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OBJECTIVE: To observe the effect of deep acupuncture of Tiantu (CV22), etc. in combination with rehabilitation training on swallowing function of patients with post-stroke dysphasia. METHODS: A total of 70 patients suffering from post-stroke dysphagia were randomly divided into control group (conventional acupuncture＋ swallowing rehabilitation training) and treatment group (deep acupuncture of CV22 ＋ rehabilitation training, n＝ 35 cases in each group). The swallowing rehabilitation procedure was conducted 30 min every time, twice daily, 5 times a week for 3 weeks. In patients of the treatment group, after deep insertion (about 80 mm) along the posterior margin of the manubrium sterna, the filiform needle in CV22 was lifted and thrusted repeatedly 9 times till the patient experienced a feeling of foreign matter blocking, followed by retaining the needle for 30 min. For patients of the control group, Lianquan (CV23) was punctured with 3 acupuncture needles (one vertical needling and bilateral slope needling toward the tongue root), and Fengfu (GV16), bilateral Bailao (EX-NH23), bilateral Renying (ST9) and bilateral Jialianquan (Extra) were punctured vertically with filiform needles. The treatment was conducted once daily, 5 times a week for 3 weeks. The swallowing function was evaluated by using Kubota water swallowing test (KWST) scale (0－5 points), Fujishima Ichiro rating scale (FIRS, 0－10 points), and video fluoroscopic swallowing study (VFSS, 0－10 points), separately. The therapeutic effect was also assessed according to the clinical scale scores and VFSS results. RESULTS: Following the treatment, of the two 35 cases in the control and treatment groups, 4 (11.43%) and 8 (22.86%) experienced marked improvement in their symptoms, 22 (62.86%) and 23 (65.71%) were effective, and 9 (25.71%) and 4 (11.43%) were failed, with the effective rates being 74.29% and 88.57%, respectively. After the treatment, the KWST score of the two groups were significantly decreased in comparison with their own pre-treatment (P<0.05), while the FIRS and VFSS scores of the two groups were considerably increased in comparison with their own pre-treatment (P<0.05). The therapeutic effects of the treatment group were obviously superior to those of the control group in the effective rate, lowering KWST score and in raising FIRS and VFSS scores (P<0.05)．. CONCLUSION: Acupuncture plus swallowing rehabilitation training is effective in improving the swallowing function of stroke patients with dysphagia, and the deep acupuncture stimulation of CV22 is apparently better than conventional acupuncture in the therapeutic effect.
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OBJECTIVE: To observe the effect of deep electroacupuncture (EA) stimulation at "Huantiao"(GB30) on hindlimb motor function and expression of p38 mitogen-activated protein kinase (p38 MAPK ) and p53 proteins in dorsal root ganglia (DRG) in rats with chronic constrictive injury (CCI) of sciatic nerve. METHODS: Forty-eight SD rats (half male and half female) were randomly divided into control, model, shallow EA (SEA) stimulation and deep EA (DEA) stimulation groups (n=12 in each group). The CCI model was constructed by implanting a silicone tube close to the sciatic nerve of the left hind limb. For DEA group and SEA group, filiform acupuncture needles were inserted into GB30 about 12-14 mm deep and 5-8 mm deep (monitored by using a high-frequency ultrasound device), respectively, followed by electrical stimulation (2 Hz/100 Hz, 1 mA) using an EA stimulator. The intervention was conducted for 15 min every time, once daily for 14 days. The sciatic nerve function index (SFI) calculated to assess the motor function status. Histopathological changes of the sciatic nerve were displayed by H.E. staining. The expression levels of phosphorylated-p38 MAPK (p-p38) and phosphorylated-tumor protein p53 (p-p53) in DRGs of L4-L5 on the affected side were observed by immunohistochemical staining. RESULTS: Following modeling, the SFI were significantly decreased (P<0.01), and the expression levels of p-p38 and p-p53 proteins of L4-L5 DRGs were considerably increased in the model group (P<0.05). After the intervention, the SFI were obviously increased, and the expression levels of p-p38 and p-p53 proteins notably down-regulated in both DEA and SEA groups relevant to the model group (P<0.01, P<0.05). The therapeutic effect of DEA was significantly superior to that of SEA in raising SFI and down-regulating expression le-vels of p-p38 and p-p53 proteins (P<0.01, P<0.05). H.E. staining showed disordered arrangement of the sciatic nerve fibers and myelin, disaggregation of the myelin and axons with deformity and vacuolation in some of them and with an increase of Schwann cells in the model group, which was relatively milder in both DEA and SEA groups. CONCLUSION: Both DEA and SEA at GB30 can obviously improve the motor function in CCI rats, which may be associated with its function in down-regulating the expression of p-p38 and p-p53 proteins in L4-L5 DRGs, restraining p38 MAPK signaling. The therapeutic effect of DEA is evidently better than that of SEA.
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OBJECTIVE: To explore the needle insertion parameters of deep acupuncture at Baliao points for clinic and teaching. METHODS: A retrospective analysis of 100 cases of prone pelvic CT from January to June 2016 in Nanjing Hospital was carried out. The 3 D images were scanned with continuous 5 mm slice thickness. The optimum needle angle is defined as the angle of the needle along the central axis of sacral anterior and posterior hole, and the angle between the needle body and the skin surface and the center line of the body was observed. The effect needle depth is defined as the thickness of the sacral back soft tissue plus 1/2 sacral depth, to observe the best needle angle of deep acupuncture parameters of Baliao points. RESULTS: For deep acupuncture at Baliao, the oblique thorn method should be used with the needle-point toward the inner bottom. The best insertion angle between needle body and skin surface is: Shangliao(BL 31) (61.04±12.15)°， Ciliao(BL 32) (57.57±10.01)°， Zhongliao(BL 33) (58.25±8.69)°， Xialiao(BL 34) (54.39±10.94)°. The optimum angle of insertion between the needle body and the posterior midline of the human body is: BL 31 (24.54±6.21)°， BL 32 (18.58±7.76)°， BL 33 (17.36±7.90)°， BL 34 (30.73±9.45)°. The effective insertion depth show a decreasing trend: BL 31 (58.16±12.43) mm, BL 32 (44.57±11.55) mm, BL 33 (33.96±10.74) mm, BL 34 (31.13±10.94) mm. The effective depth is positively correlated with BMI, and has no correlation with gender and weight. CONCLUSIONS: The study of the parameters of needle insertion should be taken into account both clinical efficacy and safety, and CT three-dimensional reconstruction can accurately, rationally and scientifically perform acupoint anatomical measurements.
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Objective To observe the clinical efficacy of deep electroacupuncture at Baliao points intreating chronic pelvic inflammatory disease (CPID) due to damp-heat stagnation.Method Sixty-four patients with CPID due to damp-heat stagnation were randomized into two groups, 32 cases in the deep-electroacupuncture group and 32 cases in ordinary-electroacupuncture group, 10 d as a treatment course, and the therapeutic efficacy was evaluated after 2 treatment courses. The pre-treatment and post-treatment body sign scores and the change of the scores in the two groups were compared.Result The total effective rates were respectively 93.8% and 75.0% in the deep-electroacupuncture group and ordinary-electroacupuncture group, and the improvement of body sign score in the deep-electroacupuncture group was statistically more significant (P<0.05).Conclusion Deep electroacupuncture at Baliao points can produce a significant efficacy in treating CPID due to damp-heat stagnation.
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Objective To observe the effects of deep electroacupuncture on carlilage tissue in knee osteoarthritis (KOA) rabbits. Meth-ods 40 New Zealand rabbits were randomly divided into normal group (A, n=10) and model group (n=30). The model group was modeled KOA with Hulth-Telhag way, and identified with X-ray. Then they were divided into no-treated group (B, n=10), deep electroacupuncture group (C, n=10) and routine electroacupuncture group (D, n=10) randomly. The groups C and D accepted electroacupuncture since 6 weeks after modeling, for 4 weeks. They were measured with pH of joint fluid, observed structure and pathology of cartilage under transmission electron microscope, detected apoptosis index, and determined the expression of acid-sensing ion channel 1 (ASIC1), p38 mitogen-activated protein kinases (p38MAPK) and p53 with Western blotting, and distribution of ASIC1 with immunohistochemistry in cartilage tissue. Re-sults The pHs of joint fluid from high to low were ranged as the groups A=C>D>B (P<0.01). The cartilage structure was more complete in the groups A, C and D than in the group B. The apoptosis rates from less to more were ranged as the groups A=C
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Tianshu (ST 25) is a frequently-used acupoint in acupuncture practice. It is reported that deep acupuncture has a better therapeutic effect than routine depth acupuncture. On the basis of reviewing the available literature,the present paper gives a definition about "deep acupuncture" of Tianshu (ST 25) from the anatomy angle,and makes a summary about its safety. This paper also puts forward a set of operation standards for needling Tianshu (ST 25). Moreover,the authors of the present paper also make a systematic analysis on the factors affecting the safety from the punctured depth,the diameter of the acupuncture needle and the operation technique. These methods and standards have an important significance in guiding clinical practice of acu-puncture.