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Xie Y, Shen Z, Zhu X, Pan Y, Sun H, Xie M, Gong Q, Hu Q, Chen J, Wu Z, Zhou S, Liu B, He X, Liu B, Shao X, Fang J. Infralimbic-basolateral amygdala circuit associated with depression-like not anxiety-like behaviors induced by chronic neuropathic pain and the antidepressant effects of electroacupuncture. Brain Res Bull 2024; 218:111092. [PMID: 39369764 DOI: 10.1016/j.brainresbull.2024.111092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 09/25/2024] [Accepted: 10/03/2024] [Indexed: 10/08/2024]
Abstract
Chronic pain, such as neuropathic pain, can lead to anxiety, depression, and other negative emotions, thereby forming comorbidities and increasing the risk of chronic pain over time. Both the infralimbic amygdala (IL) and the basolateral amygdala (BLA) are significantly associated with negative emotions and pain, and they are known to have reciprocal connections. However, the role of IL-BLA circuit pathways in neuropathic pain-induced anxiety and depression remains unexplored. Electroacupuncture (EA) is frequently employed in the treatment of chronic pain and emotional disorders. However, The mechanism by which EA mediates its analgesic and emotion-alleviating effects via the IL-BLA circuit remains uncertain. Here, we used chemogenetic manipulation combined with behavioral tests to detect pain induced anxiety-like and depression-like behaviors. We observed that activation of the IL-BLA circuit by chemogenetic activation induced depression-like behavior of mice. Additionally, we discovered that chemogenetic activation of the IL-BLA circuit successfully prevented the beneficial effects of EA on depression-like behavior brought on by chronic pain in mice with spared nerve injury (SNI). We discovered that SNI-induced depression-like behavior could be mitigated by inhibiting the circuit, and EA had a comparable depressive-relieving effect. Furthermore, the IL-BLA circuit's activation or inhibition had no effect on the anxiety-like feelings brought on by SNI. Overall, our findings identify a specific neural circuit that selectively regulates pain-induced depression-like emotions, without affecting pain-induced anxiety-like emotions. This discovery offers a precise target for future treatments of comorbid pain and depression and provides a plausible explanation for the efficacy of EA in treating depression-like emotions associated with chronic pain.
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Affiliation(s)
- Yiping Xie
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zui Shen
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xixiao Zhu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yushuang Pan
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Haiju Sun
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Mengdi Xie
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qiuzhu Gong
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qunqi Hu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jie Chen
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zemin Wu
- Department of Acupuncture and Moxibustion, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuting Zhou
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Boyu Liu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaofen He
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Boyi Liu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaomei Shao
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Jianqiao Fang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
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Wang Y, Chen Y, Li Z, Tang L, Wen D, Wu Y, Guo Z. Electroacupuncture enhances cerebral blood perfusion by inhibiting HIF-1α in rat subarachnoid hemorrhage. Brain Res 2024; 1839:149010. [PMID: 38763503 DOI: 10.1016/j.brainres.2024.149010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/06/2024] [Accepted: 05/16/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE Cerebral blood perfusion (CBP) reduction is a prevalent complication following subarachnoid hemorrhage (SAH) in clinical practice, often associated with long-term cognitive impairment and prognosis. Electroacupuncture (EA), a widely utilized traditional Chinese therapy for central nervous system disorders, has demonstrated promising therapeutic effects. This study aims to investigate the therapeutic potential of EA in restoring CBP in SAH rats and to explore the mechanisms involving HIF-1α in this process. METHODS Rats were randomly assigned to one of five groups, including Sham, SAH, EA, EA + Saline, and EA + dimethyloxallyl glycine (DMOG) groups. EA treatment was administered for 10 min daily, while DMOG were intraperitoneally injected. Behavioral tests, cerebral blood flow monitoring, vascular thickness measurement, western blotting, and immunofluorescence staining were conducted to assess the therapeutic effects of EA on cerebral blood flow. RESULTS SAH resulted in elevated levels of HIF-1α, endothelin (ET), ICAM-1, P-SELECTIN, E-SELECTIN, and decreased level of eNOS in the brain. This led to cerebral vasospasm, decreased CBF, and cognitive deficits in the rat SAH model. EA intervention downregulated the expression of HIF-1α, ET, ICAM-1, P-SELECTIN, and E-SELECTIN, while increasing eNOS expression. This alleviated cerebral vasospasm, restored CBF, and improved cognitive function. However, the administration of the HIF-1α stabilizer (DMOG) counteracted the therapeutic effects of EA. CONCLUSION EA promotes the recovery of cerebral blood flow after SAH injury, attenuates cerebral vasospasm, and accelerates the recovery of cognitive dysfunction, and its mechanism of action may be related to the inhibition of the HIF-1α signaling pathway.
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Affiliation(s)
- Yingwen Wang
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yu Chen
- Department of Rehabilitation, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Zhao Li
- Emergency Department, Chengdu First People's Hospital, Chengdu, Sichuan Province, China.
| | - Liuyang Tang
- Department of Neurosurgery, The People's Hospital of Qijiang District, 401420, China
| | - Daochen Wen
- Department of Neurosurgery, Xuanhan County People's Hospital, Dazhou, China.
| | - Yue Wu
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
| | - Zongduo Guo
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Baeumler P, Schäfer M, Möhring L, Irnich D. Temporal summation does not predict the acupuncture response in patients with chronic non-specific low back pain. Front Neurol 2024; 15:1335356. [PMID: 39246607 PMCID: PMC11378649 DOI: 10.3389/fneur.2024.1335356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 08/05/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction Previously, we had observed that immediate pain reduction after one acupuncture treatment was associated with high temporal summation of pain (TS) at a pain free control site and younger age in a mixed population of chronic pain patients. The aim of the present study was to verify these results in chronic non-specific low back pain (LBP) and to collect pilot data on the association between TS and the response to an acupuncture series. Methods TS at a pain free control site (back of dominant hand) and at the pain site was quantified by the pin-prick induced wind-up ratio (WUR) in 60 LBP patients aged 50 years or younger. Response to one acupuncture treatment was assessed by change in pain intensity and pressure pain threshold (PPT) at the pain site. The primary hypothesis was that a high TS (WUR > 2.5) would be associated with a clinically relevant reduction in pain intensity of at least 30%. In study part two, 26 patients received nine additional treatments. Response to the acupuncture series was assessed by the pain intensity during the last week, the PPT and the Hannover functional ability questionnaire (FFbH-R). Results An immediate reduction in pain intensity of at least 30% was frequent irrespective of TS at the control site (low vs. high TS 58% vs. 72%, p = 0.266). High TS at the pain site was also not significantly associated with a clinically relevant immediate reduction in pain intensity (low vs. high TS 46% vs. 73%, p = 0.064). The PPT was not changed after one acupuncture treatment. Study part two did not reveal a consistent association between TS at the control site and any of the outcome measures but also a trend toward a higher chance for a clinically relevant response along with low TS at the pain site. Conclusion Our results do not suggest an important role of TS for predicting a clinically important acupuncture effect or the response to a series of 10 acupuncture treatments in patients with chronic non-specific LBP. Overall high response rates imply that acupuncture is a suitable treatment option for LBP patients irrespective of their TS.
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Affiliation(s)
- Petra Baeumler
- Multidisciplinary Pain Center, Department of Anaesthesiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Margherita Schäfer
- Multidisciplinary Pain Center, Department of Anaesthesiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Luise Möhring
- Multidisciplinary Pain Center, Department of Anaesthesiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Dominik Irnich
- Multidisciplinary Pain Center, Department of Anaesthesiology, LMU University Hospital, LMU Munich, Munich, Germany
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Lu M, Sharmin S, Tao Y, Xia X, Yang G, Cong Y, Yang G, Jiang J, Xiao Y, Peng L, Quan J, Xu B. Effectiveness of acupuncture in treating patients with pain and mental health concerns: the results of the Alberta Complementary Health Integration Project. Front Neurol 2024; 15:1366685. [PMID: 39165265 PMCID: PMC11333307 DOI: 10.3389/fneur.2024.1366685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 07/18/2024] [Indexed: 08/22/2024] Open
Abstract
Background This study presents real-world evidence on the clinical outcomes of the Alberta Complementary Health Integration Project (ABCHIP), which utilized acupuncture to address pain and mental health issues in two vulnerable populations in Alberta: youth (aged 24 and below) and elderly (aged 55 and above). Methods Over 282 days, a total of 606 patients received 5,424 acupuncture treatments. Tailored to each patients' specific pain and mental health concerns, an individualized treatment plan was selected, following a standard treatment protocol lasting 1 to 3 months. Patients were evaluated at least twice: initially and upon completing therapy. Primary treatment outcomes were assessed using various measures, including the Brief Pain Inventory (BPI), Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire 9 (PHQ9), PROMIS Anxiety 8a and its pediatric form PROMIS Anxiety-Pediatric, PROMIS Short Form v1.0 Fatigue 8a and its pediatric counterpart PROMIS Pediatric Short Form v2.0 Fatigue 10a, PROMIS Short Form v1.1 Anger 5a and its version PROMIS SF v2.0 5a, and EQ-5D-5L. These measures gauged pain reduction, improved sleep quality, reduced depression, anxiety, fatigue, anger, and quality of life, respectively. Results Analysis of data from 500 patients who received at least 6 acupuncture sessions through ABCHIP showed statistically significant improvements in clinical outcomes. Among this group, the subgroup of 235 patients who received at least 12 sessions demonstrated the most favorable treatment outcomes, including an 75.5% reduction in pain severity, a 53.1% improvement in sleep quality, a 78.4% drop in depression, a 41.1% decline in anxiety, a 43.7% decrease in fatigue, a 38.2% decrease in anger, and a 42.6% improvement in overall quality of life. Conclusion Integrating acupuncture with usual care demonstrates promise in enhancing mental health, alleviating chronic and general pain, and improving overall quality of life. The findings suggest that integrative programs, such as ABCHIP, present an effective approach to addressing pain and mental health concerns in vulnerable populations, providing valuable insights for future healthcare interventions.
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Affiliation(s)
- Mingshan Lu
- Department of Economics, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Alberta College of Acupuncture and Traditional Chinese Medicine, Calgary, AB, Canada
- Huatuo Clinic, Calgary, AB, Canada
| | - Sumaiya Sharmin
- Department of Economics, University of Calgary, Calgary, AB, Canada
| | - Yong Tao
- Healing Point Acupuncture Clinic/Classic Acupuncture and Herbal Clinic, Los Altos, CA, United States
| | - Xin Xia
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Alberta College of Acupuncture and Traditional Chinese Medicine, Calgary, AB, Canada
- Huatuo Clinic, Calgary, AB, Canada
- Healing Point Acupuncture Clinic/Classic Acupuncture and Herbal Clinic, Los Altos, CA, United States
| | - Gongliang Yang
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Alberta College of Acupuncture and Traditional Chinese Medicine, Calgary, AB, Canada
| | - Yingying Cong
- Alberta College of Acupuncture and Traditional Chinese Medicine, Calgary, AB, Canada
- Huatuo Clinic, Calgary, AB, Canada
| | - Guanhu Yang
- Department of Specialty Medicine, Ohio University, Athens, OH, United States
| | - Jing Jiang
- Department of Forest and Conservation Sciences, Faculty of Forestry, University of British Columbia, Vancouver, BC, Canada
| | - Yun Xiao
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Laura Peng
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Joshua Quan
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Bentong Xu
- Alberta College of Acupuncture and Traditional Chinese Medicine, Calgary, AB, Canada
- Huatuo Clinic, Calgary, AB, Canada
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Cao B, Xu Q, Shi Y, Zhao R, Li H, Zheng J, Liu F, Wan Y, Wei B. Pathology of pain and its implications for therapeutic interventions. Signal Transduct Target Ther 2024; 9:155. [PMID: 38851750 PMCID: PMC11162504 DOI: 10.1038/s41392-024-01845-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 04/08/2024] [Accepted: 04/25/2024] [Indexed: 06/10/2024] Open
Abstract
Pain is estimated to affect more than 20% of the global population, imposing incalculable health and economic burdens. Effective pain management is crucial for individuals suffering from pain. However, the current methods for pain assessment and treatment fall short of clinical needs. Benefiting from advances in neuroscience and biotechnology, the neuronal circuits and molecular mechanisms critically involved in pain modulation have been elucidated. These research achievements have incited progress in identifying new diagnostic and therapeutic targets. In this review, we first introduce fundamental knowledge about pain, setting the stage for the subsequent contents. The review next delves into the molecular mechanisms underlying pain disorders, including gene mutation, epigenetic modification, posttranslational modification, inflammasome, signaling pathways and microbiota. To better present a comprehensive view of pain research, two prominent issues, sexual dimorphism and pain comorbidities, are discussed in detail based on current findings. The status quo of pain evaluation and manipulation is summarized. A series of improved and innovative pain management strategies, such as gene therapy, monoclonal antibody, brain-computer interface and microbial intervention, are making strides towards clinical application. We highlight existing limitations and future directions for enhancing the quality of preclinical and clinical research. Efforts to decipher the complexities of pain pathology will be instrumental in translating scientific discoveries into clinical practice, thereby improving pain management from bench to bedside.
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Affiliation(s)
- Bo Cao
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Qixuan Xu
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Yajiao Shi
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China
| | - Ruiyang Zhao
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Hanghang Li
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Jie Zheng
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China
| | - Fengyu Liu
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China.
| | - You Wan
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, 100191, China.
| | - Bo Wei
- Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
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Li X, Baser RE, Bryl K, Amann L, Chimonas S, Mao JJ. How does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors?: Pretreatment expectancy and pain reduction by acupuncture. Integr Med Res 2024; 13:101040. [PMID: 38721341 PMCID: PMC11077026 DOI: 10.1016/j.imr.2024.101040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 03/01/2024] [Accepted: 03/25/2024] [Indexed: 07/15/2024] Open
Abstract
Background Outcome expectancy is an important component of non-specific effect that may play an important role in pain research and clinical care. We sought to evaluate whether pretreatment expectancy predicts pain reduction in cancer survivors receiving electroacupuncture (EA) or battlefield acupuncture (BFA). Methods We analyzed data from a randomized clinical trial that compared EA and BFA versus wait list control (WLC) for chronic musculoskeletal pain in cancer survivors. Expectancy was measured by the Acupuncture Expectancy Scale (AES) at baseline. Pain severity was assessed using the Brief Pain Inventory (BPI) at baseline and week 12. For each treatment arm, multivariable regression models were used to evaluate the association between pretreatment expectancy and week 12 pain severity, controlling for baseline pain severity, age, sex, race, and education. Results Among 360 participants enrolled, the mean age was 62.1 years (SD 12.7), with 251 (69.7 %) women and 88 (24.4 %) non-white survivors. Pretreatment expectancy was similar for all groups at baseline (EA: 13.9 ± 3.6; BFA: 13.2 ± 3.7, WLC:12.8 ± 3.3, p = 0.14). Greater pretreatment expectancy was not significantly associated with greater pain reduction in any group, after adjusting for co-variates (EA: Coef. = -0.05, 95 % CI = -0.14 - 0.04, p = 0.28; BFA: Coef. = -0.07, 95 % CI = -0.16 - 0.02, p = 0.15; WLC: Coef. = -0.09, 95 % CI = -0.25 - 0.06, p = 0.23). Conclusions Pretreatment expectancy did not predict pain reduction for either EA or BFA in cancer survivors. Our study contributes to the interpretation of analgesic effects of EA or BFA, beyond the notion of a mere 'placebo effect'.
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Affiliation(s)
- Xiaotong Li
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Raymond E. Baser
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States
| | - Karolina Bryl
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Lindsay Amann
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Susan Chimonas
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States
- Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jun J. Mao
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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Ma LW, Liu YF, Zhang H, Huang CJ, Li A, Qu XZ, Lin JP, Yang Y, Yao YX. Electroacupuncture attenuates neuropathic pain via suppressing BIP-IRE-1α-mediated endoplasmic reticulum stress in the anterior cingulate cortex. Biol Res 2024; 57:34. [PMID: 38812057 PMCID: PMC11134655 DOI: 10.1186/s40659-024-00511-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/30/2024] [Indexed: 05/31/2024] Open
Abstract
Studies have suggested that endoplasmic reticulum stress (ERS) is involved in neurological dysfunction and that electroacupuncture (EA) attenuates neuropathic pain (NP) via undefined pathways. However, the role of ERS in the anterior cingulate cortex (ACC) in NP and the effect of EA on ERS in the ACC have not yet been investigated. In this study, an NP model was established by chronic constriction injury (CCI) of the left sciatic nerve in rats, and mechanical and cold tests were used to evaluate behavioral hyperalgesia. The protein expression and distribution were evaluated using western blotting and immunofluorescence. The results showed that glucose-regulated protein 78 (BIP) and inositol-requiring enzyme 1α (IRE-1α) were co-localized in neurons in the ACC. After CCI, BIP, IRE-1α, and phosphorylation of IRE-1α were upregulated in the ACC. Intra-ACC administration of 4-PBA and Kira-6 attenuated pain hypersensitivity and downregulated phosphorylation of IRE-1α, while intraperitoneal injection of 4-PBA attenuated hyperalgesia and inhibited the activation of P38 and JNK in ACC. In contrast, ERS activation by intraperitoneal injection of tunicamycin induced behavioral hyperalgesia in naive rats. Furthermore, EA attenuated pain hypersensitivity and inhibited the CCI-induced overexpression of BIP and pIRE-1α. Taken together, these results demonstrate that EA attenuates NP by suppressing BIP- and IRE-1α-mediated ERS in the ACC. Our study presents novel evidence that ERS in the ACC is implicated in the development of NP and provides insights into the molecular mechanisms involved in the analgesic effect of EA.
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Affiliation(s)
- Lin-Wei Ma
- Department of Anesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
- Department of Anesthesia, First People's Hospital of Linping District of Hangzhou City, 369 Yingbin Road, Hangzhou, 311100, China
| | - Yu-Fan Liu
- Department of Anesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - Hui Zhang
- Department of Anesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - Chang-Jun Huang
- Department of Anesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
- Department of Anesthesia, First People's Hospital of Linping District of Hangzhou City, 369 Yingbin Road, Hangzhou, 311100, China
| | - Ang Li
- Department of Anesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - Xin-Zhe Qu
- Department of Orthopedics, Graduated School, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, 221004, China
| | - Jia-Piao Lin
- Department of Anesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - Yan Yang
- Department of Neurobiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310020, China.
- School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, 310058, China.
| | - Yong-Xing Yao
- Department of Anesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China.
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Yu H, Wang D, Verville L, Southerst D, Bussières A, Gross DP, Pereira P, Mior S, Tricco AC, Cedraschi C, Brunton G, Nordin M, Shearer HM, Wong JJ, Connell G, Myrtos D, da Silva-Oolup S, Young JJ, Funabashi M, Romanelli A, Lee JGB, Stuber K, Guist B, Muñoz Laguna J, Hofstetter L, Murnaghan K, Hincapié CA, Cancelliere C. Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Needling Therapies for Chronic Primary Low Back Pain in Adults. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:661-672. [PMID: 37991648 PMCID: PMC10684627 DOI: 10.1007/s10926-023-10125-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/15/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE Evaluate benefits and harms of needling therapies (NT) for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. METHODS Electronic databases were searched for randomized controlled trials (RCTs) assessing NT compared with placebo/sham, usual care, or no intervention (comparing interventions where the attributable effect could be isolated). We conducted meta-analyses where indicated and graded the certainty of evidence. RESULTS We screened 1831 citations and 109 full text RCTs, yeilding 37 RCTs. The certainty of evidence was low or very low across all included outcomes. There was little or no difference between NT and comparisons across most outcomes; there may be some benefits for certain outcomes. Compared with sham, NT improved health-related quality of life (HRQoL) (physical) (2 RCTs; SMD = 0.20, 95%CI 0.07; 0.32) at 6 months. Compared with no intervention, NT reduced pain at 2 weeks (21 RCTs; MD = - 1.21, 95%CI - 1.50; - 0.92) and 3 months (9 RCTs; MD = - 1.56, 95%CI - 2.80; - 0.95); and reduced functional limitations at 2 weeks (19 RCTs; SMD = - 1.39, 95%CI - 2.00; - 0.77) and 3 months (8 RCTs; SMD = - 0.57, 95%CI - 0.92; - 0.22). In older adults, NT reduced functional limitations at 2 weeks (SMD = - 1.10, 95%CI - 1.71; - 0.48) and 3 months (SMD = - 1.04, 95%CI - 1.66; - 0.43). Compared with usual care, NT reduced pain (MD = - 1.35, 95%CI - 1.86; - 0.84) and functional limitations (MD = - 2.55, 95%CI - 3.70; - 1.40) at 3 months. CONCLUSION Based on low to very low certainty evidence, adults with CPLBP experienced some benefits in pain, functioning, or HRQoL with NT; however, evidence showed little to no differences for other outcomes.
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Affiliation(s)
- Hainan Yu
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Dan Wang
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Leslie Verville
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Danielle Southerst
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - André Bussières
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - Paulo Pereira
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Silvano Mior
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
- Epidemiology Division and Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Geneva University and University Hospitals, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Ginny Brunton
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- EPPI-Centre, UCL Institute of Education, University College London, London, England, UK
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, NYU Grossman School of Medicine, New York University, New York, USA
| | - Heather M Shearer
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Jessica J Wong
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Gaelan Connell
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Danny Myrtos
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Sophia da Silva-Oolup
- Department of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, Canada
- Department of Graduate Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - James J Young
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Martha Funabashi
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Andrew Romanelli
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Joyce G B Lee
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Kent Stuber
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
- Parker University Research Center, Dallas, USA
| | - Brett Guist
- Department of Graduate Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Javier Muñoz Laguna
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital and University of Zurich, Zurich, Switzerland
| | - Léonie Hofstetter
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital and University of Zurich, Zurich, Switzerland
| | - Kent Murnaghan
- Library and Information Services, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Cesar A Hincapié
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland.
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.
- University Spine Centre Zurich (UWZH), Balgrist University Hospital and University of Zurich, Zurich, Switzerland.
| | - Carol Cancelliere
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
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Xiong ZY, Liu XY, Ma PH, Sun CY, Sun CY, Liu TL, Liu BY, Liu CZ, Yan SY. Placebo Response among Different Types of Sham Acupuncture for Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Chin J Integr Med 2023; 29:941-950. [PMID: 37580465 DOI: 10.1007/s11655-023-3608-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Low back pain (LBP) is a prevalent and debilitating condition that poses a significant burden on healthcare systems. Acupuncture has been proposed as a promising intervention for LBP, but the evidence supporting its specific effect is insufficient, and the use of sham acupuncture as a control in clinical trials presents challenges due to variations in sham acupuncture techniques and the magnitude of the placebo effect. OBJECTIVE To investigate the magnitude of the placebo response of sham acupuncture in trials of acupuncture for nonspecific LBP, and to assess whether different types of sham acupuncture are associated with different responses. METHODS Four databases including PubMed, EMBASE, MEDLINE, and the Cochrane Library were searched through April 15, 2023, and randomized controlled trials (RCTs) were included if they randomized patients with LBP to receive acupuncture or sham acupuncture intervention. The main outcomes included the placebo response in pain intensity, back-specific function and quality of life. Placebo response was defined as the change in these outcome measures from baseline to the end of treatment. Random-effects models were used to synthesize the results, standardized mean differences (SMDs, Hedges'g) were applied to estimate the effect size. RESULTS A total of 18 RCTs with 3,321 patients were included. Sham acupuncture showed a noteworthy pooled placebo response in pain intensity in patients with LBP [SMD -1.43, 95% confidence interval (CI) -1.95 to -0.91, I2=89%]. A significant placebo response was also shown in back-specific functional status (SMD -0.49, 95% CI -0.70 to -0.29, I2=73%), but not in quality of life (SMD 0.34, 95% CI -0.20 to 0.88, I2=84%). Trials in which the sham acupuncture penetrated the skin or performed with regular needles had a significantly higher placebo response in pain intensity reduction, but other factors such as the location of sham acupuncture did not have a significant impact on the placebo response. CONCLUSIONS Sham acupuncture is associated with a large placebo response in pain intensity among patients with LBP. Researchers should also be aware that the types of sham acupuncture applied may potentially impact the evaluation of the efficacy of acupuncture. Nonetheless, considering the nature of placebo response, the effect of other contextual factors cannot be ruled out in this study. (PROSPERO registration No. CRD42022304416).
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Affiliation(s)
- Zhi-Yi Xiong
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Xiao-Yu Liu
- School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Pei-Hong Ma
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Chong-Yang Sun
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Cheng-Yi Sun
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Ting-Lan Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Bao-Yan Liu
- China Academy of Chinese Medical Sciences, Beijing, 100007, China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Shi-Yan Yan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China.
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10
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LI Z, HAN W, SONG X, LI Y, CHEN Y. Electroacupuncture stimulating Zhongji (CV3), Guanyuan (CV4), and bilateral Dahe (KI12) attenuates inflammation in rats with chronic nonbacterial prostatitis induced by estradiol through inhibiting toll-like receptor 4 pathway. J TRADIT CHIN MED 2023; 43:963-972. [PMID: 37679984 PMCID: PMC10465839 DOI: 10.19852/j.cnki.jtcm.20230608.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/15/2022] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To investigate the anti-inflammatory effect of electroacupuncture (EA) on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), also known as chronic nonbacterial prostatitis (CNP), and explore its underlying mechanism. METHODS A CNP rat was established by surgical castration combined with 17-β estradiol injection in male Sprague-Dawley rats for thirty consecutive days. The CNP rats received EA treatment once a day for eight days. Chronic pelvic pain was evaluated by mechanical withdrawal threshold measurement. The histological change was assessed by hematoxylin-eosin staining. The inflammatory cytokines in prostates were determined by enzyme-linked immunosorbent assays. The expressions of toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), inhibitors of kappa-B alpha (IκBα), and nuclear factor-kappa B (NF-κB) were detected by Western blotting. The nuclear translocation of NF-κB and the location of TLR4 were observed with immunofluorescence staining. RESULTS The results showed that EA decreased the prostate index, upregulated the mechanical withdrawal threshold, restored the histomorphology of the prostate, reduced the inflammatory factor levels, inhibited NF-κB p65 nuclear translocation, and downregulated the expression levels of critical proteins involved in the TLR4/NF-κB signaling pathway in prostates. CONCLUSIONS Our findings suggested that EA could relieve pelvic pain and attenuate prostatic inflammation in estradiol-induced CNP rats. The underlying mechanism may be related to the inhibition of the TLR4/NF-κB signaling pathway.
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Affiliation(s)
- Zhihao LI
- 1 Department of Acupuncture-Moxibustion, Tuina and Traumatology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University Shool of Medicine, Shanghai 200233, China
| | - Wenjun HAN
- 3 Department of Andrology, the Seventh People's Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China
| | - Xiuling SONG
- 4 Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yan LI
- 1 Department of Acupuncture-Moxibustion, Tuina and Traumatology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University Shool of Medicine, Shanghai 200233, China
| | - Yuelai CHEN
- 2 Sleep Medical Center, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
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Wu J, Xiong X, Hu X. Electroacupuncture Alleviates Lung Injury in CpG1826-Challenged Mice via Modulating CD39-NLRP3 Pathway. J Inflamm Res 2023; 16:3245-3258. [PMID: 37555014 PMCID: PMC10406113 DOI: 10.2147/jir.s413892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/25/2023] [Indexed: 08/10/2023] Open
Abstract
PURPOSE Cytokine storm secondary lung injury (CSSLI) is the leading death cause in COVID-19 virus infection, and CD39-dominated purinergic brake drives NLRP3 inflammasome activation and pyroptosis, which plays a crucial role in the pathogenesis of CSSLI. Though electroacupuncture (EA) can alleviate lung injury caused by a variety of inducers, its effect on CSSLI and the underlying mechanism needs further investigation. METHODS We established a widely recognized CSSLI mice model with CpG1826 (CpG), a TLR-9 agonist agent. Luminex liquid chip was employed to detect serum levels of 12 cytokines/chemokines to evaluate cytokine storm formation. H+E staining and transmission electron microscope were applied to examine pulmonary pathological injury and alveolar macrophage structure, respectively. IL-1β, IL-18, IL-1α, and HMGB-1 in BAL fluid were determined by ELISA kits. mRNA and protein levels of lung CD39 and NLRP3 were assessed by qRT-PCR and Western blotting. An in vitro model was also established by incubating PMA-differentiated THP-1 cells with serum samples obtained from relevant group of mice. RESULTS Repeated CpG induced CSSLI together with the elevation of 11 cytokines/chemokines including GM-CSF, IL-16, IL-1α, MCP-1, IL-2, IL-10, CCL3, IL-1β, TNF-α, IL-6, and IL-17A, though not IFN-γ, which was reduced by EA pretreatment to a different extent. EA also alleviated lung injury and recovered lung macrophage structure. Moreover, CpG enhanced IL-1β and IL-18 level in BAL fluid, promoted NLRP3, while suppressing CD39 expression in lung, all of which were reversed by EA pretreatment. Of note, EA failed to further decrease BAL fluid IL-1β, IL-18, IL-1α, and HMGB-1 levels when A438079, a selective inhibitor of P2X7, was administered. However, both CD39 and NLRP3 are dispensable for EA decreasing multi-cytokine secretion in serum-incubated and CpG-stimulated THP-1 cells. Taken together, EA alleviated CSSLI in CpG-challenged mice by regulating the CD39-NLRP3 pathway in a P2X7-dependent way. CONCLUSION EA demonstrated potential to be applied in COVID-19 treatment.
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Affiliation(s)
- Jiasi Wu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
| | - Xin Xiong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
| | - Xiumin Hu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
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Jordon M, Grubb M, Tudini F. Duration of Electro-Dry Needling Does Not Change the Pain Response After Repeated Nociceptive Thermal Stimuli in Asymptomatic Individuals: A Randomized Intervention Study. Arch Rehabil Res Clin Transl 2023; 5:100267. [PMID: 37312978 PMCID: PMC10258375 DOI: 10.1016/j.arrct.2023.100267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Objective To assess the effects of 5 different durations of electro-dry needling (EDN) on asymptomatic individuals' pain response after repeated noxious thermal stimuli. Design Randomized, non-controlled intervention trial. Setting University laboratory. Participants Asymptomatic participants (N=50) were recruited for the study and randomized into 5 groups. There were 33 women with an average age of 26.8 (±4.8) years. To participate in the study, individuals had to be between the ages of 18 and 40, free of any musculoskeletal injury which prevented participation of daily activities, and not pregnant or trying to become pregnant. Interventions Participants were randomly assigned to receive 5 different durations of EDN: 10, 15, 20, 25, and 30 minutes. To perform the EDN, 2 monofilament needles were inserted lateral to the lumbar spinous processes of L3 and L5 on the right. Needles were left in situ with electrical stimulation at a frequency of 2 Hz and an amplitude which resulted in a 3 to 6 out of 10 intensity pain rating by the participant. Main Outcome Measures The change in the magnitude of pain in response to repetitive heat-pulses before and after the EDN procedure. Results There was a significant reduction in the magnitude of pain in response across the groups after EDN (F(1,42)=94.12, P<.001, ƞp2=.691). However, the interaction between time and group was not significant (F(4,42)=1.019, P=.409, ƞp2=.088), indicating that no duration of EDN was superior to another in reducing temporal summation. Conclusions This study suggests that in asymptomatic individuals, performing EDN beyond 10 minutes does not provide any additional benefits in the reduction of the magnitude of pain in response to thermal nociceptive stimuli. Additional study in symptomatic populations is required for generalizability in clinical settings.
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Affiliation(s)
- Max Jordon
- Department of Physical Therapy, University of Tennessee at Chattanooga, Chattanooga, TN
| | - Matthew Grubb
- Department of Physical Therapy, University of Tennessee at Chattanooga, Chattanooga, TN
| | - Frank Tudini
- Department of Physical Therapy, University of Tennessee at Chattanooga, Chattanooga, TN
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Wang Y, Chen N, Guo K, Li Y, E F, Yang C, Shang X, Li X, Yang K. Reporting and methodological quality of acupuncture network meta-analyses could be improved: an evidence mapping. J Clin Epidemiol 2023; 153:1-12. [PMID: 36351510 DOI: 10.1016/j.jclinepi.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/11/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES To evaluate and map the reporting and methodological quality of network meta-analysis (NMA) on acupuncture. METHODS Published acupuncture NMAs were searched through eight databases from inception to February 2022. The reporting and methodological quality of included studies was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Network Meta-Analysis (PRISMA-NMA) statement and the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) checklist. RESULTS A total of 113 NMAs were identified. Most (99, 87.61%) studies were performed in China. Most studies focused on multiple acupuncture techniques (82.30%), and the main studied ailments were pain and poststroke sequelae (20.24%). The median (interquartile range (IQR)) score of the reporting quality was 26.5 (25-28.5). However, poor reporting rates in the protocol and registration (33.63%) and geometry of the network (35.40%), especially for China-based studies, were identified. The methodological quality of only 2 (1.77%) English studies was high. The reporting rate of Chinese studies was below 15% on each of items 4, 7, 10, and 12. CONCLUSION The reporting quality of the NMAs was moderate, but the methodological quality was very low. The reporting and methodological quality of future NMAs, especially for Chinese studies, need further improvement.
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Affiliation(s)
- Yan Wang
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Nan Chen
- Research and Education Department, Shaanxi Provincial Rehabilitation Hospital, Xi'an, China
| | - Kangle Guo
- Gansu Provincial Hospital, Lanzhou, China
| | - Yanfei Li
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Fenfen E
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Chaoqun Yang
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xue Shang
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xiuxia Li
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
| | - Kehu Yang
- Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
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14
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Meng XY, Bu L, Chen JY, Liu QJ, Sun L, Li XL, Wu FX. Comparative effectiveness of electroacupuncture VS neuromuscular electrical stimulation in the treatment of chronic low back pain in active-duty personals: A single-center, randomized control study. Front Neurol 2022; 13:945210. [PMID: 36176555 PMCID: PMC9513143 DOI: 10.3389/fneur.2022.945210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/10/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Low back pain (LBP) is the most prevalent form of chronic pain in active-duty military personnel worldwide. Electroacupuncture (EA) and neuromuscular electrical stimulation (NMES) are the two most widely used treatment methods in the military, while evidence for their benefits is lacking. The aim of this randomized clinical trial is to investigate the effectiveness of EA vs. NMES in reducing pain intensity among active-duty navy personals with chronic LBP. Methods The study is designed as a single-center, randomized controlled trial. The primary outcome is a positive categorical response for treatment success in the first-time follow-up, which is predesignated as a two-point or greater decrease in the NRS score and combined with a score > 3 on the treatment satisfaction scale. The secondary outcomes include pain intensity, rate of treatment success, and Oswestry Disability Index (ODI) fear-avoidance beliefs questionnaire (FABQ) score along with muscular performance. The first follow-up starts on the first day after completing the last treatment session, and then the 4-weeks and 12-weeks follow-up are applied via telephone visit. Results Eighty-five subjects complete the treatment diagram and are included in the analysis. For the primary outcome, no difference has been found between EA and NMES, with 65.1% (28 in 43) individuals reporting a positive response to EA treatment, while 53.5% (23 in 43) in NMES. However, for longer follow-ups, superiority in positive response of EA has been found in 4-weeks (26 in 39, 66.7% vs. 16 in 40, 40%; P = 0.018) and 12-weeks (24 in 36, 66.7% vs. 12 in 36, 33.3%; P = 0.005) follow-up. In the regression analysis, baseline pain intensity and FABQ score are identified to be highly associated with positive treatment outcomes. Finally, the subgroup analysis suggests that EA treatment is associated with better long-term outcomes in patients with LBP with a severe pain score (NRS score >4, Figure 4B) and stronger fear-avoidance beliefs. Conclusion Both the EA and NMES are associated with a positive response in treating military LBP, and the former offers lasting benefits in the later follow-ups. Thus, electroacupuncture is a more recommended treatment for military LBP. A lot of research is needed to verify an efficient and standardized treatment session, with more information and evidence about indications for these treatments. Trial registration ChiCTR, (ChiCTR2100043726); registered February 27, 2021.
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Affiliation(s)
- Xiao-yan Meng
- Department of Critical Care Medicine, Eastern Hepatobiliary Surgery Hospital, Navel Medical University, Shanghai, China
| | - Lan Bu
- Department of Anesthesiology and Pain Center, Shanghai Changhai Hospital, Navel Medical University, Shanghai, China
| | - Jia-ying Chen
- Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, Navel Medical University, Shanghai, China
| | - Qiu-jia Liu
- Department of Traditional Chinese Medicine, Shanghai Changhai Hospital, Navel Medical University, Shanghai, China
| | - Li Sun
- Department of Anesthesiology and Pain Center, Shanghai Changhai Hospital, Navel Medical University, Shanghai, China
| | - Xiao-long Li
- Department of Spinal Surgery, Shanghai Changhai Hospital, Navel Medical University, Shanghai, China
- Xiao-long Li
| | - Fei-xiang Wu
- Department of Critical Care Medicine, Eastern Hepatobiliary Surgery Hospital, Navel Medical University, Shanghai, China
- *Correspondence: Fei-xiang Wu
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15
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Zhang Y, Yang G, Wei J, Chen F, Zhang MZ, Mao S. Prospective comparison of acupuncture with sham acupuncture to determine impact on sedation and analgesia in mechanically ventilated critically ill patients (PASSION study): protocol for a randomised controlled trial. BMJ Open 2022; 12:e059741. [PMID: 36041767 PMCID: PMC9438044 DOI: 10.1136/bmjopen-2021-059741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Sedation and analgesia are recommended to be employed in the intensive care unit (ICU) to enhance patient comfort and safety, facilitate mechanical ventilation and reduce oxygen demands. However, the increasing evidence demonstrates that excessive sedation and analgesia might prolong mechanical ventilation and increase costs and mortality. Acupuncture is known to be able to attenuate pain, anxiety and agitation symptoms while avoiding excessive sedation and analgesia caused by drugs. Therefore, we present a protocol to investigate whether acupuncture, used for sedation and analgesia, can reduce the duration of mechanical ventilation, save medical resources and reduce the mortality of critically ill patients receiving mechanical ventilation. METHODS AND ANALYSIS Prospective, randomised controlled trial is conducted on 180 adult medical/surgical ICU patients with mechanical ventilation needing sedation at 3 ICUs between 03 November 2021 and 16 August 2023. Patients will be treated with analgesia and sedation to achieve desired target sedation levels (Richmond Agitation Sedation Score of -2 to 1). Enrolled patients will be randomly assigned in a ratio of 1:1:1 to receive deep needle insertion with combined manual and alternating-mode electrical stimulation on acupoints (AC group), superficial needle insertion without manual stimulation and electrical stimulation on non-acupoints (SAC group), or no acupuncture intervention (NAC group). The primary outcome is the duration of mechanical ventilation from randomisation until patients are free of mechanical ventilation (including non-invasive) without reinstitution for the following 48 hours. Secondary endpoints include the dose of administered sedatives and analgesic at comparable sedation levels throughout the study, ICU length of stay, hospital length of stay. Additional outcomes include the prevalence and days of delirium in ICU, mortality in ICU and within 28 days after randomisation, and the number of ventilator free days in 28 days. ETHICS AND DISSEMINATION This trial was approved by the ethics committee at Guangdong Provincial Hospital of Chinese Medicine. We will publish the study results. TRIAL REGISTRATION NUMBER ChiCTR2100052650.
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Affiliation(s)
- Yuzhuo Zhang
- Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guang Yang
- Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinyi Wei
- Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fangliang Chen
- Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Min-Zhou Zhang
- Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shuai Mao
- Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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16
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Wang LX, Li WH, He F. Efficacy and Safety of Electroacupuncture in the Treatment of Cerebral Infarction: Systematic Review and Meta-Analysis. Appl Bionics Biomech 2022; 2022:1350501. [PMID: 35800118 PMCID: PMC9256421 DOI: 10.1155/2022/1350501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/02/2022] [Accepted: 06/04/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The goal of this study was to see if electroacupuncture was effective and safe in the management of cerebral infarction. PubMed, Embase, Cochrane Library, and Web of Science were used to conduct a comprehensive literature survey. Methods Basic features of 7 studies were identified using the searching strategy. The investigation was found in PubMed, Embase, and Web of Science, with the most recent search being in March 2022. "Electroacupuncture," "cerebral infarction," and their permutations were among the MeSH terms and free words used. As literature, two reviewers independently used a standardized form to gather pertinent data from qualifying research. Results 157 literatures were identified and evaluated. Electroacupuncture improved the BI score in individuals with cerebral infarction (mean difference = 0.10, 95 percent CI: 0.00-0.20, p = 0.04). Electroacupuncture enhanced BI score in individuals with cerebral infarction (mean difference = 0.10, 95 percent CI: 0.00-0.20, p = 0.04). The effects of electroacupuncture increased Fugl-Meyer index in patients with cerebral infarction (mean difference = 25.92, 95% CI: 25.28-26.56, p < 0.00001). Electroacupuncture effects decreased CSS in patients with cerebral infarction in the experiment group (mean difference = -2.10, 95% CI: -2.53--1.67, p < 0.0001). Electroacupuncture also reduced CSS individuals with cerebral infarction in the control group; however, there was no statistically significant (risk difference = 0.06, 95 percent CI: 0.02-0.13, p = 0.12). Conclusion This study demonstrated that electroacupuncture helped decreased CSS in patients with cerebral infarction.
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Affiliation(s)
- Lan Xiang Wang
- Department of Rehabilitation Medicine, The 8th Medical Center of Chinese PLA General Hospital, China
| | - Wei Hong Li
- Beijing University of Chinese Medicine, China
| | - Fang He
- Department of Outpatient, The 8th Medical Center of Chinese PLA General Hospital, China
- Jia NO2 Niangniang Mansion, Xiangshan Road, Haidian District, Beijing 100093, China
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He K, Zhan M, Li X, Wu L, Liang K, Ma R. A Bibliometric of Trends on Acupuncture Research About Migraine: Quantitative and Qualitative Analyses. J Pain Res 2022; 15:1257-1269. [PMID: 35509621 PMCID: PMC9059996 DOI: 10.2147/jpr.s361652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/11/2022] [Indexed: 12/18/2022] Open
Affiliation(s)
- Kelin He
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, the Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Mingjie Zhan
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
| | - Xinyun Li
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, the Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Lei Wu
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, the Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Kang Liang
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
| | - Ruijie Ma
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, the Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
- Correspondence: Ruijie Ma, Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), No. 219 Moganshan Road, Xihu District, Hangzhou, Zhejiang, People’s Republic of China, Email
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Error in Conflict of Interest. JAMA Netw Open 2022; 5:e229687. [PMID: 35385098 PMCID: PMC8987897 DOI: 10.1001/jamanetworkopen.2022.9687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lara-Palomo IC, Gil-Martínez E, Antequera-Soler E, Castro-Sánchez AM, Fernández-Sánchez M, García-López H. Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Trials 2022; 23:238. [PMID: 35346331 PMCID: PMC8961901 DOI: 10.1186/s13063-022-06179-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Chronic low back pain is considered to be one of the main causes of absenteeism from work and primary and specialized consultations. The symptoms of nonspecific chronic low back pain may be accompanied by the activation of myofascial trigger points in the muscles, together with local and/or referred pain. Electrical dry needling is increasingly used in the treatment of lumbar myofascial pain. Conventional physiotherapy, however, is a popular approach to chronic pathologies, and there is evidence of different modalities of physiotherapy being used in the treatment of chronic low back pain. The aim of this study has been to determine the effectiveness of electrical dry needling versus conventional physiotherapy when applied to active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Methods This is a controlled, randomized, two-arm, double-blind study. A total of 92 patients with chronic low back pain (time to onset ≥ 3 months, Roland Morris Disability Questionnaire score ≥ 4) will be recruited from the University of Almería. Participants will be divided into two study groups (n = 40) to receive treatment of low back pain with electrical dry needling and conventional physiotherapy (ischaemic compression, analytic stretching and postural education training dossier). A total of 6 sessions will be administered once a week for 6 weeks. Pain intensity, disability, fear of movement, quality of life, quality of sleep, anxiety and depression, pressure pain threshold, abdominal strength and lumbar mobility will be recorded at 6 weeks (post-immediate) and 2 months after the end of treatment. Discussion We believe that an approach including electrical dry needling to chronic low back pain dysfunction will be more effective in these patients. The results of this study will inform clinicians on which type of treatment is more beneficial for patients with chronic low back pain. Trial registration ClinicalTrials.gov NCT04804228. Registered on 14 January 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06179-y.
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Affiliation(s)
- Inmaculada Carmen Lara-Palomo
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain.
| | - Esther Gil-Martínez
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain
| | - Eduardo Antequera-Soler
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain
| | - Adelaida María Castro-Sánchez
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain
| | - Manuel Fernández-Sánchez
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain
| | - Héctor García-López
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Ctra. Sacramento s/n La Cañada de San Urbano, 04120, Almeria, Spain
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20
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Zhu J, Li S, Wu W, Guo J, Wang X, Yang G, Lu Z, Ji F, Zou R, Zheng Z, Zheng M. Preoperative electroacupuncture for postoperative nausea and vomiting in laparoscopic gynecological surgery: a randomized controlled trial. Acupunct Med 2022; 40:415-424. [PMID: 35229627 DOI: 10.1177/09645284221076517] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: We aimed to evaluate the effectiveness and safety of preoperative electroacupuncture (EA) on the incidence of postoperative nausea and vomiting (PONV), and severity of postoperative pain, in gynecological patients undergoing laparoscopic surgery. The effects of EA administered at different preoperative time points were compared. Methods: A total of 413 patients undergoing elective laparoscopic gynecological surgery were randomly allocated into 4 groups receiving EA the day before surgery (Group Pre, n = 103), 30 min before (Group 30, n = 104) or both (Group Comb, n = 103), or usual care alone (Group Usual, n = 103). All acupuncture groups had usual care. The incidence of PONV and pain at 24 h were primary outcomes. Secondary outcomes included the severity of postoperative nausea, vomiting and pain, requirement for antiemetic medication and quality of recovery (QoR)-15 scores after surgery. Results: There were significant differences between the four groups in nausea and vomiting incidence (0–24 h), postoperative antiemetic use (0–48 h), and postoperative pain (0–6 h), with the EA groups recording the lowest levels. Regarding primary outcomes, incidence of nausea and vomiting at 6-24 h was 28/11/18/11% (p = 0.003) 23/5/8/9% (p < 0.001), respectively, for Groups Usual/Pre/30/Comb. Accordingly, EA reduced the incidence of nausea and vomiting at 6-24 h by 61/34/60% and 79/65/61% for Groups Pre/30/Comb, respectively. Regarding secondary outcomes, incidence of nausea and vomiting at 0-6 h was 20/9/11/7% (p = 0.013) and 17/7/9/6% (p = 0.021), respectively, for Groups Usual/Pre/30/Comb. Rescue antiemetics at 0–6 h were required by 18/4/11/4% (p = 0.001) in Groups Usual/Pre/30/Comb. The mean numerical rating scale (NRS) pain score (0–10) at 0–6 h was significantly different between groups (2.45/1.89/2.01/1.97 for Groups Usual/Pre/30/Comb, p = 0.024). There were no significant differences between the three EA-treated groups. Conclusion: In gynecological patients undergoing laparoscopic surgery and treated with multimodal antiemetic methods, one session of preoperative EA may be a safe adjunctive treatment for PONV prophylaxis. Optimal timing of EA requires further verification. Trial registration number: ChiCTR-INR-16010035 (Chinese Clinical Trial Registry).
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Affiliation(s)
- Juan Zhu
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Sha Li
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenzhong Wu
- Department of Acupuncture, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Guo
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiaoqiu Wang
- Department of Acupuncture, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Guang Yang
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhigang Lu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Fangbing Ji
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Rong Zou
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhen Zheng
- Discipline of Chinese Medicine, School of Health and Biomedical Sciences, World Health Organization Collaborating Centre for Traditional Medicine, RMIT University, Melbourne, VIC, Australia
| | - Man Zheng
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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21
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Progress on the Experimental Research of Sciatic Nerve Injury with Acupuncture. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2021:1401756. [PMID: 34976092 PMCID: PMC8718293 DOI: 10.1155/2021/1401756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
Objective To collect and summarize relevant literatures on the experimental researches of sciatic nerve injury (SNI) with acupuncture during the last decade providing a guideline for effectively treating SNI with acupuncture in the future. Methods The Chinese and English databases including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (WanFang Data), VIP Information Chinese Journal Service Platform (VIP Date), and PubMed were searched from 2009 to 2020 with keywords of “acupuncture and moxibustion OR acupuncture OR electroacupuncture OR scalp acupuncture OR wrist-ankle acupuncture OR acupoint injection OR ear acupuncture” AND “sciatic nerve OR sciatic nerve injury OR sciatic injury OR SNI.” The collected data were mainly evaluated in the items of animal model of SNI, type of interventions, selection of acupuncture points (acupoints), course of treatment and its frequency, and approaches of assessment. Results A total of 89 studies were included in this analysis. Among them, the most commonly used animal models of SNI were produced by the clamp or transverse injury in the rats; the most frequently used intervention was electroacupuncture with dilatational wave of 2/100 Hz; the frequency of acupuncture was mainly performed once per day lasting for more than 2 weeks; the mainly selected acupoints were Huantiao (GB30), Zusanli (ST36), and Yanglingquan (GB34); and the approaches of assessment were contained with behavioral, functional, morphological, histological, cellular, and molecular measurements. Conclusion The results indicated that the experimental researches of SNI with acupuncture has made marked progress in recent years, which may provide important clues for further investigating the underlying mechanisms of acupuncture for the treatment of SNI in the future.
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22
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Zhang Z, Cai X, Liang Y, Zhang R, Liu X, Lu L, Huang Y. Electroacupuncture as a rapid-onset and safer complementary therapy for depression: A systematic review and meta-analysis. Front Psychiatry 2022; 13:1012606. [PMID: 36684018 PMCID: PMC9853905 DOI: 10.3389/fpsyt.2022.1012606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Electroacupuncture (EA) is a promising therapy for depression. However, a comprehensive review of EA for depression is needed. METHODS We conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA 2020) guidelines to evaluate the efficacy and safety of EA for depression. Potentially relevant trials and reviews were searched in MEDLINE, EMBASE, PsycINFO, and CENTRAL from inception to March 2022. EA alone and combined with other therapy were eligible for inclusion. The severity of depression during and after treatment and the number of adverse events were assessed as outcomes. Risk of bias (ROB) evaluation, subgroup analysis, sensitivity analysis, reporting bias assessment, and GRADE system evaluation were also conducted. RESULTS Thirty-four trials were included. The overall ROB was medium. Low-quality evidence showed that the efficacy of EA was not less than that of antidepressants [EA + selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs)] and manual acupuncture (MA). EA and EA + SSRIs had better efficacy than SSRIs alone in decreasing the severity of depression during the early treatment. Moderate-quality evidence also showed that EA and EA + SSRIs were safer than SSRIs alone. Sensitivity analysis was mostly not feasible. Major publication bias was unlikely. CONCLUSION These results indicate that the efficacy of EA is not less than that of antidepressants and MA. Moreover, EA and EA + SSRI treatments show a more rapid onset and greater safety than SSRIs. More high-quality trials are needed for further confirmation. SYSTEMATIC REVIEW REGISTRATION [www.crd.york.ac.uk/prospero/display_ record.php?RecordID=329143], identifier [CRD42022329143].
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Affiliation(s)
- Zhinan Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaowen Cai
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuying Liang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Rui Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Xinyu Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Liming Lu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
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Li X, Wei W, Wang Y, Wang Q, Liu Z. Touching-bone acupuncture in the treatment of chronic pain: A protocol for an overview of systematic reviews and meta-analysis. Medicine (Baltimore) 2021; 100:e27195. [PMID: 34797271 PMCID: PMC8601311 DOI: 10.1097/md.0000000000027195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Chronic pain is the most common disease in the world, which lead the patients to suffer the disability both physically and psychologically. The chronic pain can affects the patients to work, socialize, sleep and can lead to depressive illness, decreased motivation, and a reduction in physical activity. Acupuncture is a promising treatment for the chronic pain which has a long history of use in China. This protocol aims to assess the effectiveness and safety of touching periosteum acupuncture therapy on patients with chronic pain. METHODS Randomized controlled trial literatures which include touching periosteum acupuncture therapy for treating chronic pain will be searched from 8 electronic databases including China Biology Medicine disc, VIP database, WanFang database, China National Knowledge Infrastructure, PubMed, Cochrane Library, Excerpt Medical Database, and Web of Science. The language will be restricted to Chinese and English. The primary outcome is to measure the relief of the pain by Visual Analogue Scale. Two or 3 reviewers will conduct the study selection, data extraction and the evaluation of the risk of bias. RevMan software (V.5.3) will be used to perform the assessment of the risk of bias and data synthesis. RESULTS From this study, we will confirm the effectiveness of safety of in the treatment of chronic pain. CONCLUSIONS We will ascertain the effectiveness of safety of touching periosteum acupuncture therapy in the treatment of chronic pain, to provide evidence to guide touching periosteum acupuncture therapy for patients with chronic pain in the future. ETHICS AND DISSEMINATION Ethics approval will not be necessary, because the included publications in our study are all from published articles. This systematic review will be published in a peer-reviewed journal or conference report to provide a reference in this field. TRIAL REGISTRATION CRD42021243387.
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Affiliation(s)
- Xiaoping Li
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wan Wei
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuan Wang
- Innovation Research Center of Acupuncture and Medicine, Shaanxi University of Chinese Medicine, Qindu District, Xianyang, Shaanxi, China
- Shaanxi Key Laboratory of Acupuncture and Medicine, Qindu District, Xianyang, Shaanxi, China
| | - Qiang Wang
- Innovation Research Center of Acupuncture and Medicine, Shaanxi University of Chinese Medicine, Qindu District, Xianyang, Shaanxi, China
- Shaanxi Key Laboratory of Acupuncture and Medicine, Qindu District, Xianyang, Shaanxi, China
| | - Zhibin Liu
- Innovation Research Center of Acupuncture and Medicine, Shaanxi University of Chinese Medicine, Qindu District, Xianyang, Shaanxi, China
- Shaanxi Key Laboratory of Acupuncture and Medicine, Qindu District, Xianyang, Shaanxi, China
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Li B, Chen L, Wang D. Effect of Electroacupuncture Combined with Guizhi Gegen Decoction on Cervical Vertigo and Its Influence on TCD of Vertebrobasilar Artery, Blood Rheology Indexes, and Quality of Life. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:2676485. [PMID: 34567207 PMCID: PMC8457937 DOI: 10.1155/2021/2676485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/31/2021] [Indexed: 11/18/2022]
Abstract
Cervical vertigo is a common clinical disease. In this study, we investigated the clinical efficacy of adding the treatment protocol of Gui Zhi Ge Gen Tang and electroacupuncture to the Western medical treatment in cervical vertigo. The results showed that the total effective rate of the study group was higher than that of the control group (P < 0.05). After treatment, the vertigo, headache, neck and shoulder pain, daily life and work, and psychological and social adjustment scores were higher in the study group than in the control group (P < 0.05). LVA, RVA, and VB were higher in the study group than in the control group after treatment (P < 0.05). The whole blood viscosity high cut, whole blood viscosity low cut, and plasma viscosity levels were lower in the study group than in the control group after treatment (P < 0.05). After treatment, PF, RF, RE, BP, GH, VT, SF, MH, and HT were higher in the study group than those before treatment (P < 0.05). The incidence of adverse reactions was not statistically significant in the study group compared with the control group (P > 0.05). This means that electroacupuncture combined with Gui Zhi Ge Gen Tang can effectively increase the blood flow velocity of the vertebrobasilar artery in patients with cervical vertigo and improve their blood rheology and quality of life with definite efficacy and high safety.
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Affiliation(s)
- Bo Li
- Combined Chinese and Western Medicine Division, Tianjin First Central Hospital, Tianjin 300192, China
| | - Li Chen
- Combined Chinese and Western Medicine Division, Tianjin First Central Hospital, Tianjin 300192, China
| | - Dongqiang Wang
- Combined Chinese and Western Medicine Division, Tianjin First Central Hospital, Tianjin 300192, China
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Park KH, Jeon CH, Chung NS, Lee HD. Rapid Progression to Complete Paraplegia After Electroacupuncture in a Patient With Spinal Dural Arteriovenous Fistula: A Case Report. Front Surg 2021; 8:645884. [PMID: 34513911 PMCID: PMC8429830 DOI: 10.3389/fsurg.2021.645884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 07/30/2021] [Indexed: 11/16/2022] Open
Abstract
Spinal dural arteriovenous fistula (SDAVF) usually has an insidious clinical course, but 5–15% of the cases have acute exacerbations. In some cases, there is an abrupt progression to paraplegia following an epidural injection or anesthesia. Electroacupuncture is a form of acupuncture that applies a small electrical current to needles inserted at specific points in the body. It is widely used for its analgesic effect on back pain. In this study, we report a rare case of SDAVF in which the symptoms of a patient worsened rapidly to complete paraplegia within a few hours after applying electroacupuncture to his back. A 49-year-old man had rapid progression to complete paraplegia within a few hours of electroacupuncture on his back. MRI showed SDAVF and worsening of cord signal change. An emergency operation was performed to ligate the SDAVF. The patient was able to walk 1 month post-operatively. Most of the neurological deficits had disappeared by 1 year post-operatively, with normalization of MRI. Our case emphasizes that SDAVF patients should be careful when exposed to any circumstances that might affect the circulation around the dural arteriovenous fistula, such as electroacupuncture. Patients should also be warned in advance about the possibility of rapid exacerbation of neurological symptoms. Regardless of the severity of the neurological symptoms, immediate treatment is essential for recovery and a better outcome.
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Affiliation(s)
- Ki-Hoon Park
- Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, South Korea
| | - Chang-Hoon Jeon
- Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, South Korea
| | - Nam-Su Chung
- Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, South Korea
| | - Han-Dong Lee
- Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, South Korea
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Kong JT. Electroacupuncture for Treating Chronic Low-Back Pain: Preliminary Research Results. Med Acupunct 2020; 32:396-397. [PMID: 33362897 DOI: 10.1089/acu.2020.1495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This report, prepared by a lead researcher, describes 2 independent, but similarly designed, clinical trials that were conducted to investigate the effectiveness, mechanisms, and predictors of electroacupuncture (EA) for treating chronic low-back pain (CLBP). Both trials recruited adults (ages 21-65) who had CLBP with an intensity ≥4/10 and a duration ≥6 months. Verum EA or sham EA was administered twice per week for 6-8 weeks. The common outcome between the 2 studies was the patients' responses to the Roland Morris Disability Questionnaire. Using least absolute shrinkage and selection operator (LASSO), the authors were able to predict clinical outcome in the second study by using a prediction model based on data from the first study. This work demonstrated the feasibility of predicting clinical outcomes when using acupuncture for treating CLBP.
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Affiliation(s)
- Jiang-Ti Kong
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
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