Effect of Tai Chi Chuan in Breast Cancer Patients: A Systematic Review and Meta-Analysis.

Background: Tai Chi Chuan(TCC), as a mind-body exercise, may have a positive impact on physical function and psychological well-being in breast cancer patients. The latest systematic review and meta-analysis of TCC for breast cancer was made 4 years ago and some new clinical trials about it were published. We remade a systematic review and meta-analysis to evaluate the effect of TCC in breast cancer patients. Methods: In this systematic review and meta-analysis, we searched MEDLINE (via PubMed), EMBASE (via embase.com), CENTRAL, CNKI, COVIP, Wanfang, Chaoxing, CiNii, J-SSTAGE, DBpia, and ThaiJO with no language restrictions from inception to December 31, 2018 (updated on February 16, 2020), for randomized clinical trials comparing TCC with non-exercised therapy in breast cancer patients. The primary outcome was quality of life in patients with breast cancer and data pooled by a random-effects model. Subgroup analyses were conducted to estimate the effect of different durations of TCC for breast cancer patients. This study was registered in PROSPERO, number CRD 4201810326. Results: Fifteen articles involving a total of 885 breast cancer participants were included in this review. Compared with non-exercised therapy, TCC had a significant effect on quality of life in breast cancer patients (SMD = 0.37, 95% CI 0.15-0.59, p = 0.001), and subgroup analysis found that TCC showed beneficial effect in 12 weeks and 25 weeks (12 weeks: SMD = 0.40, 95% CI 0.19-0.62, p = 0.0003; 25 weeks: SMD = 0.38, 95% CI 0.15-0.62, p = 0.002). Meta-analyses of secondary outcomes showed that 3 weeks TCC increased shoulder function (SMD = 1.08, 95% CI 0.28-1.87, p = 0.008), 12 weeks TCC improved pain (SMD = 0.30, 95% CI 0.08-0.51, p = 0.007), shoulder function (SMD = 1.34, 95% CI 0.43-2.25, p = 0.004), strength of arm (SMD = 0.44, 95% CI 0.20-0.68, p = 0.0004), and anxiety (MD = -4.90, 95% CI -7.83 to -1.98, p = 0.001) in breast cancer patients compared with the control group. Conclusions: TCC appears to be effective on some physical and psychological symptoms and improves the quality of life in patients with breast cancer. Additional randomized controlled trials with a rigorous methodology and low risk of bias are needed to provide more reliable evidence.

[Double-center randomized controlled trial on post-stroke shoulder pain treated by electroacupuncture combined with Tuina].

OBJECTIVE: To evaluate clinical therapeutic effect of post-stroke shoulder pain treated by acupuncture combined with Tuina. METHODS: Three hundred cases of post-stroke shoulder pain were randomly divided into an acupuncture and Tuina group and a rehabilitation group by double-center randomized controlled clinical trial method. In acupuncture and Tuina group, normalized electroacupuncture and Tuina therapy were applied, that was electroacupuncture at main points, such as Chize (LU 5), Quze (PC 3), Shaohai (HT 3), Jianyu (LI 15), Jianliao (TE 14) and Jianjing (GB 21),etc., combined with traditional Tuina manipulations; in rehabilitation group, the rehabilitation methods such as the electrostimulation through nervus cutaneus and the squeezing and stabilizing manipulations of Proprioceptive Neuromuscular Facilitation (PNF), etc. were applied. The treatment courses of both groups were 6 weeks. The main therapeutic effect indices were the Assessment Face Scale (AFS) for pain when shoulder was in passive motion and the Fugl-Meyer Motor Assessment for upper limbs active function; the secondary indices were the moditied Rankin Scale (mRS) and the clinical incidences of shoulder-hand syndrome of hemiplegia and shoulder joint subluxation of hemiplegia. RESULTS: After 6 weeks treatment and 12 weeks follow-up, AFS score, Fugl-Meyer motor assessment of upper limbs active function and mRS evaluation in acupuncture and Tuina group were more obviously improved than those in rehabilitation group (P < 0.05, P < 0.01). Although the clinical incidences of shoulder-hand syndrome of hemiplegia and shoulder joint subluxation of hemiplegia in acupuncture and Tuina group was equal to those in rehabilitation group [3.55% (5/141) vs 8.45% (12/142), 1.42% (2/141) vs 5.63% (8/142), both P > 0.05], the data indicated that there was a superiority tendency in acupuncture and Tuina group. CONCLUSION: The combined therapy of electroacupuncture and Tuina is a normative manipulation, and the therapeutic effect is satisfying for post-stroke shoulder pain, superior to that of comprehensive rehabilitation treatment.

[Effect of electroacupuncture on the contents of excitatory amino acids in cerebral tissue at different time courses in rats with cerebral ischemia and reperfusion injury].

OBJECTIVE: To observe changes of contents of excitatory amino acids in focal cerebral ischemic tissue after electroacupuncture (EA) treatment at different time courses in cerebral ischemia and reperfusion (CI/R) rats so as to provide experimental evidence for selecting the best duration of EA stimulation in the treatment of apoplexy. METHODS: Forty SD rats were randomized into control, model, EA-10 min, EA-30 min and EA-60 min groups. CI/R model was established by middle cerebral artery occlusion (MCAO) and reperfusion. EA (2 Hz, 3.5 mA and continuous waves) was applied to "Baihui" (GV 20) and "Shuigou" (GV 26) for 10 min, 30 min and 60 min respectively. Cerebral glutamate (Glu) and aspartic acid (Asp) concentrations were detected by using an amino acid automatic analyzer after homogenate and centrifugalization of the right brain tissue. RESULTS: Compared with control group, Asp and Glu contents of model group and EA-10 min group increased significantly (P < 0.01); while in comparison with model group, Asp level in EA-60 min group, and Glu level in EA-10 min, EA-30 min and EA-60 min groups decreased considerably (P < 0.05). No significant differences were found between control and EA-30 min groups, and between control and EA-60 min groups in Asp and Glu levels (P > 0.05). CONCLUSION: EA of GV20 and GV26 for 60 min can markedly reduce Glu and Asp levels in the topical cerebral infarct area in CI/R rats, which may contribute to its effect in relieving cerebral ischemic injury. Suitable duration of EA stimulation is definitely necessary for inducing a better therapeutic effect.