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Li Z, Niu Q, Yang K, Zhao K, Yin S, Zhu F. Acupuncture for constipation in Parkinson's disease: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2024; 103:e38937. [PMID: 39029044 DOI: 10.1097/md.0000000000038937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurological disease worldwide, and there is a potential interaction between PD and constipation. PD constipation often causes significant trouble for patients and seriously affects their quality of life. Acupuncture is widely used for treating constipation and has been clinically proven. However, it is unclear whether the current evidence is sufficient to support acupuncture to improve PD constipation. METHODS We searched the Cochrane Central Register of Controlled Trials, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, Wan Fang Data Knowledge Service Platform, and Chinese Scientific Journal Database (VIP database) for randomized controlled trials from inception through July 1, 2023. Randomized controlled trials (RCTs) included acupuncture, sham acupuncture, and medication for PD constipation. Stata 16.0 software and Cochrane RoB2.0 were used for data processing and migration risk analysis. RESULTS The 11 studies included a total of 960 patients. The results showed that acupuncture or acupuncture combined with conventional treatment seemed to have advantages in improving complete spontaneous bowel movements (WMD: 1.49, 95% CI: 0.86, 2.11; P < .00001), Patient-Assessment of Constipation Quality of Life questionnaire (WMD: -11.83, 95% CI: -15.67, -7.99; P < .00001), the chronic constipation severity scale (CCS) (SMD: -0.99, 95% CI: -1.40, -0.58; P < .01), and c(RRP) (WMD: 2.13, 95% CI: 0.44, 3.82; P < .05). CONCLUSION The present results show that compared with conventional treatment, acupuncture combined with conventional treatment seems to increase the number of spontaneous defecations in PD patients, improve quality of life, increase rectal resting pressure, and alleviate the severity of chronic constipation. Thus, acupuncture has the potential to treat PD constipation. However, due to the study's limitations, higher-quality RCTs are needed for verification.
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Affiliation(s)
- Zhao Li
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qun Niu
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Kai Yang
- Department of Orthopaedics, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, China
| | - Keni Zhao
- Deriatric Department, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, China
| | - Shao Yin
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fengya Zhu
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
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Choi I, Park S, Lee SH, Seo JW, Seol IC, Kim YS, Park MS, Yoo H. Effectiveness and Safety of Meridian Activation Remedy System for Alleviating Motor Symptoms in Parkinson's Disease: an Observational Study. J Acupunct Meridian Stud 2024; 17:55-68. [PMID: 38686429 DOI: 10.51507/j.jams.2024.17.2.55] [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: 07/15/2023] [Revised: 12/19/2023] [Accepted: 03/24/2024] [Indexed: 05/02/2024] Open
Abstract
Background Parkinson's disease (PD) lacks disease-modifying drugs or sustainable interventions, creating an unmet treatment need. Investigating complementary and alternative medicines aims to improve PD patients' quality of life by alleviating symptoms and delaying the course of the disease. Objectives In this single-center, prospective, observational, single-arm study, we aimed to assess the effectiveness and safety of acupuncture combined with exercise therapy and the Meridian Activation Remedy System (MARS). Methods From March to October 2021, 13 PD patients with Hoehn and Yahr stages 1 to 3 were recruited. For 8 weeks, MARS intervention was carried out twice a week. T-statistics were used to evaluate functional near-infrared spectroscopy (fNIRS) and GAITRite outcomes. All of the remaining outcome variables were evaluated using the Wilcoxon signed-rank test. Results The MARS intervention significantly reduced PD patients' Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDSUPDRS) Part III score (from 20.0 ± 11.8 to 8.8 ± 5.5, p = 0.003), 10-meter walk test speed (from 9.5 ± 1.8 to 8.7 ± 1.3 seconds, p = 0.040), and timed up and go time (from 9.8 ± 1.8 to 8.9 ± 1.4 seconds, p = 0.040). Moreover, the MDS-UPDRS Part II, fNIRS hemodynamics, 360-degree turn test, fall efficacy scale, and Parkinson's Disease Questionnaire 39 scores improved but not significantly. All participants completed the 8-week intervention without any adverse reactions. Conclusion An 8-week MARS intervention improved motor symptoms in PD patients. In particular, improvements in UPDRS Part III scores exhibited large clinically important differences. The findings are encouraging, and a randomized controlled trial will be conducted to determine the efficacy and cost-effectiveness of MARS intervention.
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Affiliation(s)
- InWoo Choi
- Department of Cardiology and Neurology of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, Korea
| | - Sangsoo Park
- Clinical Trial Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, Korea
| | - Seung Hyun Lee
- Global Health Technology Research Center, Korea University, Seoul, Korea
| | - Jeong-Woo Seo
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - In-Chan Seol
- Department of Cardiology and Neurology of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, Korea
| | - Yoon-Sik Kim
- Department of Cardiology and Neurology of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, Korea
| | - Miso S Park
- Clinical Trial Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, Korea
| | - Horyong Yoo
- Department of Cardiology and Neurology of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, Korea
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Zhu F, Yin S, Ma T, Li L, Li S, Liu J, Wang Y, Mao S, Wu J. An overview of systematic reviews of acupuncture for neurodegenerative disease. Asian J Psychiatr 2024; 91:103882. [PMID: 38150809 DOI: 10.1016/j.ajp.2023.103882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/24/2023] [Accepted: 12/15/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Acupuncture has been widely used in the treatment of neurodegenerative diseases and a large number of systematic reviews (SRs) have been published, but the results are controversial. Therefore, it is necessary to comprehensively summarize and objectively evaluate the clinical evidence of acupuncture for neurodegenerative diseases. OBJECTIVE To evaluate the SRs that assess the efficacy and safety of acupuncture for neurodegenerative diseases. This overview is intended to provide evidence for clinical decision making by healthcare providers and policymakers and to provide evidence for clinical decision making by healthcare providers and policymakers and to provide recommendations for researchers to conduct high quality SRs and clinical studies. METHODS We searched four Chinese databases (SinoMed, CNKI, Wanfang and VIP) and four international databases (Cochrane Library, Embase, PubMed and Web of Science) for SRs of acupuncture for neurodegenerative diseases. The search period ran from the beginning of the database to March 5, 2023. Literature screening and data extraction were performed independently by two individuals. Methodological quality, risk of bias and associated evidence levels were assessed for all SRs using AMSTER 2, ROBIS and GRADE tools. In addition, the RCT overlap between SRs was calculated by corrected coverage area (CCA). We also conducted quantitative synthesis or descriptive analysis of the relevant data. RESULTS Finally, we identified 53 SRs (three were qualitative descriptions and fifty were meta-analyses). Under AMSTAR 2, only one SR was rated as moderate quality, six SRs as low quality and 46 SRs as very low quality. According to ROBIS, 33 SRs were rated as a high risk of bias and 20 as a low risk of bias. Cognitive functions in neurodegenerative diseases, activities of daily living and the motor and non-motor outcomes associated with PD were included to summary description. The pooled results show that acupuncture combined with conventional treatment may have an overall advantage over conventional treatment, but the quality of evidence is low. Specific adverse reactions/events were reported in 20 SRs. Common needle-related adverse events included pain, dizziness, bleeding, or subcutaneous hematoma. No severe adverse events were reported in any SRs. CONCLUSION Evidence suggests that acupuncture is generally effective and relatively safe for cognitive function and activities of daily living in neurodegenerative diseases. In addition, acupuncture may have some benefits in improving motor and non-motor symptoms in patients with PD. However, high-quality RCTs and SRs are still needed to further clarify the efficacy and safety of acupuncture in treating neurodegenerative diseases.
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Affiliation(s)
- Fengya Zhu
- Zigong First People's Hospital, Zigong, China; Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shao Yin
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tingting Ma
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liuying Li
- Zigong First People's Hospital, Zigong, China; Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siyun Li
- Zigong First People's Hospital, Zigong, China; Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Junqian Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuan Wang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siyi Mao
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jie Wu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Jiayu L, Minmin W, Zhu L. Meta-analysis of the therapeutic effect of acupuncture on dysphagia in patients with Parkinson disease. Medicine (Baltimore) 2023; 102:e36698. [PMID: 38134058 PMCID: PMC10735101 DOI: 10.1097/md.0000000000036698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE To systematically evaluate the therapeutic effect of acupuncture on dysphagia in patients with Parkinson disease (PD). METHOD We searched CNKI, WF, VIP, CBM, Cochrane Library, and Web of Chinese Biomedical Literature Randomized controlled trials on the efficacy of acupuncture in the treatment of dysphagia in patients with PD was retrieved from Science, Embase, and PubMed databases from establishment to October 2022. Outcome indicators included clinical efficacy, swallowing function, hemoglobin, and serum albumin. Literature screening and data extraction of included literature were conducted independently by 2 reviewers, and literature quality was evaluated according to the standards of the Cochrane Collaboration network. Data analysis was performed using Review Manager 5.3 and Stata14.0 software. RESULTS 466 patients were included in 7 literature, 234 in the observation, and 232 in the control groups. The results of the meta-analysis showed the clinical efficacy in the observation group [odd ratio = 0.25, 95% confidence interval (95%CI) (0.15, 0.40), P < .01]. Swallowing function [standardized mean difference (SMD) = -0.96, 95%CI (-1.24, -0.68), P < .01]; hemoglobin index level [SMD = -0.72, 95%CI (-1.25, -0.20), P < .01]; serum albumin index level [SMD = -1.25, 95%CI (-2.19, -0.31), P < .01]. CONCLUSION Acupuncture has a specific curative effect on dysphagia in patients with PD, and the therapeutic effect is more significant than that in the control group, which can improve the dysphagia function and nutrition level in patients with PD more effectively.
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Affiliation(s)
- Liu Jiayu
- Graduate School, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Wu Minmin
- Graduate School, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Luwen Zhu
- The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harin, China
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Yu B, Ma SQ, Huang HP, Zhong Z, Yu S, Huang K, Zhang LY, Li MY, Yao L. Research methods and efficacy of acupuncture in the treatment of Parkinson's disease: a scoping review of systematic reviews and meta-analyses. Front Neurol 2023; 14:1196446. [PMID: 37332994 PMCID: PMC10272821 DOI: 10.3389/fneur.2023.1196446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Research on acupuncture for Parkinson's Disease is growing rapidly. A scoping review examines emerging evidence and is important to guide policy and practice. The purpose of this scoping review was to examine the breadth and methodological quality of systematic reviews and meta-analyses, and to map the quality of evidence of these studies to evaluate the efficacy of acupuncture for treatment of PD. Methods Seven literature databases were searched. Two researchers independently screened the literature and extracted relevant information (such as general characteristics, inclusion criteria, study results, and report quality).The inclusion criteria include publicly published systematic reviews/meta-analyses/systematic reviews of acupuncture treatment for Parkinson's disease. The research subjects are any patients who meet the diagnostic criteria for Parkinson's disease, and intervention measures include acupuncture treatment including electro acupuncture, scalp acupuncture, or combination with other treatment methods. The outcome indicators are all types of results related to PD and the effective measurement tools used. Results A total of 23 systematic reviews and/or meta-analyses of studies were included. Most of the articles were published between 2019 and 2023 (47.8%). A total of 14 articles (60.9%) were evaluated and classified, and 89 (36.8.1%) of the 242 included articles were of medium and high quality. Discussion This study comprehensively evaluates the quality and research methods of incorporating SRs/MAs, and concludes that acupuncture treatment for Parkinson's disease may be significant. Considering the shortcomings in research design and methodology, it is not possible to draw conclusions on the evidence of acupuncture treatment for PD at this stage, but it does not mean that acupuncture treatment is ineffective. We hope to focus on improving research design and methods in the study of acupuncture treatment for Parkinson's disease, an increase the credibility of research results.
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Affiliation(s)
- Bin Yu
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Shi-qi Ma
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Hai-peng Huang
- Institute of Acupuncture and Tuina, Northeast Asia Academy of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Zhen Zhong
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Shuo Yu
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Ke Huang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Li-ying Zhang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Meng-yuan Li
- Institute of Acupuncture and Tuina, Northeast Asia Academy of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Lin Yao
- Institute of Acupuncture and Tuina, Northeast Asia Academy of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
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Ettinger T, Berberian M, Acosta I, Cucca A, Feigin A, Genovese D, Pollen T, Rieders J, Kilachand R, Gomez C, Kaimal G, Biagioni M, Di Rocco A, Ghilardi FM, Rizzo JR. Art therapy as a comprehensive complementary treatment for Parkinson's disease. Front Hum Neurosci 2023; 17:1110531. [PMID: 37250693 PMCID: PMC10215005 DOI: 10.3389/fnhum.2023.1110531] [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: 11/28/2022] [Accepted: 04/11/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Parkinson's disease (PD) is the second most prevalent neurodegenerative disease. Complementary and alternative therapies are increasingly utilized to address its complex multisystem symptomatology. Art therapy involves motoric action and visuospatial processing while promoting broad biopsychosocial wellness. The process involves hedonic absorption, which provides an escape from otherwise persistent and cumulative PD symptoms, refreshing internal resources. It involves the expression in nonverbal form of multilayered psychological and somatic phenomena; once these are externalized in a symbolic arts medium, they can be explored, understood, integrated, and reorganized through verbal dialogue, effecting relief and positive change. Methods 42 participants with mild to moderate PD were treated with 20 sessions of group art therapy. They were assessed before and after therapy with a novel arts-based instrument developed to match the treatment modality for maximum sensitivity. The House-Tree-Person PD Scale (HTP-PDS) assesses motoric and visuospatial processing-core PD symptoms-as well as cognition (thought and logic), affect/mood, motivation, self (including body-image, self-image, and self- efficacy), interpersonal functioning, creativity, and overall level of functioning. It was hypothesized that art therapy will ameliorate core PD symptoms and that this will correlate with improvements in all other variables. Results HTP-PDS scores across all symptoms and variables improved significantly, though causality among variables was indeterminate. Discussion Art therapy is a clinically efficacious complementary treatment for PD. Further research is warranted to disentangle causal pathways among the aforementioned variables, and additionally, to isolate and examine the multiple, discrete healing mechanisms believed to operate simultaneously in art therapy.
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Affiliation(s)
- Tom Ettinger
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Marygrace Berberian
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Ikuko Acosta
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Alberto Cucca
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
- Doctoral Program in Neural and Cognitive Neurosciences, Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Andrew Feigin
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - Danilo Genovese
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - Travis Pollen
- Department of Exercise Science, Thomas Jefferson University, Philadelphia, PA, United States
| | - Julianne Rieders
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - Rohita Kilachand
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Clara Gomez
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Girija Kaimal
- Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Milton Biagioni
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | | | - Felice M. Ghilardi
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - John-Ross Rizzo
- Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, United States
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Lei S, Fan J, Liu X, Xv X, Zhang J, Zhou Z, Zhuang L. Qualitative and quantitative meta-analysis of acupuncture effects on the motor function of Parkinson's disease patients. Front Neurosci 2023; 17:1125626. [PMID: 37229426 PMCID: PMC10203172 DOI: 10.3389/fnins.2023.1125626] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
Objective To explore the association between acupuncture sessions and its effects on the motor function of Parkinson's Disease (PD). Methods Eight databases and two clinical trials registries were searched from inception to August 2022. Randomized controlled trials (RCTs) that compared acupuncture with sham acupuncture, or antiparkinsonian drugs, were included. After qualitative meta-analysis, a non-linear meta regression approach with restricted cubic spline was used to investigate the dose-response relationship between acupuncture sessions and their efficacy on the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score. Subgroup meta-analysis was performed of the included studies according to the weekly acupuncture frequency. And finally, the included studies containing the determination of intermediate efficacy were compared. Results Of the 268 citations screened, 16 studies (462 patients of PD) were included. The qualitative meta-analysis showed that the acupuncture group had better effect on UPDRS-III scores than the control group. And the quantitative meta-analysis suggested that acupuncture dose was correlated with the reduction of UPDRS-III score in PD patients with motor symptoms. In subgroup analysis, on the one hand, when the frequency of acupuncture was no more than 3 times a week, with the increase of acupuncture session, the changes of UPDRS-III score decreased and then increased (P = 0.000). On the other hand, when acupuncture for more than 3 times a week and the dose of acupuncture treatment was <60 times, the changes of UPDRS-III score increased with the increase of acupuncture dose, but the score stopped to decrease if the dose continued to increase (P = 0.020). The comparative analysis of two quantitative RCTs found that the score improvement was more significant at the higher weekly acupuncture frequency. Interpretation This study found that when treating PD patients with motor symptoms, acupuncture treatment may need to reach a certain dose to obtain better therapeutic effect and excessive acupuncture stimulation may cause the body to develop a certain tolerance. However, the above results still need to be verified by more high-quality clinical studies. The protocol was registered on PROSPERO International Prospective Register of Systematic Reviews (CRD42022351428).
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Affiliation(s)
- Suying Lei
- The First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jingqi Fan
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xin Liu
- The First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaoyan Xv
- The First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jiayan Zhang
- The First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zipu Zhou
- The First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Lixing Zhuang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Liao CC, Chien CH, Shih YH, Tsai FJ, Li JM. Acupuncture Is Effective at Reducing the Risk of Stroke in Patients with Migraines: A Real-World, Large-Scale Cohort Study with 19-Years of Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1690. [PMID: 36767053 PMCID: PMC9914783 DOI: 10.3390/ijerph20031690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/09/2023] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
Migraines are common headache disorders and risk factors for subsequent strokes. Acupuncture has been widely used in the treatment of migraines; however, few studies have examined whether its use reduces the risk of strokes in migraineurs. This study explored the long-term effects of acupuncture treatment on stroke risk in migraineurs using national real-world data. We collected new migraine patients from the Taiwan National Health Insurance Research Database (NHIRD) from 1 January 2000 to 31 December 2017. Using 1:1 propensity-score matching, we assigned patients to either an acupuncture or non-acupuncture cohort and followed up until the end of 2018. The incidence of stroke in the two cohorts was compared using the Cox proportional hazards regression analysis. Each cohort was composed of 1354 newly diagnosed migraineurs with similar baseline characteristics. Compared with the non-acupuncture cohort, the acupuncture cohort had a significantly reduced risk of stroke (adjusted hazard ratio, 0.4; 95% confidence interval, 0.35-0.46). The Kaplan-Meier model showed a significantly lower cumulative incidence of stroke in migraine patients who received acupuncture during the 19-year follow-up (log-rank test, p < 0.001). Acupuncture confers protective benefits on migraineurs by reducing the risk of stroke. Our results provide new insights for clinicians and public health experts.
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Affiliation(s)
- Chung-Chih Liao
- Department of Post-Baccalaureate Veterinary Medicine, Asia University, Taichung 41354, Taiwan
| | - Chi-Hsien Chien
- Department of Post-Baccalaureate Veterinary Medicine, Asia University, Taichung 41354, Taiwan
| | - Ying-Hsiu Shih
- Management Office for Health Data, China Medical University Hospital, Taichung 40201, Taiwan
- College of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
- Division of Medical Genetics, China Medical University Children’s Hospital, Taichung 40447, Taiwan
- Department of Biotechnology and Bioinformatics, Asia University, Taichung 41354, Taiwan
| | - Jung-Miao Li
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan
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Pereira CR, Machado J, Rodrigues J, de Oliveira NM, Criado MB, Greten HJ. Effectiveness of Acupuncture in Parkinson’s Disease Symptoms—A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10112334. [PMID: 36421658 PMCID: PMC9690518 DOI: 10.3390/healthcare10112334] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/22/2022] [Accepted: 11/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Parkinson’s disease (PD) is the second most common neurodegenerative disease. Several pharmacological and surgical therapies have been developed; however, they are accompanied by some adverse effects. As a result, many patients have been resorting to complementary medicine, namely acupuncture, in the hope of obtaining symptomatic improvements without having disruptive side effects. Therefore, advances in research in this area are very important. This work presents a systematic review of the effectiveness of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central) and Scielo databases, were systematically searched from January 2011 through July 2021. Randomised controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles was conducted by two blinding authors through Rayyan application. Results: A total of 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35 articles, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Although all the studies reviewed pointed out a positive effect of acupuncture on improving motor and non-motor symptoms in Parkinson’s disease, we found great discrepancies regarding the studies’ design and methodology, making difficult any comparison between them.
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Affiliation(s)
- Catarina Ramos Pereira
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, 4099-002 Porto, Portugal
- CBSIn—Center of Biosciences in Integrative Health, 4000-105 Porto, Portugal
- Correspondence:
| | - Jorge Machado
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, 4099-002 Porto, Portugal
- CBSIn—Center of Biosciences in Integrative Health, 4000-105 Porto, Portugal
| | - Jorge Rodrigues
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, 4099-002 Porto, Portugal
- CBSIn—Center of Biosciences in Integrative Health, 4000-105 Porto, Portugal
- IPTC—Research Department in Complementary Medicine, Portuguese Institute of Taiji and Qigong, 4470-765 Maia, Portugal
| | - Natália M. de Oliveira
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, 4099-002 Porto, Portugal
- CBSIn—Center of Biosciences in Integrative Health, 4000-105 Porto, Portugal
| | - Maria Begoña Criado
- CBSIn—Center of Biosciences in Integrative Health, 4000-105 Porto, Portugal
- TOXRUN—Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, 4585-116 Gandra, Portugal
| | - Henri J. Greten
- HSCM—Heidelberg School of Chinese Medicine, 69126 Heidelberg, Germany
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Jin C, Cho KH, Kwon S, Lee HG, Kim TH, Jung WS, Moon SK, Cho SY, Kang BK, Park JM, Park HJ, Ko CN. Effectiveness and safety of herbal medicine Ukgansan for clinical symptoms in Parkinson's disease: A pilot, randomized, assessor-blinded clinical trial. Front Neurol 2022; 13:1025269. [DOI: 10.3389/fneur.2022.1025269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/18/2022] [Indexed: 11/12/2022] Open
Abstract
ObjectivesParkinson's disease (PD) is a neurodegenerative disease in which patients are suffering various symptoms. Previous experimental studies suggested that herbal medicine Ukgansan (UGS) could be beneficial for PD. The aim of this pilot clinical trial was to evaluate the efficacy of UGS for improving clinical symptoms in patients with PD.MethodsSixty patients with idiopathic PD were randomly assigned to receive either UGS plus acupuncture or acupuncture alone for 6 weeks. During the trial, all anti-parkinsonian medications were maintained. Subjects were evaluated for various clinical assessments of PD, including the Movement Disorder Society-Sponsored Revision of the Unified PD Rating Scale (MDS-UPDRS) and the 39-item Parkinson's Disease Questionnaire (PDQ-39), until 12 weeks.ResultsIn MDS-UPDRS between the groups, no significant time x group interaction was found. In the subgroup analysis of participants with anxiety, a significant time x group interaction was found in the PDQ-39 domain of mobility (P = 0.007), activities of daily living (P = 0.042), and the PDQ-39 summary index (P = 0.048). In addition, post-hoc analysis in participants with anxiety showed a significant decrease in the domains of mobility (P = 0.001) and activities of daily living (P = 0.013) at week 7. There were no adverse events associated with UGS.ConclusionThe additional administration of UGS has the potential to significantly improve the quality of life of PD patients with anxiety. In order to create more definitive evidence, clinical trials with more rigorous methodologies should be conducted in future.Clinical trial registrationhttp://cris.nih.go.kr, identifier: KCT0003444.
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Li Q, Wu C, Wang X, Li Z, Hao X, Zhao L, Li M, Zhu M. Effect of acupuncture for non-motor symptoms in patients with Parkinson's disease: A systematic review and meta-analysis. Front Aging Neurosci 2022; 14:995850. [PMID: 36275001 PMCID: PMC9582755 DOI: 10.3389/fnagi.2022.995850] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although non-motor symptoms of Parkinson's disease (PD) are serious, effective treatments are still lacking. Acupuncture may have clinical benefits for non-motor symptoms of PD patients, but high-quality evidence supporting this possibility is still limited. Hence, we conducted this meta-analysis to evaluate the effect of acupuncture treatment on non-motor symptoms in patients with PD. Methods Randomized controlled trials (RCTs) of acupuncture treatment for PD were retrieved from the following electronic databases: Medline (OVID), Embase (OVID), Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese BioMedical Literature Database, Chonqing VIP (CQVIP), and Wangfang database. Studies evaluating non-motor symptoms of PD were retrieved. Methodological quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Results A total of 27 RCTs were included, among which 8 outcomes related to non-motor symptoms were evaluated. The results showed that acupuncture combined with medication had benefits for PD-related insomnia relative to medication alone or sham acupuncture [standardized mean difference (SMD) = 0.517; 95% confidence interval (CI) = 0.242-0.793; p = 0.000], and acupuncture treatment had benefits at 8 weeks (SMD = 0.519; 95% CI = 0.181-0.857; p = 0.003). Regarding depression, acupuncture treatment was more effective (SMD = -0.353; 95% CI = -0.669 to -0.037; p = 0.029) within 2 months (SMD = -0.671; 95% CI = -1.332 to -0.011; p = 0.046). Regarding cognition, quality of life, and Unified Parkinson's Disease Rating Scale (UPDRS) I and II scores, acupuncture treatment was effective [SMD = 0.878, 95% CI = 0.046-1.711, p = 0.039; SMD = -0.690, 95% CI = -1.226 to -0.155, p = 0.011; weighted mean difference (WMD) = -1.536, 95% CI = -2.201 to -0.871, p = 0.000; WMD = -2.071, 95% CI = -3.792 to -0.351, p = 0.018; respectively]. A significant difference was not found in terms of PD-related constipation. Only one study evaluated PD-related fatigue. Conclusion The results of the analysis suggested that acupuncture treatment could ameliorate the symptoms of depression, quality of life, cognition, total mentation, behavior and mood, and activities of daily living in PD patients. Nevertheless, more prospective, well-designed RCTs with larger sample sizes are required to confirm our findings.
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Affiliation(s)
- Qinglian Li
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Chunxiao Wu
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Shenzhen, China
- The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaoling Wang
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Zhen Li
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Xiaoqian Hao
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Lijun Zhao
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Mengzhu Li
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Meiling Zhu
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Shenzhen, China
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12
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Wen X, Liu Z, Liu X, Peng Y, Liu H. The effects of physiotherapy treatments on dysphagia in Parkinson's disease: a systematic review of randomized controlled trials. Brain Res Bull 2022; 188:59-66. [PMID: 35882280 DOI: 10.1016/j.brainresbull.2022.07.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/18/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The prevalence of swallowing disorders in Parkinson's disease (PD) is relatively high. Different physiotherapy interventions for swallowing disorders are available but there is a lack of evidence-based medicine for their effectiveness in PD. OBJECTIVE The purpose of this systematic review was to investigate the effects of different physiotherapy interventions on dysphagia in PD. METHODS This systematic review was conducted according to PRISMA guidelines. We methodically searched databases including PubMed, PEDro, Cochrane Library, Embase, and Web of Science. Studies of any language published up to March 2022 were searched. Randomized controlled trials (RCTs) of non-pharmacological treatment for dysphagia in PD were selected in strict accordance with our exclusion and inclusion criteria. RESULTS In total, we identified and included 10 RCTs in patients with PD undergoing dysphagia. This review involved seven rehabilitation treatments, including acupuncture, expiratory muscle strength training (EMST), repetitive transcranial magnetic stimulation (rTMS), video-assisted swallowing therapy (VAST), electrical stimulation, and speech and language therapy (SLT). CONCLUSION For physiotherapy treatments, including acupuncture, EMST, high-frequency rTMS and VAST may be effective treatments for dysphagia in patients with PD. However, there was not enough evidence that electrical stimulation has therapeutic effects on dysphagia in patients with PD.
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Affiliation(s)
- Xin Wen
- School of Rehabilitation Medicine Gannan Medical University, Ganzhou, Jiangxi, China.
| | - Zicai Liu
- School of Rehabilitation Medicine Gannan Medical University, Ganzhou, Jiangxi, China.
| | - Xuejin Liu
- School of Rehabilitation Medicine Gannan Medical University, Ganzhou, Jiangxi, China.
| | - Yang Peng
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, Guangdong, China.
| | - Huiyu Liu
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, Guangdong, China.
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13
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Chen P, Zhang J, Wang C, Chai YH, Wu AG, Huang NY, Wang L. The pathogenesis and treatment mechanism of Parkinson's disease from the perspective of traditional Chinese medicine. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 100:154044. [PMID: 35338993 DOI: 10.1016/j.phymed.2022.154044] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/26/2022] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disease with no treatment currently available to modify its progression. Traditional Chinese medicine (TCM) has gained attention for its unique theoretical basis and clinical effects. Many studies have reported on the clinical effects and pharmacological mechanisms of Chinese herbs in PD. However, few studies have focused on the treatment mechanisms of anti-PD TCM drugs from the perspective of TCM itself. PURPOSE To elaborate the treatment mechanisms of anti-PD TCM drugs in the perspective of TCM. METHODS We performed a literature survey using traditional books of Chinese medicine and online scientific databases including PubMed, Web of Science, Google Scholar, China National Knowledge Infrastructure (CNKI), and others up to July 2021. RESULTS TCM theory states that PD is caused by a dysfunction of the zang-fu organs (liver, spleen, kidney, and lung) and subsequent pathogenic factors (wind, fire, phlegm, and blood stasis). Based on the pathogenesis, removing pathogenic factors and restoring visceral function are two primary treatment principles for PD in TCM. The former includes dispelling wind, clearing heat, resolving phlegm, and promoting blood circulation, while the latter involves nourishing the liver and kidney and strengthening the spleen. The anti-PD mechanisms of the active ingredients of TCM compounds and herbs at different levels include anti-apoptosis, anti-inflammation, and anti-oxidative stress, as well as the restoration of mitochondrial function and the regulation of autophagy and neurotransmitters. CONCLUSION Chinese herbs and prescriptions can be used to treat PD by targeting multiple pharmacological mechanisms.
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Affiliation(s)
- Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China; Accreditation Center of Traditional Chinese Medicine Physician, National Administration of Traditional Chinese Medicine, Beijing, China.
| | - Jie Zhang
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Chen Wang
- Department of Traditional Chinese Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Yi-Hui Chai
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - An-Guo Wu
- School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, China
| | - Ning-Yu Huang
- Accreditation Center of Traditional Chinese Medicine Physician, National Administration of Traditional Chinese Medicine, Beijing, China.
| | - Long Wang
- School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, China.
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Ma C, Li N, Zhang X. Exploring the Clinical Point Selection Rules of Acupuncture and Moxibustion in the Treatment of Infantile Enuresis Based on Data Mining Technology. SCANNING 2022; 2022:7928052. [PMID: 35571572 PMCID: PMC9068298 DOI: 10.1155/2022/7928052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/27/2022] [Accepted: 04/04/2022] [Indexed: 06/15/2023]
Abstract
In order to explore the clinical point selection rules of acupuncture and moxibustion in the treatment of infantile enuresis based on data mining technology, first, it introduces the principle of data mining technology, the global optimization strategy of information extraction + genetic search. In China Biomedical Literature Database, CNKI, Weipu, Wanfang. Use "enuresis," "enuresis," "leathering," "urinary discharge," "drowning," "bedwetting," "nocturia," "drowning," "moxibustion," "moxibustion," and "moxibustion" as search terms, take (enuresis + enuresis + urination + urination + addiction + bedwetting), (moxibustion + moxibustion + moxibustion)" as the retrieval style. The analysis of the use of moxibustion, the law of acupoint selection by different moxibustion methods, and the frequency analysis of meridian use show that most of the moxibustion methods are used (62 articles, of which 3 articles use 2 moxibustion methods), including non-suppurative moxibustion, ginger moxibustion, medicinal cake moxibustion, salt moxibustion, mild moxibustion, warm acupuncture moxibustion, bird pecking moxibustion, circling moxibustion, and warm moxibustion; among them, mild moxibustion has the highest frequency of use 24 and non-suppurative moxibustion and salt-separated moxibustion have the lowest frequency of use1; there are 4 non-moxibustion methods, which are medicated thread moxibustion methods. Different moxibustion methods for acupoint selection have their own emphasis. The 63 included literatures included 63 prescriptions for moxibustion, 11 prescriptions for acupoints. Analyzing the frequency of acupoint selection, a total of 18 ear acupoints are involved, and the total frequency of auricular acupoints is 54 times; 44 points are involved (including 1 odd point outside the meridian), the total frequency of acupoints is 300 times, and the total frequency of meridian points is 298, and the total frequency of Jingwaiqi acupoints (Sishencong) is 2. The results can provide great help for the clinical selection of acupuncture points for the treatment of infantile enuresis.
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Affiliation(s)
- Cuicui Ma
- Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang, Hebei 050000, China
| | - Nan Li
- Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang, Hebei 050000, China
| | - Xu Zhang
- Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang, Hebei 050000, China
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Kwon M, Cheong MJ, Leem J, Kim TH. Effect of Acupuncture on Movement Function in Patients with Parkinson's Disease: Network Meta-Analysis of Randomized Controlled Trials. Healthcare (Basel) 2021; 9:healthcare9111502. [PMID: 34828548 PMCID: PMC8619200 DOI: 10.3390/healthcare9111502] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 11/17/2022] Open
Abstract
We aimed to compare the effectiveness of some different acupuncture modalities on motor function using the unified Parkinson disease rating scale (UPDRS)-III scores of idiopathic Parkinson’s disease (PD) via pairwise and network meta-analyses (NMA) of randomized controlled trials (RCTs). The Cochrane risk of bias assessment tool was used to assess the methodological quality of the included RCTs. A frequentist approach-based random effect model NMA was performed. Seventeen RCTs with 1071 participants were included. The five following modalities were identified: combination of conventional medication (levodopa) with (1) electroacupuncture (ELEC), (2) manual acupuncture (MANU), (3) bee venom acupuncture (BEEV), (4) sham acupuncture (SHAM), and (5) conventional medication alone (CONV). In NMA on UPDRS-III, BEEV was the best modality compared to CONV (mean difference [MD]) −7.37, 95% confidence interval [−11.97, −2.77]). The comparative ranking assessed through NMA was suggested to be BEEV, MANU, ELEC, SHAM, and CONV. Regarding daily activity assessment (UPDRS-II), the magnitude of effectiveness was in the order of BEEV, ELEC, MANU, SHAM, and CONV. Combination treatment with BEEV (MANU or ELEC) and CONV can be recommended to improve motor function in PD patients. Due to the limited number of included RCTs, further NMA with more rigorous RCTs are warranted.
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Affiliation(s)
- Miri Kwon
- Department of Clinical Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea;
| | - Moon Joo Cheong
- Rare Diseases Integrative Treatment Research Institute, Wonkwang University, Jangheung Integrative Medical Hospital, Iksan 59338, Korea;
| | - Jungtae Leem
- Research Center of Traditional Korean Medicine, Wonkwang University, Iksan 54538, Korea
- Correspondence: (J.L.); (T.-h.K.); Tel.: +82-063-850-5114 (J.L.); +82-02-958-9194 (T.-h.K.)
| | - Tae-hun Kim
- Department of Clinical Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea;
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University Medical Center, Seoul 02447, Korea
- Correspondence: (J.L.); (T.-h.K.); Tel.: +82-063-850-5114 (J.L.); +82-02-958-9194 (T.-h.K.)
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Tsai ST, Wei TH, Yang YW, Lu MK, San S, Tsai CH, Lin YW. Transient receptor potential V1 modulates neuroinflammation in Parkinson's disease dementia: Molecular implications for electroacupuncture and rivastigmine. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2021; 24:1336-1345. [PMID: 35096291 PMCID: PMC8769514 DOI: 10.22038/ijbms.2021.56156.12531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/17/2021] [Indexed: 12/05/2022]
Abstract
OBJECTIVES Parkinson's disease (PD) is a common progressive neurodegeneration disease. Its incidence increases with age and affects about 1% of people over 60. Incidentally, transient receptor potential V1 (TRPV1) and its relation with neuroinflammation in mouse brain has been widely reported. MATERIALS AND METHODS We used 6-hydroxydopamine (6-OHDA) to induce PDD in mice. We then used the Morris water maze and Bio-Plex to test learning and inflammatory mediators in mouse plasma. Western blotting and immunostaining were used to examine TRPV1 pathway in the hippocampus and medial prefrontal cortex (mPFC). RESULTS On acquisition days 3 (Control = 4.40 ± 0.8 sec, PDD = 9.82 ± 1.52 sec, EA = 5.04 ± 0.58 sec, Riva = 4.75 ± 0.87 sec; P=0.001) and 4, reversal learning days 1, 2, 3 (Control = 2.86 ± 0.46 sec, PDD = 9.80 ± 1.83 sec, EA = 4.6 ± 0.82 sec, Riva = 4.6 ± 1.03 sec; P=0.001) and 4, PDD mice showed significantly longer escape latency than the other three groups. Results showed that several cytokines were up-regulated in PDD mice and reversed by EA and rivastigmine. TRPV1 and downstream molecules were up-regulated in PDD mice and further reversed by EA and rivastigmine. Interestingly, α7 nicotinic receptors and parvalbumin levels in both the hippocampus and prefrontal cortex increased in EA-treated mice, but not in rivastigmine-treated mice. CONCLUSION Our results showed that TRPV1 played a role in the modulation of neuroinflammation of PDD, and could potentially be a new target for treatment.
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Affiliation(s)
- Sheng-Ta Tsai
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan, Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan, Everflourish Neuroscience and Brain Disease Center, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Hsuan Wei
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Wan Yang
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan, College of Medicine, China Medical University, Taichung, Taiwan
| | - Ming-Kuei Lu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan, Everflourish Neuroscience and Brain Disease Center, China Medical University Hospital, Taichung, Taiwan, College of Medicine, China Medical University, Taichung, Taiwan
| | - Shao San
- Department of Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Chon-Haw Tsai
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan, Everflourish Neuroscience and Brain Disease Center, China Medical University Hospital, Taichung, Taiwan, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yi-Wen Lin
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan, Chinese Medicine Research Center, China Medical University, Taichung, Taiwan,Corresponding author: Yi-Wen Lin. Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, No. 91, Xueshi Road, North District, Taichung 404, Taiwan. Tel: 886-970055508;
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Bayen S, Carpentier C, Baran J, Cottencin O, Defebvre L, Moreau C, Devos D, Messaadi N. Parkinson's disease: Content analysis of patient online discussion forums. A prospective observational study using Netnography. PATIENT EDUCATION AND COUNSELING 2021; 104:2060-2066. [PMID: 33551207 DOI: 10.1016/j.pec.2021.01.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To assess the users' characteristics, discussion contents, and the atmosphere of virtual peer communities. METHODS A qualitative, prospective study was conducted using the Netnography method. The most popular, publicly accessible French discussion forums were investigated. The web users' quotes were collected from May to October 2018. Data analysis triangulation was performed by two researchers using the NVivo 12® software. RESULTS The users discussed their experience with Parkinson's disease (PD) in a warm atmosphere. 23 discussion threads were analysed: 302 messages posted by 70 users (70% were females; the average illness duration was 6 years); 115 encoded nodes were created. Five user profiles appeared: leader, follower, expert, mixed, and undetermined. Common preoccupations were a lack of time and listening from the physicians' side. Three themes emerged: managing symptoms, living with PD, and sharing illness experiences. Users sought actively for a cure to limit or stop disease evolution, using alternative and complementary therapies to optimize their daily condition. CONCLUSIONS Online forums foster person's informal learnings about coping with PD. Healthcare professionals can use these learnings to optimize person-centred support. PRACTICE IMPLICATIONS During consultations, healthcare professionals should invite persons to discuss their online activity, informal learnings, beliefs and expectations towards therapeutic strategies.
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Affiliation(s)
- Sabine Bayen
- Department of General Practice, University of Lille, Lille, France; Department of Medical Pharmacology & Neurology, INSERM UMRS 1172, University of Lille, Lille, France.
| | | | - Jan Baran
- Department of General Practice, University of Lille, Lille, France
| | - Olivier Cottencin
- Department of Psychiatry & Addiction Medicine, University of Lille, Lille, France
| | - Luc Defebvre
- Department of Medical Pharmacology & Neurology, INSERM UMRS 1172, University of Lille, Lille, France; Department of Neurology, University of Lille, Lille, France
| | - Caroline Moreau
- Department of Medical Pharmacology & Neurology, INSERM UMRS 1172, University of Lille, Lille, France; Department of Neurology, University of Lille, Lille, France
| | - David Devos
- Department of Medical Pharmacology & Neurology, INSERM UMRS 1172, University of Lille, Lille, France; Department of Neurology, University of Lille, Lille, France
| | - Nassir Messaadi
- Department of General Practice, University of Lille, Lille, France; CN2R-Centre National de Ressources et de Résilience, Lille, France
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Wen X, Li K, Wen H, Wang Q, Wu Z, Yao X, Jiao B, Sun P, Ge S, Wen C, Lu L. Acupuncture-Related Therapies for Parkinson's Disease: A Meta-Analysis and Qualitative Review. Front Aging Neurosci 2021; 13:676827. [PMID: 34276340 PMCID: PMC8282198 DOI: 10.3389/fnagi.2021.676827] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This systematic review and meta-analysis aimed to assess the effects of the combination of acupuncture-related therapies with conventional medication compared with conventional medication in patients with Parkinson's disease (PD). Methods: A literature search within eight databases [including Medline, Embase, the Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), VIP, and Wanfang Database] was performed covering a time frame from their inception to August 2020. Randomized controlled trials (RCTs) comparing acupuncture-related therapies combined with conventional medication vs. conventional medication in patients with PD were eligible. Two authors independently assessed the risk of bias. Assessments were performed with the total and subscales scores of the Unified Parkinson's Disease Rating Scale (UPDRS), 39-item Parkinson's Disease Questionnaire (PDQ-39), the dosage of Madopar, Mini-Mental State Examination (MMSE), and 17-item Hamilton Depression Scale (HAMD). Data were analyzed by adopting the Cochrane Collaboration's RevMan 5.4 (Review Man, Copenhagen, Denmark); and mean effect sizes and 95% confidence intervals were estimated. Tests for heterogeneity were used to assess differences in treatment effects across different types of acupuncture used. Results: Sixty-six trials met the inclusion criteria, of which 61 trials provided data for the meta-analysis. We defined high-quality articles as those with a low risk of bias in four or more domains; and only 10 (15.15%) articles were of high quality. Compared with the controls, acupuncture-related therapies with conventional medication achieved a benefit in the primary outcomes of UPDRS (motor subscore: −3.90, −4.33 to −3.49, P < 0.01; total score: −7.37 points, −8.91 to −5.82, P < 0.001; activities of daily living subscore: −3.96, −4.96 to −2.95, P < 0.01). For the subgroup difference test among the effects of different acupuncture methods, significant differences existed in outcomes with the UPDRS-III, UPDRS-I, UPDRS-IV, and PDQ-39 scores and Madopar dosage, while non-significant differences existed with the UPDRS-total, UPDRS-II, HAMD, and MMSE scores. Conclusions: Acupuncture-related therapies combined with conventional medication may benefit individuals with PD. Our review findings should be considered with caution because of the methodological weaknesses in the included trials. Future, large randomized trials of acupuncture-related therapies for PD with high methodological quality are warranted. Systematic Review Registration: Identifier CRD42021228110.
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Affiliation(s)
- Xiaopeng Wen
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Kunbin Li
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Hao Wen
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qian Wang
- Department of Medical Imaging, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Zhiyuan Wu
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Xianli Yao
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Bing Jiao
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Pingge Sun
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Shuqi Ge
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chenyang Wen
- Department of Rehabilitation Medicine, Dengfeng City Second People' s Hospital, Zhengzhou, China
| | - Liming Lu
- Evidence-Based Medicine and Data Science Centre, Guangzhou University of Chinese Medicine, Guangzhou, China
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Acupuncture for Parkinson's Disease: Efficacy Evaluation and Mechanisms in the Dopaminergic Neural Circuit. Neural Plast 2021; 2021:9926445. [PMID: 34221005 PMCID: PMC8221898 DOI: 10.1155/2021/9926445] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/10/2021] [Accepted: 05/27/2021] [Indexed: 01/10/2023] Open
Abstract
Parkinson's disease (PD) is a chronic and progressive neurodegenerative disease caused by degeneration of dopaminergic neurons in the substantia nigra. Existing pharmaceutical treatments offer alleviation of symptoms but cannot delay disease progression and are often associated with significant side effects. Clinical studies have demonstrated that acupuncture may be beneficial for PD treatment, particularly in terms of ameliorating PD symptoms when combined with anti-PD medication, reducing the required dose of medication and associated side effects. During early stages of PD, acupuncture may even be used to replace medication. It has also been found that acupuncture can protect dopaminergic neurons from degeneration via antioxidative stress, anti-inflammatory, and antiapoptotic pathways as well as modulating the neurotransmitter balance in the basal ganglia circuit. Here, we review current studies and reflect on the potential of acupuncture as a novel and effective treatment strategy for PD. We found that particularly during the early stages, acupuncture may reduce neurodegeneration of dopaminergic neurons and regulate the balance of the dopaminergic circuit, thus delaying the progression of the disease. The benefits of acupuncture will need to be further verified through basic and clinical studies.
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Seo SY, Moon JY, Kang SY, Kwon OS, Bang SK, Choi KH, Ryu Y. Acupuncture stimulation at HT7 as a non-pharmacological therapy for sleep disorder caused by caffeine administration in rats. Acupunct Med 2021; 39:691-699. [PMID: 34056932 DOI: 10.1177/09645284211011489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Insomnia is one of the most common sleep disorders and is difficult to completely treat because of the undesirable side effects of hypnotics. The present study was designed to investigate the hypnotic effect of acupuncture stimulation at HT7 on caffeine-induced sleep disorders and locomotor activity in rats. We also evaluated neuronal activity changes in the arousal region of the basal forebrain. METHODS Rats received intraperitoneal injections of caffeine, and then electroencephalogram power spectrum analysis and locomotor activity measurements were performed. Stimulation at HT7 was performed using a mechanical acupuncture instrument (MAI) before caffeine injection, and its effects on caffeine-induced changes in sleep architecture, locomotor activity and c-Fos expression were examined. RESULTS Caffeine injection (7.5 mg/kg) produced a significant decrease in slow-wave sleep and an increase in wake time compared with saline injection. Caffeine injection also increased locomotor activity and c-Fos expression in the medial septum-vertical limb of the diagonal band of Broca (MS-VDB), one of the arousal regions of the basal forebrain. Stimulation at HT7 with the MAI alleviated the caffeine-induced sleep disturbance and the increase in locomotor activity. In addition, MAI treatment at HT7, compared with treatment at a location not corresponding to any traditional acupuncture point, reduced the caffeine-induced increase in c-Fos expression. CONCLUSION These results indicate that the hypnotic effect of HT7 acupuncture stimulation on caffeine-induced insomnia was associated with suppression of neuronal activity in the basal forebrain.
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Affiliation(s)
- Su Yeon Seo
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ji-Young Moon
- Animal and Plant Quarantine Agency, Gimcheon-si, South Korea
| | - Suk-Yun Kang
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - O Sang Kwon
- Department of Meridian & Acupoint, College of Korean Medicine, Wonkwang University, Iksan, South Korea
| | - Se Kyun Bang
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kwang-Ho Choi
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Yeonhee Ryu
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
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Xu W, OuYang S, Chi Z, Wang Z, Zhu D, Chen R, Zhong G, Zhang F, Zhou G, Duan S, Jiao L. Effectiveness and safety of electroacupuncture in treating Parkinson disease: A protocol for systematic review and meta-analyses. Medicine (Baltimore) 2021; 100:e25095. [PMID: 33725902 PMCID: PMC7969292 DOI: 10.1097/md.0000000000025095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 02/18/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Parkinson disease (PD) is an Extrapyramidal Disease mainly characterized by static tremor, myotonia, bradykinesia and postural gait disorder. As China's population ages, the number of people suffering from PD is increasing. Since there are many side effects of western medicine for Parkinson's patients, and the high price of the drugs make it difficult for many patients to adhere to treat. At present, many clinical studies have shown that electroacupuncture is effective in treating PD. Therefore, this systematic review aims to explore the effectiveness and safety of electroacupuncture in the treatment of PD. METHODS Comprehensive search of PubMed, Embase, Medline, Cochrane Database of Systematic Reviews, Chinese Biomedical Literatures Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wang Fang Database from inception to February 2021, the literature selected is not restricted by language. In addition, we will search for unpublished studies and the references that were originally included in the literature manually. There were two reviewers screened the data and cross-checked the information individually, the quality of the literature was assessed by reviewers independently. The outcomes of interest include:the scale of Unifified PD Rating Scales, the Webster scale, the Quality of Life Questionnaire, total effective rate, recurrence rate, adverse events. The laboratory inspection indicators include:the content of lipid peroxidase, Superoxide dismutase activity in plasma and erythrocyte. The relevant randomized controlled trials will be included in this study. And we will evaluate the quality of the selected literature according to the Cochrane Handbook. Meta-analysis will be performed using RevMan 5.4.0 software. The heterogeneity test will be implemented in the included literature, the tests' thresholds will be P < .1 and I2 > 50%. We will use either fixed effects model or random effects model according to the size of heterogeneity. RESULTS The results of this systematic review will provide a comprehensive evidence for the clinical treatment of PD, and we will report this result soon. CONCLUSION This paper will explore whether or not electroacupuncture can be used as a non-drug therapy for PD. ETHICS AND DISSEMINATION Ethical approval is not required for this paper, our plan will be published in the journal. TRIAL REGISTRATION NUMBER INPLASY202120031.
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Affiliation(s)
- Wei Xu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Sha OuYang
- Science and Technology college of Jiangxi University of Traditional Chinese Medicine
| | - Zhenhai Chi
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - ZhiQin Wang
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - DaoCheng Zhu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - RiXin Chen
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - GenPing Zhong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - FengTing Zhang
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - GuiQin Zhou
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - SiWei Duan
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Lin Jiao
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Effects of Acupuncture & Qigong Meditation on Nonmotor Symptoms of Parkinson’s Disease. JOURNAL OF ACUPUNCTURE RESEARCH 2020. [DOI: 10.13045/jar.2020.00066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Parkinson's disease(PD) affects not only motor symptoms, but also nonmotor symptoms. This study is a clinical trial to determine whether Qigong and acupuncture affect nonmotor symptoms of PD.Methods: A 2-arm parallel and randomized trial was performed with 21 participants who had received either Qigong meditation only [control group (CG)] or acupuncture and Qigong meditation [experimental group (EG)]. The participants' levels of the discomfort in nonmotor symptoms from Parkinson's disease were evaluated by using the Unified Parkinson's Disease Rating Scales (UPDRS 1) and Test of Smell Identification (TSI) before and after 12 treatments at baseline and 1 month after 12 treatments.Results: The both CG and EG showed improvements in the UPDRS 1 score after treatment by 5.6 ± 5.15 (<i>p</i>= 0.003; 74%) and 4.8 ± 3.80 (<i>p</i> = 0.004; 79%), respectively. The both CG and the EG did improvements in the TSI after treatment by 10.3 ± 4.37 (<i>p</i> < 0.001; 84%) and 12.6 ± 1.77 (<i>p</i> = 0.022; 100%), respectively. However, statistical differences were not observed between the CG and the EG using the UPDRS 1 and the TSI scores.Conclusion: The combination of Qigong and acupuncture and Qigong alone was shown to improve the nonmotor symptoms and olfactory function of PD. In the future, large-scale clinical studies on alternative treatment for PD and studies on mechanisms affecting nonmotor symptoms of acupuncture and Qigong are needed.
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Jang JH, Park S, An J, Choi JD, Seol IC, Park G, Lee SH, Moon Y, Kang W, Jung ES, Cha JY, Kim CY, Kim S, Jung IC, Yoo H. Gait Disturbance Improvement and Cerebral Cortex Rearrangement by Acupuncture in Parkinson's Disease: A Pilot Assessor-Blinded, Randomized, Controlled, Parallel-Group Trial. Neurorehabil Neural Repair 2020; 34:1111-1123. [PMID: 33198568 DOI: 10.1177/1545968320969942] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Parkinson's disease (PD) leads to impaired mobility and limited independence. OBJECTIVE We investigated the effects of acupuncture on gait disturbance and analyzed hemodynamic changes caused by acupuncture in the cerebral cortex of patients with PD. METHODS Participants (n = 26) with gait disturbance due to PD were randomly assigned to the intervention (acupuncture twice a week for 4 weeks + conventional therapy) or control (conventional therapy) groups. We analyzed gait parameters using the GAITRite system and hemodynamic responses in the cerebral cortices using functional near-infrared spectroscopy, Unified Parkinson's Disease Rating Scale (UPDRS) scores, neurotransmitter levels, as well as the immediate effects of acupuncture in patients with PD. RESULTS The participants tended to walk with hypometric gait (high cadence, short steps) overground. After acupuncture treatment, those in the intervention group showed a significant reduction in cadence and the UPDRS scores involving "walking and balance" compared with those in the control group (P = .004 and P = .020, respectively); the stride, swing, and single support times were significantly increased (P = .006, P = .001, and P = .001, respectively). Oxyhemoglobin levels in the intervention group while walking on a treadmill were significantly increased in the prefrontal and supplementary motor areas. The oxyhemoglobin levels in the prefrontal cortex and swing time revealed significant positive correlations. CONCLUSIONS Our findings indicated that acupuncture tended to improve hypometric gait and rearranged activation of the cerebral cortex. Thus, acupuncture may be a useful complementary treatment for gait disturbance, including hypometric gait, in patients with PD. Trial Registration Number. Clinical Research Information Service (KCT0002603), https://cris.nih.go.kr/cris/index.jsp.
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Affiliation(s)
- Jung-Hee Jang
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea.,Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sangsoo Park
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Jinung An
- Convergence Research Center for Wellness, Digist R4-814, Dalseong-Gun, Daegu, Republic of Korea
| | - Jong-Duk Choi
- College of Health & Medical Science, Graduate School, Daejeon City, Republic of Korea
| | - In Chan Seol
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Gunhyuk Park
- Korea Institute of Oriental Medicine, Naju-si, Jeollanam-do, Republic of Korea
| | | | - Young Moon
- College of Health & Medical Science, Graduate School, Daejeon City, Republic of Korea
| | - Weechang Kang
- Daejeon University, Dong-gu, Daejeon City, Republic of Korea
| | - Eun-Sun Jung
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Ji-Yun Cha
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Chan-Young Kim
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Siyeon Kim
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - In Chul Jung
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Horyong Yoo
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
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Microglia TREM2: A Potential Role in the Mechanism of Action of Electroacupuncture in an Alzheimer's Disease Animal Model. Neural Plast 2020; 2020:8867547. [PMID: 32952550 PMCID: PMC7487106 DOI: 10.1155/2020/8867547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/29/2020] [Accepted: 08/18/2020] [Indexed: 12/31/2022] Open
Abstract
Alzheimer's disease (AD) is one of the most serious public health concerns facing the world. Its characteristic feature is neuroinflammation due to microglial activation. Electroacupuncture is one of the therapies employed to improve the condition of patients with AD, although its mechanism of action is still to be determined. Triggering receptor expressed on myeloid cells 2 (TREM2) is a microglia-specific receptor that is involved in regulating neuroinflammation in AD. In this study, we applied senescence-accelerated mouse-prone 8 mice as the AD animal model, used the Morris water maze, and applied hematoxylin and eosin staining, immunofluorescence double staining, and Western blotting, to explore the effects and potential mechanisms of action of electroacupuncture. In summary, this study suggested that electroacupuncture treatment could improve the learning and memory abilities (p < 0.05) and protect neurons. These effects result from acupuncture could upregulate TREM2 expression in the hippocampus (p < 0.01), which was essential for the anti-inflammatory effects in the AD animal model. However, further studies are needed to conclusively demonstrate the mechanism of action of electroacupuncture in AD.
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Huang J, Qin X, Cai X, Huang Y. Effectiveness of Acupuncture in the Treatment of Parkinson's Disease: An Overview of Systematic Reviews. Front Neurol 2020; 11:917. [PMID: 32973668 PMCID: PMC7482669 DOI: 10.3389/fneur.2020.00917] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/16/2020] [Indexed: 01/08/2023] Open
Abstract
Background: The effects of acupuncture on Parkinson's disease (PD) outcomes remain unclear. The aim of this overview was to comprehensively evaluate the methodological quality and applicability of the results of systematic reviews (SRs)/meta-analyses (MAs) that examined the use of acupuncture to treat PD. Methods: Eight databases were searched to retrieve SRs/MAs on the use of acupuncture for the treatment of PD. Two reviewers independently screened and extracted the data using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) checklist to evaluate the methodological quality and using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria to assess the evidence quality of the included reviews. Results: A total of 11 SRs/MAs were included. According to the AMSTAR-2 checklist results, all included SRs/MAs were rated as very-low-quality studies. The GRADE criteria revealed 20 studies with very-low-quality evidence, 9 with low-quality evidence, 3 with moderate-quality evidence, and 0 with high-quality evidence. Descriptive analysis showed that acupuncture appears to be a clinically effective and safe treatment for PD. Conclusions: The use of acupuncture for the treatment of PD may be clinically effective and safe. This conclusion must be interpreted cautiously due to the generally low methodological quality and low quality of evidence of the included studies.
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Affiliation(s)
- Jinke Huang
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaohui Qin
- Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine; Guangdong Provincial Academy of Chinese Medical Sciences), Guangzhou, China
| | - Xiaowen Cai
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
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Cao L, Li X, Li M, Yao L, Hou L, Zhang W, Wang Y, Niu J, Yang K. The effectiveness of acupuncture for Parkinson's disease: An overview of systematic reviews. Complement Ther Med 2020; 50:102383. [PMID: 32444048 DOI: 10.1016/j.ctim.2020.102383] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/01/2020] [Accepted: 03/11/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Acupuncture is an alternative therapy for Parkinson's disease (PD), but its efficacy and safety are controversial. This overview aimed to summarize the existing evidence from systematic reviews (SRs) and meta-analyses (MAs) in order to assess the effectiveness of acupuncture as a treatment for PD. METHODS Seven electronic databases were searched from their inception until July 2019. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) and Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklists were used to assess evidence quality and methodological quality, respectively. The outcomes of study were calculated using mean differences (MDs) and risk ratios (RRs) with 95 % confidence intervals (CIs). A meta-analysis was performed using RevMan 5.3 software. RESULTS A total of 12 SRs/MAs were included. All 12 SRs/MAs had more than one critical weakness in AMSTAR 2 and were considered of critically low methodological quality. The quality of evidence was unsatisfactory according to the GRADE checklist. Meta-analyses showed that acupuncture combined with drug for the treatment of PD can significantly improve the total effectiveness rate compared with drug alone (RR = 1.25, 95 % CI 1.16-1.34, P < 0.001). It was also found that acupuncture combined with drug significantly improved the UPDRS I-IV total summed scores (WMD=-6.18, 95 % CI -10.32 to -2.04, P < 0.001) and Webster scores (WMD=-4.20, 95 % CI -7.59 to -0.81, P < 0.001). CONCLUSION Acupuncture might improve the UPDRS score, Webster score, and total effective rate in treatment of PD. It might be a safe and useful adjunctive treatment for patients with PD. However, we should interpret the findings of these reviews with caution, considering the overall limited methodological and reporting quality.
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Affiliation(s)
- Liujiao Cao
- School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Xiuxia Li
- School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Meixuan Li
- School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Liang Yao
- Chinese Medicine Faculty of Hong Kong Baptist University, Hong Kong
| | - Liangying Hou
- School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Weiyi Zhang
- School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Yongfeng Wang
- Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Junqiang Niu
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China.
| | - Kehu Yang
- School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.
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Xu Y, Cai X, Qu S, Zhang J, Zhang Z, Yao Z, Huang Y, Zhong Z. Madopar combined with acupuncture improves motor and non-motor symptoms in Parkinson’s disease patients: A multicenter randomized controlled trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2019.101049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Physiological impact of nanoporous acupuncture needles: Laser Doppler perfusion imaging in healthy volunteers. PLoS One 2019; 14:e0226304. [PMID: 31826009 PMCID: PMC6905535 DOI: 10.1371/journal.pone.0226304] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/22/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Recently, porous acupuncture (PA), which is anodized to increase its surface area for higher stimulation intensity, was developed and showed significantly improved therapeutic effects with more comfort as compared with original acupuncture (OA) in vivo. However, the impact of PA on the change of local blood flow as well as its efficacy and acceptability has not yet been confirmed in a clinical trial. In a randomized, controlled crossover clinical trial, we investigated the effects of PA on the change in local blood flow using laser Doppler perfusion imaging and considered the sensation of pain intensity and discomfort severity using a visual analogue scale (VAS) to explore its physiological impact and the possibility of PA in clinical use. METHODS Twenty-one healthy participants were randomly treated with PA or OA on one side of Zusanli (ST36) and each participant served as his or her own control. Baseline local blood flow and galvanic skin response (GSR) were obtained for 5 min and acupuncture interventions were subsequently performed. Next, local blood flow and GSR were subsequently obtained for 10 min after insertion, 10 min after manipulation, and 5 min after the withdrawal of acupuncture. At the end of the experiment, participants were asked to indicate the sensation of pain intensity at each session of insertion, retention, manipulation, and withdrawal as well as the overall pain intensity and discomfort severity. RESULTS PA significantly increased the local blood flow as compared with OA and there was no significant difference in GSR between patients treated with PA versus OA in each phase of insertion and manipulation. No significant difference in pain intensity or discomfort severity was found during manipulation, retention, or withdrawal of acupuncture. CONCLUSIONS These results indicate that PA increases local blood flow, which can be closely related to the observed enhanced performance, without any associated discomfort or pain, suggesting its applicability in clinical practice.
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Li K, Wang Z, Chen Y, Shen L, Li Z, Wu Y, Yuan C, Huang Y, Wu L, Bao C, Zhang W, Xu S, Wu H. Efficacy of electroacupuncture for the treatment of constipation in Parkinson's disease: study protocol for a multicentre randomised controlled trial. BMJ Open 2019; 9:e029841. [PMID: 31780587 PMCID: PMC6886972 DOI: 10.1136/bmjopen-2019-029841] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 08/27/2019] [Accepted: 10/31/2019] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Constipation is one of the most common non-motor symptoms in Parkinson's disease (PD). Acupuncture can have a positive on chronic functional constipation and PD, but its efficacy for the treatment of constipation in PD has not yet been confirmed by high-quality clinical trials. Therefore, this study aims to evaluate the efficacy and safety of electroacupuncture (EA) in the treatment of constipation in PD. METHODS AND ANALYSIS This study is a multicentre randomised controlled trial. A total of 124 qualified patients with PD and constipation will be randomly divided into the intervention group (62 participants will receive 12 weeks of EA +usual care) or the waitlist control group (62 participants will receive 12 weeks of usual care). EA will be performed three times per week from weeks 1-8, two times per week during weeks 9 and 10, and once a week during weeks 11 and 12. The primary outcome is the change in mean weekly spontaneous bowel movements from baseline to weeks 8 and 9. The secondary outcomes are the changes from baseline in mean weekly bowel movements, mean weekly stool consistency, and mean weekly straining. Other secondary outcomes include the weekly doses of defecation drugs, Visual Analogue Scale for subjective improvements in stool symptoms, Unified Parkinson's Disease Rating Scale, and the time and number of steps required to walk 20 m. Outcomes will be assessed at baseline, week 4, 8, 12 (intervention period); as well as at week 16, 24 (follow-up period). ETHICS AND DISSEMINATION Ethical approval has been obtained from four local ethics committees. The results of the study will be published in peer-reviewed journals and will be disseminated through national and international conferences. TRIAL REGISTRATION NUMBER ChiCTR1900021053.
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Affiliation(s)
- Kunshan Li
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhaoqin Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yiyi Chen
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lirong Shen
- Shanghai Pudong New Area Hospital of Chinese Medicine, Shanghai, China
| | - Zhongqiu Li
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yiwen Wu
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Canxing Yuan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Huang
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Luyi Wu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunhui Bao
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Zhang
- Departement of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Shifen Xu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huangan Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Chien TJ, Liu CY, Fang CJ, Kuo CY. The maintenance effect of acupuncture on breast cancer-related menopause symptoms: a systematic review. Climacteric 2019; 23:130-139. [PMID: 31612733 DOI: 10.1080/13697137.2019.1664460] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Acupuncture has been used for many breast cancer treatment-related problems, but how long the effect lasts is unknown. This meta-analysis aims to evaluate how long the effect of acupuncture on breast cancer-related hot flushes and menopause symptoms lasts.Methods: The research design followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, without language restrictions. Seven databases from inception through February 2019 were accessed; only randomized clinical trials (RCTs) that examined the maintenance effect of acupuncture on hot flushes or menopause symptoms after treatment were included. Cochrane criteria were followed and RevMan 5.2 software was used to analyze trials.Results: In total, 943 patients from 13 RCTs were analyzed. The meta-analysis showed that acupuncture had no significant long-term maintenance effect on the frequency or severity of hot flushes (p = 0.29; p = 0.34), but had a significant 3-month maintenance effect of ameliorating menopause symptoms at 3 months after treatment ended (p = 0.001). No adverse events were reported.Conclusions: Acupuncture significantly alleviated menopause symptoms for at least 3 months, but not hot flushes. Breast cancer patients concerned about the adverse effects of hormone therapy could consider acupuncture as an alternative. Additional acupuncture at 3 months after the initial treatment course could be considered. A large-scale study may help to define the optimal guideline for this issue.
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Affiliation(s)
- T-J Chien
- Division of Hemato-Oncology, Department of Internal Medicine, Branch of Zhong-Zhou and Jen-Ai, Taipei City Hospital, Taipei, Taiwan.,Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
| | - C-Y Liu
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan.,School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Flourish Traditional Chinese Medicine Clinic, Taipei, Taiwan
| | - C-J Fang
- Medical Library, National Cheng Kung University, Tainan, Taiwan.,Department of Secretariat, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - C-Y Kuo
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
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31
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Drug-Induced Gastrointestinal Dysfunction in Parkinson’s Disease: Treatment with Korean Medicine. JOURNAL OF ACUPUNCTURE RESEARCH 2019. [DOI: 10.13045/jar.2019.00066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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32
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The Neuroscience of Nonpharmacological Traditional Chinese Therapy (NTCT) for Major Depressive Disorder: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2183403. [PMID: 31223326 PMCID: PMC6541968 DOI: 10.1155/2019/2183403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 04/18/2019] [Accepted: 05/05/2019] [Indexed: 02/05/2023]
Abstract
Background Depression is a common disease affecting a large number of people across the world. Many researchers have focused on treatment for depression based on Western scientific approaches, but research based on traditional Chinese medicine (TCM) interventions, studying its clinical effectiveness and the underlying mechanisms involved, has been limited. The aim of this review is to conduct a pioneering systematic review with meta-analysis of existing studies that investigate the neuroscience basis of nonpharmacological traditional Chinese therapy (NTCT). Methods Both English (Pubmed, Embase, Scopus, SPORTDiscus, PsycINFO) and Chinese (China National Knowledge Infrastructure (CNKI)) databases were searched from inception to October 2018. The effects of NTCT on major depressive disorder, brain activity, and neurophysiological biomarker related outcomes were extracted. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. The effect size of each study was reported by the mean difference of change scores. Results Six of twelve eligible studies showed that there was a significant improvement in favor of acupuncture in depressive symptoms (SMD -0.69, 95% CI -1.09 to -0.28, p=0.002, I 2 = 73%, p< 0.0008). Based on the available evidence, NTCT including acupuncture, Qigong, and Tai Chi was found to possibly improve brain metabolites, brain activity, and immune and endocrine systems in patients with major depressive disorder. Conclusions Acupuncture could effectively relieve depressive syndromes. The clinical effects of acupuncture might be attributable to their influence on three proposed pathways, namely, the hypothalamic-pituitary-adrenal (HPA) axis, the locus coeruleus (LC)-immunity pathway, and the negative feedback loop of the hippocampus. Nevertheless, conclusions are limited due to the small number of studies included and the low-quality of the study designs. In the future, a cross-sectional study is needed to test the proposed plausible pathways. PROSPERO registration number is CRD42017080937.
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Woo Y, Hyun MK. Effectiveness of Integrative Therapy for Parkinson's Disease Management. Front Aging Neurosci 2019; 11:40. [PMID: 30863304 PMCID: PMC6399136 DOI: 10.3389/fnagi.2019.00040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 02/11/2019] [Indexed: 01/26/2023] Open
Abstract
Objectives: To investigate the effectiveness of integrative therapy on prevalence and length of hospitalization and management of major complications of Parkinson’s disease (PD) in the South Korea. Methods: This study was a retrospective cohort analysis conducted using the National Health Insurance Service-National Sample Cohort in the South Korea. Patients over 65 years old who were newly diagnosed with PD during 2007–2011 were identified. The integrative therapy group was defined as patients treated with both Korean medicine (KM) and biomedicine, and the monotherapy group consisted of patients treated with biomedicine alone. From PD diagnosis to 2013, the prevalence and annual length of hospitalization because of PD and major complications (dementia, depression and pneumonia/sepsis) were analyzed using logistic regression, ANOVA and t-tests after propensity score (PS) matching with a 1:1 ratio. Results: After PS estimation and matching, the cohort used in the analysis included 228 subjects (114 integrative therapy group, 114 monotherapy group). Sex, age, index year, comorbidity, severity of disability, neurologic care, and anti-parkinsonism medication (levodopa, ropinirole, pramipexole, selegiline) were adjusted in both groups. The prevalence of hospitalization due to pneumonia/sepsis was 0.50 times (95% C.I.: 0.26–0.96) lower in the integrative therapy group than the monotherapy group, which was statistically significant (p = 0.038). The prevalence and annual length of total hospitalization and hospitalization because of PD, dementia, and depression in the integrative therapy group showed positive results compared to the monotherapy group, but these differences were not statistically significant. Conclusion: It has not been clearly identified that integrative therapy with KM and biomedicine for PD management is better treatment for patients compared to biomedicine monotherapy; however, we found a clue of better result in integrated therapy. Therefore, further investigation by increasing the number of subjects is needed to confirm the findings presented herein.
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Affiliation(s)
- Yeonju Woo
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University Graduate School, Seoul, South Korea
| | - Min Kyung Hyun
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, South Korea
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Jiang F, Yang T, Yin H, Guo Y, Namba H, Sun Z, Asakawa T. Evidence for the Use of Acupuncture in Treating Parkinson's Disease: Update of Information From the Past 5 Years, a Mini Review of the Literature. Front Neurol 2018; 9:596. [PMID: 30090084 PMCID: PMC6068266 DOI: 10.3389/fneur.2018.00596] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/04/2018] [Indexed: 12/24/2022] Open
Abstract
Acupuncture is an alternative therapy for Parkinson's disease (PD), but its efficacy and safety are controversial. Our previous study, which reviewed the literature from 1974 to 2012, could not find enough evidence from rigorously designed randomized, controlled trials (RCTs) to make a conclusion about the efficacy of acupuncture. Recently, more RCTs and meta-analyses have been conducted to evaluate the efficacy of acupuncture. The aim of our current study is to provide updated information in brief on this topic. In this study, we analyzed and summarized seven RCTs and four meta-analyses. Although all included studies were not of high quality, we found that there has been a tremendous progress in acupuncture research in treating Parkinson's disease (PD) during the past 5 years, based on our experience and insights into the behavioral assessments of PD. First, the numbers of RCTs and meta-analyses based on RCTs are increasing. Second, non-motor symptoms are increasingly emphasized. Third, objective behavioral assessment tools are being employed. Although recent studies can provide limited evidence for the efficacy of acupuncture, we make the following recommendations for the future investigation: First, large, multicenter, well-designed RCTs should be organized for evaluation of the efficacy of acupuncture. Second, objective assessments using novel computerized technologies should be considered. Third, target symptoms should be selected and evaluated instead of only performing global evaluations. Fourth, attention should be paid to the efficacy of scalp acupuncture. Fifth, the safety of acupuncture should be evaluated and reported.
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Affiliation(s)
- Fan Jiang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tiansong Yang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hongna Yin
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yuhuai Guo
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hiroki Namba
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Japan
| | - Zhongren Sun
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tetsuya Asakawa
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Japan.,Research Base of Traditional Chinese Medicine Syndrome, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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35
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Otayza J, Juri C. Is acupuncture an alternative for the treatment of Parkinson’s Disease? Medwave 2018; 18:e7198. [DOI: 10.5867/medwave.2018.03.7197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 12/28/2017] [Indexed: 11/27/2022] Open
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Birch S, Lee MS, Alraek T, Kim TH. Overview of Treatment Guidelines and Clinical Practical Guidelines That Recommend the Use of Acupuncture: A Bibliometric Analysis. J Altern Complement Med 2018; 24:752-769. [PMID: 29912569 DOI: 10.1089/acm.2018.0092] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION As positive evidence emerges for the use of an intervention to treat a health problem, the intervention gradually becomes incorporated into treatment guidelines (TGs) or clinical practice guidelines (CPGs) that are related to that health problem. To assess whether this general hypothesis can apply to acupuncture, 96 health problems were identified for which positive conclusions in systematic reviews and meta-analyses regarding the effectiveness of acupuncture have been made and then searched for TGs or CPGs that have recommended the use of acupuncture. METHODS Through August 31, 2017, searches were performed in relevant medical databases and Google using "treatment guideline," "clinical practice guideline," and the names of the 96 medical conditions as search terms. A "snow-balling" search approach was adopted. All positive recommendations were added into the registry. RESULTS A total of 1311 publications were found that recommended using acupuncture published between 1991 and 2017. The number per year reached 50 in 2005 and 100 in 2009. In addition, 2189 positive recommendations were found for the use of acupuncture. Of these, 1486 were related to 107 pain indications and 703 were related to 97 nonpain indications. These recommendations were made by a wide range of groups, such as government health institutions, national guideline, and medical specialty groups. The recommendations came from around the world but were especially abundant in North America, Europe, and Australasia. DISCUSSION AND CONCLUSION Considerably more recommendations were found for the use of acupuncture than are known within the acupuncture or medical communities. A trend by year was also found; a rise in the number of positive statements about acupuncture was typically followed by a rise in the number of recommendations of acupuncture. Thus, the recommendations followed the emergent evidence for acupuncture. Better implementation plans need to be developed for the CPG/TG recommendations about acupuncture to be more effective/efficient.
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Affiliation(s)
- Stephen Birch
- 1 Department of Health Sciences, Kristiania University College , Oslo, Norway
| | - Myeong Soo Lee
- 2 Clinical Medicine Division, Korea Institute of Oriental Medicine , Daejeon, Republic of South Korea
| | - Terje Alraek
- 1 Department of Health Sciences, Kristiania University College , Oslo, Norway .,3 Department of Community Medicine, Faculty of Medicine, National Research Centre in Complementary and Alternative Medicine, UiT The Arctic University of Norway , Tromso, Norway
| | - Tae-Hun Kim
- 4 Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University , Seoul, Republic of Korea
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37
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Blonder LX. Historical and cross-cultural perspectives on Parkinson's disease. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2018; 15:/j/jcim.ahead-of-print/jcim-2016-0065/jcim-2016-0065.xml. [PMID: 29738310 DOI: 10.1515/jcim-2016-0065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 03/22/2018] [Indexed: 12/14/2022]
Abstract
Abstract
Parkinson’s disease (PD) is a common neurodegenerative disorder, affecting up to 10 million people worldwide according to the Parkinson’s Disease Foundation. Epidemiological and genetic studies show a preponderance of idiopathic cases and a subset linked to genetic polymorphisms of a familial nature. Traditional Chinese medicine and Ayurveda recognized and treated the illness that Western Medicine terms PD millennia ago, and descriptions of Parkinson’s symptomatology by Europeans date back 2000 years to the ancient Greek physician Galen. However, the Western nosological classification now referred to in English as “Parkinson’s disease” and the description of symptoms that define it, are accredited to British physician James Parkinson, who in 1817 authored The Shaking Palsy. Later in the nineteenth century, French neurologist Jean-Martin Charcot re-labeled paralysis agitans “Parkinson’s disease” and over a century of scientific research ensued. This review discusses European, North American, and Asian contributions to the understanding and treatment of PD from ancient times through the twentieth century.
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Affiliation(s)
- Lee Xenakis Blonder
- Sanders- Brown Center on Aging and Departments of Behavioral Science, Neurology and Anthropology, University of Kentucky, 101 Sanders-Brown Center on Aging, Lexington, KY 40536-0230,USA
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Li W, Luo Y, Fu W, Lei R. Acupuncture May Improve Quality of Life in Menopausal Women: A Meta-Analysis of Randomized Controlled Trials. Complement Med Res 2017; 25:183-190. [PMID: 29020676 DOI: 10.1159/000479630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This analysis aims to identify, on the basis of the results of randomized controlled trials (RCTs), whether acupuncture therapy can alleviate menopausal symptoms and promote health-related quality of life. METHODS We included RCTs that directly compared any type of acupuncture with sham acupuncture in treating menopause-related symptoms and which were published from January 1, 2010 to December 31, 2016 in 6 electronic databases. Two authors performed this work independently; 'risk-of-bias' assessment and data extraction were also independently performed by these 2 review authors. The outcomes are presented as scores of the menopause rating scale (MRS), which represents the self-assessment of patients. RESULTS Six studies were included. Our analysis found that acupuncture can reduce the MRS score in menopausal women by the end of the treating period (2-3 months, on average) and even in the follow-up period (1-3 months), not only in the total score but also in each subscale score. But the grade of evidence is very low. CONCLUSIONS Both the total score and the subgroup analysis strongly indicated that acupuncture can alleviate menopause-related symptoms. However, the evidence is not very strong. Thus, further studies about the efficiency of acupuncture on menopausal symptoms based on well-designed trials are needed.
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Moxibustion for idiopathic Parkinson’s disease: A systematic review and meta-analysis of randomized controlled trials. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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40
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Gandolfi M, Geroin C, Antonini A, Smania N, Tinazzi M. Understanding and Treating Pain Syndromes in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:827-858. [PMID: 28805585 DOI: 10.1016/bs.irn.2017.05.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pain affects many people with Parkinson's disease (PD) and diminishes their quality of life. Different types of pain have been described, but their related pathophysiological mechanisms remain unclear. The aim of this chapter is to provide movement disorders specialists an update about the pathophysiology of pain and a practical guide for the management of pain syndromes in clinical practice. This chapter reviews current knowledge on the pathophysiological mechanisms of sensory changes and pain in PD, as well as assessment and treatment procedures to manage these symptoms. In summary, changes in peripheral and central pain processing have been demonstrated in PD patients. A decrease in pain threshold and tolerance to several stimuli, a reduced nociceptive withdrawal reflex, a reduced pain threshold, and abnormal pain-induced activation in cortical pain-related areas have been reported. There is no direct association between improvement of motor symptoms and sensory/pain changes, suggesting that motor and nonmotor symptoms do not inevitably share the same mechanisms. Special care in pain assessment in PD is warranted by the specific pathophysiological aspects and the complexity of motor and nonmotor symptoms associated with pain symptoms. Rehabilitation may represent a valid option to manage pain syndromes in PD. However, further research in this field is needed. An integrated approach to pain involving a multidisciplinary team of medical specialists and rehabilitation experts should allow a comprehensive approach to pain in PD.
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Affiliation(s)
- Marialuisa Gandolfi
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), University of Verona, Verona, Italy; Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Christian Geroin
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), University of Verona, Verona, Italy
| | - Angelo Antonini
- University of Padua and Hospital San Camillo IRCCS, Venice, Italy
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), University of Verona, Verona, Italy; Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Michele Tinazzi
- Neurology Unit, Movement Disorders Division, University of Verona, Verona, Italy.
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The endocannabinoid system, a novel and key participant in acupuncture's multiple beneficial effects. Neurosci Biobehav Rev 2017; 77:340-357. [PMID: 28412017 DOI: 10.1016/j.neubiorev.2017.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/31/2017] [Accepted: 04/06/2017] [Indexed: 12/22/2022]
Abstract
Acupuncture and its modified forms have been used to treat multiple medical conditions, but whether the diverse effects of acupuncture are intrinsically linked at the cellular and molecular level and how they might be connected have yet to be determined. Recently, an emerging role for the endocannabinoid system (ECS) in the regulation of a variety of physiological/pathological conditions has been identified. Overlap between the biological and therapeutic effects induced by ECS activation and acupuncture has facilitated investigations into the participation of ECS in the acupuncture-induced beneficial effects, which have shed light on the idea that the ECS may be a primary mediator and regulatory factor of acupuncture's beneficial effects. This review seeks to provide a comprehensive summary of the existing literature concerning the role of endocannabinoid signaling in the various effects of acupuncture, and suggests a novel notion that acupuncture may restore homeostasis under different pathological conditions by regulating similar networks of signaling pathways, resulting in the activation of different reaction cascades in specific tissues in response to pathological insults.
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