腕踝针对甲状腺结节射频消融术后恶心呕吐的影响:随机对照试验

ObjectiveTo observe the influence of wrist-ankle acupuncture (WAA) on postoperative nausea and vomiting (PONV) undergoing radiofrequency ablation (RFA) in thyroid nodule and its analgesic effect.MethodsA total of 66 patients with thyroid nodule and undergoing RFA were randomized into a WAA group and a sham-acupuncture(SA) group, 33 cases in each one. Acupuncture was exerted after the patients entering operation room. In the WAA group, WAA was applied on the bilateral Upper 1, 2 and 3 areas. In the SA group, the sham-acupuncture was given on the same areas. In 30 min after needle insertion, the routine RFA started in the patients of the two groups. All the needles were removed when the operation was finished. The proportion of intraoperative sufentanil supplementation, the incidence of 24 h PONV and the proportion of intraoperative intravenous injection of urapidil were recorded in the patients of the two groups.ResultsIn the WAA group, sufentanil was supplemented by 12.90%, obviously less than 36.36% in the SA group. The incidence of 24 h PONV was 9.68% in the WAA group, remarkably lower than 27.27% in the SA group, indicating statistical significances (both P < 0.05). The intravenous injection of urapidil was not applied during operation in the two groups, without statistical difference between the groups (P > 0.05).ConclusionWrist-ankle acupuncture reduces the intraoperative demand of sufentanil in radiofrequency ablation of thyroid nodule and this therapy is preventive for PONV.     

腕踝针结合体针治疗急性腰扭伤临床观察

  目的：观察腕踝针治疗急性腰扭伤的临床疗效  方法：将180例急性腰扭伤患者随机分为腕踝针组、体针组、结合组,每组60例;各组施予相应治疗,疗程3天  结果：腕踝针组治愈率为78.3%,体针组为81.6%,结合组为98.3%;结合组的临床疗效优于腕踝针组(P<0.01)和体针组(P<0.05)。治疗后,三组腰痛VAS评分均较治疗前显著降低(P<0.01);治疗前后VAS评分差值比较,结合组大于体针组(P<0.05)和腕踝针组(P<0.01)  结论：腕踝针结合体针治疗急性腰扭伤可提高临床疗效。     

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.     

Cupping therapy for acute and chronic pain management: a systematic review of randomized clinical trials

ObjectiveCupping as a traditional therapy is used to treat a myriad of health conditions, including pain. This systematic review assessed the effectiveness and safety of cupping for different types of pain.MethodsThirteen databases and four trial registries were searched for randomized clinical trials. Meta-analysis of data was conducted if there was non-significant clinical and statistical heterogeneity (measured by I² test) among trials.ResultsSixteen trials with 921 participants were eligible and included. Six trials were assessed as low risk of bias, another six trials were of unclear risk of bias, and the remaining four trials were of high risk of bias. Pain was related to three acute and seven chronic diseases. Meta-analysis showed a beneficial effect of cupping compared to wait-list control (visual analogue scale (VAS), MD −1.85 cm, 95%CI −2.66 to −1.04) and heat therapy (numerical rating scale, MD −2.05 cm, 95%CI −2.93 to −1.17). Cupping combined with acupuncture was superior to acupuncture alone on post-treatment pain intensity (VAS, MD −1.18 cm, 95%CI −1.68 to −0.68), however, no difference was found between this comparison based on changes in pain intensity (difference of VAS, MD 0.16 cm, 95%CI −0.54 to 0.87). Results from other single studies showed significant benefit of cupping compared with conventional drugs or usual care. Hematoma and pain at the treated site, increasing local pain or tingling were reported as mild adverse effects of cupping.ConclusionThis review suggests a potential positive short-term effect of cupping therapy on reducing pain intensity compared with no treatment, heat therapy, usual care, or conventional drugs.     

Effects of the pestle needle therapy,a type of acupoint stimulation,on post-hemorrhoidectomy pain: A randomized controlled trial

BackgroundHemorrhoids are one of the most common conditions that lead to surgery, and until now surgical hemorrhoidectomy has been the major effective treatment. Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation.ObjectiveThis study evaluates the clinical efficacy of the pestle needle therapy, an acupoint stimulation method, for relief of post-hemorrhoidectomy pain.Design, setting, participants and interventionsThis was a single-center, patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery. Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1:1. The treatment group received the pestle needle therapy, with manual stimulation at Yaoshu (DU2), Mingmen (DU4), Changqiang (DU1), Chengshan (BL57), Erbai (EX-UE2) and the perianal points (1, 3, 5, 7, 9, and 11o’clock around the lesion); while the control group received a sham treatment with very light pressure. Three sessions of treatment were performed at 30 min, 4 h and 12 h after the surgery, and each lasted for 15 min.Main outcome measuresThe primary outcome was post-operative pain measured with the visual analogue scale (VAS) at 12 h after surgery. The secondary outcomes included the VAS scores measured at 0.5, 2, 4, 6, 8, 24 and 48 h after surgery, the analgesic dose, the time and the VAS score of the patients’ first defecation after surgery, as well as the Hamilton Rating Scale for Anxiety (HAMA) evaluated before discharge.ResultsThe mean pain score of the treatment group was significantly lower than that of the control group (3.10 ± 1.27 vs 4.82 ± 1.29; P < 0.001) at 12 h after surgery. Compared with the control group, patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery (P = 0.002); and their HAMA scores before discharge were lower (4.07 ± 2.40 vs 5.10 ± 2.45, P = 0.009). Compared to the treatment group, patients in the control group had a greater time to the first defecation after surgery ([52.34 ± 15.72] h vs [27.08 ± 13.68] h; P < 0.001), but there was no difference in their VAS scores at the first defecation (P = 0.092).ConclusionThe pestle needle therapy was effective for relieving pain, reducing anxiety and improving bowel function after hemorrhoidectomy, and it is worthy of clinical application.     

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.     

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.     

低频电针治疗膝骨关节炎临床疗效分析

  目的：观察低频电针治疗膝骨关节炎的临床疗效  方法：将80例膝骨关节炎患者随机分为电针组和对照组(各40例),分别予以低频电针和双氯芬酸钠缓释胶囊治疗,疗程28天。采用视觉模拟评分法(VAS)和Lysholm膝关节评分量表法(LKSS)观察两组膝关节疼痛及功能改善情况  结果：治疗后两组膝关节疼痛VAS评分均明显低于治疗前(P<0.01),且治疗组明显低于对照组(P<0.05)。治疗后治疗组LKSS评分明显高于治疗前(P<0.01),治疗组明显高于对照组(P<0.05)  结论：低频电针治疗膝骨关节炎可减轻疼痛和改善关节功能。     

Effects of l-arginine supplementation on glycemic profile: Evidence from a systematic review and meta-analysis of clinical trials

BackgroundThe effects of l-arginine supplementation on indices of glycemic control and the role of many factors influencing this intervention have been controversial in clinical trials.ObjectiveThis meta-analysis was performed to assess the effects of l-arginine supplementation on indices of glycemic control, including fasting blood glucose (FBG), hemoglobin A1c (HbA1c), serum insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels in randomized controlled trials (RCTs).Search strategyThis study conducted a systematic review of RCTs published in PubMed, Scopus, Web of Science, Cochrane Library and Embase, up to 5 May, 2018.Inclusion criteriaStudies were included in this meta-analysis if they were RCTs with parallel design and reported sufficient data on participants before and after intervention, and outcomes of glycemic profile parameters in both the arginine supplementation and control groups.Data extraction and analysisThe screening of titles and abstracts was performed independently by two reviewers. Selected articles were considered if they met the study’s inclusion criteria. The quality of included studies was assessed by using the Cochrane Collaboration modified tool. From 710 articles retrieved in the initial search, only 10 trials were suitable for pooling the effects of arginine supplementation on serum glucose, insulin, HOMA-IR and HbA1c levels, with effect sizes of nine, eight, five and five, respectively.ResultsPooled random-effect analysis revealed that l-arginine supplementation could significantly decrease FBG level (weighted mean difference [WMD]: 3.35 mg/dL; 95% confidence interval [CI] = [−6.55, −0.16]; P = 0.04) and serum insulin level (WMD: −2.19 μIU/mL; 95% CI = [−3.70, −0.67]; P = 0.005). However, the effects of l-arginine supplementation on HOMA-IR and HbA1c were not significant. Results of subgroup analysis showed that supplementation with l-arginine could significantly decrease serum insulin levels when the dosage of l-arginine is > 6.5 g/d (WMD: −3.49 μIU/mL; 95% CI = [−5.59, −1.38]; P = 0.001), when the duration of supplementation is ≤ 12.8 weeks (WMD: −3.76; 95% CI = [−6.50, −0.98]; P = 0.008), when the participants are not diabetic patients (WMD: −2.54 μIU/mL; 95% CI = [−4.50, −0.50]; P = 0.01) and when the baseline serum level of insulin was > 20 μIU/mL (WMD: −3.98; 95% CI = [−6.31, −1.65]; P = 0.001).ConclusionAlthough the results of this study confirmed that supplementation with l-arginine could have significant effects on some glycemic profile indices of participants in clinical trials, the clinical importance of this reduction may not be meaningful.     

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.     

Analgesic effects and hemodynamic mechanisms of perpendicular and transverse needling at Sanyinjiao (SP 6) in patients with primary dysmenorrhea: A randomized controlled trial

ObjectiveTo explore the analgesic effects and uterine hemodynamics of perpendicular needling (PN) and transverse needling (TN) at SP 6 in patients with primary dysmenorrhea (PD).MethodsIn this randomized controlled trial, patients with PD diagnosed with cold-dampness congealing pattern were randomly assigned in a ratio of 1:1 to receive PN or TN at bilateral SP 6 for 10 min. Acupuncture was performed when the menstrual pain score was over 40 mm on the first day of menstruation, as measured using the visual analog scale for pain (VAS-P). The primary outcome was average menstrual pain (VAS-P). Secondary outcomes included the pulsatility index (PI), resistance index (RI), and systolic-diastolic peaks ratio (S/D) in uterine arteries as measured using color Doppler ultrasonography; anxiety as assessed using the Hamilton Anxiety Rating Scale (HAMA), blood pressure (BP), and heart rate (HR).ResultsForty-eight patients completed the study. The TN group exhibited a significant reduction in VAS-P scores (–5.71 mm, 95% confidence interval (CI): –8.78, –2.63, P = .001), RI values (–0.05, 95% CI: –0.09, –0.01, P = .015), and HAMA values (–2.50, 95% CI: –4.78, –0.22, P = .032) when compared with the PN group. No significant differences in PI, S/D, BP, or HR values were observed between the two groups (P > .05).ConclusionTN at SP 6 was superior to PN in alleviating menstrual pain and anxiety in patients with PD. This analgesic effect of TN may be due to its better ability to improve uterine arterial blood flow via decreases in RI values.     

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...     

Effects of traditional Chinese exercises on blood glucose and hemoglobin A1c levels in patients with prediabetes: A systematic review and meta-analysis

BackgroundTraditional Chinese exercises (TCEs) have a positive effect on glycemic control and hemoglobin A1c (HbA1c), but there is no consensus on the benefits of TCEs for patients with prediabetes.ObjectiveThe objective of this study was to systematically investigate the effects of TCEs on blood glucose control in patients with prediabetes.Search strategyComprehensive retrieval of randomized controlled trials (RCTs) was carried out using PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Wanfang Data Knowledge Service Platform, China Biology Medicine disc, Google Scholar and Baidu academic databases. The retrieval window ranged from the establishment of the database to December 2018, and references related to the included trials were searched without language restrictions.Inclusion criteriaThe study included RCTs with a clinical diagnosis of prediabetes that was also treated with TCEs.Data extraction and analysisLiterature screening, data extraction and literature quality assessment were performed independently by two researchers. In the case of disagreement, a third party was invited to negotiate and make a decision. Standardized mean difference (SMD) was used to estimate the therapeutic effect. Meta-analysis was performed using Review Manager 5.3.5 and Stata 15.0. Heterogeneity was assessed using Q test and I², and the source of heterogeneity was determined using Galbraith diagram and sensitivity analysis. A Q test resulting in P < 0.1 and I² > 50% indicated significant difference and random effect model analysis was performed. Otherwise, a fixed effect model was applied. Begg’s and Egger’s tests were used to assess publication bias.ResultsNine RCTs involving 485 participants were included in this study. The results showed that TCEs could reduce fasting blood glucose (FBG), 2 h blood glucose (2hPBG) and HbA1c in patients with prediabetes. The treatment subgroup showed that an intervention of 6 months had better results, while the Gongfa subgroup showed that the TCE Baduanjin yielded better results. (1) FBG: SMD = −0.73, 95% confidence interval (CI) [−0.97, −0.50], P < 0.00001; Baduanjin: SMD = −0.83, 95% CI [−1.13, −0.53], P < 0.00001; 6 month treatment: SMD = −0.73, 95% CI [−1.20, −0.26], P = 0.002. (2) 2hPBG: SMD = −0.75, 95% CI [−0.94, −0.57], P < 0.00001; Baduanjin: SMD = −0.62, 95% CI [−0.91, −0.32], P < 0.00001; 6 month treatment: SMD = −0.91, 95% CI [−1.39, −0.44], P = 0.0002. (3) HbA1c: SMD = −0.56, 95% CI [−0.89, −0.23], P = 0.00008; Baduanjin: SMD = −0.46, 95% CI [−0.83, −0.08], P = 0.02; 6 month treatment: SMD = −0.77, 95% CI [−1.24, −0.29], P = 0.002.ConclusionTCEs had positive effects in improving blood glucose levels in patients with prediabetes. Hence, TCEs may be of potential therapeutic value for patients with prediabetes, as an adjuvant therapy along with other treatments. Although the evidence suggests that the intervention is effective for 6 months, the mechanism of TCEs on glycemic control, the minimum exercise dose and their safety remain to be further studied.     

雷火温针灸治疗风寒入络型膝骨关节炎临床研究

目的观察雷火温针灸治疗风寒入络型膝骨关节炎的临床疗效。方法将120例风寒入络型膝骨关节炎患者随机分为治疗组和对照组,各60例;治疗组予雷火温针灸治疗,对照组口服盐酸氨基葡萄糖片,疗程30天;观察两组临床疗效、膝关节疼痛视觉模拟(VAS)评分、Fairbank病情评分、Lysholm膝关节评分的变化情况。结果 1治疗组总有效率为93.33%,对照组为66.67%;治疗组临床疗效优于对照组(P0.05)。2治疗后,两组膝关节疼痛VAS评分均较治疗前明显降低(P0.05),Fairbank病情评分、Lysholm膝关节评分均较治疗前明显升高(P0.05);且治疗组疼痛VAS评分、Fairbank病情评分、Lysholm膝关节评分改善均优于对照组(P0.05)。结论雷火温针灸治疗风寒入络型膝骨关节炎能明显减轻临床症状、改善膝关节功能。     

电针联合雷火灸治疗寒湿型膝骨性关节炎:随机对照试验

ObjectiveTo observe the clinical effect differences of knee osteoarthritis (KOA) with cold-damp type between electroacupuncture (EA) combined with thunder-fire moxibustion and medication.MethodsA total of 72 cases of KOA patients with cold-damp type were randomly divided into a combined treatment group of EA and thunder-fire moxibustion (combined treatment group) and a medication group, 36 cases in each group. In the combined treatment group, the acupoints for EA were Dúbí (犊鼻 ST35), Nèixīyăn (内膝眼 EX-LE4), Zúsānlĭ (足三里 ST36), Yánglíngquán (阳陵泉 GB34), Yīnlíngquán(阴陵泉 SP9), Xuèhăi (血海 SP10), Liángqiū (梁丘 ST34) and Hèdĭng (鹤顶 EX-LE2). During the period of EA, the suspending thunder-fire moxibustion was applied to Shénquè (神阙 CV8) and Guānyuán (关元 CV4). In the medication group, diclofenac sodium double release intestine-sol capsule and Fugui gutong capsules were prescribed for oral administration. The treatment for 14 days was taken as one course and the consecutive 2 courses of treatment were required in each group. Before and after treatment, as well as in the follow-up visit, the pain score (visual analogue scale, VAS), the knee function score(Western Ontario and McMaster University, WOMAC, the expressions of interleukin 6 (IL-6) and transforming growth factor β1 (TGF-β1) in the joint fluid as well as the difference in the clinical therapeutic effect were observed in the two groups separately.Results(1) The pain score: compared with those before treatment, the VAS scores were all reduced after treatment and in the follow-up in the two groups (all P < 0.05). After treatment and in the follow-up, VAS scores in the combined treatment group were lower than those in the medication group (both P < 0.05). (2) The knee function score: WOMAC score of each item, i.e. pain, stiffness and function, as well as the total score after treatment and the follow-up were all lower than those before treatment in the patients of the two groups (all P < 0.05). The score of each item, i.e. pain and function, as well as the total score in the combined treatment group were all lower than those in the medication group after treatment and the follow-up respectively (all P < 0.05). (3)The expressions of IL-6 and TGF-β1: the level of IL-6 in the joint fluid was reduced after treatment as compared with that before treatment in either group and the level of TGF-β1 was increased, indicating the statistical differences (all P < 0.05). After treatment, the level of IL-6 in the combined treatment group was lower than that in the medication group and the level of TGF-β1 was higher than that of the medicating group, indicating the statistical significance (both P < 0.05). (4)The total effective rate in the combined treatment group was 97.1%, higher than 78.8% in the medication group, indicating the statistical significance (P < 0.05).ConclusionThe clinical effect of the combined treatment of electroacupuncture and the thunder-fire moxibustion is remarkable on knee osteoarthritis of cold-damp type. The combined treatment presents a more advantageous at the sustainability of the therapeutic effect as compared with medication.     

Acupuncture for dysmenorrhea of adenomyosis: A randomized controlled trial 针刺治疗子宫腺肌病痛经:随机对照试验

ObjectiveTo compare the difference in the clinical therapeutic effect on dysmenorrhea in the patients with adenomyosis between acupuncture and ibuprofen sustained release capsules.MethodsA total of 40 patients were randomized into an acupuncture group and an ibuprofen group, 20 cases in each one. The treatment was given consecutively for 3 menstrual cycles and the follow-up lasted for 2 menstrual cycles. The score of visual analogue scale (VAS) at the most painful time during menstruation, menstrual flow, the score of COX menstrual symptom scale (CMSS) and the score of endometriosis health profile-5 (EHP-5), as well as the patients’ satisfaction and acceptance were compared between the two groups.ResultsThree menstrual cycles after treatment, the VAS score at the most painful time, menstrual flow, CMSS score and EHP-5 score were all lower than those before treatment in either group, with statistical significance (all P < 0.05). Three menstrual cycles after treatment, compared with the ibuprofen group, in the acupuncture group, the VAS score at the most painful time was slightly higher (P > 0.05), the menstrual flow was lower (P > 0.05), CMSS score was higher (P < 0.05) and EHP-5 was higher (P > 0.05). The score of the patients’ satisfaction and acceptance in the acupuncture group were all higher than the ibuprofen group (both P < 0.05). In 2- menstrual cycles follow-up, the VAS score at the most painful time, menstrual flow, CMSS score and EHP-5 score in the acupuncture group were all lower than those in the ibuprofen group (all P < 0.05).ConclusionAcupuncture is effective for analgesia and symptom-relief and the long-term effect is superior to the oral administration of ibuprofen.     

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.     

揿针治疗老年膝关节骨性关节炎疗效观察：随机对照试验

ObjectiveTo observe the effects of the thumb-tack needling therapy on knee joint pain and joint function in the elderly patients with knee osteoarthritis (KOA) and compared with medication.MethodsA total of 60 patients were randomized into a thumb-tack needling group and a medication group, 30 cases in each one. In the thumb-tack needling group, the therapy with the thumb-tack needle retaining and waiting for qi was adopted. The acupoints were Hèdĭng (EX-LE2鹤顶), Nèixīyăn (内膝眼EX-LE4), Dúbí (犊鼻ST35), Xuèhăi (血海SP10), Liángqiū (梁丘ST34) and Ashi points on the affected side. The needles were retained for 24 h. This therapy was given once every two days, 3 times a week. The treatment for 2 weeks was as one course and consecutive 2 courses of treatment were required. In the medication group, diclofenac sodium sustained release tablets were taken orally, 75 mg each time, once daily, consecutively for 4 weeks. Successively, the score of visual analogue scale (VAS) at the affected knee before treatment, after treatment and 3 months after treatment as well as Lequesne indicator before and after treatment were evaluated. The clinical therapeutic effect was observed in the patients of the two groups after treatment.Results(1) After treatment, VAS scores were reduced as compared with those before treatment in the patients of the two groups (both P < 0.05). After treatment, VAS score in the thumb-tack needling group was lower than that in the medication group (P < 0.05). (2) After treatment, the scores of all the items of Lequesne indices reduced as compared with those before treatment in the patients of the both groups, indicating significance differences (all P < 0.05). After treatment, compared with the medication group, the score of pain, morning stiffness and walking ability as well as the total score were all lower in the thumb-tack needling group, indicating significant differences (all P < 0.05). (3) The curative and remarkably effective rate and the total effective rate were 66.7% and 93.3% in the thumb-tack needling group, higher than 56.7% and 86.7% in the medication group respectively (both P < 0.05).ConclusionThe thumb-tack needling therapy effectively relieves knee joint pain and improves joint function in the patients and the therapeutic effect is better than medication group. Hence, this therapy deserves to be promoted in clinical practice.     

Wrist-ankle acupuncture and Fluoxetine in the treatment of post-stroke depression: a randomized controlled clinical trial

OBJECTIVE: To investigate the effects of WAA combined with fluoxetine in the clinical treatment of post-stroke depression(PSD).METHODS: In this randomized, controlled and single-blind trial, 105 PSD patients who met the inclusion criteria were randomly divided into three equal groups: Thin wrist-ankle acupuncture(WAA)group(Thin WAA needle + Fluoxetine), Thick WAA group(Thick WAA needle + Fluoxetine), and Sham WAA group(sham WAA needle + Fluoxetine). In this trial, the primary outcome was Hamilton Depression Scale(HAMD), while the secondary outcomes included Zung self-rating depression scale(SDS) and World Health Organization Quality of Life BREF(QQL).RESULTS: Ninety nine PSD patients completed all the treatment. The HAMD scores and SDS scores of all the three groups decreased after treatment(P 0.05); thick WAA group and thin WAA group decreased more obviously than the sham WAA group(P 0.05). There was no significant difference between the QQL scores of the three groups(P 0.05). There was no significant difference in the scores of the three scales between the thick wrist ankle needles and the thin wrist ankle needles(P 0.05).CONCLUSION: The present study showed that WAA combined with fluoxetine can relieve the symptoms of depression after stroke. WAA therapy could improve the antidepressant effect of fluoxetine.