Acupuncture Treatment Research Articles

Clinical Effect Analysis of Fire-needle Acupuncture at Neiyingxiang Treating Persistent Allergic Rhinitis.

We conducted the first trial to evaluate the effect that fire-needle acupuncture at Neiyingxiang (ExHN 9) in patients with moderate to severe persistent AR. This was a randomized, single-center, sham, and placebo-controlled rial. Patients were kept blinded to their group assignment. All participants were equally assigned to the fire-needle acupuncture (FA) treatment group, sham fire-needle acupuncture (SFA) group, or loratadine group. The trial was designed with an acupuncture intervention once a week for 4 weeks and follow-up 4 weeks. The Total Nasal Symptom Scores (TNSS), Total Non-Nasal Symptom Scores (TNNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), Allergic Rhinitis Control Test (ARCT), and total nasal resistance of 150 Pa were evaluated as outcome measures. A total of 180 participants were enrolled, and 175 participants completed the trials. At 2 and 4 weeks, the TNSS, TNNSS, and RQLQ scores of the FA and loratadine groups were significantly lower than those of the SFA group. At 8 weeks, the scores of loratadine group increased compared with the FA group (Cohen's d >0.80, p < 0.01). The ACRT score of the FA treatment group rose gradually. After treatment, the total nasal resistance of the FA group was significantly decreased and was lower than that of the other two groups (Cohen's d >0.80, p < 0.01). Fire-needle acupuncture at Neiyingxiang (ExHN 9) is effective for improving nasal allergy symptoms and quality of life in patients with moderate and severe persistent AR, and the duration of its effects is long. 2 Laryngoscope, 134:4471-4479, 2024.

Effectiveness of acupuncture on urinary retention after radical hysterectomy for cervical cancer in China: a systematic review and meta-analysis.

Cervical cancer is one of the most common malignant tumors worldwide. Radical hysterectomy is the first choice for patients with early-stage cervical cancer. Studies have suggested that acupuncture may be a more effective therapy for the prevention and treatment of urinary retention after radical hysterectomy. To systematically evaluate the clinical efficacy of acupuncture in the prevention and treatment of urinary retention after radical hysterectomy. We searched the Cochrane library, Web of science, PubMed, Embase, Chinese Biomedical Literature Database, Wanfang database, Wipu database, China National Knowledge Infrastructure Database and ClinicalTrials.gov with the time from inception until December 2023, to collect randomized controlled studies on the clinical efficacy of acupuncture for prevention and treatment of urinary retention after radical hysterectomy. Literature meeting criteria was screened for data extraction. Quality evaluation was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. And meta-analysis was performed using RevMan5.3 and stata14.0 software. 22 Randomized controlled trials with 1,563 patients, 854 in treatment group and 709 in control group, were included totally. Meta-analysis results showed that: the total effective rate in acupuncture group was higher than that in control group, with a statistically significant difference [relative risk (RR)] = 1.43, 95% confidence interval (CI 1.22, 1.68), p < 0.0001; the rate of urinary tract infection in acupuncture group was lower than that in control group, with a statistically significant difference [RR] = 0.23, 95% CI (0.07, 0.78), p < 0.05; the time of indwelling urinary catheter was reduced in acupuncture group compared with control group, with a statistically significant mean difference = -3.45, 95% CI (-4.30, -2.59), p < 0.00001; the incidence of urinary retention was lower in acupuncture group than in control group, and the difference was statistically significant [RR = 0.37, 95% CI (0.27, 0.50), p < 0.00001]; the residual urine volume was reduced in acupuncture group compared with control group, with a statistically significant mean difference = -50.73, 95% CI (-63.61, -7.85), p < 0.00001. Acupuncture treatment based on conventional therapy can better prevent and improve urinary retention after radical hysterectomy for cervical cancer, could be a better option for them. Registered by PROSPERO and the registration number is CRD42023452387.

Complementary acupuncture treatment and reduced risk of sudden sensorineural hearing loss in nasopharyngeal carcinoma patients: a retrospective, nested case-control study.

Hearing loss is a frequently observed comorbidity in patients with nasopharyngeal carcinoma (NPC). Accumulating evidence demonstrated that acupuncture can safely manage cancer and its treatment-related symptoms, but its effect in minimizing the likelihood of experiencing sudden sensorineural hearing loss (SSHL) has not been established. So this work aimed to determine the risk of SSHL among NPC persons with or without acupuncture use. One population-level, nested case-control design within a cohort study is employed. Relevant information on persons aged 20-80years who were afflicted with NPC between 2000 and 2010 was extracted from a nationwide health claims database. From them, we identified the cases who had the first SSHL diagnosis occurring after NPC, and all of them were randomly matched to two controls without SSHL. Conditional logistic regression was employed to calculate odds ratios (OR) and its respective 95% confidence intervals (CI) for incident SSHL in relation to acupuncture treatment. Eight hundred eleven SSHL cases were randomly matched to 1452 controls. Those receiving conventional care plus acupuncture use had a reduced adjusted OR of 0.39 (95% CI, 0.25-0.60) for SSHL. We further discovered that the longer usage of acupuncture remarkably correlated with reduction of SSHL risk in a dose-dependent manner. Delineation of the benefit from integration of acupuncture into conventional care may be a reference in instituting more appropriate care for NPC subjects. Patients living with NPC may benefit from a timely integration of acupuncture into routine care to lessen SSHL risk.

Clinical Study on the Treatment of Residual Dizziness in Benign Paroxysmal Positional Vertigo with the Structural Balancing Acupuncture Method

Benign paroxysmal positional vertigo (BPPV) often has residual dizziness symptoms after manipulative repositioning, and acupuncture is experienced in treating this disease. In this study, 68 cases of BPPV were recruited and randomly divided into 2 groups: acupuncture combined with manipulative reset group and reset group, and acupuncture treatment was performed with empirically prescribed structural balancing acupuncture method. The Dizziness Handicap Inventory (DHI), Dizziness Visual Analog Scale (VAS), and the effective rate were assessed after two treatments. The results showed that the acupuncture combined with manipulative restoration group was able to reduce the DHI scale score significantly, and a trend change was seen in the visual analog scale (VAS) of dizziness and the effective rate between groups after treatment. The results showed that the combination of structural balancing and manipulative repositioning in the treatment of benign paroxysmal positional vertigo could improve the residual dizziness symptoms compared with manipulative repositioning alone, which can be clinically promoted and further validated in a large-sample RCT in the future.

Acupuncture Treatment on Prolapsed Lumbar Intervertebral Disease (PLID) - A Report in Bangladesh

Background: Both low back pain and sciatica are among the top ten most prevalent medical complaints. As a consequence of these adjustments, both the number of hours worked and the national economic loss will decrease significantly. It is crucial to do a complete physical evaluation of these patients before initiating any form of therapy. Inadequate medical or surgical therapy might cause symptoms to worsen, increasing the probability of this occurring. This research aims to assess how well acupuncture complements standard PLID care. Methods: This inquiry took place at SUOXI Healthcare Limited in Shantinagar, Dhaka, Bangladesh. A 45-year-old male patient has been complaining of lower back discomfort for the last five years. The diagnosis was confirmed with a MRI of lumbo sacral with screening of whole spine. Results: Positive findings emerged from further studies. It had been five years since he had found relief from the pain in his lower back, but now he was pain-free. The results of this research suggest that acupuncture may be helpful for those with PLID.

Understanding discordance in systematic reviews for treating chemotherapy-induced peripheral neuropathy: A focused umbrella review.

e24111 Background: Despite the abundance of publications on chemotherapy-induced peripheral neuropathy (CIPN), we are still lacking effective management options. CIPN-focused systematic reviews (SRs) are increasingly encountered but have not aided much in clarifying treatment guidance. Additionally, there is a rising concern that SRs are now over-saturating the clinical literature, leading to redundant and misleading publications. Umbrella reviews (URs) are an attempt to appraise SRs but do not yet have firm methodologic frameworks. The aims of our UR were to appraise the discordance in recently published CIPN SRs and use content analysis as a method for identifying risks of discordance. Methods: This is a focused UR as part of a larger study to characterize the number of efficacy trials for established CIPN. Following PRISMA guidelines, we conducted a systematic literature search of databases MEDLINE, Embase, and Cochrane Library for publications in English from 1/1/2023 to 11/21/2023. Inclusion criteria were published systematic reviews attempting a comprehensive effort to synthesize any treatment outcomes for established CIPN. The AMSTAR 2 framework was used to appraise results for bias. Measures of randomized controlled trial (RCT) overlap are presented using a novel measure of time-adjusted CA, which accounts for RCT publication dates and SR search dates. Grounded theory coding was used for content analysis on efficacy. Results: We identified 18 SRs containing CIPN treatment RCTs published in less than 1 year, resulting in 32 unique CIPN RCTs. Seven SRs assessed exercise interventions, covering 6 exercise RCTs (41% time-adjusted CA). Five SRs assessed acupuncture, with 9 RCTs (50% time-adjusted CA). One SR searched for all CIPN treatments for pain but missed 4 RCTs. One SR was concerning for spurious data. Bias was variable and imperfect across SRs. Contextual analysis identified the themes of SRs combining preventative and treatment RCTs, confusing comparative vs. controlled trials, and frequent use of p-value only reporting to conclude treatment efficacy as major risks of SR discordance. Conclusions: UR was useful in identifying 32 CIPN RCTs that were not comprehensively identified by SRs. We presented a time-adjusted CA measure to indicate concordance percentage. A higher percentage indicates more re-citation of the same RCTs across SRs, with likely better chances of more concordant conclusions. This measure showed that SRs for CIPN treatment are discordant across the topics of exercise and acupuncture interventions. Content analysis revealed multiple potential causes of discordance. However, SR redundancy was helpful for identifying more unique RCTs. CIPN SR content standards should be developed to minimize discordancy and improve clinical applicability. Clinicians should be cautious when applying CIPN SR recommendations given the high discordance.

A Comprehensive Analysis of Conventional Acupuncture and Pharmacological Approaches for Cardiac Arrhythmias: An Umbrella Review.

With a global incidence of approximately 3.4% and an annual mortality rate of 3.7 million, cardiac arrhythmias (CAs) are a pressing global health issue. Their increasing prevalence, especially among older people, is intensifying the challenge for health care systems worldwide. This study aims to compare the safety and effectiveness of acupuncture and pharmacological treatments for CAs, addressing critical gaps in understanding optimal therapeutic approaches. A search of PubMed, EMBASE, and the Cochrane database of systematic reviews was performed to identify data compiled through September 2023 for this umbrella review. Randomized controlled trials (RCTs) as the foundation for meta-analyses and peer-reviewed systematic reviews were the primary focus of the literature search. The Grading of Recommendations Assessment, Development, and Evaluation method was used to assess the overall certainty of the evidence, whereas AMSTAR 2 and the Cochrane Collaboration tool were used to evaluate the quality of the included reviews. Following a comprehensive review, three systematic analyses of 27 RCTs were integrated. Acupuncture led to a slightly greater reduction in the recurrence rate of paroxysmal supraventricular tachycardia (SVT) compared to standard pharmaceutical therapy (risk ratio [RR], 1.06; 95% confidence interval [CI], 0.88-1.27; I2 = 56%; P = .55), although the difference was not statistically significant. In contrast, acupuncture significantly outperformed pharmacological treatment in the context of ventricular premature beats (VPBs) (RR, 1.16; 95 CI, 1.08-1.25; I2 = 0%; P < .0001). The reduction in paroxysmal atrial fibrillation (AF)/atrial flutter was increased with acupuncture, albeit without statistical significance (RR, 1.12; 95% CI, 0.88-1.42; I2 = 0%; P = .36). Acupuncture also led to a greater reduction in heart rate (HR) compared to pharmaceutical treatment despite notable heterogeneity and a lack of statistical significance (mean difference, -1.55; 95% CI, -41.37 to 38.28; I2 = 99%; P = .94). Adverse events were effectively managed, affirming the favorable safety profile of acupuncture. Our study suggests that acupuncture leads to a greater reduction in the recurrence rates of VPBs, AF, and atrial flutter but not significantly so in paroxysmal SVT or post-treatment HR. While promising for specific arrhythmias, the varying effectiveness of acupuncture underscores the need for further research and clinical assessment to determine its precise role and suitability in managing particular cardiac conditions.

A randomized phase III clinical trial of acupuncture for chemotherapy-induced peripheral neuropathy treatment (ACT).

TPS12151 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and potentially dose-limiting side effect of neurotoxic chemotherapy among people who experience cancer, presenting pain, numbness, tingling, and motor weakness. CIPN worsens quality of life and disrupts active treatment regimens. Currently, duloxetine is the only ASCO-recommended painful CIPN treatment after chemotherapy completion. Still, it has undesirable side effects, i.e., fatigue, sleep disturbance, and digestive symptoms, posing a pressing need for well-tolerated, evidence-based interventions. Our pilot study demonstrated the feasibility and preliminary efficacy of acupuncture in relieving CIPN pain. Based on that, we developed the ACT trial to evaluate the effect of acupuncture on improving pain and other related symptoms among cancer survivors with CIPN pain. Methods: ACT is a prospective phase III multicenter, parallel two-arm randomized clinical trial at Dana-Farber Cancer Institute (DFCI) and Memorial Sloan Kettering Cancer Center (MSK) (ClinicalTrials.gov Identifier: NCT04917796). ACT aims to determine the efficacy of an eight-week electroacupuncture (EA) treatment vs. sham acupuncture (SA) on improving CIPN symptoms severity in cancer survivors. We plan to enroll 250 participants to detect an effect size of at least 0.45 for the primary pain outcome at 12 weeks post-randomization between EA vs. SA, with 80% power and a 1% Type I error rate, assuming a 10% loss to follow-up. Major eligibility criteria include 1) adults who have no evidence of disease or stable diseases, 2) who have completed neurotoxic chemotherapy such as platinum agents, taxanes, vinca alkaloids, and bortezomib at least three months before enrollment, and 3) who have a clinical diagnosis of CIPN with moderate to severe pain, defined as a score of at least four on the Brief Pain Inventory (BPI) average pain item. We randomly allocate participants to receive ten real or sham acupuncture treatments over eight weeks at two centers and their regional clinics. Aside from patient-reported outcome measures (i.e., BPI, Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity, EORTC Quality of Life Questionnaire-CIPN 20), we conduct quantitative sensory testing to assess changes in sensory function. The primary study endpoint is week 12, and the secondary study endpoint is week 24. Progress: 1) We are currently transitioning this trial to a multicenter trial, with DFCI being the coordinating center and MSK a subsite; 2) As of January 18, 2024, a total of 133 of the planned 250 participants have been enrolled; 3) The DSMB last reviewed the trial in December 2023, and suggested that the trial continue as planned at MSK. We anticipate initiating participant enrollment at DFCI in February 2024. Accrual completion is expected by December 2024. Clinical trial information: NCT04917796 .

Research progress on the mechanism of acupuncture treatment for vascular dementia

Acupuncture can intervene with and treat vascular dementia (VD) through multiple targets and pathways. The mechanisms of its action involve inhibiting central inflammatory responses, regulating neuronal synaptic plasticity, modulating oxidative stress, reducing neuronal apoptosis, and adjusting cellular autophagy. This paper summarizes researches on the mechanisms of acupuncture treatment for VD over the past decade, aiming to provide theoretical support for the clinical application of acupuncture in treating VD and offer a reference for future in-depth research in this field.

Transcranial magnetic stimulation in the assessment of acupuncture effect on exercise-induced fatigue.

Acupuncture as a traditional Chinese medicine therapy relies on unique theories to alleviate fatigue. The aim of this study is to evaluate the effect of acupuncture on exercise-induced fatigue utilizing transcranial magnetic stimulation (TMS). A total of 20 participants with regular exercise habits were recruited for this study. All participants were randomly assigned to receive either acupuncture or sham acupuncture intervention for exercise-induced fatigue. TMS and a heart rate monitor were used to measure the amplitude and latency of motor evoked potential (MEP) as well as heart rate every 5min over a 30-min period. The blood lactic acid (BLA) levels were measured using Lactate Scout+ at baseline, 0min, and 30min after fatigue. Two-way repeated measures analysis of variance was utilized to compare the differences between the effects of acupuncture method and time. Bonferroni post hoc tests were conducted to compare specific differences. Statistical significance was set at p<.05. Interaction effect was observed between acupuncture method and time effect in terms of amplitude (F(1, 38)=5.40, p<.001, η2=0.12) and latency (F(1, 38)=3.78, p=.008, η2=.09) of MEP. The application of acupuncture can promote the recovery of heart rate especially at 30min (p<.05), but which seem insufficient to generate significant difference in BLA (F(1, 38)=0.067, p=.797, η2=0.002). Acupuncture can promote the increase of MEP amplitude, shorten MEP latency, and restore heart rate. Preliminary findings provide novel insights for individuals with exercise habits to alleviate fatigue and enhance sports performance.

Efficacy of acupuncture on craniomandibular myofascial pain in temporomandibular disorder patients: A systematic review

BackgroundThis systematic review aimed to answer the question, “What is the efficacy of acupuncture treatment in patients with temporomandibular disorder (TMD) with myofascial pain?“. Data, sources, and study selectionThis study followed PRISMA guidelines and was registered in PROSPERO. The electronic search strategy was applied to the Scopus, PubMed, Embase, and Science Direct databases. As inclusion criteria, were selected randomized clinical articles that evaluated patients with myofascial pain symptoms treated by acupuncture without the restriction of time and language. ResultsThe search in the databases resulted in 286 articles, after removing the duplicates 251 were analyzed by title and abstract. Twenty were selected for full reading and 10 were included in the systematic review. The studies evaluated acupuncture treatments by puncture and laser, auriculotherapy by puncture and laser, and an occlusal device for treating myofascial TMD. ConclusionsComparing acupuncture with placebo acupuncture, it was observed that it is effective for subjective pain relief and palpation of orofacial structures with immediate results; it should be noted that there is still no specific protocol and that the duration of treatment must be personalized. When comparing it with the occlusal device, the associated treatment has enhanced the results. Future studies are suggested by the current literature gap that prevents the determination of clinical guidelines for effective acupuncture treatment in TMD patients with myofascial pain. Practical implicationsLaser and needle puncture acupuncture treatment and laser and needle puncture auriculotherapy have shown favorable results in short-term myofascial pain relief. The need for long-term studies to assess benefits and reduce possible biases is highlighted. Clinical trial registry namePROSPERO (CRD42021271505).

Peripheral Rho-associated protein kinase activation mediates acupuncture analgesia

BackgroundAcupuncture has been proven effective for various types of pain, and peripheral molecular signals around acupuncture-treated areas have been suggested to contribute to the analgesic effects of acupuncture. However, the underlying mechanism from these peripheral molecular signals to central ones remains unclear. The purpose of this study was to investigate whether peripheral Rho-associated protein kinase (ROCK) activation induced by acupuncture treatment mediates acupuncture analgesia, and also to investigate the relationship between ROCK activation and extracellular signal-regulated kinase (ERK), which has previously been proven to mediate acupuncture analgesia and other related molecular changes during acupuncture. MethodsAcupuncture was treated at the bilateral GB34 acupoints of C57BL/6 mice, after which changes in ROCK activation and the location of its expression in the skin were analyzed. To verify the role of ROCK in acupuncture analgesia, we administrated ROCK inhibitor Y-27632 (0.3 μg/ul) into the skin before acupuncture treatment with formalin and complete Freund adjuvant (CFA) induced pain models, then the nociceptive responses were analyzed. ResultsAcupuncture treatment produced ROCK2 activation in the skin after 30 and 60 min, and the histological analyses revealed that ROCK2 was activated in the fibroblast of the dermis. The acupuncture-induced ROCK2 expression was significantly attenuated by the ERK inhibitor, whereas phospho-ERK expression was not inhibited by ROCK inhibitor. In both the formalin- and CFA-induced mouse pain models, acupuncture analgesia was blocked by ROCK inhibitor administration. ConclusionAcupuncture treatment-induced ROCK2 expression is a downstream effector of phospho-ERK in the skin and plays a crucial role in acupuncture analgesia.

Mitigating inflammatory response in breast cancer patients: the inhibitory effect of acupuncture and emotional nursing on the ST8SIA6-AS1/LINC00504/p38 pathway

IntroductionBreast cancer patients often suffer from psychological distress such as anxiety and depression, which can exacerbate inflammation and potentially hinder treatment outcomes. This research investigates the effects of emotional nursing combined with acupuncture on inflammation in breast cancer patients diagnosed with liver depression and stagnation.Material and methodsA total of 40 breast cancer patients with liver depression and stagnation were divided into 2 groups: a control group (n = 20) and an observational group (n = 20). The control group was subjected to standard nursing care, whereas the observational group received a synergised regimen of emotional nursing and acupuncture alongside the regular nursing care. Depression and anxiety levels were assessed using the Self-rating Depression Scale (SDS) and Self-rated Anxiety Scale (SAS). Inflammatory cytokine levels were analysed using ELISA and Western blot, while cell viability and apoptosis rate in breast cancer cells were assessed through specific assays.ResultsEmotional nursing and acupuncture significantly reduced psychological distress and inflammation. Moreover, a significant reduction in ST8SIA6-AS1 and LINC00504 expression levels in tumour tissues was observed following the emotional nursing and acupuncture intervention – 2 entities known to be elevated in breast cancer scenarios and associated with patient survival. Additionally, this therapy restrained the activation of p38 signalling in breast cancer tumour tissues. Furthermore, the silencing of ST8SIA6-AS1 and LINC00504 dampened IL-6-mediated inflammation in breast cancer cells through the p38 pathway.ConclusionsEmotional nursing and acupuncture potentially reduce inflammation in breast cancer patients with liver depression and stagnation by modulating specific factors and deactivating the p38 pathway.

Research progress of acupuncture regulating ERK signaling pathway in the treatment of depression.

Acupuncture treatment for depression has definite therapeutic efficacy, and its mechanism has been extensively studied. The extracellular regulatory protein kinase(ERK) signaling pathway is involved in the development and progression of depression. This article reviewed and summarized the research progress on the regulation of the ERK signaling pathway by acupuncture in the treatment of depression in recent years, focusing on the physiological activation and regulatory mechanism of the ERK signaling pathway, its association with the occurrence of depression, and the mechanisms through which acupuncture activates the ERK signaling pathway to treat depression (including enhancing neuronal synaptic plasticity, promoting the release of neurotrophic factors, and inhibiting neuronal apoptosis). Future research could explore the relationship between the ERK pathway and other pathways, investigate other brain regions besides the prefrontal cortex and hippocampus, examine differences in regulatory mechanisms between male and female patients, assess the effects of different acupuncture techniques on the ERK pathway, and increase efforts to explore mechanism of synaptic plasticity regulation, so as to provide reference for the clinical application and mechanism sludy of acupuncture in depression treatment.

Effects of acupuncture on pain and function in patients with subacromial impingement syndrome: A randomized sham-controlled trial

BackgroundSubacromial impingement syndrome (SIS) is the most common cause of shoulder pain. Acupuncture is a traditional medicine that is effective on pain. This study aimed to evaluate the effect of acupuncture treatment on pain, function, range of motion (ROM) and quality of life compared to sham acupuncture in patients diagnosed with SIS. MethodsA randomized, prospective, double-blinded, sham-controlled trial was conducted. In acupuncture group 40 participants received acupuncture treatment plus exercise therapy while in control group 40 participants received sham acupuncture plus exercise therapy. Primary outcomes included pain-rest, activity and night pain. Secondary outcomes included function [Shoulder Pain and Disability Index (SPADI) and The Disabilities of the Arm, Shoulder and Hand Score (Quick DASH)], ROM, and quality of life [The Western Ontario Rotator Cuff Index (WORC)] in patients with SIS. ResultsBoth groups had significant improvements for pain-rest, activity night pain scores, SPADI, Quick DASH and WORC after treatment and at the first month follow-up. Significant improvements were recorded in the acupuncture group for all ROM after treatment and at the first month follow-up while in control group only in passive internal rotation. Acupuncture group had better improvements for Quick DASH, WORC and all ROM parameters after the treatment, as well as for all parameters except pain-night and passive flexion at the first month follow-up. ConclusionThis study suggest that acupuncture treatment is a safe, effective and non-invasive treatment option in patients with SIS. Trial registrationThe study protocol is registered at clinicaltrials.gov (NCT05794633).

Acupuncture at "Die E acupoint" alleviates inflammatory reaction via inhibiting TLR4/MyD88/NF-κB signaling in rats with allergic rhinitis.

To observe effects of acupuncture at "Die E acupoint" on the protein expression levels of Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), nuclear transcription factor κB (NF-κB), transcription factor T-bet (T-bet), and GATA-binding protein-3 (GATA-3) in the nasal mucosa and the serum contents of related inflammatory cytokines in rats with allergic rhinitis, so as to explore the mechanism of acupuncture in treating allergic rhinitis. Twenty-four healthy SD rats were randomly divided into blank, model, acupuncture, and sham acupuncture groups, with 6 rats in each group. The rat model of allergic rhinitis was established by using ovalbumin induction. The rats in the acupuncture group received bilateral acupuncture at the "Die E acupoint" with a depth of 15-20 mm, while the rats in the sham acupuncture group received only sham acupuncture (light and shallow acupunture of the skin at the "Die E acupoint" ). Both interventions were performed once daily for a total of 6 days. Behavioral scores of rats in each group were recorded. Pathological changes of nasal mucosa were observed by H.E. staining. Serum contents of IgE, ovalbumin-specific IgE (OVA-sIgE), interferon(IFN)-γ, interleukin(IL)-4, IL-10 and IL-17 were measured by ELISA and the protein expression levels of T-bet, GATA-3, TLR4, MyD88 and NF-κB p65 in the nasal mucosa were detected by Western blot. After modeling, compared with the blank group, rats in the model group showed increased behavioral scores, serum IgE, OVA-sIgE, IL-4, and IL-17 contents, and nasal mucosal GATA-3, TLR4, MyD88, and NF-κB p65 protein expression levels (P<0.05), whereas the contents of serum IFN-γ, IL-10 and the protein expression level of T-bet in the nasal mucosa were decreased (P<0.05). Comparison between the EA and model groups showed that acupuncture intervention can decrease the behavioral scores of rats with allergic rhinitis, the contents of serum IgE, OVA-sIgE, IL-4, IL-17, and the protein expression levels of GATA-3, TLR4, MyD88, and NF-κB p65 in the nasal mucosa (P<0.05), and up-regulate the contents of serum IFN-γ, IL-10, and the nasal mucosal T-bet protein expression level. Sham acupuncture did not have a significant modulating effect on the above indicators. Inflammatory infiltration of nasal mucosa was seen in the model group and sham acupuncture, and the inflammatory reaction was milder in the acupuncture group. Acupuncture at "Die E acupoint" can alleviate the symptoms of allergic rhinitis and suppress the inflammation of nasal mucosa in rats, which may be related to inhibiting the TLR4/MyD88/NF-κB signaling and balancing the levels of cytokines of Th1/Th2 and Treg/Th17, and T-bet/GATA-3.

Progress of researches on mechanisms of acupuncture therapy in the treatment of lumbar disc herniation.

Lumbar intervertebral disc herniation (LDH) is a common and frequently-occurring disease, which usually causes lumbar and leg pain. Studies have shown that acupuncture can improve the symptoms of LDH patients. In the present paper, we summarize the progress of researches on the mechanisms of acupuncture underlying improvement of symptoms of LDH in recent 10 years from 1) delaying the intervertibral disc degeneration (by down-regulating the expressions of matrix metalloproteinase ［MMP］-3 and MMP-4, up-regulating the expressions of diosaccharides and polyglycoprotein, inhibiting apoptosis and promoting mitochondrial autophagy of nucleus pulposus cells, etc.), 2) maintaining spinal column stability (by relieving rachiasmus and improving lumbar flexor and extensor muscle strength, lowering the degree of polyfidus edema and fat infiltration, and restoring the biomechanics of the spine), 3) regulating inflammation (by inhibiting the production of proinflammatory factors and increasing the production of anti-inflammatory factors, etc.), 4) regulating immune response (by promoting the activity of T cells and other immune cells, lowering serum levels of MMP-3, transforming growth factor-β1 and prostaglandin E2, raising serum levels of IgA, IgG and IgM to improve immune function ), 5) modulating neural structure and function (by promoting myelin regeneration of sciatic nerve fibers, and reducing the edema of Schwann cells' cytoplasm and mitochondria, and improving neural ultrastructure, and sensory and motor functions of peripheral nerves, etc.), 6) relieving lumbar pain (by down-regulating expression of Ca2+/calmodulin-dependent protein kinase and activation of lumbar spinal cord glial cells, blocking nociceptive signal conduction, regulating the levels of pain-related factors, etc.), and 7) improving local microcirculation. These results may provide scientific evidence for acupuncture treatment of LDH.

Clinical Data Analysis of 10,152 Patients Treated with Acupuncture during Perioperative Period

Objective: To analyze applications of acupuncture treatments during perioperative period and foresee the development of acupuncture in general hospitals by analyzing the clinical data of 10,152 patients treated with acupuncture during perioperative period. Methods: Extracted the perioperative acupuncture treatment records from surgical departments from January 2015 to December 2020 through the Information Management Center of Qilu Hospital. Diagnosis, primary disease, and the department applying for perioperative acupuncture treatments were extracted from their medical records. Frequency of perioperative acupuncture treatments from each department, diseases treated by acupuncture, and primary diseases were counted. The number of acupuncture treatments were counted though the Lianzhong Digital Medical Record Retrieval System of the hospital and effectiveness was evaluated according to the course of disease. Results: There were 10,152 perioperative acupuncture treatments from 17 surgical departments with 43 wards. Each ward had at least one request for acupuncture treatments every month, and the utilization rate of acupuncture increased year over year. The top five departments with the highest number of requests for perioperative acupuncture treatments were the gynecology department, orthopedics department, neurosurgery department, general surgery department and urology department. Acupuncture was mainly used to promote gastrointestinal function (50%) and nerve function (39%), followed by promoting recovery of bladder function (6%) and other diseases existing in the perioperative period (5%). The effectiveness is recognized by patients and surgeons. Conclusion: Acupuncture has been widely used in postoperative rehabilitation and can go further. The treatment of perioperative conditions is an opportunity for the development of acupuncture in general hospitals.

Efficacy of acupuncture treatment for breast cancer-related insomnia: study protocol for a multicenter randomized controlled trial

BackgroundInsomnia is one of the most common symptoms among breast cancer patients, which can be present throughout all stages of breast cancer. As a non-pharmacological alternative treatment, acupuncture has been suggested to improve sleep situations in patients with cancer suffering from insomnia. However, there is a lack of well-designed, high-quality clinical evidence regarding the efficacy of acupuncture in the treatment of breast cancer-related insomnia. This study is conducted to evaluate the efficacy and safety of acupuncture treatment for breast cancer-related insomnia.MethodsThis study was designed as a multicenter, randomized, sham-controlled clinical trial. A total of 264 eligible patients with breast cancer-related insomnia will be randomized into an acupuncture group and a sham acupuncture group in a 1:1 ratio. In the trial, patients in the acupuncture and sham acupuncture groups will receive 12 sessions over a consecutive 4-week period. The primary outcome will be the treatment response rate of Insomnia Severity Index (ISI) at week 4; secondary outcomes include treatment remission rate of ISI, Sleep Efficiency (SE) obtained by the use of Sleep diary, treatment response rate of ISI at 8th and 16th weeks of follow-up, the mean changes of ISI, Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Quality of Life Questionnaire - Core 30 (QLQ-C30), sleep parameters recorded in Actigraphy and weekly usage of remedial drugs. Adverse events will be recorded throughout the study. All analyses will be based on the ITT principle and performed with SAS 9.4 statistical software.DiscussionThis trial will evaluate the clinical efficacy and safety of acupuncture for breast cancer-related insomnia. If proven effective, acupuncture will provide an effective option for patients with breast cancer-related insomnia, which will play a positive role in helping patients reduce their use of sleeping medications.Clinical trial registrationClinicalTrials.gov, identifier NCT05510700.

An Adaptive Pragmatic Randomized Controlled Trial of Emergency Department Acupuncture for Acute Musculoskeletal Pain Management

Acute musculoskeletal pain in emergency department (ED) patients is frequently severe and challenging to treat with medications alone. The purpose of this study was to determine the feasibility, acceptability, and effectiveness of adding ED acupuncture to treat acute episodes of musculoskeletal pain in the neck, back, and extremities. In this pragmatic 2-stage adaptive open-label randomized clinical trial, Stage 1 identified whether auricular acupuncture (AA; based on the battlefield acupuncture protocol) or peripheral acupuncture (PA; needles in head, neck, and extremities only), when added to usual care was more feasible, acceptable, and efficacious in the ED. Stage 2 assessed effectiveness of the selected acupuncture intervention(s) on pain reduction compared to usual care only (UC). Licensed acupuncturists delivered AA and PA. They saw and evaluated but did not deliver acupuncture to the UC group as an attention control. All participants received UC from blinded ED providers. Primary outcome was 1-hour change in 11-point pain numeric rating scale. Stage 1 interim analysis found both acupuncture styles similar, so Stage 2 continued all 3 treatment arms. Among 236 participants randomized, demographics and baseline pain were comparable across groups. When compared to UC alone, reduction in pain was 1.6 (95% confidence interval [CI]: 0.7 to 2.6) points greater for AA+UC and 1.2 (95% CI: 0.3 to 2.1) points greater for PA+UC patients. Participants in both treatment arms reported high satisfaction with acupuncture. ED acupuncture is feasible and acceptable and can reduce acute musculoskeletal pain better than UC alone.