Nonmeridian Points Research Articles

Efficacy of electroacupuncture combined with intravenous patient-controlled analgesia after cesarean delivery: a randomized clinical trial

Electroacupuncture is a nonpharmacologic intervention for analgesia that is widely recognized as therapy for pain. However, the clinical efficacy of electroacupuncture combined with patient-controlled intravenous analgesia for postoperative analgesia after cesarean delivery remains unclear. This study aimed to assess the efficacy of electroacupuncture + patient-controlled intravenous analgesia for postoperative analgesia after cesarean delivery, determine the optimal frequency for the best analgesic effect, and explore the underlying mechanism of action. This single-center, randomized, single-blinded, sham acupuncture controlled clinical trial was conducted at a tertiary university hospital in China. Female patients who underwent cesarean delivery and received fentanyl as patient-controlled intravenous analgesia for postoperative analgesia were enrolled. Patients were after surgery randomized to receive 2 Hz electroacupuncture treatment (n=53), 20/100 Hz electroacupuncture treatment (n=53), or sham electroacupuncture treatment (n=52) (controls). The 2 electroacupuncture groups received electroacupuncture treatment at 2 or 20/100 Hz at the ST36 and SP6 points, whereas, in the sham electroacupuncture group, sham electroacupuncture was performed at nonmeridian points with nonenergized electroacupuncture instruments. Of note, 4 electroacupuncture treatments were performed in all groups at 6, 12, 24, and 48 hours after surgery. The primary outcome was the number of analgesic pump compressions at 48 hours after surgery. The secondary outcomes included number of analgesic pump compressions at 6, 12, and 24 hours after surgery; pain scores at 6, 12, 24, and 48 hours after surgery; fentanyl consumption at 48 hours after surgery; interleukin 6 and procalcitonin levels at 12 and 48 hours after surgery; and time to first exhaust. Overall, 174 primigravida women were included in the intention-to-treat analysis. The number of analgesic pump compressions and pain scores at all 4 time points and fentanyl consumption at 48 hours after surgery were significantly lower in the electroacupuncture treatment groups than in the sham electroacupuncture group (P<.001). Electroacupuncture + patient-controlled intravenous analgesia had a significantly better analgesic effect than sham electroacupuncture + patient-controlled intravenous analgesia within 48 hours after surgery. Thus, electroacupuncture can be considered safe and effective and may improve the efficacy of patient-controlled intravenous analgesia for pain management after cesarean delivery. Electroacupuncture can be recommended as a routine complementary therapy for pain control after cesarean delivery.

Acupuncture for chronic prostatitis: A randomized controlled trial: 针刺治疗慢性前列腺炎:随机对照研究

ObjectiveTo explore whether there is a specific clinical effect of acupuncture in the treatment of chronic prostatitis. MethodsA total of 52 patients with chronic prostatitis were randomly divided into an acupuncture group (24 cases) and a placebo acupuncture group (28 cases). During the treatment, 1 case was dropped out in the placebo acupuncture group and 51 patients accomplished the clinical trial finally in two groups. In the acupuncture group, Shènshū (肾俞BL23), Zhōngliáo (中髎BL33), Huìyáng (会阳BL35) and Sānyīnjiāo (三阴交SP6) were selected. In the placebo acupuncture group, the non-meridian points located lateral to BL23, BL33, BL35 and SP6 were selected, respectively. The duration of treatment was 8 weeks in each group. In the first 4 weeks of treatment, the treatment was given once every two days, three times weekly. In the last 4 weeks of treatment, the treatment was given once every three days, twice a week. Totally, 20 acupuncture treatments were required in the whole trial. Before treatment, in week 4 and 8 of treatment and in follow-up, National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score and the comprehensive effect were evaluated in the two groups successively. ResultsIn week 4 and 8 of treatment, NIH-CPSI score in the acupuncture group was lower than that before treatment, respectively (both P < 0.05). In week 8 of treatment, NIH-CPSI score in the placebo acupuncture group was lower than that before treatment (P < 0.05). NIH-CPSI score in the acupuncture group was lower than the placebo acupuncture group in week 8 of treatment (P < 0.05). In follow-up, NIH-CPSI score of the two groups all decreased as compared with the score before treatment (both P < 0.05), and the score in the acupuncture group was lower than the placebo acupuncture group (P < 0.05). In the comparison of comprehensive effect, the total effective rate was 91.7% in the acupuncture group and was 74.1% in the placebo acupuncture group. The therapeutic effect in the acupuncture group was better than that of the placebo acupuncture group (P < 0.05). ConclusionAcupuncture relieves pelvic pain and urination symptoms and has a certain of long-term effect in patients with chronic prostatitis.

Impact of Low Frequency Electro-acupuncture on Glucose and Lipid Metabolism in Unmarried PCOS Women: A Randomized Controlled Trial.

To explore the effect of electro-acupuncture (EA) on glucose and lipid metabolism in unmarried patients with polycystic ovary syndrome (PCOS). Fifty-four PCOS patients were equally randomized into true acupuncture group and sham acupuncture group (control) for totally 16 weeks of treatment by random method with a computerized randomization program. Patients in true acupuncture group accepted traditional acupuncture methods with EA and two sets of acupoint groups were used alternatively. The first set consisted of Zhongji (CV 3), Qihai (CV 6), Guilai (ST 29), Sanyinjiao (SP 6), Yinlingquan (SP 9), Hegu (LI4) and Baihui (GV 20), and the second set consisted of Tianshu (ST 25), ST 29, CV 3, CV 6, SP 6, Taichong (LR 3), Neiguan (PC) 6 and GV 20. Patients in the sham acupuncture group accepted shallow acupuncture methods through EA without electricity at 4 non-meridian points in each shoulder and upper arm. Outcome measures included body mass index (BMI), waist-hip-ratio (WHR), oral glucose tolerance test (OGTT), insulin release test, glucose and lipid metabolism indicators such as total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, adiponectin, leptin, visfatin, resistin, and interleukin (IL-6). Twenty-six subjects in the true acupuncture group and 20 subjects in the sham group completed the clinical trial. After 16 weeks of treatment, no significant difference in the outcome measures were observed between the two groups (P>0.05). However, as compared with baseline data, a reduction in weight, BMI, hipline, WHR, fasting glucose, homeostatic model assessment of insulin sensitivity, visfatin and HDL-C, and an increase in resistin and IL-6 were observed in the true acupuncture group (P<0.05). In addition, a reduction in visfatin and an increase in TC were also observed in the sham group (P<0.05). Acupuncture may have a beneficial effect in the treatment of PCOS by improving glucose and lipid metabolism. Moreover, the sham acupuncture may be not completely ineffective. Sham acupuncture may improve some of the aspects of the glucose and lipid metabolism of PCOS patients through a placebo effect. (Registration Nos. ChiCTR-TRC-12002529 and NCT01812161).

Research on the body surface resistance imbalance degree at yuan-source points of three yin meridians of foot in the patients with primary dysmenorrhea

ObjectiveTo explore whether or not the changes in body surface resistance at yuan-source points of three yin meridians of foot can specifically responds the onset of primary dysmenorrhea (PD) in females of menstrual period and the before and after, so as to provide the evidence for acupoint selection in clinic. MethodsA total of 90 cases of PD were recruited in a PD group and 90 healthy female undergraduates were recruited in a normal group. The yuan-source of points of three yin meridians of foot were selected, i.e. Tàibái (太白SP3), Tàichōng (太冲LR3) and Tàixī (太溪KI3). The acupoints for control were Xuèhăi (血海SP10), the non-special acupoint, Xuánzhōng (悬钟GB39), the acupoint not on the relevant meridian, as well as a non-meridian point. Successively, before menstruation, on Day 1 during menstruation and on Day 3 after menstruation, the body surface resistance at the above-mentioned test sites was detected in the participants of two groups each day. The resistance imbalance degree (RID) of the bilateral acupoints was taken as the outcome indicator. The observation lasted one menstrual cycle. Results(1) Intra-group comparison: at LR3, the RID was lower on Day 1 during menstruation than that before menstruation significantly in the normal group (P ≤ 0.05). There was no significant change in RID at the same time points, but RID on Day 3 after menstruation was lower significantly than that before menstruation in the PD group (P ≤ 0.05). At SP3, KI3, SP10, GB39 and sham acupoint, there were no significant differences in RID among different time points within the same group (all P > 0.05). (2) Inter-group comparison: there were no significant differences in RID among different time points at the same point. (all P > 0.05). ConclusionRID at yuan-source points of three yin meridians of foot cannot specifically respond to PD. However, at LR3, before and after menstruation, RID changes are different between PD patients and healthy female undergraduates, which needs a further study in the future.

Study on the acupoints belonging to the three yin meridians of foot reflecting the variation pattern of uterine qi and blood in women with moderate constitution

To observe the blood perfusion volume variation pattern in the body surface microcirculation at the Yuan-Primary and the Xi-Cleft points during the menstrual cycle in female college students with moderate constitution under normal physiological state of the uterus; to explore the specific laws of the body surface microcirculation at the Yuan-Primary and Xi-Cleft points in response to the uterine qi and blood changes under normal physiological conditions, and to provide the experimental basis for the specificity of acupoints reflecting the uterine function. Forty-three healthy and moderate constitution female college students with regular menstrual cycles, without dysmenorrhea and not yet giving birth were recruited. Bilateral Yuan-Primary points [Taichong (LR 3), Taibai (SP 3) and Taixi (KI 3)] and Xi-Cleft points [Zhongdu (LR 6), Diji (SP 8) and Shuiquan (KI 5)], belonging to the three yin meridians of foot and adjacent to the spinal cord segment of the uterus, were selected as the detection acupoints; the crossing point of the three yin meridians of foot [Sanyinjiao (SP 6)], the uterus-related meridian acupoint [Xuehai (SP 10)], the uterus-non-related meridian acupoint [Xuanzhong (GB 39)], and the non-meridian non-acupoint point were selected as the control points. The laser speckle blood flow imaging technique was used to monitor the blood perfusion volume in skin microcirculation at the above points at the menstrual, follicular, ovulatory, and luteal phases of the subjects. The blood perfusion volume in the body surface microcirculation at the right Zhongdu (LR 6) at the ovulatory phase was higher than that at the menstrual, follicular and luteal phases (all P<0.05); there was no significant difference in the microcirculation blood perfusion volume at the other points among different phases (all P<0.05). The blood perfusion volume in the body surface microcirculation at Zhongdu (LR 6), the Xi-Cleft point of the Liver Meridian, shows a specific response to qi and blood changes in the uterus of women with moderate constitution.

Study on the body surface temperature variation patterns of the meridian acupoints related to the physiological status of the uterus

By observing the body surface temperature changes of different meridian acupoints located at the same or adjacent spinal segments of the uterus during the whole storing and releasing process of the uterus under normal physiological condition by the infrared thermal imaging technology, to explore the specific patterns that the functions of Zang-fu organs are reflected on the biophysical characteristics of acupoints, and to enrich the functional specificity theory of the meridian acupoints, thus to provide a reference for discussing the biophysical characteristics of meridian acupoints associated with the menstrual cycle in healthy female college students. Ninety healthy subjects were included. Infrared thermal imaging device was used to detect the body surface temperature of the Yuan-Primary points, the Xi-Cleft points, the crossing points, the non-specific points, the unrelated meridian acupoints and the non-meridian non-acupoint points of the three yin meridians of foot located at the same or adjacent spinal cord segment with uterus, during the menstrual phase, the follicular phase, the ovulation phase and the luteal phase. The absolute skin temperature difference between the left and right acupoints with the same name was used as the main outcome indicator. The temperature difference between left and right Diji (SP 8, the Xi-Cleft point of the Spleen Meridian) during the ovulation phase was significantly higher than that during the other 3 phases (all P 0.05); the absolute temperature difference value of each meridian acupoint was not statistically different from each other in the same phase (all P>0.05). The temperature of Diji (SP 8) specifically reflected the onset of ovulation, and the thermal characteristics of Diji (SP 8) specifically reflected the physiological changes of uterus. The meridian acupoints reflecting the performance of Zang-fu function is not only associated with the spinal cord segment innervating the acupoints, but also associated with the characteristics of the acupoints and the meridians to which the acupoints belong.

Display of low hydraulic resistance channels along Conception Vessel by in vivo fluorography in rats

To display the low hydraulic resistance channel along the running course of the Conception Vessel (CV) by using in vivo fluorography, so as to provide evidence for the existence of meridians of traditional Chinese medicine from the aspect of interstitial fluid channel. A total of 24 male SD rats were randomly divided into 3 groups, namely CV-low impedance spots (CV-LIS), CV-low hydraulic resistance points (CV-LHRP) and non-meridian points (NMP) groups (n＝8 in each group). The CV-LIS (the imaged line between the xiphoid process and symphysis pubis), CV-LHRP (lateral and parallel to LIS) and NMP (lateral and parallel to CV-LHRP) were detected by using meridian detector and biofluid resistance meter, respectively. Sodium fluorescein solution (1%) was injected into the spot (A-spot, upper 1/5 of the CV-LIS), and one of the NMP (about 1 cm lateral and parallel to the A-spot, and the mid-point between the Kidney and Stomach meridian running courses) by using a microsyringe for observing the migration trace of sodium fluorescein. After injection of fluorescein, the migration trace of fluorescein appeared along the CV-LIS and CV-LHRP lines, and only local diffusion was found in the NMP group. The migration trace lengths along the CV-LIS and CV-LHRP were significantly longer than that of the NMP group (P<0.01), and the migration width of CV-LIS and CV-LHRP groups was significantly smaller than that of the NMP group (P<0.01). The migration speed of CV-LIS and CV-LHRP groups was significantly higher than that of the NMP group (P<0.01). Fluorography is able to be used to display the running course of CV, possibly supporting the existence of meridians from the interstitial fluid channel and providing a new method for visualization of meridians.

Therapeutic efficacy observation on acupuncture for persistent allergic rhinitis

To observe the clinical effect of acupuncture for persistent allergic rhinitis (PAR). A total of 154 PAR patients were randomized into a treatment group and a control group, 78 cases in the treatment group received acupuncture at meridian points, while 76 cases in the control group received acupuncture at non-meridian points. The treatment was done every other day, 3 times a week for a total 4 weeks. The total nasal symptom score (TNSS), the total non-nasal symptom score (TNNSS) and the rhinoconjunctivitis quality of life questionnaire (RQLQ) were measured before the treatment and after 2 weeks and 4 weeks of treatment, as well as 1 month and 3 months after the treatment to compare the clinical effect between the two groups. After 4 weeks of treatment, the total effective rate in the treatment group was 92.3%, versus 76.3% in the control group, showing a statistically significant difference (P<0.05). Intra-group comparisons of TNSS, TNNSS and RQLQ scores after 4 weeks of treatment showed statistically significant differences (all P<0.05). Between-group comparisons of TNSS, TNNSS and RQLQ score after 4 weeks of treatment and in follow-up visits showed statistically significant differences (all P<0.05). Acupuncture is effective for PAR, and acupuncture at meridian points can produce a better effect than acupuncture at non-meridian points.

Effect of acupuncture at points selected from different regions on SCF-kit signaling pathway in diabetic gastroparesis rats

To observe the effect of acupuncture at points selected from different regions on the positive expression of interstitial cells of Cajal (ICC) and the stem cell factor (SCF) in gastric antrum tissues in diabetic gastroparesis (DGP) rats, and to explore the influence of region-based point selection on the acupoint combination efficacy. Sixty Sprague-Dawley (SD) rats were randomly divided into a normal group (group A), a model group (group B), a group of Zusanli (ST 36) plus Zhongwan (CV 12) (group C), a group of Zusanli (ST 36) plus Neiguan (PC 6) (group D), and a group of Zusanli (ST 36) plus non-meridian non-acupoint points (group E), based on the random number table (n=12). DGP rat model was established by single intraperitoneal injection of 2% streptozotocin and common diet. After successful modeling, the rats were treated once a day for 4 weeks. Positive ICC and SCF expressions were measured by immunohistochemistry. Compared with group A, the gastrointestinal propulsion rate of group B showed a statistically significant decrease (P<0.05). Compared with group B, the gastrointestinal propulsion rate and the expression of ICC in the gastric antrum were significantly higher in group C, group D and group E, and the between-group differences were statistically significant (P<0.05); the expression of C-kit protein in group C was statistically significantly higher than that in group D and group E (P<0.05). The expression of SCF protein was significantly increased in group C than in group B, and the difference was statistically significant (P<0.05). Acupuncture can improve the symptoms of delayed gastric emptying in DGP model rats, and regulate the expression of ICC and SCF in gastric antrum tissues. The effect of Zusanli (ST 36) plus Zhongwan (CV 12) in the gastric region is superior to that of the Zusanli (ST 36) plus distal Neiguan (PC 6) or non-meridian non-acupoint point, indicating that region-based point selection is the key factor affecting the effect of acupoint combination.

Effects of electroacupuncture at meridian point on the mRNA expressions of corticotropin-releasing factor and corticosteroid in the hippocampus after cerebral ischemia reperfusion in rats

Objective To investigate the effects of electroacupuncture at meridian point on the mRNA expressions of corticotropin-releasing factor (CRF) and corticosteroid (CORT) in the hippocampus after cerebral ischemia reperfusion in rats. Methods A total of 150 SD rats were randomly divided into 5 groups by random number table method: normal control group, sham operation group, model group, meridian point electroacupuncture group and non-meridian point electroacupuncture group, with 30 rats in each group. A model of focal cerebral ischemic reperfusion was induced using the modified intraluminal thread method. In the meridian point electroacupuncture group, at 6 h after cerebral ischemia reperfusion, acupuncture “LI11” on both sides, bilateral “ST36”, “GV20”, ”GV16” daily for 7 d. The neurological deficits were evaluated 1 d, 3 d, and 7 d after cerebral ischemia reperfusion, and then all rats were sacrificed and the hippocampi were harvested. The mRNA expressions of CRF and CORT in the hippocampus were determined by quantitative real-time PCR. Results The mRNA expressions of CRF (1.122 ± 0.249, 1.190 ± 0.666, 0.454 ± 0.612 in the model group; 0.021 ± 0.049, 0.021 ± 0.027, 0.035 ± 0.005 in the sham operation group) and CORT (0.917 ± 0.113, 1.024 ± 0.290, 0.709 ± 0.055 in the model group; 0.016 ± 0.013, 0.016 ± 0.006, 0.043 ± 0.006 in the sham operation group) in the hippocampus 1 d, 3 d, 7 d after cerebral ischemic reperfusion were significantly increased in the model group compared with the sham operation group (all P<0.01). The mRNA expressions of CRF (0.424 ± 0.104, 0.339 ± 0.476, 0.095 ± 0.021) and CORT (0.377 ± 0.073, 0.138 ± 0.025, 0.158 ± 0.010) in the hippocampus 1 d, 3 d, 7 d after cerebral ischemic reperfusion were significantly decreased in the meridian point electroacupuncture group compared with the mode1 group (all P<0.01). The neurological deficits scale 1 d, 3 d, 7 d after cerebral ischemic reperfusion were significantly decreased in the meridian point electroacupuncture group compared with the mode1 group (1.83 ± 0.75, 1.50 ± 0.55 and 1.17±0.41 in the meridian point electroacupuncture group; 2.50 ± 0.84, 2.33 ± 0.52 and 1.67 ± 0.52 in the model graoup; all P<0.01). Conclusion Electricacupuncture at meridian point can reduce the mRNA expressions of CRF and CORT in the hippocampus, and improve neurological deficits after cerebral ischemia reperfusion in rats. Key words: Brain ischemia; Reperfusion injury; Electroacupuncture; Corticotropin-releasing hormone; Glucocorticoids; Gene expression; Rats

Additional Evidence for the Sustained Effect of Acupuncture at the Vision-Related Acupuncture Point, Gb37

To investigate the dynamics underlying the sustained effect of acupuncture as a possible explanation of earlier findings that acupuncture stimulation at the vision-related acupuncture point, GB37, cannot specifically change the functional MRI (fMRI) signals of the visual cortex compared with stimulation at an adjacent non-meridian point. The 'on-off' experimental design was separated into four series conditions: 1 min of baseline scanning at the beginning, then two stimulation epochs separated by a 50 s 'rest' period, and then a 1 min 'rest' epoch. The standard General Linear Model (GLM) approach and multi-conditions analysis were used. Results from the multi-conditions analysis were different from those from the standard GLM analysis. We found that the neural signal of the limbic-paralimbic-neocortical system after acupuncture stimulus lasted longer than the putative period. Furthermore, the fMRI signal changes in the occipital cortex showed different temporal patterns between GB37 and the non-meridian point. Owing to the sustained effect of acupuncture, standard GLM analysis may be unsuitable for 'on-off' design acupuncture studies and lead to uncertain and contradictory results. The findings from this study suggest that acupuncture at GB37 can induce complex brain activity in the vision cortex. The state-related neural signal may reflect one of the significant characteristics underlying acupuncture.

Effects and Mechanism of Acupuncture Based on the Principle of Meridians

Effects and Mechanism of Acupuncture Based on the Principle of Meridians

Divergent neural processes specific to the acute and sustained phases of verum and SHAM acupuncture

To discuss which brain region potentially functioned and switched between the immediate and delayed response of acupuncture. A nonrepeated event-related functional MRI (fMRI) design was used to investigate the spatial and temporal patterns of acupuncture effects induced by needling an acupoint ST36 (ACU) and a nonmeridian point (SHAM). The standard general linear model was used to detect the immediate neural responses of acupuncture. Graph theory analysis was used to characterize the functional integrated network of the acupuncture delayed effect. Acupuncture induced significant signal changes in the limbic/paralimbic areas, neocortical regions, brainstem, and cerebellum for immediate effect both in ACU and SHAM. Some of these brain regions showed strong functional connectivity for a delayed effect in ACU. Conjunction analysis showed that the insula played a critical role during the overall process of ACU. No overlapping brain regions were found in SHAM. The findings of this study suggested that the delayed effects may reflect a more significant characteristic underlying acupuncture. Given that the insula as a relay station switched between the immediate and delayed response, it suggested that divergent functional connectivity patterns may mediate the acupuncture-related effects for ACU and SHAM.

Auricular Acupressure for Smoking Cessation: A Pilot Randomized Controlled Trial

Abstract Background: Many health hazards are related to smoking. Patients who wish to stop smoking often need assistance. Objective: To determine the effectiveness of auricular acupressure for smoking cessation and for the relief of withdrawal symptoms in habitual smokers. Design, Setting, Intervention, and Participants: A prospective, randomized, sham-controlled trial using auricular acupressure was conducted from November 2007 to March 2009 in 70 active smokers in Hong Kong. The active group (n = 38) used Shenmen, Lung, Mouth, and Brain acupoints for 3 weeks. The sham group (n = 32) used non-meridian points. The selected acupoints were stimulated with small hard beads fixed in place with adhesive tape. The enrolled participants were then followed up weekly for 3 weeks and for 3 months after acupressure treatment. Main Outcome Measures: Individual daily cigarette consumption, expiration test for carbon monoxide content, and cigarette withdrawal symptom scores were recorded. Results: At the end of the tre...

A Comparative Study on the Immediate Effects of Electroacupuncture at Sanyinjiao (SP6), Xuanzhong (GB39) and a Non-Meridian Point, on Menstrual Pain and Uterine Arterial Blood Flow, in Primary Dysmenorrhea Patients

The objective of this study was to compare the effects of Sanyinjiao (SP6), Xuanzhong (GB39), and an adjacent non-meridian point on menstrual pain and uterine arterial blood flow in primary dysmenorrhea patients. The design of the study was a prospective, randomized controlled trial. The setting of the study was the Shandong Institute of Medical Imaging, Jinan, China. The patients were 52 women with primary dysmenorrhea. Women received electroacupuncture (EA) at SP6 (n=13), GB39 (n=14), and an adjacent non-meridian point (n=12), respectively, for 10 minutes when scored ≥40 on a 100-mm visual analog scale (VAS), and for 30 minutes on the next 2 days. There was no EA in the waiting list group (n=13). Primary outcomes were menstrual pain, resistance index (RI), and the ratio between peak systolic to end-diastolic flow velocity (S/D) in uterine arteries. Secondary outcomes included verbal rating scale (VRS) and retrospective symptom scale (RSS). The SP6 group had a highly significant reduction in VAS scores compared with the waiting list group (-23.19mm, 95% confidence interval [CI]-32.06 to -14.33, P<0.0001), GB39 group (-18.58mm, 95% CI -27.29 to -9.88, P<0.0001) and the non-meridian point group (-20.78mm, 95% CI -29.82 to -11.73, P<0.0001), respectively. A significant reduction in VRS scores was found in the SP6 group compared with the GB39 group (P=0.034) and the non-meridian point group (P=0.038). There were no significant differences of RI, S/D-values and RSS scores among the four groups (P>0.05). EA at SP6 can immediately relieve menstrual pain and minimize the influence of pain on daily life compared with GB39 and an adjacent non-meridian point. The data preliminarily show the specificity of SP6 for the immediate pain relief of primary dysmenorrhea.

A randomized controlled trial of acupuncture for osteoarthritis of the knee: Effects of patient‐provider communication

There is conflicting evidence on the efficacy of traditional Chinese acupuncture (TCA), and the role of placebo effects elicited by acupuncturists' behavior has not been elucidated. We conducted a 3-month randomized clinical trial in patients with knee osteoarthritis to compare the efficacy of TCA with sham acupuncture and to examine the effects of acupuncturists' communication styles. Acupuncturists were trained to interact in 1 of 2 communication styles: high or neutral expectations. Patients were randomized to 1 of 3 style groups, waiting list, high, or neutral, and nested within style, TCA or sham acupuncture twice a week over 6 weeks. Sham acupuncture was performed in nonmeridian points with shallow needles and minimal stimulation. Primary outcome measures were Joint-Specific Multidimensional Assessment of Pain (J-MAP), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and satisfaction scores. Patients (n = 455) received treatment (TCA or sham) and 72 controls were included. No statistically significant differences were observed between TCA or sham acupuncture, but both groups had significant reductions in J-MAP (-1.1, -1.0, and -0.1, respectively; P < 0.001) and WOMAC pain (-13.7, -14, and -1.7, respectively; P < 0.001) compared with the waiting group. Statistically significant differences were observed in J-MAP pain reduction and satisfaction, favoring the high expectations group. In the TCA and sham groups, 52% and 43%, respectively, thought they had received TCA (κ = 0.05), suggesting successful blinding. TCA was not superior to sham acupuncture. However, acupuncturists' styles had significant effects on pain reduction and satisfaction, suggesting that the analgesic benefits of acupuncture can be partially mediated through placebo effects related to the acupuncturist's behavior.

Time-varied characteristics of acupuncture effects in fMRI studies.

When studying the neural responses to acupuncture with a block-designed paradigm, its temporal dynamics predicted by the general linear model (GLM) conforms to typical "on-off" variations during a limited period of the experiment manipulation. Despite a lack of direct evidence associating its psychophysiological response, numerous clinical reports suggest that acupuncture can provide pain relief beyond a needling session. Therefore, a typical GLM analysis may be insensitive or inappropriate for identifying altered neural responses resulting from acupuncture. We developed a new approach to investigate the dynamics underlying sustained effects of acupuncture. Specifically, we designed two separate models to evaluate the baseline activities (prior to stimulation) and neural activities in sequential epochs, using three block-designed functional runs: acupuncture at acupoint ST36, nonmeridian point (NMP) stimulation, and a visual task. We found that the activity patterns during rest were associated with the stimulus types and that the resting activities might be even higher than that of stimulation phases. Such effects of the elevated activity during rest may reduce or eliminate the activity during stimulus conditions or even reverse the sign of brain activation using conventional GLM analysis. Moreover, such sustained responses, followed by acupuncture at ST36 and NMP, exhibited distinct patterns in wide brain structures, particularly in the limbic system and brainstem. These findings may pose great implications for the design and interpretation of a range of acupuncture neuroimaging studies.

Effects of Hegu Acupuncturing and Heating on Transcutaneous Oxygen Pressure and Subcutaneous Microcirculatory Perfusion along the Skin of Large Intestine Channel of Hand-Yangming

Abstract Objective This study attempts to clarify the causes behind a partially changed oxygen pressure by observing subcutaneous microcirculatory perfusion (abbr. SMP) and transcutaneous oxygen pressure (TcPO2) along the skin of Large Intestine Channel (LI) simultaneously. Methods Take SMP and TcPO2 as the two main indexes and one-cun-above-LI6 (Pianli), LI10 (Shousanli), and LI13 (Shouwuli) as the three destined points along the skin of LI to test the indexes on the destined points in 15 healthy volunteers using PeriFlux System 5000 and to observe their variation during acupuncturing Hegu (LI4). Besides, the experiment has also been performed in another 8 volunteers with all the other conditions equal but heating Hegu as the intervention instead. To investigate the difference in energy metabolism between Meridian and Non-Meridian further, SMP was observed on acupoints LI10, LI13, and their bilateral Non-Meridian control points. Results In Hegu acupuncturing group, the means of the two main indexes in the three vertical levels mentioned above before acupuncture and during acupuncture were analyzed by homebody paired sample T test, and SMP during acupuncture was a little higher than that before acupuncture, whereas TcPO2 significantly decreased (P Conclusion A reduced TcPO2 along the meridian course when acupoint being stimulated is not caused by reduced oxygen supply but rather by increased oxygen consumption resulted from enhanced energy metabolism in some relative tissues.

Neuronal Specificity of Needling Acupoints at Same Meridian: A Control Functional Magnetic Resonance Imaging Study with Electroacupuncture

The purpose of this study was to investigate the neuronal specificity of needling acupoints at same meridian by functional Magnetic Resonance Imaging (fMRI). The selected acupoints GB34 (Yanglinquan) and GB39 (Xuanzhong) were at the same gallbladder meridian based on traditional Chinese medicine. In our study we devise three distinct EA (electroacupuncture) manipulations: real EA (deep needling at acupoints), sham EA (deep needling at no-meridian points) and shallow EA (subcutaneous needling at acupoints). Twelve healthy volunteers with right-handiness were enrolled and received three different EA manipulations in counter-balanced orders. DeQi scores were used to evaluate the degree of needling sensation. We found real EA can induce significant stronger needling sensation than sham EA and shallow EA. Multisubjects group mean analysis showed that pain-related cortex including primary and secondary somatosensory cortex (SI and S II), anterior cingulated cortex (ACC), insula were involved in three EA stimulation. Bilateral activation of prefrontal gyrus and occipital cortex were exclusively found in real EA. Deactivation over the rostral segment of ACC was also shown in real and shallow EA. Further paired two difference analysis indicated that real EA induced higher activation than sham EA over bilateral prefrontal gyrus, right-side occipital gyrus and deactivation over the rostral segment of ACC. In the comparing with real EA versus shallow EA, there was right-side activation over the SI, S II, motor cortex, ACC, insula, thalamus, hippocampus, occipital cortex, and cerebellum; also activation over bilateral prefrontal gyrus, caudate and pons. Although no significant activation was found over periaqueductal gray (PAG), further analysis showed the mean and maximal signal changes were different under three EA manipulations. We concluded that EA at analgesic acupoints of same meridian maybe involved the pain-related neuromatrix especially the hypothalamus-limbic system; deep EA at meridian points could elicit stronger needling sensation and modulate the pain-related neuromatrix more effectively than EA at nonmeridian points or shallow EA at meridian points.

Hydrodynamic Analysis of Waveforms Induced by Vibrational Stimuli at Meridian and Non-meridian Points

Meridian theory is an important part of traditional Chinese medicine (TCM). Although acupuncture has been accepted in many countries, the nature of the meridian theory and the principles of acupuncture are still unclear in the modern scientific view. The purpose of this study was to determine the differences in wave propagation of mechanical vibrations (optimal stimulator frequency of 40 Hz) through the pericardium meridian [EH-4 (Chieh-Men) and EH-5 (Chien-Shih)] and adjacent control regions in 20 subjects using hydrodynamic analysis. The mean transfer speed was significantly lower in the meridian (4 m/s) than in the adjacent control region (8.5 m/s, P < 0.001). There were also significant differences between the meridian and control points in the attenuation rate (P < 0.001) and peak amplitude (P < 0.001). In conclusion, these results imply that the substance of the meridian differs from that of the adjacent control regions.