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Trinh DTT, Nguyen NC, Tran AH, Bui MMP, Vuong NL. Enhancing Vagal Tone, Modulating Heart Rate Variability with Auricular Acupressure at Point Zero: A Randomized Controlled Trial. Med Acupunct 2024; 36:203-214. [PMID: 39309627 PMCID: PMC11411280 DOI: 10.1089/acu.2024.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024] Open
Abstract
Introduction Point Zero located within the vagus nerve's auricular branch shows promise in addressing imbalances. This study aims to explore its effects on vagal activity using auricular acupressure (AA), measured through heart rate variability (HRV). Methods This single-blinded randomized controlled trial involved 114 healthy volunteers randomly assigned to receive AA (AA group, n = 57) or sham-AA (SA group, n = 57) at Point Zero. The 30-minute procedure comprised six stages: T1 and T2 (pre-intervention), T3 to T5 (intervention), and T6 (post-intervention). Interventions involving 30-s acupoint pressure stimulations at T3 and T5. The HRV-measured outcomes included heart rate (HR), standard deviation of R-R intervals (SDNN), root mean square of successive RR interval differences (RMSSD), natural logarithm of low-frequency power (LnLF), and natural logarithm of high-frequency power (LnHF). In addition, respiratory rate (RR) was monitored for its stability. Results The AA group demonstrated a significant decrease in HR and increases in SDNN, RMSSD, and LnHF from stages T3 to T6 compared with T1 (baseline), notably prominent at T3 (median changes [25th; 75th percentiles]: -2 [-5; -1], 17.85 [9.65; 31.72], 4.9 [1.08; 10.65], 0.26 [0.00; 0.62], respectively) and T5 (-3 [-6; -1], 19.45 [10.6; 32.89], 6.17 [-0.17; 16.34], 0.40 [-0.14; 0.83], respectively), while the SA group did not. LnLF showed nonsignificant alterations, and RR remained stable in both groups. Despite minor HRV fluctuations, the AA group consistently displayed significantly higher changes in SDNN and RMSSD compared with the SA group from T3 onwards. HR remained unchanged at T6, and LnHF significantly differed only at T5. Conclusion AA at Point Zero may promptly enhance vagal activity, evident in the modulation of HRV, notably pronounced with pressure stimulation, and can be sustained for at least 5 min. Further studies are needed to assess its long-term effectiveness and efficacy in preventing or treating patients.(Clinical Trial Registration: NCT05586698).
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Affiliation(s)
| | - Nguyen Cong Nguyen
- Faculty of Traditional Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - An Hoa Tran
- Faculty of Traditional Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Minh-Man Pham Bui
- Faculty of Traditional Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Lam Vuong
- Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Effect of Low- and High-Frequency Auricular Stimulation with Electro-Acupuncture on Cutaneous Microcirculation: A Cross-Over Study in Healthy Subjects. MEDICINES (BASEL, SWITZERLAND) 2023; 10:medicines10020017. [PMID: 36827217 PMCID: PMC9967478 DOI: 10.3390/medicines10020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/29/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023]
Abstract
Background: The regulation of microcirculation depends on the dynamic interaction of different factors: the autonomic nervous system plays a pivotal role in the blood flow and acupuncture can modulate it, obtaining different results depending on the site, the frequency, and the intensity of the stimulation. Methods: 18 healthy subjects have been enrolled and have undergone two sessions of electroacupuncture stimulations: one session using high frequency and one with low frequency. Microcirculation has been monitored continuously during stimulation using the laser Doppler method. Results: The microcirculatory parameters have shown a significant difference between high and low-frequency stimulation, suggesting that low-frequency stimulation is more effective for obtaining a vasodilator effect. Discussion: Our results show that low-frequency stimulation can increase the cutaneous microcirculatory flux, without significantly modifying blood pressure and heart rate. The auricular stimulation causes an increase in the activity of the vagus nerve, increasing the cholinergic activity without acting on post-junctional muscarinic receptors. Conclusion: Auricular acupuncture has a significant impact on the regulation of microcirculation.
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Stringer J, Ryder WD, Mackereth PA, Misra V, Wardley AM. A randomised, pragmatic clinical trial of ACUpuncture plus standard care versus standard care alone FOr Chemotherapy Induced peripheral Neuropathy (ACUFOCIN). Eur J Oncol Nurs 2022; 60:102171. [PMID: 35952460 PMCID: PMC9592667 DOI: 10.1016/j.ejon.2022.102171] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/21/2022] [Accepted: 07/03/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE Chemotherapy-induced peripheral neuropathy (CIPN) is a dose limiting toxicity posing a major clinical challenge for managing patients receiving specific chemotherapy regimens (e.g., Taxanes). There is a growing body of literature suggesting acupuncture can improve CIPN symptoms. The purpose of the ACUFOCIN trial was to collect preliminary data on the safety, feasibility, acceptability and initial effectiveness of acupuncture as a treatment for CIPN, comparing use of acupuncture plus standard care (Acupuncture) against standard care alone (Control). METHOD At a tertiary cancer centre, a pragmatic, randomised, parallel group design study was used to investigate the effectiveness of a 10-week course of acupuncture. Participants experiencing CIPN of ≥ Grade II, recording a 'Most Troublesome' CIPN symptom score of ≥3 using the "Measure Yourself Medical Outcome Profile" (MYMOP 2), were randomised to 'Acupuncture' or 'Control' arms. Clinicians were blinded to allocated groups, however as it was not possible to blind participants, it cannot be guaranteed they did not disclose study allocation within their clinic assessments. The primary outcome measure was the number of patients reporting a ≥ 2-point improvement (success) in their MYMOP2 score at week 10. 100 participants (120 to allow for attrition) were required for a hypothesised improvement in success proportions from 30% to 55% using a primary analysis model with logistic regression adjusted for stratification factors and baseline MYMOP2 scores. Feasibility and acceptability of study design was addressed through percentage return of primary outcome, retention rate and a nested qualitative study. RESULTS Primary MYMOP2 outcome data at week 10 was available for 108/120 randomised participants; this is greater than the 100 participants required to adequately power the study. There were 36/53 (68%) successes in 'Acupuncture' compared to 18/55 (33%) in 'Control'. Beneficial effects were seen in the secondary outcome data, including clinicians' grading of neuropathy, EORTC, QLQ-CIPN20, QLQ-C30 summary scores and patient reported pain scores. There were no serious adverse events reported within the study and only 16 acupuncture associated events, none of which required intervention. CONCLUSION A 10-week course of acupuncture resulted in measurable improvement in participants symptoms of CIPN. The results warrant further investigation.
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Affiliation(s)
- Jacqui Stringer
- The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK; School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - W David Ryder
- Manchester Clinical Trials Unit, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Peter A Mackereth
- The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK.
| | - Vivek Misra
- The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK.
| | - Andrew M Wardley
- School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK; Outreach Research & Innovation Group, Adamson House, Ground Floor, Towers Business Park, Wilmslow Road, Didsbury, M20 2YY, UK.
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Li X, Yin Z, Ling F, Zheng Q, Li X, Qi W, Liang F. The application of acupuncture in cardiopathy: A bibliometric analysis based on Web of Science across ten recent years. Front Cardiovasc Med 2022; 9:920491. [PMID: 36148057 PMCID: PMC9485815 DOI: 10.3389/fcvm.2022.920491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background With high morbidity and mortality, cardiopathy is a major component of cardiovascular disease, causing a huge burden of disease to public health worldwide. In recent years, research on acupuncture treatment of cardiopathies has been increasing. However, no bibliometric analysis has been conducted to systematically describe the research progress and hotspots in this field. Therefore, this study aimed to conduct a bibliometric analysis of the relevant literature to explore the current status and future development of acupuncture for cardiopathies. Methods The Web of Science (WoS) Core Collection Database was searched for literature related to acupuncture therapies for cardiopathies from 2011 to 2021. Using CiteSpace 5.8 R3, cooperation network diagrams of authors, institutions, countries and journals, keyword co-occurrences, and clustering were performed and analyzed. Results A total of 321 studies were included. Overall, the number of annual publications increased yearly. These publications came from 31 countries or regions, of which China and the United States made the greatest contributions. In total, 333 authors from 258 institutions participated in this field, and Beijing University of Chinese Medicine and Professor Fanrong Liang were the most published institution and author, respectively. Evidence-based Complementary and Alternative Medicine published the largest number of articles, and CIRCULATION was the most commonly cited journal. Based on co-occurrences and cluster analysis of 257 keywords, three research frontiers and hotspots were identified: acupuncture for blood pressure regulation, acupuncture for coronary heart disease, and acupuncture for regulation of heart rate. In these three research frontiers, the rostral ventrolateral medulla (RVLM) and autonomic nervous system (ANS) are the most popular mechanisms. Conclusion A stable development trend has formed in this field. Further research should focus on the role of acupuncture therapies in the treatment of hypertension or hypertensive heart disease, coronary heart disease, and arrhythmia based on the mechanisms related to the RVLM and ANS.
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Affiliation(s)
- Xiao Li
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zihan Yin
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Acupuncture and Tuina School/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, Sichuan, China
| | - Fayang Ling
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qianhua Zheng
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xiang Li
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- *Correspondence: Xiang Li,
| | - Wenchuan Qi
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Wenchuan Qi,
| | - Fanrong Liang
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Acupuncture and Tuina School/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, Sichuan, China
- Fanrong Liang,
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Wu Y, Yang L, Zhong Z, Wu X, He Z, Ma H, Cai C, Li Y, Wu X, Fu B, Chen X, Wang L, Zhao D, Meng X, Qi A, Yang A, Li L, Liu X, Zou C, Lin Q. Auricular Acupressure for Hemodialysis Patients with Insomnia: A Multicenter Double-Blind Randomized Sham-Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:339-348. [PMID: 35426736 DOI: 10.1089/jicm.2021.0332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background and objectives: The effect of auricular acupressure (AA) for maintenance hemodialysis (MHD) patients with insomnia has been controversial. This study assessed the efficacy and safety of AA for MHD patients with chronic insomnia. Design, setting, participants, and measurements: This was a multicenter, double-blind (participant and assessor), randomized sham-controlled trial. A total of 133 subjects were randomized to receive AA on active points (AA group, n = 64) or on sham auricular acupressure (SAA) points (SAA group, n = 69) for 8 weeks and followed up for 12 weeks. AA was provided by assigned qualified nurses who were not involved in assessment. The primary outcome was the clinical response rate, which was defined as the percentage of participants who reached a reduction of Pittsburgh Sleep Quality Index (PSQI) global score ≥3 in each group. Secondary outcomes included changes in PSQI scores over time, PSQI scores and hypnotics use at each visit, and changes in the weekly dose of hypnotics for drug-dependent subjects. Results: At week 8, the AA group yielded a higher clinical response rate than the SAA group (AA: 55% vs. SAA: 36%, odds ratio: 1.5, 95% confidence interval: 1.0-2.2, p = 0.033). Both groups showed a reduction in PSQI global scores during treatment and follow-up, compared with the baseline, respectively. A significant change of PSQI global score was observed over time (F = 28.387, p < 0.001). PSQI global score of the AA group was relatively lower than that of the SAA group at each visit (p < 0.05 at week 16 and 20). For those depending on hypnotics, AA reduced their consumption of hypnotics. The intervention was safe, and its adherence was satisfactory. Conclusion: AA could serve as a complementary or alternative therapy for MHD patients with insomnia by improving their sleep quality and reducing their use of hypnotics. Clinical trial registration: Clinicaltrials.gov, Identifier: NCT03015766.
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Affiliation(s)
- Yuchi Wu
- Hemodialysis Department, Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lihong Yang
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Evidence-based Chinese Medicine and Clinical Research Service Group, Guangdong Provincial Academy of Chinese Medical Sciences/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Zhicong Zhong
- Hemodialysis Department, Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Xiuqing Wu
- Hemodialysis Department, Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Zhiren He
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou Charity Hospital, Guangzhou, China
| | - Hongyan Ma
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou Charity Hospital, Guangzhou, China
| | - Cun Cai
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou HEMC (Higher Education Mega Center) Hospital, Guangzhou, China
| | - Yin Li
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou HEMC (Higher Education Mega Center) Hospital, Guangzhou, China
| | - Xufang Wu
- Hemodialysis Department, Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Bo Fu
- Hemodialysis Department, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Xiaoling Chen
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Lixin Wang
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou Charity Hospital, Guangzhou, China
| | - Daixin Zhao
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou HEMC (Higher Education Mega Center) Hospital, Guangzhou, China
| | - Xiangxin Meng
- Hemodialysis Department, Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Airong Qi
- Hemodialysis Department, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Aicheng Yang
- Hemodialysis Department, Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Lingli Li
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xusheng Liu
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chuan Zou
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qizhan Lin
- Hemodialysis Department, Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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Protection against Doxorubicin-Induced Cardiotoxicity through Modulating iNOS/ARG 2 Balance by Electroacupuncture at PC6. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6628957. [PMID: 33824696 PMCID: PMC8007344 DOI: 10.1155/2021/6628957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/24/2021] [Accepted: 02/28/2021] [Indexed: 12/16/2022]
Abstract
Background Doxorubicin (DOX) is a commonly used chemotherapeutic drug but is limited in clinical applications by its cardiotoxicity. Neiguan acupoint (PC6) is a well-recognized acupoint for the treatment of cardiothoracic disease. However, whether acupuncture at PC6 could be effective in preventing DOX-induced cardiotoxicity is still unknown. Methods A set of experiments were performed with myocardial cells, wild type, inducible nitric oxide synthase knockout (iNOS-/-), and myocardial-specific ablation arginase 2 (Myh6-ARG 2-/-) mice. We investigated the protective effect and the underlying mechanisms for electroacupuncture (EA) against DOX-induced cardiotoxicity by echocardiography, immunostaining, biochemical analysis, and molecular biotechnology in vivo and in vitro analysis. Results We found that DOX-mediated nitric oxide (NO) production was positively correlated with the iNOS level but has a negative correlation with the arginase 2 (ARG 2) level in both myocardial cells and tissues. Meanwhile, EA at PC6 alleviated cardiac dysfunction and cardiac hypertrophy in DOX-treated mice. EA at PC6 blocked the upregulation of NO production in accompanied with the downregulated iNOS and upregulated ARG 2 levels in myocardial tissue induced by DOX. Furthermore, knockout iNOS prevented cardiotoxicity and EA treatment did not cause the further improvement of cardiac function in iNOS-/- mice treated by DOX. In contrast, deficiency of myocardial ARG 2 aggravated DOX-induced cardiotoxicity and reduced EA protective effect. Conclusion These results suggest that EA treatment at PC6 can prevent DOX-induced cardiotoxicity through modulating NO production by modulating the iNOS/ARG 2 balance in myocardial cells.
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