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Dunning J, Mourad F, Bliton P, Charlebois C, Gorby P, Zacharko N, Layson B, Maselli F, Young I, Fernández-de-Las-Peñas C. Percutaneous tendon dry needling and thrust manipulation as an adjunct to multimodal physical therapy in patients with lateral elbow tendinopathy: A multicenter randomized clinical trial. Clin Rehabil 2024:2692155241249968. [PMID: 38676324 DOI: 10.1177/02692155241249968] [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: 04/28/2024]
Abstract
OBJECTIVE The purpose of this study was to assess the effects of adding electrical dry needling and thrust manipulation into a multimodal program of exercise, mobilization, and ultrasound in patients with lateral elbow tendinopathy. DESIGN Randomized, single-blinded, multicenter, parallel-group trial. SETTING Thirteen outpatient physical therapy clinics in nine different US states. PARTICIPANTS One hundred and forty-three participants (n = 143) with lateral elbow tendinopathy were randomized. INTERVENTION Cervical spine manipulation, extremity manipulation, and percutaneous tendon electrical dry needling plus multimodal physical therapy (n = 73) or multimodal physical therapy (n = 70) alone. MAIN MEASURES The primary outcome was elbow pain intensity and disability as measured by the Patient-Rated Tennis Elbow Evaluation at baseline, 1 week, 4 weeks, and 3 months. Secondary outcomes included the Numeric Pain Rating Scale, Tennis Elbow Functional Scale, Global Rating of Change, and medication intake. RESULTS The 2 × 4 analysis of covariance demonstrated that individuals with lateral elbow tendinopathy receiving electrical dry needling and thrust manipulation plus multimodal physical therapy experienced significantly greater improvements in disability (Patient-Rated Tennis Elbow Evaluation: F = 19.675; P < 0.001), elbow pain intensity (Numeric Pain Rating Scale: F = 22.769; P < 0.001), and function (Tennis Elbow Function Scale: F = 13.269; P < 0.001) than those receiving multimodal physical therapy alone at 3 months. The between-group effect size was large for pain and disability (Patient-Rated Tennis Elbow Evaluation: standardized mean difference = 1.13; 95% confidence interval: 0.78, 1.48) in favor of the electrical dry needling and thrust manipulation group. CONCLUSIONS The inclusion of percutaneous tendon electrical dry needling and thrust manipulation into a multimodal program of exercise, mobilization and ultrasound was more effective than multimodal physical therapy alone in individuals with lateral elbow tendinopathy.Trial Registration: www.clinicaltrials.gov NCT03167710 May 30, 2017.
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Affiliation(s)
- James Dunning
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA
- Montgomery Osteopractic Physical Therapy & Acupuncture, Montgomery, AL, USA
| | - Firas Mourad
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
- Luxembourg Health & Sport Sciences Research Institute, Differdange, Luxembourg
| | - Paul Bliton
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA
- William Middleton VA Hospital, Madison, WI, USA
| | - Casey Charlebois
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA
| | - Patrick Gorby
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA
- Gorby Osteopractic Physiotherapy, Colorado Springs, CO, USA
| | - Noah Zacharko
- Osteopractic Physical Therapy of the Carolinas, Fort Mill, SC, USA
| | | | - Filippo Maselli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Ian Young
- Tybee Wellness & Osteopractic, Tybee Island, GA, USA
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- Cátedra de Clínica, Investigación y Docencia en Fisioterapia, Terapia Manual, Punción Seca y Ejercicio, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Lee Y, Lee H, Kim EJ, Lee SD, Jung CY. Potential use of polydimethylsiloxane phantom in acupuncture manipulation practice. Heliyon 2024; 10:e25428. [PMID: 38322835 PMCID: PMC10845916 DOI: 10.1016/j.heliyon.2024.e25428] [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: 08/14/2022] [Revised: 01/14/2024] [Accepted: 01/26/2024] [Indexed: 02/08/2024] Open
Abstract
Objectives Sufficient trials of acupuncture manipulations should be practiced to obtain proficiency. However, there is not an adequate quantitative methodology for selecting a tissue-mimicking phantom that effectively reproduces the mechanical behavior that occurs during acupuncture. The objective of this study was to determine the proper mixing ratio of polydimethylsiloxane (PDMS) to obtain tissue phantom that is the most similar to porcine phantoms. Design An automatic needle manipulator equipped with a six-degrees-of-freedom force/torque sensor was installed to monitor the interaction force that occurred when the acupuncture needle performed lifting-thrusting and twirling manipulations. Four types of PDMS phantoms, composed of two silicone elastomers with different hardener ratios, were studied alongside four control groups consisting of different porcine sites. A Visual Analog Scale was used to quantify the similarity of the PDMS phantoms to the controls by 11 Korean medical doctors. Results Using the lifting-thrusting method, PDMS D (mixing ratio of 1:4.5) and control 2 (porcine blade shoulder) revealed no significant difference in the dynamic friction coefficients or maximum and minimum friction force values (P < 0.001). Using the twirling method, PDMS D showed no significant difference from all controls in the viscosity coefficient or maximum and minimum torque values (P ≤ 0.001). By practitioners, PDMS D showed the greatest score. Conclusion PDMS D delivered a haptic sensation that is most similar to that of biological tissues in the case of acu-needle lifting-thrusting and twirling methods. This finding guides the preparation of tissue phantoms for acu-needle studies and acupuncture training.
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Affiliation(s)
- Yeonsun Lee
- Department of Acupuncture & Moxibustion, Bucheon Jaseng Hospital of Oriental Medicine, Bucheon, 14598, Republic of Korea
| | - Hyosang Lee
- Haptic intelligence Department, Max Planck Institute for Intelligent Systems, Stuttgart 70569, Germany
| | - Eun Jung Kim
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam, 13601, Republic of Korea
| | - Seung Deok Lee
- Dongguk University Los Angeles, 440 Shatto PI, Los Angeles, CA 90020, USA
| | - Chan Yung Jung
- Department of Acupuncture & Moxibustion, Dongguk University Ilsan Oriental Hospital, Goyang, 10326, Republic of Korea
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Lee JH, Lee SH, Suh HS, Hwang MS, Jang S, Choi S, Lim YS, Byun SH, Yoon SH, Park S, Park TY. Effectiveness of Acupotomy Combined with Epidural Steroid Injection for Lumbosacral Radiculopathy: A Randomized Controlled Pragmatic Pilot Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:175. [PMID: 38276054 PMCID: PMC10818306 DOI: 10.3390/medicina60010175] [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] [Received: 12/04/2023] [Revised: 01/04/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
Background and Objectives: This pilot study aimed to evaluate the clinical effectiveness, cost-effectiveness, and safety of acupotomy combined with epidural steroid injection (ESI) in lumbosacral radiculopathy and examine its feasibility for the main study. Materials and Methods: This randomized, controlled, two-arm, parallel, assessor-blinded, pragmatic study included 50 patients with severe lumbosacral radiculopathy who had insufficient improvement after an ESI. Patients were randomized (1:1 ratio) into a combined treatment (acupotomy + ESI, experimental) and an ESI single treatment (control) group. Both groups underwent a total of two ESIs once every 2 weeks; the experimental group received eight additional acupotomy treatments twice a week for 4 weeks. Types of ESI included interlaminar, transforaminal, and caudal approaches. Drugs used in ESI comprised a 5-10 mL mixture of dexamethasone sodium phosphate (2.5 mg), mepivacaine (0.3%), and hyaluronidase (1500 IU). The primary outcome was the difference in changes from baseline in the Oswestry Disability Index (ODI) scores between the groups at weeks 4 and 8. The incremental cost-utility ratio (ICUR) was calculated to evaluate the cost-effectiveness between the groups. Adverse events (AEs) were assessed at all visits. Results: Mean ODI scores for the experimental and control groups were -9.44 (95% confidence interval [CI]: -12.71, -6.17) and -2.16 (95% CI: -5.01, 0.69) at week 4, and -9.04 (95% CI: -12.09, -5.99) and -4.76 (95% CI: -7.68, -1.84) at week 8, respectively. The difference in ODI score changes was significant between the groups at week 4 (p = 0.0021). The ICUR of the experimental group versus the control group was as economical as 18,267,754 won/quality-adjusted life years. No serious AEs were observed. Conclusions: These results demonstrate the potential clinical effectiveness and cost-effectiveness of acupotomy combined with ESI for lumbosacral radiculopathy and its feasibility for a full-scale study. Larger, long-term follow-up clinical trials are needed to confirm these findings.
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Affiliation(s)
- Jin-Hyun Lee
- Institute for Integrative Medicine, International St. Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Republic of Korea;
| | - Sang-Hyun Lee
- Department of Korean Medicine, Graduate School, Pusan National University, Yangsan 50612, Republic of Korea;
| | - Hae Sun Suh
- College of Pharmacy, Kyung Hee University, Seoul 02453, Republic of Korea
- Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul 02453, Republic of Korea
- Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul 02453, Republic of Korea
| | - Man-Suk Hwang
- Department of Korean Medicine Rehabilitation, Spine and Joint Center, Pusan National University Korean Medicine Hospital, Yangsan 50612, Republic of Korea
- Third Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea
| | - Semin Jang
- Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul 02453, Republic of Korea
- Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul 02453, Republic of Korea
| | - Sooil Choi
- Department of Anesthesiology and Pain Medicine, International St. Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Republic of Korea; (S.C.)
| | - Young-Soo Lim
- Department of Anesthesiology and Pain Medicine, International St. Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Republic of Korea; (S.C.)
| | - Sang Hyun Byun
- SAGAJEONG Pain and Korean Medicine Clinic, Seoul 02238, Republic of Korea
| | - Sang-Hoon Yoon
- Department of Applied Korean Medicine, Graduate School, Kyung Hee University, Seoul 02453, Republic of Korea
| | - Sukhee Park
- Department of Anesthesiology and Pain Medicine, International St. Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Republic of Korea; (S.C.)
| | - Tae-Yong Park
- Institute for Integrative Medicine, International St. Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Republic of Korea;
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Yoon DE, Lee S, Kim J, Kim K, Park HJ, Napadow V, Lee IS, Chae Y. Graded brain fMRI response to somatic and visual acupuncture stimulation. Cereb Cortex 2023; 33:11269-11278. [PMID: 37804240 DOI: 10.1093/cercor/bhad364] [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: 07/31/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/09/2023] Open
Abstract
Increased stimulation can enhance acupuncture clinical response; however, the impact of acupuncture stimulation as "dosage" has rarely been studied. Furthermore, acupuncture can include both somatic and visual components. We assessed both somatic and visual acupuncture dosage effects on sensory ratings and brain response. Twenty-four healthy participants received somatic (needle inserted, manually stimulated) and visual (needle video, no manual stimulation) acupuncture over the leg at three different dosage levels (control, low-dose, and high-dose) during functional magnetic resonance imaging (fMRI). Participants reported the perceived deqi sensation for each acupuncture dose level. Blood-oxygen-level dependent imaging data were analyzed by general linear model and multivariate pattern analysis. For both somatic and visual acupuncture, reported deqi sensation increased with increased dosage of acupuncture stimulation. Brain fMRI analysis demonstrated that higher dosage of somatic acupuncture produced greater brain responses in sensorimotor processing areas, including anterior and posterior insula and secondary somatosensory cortex. For visual acupuncture, higher dosage of stimulation produced greater brain responses in visual-processing areas, including the middle temporal visual areas (V5/MT+) and occipital cortex. Psychophysical and psychophysiological responses to both somatic and visual acupuncture were graded in response to higher doses. Our findings suggest that acupuncture response may be enhanced by the dosage of needling-specific and nonspecific components, represented by different neural mechanisms.
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Affiliation(s)
- Da-Eun Yoon
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seoyoung Lee
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jundong Kim
- Department of Ophthalmology, Otorhinolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Kyuseok Kim
- Department of Ophthalmology, Otorhinolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Hi-Joon Park
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Vitaly Napadow
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA 02129, United States
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, United States
| | - In-Seon Lee
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Younbyoung Chae
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA 02129, United States
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Hu NJ, Li CH, Wang P, Wu GW, Ma LX, Zhu J. Influence of Psychological Factors in Primary Dysmenorrhea Patients on De qi: a Secondary Analysis of a Randomized Controlled Trial. J Acupunct Meridian Stud 2023; 16:20-29. [PMID: 36804818 DOI: 10.51507/j.jams.2023.16.1.20] [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: 06/25/2022] [Revised: 09/22/2022] [Accepted: 01/10/2023] [Indexed: 02/22/2023] Open
Abstract
Background De qi , the needling sensation, is important in acupuncture treatment. Almost all studies believe that deep needling and manipulation could achieve a significant de qi sensation. However, relatively few studies have examined the effect of psychological factors on de qi, and those that did often reached different conclusions. Objectives To explore the influence of psychologic factors on de qi in patients with primary dysmenorrhea (PD). Methods Sixty-eight PD patients with cold and dampness stagnation were randomly allocated to de qi (deep insertion using thick needles, with manipulation, n=17) and non-de qi groups (shallow insertion using thin needles, without manipulation, n=51). Both groups received bilateral needling at Sanyinjiao (SP6) for 30 min. De qi was assessed using the Acupuncture De qi Clinical Assessment Scale (ADCAS). The patients' acupuncture-related anxiety and their expectations of the relationship between needle sensation and curative effect were evaluated using a five-point and four-point scale, respectively. Results Within the de qi group, all patients experienced the de qi sensation, although anxiety levels were unrelated to de qi. Patients' expectations correlated negatively with de qi timing, and positively with electric sensation. Within the non-de qi group, 59.5% of patients experienced de qi. Between those who experienced it and those who did not, no significant differences were found in anxiety levels, although patients' expectations differed significantly. Among patients who experienced de qi sensations in the non-de qi group, anxiety and throbbing were positively correlated. Additionally, patients' expectations correlated positively with de qi intensity, as well as coldness, and numbness. Conclusion Psychological factors should be considered when studying de qi since PD patients' expectations could influence the de qi sensation at SP6.
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Affiliation(s)
- Ni-Juan Hu
- Capital Medical University Electric Power Teaching Hospital, Beijing, China
| | - Chun-Hua Li
- Capital Medical University Electric Power Teaching Hospital, Beijing, China
| | - Pei Wang
- Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
| | - Gui-Wen Wu
- The First People's Hospital of Changzhou, Jiangsu, China
| | - Liang-Xiao Ma
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jiang Zhu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Wang BG, Xu LL, Yang HY, Xie J, Xu G, Tang WC. Manual acupuncture for neuromusculoskeletal disorders: The selection of stimulation parameters and corresponding effects. Front Neurosci 2023; 17:1096339. [PMID: 36793537 PMCID: PMC9922711 DOI: 10.3389/fnins.2023.1096339] [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: 11/12/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
As a minimally invasive method of physical stimulation, manual acupuncture (MA) is used globally as a sort of therapy for neuromusculoskeletal disorders. In addition to selecting appropriate acupoints, acupuncturists should also determine the stimulation parameters of needling, such as the manipulation (lifting-thrusting or twirling), needling amplitude, velocity, and stimulation time. At present, most studies focus on acupoint combination and mechanism of MA, the relationship between stimulation parameters and their therapeutic effects, as well as the influence on mechanism of action are relatively scattered, and lack of systematic summary and analysis. This paper reviewed the three types of stimulation parameters of MA, their common options and values, corresponding effects and potential mechanisms of action. The purpose of such efforts is to provide a useful reference for the dose-effect relationship of MA and the quantification and standardization of its clinical treatment of neuromusculoskeletal disorders to further promote the application of acupuncture in the world.
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Affiliation(s)
- Bing-Gan Wang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Liu-Liu Xu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hua-Yuan Yang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian Xie
- Department of Acupuncture and Moxibustion, Yuhuan Hospital of Traditional Chinese Medicine, Taizhou, Zhejiang, China
| | - Gang Xu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen-Chao Tang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Comparison of the acupuncture manipulation properties of traditional East Asian medicine and Western medical acupuncture. Integr Med Res 2022; 11:100893. [PMID: 36353444 PMCID: PMC9637804 DOI: 10.1016/j.imr.2022.100893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 11/05/2022] Open
Abstract
Background Acupuncture treatments frequently use manipulation techniques. The therapeutic advantages of acupuncture differ depending on the acupuncture manipulation. The purpose of this article was to compare manipulation techniques in traditional East Asian medicine (TEAM) and Western medical acupuncture (WMA). Methods Manipulation techniques in TEAM and WMA were compared according to purpose, modulating parameters, and indications. The practical understanding of manipulation in terms of acupuncture stimulation intensity was also explored. The TEAM manipulation techniques of twirling and lifting and thrusting are discussed in terms of the objectives of tonification and sedation. Results The main therapeutic effect of WMA is mediated through activation of the nervous system, which is achieved with adequate intensity of needling. The TEAM tonification and sedation techniques were designed to produce mild or intense stimulation, respectively, to elicit varying degrees of deqi sensation. Conclusions Further research is needed to clarify the differences between the TEAM and WMA practices, and to determine whether different needling manipulations affect treatment outcomes.
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Ma X, Chen W, Yang NN, Wang L, Hao XW, Tan CX, Li HP, Liu CZ. Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system. Front Neurosci 2022; 16:940343. [PMID: 36203799 PMCID: PMC9530146 DOI: 10.3389/fnins.2022.940343] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/29/2022] [Indexed: 12/04/2022] Open
Abstract
Neuropathic pain, caused by a lesion or disease of the somatosensory system, is common and distressing. In view of the high human and economic burden, more effective treatment strategies were urgently needed. Acupuncture has been increasingly used as an adjuvant or complementary therapy for neuropathic pain. Although the therapeutic effects of acupuncture have been demonstrated in various high-quality randomized controlled trials, there is significant heterogeneity in the underlying mechanisms. This review aimed to summarize the potential mechanisms of acupuncture on neuropathic pain based on the somatosensory system, and guided for future both foundational and clinical studies. Here, we argued that acupuncture may have the potential to inhibit neuronal activity caused by neuropathic pain, through reducing the activation of pain-related ion channels and suppressing glial cells (including microglia and astrocytes) to release inflammatory cytokines, chemokines, amongst others. Meanwhile, acupuncture as a non-pharmacologic treatment, may have potential to activate descending pain control system via increasing the level of spinal or brain 5-hydroxytryptamine (5-HT), norepinephrine (NE), and opioid peptides. And the types of endogenously opioid peptides was influenced by electroacupuncture-frequency. The cumulative evidence demonstrated that acupuncture provided an alternative or adjunctive therapy for neuropathic pain.
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Affiliation(s)
- Xin Ma
- School of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Wen Chen
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Na-Na Yang
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Lu Wang
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Wan Hao
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Chun-Xia Tan
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
| | - Hong-Ping Li
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- Hong-Ping Li,
| | - Cun-Zhi Liu
- School of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
- School of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Cun-Zhi Liu,
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Cerebral Blood Flow Velocity Modulation and Clinical Efficacy of Acupuncture for Posterior Circulation Infarction Vertigo: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3740856. [PMID: 35800002 PMCID: PMC9256413 DOI: 10.1155/2022/3740856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 12/04/2022]
Abstract
Background Vertigo is a cardinal symptom of posterior circulation infarction (POCI). Acupuncture is demonstrated to have a beneficial effect on posterior circulation infarction vertigo (PCIV). However, the mechanism of acupuncture therapy is not clarified. This study aims to assess the cerebral blood flow velocity modulation and clinical efficacy of acupuncture for PCIV patients. Methods We conducted this systematic review for clinical randomized controlled trials (RCTs) regarding acupuncture on PCIV. The study duration was from September 2020 to September 2021. We searched the PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP. The publication date was set from inception to August 31, 2020. Based on the inclusion and exclusion criteria, two researchers independently screened literature and extracted data including basic study information, intervention details, outcome details, and adverse events. Outcome measures included the blood flow velocities of vertebrobasilar arteries and the Clinical Effective Rate of posterior circulation infarction vertigo. Pooled data were presented as standardized mean differences (SMDs) and relative risks (RR), with 95% confidence intervals (CIs). The meta-analysis was conducted using Review Manager software version 5.3.0. Results A total of 20 eligible RCTs (1541 participants) were included in this review, which compared acupuncture therapy (1 RCT) or acupuncture combined with pharmaceutical therapy (19 RCTs) to pharmaceutical therapy in patients with posterior circulation infarction vertigo. 7 studies assessed the blood flow velocities of the basilar artery examined by Transcranial Doppler (TCD), 8 studies assessed the bilateral vertebral arteries, and 13 studies evaluated the Clinical Effective Rate of posterior circulation infarction vertigo. Meta-analysis results showed that blood flow velocities of the basilar artery (SMD = 0.58, 95% CI = 0.40–0.76; P < 0.05), left vertebral artery (SMD = 0.48, 95% CI = 0.22–0.73; P < 0.05), and right vertebral artery (SMD = 0.44, 95% CI = 0.19–0.69; P < 0.05) were significantly higher in the acupuncture group compared with the control group. Clinical Effective Rate (RR = 1.22, 95% CI = 1.15–1.29; P = 0.792) was significantly better in the acupuncture group compared with the control group. Conclusions This study shows that acupuncture therapy is useful in improving the blood flow velocity of vertebrobasilar arteries and Clinical Effective Rate in patients with posterior circulation infarction vertigo. However, double-blind, sham-controlled trials with large sample sizes are required to support our conclusions.
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Chao YL, Rau YA, Shiue HS, Yan JL, Tang YY, Yu SW, Yeh BY, Chen YL, Yang TH, Cheng SC, Hsieh YW, Huang HC, Tsai FK, Chen YS, Liu GH. Using a consensus acupoints regimen to explore the relationship between acupuncture sensation and lumbar spinal postoperative analgesia: A retrospective analysis of prospective clinical cooperation. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:329-337. [PMID: 35487866 DOI: 10.1016/j.joim.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study evaluated the effectiveness of acupuncture treatment on postoperative pain in patients with degenerative lumbar spine disease, and explored the relationship between the postoperative analgesic effect of acupuncture and the sensation of acupuncture experienced by the patients. METHODS This retrospective study analyzed the medical records of 97 patients who had undergone an operation by the same surgeon due to degenerative lumbar disease. These patients were divided into acupuncture group (n = 32), patient-controlled analgesia (PCA) group (n = 27), and oral analgesia group (n = 38) according to the different postoperative analgesic methods. During their hospitalization, patients completed daily evaluations of their pain using a visual analogue scale (VAS), and injection times of supplemental meperidine were recorded. Also, the Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale (C-MASS) was used in the acupuncture group. RESULTS Each of the three treatment groups showed significant reductions in postoperative pain, as shown by reduced VAS scores. The acupuncture group, however, had less rebound pain (P < 0.05) than the other two groups. Both the acupuncture and PCA groups experienced acute analgesic effects that were superior to those in the oral analgesia group. In addition, the higher the C-MASS index on the second day after surgery, the lower the VAS score on the fourth day after surgery. There was also a significant difference in the "dull pain" in the acupuncture sensation. CONCLUSION The results demonstrated that acupuncture was beneficial for postoperative pain and discomfort after simple surgery for degenerative spinal disease. It is worth noting that there was a disproportionate relevance between the patient's acupuncture sensation and the improvement of pain VAS score.
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Affiliation(s)
- Yen-Lin Chao
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Yi-Ai Rau
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Hong-Sheng Shiue
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, China
| | - Jiun-Lin Yan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, China; Department of Neurosurgery, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan, China
| | - Yuan-Yun Tang
- Department of Traditional Chinese Medicine, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei 236, Taiwan, China
| | - Shao-Wen Yu
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Bo-Yan Yeh
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Yen-Lung Chen
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Tsung-Hsien Yang
- Department of Traditional Chinese Medicine, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei 236, Taiwan, China
| | - Shu-Chen Cheng
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Yi-Wen Hsieh
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Hsin-Chia Huang
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Fu-Kuang Tsai
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Yu-Sheng Chen
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, China
| | - Geng-Hao Liu
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, China; Sleep Center, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China.
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11
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Cerebral Responses to Different Reinforcing-reducing Acupuncture Manipulations: Study Protocol for a Randomized Crossover Functional Near-Infrared Spectroscopy (fNIRS) Trial. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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12
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Dunning J, Butts R, Bliton P, Vathrakokoilis K, Smith G, Lineberger C, Eshleman N, Fernández-de-Las-Peñas C, Young IA. Dry needling and upper cervical spinal manipulation in patients with temporomandibular disorder: A multi-center randomized clinical trial. Cranio 2022:1-14. [PMID: 35412448 DOI: 10.1080/08869634.2022.2062137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare the effects of dry needling and upper cervical spinal manipulation with interocclusal splint therapy, diclofenac, and temporomandibular joint (TMJ) mobilization in patients with temporomandibular disorder (TMD). METHODS One hundred-twenty patients with TMD were randomized to receive six treatment sessions of dry needling plus upper cervical spinal manipulation (n = 62) or interocclusal splint therapy, diclofenac, and joint mobilization to the TMJ (n = 58). RESULTS Patients receiving dry needling and upper cervical spinal manipulation experienced significantly greater reductions in jaw pain intensity over the last 7 days (VAS: F = 23.696; p < 0.001) and active pain-free mouth opening (F = 29.902; p < 0.001) than those receiving interocclusal splint therapy, diclofenac, and TMJ mobilization at the 3-month follow-up. CONCLUSION Dry needling and upper cervical spinal manipulation was more effective than interocclusal splint therapy, diclofenac, and TMJ mobilization in patients with TMD.
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Affiliation(s)
- James Dunning
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA
- Montgomery Osteopractic Physical Therapy & Acupuncture Clinic, Montgomery, AL, USA
| | - Raymond Butts
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA
- Research Physical Therapy Specialists, Columbia, SC, USA
| | - Paul Bliton
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA
- Athletico Physical Therapy, Roscoe, IL, USA
| | | | - Grant Smith
- Advanced Manual Therapies, Alpharetta, GA, USA
| | | | - Noah Eshleman
- Peak Physical Therapy & Sports Rehab, Helena, MT, USA
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- Ejercicio, Universidad Rey Juan CarlosCátedra de Clínica, Investigación y Docencia en Fisioterapia: Terapia Manual, Punción Seca y, Alcorcón, Spain
| | - Ian A Young
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA
- Tybee Wellness & Osteopractic, Tybee Island, GA, USA
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13
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Yoon DE, Lee IS, Chae Y. Identifying Dose Components of Manual Acupuncture to Determine the Dose-Response Relationship of Acupuncture Treatment: A Systematic Review. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2022; 50:653-671. [PMID: 35300569 DOI: 10.1142/s0192415x22500264] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The dose-response relationship is a hallmark of pharmacological studies. However, this relationship has not been fully established in acupuncture research. This systematic review aims to provide the characteristics of the dose-response relationship in acupuncture research. We further summarized the differences in acupuncture effects according to dose components. Dose components of acupuncture were categorized into three groups: number of needles, stimulation intensity, and total number/frequency of treatments. The PubMed database was used to identify studies examining the effects of different doses of acupuncture from the establishment of the database to August 13, 2020. Dose components and responses were extracted from each study, and the results of low- and high-dose conditions were compared. Fourteen studies were included in this study. Of the included studies, 37.5% showed statistically significant enhanced responses to acupuncture treatment under high-dose conditions compared to low-dose conditions. Significant differences between high- and low-dose conditions were observed most frequently in studies that used various stimulation intensities (four out of six studies), followed in order by studies that used various numbers of needles (two out of seven studies), and those that used various numbers or frequencies of treatment (none of the three studies). Responses were categorized into symptom changes, physiological changes, experimentally induced pain/stimuli perception, and needling sensation. Stimulation intensity, which is considered one of the most important needling components, might indeed have a great impact on clinical responses to acupuncture.
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Affiliation(s)
- Da-Eun Yoon
- Department of Science in Korean Medicine, Graduate School, Republic of Korea
| | - In-Seon Lee
- Department of Science in Korean Medicine, Graduate School, Republic of Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine Kyung Hee University, Seoul 02447, Republic of Korea
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14
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Fei YT, Cao HJ, Xia RY, Chai QY, Liang CH, Feng YT, Du YR, Yu MK, Guyatt G, Thabane L, Lao LX, Liu JP, Zhang YQ. Methodological challenges in design and conduct of randomised controlled trials in acupuncture. BMJ 2022; 376:e064345. [PMID: 35217507 PMCID: PMC8868049 DOI: 10.1136/bmj-2021-064345] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Yu-Tong Fei and colleagues examine the problems with designing and implementing trials of acupuncture
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Affiliation(s)
- Yu-Tong Fei
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
| | - Hui-Juan Cao
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
| | - Ru-Yu Xia
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
| | - Qian-Yun Chai
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
| | - Chang-Hao Liang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
| | - Yu-Ting Feng
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
| | - Yi-Ran Du
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ming-Kun Yu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada
| | - Li-Xing Lao
- Virginia University of Integrative Medicine, Virginia, USA
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
| | - Yu-Qing Zhang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada
- Ningbo GRADE Centre, University of Nottingham Ningbo, China
- Chinese Academy of Medical Sciences, Beijing, China
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15
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Spinal Manipulation and Electrical Dry Needling in Patients With Subacromial Pain Syndrome: A Multicenter Randomized Clinical Trial. J Orthop Sports Phys Ther 2021; 51:72-81. [PMID: 32857944 DOI: 10.2519/jospt.2021.9785] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To compare the effects of spinal thrust manipulation and electrical dry needling (TMEDN group) to those of nonthrust peripheral joint/soft tissue mobilization, exercise, and interferential current (NTMEX group) on pain and disability in patients with subacromial pain syndrome (SAPS). DESIGN Randomized, single-blinded, multicenter parallel-group trial. METHODS Patients with SAPS were randomized into the TMEDN group (n = 73) or the NTMEX group (n = 72). Primary outcomes included the Shoulder Pain and Disability Index and the numeric pain-rating scale. Secondary outcomes included the global rating of change scale (GROC) and medication intake. The treatment period was 6 weeks, with follow-ups at 2 weeks, 4 weeks, and 3 months. RESULTS At 3 months, the TMEDN group experienced greater reductions in shoulder pain and disability (P<.001) compared to the NTMEX group. Effect sizes were large in favor of the TMEDN group. At 3 months, a greater proportion of patients within the TMEDN group achieved a successful outcome (GROC score of 5 or greater) and stopped taking medication (P<.001). CONCLUSION Cervicothoracic and upper-rib thrust manipulation combined with electrical dry needling resulted in greater reductions in pain, disability, and medication intake than nonthrust peripheral joint/soft tissue mobilization, exercise, and interferential current in patients with SAPS. The effects were maintained at 3 months. J Orthop Sports Phys Ther 2021;51(2):72-81. Epub 28 Aug 2020. doi:10.2519/jospt.2021.9785.
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16
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Huo R, Han SP, Liu FY, Shou XJ, Liu LY, Song TJ, Zhai FJ, Zhang R, Xing GG, Han JS. Responses of Primary Afferent Fibers to Acupuncture-Like Peripheral Stimulation at Different Frequencies: Characterization by Single-Unit Recording in Rats. Neurosci Bull 2020; 36:907-918. [PMID: 32394277 DOI: 10.1007/s12264-020-00509-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 01/18/2020] [Indexed: 10/24/2022] Open
Abstract
The pain-relieving effect of acupuncture is known to involve primary afferent nerves (PANs) via their roles in signal transmission to the CNS. Using single-unit recording in rats, we characterized the generation and transmission of electrical signals in Aβ and Aδ fibers induced by acupuncture-like stimuli. Acupuncture-like signals were elicited in PANs using three techniques: manual acupuncture (MAc), emulated acupuncture (EAc), and electro-acupuncture (EA)-like peripheral electrical stimulation (PES). The discharges evoked by MAc and EAc were mostly in a burst pattern with average intra-burst and inter-burst firing rates of 90 Hz and 2 Hz, respectively. The frequency of discharges in PANs was correlated with the frequency of PES. The highest discharge frequency was 246 Hz in Aβ fibers and 180 Hz in Aδ fibers. Therefore, EA in a dense-disperse mode (at alternating frequency between 2 Hz and 15 Hz or between 2 Hz and 100 Hz) best mimics MAc. Frequencies of EA output >250 Hz appear to be obsolete for pain relief.
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Affiliation(s)
- Ran Huo
- Neuroscience Research Institute, Peking University, Beijing, 100191, China.,Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China.,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, 100191, China.,Department of Radiology, Peking University Third Hospital, Beijing, 100191, China
| | - Song-Ping Han
- Neuroscience Research Institute, Peking University, Beijing, 100191, China.,Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China.,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, 100191, China
| | - Feng-Yu Liu
- Neuroscience Research Institute, Peking University, Beijing, 100191, China.,Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China.,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, 100191, China
| | - Xiao-Jing Shou
- Neuroscience Research Institute, Peking University, Beijing, 100191, China.,Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China.,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, 100191, China
| | - Ling-Yu Liu
- Neuroscience Research Institute, Peking University, Beijing, 100191, China.,Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China.,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, 100191, China
| | - Tian-Jia Song
- Neuroscience Research Institute, Peking University, Beijing, 100191, China.,Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China.,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, 100191, China
| | - Fu-Jun Zhai
- Neuroscience Research Institute, Peking University, Beijing, 100191, China.,Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China.,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, 100191, China
| | - Rong Zhang
- Neuroscience Research Institute, Peking University, Beijing, 100191, China.,Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China.,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, 100191, China.,Department of Integration of Chinese and Western Medicine, Peking University School of Basic Medical Sciences, Beijing, 100191, China
| | - Guo-Gang Xing
- Neuroscience Research Institute, Peking University, Beijing, 100191, China. .,Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China. .,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, 100191, China. .,Department of Integration of Chinese and Western Medicine, Peking University School of Basic Medical Sciences, Beijing, 100191, China.
| | - Ji-Sheng Han
- Neuroscience Research Institute, Peking University, Beijing, 100191, China. .,Department of Neurobiology, Peking University School of Basic Medical Sciences, Beijing, 100191, China. .,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, 100191, China.
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17
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Wang-Price S, Zafereo J, Couch Z, Brizzolara K, Heins T, Smith L. Short-term effects of two deep dry needling techniques on pressure pain thresholds and electromyographic amplitude of the lumbosacral multifidus in patients with low back pain - a randomized clinical trial. J Man Manip Ther 2020; 28:254-265. [PMID: 31960773 DOI: 10.1080/10669817.2020.1714165] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Objectives: The purpose of this study was to compare the effects of deep dry needling (DN) with and without needle manipulation on pressure pain thresholds (PPTs) and electromyographic (EMG) amplitude of the lumbosacral multifidus (LM) in adults with low back pain (LBP). Methods: Participants were randomized into two treatment groups: with needle manipulation (n = 21) and without needle manipulation (n = 21). All participants received a single session of the assigned DN intervention. PPTs and EMG amplitude of the LM muscle were collected three times: before DN, immediately after DN, and one week after DN. Results: The needle manipulation group had a significantly greater increase in PPT immediately after the intervention and at the one-week follow-up as compared to the no needle manipulation group. The increase of PPT in the needle manipulation group was significant immediately after the intervention, and the increase remained significant at the one-week follow-up. However, there was no significant difference in EMG amplitude of the LM muscle between groups across the three time points. Discussion: Deep DN with needle manipulation appeared to reduce mechanical pressure sensitivity more than DN without manipulation for patients with LBP. Although a single session of DN could reduce pressure pain sensitivity, it may not be sufficient to improve LM muscle function. Level of Evidence: 1b. Trial registration numbers: NCT03970486.
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Affiliation(s)
- Sharon Wang-Price
- School of Physical Therapy, Texas Woman's University , Dallas, TX, USA
| | - Jason Zafereo
- Department of Physical Therapy, University of Texas Southwestern Medical Center , Dallas, TX, USA
| | - Zach Couch
- School of Physical Therapy, Texas Woman's University , Dallas, TX, USA.,Texas Physical Therapy Specialists, Dallas, TX, USA
| | - Kelli Brizzolara
- School of Physical Therapy, Texas Woman's University , Dallas, TX, USA
| | - Taylor Heins
- School of Physical Therapy, Texas Woman's University , Dallas, TX, USA
| | - Lindsey Smith
- School of Physical Therapy, Texas Woman's University , Dallas, TX, USA
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18
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Musial F. Acupuncture for the Treatment of Pain - A Mega-Placebo? Front Neurosci 2019; 13:1110. [PMID: 31680841 PMCID: PMC6811493 DOI: 10.3389/fnins.2019.01110] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 10/01/2019] [Indexed: 12/12/2022] Open
Abstract
Several control conditions, such as penetrating sham acupuncture and non-penetrating placebo needles, have been used in clinical trials on acupuncture effects in chronic pain syndromes. All these control conditions are surprisingly effective with regard to their analgesic properties. These findings have fostered a discussion as to whether acupuncture is merely a placebo. Meta-analyses on the clinical effectiveness of placebo revealed that placebo interventions in general have minor, clinically important effects. Only in trials on pain and nausea, including acupuncture studies, did placebo effects vary from negligible to clinically important. At the same time, individual patient meta-analyses confirm that acupuncture is effective for the treatment of chronic pain, including small but statistically significant differences between acupuncture and sham acupuncture. All acupuncture control conditions induce de qi, a distinct stimulation associated with pain and needling which has been shown to be a nociceptive/pain stimulus. Acupuncture therefore probably activates the pain matrix in the brain in a bottom-up fashion via the spino-thalamic tract. Central nervous system effects of acupuncture can be modulated through expectations, which are believed to be a central component of the placebo response. However, further investigation is required to determine how strong the influence of placebo on the attenuation of activity in the pain matrix really is. A meta-analysis of individual participant functional magnetic imaging data reveals only weak effects of placebo on the activity of the pain network. The clinical acupuncture setting is comprised of a combination of a distinct neurophysiological stimulus, the needling stimulus/experience, and a complex treatment situation. A broader definition of placebo, such as that proposed by Howick (2017) acknowledges a role for expectation, treatment context, emotions, learning, and other contextual variables of a treatment situation. The inclusion of particular treatment feature as a definitional element permits a contextual definition of placebo, which in turn can be helpful in constructing future clinical trials on acupuncture.
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Affiliation(s)
- Frauke Musial
- Department of Community Medicine, National Research Center in Complementary and Alternative Medicine, NAFKAM, Faculty of Health Science, UiT – The Arctic University of Norway, Tromsø, Norway
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19
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Stimulation Parameters of Manual Acupuncture and Their Measurement. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:1725936. [PMID: 31558907 PMCID: PMC6735182 DOI: 10.1155/2019/1725936] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 07/10/2019] [Accepted: 08/06/2019] [Indexed: 01/13/2023]
Abstract
The therapeutic effect of manual acupuncture (MA) is closely related to the stimulation amount. In the clinical studies, the stimulation amount is often difficult to be determined. The reason is that there are many parameters affecting the stimulation amount, including manipulation selection, treatment time, needling velocity, and force, and no complete and reasonable scheme is available for the measurement of stimulation parameters. This paper reviewed the theoretical and laboratory measurement studies on MA stimulation, summarized 4 types of available parameters according to the theory of physics, and compared the advantages and disadvantages of the existing methods of parameter measurement. Such efforts are hoped for providing reference for the establishment of the stimulation parameter system of MA and possible technical solutions for future measurement experiments.
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20
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Paley CA, Johnson MI. Investigation into the Effects of Using Two Or Four Acupuncture Needles with Bidirectional Rotation on Experimentally-Induced Contact Heat Pain in Healthy Subjects. Acupunct Med 2018; 33:23-9. [DOI: 10.1136/acupmed-2014-010617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objectives There is growing evidence from experimental studies that the acupuncture dose or technique influences the speed of onset of hypoalgesia. The aim of this study was to investigate the effects of acupuncture using two or four needles on experimental contact thermal pain in healthy volunteers. Methods Forty two participants were randomised into three groups: four-needle group (LI4, LI11, LI10, TE5), two-needle group (verum at LI4, LI11 and mock at LI10, TE5) and mock acupuncture group (LI4, LI11, LI10, TE5). Each participant rated pain intensity (visual analogue scale, VAS) to a series of noxious stimuli administered to the forearm 2°C above the heat pain threshold during needling and immediately after removal of the needles. Results Experimentally-induced heat pain intensity (VAS) during and after the intervention was lower than pre-intervention but there were no statistically significant differences in this change between groups. There were no statistically significant differences between groups in the time taken for pain intensity to decrease by 33% from pre-intervention. However, a 33% decrease in pain intensity within 3 min of needle insertion was observed for 13 participants (92.9%) in the four-needle group compared with 66.7% of participants in the two-needle group and 57.1% in the mock acupuncture group. There was less variance in VAS in the four-needle group, suggesting more consistency in hypoalgesic response when using more needles. Conclusions There is tentative evidence that four needles may be superior to two needles in generating rapid onset hypoalgesia. The findings suggest that further investigation is warranted.
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Affiliation(s)
- Carole A Paley
- Research & Development, Research Office, Airedale NHS Foundation Trust, Keighley, UK
- Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, UK
- Leeds Pallium Research Group, Leeds, UK
| | - Mark I Johnson
- Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, UK
- Leeds Pallium Research Group, Leeds, UK
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21
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Fleckenstein J, Baeumler P, Gurschler C, Weissenbacher T, Annecke T, Geisenberger T, Irnich D. Acupuncture reduces the time from extubation to 'ready for discharge' from the post anaesthesia care unit: results from the randomised controlled AcuARP trial. Sci Rep 2018; 8:15734. [PMID: 30356057 PMCID: PMC6200780 DOI: 10.1038/s41598-018-33459-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 09/25/2018] [Indexed: 12/11/2022] Open
Abstract
Acupuncture may improve peri-operative care as it reduces post-operative symptoms, such as pain, nausea and vomiting, or sedation. This patient-assessor blinded, randomised trial in 75 women undergoing gynaecologic laparoscopy evaluated the effects of acupuncture combined with a standardised anaesthetic regimen (ACU) on post-anaesthetic recovery, when compared to acupressure (APU) or standard anaesthesia alone (CON). Main outcome measure was the time from extubation to ‘ready for discharge’ from recovery as assessed by validated questionnaires. The main outcome differed significantly between groups (p = 0.013). Median time to ready for discharge in the ACU group (30 (IQR: 24–41) min) was 16 minutes (35%) shorter than in the CON group (46 (36–64) min; p = 0.015) and tended to be shorter than in the APU group (43 (31–58) min; p = 0.08). Compared to CON (p = 0.029), median time to extubation was approximately 7 minutes shorter in both, the ACU and the APU group. No acupuncture or acupressure-related side-effects could be observed. A difference in time to recovery of 16 minutes compared to standard alone can be considered clinically relevant. Thus, results of this study encourage the application of acupuncture in gynaecological laparoscopy as it improves post-anaesthetic recovery.
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Affiliation(s)
- J Fleckenstein
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany. .,Department of Traditional Chinese Medicine/Acupuncture, Institute of Complementary Medicine IKOM, University of Bern, Personalhaus 4, Inselspital, CH-3010, Bern, Switzerland.
| | - P Baeumler
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany
| | - C Gurschler
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany
| | - T Weissenbacher
- Department of Obstetrics and Gynaecology, Ludwig-Maximillians-University (LMU) Hospital, Maistraße 11, D-80337, Munich, Germany
| | - T Annecke
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany.,Department of Anaesthesiology and Intensive Care, University Hospital of Cologne, Uniklinik Köln, D-50924, Cologne, Germany
| | - T Geisenberger
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany.,Department of Anaesthesiology, Ospidal Engiadina Bassa, Via da l'Ospidal 280, CH-7550, Scuol, Switzerland
| | - D Irnich
- Department of Anaesthesiology, Ludwig-Maximilians University (LMU), Marchioninistraße 15, D-81377, Munich, Germany
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Razavy S, Gadau M, Zhang SP, Wang FC, Bangrazi S, Berle C, Li T, Li WH, Zaslawski C. Anxiety related to De Qi psychophysical responses as measured by MASS: A sub-study embedded in a multisite randomised clinical trial. Complement Ther Med 2018; 39:24-35. [PMID: 30012389 DOI: 10.1016/j.ctim.2018.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 05/09/2018] [Accepted: 05/16/2018] [Indexed: 12/17/2022] Open
Abstract
Acupuncture has been broadly applied in the management of many diseases and conditions; however, its mechanism of action has been partially elucidated. Additionally, assessment of psychophysical responses in the acupuncture therapy is not common regarding anxiety disorder studies. Taken together, the therapeutic effect of acupuncture appears when De Qi psychophysical response is experienced following stimulation of the afferent sensory nerves. The present study investigates the level of anxiety perceived at different occasions in acupuncture and mock laser group. Furthermore, it examines the relationship between perceived De Qi psychophysical response and the level of anxiety experienced during administration of each intervention. The study was embedded in a two-arm parallel design multi-center, randomized clinical trial, the Tennis Elbow Acupuncture-International Study-China, Hong Kong, Australia, Italy. Participants' level of anxiety was measured using a validated instrument, the Massachusetts General Hospital Acupuncture Sensation Mood Scale. Ninety-six participants with Lateral Elbow Pain were randomly allocated into two groups; the acupuncture treatment group (n = 47) and the inactive mock laser control group (n = 49). Data were collected immediately following the interventions at the first and the ninth session within the clinical trial. Acupuncture with De Qi did not induce higher level of anxiety compared to prior administration of acupuncture. In fact, participants were more relaxed after receiving acupuncture than those who received mock laser. There was also a weak association between participants' perception of anxiety during acupuncture and the MASS De Qi Index in session nine only (p < 0.01). Further investigation of the result revealed weak positive correlation between anxiety perceived during administration of acupuncture and the following De Qi characteristics; 'soreness' (p < 0.01), 'Deep pressure' (p < 0.05), 'Heaviness' (p < 0.05), and 'Fullness/distension' (p < 0.05). Acupuncture can be regarded as a potential therapy for preoperative anxiety through its possible regulatory function of emotion. While culture may not alter the expectation of the individual regarding anxiety, symptomology associated with anxiety should be understood within the context of the cultural background.
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Affiliation(s)
- Shohreh Razavy
- School of Life Sciences, University of Technology Sydney, Sydney 2007, New South Wales, Australia
| | - Marcus Gadau
- School of Chinese Medicine, Hong Kong Baptist University, China
| | - Shi Ping Zhang
- School of Chinese Medicine, Hong Kong Baptist University, China
| | - Fu Chun Wang
- Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin, China
| | | | - Christine Berle
- School of Life Sciences, University of Technology Sydney, Sydney 2007, New South Wales, Australia
| | - Tie Li
- Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin, China
| | - Wei Hong Li
- School of Life Sciences, University of Technology Sydney, Sydney 2007, New South Wales, Australia
| | - Christopher Zaslawski
- School of Life Sciences, University of Technology Sydney, Sydney 2007, New South Wales, Australia.
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A Double-Blind Study on Acupuncture Sensations with Japanese Style of Acupuncture: Comparison between Penetrating and Placebo Needles. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:8128147. [PMID: 29849728 PMCID: PMC5941723 DOI: 10.1155/2018/8128147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/02/2018] [Accepted: 01/14/2018] [Indexed: 01/17/2023]
Abstract
To investigate the acupuncture sensations elicited by the Japanese style of acupuncture, penetrating acupuncture and skin-touch placebo needles were randomly administered at various insertion depths (5 and 10 mm for the penetrating needles and 1 and 2 mm for the placebo needles) at LI4 to 50 healthy subjects. Among the 12 acupuncture sensations in the Massachusetts General Hospital Acupuncture Sensation Scale (MASS), “heaviness” was the strongest and most frequently reported sensation with the 10 mm needles, but not with the 5 mm needles. There were no significant differences in number of sensations elicited, MASS index, range of spreading, and intensity of needle pain for 5 mm penetration versus 1 mm skin press and 10 mm penetration versus 2 mm skin press. The MASS index with 2 mm skin-touch needles was significantly larger than that with 1 mm skin-touch and 5 mm penetrating needles. The factor structures in the 12 acupuncture sensations between penetrating and skin-touch needles were different. The acupuncture sensations obtained in this study under satisfactorily performed double-blind (practitioner–patient) conditions suggest that a slight difference in insertion depth and skin press causes significant differences in quantity and quality of acupuncture sensations.
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Kwon OS, Kim J, Choi KH, Ryu Y, Park JE. Trends in deqi research: a text mining and network analysis. Integr Med Res 2018; 7:231-237. [PMID: 30271711 PMCID: PMC6160493 DOI: 10.1016/j.imr.2018.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/31/2018] [Accepted: 02/20/2018] [Indexed: 01/21/2023] Open
Abstract
Background Deqi is a term describing a special state of the human body, which is ready to cure itself through acupuncture stimulation and is believed to be a key factor in acupuncture treatment. However, knowledge about deqi remains subjective. Therefore, in this study, we aimed to determine the factors related to deqi generation based on present studies to promote the progression of deqi research. Methods A term frequency–inverse document frequency (Tf-idf) was used to extract key elements from the abstracts of 148 articles searched from Pubmed, and the network structure between key elements was analyzed. Results A total of 37 items were extracted from the abstracts. Each item was categorized into one of three groups (acupuncture-related sensation, interventions or organ/mechanism). Acupuncture-related sensation was studied by comparing the items in the interventions group with the organ/mechanism group. Key elements related to deqi generation included muscles from the organ/mechanism group and intensity, depth and pressure from the interventions group. Items that belonged to the acupuncture-related sensation group were divided into two clusters: one cluster consisted of pain, tingling, aching, soreness, heaviness, fullness and numbness; the other included warm, cold and dull. Conclusion We could find out that the trend of deqi was leaning towards the interventions group, which related to the generation of deqi; thus, authors concluded that the mechanism studies, which are aimed to investigate why deqi is generated or what kind of meanings it has, are needed for evolution of acupuncture theory and application of the brand new technologies and related devices.
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Affiliation(s)
- O Sang Kwon
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Junbeom Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Kwang-Ho Choi
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Yeonhee Ryu
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Ji-Eun Park
- Mibyeong Research Center, Korea Institute of Oriental Medicine, Daejeon, Korea
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Mast Cells and Nerve Signal Conduction in Acupuncture. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:3524279. [PMID: 29707031 PMCID: PMC5863328 DOI: 10.1155/2018/3524279] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 01/08/2018] [Accepted: 02/05/2018] [Indexed: 01/17/2023]
Abstract
Nerve and mast cells are densely distributed around acupoints in connective tissue. To explore the internal relations between them in acupuncture effect, we examined dorsal root potential (DRP) response to acupuncture at Zusanli (ST36) under sodium cromoglicate (DSCG, a mast cell stabilizer) intervention in anesthetized Sprague-Dawley (SD) rats. We used single unit nerve recording techniques to collect nerve signals from DRP afferent nerves for a 45-minute period that includes 4 stages, that is, base, drug absorption, acupuncture, and recovery stages. We analyzed the recorded signals from time-domain and frequency-domain perspectives. The results showed that once acupuncture needle was inserted, twisting needle excited more nerves discharges than those at base discharges in ACU (from 35.1 ± 7.2 to 47 ± 9.2 Hz, P = 0.004), and there existed the same trend in Saline + ACU group (from 23.8 ± 2.6 to 29.8 ± 4.2 Hz, P = 0.059). There was no change of nerve discharges under twisting needle with injection of DSCG (from 34.8 ± 5.3 to 34.7 ± 4.4 Hz, P = 0.480). We conclude that acupuncture manipulation promotes neural signal production and DSCG could partly inhibit nerve discharges.
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Abstract
Because acupuncture treatment is defined by the process of needles penetrating the body, placebo needles were originally developed with non-penetrating mechanisms. However, whether placebo needles are valid controls in acupuncture research is subject of an ongoing debate. The present review provides an overview of the characteristics of placebo needles and how they differ from placebo pills in two aspects: (1) physiological response and (2) blinding efficacy. We argue that placebo needles elicit physiological responses similar to real acupuncture and therefore provide similar clinical efficacy. We also demonstrate that this efficacy is further supported by ineffective blinding (even in acupuncture-naïve patients) which may lead to opposite guesses that will further enhances efficacy, as compared to no-treatment, e.g., with waiting list controls. Additionally, the manner in which placebo needles can exhibit therapeutic effects relative to placebo pills include enhanced touch sensations, direct stimulation of the somatosensory system and activation of multiple brain systems. We finally discuss alternative control strategies for the placebo effects in acupuncture therapy.
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Affiliation(s)
- Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Ye-Seul Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, South Korea.,Department of Anatomy and Meridians, College of Korean Medicine, Gachon University, Seongnam, South Korea
| | - Paul Enck
- Department of Internal Medicine, Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tübingen, Germany
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Tang WC, Yang HY, Liu TY, Gao M, Xu G. Motion video-based quantitative analysis of the 'lifting-thrusting' method: a comparison between teachers and students of acupuncture. Acupunct Med 2017; 36:21-28. [PMID: 28844062 PMCID: PMC5865511 DOI: 10.1136/acupmed-2016-011348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To compare objective measures of needle manipulation between students and teachers of acupuncture using motion video analysis technology, to help support instructional acupuncture education. METHODS A total of 30 teachers and 60 students participated in this study. Acupuncture needles were inserted at LI11 and motion videos were recorded for three subtypes of 'lifting-thrusting' manipulation: (1) 'mild reinforcing-attenuating'; (2) 'reinforcing'; and (3) 'attenuating'. The videos were analysed using Simi Motion 3D software to acquire the movement parameters of four trace marks: 'thumb tip'; 'forefinger tip'; 'forefinger middle joint'; and 'forefinger base joint'. Differences between the two groups were compared using t-tests, X2 tests and/or rank-sum tests. RESULTS Changes in the near-end interphalangeal joint were positively associated with a range of movement along the X axis. Motion parameters for the thumb tip, the proximal interphalangeal (PIP) joint of the forefinger and the X axis shaft swing near the end of the forefinger in the teacher group were higher than those in the student group. The teacher group featured smaller trough dispersion and smaller crest dispersion during 'reinforcing' and 'attenuating' manipulations, respectively. CONCLUSIONS The 'lifting-thrusting' manipulation could be simplified as a fixed-axis rotation using metacarpophalangeal joints in the thumb and forefinger as the shaft centre. Teachers opened at a larger angular variation for the PIP during the lifting and thrusting processes with better spatial control. Temporal control was similar between groups and therefore appears easier to grasp. Repetitive training might be helpful for improving athletic and spatial stability during needle manipulation.
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Affiliation(s)
- Wen-Chao Tang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hua-Yuan Yang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tang-Yi Liu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ming Gao
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Gang Xu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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28
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Razavy S, Gadau M, Zhang SP, Wang FC, Bangrazi S, Berle C, Harahap M, Li T, Li WH, Zaslawski C. Psychophysical responses in patients receiving a mock laser within context of an acupuncture clinical trial: an interoceptive perspective. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:348. [PMID: 28673350 PMCID: PMC5496139 DOI: 10.1186/s12906-017-1859-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/26/2017] [Indexed: 11/10/2022]
Abstract
Background The psychophysical responses induced by verum acupuncture are characterized by a constellation of unique subjective sensory responses commonly termed De Qi. Furthermore, a variety of sham interventions have been used as a control for acupuncture clinical trials. Indeed, one such control has been mock laser which has been used as control intervention in several acupuncture clinical controlled trials. The current study aim was to examine the De Qi sensory responses and its related characteristics elicited from acupuncture and compare them to those reported following sham laser in participants enrolled in a clinical trial. Methods The study was embedded in a multi-center, two-arm randomised clinical trial, which evaluated the effect of acupuncture on lateral elbow pain. De Qi was assessed using the Massachusetts General Hospital Acupuncture Sensation Scale (MASS). Ninety-six participants were randomly allocated to receive either acupuncture (n = 47) or mock laser (n = 49) at the acupoints LI 10 and LI 11. Results Participants in both intervention groups reported similar De Qi psychophysical characteristics; however, both intensity and frequency of the individually perceived De Qi characteristics were significantly higher in the acupuncture group. ‘Soreness’, ‘deep pressure’, and ‘fullness-distension’ in the acupuncture group and ‘tingling’, and ‘sharp pain’ in mock laser group, were identified as the leading characteristics. Similar level of MASS De Qi Index (MDI) scores were reported for ‘Hong Kong-China’ and ‘Australia-Italy’ with a significantly higher level of De Qi reported by ‘Hong Kong-China’. Furthermore, two distinct De Qi categories were identified, namely De Qi (in line with classical sensory responses of Suan, Ma, Zhang, and Zhong) and pain. Conclusions Subjective ‘somatic or interoceptive awareness’ should be taken into account when De Qi psychophysical responses are examined. The study accentuates the necessity and the significance of further research into interoception phenomenon which may contribute to a better understanding of the placebo effect and De Qi psychophysical responses. Trial registration Australian and New Zealand Clinical Trial Registry reference: ACTRN12613001138774 on 11th of October 2013.
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Butts R, Dunning J, Pavkovich R, Mettille J, Mourad F. Conservative management of temporomandibular dysfunction: A literature review with implications for clinical practice guidelines (Narrative review part 2). J Bodyw Mov Ther 2017; 21:541-548. [DOI: 10.1016/j.jbmt.2017.05.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 05/22/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022]
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Li M, Yuan H, Wang P, Xin S, Hao J, Liu M, Li J, Yu M, Zhang X. Influences of De Qi induced by acupuncture on immediate and accumulated analgesic effects in patients with knee osteoarthritis: study protocol for a randomized controlled trial. Trials 2017; 18:251. [PMID: 28583145 PMCID: PMC5460357 DOI: 10.1186/s13063-017-1975-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 05/04/2017] [Indexed: 11/15/2022] Open
Abstract
Background De Qi is a special sensational response upon acupuncture needling. According to traditional acupuncture theory, the treatment is “effective only after Qi arrival”; that is, De Qi is an important indicator of therapeutic efficacy and good prognosis. However, it is still disputable whether De Qi improves the efficacy of acupuncture therapy. This prospective, randomized controlled trial aims to explore the influence of De Qi induced by acupuncture on immediate and accumulated analgesic effects in patients with knee osteoarthritis (KOA). Methods/design Eighty-eight patients with KOA will be recruited and randomly assigned to the De Qi group (enhanced stimulation to evoke De Qi) and the control group (weak stimulation to avoid De Qi) in the Department of Acupuncture and Physical Therapy, Beijing Luhe Hospital Affiliated to Capital Medical University. Each patient will receive three 30-minute sessions per week for 4 consecutive weeks and undergo a 1 month follow-up. The severity of knee pain, as measured on a 100-mm visual analog scale (where 0 indicates no pain and 100 indicates intolerable pain) will be used as the primary outcome, and the Knee injury and Osteoarthritis Outcome Score will be used as the secondary outcome. Both indexes will be measured before and after the 1st (for evaluating the immediate analgesic effects), 3rd, 6th, 9th, and 12th (for evaluating the accumulated analgesic effects) treatments and at the end of the follow-up. The intensity of the De Qi sensation will be assessed by the Chinese-Modified Massachusetts General Hospital Acupuncture Sensation Scale at the end of each treatment. Side effects during the treatments will be recorded and analyzed as well. The comparisons between the De Qi group and the control group will be done by using both an intention-to-treat analysis and a per-protocol analysis. Discussion This prospective randomized controlled study will be helpful in enhancing our understanding of the analgesic effect of De Qi on patients with KOA and may provide a clinical basis for further investigation of the relationship between De Qi and the therapeutic efficacy of acupuncture, thereby offering some evidence for the role of De Qi in an efficacious acupuncture therapy. Trial registration Chinese Clinical Trial Registry, ChiCTR-IIR-16008972. Registered on 4 August 2016 Additional file 2. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1975-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Min Li
- Department of Acupuncture and Physical Therapy, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua south street, Tongzhou District, Beijing, 101149, China
| | - Hongwen Yuan
- School of Traditional Chinese Medicine, Capital Medical University, No.10, Xitoutiao, Outside of Youanmen, Fengtai District, Beijing, 100069, China
| | - Pei Wang
- Department of Acupuncture and Physical Therapy, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua south street, Tongzhou District, Beijing, 101149, China.
| | - Siyuan Xin
- Teaching and Research Section of Acupuncture-moxibustion and Tuina, Chengde Medical College, Shangerdaohezi, Shuangqiao District, Chengde, Hebei Province, 067000, China
| | - Jie Hao
- National Institute of Complementary Medicine, Western Sydney University, Locked bag 1797, Penrith, 2751, Sydney, Australia
| | - Miaomiao Liu
- Department of Acupuncture and Physical Therapy, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua south street, Tongzhou District, Beijing, 101149, China
| | - Jinfeng Li
- Department of Acupuncture and Physical Therapy, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua south street, Tongzhou District, Beijing, 101149, China
| | - Man Yu
- Department of Acupuncture and Physical Therapy, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua south street, Tongzhou District, Beijing, 101149, China
| | - Xinrui Zhang
- Department of Acupuncture and Physical Therapy, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua south street, Tongzhou District, Beijing, 101149, China
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Role of Acupoint Area Collagen Fibers in Anti-Inflammation of Acupuncture Lifting and Thrusting Manipulation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:2813437. [PMID: 28473863 PMCID: PMC5394907 DOI: 10.1155/2017/2813437] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 01/22/2017] [Accepted: 02/12/2017] [Indexed: 11/18/2022]
Abstract
The role of the acupoint area collagen fibers in the efficacy of acupuncture lifting and thrusting (L&T) manipulation will be explored in this paper. 30 male NZW rabbits were randomly divided into 6 groups: sham operation group (Group N), model group (Group M), acupuncture without manipulation group (Group W), acupuncture L&T manipulation group (Group A), collagenase pretreatment group (Group JM), and collagenase pretreatment + acupuncture L&T manipulation group (Group JA). The bacterial endotoxin was used to generate the rabbit fever models. Acupuncture was applied at IL-11. The levels of IL-1β, TNF-α, and IL-4 and the rectal temperature were measured at 2 h, 4 h, and 6 h after modeling and the collagen fiber morphology at acupoint area was observed after 6 hours. Results. As compared with Group N, the levels of IL-1β and TNF-α in Group M were significantly higher; the level of IL-4 was significantly lower (P < 0.05). As compared with Group M, IL-1β and TNF-α in Groups W and A were significantly lower and IL-4 was significantly higher (P < 0.05). As compared with Group W, IL-1β and TNF-α in Group A were lower and IL-4 was higher (P < 0.05). The collagen fiber in Group A was slightly rough, distorted, and fractured. As shown in studies, the endotoxin-induced inflammatory response can be significantly inhibited by acupuncture whose efficacy can also be significantly improved by the manipulations. Collagenase pretreatment may be the first receptor to the mechanical force of the L&T manipulation.
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The local twitch response during trigger point dry needling: Is it necessary for successful outcomes? J Bodyw Mov Ther 2017; 21:940-947. [PMID: 29037652 DOI: 10.1016/j.jbmt.2017.03.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/17/2017] [Accepted: 02/28/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Myofascial trigger point (MTrP) injection and trigger point dry needling (TrPDN) are widely accepted therapies for myofascial pain syndrome (MPS). Empirical evidence suggests eliciting a local twitch response (LTR) during needling is essential. OBJECTIVE This is the first review exploring the available literature, regardless of study design, on the neurophysiological effects and clinical significance of the LTR as it relates to reductions in pain and disability secondary to MTrP needling. METHODS PubMed, MEDLINE, Science Direct and Google Scholar were searched up until October 2016 using terms related to trigger point needling and the LTR. RESULTS and Discussion: Several studies show that eliciting a LTR does not correlate with changes in pain and disability, and multiple systematic reviews have failed to conclude whether the LTR is relevant to the outcome of TrPDN. Post needling soreness is consistently reported in studies using repeated in and out needling to elicit LTRs and increases in proportion to the number of needle insertions. In contrast, needle winding without LTRs to MTrPs and connective tissue is well supported in the literature, as it is linked to anti-nociception and factors related to tissue repair and remodeling. Additionally, the positive biochemical changes in the MTrP after needling may simply be a wash out effect related to local vasodilation. While the LTR during TrPDN appears unnecessary for managing myofascial pain and unrelated to many of the positive effects of TrPDN, further investigation is required.
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Abstract
Acupuncture is a therapeutic treatment that is characterised by the insertion of a needle at a particular location on the body. Acupuncture stimulation includes sensory-discriminative and affective-social touch dimensions. In this review, we discuss the role of touch during acupuncture stimulation with an emphasis on the therapeutic, sensory-discriminative and affective-social aspects. In the discriminative dimension, de qi, which is associated with needling, includes a combination of various sensations, such as heaviness, numbness, soreness and distension. Achieving the appropriate de qi sensation appears to be fundamental to the therapeutic outcome following acupuncture treatment. In the affective dimension, the acupuncture procedure typically includes gentle manual touch stimulation, which induces feelings of calm and well-being, perhaps by activating C tactile fibres. Enhanced activity of C tactile afferents may induce a 'limbic touch' response, resulting in emotional and hormonal reactions. Because acupuncture is a 'therapist intensive' and complex intervention, it is necessary to understand the role of social touch between the practitioner and patient. Both sensory-discriminative and affective-social touch aspects play an important role in the therapeutic effect of acupuncture treatment in clinical practice.
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Affiliation(s)
- Younbyoung Chae
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Håkan Olausson
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
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Multidimensional Aspects of de qi Sensations in MASS and ASQ Assessment: A Pilot Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:6249329. [PMID: 28265292 PMCID: PMC5318627 DOI: 10.1155/2017/6249329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/07/2017] [Accepted: 01/15/2017] [Indexed: 11/17/2022]
Abstract
Background. De qi comprises varied senses depending on the individual. No single method can yet fully measure the multiple dimensions of de qi adequately. Objective. We examined the advantages of implementing multiple questionnaires for de qi measurement. Methods. Fourteen participants completed a preacupuncture questionnaire regarding their perception toward acupuncture treatment. After acupuncture stimulation at the HT7 point, de qi sensations were measured by MASS and ASQ. In groups with different levels of expectation, we compared the subtotal scores of each phase in the ASQ, as well as the VAS de qi intensity and MASS index using Kruskal-Wallis test. For the structural comparison of questionnaires, we first performed Spearman’s rank correlation test between the scores of individual descriptors in MASS and ASQ. The subtotal scores of each phase in ASQ was compared with VAS de qi intensity and MASS index. Results. The subtotal score of the manipulation phase in ASQ strongly correlated with the VAS score of de qi intensity (Spearman’s ρ=0.654, p=0.011) and MASS index (Spearman’s ρ=0.488, p=0.076). MASS and ASQ showed strong correlations in certain analogous descriptors. Unpleasant perceptions toward acupuncture treatment did not significantly correlate with overall de qi intensity. Conclusions. De qi sensations in acupuncture treatment have multidimensional aspects. Intensity of stimulation, ASQ, and MASS index assess somewhat restricted aspects of de qi. Those questionnaires have exclusive differences of sets in spite of their strong intersections. Use of multiple questionnaires may enable a more comprehensive understanding of de qi properties and the elicitation of relevant construction in de qi features of acupuncture.
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Pang B, Jiang T, Du YH, Li J, Li B, Hu YC, Cai QH. Acupuncture for Functional Dyspepsia: What Strength Does It Have? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:3862916. [PMID: 28119758 PMCID: PMC5227170 DOI: 10.1155/2016/3862916] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 10/08/2016] [Accepted: 10/23/2016] [Indexed: 12/20/2022]
Abstract
Background. Although the effectiveness of acupuncture therapy on functional dyspepsia (FD) has been systematically reviewed, the available reports are still contradictive and no robust evidence has been provided to date. Objective. To assess the current evidence of high quality on the effects of acupuncture for patients with FD. Methods. A comprehensive literature database search was conducted to identify randomized controlled trials (RCTs) comparing acupuncture therapies (including manual acupuncture and electroacupuncture) to sham acupuncture and medication use. A meta-analysis was performed following a strict methodology. Results. 16 RCTs involving 1436 participants were included. The majority of the trials were determined to be of low quality. Positive results were found for acupuncture in improving the Nepean Dyspepsia Index (NDI) and scores of the MOS 36-Item Short-Form Health Survey (SF-36), as well as in alleviating relevant symptoms (especially postprandial fullness and early satiation) of FD patients. Conclusion. Based on current available evidence, acupuncture therapy achieves statistically significant effect for FD in comparison with sham acupuncture and is superior to medication (prokinetic agents) in improving the symptoms and quality of life of FD patients. Nonetheless, despite stringent methodological analyses, the conclusion of our review still needs to be strengthened by additional RCTs of higher quality.
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Affiliation(s)
- Bo Pang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Tao Jiang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yuan-Hao Du
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jing Li
- Key Laboratory of Acupuncture of Tianjin, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Bo Li
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ya-Cai Hu
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qiu-Han Cai
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
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dos Santos Maciel LY, dos Santos Leite PM, Neto MLP, Mendonça ACR, de Araujo CCA, da Hora Santos Souza J, DeSantana JM. Comparison of the placebo effect between different non-penetrating acupuncture devices and real acupuncture in healthy subjects: a randomized clinical trial. Altern Ther Health Med 2016; 16:518. [PMID: 27978834 PMCID: PMC5159982 DOI: 10.1186/s12906-016-1477-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 11/07/2016] [Indexed: 11/11/2022]
Abstract
Background Several studies have used placebo acupuncture methods in recent years as a way for blinding therapeutic effect of acupuncture, however placebo method selection has not followed enough methodological criteria to the point of stabilishing a consensus of what should be the best method to be used. This study aimed to evaluate the effectiveness of three different placebo acupuncture methods for blinding applied in healthy subjects. Methods This study was approved by the Ethics Committee of the Federal University of Sergipe with the number 47193015.5.0000.5546 and all individuals participating in the study signed a free and informed consent. For this study, 321 healthy volunteers were randomly divided into seven groups using the abdominal point stomach (ST) 25 and seven groups using the lumbar point bladder (Bl) 52 for stimulation. For real acupuncture procedure, three different methods of placebo acupuncture plus a mix between real acupuncture and placebo applied in the same individual, totaling fourteen groups in this study. Outcome assessments were performed before and immediately after applying the technique. Investigator who assessed variables had no knowledgement about the method was applied. Identification, weight and height were measured before puncture by using. At the end, subjects were asked if they believed they were receiving real or placebo acupuncture. Results There was no significant difference between groups for the perception about the type o stimulation (wheter real or placebo puncture). Percentage of subjects who reported to have received real acupuncture in the abdominal point was 69.56% in real group, 86.95% in group Park Sham, 82.60% in needle + foam, 91.30% in insertion and removal, 78.26% in real + Park Sham, 86.36% in real + needle and foam, 86.95% in real + insertion and removal, and for the lumbar point was 86.36% in real group, 86.95% in group Park Sham, 69.56% in needle + foam, 72% in insertion and removal, 86.95% in real + Park Sham, 81.81% in real + needle and foam and 78.26% in real + insertion and removal. Conclusion All placebo acupuncture methods proposed in this study were equally effective for bliding the study participants using either abdominal or lumbar acupoints, and none of the placebo methods presented benefit compared to the other to be used in future clinical trials. Ethics Committee Federal University of Sergipe (UFS), number of approval: 47193015.5.0000.5546 Trial registration ensaiosclinicos.gov.br RBR-3w2p32 Registered in 28th January 2016.
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Jung WM, Shim W, Lee T, Park HJ, Ryu Y, Beissner F, Chae Y. More than DeQi: Spatial Patterns of Acupuncture-Induced Bodily Sensations. Front Neurosci 2016; 10:462. [PMID: 27807402 PMCID: PMC5069343 DOI: 10.3389/fnins.2016.00462] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 09/26/2016] [Indexed: 11/24/2022] Open
Abstract
Acupuncture uses needles to stimulate certain parts of the body, inducing a specific sensation, termed DeQi, which regard as essential for acupuncture's therapeutic effect. Here, we used the newly developed tool, bodily sensation mapping, to investigate the spatial configuration of acupuncture-induced sensations throughout the body. Twenty-five participants randomly received acupuncture stimulation or tactile stimulation using a von Frey filament at four different acupoints (HT7, PC6, ST36, and SP10) on the left side of the body. Subjects evaluated the characteristics of DeQi sensations and marked the areas of induced sensations on a body outline. We compared the psychophysical responses of DeQi sensations and visualized the spatial patterns of these sensations using statistical parametric mapping. We found greater intensity of DeQi sensations following acupuncture stimulation compared with tactile stimulation, with relatively small differences among the four acupoints. The sensation maps exhibited similar spatial patterns for acupuncture and tactile stimulation in the areas close to the stimulated sites. However, acupuncture was associated with additional sensations in areas remote from the stimulated sites. This study demonstrates that acupuncture stimulation produces greater DeQi sensations than tactile stimulation and results in the spreading of sensations to areas remote from the stimulus sites. Investigating the spatial patterns of acupuncture-induced sensations may be crucial for understanding the underlying mechanisms of acupuncture.
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Affiliation(s)
- Won-Mo Jung
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University Seoul, South Korea
| | - Woosun Shim
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University Seoul, South Korea
| | - Taehyung Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University Seoul, South Korea
| | - Hi-Joon Park
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University Seoul, South Korea
| | - Yeonhee Ryu
- Acupuncture, Moxibustion and Meridian Research Center, Division of Standard Research, Korea Institute of Oriental Medicine Daejeon, South Korea
| | - Florian Beissner
- Somatosensory and Autonomic Therapy Research, Institute for Neuroradiology, Hannover Medical School Hannover, Germany
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University Seoul, South Korea
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Acupuncture-induced changes of pressure pain threshold are mediated by segmental inhibition--a randomized controlled trial. Pain 2016; 156:2245-2255. [PMID: 26133726 DOI: 10.1097/j.pain.0000000000000283] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Our aim was to distinguish between spinal and supraspinal mechanisms in the intact nervous system by comparing homosegmental and heterosegmental effects of electroacupuncture (EA) and manual acupuncture (MA) on sensory perception in healthy volunteers by means of quantitative sensory testing. Seventy-two healthy volunteers were randomly assigned to receive either MA or EA at SP 6, SP 9, GB 39, and ST 36 at the left leg or relaxed for 30 minutes (control group [CG]). Blinded examiners assessed 13 sensory modalities (thermal and mechanical detection and pain thresholds) at the upper arms and lower legs before and after intervention by means of a standardized quantitative sensory testing battery. Change scores of all 13 sensory thresholds were compared between groups. The main outcome measure was the change score of the pressure pain threshold (PPT). There were no baseline differences between groups. Pressure pain threshold change scores at the lower left leg, in the same segment as the needling site, differed significantly (P = 0.008) between the EA (median: 103.01 kPa) and CG groups (median: 0.00 kPa) but not between the MA (median: 0.00 kPa) and CG groups. No further significant change score differences were found between one of the acupuncture groups and the CG. The PPT can be changed by EA. The PPT increase was confined to the segment of needling, which indicates that it is mainly mediated by segmental inhibition in the spinal cord. This underscores the importance of segmental needling and electrical stimulation in clinical practice.
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Metabonomic study of the effects of different acupuncture directions on therapeutic efficacy. J Chromatogr B Analyt Technol Biomed Life Sci 2016; 1009-1010:87-95. [DOI: 10.1016/j.jchromb.2015.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 10/27/2015] [Accepted: 12/05/2015] [Indexed: 11/20/2022]
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Deng S, Zhao X, DU R, He SI, Wen Y, Huang L, Tian G, Zhang C, Meng Z, Shi X. Is acupuncture no more than a placebo? Extensive discussion required about possible bias. Exp Ther Med 2015; 10:1247-1252. [PMID: 26622473 DOI: 10.3892/etm.2015.2653] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 06/16/2015] [Indexed: 12/13/2022] Open
Abstract
Numerous randomized controlled trials (RCTs) of acupuncture have been conducted in recent years. The results of several studies implied that acupuncture was only a powerful placebo; however, certain studies demonstrated that verum acupuncture had a greater effect than placebo and the mechanisms between a verum acupuncture group and a placebo/sham group were different. Researchers attempted to investigate the inherent factors that may potentially influence the results of trials. Certain problems observed in acupuncture RCTs also occurred in RCTs in other fields, including insufficient sample size, high dropout rates, inadequate follow-up and randomization. The study of acupuncture is so complex that specific methodological challenges are raised, which are frequently overlooked, including sham interventions, blinding, powerful placebo effects (even stronger than an inert pill) and variations in acupuncture administration. The aforementioned problems may contribute to bias, and researchers systematically attempt to solve these problems. The present review aimed to suggest techniques to design high-quality studies, minimize the placebo effect and optimize acupuncture administration in acupuncture studies. If these problems are addressed, then the results of acupuncture studies may be different.
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Affiliation(s)
- Shizhe Deng
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P.R. China
| | - Xiaofeng Zhao
- Institute of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P.R. China
| | - Rong DU
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P.R. China
| | - S I He
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P.R. China
| | - Yan Wen
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P.R. China
| | - Linghui Huang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P.R. China
| | - Guang Tian
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P.R. China
| | - Chao Zhang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P.R. China
| | - Zhihong Meng
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P.R. China
| | - Xuemin Shi
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P.R. China
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Deng SZ, Zhao XF, Huang LH, He S, Wen Y, Zhang C, Tian G, Wang T, Wu FF, Meng ZH, Shi XM. The quantity-effect relationship and physiological mechanisms of different acupuncture manipulations on posterior circulation ischemia with vertigo: study protocol for a randomized controlled trial. Trials 2015; 16:152. [PMID: 25872507 PMCID: PMC4394417 DOI: 10.1186/s13063-015-0660-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 03/17/2015] [Indexed: 11/10/2022] Open
Abstract
Background Recent experiments have demonstrated that different needling manipulations may induce variable effects via diverse physiological mechanisms. A previous study indicated that needling at Fengchi (GB 20) improved cerebral blood flow in patients with vertigo induced by posterior circulation ischemia (PCI). In this study, we aim to explore the quantity-effect relationship and the physiological mechanisms underlying different acupuncture manipulations in PCI patients with vertigo. Methods/Design We propose a pragmatic randomized and controlled trial. All participants, outcome assessors, and statisticians will be blinded. A total of 144 eligible participants will be randomized into one of four treatment groups receiving acupuncture at Fengchi (GB 20) with different one-minute manipulation parameters. Group 1 will receive twirling at a frequency of 60 times per minute toward the contralateral outer canthus at a depth of 0.5 to 0.8 cun. Group 2 will receive twirling at a frequency of 60 times per minute toward the Adam’s apple at a depth of 0.5 to 0.8 cun. Group 3 will receive twirling at a frequency of 120 times per minute toward the contralateral outer canthus at a depth of 0.5 to 0.8 cun. Group 4 will receive twirling at a frequency of120 times per minute toward the Adam’s apple at a depth of 0.5 to 0.8 cun. Additional points will be added based on individualized pattern diagnoses. The participants will receive 14 acupuncture sessions over 3 to 4 weeks. The subjects will be assessed at two time points: baseline and post-treatment. The primary outcome measurements will include subjective measurements (Vertebrobasilar System Ischemic Neurological Impairment Scale, UCLA Dizziness Questionnaire, Activities of Daily Living Scale, and Psychological and Social Adaptation Scale) and objective measurements (Transcranial Doppler, carotid ultrasonography and changes in cerebral oxygenation) to reduce bias arising from the placebo effect. We will use metabolomics to investigate the mechanisms underlying the different manipulation parameters. Discussion This trial aims to explore the quantity-effect relationship between different acupuncture manipulations and their clinical effects. The results from this study may help explain the contradictory results found in acupuncture studies that practice different manipulations. Trial registration Chinese Clinical Trial Registry: ChiCTR-RTRCC-12002675 (registered on 14 November 2012).
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Affiliation(s)
- Shi-Zhe Deng
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, 300193, Tianjin, China.
| | - Xiao-Feng Zhao
- Institute of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, Tianjin, 300193, China.
| | - Ling-Hui Huang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, 300193, Tianjin, China.
| | - Si He
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, 300193, Tianjin, China.
| | - Yan Wen
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, 300193, Tianjin, China.
| | - Chao Zhang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, 300193, Tianjin, China.
| | - Guang Tian
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, 300193, Tianjin, China.
| | - Tian Wang
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, 300193, Tianjin, China.
| | - Fen-Fen Wu
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, 300193, Tianjin, China.
| | - Zhi-Hong Meng
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, 300193, Tianjin, China.
| | - Xue-Min Shi
- Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314, West Anshan Avenue, 300193, Tianjin, China.
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Yu Z, Luo L, Li Y, Wu Q, Deng S, Lian S, Liang F. Different manual manipulations and electrical parameters exert different therapeutic effects of acupuncture. J TRADIT CHIN MED 2015; 34:754-8. [PMID: 25618982 DOI: 10.1016/s0254-6272(15)30092-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Acupuncture is an important component part of Traditional Chinese Medicine (TCM). The therapeutic effects may be influenced by a variety of factors. Stimulation quantity is one of the factors for achieving good therapeutic effects in acupuncture practice. With the development of science and technology, besides the influence of manual manipulations, the parameters adopted for electroacupuncture have become the benchmark of stimulation quantity. This study, by referring to the related literatures, is designed to explore the influence of manual manipulations and electrical parameters on therapeutic effects of acupuncture. The results from the present study show that different manual manipulations and electrical parameters may exert different therapeutic effects of acupuncture, which are closely related to the characteristics of diseases. Different manual manipulations and electrical parameters should be adopted according to syndrome differentiation of TCM. This is very important in acupuncture treatment.
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Psychophysical and neurophysiological responses to acupuncture stimulation to incorporated rubber hand. Neurosci Lett 2015; 591:48-52. [PMID: 25681621 DOI: 10.1016/j.neulet.2015.02.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/06/2015] [Accepted: 02/10/2015] [Indexed: 01/30/2023]
Abstract
From a neuroscientific perspective, the sensations induced by acupuncture are not only the product of the bottom-up modulation of simple needling at somatosensory receptors, but also of the reciprocal interaction of top-down modulation from the brain. The present study investigated whether acupuncture stimulation to incorporated body parts produces brain responses that are similar to the responses observed following acupuncture stimulation to the real hand. The present study included 17 participants who watched a rubber hand being synchronously stroked with their unseen left hand to induce incorporation of the rubber hand into their body. After the experimental modification of body ownership, acupuncture needle stimulation was applied to the LI4 acupoint on the incorporated rubber hand while brain activity was measured with functional magnetic resonance imaging (fMRI). When the rubber hand was fully incorporated with the real body, acupuncture stimulation to the rubber hand resulted in the experience of the DeQi sensation as well as brain activations in the dorsolateral prefrontal cortex (DLPFC), insula, secondary somatosensory cortex (SII), and medial temporal (MT) visual area. The insular activation was associated with the DeQi sensation from the rubber hand. The psychophysical and neurophysiological responses associated with acupuncture stimulation to the incorporated rubber hand were influenced by an enhanced bodily awareness of the hand, which was likely due to top-down modulation from the interoceptive system in the brain.
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Chae Y, Lee IS, Jung WM, Chang DS, Napadow V, Lee H, Park HJ, Wallraven C. Decreased peripheral and central responses to acupuncture stimulation following modification of body ownership. PLoS One 2014; 9:e109489. [PMID: 25285620 PMCID: PMC4186833 DOI: 10.1371/journal.pone.0109489] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/01/2014] [Indexed: 12/23/2022] Open
Abstract
Acupuncture stimulation increases local blood flow around the site of stimulation and induces signal changes in brain regions related to the body matrix. The rubber hand illusion (RHI) is an experimental paradigm that manipulates important aspects of bodily self-awareness. The present study aimed to investigate how modifications of body ownership using the RHI affect local blood flow and cerebral responses during acupuncture needle stimulation. During the RHI, acupuncture needle stimulation was applied to the real left hand while measuring blood microcirculation with a LASER Doppler imager (Experiment 1, N = 28) and concurrent brain signal changes using functional magnetic resonance imaging (fMRI; Experiment 2, N = 17). When the body ownership of participants was altered by the RHI, acupuncture stimulation resulted in a significantly lower increase in local blood flow (Experiment 1), and significantly less brain activation was detected in the right insula (Experiment 2). This study found changes in both local blood flow and brain responses during acupuncture needle stimulation following modification of body ownership. These findings suggest that physiological responses during acupuncture stimulation can be influenced by the modification of body ownership.
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Affiliation(s)
- Younbyoung Chae
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Korea
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
- * E-mail: (YC); (CW)
| | - In-Seon Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Won-Mo Jung
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Korea
| | - Dong-Seon Chang
- Department of Human Perception, Cognition and Action, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Vitaly Napadow
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, United States of America
- Department of Biomedical Engineering, Kyunghee University, Yongin, Korea
| | - Hyejung Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Hi-Joon Park
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Christian Wallraven
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Korea
- * E-mail: (YC); (CW)
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Lee J, Napadow V, Park K. Pain and sensory detection threshold response to acupuncture is modulated by coping strategy and acupuncture sensation. Altern Ther Health Med 2014; 14:324. [PMID: 25175308 PMCID: PMC4167271 DOI: 10.1186/1472-6882-14-324] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 08/27/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Acupuncture has been shown to reduce pain, and acupuncture-induced sensation may be important for this analgesia. In addition, cognitive coping strategies can influence sensory perception. However, the role of coping strategy on acupuncture modulation of pain and sensory thresholds, and the association between acupuncture sensation and these modulatory effects, is currently unknown. METHODS Electroacupuncture (EA) was applied at acupoints ST36 and GB39 of 61 healthy adults. Different coping conditions were experimentally designed to form an active coping strategy group (AC group), who thought they could control EA stimulation intensity, and a passive coping strategy group (PC group), who did not think they had such control. Importantly, neither group was actually able to control EA stimulus intensity. Quantitative sensory testing was performed before and after EA, and consisted of vibration (VDT), mechanical (MDT), warm (WDT), and cold (CDT) detection thresholds, and pressure (PPT), mechanical (MPT), heat (HPT) and cold (CPT) pain thresholds. Autonomic measures (e.g. skin conductance response, SCR) were also acquired to quantify physiological response to EA under different coping conditions. Subjects also reported the intensity of any acupuncture-induced sensations. RESULTS Coping strategy was induced with successful blinding in 58% of AC subjects. Compared to PC, AC showed greater SCR to EA. Under AC, EA reduced PPT and CPT. In the AC group, improved pain and sensory thresholds were correlated with acupuncture sensation (VDTchange vs. MI: r=0.58, CDTchange vs. tingling: r=0.53, CPTchange vs. tingling; r=0.55, CPTchange vs. dull; r=0.55). However, in the PC group, improved sensory thresholds were negatively correlated with acupuncture sensation (CDTchange vs. intensity sensitization: r=-0.52, WDTchange vs. fullness: r=-0.57). CONCLUSIONS Our novel approach was able to successfully induce AC and PC strategies to EA stimulation. The interaction between psychological coping strategy and acupuncture sensation intensity can differentially modulate pain and sensory detection threshold response to EA. In a clinical context, our findings suggest that instructions given to the patient can significantly affect therapeutic outcomes and the relationship between acupuncture intensity and clinical response. Specifically, acupuncture analgesia can be enhanced by matching physical stimulation intensity with psychological coping strategy to acupuncture contexts. TRIAL REGISTRATION KCT0000905.
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Benham A, Johnson MI. Effect of bidirectional rotation of an acupuncture needle at LI10 on acupuncture needle sensation and experimentally-induced contact heat pain in healthy human volunteers. Acupunct Med 2014; 32:267-72. [PMID: 24509551 DOI: 10.1136/acupmed-2013-010483] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION There is insufficient evidence of a relationship between acupuncture needle sensations (de qi) and hypoalgesia. The aim of this study was to investigate the effects of bidirectional needle rotation at LI10 on acupuncture needle sensations and heat pain thresholds. METHODS Twenty-two healthy participants received one acupuncture needle at LI10 with bidirectional rotation of the needle in one experimental session and one acupuncture needle at LI10 with mock rotation in a separate session, in a randomised order. Measurements of heat pain thresholds were taken before needle insertion, during needle retention and 15 min after needle removal. At each measurement time point, participants rated needle sensations using the Massachusetts Acupuncture Sensation Scale (MASS) and a visual analogue scale (VAS) of overall intensity of needle sensation. RESULTS Bidirectional needle rotation produced significantly higher scores for VAS, MASStotal, MASSpain and MASSsensation compared with mock rotation (all p<0.001). There were significantly higher pain thresholds relative to pre-intervention baseline during (p=0.014) and after (p<0.001) bidirectional needle rotation but not during (p=0.1) or after (p=0.62) mock bidirectional needle rotation. Bidirectional needle rotation increased the pain threshold relative to baseline 15 min after the needles were removed (p=0.009). A significant but low correlation between needle sensation and change in pain threshold after needling was only found when data from mock and rotation interventions were combined. CONCLUSIONS Needle rotation increases the magnitude of hypoalgesia. There is tentative evidence that needle sensation may be associated with the amount of change in pain threshold.
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Affiliation(s)
- Alex Benham
- Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, UK Bradford Institute of Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK Leeds Pallium Research Group, Leeds, UK
| | - Mark I Johnson
- Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, UK Leeds Pallium Research Group, Leeds, UK
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Zhou T, Wang J, Han CX, Torao I, Guo Y. Analysis of interspike interval of dorsal horn neurons evoked by different needle manipulations at ST36. Acupunct Med 2013; 32:43-50. [PMID: 24192147 DOI: 10.1136/acupmed-2013-010372] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Previous research has suggested that different manual acupuncture (MA) manipulations may have different physiological effects. Recent studies have demonstrated that neural electrical signals are generated or changed when acupuncture is administered. In order to explore the effects of different MA manipulations on the neural system, an experiment was designed to record the discharges of wide dynamic range (WDR) neurons in the spinal dorsal horn evoked by MA at different frequencies (0.5, 1, 2 and 3 Hz) at ST36. METHODS Microelectrode extracellular recordings were used to record the discharges of WDR neurons evoked by different MA manipulations. Approximate firing rate and coefficient of variation of interspike interval (ISI) were used to extract the characteristic parameters of the neural electrical signals after spike sorting, and the neural coding of the evoked discharges by different MA manipulations was obtained. RESULTS Our results indicated that the neuronal firing rate and time sequences of ISI showed distinct clustering properties for different MA manipulations, which could distinguish them effectively. CONCLUSIONS The combination of firing rate and ISI codes carries information about the acupuncture stimulus frequency. Different MA manipulations appear to change the neural coding of electrical signals in the spinal dorsal horn through WDR neurons.
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Affiliation(s)
- Tao Zhou
- College of Chinese Medicine, Tianjin University of Traditional Chinese Medicine, , Tianjin, China
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The Observation of the Change of TCE Caused by Different Acupuncture Stimulation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:856905. [PMID: 24069059 PMCID: PMC3773438 DOI: 10.1155/2013/856905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Revised: 06/17/2013] [Accepted: 07/08/2013] [Indexed: 12/05/2022]
Abstract
Purpose. To observe the change of transcutaneous CO2 emission on meridian points or nonacupoints when the different needle sensations were gotten and study the associativity between Deqi acupuncture and periphery constitution energy metabolism effect. Method. 20 healthy volunteers were punctured on Neiguan (P6) in different ways including sham, shallow, Deqi acupuncture, and Deqi plus pressed P5, and measured TCE of different points before, during, and after acupuncture. Result. Needle sensations of sham acupuncture and shallow acupuncture were less than those of Deqi acupuncture. TCE of meridian points increased significantly and showed the specificity of meridian/channels. Conclusion. Verum acupuncture could cause the stronger needling sensations including distention, aching, numbness, and tingling than sham and shallow acupuncture. The strength of needling sensation caused by Deqi acupuncture is moderate and brought the best curative effects in TCE measurement. Deqi acupuncture could improve the energy metabolism of the points on the corresponding meridian/channel.
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