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Silva MVFP, Lustosa TC, Arai VJ, Couto Patriota TLG, Lira MPF, Lins-Filho OL, Chalegre ST, B B A S K, Secundo IV, Pedrosa RP. Effects of acupuncture on obstructive sleep apnea severity, blood pressure control and quality of life in patients with hypertension: A randomized controlled trial. J Sleep Res 2019; 29:e12954. [PMID: 31868987 DOI: 10.1111/jsr.12954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/21/2019] [Accepted: 11/06/2019] [Indexed: 11/28/2022]
Abstract
Obstructive sleep apnea (OSA) is a common condition among patients with hypertension and treatment with continuous positive airway pressure (CPAP) can decrease blood pressure (BP). However, CPAP is not well tolerated by a significant proportion of patients. The authors investigated the effects of acupuncture on OSA severity and BP control in patients with hypertension. Hypertensive patients with mild to moderate OSA (apnea-hypopnea index, 5-30 events/hr) were randomly assigned to receive acupuncture or sham-acupuncture treatment. Patients were assessed at baseline and after 10 acupuncture sessions using polysomnography, 24-hr ambulatory BP monitoring and a quality of life questionnaire. Forty-four patients (34% men; mean age, 57.0 ± 5.4 years; body mass index, 29.6 ± 3.2 kg/m2 ; apnea-hypopnea index, 16.3 ± 6.7 events/hr) completed the study. There were no differences in pre-post-intervention apnea-hypopnea index, daytime or nocturnal BP, or quality of life between the acupuncture and sham-acupuncture groups (p > .05). Acupuncture therapy in hypertensive patients with OSA did not reduce OSA severity, daytime or nocturnal BP, or quality of life.
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Affiliation(s)
- Marcus Vinícius F P Silva
- Sleep and Heart Laboratory, Pronto Socorro Cardiologico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brazil
| | - Thais C Lustosa
- Sleep and Heart Laboratory, Pronto Socorro Cardiologico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brazil
| | - Victor J Arai
- Sleep and Heart Laboratory, Pronto Socorro Cardiologico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brazil
| | - Tarcya L G Couto Patriota
- Sleep and Heart Laboratory, Pronto Socorro Cardiologico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brazil
| | - Maria P F Lira
- Sleep and Heart Laboratory, Pronto Socorro Cardiologico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brazil
| | - Ozeas L Lins-Filho
- Sleep and Heart Laboratory, Pronto Socorro Cardiologico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brazil
| | - Sintya T Chalegre
- Sleep and Heart Laboratory, Pronto Socorro Cardiologico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brazil
| | - Kamilla B B A S
- Sleep and Heart Laboratory, Pronto Socorro Cardiologico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brazil
| | - Isaac V Secundo
- Sleep and Heart Laboratory, Pronto Socorro Cardiologico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brazil
| | - Rodrigo P Pedrosa
- Sleep and Heart Laboratory, Pronto Socorro Cardiologico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, Brazil
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A New Perspective of Acupuncture: The Interaction among Three Networks Leads to Neutralization. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2326867. [PMID: 30915143 PMCID: PMC6409053 DOI: 10.1155/2019/2326867] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/05/2019] [Accepted: 02/11/2019] [Indexed: 12/23/2022]
Abstract
Acupuncture has been used to treat multiple medical conditions, but whether the diverse effects of acupuncture are intrinsically linked and how they might be connected have yet to be determined. More and more researches have shown that acupuncture is a kind of nociceptive stimulus, which can cause inflammatory reaction in the sites of acupuncture and then further activate the nerve-endocrine-immune systems to cause the cascade amplification of the acupuncture effect. This review seeks to provide a comprehensive summary of the existing literature concerning the role of “acupoint-meridian-disease network” in various effects of acupuncture and suggest a novel notion that acupuncture may restore homeostasis under different pathological conditions by regulating this network, resulting in the activation of different reaction cascades in response to pathological injury. We think that acupuncture acts on acupoints, first activating the small network of acupoints (Acupoint Network). The information of acupuncture is amplified by cascade, and the nerve endocrine immune system (NEI) is activated through the large network of meridians (Meridian Network) of the body itself. The nerve-endocrine-immune system (NEI) further outputs the effect information to the target organ through multilevel and multisystems and finally acts on the disease network (Disease Network) to produce acupuncture effect.
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The effect of acupuncture on mood and working memory in patients with depression and schizophrenia. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2015; 13:380-90. [DOI: 10.1016/s2095-4964(15)60204-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Lee S, Kim JH, Shin KM, Kim JE, Kim TH, Kang KW, Lee M, Jung SY, Shin MS, Kim AR, Park HJ, Hong KE, Choi SM. Electroacupuncture to treat painful diabetic neuropathy: study protocol for a three-armed, randomized, controlled pilot trial. Trials 2013; 14:225. [PMID: 23866906 PMCID: PMC3720209 DOI: 10.1186/1745-6215-14-225] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 07/04/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study is to conduct a basic analysis of the effectiveness and safety of electroacupuncture in the treatment of painful diabetic neuropathy (PDN) as compared to placebo and usual care and to evaluate the feasibility of large-scale clinical research. METHODS/DESIGN This study is a protocol for a three-armed, randomized, patient-assessor-blinded (to the type of treatment), controlled pilot trial. Forty-five participants with a ≥ six month history of PDN and a mean weekly pain score of ≥ 4 on the 11-point Pain Intensity Numerical Rating Scale (PI-NRS) will be assigned to the electroacupuncture group (n = 15), sham group (n = 15) or usual care group (n = 15). The participants assigned to the electroacupuncture group will receive electroacupuncture (remaining for 30 minutes with a mixed current of 2 Hz/120 Hz and 80% of the bearable intensity) at 12 standard acupuncture points (bilateral ST36, GB39, SP9, SP6, LR3 and GB41) twice per week for eight weeks (a total of 16 sessions) as well as the usual care. The participants in the sham group will receive sham electroacupuncture (no electrical current will be passed to the needle, but the light will be seen, and the sound of the pulse generator will be heard by the participants) at non-acupuncture points as well as the usual care. The participants in the usual care group will not receive electroacupuncture treatment during the study period and will receive only the usual care. The follow-up will be in the 5th, 9th and 17th weeks after random allocation. The PI-NRS score assessed at the ninth week will be the primary outcome measurement used in this study. The Short-Form McGill Pain Questionnaire (SF-MPQ), a sleep disturbance score (11-point Likert scale), the Short-Form 36v2 Health Survey (SF-36), the Beck Depression Inventory (BDI) and the Patient Global Impression of Change (PGIC) will be used as outcome variables to evaluate the effectiveness of the acupuncture. Safety will be assessed at every visit. DISCUSSION The result of this trial will provide a basis for the effectiveness and safety of electroacupuncture for PDN. TRIAL REGISTRATION Clinical Research information Service. Unique identifier: KCT0000466.
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Affiliation(s)
- Seunghoon Lee
- Acupuncture, Moxibustion & Meridian Research Group, Korea Institute of Oriental Medicine, Daejeon, Korea
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Nasiri E, Raei M, Vatani J, Kazemi RK. The Effect of Acupressure on Quality of Sleep in Hemodialysis Patients. JOURNAL OF MEDICAL SCIENCES 2011. [DOI: 10.3923/jms.2011.236.240] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Wang H, Pan Y, Xue B, Wang X, Zhao F, Jia J, Liang X, Wang X. The antioxidative effect of electro-acupuncture in a mouse model of Parkinson's disease. PLoS One 2011; 6:e19790. [PMID: 21625423 PMCID: PMC3100295 DOI: 10.1371/journal.pone.0019790] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 04/05/2011] [Indexed: 01/19/2023] Open
Abstract
Accumulating evidence indicates that oxidative stress plays a critical role in
Parkinson's disease (PD). Our previous work has shown that 100 Hz
electro-acupuncture (EA) stimulation at ZUSANLI (ST36) and SANYINJIAO (SP6)
protects neurons in the substantia nigra pars compacta from
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) toxicity in male C57BL/6
mice, a model of PD. In the present study we administered 100 Hz EA stimulation
at the two acupoints to MPTP-lesioned mice for 12 sessions starting from the day
prior to the first MPTP injection. We found that in the striatum of MPTP treated
mice 100 Hz EA stimulation effectively inhibited the production of hydrogen
peroxide and malonaldehyde, and increased glutathione concentration and total
superoxide dismutase activity through biochemical methods. However, it decreased
glutathione peroxidase activity via biochemical analysis and did not affect the
level of 1-methyl-4-phenylpyridinium in the striatum revealed by high
performance liquid chromatography with ultraviolet detection. These data suggest
that 100 Hz EA stimulation at ST36 and SP6 has antioxidative effects in the MPTP
model of PD. This data, along with our previous work, indicates that 100 Hz EA
stimulation at ST36 and SP6 protects the nigrostriatal system by multiple
mechanisms including antioxidation and antiapoptosis, and suggests that EA
stimulation is a promising therapy for treating PD.
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Affiliation(s)
- Haomin Wang
- Neuroscience Research Institute, Peking
University, Beijing, People's Republic of China
| | - Yanli Pan
- Science and Education Office, Beijing An Ding
Hospital, Beijing, People's Republic of China
| | - Bing Xue
- Medical Experiment and Test Center, Capital
Medical University, Beijing, People's Republic of China
| | - Xinhong Wang
- Neuroscience Research Institute, Peking
University, Beijing, People's Republic of China
| | - Feng Zhao
- School of Public Health and Family Medicine,
Capital Medical University, Beijing, People's Republic of China
| | - Jun Jia
- Department of Physiology, Capital Medical
University, Key Laboratory for Neurodegenerative Disorders of the Ministry of
Education, Beijing, People's Republic of China
| | - Xibin Liang
- Department of Neurology and Neurological
Sciences, Stanford University, Stanford, California, United States of
America
| | - Xiaomin Wang
- Neuroscience Research Institute, Peking
University, Beijing, People's Republic of China
- Department of Physiology, Capital Medical
University, Key Laboratory for Neurodegenerative Disorders of the Ministry of
Education, Beijing, People's Republic of China
- * E-mail:
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SEO JH, SUNG YH, KIM KJ, SHIN MS, LEE EK, KIM CJ. Effects of Phellinus linteus Administration on Serotonin Synthesis in the Brain and Expression of Monocarboxylate Transporters in the Muscle during Exhaustive Exercise in Rats. J Nutr Sci Vitaminol (Tokyo) 2011; 57:95-103. [DOI: 10.3177/jnsv.57.95] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jin-Hee SEO
- Department of Physiology, College of Medicine, Kyung Hee University
| | - Yun-Hee SUNG
- Department of Physiology, College of Medicine, Kyung Hee University
| | - Ki-Jeong KIM
- Department of Physiology, College of Medicine, Kyung Hee University
| | - Mal-Soon SHIN
- Department of Physiology, College of Medicine, Kyung Hee University
| | - Eun-Kyu LEE
- Department of Physiology, College of Medicine, Kyung Hee University
- Department of Internal Medicine, Andong Medical Group
| | - Chang-Ju KIM
- Department of Physiology, College of Medicine, Kyung Hee University
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Wu JC, Ziea ET, Lao L, Lam EF, Chan CS, Liang AY, Chu SL, Yew DT, Berman BM, Sung JJ. Effect of electroacupuncture on visceral hyperalgesia, serotonin and fos expression in an animal model of irritable bowel syndrome. J Neurogastroenterol Motil 2010; 16:306-14. [PMID: 20680170 PMCID: PMC2912124 DOI: 10.5056/jnm.2010.16.3.306] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 07/14/2010] [Accepted: 07/15/2010] [Indexed: 12/13/2022] Open
Abstract
Background/Aims While it is well established that acupuncture relieves somatic pain, its therapeutic effect on visceral pain such as irritable bowel syndrome (IBS) is unclear. We evaluated the effect of acupuncture in treating visceral hyperalgesia in an animal model. Methods Sprague-Dawley rats (n = 8 per group) with prior neonatal maternal separation stress were randomly allocated to receive 3-day treatment of either electroacupuncture (EA) or sham acupuncture at acupoint ST-36. Another group of rats without prior maternal separation was included as non-handled controls. Colorectal distension was performed on the day after acupuncture treatment. The 3 groups were compared for pain threshold as determined by abdominal withdrawal reflex and visceromotor response as measured by electromyogram. Colon, spinal cord, and brainstem were sampled for topographic distribution and quantitative assessment of serotonin and Fos expression by immunohistochemistry. Results Rats in EA group had significantly higher pain threshold compared to those in sham acpuncture group (25.0 ± 5.7 mmHg vs 18.7 ± 5.2 mmHg, p = 0.01) and it was comparable with that of non-handled treatment naïve controls (29.4 ± 9.3 mmHg, p = 0.28). They also had lower visceromotor response as measured by electromyogram compared to those received sham acupuncture at all colorectal distension pressures. EA significantly suppressed Fos expression in doral raphe nuclei of brainstem, superficial dorsal horn of spinal cord and colonic epithelium but suppressed 5-HT expression only in brainstem and spinal cord. Conclusions Electro acupuncture attenuates visceral hyperlagesia through down-regulation of central serotonergic activities in the brain-gut axis.
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Affiliation(s)
- Justin Cy Wu
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
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Freire AO, Mello LE. Acupuncture may be an alternative to treat moderate obstructive sleep apnea. Sleep Med 2008. [DOI: 10.1016/j.sleep.2007.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Freire AO, Sugai GCM, Chrispin FS, Togeiro SM, Yamamura Y, Mello LE, Tufik S. Treatment of moderate obstructive sleep apnea syndrome with acupuncture: a randomised, placebo-controlled pilot trial. Sleep Med 2006; 8:43-50. [PMID: 17023212 DOI: 10.1016/j.sleep.2006.04.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2005] [Revised: 04/14/2006] [Accepted: 04/14/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE To investigate the efficacy of acupuncture in the treatment of moderate obstructive sleep apnea syndrome (OSAS), assessed by polysomnography (PSG) and questionnaires of functional quality of life (SF-36) and excessive daytime sleepiness (Epworth). PATIENTS AND METHODS We performed a randomised, placebo-controlled, single-blinded study, with blinded evaluation on 36 patients presenting an apnea/hypopnea index (AHI) of 15-30/h, assessed by PSG. The study took place at the Public Hospital of the Universidade Federal de São Paulo, Brazil, in the Division of Sleep Disorders of the Department of Psychobiology, between January, 2002 and August, 2004. Patients were randomly assigned to three groups: the acupuncture group (n=12); the sham group, submitted to needle insertion in non-acupoints (n=12); and the control group, receiving no treatment (n=12). Patients received acupuncture or sham acupuncture once a week for 10 weeks. RESULTS Twenty-six patients completed the study. The AHI (P=0.005), the apnea index (AI) (P=0.008) and the number of respiratory events (P=0.005) decreased significantly in the acupuncture group but not in the sham group. On the other hand, the control group displayed significant deterioration in some of the polysomnographic parameters, with a significant increase in the number of respiratory events (P=0.025). Acupuncture treatment significantly improved (before vs. after treatment) several dimensions of the SF-36 and Epworth questionnaires. There was no significant association between changes in the body mass index (BMI) and AHI. CONCLUSIONS Acupuncture is more effective than sham acupuncture in ameliorating the respiratory events of patients presenting with moderate OSAS.
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Affiliation(s)
- Anaflávia O Freire
- Sleep Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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