Construction of the integrative evidence chain in clinical trial of acupuncture and moxibustion / 中国针灸

The research aims to propose the approaches to the clinical trial of acupuncture and moxibustion and provide the methodological guide for the research in this field in terms of the inadequate systematic collection, lack of the specific characteristics of acupuncture-moxibustion treatment and insufficient persuasion in clinical evidences of acupuncture-moxibustion research. Through a systematic review of the registration of acupuncture-moxibustion clinical trials at home and abroad, the distribution of diseases with the recommendation of acupuncture and moxibustion in Cochrane Library database, combined with the evidence grade of the evidence-based medicine and the individual characteristics of clinical practice with acupuncture and moxibustion, some research ideas and framework are proposed for the clinical trial of acupuncture and moxibustion. To take the curative effect as the forerumer, the dominant disease and therapeutic methods of acupuncture and moxibustion should be initially generalized by the case experiences and clinical observation at the first. In view of the potential function of acupuncture and moxibustion in treatment, the rigorous and standardized clinical trial should be carried out to verify their therapeutic effect. Finally, the experimental research is adopted to explore the mechanism of acupuncture and moxibustion. Through the combination of quantitative and qualitative methods, all of the evidences are integrated to form an integrative evidence chain. It is anticipated that the construction of the integrative evidence chain in clinical trial of acupuncture and moxibustion may enhance the promotion of clinical practice with acupuncture and moxibustion and increase the influence of acupuncture-moxibusiton discipline.

Effect of Acupuncture on the Notch Signaling Pathway in Rats with Brain Injury / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the effect of acupuncture on the Notch signaling pathway in rats with traumatic brain injury and to explore the pathogenesis of acupuncture intervention on traumatic brain injury.</p><p><b>METHODS</b>Feeney's freefall epidural impact method was used to establish a traumatic brain injury model in rats; the rats were randomly divided into a normal group, sham operation group, model group and acupuncture group. Acupuncture was performed in the Baihui (DU 20), Shuigou (DU 26), Fengfu (DU 16), Yamen (DU 15) and Hegu (LI 4) acupoints in the rat, and Yamen was punctured via Fengfu. Then, the rats in each group were randomly divided into three subgroups, namely the day 3 subgroup, day 7 subgroup and day 14 subgroup according to treatment duration. The modified neurological severity scores (mNss) method was used to perform neurobehavioral scoring for evaluating the degree of injury in the rats. The hematoxylin-eosin (HE) staining method was used to observe the pathological change in the brain tissue of rats in each group. Real-time fluorescent quantitative polymerase chain reaction (Q-PCR) technology was used to detect changes in the Notch1, Hes1 and Hes5 gene expression levels in the cortex on the injured side. Western blot was used to detect the protein expression changes.</p><p><b>RESULTS</b>One day after modeling, the mNss scores in the model group and in the acupuncture group were significantly higher than those in the normal and sham operation groups (P<0.01) ; there was no statistically significant difference between the normal group and the sham operation group. The scores decreased with increased treatment time, and the scores in the acupuncture group decreased more significantly than those in the model group (P<0.01). The pathological examination by the HE staining method demonstrated that the brain tissue of the rats in the acupuncture and model groups relatively significantly changed. The Notch1 gene expression level in the acupuncture group was significantly higher than the level in all of the other groups (P<0.01) ; the Hes1 and Hes5 gene expression levels were also higher in the acupuncture group. The expression changes of the Notch1 and Hes1 protein were consistent with that of mRNA. In each experimental group, the mNss score and the pathological results by the HE staining method were consistent with the mRNA results.</p><p><b>CONCLUSION</b>Acupuncture could significantly promote high expression levels of Notch1, Hes1 and Hes5 in the brain tissue of traumatic brain injury rats. Therefore, acupuncture might be an important intervention for inducing endogenous stem cell proliferation and for promoting nerve repair.</p>

Effect of needling at waiguan (SJ5) on brain glucose metabolism in patients with cerebral infarction / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe changes of brain glucose metabolism by needling at Waiguan (SJ5) in cerebral infraction (CI) patients using 18F-fluorodeoxyglucose (FDG) positron-emission computer tomography (PET/CT), thus exploring its effect and mechanisms.</p><p><b>METHODS</b>A total of 21 patients with CI were recruited in this study. The location of lesion was limited to the left basal ganglia by CT or MRI scan. All patients were randomly assigned to three groups. i.e., the acupoint group (Group A), the non-acupoint group (Group B), the blank control group (Group C), 7 in each group. Patients in Group A were needled at right Waiguan (SJ5). Those in Group B were needled at non-acupoint [10 mm beside Waiguan (SJ5)], whereas those in Group C did not receive any treatment. All patients underwent PET/CT head scan. All data were statistically analyzed using SPSS 13.0 Software and SPM8 Software.</p><p><b>RESULTS</b>Compared with Group C, glucose metabolism increased in bilateral superior temporal gyrus (BA38), right superior frontal gyrus (BA9), left cingulate gyrus (BA24), left culmen and pyramid of cerebellum, and right cerebellar tonsil of cerebellum in Group A. Compared with Group C, glucose metabolism increased in bilateral superior frontal gyrus (BA6, BA9, BA10), bilateral middle frontal gyrus (BA6, BA10), left middle frontal gyrus (BA4), bilateral uncus of limbic lobe (BA36, BA38), left cingulate gyrus (BA24, BA31), left posterior cingulate gyrus (BA30), left precuneus (BA7), left inferior parietal lobule (BA4), and left lingual gyrus of occipital lobe (BA18) in Group B. Compared with Group B, glucose metabolism increased in bilateral superior temporal gyrus (BA22, BA38), right inferior frontal gyrus (BA47), left culmen and cerebellar tonsil of cerebellum in Group A. Activated encephalic regions of needling at Waiguan (SJ5) were mainly dominated in the healthy side, bilateral superior temporal gyrus, and right inferior frontal gyrus. Activated encephalic regions of cerebellum were located at the left cerebellar hemisphere, left culmen of anterior cerebella lobe, and bilateral cerebellar tonsil of posterior cerebella lobe.</p><p><b>CONCLUSIONS</b>Needling at Waiguan (SJ5) of CI patients induced increased glucose metabolism in local cerebral regions. Functional neuroimaging using PET/CT could directly reflect changes of brain glucose metabolism by acupuncture.</p>

Effect of acupuncture on proliferation and differentiation of neural stem cells in brain tissues of rats with traumatic brain injury / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the effect of acupuncture on proliferation and differentiation of neural stem cells in brain tissues of rats with traumatic brain injuny.</p><p><b>METHODS</b>Thirty SD rats were randomly and equally allocated to the sham-operated, the model and the acupuncture groups. The traumatic brain injury model was established by the free drop method. For the rats in the acupuncture group, acupuncture was applied once a day for 7 days. Brain histotomy was carried out when treatments were completed. Immunohistochemical techniques were adopted to detect the cells that express nestin, neurofilament proteins (NF)-200 and glial fibrillary acidic proteins (GFAP), the markers of neural stem cells, neurons, astrocytes respectively.</p><p><b>RESULTS</b>Compared to the sham-operated group, the number of nestin-positive cells and NF-200-positive cells in brain tissues was decreased significantly in the model group (P < 0.01), whereas the number of GFAP-positive cells was significantly increased P<0.01). Compared to the model group, the positive cells of nestin, NF-200, GFAP in brain tissues in the acupuncture group were increased obviously (P<0.01).</p><p><b>CONCLUSIONS</b>Acupuncture can significantly increase the number of nestin-positive cells, NF-200-positive cells and GFAP-positive cells, indicating the significant increase of neural stem cells, neurons and astrocytes in number. Acupuncture can improve neuranagenesis by promoting the proliferation and differentiation of neural stem cells in brain tissues. This might be one of the mechanisms for acupuncture to treat traumatic brain injury and to promote the repair of nervous function.</p>

Effects of electroacupuncture on IL-2-IFN-NKC immunity immunoloregulation net and IL-2 receptor in rats with exercise stress / 中国针灸

<p><b>OBJECTIVE</b>To explore the effects of electroacupuncture on exercise-induced immunosuppression in rats and its mechanism.</p><p><b>METHODS</b>Sports immunosuppressive model was established successfully by the rats were conducted high intensity swimming training 150 min/day, 6 days/wk for 8 weeks in this study. Forty-three SD rats were randomly divided into a control group (group A, n = 10), a high intensity swimming training group (group B, n = 17), and a high intensity plus electroacupuncture group (group C, n = 16). Group A did not receive any intervention. Group B was conducted 150 min/day, 6 days/wk swimming training for 8 weeks. Group C was treated with electroacupuncture at "Baihui" (GV 20), "Guanyuan" (CV 4) and "Zusanli" (ST 36) after every exercise-time from the second week, once each day for 7 weeks. The changes of the rats' weight, gamma-interferon (gamma-IFN), interleukin-2 (IL-2), solubility IL-2 receptor (SIL-2R) and nature killer cell (NKC) were detected.</p><p><b>RESULTS</b>(1) Compared with group A, gamma-IFN and IL-2 in group B were significantly decreased (P < 0.01, P < 0.05), and NKC in group C was significantly increased (P < 0.01). Meanwhile, gamma-IFN and NKC in group C were both significantly higher than that in group B (P < 0.05, P < 0.01). (2) Compared with group A, the weight of the rats in group B and group C were significantly decreased (both P < 0.01), but SIL-2R in group B was significantly increased (P < 0.05). The weight of the rats in group C was significantly higher than that in group B (P < 0.05) and SIL-2R in group C was significantly lower than that in group B (P < 0.01).</p><p><b>CONCLUSION</b>Lasting gravis exercise stress does decrease the immune function in rats and is even inhibited significantly, but electroacupuncture can up-regulate the exercise-induced immunosuppression.</p>

Randomized controlled study on acupuncture treatment for chronic fatigue syndrome / 中国针灸

<p><b>OBJECTIVE</b>To observe the therapeutic effect of acpuncture treatment for chronic fatigue syndrome (CFS).</p><p><b>METHODS</b>Nighty cases of CFS were randomly divided into an observation group and a control group, 45 cases in each group. The observation group was treated with acupunture at Renying (ST 9), Fengfu (GV 16), Baihui (GV 20); the control group was treated with 250 mL 5% Glucose injectio combined with 20 mL Shenmai injectio. Fatigue Scale (FS) was used to compare the scores between the two groups after treatment.</p><p><b>RESULTS</b>The total scores in the observation group were 9.37 +/- 2.33 and 5.41 +/- 1.96 before and after treatment respectively, and in the control group, they were 9.08 +/- 2.27 and 7.34 +/- 2.03 respectively. FS brainwork integral, physical fatigue integral, and total integral all decreased after treatment in two groups (all P < 0.001), and it decreased much more obviously in the observation group (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>Both of the acpuncture treatment and Shenmai injectio are able to decrease fatigue scale score, improve the fatigue symptoms of CFS patients, and the effect of acupucture treatment is obviously superior to that of Shenmai injectio.</p>

Acupuncture for treatment of depressive neurosis: a multi-center randomized controlled study / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical therapeutic effect of acupuncture on depressive neurosis.</p><p><b>METHODS</b>With a multi-center randomized controlled study, 440 cases were randomly divided into an acupuncture group, a prozac group, a non-acupoint needling group. In the acupuncture group, Hegu (LI 4) and Taichong (LR 3) were selected, and the Prozac group were treated with administration of 20 mg/d and the non-acupoint needling group were treated with needling the points deviating from the acupoints. The therapeutic effect was evaluated by HAMD score reduction rate, and Asberg's anti-depressant side-effect rating scale (SERS) and severe adverse reaction were used for safety evaluation, and the data were analyzed with ITT.</p><p><b>RESULTS</b>The total effective rate was 86. 4% in the acupuncture group, which was better than 59.1% in the non-acupoint needling group and 72.7% in the prozac group; HAMD score in the acupuncture group was similar to that in the Prozac group, which was better than that in the non-acupoint needling group; the SERS scores in the acupuncture group and the non-acupoint needling group were significantly lower than that in the Prozac group, with no severe side-effects found for acupuncture.</p><p><b>CONCLUSION</b>Acupuncture is an effective and safe therapy for depressive neurosis; therapeutic effect of acupuncture on depressive neurosis possibly is better than or similar to that of Prozac, but with less side-effects.</p>

Effects of acupuncture and embedding thread on central monoamine neurotransmitters in the depression model rat / 中国针灸

<p><b>OBJECTIVE</b>To compare therapeutic effects of acupuncture and embedding thread on depression and to probe the mechanism.</p><p><b>METHODS</b>Thirty-two adult SD rats, 16 females and 16 males, were randomly divided into a normal group, a model group, an acupuncture group and an embedding thread group, 8 rats in each group. Separated feeding, long-term unpredictable and middle stimulation stress were used for development of depression rat model. At the same time, the treatment groups were treated for 21 days. The changes of norepinephrine (NE), 5-hydoxytryptamine (5-HT) and dopamine (DA) contents in the brain were detected by high performance liquid chromatography-electrochemical detector.</p><p><b>RESULTS</b>Compared with the normal group, 5-HT, NE and DA contents in the hypothalamus and hippocampus decreased significantly in the model group (P < 0.05, P < 0.01); compared with the model group, the contents of the central monoamine neurotransmitters increased in both the acupuncture group and the embedding thread group, but the embedding thread group had more obvious action in improvement of 5-HT and DA levels in the hypothalamus and DA level in the hippocampus than the acupuncture group with no significant difference between the two groups.</p><p><b>CONCLUSION</b>Both acupuncture and embedding thread therapy are effective for the depression model rat. They play the therapeutic role through regulating central monoamine neurotransmitters.</p>

Effects of thread embedding therapy on nucleotides and gastrointestinal hormones in the patient of chronic gastritis / 中国针灸

<p><b>OBJECTIVE</b>To observe therapeutic effect of thread embedding therapy on chronic gastritis.</p><p><b>METHODS</b>Seventy cases of chronic gastritis were randomly divided into the treatment group (n = 36) treated by thread embedding therapy and the control group (n = 34) by acupuncture. Weishu (BL 21), Zhongwan (CV 12) and Zusanli (ST 36) were selected as main points. And plasma contents of cAMP, cGMP, gastrin and substance P were observed before and after treatment.</p><p><b>RESULTS</b>The total effective rate was 88.89% in the treatment group and 76.47% in the control group with a significant difference between the two groups (P < 0.05); there were significant differences before and after treatment in plasma contents of cAMP, cGMP, gastrin and substance P in the two groups (P < 0.01), and the changes of these indexes in the treatment group were significantly superior to the control group (P < 0.05).</p><p><b>CONCLUSION</b>Thread embedding therapy has a definite therapeutic effect on chronic gastritis and it can adjust nucleotides, gastrin and substance P to improve the functions of the nerve-endocrine-immunity network.</p>