[Therapeutic observation on Fu's acupuncture for cervical spondylosis of vertebral artery type based on Tongtuo method].

OBJECTIVE: To verify the superiority of Fu's acupuncture for cervical spondylosis of vertebral artery type (CSA) based on Cheng's Tongtuo method. METHODS: A total of 150 patients with CSA were randomly divided into a Tongtuo Fu's acupuncture group, a Tongtuo acupuncture group and a conventional Fu's acupuncture group, 50 cases in each group. Under the guidance of the theory of Tongtuo method, the Tongtuo Fu's acupuncture group was treated with Fu's acupuncture, the distal Tong method was performed at the distal myofascial trigger point (MTrP) of the dorsal forearm, and then the Tuo method was performed at the proximal MTrP of the cervical muscle group. In the Tongtuo acupuncture group, acupuncture was given at distal acupoints (Neiguan [PC 6], Quchi [LI 11], Taichong [LR 3], Xingjian [LR 2], etc.), and then at proximal acupoints (Fengchi [GB 20] and Baihui [GV 20]). In the conventional Fu's acupuncture group, Fu's acupuncture was only performed at the MTrP of cervical muscle group. Each group was treated once a day, 3 days were taken as one course, and 2 courses were given. The score of cervical vertigo symptoms and function evaluation scale, peak systolic velocity (PSV) and resistance index (RI) of vertebral artery were observed before and after treatment in the 3 groups. RESULTS: After treatment, the scores of cervical vertigo symptoms and function evaluation scale and PSV in each group were higher than those before treatment (P<0.01), and the RI was lower than that before treatment (P<0.01). The score of cervical vertigo symptoms and function evaluation scale and PSV in Tongtuo Fu's acupuncture group were higher than those in the other two groups (P<0.01), and the RI was lower than that in the other two groups (P<0.01). CONCLUSION: Fu's acupuncture based on Tongtuo method could improve the symptoms of cervical vertigo and the blood flow state of vertebral artery in patients with CSA, and the curative effect is better than Tongtuo acupuncture and conventional Fu's acupuncture.

[Effect of Electroacupuncture on Intracellular Calcium Ion Concentration and Expression of Calcium/Calmodulin Dependent Protein Kinase â ¡ in Lumbar Spinal Cord in Rats with Neuropathic Pain].

OBJECTIVE: To observe the changes of intracellular calcium ([Ca2＋]i) concentration and expression of calcium/calmodulin dependent protein kinaseⅡ (CaMKⅡ) in spinal dorsal horn neurons of spared nerve injury (SNI) rats, so as to explore its mechanisms underlying improvement of neuropathic pain. METHODS: One hundred and ten SD rats were randomly divided into 5 groups: sham control, model, EA, AP-5 and L-NAME groups. The sham group underwent only a simple separation of the sciatic nerve but without ligation and abscission. The neuropathic pain model was established by abscission of the right tibial and common peroneal nerve. EA (2 Hz, 1－3 mA) was applied to right "Weizhong" (BL 40) and "Huantiao" (GB 30) for 30 min, once a day for 7 days, starting from day 11 after surgery. For rats of the AP-5 and L-NAME groups, AP-5 (a competitive antagonist for NMDA receptor, 0.7 mg·kg－1·d－1) and L-NAME (a non-selective antagonist for nitric oxide synthase [NOS], 60 mg·kg－1·d－1) were respectively administrated by intraperitoneal injection, once daily for 7 days. The mechanical pain threshold was measured, and the calcium fluorescence intensity (shown by Fluo-3/AM calcium fluorescence indicator) of the superficial layer of the lumbar spinal cord (L 4－L 6) was measured by immunohistochemical staining and the expression of spinal cord (L 4－L 6) CaMK Ⅱ protein was detected by Western blot (WB). RESULTS: After modeling, the mechanical pain threshold was significantly decreased on day 10 and 16 after operation in comparison with the sham operation group and baseline data of pre-operation in each group (P<0.01), and remarkably increased in the EA, AP-5 and L-NAME groups relevant to the model group on day 16 (P<0.01, P<0.05), while the effect of EA was significantly superior to that of AP-5 and L-NAME groups (P<0.05), suggesting a reduction of EA analgesia after administration of AP-5 and L-NAME. The concentration of intracellular [Ca2＋]i was significantly higher in the model group than in the sham group, and considerably lower in the EA, AP-5 and L-NAME groups than in the model group (P<0.01, P<0.05). Moreover, the expression level of CaMKⅡ shown by WB and immunohistochemical staining was significantly higher in the model group than in the sham group (P<0.05) and obviously lower in the EA group (not the AP-5 and L-NAME groups) than in the model group on day 16 after the intervention (P<0.05). It suggests an involvement of glutamate NMDA receptor and NMDAR-NOS/NO signaling in the analgesic effect and CaMKⅡ expression down-regulation of EA. CONCLUSIONS: EA can ease pain in rats with neuropathic pain, which is closely related to its effect in reducing the calcium concentration and the expression of CaMKⅡ in the lumbar spinal cord, possibly mediated by glutamate NMDA receptor and NMDAR-NOS/NO signaling.

[Effect of electroacupuncture intervention on N-methyl-D-aspartic acid receptor expression in spinal cord in rats with chronic constrictive injury of the sciatic nerve].

UNLABELLED: OBJECTIVE; To observe the changes of N-methyl-D-aspartic acid (NMDA) receptor expression of spinal cord after electroacupuncture (EA) intervention in rats with chronic constrictive injury (CCI) of the sciatic nerve so as to reveal the mechanism underlying improvement of neuropathic pain. METHODS: Sixty male SD rats were randomly divided into sham operation (sham) group, CCI model group and EA group (n = 20). CCI model was established by ligature of the right sciatic nerve with a piece of surgical chromic suture. For rats of the sham group, the right sciatic nerve was just isolated without ligature. The rats of the EA group were given with EA stimulation of "Weizhong" (BL 40) and "Huantiao" (GB 30) on the injured side at a frequency of 2 Hz, electric current of 1-3 mA for 30 min (increasing 1 mA every 10 min). The treatment was conducted once a day from the 11th day to the 20th day after modeling. NMDA receptor 2 B subunit (NR 2 B) protein and mRNA expression levels in the spinal cord were determined by immunohistochemistry, Western blot and reverse transcription (RT)-polymerase chain reaction (PCR), respectively, and spinal NMDA receptor subunit 1 (NR 1) protein and mRNA expression levels were measured by Western blot and RT-PCR, respectively. RESULTS: In comparison with the sham group, NR 1 protein and mRNA expression levels of the model group in the spinal cord were considerably upregulated after CCI (P < 0.01, P < 0.05). In comparison with the model group NR 1 protein and mRNA expression levels of the EA group in the spinal cord were evidently down-regulated (P < 0.05). No significant changes of NR 2 B protein and mRNA expression after CCI and EA stimulation were found after immunohistochemistry, Western blot and RT-PCR measurements (P > 0.05). CONCLUSION: EA intervention is effective in alleviating neuropathic pain in CCI rats, which may be closely related to its effects in lowering functional activity of NR 1 protein and mRNA in the spinal cord.

[Clinical efficacy observation on primary trigeminal neuralgia treated with joint needling method at the trigger point].

OBJECTIVE: To observe the clinical efficacy on primary trigeminal neuralgia treated with joint needling method at the trigger point. METHODS: One hundred and three cases of primary trigeminal neuralgia were divided into a joint needling group (53 cases) and a conventional needling group (50 cases) according to the visit sequence. In the joint needling group, the joint needling method was used at the trigger point in the mandibular joint [the positive point near to Xiaguan (ST 7)]; the conventional needling was used at Hegu (LI 4), Waiguan (TE 5), Taichong (LR 3) and Neiting (ST 44). In the conventional needling group, Xiaguan (ST 7) and Fengchi (GB 20) were used and the supplementary acupoints were selected according to the involved branches of trigeminal nerve. The conventional needling method was used. The Visual Analogue Scale (VAS) and the score of trigeminal neuralgia were adopted to assess the pain severity and the comprehensive symptoms before treatment and after the 1st and 2nd sessions of treatment separately. The efficacy was assessed. RESULTS: After the 1st and 2nd sessions of treatment, VAS score and the comprehensive symptom score were reduced obviously as compared with those before treatment in either group (P < 0.05, P < 0.01). The score reducing in the joint needling group was much superior to that in the conventional needling group (both P < 0.05). The total effective rate was 90.6% (48/53) and 72. 0% (36/50) in the joint needling group and the conventional needling group respectively. The effect in the joint needling group was better than that in the conventional needling group (P < 0.05). CONCLUSION: The joint needling method at the trigger point achieves the significant efficacy on primary trigeminal neuralgia, which is superior to that with the conventional needling method.

[Effect of electroacupuncture on expression of spinal neuronal nitric oxide synthase protein and mRNA in rats with neuropathic pain].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on expression of neuronal nitric oxide synthase (nNOS) protein and mRNA in the spinal cord in rats with chronic constrictive injury (CCI) of the sciatic nerve so as to explore its mechanisms underlying pain relief. METHODS: Thirty-six male SD rats were randomly divided into sham operation (control) group (n = 12), CCI model group (n = 12) and EA group (n = 12). EA was applied to bilateral "Weizhong" (BL 40) and "Huan-tiao" (GB 30) on the injured side for 30 min, once a day for 7 days (from the 11th day on after CCI). The mechanical and thermal pain thresholds were measured before and after CCI. Spinal nNOS protein and mRNA expression levels were detected by Western blot and reverse transcription-polymerase chain reaction (RT-PCR), respectively. RESULTS: In comparison with the control group, both mechanical and thermal pain thresholds were significantly lower in the model group (P < 0.01). Compared with the model group, the two types of pain threshold were increased considerably on the 16th day in the EA group (P < 0.01). In comparison with the control group, the spinal nNOS protein and mRNA expression levels were increased significantly in the model group (P < 0.05, P < 0.01). In comparison with the model group, both nNOS protein and mRNA expression levels in the spinal cord were down-regulated obviously in the EA group (P < 0.05). CONCLUSION: Electroacupuncture can alleviate neuropathic pain in CCI rats, which is closely related to its effect in down-regulating the expression of nNOS protein and mRNA in the spinal cord.

[Effect of electroacupuncture on the levels of amino acid neurotransmitters in the spinal cord in rats with chronic constrictive injury].

OBJECTIVE: To observe the changes of amino acid neurotransmitter contents in the lumbar spinal cord after electroacupuncture (EA) in rats with neuropathic pain so as to study its spinal mechanism underlying pain relief. METHODS: Forty SD rats were randomly divided into control, sham surgery, model and EA groups (n=10). Chronic constrictive injury (CCI) (neuropathic pain) model was duplicated by ligature of the right sciatic nerve with a piece of catgut. EA (1-3 mA, 2 Hz) was applied to "Huantiao" (GB 30) and "Weizhong" (BL 40) on the injured side for 30 minutes, once a day for 7 days. The mechanical and thermal pain thresholds were measured before and after CCI, and after EA intervention. Concentrations of glutamate (Glu), aspartate (Asp), glutamine (Gln), gamma-aminobutyric acid (GABA), Glycine (Gly) and taurine (Tau) in the lumbar spinal cord (L4-6) were detected by O-phthaladehyde derivatization + high performance liquid chromatography (HPLC). RESULTS: Compared with the control group, both the mechanical and thermal pain thresholds of the model group were decreased significantly on day 10 and day 16 after CCI (P < 0.01). Compared with the model group, the mechanical and thermal pain thresholds in the EA group on day 16 after CCI were upregulated strikingly (P < 0.01). In comparison with the control group, Glu, Asp, Gin and GABA levels in the lumbar spinal cord were significantly higher in the model group (P < 0.05, P < 0.01), while Gly and Tau levels in the lumbar spinal cord were markedly lower in the model group (P < 0.05). In comparison with the model group, spinal Glu, Asp, and Gin contents were downregulated significantly in the EA group (P < 0.01), while Gly, GABA and Tau levels were upregulated obviously (P < 0.01, P < 0.05). No significant differences were found between the control and sham surgery groups in the mechanical and thermal pain thresholds, and in the spinal Glu, Asp, GIn, GABA, Gly and Tau levels (P > 0.05). CONCLUSION: EA of GB 30 and BL 40 may alleviate neuropathic pain in CCI rats, which is closely with its effects in reducing the release of excitatory amino acids and promoting the release of inhibitory amino acid neurotransmitters.