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Wei L, Han H, Meng J, Li X, Yao QP. Meta-analysis and sequential analysis of acupuncture compared to carbamazepine in the treatment of trigeminal neuralgia. World J Clin Cases 2024; 12:5083-5093. [DOI: 10.12998/wjcc.v12.i22.5083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/24/2024] [Accepted: 06/11/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND In this randomized controlled trial (RCT) comparing current acupuncture with carbamazepine for trigeminal neuralgia, meta- and sequential analyses were utilized.
AIM To guide clinical decision making regarding the treatment of trigeminal neuralgia with carbamazepine.
METHODS The RCT literature on needle comparison was searched in various Chinese biomedical databases including Chinese Biomedical Literature Database, Wanfang Data, VIP Database, as well as international databases such as Excerpt Medica Database, Cochrane Library, PubMed, and Web of Science, along with related clinical registration platforms such as World Health Organization International Clinical Trial Registry Platform, ChiCTR, and Clinical Trials up to 1 April 2020. Risk of bias was evaluated using the Cochrane Collaborative Risk Bias tool, primary outcome measures (pain reduction) were analyzed using STATA meta-analysis, outcome measures were analyzed using trial sequential analysis 0.9.5.10 Beta sequential analysis, GRADE was used to assess the evidence, and adverse reactions were documented.
RESULTS This study analyzed 16 RCTs with a total of 1231 participants. The meta-analysis revealed a statistically significant difference in pain reduction between acupuncture and carbamazepine [standardized mean difference (SMD) = 1.47; 95% confidence interval (CI): 0.99-1.95], although the quality of evidence was deemed to be of extremely low quality. Cumulative meta-analysis based on the year of publication indicated that carbamazepine treatment first demonstrated a statistically significant difference in pain reduction in 2014 and remained relatively stable over time [SMD = 1.84; 95%CI: 0.22-3.47]. Additionally, the number of adverse events associated with acupuncture was significantly lower compared to carbamazepine.
CONCLUSION Acupuncture for trigeminal neuralgia is better than analgesia and safer than carbamazepine; however, firm conclusions still require a high-quality, multicenter, large-sample RCT to confirm these findings.
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Affiliation(s)
- Li Wei
- Department of Encephalopathy, Tianjin Beichen Traditional Chinese Medicine Hospital, Tianjin 300400, China
| | - Hui Han
- Department of Encephalopathy, Tianjin Beichen Traditional Chinese Medicine Hospital, Tianjin 300400, China
| | - Jie Meng
- Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Xin Li
- Bio-engineering Institute, Tianjin Modern Vocational Technology College, Tianjin 300350, China
| | - Qing-Ping Yao
- Department of Encephalopathy, Tianjin Beichen Traditional Chinese Medicine Hospital, Tianjin 300400, China
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Pergolizzi JV, LeQuang JA, El-Tallawy SN, Wagner M, Ahmed RS, Varrassi G. An update on pharmacotherapy for trigeminal neuralgia. Expert Rev Neurother 2024; 24:773-786. [PMID: 38870050 DOI: 10.1080/14737175.2024.2365946] [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: 03/28/2024] [Accepted: 06/05/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Trigeminal neuralgia is a rare condition that can be effectively treated by carbamazepine or oxcarbazepine but these older drugs are associated with dose-dependent and potentially treatment-limiting adverse effects. Third-generation anticonvulsants, new calcitonin gene-related peptide blockers for migraine, and older drugs such as ketamine and cannabinoids may be promising adjuvants or monotherapeutic options. AREAS COVERED The new drugs, their presumed mechanisms of action, safety and efficacy are discussed herein. There is a paucity of robust clinical evidence in support of these drugs for trigeminal neuralgia. New migraine agents are considered as well although migraines and trigeminal neuralgia are distinct, albeit similar, conditions. No new drugs have been released to market in recent years with the specific indication of trigeminal neuralgia. EXPERT OPINION In real-world clinical practice, about half of trigeminal neuralgia patients take more than one agent for prevention and combination therapy may be the optimal approach. Combination therapy might allow for lower doses of carbamazepine or oxcarbazepine, thus reducing the number and severity of potential adverse events but the potential for pharmacokinetic drug-drug interactions must be considered. Drug therapy for trigeminal neuralgia involves acute or abortive treatments, often administered in hospital versus long-term preventive therapy, usually involving oral agents.
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Affiliation(s)
| | | | - Salah N El-Tallawy
- Anesthesia and Pain Department, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Anesthesia Department, Medicine, Minia University & NCI, Minia, Egypt
| | | | - Rania S Ahmed
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Su SH, Lai PF, Yu HY, Chen KC, Wu K, Huang CK, Tseng WC, Lai CY, Huang CP, Ho TJ. Application of acupuncture in the emergency department for patients with ileus: A pilot prospective cohort clinical study. Medicine (Baltimore) 2022; 101:e31245. [PMID: 36316877 PMCID: PMC9622632 DOI: 10.1097/md.0000000000031245] [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] [Indexed: 11/07/2022] Open
Abstract
Acupuncture can be conveniently used for pain control in patients with a variety of conditions, and it has obvious effects on various acute pains. In 2018, we implemented a program for emergency treatment with Chinese medicine to promote the integration of Chinese and Western medicine at the Emergency Department (ED). Ileus is a common cause of abdominal pain among patients in the ED, and it is an indication for emergency treatment with Chinese medicine. This study investigated the efficacy of acupuncture as a traditional Chinese medicine (TCM)-based treatment method for the treatment of patients with ileus in the ED. We analyzed data of patients with ileus, who visited ED between January and December 2019, and compared the length of ED stay between the Western medicine group and the Western medicine plus acupuncture group. Furthermore, pain intensity was measured by a visual analogue scale before and after acupuncture. We found that the length of ED stay was 10.8 hours lesser in the Western medicine plus acupuncture group than in the Western medicine group (P = .04), and the visual analogue scale score decreased by 2.0 on average from before to after acupuncture treatment (P = .02). Acupuncture treatment was effective and rapid in relieving the symptoms and discomfort in patients with ileus and in reducing their length of stay in the ED.
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Affiliation(s)
- San-Hua Su
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Pei-Fang Lai
- Department of Emergency Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Hsin-Yuan Yu
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Kun-Chuan Chen
- Department of Emergency Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Kari Wu
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Chih-Kai Huang
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Wei-Chun Tseng
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Chun-Yu Lai
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Chun-Ping Huang
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Tsung-Jung Ho
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
- * Correspondence: Tsung-Jung Ho, Department of Chinese Medicine, Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan, ROC Taiwan (e-mail: )
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He K, Hu R, Huang Y, Qiu B, Chen Q, Ma R. Effects of Acupuncture on Neuropathic Pain Induced by Spinal Cord Injury: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:6297484. [PMID: 36034938 PMCID: PMC9417762 DOI: 10.1155/2022/6297484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 06/13/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022]
Abstract
Introduction Neuropathic pain is a commonly seen symptom and one of the most intractable comorbidities following spinal cord injury (SCI). Acupuncture has been widely used for neuropathic pain after SCI in clinical settings. There is no systematic review or meta-analysis evaluating the efficacy of acupuncture in the treatment of SCI-induced neuropathic pain. Thus, this study aimed to conduct a systematic review and meta-analysis to assess the efficacy of acupuncture on SCI-induced neuropathic pain. Methods Seven databases were comprehensively searched, including PubMed, the Cochrane Library, the Web of Science, the China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Service System (SinoMed), the Wanfang Database, and the Chinese Scientific Journals Database (VIP) from their inception to 30 September 2021. Two independent reviewers evaluated the eligibility of the data retrieved based on the pre-established eligibility criteria and assessed the methodological quality of the included studies using the Cochrane Risk of Bias Tool. The outcome indexes in this study included the visual analogue scale, the numeric rating scale, the present pain intensity, and the pain region index. Sensitivity and subgroup analyses were also performed to specifically evaluate the intervention effects. In addition, publication bias was analyzed. Results Six randomized controlled trials (145 participants in the experimental groups and 141 participants in the control groups) were identified that evaluated the application of acupuncture for neuropathic pain after SCI and were included in this study. The results of our study revealed that acupuncture had a positive effect on the pain severity (standardized mean difference (SMD): -1.40, 95% confidence interval (CI): -2.23; -0.57), the present pain intensity (MD = -0.61, 95% CIs = -0.98; -0.23), and the pain region index (MD = -3.04, 95% CI = -3.98; -2.11). In addition, sensitivity analyses showed that these results were robust and stable. Subgroup analyses indicated that electroacupuncture (EA) had better effects on SCI-induced neuropathic pain. However, a publication bias was observed. Conclusion Available evidence appears to suggest that acupuncture may have a role in SCI-induced neuropathic pain management, but this remains to be determined.
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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, 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, China
| | - Rong Hu
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, 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, China
| | - Yi Huang
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, 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, China
| | - Bei Qiu
- 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, China
| | - Qinqin Chen
- 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, China
| | - Ruijie Ma
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, 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, China
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Acupuncture and Moxibustion for Peripheral Neuropathic Pain: A Frequentist Network Meta-Analysis and Cost-Effectiveness Evaluation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6886465. [PMID: 35341147 PMCID: PMC8942664 DOI: 10.1155/2022/6886465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 02/17/2022] [Indexed: 01/27/2023]
Abstract
Purpose Acupuncture and moxibustion techniques have been increasingly used to treat peripheral neuropathic pain (PNP). However, there is a paucity of comparative information and cost-effectiveness assessment for techniques on PNP management. Patients and Methods. Randomized controlled trials studying the acupuncture or moxibustion treatments on PNP were identified from electronic databases. The quality of the included studies and the potential risk of bias was evaluated using the ROB 2.0 assessment tool. The primary outcome was at least 20% pain relief. The treatment effects were pooled through a frequentist-based network meta approach. Subsequently, the cost-effectiveness measured by incremental cost per additional responder (ICPR) was calculated. Results One three-arm trial and 15 two-arm trials comprising 1308 participants that satisfy the eligibility criteria were identified. Among the included studies, 12.5% were at low risk of bias, 68.75% had some concerns about the risk of bias, and 18.75% were at high risk of bias. The major sources of bias originated from the randomization processes of the studies. The patients were assigned to seven different acupuncture or moxibustion interventions and two pharmaceutical treatments. Except for acupoint injection, all the included acupuncture and moxibustion techniques showed superior improvements in PNP and were more cost-effective as compared to pharmaceutical treatments. Warm needling, fire needling, and moxibustion were the most effective treatments. Fire needling showed the lowest ICPR relative to the nonsteroidal anti-inflammatory drugs in the cost-effectiveness analysis of direct and indirect costs. Conclusion Acupuncture and moxibustion techniques are beneficial and cost-effective approaches for easing PNP and hence can be considered for PNP management.
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Acupuncture Methods for Primary Trigeminal Neuralgia: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3178154. [PMID: 35237333 PMCID: PMC8885188 DOI: 10.1155/2022/3178154] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 01/25/2022] [Indexed: 12/12/2022]
Abstract
Background Primary trigeminal neuralgia (PTN) is a clinical refractory disorder characterized by excruciating pain that severely impacts the quality of life. Several studies have shown that acupuncture can improve PTN pain. However, the comparative efficacy and safety of acupuncture are unknown. Herein, a systematic review was conducted to compare the efficacy and safety of various acupuncture methods for PTN treatment. Methods Relevant randomized controlled trials (RCTs) published up to 1 August 2021 were obtained from PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, CQVIP Database, Wanfang Database, Allied and Alternative Medicine Database, and related registration platforms. Two authors independently selected the studies and obtained data. Cochrane Handbook was used to assess the methodological quality. We put the pain relief as the primary outcome and the response rate and adverse events as the secondary outcomes. Review Manager v5.3, ADDIS v1.16.8, and STATA v15.0 software were used for data analysis. The intraclass correlation coefficient was used to assess the consistency of the two investigators. Results A total of 58 RCTs with 4,126 participants were obtained. The meta-analysis indicated that five acupuncture methods were superior to conventional medicine (carbamazepine) in pain reduction intensity and response rate. Meanwhile, electronic acupuncture plus manual acupuncture was the most effective therapy since it reduced pain intensity in 11 methods and improved the response rate in 10 interventions. Moreover, six interventions had acceptable adverse events, and none of the included studies reported severe adverse events. However, most pieces of evidence were ranked as critically low. Conclusion These findings show that acupuncture methods can be effective and safe for PTN. Moreover, electronic acupuncture plus manual acupuncture maybe the best acupuncture treatment for PTN and should be administered to PTN patients. However, additional well-designed and high-quality RCTs should be conducted to verify the above findings in the future. The systematic review is registered with CRD42020221456.
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Luo N, Li R, Wang Y, Xia Y, Sun J, Zhao L, Sun C, Sun J, Fang J. Effectiveness and safety of acupuncture for treating trigeminal neuralgia associated anxiety and depression: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28631. [PMID: 35060545 PMCID: PMC8772693 DOI: 10.1097/md.0000000000028631] [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: 12/23/2021] [Accepted: 01/04/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Patients with trigeminal neuralgia (TN) often develop a terrible fear of triggering pain, which may lead to anxiety and depression, exerting a negative effect on their quality of life. This protocol is carried out to comprehensively explore the effectiveness and safety of acupuncture for treating anxiety and depression induced by TN. METHODS Randomized control trials involving acupuncture for treating patients with anxiety and depression caused by TN will be searched in eight electric databases, including PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database and Technology Periodical Database (VIP). In addition, studies that were reported in Chinese or English will be considered. Studies selection, data extraction and risk of bias assessment of the included studies will be conducted independently by two reviewers. Quality of the included studies will be performed according to the Cochrane Risk of Bias tool. Meanwhile, the level of evidence for results will be assessed by using the Grading of Recommendations Assessment, Development, and Evaluation method. The primary outcomes will be the Hamilton Anxiety/Depression Scale or Zung Self-Rating Anxiety/Depression Scale, secondary outcomes will be the visual analog score, numerical rating score, SF-36, and adverse events. All analyses will be conducted by using the RevMan software V5.3. RESULTS A high-quality synthesis of current evidence of acupuncture for TN patients associated with anxiety and depression will be provided in this study. CONCLUSION This systematic review will offer comprehensive evidence of acupuncture on specific outcomes induced by TN and TN-related anxiety and depression. TRIAL REGISTRATION PROSPERO registration number: CRD42020219775.
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Affiliation(s)
- Ning Luo
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Rongrong Li
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Yiyi Wang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Yunfan Xia
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Jing Sun
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Linfang Zhao
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Chao Sun
- Community Health Service Center of Puyan Street, Binjiang District, Hangzhou City, Zhejiang Province, China
| | - Jiemin Sun
- Community Health Service Center of Puyan Street, Binjiang District, Hangzhou City, Zhejiang Province, China
| | - Jianqiao Fang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
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Shao G, Xie W, Jia X, Bade R, Xie Y, Qi R, Gong K, Bai H, Si L, Chen Y, Sun K, Bo A. Overview of Traditional Mongolian Medical Warm Acupuncture. Aging Dis 2022; 13:1030-1041. [PMID: 35855342 PMCID: PMC9286911 DOI: 10.14336/ad.2022.0115] [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: 12/02/2021] [Accepted: 01/07/2022] [Indexed: 11/09/2022] Open
Abstract
Mongolian medical warm acupuncture is a traditional therapy of Mongolian medicine and was developed by people living on the Mongolian Plateau. This kind of traditional oriental medicine has a long history. The main characteristics of Mongolian medical warm acupuncture are the acupoints and the needles used. Its theory is based on the human anatomical structure and the distinct local culture. Mongolian medical warm acupuncture has been practiced for centuries and proved to be very effective in the treatment of age-related diseases, including the musculoskeletal and nervous diseases. This paper aims to briefly introduce the history and scope of Mongolian medical warm acupuncture, with a particular focus on age-related diseases, where Mongolian medical warm acupuncture has shown significant beneficial effects.
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Affiliation(s)
- Guo Shao
- Center for Translational Medicine and Department of Laboratory Medicine, the Third People’s Hospital of Longgang District Shenzhen, Shenzhen, China.
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Correspondence should be addressed to: Dr. Guo Shao (), Dr. Kai Sun (), and Dr. Agula Bo (), Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China
| | - Wei Xie
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Xiaoe Jia
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Rengui Bade
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Yabing Xie
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Ruifang Qi
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Kerui Gong
- Department of Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, USA.
| | - Haihua Bai
- Inner Mongolia Minzu University, Tongliao, China.
| | - Lengge Si
- Inner Mongolia Minzu University, Tongliao, China.
| | | | - Kai Sun
- Center for Translational Medicine and Department of Laboratory Medicine, the Third People’s Hospital of Longgang District Shenzhen, Shenzhen, China.
- Correspondence should be addressed to: Dr. Guo Shao (), Dr. Kai Sun (), and Dr. Agula Bo (), Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China
| | - Agula Bo
- Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China.
- Correspondence should be addressed to: Dr. Guo Shao (), Dr. Kai Sun (), and Dr. Agula Bo (), Inner Mongolia Key Laboratory of Hypoxic Translational Medicine, Baotou Medical College of Neuroscience Institute, Baotou Medical College, Baotou, China
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Tang D, Zhang X, Xu Y, Dai L, Sun J, Hu H, Jiang H, Jin P, Chen L, Fang J. The Central Response of Electroacupuncture on Trigeminal Neuralgia Based on Resting-State Functional Magnetic Resonance Imaging: A Protocol for a Pre-Experimental, Single-Centre, Randomized, Controlled Trial. J Pain Res 2021; 14:3321-3331. [PMID: 34707400 PMCID: PMC8543029 DOI: 10.2147/jpr.s334078] [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: 08/17/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To verify the efficacy of electroacupuncture (EA) on classical trigeminal neuralgia (CTN), and to observe the brain functional status of patients with CTN and the intervention effects of EA on brain function by resting-state functional magnetic resonance imaging (rs-fMRI). Methods and Analysis Thirty CTN patients will be randomly divided into EA combined with carbamazepine group and carbamazepine group in 2:1 ratio by using a random number table. Patients in EA combined with carbamazepine will receive EA treatment and carbamazepine for four weeks. The carbamazepine group will only receive carbamazepine treatment. VAS (visual analogue scale), HAMA (Hamilton Anxiety Scale), HAMD (Hamilton Depression Scale) and SF-36 (short form 36 health survey) will be performed before, after four-week treatments and at three-month follow-up in CTN patients. Six CTN patients will be randomly selected from EA combined with carbamazepine group and carbamazepine group, respectively, before treatment, and twelve paired healthy participants will be recruited at the same time. The twelve CTN patients will be scanned by rs-fMRI before and after treatment, and the healthy participants will be scanned by rs-fMRI only at baseline. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) analysis will be carried out to compare the dysfunctional brain regions between CTN patients and healthy participants, as well as the differences between two groups of patients with CTN after treatment. Trial Registration ChiCTR-1900027873.
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Affiliation(s)
- Ding Tang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Xufen Zhang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Yani Xu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Linglin Dai
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Jianlan Sun
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Hantong Hu
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Huangwei Jiang
- Department of Radiological, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Ping Jin
- Department of Radiological, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Lifang Chen
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Jianqiao Fang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
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Evaluation of the effect of acupuncture on pain of patients with refractory trigeminal neuralgia. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2021. [DOI: 10.1007/s11726-021-1273-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gerwin R. Chronic Facial Pain: Trigeminal Neuralgia, Persistent Idiopathic Facial Pain, and Myofascial Pain Syndrome-An Evidence-Based Narrative Review and Etiological Hypothesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7012. [PMID: 32992770 PMCID: PMC7579138 DOI: 10.3390/ijerph17197012] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023]
Abstract
Trigeminal neuralgia (TN), the most common form of severe facial pain, may be confused with an ill-defined persistent idiopathic facial pain (PIFP). Facial pain is reviewed and a detailed discussion of TN and PIFP is presented. A possible cause for PIFP is proposed. (1) Methods: Databases were searched for articles related to facial pain, TN, and PIFP. Relevant articles were selected, and all systematic reviews and meta-analyses were included. (2) Discussion: The lifetime prevalence for TN is approximately 0.3% and for PIFP approximately 0.03%. TN is 15-20 times more common in persons with multiple sclerosis. Most cases of TN are caused by neurovascular compression, but a significant number are secondary to inflammation, tumor or trauma. The cause of PIFP remains unknown. Well-established TN treatment protocols include pharmacotherapy, neurotoxin denervation, peripheral nerve ablation, focused radiation, and microvascular decompression, with high rates of relief and varying degrees of adverse outcomes. No such protocols exist for PIFP. (3) Conclusion: PIFP may be confused with TN, but treatment possibilities differ greatly. Head and neck muscle myofascial pain syndrome is suggested as a possible cause of PIFP, a consideration that could open new approaches to treatment.
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Affiliation(s)
- Robert Gerwin
- Department of Neurology School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA
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12
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Abstract
BACKGROUND We aimed to assess the standing of acupuncture as a clinical tool in the management of trigeminal neuralgia against the current first-line drug treatment (carbamazepine) and the most effective surgery (microvascular decompression (MVD)). METHODS Data regarding efficacy, side effects and cost were compiled for each of these three modalities from the PubMed and Cochrane Library databases. Patient stress was estimated according to Holmes and Rahe's Social Readjustment Rating Scale (SRRS). RESULTS Acupuncture was not significantly more effective than its corresponding control (p = 0.088), but had the greatest efficacy (mean ± 95% confidence interval) of the modalities considered (86.5% ± 5.6% compared to surgery (79.3% ± 7.7%) and pharmacotherapy (71.7% ± 2.5%), respectively). Acupuncture also had fewer mean reported side effects (22.7% ± 5.9%) compared with surgery (25.3% ± 12.6%) and pharmacotherapy (88.8% ± 25.0%), and the lowest cost; after 5 years, the cost of acupuncture was estimated to be £750, compared to £1507.73 for carbamazepine and £4878.42 for MVD. Acupuncture was the least stressful according to the SRRS (53 points), whereas surgery was second most stressful (153 points) and pharmacotherapy was the most stressful intervention to patients (217 points). CONCLUSION Acupuncture appears more effective than pharmacotherapy or surgery. Statistical analysis of side effects was not possible due to inconsistent reporting protocols, but the data suggest that acupuncture is considerably safer than pharmacotherapy or surgery. Acupuncture also appears to be the least expensive therapeutic modality to deliver long-term (65 weeks onwards), and our analysis indicated that it was less stressful to patients than pharmacotherapy or surgery. Further study into these areas and the practicality of its availability in the UK National Health Service (NHS) and other health systems is recommended.
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Affiliation(s)
| | - Vivien Shaw
- School of Medical Sciences, Bangor University, Bangor, UK
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13
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Nova CV, Zakrzewska JM, Baker SR, Riordain RN. Treatment Outcomes in Trigeminal Neuralgia-A Systematic Review of Domains, Dimensions and Measures. World Neurosurg X 2020; 6:100070. [PMID: 32123867 PMCID: PMC7036566 DOI: 10.1016/j.wnsx.2020.100070] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/16/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Trigeminal neuralgia (TN) is a painful disorder characterized by sudden electric shock-like pain. It is a rare condition for which multiple treatments are available, including medical and surgical. The best treatment option is yet to be defined, and this is related to the lack of definition in the treatment outcomes and outcome measures. The aim of this systematic review was to summarize all the outcomes and outcomes measures that have been published to date and highlight variability in their use. METHODS We have conducted a literature search using a wide range of databases (1946-2019 for medical and 2008-2019 for surgical treatment), for all intervention studies in TN. Four hundred and sixty-seven studies were selected for data extraction on TN classification, data collection method, intervention, and treatment outcomes mapped to the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT guidelines). RESULTS Most studies collected data on pain (n = 459) and side effects (n = 386) domains; however, very few collected data on the impact of treatment on physical (n = 46) and emotional functioning (n = 17) and on patient satisfaction (n = 35). There was high variability on outcome measures used for pain relief (n = 10), pain intensity (n = 9), and frequency of pain episodes (n = 3). CONCLUSIONS A clear definition of what are the important outcomes for patients with TN is essential. The choice of standardized outcome measures allowing for consistent reporting in TN treatment will allow for comparison of studies and facilitate treatment choice for patients and clinicians thus, improving health outcomes and reducing health care cost.
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Affiliation(s)
| | | | - Sarah R. Baker
- School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Richeal Ni Riordain
- UCL Eastman Dental Institute, London, United Kingdom
- Department of Oral Medicine, Cork University Dental School and Hospital, Cork, Ireland
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14
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Liao CC, Lin CL, Liao KR, Li JM. Long-Term Beneficial Effects of Acupuncture with Reduced Risk of Depression Development Following Trigeminal Neuralgia: A Nationwide Population-Based Cohort Study. Neuropsychiatr Dis Treat 2020; 16:2961-2973. [PMID: 33311982 PMCID: PMC7725145 DOI: 10.2147/ndt.s284857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/20/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Existing evidence has shown that patients with trigeminal neuralgia (TN) have a higher risk of developing depression than the normal population. Clinically, acupuncture has been widely used to alleviate pain in TN. However, few studies have explored the use of acupuncture to prevent depression in TN. Therefore, this study aimed to apply national real-world data to investigate the long-term effect of acupuncture on the risk of depression in patients with TN. METHODS We recruited participants with newly diagnosed TN from the Taiwanese National Health Insurance Research Database between January 1, 2000 and December 31, 2010, and categorized them into either the acupuncture cohort or non-acupuncture cohort using the 1:1 propensity score-matched method. All patients in the two cohorts were followed up until the end of 2013. Cox proportional hazards regression analysis was used to compare the incidence of depression between the two cohorts. RESULTS In total, 776 patients with newly diagnosed TN in each cohort with similar baseline characteristics were enrolled in the study. The acupuncture cohort had a reduced risk of depression compared to the non-acupuncture cohort (adjusted hazard ratio, 0.47; 95% confidence interval, 0.31-0.70). Kaplan-Meier analysis also revealed that the cumulative incidence of depression was significantly lower in the acupuncture cohort during the 13-year follow-up period (Log rank test, p < 0.001). In particular, the beneficial effect of acupuncture was a decrease in the risk of depression among TN patients aged 50-69 years who had also used carbamazepine. CONCLUSION This study demonstrated that acupuncture is associated with a reduction in the risk of depression during long-term follow-up in patients with TN. The results provide new insights for clinical practitioners as well as for health resource allocation.
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Affiliation(s)
- Chung-Chih Liao
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan.,College of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Ke-Ru Liao
- Department of Neurology, Yuanlin Christian Hospital, Yuanlin 51052, Taiwan
| | - Jung-Miao Li
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.,Department of Chinese Medicine, Show Chwan Memorial Hospital, Changhua 50008, Taiwan
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15
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Yang H, Zhou J, Zhong D, Yin Z, Xu G, Chen J, Li J, Liang F. Acupuncture therapy for patients with hemifacial spasm: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e18329. [PMID: 31860984 PMCID: PMC6940167 DOI: 10.1097/md.0000000000018329] [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] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Hemifacial spasm (HFS) brings a lot of trouble to patients' daily life, having a severe influence on the psychological and physical wellbeing of patients. Relevant researches suggested that acupuncture therapy has potential benefits for HFS. However, there is no consistent conclusion. The purpose of our study is to assess whether acupuncture therapy is effective and safe for HFS. METHODS To collect relevant randomized controlled trials (RCTs), the following electronic databases will be searched: Web of Science, the Cochrane Library, EMBASE, MEDLINE, ISI Web of Knowledge, PsycINFO, Allied and Alternative Medieine, Chinese National Knowledge Infrastructure, Wanfang data, and Chinese Scientific Journals Database. We will take the cure rate and the total effective rate as the primary outcomes, and change in intensity after treatment, change in frequency after treatment, the recurrence rate, and adverse events as secondary outcomes. Endnote software 9.1 will be used for study selection, Review Manager software 5.3, and STATA 13.0 software will be used for analysis and synthesis. RESULTS Current relevant studies will be synthesized to assess whether acupuncture therapy is effective and safe for HFS. CONCLUSION Our research will provide evidence of acupuncture therapy for HFS. REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) CRD42019142473.
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Affiliation(s)
- Han Yang
- College of Acupuncture and Moxibustion and Tuina
| | - Jun Zhou
- College of Acupuncture and Moxibustion and Tuina
| | - Dongling Zhong
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zihan Yin
- College of Acupuncture and Moxibustion and Tuina
| | - Guixing Xu
- College of Acupuncture and Moxibustion and Tuina
| | - Jiao Chen
- College of Acupuncture and Moxibustion and Tuina
| | - Juan Li
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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16
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Zhang YP, Wang Y, Xia WG, Song AQ. Triple Puncture for Primary Trigeminal Neuralgia: A Randomized Clinical Trial. Curr Med Sci 2019; 39:638-644. [DOI: 10.1007/s11596-019-2085-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/21/2019] [Indexed: 12/30/2022]
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17
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Effect of Acupuncture on Cognitive Function and Quality of Life in Patients With Idiopathic Trigeminal Neuralgia. J Nerv Ment Dis 2019; 207:171-174. [PMID: 30720599 DOI: 10.1097/nmd.0000000000000937] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To estimate the effect of acupuncture on idiopathic trigeminal neuralgia (ITN), we recruited 116 patients with ITN from December 2016 to April 2018 and further divided into them into two groups: acupuncture intervention group (n = 62) and sham control group (n = 54). Clinical pain, cognitive function, and quality of life (QoL) assessed with the 36-Item Short Form Health Survey (SF-36) were evaluated at the initial time of treatment, at the end of treatment, and 6 weeks after the treatment. Pain intensity, headache, and generalized body pain showed significant decrease both at the end of treatment and after 6 weeks of treatment when compared with initial time. The scores of the cognitive tests (Mini-Mental State Examination, Trail Making Test, Verbal Fluency Test, tracing score, and memory score) and five aspects of the SF-36 assessment (role emotional, general health, body pain, role physical, and mental health scores) showed significant improvement at the end of treatment compared with the initial time. Whereas after 6 weeks of treatment, the Mini-Mental State Examination, memory score, and Trail Making Test-A score and four aspects of the SF-36 assessment (vitality, bodily pain, mental health, and role physical) showed significant improvement when compared with the end of treatment. Acupuncture can be used as an alternative treatment to improve cognitive function and QoL of patients with ITN.
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18
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Wang J, Cui J, She C, Xu D, Zhang Z, Wang H, Bai W. Differential innervation of tissues located at traditional acupuncture points in the rat forehead and face. Acupunct Med 2018; 36:408-414. [PMID: 30158109 DOI: 10.1136/acupmed-2017-011595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To compare the neural pathways associated with the tissues located at different traditional acupuncture points in the rat forehead and face using the cholera toxin B subunit (CTB) neural tracing technique. METHODS After injection of CTB into the tissues at GB14, ST2 and ST6 in the rat, the neural labelling associated with each acupuncture point was revealed by fluorescent immunohistochemistry of the nervous system, including the trigeminal ganglion (TRG), cervical dorsal root ganglia (DRG), spinal cord and brain. RESULTS The CTB labelling included sensory neurons and their transganglionic axonal terminals, as well as motor neurons. The labelled sensory neurons associated with GB14, ST2 and ST6 were distributed in both the TRG and cervical DRG, and their centrally projected axons terminated in an orderly fashion at their corresponding targets in the spinal trigeminal nucleus and cervical spinal dorsal horn. In addition, labelled motor neurons were observed in the facial motor nucleus, trigeminal motor nucleus and cervical spinal ventral horn, in which facial motor neurons projected to the tissues located at all three acupuncture points. Trigeminal motor neurons innervated both ST2 and ST6, while spinal motor neurons only correlated with ST6. CONCLUSIONS These results indicate that the tissues located at each of these three traditional acupuncture points in the rat forehead and face has its own sensory and motor connection with the nervous system in a region-specific pattern through distinct neural pathways. Understanding the neuroanatomical characteristics of acupuncture points from the peripheral nervous system to the central nervous system should help inform acupuncture point selection according to the demands of the clinical situation.
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Affiliation(s)
- Jia Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jingjing Cui
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chen She
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dongsheng Xu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhiyun Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hui Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wanzhu Bai
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
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