhu (BL 2), Jingming (BL 1), Taiyang (EX-HN 5), and the most commonly used auricular points were yan (LO5), gan (CO12) and shen (CO10). As for the methods of acupoint combination, local acupoints were mainly selected, combined with distal acupoint to assist treatment.

TREATMENT OF SPORT INJURIES WITH ACUPUNCTURE: A LITERATURE REVIEW

ABSTRACT As acupuncture is growing in popularity in Brazil and worldwide, it is necessary to study the benefits and possibilities of this type of treatment more in depth, especially as it is believed to produce fast results with few side effects and does not involve substances banned in sports. Thus, it seems like a good option to be considered as main or adjuvant therapy in sports-related injuries. In order to gain more knowledge about this subject, this article is an integrative review analyzing the publications of the period between January 2012 and January 2017 on the Cochrane and Pubmed platforms that analyzed acupuncture in the treatment of sports injuries. We found 49 articles, 11 of which fulfilled the inclusion criteria: two case reports, three clinical trials and six literature reviews. Although all the articles analyzed produced favorable results with the use of the therapeutic technique in question, flaws in the designs of the studies and the difficulty of creating a placebo control group in acupuncture hinder the qualification of the articles on evidence rating scales. Therefore, it is suggested to the researchers that further studies be published with experimental animal models and observational studies, and that STRICTA recommendations be followed to improve the level of evidence of acupuncture research. Level of Evidence II; Systematic review of level II studies.

Evidence for the Use of Acupuncture in Treating Parkinson's Disease: Update of Information From the Past 5 Years, a Mini Review of the Literature.

Acupuncture is an alternative therapy for Parkinson's disease (PD), but its efficacy and safety are controversial. Our previous study, which reviewed the literature from 1974 to 2012, could not find enough evidence from rigorously designed randomized, controlled trials (RCTs) to make a conclusion about the efficacy of acupuncture. Recently, more RCTs and meta-analyses have been conducted to evaluate the efficacy of acupuncture. The aim of our current study is to provide updated information in brief on this topic. In this study, we analyzed and summarized seven RCTs and four meta-analyses. Although all included studies were not of high quality, we found that there has been a tremendous progress in acupuncture research in treating Parkinson's disease (PD) during the past 5 years, based on our experience and insights into the behavioral assessments of PD. First, the numbers of RCTs and meta-analyses based on RCTs are increasing. Second, non-motor symptoms are increasingly emphasized. Third, objective behavioral assessment tools are being employed. Although recent studies can provide limited evidence for the efficacy of acupuncture, we make the following recommendations for the future investigation: First, large, multicenter, well-designed RCTs should be organized for evaluation of the efficacy of acupuncture. Second, objective assessments using novel computerized technologies should be considered. Third, target symptoms should be selected and evaluated instead of only performing global evaluations. Fourth, attention should be paid to the efficacy of scalp acupuncture. Fifth, the safety of acupuncture should be evaluated and reported.

Evidencia del uso de la acupuntura en el tratamiento de la enfermedad de Parkinson: actualización de la información de los últimos 5 años, una mini revisión de la bibliografía

Acupuncture is an alternative therapy for Parkinson's disease (PD), but its efficacy and safety are controversial. Our previous study, which reviewed the literature from 1974 to 2012, could not find enough evidence from rigorously designed randomized, controlled trials (RCTs) to make a conclusion about the efficacy of acupuncture. Recently, more RCTs and meta-analyses have been conducted to evaluate the efficacy of acupuncture. The aim of our current study is to provide updated information in brief on this topic. In this study, we analyzed and summarized seven RCTs and four meta-analyses. Although all included studies were not of high quality, we found that there has been a tremendous progress in acupuncture research in treating PD during the past 5 years, based on our experience and insights into the behavioral assessments of PD. First, the numbers of RCTs and meta-analyses based on RCTs are increasing. Second, non-motor symptoms are increasingly emphasized. Third, objective behavioral assessment tools are being employed. Although recent studies can provide limited evidence for the efficacy of acupuncture, we make the following recommendations for the future investigation: First, large, multicenter, well-designed RCTs should be organized for evaluation of the efficacy of acupuncture. Second, objective assessments using novel computerized technologies should be considered. Third, target symptoms should be selected and evaluated instead of only performing global evaluations. Fourth, attention should be paid to the efficacy of scalp acupuncture. Fifth, the safety of acupuncture should be evaluated and reported.

Biological Ultra-weak Luminescence and Its Application to Research of Acupuncture

Ultra-weak bioluminescence (UWL) is a physiological phenomenon widely existing in all the biological activities including human, animals, plants, etc., which reflects the energy metabolism of the organism. Since the last century, ultra-weak photon emission (UPE) has been applied to the study of the essence of meridians and acupoints of traditional Chinese medicine and obtained some results as the higher luminescence characteristics, but many problems remain unsolved due to the limitation of detection technology. In recent years, along with the development of bioluminescence signal acquiring system and imaging system, we are able to further explore the characteristics and biological mechanisms of UWL of acupuncture points and meridians in the human body. We proposed to study changes of ultra-weak luminous intensity of acupuncture points and meridians before and after needling stimulation, and the delayed effect of UPE phenomenon, etc., trying to reveal their regularities and essence. In this paper, the prospect of application of UPE to acupuncture research is also discussed by combining newly acquired results of some biological substances of acupoints in experimental studies.