Acupuncture-adjuvant therapies for treating perimenopausal depression: A network meta-analysis.

BACKGROUND: The issues related to the treatment of perimenopausal depression (PMD) are the side effects of antidepressants and hormone replacement therapy. The aim of this study was to assess the efficiency and safety of acupuncture and moxibustion in PMD patients. METHODS: Databases, namely PubMed, Cochrane Library, Web of Science, EMBASE, CNKI, CBM, VIP, and WanFang, were reviewed for related randomized controlled trials dated between database inception and November 22, 2022. The primary outcomes were the efficacy rate and the Hamilton Depression Scale score. The secondary outcomes were the levels of follicle-stimulating hormone, luteinizing hormone, and estradiol and the Kupperman score. Odds ratios (ORs) were generated as the effect size for dichotomous outcomes, while the standard mean difference (SMD) ± standard deviation was used for continuous outcomes. Matrices were developed to demonstrate pairwise comparisons of regimens related to each endpoint. Utilizing Review Manager (RevMan) 5.3, Stata 16.0 and SPSS 21, data were analyzed. RESULTS: In total, 27 studies involving 2269 PMD patients and 8 therapeutic measures were incorporated into the network meta-analysis (NMA). The NMA showed that warm acupuncture (OR = 1.55, 95% CI: 1.00-2.44), electroacupuncture (OR = 1.34, 95% CI: 1.00-1.8), abdominal acupuncture (OR = 1.19, 95% CI: 0.73-1.96), and common acupuncture (OR = 1.4, 95% CI: 0.9-2.17) were more effective than fluoxetine + menopausal hormone treatment in the treatment of PMD. The NMA also showed that, based on the Hamilton Depression Scale score, warm acupuncture was more effective than the other 4 acupuncture-related treatments, i.e., electroacupuncture (SMD = -1.22, 95% CI: -2.34 to -0.09), thread embedding (SMD = -1.31, 95% CI: -2.21 to -0.40), abdominal acupuncture (SMD = -1.33, 95% CI: -2.42 to -0.24), and common acupuncture (SMD = -1.46, 95% CI: -2.26 to -0.66). The cumulative ranking probability (SUCRA) showed that warm acupuncture (99.6%) was the best treatment method. CONCLUSIONS: The findings of this network meta-analysis may help patients and therapists choose the best acupuncture therapy for treating perimenopausal depression patients and furnish reliable evidence for guidelines.

[Effect on clinical symptoms and mechanism of chloasma in premenopausal women with liver qi stagnation treated with acupoint catgut embedding].

OBJECTIVE: To explore the therapeutic effect and mechanism of acupoint catgut embedding for chloasma in premenopausal women with liver qi stagnation. METHODS: A total of 92 patients of chloasma in premenopausal women with liver qi stagnation were randomized into an observation group and a control group, 46 cases in each one.In the observation group, acupoint catgut embedding was applied at Ganshu (BL 18), Pishu (BL 20), Sanyinjiao (SP 6), also the surrounding acupuncture was performed at facial part, once a week. In the control group, vitamin C (200 mg per time, 3 times a day) and vitamin E (100 mg per time, once a day) were prescribed for oral administration. Both of the two groups were given treatment for 12 weeks. The score of chloasma area and severity index (MASI), the serum levels of follicular stimulating hormone (FSH), leuteinizing hormone (LH) and estradiol (E2) before and after treatment were observed in the two groups, and the clinical effect of the two groups were compared after 3 months of treatment. RESULTS: Finally, 44 cases in the observation group and 43 cases in the control group completed the study. The effective rate in the observation group was 88.6% (39/44), which was higher than 55.8% (24/43) in the control group (P<0.01). Compared before treatment, the MASI scores after treatment were reduced in the two groups (P<0.01, P<0.05), the MASI score in follow-up in the observation group was reduced as compared with after treatment (P<0.01), and the MASI scores after treatment and in follow-up in the observation group were lower than the control group (P<0.01). Compared before treatment, the levels of FSH and LH in follow-up were reduced (P<0.01), there was no significant difference between before treatment and in follow-up in the level of E2 in the observation group (P>0.05). There was no significant difference between before treatment and in follow-up in the levels of FSH, LH and E2 in the control group (P>0.05). In follow-up, the levels of FSH and LH in the observation group were lower than the control group (P<0.01, P<0.05), there was no significant difference in the level of E2 between the two groups (P>0.05). CONCLUSION: Acupoint catgut embedding can improve the clinical symptoms of chloasma in premenopausal women with liver qi stagnation, the mechanism may be related to regulate the serum level of sex hormone to reduce high sensitivity of melanocytes to estrogen.

[Clinical observation on mild perimenopausal depression of kidney deficiency and liver stagnation syndrome treated with acupoint catgut implantation].

OBJECTIVE: To observe the efficacy of catgut implantation at back-shu points in treatment of mild perimenopausal depression of kidney, deficiency and liver stagnation syndrome and analyze its essential function on target symptoms. METHODS: Forty-five cases were randomized into a catgut implantation group (23 cases) and atid acupuncture group (22 cases). In the catgut implantation group, catguts were implanted at Shenshu (BL 23), Ganshu (BL 18), Xinshu (BL 15), Pishu (BL 20), etc., once every week. In the acupuncture group, the conventional acupuncture was applied to the same acupoints as the catgut implantation group, once every two days. The: treatment of 4 weeks made one session, and continuous 2 sessions were required. The efficacy was evaluated in, 2 sessions. The follow-up started in the 12th week. Before treatment, after treatment and in the follow-up period, Kupperman score and the total score in Hamilton depression scale (HAMD), as well as the factor score were observed in the patients separately. RESULTS: Kupperman score, the total HAMD score and the scores in the items of anxiety/somatization, retardation, sleep disorder and cognitive disorder after treatment were all reduced significantly as compared with those before treatment in the two groups (P<0.01, P<0.05). In the follow-up period, the difference in Kupperman was not significant in comparison with that after treatment in the catgut implantation: group (P>0.05). The total HAMD score and sleep disorder were reduced significantly as compared with those after treatment in the catgut implantation group (both P<0.01); in the acupuncture group, Kupperman score, the total HAMD score and sleep disorder were all increased as compared with those after treatment (all P<0.05). In; the catgut implantation group, the total HAMD score was lower than that in the acupuncture group (P<0. 05), and the scores in the items of retardation and sleep disorder were reduced significantly as compared with those in the acupuncture group (both P<0.01). CONCLUSION: The catgut implantation at back-shu points alleviates perimenopasual sympton is in patients of mild perimenopausal depression of kidney deficiency and liver stagnation syndrome. This therapy effectively relieves depressive disorders by regulating the target symptoms such as anxiety/ somatization, retardation, sleep disorder and cognitive' disorder. The long-term efficacy of this therapy is better than the conventional acupuncture.

[Acupoint injection of kakkonein for early- or mid-stage Parkinson's disease: a multicenter randomized controlled clinical trial].

OBJECTIVE: To investigate short- and long-term benefits and safety of acupoint injection of kakkonein for early- or mid-stage Parkinson's disease (PD). METHODS: A total of 135 patients with early- or mid-stage PD were enlisted and 116 cases completed the observation, including 40 cases in the acupoint-injection group, 37 cases in the acupuncture group and 39 cases in the medication group. Patients of the acupoint-injection group were treated by injection of kakkonein (2 mL) into bilateral Fengchi (GB 20), once very other day for 8 weeks. For acupuncture intervention, bilateral GB 20 acupoints were punctured with filiform needles, once every other day for 8 weeks. Patients of the medication group were treated by oral administration of compound levodopa (125 mg/time, twice a day) for 8 weeks. The disease severity was assessed by using Unified Parkinson's Disease Rating Scale (UPDRS, version 3. 0) before and after treatment, and one month after the treatment. RESULTS: After the treatment, scores of psychosis, behavior and emotion, daily life activity and motor function were all significantly decreased in the three groups in comparison with pre-treatment in each group (P<0.05), suggesting an improvement of the PD patients' conditions. The therapeutic effect of acupoint-injection and acupuncture groups was markedly superior to that of the medication group (P<0.05). One-month's follow-up showed that the scores of behavior-emotion and daily life activity were obviously lower in the acupoint-injection group than in the acupuncture and medication groups (P<0.05). No significant differences were found between the acupuncture and medication groups in down-regulating scores of behavior-emotion, daily life activity and motor function (P>0.05). CONCLUSION: Acupoint injection of kakkonein can improve patients' behavior, emotion, and daily life activity in early- or mid-stage PD patients and has both short- and longer-term benefits.

Electroacupuncture exerts an anti-inflammatory effect in a rat tissue chamber model of inflammation via suppression of NF-κB activation.

OBJECTIVE: Electroacupuncture (EA) has beneficial effects in patients with various inflammatory diseases. However, the underlying mechanism remains unclear. As the kappa B inhibitor/nuclear factor-kappa B (IκB/NF-κB) pathway exerts a pivotal role in the mammalian immune response, we examined the involvement of the IκB/NF-κB pathway in EA-induced anti-inflammation. METHODS: Ninety tissue chamber implanted rats were randomly divided into control (C), model (M) and EA (E) groups. Physiological saline and human recombinant interleukin-1ß (hr IL-1ß) were injected into the rats in groups C and M, respectively, and EA treatment was applied to the rats in group E after IL-1ß injection. Nuclear staining of p65 (a subunit of NF-κB) was quantified in the exudate cells by immunohistochemical analysis and IκBα expression in the cytoplasm was quantified by western blot analysis. RESULTS: Our results showed that, compared with group C, the percentage of cells with nuclear-localised p65 was increased in group M by 71.3%, 50.7% and 33.1% at 1, 5 and 24 h time points (p<0.01), respectively. This increase was fully inhibited in group E at 5 and 24 h time points (p<0.01). The expression of IκBα was stably enhanced in group M (p<0.05) during the test period. Compared with group M, greater expression of IκBα in group E was only observed at the 1 h time point (p<0.01). CONCLUSIONS: Collectively, our data suggest that EA inhibits the nuclear translocation of p65 and increases the expression of IκBα, which leads to the suppression of NF-κB activation in a rat tissue chamber model of inflammation.

[Efficacy observation on abdominal acupuncture for adhesion-stage shoulder periarthritis].

OBJECTIVE: To evaluate the efficacy of abdominal acupuncture for adhesion-stage shoulder periarthritis. METHODS: One hundred and fifty-seven cases of shoulder periarthritis were randomly divided into an abdominal acupuncture group (79 cases) and a body acupuncture group (78 cases). The abdominal acupuncture was applied at Zhongwan (CV 12), Shangqu (KI 17) and Huaroumen (ST 24) in the abdominal acupuncture group while conventional acupuncture was applied at Jianyu (LI 15), Jianliao (TE 14) and Jianzhen (SI 9) in the body acupuncture group. The treatment was given three times a week for both groups and ten times made an observation course. Before and after treatment, visual analogue scale (VAS) was adopted for pain assessment and functional activity score (Mallet score) was used for shoulder joint function assessment for all the patients. Also the efficacy of both groups was compared. RESULTS: The total effective rate in the abdominal acupuncture group was 92.4% (73/79), which was superior to 71.8% (56/78) in the body acupuncture group. The score of VAS after the treatment was 2.58 +/- 1.64 in the abdominal acupuncture group while 3.12 +/- 1.93 in the body acupuncture group, which had no statistical significance between each other (P > 0.05). The functional activity score after the treatment was 8.34 +/- 3.02 in the abdominal acupuncture group while 7.49 +/- 3.36 in the body acupuncture group, which had no statistical significance between each other (P > 0.05). CONCLUSION: The abdominal acupuncture is an ideal treatment for adhesion-stage shoulder periarthritis, which has better total efficacy than conventional acupuncture. It achieves the same effect in relieving pain and improving functional activity as conventional acupuncture, but also has an advantage at fast selection of acupoint and less discomfort of needling sensation.

[Observation on the analgesic effect of transcutaneous electrical acupoint stimulation for breast radical carcinoma operation].

OBJECTIVE: To observe the analgesic effect of transcutaneous electrical acupoint stimulation (TEAS) in assisting general anesthesia (GA) for radical operation of breast carcinoma so as to explore its clinical application value. METHODS: Sixty patients scheduled for radical operations of the breast carcinoma were randomly and equally divided into GA group and TEAS+ GA group. For GA, Propofol [4.5 microg/mL, target concentration; (3.0 +/- 0.5) microg/mL during operation] was used in combination with Sufentanil (0.25 microg/kg) and Cis-atracurium amine (0.2 mg/kg). TEAS (5-10 mA, 2 Hz/100 Hz) was applied to Hegu (LI 4)-Laogong (PC 8) and Neiguan (PC 6)-Waiguan (SJ 5) on the affected side of the body for 30 min. Heart rate (HR), mean aterial pressure (MAP), tube removing time and postoperative complications were recorded. Plasma beta-endorphin content was assayed by radioimmunoassay. RESULTS: After anesthesia, patients with reduction in MAP in GA group were significantly more than those in TEAS+GA group (P < 0.05), and their HR decreased remarkably (P < 0.05). After tracheal intubation, MAP in TEAS+GA group kept relatively stable, which was superior to that of GA group (P < 0.05). In comparison with GA group, the patients' analepsia time and tube withdrawal time of TEAS+ GA group were significantly shorter; and the dosage of analgesics of TEAS+GA group was significantly smaller than that of GA group (P < 0.05). Patients with complications of pain, restlessness, drowsiness, nausea and vomitting were obviously fewer in TEAS + GA group than those in GA group. Compared with GA group, plasma beta-endorphin content in TEAS+GA group increased considerably 30 min after TEAS, 5 min after skin-incision and after operation (P < 0.05). CONCLUSION: TEAS combined with general anesthesia for breast radical carcinoma operation can help keep a stable blood pressure during surgery, reduce the dosage of analgesics and strengthen pain relief. The analgesic effect of TEAS may be related to its effect in up-regulating plasma beta-endorphin level.

[Randomized controlled study on ear-electroacupuncture treatment of endometriosis-induced dysmenorrhea in patients].

OBJECTIVE: To observe the therapeutic effect of ear-electroacupuncture (Ear-EA) on dysmenorrhea in patients with endometriosis and to explore its underlying mechanism. METHODS: A total of 80 endometriosis patients were randomly and equally divided into ear-EA group and body-EA group. EA (50 Hz, 0.5-0.8 mA) was applied to auricular points (Uterus, Subcortex, Shenmen, Endocrine, etc.) and body acupoints [Tianshu (ST 25), Qihai (CV 6), Guanyuan (CV 4), Sanyinjiao (SP 6), Diji (SP 8), Uterus (EX-CA 1), etc.] respectively for 30 min, once every other day for 3 months. Dysmenorrhea severity score (DSS) was assessed and plasma prostaglandin (PGE2) and 6-Keto-PGF1alpha levels detected by radioimmunoassay. RESULTS: Compared with pre-treatment, DSS lowered significantly during the 1st and 2nd menstrual cycle in body-EA group, and during the 1st, 2nd and 3rd menstruation in ear-EA group; and the DSS of ear-EA group during the 3rd menstruation was evidently lower than that of body-EA group (P < 0.05). During the 3rd menstrual onset after the treatment, plasma PGE2 contents in both groups decreased obviously (P < 0.01), and plasma 6-Keto-PGF1alpha, levels increased considerably in comparison with pre-treatment (P < 0.01). Comparison between two groups during the 3rd menstruation showed that plasma PGE2 level of ear-EA group was markedly lower than that of body-EA group, and 6-Keto-PGF1alpha, level of ear-EA group was significantly higher than that of body-EA group (P < 0.05). No significant difference was found between two groups in clinical therapeutic effect (P > 0.05). CONCLUSION: Both ear-EA and body-EA can effectively relieve endometriosis-induced dysmenorrhea, and the former is superior to the later in reducing pain severity, which may be closely related to their effects in reducing plasma PGE2 and raising 6-Keto-PGF1alpha level.

[Treatment of hypomenorrhea by acupoint catgut embedding].

OBJECTIVE: To observe therapeutic effect of acupoint catgut embedding on hypomenorrhea. METHODS: The patients were divided into an acupoint catgut embedding group and an electroacupuncture group. They were treated respectively by acupoint catgut embedding and electroacupuncture at Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1), Ciliao (BL 32) , etc. The effects of the two therapies on the menses amount in different therapeutic periods were compared and their therapeutic effects were analyzed. RESULTS: The total effective rate was 100.0% in the acupoint catgut embedding group and 95.0% in the electroacupuncture group with no significant difference. One month and two months after treatment, the acupoint catgut embedding group in improving degree of the menses amount was better than the electroacupuncture group. CONCLUSION: Both acupoint catgut embedding and electroacupuncture can effectively treat hypomenorrhea, but the former more rapidly produces the effect and has a better short-term therapeutic effect.

[Acupuncture and moxibustion academic essence of Classic On 81 Medical Problems and analysis].

Discuss contribution of Classic on 81 Medical Problems to acupuncture and moxibustion science, and emphatically introduce theories of Eight Extra Channels, eight Hui-points, five Back-shu points, clinical application of source points, theory of Back-shu and Front-mu points, and special needling technique, etc., which provide thinking and methods for the modern workers of acupuncture and moxibustion to study and research classical works of TCM in combination with clinical practice.

[Study and clinical application of the book "A Study on The Eight Extra-Channels"].

Li Shi-zhen's contribution for eight extra-channel theory and effects of this theory on medicine, and the author's experiences on clinical application of this theory are introduced. It is held that the eight extra-channel theory, one of the essence of TCM, has wide application values in resolving clinical practical problems.

A combined use of acupuncture, moxibustion and long dan xie gan tang for treatment of 36 cases of chronic pelvic inflammation.

OBJECTIVE: To observe the therapeutic effect of acupuncture and moxibustion on chronic pelvic inflammation. METHOD: Thirty-six cases of chronic pelvic inflammation were treated with acupuncture, the ancient recipe of Long Dan Xie Gan Tang ([symbol: see text] Decoction of Radix Gentianae for Purging the Pathogenic Fire of the Liver) and medicinal cake moxibustion. RESULT: The treatment resulted in cure in 9 cases, obvious effect in 16 cases, effect in 7 cases and no effect in 4 cases. CONCLUSION: Acupuncture, moxibustion and the ancient recipe Long Dan Xie Gan Tang used together can enhance the therapeutic effects on chronic pelvic inflammation.