Warm needle acupuncture at Pungsi (GB31) has an enhanced analgesic effect on formalin-induced pain in rats

Best acupuncture method for mammary gland hyperplasia: Evaluation of randomized controlled trials and Bayesian network meta-analysis

Objective

To evaluate the effectiveness of different acupuncture treatments for mammary gland hyperplasia (MGH) using a network meta-analysis.

Methods

Several databases were searched without language restrictions from 2000 to February 2023, including PubMed, Embase, Web of Science, Cochrane Library, China Science and Technology Journal Database, China Biology Medicine Database, Wanfang Database, China National Knowledge Infrastructure Database, and other professional websites and gray literature. Inclusion criteria were adult women diagnosed with MGH; intervention measures included acupuncture and related therapies; the control group was treated with simple drugs; and the research type was a randomized controlled trial (RCT). The primary outcomes were treatment effectiveness and estradiol and progesterone levels. Secondary outcomes were breast lump size and visual analog scale (VAS) score of breast pain. Exclusion criteria were studies unrelated to MGH, incorrect study populations, control measures or interventions, incomplete data, non-RCTs, case reports, and animal experiments. Cochrane tools were used to assess the risk of bias. The R software (x64 version 4.2.1), Review Manager 5.3 software and STATA 16.0 software were used for data analysis.

Results

Following a rigorous screening process, data extraction, and quality assessment, 48 eligible RCTs encompassing 4,500 patients with MGH and 16 interventions were included. The results indicated that acupuncture, alone or in combination with traditional Chinese or Western medicine, had better therapeutic effects than conventional therapy. In terms of effectiveness, warm needle acupuncture was the best choice (94.6%). Bloodletting pricking was the most effective method (85.7%) for lowering progesterone levels. Bloodletting pricking was the most effective method (98.3%) for lowering estradiol levels. Manual acupuncture combined with traditional Chinese medicine was the most effective (74.5%) treatment to improve the size of the breast lump. Warm needle acupuncture was the most effective (69.8%) in improving the VAS score.

Conclusion

Acupuncture therapy was more effective in treating MGH than drug therapy alone, and warm needle acupuncture and bloodletting pricking were the two best options. However, larger sample sizes and high-quality RCTs are required.

Attenuation of immobilization stress-induced hypertension by temperature-controllable warm needle acupuncture in rats and the peripheral neural mechanisms

Introduction

We and others have shown that electrical stimulation of the PC-6 acupoint over the wrist relieves hypertension by stimulating afferent sensory nerve fibers and activating the central endogenous opioid system. Warm needle acupuncture has long been utilized to treat various diseases in clinics.

Methods

Here, we developed a temperature-controllable warm needle acupuncture instrument (WAI) and investigated the peripheral mechanism underlying the effect of warm needle acupuncture at PC-6 on hypertension in a rat model of immobilization stress-induced hypertension.

Results

Stimulation with our newly developed WAI and traditional warm needle acupuncture attenuated hypertension development. Such effects were reproduced by capsaicin (a TRPV1 agonist) injection into PC-6 or WAI stimulation at 48°C. In contrast, PC-6 pretreatment with the TRPV1 antagonist capsazepine blocked the antihypertensive effect of WAI stimulation at PC-6. WAI stimulation at PC-6 increased the number of dorsal root ganglia double-stained with TRPV1 and CGRP. QX-314 and capsaicin perineural injection into the median nerve for chemical ablation of small afferent nerve fibers (C-fibers) prevented the antihypertensive effect of WAI stimulation at PC-6. Additionally, PC-6 pretreatment with RTX ablated the antihypertensive effect of WAI stimulation.

Conclusion

These findings suggest that warm needle acupuncture at PC-6 activates C-fiber of median nerve and the peripheral TRPV1 receptors to attenuate the development of immobilization stress-induced hypertension in rats.

Effect of moxibustion on meridian in a warm needling model: A protocol for a prospective observational study

BACKGROUND

Warm needling is a type of traditional Chinese medicine (TCM), which uses burned moxa to generate warmth and exerts a therapeutic effect on human skin. Additionally, based on TCM theory, warm needling could improve deficiency-cold syndrome. Research has found that warm needling has analgesic effects as well as effects on the immune system, endocrine system, nervous system, and lower urinary tract symptoms. However, the mechanism of warm needling on the meridians is not fully understood. In modern studies, the electric characteristics of the meridians have been discovered and the combination of semiconductor and TCM theory could explain the meridian phenomena through physics. However, there is no known research exploring the relationship between thermal effect and electric property on the meridians.

METHODS

A total of 30 healthy participants older than 20 years of age will be recruited for this study. The participants would first be administered acupuncture, following which the electric characteristics will be measured using the semiconductor analyzer Agilent B1500A/Agilent 4156C. The visual analog score (VAS) will also be rated. Thereafter, a burned moxa will be added to the acupuncture needles as a method for warm needling. The electric characteristics and VAS will be measured again. We will use the paired t-test and repeated measure two-way ANOVA to compare the electric characteristics and VAS before and after warm needling in each participant.

OBJECTIVES

This protocol aims to explore the thermal effect on the electric characteristics of meridians in a warm needling model and provide a scientific explanation of TCM through the aspect of physics.

Effects of warm needling therapy on symptoms of benign prostatic hyperplasia: A protocol for a systematic review and meta-analysis

BACKGROUND

Benign prostatic hyperplasia (BPH) is the term for a type of non-malignant prostate enlargement that is most often diagnosed in men of middle age and older. Lower urinary tract symptoms (LUTS) are commonly observed in men afflicted with BPH. Evidence suggests that warm needling therapy could be applied clinically to relieve the LUTS associated with BPH, particularly in China, where experienced practitioners are readily available. In this review, the safety and effects of warm needling therapy are assessed in the context of treatment for LUTS associated with BPH.

METHODS

First, data for relevant randomised controlled trials and the initial periods of randomised cross-over trials will be obtained from four English databases (MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, and Allied and Complementary Medicine Database) and six Chinese databases (China National Knowledge Infrastructure, Wanfang Database, SinoMed, Chongqing VIP Chinese Science and Technology Periodical Database, China Master's Theses Full-text Database and China Doctoral Dissertations Full-text Database). The primary outcomes analysed in this protocol are improvements in urological symptoms as measured by recognized urological symptom scores, while secondary outcomes include improvement of urine flow rate measures, residual urine volume, nocturia, prostate size, and quality-of-life score. In addition, safety outcomes will be analysed by assessing incidences of adverse events. Two reviewers will independently assess and select studies, extract data and assess the risk of bias. Data synthesis and risk bias assessment will be performed with Review Manager software (version 5.3).

RESULTS

This systematic review provides a synthesis to assess the therapeutic efficacy of warm needling therapy for LUTS associated with BPH.

CONCLUSION

The present study will provide a clinically relevant evaluation of the current state of evidence regarding the therapeutic efficacy of warm needling therapy for LUTS associated with BPH.

ETHICS AND DISSEMINATION

Ethical approval is not required for this review, because private information will not be collected from the included participants. The results of the study will be published in a peer-reviewed journal.

REGISTRATION NUMBER

PROSPERO CRD42020198360.

Effectiveness and safety of warm needle acupuncture for sciatica: A protocol for systematic review and meta-analysis

BACKGROUND

Sciatica is a syndrome characterized by sciatic nerve path and distribution area pain. Many kinds of literature reported the definite effect of warm needle acupuncture (WNA) on sciatica. However, there is no systematic review or meta-analysis on WNA for sciatica. Therefore, this study will design a protocol to comprehensively and systematically evaluate the effectiveness and safety of WNA on sciatica.

METHODS

The two researchers in this study will search the electronic database for randomized controlled trials, (RCTs) of WNA on sciatica, The databases we will search include PubMed, EMBASE, Cochrane Library, Web of Science, Chinese national knowledge infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Database, and Chinese biomedical literature database (CBM). Review Manager 5.4 software and Cochrane risk bias tool will be us used for data analysis and to evaluate research quality. The main clinical indicators will include visual analogue scale (VAS) and Oswestry Disability Index (ODI).

RESULTS

This study will evaluate the efficacy and safety of WNA for sciatica.

CONCLUSION

This study will provide a reliable scheme for objectively and comprehensively evaluating the efficacy and safety of WNA on sciatica.

TRIAL REGISTRATION NUMBER

INPLASY2020110074.

Efficacy and safety of warm needle acupuncture in knee osteoarthritis: A protocol for systematic review and meta-analysis

BACKGROUND

Knee osteoarthritis (KOA) is a chronic disease, which is also recognized as a common disease affecting the elderly. However, the application of Western medicine is limited in clinical because of its obvious adverse reactions. Warm needle acupuncture (WNA) has a long history in the treatment of KOA and is widely used in Chinese. Here we will submit a protocol to evaluate the efficacy and safety of WNA in the treatment of KOA.

METHODS

We will search 5 English databases (PubMed, MEDLINE, Embase, Cochrane Library, Web of Science), 4 Chinese databases [China National Knowledge Infrastructure (CNKI), China Biology Medicine, Chinese Science and Technology Journal Database (VIP), and Wanfang database] and grey literature for randomized controlled trials of WNA in the treatment of KOA. The primary outcome measure is Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the secondary outcome will include degree of knee flexion and adverse events caused by WNA, such as dizziness, nausea, abdominal pain, arrhythmia, etc. The selection of the literatures will be conducted by endnote X7 software, and we will use Review Manger V.5.3 software to conduct the meta-analysis.

RESULTS

This study will provide reliable evidence for WNA in the treatment of KAO.

CONCLUSION

The conclusion of this study will testify the efficacy and safety of WNA in the treatment of KAO.

REGISTRATION

OSF Preregistration. 2020, October 11; osf.io/bu5qw.

Effectiveness of warm needling acupuncture for pain relief in patients with diabetic peripheral neuropathy: A protocol of systematic review

BACKGROUND

Warm needling acupuncture (WNA) has been widely utilized for pain management in patients with diabetic peripheral neuropathy (DPN). However, its results are still inconsistent, and no systematic review has specifically addressed this issue. Thus, this systematic review will comprehensively and systematically investigate the effectiveness and safety of WNA for pain relief in DPN.

METHODS

A comprehensive literature search of MEDLINE, EMBASE, Cochrane Library, Web of Science, Scopus, Allied and Complementary Medicine Database, CBM database, and China National Knowledge Infrastructure will be performed for randomized controlled trials that report WNA for pain relief in patients with DPN. All electronic databases will be searched from initial to the present without limitations of language and publication status. Two investigators will independently screen papers, collect data, and assess study quality. Cochrane risk of bias tool will be used for study quality assessment, and evidence quality will be evaluated using Grading of Recommendations Assessment, Development and Evaluations approach. RevMan 5.3 software will be applied for running statistical analysis.

RESULTS

This study will summarize the evidence for the effectiveness and safety of WNA for the management of pain in patients with DPN.

CONCLUSIONS

The findings of this study may provide helpful evidence to judge whether WNA for pain relief in DPN is effective or not.

Efficacy of electroacupuncture plus warm needling therapy for plantar heel pain: a randomised waitlist-controlled trial

OBJECTIVE

To investigate the therapeutic effects of electroacupuncture plus warm needling (EAWN) therapy on pain and foot function in adults with plantar heel pain (PHP).

METHODS

This prospective, randomised, parallel-group, waitlist-controlled trial was conducted at a Chinese medicine centre in Hong Kong between May 2018 and February 2019. Eighty eligible community-dwelling subjects with PHP (mean age 59.7 years; 85% female) were equally randomised to receive EAWN therapy or remain on a waitlist. The treatment group received six 30-min sessions of standardised EAWN therapy over 4 weeks; the control group received no treatment. The outcome measures were the visual analogue scale (VAS) score for first-step pain, foot function index (FFI) scores and global rating of change (GRC) scale scores. Assessments were made at baseline, week 2 and week 4 (primary endpoint). The treatment group underwent additional assessments at week 8. Outcomes were evaluated by intention-to-treat analysis.

RESULTS

Patients who received EAWN therapy exhibited greater improvements in the mean first-step pain VAS and all FFI scores than did those in the control group at weeks 2 and 4, with significant between-group differences (all P < 0.001). Compared with baseline, there were significant decreases in mean first-step pain VAS scores at weeks 2 and 4, and FFI scores at week 4, in the treatment group but not in the control group. The improvements in the treatment group continued until week 8. GRC scores at week 4 indicated improvement in all treated patients and only 22.5% of the control group patients (P < 0.001). There were no study-related adverse events.

CONCLUSION

EAWN therapy could be an effective treatment for PHP in middle-aged and older adults.

TRIAL REGISTRATION NUMBER

ChiCTR1800014906 (Chinese Clinical Trials Registry).

Efficacy and safety of electroacupuncture plus warm needling therapy for heel pain: study protocol for a randomized controlled trial

BACKGROUND

Heel pain is a common foot disorder that causes pain and functional limitations. The prevalence of disabling foot pain will increase as the population ages. Previous studies have reported the positive therapeutic effects of electroacupuncture, warm needling, or the combination of both for heel pain but with limitations in the study methodologies. The current study is a rigorously designed randomized controlled trial that aims to evaluate the clinical efficacy and safety of electroacupuncture plus warm needling therapy in patients with heel pain.

METHODS/DESIGN

The study protocol describes a prospective, open-label, parallel-group, randomized controlled trial to be conducted in Hong Kong. Eighty patients aged 50-80 years who have reported heel pain and first-step pain equal to or exceeding 50 mm on the 100-mm visual analog scale (VAS) will be recruited. They will be randomly assigned (1:1 ratio) to the electroacupuncture plus warm needling therapy (i.e., treatment) group or the waitlist (i.e., control) group. The treatment group will undergo six treatment sessions in 4 weeks. The control group will receive no treatment during the study period. The primary outcome measure is a mean change in the first-step pain VAS score from the baseline to week 4. Secondary outcome measures include a mean change in first-step pain VAS score from the baseline to week 2, a mean change in Foot Function Index (FFI) subscale scores and the total score from the baseline to week 2 and week 4, and patients' self-reported level of improvement at week 4. Additional week 8 follow-up assessments with first-step pain VAS and FFI measurements will be arranged for the treatment group. Any adverse events will be recorded throughout the study to evaluate safety. An intention-to-treat approach will be used to analyze the study results.

DISCUSSION

This study will provide evidence on the efficacy and safety of electroacupuncture plus warm needling therapy as an alternative treatment method for heel pain. The findings will determine whether the treatment protocol is efficacious in relieving pain and improving foot function among older adults with heel pain. The study will also provide information for subsequent large-scale randomized controlled trials in the future.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR1800014906 . Registered on 12 February 2018.

Effectiveness and safety of warm needle acupuncture on children with cerebral palsy: Protocol for a systematic review and meta-analysis

BACKGROUND

Warm needle acupuncture (WNA) is an integral part of the acupuncture therapy, which combines acupuncture and moxibustion. Children with cerebral palsy (CP) is a common disease in children, which seriously affects children's growing development, physical and mental health. The clinical practice indicates that WNA has a therapeutic effect on children with CP. Here we will provide a protocol to explore the effectiveness and safety of WNA for children with CP.

METHODS

We will search the randomized controlled trails (RCT) literatures of WNA for children with CP in 5 English databases [PubMed, Web of Science, EMBASE, the Cochrane Central Register of Controlled Trials (Cochrane Library), and WHO International Clinical Trials Registry Platform (ICTRP)] and 4 Chinese databases [Chinese National Knowledge Infrastructure (CNKI), Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database (CBM)]. Activity of Daily Living Scales (ADL) of the patient will be considered as the primary outcome and the secondary outcome will include 88 items of gross motor function scale (GMFM-88), Gesell Growth Table (GGT), Criteria for judging efficacy and adverse events caused by WNA such as dizziness, nausea, vomiting, weariness, etc. The selection of the studies will be performed by EndnoteX7 software. And we will conduct all analyses with RevMan software V5.3.

RESULT

This study will provide a rational synthesis of current evidences for WNA on children with CP.

CONCLUSION

The conclusion of this study will provide evidence to judge the effectiveness and safety of WNA on children with CP.

REGISTRATION

PROS-PERO CRD42019122034.

Effectiveness and safety of warm needle acupuncture on insomnia: Protocol for a systematic review and meta-analysis

BACKGROUND

Warm needle acupuncture (WNA) combines acupuncture and moxibustion, which is an integral part of the acupuncture therapy. Insomnia is a common sleep disorder, which affects sub-healthy people and patients with chronic disease. The clinical practice indicates that WNA has a therapeutic effect on insomnia. Here we will provide a protocol to explore the effectiveness and safety of WNA for insomnia.

METHODS

We will search the randomized controlled trails (RCT) literatures of WNA for insomnia in 9 electronic databases, including 5 English databases [PubMed, Web of Science, EMBASE, the Cochrane Central Register of Controlled Trials (Cochrane Library), and WHO International Clinical Trials Registry Platform (TCTRP)] and 4 Chinese databases [Chinese National Knowledge Infrastructure (CNKI), Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database (CBM)]. Sleep quality value of the patient will be considered as the primary outcome and the secondary outcome will include biochemical, indicators total scores on the insomnia severity index, quality of life, adverse events caused by WNA, and changes of symptom in Traditional Chinese Medicine. The selection of the studies will be performed by EndnoteX7 software. All analyses will be conducted by using RevMan software V5.3.

RESULT

This study will provide a rational synthesis of current evidences for warm needle acupuncture on insomnia.

CONCLUSION

The conclusion of this study will provide evidence to judge the effectiveness and safety of WNA on insomnia.

REGISTRATION

PROS-PERO CRD42018112645.

Antinociceptive Effects of Spinal Manipulative Therapy on Nociceptive Behavior of Adult Rats during the Formalin Test

Optimizing pain relief resulting from spinal manipulative therapies, including low velocity variable amplitude spinal manipulation (LVVA-SM), requires determining their mechanisms. Pain models that incorporate simulated spinal manipulative therapy treatments are needed for these studies. The antinociceptive effects of a single LVVA-SM treatment on rat nociceptive behavior during the commonly used formalin test were investigated. Dilute formalin was injected subcutaneously into a plantar hindpaw. Licking behavior was video-recorded for 5 minutes. Ten minutes of LVVA-SM at 20° flexion was administered with a custom-made device at the lumbar (L5) vertebra of isoflurane-anesthetized experimental rats (n = 12) beginning 10 minutes after formalin injection. Hindpaw licking was video-recorded for 60 minutes beginning 5 minutes after LVVA-SM. Control rats (n = 12) underwent the same methods except for LVVA-SM. The mean times spent licking the formalin-injected hindpaw of both groups 1–5 minutes after injection were not different. The mean licking time during the first 20 minutes post-LVVA-SM of experimental rats was significantly less than that of control rats (P < 0.001). The mean licking times of both groups during the second and third 20 minutes post-LVVA-SM were not different. Administration of LVVA-SM had a short-term, remote antinociceptive effect similar to clinical findings. Therefore, mechanistic investigations using this experimental approach are warranted.

Research advances in treatment of neurological and psychological diseases by acupuncture at the Acupuncture Meridian Science Research Center

Acupuncture is an ancient therapeutic intervention that can be traced back at least 2100 years and is emerging worldwide as one of the most widely used therapies in the field of complementary and alternative medicine. Due to limitations associated with Western medicine's focus on the treatment of diseases rather than on their causes, interests are shifting to complementary and alternative medicines. The Acupuncture and Meridian Science Research Center (AMSRC) was established in 2005 to elucidate the neurophysiological mechanisms of acupuncture for neurological diseases based on multidisciplinary research supported by the Korean Ministry of Science and Technology. In the AMSRC, resultant research articles have shown that acupuncture can improve neurological and psychological problems, including Parkinson's disease, pain, and depression, in animal models. Basic research studies suggest its effectiveness in treating various problems such as depression, drug addiction, epilepsy, ischemia, dementia, Parkinson's disease, and pain. We strongly believe that these effects, evident from the AMSRC research results, can play leading roles in the use of acupuncture for treating neurological diseases, based on collaboration among various academic fields such as neurophysiology, molecular genetics, and traditional Korean medicine.

The effects of adding elements of zinc and magnesium on ag-cu eutectic alloy for warming acupuncture

The warming acupuncture for hyperthermia therapy is made of STS304. However, its needle point cannot be reached to a desirable temperature due to heat loss caused by low thermal conductivity, and the quantification of stimulation condition and the effective standard establishment of warming acupuncture are required as a heat source. Accordingly, in this study, after Ag-Cu alloys with different composition ratios were casted and then mixed with additives to improve their physical and mechanical properties, the thermal conductivity and biocompatibility of the alloy specimens were evaluated for selecting suitable material. Ag-Cu binary alloys and ternary alloys added 5 wt% Zn or 2 wt% Mg were casted and then cold drawn to manufacture needles for acupuncture, and their physical properties, thermal conductivity, and biocompatibility were evaluated for their potential use in warming acupuncture. The results of this study showed that the physical and mechanical properties of the Ag-Cu alloys were improved by additives and that the thermal conductivity, machinability, and biocompatibility of the Ag-Cu alloys were improved by Mg addition.

Heat stimulation on the skin for medical treatment: can it be controlled?

OBJECTIVES

It has become increasingly important for evidence-based medicine to have a proper control for randomized-controlled trials. However, appropriately controlling manual therapies such as moxibustion has proved challenging. Our team designed a novel device based on sensory illusion, and tested its feasibility.

DESIGN AND RESULTS

A sham moxibustion device was constructed to allow participants to feel moxibustion treatment without actually stimulating the corresponding acupoint. The device consisted of two pieces of aluminum, each shaped like a horseshoe, so that the center of the device would not touch the skin. Participants perceived two heat stimuli as one when the distances of two heat sources were within 15 mm on the forearm. The thermal stimulation of the sham device was adjusted to the lowest possible temperature, but enough to elicit a heat sensation (39°C), while that of verum was set at around 44°C. The subject blinding, tested in 30 healthy volunteers, was successful. With the exception of 1 subject, subjects in the sham group described the sensation as a warm solid circle, unable to differentiate between two-pieced sham moxibustion and verum moxibustion.

CONCLUSIONS

This preliminary study indicates that this device may serve as an appropriate control for clinical studies of moxibustion, but more research is clearly needed. A validated sham moxibustion device based on sensory illusion may contribute in expanding knowledge of somatosensory studies.

Thermal properties of direct and indirect moxibustion

Moxibustion therapy chiefly utilizes heat generated by the combustion of moxa. Therefore, understanding the thermal properties of moxibustion is essential when studying the mechanisms involved in moxibustion therapy. Therefore, we measured temperatures of direct and indirect moxibustion. For indirect moxibustion, moxibustion on garlic was used. To determine the influence of the environment on moxibustion, we applied airflow of 0.0-0.8 m/s. An increase in the airflow caused a concomitant increase in the maximum temperature of direct moxibustion, from 160 to 300 degrees C and the time duration was reduced by half. However, the maximum temperature of indirect moxibustion demonstrated the opposite effect, with the temperature decreasing from 45 to 40 degrees C. This is attributed to the upstream airflow, which indicates the importance of the air inside moxa. For indirect moxibustion using garlic slices of different thicknesses, we found the optimum condition for the buffer layer of a garlic slice. The maximum number of consecutive moxibustions using one garlic slice was three. These results are consistent with traditional methods. This observation illustrates that the importance of garlic slices in modulating the combustion heat and proper thermal stimulus to the patient.