Therapeutic Mechanism Of Acupuncture Research Articles

Acupuncture for treating adolescent depression: Study protocol for a randomized controlled trial

The prevalence of depression among adolescents has been significantly increasing in recent years. However, current antidepressants for adolescents have limited safety and efficacy. Acupuncture has been shown to be effective in treating depression in adults, but there is a lack of high-quality evidence for its effect on the treatment of adolescent depression, and the underlying mechanism is still unclear. Therefore, we designed a randomized controlled trial to explore the effectiveness and the therapeutic mechanisms of acupuncture on adolescent depression. This study will be designed as a multi-center, sham and randomized controlled clinical trial. For this purpose, a total of 96 adolescent depression patients diagnosed with moderate and severe depression will be randomly divided into the manual acupuncture group and the sham one, respectively. The two groups received acupuncture treatment 3 times a week for a total course lasting 4 weeks. All patients will be assessed according to the primary outcomes including Beck Depression Inventory-II (BDI-II), Hamilton Depression Rating Scale (HAMD-24) and Zung self-rating depression scale (SDS) at baseline, week 2, 4 and 8. Additionally, the secondary outcomes will be assessed at baseline and week 4, which includes intestinal flora structure, fecal short chain fatty acids (SCFAs) content and serum serotonin (5-HT) level. This study is the first randomized trial of acupuncture treatment of adolescent depression. Trial registrationChinese Clinical Trial Registry, ChiCTR2200064359. Registered on October 4, 2022.

Acupuncture Medical Therapy and its Underlying Mechanisms: A Systematic Review.

As a traditional Chinese alternative health care approach, acupuncture is gaining increasing attention and reputation in China and overseas. While becoming increasingly popular globally, some consumers and professionals still know little about the therapy and underlying mechanisms of acupuncture. Due to local superiority, there are large numbers of both clinical applications and mechanistic studies performed in China compared to countries overseas. Herein, this review attempts to give a comprehensive profile of the development, application, and mechanisms of acupuncture in treating major diseases. The number of clinical publications concerning acupuncture-treated neurological diseases, endocrine and metabolic diseases, circulatory diseases, respiratory diseases, etc. is first counted, and then, the application and therapeutic mechanisms of acupuncture on the predominant diseases in each category, including obesity, facial paralysis, sciatica, depression, hypertension, asthma, etc., are specifically discussed in this paper. The evolution of acupuncture tools and the rationality of acupoints are also discussed. This review not only summarizes the mechanisms of acupuncture but also provides useful information, such as specific acupoints and acupuncture procedures, for treating common diseases. Therefore, the current study provides useful information for both investigators and acupuncturists.

Effect of Acupuncture on the p38 Signaling Pathway in Several Nervous System Diseases: A Systematic Review.

Acupuncture is clinically used to treat various diseases and exerts positive local and systemic effects in several nervous system diseases. Advanced molecular and clinical studies have continually attempted to decipher the mechanisms underlying these effects of acupuncture. While a growing understanding of the pathophysiology underlying several nervous system diseases shows it to be related to inflammation and impair cell regeneration after ischemic events, the relationship between the therapeutic mechanism of acupuncture and the p38 MAPK signal pathway has yet to be elucidated. This review discusses the latest advancements in the identification of the effect of acupuncture on the p38 signaling pathway in several nervous system diseases. We electronically searched databases including PubMed, Embase, and the Cochrane Library from their inception to April 2020, using the following keywords alone or in various combinations: “acupuncture”, “p38 MAPK pathway”, “signaling”, “stress response”, “inflammation”, “immune”, “pain”, “analgesic”, “cerebral ischemic injury”, “epilepsy”, “Alzheimer’s disease”, “Parkinson’s disease”, “dementia”, “degenerative”, and “homeostasis”. Manual acupuncture and electroacupuncture confer positive therapeutic effects by regulating proinflammatory cytokines, ion channels, scaffold proteins, and transcription factors including TRPV1/4, Nav, BDNF, and NADMR1; consequently, p38 regulates various phenomena including cell communication, remodeling, regeneration, and gene expression. In this review article, we found the most common acupoints for the relief of nervous system disorders including GV20, GV14, ST36, ST37, and LI4. Acupuncture exhibits dual regulatory functions of activating or inhibiting different p38 MAPK pathways, contributing to an overall improvement of clinical symptoms and function in several nervous system diseases.

Morphological Features of the Acupuncture Points of Bladder Meridian in the Giant Anteater (Myrmecophaga tridactyla)

Background: The acupuncture points are considered a point in the skin of sensitivity to stimulation. The acupuncture meridians represent the communication between acupuncture points and internal organs. The giant anteater (Mirmecophaga tridactyla) is routinely attended in veterinary centers, and is pivotal to know its morphology and therapies such as acupuncture that, probably, can be used in medical practice. Thus, the aim of this study was to evaluate the morphological substrate in regions that correspond to the transposition of acupuncture points of the Bladder Meridian using radiography, ultrasonography, electrical impedance and histology in the giant anteater.Material, Methods & Results: Seven giant anteaters (six males and one female) were used. The animals were from the Center of Medicine and Research in Wild Animals (CEMPAS), School of Veterinary Medicine and Animal Science, UNESP, Botucatu, São Paulo. The acupoints of Bladder Meridian evaluated were Bladder 11 (B-11), Bladder 18 (B-18), Bladder 23 (B-23), Bladder 25 (B-25), and Bladder 28 (B-28). The locations of the acupoints were transposed based on the location of these acupuncture points in dogs. Four animals were live and were used for radiographic, ultrasonographic, and electrical impedance analysis. Three animals were died and the fragments of this acupoints were destined to histological routine with hematoxylin and eosin (HE) and Masson’s Trichrome stains. The giant anteaters studied had fifteen thoracic vertebrae, three lumbar vertebrae, and five sacral vertebrae fused in a single bone. The acupuncture points were characterized by presence of abundant connective tissue at the superficial and intermuscular level, muscular fascia, and many neurovascular bundles in the dermal layer. These bundles consisted of nerves, arteries and veins of various calibers. The spaces between the nerves and blood vessels were filled by loose connective tissue containing adipose cells, capillaries, and sweat glands.Discussion: The network of acupuncture points can be seen as a representation of a network formed by interstitial connective tissue. This hypothesis is supported by ultrasound imaging that demonstrated plans for cleavage of connective tissue at acupuncture points in normal humans. It seems that the anatomical relationship of acupoints and meridians with connective tissue planes is relevant to the mechanism of action of acupuncture and suggests an important integrative role for interstitial connective tissue. The presence of connective tissue was observed in the transposition areas studied in the giant anteater using ultrasound. The main histological structures found in the transposition regions of the acupoints in the giant anteater were the nerve and connective tissue, similar to other studies, who claimed that the nerve is the main histological component of an acupoint. Therefore, there are reports suggesting that the network of acupoints and meridians can be seen as a representation of a network formed by interstitial connective tissue and that this relationship is important for the therapeutic mechanism of acupuncture. Based on the results of this study, it is possible to infer that the studied regions present a morphological substrate that is consistent with the characteristics of an acupuncture point. Thus, it is suggested that there are probably acupuncture points in these regions in the giant anteater, which makes possible the use of this alternative medical therapy for the treatment of these animals.

Acupuncture for improving gait disturbance in Parkinson’s disease: A study protocol for a pilot randomized controlled trial

IntroductionParkinson’s disease (PD) is the progressive neurodegenerative disorder, characterized by bradykinesia, resting tremor, and muscle rigidity. Levodopa constitutes the preferred treatment for PD, but is limited by attenuated drug effect and dyskinesia. Therefore, alternative approaches may be useful to enhance levodopa treatment. Acupuncture may relieve PD symptoms, but there is little evidence to support its efficacy. We will assess whether acupuncture improves mobility, and will identify acupuncture-related changes in hemodynamic parameters and neurotransmitter levels, in PD patients with gait disturbance. MethodsAn assessor-blinded, randomized, controlled parallel trial will be conducted in 26 patients diagnosed with PD and gait disturbance. Patients will be randomly allocated to control (n = 13) or intervention groups (n = 13). Intervention will consist of acupuncture for 4 weeks and follow-up for 4 weeks. Control patients will not receive acupuncture and will be followed for 8 weeks. Conventional treatment will be allowed for both groups. ResultsPrimary outcome measure is gait speed using GAITRite analysis. Secondary outcome measures are fNIRS-measured hemodynamic changes in motor and prefrontal cortices, along with neurotransmitter alterations, mobility parameters, and immediate, cumulative, and sustained effects of acupuncture. Discussion/ConclusionsThis trial will evaluate clinical effects of acupuncture in PD patients, and will confirm whether acupuncture alters neurotransmitter levels and associated activities. We expect improvement in gait parameters, changes in motor and prefrontal cortex activity, and changes in neurotransmitter activity, thereby providing insight into the therapeutic mechanism of acupuncture in PD and supporting further studies of whether acupuncture may improve motor symptoms in PD.

Possible Mechanisms of Acupuncture for the Treatment of Chronic Inflammatory Disorders of the Equine Lower Airway

Inflammatory airway disease, recurrent airway obstruction and summer pasture associated obstructive pulmonary disease are chronic inflammatory disorders of the equine lower airway. They are characterized by chronic bronchitis, an increase in respiratory resistance and an increase in the number of neutrophils in the bronchoalveolar lavage fluid. Besides the conventional treatment with bronchodilators and anti-inflammatory agents, acupuncture (AC) and electro-acupuncture (EA) can provide a safe and effective alternative therapy that possesses little or no negative side effects. Possible therapeutic mechanisms of AC and EA for chronic inflammatory disorders of the equine lower airway are proposed based on research in other species. These therapeutic mechanisms include an increase in the mucocilliary action of the airway epithelium, reduction in airway and pulmonary tissue inflammation, activation of cholinergic anti-inflammatory responses, alteration of the immune response, modulation of the autonomic nervous system and alteration in the peripheral sensory input from the inflamed pulmonary tissue.