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ObjectiveTo explore the possible peripheral analgesic mechanism of electroacupuncture （EA） at promimal and distal acupoints in treatment of myofascial pain syndrome （MPS）. MethodsTwenty-four SD rats were randomly divided into blank group， model group， proximal group， and distal group， with six rats in each group. MPS model was prepared by “strike combined with centrifugal exercise” in all groups except for the blank group. After modeling， the rats in the proximal group received EA at the local myofascial trigger points （MTrPs）， namely the Ashi points， with dilatational waves of frequency of 2/100 HZ and voltage of 2-4 V， current intensity depending on a slight trembling of the left lower limbs， once a day， 15min each time，for 14 days. The rats in the distal group received EA at “Yanglingquan” （GB 34） and “Yinlingquan” （SP 9）， with the same operations as the proximal group. The rats in the blank group and the model group were only grasped and hedged， without other interventions. After intervention， the paw withdrawl mechanical threshold （PWMT） was measured， and variability between the left and right hind paws was calculated. Musculoskeletal ultrasound imaging and electromyography monitoring were performed on the left lower extremity vastus medialis. The morphological changes of vastus medialis muscle of the left lower extremity were observed by HE staining. The positive expression of substance P （SP）， calcitonin gene-related peptide （CGRP）， CD68 and CD206 in muscle tissue was detected by immunohistochemistry. Abdominal aortic serum interleukin-1β （IL-1β）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， interleukin-10 （IL-10）， and interleukin-8 （interleukin-8） were detected by ELISA. ResultsCompared to those in the blank group， the fibers of the vastus medial muscle of the rats in the model group were broken and distorted with thickness in variation， and the myofascia was broken， with fibrillation potential， enlarged muscle cells， inward moved nucleus， and widened muscle space； the variability of PWMT between the left and right hind paws significantly increased， as well as the levels of SP， CGRP， CD68， and CD206 in the vastus medialis muscle （P＜0.01）， and the serum IL-8 and TNF-αlevels were significantly elevated （P＜0.05 or P＜0.01）. Compared to those in the model group， the muscle fibers in the proximal and distal group were complete in shape and arranged in an orderly manner， with continued non-broken myofascia， regular shape of muscle cells， and significantly reduced level of IL-8 （P＜0.01）； the amplitude and frequency of spontaneous discharge in the proximal group significantly decreased， as well as the variability of PWMT between the left and right hind paws， and the levels of SP， CGRP， and CD68 in the vastus medialis muscle， while the CD206 level increased significantly （P＜0.05 or P＜0.01 ）； there was complex discharges in the distal group， with significantly decreased level of CD68 in the vastus medialis muscle and increased level of CD206 （P＜0.01）. Compared to the proximal group， the level of IL-8 in the distal group was significantly higher （P＜0.05）. ConclusionsEA at proximal acupoints can significantly improve the pain threshold and local muscle tissue morpho-logy in rats， and its mechanism may be related to reducing the levels of pain-causing substances and related inflammatory factors and promoting the polarization of macrophages. The analgesic effect of EA at distal acupoints is not obvious， and the mechanism is still unclear.
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One of the most important aspects of clinical acupuncture practice, like diabetic gastroparesis, is the selection of suitable acupoints. Furthermore, it is critical to examine the therapeutic impact differences between distal and local acupoints, as well as the prescription of their combination. In this study, diabetic gastroparesis rats were treated by needling Zhongwan (CV12) and Zusanli (ST36), and then used Single Photon Emission Computed Tomography-CT (SPECT-CT) technology to assess the effects of promoting gastric motility. In addition, morphological observation, immunohistochemical examination, and biomarker assays, such as determination of growth factor 1, motilin, and ghrelin contents in serum samples, were performed to better understand the impact of certain various acupuncture treatments. All of the therapies improved the symptoms of diabetic gastroparesis rats, according to the findings. Stimulating these acupoints, on the other hand, can have a different therapeutic effect. In addition, needling local and distal acupoints together can have an antagonistic or synergistic impact on specific physiological and biochemical indexes such as gastric motility, ghrelin, gastrin, and growth factor 1, among others. Our findings demonstrated the benefits of acupoints and acupuncture in the management of diabetic gastroparesis, as well as a new insight into acupuncture therapeutics.
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Pontos de Acupuntura , Terapia por Acupuntura/métodos , Complicações do Diabetes/terapia , Gastroparesia/terapia , Animais , Modelos Animais de Doenças , Masculino , Ratos , Ratos Sprague-Dawley , EstreptozocinaRESUMO
OBJECTIVE: To explore the effect of acupuncture at the proximal and distal acupoints combined with neuromuscular electrical stimulation (NMES) for the children with cerebral palsy salivation on the basis of oral function training. METHODS: A total of 124 children were randomized into an observation group and a control group, 62 cases in each one. Oral function training (30 min a time) and NMES (20 min a time) were used in the two groups. Acupuncture was applied after NMES in the observation group. The main acupoints were Baihui (GV 20), Sishencong (EX-HN 1), Speech Areaâ , Dicang (ST 4), Jiache (ST 6), Hegu (LI 4), Zusanli (ST 36), etc. Scalp acupuncture was for 1 h, and body acupuncture was for 30 min. Pricking blood was used at Jinjin (EX-HN 12) and Yuye (EX-HN 13) for the patients of â ¤ in teacher salivation grading (TDS). All the treatment was given for 3 courses, 30 days as a course, 5 times a week, once a day. TDS, safety, dysphagia and Gesell development scale were assessed before and after treatment. RESULTS: After treatment, the total effective rate of TDS in the observation group was 83.9% (52/62), which was better than 58.1% (36/62) in the control group (P<0.05). The total effective rate of dysphasia in the observation group was 88.7% (55/62), which was better than 69.4% (43/62) in the control group (P<0.05). The lip and tongue movement, chewing and swallowing after treatment in the observation group were superior to those in the control group (all P<0.05). After treatment, the Gesell development scale of adaptability, language behavior and personal social development quotient were better compared with those before treatment in the observation group (all P<0.05); the language behavior improved after treatment in the control group (P<0.05). The adaptability, language behavior and personal social development quotient after treatment in the observation group were superior to those in the control group (P<0.05ï¼P<0.01). The adverse reactions in the observation group were less than those in the control group. CONCLUSION: Acupuncture at the proximal and distal acupoints combined with NMES are better than simple NMES for children with cerebral palsy salivation. The methods could not only improve children's behavior cognitive ability, but also improve the sensation and motor coordination of the lip, tongue, pharynx, etc. As a result, the salivation and swallowing function improve.
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Paralisia Cerebral , Pontos de Acupuntura , Paralisia Cerebral/terapia , Criança , Estimulação Elétrica , Humanos , Salivação , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To explore the effect of acupuncture at the proximal and distal acupoints combined with neuromuscular electrical stimulation (NMES) for the children with cerebral palsy salivation on the basis of oral function training.</p><p><b>METHODS</b>A total of 124 children were randomized into an observation group and a control group, 62 cases in each one. Oral function training (30 min a time) and NMES (20 min a time) were used in the two groups. Acupuncture was applied after NMES in the observation group. The main acupoints were Baihui (GV 20), Sishencong (EX-HN 1), Speech AreaⅠ, Dicang (ST 4), Jiache (ST 6), Hegu (LI 4), Zusanli (ST 36), etc. Scalp acupuncture was for 1 h, and body acupuncture was for 30 min. Pricking blood was used at Jinjin (EX-HN 12) and Yuye (EX-HN 13) for the patients of Ⅴ in teacher salivation grading (TDS). All the treatment was given for 3 courses, 30 days as a course, 5 times a week, once a day. TDS, safety, dysphagia and Gesell development scale were assessed before and after treatment.</p><p><b>RESULTS</b>After treatment, the total effective rate of TDS in the observation group was 83.9% (52/62), which was better than 58.1% (36/62) in the control group (<0.05). The total effective rate of dysphasia in the observation group was 88.7% (55/62), which was better than 69.4% (43/62) in the control group (<0.05). The lip and tongue movement, chewing and swallowing after treatment in the observation group were superior to those in the control group (all <0.05). After treatment, the Gesell development scale of adaptability, language behavior and personal social development quotient were better compared with those before treatment in the observation group (all <0.05); the language behavior improved after treatment in the control group (<0.05). The adaptability, language behavior and personal social development quotient after treatment in the observation group were superior to those in the control group (<0.05，<0.01). The adverse reactions in the observation group were less than those in the control group.</p><p><b>CONCLUSION</b>Acupuncture at the proximal and distal acupoints combined with NMES are better than simple NMES for children with cerebral palsy salivation. The methods could not only improve children's behavior cognitive ability, but also improve the sensation and motor coordination of the lip, tongue, pharynx, etc. As a result, the salivation and swallowing function improve.</p>
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BACKGROUND: Many previous studies of electroacupuncture used combined therapy of electroacupuncture and systemic manual acupuncture, so it was uncertain which treatment was effective. This study evaluated and compared the effects of systemic manual acupuncture, periauricular electroacupuncture and distal electroacupuncture for treating patients with tinnitus. METHODS: A randomized, parallel, open-labeled exploratory trial was conducted. Subjects aged 20-75 years who had suffered from idiopathic tinnitus for > 2 weeks were recruited from May 2013 to April 2014. The subjects were divided into three groups by systemic manual acupuncture group (MA), periauricular electroacupuncture group (PE), and distal electroacupuncture group (DE). The groups were selected by random drawing. Nine acupoints (TE 17, TE21, SI19, GB2, GB8, ST36, ST37, TE3 and TE9), two periauricular acupoints (TE17 and TE21), and four distal acupoints (TE3, TE9, ST36, and ST37) were selected. The treatment sessions were performed twice weekly for a total of eight sessions over 4 weeks. Outcomes were the tinnitus handicap inventory (THI) score and the loud and uncomfortable visual analogue scales (VAS). Demographic and clinical characteristics of all participants were compared between the groups upon admission using one-way analysis of variance (ANOVA). One-way ANOVA was used to evaluate the THI, VAS loud, and VAS uncomfortable scores. The least significant difference test was used as a post-hoc test. RESULTS: Thirty-nine subjects were eligible and their data were analyzed. No difference in THI and VAS loudness scores was observed in between groups. The VAS uncomfortable scores decreased significantly in MA and DE compared with those in PE. Within the group, all three treatments showed some effect on THI, VAS loudness scores and VAS uncomfortable scores after treatment except DE in THI. CONCLUSIONS: There was no statistically significant difference between systemic manual acupuncture, periauricular electroacupuncture and distal electroacupuncture in tinnitus. However, all three treatments had some effect on tinnitus within the group before and after treatment. Systemic manual acupuncture and distal electroacupuncture have some effect on VAS uncomfortable. TRIAL REGISTRATION: KCT0001991 by CRIS (Clinical Research Information Service), 2016-8-1, retrospectively registered.
