Acupuncture and Tuina Science

Effect of electroacupuncture on NF-κB and NLRP3 inflammasome in uterine tissues of rats with primary dysmenorrhea Abstract Objective To observe the effect of electroacupuncture (EA) on nuclear factor kappa B (NF-κB) and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome in uterine tissues of rats with primary dysmenorrhea (PD), thus to explore the possible mechanism of EA for PD. Methods Fifty female Sprague-Dawley (SD) rats were randomly divided into a normal group, a model group, an EA at non-acupoint group, an EA at acupoint group and a Western medicine group, with 10 rats in each group. Except for the normal group, rats in the other four groups were treated with estradiol benzoate combined with oxytocin for 11 d to establish PD rat models. From day 1 of the modeling, rats in the normal group and the model group were only properly grasped without any intervention; Guanyuan (CV 4) and Sanyinjiao (SP 6) were selected for EA treatment in the EA at acupoint group; rats in the EA at non-acupoint group were treated with EA at 5 mm away from the acupoints selected above; rats in the Western medicine group were treated with ibuprofen via gavage. Rats in each group were treated for 10-day successively. On the 11th day, except for the normal group, rats in the other groups were intraperitoneally injected with oxytocin (2 U/rat), and the writhing number within 30 min in each group was compared; the pathological changes in rat uteruses were observed by hematoxylin-eosin (HE) staining, and the pathological damage scores were evaluated. Protein expression levels of NF-κB p65, phospho-NF-κB p65, NLRP3, cysteine aspastic acid-specific protease 1 (caspase-1), interleukin (IL)-1β and IL-18 were detected by Western blot. Results Compared with the normal group, the writhing number increased significantly (P<0.05), and the extensive exfoliation of the endometrium, severe edema, and histopathological score all increased significantly in the model group (P<0.05) as well as the protein levels of NLRP3, caspase-1, IL-1β and IL-18, and the ratio of phospho-NF-κB p65/NF-κB p65 in rat uterine tissues (all P<0.05); compared with the model group, the numbers of writhing reaction decreased within 30 min (P<0.05), the endometrial exfoliation was rare, the edema degree was mild, and the histopathological scores decreased significantly (all P<0.05) in the EA at acupoint group and the Western medicine group; compared with the model group, the phospho-NF-κB p65/NF-κB p65 ratio and the NLRP3, caspase-1, IL-1β and IL-18 protein levels of rat uterine tissues in the EA at acupoint group were significantly lower (P<0.05); compared with the model group, the caspase-1, IL-1β and IL-18 protein levels of the rat uterine tissues decreased significantly (all P<0.05), and the differences in the NLRP3 and phospho-NF-κB p65/NF-κB p65 levels were statistically insignificant (all P>0.05) in the Western medicine group; compared with the Western medicine group, the phospho-NF-κB p65/NF-κB p65 ratio, also the NLRP3, IL-1β and IL-18 protein levels of the uterine tissues decreased significantly in the EA at acupoint group (all P>0.05), while the difference in the caspase-1 level was statistically insignificant (P>0.05); there were no significant differences between the EA at non-acupoint group and the model group in any indicators(P>0.05). Conclusion EA at acupoints significantly improves the pain and pathological damages of PD rats. The mechanism may be related to the reduced uterine inflammation via inhibiting NF-κB phosphorylation and NLRP3 activation in uteruses of PD rats.

Research advances in neurobiological mechanism of acupuncture for amblyopia Abstract Amblyopia greatly affects the physical and mental development of children. Acupuncture is effective for amblyopia, though its mechanism remains unclear. This article summarized the mechanism of acupuncture treatment of amblyopia from the perspectives of morphology of neurons in visual cortex, visual electrophysiology, and molecular biology, etc. It was found that acupuncture may treat amblyopia through repairing the morphological and ultrastructural damages of neurons in visual cortex, promoting the electrical activities in visual pathway and visual cortical neurons, and modulating the synthesis and expression levels of factors involved in visual system. Nevertheless, further studies are required to unveil the mechanism of acupuncture treatment of amblyopia.

Analysis of clinical literature on acupuncture-moxibustion for dyspepsia based on data mining Abstract Objective To summarize the point selection pattern and treatment method in acupuncture-moxibustion for dyspepsia through data mining of the related clinical literatures in recent two decades, and to provide reference for clinical application. Methods With data mining technology, clinical literatures related to acupuncture-moxibustion for dyspepsia published between January 1997 and July 2018 were collected from major Chinese databases, and the treatment methods, point and meridian frequencies were summarized and analyzed. Results A total of 106 studies were included. For meridians, the top 5 meridians used were the Stomach Meridian, Conception Vessel, Spleen Meridian, Liver Meridian and Pericardium Meridian. For point selection, the leading 5 points were Zusanli (ST 36), Zhongwan (CV 12), Shangwan (CV 13), Xiawan (CV 10) and Sanyinjiao (SP 6). For major and adjunct points, the 5 most significant major points were Zusanli (ST 36), Zhongwan (CV 12), Neiguan (PC 6), Sanyinjiao (SP 6) and Shangwan (CV 13); the 5 most significant adjunct points were Neiting (ST 44), Qihai (CV 6), Fenglong (ST 40), Yinlingquan (SP 9) and Tianshu (ST 25). For treatment method, the top 3 methods used were moxibustion alone, acupuncture alone and acupuncture combined with medicinal herbs. Conclusion The main meridian chosen in acupuncture-moxibustion for dyspepsia was the Stomach Meridian, and the points were mainly selected from the Stomach Meridian; treatment method was moxibustion alone, which may provide reference for clinical treatment of this disease.

Treatment of neck type cervical spondylopathy with Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture method: a randomized controlled trial Abstract Objective To observe the clinical effect of Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture method versus ordinary acupuncture on superficial fascia for treating neck type cervical spondylopathy in Kyrgyz. Methods A total of 64 Kyrgyz patients conforming to the diagnostic criteria of neck type cervical spondylopathy were included. The patients were randomized into a Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture group and a conventional acupuncture group, with 32 cases in each group. Patients in the Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture group were treated with Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture method to stimulate the superficial fascia, the stimulation sites were primarily located at bilateral sides of the cervical vertebra as well as the trigger points in shoulder-neck region; patients in the conventional acupuncture group were punctured at the same acupoints, with twirling reducing method, and the depth of insertion was determined by the treated region. Patients in both groups received treatment every day for a succession of 5 d as a course, with a 2-day interval between 2 courses, and the whole treatment lasted for 3 courses. After 3 courses of treatment, the McGill pain questionnaire (MPQ) and neck disability index (NDI) were measured to compare the clinical effect between the two groups. Results After treatment, scores of MPQ and NDI scale dropped when compared with those before treatment, and the differences showed statistical significance (all P<0.05); scores of MPQ and NDI in the Jin Gou Diao Yu (gold-hook-fishing) acupuncture group were substantially lower than those in the conventional acupuncture group, and the differences showed statistical significance (all P<0.05). The total effective rate was 96.9% in the Jin Gou Diao Yu (gold-hook-fishing) acupuncture group and the cured rate was 78.1%, which were higher than 81.3% and 40.6% in the conventional acupuncture group, and the differences showed statistical significance (all P<0.05). Conclusion Zheng's Jin Gou Diao Yu (gold-hook-fishing) acupuncture method by stimulating superficial fascia to treat cervical spondylopathy in Kyrgyz can produce a better clinical effect than conventional acupuncture treatment, and is effective in improving pain and stiffness in patients, and thus is worth clinical popularization.

Review on the development and application of electroacupuncture apparatus in the past 5 years in China Abstract Objective To review the problems existing in the development and application of current electroacupuncture (EA) apparatuses, and provide reference for the development of EA apparatuses. Methods Related literatures about EA apparatus were derived from China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang) and Chongqing VIP Database (CQVIP) between 2013 and 2017. Literatures about the development of EA apparatuses and the application for experimental research and clinical treatment published in Chinese journals were retrieved, and the development and application of EA apparatuses were summarized. Results Among the 107 selected literatures, 48 types of EA apparatuses were used, of which only 11 models could be found in the registration list and within the validity period. There was no registration information for the EA apparatus newly developed in the past 5 years. The EA parameters used in experimental research and clinical treatment in Chinese medicine were different, and the combination of stimulation parameters was diverse. Conclusion At present, most of the new EA products are still in the experimental or research stage, and the transformation of results has not yet been achieved. Moreover, there is no unified standard for the use of EA apparatus and its stimulation parameters in experimental research and clinical treatment, which is not conducive to the standardization process of EA stimulation.

Effect of moxibustion on VEGF and EGF expressions in tumor tissues of rats with gastric tumor Abstract Objective To explore the inhibitory effect of moxibustion on tumor growth and metastasis, and also its possible mechanism, in gastric tumor-bearing rats by investigating the expressions of vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF). Methods Fifty healthy Sprague-Dawley (SD) rats (half male and half female) were routinely housed for 1 week. A total of 20 rats were randomly divided into a blank group and a sham operation group, with 10 rats in each group. The remaining 30 rats were used to make gastric cancer models by implantation of ascites-type Walker-256 cancer cells. After successful modeling, rats were randomly divided into a model group, a moxibustion group and an infrared group, with 10 rats in each group. From the day of modeling, the body weight of each group was weighed every 4 days. Warm moxibustion was alternately performed at two-group acupoints [Zhongwan (CV 12), Guanyuan (CV 4) and bilateral Zusanli (ST 36) in one group, and bilateral Pishu (BL 20) and Weishu (BL 21) in another group] in the moxibustion group. The body surface projection area of the stomach was irradiated with short-wave infrared rays in the infrared group, once a day, 20 min per time for 21 d. At the end of the treatment, the gastric tumor was completely dissected, and the tumor volume and tumor growth inhibition rate were calculated. Then the gastric tumor cell metastasis was recorded. The levels of VEGF and EGF in rat gastric tumor tissues were determined by enzyme-linked immunosorbent assay (ELISA). Results Compared with the blank group, the body weight of the model group decreased significantly after modeling (P<0.05); compared with the model group, the rats in the moxibustion group had increased body weight during the middle and late stages (both P<0.05). The tumor volumes of rats in the moxibustion group and the infrared group were smaller than the volume in the model group (both P<0.05). The tumor growth inhibition rate in the moxibustion group was significantly higher than that in the infrared group (P<0.05). The case number of tumor metastasis in the moxibustion group was smaller than that in the model group and the infrared group. The VEGF level in the tumor tissues of the model group was statistically significantly higher than that in the blank group (P<0.05). Compared with the model group, the VEGF levels in the moxibustion group and the infrared group were statistically significantly lower (both P<0.05). The EGF levels in the tumor tissues of the model group was statistically significantly lower than that in the blank group (P<0.05); compared with the model group, the EGF levels in the moxibustion group and the infrared group were statistically significantly increased (both P<0.05). Conclusion Moxibustion can increase the body weight, inhibit the tumor growth, invasion and metastasis in gastric tumor-bearing rats, which may be related to the regulation of VEGF and EGF expressions in tumor tissues.

Efficacy observation on pediatric tuina plus Chinese medicine for exogenous fever in children Abstract Objective To observe the clinical effects of pediatric tuina plus Chinese medicine for exogenous fever in children. Methods A total of 150 children with exogenous fever were randomly divided based on the random digital table into a control group (75 cases) and a treatment group (75 cases). The control group was treated with oral Xiao'er Chaigui Tuire Keli (<1 year old, 0.5 bag/time; 1–3 years old, 1 bag/time; 4–6 years old, 1.5 bags/time), 4 times/day. The treatment group was treated with pediatric tuina plus the intervention of the control group. The amount and usage of Chinese medicine were the same as those of the control group; tuina was conducted 1 time/day. The clinical effects and adverse reactions were observed after 3 d of treatment in both groups. The recurrence was observed within 7 d after the end of treatment. Results The total effective rate was 92.0% in the treatment group and 81.3% in the control group. The difference between the two groups was statistically significant (P<0.05). There were no obvious adverse reactions in the two groups after treatment. The recurrence rate was 1.5% in the treatment group and 13.1% in the control group. The difference in the recurrence rate between the two groups was statistically significant (P<0.05). Conclusion Pediatric tuina plus Chinese medicine is effective in treating children with exogenous fever.

Study on the angle of needling Yamen (GV 15) in atlanto-axial dislocation patients Abstract Objective To compare the risk angle and safety angle of needling Yamen (GV 15) between the atlanto-axial dislocation (AAD) patients and healthy subjects. Methods A total of 177 AAD patients diagnosed and treated at the Center of Upper Cervical Vertebra of Beijing China-Japan Friendship Hospital between January 2010 and January 2018 were included in the AAD group. Another 207 healthy subjects were included in the normal group. There were totally 191 males and 193 females. The MRI scan was performed for the cervical vertebrae to measure the risk angle and safety angle of acupuncture at Yamen (GV 15) on the sagittal image. Results In the AAD group, the risk angle was (13.14±3.99)° and the relative safety angle was (10.31±3.23)° for the perpendicular needling, while the oblique needling risk angle was (9.09±3.09)° for the male; the risk angle was (12.12±2.74)° and the relative safety angle was (10.56±2.09)° for the perpendicular needling, while the oblique needling risk angle was (9.70±2.95)° for the female. In the normal group, the risk angle was (7.89±1.59)° and the relative safety angle was (10.21±3.55)° for the perpendicular needling, while the oblique needling risk angle was (16.07±1.77)° for the male; the risk angle was (6.93±1.45)° and the relative safety angle was (10.70±2.94)° for the perpendicular needling, while the oblique needling risk angle was (14.89±2.18)° for the female. The perpendicular needling risk angles for the males and females in the AAD group were larger than those in the normal group, and the differences were statistically significant (both P<0.01); for the inner-group comparison, there was no significant difference in the perpendicular needling risk angle between the male and the female in the AAD group (P>0.05); however, the perpendicular needling risk angle for the male was larger than the female, and the difference was statistically significant in the normal group (P<0.01). There were no significant differences in the relative safety angle for both the male and the female between the AAD group and the normal group (both P>0.05). For the inner-group comparison, there was no significant difference in the relative safety angle between the male and the female (P>0.05). The oblique needling risk angles for both the males and females were smaller in the AAD group than those in the normal group, and the differences were statistically significant (both P<0.01); the oblique needling risk angle for the male was not significantly different from that for the female in the AAD group (P>0.05); in the normal group, the oblique needling risk angle for the male was larger than that for the female, and the difference was statistically significant (P<0.01). Conclusion Under the AAD condition, the risk angle and safety angle of acupuncture at Yamen (GV 15) change significantly, perpendicular needling should be better if performed slightly lower than the horizontal direction, and the oblique needling should be safer across the occipital foramen toward the occipital bone.

Efficacy and safety of electroacupuncture for perimenopausal insomnia: a randomized controlled trial Abstract Objective To observe the effectiveness and safety of electroacupuncture (EA) plus Luohua Anshen oral liquid for patients with perimenopausal insomnia. Methods A total of 66 participants who met the inclusion criteria were enrolled in the randomized controlled trial and allocated to a treatment group and a control group at a ratio of 1:1, with 33 cases in each group. Both groups were given Luohua Anshen oral liquid as a basic treatment. The treatment group was additionally given EA every other day, three times a week. Both groups were treated for four weeks and a four-week follow-up was conducted. The scores of Pittsburgh sleep quality index (PSQI), Kupperman index (KI) and traditional Chinese medicine sleep syndrome scale (TCMSSS) were recorded at pre- and post-treatment, and at the follow-up. Meanwhile, adverse effects were monitored and recorded. Results After four-week treatment, the global scores of PSQI, KI and TCMSSS in both groups declined significantly (all P<0.05), and the decreases in the treatment group were more significant than those in the control group (all P<0.05). The global scores of PSQI, KI and TCMSSS in both groups at the follow-up visit were significantly different from the corresponding baseline (all P<0.05), while insignificantly different from those assessed at post-treatment (all P>0.05). The total effective rate was 93.9% in the treatment group, significantly higher than 72.2% in the control group (P<0.05). No significant adverse event was reported in this trial excepted one patient experienced slight dizziness in the first acupuncture treatment. Conclusion EA plus Luohua Anshen oral liquid is safe for perimenopausal insomnia with satisfactory short- and long-term effectiveness, and it shows certain advantage compared with using Luohua Anshen oral liquid alone.

Efficacy comparison of different forms of dog-days acupoint application for prevention and treatment of chronic bronchitis Abstract Objective To analyze the clinical effect of traditional dog-days acupoint application and Magic Acupuncture Patch (Manji) in the prevention and treatment of chronic bronchitis (CB) in remission stage in the past five years, and explore the principle of action and effective stimulation, to provide the evidence for treating CB by acupoint application. Methods A retrospective study was conducted on 405 patients with CB who met the inclusion criteria. All patients were treated with dog-days acupoint application or Magic Acupuncture Patch between 2013 and 2017. The clinical data of 405 patients were statistically analyzed to compare the prevention and treatment effects of dog-days acupoint application and Magic Acupuncture Patch, and different degrees of stimulation of dog-days acupoint application. Results Among the dog-days acupoint application groups, the total effective rate was 63.6% in the light stimulation group, 93.1% in the moderate stimulation group, and 94.8% in the strong stimulation group. The differences in the total effective rate between the light stimulation group and the moderate stimulation group, as well as the strong stimulation group, were statistically significant (both P<0.05). There was no significant difference in the total effective rate between the moderate stimulation group and the strong stimulation group (P>0.05). The total effective rate was 83.9% in the dog-days acupoint application group, versus 45.4% in the Magic Acupuncture Patch group, and there was a statistically significant difference between the two groups (P<0.05). Conclusion The efficacy of dog-days acupoint application in the prevention and treatment of CB is better than that of Magic Acupuncture Patch; the degree of stimulation is the basis for the effect of dog-days acupoint application on prevention and treatment of CB, and the moderate and strong stimulations are more appropriate.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
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6948891480

alsfakia@gmail.com