Effects of trigger point acupuncture treatment on temporomandibular disorders: a preliminary randomized clinical trial

We compared the effects of trigger point acupuncture with that of sham acupuncture treatments on pain and oral function in patients with temporomandibular disorders (TMDs). This 10-week study included 16 volunteers from an acupuncture school with complaints of chronic temporomandibular joint myofascial pain for at least 6 months. The participants were randomized to one of two groups, each receiving five acupuncture treatment sessions. The trigger point acupuncture group received treatment at trigger points for the same muscle, while the other acupuncture group received sham treatment on the trigger points. Outcome measures were pain intensity (visual analogue scale) and oral function (maximal mouth opening). After treatment, pain intensity was less in the trigger point acupuncture group than in the sham treatment group, but oral function remained unchanged in both groups. Pain intensity decreased significantly between pretreatment and 5 weeks after trigger point (p<0.001) and sham acupunctures (p<0.050). Group comparison using the area under the curve demonstrated a significant difference between groups (p=0.0152). Compared with sham acupuncture therapy, trigger point acupuncture therapy may be more effective for chronic temporomandibular joint myofascial pain.     

Clinical observation of needling gluteus medius muscle trigger point plus chiropractic for sacroiliac joint subluxation

Objective

To observe the clinical effect of needling gluteus medius muscle trigger point (TrP) plus chiropractic for sacroiliac joint subluxation.

Methods

A total of 124 cases conforming to the inclusion criteria of sacroiliac joint subluxation were classified by anterior subluxation and posterior subluxation, and randomized into a TrP group and a conventional group respectively. There were 63 patients with anterior subluxation who were randomized into a TrP group of 32 cases (including 4 dropped out cases) and a conventional group of 31 cases (including 3 dropped out cases); and 61 patients with posterior subluxation who were randomized into a TrP group of 31 cases (including 3 dropped out cases) and a conventional group of 30 cases (including 3 dropped out cases). Patients in the TrP group received the treatment of needling gluteus medius muscle TrP plus chiropractic, while patients in the conventional group received conventional acupuncture treatment plus chiropractic. The treatment was done twice a week for a succession of 8 weeks. Then, the pain visual analog scale (VAS), Oswestry disability index (ODI) and therapeutic efficacy were evaluated.

Results

After treatment, the total effective rate of TrP group with anterior subluxation was 96.9%, higher than 77.4% in the conventional group, the difference showed a statistical significance (P<0.05); the total effective rate was 93.5% in the TrP group with posterior subluxation, higher than 73.3% in the conventional group. After treatment, the VAS and ODI scores in both groups dropped obviously, the differences showed statistical significance (all P<0.05); the scores of VAS and ODI in the TrP group were obviously lower than those in the conventional group (all P<0.05).

Conclusion

Needling gluteus medius muscle TrP plus chiropractic had a better therapeutic effect than conventional acupuncture plus chiropractic for sacroiliac joint subluxation.

     

Laser acupuncture combined with auricular acupressure improves low-back pain and quality of life in nurses: A randomized controlled trial

BackgroundLow-back pain (LBP) in nurses is a major health concern that affects their quality of life and ability to work, with consequences for their economic status.ObjectiveThis study evaluates the effect of low-level laser acupuncture combined with auricular acupressure (LAA) on pain intensity, pain interference and quality of life in nurses with LBP.Design, setting, participants and interventionsThis randomized controlled trial recruited a convenience sample of hospital-based nurses from one teaching hospital in Taiwan, China. Participants were randomly assigned to the LAA group (n = 38) receiving low-level laser acupuncture and auricular acupressure for 4 weeks, and the control group (n = 38) receiving only sham laser acupuncture treatment without laser energy output.Main outcome measuresData were collected for the primary pain outcome using the Short Form of the Brief Pain Inventory, while the secondary outcome, quality of life, was evaluated using the Roland-Morris Disability Questionnaire. Both primary and secondary outcomes were scored before the intervention, and after 2-week and 4-week intervention. The rate of LBP recurrence was evaluated at the 4th week and 8th week after the end of intervention.ResultsAfter controlling for prior pain, the result of linear mixed model analysis showed trends in significant between-group differences in the level of current pain occurring in week 4 (P < 0.001), worst pain in week 2 (P < 0.001) and week 4 (P < 0.001), least pain in week 2 (P = 0.032) and week 4 (P < 0.001), pain interference in week 2 (P = 0.009) and week 4 (P < 0.001), and in the life dysfunction in week 2 (P < 0.001) and week 4 (P < 0.001). Recurrence rates of LBP at the 4th and 8th weeks after the end of intervention were 0% and 36.89% in the LAA group, and 69.44% and 36.11% in the control group.ConclusionThis study shows that 4-week LAA intervention reduced pain intensity and pain interference, and improved quality of life for hospital-based nurses with LBP. These effects were maintained continuously for at least 4 weeks after the intervention. The nonpharmacological intervention, LAA, may be another efficacious, feasible, noninvasive, analgesic intervention for LBP.Trial registrationThis study is registered at Clinicaltrials.gov (registration number NCT04423445).     

Exploration of the therapeutic effect and clinical outcomes of acupuncture at pain-sensitive points to treat chronic nonspecific low back pain: Application of the acupoint sensitization theory 基于穴位敏化理论探讨针刺痛敏点对慢性非特异性腰痛患者的临床疗效

Objectives To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspecific low back pain.Methods Using the FDK 20 pressure algometer, the pain-sensitive points were probed in 30 patients with chronic nonspecific low back pain. The top 5 points that elicited the most painful reaction were selected and stimulated with an even-needling technique after deqi. The needles were retained for 30 min. TDP irradiation was concurrently administered. The treatment was administered once daily on weekdays (Monday to Friday) and discontinued for 2 days during the weekend (Saturday and Sunday). The treatment lasted for 2 consecutive weeks. The changes in the range of motion (ROM) of the lumbar vertebrae, visual analogous scale (VAS) score, and the Oswestry disability index (ODI) score of the lumbar vertebrae were assessed before treatment and after 5 and 10 treatment sessions.Results Compared with the data before treatment, the spinal ROM increased after 5 and 10 treatment sessions in the patients with chronic nonspecific low back pain.The ROM after 10 treatment sessions was remarkably wider than that after 5 treatments, with statistical significance (all P < 0.05). Compared with that before treatment, the immediate VAS score showed statistically significant reduction after 5 treatment sessions (P < 0.05). Moreover, compared with the score after 5 treatment sessions, the immediate VAS score reduced after 10 treatment sessions, but without any statistical significance. After 5 and 10 treatment sessions, the ODI score was reduced in the patients and it was significantly different from that before treatment (both P < 0.05).Conclusion Acupuncture at the pain-sensitive points alleviates pain and improves lumbar vertebral function in patients with chronic nonspecific low back pain. Thus, further research is needed to confirm whether acupuncture can be a better intervention for chronic nonspecific low back pain.     

温和灸激痛点治疗肩背部肌筋膜疼痛综合征:随机对照研究

目的:比较温和灸与针刺激痛点治疗肩背部肌筋膜疼痛综合征(MPS)的疗效差异,为肩背部MPS的治疗提供参考。方法:60例肩背部MPS患者随机分为温和灸组和针刺组,每组30例,两组均选取疼痛部位的激痛点进行治疗。温和灸组采用温和灸疗法,每次艾灸因人而异,20~100min不等,以患者出现透热感为度;针刺组采用毫针与皮肤呈45°角斜刺入并贯穿激痛点结节,每次留针30min。两组每日均治疗1次,10次为一疗程,治疗1个疗程后,采用国际公认的简化麦吉尔疼痛量表(McGill)作为观察指标,以治疗前后疼痛分级指数(PRI)、视觉模拟评分(VAS)和现时疼痛强度(PPI)的变化来评价疗效。结果:温和灸组愈显率80.0%(24/30),优于针刺组愈显率40.0%(12/30,P0.001)。治疗后两组PRI、VAS、PPI评分较治疗前均降低(均P0.001);两组治疗后PRI、VAS、PPI评分比较,差异均无统计学意义(均P0.05)。结论:温和灸激痛点与针刺激痛点对肩背部MPS均具有良好的治疗效果,但温和灸治愈显效更为明显,且操作简便,易于推广。     

The Effects of Auriculotherapy on Shoulder Pain After a Cesarean Section

BackgroundPostcesarean section shoulder pain caused by constrained upper extremity movement limits the maternal activities of breastfeeding and neonatal care.ObjectivesThis study aims at investigating the effects of auriculotherapy on shoulder pain after a cesarean section.MethodsIn this randomized controlled trial, 90 candidates for a cesarean section were selected according to the inclusion and exclusion criteria and randomly allocated into control and intervention groups by the minimization method. In the intervention group, ear seeds were placed on shoulder and muscle relaxation points from two hours prior to surgery until 24 hours after it. In the control group, ear seeds were placed on placebo points. Shoulder pain was assessed on a numerical pain scale in 1, 6, and 24 hours after surgery.ResultsThere was no significant difference between the two groups 1 and 6 hours after surgery. However, there was a significant difference between the two groups 24 hours after surgery and the mean pain score was lower in the intervention group (independent t-test, p < 0.001).ConclusionThe use of auriculotherapy is recommended for the prevention and alleviation of shoulder pain after a cesarean section.     

Acupuncture for chronic prostatitis: A randomized controlled trial: 针刺治疗慢性前列腺炎:随机对照研究

ObjectiveTo explore whether there is a specific clinical effect of acupuncture in the treatment of chronic prostatitis.MethodsA total of 52 patients with chronic prostatitis were randomly divided into an acupuncture group (24 cases) and a placebo acupuncture group (28 cases). During the treatment, 1 case was dropped out in the placebo acupuncture group and 51 patients accomplished the clinical trial finally in two groups. In the acupuncture group, Shènshū (肾俞BL23), Zhōngliáo (中髎BL33), Huìyáng (会阳BL35) and Sānyīnjiāo (三阴交SP6) were selected. In the placebo acupuncture group, the non-meridian points located lateral to BL23, BL33, BL35 and SP6 were selected, respectively. The duration of treatment was 8 weeks in each group. In the first 4 weeks of treatment, the treatment was given once every two days, three times weekly. In the last 4 weeks of treatment, the treatment was given once every three days, twice a week. Totally, 20 acupuncture treatments were required in the whole trial. Before treatment, in week 4 and 8 of treatment and in follow-up, National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score and the comprehensive effect were evaluated in the two groups successively.ResultsIn week 4 and 8 of treatment, NIH-CPSI score in the acupuncture group was lower than that before treatment, respectively (both P < 0.05). In week 8 of treatment, NIH-CPSI score in the placebo acupuncture group was lower than that before treatment (P < 0.05). NIH-CPSI score in the acupuncture group was lower than the placebo acupuncture group in week 8 of treatment (P < 0.05). In follow-up, NIH-CPSI score of the two groups all decreased as compared with the score before treatment (both P < 0.05), and the score in the acupuncture group was lower than the placebo acupuncture group (P < 0.05). In the comparison of comprehensive effect, the total effective rate was 91.7% in the acupuncture group and was 74.1% in the placebo acupuncture group. The therapeutic effect in the acupuncture group was better than that of the placebo acupuncture group (P < 0.05).ConclusionAcupuncture relieves pelvic pain and urination symptoms and has a certain of long-term effect in patients with chronic prostatitis.     

Electromyographic and Strength Analyses of Activation Patterns of the Wrist Flexor Muscles after Acupuncture

This study analyzed the electromyographic and strength responses of the flexor muscles of the wrist following stimulation of acupuncture points. A total of 52 participants were randomly divided into four groups: local (heart 3, HT3), distant (heart 4, HT4), control (bladder 60, BL60), and naïve control groups. To obtain the root mean square electromyographic activity, we placed surface electrodes over the wrist flexors. To obtain kilogram force (kgf) values, we attached a force transducer to the floor and to the hands of participants. Both values were recorded over three repetitions of maximal isometric wrist flexion contractions. Data were analyzed using one-way analyses of variance, followed by Dunnett's post-hoc tests. We found reductions in electromyographic activity contralateral to the stimulated point in the distant group 10 minutes after removal of the needles (F_3,48 = 3.25; p < 0.05). Regarding muscle strength, ipsilateral and contralateral stimulation in the distant group produced kgf levels prior to and 10 minute and 20 minutes after withdrawal of the acupuncture needle that were lower than that obtained prior to insertion of the needle (F_3,48 = 5.82; p < 0.05). Thus, stimulation of the acupuncture points distant from the wrist flexors reduced ipsilateral and contralateral muscle strength and decreased the root mean square values contralateral to the site of stimulation.     

Resisting method of acupuncture at movement-painful points for treating the refractory cases of frozen shoulder during adhesion period: A randomized controlled study: 动痛穴阻力针法治疗粘连期难治性肩凝症的随机对照观察

ObjectiveTo objectively evaluate the clinical effect of resisting method of acupuncture at movement-painful points on treating the refractory cases of frozen shoulder during adhesion period, and to compare with that of the conventional acupuncture method.MethodsAccording to the random grouping principle, 90 patients with frozen shoulder during adhesion period were divided into “resisting method acupuncture group, general acupuncture group, and physiotherapy group”, 30 patients in each. In the resisting method acupuncture group, the resisting method of needling was applied at the “movement-painful points”, and during acupuncture the patient was asked to do shoulder movements. In the general acupuncture group, the conventional needling method of acupuncture was applied at the conventional three shoulder-acupoints. In the physiotherapy group, the patients were treated with shock wave at the affected shoulder. All groups were treated once a day, 5 times a week, a total of 2 weeks as a course of treatment. After one course of treatment, the clinical effect of the three groups was evaluated. The shoulder pain and shoulder function scale (Constant-Murley), Rating Scale of the American Shoulder and Elbow Surgeons (ASES), and infrared thermal imaging temperature change score were observed.ResultsAfter treatment, the shoulder pain was relieved and movement improved in all three groups, whilst the cured and remarkably effective rate of the resisting method acupuncture group was 96.7% (29/30), better than those of the general acupuncture group 86.2% (25/29) and the physiotherapy group 73.3% (22/30), with a statistically significant difference (P<0.05); the VAS score of the resisting method acupuncture group was significantly lower than those of the other two groups (P<0.05), the Constant-Murley score and the ASES score were significantly lower than those of the other two groups (all P<0.05), and the infrared thermal imaging temperature change score was significantly improved in comparing with those of the other two groups, with a statistically significant difference (both P<0.05).ConclusionThe resisting method of needling has an obvious analgesic effect and is able to restore the joint movement function in the treatment of refractory frozen shoulder during adhesion period.     

Effects of Scalp Acupuncture on Functional Deficits Induced by Early Sensorimotor Restriction

The aim of this study was to investigate the effects of scalp acupuncture and electrostimulation, combined or not, in a disuse model consisted of early sensorimotor restriction in rats. Male Wistar pups received sensorimotor restriction from the second postnatal day (P2) until P28. Animals were divided into five different groups (n = 6): control (CT), sensorimotor restricted (SR), acupuncture (AC), electrostimulation (EL), and electroacupuncture (AC+EL). Experimental animals received sham, acupuncture, or electrical stimulation, combined or not, of two scalp regions for 7 days (P29-P35). Before treatment period (P29) and after treatment (P36), animals were evaluated with the narrow suspended bar, horizontal ladder, and stride length tests. SR animals had worse performance in the narrow suspended and horizontal ladder tasks compared with SR animals at P29 (p ≤ 0.005). Significant improvements were observed in both tasks in AC, EL, and EL+AC groups comparing P29 and P36 (p < 0.001). Also, at P35, all treated animals performed significantly better motor tasks compared with SR group (p < 0.05). There was no difference between treated groups. Finally, acupuncture and electrical stimulation, combined or not, have beneficial effect on motor performance following early developmental disuse.     

Antidiabetic Properties and Mechanism of Action of Orthosiphon stamineus Benth Bioactive Sub-fraction in Streptozotocin-induced Diabetic Rats

Orthosiphon stamineus is a popular folk medicine widely used to treat many diseases including diabetes. Previous studies have shown that the sub-fraction of chloroform extract was able to inhibit the rise of blood glucose levels in a glucose tolerance test. This study was carried out to evaluate the chronic effect and possible mechanism of action of the bioactive chloroform sub-fraction of O. stamineus using streptozotocin-induced diabetic rats and in vitro methods. Administration of the chloroform extract sub-fraction 2 (C?2-b) at a dose of 1 g/kg twice daily on diabetic rats for 14 days showed a significant lowering (p < 0.05) of the final blood glucose level compared to the pretreatment level. However, there were no significant differences in the plasma insulin levels post-treatment compared to the pretreatment levels for all doses of C?2-b. Conversely, C?2-b at a concentration of 2 mg/mL significantly increased (p < 0.001) the glucose uptake by the rat diaphragm muscle. The increase in glucose uptake was also shown when the muscle was incubated in a solution containing 1 IU/mL of insulin or 1 mg/mL of metformin. Furthermore, the effect of this sub-fraction on glucose absorption in the everted rat jejunum showed that C?2-b at concentrations of 0.5 mg/mL, 1 mg/mL and, 2 mg/mL significantly reduced the glucose absorption of the jejunum (p < 0.05–0.001). Similarly, the absorption of glucose was also inhibited by 1 mg/mL and 2 mg/mL of metformin (p < 0.001). These results suggest that the effect of C?2-b may be due to extra-pancreatic mechanisms. There was no evidence that the plant extract stimulated the release of insulin in order to lower the blood glucose level.     

Acupuncture Treatment in Geriatric Rehabilitation: A Retrospective Study

The main goal of geriatric rehabilitation reconditioning following an acute illness is rapid restoration of normal activity. Key elements are pain control, restoration of bowel function, sleep, appetite and general well being, alongside physical activity. The aim of this retrospective study was to assess the effect of acupuncture as an adjunct to medical and physical rehabilitation in geriatric patients. The setting was a university-affiliated large city general hospital. The participants comprised 27 consenting consecutive patients in a subacute geriatric rehabilitation department. The interventions consisted of biweekly acupuncture treatment in conjunction with medical and physical therapy. The outcome measures of pain, appetite, quality of sleep, bowel function and general well being were assessed using a 10-point Likert scale at the onset and close of treatment. The results showed that a significant post-treatment improvement was seen in pain (p=0.005), appetite (p=0.0034), bowel function (p=0.029) and general well being (p=0.0012) scores in patients' treatment when compared with pretreatment baseline scores. The “quality of sleep” score showed a trend towards improvement (p=0.073). In conclusion, acupuncture may be beneficial as an adjunctive treatment in geriatric postacute illness rehabilitation. Randomized controlled trials are needed to further assess the role of acupuncture as part of treatment management for restoring normal physical activity in geriatric patients.     

Electromagnetic Acupuncture to Enhance the Effects of Manual Acupuncture on Recovery from Muscle Fatigue of the Quadriceps

The aim of this study was to investigate a new method of manual acupuncture that used a magnetic field to stimulate only one acupoint vertically. We developed an eight-channel electromagnetic acupuncture (EMA) system that uses a solenoid-type electrode to insert the manual acupuncture needle into a hole in an electrode. We used a manual acupuncture needle for magnetic induction in order to penetrate vertically and deeply into tissues. In order to confirm the usefulness of EMA, we investigated the effects of treatment on muscle fatigue after strenuous knee extension/flexion exercises that had been performed by three groups: the nonstimulation, the manual acupuncture, and the EMA groups. Electromyograms showed that the median frequency (MF) in the EMA group had rapidly recovered after 4 minutes (p = 0.608), but that the peak torque had not recovered to the normal state (p < 0.05). Thus, we confirmed that compared with manual acupuncture, EMA resulted in better recovery from muscle fatigue.     

Prevention and treatment of acupuncture for cancer-related fatigue caused by chemotherapy of intestinal cancer: A randomized controlled trial: 针刺防治肠癌化疗所致癌因性疲乏的随机对照研究

ObjectiveTo observe the clinical therapeutic effect and safety on cancer-related fatigue (CRF) after chemotherapy treated with the reinforcing technique of acupuncture at Qìh?i (气海 CV6), Guānyuán (关元 CV4) and bilateral Zúsānl? (足三里 ST36) in the patients with colorectal cancer.MethodsA total of 61 cases of CRF after chemotherapy for colorectal cancer were included in the trial and randomized into a control group (30 cases) and an observation group (31 cases). The patients of the two groups all accepted the regular chemotherapy. Each duration of chemotherapy was 3 weeks. In the observation group, 8 treatments with acupuncture were combined before chemotherapy and from the day 1 to 3 of chemotherapy separately, once daily, 30 min in each time, for two courses totally. Acupoints included bilateral ST36, CV6 and CV4. Separately, 1 day before the first cycle of chemotherapy, 1 day before the second cycle of chemotherapy and in 3 weeks after the second cycle of chemotherapy, the score of Piper fatigue scale (PFS) and the score of the scale for quality of life (QOL) were adopted to evaluate the improvement degree of cancer-related fatigue.ResultsRegarding PFS score, in 3-week followup after acupuncture treatment, compared with the control group, the mean value of the score of perception dimension was reduced obviously in the acupuncture treatment group, indicating the significant difference (p < 0.05). Compared with the values before treatment, after acupuncture, the mean values of the scores in behavior dimension, affection dimension, perception dimension, cognition dimension and the overall score were all reduced obviously, indicating the significant differences in the treatment group (all p < 0.05). But the differences were not significant in the control group in the mean values of the scores in behavior dimension, affection dimension, perception dimension and cognition dimension as well as in the overall score (all p > 0.05). Regarding the score of QOL scale, compared with the control group, in the treatment group, the mean value of physical function score was increased significantly (p < 0.05) and the mean values of the scores for overall health, fatigue and dyspnea were all reduced significantly, indicating the statistical differences (all p < 0.05). Compared with the values before treatment, after treatment, the mean values of the scores for physical function, role function and social function, as well as the scores of overall health, fatigue and dyspnea were all different significantly in the treatment group (all p < 0.05). But the mean values of the scores for each item as well as for overall health, fatigue and dyspnea were not different significantly in the control group (all p > 0.05).ConclusionIn terms of the evaluation with PFS, acupuncture alleviates fatigue degree to the mild from the moderate in the patients with CRF, especially brings a positive effect on perception dimension, meaning the improvement of mental state. Regarding the evaluation of QOL scale, acupuncture improves overall health and physical function and alleviates fatigue and dyspnea. Acupuncture therapy has no obvious toxic side effect and achieves the definite therapeutic effect.     

Fifteen-day Acupuncture Treatment Relieves Diabetic Peripheral Neuropathy

Our study aimed to investigate the effects of acupuncture on diabetic peripheral neuropathy. We compared 42 cases treated with acupuncture with 21 cases exposed to sham acupuncture and observed the effects on nerve conduction velocity and a variety of subjective symptoms associated with diabetic peripheral neuropathy. Three of the six measures of motor nerves, and two measures of sensory function, demonstrated significant improvement (p < 0.05) over the 15-day treatment period in the acupuncture group, while no motor or sensory function significantly improved in the sham acupuncture group. There were also significant differences in vibration perception threshold between the groups (p < 0.05) and when compared to the baseline levels (p < 0.01) in the acupuncture group. Acupuncture was significantly more effective than sham for treatment of numbness of the lower extremities, spontaneous pain in the lower extremities, rigidity in the upper extremities and alterations in temperature perception in the lower extremities after therapy. Our pilot study has, therefore, provided evidence that acupuncture may be clinically useful for the radical treatment of diabetic peripheral neuropathy.     

埃德蒙顿症状评估量表在针灸治疗癌痛患者中的应用:基于肿瘤科住院患者的回顾性分析和一项前瞻性预试验（英文）

Background:As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms,it is necessary to have a comprehensive assessment on promising intervention to improve pain management.Methods:A retrospective study of 489 inpatient cancer patients(1081 visits) was conducted by querying the electronic medical record database to test the reliability and validity of the Edmonton Symptom Assessment System.Data from a pilot prospective randomized controlled study on...     

Combination of Exercise and Acupuncture Versus Acupuncture Alone for Treatment of Myofascial Pain Syndrome: A Randomized Clinical Trial

Myofascial pain syndrome (MPS) is a common musculoskeletal disorder. This study was designed to compare the effects of aerobic exercise plus acupuncture with acupuncture alone in treatment of patients with MPS. Sixty-four patients (55 female and 9 male) with MPS in their neck and shoulders participated in the study with mean age of 33.1 ± 6.4 years. Participants were randomly allocated to aerobic exercise plus acupuncture (n = 32) or acupuncture alone (n = 32) groups. Outcome measurements included visual analog scale, pressure pain threshold, neck disability index, and quality of life that was measured with QoL-SF36 scale. Each group received 10 sessions of acupuncture in combination with aerobic exercise or acupuncture alone. The outcome measures were evaluated at baseline, at the end of the last treatment session, and at 1-month follow-up visit. While participants were waiting for their 1-month follow-up visit, the patients who received combination therapy were asked to continue their aerobic exercise by jogging 40 minutes a day. Although mean visual analog scale, pressure pain threshold, neck disability index, and QoL-SF36 were significantly improved in both groups (p < 0.001), there was no statistically significant difference among the measures between the two groups throughout the evaluated sessions. The interaction effect of time and groups did not show any significant difference among the outcome measures (p > 0.29).     

Treatment duration of wrist-ankle acupuncture for relieving post-thyroidectomy pain: A randomized controlled trial

BackgroundTreatment duration of wrist-ankle acupuncture (WAA) is uncertain for post-thyroidectomy pain relief.ObjectiveThis study evaluated the effect of different WAA treatment duration on post-operative pain relief and other discomforts associated with thyroidectomy.Design, setting, participants and interventionThis randomized controlled trial was conducted at a single research site in Guangzhou, China. A total of 132 patients receiving thyroidectomy were randomly divided into the control group (sham WAA, 30 min) and three intervention groups (group 1: WAA, 30 min; group 2: WAA, 45 min; group 3: WAA, 60 min), with group allocation ratio of 1:1:1:1. Acupuncture was administered within 1 hour of leaving the operating room.Outcomes and measuresPrimary outcome was patients’ pain at the surgical site assessed by visual analogue scale (VAS) at the moment after acupuncture treatment (post-intervention). Secondary outcomes included the patients’ pain VAS scores at 6, 12, 24, 48 and 72 h after the thyroidectomy, the 40-item Quality of Recovery (QoR-40) score, the grade of post-operative nausea and vomiting (PONV), and the use of additional analgesic therapy.ResultsThe adjusted mean difference (AMD) in VAS scores from baseline to post-intervention in group 1 was −0.89 (95% confidence interval [CI], −1.02 to −0.76). The decrease in VAS score at post-intervention was statistically significant in group 1 compared to the control group (AMD, −0.43; 95% CI, −0.58 to −0.28; P < 0.001), and in groups 2 and 3 compared to group 1 (group 2 vs group 1: AMD, −0.65; 95% CI, −0.81 to −0.48; P < 0.001; group 3 vs group 1: AMD, −0.66; 95% CI, −0.86 to −0.47; P < 0.001). The VAS scores in the four groups converged beyond 24 h after the operation. Fewer patients in group 2 and group 3 experienced PONV in the first 24 h after operation. No statistical differences were measured in QoR-40 score and the number of patients with additional analgesic therapy.ConclusionCompared with the 30 min intervention, WAA treatment with longer needle retention time (45 or 60 min) had an advantage in pain relief within 6 h after surgery. WAA’s analgesic effect lasted for 6–12 h post-operatively.Please cite this article as: Han XR, Yue W, Chen HC, He W, Luo JH, Chen SX, Liu N, Yang M. Treatment duration of wrist-ankle acupuncture for relieving post-thyroidectomy pain: A randomized controlled trial. J Integr Med. 2023; 21(2): 168–175.