ABSTRACT
Objective: To explore the mechanism of An-Pressing manipulation in relieving energy crisis in chronic myofascial trigger points (MTrPs) by observing the effects of An-Pressing manipulation on adenosine triphosphate (ATP), adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK)/peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) pathway and mitochondrial ultrastructure of skeletal muscle cells in MTrPs rats. Methods: Forty-eight male Sprague-Dawley rats were randomly divided into a blank group, a model group, a lidocaine group, and an An-Pressing manipulation group, with 12 rats in each group. The model group, lidocaine group and An-Pressing manipulation group were used to replicate the MTrPs rat model by blunt shock and centrifugal motion method. After modeling, the An-Pressing manipulation group was subjected to 7 times An-Pressing manipulation, once every other day; the lidocaine group was treated with 3 times of injection of lidocaine at the MTrPs, once every 6 d. The blank group and the model group were fed normally without intervention. After the intervention, local muscle tissue was taken to detect the content of ATP and the expression of AMPK, phosphorylated AMPK (phospho-AMPK), PGC-1α, and glucose transporter 4 (GluT4), and the ultrastructure of mitochondria was observed under an electron microscope. Results: Compared with the blank group, the ATP content in the model group was decreased (P<0.05), the protein expression levels of phospho-AMPK, PGC-1α, and GluT4 and the ratio of phospho-AMPK to AMPK were decreased (P<0.05); under the electron microscope, the number of mitochondria decreased, and they were deformed, small in volume, and had deformed cristae. Compared with the model group, the ATP contents in the An-Pressing manipulation group and the lidocaine group were increased (P<0.05), and the protein expression levels of phospho-AMPK, PGC-1α, and GluT4 and the ratio of phospho-AMPK to AMPK were increased (P<0.05); under the electron microscope, the number of mitochondria increased, the shape and size of the mitochondria were basically normal, and the cristae could be seen. Compared with the lidocaine group, phospho-AMPK and the ratio of phospho-AMPK to AMPK in the An-Pressing manipulation group were increased (P<0.05); under the electron microscope, the numbers of mitochondria were similar, and the shape and size of the mitochondria were basically normal without swelling, and the cristae could be observed. Conclusion: An-Pressing manipulation can increase the ATP content in MTrPs tissue, improve the expression levels of PGC-1α and GluT4 proteins and the ratio of phospho-AMPK to AMPK; its mechanism may relate to the activation of AMPK/PGC-1α signaling pathway to promote the repair of mitochondrial damages.
ABSTRACT
<p><b>OBJECTIVE</b>The clinical research literature regarding acupuncture treatment for vascular dementia was reviewed and analyzed to provide the references for clinical selection and compatibility of acupoints.</p><p><b>METHODS</b>With computer and manual retrieval method, the clinical literature regarding acupuncture treatment for vascular dementia in recent 10 years was collected. The acupoint type, meridian and use frequency were analyzed.</p><p><b>RESULTS</b>Totally 38 articles of acupuncture treatment for vascular dementia were screened; the most selected meridians were the governor vessel, gallbladder meridian, stomach meridian and spleen meridian; the main acupoints with frequency of more than 5 times were Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Fengchi (SP 40) and Shuigou (GV 26); the matching acupoints with frequency of more than 5 times were Fenglong (ST 40), Zusanli (ST 36), Taichong (LR 3), Taixi (KI 3), Sanyinjiao (SP 6), Xuehai (SP 10), Zhongwan (CV 12), Neiguan (PC 6), Fengchi (GB 20).</p><p><b>CONCLUSIONS</b>The rules and characteristics of acupoint selection for vascular dementia were featured with taking the local acupoints at head as main points, combining disease differentiation and syndrome differentiation as clinical principle, valuing local acupoints and distal acupoints, applying various techniques of acupuncture and moxibustion and combing traditional acupuncture manipulation and modern electroacupuncture stimulation.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To systematically evaluate the efficacy and safety of acupuncture on diarrhea-predominant irritable bowel syndrome (IBS) in the past five years.</p><p><b>METHODS</b>Online databases, including CNKI, VIP, WANFANG, PubMed, CBM, ScienceDirect OnSite, Cochrane Library, etc. were searched for randomized controlled trials (RCTs) of acupuncture for diarrhea-predominant IBS. Retrieval time was from January of 2011 to January of 2016. According to modified Jadad standard, the bias risk and quality assessment of each RCT included were evaluated by two researchers. RevMan 5.3 software was adopted for the meta-analysis.</p><p><b>RESULTS</b>Totally 17 RCTs were included with 1 333 patients. The result of meta-analysis indicated the total effective rate of clinical symptoms improvement in the acupuncture group or acupuncture combined with western medicine group was superior to that in the western medicine group (=3.92, 95%:2.83~5.43,<0.01), and the funnel plot was basically symmetry. The result of meta-analysis showed 3-month recurrence rate:=0.22, 95%:0.12~0.41 (<0.01), indicating the recurrence rate in the acupuncture group was lower than that in the western medicine group in three month.</p><p><b>CONCLUSIONS</b>Acupuncture for diarrhea-predominant irritable bowel syndrome is superior to conventional treatment of western medication, which can improve the clinical symptoms and reduce the recurrence rate of patients.</p>