Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels and targets and is not limited to "driving the vagus-adrenal axis" / 中西医结合学报

In October 2021, an international collaborative study on the use of electroacupuncture (EA) to treat inflammation was published in the journal Nature by Dr. Qiufu Ma's team. Based on the results of EA on inflammation in the mouse model of lipopolysaccharide inflammatory storm, the study showed that the distal effect of acupuncture can be achieved by "driving the vagus-adrenal axis (through the adrenal medulla, by releasing catecholamines)." PROKR2Cre-marked sensory neurons, which innervate the deep hindlimb fascia but not the abdominal fascia, are crucial for driving this axis. The study suggests the existence of specificity distribution of acupoints, that different EA stimulation intensities or different needle penetration depths have different therapeutic effects, that photosensitive stimulation may be a substitute for needle acupuncture, and that massage, stretching and body movements may also activate PROKR2Cre-markable dorsal root ganglion sensory neurons and elicit anti-inflammatory effects. However, results of some other studies are contrary to the conclusions of Ma's team. For examples: low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation, which is more relevant to the real daily acupuncture practice, and this effect was partly related to the adrenal cortex and associated with the stimulation of corticosterone and adrenocorticotropic hormone; manual acupuncture (similar to the low-intensity EA) at KI3, Zhichuan point (an extra point), etc. was effective in a severe COVID-19 patient with sepsis; stimulating ST25 with low-intensity EA or manual acupuncture was effective against gastrointestinal inflammations; the above mentioned points are not in an area enriched with PROKR2Cre-marked sensory nerve endings. Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems, multi-levels and multi-targets, which does not limit to "driving the vagus-adrenal axis." Please cite this article as: Fan AY. Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels and targets and is not limited to "driving the vagus-adrenal axis." J Integr Med. 2023; 21(4):320-323.

Recovery of a patient with severe COVID-19 by acupuncture and Chinese herbal medicine adjuvant to standard care / 中西医结合学报

There is currently no drug or therapy that can cure the coronavirus disease 2019 (COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation (SpO

Literature Study on Current Status of Traditional Chinese Medicine for Chronic Atrophic Gastritis Based on PubMed and Web of Science Databases / 中国实验方剂学杂志

Objective:To review and summarize the current research status of traditional Chinese medicine（TCM） for the treatment of chronic atrophic gastritis（CAG），provide references and hints for relevant studies，and contribute to the further understanding of TCM and the application of TCM in the treatment of CAG with scientific evidence. Method:The PubMed and Web of Science databases were searched for relevant literature on the treatment of CAG with TCM from their establishment to August 31，2020. Eligible randomized controlled trials （RCTs） and animal studies were included according to the inclusion and exclusion criteria，and then the information of the included studies was extracted，summarized，and organized for further analysis. Result:A total of 4 RCTs and 21 animal studies （including 13 papers on compound studies，3 papers on single herb studies，and 5 papers on monomer studies） about TCM treatment for CAG were included in this study. RCTs showed that TCM could work well in improving the pathological state of gastric mucosa and clinical symptoms in patients. However，there were problems of low study quality，and non-uniform diagnostic criteria for gastric mucosal pathology and clinical efficiency evaluation. Animal experiments mainly focused on the study of drug mechanism exploration，and their results showed that TCM treatment of CAG was characterized by multi-target action. However，the animal experiments also had some problems such as inconsistence of CAG animal model establishment，positive drug selection，drug intervention methods as well as intervention cycles among different experiments. Conclusion:The efficacy of TCM in the treatment of CAG has gradually gained global recognition，but there is still a need for further standardization and unification of research methods. In the future，high-quality clinical trials and standardized animal experiments are still needed to conduct in-depth studies on the time for intervention，intervention methods，active ingredients and mechanisms of TCM，so as to make contributions to the full understanding and application of TCM in the treatment of CAG.

Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis / 中西医结合学报

BACKGROUND@#There is currently no drug or therapy that cures COVID-19, a highly contagious and life-threatening disease.@*OBJECTIVE@#This systematic review and meta-analysis summarized contemporary studies that report the use of Chinese herbal medicine (CHM) to treat COVID-19.@*SEARCH STRATEGY@#Six electronic databases (PubMed/MEDLINE, Cochrane Library, ScienceDirect, Google Scholar, Wanfang Data and China National Knowledge Infrastructure) were searched from their beginning to May 15, 2020 with the following search terms: traditional Chinese medicine, Chinese medicine, Chinese herbal medicine, COVID-19, new coronavirus pneumonia, SARS-CoV-2, and randomized controlled trial.@*INCLUSION CRITERIA@#Randomized controlled trials (RCTs) from peer-reviewed journals and non-reviewed publications were included. Further, included RCTs had a control group that was given standard care (SC; such as conventional Western medicine treatments or routine medical care), and a treatment group that was given SC plus CHM.@*DATA EXTRACTION AND ANALYSIS@#Two evaluators screened and collected literature independently; information on participants, study design, interventions, follow-up and adverse events were extracted, and risk of bias was assessed. The primary outcomes included scores that represented changes in symptoms and signs over the course of treatment. Secondary outcomes included the level of inflammatory markers, improvement of pneumonia confirmed by computed tomography (CT), and adverse events. Dichotomous data were expressed as risk ratio or hazard ratio with 95% confidence interval (CI); where time-to-event analysis was used, outcomes were expressed as odds ratio with 95% CI. Continuous data were expressed as difference in means (MD) with 95% CI, and standardized mean difference (SMD) was used when different outcome scales were pooled.@*RESULTS@#Seven original studies, comprising a total of 732 adults, were included in this meta-analysis. Compared to SC alone, CHM plus SC had a superior effect on the change of symptom and sign score (-1.30 by SMD, 95% CI [-2.43, -0.16]; 3 studies; n = 261, P = 0.03), on inflammatory marker C-reactive protein (CRP, mg/L; -11.82 by MD, 95% CI [-17.95, -5.69]; 5 studies; n = 325, P = 0.0002), on number of patients with improved lung CT scans (1.34 by risk ratio, 95% CI [1.19, 1.51]; 4 studies; n = 489, P < 0.00001). No significant adverse events were recorded in the included RCTs.@*CONCLUSION@#Current evidence shows that CHM, as an adjunct treatment with standard care, helps to improve treatment outcomes in COVID-19 cases.

Research Status on Animal Models for Melasma / 中国实验方剂学杂志

Melasma， as a kind of melanosis， often occurs over the face of young and middle-aged women， which seriously affects the physical and mental health of patients. At present， it is believed that the occurrence of melasma is related to various factors such as ultraviolet radiation and changes in sex hormone levels in the body. However， the exact pathogenesis of melasma is still unclear and its clinical efficacy is not ideal. Therefore， it is of great clinical significance and social value to carry out basic researches on melasma diseases. Among them， the animal model of melasma acts as an important tool for studying melasma， and it is particularly important to clarify the pathophysiological mechanism of the occurrence and development of melasma. The common modeling methods include ultraviolet modeling， progesterone modeling and ultraviolet combined with progesterone modeling. However， there are still some problems in the practical application of animal models of melasma due to many influencing factors in the preparation of such animal models， and there is still a lack of a more complete and recognized model preparation scheme to this day， which reduces the success rate of model preparation and limits its application and popularization to some extent. In view of the key problems in the establishment and application of animal models of melasma， we comprehensively summarized the research status of the models from such aspects as experimental animals， modeling methods and model evaluation， and discussed the effects of different modeling methods and animal species， animal age and other factors on animal model of melasma by referring to and sorting out the recent literatures at home and abroad in recent years. This is to provide references for the preparation of more scientific， reasonable， economic and convenient animal models of melasma， lay a foundation for in-depth researches on the pathogenesis， prevention and treatment of melasma， and also provide reference for other animal model research.

Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis / 中西医结合学报

BACKGROUND@#There is currently no drug or therapy that cures COVID-19, a highly contagious and life-threatening disease.@*OBJECTIVE@#This systematic review and meta-analysis summarized contemporary studies that report the use of Chinese herbal medicine (CHM) to treat COVID-19.@*SEARCH STRATEGY@#Six electronic databases (PubMed/MEDLINE, Cochrane Library, ScienceDirect, Google Scholar, Wanfang Data and China National Knowledge Infrastructure) were searched from their beginning to May 15, 2020 with the following search terms: traditional Chinese medicine, Chinese medicine, Chinese herbal medicine, COVID-19, new coronavirus pneumonia, SARS-CoV-2, and randomized controlled trial.@*INCLUSION CRITERIA@#Randomized controlled trials (RCTs) from peer-reviewed journals and non-reviewed publications were included. Further, included RCTs had a control group that was given standard care (SC; such as conventional Western medicine treatments or routine medical care), and a treatment group that was given SC plus CHM.@*DATA EXTRACTION AND ANALYSIS@#Two evaluators screened and collected literature independently; information on participants, study design, interventions, follow-up and adverse events were extracted, and risk of bias was assessed. The primary outcomes included scores that represented changes in symptoms and signs over the course of treatment. Secondary outcomes included the level of inflammatory markers, improvement of pneumonia confirmed by computed tomography (CT), and adverse events. Dichotomous data were expressed as risk ratio or hazard ratio with 95% confidence interval (CI); where time-to-event analysis was used, outcomes were expressed as odds ratio with 95% CI. Continuous data were expressed as difference in means (MD) with 95% CI, and standardized mean difference (SMD) was used when different outcome scales were pooled.@*RESULTS@#Seven original studies, comprising a total of 732 adults, were included in this meta-analysis. Compared to SC alone, CHM plus SC had a superior effect on the change of symptom and sign score (-1.30 by SMD, 95% CI [-2.43, -0.16]; 3 studies; n = 261, P = 0.03), on inflammatory marker C-reactive protein (CRP, mg/L; -11.82 by MD, 95% CI [-17.95, -5.69]; 5 studies; n = 325, P = 0.0002), on number of patients with improved lung CT scans (1.34 by risk ratio, 95% CI [1.19, 1.51]; 4 studies; n = 489, P < 0.00001). No significant adverse events were recorded in the included RCTs.@*CONCLUSION@#Current evidence shows that CHM, as an adjunct treatment with standard care, helps to improve treatment outcomes in COVID-19 cases.

Anxiolytic Effect of Chanmu Anshen Granule and Its Bioactive Mechanism / 中国实验方剂学杂志

Objective:To assess the anxiolytic effect of Chaimu Anshen granules (CMASG) and investigate its bioactive mechanism. Method:ICR mice were randomly divided into normal group, diazepam group(0.002 g·kg-1),Jieyu Anshen granules group(0.001 4 g·kg-1), high, medium, and low-dose (0.001 98,0.000 99,0.000 495 g·kg-1)Chaimu Anshen granule groups, with 20 mice in each group. To detect the anxiolytic effect of CMASG, mice were intragastrically administered for 4 weeks in the morning, and light-dark box transition test and open field test were performed once the other day. After the behavior tests, blood samples were collected. Six mice of each group were perfused with formalin through heart, and then the brains were fixed for immunohistochemistry test. Hippocampus of the other mice in each group were collected and stored in liquid nitrogen. The content of γ-aminobutyric acid(GABA)and glutamic acid(Glu)in hippocampus and blood samples were detected by enzyme-linked immunosorbent assay (ELISA), and the ratio of GABA/Glu was calculated. The expression of GABAα1 receptor was evaluated by the immunohistochemistry method. To test the hypnosis effect of CMASG, mice were administered intragastrically for 7 days. The sub-threshold dose of pentobarbital sodium in the sleep experiment was tested. Result:Compared with normal group, the light-dark box transitions test demonstrated that low-dose and medium-dose CMASG groups significantly prolonged the duration in light box(PPPPPPPPPPα1 receptor protein in hippocampus showed that the medium-dose CMASG significantly increased the expression of GABAα1 protein. The sub-threshold dose of pentobarbital sodium on sleep experiments confirmed that the medium-dose CMASG significantly increased the rate of sleep in mice. Conclusion:CMASG showed an anxiolytic effect, and its bioactive mechanism was related with the increase of GABA content, and the decrease of Glu content in hippocampus. Furthermore, it increased the expression of GABAα1 protein in hippocampus. The changes in content of GABA and Glu in peripheral blood were positively correlated with the changes in hippocampal tissues, which provided reference for clinical diagnosis. CMASG also exhibited an effect in improvement of sleep.

Literature Research on Traditional Chinese Medicine Therapeutic Principles and Methods and Common Prescriptions of Benign Prostatic Hyperplasia / 中国实验方剂学杂志

Objective:Define traditional Chinese medicine (TCM) therapeutic principles and methods and common prescriptions of benign prostatic hyperplasia (BPH) based on clinical experience of famous doctors. Method:China National Knowledge Infrastructure, China Biology Medicine disc, China Science and Technology Journal Database, Wanfang database were systematically retrieved for literatures of famous doctors in diagnosis and treatment of BPH from January 1, 1997 to December 31, 2018.A literature analysis database was established for integration and analysis of relevant content of TCM therapeutic principles and methods and prescriptions. SPSS 20.0 software was used for statistics to obtain TCM therapeutic principles and methods, common prescriptions and drug distribution regularity of BPH. Result:A total of 109 qualified literatures were included in this study, involving 66 famous doctors and experts, and 9 kinds of BPH therapeutic principles were obtained, including "treatment of both symptoms and root cause of disease", "tonification and purgation in combination", "coordination of Yin and Yang". There are 55 kinds of therapies, including "promoting blood circulation for removing blood stasis", "clearing heat and promoting dampness", "warming and recuperating kidney Yang", "softening and resolving hard mass" and " invigorating kidney Qi". And BPH was mostly diagnosed and treated based on kidney, spleen and lung. Through collection and summarization, totally 38 formulas commonly used in treating BPH obtained. The most commonly used ones were "Guizhi Fuling Wan", "Zishen Tongguan Wan", "Buzhong Yiqi Tang", " Bazheng Tang" and "Jisheng Shenqi Wan". There were 217 commonly used herbs, mainly including " Astragali Radix", "Rehmanniae Radix Praeparata", "Atractylodis Macrocephalae Rhizoma", "Glycyrrhizae Radix et Rhizoma", "Angelicae Sinensis Radix", "Radix Achyranthis Bidentatae", "Peach Kernel", "Pangolin Scales", "Vaccariae Semen", "Salviae Miltiorrhizae Radix et Rhizoma", "Poria", "Rhizoma Alismatis" and "Plantain Seed". Conclusion:The treatment of BPH is based on the principles of "treatment of both symptoms and root cause of disease, and tonification and purgation in combination". The commonly used therapies include prescription for "promoting blood circulation for removing blood stasis", "clearing heat and promoting dampness" and "warming and recuperating kidney Yang". The corresponding prescriptions shall be based on symptoms.

Literatures on Distribution Features of Traditional Chinese Medicine Syndromes and Syndrome Elements of Benign Prostatic Hyperplasia Based on Experience of Famous Doctors / 中国实验方剂学杂志

Objective:Based on the experience of famous doctors, the pattern of syndromes of benign prostatic hyperplasia (BPH) and the distribution of syndrome elements are defined to provide a basis for guiding clinical practice and scientific research. Method:The name list of famous doctors was defined. Relevant literatures on famous doctors' diagnosis and treatment of BPH between January 1, 1997 and December 31, 2018, were systematically retrieved in CNKI, CBM, CQVIP, Wanfang database. According to the inclusion criteria and exclusion criteria, relevant literatures were read, and eligible literatures were included. A literature analysis database was established for analysis and integration of relevant content of traditional Chinese medicine(TCM) syndromes and syndrome elements. SPSS 20.0 software was used for statistics and analysis of BPH TCM syndrome types and distribution characteristics of syndrome elements. Result:This study included a total of 141 eligible documents, involving 92 famous doctors. Based on the doctors' overall discussion of BPH and medical case examples, common types of BPH syndrome included kidney deficiency and blood stasis syndrome, bladder dampness syndrome, kidney Yin deficiency syndrome, kidney Yang deficiency Syndrome, liver Qi stagnation syndrome, main symptom factors of disease location included kidney, bladder, spleen, lung, liver, and main symptom factors of disease nature included blood stasis, Qi deficiency, heat, yang deficiency, and dampness. The characteristics of the symptoms in the medical case were collected and summarized, including frequent urinary symptoms, frequent urination, urinary drip, urgency, nocturia, difficulty in urinating, the tongue is mainly light red, red, dark red, and sputum, the tongue coating is mainly yellow, thin white, thin yellow and white greasy, and the pulse is mainly composed of deep, fine, string and slipping. Conclusion:Based on the experience of famous doctors, the core pathogenesis of BPH is deficient in origin and excessive in superficiality, the kidney deficiency is the root cause, the dampness heat is the symptom, and the compound syndrome is common.

Analysis of infection status in severe pneumonia cases infection with influenza A virus in Nanchang from 2013 to 2018 / 中华疾病控制杂志

Objective To explore the distribution and disease characteristics of influenza virus A in severe pneumonia cases in Nanchang city, so as to provide evidence for clinical prevention and treatment of severe pneumonia cases. Methods The respiratory samples and clinical case data of severe pneumonia cases were collected and the etiology and epidemiology were analyzed in Nanchang from April 2013 to March 2018. Results From April 2013 to March 2018, 261 case patients of severe pneumonia from 17 medical institutions in Nanchang were enrolled. 77 cases was detected as positive for influenza A virus nucleic acid, accounting for 29.50% of the total cases, as follow: 39 cases of A (H1N1pdm) influenza, 13 A (H3), 16 H7N9 and 3 H10N8 avian influenza. Cases were mainly concentrated in winter and spring (from December to May of next year, with median age 48 of years, including 48 males and 31 females. 21 cases of human infection with H7N9/H10N8 avian influenza were reported in Nanchang during 5 years, with the fatality rate of 33.33%. 90.48% (19/21) cases were detected by unexplained pneumonia surveillance system. The median age was 69 years, most of them had underlying diseases and a clear history of poultry contact. Conclusions Nearly 30% of the severe pneumonia cases in Nanchang city were infected with influenza A virus, among which influenza A (H1N1pdm) virus was the main epidemic strain. All deaths were caused by avian influenza virus infection.

Analysis of infection status in severe pneumonia cases infection with influenza A virus in Nanchang from 2013 to 2018 / 中华疾病控制杂志

Objective To explore the distribution and disease characteristics of influenza virus A in severe pneumonia cases in Nanchang city, so as to provide evidence for clinical prevention and treatment of severe pneumonia cases. Methods The respiratory samples and clinical case data of severe pneumonia cases were collected and the etiology and epidemiology were analyzed in Nanchang from April 2013 to March 2018. Results From April 2013 to March 2018, 261 case patients of severe pneumonia from 17 medical institutions in Nanchang were enrolled. 77 cases was detected as positive for influenza A virus nucleic acid, accounting for 29.50% of the total cases, as follow: 39 cases of A (H1N1pdm) influenza, 13 A (H3), 16 H7N9 and 3 H10N8 avian influenza. Cases were mainly concentrated in winter and spring (from December to May of next year, with median age 48 of years, including 48 males and 31 females. 21 cases of human infection with H7N9/H10N8 avian influenza were reported in Nanchang during 5 years, with the fatality rate of 33.33%. 90.48% (19/21) cases were detected by unexplained pneumonia surveillance system. The median age was 69 years, most of them had underlying diseases and a clear history of poultry contact. Conclusions Nearly 30% of the severe pneumonia cases in Nanchang city were infected with influenza A virus, among which influenza A (H1N1pdm) virus was the main epidemic strain. All deaths were caused by avian influenza virus infection.

Discussions on real-world acupuncture treatments for chronic low-back pain in older adults / 中西医结合学报

Chronic low-back pain (CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association (ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity; therefore, it should be effective for CLBP in older adults.

Acupuncture price in forty-one metropolitan regions in the United States: An out-of-pocket cost analysis based on OkCopay.com / 中西医结合学报

Few studies have focused on the cost of acupuncture treatments although acupuncture has become popular in the United States (U.S.). The purpose of the current study was to examine the out-of-pocket costs incurred from acupuncture services based on an online website, OkCopay.com. We examined descriptive statistics (range, median and 20% intervals) for the cost of acupuncture "first-time visits" and "follow-up visits" in 41 metropolitan regions in the U.S. The acupuncture prices of 723 clinics throughout 39 metropolitan regions were included, except for Birmingham, Alabama and Detroit, Michigan as there was no online data available at the time of the study for these two regions. The cost range for a first-time acupuncture visit was $15-400; the highest median was $150 in Charleston, South Carolina, while the lowest was $45 in St. Louis, Missouri. The top 10 cities for the highest median were: Baltimore, Washington, D.C., New York, San Francisco, San Jose, Boston, Atlanta, Seattle, Portland and Indianapolis, with the median $120, while the median for all 723 clinics was $112. For the follow-up visits, the cost range was $15-300; the highest median was $108 in Charleston, South Carolina, and the lowest $40 in Miami, Florida. The 10 cities with highest median follow-up acupuncture visit costs were: New York, Baltimore, New Orleans, Washington, D.C., Philadelphia, San Francisco, San Jose, Seattle, Boston and Atlanta, with the median $85, while for all 723 clinics the median price was $80. The estimation of the average gross annual income of each acupuncturist from the regions studied was $95,760, while the total annual cost of patients seeking acupuncture services in the U.S. was about $3.5 billion in 2018.

Distribution of licensed acupuncturists and educational institutions in the United States in early 2015 / 中西医结合学报

In recent decades, acupuncture has been used more widely and extensively in the United States (U.S.). However, there have been no national surveys or analyses reported in academic journals on the number of practicing or licensed acupuncturists. This study was conducted to identify the approximate number of licensed acupuncturists active in 2015. The Board of Acupuncture or Board of Medicine in each state or U.S. territory was contacted to collect data. Online license information searching was also performed in order to get accurate numbers of licensed acupuncturists for those states in which a board was unable to be contacted. The study found that the number of licensed acupuncturists in 2015 in the U.S. was 34,481. Of this, more than 50% were licensed in three states alone: California (32.39%), New York (11.89%) and Florida (7.06%). The number of licensed acupuncturists increased 23.30% and 52.09%, compared to the year 2009 (n = 27,965) and 2004 (n = 22,671), respectively; increasing about 1,266 per year. There were 62 and 10 accredited acupuncture institutions providing master and doctoral degrees, respectively. The West Coast comprised 51.39% of degree granting programs, while the East Coast comprised 29.17%; together the coastal states housed more than 80% of all programs, with the remainder sprinkled across the southern (9.72%), northern (8.33%), and the middle/central states (1.39%). Forty-four states and the District of Columbia regulated acupuncture practice by law at the time of data collection. Acupuncture continues to be a quickly growing profession in the U.S.

Effectiveness of two different acupuncture strategies in patients with vulvodynia: Study protocol for a pilot pragmatic controlled trial / 中西医结合学报

<p><b>BACKGROUND</b>Vulvodynia, or vulvar pain, is a common condition in women; however, there are few evidence-based clinical trials evaluating nonpharmacological therapies for this condition. Acupuncture is one complementary and integrative medicine therapy used by some patients with vulvodynia. This study evaluates two different acupuncture strategies for the treatment of vulvodynia and aims to evaluate whether either of the acupuncture protocols reduces vulvar pain, pain duration or pain with intercourse. The study also examines how long the effect of acupuncture lasts in women with vulvodynia.</p><p><b>METHODS/DESIGN</b>The study is designed as a randomized controlled trial, focused on two acupuncture protocols. Fifty-one patients who have had vulvodynia for more than 3 months will be recruited. Among them, 34 patients will be randomized into Groups 1a and 1b; those who are unwilling to receive acupuncture will be recruited into the standard care group (Group 2). Patients in Group 1a will have acupuncture focused on the points in the pudendal nerve distribution area, while patients in Group 1b will receive acupuncture focused on traditional (distal) meridian points. Patients in Group 2 will receive routine conventional treatments, such as using pain medications, local injections and physical therapies or other nonsurgical procedures. Acupuncture will last 45 min per session, once or twice a week for 6 weeks. The primary outcome measurement will be objective pain intensity, using the cotton swab test. The secondary outcome measurement will be subjective patient self-reported pain intensity, which will be conducted before cotton swab test. Pain intensities will be measured by an 11-point Numeric Pain Rating Scale. Pain duration and pain score during intercourse are recorded. Local muscle tension, tenderness and trigger points (Ashi points) are also recorded. All measurements will be recorded at baseline (before the treatment), at the end of each week during treatment and at the end of the 6 weeks. Follow-up will be done 6 weeks following the last treatment.</p><p><b>DISCUSSION</b>Results of this trial will provide preliminary data on whether acupuncture provides better outcomes than nonacupuncture treatments, i.e., standard care, and whether acupuncture focused on the points in pudendal nerve distribution, near the pain area, has better results than traditional acupuncture focused on distal meridian points for vulvodynia.</p><p><b>TRIAL REGISTRATION</b>Clinicaltrials.gov: NCT03481621. Register: March 29, 2018.</p>

Evidence and expert opinions: Dry needling versus acupuncture (I) : The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016 / 中国结合医学杂志

In the last twenty years, in the United States and other Western countries, dry needling (DN) became a hot and debatable topic, not only in academic but also in legal fields. This White Paper is to provide the authoritative information of DN versus acupuncture to academic scholars, healthcare professional administrators, lawmakers, and the general public through providing the authoritative evidence and experts' opinions regarding critical issues of DN versus acupuncture, and then reach consensus. DN is the use of dry needles alone, either solid filiform acupuncture needles or hollow-core hypodermic needles, to insert into the body for the treatment of muscle pain and related myofascial pain syndrome. DN is sometimes also known as intramuscular stimulati on, trigger points (TrP) acupuncture, TrP DN, myofascial TrP DN, or biomedical acupuncture. In Western countries, DN is a form of simplified acupuncture using biomedical language in treating myofascial pain, a contemporary development of a portion of Ashi point acupuncture from Chinese acupuncture. It seeks to redefine acupuncture by reframing its theoretical principles in a Western manner. DN-like needling with filiform needles have been widely used in Chinese acupuncture practice over the past 2,000 years, and with hypodermic needles has been used in China in acupuncture practice for at least 72 years. In Eastern countries, such as China, since late of 1800s or earlier, DN is a common name of acupuncture among acupuncturists and the general public, which has a broader scope of indications, not limited to treating the myofascial pain.

Evidence and expert opinions: Dry needling versus acupuncture (II) : The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016 / 中国结合医学杂志

In the United States and other Western countries, dry needling has been a topic in academic and legal fields. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by providing the authoritative evidence and expertise regarding critical issues of dry needling and reaching a consensus. We conclude that Dr. Travell, Dr. Gunn, Dr. Baldry and others who have promoted dry needling by simply rebranding (1) acupuncture as dry needling and (2) acupuncture points as trigger points (dry needling points). Dry needling simply using English biomedical terms (especially using "fascia" hypothesis) in replace of their equivalent Chinese medical terms. Dry needling is an over-simplified version of acupuncture derived from traditional Chinese acupuncture except for emphasis on biomedical language when treating neuromuscularskeletal pain (dry needling promoters redefined it as "myofascial pain"). Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy (a surgical procedure) instead of manual therapy. Dr. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture's local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients' safety, dry needling practitioners should meet standards required for licensed acupuncturists and physicians.

Acupuncture's Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management-White Paper 2017 / 中西医结合学报

The United States (U.S.) is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public's opioid dependence. Acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain conditions, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture's cost-effectiveness can dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding addiction to opioids that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options for pain. Acupuncture stands out as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost-effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, and neonatal intensive care units to treat a variety of commonly seen pain conditions. Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military, in some studies demonstrably decreasing the volume of opioids prescribed when included in care.

The history of acupuncture anesthesia for pneumonectomy in Shanghai during the 1960s / 中西医结合学报

The success of acupuncture anesthesia (AA) for pneumonectomy in Shanghai in 1960 was a key event for AA gaining practical clinical application. The effort was a close collaboration between the Shanghai First Tuberculosis Hospital and the Shanghai Institute of Acupuncture and Moxibustion. One of the most important factors of AA success was the great financial and political support provided by the Chinese central government and Shanghai local government. In December1965 the State Science and Technology Commission of China issued a formal document acknowledging AA as an important first-level national achievement of the integration of Chinese and Western medicine, and a collaborative effort of the whole scientific community in China. AA was an important influential factor that helped acupuncture spread across the world.