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Sun TY, Ma LX, Mu JD, Zhang Z, Yu WY, Qian X, Tian Y, Zhang YD, Wang JX. Acupuncture improves the structure of spastic muscle and decreases spasticity by enhancing GABA, KCC2, and GABAAγ2 in the brainstem in rats after ischemic stroke. Neuroreport 2022; 33:399-407. [PMID: 35594431 DOI: 10.1097/wnr.0000000000001798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Increasing data show that structural changes of spastic muscle and hyperexcitability of reticulospinal tract (RST) are involved in the pathogenesis of spasticity after stroke (SAS). Our previous study has indicated that the anti-spastic effect of acupuncture, especially waggle needling (WN, a multiple directional needling method with joint movement), on SAS rats was related to the KCC2-GABAA pathway in cerebral cortex. Furthermore, as a peripheral stimulation to treat upper motor neuron injury-related spasticity, acupuncture's effect on peripheral spastic muscles and inhibitory neurotransmitters in the brainstem, the origin of the RST, should be further clarified. This study aimed to examine the effect of acupuncture on the structure of spastic muscle and on the KCC2-GABAA pathway in the brainstem of SAS rats. METHODS Middle cerebral artery occlusion (MCAO) or a sham operation were conducted in SD rats to establish SAS and control models. Behavioral assays, muscle myosin ATPase staining, and molecular biology technologies were used to compare different groups. RESULTS In SAS models, hindlimb motor ability was decreased, neurologic deficits and spasticity were induced, the proportion of type I muscle fibers in spastic muscle was increased, and the expressions of γ-aminobutyric acid (GABA), KCC2, and the GABAAγ2 subunit of the pentameric GABAA receptor in the brainstem were decreased. Acupuncture including WN and perpendicular needling (PN) reversed these effects of MCAO. Furthermore, the therapeutic effect of WN was better than that of PN. CONCLUSIONS Acupuncture after MCAO improves the structure of spastic muscle and decreases spasticity probably at least partly by enhancing GABA, KCC2, and GABAAγ2 in the brainstem in SAS rats.
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Affiliation(s)
- Tian-Yi Sun
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine
| | - Liang-Xiao Ma
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine
- The Key Unit of State Administration of Traditional Chinese Medicine, Evaluation of Characteristic Acupuncture Therapy
| | - Jie-Dan Mu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine
| | - Zhou Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine
| | - Wen-Yan Yu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine
| | - Xu Qian
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine
| | - Yuan Tian
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine
| | - Yi-Dan Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine
| | - Jun-Xiang Wang
- School of Nursing, Beijing University of Chinese Medicine, Beijing 100029, China
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Therapeutic Effect of Catgut Implantation at Acupoint in a Mouse Model of Hepatocellular Carcinoma by Suppressing Immune Escape. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5572869. [PMID: 35178106 PMCID: PMC8846981 DOI: 10.1155/2022/5572869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 12/14/2022]
Abstract
Background The occurrence and development of hepatocellular carcinoma (HCC) are closely related to immune function, as is the capacity of hepatoma cells to escape. Immunosurveillance is a key mechanism. Catgut implantation at acupoint (CIAA) is a promising acupuncture improvement method that can regulate immunity and has been widely used in the clinical treatment of a variety of diseases. The aim of this study is to observe the therapeutic effect of CIAA on HCC and to investigate the potential mechanism of immune escape. Materials and Methods A total of 40 mice were randomly divided into three groups: the HCC model group (n = 15), the CIAA treatment group (n = 15), and the control group (n = 10). HCC was chemically induced in 30 mice by the combination of DEN, carbon tetrachloride, and ethanol for 150 days. Among them, 15 were selected for CIAA treatment to ascertain the therapeutic effect. The mRNA expression levels of AFP, IL-10, PD-1, and CTLA-4 in three groups were examined by using RT-PCR. AFP and AKT expressions were measured by using western blotting. PD1, CTLA-4, IL-10, CD4+, and CD8+ protein expression levels were evaluated by using IHC. The mortality rate, body weight, and psychological conditions of three groups were also compared. Results The mRNA and protein expression levels of AFP, PD-1, CTLA-4, and IL-10 were significantly downregulated in the CIAA-treated mice in comparison with HCC mice. IHC assay shows that CD4+ and CD8+ expression levels were notably upregulated after CIAA treatment. Western blotting assay shows that AKT pathway was deactivated in CIAA-treated mice. CIAA notably reduced the mortality rate and inhibited weight loss caused by HCC and improved the overall psychological condition of the mice. Conclusions Taken together, our data corroborate the effective potency of CIAA in the treatment of HCC by and inhibiting immune escape and deactivating the AKT pathway.
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Waggle needling wields preferable neuroprotective and anti-spastic effects on post-stroke spasticity rats by attenuating γ-aminobutyric acid transaminase and enhancing γ-aminobutyric acid. Neuroreport 2021; 31:708-716. [PMID: 32453018 PMCID: PMC7289130 DOI: 10.1097/wnr.0000000000001471] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Waggle needling, a classical anti-spastic needling technique characterized by combination of acupuncture with joint movement, has gained increasing popularity of spasticity treatment in China. This study was designed to compare the anti-spastic effect of waggle needling to the routine needling and to explore its underlying mechanism. We established post-stroke spasticity model based on ischemia stroke operation (middle cerebral artery occlusion). Rats were divided into six groups: normal control group, sham-operated control group, ischemia stroke model group, waggle needling group, routine needling group and baclofen group. Neurological function and muscle tone were assessed by the Zea Longa score and modified Ashworth scale, respectively. Indirect muscle tone was testified with electrophysiological recording. Cerebral infarction was measured by 2,3,5-triphenyltetrazolium chloride staining. The concentrations and expressions of γ-aminobutyric acid transaminase (GABAT) and γ-aminobutyric acid (GABA) were detected by enzyme-linked immunosorbent assay and western blot assay. Waggle needling markedly alleviated neurological deficits, decreased cerebral infarction and eased muscle tone; simultaneously, attenuated GABAT and enhanced GABA expression in the cortical infarct regions in comparison with the routine needling (P < 0.01), yet showed similar therapeutic effect to the baclofen group (P > 0.05). These results preliminary supported that waggle needling as a potential promising non-pharmacological intervention for the treatment of cerebral ischemia and spasticity.
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Qiu X, Gao Y, Zhang Z, Cheng S, Zhang S. Fire Acupuncture versus conventional acupuncture to treat spasticity after stroke: A systematic review and meta-analysis. PLoS One 2021; 16:e0249313. [PMID: 33836008 PMCID: PMC8034732 DOI: 10.1371/journal.pone.0249313] [Citation(s) in RCA: 5] [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: 09/26/2020] [Accepted: 03/09/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Post-stroke spasm is currently a complex clinical problem that remains to be resolved. Due to its excellent efficacy and few side effects, clinicians have used fire acupuncture to treat post-stroke spasticity in China. OBJECTIVES The purpose of this study was to evaluate the clinical efficacy of fire acupuncture compared with conventional acupuncture to treat post-stroke spasms and provide a detailed summary of the commonly used acupoints. METHODS Eight databases (MEDLINE/PubMed, Web of Science, the Cochrane database, EMBASE, CBM, CNKI, WanFang, and VIP) were searched for randomized controlled trials (RCTs) published from database inception through August 30, 2020. RCTs that compared fire acupuncture with conventional acupuncture as a treatment intervention for patients with spasticity after stroke were included. Revman 5.3 software was used to calculate risk ratios (RR) and standard mean differences (SMD) with 95% confidence intervals (CI). Methodological evaluation or critical appraisal of the included articles was assessed using RoB-2. RESULTS Sixteen studies with a total of 1,118 patients were included. Although according to the standards of the Rob 2.0 tool, most studies are considered to have some problems. Comprehensive analysis of the results revealed a consistent trend indicating several advantages of using fire needles compared to conventional acupuncture in treating post-stroke spasms, including the effective rate, recovery rate, and improvement of multiple scales represented by MAS. Concerning secondary outcomes, using the scales of FMA, BI, or NDS in this random model meta-analysis, fire acupuncture exhibited better performance compared to acupuncture [SMD = 2.27, 95%CI [1.40,3.13 (random-effects model) ], [SMD = 1.46,95% CI [1.03,1.90 (random-effects model)], and [SMD = 0.90, 95%CI [0.44,1.35 (random-effects model)], respectively, with moderately high heterogeneity. When the effective rate was used as an outcome in the subgroup analysis, fire needles performed better than conventional acupuncture with respect to damage to the upper or lower limbs, and the thickness and depth of acupuncture. When the modified Ashworth scale (MAS) was used as the outcome, and the damage occurred in the lower extremity, the acupuncture depth exceeded 15mm, or the duration of stroke was longer than six months, the fire needles did not perform better than conventional acupuncture, [SMD = 0.01, 95%CI [-0.47,0.48 (fix-effects model)], [SMD = 0.21 [-0.51,0.93(random-effects model)], and [SMD = 0.76, 95%CI [-0.08,1.60 (random-effects model)], respectively. The acupoints identified with the highest frequencies in this study were Yang-meridian, including LI11-Quchi (nine times), LI4-Hegu (seven times), and ST36-Zusanli (five times). Moreover, no serious adverse effects were reported in any of the studies included in this analysis. CONCLUSIONS Despite several limitations, this was the first meta-analysis to focus on the treatment of post-stroke spasticity using fire needle acupuncture compared with conventional acupuncture. Our results confirmed that fire needles could provide a better clinical effect than conventional acupuncture, which will help standardize fire needle treatment strategies for post-stroke spasms.
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Affiliation(s)
- Xuan Qiu
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, GuangZhou, China
- Guangzhou University of Traditional Chinese Medicine, GuangZhou, China
| | - Yicheng Gao
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, GuangZhou, China
- Guangzhou University of Traditional Chinese Medicine, GuangZhou, China
| | - Zhaoxu Zhang
- Department of Neurology, Peking University People’s Hospital, Beijing, China
| | - Sijia Cheng
- Guangzhou University of Traditional Chinese Medicine, GuangZhou, China
| | - Shuangmei Zhang
- Department of Rehabilitation, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), HangZhou, China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, HangZhou, China
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Xie R, Wang Y, He J, Yang Y. Acupuncture treatment for spasticity after brain injury. JOURNAL OF NEURORESTORATOLOGY 2021. [DOI: 10.26599/jnr.2021.9040001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Spasticity after brain injury is a neurological sequela caused by damage to upper motor neurons. The primary symptoms are involuntary muscle activity, decreased muscle strength, and joint contracture. Acupuncture as a therapeutic method to regulate central nervous system function has been studied widely in recent years. Many clinical experiments have proved that acupuncture has positive effects on spasticity after brain injury. In this review, we discuss recent research of acupuncture treatment and the need for large randomized controlled trials.
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Shi LH, Guo LX, Zhang HL, Li YX, Zhong DL, Xiao QW, Li J, Ye XQ, Jin RJ. Acupuncture for poststroke spasticity: A protocol of a systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17124. [PMID: 31574812 PMCID: PMC6775425 DOI: 10.1097/md.0000000000017124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Spasticity is the most common complication after stroke, which is the main obstacle in the recovery of motor function. Spasticity seriously affects the quality of life and brings a heavy burden to families and society. Acupuncture is an effective method for stroke. However, whether acupuncture is effective for poststroke spasticity is still unknown. The purpose of this systematic review (SR) is to evaluate the effectiveness and safety of acupuncture for poststroke spasticity. METHODS AND ANALYSIS We will search the following databases from inception to July 2019: China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wan Fang Data, the Chinese Science and Technology Periodical Database (VIP), PubMed, Embase, The Cochrane Library, and Web of Science. All relevant randomized controlled trials (RCTs) utilizing acupuncture for poststroke spasticity will be included. The primary outcome is the modified Ashworth scale. Secondary outcomes include composite spasticity scale, clinic spasticity index, electromyographic activity, Hoffmann reflex activity, or other spasticity-related outcomes. Study selection, data extraction, and quality assessment will be performed independently by 2 reviewers. Assessment of risk of bias and data synthesis will be conducted using Review Manager V5.3 software. ETHICS AND DISSEMINATION The ethical approval is not required since SR is based on published studies. The results of this SR will be published in a peer-reviewed scientific journal according to the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines. PROSPERO REGISTRATION NUMBER CRD42019129779.
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Affiliation(s)
- Li-hong Shi
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine
| | - Liu-xue Guo
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine
| | - Hui-ling Zhang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine
| | - Yu-xi Li
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan
| | - Dong-ling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine
| | - Qi-wei Xiao
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine
| | - Xiao-qian Ye
- School of Acupuncture, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Rong-jiang Jin
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine
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Exploration of the establishment of manganese poisoning rat model and analysis of discriminant methods. Toxicology 2018; 410:193-198. [DOI: 10.1016/j.tox.2018.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/22/2018] [Accepted: 08/12/2018] [Indexed: 11/23/2022]
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Cui W, Sun W, Mao-Ying QL, Mi W, Chu Y, Wang Y. Evaluation of catgut implantation at acupoints for asthma: A systematic review and meta-analysis. TRADITIONAL MEDICINE AND MODERN MEDICINE 2018. [DOI: 10.1142/s2575900018400025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective: This study aims to systematically evaluate the efficacy and safety of catgut implantation at acupoints (CIA) treating asthma, extracting data from the published clinical trials. Methods: The Cochrane Library, PubMed, Chinese Biomedical Database (CBM), CNKI, WANFANG and VIP databases were searched up to February 2017. Randomized controlled trials (RCTs) involving CIA or CIA plus conventional medicine treatment (CMT) were selected with CMT as control. We assessed the methodological quality of RCTs using the Cochrane Handbook for Systematic Review of Interventions. The outcome data of trials were analyzed using RevMan5.3. Results: A total of 12 studies ([Formula: see text]) were included. Most of the included studies were assessed to have high risk of bias with low quality of methodology. CIA application significantly improved the overall therapeutic efficacy ([Formula: see text]) and pulmonary function (forced expiratory volume in 1[Formula: see text]s (FEV1) and FEV1%, [Formula: see text] and [Formula: see text]) and reduced the overall scores of TCM symptoms ([Formula: see text]). Further, it significantly relieved several TCM symptoms including shortness of breath, chest distress and cough ([Formula: see text]). However, CIA only exerted a protective tendency for expectoration and wheezing without significant difference and had no effects on recurrence rate (all [Formula: see text]). Conclusions: CIA treatment could improve the overall efficacy and pulmonary function and relief several symptoms. However, the evidence remains weak. Rigorous and larger trials will be the basis of the effectiveness and long-term effects of CIA therapies.
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Affiliation(s)
- Wenqiang Cui
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Fudan University, Shanghai, P. R. China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai, P. R. China
| | - Wenshan Sun
- Department of Traditional Chinese Medicine, The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai, P. R. China
| | - Qi-Liang Mao-Ying
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Fudan University, Shanghai, P. R. China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai, P. R. China
| | - Wenli Mi
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Fudan University, Shanghai, P. R. China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai, P. R. China
| | - Yuxia Chu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Fudan University, Shanghai, P. R. China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai, P. R. China
| | - Yanqing Wang
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Fudan University, Shanghai, P. R. China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai, P. R. China
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ZHU XIAOQIN, HU HAIXIA, LI ZUANFANG, LIN RUHUI, MAO JINGJIE, CHEN LIDIAN. Gua Lou Gui Zhi decoction attenuates post-stroke spasticity via the modulation of GABAB receptors. Mol Med Rep 2015; 12:5957-62. [DOI: 10.3892/mmr.2015.4207] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 06/11/2015] [Indexed: 11/06/2022] Open
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