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Zhang B, Lin Y, Yao B, Li T. Noninvasive Assessing Low Back Pain by a Novel Near-Infrared Spectroscopy Flexible Probe With the Aid of Cupping Protocol. JOURNAL OF BIOPHOTONICS 2024:e202400204. [PMID: 39218435 DOI: 10.1002/jbio.202400204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/20/2024] [Accepted: 07/15/2024] [Indexed: 09/04/2024]
Abstract
Low back pain (LBP) is the leading cause of disability worldwide, yet its quantitative and noninvasive assessment remains challenging. Considering that near-infrared spectroscopy (NIRS) became a promising noninvasive tool for monitoring muscle and cupping therapy could regulate muscle blood flow to relieve LBP, we attempted to incorporate cupping and hemodynamics monitoring in muscle tissue by NIRS to assess LBP. We collected 3-min NIRS recordings on 12 LBP patients and 12 healthy subjects before and after 20-min cupping. Initially, no significant hemodynamic differences were observed between the groups. After cupping, the concentration changes of oxy-hemoglobin (Δ[HbO2]) in the emitter-detector channel parallel to spine unexpectedly exhibited that LBP was remarkably lower by approximately 67% compared with the controls. This study highlighted the potential of combining NIRS and cupping protocol as a quantitative assessment technique for LBP, also providing a new idea for clinical integration of novel optical assessment technologies.
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Affiliation(s)
- Bowen Zhang
- Biomedical Engineering Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Yu Lin
- Biomedical Engineering Department, North Carolina State University, Raleigh, North Carolina, USA
| | - Bo Yao
- Biomedical Engineering Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Ting Li
- Biomedical Engineering Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
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Zhang Z, Pasapula M, Wang Z, Edwards K, Norrish A. The effectiveness of cupping therapy on low back pain: A systematic review and meta-analysis of randomized control trials. Complement Ther Med 2024; 80:103013. [PMID: 38184285 DOI: 10.1016/j.ctim.2024.103013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 01/08/2024] Open
Abstract
OBJECTIVES This study aims to investigate the effectiveness of cupping therapy on low back pain (LBP). METHODS Medline, Embase, Scopus and WANFANG databases were searched for relevant cupping RCTs on low back pain articles up to 2023. A complementary search was manually made on 27 September for update screening. Full-text English and Chinese articles on all ethnic adults with LBP of cupping management were included in this study. Studies looking at acute low back pain only were excluded. Two independent reviewers screened and extracted data, with any disagreement resolved through consensus by a third reviewer. The methodological quality of the included studies was evaluated independently by two reviewers using an adapted tool. Change-from-baseline outcomes were treated as continuous variables and calculated according to the Cochrane Handbook. Data were extracted and pooled into the meta-analysis by Review Manager software (version 5.4, Nordic Cochrane Centre). RESULTS Eleven trials involving 921 participants were included. Five studies were assessed as being at low risk of bias, and six studies were of acceptable quality. High-quality evidence demonstrated cupping significantly improves pain at 2-8 weeks endpoint intervention (d=1.09, 95% CI: [0.35-1.83], p = 0.004). There was no continuous pain improvement observed at one month (d=0.11, 95% CI: [-1.02-1.23], p = 0.85) and 3-6 months (d=0.39, 95% CI: [-0.09-0.87], p = 0.11). Dry cupping did not improve pain (d=1.06, 95% CI: [-0.34, 2.45], p = 0.14) compared with wet cupping (d=1.5, 95% CI: [0.39-2.6], p = 0.008) at the endpoint intervention. There was no evidence indicating the association between pain reduction and different types of cupping (p = 0.2). Moderate- to low-quality evidence showed that cupping did not reduce chronic low back pain (d=0.74, 95% CI: [-0.67-2.15], p = 0.30) and non-specific chronic low back pain (d=0.27, 95% CI: [-1.69-2.24], p = 0.78) at the endpoint intervention. Cupping on acupoints showed a significant improvement in pain (d=1.29, 95% CI: [0.63-1.94], p < 0.01) compared with the lower back area (d=0.35, 95% CI: [-0.29-0.99], p = 0.29). A potential association between pain reduction and different cupping locations (p = 0.05) was found. Meta-analysis showed a significant effect on pain improvement compared to medication therapy (n = 8; d=1.8 [95% CI: 1.22 - 2.39], p < 0.001) and usual care (n = 5; d=1.07 [95% CI: 0.21- 1.93], p = 0.01). Two studies demonstrated that cupping significantly mediated sensory and emotional pain immediately, after 24 h, and 2 weeks post-intervention (d= 5.49, 95% CI [4.13-6.84], p < 0.001). Moderate evidence suggested that cupping improved disability at the 1-6 months follow-up (d=0.67, 95% CI: [0.06-1.28], p = 0.03). There was no immediate effect observed at the 2-8 weeks endpoint (d=0.40, 95% CI: [-0.51-1.30], p = 0.39). A high degree of heterogeneity was noted in the subgroup analysis (I2 >50%). CONCLUSION High- to moderate-quality evidence indicates that cupping significantly improves pain and disability. The effectiveness of cupping for LBP varies based on treatment durations, cupping types, treatment locations, and LBP classifications. Cupping demonstrated a superior and sustained effect on pain reduction compared with medication and usual care. The notable heterogeneity among studies raises concerns about the certainty of these findings. Further research should be designed with a standardized cupping manipulation that specifies treatment sessions, frequency, cupping types, and treatment locations. The actual therapeutic effects of cupping could be confirmed by using objective pain assessments. Studies with at least six- to twelve-month follow-ups are needed to investigate the long-term efficacy of cupping in managing LBP. TRIAL REGISTRATION This systematic review was initially registered on PROSPERO with registration code: CRD42021271245 on 08 September 2021.
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Affiliation(s)
- Zixin Zhang
- University of Nottingham, Nottingham NG7 2RD, United Kingdom; University of Sydney, Faculty of Medicine and Health, Institute of Musculoskeletal Health.
| | - Mahesh Pasapula
- University of Nottingham, Nottingham NG7 2RD, United Kingdom.
| | - Zelu Wang
- University of Nottingham, Nottingham NG7 2RD, United Kingdom.
| | | | - Alan Norrish
- University of Nottingham, Nottingham NG7 2RD, United Kingdom.
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Harper B, Dudek A, Williamson J, Siyufy A, Smith JA. Combining Static and Dynamic Myofascial Dry Cupping Therapy to Improve Local and Regional Symptoms in Individuals with Low Back Pain: A Case Series. Int J Sports Phys Ther 2024; 19:227-237. [PMID: 38313662 PMCID: PMC10837828 DOI: 10.26603/001c.91653] [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: 09/14/2023] [Accepted: 12/16/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Chronic low back pain is a common musculoskeletal healthcare presentation with an expense of over $100 billion annually. The clinical effect of myofascial cupping on pain and function is not clear, especially when different cupping techniques are combined. The purpose of this case series was to explore changes in pain and function following local static and distal dynamic myofascial dry cupping treatments in patients with chronic low back pain. Case Descriptions Three adults from the general population received three ten-minute treatment sessions, 48 hours between each session, of static dry cupping to the low back followed by dynamic myofascial cupping of the quadriceps and hamstring musculature. Outcome measures were taken at two different time points within one-week per participant. Subjective measures included the numeric pain rating scale and the Oswestry Disability Index, objective measures included passive straight leg raise measurements, and pressure pain threshold. Results and Discussion Local static combined with distal dynamic myofascial cupping reduced pain, pain sensitivity and perceived disability, and improved hamstring muscle extensibility in all three participants. These encouraging results support the initiation of a larger controlled trial aimed at investigating the efficacy of combined dry cupping interventions to treat musculoskeletal dysfunction and pain. Level of Evidence 4 (case series).
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Affiliation(s)
| | - Alana Dudek
- Physical Therapy Chapman University
- Physical Therapy South College
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Kui W, Xie L, Li Y, Gu Z, Liu S, Xue C, Wang K. Efficacy and safety of bloodletting puncture and cupping in postherpetic neuralgia: A systematic review and meta‑analysis. Biomed Rep 2024; 20:30. [PMID: 38259587 PMCID: PMC10801353 DOI: 10.3892/br.2023.1718] [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: 06/06/2023] [Accepted: 11/09/2023] [Indexed: 01/24/2024] Open
Abstract
The present study aimed to evaluate the efficacy and safety of bloodletting puncture and cupping (BLP-C) in postherpetic neuralgia (PHN) and to provide guidance for clinical treatment. Randomized controlled trials (RCTs) of BLP-C therapy in PHN were systematically searched in eight databases from inception to September 2022. Literature screening, data extraction and quality assessment were performed by two independent researchers. Dichotomous and continuous variables were pooled using the risk ratio (RR) and weighted mean difference (WMD), respectively. A total of 13 studies involving 1,129 patients with PHN (571 in the experimental group and 558 in the control group) were included in the present meta-analysis. Overall efficacy (RR=1.21, 95% CI: 1.15 to 1.28, P<0.00001), VAS score (WMD=-1.10, 95% CI: -1.31 to -0.90, P<0.00001) and PSQI score (WMD=-2.42, 95% CI: -2.87 to -1.96, P<0.0001) were significantly different between the BLP-C group and Western medicine group. Furthermore, subgroup analysis demonstrated that BLP-C alone or combined with other traditional Chinese medicines was more effective than Western medicine in PHN. A total of four RCTs mentioned adverse reactions, most of which were in the Western medicine group and were relieved after treatment discontinuation. In conclusion, BLP-C is superior to Western medicine in relieving pain and improving the sleep quality of patients with PHN with a lower incidence of adverse effects.
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Affiliation(s)
- Wenyun Kui
- Department of Pain, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Lei Xie
- Department of Pain, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Yanan Li
- Department of Pain, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Zhen Gu
- Department of Pain, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Shuang Liu
- Department of Pain, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Chunchun Xue
- Department of Pain, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
| | - Kaiqiang Wang
- Department of Pain, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P.R. China
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Wang L, Cai Z, Li X, Zhu A. Efficacy of cupping therapy on pain outcomes: an evidence-mapping study. Front Neurol 2023; 14:1266712. [PMID: 37965178 PMCID: PMC10640990 DOI: 10.3389/fneur.2023.1266712] [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: 07/25/2023] [Accepted: 10/03/2023] [Indexed: 11/16/2023] Open
Abstract
Objective Cupping therapy is an ancient technique of healing used to treat a variety of ailments. An evidence-mapping study was conducted to summarize the existing evidence of cupping therapy for pain-related outcomes and indicate the effect and the quality of evidence to provide a comprehensive view of what is known. Methods PubMed, Cochrane Library, Embase, and Web of Science were searched to collect the meta-analyses investigating the association between cupping therapy and pain-related outcomes. The methodological quality was assessed by using the AMSTAR 2 tool. Significant outcomes (p < 0.05) were assessed using the GRADE system. The summary of evidence is presented by bubble plots and human evidence mapping. Results Fourteen meta-analyses covering five distinct pain-related conditions were identified and assessed for methodological quality using the AMSTAR 2, which categorized the quality as critically low (36%), low (50.0%), moderate (7%), and high (7%). In accordance with the GRADE system, no high-quality evidence was found that demonstrates the efficacy of cupping therapy for pain-related outcomes. Specifically, for neck pain, there were two moderate-quality, four low-quality, and two very low-quality evidence, while only one very low-quality evidence supports its efficacy in treating herpes zoster and one low-quality evidence for chronic back pain. Additionally, for low back pain, there were two moderate-quality, one low-quality, and four very low-quality evidence, and for knee osteoarthritis, three moderate-quality evidence suggest that cupping therapy may alleviate pain score. Conclusion The available evidence of very low-to-moderate quality suggests that cupping therapy is effective in managing chronic pain, knee osteoarthritis, low back pain, neck pain, chronic back pain, and herpes zoster. Moreover, it represents a promising, safe, and effective non-pharmacological therapy that warrants wider application and promotion.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255879, identifier: CRD42021255879.
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Affiliation(s)
- Liaoyao Wang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ziling Cai
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xuanlin Li
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Aisong Zhu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
- Key Laboratory of Blood-Stasis-Toxin Syndrome of Zhejiang Province, Hangzhou, China
- Zhejiang Engineering Research Center for “Preventive Treatment” Smart Health of Traditional Chinese Medicine, Hangzhou, China
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Song C, Wang Q, Song N. Hemorphin-Based Analgesia: A Mechanism of Cupping Technique? J Pain Res 2023; 16:1751-1754. [PMID: 37273272 PMCID: PMC10237328 DOI: 10.2147/jpr.s413021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/24/2023] [Indexed: 06/06/2023] Open
Abstract
Background and Objective Cupping is a time-honoured traditional healing modality for pain management and remains favoured by professionals and lay people across several cultures today. However, the analgesic mechanism of cupping is still poorly understood. In addition, clinical guidelines for standardized applications of cupping are currently lacking. The awareness of cupping marks has provoked curiosity about the connection between skin color changes and their benefit for local pain relief. Computer simulation is a promising approach for numerical modeling the cupping-evoked erythrocyte emigration. Quantitative proteomic profiling of cupping-induced blister fluid exhibited a significant decrease in the abundance of haemoglobin β subunit. This finding provides a critical clue to paint a novel picture of the mechanism behind cupping. The hemorphins are a set of non-classical opioid peptides derived from the proteolysis of haemoglobin β subunit. In the present study, a probable mechanism of hemorphin-based cupping analgesia is proposed. The hemorphin could also act as a potential biomarker for objective and timely quantitative clinical assessment of cupping in the management of pain conditions. A seminal theory may open a new avenue for future translational research on promoting the efficacy and safety of cupping analgesia. Conclusion The local analgesic effect of cupping is probable in the context of haemoglobin degradation that bestows the appearance of hemorphins along with engaging opioid receptor signalling. Exploring the potential novel mechanism of cupping analgesia facilitates seeking non-pharmacologic pain interventions.
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Affiliation(s)
- Changzheng Song
- Erythrocrine Research Initiative of Translational Medicine, Shandong Academy of Medical Sciences, Jinan, People’s Republic of China
| | - Qingwei Wang
- Cancer Therapy Center, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Nianci Song
- Biodesign Lab, Geriatricare Biorobotics Studio, Baltimore, MD, USA
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Peluso R, Hesson J, Aikens J, Bullock M. An Update on Physical Therapy Adjuncts in Orthopedics. Arthroplast Today 2022; 14:163-169. [PMID: 35330664 PMCID: PMC8938198 DOI: 10.1016/j.artd.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/20/2022] [Accepted: 02/13/2022] [Indexed: 11/24/2022] Open
Abstract
Physical therapy is a necessary part of the recovery process after most orthopedic procedures. Effective treatment, patient satisfaction, and financial reimbursement hinge on the successful implementation of both surgical and nonsurgical interventions. Evidence-based practice and open communication between therapists and orthopedic surgeons continue to form the foundation of patient care. The aim of this paper is to familiarize orthopedic surgeons with the relevant data behind some of the recent advances in rehabilitation adjuncts to better address the needs of our patients. Although each intervention has been found to be relatively safe, high-quality evidence is still sparse. Opportunities exist for improved outcomes with further well-designed studies to investigate the role of these therapy modalities among orthopedic patients.
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Affiliation(s)
- Richard Peluso
- Department of Orthopaedics, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Jacob Hesson
- Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Jordan Aikens
- Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Matthew Bullock
- Department of Orthopaedics, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
- Corresponding author. 1600 Medical Center Drive Suite G500, Huntington, WV 25701, USA. Tel.: +1 724 825 6766.
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Trigger point therapy – ischemic compression or perhaps cupping? BIOMEDICAL HUMAN KINETICS 2022. [DOI: 10.2478/bhk-2022-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Study aim: To evaluate and compare the effectiveness of single ischemic compression and cupping therapy on the most common trigger point, on the descending part of the trapezius muscle.
Materials and methods: Twenty-five students (15 women and 10 men) aged 24.20 ± 1.27 years were enrolled in the study. The mobility of the cervical spine area was measured with a measuring tape. The pain pressure threshold of the trigger point of the trapezius muscle was tested using a Wagner FDX 50 Force Gage digital algometer. Each person participated in three tests with an interval of approximately one week between them. The following study protocol was followed; 1) cupping therapy, with a cup statically positioned on the trigger point for two minutes, 2) at a minimum interval of 7 days, ischemic compression performed with the thumb twice for 1 minute on each side 3) control test at an interval of another 7 days.
Results: Ischemic compression resulted in a statistically significant difference in cervical spine mobility scores (except for extension) and pain pressure threshold values. After applying cups, statistically significant differences were also observed in the results of cervical spine mobility and pain pressure threshold values. No statistically significant differences were found in the effectiveness of the therapies tested.
Conclusions: In the present study, single trigger point cupping and ischemic compression therapies improved cervical spine mobility and resulted in an increase in the pain pressure threshold in the trapezius muscle trigger point. These two therapies did not differ in terms of their effectiveness.
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He X, Zhang X, Liao F, He L, Xu X, Jan YK. Using reactive hyperemia to investigate the effect of cupping sizes of cupping therapy on skin blood flow responses. J Back Musculoskelet Rehabil 2021; 34:327-333. [PMID: 33459698 DOI: 10.3233/bmr-200120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Various cupping sizes of cupping therapy have been used in managing musculoskeletal conditions; however, the effect of cupping sizes on skin blood flow (SBF) responses is largely unknown. OBJECTIVE The objective of this study was to compare the effect of three cupping sizes of cupping therapy on SBF responses. METHODS Laser Doppler flowmetry (LDF) was used to measure SBF on the triceps in 12 healthy participants in this repeated measures study. Three cup sizes (35, 40 and 45 mm in diameter) were blinded to the participants and were tested at -300 mmHg for 5 minutes. Reactive hyperemic response to cupping therapy was expressed as a ratio of baseline SBF. RESULTS All three sizes of cupping cups resulted in a significant increase in peak SBF (p< 0.001). Peak SBF of the 45 mm cup (9.41 ± 1.32 times) was significantly higher than the 35 mm cup (5.62 ± 1.42 times, p< 0.05). Total SBF of the 45 mm cup ((24.33 ± 8.72) × 103 times) was significantly higher than the 35 mm cup ((8.05 ± 1.63) × 103 times, p< 0.05). Recovery time of the 45 mm cup (287.46 ± 39.54 seconds) was significantly longer than the 35 mm cup (180.12 ± 1.42 seconds, p< 0.05). CONCLUSIONS Our results show that all three cup sizes can significantly increase SBF. The 45 mm cup is more effective in increasing SBF compared to the 35 mm cup.
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Affiliation(s)
- Xiangfeng He
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Xueyan Zhang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Fuyuan Liao
- Department of Biomedical Engineering, Xi'an Technological University, Xi'an, China
| | - Li He
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Xin Xu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yih-Kuen Jan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Tao J, Zhao P, Mo T, Zhao R, Yang N, Lee MS, Liu J, Cao H. Key elements that determine the efficacy of cupping therapy: A bibliometric analysis and review of clinical studies. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2020. [DOI: 10.1016/j.jtcms.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Wood S, Fryer G, Tan LLF, Cleary C. Dry cupping for musculoskeletal pain and range of motion: A systematic review and meta-analysis. J Bodyw Mov Ther 2020; 24:503-518. [PMID: 33218554 DOI: 10.1016/j.jbmt.2020.06.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 03/16/2020] [Accepted: 06/07/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVES This review evaluated the efficacy and safety of western dry cupping methods for the treatment of musculoskeletal pain and reduced range of motion. METHODS A systematic literature search was performed until April 2018 for randomised controlled trials (RCTs) pertaining to musculoskeletal pain or reduced range of motion, treated with dry cupping. Outcomes were pain, functional status, range of motion and adverse events. Risk of bias and quality of evidence was assessed using the modified Downs & Black (D&B) checklist and GRADE. RESULTS A total of 21 RCTs with 1049 participants were included. Overall, the quality of evidence was fair, with a mean D&B score of 18/28. Low-quality evidence revealed dry cupping had a significant effect on pain reduction for chronic neck pain (MD, -21.67; 95% CI, -36.55, to -6.80) and low back pain (MD, -19.38; 95%CI, -28.09, to -10.66). Moderate-quality evidence suggested that dry cupping improved functional status for chronic neck pain (MD, -4.65; 95%CI, -6.44, to -2.85). For range of motion, low quality evidence revealed a significant difference when compared to no treatment (SMD, -0.75; 95%CI, -0.75, to -0.32). CONCLUSION Dry cupping was found to be effective for reducing pain in patients with chronic neck pain and non-specific low back pain. However, definitive conclusions regarding the effectiveness and safety of dry cupping for musculoskeletal pain and range of motion were unable to be made due to the low-moderate quality of evidence. Further high-quality trials with larger sample sizes, long-term follow up, and reporting of adverse events are warranted.
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Affiliation(s)
- Sarah Wood
- The Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Gary Fryer
- College of Health & Biomedicine, Victoria University, Melbourne, Australia
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Cupping Therapy for Diseases: An Overview of Scientific Evidence from 2009 to 2019. Chin J Integr Med 2020; 27:394-400. [PMID: 32524396 DOI: 10.1007/s11655-020-3060-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2020] [Indexed: 10/24/2022]
Abstract
Cupping therapy has been accepted worldwide, and many studies have been conducted to reveal its curative effects and mechanisms. To comprehensively evaluate the effect of cupping therapy, database including China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database VIP, Wan Fang Database, Chinese Biomedicine (CBM), PubMed and Web of Science were searched from 2009-2019. We summarized all the meta-analyses, randomized controlled trials, clinical trials and the mechanisms studies of cupping therapy in the previous 10 years, hoping to provide a reference for the clinical applications and studies.
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Husain NRN, Hairon SM, Zain RM, Bakar M, Bee TG, Ismail MS. The Effects of Wet Cupping Therapy on Fasting Blood Sugar, Renal Function Parameters, and Endothelial Function: A Single-arm Intervention Study. Oman Med J 2020; 35:e108. [PMID: 32257417 PMCID: PMC7086389 DOI: 10.5001/omj.2020.26] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/21/2019] [Indexed: 12/22/2022] Open
Abstract
Objectives Despite being recognized worldwide as an alternative therapy in treating various chronic diseases and pain, the mechanism of wet cupping is still not well understood. The purpose of this study was to evaluate fasting blood sugar (FBS), renal function parameters, and endothelial function changes following wet cupping in healthy individuals. Methods We conducted a single-arm intervention study at the Clinical Lab of Community Medicine, Universiti Sains Malaysia, and included 31 healthy individuals aged between 30 and 60 years old. Wet cupping therapy was performed at five treatment points at the beginning of the study and repeated after three months. Health outcomes at baseline, one, three, and four months were assessed for FBS, renal function parameters (urea, creatinine, and uric acid), systolic blood pressure (SBP), and von Willebrand factor (vWF). Results Forty-five percent of participants were female, and the mean age of study participants was 44.9±6.4 years. Wet cupping therapy significantly reduced FBS, serum urea, and serum creatinine at one, three, and four months compared with baseline values. Serum uric acid and SBP showed a significant reduction at one and four months compared with baseline. The vWF (a measure of endothelial function) had a 4.0% reduction at four months compared to baseline, with a mean difference of 5.3 (95% confidence interval (CI): 2.20 = 8.55; p = 0.002). Conclusions This study provides preliminary support that repeated wet cupping therapy enhances body health status; thus, it could be an effective complementary medicine in disease prevention.
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Affiliation(s)
- Nik-Rosmawati Nik Husain
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Suhaily Mohd Hairon
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Rehanah Mohd Zain
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Mujahid Bakar
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Tee Get Bee
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Mohamed Saat Ismail
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
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Single Cupping Thearpy Session Improves Pain, Sleep, and Disability in Patients with Nonspecific Chronic Low Back Pain. J Acupunct Meridian Stud 2020; 13:48-52. [DOI: 10.1016/j.jams.2019.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 04/09/2019] [Accepted: 11/10/2019] [Indexed: 11/23/2022] Open
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Abstract
This is a systematic review of the clinical use of cupping therapy. Four domestic databases and 2 foreign databases were searched. Studies that reported the cupping pressure used during cupping therapy were included in this study. The types of cupping, cupping site, pressure, and duration of cupping were the main parameters analyzed. A total of 27 studies, including 24 experimental studies were analyzed. There were 12 constant negative pressure (domestic) studies with a range between 60 mmHg and 600 mmHg. There were 5 maximum negative pressure (domestic) studies and the maximum negative pressure was 620 mmHg. Three studies used a maximum negative pressure of 600 mmHg. There were 4 constant negative pressure (foreign) studies with a range between 75 mmHg to 750 mmHg. There were 3 maximum negative pressure (foreign) studies with a maximum pressure of 420 mmHg. The studies differed with regards to the materials used and the amount of pressure applied. Many studies had limited information and therefore generalizability of the results in this review is limited. Further experimental studies are required to establish the correlation between cupping pressure and treatment effects so that cupping therapy can be standardised.
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Tissue Stiffness is Not Related to Pain Experience: An Individually Controlled Study in Patients with Chronic Neck and Back Pain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2019:1907168. [PMID: 31929809 PMCID: PMC6942862 DOI: 10.1155/2019/1907168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/04/2019] [Accepted: 11/06/2019] [Indexed: 12/21/2022]
Abstract
Background Massage therapies such as cupping are often applied in patients with chronic neck and back pain with the assumption that they can reduce increased tissue stiffness and, therefore, improve pain. The aim of this study was to clarify whether tissue stiffness is related to pain experience in patients with chronic (>3 months) back and neck pain and whether it can be altered by a cupping massage. Methods The tissue stiffness of the point of subjectively felt maximum pain intensity of 40 patients with neck (n = 20) or lower back pain (n = 20) was measured by a myometer. Exact contralateral side served as an individual control. Side of higher stiffness was then treated with a cupping massage. 5, 10, 15, and 20 minutes as well as 24 hours after treatment, tissue stiffness was measured again. Patients rated their pain on a standardized pain questionnaire (neck pain disability score (NDI) or Oswestry disability index (ODI), respectively) before and 24 hours after treatment. Results Compared to the contralateral control side, the more painful side did not exhibit an increased stiffness of myofascial tissue before treatment (p=0.827). The tissue stiffness and the side difference between treated and nontreated control sides decreased significantly after cupping (p=0.002 and p=0.001, respectively) but returned to baseline after 24 hours. NDI and ODI scores significantly decreased 24 hours after cupping (NDI: p=0.012, ODI: p=0.002). Conclusion Tissue stiffness might not be related to pain experience in patients with chronic neck and lower back pain. Trial registration: German Clinical Trial Register (DRKS00011281).
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Nasb M, Qun X, Ruckmal Withanage C, Lingfeng X, Hong C. Dry Cupping, Ischemic Compression, or Their Combination for the Treatment of Trigger Points: A Pilot Randomized Trial. J Altern Complement Med 2019; 26:44-50. [PMID: 31580695 PMCID: PMC6983744 DOI: 10.1089/acm.2019.0231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: Chronic neck pain (NP) attributed to myofascial pain syndrome is one of the particularly common skeletal muscle disorder associated with the hyperirritable zone in the taut band of muscle. Trigger points (TPs) are the physical interpretation of the myofascial pain syndrome. In the United States, 30%–85% of pain patients have been affected by myofascial TPs. Objectives: To reveal preliminary evidence on the clinical efficacy of ischemic compression therapy, dry cupping, and their combination on improving the TPs' pressure pain threshold (PPT), neck range of motion (NROM), and neck disability index (NDI) in patients with TPs and nonspecific NP. Besides, assess the feasibility of conducting a randomized clinical trial (RCT). Design: A randomized pilot study was conducted on 24 patients with TPs and nonspecific NP. Patients were randomly assigned to three groups: the cupping group, the ischemic compression group, and the combination therapy group. PPT, NROM, and NDI were assessed before and after 4 weeks of treatment. Results: The results showed a statistically significant improvement in NDI, PPT, and NROM compared with values before the treatment (p < 0.05) in all groups. Although no significant difference was detected between ischemic compression (IC) and dry cupping, the combination approach showed significantly higher and faster improvement (p < 0.05). Conclusions: It is feasible to conduct a main RCT. Both IC and dry cupping may hold promise in treating TPs; a combination of the two therapies may provide superior improving rate.
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Affiliation(s)
- Mohammad Nasb
- Department of Rehabilitation Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Xu Qun
- Department of Rehabilitation Medicine, Zhongnan Hospital, Wuhan University School of Medicine, Wuhan, P.R. China
| | - Charith Ruckmal Withanage
- Department of Rehabilitation Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Xie Lingfeng
- Department of Rehabilitation Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Chen Hong
- Department of Rehabilitation Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, P.R. China
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Al-Jaralla FA, Sharquie KE. Cupping (Hijama) in Skin diseases with positive Koebner’s Phenomenon: What is New? JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2019. [DOI: 10.5799/jcei/5856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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19
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Brinkhaus B, Dobos GJ. The Crisis of Medicine and the Benefits of Complex Pain Therapy Procedures Such As Cupping: More Research Needed. Complement Med Res 2019; 26:145-147. [PMID: 31132767 DOI: 10.1159/000500466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Benno Brinkhaus
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Projektbereich Komplementäre und Integrative Medizin, Charité - Universitätsmedizin Berlin, Berlin, Germany,
| | - Gustav J Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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AlKhadhrawi N, Alshami A. Effects of myofascial trigger point dry cupping on pain and function in patients with plantar heel pain: A randomized controlled trial. J Bodyw Mov Ther 2019; 23:532-538. [PMID: 31563366 DOI: 10.1016/j.jbmt.2019.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 05/18/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the effects of dry cupping on calf muscle myofascial trigger points (MTrPs) on pain and function in patients with plantar heel pain. METHODS Seventy-one patients were randomly divided into an intervention group or control group. Both groups performed stretching exercises for the calf muscle and plantar fascia and ankle dorsiflexion exercises. The intervention group also received dry cupping. The primary outcome measures were visual analogue scale (VAS), pressure pain threshold (PPT), and patient-specific functional scale (PSFS). The secondary outcomes were ankle dorsiflexion range of motion (ROM) and ankle plantar flexor strength. These measurements were performed at baseline, immediately after intervention, and after 2 days. RESULTS Current VAS significantly decreased immediately in the intervention group (p = 0.002), but not in the control group (p ≥ 0.220). Morning VAS decreased significantly in both groups (p < 0.001) after 2 days, but decreased more in the intervention group (p = 0.006). Trigger point PPT significantly improved immediately in the intervention group (p = 0.003), but not in the control group (p = 0.112). Both groups improved significantly in PSFS (p < 0.001) and ankle dorsiflexion ROM (p < 0.001). Plantar flexor strength significantly increased immediately in the intervention group (p < 0.001), but not in the control group (p = 0.556). CONCLUSION Adding dry cupping on calf MTrPs to self-stretching and ankle dorsiflexion exercises for patients with plantar heel pain was superior to only self-stretching and active ankle dorsiflexion exercises in pain, ankle dorsiflexion ROM, and plantar flexor strength.
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Affiliation(s)
- Nazar AlKhadhrawi
- Department of Physical Therapy, Qatif Central Hospital, P.O.Box: 3718 Qudaih, Unit No. 1, Qatif, 32661, Saudi Arabia.
| | - Ali Alshami
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Saudi Arabia.
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Feng F, Yu S, Wang Z, Wang J, Park J, Wilson G, Deng M, Hu Y, Yan B, Kong J. Non-pharmacological and pharmacological interventions relieve insomnia symptoms by modulating a shared network: A controlled longitudinal study. Neuroimage Clin 2019; 22:101745. [PMID: 30878612 PMCID: PMC6423470 DOI: 10.1016/j.nicl.2019.101745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/10/2019] [Accepted: 03/02/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Primary insomnia (PI) is one of the most common complaints among the general population. Both non-pharmacological and pharmacological therapies have proven effective in treating primary insomnia. However, the underlying mechanism of treatment remains unclear, and no studies have compared the underlying mechanisms of different treatments. METHODS In this study, we investigated gray matter volume (GMV) and resting-state functional connectivity (rsFC) changes following both pharmacological and non-pharmacological treatments in patients with PI. A total of 67 PI patients were randomized into benzodiazepine treatment, cupping treatment, or a wait-list control group for 4 weeks. The Pittsburgh Sleep Quality Index (PSQI), gray matter volume (GMV), and resting-state functional connectivity (rsFC) of the hippocampus were measured at the beginning and end of the experiment. RESULTS We found 1) significantly decreased PSQI scores in the cupping and benzodiazepine treatment groups compared to the control group with no significant differences between the two treatment groups; 2) significant GMV increases in the cupping group compared to the control group at the right hippocampus after 4 weeks of treatment; 3) significantly increased rsFC between the right hippocampus and left rostral anterior cingulate cortex/medial prefrontal cortex (rACC/mPFC) in the two treatment groups, which was significantly associated with PSQI score decreases. DISCUSSION Our findings suggest that benzodiazepine and cupping may share a common mechanism to relieve the symptoms of patients with PI.
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Affiliation(s)
- Fen Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Siyi Yu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China; Department of Psychiatry, Massachusetts General Hospital, Charlestown 02129, MA, USA
| | - Zhengyan Wang
- Sichuan Integrative Medicine Hospital, Chengdu 610041, China
| | - Jialin Wang
- College of nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Joel Park
- Department of Psychiatry, Massachusetts General Hospital, Charlestown 02129, MA, USA
| | - Georgia Wilson
- Department of Psychiatry, Massachusetts General Hospital, Charlestown 02129, MA, USA
| | - Mou Deng
- Department of mathematics and statistics, Sichuan Institute of Industrial Technology, Deyang 618005, Sichuan, China
| | - Youping Hu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Bohua Yan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Charlestown 02129, MA, USA.
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Yang Y, Ma LX, Niu TL, Niu X, Yang XZ, Wang JX, Lu Y, Gao LJ, Chen TY, Zhang YJ, Wu YJ, Song Y. Effects of Pulsatile Cupping on Body Pain and Quality of Life in People with Suboptimal Health:A Randomized Controlled Exploratory Trial. Med Acupunct 2018; 30:326-335. [PMID: 30671153 DOI: 10.1089/acu.2018.1313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objective: The curative effect of pneumatic pulsatile cupping on pain has been shown. This study was conducted to investigate effects of the pulsating frequency of pneumatic pulsatile cupping, compared with traditional cupping (TC), on body pain and quality of life (QoL) in people with suboptimal health status (SHS). Materials and Methods: Ninety-six participants with SHS were randomized to low-frequency (LF; n = 24) or high-frequency (HF; n = 24) pulsating cupping, traditional cupping (TC; n = 24), or wait-list (WL; n = 24) groups. The LF, HF, and TC groups received 4 sessions of cupping over 2 weeks. Visual analogue scale (VAS; 0-100 mm) pain level and Short-Form-36 (SF-36) QoL measurements were taken before and after the intervention. Results: Both LF and HF reduced pain significantly (VAS: -28.26; 95% confidence interval [CI] -36.18 to -20.34; and -31.88, 95% CI -39.81 to -23.96; both P = 0.000) and improved QoL more than WL (SF-36, Bodily Pain dimension: 1.46, 95% CI: 0.85 to 2.07; and 1.75, 95% CI: 1.14 to 2.36, both P = 0.000). Compared to TC, LF and HF significantly reduced pain (VAS: -7.92, 95% CI: -15.75 to -0.08, P LT = 0.048; and -11.54, 95% CI: -19.38 to -3.70, P HT = 0.004) and improved QoL (SF-36, Bodily Pain dimension: 0.61, 95% CI: 0.01 to 1.21, P LT = 0.046; and 0.90, 95% CI: 0.30 to 1.50, P HT = 0.004). There was no significant difference between LF and HF. Conclusions: This study showed that, in patients with SHS, pulsatile cupping therapy could have a more-favorable effect to relieve body pain, compared to TC. LF and HF pulsation produced equivalent pain relief. Further studies investigating the underlying mechanism are needed. Trial registration: This trial was registered in the Chinese Clinical Trial Registry (ChiCTR-INR-16009345).
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Affiliation(s)
- Yang Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Liang-Xiao Ma
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ting-Li Niu
- Affiliated Dong Fang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xin Niu
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xue-Zhi Yang
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jun-Xiang Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Lu
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lu-Jiao Gao
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tian-Yu Chen
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yu-Jing Zhang
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yan-Jing Wu
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Song
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Moura CDC, Chaves ÉDCL, Cardoso ACLR, Nogueira DA, Corrêa HP, Chianca TCM. Cupping therapy and chronic back pain: systematic review and meta-analysis. Rev Lat Am Enfermagem 2018; 26:e3094. [PMID: 30462793 PMCID: PMC6248735 DOI: 10.1590/1518-8345.2888.3094] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 09/17/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to evaluate the evidence from the literature regarding the effects of cupping therapy on chronic back pain in adults, the most used outcomes to evaluate this condition, the protocol used to apply the intervention and to investigate the effectiveness of cupping therapy on the intensity of chronic back pain. METHOD systematic review and meta-analysis carried out by two independent researchers in national and international databases. Reference lists of systematic reviews were also explored. The quality of evidence was assessed according to the Jadad scale. RESULTS 611 studies were identified, of which 16 were included in the qualitative analysis and 10 in the quantitative analysis. Cupping therapy has shown positive results on chronic back pain. There is no standardization in the treatment protocol. The main assessed outcomes were pain intensity, physical incapacity, quality of life and nociceptive threshold before the mechanical stimulus. There was a significant reduction in the pain intensity score through the use of cupping therapy (p = 0.001). CONCLUSION cupping therapy is a promising method for the treatment of chronic back pain in adults. There is the need to establish standardized application protocols for this intervention.
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Yang Y, Ma L, Niu T, Wang J, Song Y, Lu Y, Yang X, Niu X, Mohammadi A. Comparative pilot study on the effects of pulsating and static cupping on non-specific neck pain and local skin blood perfusion. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2018. [DOI: 10.1016/j.jtcms.2018.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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The Compound Effect of Cupping Therapy: Searching Beyond the Meridians. JOURNAL OF ACUPUNCTURE RESEARCH 2018. [DOI: 10.13045/jar.2018.00136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Short-Term Efficacy of Pulsed Radiofrequency Thermal Stimulation on Acupoints for Chronic Low Back Pain: A Preliminary Study of a Randomized, Single-Blinded, Placebo-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:4510909. [PMID: 30158995 PMCID: PMC6109568 DOI: 10.1155/2018/4510909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/30/2018] [Indexed: 01/31/2023]
Abstract
Background The objective of this study was to evaluate the pain-relief efficacy of thermal stimulation induced by a pulsed radiofrequency (PRF) thermal stimulation applied to acupoints (APs) in patients with low back pain (LBP). The study was designed as a randomized, single-blinded, placebo-controlled trial. Methods. Fifty-six LBP patients whose minimum pain intensity score on a visual analogue scale (VAS, 0-100 mm) was more than 30 mm were randomly allocated to either the placebo-controlled or the treatment group at a 1:1 ratio. The treatment and placebo-controlled groups received PRF thermal stimulation plus cupping therapy and cupping therapy only, respectively. Each patient was scheduled to receive a total of three treatment sessions over one week with allowing a window up to 4 days. Six of the 13 predefined APs were selected differently for each session depending on the change in patient's symptoms and intensity of pain. The primary outcome was the mean difference between the placebo-controlled and treatment group of VAS changes from the baseline to the end of the follow-up period. Results The patients' reported VAS scores from baseline to the end of follow-up (average: 9.8 days) were significantly decreased by 8.036 points (two-sided 95% CI, -11.841 to -4.231) and 13.393 points (two-sided 95% CI: 17.198 to -9.588) in the treatment and the placebo-controlled groups, respectively. However, the change in VAS scores between the treatment group and the placebo-controlled group was not significantly different (2.015 mm, two-sided 95% CI: -5.288 to 9.317). Conclusion The trial results indicated that treatment with either PRF thermal stimulation with cupping therapy or cupping therapy alone effectively relieved LBP. The efficacy of PRF thermal stimulation combined with cupping therapy was not superior to that of cupping therapy alone. Trial registration number: Clinical Research Information Service (KCT0002137). The trial was registered retrospectively on 10 November, 2016.
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Aboushanab TS, AlSanad S. Cupping Therapy: An Overview from a Modern Medicine Perspective. J Acupunct Meridian Stud 2018; 11:83-87. [DOI: 10.1016/j.jams.2018.02.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 11/25/2017] [Accepted: 02/01/2018] [Indexed: 12/25/2022] Open
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The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med 2018; 9:90-97. [PMID: 30963043 PMCID: PMC6435947 DOI: 10.1016/j.jtcme.2018.03.003] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 03/12/2018] [Indexed: 12/28/2022] Open
Abstract
Cupping Therapy (CT) is an ancient method and currently used in the treatment of a broad range of medical conditions. Nonetheless the mechanism of action of (CT) is not fully understood. This review aimed to identify possible mechanisms of action of (CT) from modern medicine perspective and offer possible explanations of its effects. English literature in PubMed, Cochrane Library and Google Scholar was searched using key words. Only 223 articles identified, 149 records screened, and 74 articles excluded for irrelevancy. Only 75 full-text articles were assessed for eligibility, included studies in this review were 64. Six theories have been suggested to explain the effects produced by cupping therapy. Pain reduction and changes in biomechanical properties of the skin could be explained by "Pain-Gate Theory", "Diffuse Noxious Inhibitory Controls" and "Reflex zone theory". Muscle relaxation, changes in local tissue structures and increase in blood circulation might be explained by "Nitric Oxide theory". Immunological effects and hormonal adjustments might be attributed to "Activation of immune system theory". Releasing of toxins and removal of wastes and heavy metals might be explained by "Blood Detoxification Theory". These theories may overlap or work interchangeably to produce various therapeutic effects in specific ailments and diseases. Apparently, no single theory exists to explain the whole effects of cupping. Further researches are needed to support or refute the aforesaid theories, and also develop innovative conceptualizations of (CT) in future.
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Teut M, Ullmann A, Ortiz M, Rotter G, Binting S, Cree M, Lotz F, Roll S, Brinkhaus B. Pulsatile dry cupping in chronic low back pain - a randomized three-armed controlled clinical trial. Altern Ther Health Med 2018; 18:115. [PMID: 29609566 PMCID: PMC5879872 DOI: 10.1186/s12906-018-2187-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/22/2018] [Indexed: 01/13/2023]
Abstract
Background We aimed to investigate the effectiveness of two different forms of dry pulsatile cupping in patients with chronic low back pain (cLBP) compared to medication on demand only in a three-armed randomized trial. Methods 110 cLBP patients were randomized to regular pulsatile cupping with 8 treatments plus paracetamol on demand (n = 37), minimal cupping with 8 treatments plus paracetamol on demand (n = 36) or the control group with paracetamol on demand only (n = 37). Primary outcome was the pain intensity on a visual analogue scale (VAS, 0–100 mm) after 4 weeks, secondary outcome parameter included VAS pain intensity after 12 weeks, back function as measured with the ‘Funktionsfragebogen Hannover Rücken’ (FFbH-R) and health related quality of life questionnaire Short form 36 (SF-36) after 4 and 12 weeks. Results The mean baseline-adjusted VAS after 4 weeks was 34.9 mm (95% CI: 28.7; 41.2) for pulsatile cupping, 40.4 (34.2; 46.7) for minimal cupping and 56.1 (49.8; 62.4) for control group, resulting in statistically significant differences between pulsatile cupping vs. control (21.2 (12.2; 30.1); p < 0.001) and minimal cupping vs. control (15.7 (6.9; 24.4); p = 0.001). After 12 weeks, mean adjusted VAS difference between pulsatile cupping vs. control was 15.1 ((3.1; 27.1); p = 0.014), and between minimal cupping vs. control 11.5 ((− 0.44; 23.4); p = 0.059). Differences of VAS between pulsatile cupping and minimal cupping showed no significant differences after 4 or 12 weeks. Pulsatile cupping was also better (− 5.8 (− 11.5;-0.1); p = 0.045) compared to control for back function after 4 weeks, but not after 12 weeks (− 5.4 (− 11.7;0.8); p = 0.088), pulsatile cupping also showed better improvements on SF-36 physical component scale compared to control at 4 and 12 weeks (− 5.6 (− 9.3;-2.0); p = 0.003; − 6.1 (− 9.9;-2.4); p = 0.002). For back function and quality of life minimal cupping group was not statistically different to control after 4 and 12 weeks. Paracetamol intake did not differ between the groups (cupping vs. control (7.3 (− 0.4;15.0); p = 0.063); minimal cupping vs. control (6.3 (− 2.0;14.5); p = 0.133). Conclusions Both forms of cupping were effective in cLBP without showing significant differences in direct comparison after four weeks, only pulsatile cupping showed effects compared to control after 12 weeks. Trial registration The study was registered at ClinicalTrials.gov (identifier: NCT02090686).
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Abstract
Wet cupping (Al-hijamah) is a therapeutic technique practiced worldwide as a part of the Unani system of medicine. It involves bloodletting from acupoints on a patient’s skin to produce a therapeutic outcome. A thorough review of research articles on wet cupping with relevance to proteomics field that are indexed by Google Scholar, PubMed, and/or Science Direct databases was performed. Eight original research articles were summarized in this paper. Overall, wet cupping did not have a significant effect on C-reactive protein, Hsp-27, sister chromatid exchanges, and cell replication index. In contrast, wet cupping was found to produce higher oxygen saturation, eliminate lactate from subcutaneous tissues, remove blood containing higher levels of malondialdehyde and nitric oxide, and produce higher activity of myeloperoxidase. The proteomic effects of wet cupping therapy have not been adequately investigated. Thus, future studies on wet cupping that use systemic and sound protocols to avoid bias should be conducted.
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Affiliation(s)
- Amer A Almaiman
- Department of Applied Medical Sciences, Community College of Unaizah, Qassim University, Qassim, Kingdom of Saudi Arabia. E-mail.
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Bridgett R, Klose P, Duffield R, Mydock S, Lauche R. Effects of Cupping Therapy in Amateur and Professional Athletes: Systematic Review of Randomized Controlled Trials. J Altern Complement Med 2017; 24:208-219. [PMID: 29185802 DOI: 10.1089/acm.2017.0191] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Despite the recent re-emergence of the process of cupping by athletes, supporting evidence for its efficacy and safety remains scarce. This systematic review aims to summarize the evidence of clinical trials on cupping for athletes. METHODS SCOPUS, Cochrane Library, PubMed, AMED, and CNKI databases were searched from their inception to December 10, 2016. Randomized controlled trials on cupping therapy with no restriction regarding the technique, or cointerventions, were included, if they measured the effects of cupping compared with any other intervention on health and performance outcomes in professionals, semi-professionals, and leisure athletes. Data extraction and risk of bias assessment using the Cochrane Risk of Bias Tool were conducted independently by two pairs of reviewers. RESULTS Eleven trials with n = 498 participants from China, the United States, Greece, Iran, and the United Arab Emirates were included, reporting effects on different populations, including soccer, football, and handball players, swimmers, gymnasts, and track and field athletes of both amateur and professional nature. Cupping was applied between 1 and 20 times, in daily or weekly intervals, alone or in combination with, for example, acupuncture. Outcomes varied greatly from symptom intensity, recovery measures, functional measures, serum markers, and experimental outcomes. Cupping was reported as beneficial for perceptions of pain and disability, increased range of motion, and reductions in creatine kinase when compared to mostly untreated control groups. The majority of trials had an unclear or high risk of bias. None of the studies reported safety. CONCLUSIONS No explicit recommendation for or against the use of cupping for athletes can be made. More studies are necessary for conclusive judgment on the efficacy and safety of cupping in athletes.
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Affiliation(s)
- Rhianna Bridgett
- 1 Endeavour College of Natural Health , Fortitude Valley, Australia
| | - Petra Klose
- 2 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen , Essen, Germany
| | - Rob Duffield
- 3 Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney , Sydney, NSW, Australia
| | - Suni Mydock
- 1 Endeavour College of Natural Health , Fortitude Valley, Australia
| | - Romy Lauche
- 4 Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney , Sydney, NSW, Australia
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Lauche R, Spitzer J, Schwahn B, Ostermann T, Bernardy K, Cramer H, Dobos G, Langhorst J. Efficacy of cupping therapy in patients with the fibromyalgia syndrome-a randomised placebo controlled trial. Sci Rep 2016; 6:37316. [PMID: 27853272 PMCID: PMC5112514 DOI: 10.1038/srep37316] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/19/2016] [Indexed: 01/27/2023] Open
Abstract
This study aimed to test the efficacy of cupping therapy to improve symptoms and quality of life in patients diagnosed with the fibromyalgia syndrome. Participants were randomly assigned to cupping therapy, sham or usual care. Cupping was administered five times at twice weekly intervals on the upper and lower back. The primary outcome measure was pain intensity at day 18. Secondary outcomes included functional disability, quality of life, fatigue and sleep quality as well as pressure pain sensitivity, satisfaction and safety at day 18 and 6 months. Altogether 141 patients were included in this study (139 females, 55.8 ± 9.1 years). After 18 days patients reported significant less pain after cupping compared to usual care (difference −12.4; 95% CI: −18.9; −5.9, p < 0.001) but not compared to sham (difference −3.0; 95% CI: −9.9, 3.9, p = 0.396). Further effects were found for quality of life compared to usual care. Patients were mildly satisfied with cupping and sham cupping; and only minor side effects were observed. Despite cupping therapy being more effective than usual care to improve pain intensity and quality of life, effects of cupping therapy were small and comparable to those of a sham treatment, and as such cupping cannot be recommended for fibromyalgia at the current time.
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Affiliation(s)
- Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
| | - Julia Spitzer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Barbara Schwahn
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Thomas Ostermann
- Institute of Integrative Medicine, Department of Health, University of Witten/Herdecke, Herdecke, Germany
| | - Kathrin Bernardy
- Department of Anesthesiology, Berufsgenossenschaftliche Universitätsklinik Bergmannsheil, Bochum, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Farhadi K, Choubsaz M, Setayeshi K, Kameli M, Bazargan-Hejazi S, Zadie ZH, Ahmadi A. The effectiveness of dry-cupping in preventing post-operative nausea and vomiting by P6 acupoint stimulation: A randomized controlled trial. Medicine (Baltimore) 2016; 95:e4770. [PMID: 27661022 PMCID: PMC5044892 DOI: 10.1097/md.0000000000004770] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia, and the prevalence ranges between 25% and 30%. The aim of this study was to determine the preventive effects of dry cupping on PONV by stimulating point P6 in the wrist. METHODS This was a randomized controlled trial conducted at the Imam Reza Hospital in Kermanshah, Iran. The final study sample included 206 patients (107 experimental and 99 controls). Inclusion criteria included the following: female sex; age>18 years; ASA Class I-II; type of surgery: laparoscopic cholecystectomy; type of anesthesia: general anesthesia. Exclusion criteria included: change in the type of surgery, that is, from laparoscopic cholecystectomy to laparotomy, and ASA-classification III or more. Interventions are as follows: pre surgery, before the induction of anesthesia, the experimental group received dry cupping on point P6 of the dominant hand's wrist with activation of intermittent negative pressure. The sham group received cupping without activation of negative pressure at the same point. Main outcome was that the visual analogue scale was used to measure the severity of PONV. RESULTS The experimental group who received dry cupping had significantly lower levels of PONV severity after surgery (P < 0.001) than the control group. The differences in measure were maintained after controlling for age and ASA in regression models (P < 0.01). CONCLUSION Traditional dry cupping delivered in an operation room setting prevented PONV in laparoscopic cholecystectomy patients.
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Affiliation(s)
- Khosro Farhadi
- Department of Anesthesiology, Critical Care and Pain Management
| | | | - Khosro Setayeshi
- Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Kameli
- Department of Anesthesiology, Critical Care and Pain Management
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science and David Geffen School of Medicine at University of California, Los Angeles, CA
- Correspondence: Shahrzad Bazargan-Hejazi, Department of Psychiatry, College of Medicine, Charles R. Drew University of Medicine & Science, & David Geffen School of Medicine, University of California at Los Angeles. 1731 East 120th Street, Los Angeles, CA 90059 (e-mail: ); Alireza Ahmadi, Department of Anesthesiology, Critical Care and Pain Management, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah 6714415333, Iran (e-mail: )
| | - Zahra H. Zadie
- Department of Anesthesiology, Critical Care and Pain Management
| | - Alireza Ahmadi
- Department of Anesthesiology, Critical Care and Pain Management
- Correspondence: Shahrzad Bazargan-Hejazi, Department of Psychiatry, College of Medicine, Charles R. Drew University of Medicine & Science, & David Geffen School of Medicine, University of California at Los Angeles. 1731 East 120th Street, Los Angeles, CA 90059 (e-mail: ); Alireza Ahmadi, Department of Anesthesiology, Critical Care and Pain Management, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah 6714415333, Iran (e-mail: )
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Cupping: The common wealth of world traditional medicine. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2016. [DOI: 10.1016/s1003-5257(17)30055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Dons'koi BV, Chernyshov VP, Osypchuk DV, Baksheev SM. Repeated cupping manipulation temporary decreases natural killer lymphocyte frequency, activity and cytotoxicity. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2016; 14:197-202. [DOI: 10.1016/s2095-4964(16)60250-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
To know the research progress of cupping therapy all over the world, the authors analyze the research of cupping therapy in recent 5 years. It indicates that cupping therapy can be applied to extensive curable disease, but has poor clinical evidence. Some improvements in the mechanism research of cupping therapy have been made, but it needs further research. The adverse events of cupping therapy attract attention. The standardization of cupping therapy has emerged.
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Affiliation(s)
- B Chen
- From the Acupuncture Research Center, Institute of Acupuncture and Massage and Clinical Practice Teaching Department, Tianjin University of Traditional Chinese Medicine, Tianjin, China From the Acupuncture Research Center, Institute of Acupuncture and Massage and Clinical Practice Teaching Department, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - M-Y Li
- From the Acupuncture Research Center, Institute of Acupuncture and Massage and Clinical Practice Teaching Department, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - P-D Liu
- From the Acupuncture Research Center, Institute of Acupuncture and Massage and Clinical Practice Teaching Department, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Y Guo
- From the Acupuncture Research Center, Institute of Acupuncture and Massage and Clinical Practice Teaching Department, Tianjin University of Traditional Chinese Medicine, Tianjin, China From the Acupuncture Research Center, Institute of Acupuncture and Massage and Clinical Practice Teaching Department, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Z-L Chen
- From the Acupuncture Research Center, Institute of Acupuncture and Massage and Clinical Practice Teaching Department, Tianjin University of Traditional Chinese Medicine, Tianjin, China From the Acupuncture Research Center, Institute of Acupuncture and Massage and Clinical Practice Teaching Department, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Mehta P, Dhapte V. Cupping therapy: A prudent remedy for a plethora of medical ailments. J Tradit Complement Med 2015; 5:127-34. [PMID: 26151023 PMCID: PMC4488563 DOI: 10.1016/j.jtcme.2014.11.036] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 10/28/2014] [Accepted: 11/21/2014] [Indexed: 12/17/2022] Open
Abstract
Since ancient times, complementary and alternative medicine (CAM; bǔ chōng yǔ tì dài yī xué) have played an important role in human health and welfare. Many therapeutic approaches in healthcare outside the realm of conventional medicine persist in various parts of the world. There is considerable scientific and commercial potential in CAM, which needs to be explored precisely. Cupping therapy ( bá guàn liáo fǎ), one of the CAM, is practiced across the world. This therapy is believed to act by correcting imbalances in the internal bio field, such as by restoring the flow of "Qi (qì)". Cupping involves applying a heated cup to generate a partial vacuum that mobilizes the blood flow and promotes effective healing. This review outlines various tools and techniques of cupping therapy.
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Affiliation(s)
- Piyush Mehta
- Department of Quality Assurance, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, India
| | - Vividha Dhapte
- Department of Pharmaceutics, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, India
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