Effect of acupuncture for regulating spleen and stomach on aspirin resistance in patients with type 2 diabetes mellitus: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture for regulating spleen and stomach on aspirin resistance in patients with type 2 diabetes mellitus (T2DM) and explore the effect mechanism.@*METHODS@#A total of 68 T2DM patients complicated with aspirin resistance were randomized into an observation group and a control group, 34 cases in each one. On the base of the conventional treatment for diabetes, aspirin enteric-coated tablets were prescribed for oral administration, 100 mg each time, once daily in the control group. In the observation group, on the basis of the treatment as the control group, acupuncture was used for regulating spleen and stomach at Zhongwan (CV 12), Zusanli (ST 36), Yinlingquan (SP 9), Hegu (LI 4), etc., once daily. The treatment for 1 week was as one course and 4 courses of treatment were required totally in two groups. Before and After treatment, the indexes of platelet function (platelet aggregation rate [PAG] and salicylic acid concentration), the indexes of vascular endothelial function (6-keone prostaglandin F1α[6-keto-PGF1α], thromin B2 [TXB2] and cyclooxysynthase-2 [COX-2]), blood glucose (fasting plasma glucose [FPG], 2 h plasma glucose [2h PG] and glycosylated hemoglobin [HbA1c]), insulin resistance index (HOMA-IR), blood lipid indexes (total cholesterol [TC], triacylglycerol [TG], high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C]) and the total score of TCM symptoms were observed in the patients of two groups. Clinical therapeutic effect and safety was compared in the patients between the two groups after treatment and the recurrence rate of cardiocerebrovascular events was followed up 6 months after treatment.@*RESULTS@#After treatment, PAG, salicylic acid concentration, TXB2, COX-2, FPG, 2h PG, HbA1c, HOMA-IR, LDL-C, TC, TG and the total scores of TCM symptoms were all reduced as compared with those before treatment in the two groups (@*CONCLUSION@#Acupuncture for regulating spleen and stomach combined with aspirin enteric-coated tablets relieve insulin resistance and reduces blood glucose and lipid as well as the recurrence rate of cardiocerebrovascular events in the patients with T2DM, which is probably related to the regulation of insulin resistance and the improvement of vascular endothelial function. This combined therapy achieves the better effect on aspirin resistance as compared with simple aspirin enteric-coated tablets.

Therapeutic Observation of Regulating Spleen-stomach Needling for Type 2 Diabetic Foot / 上海针灸杂志

Objective To observe the clinical efficacy of needling method of regulating spleen-stomach in treating early-stage type 2 diabetic foot (DF).Method A hundred patients with early-stage type 2 DF were randomized into a treatment group and a control group,50 cases each.The two groups both received conventional treatment for diabetes.In addition,the treatment group was intervened by needling method of regulating spleen-stomach;the control group was given oral administration of Pancreatic kininogenase enteric-coated tablets.After 6-week treatment,the changes in fasting blood glucose (FBG),2-hour postprandial blood glucose (P2hBG),serum total cholesterol (TC),triglyceride (TG),6-keto-PGF1α and thromboxane B2 (TXB2) contents were observed.The clinical efficacies of the two groups were also compared.Result The total effective rate was 91.8％ in the treatment group versus 75.5％ in the control group,and the between-group difference was statistically significant (P＜0.05).The levels of FBG,P2hBG,TC,TG,6-keto-PGF1α and TXB2 were significantly changed after the intervention in the two groups (P＜0.01,P＜0.05).The treatment group was significantly different from the control group in comparing each parameter after the intervention (P＜0.01,P＜0.05).Conclusion Needling method of regulating spleen-stomach is an effective method in treating early-stage type 2 DF,and can improve the progressive injury induced by abnormal glucose metabolism.

Clinical observation on repair of lymphocyte injury in patients with diabetic nephropathy treated by regulating spleen-stomach needling / 中国针灸

<p><b>OBJECTIVE</b>To explore therapeutic effect and action mechanism of regulating spleen-stomach needling on diabetic nephropathy (DN).</p><p><b>METHODS</b>Using multi-centric, randomized, controlled and blind principles, 144 cases of DN were divided into an observation group and a control group according to random digital tab, 72 cases in each one. Based on regular treatment of diabetes, the regulating spleen-stomach needling was applied at Zhongwan (CV 12), Quchi (LI 11), Hegu (LI 4) and Xuehai (SP 10), etc. in the observation group while Shenshu (BL 23), Taixi (KI 3), Sanyinjiao (SP 6), Yanglingquan (GB 34), etc. were selected in the control group by reference of Acupuncture and moxibustion. The treatment was given twice a day, six days as a treatment session with interval of one day between sessions. Totally six weeks were required. Changes of clinical symptoms and signs, fast blood glucose (FBG), urinary albumin excretion rate (UAER), beta2-microglobulin (beta2-MG), monocyte chemotactic protein-1 (MCP-1), lymphocyte membrane cholesterol, propanediol (MDA), PCO, 8-hydroxydeoxy guanosine (8-OHdG), superoxide dismutase (SOD), CD3+, CD4+, CD8+, and CD4+/CD8+ were observed before and after treatment in two groups.</p><p><b>RESULTS</b>As for improving clinical symptoms and signs, total effective rate was 84.29% (59/70) in the observation group and 55.56% (40/72) in the control group, which had statistical difference between two groups (P<0.01). As for regulating glycometabolism [(6.25 +/- 0.32) mmol/L vs (8.09 +/- 0.63) mmol/L], reducing UAER [(154.43 +/- 55.14) mg/24h vs (268.91 +/- 77.65) mg/24h], restraining over-expression of MCP-1 [(137.59 +/- 36.15) pg/mL vs (166.89 +/- 42.82) pg/mL], regulating level of oxidative stress, prohibiting oxidation of protein and adjusting quantity and activity of T lymphocyte subgroup, the observation group was superior to the control group (P< 0.05, P<0.01).</p><p><b>CONCLUSION</b>The regulating spleen-stomach needling is an effective method for treatment of DN, which cold improve glycometabolism disturbance-induced progressive kidney injury, recover glomerular filtration, reduce urinary albumin excretion rate, restrain overexpression of MCP-1, adjust level of oxidative stress, prohibit oxidation of protein, increase protectiveness of membrane, adjust quantity and activity abnormity of T lymphocyte subgroup, leading to repairing lymphocyte damage and improving immune expression to delay kidney damage.</p>

Randomized controlled study on dysphagia after stroke treated with deep insertion of Chonggu (EX-HN 27) by electroacupuncture / 中国针灸

<p><b>OBJECTIVE</b>To explore the therapeutic effect of dysphagia after stroke treated with different depth of Chonggu (EX-HN 27) by electroacupuncture.</p><p><b>METHODS</b>Two hundreds and eighty-three cases of dysphagia after stroke were randomly divided into Chonggu (EX-HN 27) deep insertion group (99 cases), Chonggu (EX-HN 27) shallow insertion group (94 cases) and traditional acupuncture group (90 cases) based on multi-central randomized control and blinding methods. Besides routine therapy, Chonggu (EX-HN 27) and Lianquan (CV 23) were selected in the Chonggu (EX-HN 27) deep insertion group and the Chonggu (EX-HN 27) shallow insertion group; the needles were inserted for 60-75 mm and 30 mm respectively and the electroacupuncture was applied in both groups; in traditional acupuncture group, Fengchi (GB 20), Yifeng (TE 17), Wangu (GB 12) and Lianquan (CV 23), etc. were selected. The needles were retained for 30 min, twice a day and 30 treatments totally in 3 groups. The clinical therapeutic effects were evaluated by Kubota's Water Drinking Test Scale, Standard Swallowing Function Scale and TCM Scale of Dysphagia After Stroke.</p><p><b>RESULTS</b>The total effective rate was 97.0% (96/99) in the Chonggu (EX-HN 27) deep insertion group, superior to that of 64.9% (61/94) in Chonggu (EX-HN 27) shallow insertion group and 70.0% (63/90) in traditional acupuncture group (both P < 0.05). Compared with the scores before and after treatment, significant differences were presented statistically in score reduction of TCM Scale in Chonggu (EX-HN 27) shallow insertion group (P < 0.01); the scores of Kubota's Water Drinking Test Scale, Standard Swallowing Function Scale and TCM Scale of Dysphagia After Stroke were obviously reduced in Chonggu (EX-HN 27) deep insertion group and traditional acupuncture group (all P < 0.01); compared with the scores between groups after treatment, the reduction of scores in Chonggu (EX-HN 27) deep insertion group was superior to those in Chonggu (EX-HN 27) shallow insertion group and traditional acupuncture group ( P < 0.05, P < 0.01) respectively.</p><p><b>CONCLUSION</b>Puncture at Chonggu (EX-HN 27) can improve the dysfunction of swallowing after stroke; it is safe and effective, and the needle should be inserted deeply.</p>

Comparative study on transperitoneal retroperitoneal laparoscopic adrenalectomy and open adrenalectomy for adrenal tumours / 中华外科杂志

<p><b>OBJECTIVE</b>To compare and evaluate the clinical value among transperitoneal, retroperitoneal laparoscopic adrenalectomy and open adrenalectomy for the treatment of adrenal tumours.</p><p><b>METHODS</b>From January 1996 to June 2002, transperitoneal laparoscopic adrenalectomy (TLA) was performed for 19 cases, 17 cases were successful (Group A), retroperitoneal laparoscopic adrenalectomy (RLA) for 21 cases, 19 cases were successful (Group B), during the same period 41 patients with adrenal tumours under 6 cm in diameter underwent open adrenalectomy (Group C). The procedure was evaluated and compared in the respects of tumors weight, operation time, blood loss, recovery time of GI function, hospital stay, complications transferable rate and indications among three groups.</p><p><b>RESULTS</b>Average tumors weight was (13.86) g in group A, (15.66) g in group B and (18.03) g in group C; mean operating time: group A was 17.21 min longer than group B, group A. B was 48.53 min longer and 31.32 min longer han group C respectively, mean blood loss in group A. B was less diminished by 121.55 ml and 137.05 ml than group C, and the blood loss in group B was less diminished by 15.50 ml than group A; mean recovery of Gl function, group A and B was 1.87 day and 2.17 day earlier than group C respectively, group B was 0.3 day earlier than group A, mean hospital stay was 2.60 day and 3.87 day shorter than group C, group B was 1.27 day shorter, than group A; transferable rate of operation was 10.5% (group A) and 9.5% (group B). Postoperative complication rate was 10.5%, 14.3% and 9.7% in group A. B and C respectively.</p><p><b>CONCLUSIONS</b>TLA and RLA were better than open method. On the hand of approach to adrenal gland disturbs to abdominal organ and postoperative recovery on RLA have some slight advantage.</p>