Acupressure therapy inhibits the development of diabetic complications in Chinese patients with type 2 diabetes

Hydrogel Sensors in an IoT System for Self-Monitoring and Remote Monitoring of Massage Pressure

The effectiveness of massage can be enhanced if the pressure applied can be monitored continuously. In this study, we described an Internet-of-Things (IoT) system based on hydrogel sensors, which allows for self-monitoring and remote monitoring of massage pressure. The piezoresistive hydrogel with the compressive energy loss coefficient of 15.7% was developed, which was attributed to the strong polarization of ammonium phosphate on water molecules, which was evidenced by nuclear magnetic resonance (NMR) transverse relaxation analyses and atomic force microscopy. Using this hydrogel as a pressure-sensing component, we assembled a wearable sensor capable of quantifying and transmitting massage pressure with insignificant energy dissipation. By integrating RGB LED arrays, the message pressure was indicated by the color states of the LEDs. Furthermore, the wearable sensors and LEDs were connected to a microcontroller (MCU) chip, an IoT chip, and a cloud server to form a sensing-controlled IoT system, enabling visible and remote monitoring of massage pressure.

Traditional Chinese acupoint massage, acupuncture, and moxibustion for people with diabetic gastroparesis: A systematic review and meta-analysis

BACKGROUND

Traditional Chinese acupoint therapy has been used for thousands of years on gastrointestinal diseases. In this work, we evaluated the efficiency and safety of traditional Chinese acupoint therapies versus standard therapies, nursing or recovery treatments in the treatment of diabetic gastroparesis.e expect that traditional Chinese medicine acupoint therapy can be noticed by more people, so as to provide more high-quality clinical evidence.

METHODS

Randomized controlled trials were included in this meta-analysis. The treatment groups received traditional Chinese acupoint therapy, while the control groups received standard therapies, nursing, or recovery treatments. The relative risk and weighted mean difference with 95% confidence interval for the total effective rate, gastrin level, gastric-emptying time, fasting blood glucose level, 2-hour blood glucose level, and glycosylated hemoglobin level were evaluated using RevMan 5.3 software. Bias assessment was performed using the Cochrane risk-of-bias tool.

RESULTS

A total of 59 articles were included in the analysis. In comparison with the control groups, the acupoint therapy groups showed higher total effective rates (P < .00001), enhanced gastric-emptying rates (P < .00001), and reduced glycosylated hemoglobin levels.

CONCLUSION

In comparison with Western medicine or conventional care, traditional Chinese acupoint therapies showed a significant advantage in the treatment of diabetic gastroparesis. However, considering the low quality and high risk of the included studies, more high-quality randomized controlled trials are needed to confirm the results.

Advances in traditional Chinese medicine as adjuvant therapy for diabetic foot

Diabetes mellitus (DM) is a complex disease that often causes multiple systemic complications that have become a major international public health problem. Diabetic foot (DF) is one of the severe and frequent chronic complications of DM due to vascular lesions and neuropathy. DF ulcers (DFU) affect approximately 15% of people with DM and are the leading cause of death and disability. The prevalence and recurrence of DF are worrisome, and morbidity and mortality are also on the rise, which poses a substantial socioeconomic burden. Treating DF is difficult for clinicians and requires multidisciplinary cooperation, combining local and systemic therapy to reduce amputation and case-fatality rates. Traditional Chinese Medicine (TCM) has received extensive attention due to noticeable therapeutic effects and few adverse reactions. In recent years, research on DF treatment by TCM has been increasing, and further progress has been made. TCM includes oral medication, injectable preparations, and adjuvant therapy. This article reviews the relevant research on TCM-related adjuvant therapy for DF. We describe current progress in TCM in terms of external application, acupuncture, massage, acupoint injection, foot bath, fumigation, and moxibustion, as well as the mechanisms involved.

AKUPRESSUR, NEUROPHARMAKOLOGIE UND PSYCHISCHE GESUNDHEIT

Akupressur ist eine nicht pharmakologische Technik, die das Potenzial hat, verschiedene Krankheiten zu lindern. Diese Kurzübersicht beschäftigt sich mit Fakten wissenschaftlicher Akupressurstudien und fasst einige wichtige Aspekte zusammen. Wissenschaftliche Artikel aus den Datenbanken PubMed, Google Scholar und CNKI dienten als Forschungsdokumente. Darüber hinaus umfasste die Forschung zur Akupressur im Vergleich zu pharmakologischen Interventionen bei mentalen Erkrankungen eigenes Material, das bereits in wissenschaftlichen Artikeln veröffentlicht wurde. Insgesamt wurden 9 gelistete Publikationen identifiziert, von denen 8 als relevant angesehen wurden. Der Autor überprüfte den Inhalt auf Wertigkeit und diskutiert in diesem Artikel die Einschränkungen der nicht pharmakologischen Behandlungsmethode kritisch. Die verfügbaren Beweise, dass Akupressur als zusätzliche nicht pharmakologische Methode zur Intervention bei mentalen Erkrankungen eingesetzt werden kann, sind spärlich. Es konnte keine evidenzbasierte Qualitätsstudie identifiziert werden, in der Akupressur mit pharmakologischen Behandlungen bei mentalen Erkrankungen direkt verglichen wird. Obwohl bei der Bewertung der alten traditionellen Akupressurmethode erhebliche Fortschritte erzielt wurden, werden in den kommenden Jahren weitere Forschungsarbeiten wie beispielsweise gut konzipierte randomisierte kontrollierte Studien erforderlich sein.

Acupuncture for type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Acupuncture has been used to treat type 2 diabetes (T2DM) for 2000 years and there are emerging clinical evidence and animal studies for its efficacy. However, we are unable to conclude the effectiveness and safety on this issue yet.

OBJECTIVES

To assess the effects and safety of acupuncture for T2DM.

METHODS

We systematically searched 5 databases and 2 clinical registry platforms from inception to 2018-6-4. RCTs for acupuncture or its variants compared with sham acupuncture or no acupuncture controls for T2DM were included. The primary outcomes were glycemic control and adverse events.

RESULTS

A total of 21 studies, which comprised a total of 1943 participants, were included in the final meta-analysis. Compared with sham acupuncture or no acupuncture plus baseline treatments, acupuncture plus baseline treatments yield reduction in FBG(MD 1.21 mmol/l, 95%CI 1.56 to 0.87), 2 h BG(MD 2.13 mmol/l, 95%CI 2.79 to 1.46), HA1c (MD 1.12%, 95%CI 1.62 to 0.62). Our results also show acupuncture can improve blood lipids and blood pressure control, and reduce weight.

CONCLUSIONS

As one type of multifactorial intervention, acupuncture could be recommended as a supplementary treatment in the management of T2DM, especially in those with obesity or metabolic disorders. However, due to the small sample size, poor methodological quality of trials reviewed, the amount of evidence is not fully convincing. There is a need for well-planned, long-term studies.

REGISTRATION

International Prospective Register of Systematic Reviews (Number CRD42018094573).

Effect of self-acupressure on fasting blood sugar (FBS) and insulin level in type 2 diabetes patients: a randomized clinical trial

Background

Uncontrolled symptoms of diabetes can lead to irreparable damage to vital organs. Despite the global trend towards the use of complementary alternative therapies, few studies have evaluated the effectiveness of self-acupressure in diabetes patients.

Objective

The aim of this study was to determine the effect of self-acupressure on FBS and insulin level in type 2 diabetes patients.

Methods

This randomized clinical trial was performed from September 2016 to February 2017. A total of 60 diabetic patients were selected from diabetes clinic in Rafsanjan in Iran, according to inclusion and exclusion criteria and then assigned to 2 groups (30 in acupressure and 30 in control) randomly by the minimization method. The intervention group received acupressure at ST-36, LIV-3, KD-3 and SP-6 points bilaterally for five minutes for each point in 10 seconds pressure and 2 seconds rest periods. Subjects in the control group received no intervention. The FBS and insulin levels were measured before and after the intervention for both groups. The data were analyzed by SPSS version 16 by the Chi-square test, independent-samples t-test, and paired-samples t-test. A level of 0.05 was considered significant for examining the hypotheses.

Results

There were no significant differences between the acupressure and control group regarding age, sex and level of education. The insulin level significantly increased after treatment in the acupressure group (p=0.001). There were no significant differences between the levels of insulin in study or control groups. Serum FBS level decreased significantly after intervention in the acupressure group compared to the control group (p=0.02).

Conclusion

Self-acupressure as a complementary alternative medicine can be a helpful complementary method in reducing FBS and increasing insulin levels in type 2 diabetic patients.

Trial registration

This trial was registered at the Iranian Registry of Clinical Trials with clinical trial registration number: IRCT2016122131459N1.

Funding

This study was financially sported by Deputy of Research and Technology of Rafsanjan University of Medical Sciences (Ref: 20.519).

Shiatsu and Acupressure: Two Different and Distinct Techniques

BACKGROUND

Although shiatsu has been taught in specialized schools in Japan since 1940, there is a limited amount of research for its practice. As a result, authors substitute shiatsu with acupressure to use available research on acupressure. It is the position of the authors that, while the two share common aspects, they are substantively different. This project was undertaken to describe technical differences and advocate for a clear distinction, especially in research studies and academic discussions.

METHODS

To understand whether it is appropriate to include acupressure studies in the evidence for shiatsu an analysis of the references included in a frequently cited systematic review was conducted to collect information about the protocols. In addition, a preliminary exploration of shiatsu practitioners' perceptions about the differences between shiatsu and acupressure is described. This exploration used videos of shiatsu and acupressure techniques and asked practitioners to comment on their perception of similarity.

DISCUSSION

The results identified several key technical differences between the two, including type of pressure applied, the positioning of the thumb, and the way in which body weight is used. Researchers should separate shiatsu and acupressure in their designs and purposively choose one or the other. To facilitate such clarification, we have proposed a definition for shiatsu that may facilitate the differentiation between these two techniques.

CONCLUSION

The authors hope to stimulate discussion about the differences between shiatsu and acupressure, and to question the appropriateness of using acupressure studies as evidence of the efficacy of shiatsu. A true understanding of the efficacy of shiatsu cannot be determined until studies use a common definition of shiatsu and discontinue substituting acupressure research for evidence of shiatsu efficacy. When this happens, it is proposed that a clearer picture of the safety, efficacy, and mechanism of action of both shiatsu and acupressure will emerge.

Acupuncture and related interventions for symptoms of chronic kidney disease

BACKGROUND

People living with chronic kidney disease (CKD) experience a range of symptoms and often have complex comorbidities. Many pharmacological interventions for people with CKD have known risks of adverse events. Acupuncture is widely used for symptom management in patients with chronic diseases and in other palliative care settings. However, the safety and efficacy of acupuncture for people with CKD remains largely unknown.

OBJECTIVES

We aimed to evaluate the benefits and harms of acupuncture, electro-acupuncture, acupressure, moxibustion and other acupuncture-related interventions (alone or combined with other acupuncture-related interventions) for symptoms of CKD. In particular, we planned to compare acupuncture and related interventions with conventional medicine, active non-pharmacological interventions, and routine care for symptoms of CKD.

SEARCH METHODS

We searched the Cochrane Kidney and Transplant Specialised Register up to 28 January 2016 through contact with the Information Specialist using search terms relevant to this review. We also searched Korean medical databases (including Korean Studies Information, DBPIA, Korea Institute of Science and Technology Information, Research Information Centre for Health Database, KoreaMed, the National Assembly Library) and Chinese databases (including the China Academic Journal).

SELECTION CRITERIA

We included randomised controlled trials (RCTs) and quasi-RCTs that investigated the effects of acupuncture and related point-stimulation interventions with or without needle penetration that involved six sessions or more in adults with CKD stage 3 to 5, regardless of the language and type of publication. We excluded studies that used herbal medicine or co-interventions administered unequally among the study groups.

DATA COLLECTION AND ANALYSIS

Two authors independently extracted data and assessed risk of bias. We calculated the mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals (CI) for continuous outcomes and risk ratio (RR) for dichotomous outcomes. Primary outcomes were changes in pain and depression, and occurrence of serious of adverse events.

MAIN RESULTS

We included 24 studies that involved a total of 1787 participants. Studies reported on various types of acupuncture and related interventions including manual acupuncture and acupressure, ear acupressure, transcutaneous electrical acupuncture point stimulation, far-infrared radiation on acupuncture points and indirect moxibustion. CKD stages included pre-dialysis stage 3 or 4 and end-stage kidney disease on either haemodialysis or peritoneal dialysis.None of the included studies assessed pain outcomes, nor formally addressed occurrence of serious adverse events, although three studies reported three participant deaths and three hospitalisations as reasons for attrition. Three studies reported minor acupuncture-related harms; the remainder did not report if those events occurred.All studies were assessed at high or unclear risk of bias in terms of allocation concealment. Seventeen studies reported outcomes measured for only two months.There was very low quality of evidence that compared with routine care, manual acupressure reduced scores of the Beck Depression Inventory score (scale from 0 to 63) (3 studies, 128 participants: MD -4.29, 95% CI -7.48 to -1.11, I(2) = 0%), the revised Piper Fatigue Scale (scale from 0 to 10) (3 studies, 128 participants: MD -1.19, 95% CI -1.77 to -0.60, I(2) = 0%), and the Pittsburgh Sleep Quality Index (scale from 0 to 21) (4 studies, 180 participants: MD -2.46, 95% CI -4.23 to -0.69, I(2) = 50%).We were unable to perform further meta-analyses because of the paucity of data and problems with clinical heterogeneity, such as different interventions, comparisons and timing of outcome measurements.

AUTHORS' CONCLUSIONS

There was very low quality of evidence of the short-term effects of manual acupressure as an adjuvant intervention for fatigue, depression, sleep disturbance and uraemic pruritus in patients undergoing regular haemodialysis. The paucity of evidence indicates that there is little evidence of the effects of other types of acupuncture for other outcomes, including pain, in patients with other stages of CKD. Overall high or unclear risk of bias distorts the validity of the reported benefit of acupuncture and makes the estimated effects uncertain. The incomplete reporting of acupuncture-related harm does not permit us to assess the safety of acupuncture and related interventions. Future studies should investigate the effects and safety of acupuncture for pain and other common symptoms in patients with CKD and those undergoing dialysis.

The effect of convalescent meridian acupressure after exercise on stress hormones and lactic acid concentration changes

Meridian acupressure has been used as the one way recovering body conditions. The purpose of this study was to investigate whether meridian acupressure is effective on removing cortisol, norepinephrine, epinephrine, and lactic acid in blood following exercise. The subjects were 12 healthy male college students and data were processed using SPSS 12.0 statistical program and the results were calculated by setting the significance level at P< 0.05. First, there was a significant difference between exercise recovery group except for stability group and acupressure recovery group in convalescent cortisol concentration changes after exercise (P= 0.001). And acupressure recovery group showed a significant difference compared with two groups (P= 0.001). Second, exercise recovery group showed nonsignificant difference in convalescent norepinephrine concentration changes but meridian acupressure recovery group showed a significant difference (P= 0.001). There was a significance difference in the groups rather than exercise recovery group and rest recovery group (P= 0.001). Third, exercise recovery group and acupressure recovery group showed a significant difference in convalescent epinephrine concentration changes after exercise (P= 0.001). However, rest recovery group showed nonsignificant difference. In addition, three groups showed nonsignificant difference in the groups. However, it showed in order of acupressure= exercise> rest recovery. Fourth, three groups showed a significant difference in convalescent lactic acid concentration changes after exercise (P = 0.001). And it showed in order of acupressure= exercise> rest recovery after recovery treatment in the groups (P= 0.001).

The evidence for Shiatsu: a systematic review of Shiatsu and acupressure

Background

Shiatsu, similar to acupressure, uses finger pressure, manipulations and stretches, along Traditional Chinese Medicine meridians. Shiatsu is popular in Europe, but lacks reviews on its evidence-base.

Methods

Acupressure and Shiatsu clinical trials were identified using the MeSH term 'acupressure' in: EBM reviews; AMED; BNI; CINAHL; EMBASE; MEDLINE; PsycARTICLES; Science Direct; Blackwell Synergy; Ingenta Select; Wiley Interscience; Index to Theses and ZETOC. References of articles were checked. Inclusion criteria were Shiatsu or acupressure administered manually/bodily, published after January 1990. Two reviewers performed independent study selection and evaluation of study design and reporting, using standardised checklists (CONSORT, TREND, CASP and STRICTA).

Results

Searches identified 1714 publications. Final inclusions were 9 Shiatsu and 71 acupressure studies. A quarter were graded A (highest quality). Shiatsu studies comprised 1 RCT, three controlled non-randomised, one within-subjects, one observational and 3 uncontrolled studies investigating mental and physical health issues. Evidence was of insufficient quantity and quality. Acupressure studies included 2 meta-analyses, 6 systematic reviews and 39 RCTs. Strongest evidence was for pain (particularly dysmenorrhoea, lower back and labour), post-operative nausea and vomiting. Additionally quality evidence found improvements in sleep in institutionalised elderly. Variable/poor quality evidence existed for renal disease symptoms, dementia, stress, anxiety and respiratory conditions. Appraisal tools may be inappropriate for some study designs. Potential biases included focus on UK/USA databases, limited grey literature, and exclusion of qualitative and pre-1989 studies.

Conclusions

Evidence is improving in quantity, quality and reporting, but more research is needed, particularly for Shiatsu, where evidence is poor. Acupressure may be beneficial for pain, nausea and vomiting and sleep.

Differences in the microcirculatory effects of local skin surface contact pressure stimulation between acupoints and nonacupoints: possible relevance to acupressure

In the present study, laser Doppler measurement was used to quantitatively investigate the microcirculatory effects of contact pressure stimulation (PS) underneath the Hoku acupoint and its nearby nonacupoint, to improve the understanding of the mechanisms underlying acupressure therapy. A control group (no PS applied) and three experimental groups with different applied PS (group A, 60 mmHg on the Hoku acupoint; group B, 60 mmHg on a nearby nonacupoint; group C, 50 mmHg on a nearby nonacupoint) were studied. Each experiment involved recording data of a 20 min baseline and two periods of effects after stopping PS. The relative energy contribution (REC) in five frequency bands, as revealed by Morlet wavelet transformation, was calculated. At the pressed site, the average value of the laser Doppler flux signal was increased only in group A, and coefficient of variance of the amplitude sequence was only significantly decreased during measurement (M1: 0 to 20 min) in group B. The RECs of the myogenic-related band were significantly increased in groups A and C, whereas there were no significant changes found in group B. The improved microcirculatory blood-flow perfusion at Hoku may partly explain why acupressure can exert better therapeutic effects than PS applied to other sites. The laser Doppler spectra responses illustrated that the induced pressure-induced vasodilation can be attributed mainly to the myogenic response. Laser Doppler measurement and analysis therefore represent a noninvasive method of examining the microcirculatory efficacy of acupressure therapy.