Evaluating the efficacy and safety of electro-acupuncture in patients with antipsychotic-related constipation: protocol for a randomized controlled trial.

BACKGROUND: Constipation is known as a common adverse effect of antipsychotics. Advice for its management remains inadequate. This study is designed to investigate the efficacy and safety of electro-acupuncture (EA) for antipsychotic-related constipation. METHODS: This is a single-centric, parallel-group, randomized controlled trial with blinded participants, outcome assessor, and statistician. One hundred twelve participants will be randomly assigned into the EA group or sham acupuncture (SA) group in a 1:1 ratio. The study will last for 22 weeks for each participant, including a 2-week baseline assessment period, an 8-week treatment period, and a follow-up for 12 weeks. The primary outcome is the change of mean weekly complete spontaneous bowel movements (CSBMs) during weeks 1 to 8 from baseline. Secondary outcomes include the change from baseline of mean weekly CSBMs during the follow-up period, mean weekly spontaneous bowel movements (SBMs), overall CSBM response rate, scores on Bristol Stool Form Scale (BSFS), straining level, Patient Assessment of Constipation Symptoms (PAC-SYM), Patient Assessment of Constipation Quality of life questionnaire (PAC-QOL), and Brief Psychiatric Rating Scale (BPRS). Adverse events and medicine use will be recorded as well. DISCUSSION: The study is designed based on a rigorous methodology to evaluate the efficacy and safety of EA for antipsychotic-related constipation. The finding will be published in peer-reviewed journals as reliable evidence. TRIAL REGISTRATION: ClinicalTrials.gov ChiCTR2000032582. Registered May 3, 2020, with the Chinese Clinical Trial Registry.

[Effects of electroacupuncture of "Neiguan (PC 6) and Taichong (LR 3) on cardiac function in acute myocardial ischemia rabbits].

OBJECTIVE: To observe the effect of electroacupuncture (EA) of "Neiguan" (PC 6) and "Taichong" (LR 3) on mechnical activities of the heart in acute myocardial ischemia (AMI) rabbits. METHODS: Fifty chinchilla rabbits were randomized into normal control, model, EA-PC 6, EA-LR 3 and non-acupoint groups (n = 8/group). AMI model was duplicated by intravenous injection (femoral vein) of posterior pituitrin (3 U/kg). The maximal ascending velocity (+ dp/dt max), maximal descending velocity (-dp/dt max) and left ventricular systolic pressure (LVSP) of the heart were recorded by using Biopac Bio-signal system. EA (1 mA, 2 Hz) was applied to PC 6, LR 3 and non-acupoint for 10 min. RESULTS: Compared with normal control group, + dp/dt max, - dp/dt max and LVSP of the heart in model group reduced significantly (P < 0.01); while in comparison with model group, left ventricular + dp/dt max and - dp/dt max at 10 min after EA in EA-PC 6 and EA-LR 3 groups increased markedly (P < 0.01), and LVSP of EA-PC 6 group increased remarkably (P < 0.05). No significant differences were found between EA-non-acupoint group and model group in the above-mentioned 3 indexes (P > 0.05). CONCLUSION: Both EA of PC 6 and LR 3 points can improve AMI induced reduction of the left ventricular myocardial mechanical activities in the rabbit, and the therapeutic effect of EA-PC 6 is superior to that of EA-LR 3.

[Effects of electroacupuncture of "Shenmen" (HT 7) and "Taixi" (KI 3) on cardiac sympathetic activities in acute myocardial ischemia rabbits].

OBJECTIVE: To observe the effect of electroacupuncture (EA) of different acupoints on activities of the cardiac sympathetic nerve in rabbits with acute myocardial schemia (AMI). METHODS: A total of 40 Chinchilla rabbits were randomized into normal control, model, Shenmen (HT 7), Taixi (KI 3) and non-acupoint groups (n8/group). AMI model was established by intravenous injection of pituitrin (3 U/kg). EA (1.1 mA, 2 Hz) was applied to bilateral HT 7, KI 3 and non-acupoint (the bulge site of the triangular muscle) for 10 mm. The rabbit's cardiac sympathetic discharges were recorded by BIOPAC under anesthesia. RESULTS: In comparison with control group, the heart rate (HR) and the frequency of cardiac sympathetic discharges (CSD) decreased significantly after AMI (P < 0.01). At the moment of cease of EA, at 20 mm after EA, HR and 050 frequency in HT 7 group were significantly higher than those of model group (P < 0.01), suggesting a favorable inhibition of EA of HT 7 on the decreased HR and OSO. No significant differences were found between KI 3 and model groups, and between KI 3 and non-acupoint groups in both HR and OSD at any time courses (P > 0.05). CONCLUSION: EA of HT 7 can correct AMI-induced decrease of both HR and OSO in the rabbit, while EA of KI 3 and non-acupoint have not this effect, suggesting a relatively specific efficacy of EA of different acupoints on cardiac sympathetic activities.

[Effects of electroacupuncture of "source-" plus "collateral-" acupoints on the cardiac function and myocardial enzymes in acute myocardial ischemia rabbits].

OBJECTIVE: To observe the effects of electroacupuncture (EA) of "Source-" + "Collateral-" acupoints ["Shenmen" (HT 7) + "Zhizheng"(SI 7)] and single acupoints "Neiguan"(PC 6) and HT 7 on cardiac function and myocardial enzymes in acute myocardial ischemia (AMI) rabbits. METHODS: Sixty Chinchilla rabbits were randomized into normal control, model, Shenmen (HT 7), Neiguan (PC 6), HT 7 + SI 7 groups, with 8 rabbits in each. AMI model was duplicated by occlusion of the anterior descending branch of left coronary artery under anesthesia. EA (2 Hz,1 mA) was applied to acupoints HT 7, PC 6,and HT 7 + SI 7 for 10 min. The maximum ascending rate (+ dp/dt max) and maximum descending rate (-dp/dt max) of the left ventricular pressure (LVP) were recorded by using PowerLab System. Serum lactate dehydrogenase (LDH) and creatine kinase MB (CK-MB) contents were detected with chromatometry. RESULTS: Serum LDH and OK-MB contents increased significantly in model group than in normal control group (P < 0.01). Compared with model group, serum LDH and CK-MB contents decreased remarkably in PC 6, HT 7 and HT 7 + SI 7 groups (P < 0.01, P < 0.05), and the effects of HT 7 + SI 7 group were significantly superior to those of PC 6 and HT 7 groups in lowering serum LDH and CK-MB levels (P < 0.01, P < 0.05). Compared with the normal control group, + dp/dt max lowered significantly and -dp/dt max increased markedly in the model group (P < 0.01), while compared with the model group, + dp/dt max increased obviously and -dp/dt max decreased significantly in the three EA groups (P < 0.01, P < 0.05). The effects of HT 7 + SI 7 group were markedly superior to those of HT 7 and PC 6 in raising + dp/dt max and lowering -dp/dt max (P < 0.05, P < 0.01), and those effects of PC 6 group were evidently better than those of HT 7 group (P < 0.05, P < 0.01). CONCLUSION: EA of "Source-" + "Collateral-" aoupoints (HT 7 + SI 7), HT 7 and PC 6 has a positive effect in improving changes of cardiac function and in lowering serum LDH and CK-MB contents in AMI rabbits, and the effect of EA of HT 7 + SI 7 is superior to that of EA of single acupoint.

[Differentially expressed genes involving the correlativity between heart meridian and hypothalamus].

OBJECTIVE: To study the bio-molecule basis of correlativity between Heart Meridian and hypothalamus from gene differential expression. METHODS: Twenty-eight healthy Sprague-Dawley male rats were divided into 4 groups randomly: normal control, model, Heart Meridian-electroacupuncture (EA) and Lung Meridian-EA groups, with 7 cases in each. Acute myocardial ischemia (AMI) model was duplicated by occlusion of the left anterior descending branch (LAD) of the coronary artery under anesthesia (3% Nemb, 40 mg/kg). EA (1.1 mA, 2 Hz, duration of waves 300 micros) was applied to bilateral "Shenmen" (HT 7)-"Tongli" (HT 5, Heart Meridian), "Taiyuan" (LU 9)-"Lieque" (LU 7, Lung Meridian) separately for 20 min, once daily for 3 days. Then, hypothalamus tissue was taken for differentially expressed gene profiling analysis (Affymetrix GeneChip Rat Genome U 230 Affymetrix). RESULTS: Compared with model group, among the differentially expressed genes above 2 times in Heart-Meridian-EA group and Lung-Meridian-EA group, 190 and 57 were up-regulated, 34 and 26 down-regulated separately. Compared with Lung-Meridian-EA group, among the 175 differentially expressed genes above 2 times in hypothalamus tissues of Heart-Meridian-EA group, 147 were up-regulated and 28 down-regulated. CONCLUSION: In comparison with EA of Lung Meridian, a different gene expression profile of hypothalamus tissue is involved in the effect of EA of Heart-Meridian on acute myocardial ischemia.