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ABSTRACT BACKGROUND AND OBJECTIVES: Angina is a clinical syndrome characterized by pain or discomfort, considered stable when it occurs for several weeks without progressing to an acute coronary event. Anginal pain management can be performed with pharmacological and non-pharmacological treatments, among which acupuncture is a non-pharmacological option. The aim of this study was to carry out an integrative review of the analgesic effect of acupuncture in patients with stable angina. CONTENTS: An integrative review was carried out in April 2021 in databases: Pubmed, Scopus, Cinahl and Bireme. Controlled descriptors "angina pectoris", "angina stable", "acupuncture", "acupuncture therapy", "acupuncture analgesia" were used. After screening and analyzing the manuscripts, seven experimental studies of the randomized controlled trial type were selected. The results suggest that acupuncture in patients with stable angina can promote an analgesic effect with clinical improvement of symptoms. CONCLUSION: Acupuncture can be an adjuvant therapeutic alternative for the treatment of patients with stable angina, since it can promote an analgesic effect with clinical improvement of symptoms.
RESUMO JUSTIFICATIVA E OBJETIVOS: A angina é uma síndrome clínica caracterizada por dor ou desconforto, considerada estável quando ocorre por várias semanas sem evoluir para um evento coronariano agudo. O manejo da dor anginosa pode ser realizado por meio de tratamentos farmacológicos e não farmacológicos, incluindo a acupuntura como uma opção não farmacológica complementar. O objetivo deste estudo foi realizar uma revisão integrativa sobre o efeito analgésico da acupuntura em pacientes com angina estável. CONTEÚDO: Foi realizada uma revisão integrativa no mês de abril de 2021 nas bases de dados: Pubmed, Scopus, Cinahl e Bireme. Foram utilizados os descritores controlados "angina pectoris", "angina stable", "acupuncture", "acupuncture therapy", "acupuncture analgesia". Após triagem e análise dos manuscritos, foram selecionados sete estudos experimentais do tipo ensaio controlado randomizado. Os resultados sugerem que a acupuntura pode promover efeito analgésico com melhora clínica dos sintomas em pacientes com angina estável. CONCLUSÃO: A acupuntura pode ser uma alternativa terapêutica complementar para tratamento de pacientes com angina estável, uma vez que pode promover efeito analgésico com melhora clínica dos sintomas.
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Objective:To investigate the effects of needle-embedding therapy on improvement of pneumoperitoneum and abdominal distension after colonoscopy.Methods:A total of 102 patients who received colonoscopy in Hangzhou Hospital of Traditional Chinese Medicine, China between June 2018 and June 2020 were included in this study. They were randomly assigned to observation and control groups ( n = 51 per group). The control group was subjected to routine symptomatic treatment and the observation group was given needle-embedding therapy. The improvement effects on pneumoperitoneum and abdominal distension, examination duration, numerical rating scale score, and grade of abdominal distension at 6 and 24 hours after colonoscopy were compared between observation and control groups. Results:Total response rate in the observation group was significantly higher than that in the control group [92.16% (47/51) vs. 74.51% (38 /51), χ 2 = 5.71, P < 0.05]. The time to enteroscope entry and the time to enteroscope withdrawal were (4.86 ± 1.23) minutes and (5.24 ± 1.13) minutes, respectively, which were significantly shorter than those in the control group [(8.79 ± 1.25) minutes, (6.97 ± 1.12) minutes, t = 16.00, 7.76, both P < 0.001]. Numerical rating scale score in the observation group was significantly lower than that in the control group [(1.50 ± 0.41) points vs. (2.30 ± 0.42) points, t = 9.73, P < 0.001). At 6 and 24 hours after colonoscopy, the amplitude of improvement of abdominal distension in the observation group was significantly greater than that in the control group (both P < 0.05). Conclusion:Needle-embedding therapy can effectively improve pneumoperitoneum and abdominal distension after enteroscopy, shorten the examination duration, and relieve pain.
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OBJECTIVE@#This study evaluated the effectiveness of acupuncture treatment on postoperative pain in patients with degenerative lumbar spine disease, and explored the relationship between the postoperative analgesic effect of acupuncture and the sensation of acupuncture experienced by the patients.@*METHODS@#This retrospective study analyzed the medical records of 97 patients who had undergone an operation by the same surgeon due to degenerative lumbar disease. These patients were divided into acupuncture group (n = 32), patient-controlled analgesia (PCA) group (n = 27), and oral analgesia group (n = 38) according to the different postoperative analgesic methods. During their hospitalization, patients completed daily evaluations of their pain using a visual analogue scale (VAS), and injection times of supplemental meperidine were recorded. Also, the Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale (C-MASS) was used in the acupuncture group.@*RESULTS@#Each of the three treatment groups showed significant reductions in postoperative pain, as shown by reduced VAS scores. The acupuncture group, however, had less rebound pain (P < 0.05) than the other two groups. Both the acupuncture and PCA groups experienced acute analgesic effects that were superior to those in the oral analgesia group. In addition, the higher the C-MASS index on the second day after surgery, the lower the VAS score on the fourth day after surgery. There was also a significant difference in the "dull pain" in the acupuncture sensation.@*CONCLUSION@#The results demonstrated that acupuncture was beneficial for postoperative pain and discomfort after simple surgery for degenerative spinal disease. It is worth noting that there was a disproportionate relevance between the patient's acupuncture sensation and the improvement of pain VAS score.
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Humans , Acupuncture Points , Acupuncture Therapy , Analgesia/methods , Analgesics/therapeutic use , Consensus , Pain, Postoperative/drug therapy , Prospective Studies , Retrospective Studies , SensationABSTRACT
Pain is a complex physiological and psychological activity, involving at least three dimensions, including pain sensation, pain emotion, and pain cognition. Acupuncture can clearly relieve the pain sensation of patients and improve pain emotion and pain cognition induced by pain; acupuncture participates in the multi-dimensional regulation of pain through brain regions of the limbic system such as anterior cingulate cortex (ACC), amygdala (AMY), and hippocampus. By analyzing relevant literature, it has been found that the regulation of acupuncture on pain emotion is mainly related to the activation of pertinent opioid receptors in the ACC, the decrease of the expression of extracellular signal-regulated kinase (ERK), and the promotion of the expression of glutamic acid (Glu) A1, metabotropic glutamate receptor-1 (mGluR1), and γ-aminobutyric acid aminobutyric acid (GABA) B2 protein in the AMY. The regulation of acupuncture on pain cognition is mainly related to the elevation of the expression of protein kinase A (PKA) and phospho-p38 mitogen-activated protein kinase (phospho-p38 MAPK) and the inhibition of cyclic adenosine monophosphate (cAMP)/PKA/cAMP response element-binding protein (CREB) signaling pathway in the ACC.
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Objective: To observe the effect of electroacupuncture (EA) at different time points during the perioperative period on the recovery of gastrointestinal function after gastrointestinal malignant neoplasms surgery. Methods: Sixty-three patients who needed radical surgery for gastrointestinal tumors were randomized into a control group, treatment group 1 (postoperative EA group), and treatment group 2 (intraoperative and postoperative EA group). The control group received surgery and conventional Western medicine treatment, and treatment groups 1 and 2 received additional EA treatment at different time points. The initial flatus time after the surgery, visual analog scale (VAS) score at different time points after the surgery, the proportion of using patient-controlled analgesia (PCA) after the surgery, and the times of adding analgesics were observed in the three groups. Results: The initial flatus time after the surgery was earlier in treatment groups 1 and 2 than in the control group (P<0.05); the difference between treatment groups 1 and 2 was statistically insignificant (P>0.05). The VAS score was lower in treatment group 2 than in the control group at 6, 12, 24, and 72 h after the surgery (P<0.05); the VAS score was lower in treatment group 1 than in the control group only at 72 h after the surgery (P<0.05). There were no significant differences in the rate of using PCA among the three groups (P>0.05). Regarding the times of adding analgesics, it was less in treatment group 2 than in the control group at 12 h after the surgery (P<0.05). Conclusion: Either EA during and after the surgery or only after the surgery can hasten the initial flatus and boost the recovery of gastrointestinal function in patients after radical resection of gastrointestinal neoplasms. Successive EA during and after the surgery should be superior to postoperative EA regarding the analgesic effect after the surgery.
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Objective: To investigate the effects of buccal acupuncture on analgesia, immune indicators, and expression levels of Survivin and Livin proteins in patients with advanced-stage primary liver cancer. Methods: Eighty patients with advanced-stage primary liver cancer were selected and divided into control and treatment groups according to the difference in treatment modalities, with 40 patients in each group. The control group received transcatheter arterial chemoembolization (TACE), and the treatment group received buccal acupuncture in addition to TACE. The recent efficacy, analgesic effect, liver function, serum tumor markers, Survivin and Livin protein expression levels in liver cancer tissue, and immune indexes were analyzed and compared between the two groups. Results: The objective response rate (ORR) and disease control rate (DCR) of the treatment group were 37.5％ and 77.5％, respectively, which were significantly higher than those of the control group (22.5％ and 52.5％), and the recent efficacy of the treatment group was significantly better than that of the control group (P<0.05). The onset of analgesia in the treatment group was significantly faster than that in the control group (P<0.05), the duration of analgesia was significantly longer than that in the control group (P<0.05), and the numeric rating scale (NRS) score of pain after treatment was significantly lower than that in the control group (P<0.05). In the treatment group, the aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin/globulin (A/G) were significantly lower than those in the control group (P<0.05), and the serum levels of alpha-fetoprotein (AFP), alpha-L-fucosidase (AFU), and carcinoembryonic antigen (CEA) were significantly lower than those in the control group (P<0.05), and the expression levels of Survivin and Livin in liver cancer tissue were significantly lower than those in the control group (P<0.05); CD4+ and CD4+/CD8+ in the treatment group were significantly higher than those in the control group, and CD8+ was significantly lower than that in the control group after treatment (P<0.05). Conclusion: Buccal acupuncture can reduce the degree of pain and liver function damage in patients with advanced- stage primary liver cancer and lower the serum tumor marker levels, and its mechanism of action may be related to the down-regulation of Survivin and Livin protein expression levels in the liver cancer tissue and the regulation of the immune function.
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Disfunção Temporomandibular (DTM) apresenta-se como principal causa de dores orofaciais de origem não dentária. A acupuntura é indicada para o alívio de da dor em casos de DTM muscular, baseada em propriedades anti-inflamatórias com efeitos neuro-hormonais. Objetivou-se nesta pesquisa a avaliação da eficácia da acupuntura como um método válido para redução imediata da sintomatologia dolorosa e limitação de abertura bucal nos casos de DTM. Realizou-se terapia acupuntural em 30 pacientes com DTM, avaliando-se a dor, a partir da Escala Verbal (EV) e da Escala Analógica Visual (EAV) e a limitação de abertura bucal com o auxílio de paquímetro digital antes e após a terapia para registro da análise. O aumento da média de abertura bucal foi de 9,2% no total de participantes. Quanto à sintomatologia dolorosa, apresentou redução média em 63%. Na EV, 27 dos pacientes tiveram resposta "moderada" e "intensa" para sensação dolorosa. Contudo, após a terapia, observou-se ausência de sensação dolorosa intensa. Os dados apontaram significância da terapia acupuntural para redução dor e limitação de abertura bucal, de forma imediata, em pacientes com DTM... (AU)
Temporomandibular Disorder (TMD) is the main cause of orofacial pain of non-dental origin. Acupuncture is indicated for pain relief in cases of muscle TMD, based on anti-inflammatory properties with neuro hormonal effects. The aim of this research was to evaluate the effectiveness of the acupuncture as a valid method for immediate reduction of painful symptoms and mouth opening limitation in TMD cases. Acupuncture therapy was performed in 30 patients with TMD, evaluating pain from the Verbal Scale (VE) and Visual Analog Scale (VAS) and mouth opening limitation with the aid of a digital caliper before and after therapy to record the analysis. The increase in the average mouth opening was 9.2% in the total number of participants. As for painful symptoms, an average reduction of 63%. In IV, 27 of the patients had "moderate" and "intense" responses to painful sensation. However, after therapy, the absence of intense painful sensation was observed. The data showed the significance of acupuncture therapy for immediate pain reduction and mouth opening limitation in patients with TMD... (AU)
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Humans , Male , Female , Adult , Middle Aged , Facial Pain , Temporomandibular Joint Disorders , Temporomandibular Joint Dysfunction Syndrome , Acupuncture Analgesia , Acupuncture Therapy , Acupuncture , Medicine, Chinese Traditional , Mouth , MusclesABSTRACT
OBJECTIVE@#To observe the clinical effect of single acupoint [Yaotu (extra)] electroacupuncture (EA) therapy on lumbar intervertebral disc herniation (LIDH) and its promotion and application in community medical institutions.@*METHODS@#This research adopted a three-level promotion model, and used multi-center collaboration topics as a platform. A total of 240 patients with LIDH were divided into a group A (top three hospital, 80 cases, 3 cases dropped off), a group B (secondary hospital, 80 cases, 8 cases dropped off), and a group C (community health center, 80 cases, 7 cases dropped off). All groups were treated with EA at a single acupoint [Yaotu (extra)] under the guidance of a unified experimental protocol. The EA was given 60 min each time and performed 3 times a week for a total of 2 weeks. The changes of visual analogue scale (VAS) scores of three groups before and after each treatment were compared, and the clinical efficacy was evaluated.@*RESULTS@#Compared with before each treatment, the VAS scores of three groups after each treatment decreased (@*CONCLUSION@#The single acupoint EA therapy has a significant effect in the treatment of LIDH, can quickly relieve the pain symptoms, and has the characteristics of simple operation and easy control, suitable for promotion and application in primary hospitals.
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Humans , Acupuncture Points , Electroacupuncture , Intervertebral Disc , Intervertebral Disc Degeneration , Intervertebral Disc Displacement/therapyABSTRACT
OBJECTIVE@#To compare differences in self-reported musculoskeletal pain before and after receiving rapid acupuncture for pain at an outpatient emergency department.@*METHODS@#Exactly 102 patients presenting to the emergency room of the Hospital Servidor Publico Estadual in Sao Paulo, Brazil, participated in this before-and-after study. All participants had musculoskeletal pain and were treated with the technique proposed by Marques Filho. This emergency acupuncture involved inserting a needle at a point defined by traditional Chinese medicine and applying intense stimulation for 10 s; no more than two points were used on any individual patient. Pain was measured using a numerical visual scale before and immediately after the procedure.@*RESULTS@#Participants in this study were mostly women (78%), had a college degree (47%) and were below the age of 60 (56%). The most common region of pain was the lower back (31%), and the most common type of pain was acute and exacerbated chronic pain. The meridians most commonly involved were the eight extra meridians (40%), and the points most often used for treatment were Houxi (SI3), Shenmai (BL62) and Zulinqi (GB41). Almost all participants reported a decrease in pain intensity, independent of sex, education level, pain site and pain type (acute/chronic; P < 0.05). At the end of the session, only 4% of the participants reported a desire for allopathic medication.@*CONCLUSION@#This emergency acupuncture technique for analgesia appears to reduce musculoskeletal pain.@*TRIAL REGISTRATION@#Brazilian Registry of Clinical Trials (http://www.ensaiosclinicos.gov.br/) with No. RBR-8dmfjf.
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OBJECTIVE: To compare the analgesic effect of manual acupuncture(MA) stimulation of "Zusanli" (ST36) in rats with inflammatory pain under unrestrained conscious, restrained and general anesthesia conditions, so as to explore the applicability of unrestrained conscious model in the evaluation of acupuncture analgesia effect. METHODS: Male SD rats were divided into 5 groups: blank control (n=9), pain model (n=7), unrestrained conscious conditions+MA (n=6), restrained conditions+MA (n=6), and general anesthesia (GA)+MA(n=6). The acute pain model was established by injection of complete Freund's adjuvant (CFA) into the left ankle joint 48 h ahead of acupuncture. Subsequently, a single 20 min session of MA was applied to the left ST36. The mechanical and thermal pain thresholds (MPT and TPT) were determined before and after injection of CFA, and after MA stimulation. In order to evaluate the autonomic behavior activities, rats were randomly divided into blank control (n=11), pain model (n=11) and conscious-unrestrained conditions +MA (n=12) groups. The rats' exploratory movements were assessed by open field tests. RESULTS: Both MPT and TPT were significantly decreased after injection of CFA in the model group relevant to the blank control group (P0.05). No significant changes were found in the total moving distance after MA and in the central area moving distance after modeling and MA (P>0.05). CONCLUSION: MA has a better therapeutic effect in relieving pain and pain-induced depression-like behavior in conscious unrestrained rats than in restrained and GA rats, implying a higher applicability of unrestrained conscious pain model to the assessment of acupuncture analgesia.
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The research progress of acupuncture analgesia in recent years is analyzed to summarize the analgesic mechanism of acupuncture on neuropathic pain. The analgesic mechanism of acupuncture on neuropathic pain is discussed from peripheral level and central level, including peripheral sensitization and immune inflammatory response, changes of ion channel, central sensitization, regulation of cell signal pathway, activation of spinal glial cells, etc. It is suggested that the focus of future research should include conducting in-vitro studies with the help of multi-omics technology to detect the changes of metabolic substances and signal pathway molecules in patients with neuropathic pain before and after acupuncture to further clarify the mechanism of acupuncture analgesia.
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Objective: To observe the effect of electroacupuncture plus drug anesthesia on pain and stress response in patients after radical surgery for stomach cancer.Methods: A total of 60 patients were randomized into a control group and an observation group by the random number table, with 30 cases in each group. The control group was given conventional drug anesthesia. The observation group was given additional electroacupuncture intervention. Before anesthesia and 2 h, 12 h and 24 h after surgery, the visual analog scale (VAS) was scored, the heart rate, the mean arterial pressure, and the levels of serum β-endorphin (β-EP) and adrenocorticotrophic hormone (ACTH) were measured. Results: Two hours, 12 h and 24 h after surgery, the VAS scores of both groups were higher than those before anesthesia (all P<0.05), and the VAS scores in the observation group were lower than those in the control group at the same time points (all P<0.05). Two hours, 12 h and 24 h after surgery, the heart rates and mean arterial pressures in the control group were significantly higher than those before anesthesia (all P<0.05), while there were no significant intra-group differences in the observation group (all P>0.05), and the indicators were lower than those in the control group at the same time points (all P<0.05). Two hours, 12 h and 24 h after surgery, the serum β-EP levels in the observation group were significantly higher than those before anesthesia (all P<0.05), and significantly higher than those in the control group at the same time points (all P<0.05). Two hours, 12 h and 24 h after surgery, the serum ACTH levels in the control group were significantly higher than those before anesthesia (all P<0.05), and were significantly higher than those in the observation group at the same time points (all P<0.05). Conclusion: Electroacupuncture plus drug anesthesia can significantly relieve pain and stress response in patients after radical surgery for stomach cancer.
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RESUMEN Introducción: la analgesia por acupuntura produce una estimulación mecánica o eléctrica en diferentes puntos del cuerpo, provocando un aumento del umbral del dolor y ayuda al paciente a soportar diversos tipos de intervención quirúrgica. Objetivo: evaluar la aplicación de analgesia acupuntural en cirugía inguino genital urológica en el Hospital Pediátrico Provincial Docente Pepe Portilla. Métodos: se realizó un estudio observacional, descriptivo y transversal de 260 pacientes operados con analgesia acupuntural entre 2011 y 2017. Los datos se obtuvieron a partir de las historias clínicas de los pacientes. Las variables (edad, sexo, área quirúrgica, eficacia del tratamiento, complicaciones, recuperación anestésica, tiempo de uso de analgésicos y gasto económico) se analizaron mediante estadística descriptiva. Resultados: predominó el sexo masculino (78,1 %) y las edades comprendidas entre 13 - 18 años. La región inguinal fue el área más intervenida (76,1 %). El 93,9 % de los pacientes presentó buena respuesta al tratamiento, el 2,7 % mostró respuesta regular en cirugía genital y el 3,4 % respuesta mala en cirugía inguinal. Solo 19 pacientes (7,3 %) presentaron algún tipo de complicación, siendo el dolor la más frecuente (10 casos). La recuperación anestésica fue favorable en 241 pacientes (92,7 %). El valor de los recursos materiales usados representa $0,99 por cada cirugía, lo cual asciende al monto de $257,4 en las 260 intervenciones realizadas. Conclusiones: el uso de analgesia acupuntural en cirugía uropediátrica presentó buena respuesta al tratamiento, aparición escasa de complicaciones, recuperación anestésica favorable y amplio valor científico y socioeconómico.
ABSTRACT Introduction: acupuncture analgesia produces mechanical or electrical stimulation in different points of the body, increasing the pain threshold and helping the patient to support different types of surgical intervention. Objective: to assess the application of acupuncture analgesia in urinary genital inguinal surgery at Pepe Portilla Provincial Pediatric Teaching Hospital. Methods: an observational, descriptive and cross-sectional study that included 260 patients undergoing surgeries applying acupuncture analgesia between 2011 and 2017 was conducted. The data were obtained from the patient's medical records. The variables were: age, gender, surgical area, effectiveness of treatment, complications, anesthetic recovery, duration of the analgesic action and economic expenses; which were analyzed by descriptive statistics. Results: male sex predominated (78,1 %), the ages comprised between 13 - 18 years. The inguinal region was the most intervened area (76,1 %); 93,9 % of the patients showed good outcomes, 2,7 % had a regular response in genital surgery and 3,4 % a poor outcome in inguinal surgery. Only 19 patients (7,3 %) presented some type of complications, pain was the most frequent (10 cases). Anesthetic recovery was favorable in 241 patients (92,7 %). The cost of the surgical materials used represents $ 0,99 for each surgery, which amounts of $ 257,4 in a total of 260 surgical interventions performed. Conclusions: the application of acupuncture analgesia in pediatric urinary genital inguinal surgery presented a good response to this treatment, observing infrequent complications, favorable anesthetic recovery and an ample scientific value, as well as low socioeconomic expenses.
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OBJECTIVE: To observe the relationship between the analgesic effect of balance acupuncture and functional changes in brain in patients with migraine without aura. METHODS: A total of 40 cases of migraine without aura were equally randomized into a headache-acupoint group and a sham-acupoint group. When acupuncture given, a filiform needle was inserted into the headache-acupoint (the midpoint of the depression region anterior to the juncture of the first and second metatarsal bones on the dorsum of the foot) or the sham point (the midpoint of the depression region anterior to the juncture site between the 3rd and 4th metatarsal joints of the dorsum of the foot) about 25-40 mm deep and manipulated for a while till the patient experienced feelings of electric shock and numbness, then withdrawn immediately. The treatment was conducted once daily for 4 weeks. The visual analogue scale (VAS) was used to evaluate the severity of pain, and the regional homogeneity (ReHo) analysis of resting state functional magnetic resonance imaging (fMRI) was used to assess changes of the spontaneous brain activity. RESULTS: After acupuncture, the analgesic effect of headache-acupoint was better than that of the sham-acupoint in both intervention stage and the follow-up stage (P0.05). Compared with pre-intervention, 4-weeks' intervention at the headache-acupoint showed an increase of ReHo values in the anterior cingulate gyrus, anterior central gyrus, superior orbital frontal gyrus, insula, inferior lobule, left anterior cingulate gyrus, ventral lateral nucleus and ventral posteromedial nucleus of the thalamus, pontine nucleus, cerebellar tonsils and orbital frontal inferior gyrus of the brain (P<0.05), and a decrease of ReHo values in the right brain bridge, central posterior gyrus, posterior cingulate gyrus, left central anterior gyrus, posterolateral nucleus of thalamus, and hippocampus (P<0.05), separately. In the sham-acupoint group, the ReHo value was increased in the right tongue gyrus, the left anterior lobe, the anterior cingulate gyrus and the lower occipital gyrus of the brain (P<0.05), and reduced in the left ventral posterolateral nucleus of the thalamus, separately (P<0.05). CONCLUSION: Balance acupuncture stimulation of headache acupoint has an analgesic effect in migraine patients without aura, which may be related to its effect in regulating resting state brain function of the limbic-system-dominated multiple brain regions.
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Objective@#To investigate the therapeutic effect of Bushen-Tongbi decoction combined with acupuncture Beishu for the treatment of lumbar disc herniation.@*Methods@#According to the random table method, 80 patients who met the inclusion criteria were divided into two groups, 40 in each group. The patients in the control group were treated with diclofenac sodium, while the patients in the treatment group were treated with Bushen-Tongbi decoction combined with acupuncture Beishu on the basis of control group. Two groups were treated for 1 month. The VAS scale was used to evaluate pain degree, Modified Japanese Orthope-dic Association (M-JOA) was used to evaluate spine function, and serum levels of TNF-α, CRP and IL-1β were detected by ELISA. Adverse reactions during treatment were recorded and clinical efficacy was evaluated.@*Results@#The total effective rate of treatment group was 95.0% (38/40) and the control group was 77.5% (31/40). The difference between two groups was statistically significant (χ2=5.165, P=0.023). After treatment, the VAS scores and M-JOA scores in the treatment group were significantly lower than those in the control group (t=6.226, 10.120, P<0.01). After treatment, the serum levels of TNF-α, CRP and IL-1β in the treatment group were significantly lower than the control group (t=8.840, 5.939, 11.397, P<0.01).@*Conclusions@#The Bushen-Tongbi decoction combined with acupuncture Beishu for the treatment of lumbar disc herniation can reduce the pain and inflammation, improve spinal function.
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RESUMEN Fundamento: la analgesia quirúrgica acupuntural permite realizar el tratamiento quirúrgico sin el uso de anestésicos convencionales, pues la acupuntura y la electroterapia, logran un aumento del umbral doloroso en el paciente, y producen una disminución o pérdida de la percepción del dolor. Este proceder combinado con otras técnicas bioenergéticas afines es más efectivo. Objetivo: divulgar información actualizada sobre el uso de la analgesia quirúrgica acupuntural y las técnicas bioenergéticas afines, en profesionales dela estomatología. Método: se realizó una revisión bibliográfica desde enero hasta marzo de 2017, en las bibliotecas de la facultad de Estomatología y Medicina, de la Universidad de Ciencias Médicas de la provincia Camagüey. Se consultó la bibliografía impresa, libros clásicos revistas y la información disponible en internet, que aparece escrita en los idiomas español, inglés y portugués. La búsqueda se realizó en bases de datos como: Medline, Lilacs, Dialnet, Redalyc, Hinari, Doyma, SciELO. De los 90 artículos encontrados, se incluyen 47 en la investigación, un alto porcentaje de ellos fue publicado en los últimos cinco años. Desarrollo: la revisión bibliográfica muestra la importancia de combinar la acupuntura con técnicas eléctricas, terapias psicológicas, la hipnosis, la homeopatía y la auriculopuntura; al realizar exodoncias. Se mencionan los antecedentes históricos, conceptos, indicaciones, precauciones, contraindicaciones, equipo e instrumental, aspectos que garantizan el éxito del tratamiento. Se señalan los puntos acupunturales más útiles, ventajas de su uso, iatrogenias y eventos adversos frecuentes. Conclusiones: la analgesia quirúrgica acupuntural es un procedimiento con bases científicas en continuo desarrollo. Su indicación para exodoncias en estomatología es favorable y su eficacia es mayor al combinarla con terapias bioenergéticas afines, por tanto es necesario potenciar y desarrollar estudios rigurosos sobre este tema, para estimular y divulgar su uso entre los profesionales de la estomatología.
ABSTRACT Background: the surgical acupunctural analgesia allows accomplishing the surgical treatment without the use of conventional anesthetics, because acupuncture and electrotherapy achieve an increase of the painful doorstep in the patient and they produce a decrease or loss of the perception of the pain. This action combined with other techniques related bioenergetics is more effective. Objective: to popularize updated information on the use of the surgical acupunctural analgesia and techniques related to bioenergetics in stomatology. Methods: a bibliographic revision was carried out from January to March 2017, at the libraries of Dentistry's and Medicine´s faculty of Medical Science's University of Camagüey´s province. It was consulted the printed bibliography, classical books, magazines and the available information in internet, which appear written in the Spanish, English and Portuguese languages. The search was carried out in databases like Medline, Lilacs, Dialnet, Redalyc, Hinari, Doyma and SciELO. Of the 90 articles found, 47 are included in the investigation; a high percentage of them were published in the last five years. Development: the bibliographical review shows the importance of combining the acupuncture with electrical techniques, psychological therapies, hypnosis, homeopathy, and auriculopuncture; when performing exodontias. There are mentioned the historic background, concepts, indications, precautions, contraindications, equipment and instruments, aspects that guarantee the success of treatment. It is pointed out the most useful acupuncture points, advantages of its use, iatrogenic and frequent adverse events. Conclusions: the surgical acupunctural analgesia is a procedure with scientific bases in continuous development. Its indication for exodontias in dentistry is clearly favorable and its efficacy is higher when combining with bioenergetics therapies, therefore it is necessary to encourage and to develop rigorous studies on this theme to stimulate and to promote its use among the professionals of dentistry.
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Objective To research of acupuncture for the perioperative analgesia and immune function of the breast cancer patients.Methods A total of 40 breast cancer patients who were carried out the radical operation was randomly (random number table method) divided into acupuncture combined drugs group and control group in our hospital during from 2015.1 to 2016.12. The patients in acupuncture combined drugs group was carried out acupuncture combined TCI anesthesia,and the patients in control group was carried out TCI anesthesia. The analgesic effect was evaluated by Visual analogue scales(VAS) in 2h, 6h, 12h, 24h and 48h after operation. The percentage of peripheral blood subgroups of T-lymphocytes (CD3+, CD4+, CD8+), natural killer cell (CD16+CD56+) and the ratio of CD4+/CD8+ was detected in 30 min before anesthesia,2h after beginning of operation,1d , 2d and 5d after operation.Results he VAS scores at 2 h (2.30 ± 1.12vs. 3.75 ± 1.06,t=2.378), 6 h (2.64 ± 1.23vs. 5.56 ± 1.41,t=3.289) and 12 h (3.49 ± 1.46vs. 4.99 ± 1.27,t=2.040) after operation of acupuncture combined drugs group wwere significantly lower than those of control group (P<0.05). The CD3+ (52.35％ ± 4.20％vs. 48.01％ ± 4.42％,t=2.127), CD4+ (27.81％ ± 2.72％vs. 24.96％ ± 2.60％,t=2.250), CD4+/CD8+ (1.12 ± 0.15vs. 1.01 ± 0.13,t=2.136) in acupuncture combined drugs group were significantly higher than those of the control group in 1d after operation (P<0.05). The CD16+ CD56+ 2 h (14.79％ ± 2.04％vs. 13.58％ ± 1.50％,t=2.852), 1 d (14.43％ ± 2.27％vs. 13.11％ ± 1.82％,t=2.933) in acupuncture combined drugs group were significantly higher han those of control group in 2h after beginning of operation and 1d after operation (P<0.05).Conclusions The analgesic effect of acupuncture could be applied to radical operation of breast cancer under general anesthesia. This method could protect the subgroups of T-lymphocytes and natural killer cell, and improve the immune function of breast cancer patients.
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Objective To explore the clinical efficacy and safety of acupuncture combined with Jintiange capsule for the patients with lumbar disc herniation (LDH).Methods According to the random table method, 95 cases of patients with LDH were divided into the control group (n=47) and the research group (n=48) from June 2015 to March 2017. The patients in the control group were treated by acupuncture, while the patients in the research group were treated withJintiange capsule on the basis of the control group. The continuous treatment for 4 weeks was a course, and the treatment of two groups was 2 courses. The clinical total effective rate and symptom control time of two groups were observed. The pain intensity, JOA, the straight leg-raising angle and the serum level of inflammatory factors of two groups of patients were detected before and after treatment respectively. In addition, the incidence of adverse reactions of two groups was analyzed. Results The total clinical effectiveness of the research group was 93.75％ (45/48), and the control group was 76.60％ (36/47). The difference of two groups was statistically significant (χ2=5.562,P=0.018). The symptom control time (9.2 ± 2.3 dvs. 14.0 ± 2.3 d,t=-10.406) of the research group was significantly lower than that of the control group (P<0.05). After treatment, the straight leg-raising angle [(78.6 ± 17.6)°vs. (59.9 ± 3.2)°,t=5.869] and JOA (18.7 ± 2.1vs. 12.1 ± 1.9,t=16.152) of research group was significantly higher than those of the control group. While the VAS score (1.1 ± 0.3vs. 2.6 ± 0.6,t=-15.997), TNF-α (1.18 ± 0.22 ng/Lvs. 1.51 ± 0.21 ng/L,t=-7.476), IL-1β (25.14 ± 6.17 ng/mlvs. 40.26 ± 6.07 ng/ml,t=-12.038), IL-6 (93.85 ± 23.02μg/Lvs. 110.63 ± 24.07μg/L, t=-3.473) and TXB2 (299.36 ± 52.16 pg/mlvs. 429.17 ± 53.62 pg/ml,t=-11.961) of research group were significantly lower than those of the control group (P<0.05). Both groups had adverse events during the treatment.Conclusions Acupuncture combined withJintiange capsule could effectively improve the clinical symptoms, release pain and decrease the serum inflammatory factors of patients with LDH.
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Since the invention of optogenetic technology, it has greatly promoted the development of neuroscience. Currently, optogenetic approaches have been mostly used to map neural circuits and new neuropharmacology but are rarely seen in the research field of acupuncture analgesia. The mechanism of neural circuits contributing to acupuncture analgesia, an important research hotspot in recent years, has not been fully determined. The optogenetic techniques can be used to modulate and control specific cells, provides highly precise spatial and temporal resolution, is repeatable, and may functionally dissect neuronal networks in vivo. The neuronal activities and their information transmission, processing and storage in intercluster neural networks in different brain regions, and the correlation between behavioral changes and electrical activities of neurons in vivo studies are mainly captured by the implanted microelectropode array, etc. If these two (or more) approaches are combined together, it is definitely and highly helpful to reveal the driving dynamics of neural circuits, plasticity and temporal-spatial activity mode of neurons, as well as behavioral reactions of animals with chronic pain during acupuncture analgesia and may open a new prospect for the application of acupuncture analgesia study.
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Although acupuncture, especially electroacupuncture (EA) is widely used to treat pain, its mechanisms have not been completely understood. In the present paper, we review the development of researches on the underlying mechanisms of EA in relieving inflammatory pain in recent years from a)peripheral inflammation-mediated immune response and neuro-immune interaction of receptors on primary nociceptors, b) crosstalk of neurotransmitters or neuromodulators, cellular signaling pathways, other related bioactive molecules, as well as glial activation in the dorsal horns of spinal cord, and c) supraspinal modulation of both sensory and affective components of pain. Inflammatory pain involves complex neuro-immune networks of neurons and non-neurons, various inflammatory mediators, neurotransmitters, neuromodulators and cellular signaling molecules in the peripheral and central nervous systems. Therefore, the analgesic mechanism of acupuncture still needs to be studied in depth at multi-levels and multi-targets, for instance, the reciprocal actions of peripheral opioid peptide, adenosine and TRPV 1 (which have been demonstrated to be involved in EA analgesia individually), the roles of spinal cord adenosine A 1 receptor (A 1 R) and A 2 R (for which fewer studies have been conducted), the interactions of classical neurotransmitters/neuromodulators/neuropeptides and their receptors, changes of intracellular molecules at transcriptional and translation levels, etc. during acupuncture analgesia. Furthermore, the mechanisms underlying reciprocal actions of neurotransmitters, neuromodulators and their receptors complicated in acupuncture-induced relief of pain affection in the higher brain regions also need to be explored further.