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.     

Core muscle functional strength training for reducing the risk of low back pain in military recruits: An open-label randomized controlled trial

BackgroundCore muscle functional strength training (CMFST) has been reported to reduce injuries to the lower extremity. However, no study has confirmed whether CMFST can reduce the risk of low back pain (LBP).ObjectiveThis study identified the effects of CMFST on the incidence of LBP in military recruits.Design, setting, participants and interventionWe performed a prospective, open-label, randomized, controlled study in a population of young healthy male naval recruits from a Chinese basic combat training program. Participants were randomly assigned to either the core group or the control group. In additional to normal basic combat training, recruits in the core group underwent a CMFST program for 12 weeks, while recruits in the control group received no extra training.Main outcome measuresAt the beginning of the study and at the 12th week, the number of participants with LBP was counted, and lumbar muscle endurance was measured. In addition, when participants complained of LBP, they were assessed using the visual analog scale (VAS) and Roland Morris Disability Questionnaire (RMDQ).ResultsA total of 588 participants were included in the final analysis (295 in the core group and 293 in the control group). The incidence of LBP in the control group was about twice that of the core group over the 12-week study (20.8% vs 10.8%, odds ratio: 2.161–2.159, P < 0.001). The core group had better lumbar muscle endurance at 12 weeks than the control group ([200.80 ± 92.98] s vs [147.00 ± 84.51] s, P < 0.01). There was no significant difference in VAS score between groups, but the core group had a significantly lower RMDQ score at week 12 than the control group (3.33 ± 0.58 vs 5.47 ± 4.41, P < 0.05).ConclusionThis study demonstrated that the CMFST effectively reduced the incidence of LBP, improved lumbar muscle endurance, and relieved the dysfunction of LBP during basic military training.     

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...     

Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial

BackgroundPatients commonly develop postoperative pain after total knee arthroplasty (TKA). Acupuncture-related techniques and low-level laser therapy could be beneficial for pain management for older individuals.ObjectiveTo examine the effect of low-level laser acupuncture (LA) in reducing postoperative pain, pain-related interference in daily life, morphine consumption, and morphine-related side effects in older patients with knee osteoarthritis who underwent TKA.Design, setting, participants and interventionA single-blind randomized placebo-controlled trial was conducted. Patients (N = 82) were recruited and randomly assigned via a computer-generated list to the LA group or a placebo group. The LA group received low-level laser therapy at Sanyinjiao (SP6), Taixi (KI3), Kunlun (BL60), Fengshi (GB31), Futu (ST32) and Neiguan (PC6) after TKA, while the placebo acupuncture group received the same treatment procedure without laser energy output.Main outcome measuresThe primary outcome was postoperative pain intensity, and it was measured at baseline and hours 2, 6, 10, 24, 48 and 72 after TKA. The secondary outcomes, including relative pain, postoperative pain-related interference in daily life and morphine consumption, were measured at hours 24, 48 and 72 after TKA.ResultsGeneralized estimating equations revealed significant between-group differences in pain intensity (P = 0.01), and trend differences in pain intensity for the LA group starting at hours 10 to 72 (P < 0.05) and morphine consumption at hours 48 and 72 (P < 0.05). The changes in pain-related interference in daily life were significant (P < 0.05) at 72 h, with the exception of the parameters for worst pain, mood, and sleep. Nausea and vomiting side effects from morphine had significant between-group differences at hours 10 and 24 (P < 0.05).ConclusionLow-level LA gradually reduced older patients’ postoperative pain intensity and morphine consumption within the first 72 h after their TKA for osteoarthritis. Low-level LA may have benefits as an adjuvant pain management technique for clinical care.Trial registrationClinicalTrials.gov registration number NCT03995446.     

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.     

Clinical study on electroacupuncture for post-withdrawal anxiety-depression mood in heroin addicts

目的：研究电针对海洛因依赖者脱毒后焦虑抑郁情绪的干预效应。方法：将120例海洛因依赖者按随机数字表法随机分入针刺1组（夹脊穴、肾俞）、针刺2组（四肢穴）、模拟组和对照组，观察治疗前及治疗4、8、10星期SAS和sDs的变化。结果：在治疗4、8、10星期，针刺1组、针刺2组的SAS、SDS积分与对照组相比，差异均有统计学意义（P＜0．01，P〈0．05）。针刺1组与针刺2组的SAS差异有统计学意义，而SDS积分差异无统计学意义。结论：电针可明显改善吸毒者脱毒后的焦虑和抑郁情绪，电针夹脊穴在改善焦虑症状方面明显优于四肢穴位，在改割印郁症状方面与四肢穴比较差异无统计学意义。     

Using a consensus acupoints regimen to explore the relationship between acupuncture sensation and lumbar spinal postoperative analgesia: A retrospective analysis of prospective clinical cooperation

ObjectiveThis study evaluated the effectiveness of acupuncture treatment on postoperative pain in patients with degenerative lumbar spine disease, and explored the relationship between the postoperative analgesic effect of acupuncture and the sensation of acupuncture experienced by the patients.MethodsThis retrospective study analyzed the medical records of 97 patients who had undergone an operation by the same surgeon due to degenerative lumbar disease. These patients were divided into acupuncture group (n = 32), patient-controlled analgesia (PCA) group (n = 27), and oral analgesia group (n = 38) according to the different postoperative analgesic methods. During their hospitalization, patients completed daily evaluations of their pain using a visual analogue scale (VAS), and injection times of supplemental meperidine were recorded. Also, the Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale (C-MASS) was used in the acupuncture group.ResultsEach of the three treatment groups showed significant reductions in postoperative pain, as shown by reduced VAS scores. The acupuncture group, however, had less rebound pain (P < 0.05) than the other two groups. Both the acupuncture and PCA groups experienced acute analgesic effects that were superior to those in the oral analgesia group. In addition, the higher the C-MASS index on the second day after surgery, the lower the VAS score on the fourth day after surgery. There was also a significant difference in the “dull pain” in the acupuncture sensation.ConclusionThe results demonstrated that acupuncture was beneficial for postoperative pain and discomfort after simple surgery for degenerative spinal disease. It is worth noting that there was a disproportionate relevance between the patient’s acupuncture sensation and the improvement of pain VAS score.     

火针围刺联合夹脊电针治疗急性期带状疱疹:随机对照试验（英文）

目的:比较火针围刺联合夹脊电针治疗急性期带状疱疹的临床疗效,并通过血清炎性因子和疼痛介质水平的变化探讨其改善疼痛症状的可能机制。方法:将60例急性期带状疱疹患者随机分为针药组和西药组,西药组患者均给予甲钴胺和更昔洛韦治疗,连续治疗14天。针药组在西药组的基础上加用火针围刺(以皮损部位为中心运用火针方法向中心快速刺入)联合夹脊电针(取皮损部位一致的神经节段及上、下各一节段的夹脊穴连取连续波通电治疗)的方法,每日1次,共治疗14天。观察两组患者从出现疱疹到结痂脱落的疱疹症状改善情况,比较两组患者治疗前后疼痛视觉模拟量表(VAS)评分及血清炎性细胞因子(IL-1 β、IL-6、TNT-a)和疼痛介质水平(CGRP、SP)的变化,比较两组患者治疗前后及随访1个月后匹兹堡睡眠指数量表(PSQI)评分、汉密尔顿抑郁量表(HAMD)评分,评估两组患者临床疗效及随访1个月后遗神经痛的发生率。结果:治疗结束后,针药组疱疹的止疱时间、结痂时间、脱痂时间,明显短于西药组(all P<0.05)。治疗后两组患者VAS评分、PSQI评分、HAMD评分均较同组治疗前明显降低(P<0.05),且针药组与...     

Effect of wrist-ankle acupuncture on propofol dosage in painless bronchoscopy of elderly patients: A randomized controlled trial: 腕踝针对高龄无痛气管镜检查患者丙泊酚用量的影响:随机对照研究

ObjectiveTo observe whether wrist-ankle acupuncture can reduce propofol dosage in painless bronchoscopy of elderly patients or not and its potential effect mechanism.MethodsA total of 60 patients undergoing painless bronchoscopy were randomized into a wrist-ankle acupuncture group and a control group, 30 cases in each one. In the wrist-ankle acupuncture group, wrist-ankle acupuncture was received and the needles were retained for 30 min before entering to the operating room. In the control group, no any intervention was provided. The patients in two groups all received venous administration of midazolam, nalorphine and lidocaine and target controlled infusion of propofol. When the patient's consciousness was lost and the eyelash reflex disappeared, bronchoscopy was performed and the propofol dosage was increased accordingly during operation. Propofol dosage, vital signs and occurrence of adverse reactions, bronchoscopist satisfaction, operation time and recovering time were recorded in the patients of two groups.ResultsPropofol dosage in induction period and the total dosage of propofol in the wrist-ankle acupuncture group were lower than those in the control group, indicating the statistical differences (both P < 0.05). The vital signs were stable during bronchoscopy in patients of two groups. The occurrence rates of hypoxemia and choking in the wrist-ankle acupuncture groups were lower than those in the control group, indicating the statistical differences (both P < 0.05). Bronchoscopist satisfaction in the wrist-ankle acupuncture group was higher than that of the control group, and the operation time and recovering time were lower than the control group, indicating the statistical differences (all P < 0.05).ConclusionIn painless bronchoscopy, wrist-ankle acupuncture may effectively reduce propofol dosage, alleviate respiratory suppression, reduce adverse reaction and shorten the recovering time in elderly patients.     

Clinical observation of acupuncture bloodletting at Ashi points on local swelling and pain after snakebite: 阿是穴针刺放血治疗蛇伤局部肿痛临床疗效观察

ObjectiveTo evaluate the clinical therapeutic effect of acupuncture bloodletting therapy on local swelling and pain of snakebite in the patients bitten by snakes.MethodsA total of 106 patients with trimeresurus stejnegeri bite were randomly divided into two groups, a conventional treatment group and a conventional treatment combined with bloodletting therapy group, 53 cases in each one. In the conventional treatment group, the convention treatment of western medicine was adopted. In the conventional treatment combined with bloodletting therapy group, on the base of the conventional treatment, bloodletting therapy was applied at Ashi points selected at the tender points around the wound. The intervention and observation were performed not less than 7 days in two groups. Before and after treatment, swelling and pain degrees were measured and remission time of both the limb swelling and pain were recorded in the patients.ResultsCompared with the values on day 1 of treatment, swelling degree and visual analogue scale (VAS) score of the upper and lower limbs were all lower on day 3 and day 7 of treatment in the patients of the two groups (all P < 0.05). Compared with the conventional treatment group, swelling degree and VAS score of the upper and lower limbs were all lower in the values of the conventional treatment combined with bloodletting therapy group on day 3 and day 7 of treatment respectively (all P < 0.05). The remission time of either limb swelling or pain in the patients of the conventional treatment combined with bloodletting therapy group was shorter than the conventional treatment group respectively (both P < 0.05).ConclusionAcupuncture bloodletting therapy can effectively relieve the local swelling and pain caused by snakebite, promote the recovery of limb function, shorten the treatment course and improve the clinical therapeutic effect.     

通腑调神针法治疗便秘型肠易激综合征:随机对照试验（英文）

目的:观察通腑调神针法对便秘型肠易激综合征(const ipat ion-predominant irritable bowel syndrome,IBS-C)患者的便秘、焦虑、抑郁症状及血清神经肽Y (NPY)含量的影响。方法:将42例IBS-C患者随机分为通腑调神针刺组(针刺组)和枸橼酸莫沙必利药物组(药物组),每组21例。治疗过程中,药物组剔除1例,实际观察20例,针刺组实际观察21例。观察两组患者治疗前、治疗后、随访时(治疗后1个月)的便秘量表(CCS)评分、焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分,并比较两组患者治疗前、治疗后血清NPY含量变化。结果:(1)CCS总评分:治疗后,针刺组和药物组的CCS总评分分别为(4.76±2.10)分和(5.60±1.88)分,均低于各自本组治疗前,差异有统计学意义(both P<0.05),而针刺组和药物组比较,差异无统计学意义(P>0.05)。随访时,针刺组和药物组的CCS总评分分别为(4.19±1.69)分和(6.35±2.06)分,药物组高于本组治疗后(P<0.05),而针刺组和药物组比较,差异无统计...     

Effect of transcutaneous auricular vagus nerve stimulation on fasting blood glucose and serum insulin concentration in Zucker diabetes fatty rats: 经皮耳迷走神经刺激对Zucker糖尿病大鼠血糖及血清胰岛素浓度的影响

ObjectiveTo observe the influence of transcutaneous auricular vagus nerve stimulation (taVNS) on fasting plasma glucose (FPG) and serum insulin (INS) in Zucker diabetes fatty (ZDF) rats and explore the regulatory effect of taVNS on blood glucose in ZDF rats.MethodsA total of 20 male ZDF rats were randomized into a model group and a taVNS group, 10 rats in each one. Besides, the other 10 Zucker Lean (ZL) rats were selected to be a control group. The rats in the control group were fed with common forage and those in the model group and the taVNS group were fed with high-sugar and high-fat forage. The intervention of electric stimulation was applied in the rats of taVNS group, with 2/15 Hz in frequency, disperse-dense wave and 2 mA in intensity. Each intervention lasted 30 min, once a day, consecutively for 12 weeks. No any intervention was given in the control group and the model group. The body mass and FPG level were recorded once every 2 weeks in the rats. After the experiment, the rats were sacrificed and blood sample was collected. Enzyme linked immunosorbent assay (ELISA) was adopted to determine the level of serum INS in the rats.ResultsAfter the modeling, compared with the control group, the body mass and FPG level were all higher (P < 0.05, P < 0.01) and the concentration of serum INS was lower (P < 0.01) in the rats of the model group. After intervention, compared with the model group, the body mass was lower in week 6 to 10 (P < 0.01, P < 0.05), FPG level was lower in week 8 to 12 (P < 0.01, P < 0.05) and serum INS concentration was higher (P < 0.01) in the rats of the taVNS group.ConclusiontaVNS apparently improves in hyperglycemia in ZDF rats and increases serum insulin concentration in the rats.     

针灸并用结合康复训练治疗中风后肩手综合征临床疗效观察

ObjectiveTo compare the clinical effects of body acupuncture, moxibustion, and body acupuncture plus moxibustion in the treatment of post-stroke shoulder hand syndrome (SHS).MethodsA total of 90 SHS patients after stroke were randomly divided into the body acupuncture group, the moxibustion group, and the body acupuncture plus moxibustion group, with 30 cases in each. On the basis of rehabilitation and routine treatment, the patients in different groups were treated with body acupuncture, moxibustion, and body acupuncture plus moxibustion respectively. Treatment was given once a day, 5 times a week, and 4 weeks in all. The visual analogue scale (VAS) scores, edema grading scores, and simplified Fugl-Meyer assessment (FMA) scores were evaluated before and after treatment, and the therapeutic effects of patients were evaluated as well.ResultsAfter treatment, the VAS and edema grading scores of the three groups were all lower and the FMA scores were all higher than those before treatment, with statistically significant differences (all P<0.05). The VAS and edema grading scores of the acupuncture plus moxibustion group were lower and the FMA score was higher than those of the body acupuncture group and the moxibustion group, with statistically significant differences (all P<0.05). The total effective rate of the acupuncture plus moxibustion group was 96.7%, higher than 80.0% of the body acupuncture group and 83.3% of the moxibustion group, with statistically significant differences (both P<0.05).ConclusionBody acupuncture, moxibustion, and body acupuncture plus moxibustion are all effective for post-stroke SHS, while the effect of acupuncture plus moxibustion is the best in relieving the pain and swelling, and improving effectively the joint movement of post-stroke SHS patients, which should be popularized in clinical practice.     

Combining electroacupuncture and transcranial direct current stimulation as an adjuvant therapy enhances spontaneous conversation and naming in subacute vascular aphasia: A retrospective analysis

ObjectiveEmerging evidence shows the effectiveness of speech and language therapy (SLT); however, precise therapeutic parameters remain unclear. Evidence for the use of adjunctive transcranial direct current stimulation (tDCS) to treat post-stroke aphasia (PSA) is promising; however, the utility of combining tDCS and electroacupuncture (EA) has not yet been analyzed. This study assessed the therapeutic consequences of EA and tDCS coupled with SLT in subacute PSA patients who were also undergoing hyperbaric oxygen therapy (HBOT).MethodsA retrospective analysis was conducted on subacute (< 6 months) PSA patients who were divided into three groups: patients who received EA plus tDCS (acupuncture group), patients who underwent tDCS (tDCS group), and patients who experienced conventional therapy (HBOT + SLT). All subjects underwent 21 days of treatment and also received conventional treatment. The aphasia battery of Chinese (ABC) was used to score pre- and post-intervention status.ResultsThe analysis comprised 238 patients. Cerebral infarction was the most frequent stroke type (137 [57.6%]), while motor (66 [27.7%]) and global aphasia (60 [25.2%]) were the most common types of aphasia. After 21 days of intervention, the ABC scores of all patients were improved. The acupuncture group had the highest ABC scores, but only repetition, naming, and spontaneous speech were statistically improved (P < 0.01). Post-hoc tests revealed significant improvement in word retrieval in the acupuncture and tDCS groups (P < 0.01, P = 0.037), while the acupuncture group had additional significant improvement in spontaneous conversation (P < 0.01).ConclusionCombining acupuncture and tDCS as an adjuvant therapy for subacute PSA led to significant spontaneous speech and word retrieval improvements. Future prospective, multi-ethnic, multi-center trials are warranted.     

Analgesic and anti-inflammatory properties of hydroalcoholic extracts of Malva sylvestris,Carum carvi or Medicago sativa,and their combination in a rat model

ObjectiveThe aim of this study was to evaluate the analgesic and anti-inflammatory effects of the hydroalcoholic extracts of Malva sylvestris flowers or Carum carvi and Medicago sativa seeds, alone and in combination, which have been used in traditional Iranian medicine.MethodsMale Wistar rats were divided into 6 treatment groups: distilled water, sodium salicylate (SS), M. sylvestris extract (600 mg/kg), C. carvi extract (600 mg/kg), M. sativa extract (300 mg/kg) and combined extract (including 300 mg/kg M. sylvestris and C. carvi extracts, and 150 mg/kg M. sativa extract). The formalin pain model was used to evaluate the antinociceptive effects of the treatments. For anti-inflammatory effect, acute (one hour after injection) and chronic (during a week after injection) paw inflammation was measured after subcutaneous injection of 2.5% formalin in the hindpaw. Finally, tissue samples from all groups were prepared for histopathological studies.ResultsThe combined extract significantly inhibited the nociception in the acute phase of the formalin test (P < 0.001). In the chronic phase, all the extracts and SS had significant analgesic effect (P < 0.001). Analgesic activity of the combined extract was significantly stronger than SS (P < 0.01). In the acute inflammation model, M. sylvestris, C. carvi and the combined drug had significant inhibitory effects against paw edema (P < 0.05). All extracts, individually and in combination, significantly alleviated chronic paw inflammation (P < 0.01). The combined extract had much more anti-inflammatory activity than SS (P < 0.05). Histopathological results indicated improvement and reduction of inflammatory factors in the treatment groups.ConclusionM. sylvestris, C. carvi and M. sativa have analgesic and anti-inflammatory properties. Potentially, each of these extracts or a mixture of them might be a valuable alternative drug to control pain and inflammation.     

Randomized Trial of Trigger Point Acupuncture Treatment for Chronic Shoulder Pain: A Preliminary Study

There is evidence for the efficacy of acupuncture treatment for chronic shoulder pain, but it remains unclear which acupuncture modes are most effective. We compared the effect of trigger point acupuncture (TrP), with that of sham (SH) acupuncture treatments, on pain and shoulder function in patients with chronic shoulder pain. The participants were 18 patients (15 women, 3 men; aged 42–65 years) with nonradiating shoulder pain for at least 6 months and normal neurological findings. The participants were randomized into two groups, each receiving five treatment sessions. The TrP group received treatment at trigger points for the muscle, while the other group received SH acupuncture treatment on the same muscle. Outcome measures were pain intensity (visual analogue scale, VAS) and shoulder function (Constant–Murley Score: CMS). After treatment, pain intensity between pretreatment and 5 weeks after TrP decreased significantly (p < 0.001). Shoulder function also increased significantly between pretreatment and 5 weeks after TrP (p < 0.001). A comparison using the area under the outcome curves demonstrated a significant difference between groups (p = 0.024). Compared with SH acupuncture therapy, TrP therapy appears more effective for chronic shoulder pain.     

Effect of electroacupuncture on knee osteoarthritis and relevant inflammatory factors: A randomized clinical trial: 电针治疗膝骨关节炎以及对相关炎症因子水平的影响

ObjectiveTo explore the treatment effects of electroacupuncture (EA), acupuncture with filiform needle, and western medication for knee osteoarthritis (KOA).MethodsIt was a randomized, controlled trial with the blinding of outcome assessors and statistician. 90 outpatients were diagnosed as KOA in Department of Acupuncture and Moxibustion, the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine. Using the random number table, they were divided into a medication group, an acupuncture group and an EA group, 30 cases in each one. In the medication group, routine medication was provided with oral administration of celebrex for 21 days. Regular acupuncture was applied in the remaining groups, at Liángqiū (梁丘ST34), Xuèh?i (血海SP10), Dúbí (犊鼻ST35), Nèixīy?n (内膝眼EX-LE4), Yánglíngquán (阳陵泉GB34), Hèd?ng (鹤顶EX-LE2) and Sānyīnjiāo (三阴交SP6) and the needles were retained for 30 min. In the EA group, electric stimulation with low-frequency pulse current and dense wave was applied for 30 min on the basis of the treatment of the acupuncture group. The treatment was applied once daily at 1-day intervals after each 6-day treatment for a total of 21 days. Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and visual analogy scale (VAS) scores and levels of serum inflammatory factors (interleukin-1β [IL-1β] and tumor necrosis factor [TNF-α]) were used to assess the clinical therapeutic effect.ResultsFollowing treatment, there were significant differences in the WOMAC score in the medication, acupuncture, and EA groups after treatment (all P < 0.01). In the comparison among groups, after treatment, the WOMAC score in the EA group was lower than that in either the acupuncture or medication group (both P < 0.01). Compared to before treatment, VAS scores were significantly different in the medication group (3.95 ± 0.55 vs 5.75 ± 1.40), the acupuncture group (2.78 ± 0.38 vs 5.78 ± 1.44) and EA group (1.72 ± 0.38 vs 5.78 ± 1.39) separately after treatment (all P < 0.01). In the comparison among groups, after treatment, the VAS score in the EA group was lower than that in either the acupuncture or medication group (both P < 0.01). Compared to before treatment, IL-1β levels were significantly different in the medication group (31.53 ± 6.84 vs 63.33 ± 10.25), acupuncture group (31.70 ± 7.54 vs 63.90 ± 9.96) and the EA groups (23.43 ± 3.94 vs 63.10 ± 10.66) separately after treatment (all P < 0.01). IL-1β levels were significantly lower in the EA group than in the acupuncture and medication groups (both P < 0.01). Compared to before treatment, TNF-α levels were significantly different in the medication group (40.20 ± 6.09 vs 68.77 ± 11.13), the acupuncture group (39.60 ± 7.55 vs 68.33 ± 11.51) and the EA groups (22.17 ± 5.72 vs 68.97 ± 10.52) separately after treatment (all P < 0.01). TNF-α levels were significantly lower in the EA group than in the acupuncture and medication groups (both P < 0.01). After treatment, there were no significant differences in TNF-α and IL-1β levels between the acupuncture and medication groups (both P > 0.05). The total effective rates were 86.67% (26/30), 73.33% (22/30) and 70.00% (21/30) in the EA, acupuncture, and medication groups, respectively. The total effective rate was higher in the EA group than in either the acupuncture or medication group (both P < 0.05). In the whole process of trial, the adverse events occurred in three groups. In consideration of the potential association between these adverse events and acupuncture treatment, the acupuncture physiotherapists and experts classified the adverse events into the treatment relevance or non-treatment relevance within 24 h of occurrence.ConclusionAll three therapeutic methods alleviated clinical symptoms of KOA and reduced levels of relevant inflammatory factors in serum. EA with dense wave is more advantageous than the traditional acupuncture technique and routine medication and is therefore worthy of clinical application.     

The effect of the combination of acupuncture and kinesiotherapy on upper cross syndrome based on mechanical balance principle – A randomized clinical trial: 浅析基于力学平衡原理针刺结合运动疗法治疗上交叉综合征疗效观察 -- 随机对照试验

ObjectiveTo observe the clinical effect of combined acupuncture and kinesiotherapy on upper cross syndrome (UCS) by a parallel randomized clinical trial.MethodsA total of 45 patients with UCS were recruited from the outpatients of Acupuncture-Moxibustion, Tuina and Rehabilitation Department of the First Affiliated Hospital of Hunan University of Chinese Medicine, the students of Hunan University of Chinese Medicine and the patients from the nearby communities in accordance with the inclusion criteria. Using the random number table method, they were divided into a combined treatment group (acupuncture plus kinesiotherapy, 23 cases) and a simple kinesiotherapy group (22 patients). Treatment for 4 weeks was one course, and two consecutive courses were required. The visual analog scale (VAS) score, the score of the assessment scale for cervical spondylosis, the value of surface electromyography (root mean square, RMS), and the cervical curvature value were used in the evaluation. The allocation scheme was concealed from the outcome assessors.ResultsThe data from 23 cases of the combined treatment group and 22 cases of the simple kinesiotherapy group were analyzed. Before treatment, the differences were not statistically significant in the general conditions, VAS score, assessment score of cervical spondylosis, cervical curvature value, and RMS in UCS patients between the two groups (all P > 0.05). After treatment, the VAS score was reduced compared with that before treatment in both groups (all P < 0.05). In two courses of treatment, the VAS score decreased as compared with that in one course of treatment in both groups (both P < 0.05), and the VAS score in the combined treatment group decreased more obviously after each course of treatment (both P < 0.05). The RMS decreased compared with that before treatment in each group (both P < 0.05), and the decrease in the combined treatment group was more obvious (P < 0.05). After treatment of each course, the assessment score was all increased as compared with that before treatment in two groups (all P < 0.05). In two courses of treatment, the assessment score was increased as compared with that in one course of treatment in both groups (both P < 0.05), and the score in the combined treatment group was increased more obviously in the two courses of treatment (P < 0.05). Regarding either the intra-group comparison or the inter-group comparison before and after treatment, the differences were not statistically significant (all P > 0.05), suggesting no obvious improvement of cervical curvature in the two courses of treatment in patients with UCS. However, cervical curvature tended to improve in the combined treatment group. The total effective rate was significantly different between the two groups (P < 0.05), indicating that the total effective rate in the combined treatment group was better than that in the simple kinesiotherapy group.No any adverse reactions occurred.ConclusionCombined treatment with acupuncture, kinesiotherapy, and kinesiotherapy alleviated pain, relieved the symptoms and physical signs, and improved the daily movement of the patients. However, the combined treatment of acupuncture and kinesiotherapy had a much better effect on UCS.     

Combination of acupuncture with rehabilitation training for pseudobulbar paralysis after stroke:A randomized controlled trial吞咽五穴联合康复训练 治疗脑卒中后假性延髓麻痹：随机对照试验

ObjectiveTo compare the clinical effects of needling at “five acupoints for swallow function” combined with rehabilitation training and only rehabilitation training in the treatment of dysphagia due to pseudobulbar paralysis after stroke.MethodsSeventy-six patients were randomized into rehabilitation group and combination group, with 38 cases in each. Both groups were treated with basic treatment of western medicine. The rehabilitation group was treated with routine rehabilitation training, and the combination group was treated with acupuncture at “five acupoints for swallow function” based on treatment in the rehabilitation group. Patients in the two groups were treated once a day, 6 days a week, 1 day for rest, for 3 weeks in succession. The changes in the grades and scores of water swallow test (WST), video fluoroscopic swallowing study (VFSS), and swallowing quality of life questionnaire (SWAL-QOL) in the two groups were observed before and after treatment, and the clinical effects of the two groups were compared.ResultsAfter treatment, the WST grades of the two groups were statistically different from that of before treatment (both P< 0.05), and the WST grade of the combination group was statistically different from that of the rehabilitation group (P< 0.05). After treatment, the VFSS and SWAL-QOL scores of the two groups were increased in comparing with those of before treatment (all P < 0.05), and the VFSS and SWAL-QOL scores of the combination group were higher than those of the rehabilitation group (both P < 0.05). The total effective rate of the combination group was 92.1% (35/38), higher than 60.1% (23/38) of the rehabilitation group.ConclusionThe acupuncture combined with rehabilitation training for pseudobulbar paralysis after stroke is more effective than rehabilitation training only. The combination of the two can significantly relieve the dysphagia and improve the patients’ quality of life.     

Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial

BackgroundMajor depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders.ObjectiveThis study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress.Design, setting, participants and interventionThis six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h.Main outcome measuresPrimary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups.ResultsFifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007).ConclusionThe herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress.Trial registration number: IRCT2016102430459N1 on Iranian Registry of Clinical Trials.