Electroacupuncture combined with lifestyle control on obese nonalcoholic fatty liver disease: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) combined with lifestyle control on hepatic fat status, hepatic enzymology, glycolipid metabolism and anthropological parameters in patients with obese nonalcoholic fatty liver disease(NAFLD).@*METHODS@#A total of 90 patients with obese NAFLD were randomized into an observation group (45 cases, 4 cases dropped off) and a control group (45 cases, 1 case dropped off). Lifestyle control was implemented in the control group. On the basis of the treatment in the control group, acupuncture was applied at Zhongwan (CV 12), Quchi (LI 11), Shuifen (CV 9), Huaroumen (ST 24), Daheng (SP 15), Guanyuan (CV 4), Qihai (CV 6), etc. EA was provided at Huaroumen (ST 24) and Daheng (SP 15) with dilatational wave, 2 Hz/100 Hz in frequency, 30 min each time, once every other day, 3 times a week. The treatment for 12 weeks was required in both of the two groups. Hepatic fat status [controlled attenuation parameter (CAP) and liver stiffness measurement (LSM)], hepatic enzymology [alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT)], glycolipid metabolism and insulin sensitivity [fasting plasma glucose (FPG), fasting serum lisulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C)] and anthropological parameters [body weight (BW), body mass index (BMI), fat percentage (FP), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR)] in the two groups were observed before and after treatment.@*RESULTS@#①Compared before treatment, hepatic CAP, LSM, serum ALT, AST and GGT after treatment were obviously reduced in the two groups (<0.05, <0.01). After treatment, CAP and ALT in the observation group were lower than the control group (<0.05). ②Compared before treatment, FINS, HOMA-IR, LDL-C, TC and TG after treatment were obviously reduced in the two groups (<0.05, <0.01),while the levels of HDL-C were increased (<0.05). Compared before treatment, FPG after treatment in the observation group was reduced (<0.05). Compared with the control group, FINS, HOMA-IR, TC and TG in the observation group were lower than those in the control group after treatment (<0.05). ③Compared before treatment, BW BMI, FP, WC, HC, WHR after treatment were obviously reduced in the two groups (<0.01). After treatment, WC and WHR in the observation group were lower than the control group (<0.05).@*CONCLUSION@#Electroacupuncture combined with lifestyle control can effectively treat obese nonalcoholic fatty liver disease, and present better therapeutic effect on hepatic fat status, glycolipid metabolism, insulin resistance, WC and WHR.

<b>A Case of Fibromyalgia Complicated by Chronic Fatigue Syndrome and Complex Regional Pain Syndrome Successfully Treated with a Combination of Kampo Treatments Including Uzu and Acupuncture </b> / 日本東洋医学雑誌

A 45-year-old woman had been suffering from fibromyalgia, chronic fatigue syndrome, and complex regional pain syndrome (CRPS) for 2 years before admission. Non-steroidal anti-inflammatory agents, selective serotonin reuptake inhibitors and pregabalin did not affect the various symptoms. A severe feeling of Coldness, the widespread systemic pain and the severe fatigue were decreased by tsumyakushigyakuto (glycyrrihza 4 g, processed ginger 9 g, aconite root 6 g). Attacks of CRPS were relieved by a dose of daiuzusen (aconite root 1 g, honey 10 g). The CRPS attacks presented mainly on the left heart meridian and the small intestine meridian where we treated them with electroacupuncture with reference to the <i>Shigoryuchu </i>(子午流注) methods. Acupuncture and electroacupuncture decreased the frequency of pain attacks, and alleviated the muscles stiffness caused by the CRPS. Thus, the combination of Kampo medicine and acupuncture were effective for the severe pain and other symptoms associated with fibromyalgia, chronic pain syndrome and CRPS.

Effects of Electroacupuncture with Different Frequencies on the Spinal c-fos and Inotropic Glutamate Receptor Expression in Carrageenan-injected Rat / 체질인류학회지

We investigated the comparative effects of electroacupuncture (EA) with different frequency on the spinal c-fos and inotropic glutamate receptor expression in carrageenan-injected rats. Bilateral EA stimulation with 2, 15 and 120 Hz were delivered at those acupoints corresponding to Zusanli and Sanyinjiao in man via the needles. The inhibitory effects of the EA on the inflammatory process were investigated in the central nociceptive sites by immunohistochemical analysis. Three hours after carrageenan injection, the number of c-fos-like immunoreactive (LI) neurons was significantly increased in all layers of the ipsilateral spinal cord at L4-5 segment. But these immunoreactive neurons were markedly reduced in the spinal gray matter, especially in the superficial laminae, by all kinds of EA stimulation. The number of NMDA (NR-1 and NR-2A) and AMPA receptors (GluR-1, GluR-2/3) -LI neurons was also increased by carrageenan injection. But NR-2A-LI neuron was significantly reduced in superficial laminae of dorsal horn by 2 Hz EA stimulation. While GluR-1-LI neuron of 15 Hz and 120 Hz EA was increased in the nucleus proprius compared with carrageenan-injected group, GluR-2/3-LI neuron of these EA stimulated groups significantly reduced in superficial laminae of dorsal horn. In conclusion, EA treatment can attenuate spinal c-fos expression in carrageenan injected rats and regulates spinal inotropic glutamate receptor expression.

Effects of Electroacupuncture with Different Frequencies on the Spinal c-fos and Inotropic Glutamate Receptor Expression in Carrageenan-injected Rat / 체질인류학회지

We investigated the comparative effects of electroacupuncture (EA) with different frequency on the spinal c-fos and inotropic glutamate receptor expression in carrageenan-injected rats. Bilateral EA stimulation with 2, 15 and 120 Hz were delivered at those acupoints corresponding to Zusanli and Sanyinjiao in man via the needles. The inhibitory effects of the EA on the inflammatory process were investigated in the central nociceptive sites by immunohistochemical analysis. Three hours after carrageenan injection, the number of c-fos-like immunoreactive (LI) neurons was significantly increased in all layers of the ipsilateral spinal cord at L4-5 segment. But these immunoreactive neurons were markedly reduced in the spinal gray matter, especially in the superficial laminae, by all kinds of EA stimulation. The number of NMDA (NR-1 and NR-2A) and AMPA receptors (GluR-1, GluR-2/3) -LI neurons was also increased by carrageenan injection. But NR-2A-LI neuron was significantly reduced in superficial laminae of dorsal horn by 2 Hz EA stimulation. While GluR-1-LI neuron of 15 Hz and 120 Hz EA was increased in the nucleus proprius compared with carrageenan-injected group, GluR-2/3-LI neuron of these EA stimulated groups significantly reduced in superficial laminae of dorsal horn. In conclusion, EA treatment can attenuate spinal c-fos expression in carrageenan injected rats and regulates spinal inotropic glutamate receptor expression.