Using a radiopaque marker with radiography for evaluating colonic transit by geometric center in conscious rats: A novel method.

This study developed a new method using radiopaque markers under X-ray to measure rat colonic transit by geometric center repeatedly and/or over a time series in the same individually. Additionally, the utility of this method was shown by elucidating the innervation of the autonomic nerve on colonic transit in detail with a pharmacological technique in conscious rats. An in-dwelling silastic cannula was inserted into the cecum and the proximal part was moved through the abdominal wall, where it was fixed to the posterior neck skin. Twenty markers were administered from the cannula to the proximal colon with saline on the fifth day after surgery. The markers were observed with soft X-ray before required repeated short anesthesia. Experimentation 1: Rats were measured colonic transit twice over 2 days with no administration. Experimentation 2: Rats were administered saline on the first day and pharmacology on the second day intraperitoneally before measurement. Experimentation 1: The markers administrated from the cannula and transited from proximal colon to distal colon over a time series. It showed no significant difference in complication rates between 2 days. Experimentation 2: The colonic transit was increasingly accelerated by neostigmine and phentolamine but not propranolol. Significant changes in 1.0 mg/kg atropine were noted although no differences were found between control and 0.05 mg/kg atropine and between each other's. We have presented the method using radiopaque markers under X-ray with short anesthesia for evaluating the colonic transit. The methods could show rat colonic transit changes in detail with a pharmacological technique.

Effect of acupuncture on the haemodynamic system in men.

BACKGROUND: Acupuncture stimulation decreases heart rate (HR) through somato-autonomic reflexes. However, the mechanisms responsible for other cardiovascular changes induced by acupuncture, such as its effects on stroke volume (SV) and blood pressure (BP), remain obscure. OBJECTIVE: To evaluate continuously the comprehensive cardiovascular changes occurring during acupuncture. METHOD: 20 healthy men participated in the study. HR, SV and BP were measured in the supine position using electrocardiogram, transthoracic impedance cardiography and continuous non-invasive finger blood pressure, respectively. Manual acupuncture stimulation using a stainless steel needle was performed at LI10 for 60 s after resting periods of approximately 15 min. RESULTS: HR was reduced and SV increased, in parallel, during the period of acupuncture stimulation (P<0.01, respectively). Diastolic blood pressure (DBP) decreased in the 10 s period of acupuncture stimulation compared with the 120 s pre-stimulation period (P<0.01) and recovered close to the pre-stimulation reading instantly after the transient reduction. No change was observed in cardiac output (CO) derived from HR and SV. CONCLUSIONS: This study indicates that HR reduction during acupuncture does occur, as previous reports have indicated. SV increased during acupuncture stimulation in parallel with HR reduction and CO was maintained during these changes. Any reduction in DBP caused by acupuncture recovered to baseline, likely due to baroreflexes.

Mechanism of Electroacupuncture on Postoperative Ileus Induced by Surgical Stress in Rats.

Objectives: Acupuncture has been used for treating gastrointestinal (GI) disorders such as postoperative nausea and vomiting. Electroacupuncture (EA) accelerates GI transit following surgery and ameliorates postoperative ileus (POI) to restore colonic transit (CT); however, the mechanisms of this EA-induced restoration remain unclear. The aims of this study were to show CT following surgery and the effects of EA at ST 36 on POI induced by surgical stress (SS) in 45 conscious, male Sprague-Dawley rats. Materials and Methods: An operation was performed in each rat, setting a cannula into the cecum to connect the proximal colon to inject markers. On the day after surgery, 20 metal radiopaque markers were administered to the proximal colon of each rat. These markers were visible throughout the GI tract on soft X-ray immediately after administration and up to 240 minutes afterward. The rats were divided into 5 groups with 9 rats in each group: (1) SS; (2) 5 days post surgery (POST-5D); (3) SS + phentolamine; (4) EA alone; and (5) EA + atropine. The EA was performed at ST 36 for 20 minutes at a frequency of 10 Hz and agents were administered in the appropriate groups before markers were administered and measurements were taken. Measurements were performed the day after surgery except in the POST 5-D group. CT was calculated by the geometric center on the images showing the CT for each rat. Results: CT after surgery was delayed significantly and phentolamine accelerated CT. EA restored CT following surgery and atropine abolished the effect of EA on CT. Conclusions: The current study demonstrated that surgery induced a delay in CT through the sympathetic pathway via α-adrenoreceptors; CT was restored by EA. These results suggest that EA can be used to treat POI through mediation of the autonomic nervous system.

Effect of electroacupuncture stimulation on long-term recovery following Achilles tendon rupture in a rat model.

AIMS: In this study we examined the effect of electroacupuncture (EA) stimulation on the mechanical strength of the rat Achilles tendon after long-term recovery. METHODS: Using 20 rats, an Achilles tendon rupture model was created in an invasive manner. The rats were assigned to one of three groups, that received EA treatment (EA group), minimal acupuncture (MA group) or remained untreated (Control group). In the EA group, EA stimulation (5 ms, 50 Hz, 20 µA, 20 min) was applied to the rupture region over a period of 90 days (five times/week). In the MA group, needles were inserted into the same positions as in the EA group but no electrical current was applied. After 90 days the tendon was measured to calculate the cross-sectional area of the rupture region. Then, the mechanical strength of the tendon was measured by tensile testing. RESULTS: No significant differences were observed between the three groups in cross-sectional area of the injured tendon. For maximum breaking strength, the EA group showed a significantly higher threshold compared with the Control group (P<0.05) but not the MA group (P=0.24). No significant difference was seen between the MA group and the Control group (P=0.96). CONCLUSION: Given the EA group showed a significant increase in maximum breaking strength, it is likely that EA stimulation increases the mechanical strength of a repaired tendon after long-term recovery, and EA stimulation could be useful for preventing re-rupture.

Acupuncture for the treatment of trigger finger in adults: a prospective case series.

OBJECTIVE: To determine the effect of acupuncture performed at the synovial and ligamentous tendon sheath (A1 pulley site) on pain during snapping and the severity of the snapping phenomenon in patients with trigger finger. METHODS: In this observational study, changes in the patients' condition were compared before and after acupuncture treatment. Acupuncture was performed on 19 fingers of 15 patients. Acupuncture needles were inserted into the radial and ulnar sides of the flexor tendon at the A1 pulley of the affected finger. Treatment was performed daily up to a maximum of five times. Before and after each treatment, pain during snapping and the severity of snapping were evaluated using a visual analogue scale (VAS). RESULTS: VAS scores for pain and snapping severity were significantly improved immediately after the first treatment (p<0.001). Pain during snapping, assessed before each treatment, improved over time, reaching statistical significance from the second treatment onwards (p<0.001); similarly, a significant improvement in the severity of snapping was observed, also from the second treatment (p<0.001). Patients with clinically significant improvements (≥50%) in pain and snapping severity had a significantly shorter duration of the disorder than those with <50% improvement (p<0.05). CONCLUSIONS: Acupuncture at the impaired A1 pulley site may be an effective treatment for trigger finger. We postulate that acupuncture may reduce inflammation/swelling of the synovial membrane of the tendon sheath, which predominates when the disorder is of short duration. Further research is required to confirm the efficacy/effectiveness of acupuncture for trigger finger and its mechanisms of action.

The effect of electroacupuncture on tendon repair in a rat Achilles tendon rupture model.

OBJECTIVE: To examine the effect of electroacupuncture (EA) on early post-rupture tendon repair in a rat model of Achilles tendon rupture using histological and mechanical evaluation. METHODS: An Achilles tendon rupture model was prepared in 90 Wistar rats, which were randomly assigned to EA, manual acupuncture or control groups. Rats in the EA group received EA (pulse width 5 ms; stimulation frequency 50 Hz; stimulation strength 20 µA; stimulation time 20 min) daily from 1 day following model preparation until the day of assessment (either 7 or 10 days after model preparation), when the region of interest was sampled to assess tendon repair using in vitro methods. Total cell count and the number of cells staining positive for transforming growth factor-ß1 (TGF-ß1) and basic fibroblast growth factor (b-FGF) were measured. Tension tests were performed 10 days after model preparation to measure the maximum breaking strength of the repaired tendon. RESULTS: Both the total cell count and the number of cells positive for b-FGF were significantly higher in the EA group (p<0.05). In the EA group only, immunostaining showed strong expression of TGF-ß1 7 days after model preparation (p<0.05). Maximum breaking strength of the repaired tendon 10 days after model preparation was significantly higher in the EA group (p<0.01). CONCLUSIONS: The marked increase in cell count and growth factor expression as well as increased tendon strength in the EA group suggest that EA may be a useful method for promoting tendon repair.

Randomized trial of trigger point acupuncture treatment for chronic shoulder pain: a preliminary study.

There is evidence for the efficacy of acupuncture treatment for chronic shoulder pain, but it remains unclear which acupuncture modes are most effective. We compared the effect of trigger point acupuncture (TrP), with that of sham (SH) acupuncture treatments, on pain and shoulder function in patients with chronic shoulder pain. The participants were 18 patients (15 women, 3 men; aged 42-65 years) with nonradiating shoulder pain for at least 6 months and normal neurological findings. The participants were randomized into two groups, each receiving five treatment sessions. The TrP group received treatment at trigger points for the muscle, while the other group received SH acupuncture treatment on the same muscle. Outcome measures were pain intensity (visual analogue scale, VAS) and shoulder function (Constant-Murley Score: CMS). After treatment, pain intensity between pretreatment and 5 weeks after TrP decreased significantly (p<0.001). Shoulder function also increased significantly between pretreatment and 5 weeks after TrP (p<0.001). A comparison using the area under the outcome curves demonstrated a significant difference between groups (p=0.024). Compared with SH acupuncture therapy, TrP therapy appears more effective for chronic shoulder pain.

Clinical effect of acupuncture on cervical spondylotic radiculopathy: results of a case series.

OBJECTIVE: To observe the effectiveness of acupuncture applied to the cervical region of patients with upper extremity radicular symptoms due to cervical spondylotic radiculopathy (CSR). METHODS: 15 subjects diagnosed with CSR and with upper extremity pain and/or paraesthesiae for 13.1±18.0 months were selected. The 15 patients had 16 affected limbs and scored a total of 17 symptom scores of pain and/or paraesthesiae. All patients were treated with acupuncture once a week for 4 weeks at up to 10 sites in the cervical paraspinal region centred on the affected area. The severity of the symptoms was recorded using a visual analogue scale (VAS) and functional evaluation was conducted using a Neck Disability Index (NDI). RESULTS: A significant reduction over time was seen for both mean VAS (p<0.0001) and NDI (p<0.0001). Changes were still significant at 4-week follow-up. A 50% reduction in symptoms was scored for 15 of the 17 symptoms scored. CONCLUSIONS: Favourable results were seen in nearly 90% of cases. These results show that acupuncture treatment to the cervical region may be effective as a conservative therapy for treating CSR.

The effect of electroacupuncture on osteotomy gap healing in a rat fibula model.

OBJECTIVE: To examine the effect of electroacupuncture (EA) on osteotomy gap healing in a rat fibula model. METHODS: A total of 40 12-week-old male Wistar rats underwent unilateral open osteotomy of the fibula to create a 2 mm gap. The rats were randomly assigned to an EA group (n=20) and a control group (n=20). In the EA group, a cathodal electrode was connected to an acupuncture needle percutaneously at the surgery site, while another acupuncture needle inserted 15 mm proximal to the surgery site was used as an anodal electrode. EA was performed 5 days a week for 6 weeks. The control group received no treatment. Some rats were killed at 3 days and 1 week after surgery and the cut end of the distal part of the fibula was surgically removed and histologically assessed. Haematoxylin and eosin (H&E) staining was used to measure total cell count and immunohistochemical staining to assess the increase in the bone morphogenetic protein 2 (BMP-2)-positive cells. The healing process was also assessed weekly after surgery via x-ray examinations. RESULTS: At each time point, total cell count showed a marked increase in the EA group (p<0.05), while BMP-2 expression showed a tendency to increase in the EA group. Radiological examination showed a marked reduction in the distance between the cut ends of the fibula in the EA group. CONCLUSIONS: There was a marked increase in cell count and expression of growth factor in the EA group. These results indicate direct current EA could be useful for promoting bone healing.

Effects of trigger point acupuncture treatment on temporomandibular disorders: a preliminary randomized clinical trial.

We compared the effects of trigger point acupuncture with that of sham acupuncture treatments on pain and oral function in patients with temporomandibular disorders (TMDs). This 10-week study included 16 volunteers from an acupuncture school with complaints of chronic temporomandibular joint myofascial pain for at least 6 months. The participants were randomized to one of two groups, each receiving five acupuncture treatment sessions. The trigger point acupuncture group received treatment at trigger points for the same muscle, while the other acupuncture group received sham treatment on the trigger points. Outcome measures were pain intensity (visual analogue scale) and oral function (maximal mouth opening). After treatment, pain intensity was less in the trigger point acupuncture group than in the sham treatment group, but oral function remained unchanged in both groups. Pain intensity decreased significantly between pretreatment and 5 weeks after trigger point (p<0.001) and sham acupunctures (p<0.050). Group comparison using the area under the curve demonstrated a significant difference between groups (p=0.0152). Compared with sham acupuncture therapy, trigger point acupuncture therapy may be more effective for chronic temporomandibular joint myofascial pain.

Spinal nerve root electroacupuncture for symptomatic treatment of lumbar spinal canal stenosis unresponsive to standard acupuncture: a prospective case series.

OBJECTIVE: To study the effectiveness of electroacupuncture of the spinal nerve root using a selective spinal nerve block technique for the treatment of lumbar and lower limb symptoms in patients with lumbar spinal canal stenosis. METHODS: Subjects were 17 patients with spinal canal stenosis who did not respond to 2 months of general conservative treatment and conventional acupuncture. Under x-ray fluoroscopy, two acupuncture needles were inserted as close as possible to the relevant nerve root, as determined by subjective symptoms and x-ray and MRI findings, and low-frequency electroacupuncture stimulation was performed (10 Hz, 10 min). Patients received 3-5 once-weekly treatments, and were evaluated immediately before and after each treatment and 3 months after completion of treatment. RESULTS: After the first nerve root electroacupuncture stimulation, scores for lumbar and lower limb symptoms improved significantly (low back pain, p<0.05; lower limb pain, p<0.05; lower limb dysaesthesia, p<0.01) with some improvement in continuous walking distance. Symptom scores and continuous walking distance showed further improvement before the final treatment (p<0.01), and a significant sustained improvement was observed 3 months after completion of treatment (p<0.01). CONCLUSION: Lumbar and lower limb symptoms, for which conventional acupuncture and general conservative treatment had been ineffective, improved significantly during a course of electroacupuncture to the spinal nerve root, showing sustained improvement even 3 months after completion of treatment. The mechanisms of these effects may involve activation of the pain inhibition system and improvement of nerve blood flow.

Effect of acupuncture depth on muscle pain.

BACKGROUND: While evidence supports efficacy of acupuncture and/or dry needling in treating musculoskeletal pain, it is unclear which needling method is most effective. This study aims to determine the effects of depth of needle penetration on muscle pain. METHODS: A total of 22 healthy volunteers performed repeated eccentric contractions to induce muscle soreness in their extensor digital muscle. Subjects were assigned randomly to four groups, namely control group, skin group (depth of 3 mm: the extensor digital muscle), muscle group (depth of 10 mm: the extensor digital muscle) and non-segmental group (depth of 10 mm: the anterior tibial muscle). Pressure pain threshold and electrical pain threshold of the skin, fascia and muscle were measured at a point 20 mm distal to the maximum tender point on the second day after the exercise. RESULTS: Pressure pain thresholds of skin group (depth of 3 mm: the extensor digital muscle) and muscle group (depth of 10 mm: the extensor digital muscle) were significantly higher than the control group, whereas the electrical pain threshold at fascia of muscle group (depth of 10 mm: the extensor digital muscle) was a significantly higher than control group; however, there was no significant difference between the control and other groups. CONCLUSION: The present study shows that acupuncture stimulation of muscle increases the PPT and EPT of fascia. The depth of needle penetration is important for the relief of muscle pain.

Repeated application of low-frequency electroacupuncture improves high-fructose diet-induced insulin resistance in rats.

BACKGROUND: Insulin resistance is frequently present in obesity and during the development of type 2 diabetes mellitus. OBJECTIVE: The purpose of the present study was to investigate the effect of electroacupuncture (EA) on high-fructose diet (HFD)-induced insulin resistance. METHODS: Male Wistar rats were fed HFD for 4 weeks and developed insulin resistance. Insulin sensitivity was assessed by clamp. The number of animals was seven, eight and seven in the control, HFD and HFD+EA groups, respectively. AMP-activated protein kinase (AMPK) and glucose transporter 4 (GLUT4) in skeletal muscle were measured by Western blotting analysis (n=7 in each group). EA stimulation was carried out 12 times over 4 weeks at an intensity of 1-3 mA and a frequency of 2/15 Hz in a conscious state without restraint. RESULTS: There was no significant difference in mean body weight and fasting blood glucose concentration between groups at the end of the experiment. The mean glucose infusion rate during the clamp was significantly lower in the HFD group than in controls (p<0.05). There was no significant difference in expression of GLUT4 in skeletal muscle in the control and each group. Phosphorylated AMPKα (Thr172) in skeletal muscle showed a significant increase immediately after the final EA stimulation when compared with the control group (p<0.05). CONCLUSION: Repeated application of EA is capable of improving diet-induced insulin resistance, probably through activation of AMPK signalling pathways in skeletal muscle. These results suggest that repeated application of EA may have beneficial effects on diet-induced insulin resistance.

Direct current electrical stimulation of acupuncture needles for peripheral nerve regeneration: an exploratory case series.

OBJECTIVE: To examine the therapeutic effect of a novel therapeutic method based on electroacupuncture with intermittent direct current (DCEA) and associated adverse events in patients with peripheral nerve damage and a poor clinical prognosis. METHODS: In seven older patients with peripheral nerve damage (neurapraxia 2, axonotmesis 4, neuromesis 1), an acupuncture needle connected to an anode electrode was inserted proximal to the site of the injury along the route of the nerve, while the cathode electrode was inserted into the innervated muscle, and DCEA was performed (100 Hz for 20 min, weekly). Muscular paralysis was evaluated weekly with manual muscle testing, the active range of motion of joints related to the muscular paralysis and, when necessary, needle electromyography. Adverse events were also recorded during the course of the treatment. RESULTS: Complete functional recovery was observed in the two cases with neurapraxia and two with axonotmesis, while one axonotmesis case achieved improvement and the other showed reinnervation potential without functional recovery. No improvement was observed in the neurotmesis case. Pigmentation of the skin where the anode needle was inserted occurred in three cases. Although there was no definite causal link, one case showed excessive formation and resorption of bone in the area close to the cathode needle site. DISCUSSION: Accelerated nerve regeneration caused by DCEA may contribute to recovery. The skin pigmentation and callus formation suggest that the shape of the anode electrode, current intensity and other factors should be examined to establish a safer treatment method.

Analysis of nocturia with 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration: concept for effective treatment modality.

OBJECTIVE: • To determine the relationship between the number of nocturia and 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration as well as to assess the significance of these factors with respect to eliminating nocturnal voidings in individual patients with nocturia. PATIENTS AND METHODS: • Among 532 participants who completed a 3-day bladder diary between April 2005 and December 2006, the diaries of 450 participants without 24-h polyuria were analyzed. • Clinical variables such as the number of daytime and night-time voids, 24-h urine volume, nocturnal polyuria index, daytime and night-time maximum voided volumes (MVV), night/day MVV ratio, sleep duration and proportion of night/day urine production rates were obtained from each diary. • Participants were classified into eight groups according to values of three factors: nocturnal MVV, proportion of night/day urine production rates and length of sleep duration. • Each group was divided into three subgroups: non-nocturics (number of nocturnal voidings is zero), mild nocturics (number of nocturnal voidings is one) and severe nocturics (number of nocturnal voidings is two or more). • The data from non-nocturics with three normal factors were regarded as the normal control and compared with the variables of the other subgroups using Dunnett's method. RESULTS: • Variables that form the basis of classifying participants into eight groups and corresponding to abnormal factors of each group were statistically significant in all the subgroups of each group. • Furthermore, a significantly increased 24-h urine volume was found in severe nocturics of the group with three normal factors. • A significantly decreased 24-h urine volume was found in non-nocturics of groups with nocturnal polyuria, decreased bladder capacity and both long sleep duration and nocturnal polyuria. • A significantly increased nocturnal MVV and night/day MVV ratio were shown in non-nocturics and mild nocturics of the groups with nocturnal polyuria and both long sleep duration and nocturnal polyuria. CONCLUSIONS: • Because nocturia is a multifactorial disorder and closely related to four factors (i.e. 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration), the evaluation of all these factors appears to be clinically useful for determining the main contributing factor in patients with nocturia as well as the suitable treatment modality on an individual basis. • Physicians should take all these factors into consideration in the evaluation and treatment of nocturia.

Impact of convenience void in a bladder diary with urinary perception grade to assess overactive bladder symptoms: a community-based study.

AIM: Bladder diaries including bladder perception grade were analyzed to assess convenience void (CV) in community-dwelling women 40 years of age or older. METHODS: A total of 310 women completed a 3-day bladder diary with a grade for bladder perception. The grade was defined on scores 0-5 as follows: 0 = No bladder sensation, 1 = Sensation of bladder filling without desire to void, 2 = Desire to void, 3 = Strong desire to void, 4 = Urgency without urge urinary incontinence (UUI), and 5 = Urge incontinence episode. CV was defined as void without desire to void: when the grade was 0, CV in a narrow sense, and when 0 or 1, CV in a broad sense. RESULTS: The incidence of CV in the broad sense significantly decreased with age. Of the 310 women, 48 (15.5%) had overactive bladder (OAB) symptoms on the medical interview, including 37 (11.9%) without UUI (OAB-Dry) and 11 (3.5%) with UUI (OAB-Wet). Of the remaining 262 women, 111 (35.8%), who had urgency but a urinary frequency of 7 or less, and another 141 (48.7%) were classified into the Normal with Urgency and Normal without Urgency groups, respectively. The incidence of CV in a broad sense in the Normal without Urgency group was significantly greater than that in the Normal with Urgency and OAB-Wet groups. The mean voided volumes of CV in the broad sense in the OAB-Wet group were significantly smaller than those in the other three groups. CONCLUSIONS: The evaluation of CV may be a new tool in assessing storage condition and voiding dysfunction.

Involvement of peripheral opioid receptors in electroacupuncture analgesia for carrageenan-induced hyperalgesia.

Acupuncture is widely used to relieve pain; however, the mechanism underlying electroacupuncture analgesia (EAA) during inflammatory pain is unclear. We investigated whether endogenous peripheral opioid receptors participated in EAA during hyperalgesia elicited by carrageenan-induced inflammation. Moreover, we investigated which subtype of opioid receptor was involved in EAA. Carrageenan was subcutaneously administered by intraplanter (i.pl.) injection into the left hind paw. Nociceptive thresholds were measured using the paw pressure threshold (PPT). Rats received 3Hz electroacupuncture (EA) for 1h after carrageenan injection. The nonselective peripheral opioid receptor antagonist, naloxone methiodide, was administered by i.pl. injection of the inflamed paw 5min before EA. Also, animals received i.pl. or intravenous (i.v.) injection of selective antagonists against µ(D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-ThrNH2, CTOP), δ(naltrindole, NTI), or κ (nor-Binaltorphimine, nor-BNI) opioid receptors 1h before EA. PPT decreased significantly 3h after carrageenan injection. EA resulted in significant increases of PPT, moreover, PPT elevations persisted for 9h after carrageenan injection. PPT elevations produced by EA were antagonized by local i.pl. injection of naloxone methiodide at 3 and 5h after cessation of EA. NTI, nor-BNI and CTOP blocked EAA from immediately, 1h, and 3h after EA cessation, respectively. The EAA in the inflamed paw could not be blocked by i.v. injection of NTI, nor-BNI and CTOP. These findings suggest that peripheral µ, δ and κ receptors on peripheral nerve terminals are activated by EA, although there is a time difference among these activations.

Effects of acupuncture to treat fibromyalgia: a preliminary randomised controlled trial.

BACKGROUND: Acupuncture is often used to treat fibromyalgia (FM), but it remains unclear whether acupuncture is effective. This study aims to evaluate the effects of acupuncture on pain and quality of life (QoL) in FM patients. METHODS: Sixteen patients (13 women and 3 men aged 25-63 years) suffering from FM were randomised into two groups: group A (n = 8) received five acupuncture treatments after the fifth week and group B received ten acupuncture treatments. Outcome measures used in this study were pain intensity (visual analogue scale, VAS) and the fibromyalgia impact questionnaire (FIQ). RESULTS: After the fifth week, pain intensity (U = 25.0; P = 0.022) in group B decreased and QoL (U = 24.5; P = 0.026) improved compared to group A. CONCLUSION: The present study suggests that acupuncture treatment is effective to relieve pain for FM patients in terms of QoL and FIQ.

The effects of sacral acupuncture on acetic acid-induced bladder irritation in conscious rats.

OBJECTIVES: To investigate the effects of sacral acupuncture on acetic acid-induced bladder irritation using cystometry in conscious rats, with particular focus on effects on afferent fibers of the bladder. METHODS: A total of 40 female Sprague-Dawley rats weighing 200-270 g were used. The animals were divided into 5 groups: (1) rats with bladder overactivity induced by acetic acid, without sacral acupuncture stimulation (irritated bladder group); (2) rats treated with sacral acupuncture stimulation after induction of bladder overactivity by acetic acid (acupuncture stimulation group); (3) rats treated with sacral acupuncture stimulation after capsaicin desensitization (capsaicin-desensitized group); (4) rats treated with atropine (atropine injection group); and (5) rats treated with sacral acupuncture stimulation after nonacetic acid infusion (nonirritated bladder group). Cystometry was carried out without anesthesia, and the following variables were measured in all animals: intercontraction interval (ICI), basal pressure, threshold pressure, and micturition pressure. RESULTS: In the acupuncture stimulation group, sacral acupuncture stimulation resulted in a 140.1 +/- 5.9% increase in ICI after acetic acid-induced irritation to an interval similar to baseline (P = .072). A significant difference in the percent of ICI increase was observed between the acupuncture stimulation and irritated bladder groups (P < .01). In the capsaicin-desensitized groups and acupuncture stimulation groups, no significant differences in ICI occurred, before and after acupuncture. CONCLUSIONS: Sacral acupuncture could contribute to improve acetic acid-induced bladder irritation through inhibition of capsaicin-sensitive C-fiber activation.

Comparison of the effectiveness of acupuncture treatment and local anaesthetic injection for low back pain: a randomised controlled clinical trial.

OBJECTIVE: To compare the effectiveness of repeated acupuncture stimulation and local anaesthetic injection at the most painful points in patients with low back pain. METHOD: This randomised controlled clinical trial involved 26 patients with low back pain randomly allocated to either an acupuncture group (n = 13) or a local anaesthetic injection group (n = 13). Both acupuncture and anaesthetic injection were performed at two to five of the most painful points on the lower back once weekly for 4 weeks. In the acupuncture group, a 0.18 mm diameter stainless steel needle was inserted to a depth of 10-20 mm and manual stimulation was applied. In the local anaesthetic injection group, a 0.5 mm diameter needle was inserted to a depth of 10-20 mm and a local anaesthetic was injected. Participants evaluated pain using a Visual Analogue Scale immediately before and after the first treatment, before each subsequent treatment, and at 2 weeks and 4 weeks after completion of treatment. RESULTS: There was a significant difference between the two groups in the change in Visual Analogue Scale pain scores (p<0.01), with acupuncture providing more favourable results than local anaesthetic injection. The reduction in pain score from baseline calculated at each time period was significantly different between the two groups after the first (p<0.05) and final (p<0.01) treatments, and during the follow-up period (after 2 weeks (p<0.01) and 4 weeks (p<0.05)). CONCLUSION: Both injection and acupuncture relieved pain, but acupuncture was superior for the immediate and sustained effects, suggesting that it is a useful treatment for low back pain. The difference in the effects may be attributable to differences in the mechanism of pain suppression.