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Lu PH, Chuo HE, Chiu LY, Lai CC, Wang JY, Lu PH. Comparative efficacy of acupuncture point stimulation treatments for dialysis patients with uremic pruritus: a systematic review and network meta-analysis. Front Neurol 2024; 15:1342788. [PMID: 38595850 PMCID: PMC11003387 DOI: 10.3389/fneur.2024.1342788] [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: 11/30/2023] [Accepted: 03/11/2024] [Indexed: 04/11/2024] Open
Abstract
Background Uremic pruritus (UP) is a common complication of chronic kidney disease that causes sleep disturbances and increases all-cause mortality. Currently, the first-line medications for UP exhibit inadequate pruritus control with adverse effects. Various acupuncture point stimulation treatments (APSTs) have been shown to be effective as adjuvant therapies in UP, and a network meta-analysis can offer relative efficacy estimates for treatments for which head-to-head studies have not been performed. Methods We conducted a random-effects network meta-analysis on a consistency model to compare the different APSTs for UP. The primary outcomes were the mean visual analog scale (VAS) score and effectiveness rate (ER). Results The network meta-analysis retrieved 27 randomized controlled trials involving 1969 patients. Compared with conventional treatment alone, combination treatment with acupuncture (mean difference, -2.63; 95% confidence interval, -3.71 to -1.55) was the most effective intervention in decreasing VAS scores, followed by acupoint injection and massage (mean difference, -2.04; 95% confidence interval, -3.96 to -0.12). In terms of the ER, conventional treatment with acupuncture and hemoperfusion (risk ratio, 14.87; 95% confidence interval, 2.18 to 101.53) was superior to other therapeutic combinations. Considering the VAS score and ER, combination treatment with acupoint injection and massage showed benefits in treating UP. Conclusion Our network meta-analysis provided relative efficacy data for choosing the optimal adjuvant treatment for UP. Combined treatment with acupuncture was more effective than conventional treatment only and was the most promising intervention for treating UP.Systematic review registration: PROSPERO (CRD42023425739: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023425739).
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Affiliation(s)
- Po-Hsuan Lu
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Hui-En Chuo
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ling-Ya Chiu
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medical Education, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chien-Cheng Lai
- Department of Medical Education, MacKay Memorial Hospital, Taipei, Taiwan
| | - Jen-Yu Wang
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ping-Hsun Lu
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
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Pérez Hernández MF, Calderón Vallejo A, Aguilar Castillo SDJ, Gómez Jiménez DC, Rodríguez Guerrero E, Aguilar Morales F, Moreno Tovar MG, Zurita Muñóz MA, Bautista Cortéz AE, Calzada Mendoza CC, De Nova Ocampo MA, Ordóñez Rodríguez JM, Gómez Esquivel ML, García Méndez A, Flores Gil O, Macías Zaragoza VM, Cortés Moreno GY, Salinas Lara C, Velázquez García G, Saldivar Cerón HI, Pérez Navarro LM, Ávila Jiménez L, Gómez Zamudio JH, Díaz Flores M, Cruz López M, Ocharan Hernández ME, Peralta Romero JDJ. Electroacupuncture efficacy in diabetic polyneuropathy: Study protocol for a double-blinded randomized controlled multicenter clinical trial. BMC Complement Med Ther 2024; 24:90. [PMID: 38360684 PMCID: PMC10868023 DOI: 10.1186/s12906-024-04375-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Diabetic peripheral neuropathy (DPN) is the most common complication of type 2 diabetes mellitus (T2DM); its diagnosis and treatment are based on symptomatic improvement. However, as pharmacological therapy causes multiple adverse effects, the implementation of acupunctural techniques, such as electroacupuncture (EA) has been suggested as an alternative treatment. Nonetheless, there is a lack of scientific evidence, and its mechanisms are still unclear. We present the design and methodology of a new clinical randomized trial, that investigates the effectiveness of EA for the treatment of DPN. METHODS This study is a four-armed, randomized, controlled, multicenter clinical trial (20-week intervention period, plus 12 weeks of follow-up after concluding intervention). A total of 48 T2DM patients with clinical signs and symptoms of DPN; and electrophysiological signs in the Nerve Conduction Study (NCS); will be treated by acupuncture specialists in outpatient units in Mexico City. Patients will be randomized in a 1:1 ratio to one of the following four groups: (a) short fibre DPN with EA, (b) short fibre DPN with sham EA, (c) axonal DPN with EA and (d) axonal DPN with sham EA treatment. The intervention will consist of 32 sessions, 20 min each, per patient over two cycles of intervention of 8 weeks each and a mid-term rest period of 4 weeks. The primary outcome will be NCS parameters, and secondary outcomes will include DPN-related symptoms and pain by Michigan Neuropathy Screening Instrument (MNSI), Michigan Diabetic Neuropathy Score (MDNS), Dolour Neuropatique Score (DN-4), Semmes-Westein monofilament, Numerical Rating Scale (NRS) for pain assessment, and the 36-item Short Form Health Survey (SF-36). To measure quality of life and improve oxidative stress, the inflammatory response; and genetic expression; will be analysed at the beginning and at the end of treatment. DISCUSSION This study will be conducted to compare the efficacy of EA versus sham EA combined with conventional diabetic and neuropathic treatments if needed. EA may improve NCS, neuropathic pain and symptoms, oxidative stress, inflammatory response, and genetic expression, and it could be considered a potential coadjutant treatment for the management of DPN with a possible remyelinating effect. TRIAL REGISTRATION ClinicalTrials.gov. NCT05521737 Registered on 30 August 2022. International Clinical Trials Registry Platform (ICTRP) ISRCTN97391213 Registered on 26 September 2022 [2b].
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Affiliation(s)
- María Fernanda Pérez Hernández
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Mexico City, 06720, Mexico
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, 11340, Mexico
- Red MEDICI. Carrera de Médico Cirujano. FES Iztacala, UNAM, Estado de México, State of Mexico, 54090, Mexico
| | - Alejandra Calderón Vallejo
- Departamento de Neurología de la Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Mexico City, 06720, Mexico
| | - Sergio de Jesús Aguilar Castillo
- Departamento de Neurofisiología de la Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Mexico City, 06720, Mexico
| | - Daniel Cuauhtémoc Gómez Jiménez
- Sección de Estudios de Posgrado e Investigación, Especialidad en Acupuntura Humana, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City, 07320, Mexico
| | - Eduardo Rodríguez Guerrero
- Sección de Estudios de Posgrado e Investigación, Especialidad en Acupuntura Humana, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City, 07320, Mexico
| | | | | | | | | | - Claudia Camelia Calzada Mendoza
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, 11340, Mexico
| | - Mónica Ascención De Nova Ocampo
- Sección de Estudios de Posgrado e Investigación, Escuela Nacional de Medicina y Homeopatía del Instituto Politécnico Nacional. Maestría en Ciencias en Biomedicina Molecular, Mexico City, 07320, Mexico
| | - Juan Manuel Ordóñez Rodríguez
- Sección de Estudios de Posgrado e Investigación, Especialidad en Acupuntura Humana, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City, 07320, Mexico
| | - Mónica Luz Gómez Esquivel
- Sección de Estudios de Posgrado e Investigación, Especialidad en Acupuntura Humana, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City, 07320, Mexico
| | | | - Octavio Flores Gil
- Coordinación de Internado y Servicio Social, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City, 07320, Mexico
| | | | | | - Citlaltepetl Salinas Lara
- Red MEDICI. Carrera de Médico Cirujano. FES Iztacala, UNAM, Estado de México, State of Mexico, 54090, Mexico
- Departamento de Neuropatología, Instituto Nacional de Neurología y Neurocirugía, Mexico City, 14269, Mexico
| | - Germán Velázquez García
- Red MEDICI. Carrera de Médico Cirujano. FES Iztacala, UNAM, Estado de México, State of Mexico, 54090, Mexico
- Carrera de Médico Cirujano Facultad de Estudios Superiores Zaragoza, UNAM, Mexico City, 09239, Mexico
- Universidad Intercultural del Estado de México Plantel Tepetlixpa, Tepetlixpa, Estado de México, 56880, México
| | - Héctor Iván Saldivar Cerón
- Red MEDICI. Carrera de Médico Cirujano. FES Iztacala, UNAM, Estado de México, State of Mexico, 54090, Mexico
- Carrera de Médico Cirujano, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla, State of Mexico, 54090, Mexico
- Unidad de Biomedicina (UBIMED), Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla, State of Mexico, 54090, Mexico
| | | | - Laura Ávila Jiménez
- Coordinación Auxiliar Médica de Investigación en Salud, Jefatura de Servicios de Prestaciones Médicas, Delegación Estatal Morelos, IMSS, Cuernavaca, Morelos, 62000, Mexico
| | - Jaime Héctor Gómez Zamudio
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Mexico City, 06720, Mexico
| | - Margarita Díaz Flores
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Mexico City, 06720, Mexico
| | - Miguel Cruz López
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Mexico City, 06720, Mexico
| | - María Esther Ocharan Hernández
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, 11340, Mexico
| | - José de Jesús Peralta Romero
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Mexico City, 06720, Mexico.
- Sección de Estudios de Posgrado e Investigación, Especialidad en Acupuntura Humana, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City, 07320, Mexico.
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Wang SH, Liang RL, Yang H, Cai XC, Wang J, Sun XY, Chen JL, Wang CX, Jiang WC, Li X. Electroacupuncture for relieving itching in atopic eczema: study protocol for a multicenter, randomized, sham-controlled trial. Front Med (Lausanne) 2023; 10:1320230. [PMID: 38173936 PMCID: PMC10761491 DOI: 10.3389/fmed.2023.1320230] [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: 10/12/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Background Atopic eczema (AE) is a common atopic inflammatory skin disease affecting 2.1-4.9% of the population in different countries. Pruritus, one of the most burdensome symptoms, is often underestimated for the problems it can cause, creating a vicious loop of itching, scratching, and lichenification. Therefore, further research into practical and safe treatments that relieve itchy symptoms and enhance skin protection is key to overcoming AE. Acupuncture, with or without electrical stimulation, is one of the most commonly used therapeutic measures to treat AE. This trial aimed to objectively evaluate the efficacy and safety of the electroacupuncture (EA) antipruritic technique in AE pruritus and obtain high-level clinical evidence for the popularization and application of EA for AE. Methods and analysis This multicenter, single-blinded, randomized controlled trial is planned to transpire from April 15, 2023, to June 30, 2025. We will recruit 132 participants with AE (44 per group). Participants will be assigned randomly to three equal-sized groups: EA, sham electroacupuncture, and sham acupuncture. Treatment will be administered three times a week during the 2-week intervention phase. The primary outcome measure is the Visual Analog Scale, with a numeric rating scale to evaluate pruritus. Secondary outcome measures include the Eczema Area and Severity Index and Dermatology Life Quality Index. Other outcome measures include physical examination, serum IgE, and safety evaluation. The number, nature, and severity of adverse events will be carefully recorded. Trial registration ClinicalTrials.gov, 22Y11922200. Registered 3 September 2022, https://register.clinicaltrials.gov.
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Affiliation(s)
- Si-han Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Rui-long Liang
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Han Yang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-ce Cai
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Jiao Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-ying Sun
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Jia-le Chen
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Chun-xiao Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Wen-cheng Jiang
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
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The Efficacy and Safety of Acupuncture in the Treatment of Neurodermatitis: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8182958. [PMID: 36091587 PMCID: PMC9458408 DOI: 10.1155/2022/8182958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/15/2022] [Indexed: 11/30/2022]
Abstract
Background Neurodermatitis is a common chronic inflammatory skin disease associated with neurological dysfunction. This study aimed to explore the efficacy and safety of acupuncture and moxibustion in the treatment of neurodermatitis through meta-analysis. Methods We comprehensively searched 9 databases, including PubMed, Cochrane Library, EMBASE, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and China Biomedicine (CBM), from their inception to November 15, 2021, for published neurological and clinical randomized controlled trials (RCTs) using acupuncture to treat dermatitis. We also searched gray literature in four databases: Chinese Clinical Trials Registry, Chinese Cochrane Center, Open Grey, and GreyNet International. Two authors independently screened the data, extracted the literature, and evaluated the quality of the literature using Cochrane 5.3.3 and Review Manager 5.4.1 software. Results The meta-analysis included 8 studies with a total of 728 participants, including 369 patients in the treatment group and 359 patients in the control group. Compared with conventional treatment, acupuncture significantly increased the effective rate (OR: 2.90, 95% CI: 1.78∼4.75; p < 0.001) and decreased the recurrence rate after treatment (OR: 0.26, 95% CI: 0.12∼0.59; p=0.001). Meanwhile, analysis of disease symptom scores showed that acupuncture group had a greater impact (OR: 3.51, 95% CI: 2.12∼4.91; p < 0.00001). Furthermore, no significant difference in the adverse reaction rate was observed. Conclusion Acupuncture is safe and effective in treating neurodermatitis. However, the current level of research evidence is limited, and therefore, larger sample and high-quality RCTs are needed to confirm its safety and effectiveness. Protocol registration number is INPLASY2021110041.
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Israel L, Rotter G, Förster-Ruhrmann U, Hummelsberger J, Nögel R, Michalsen A, Tissen-Diabaté T, Binting S, Reinhold T, Ortiz M, Brinkhaus B. Acupressure in patients with seasonal allergic rhinitis: a randomized controlled exploratory trial. Chin Med 2021; 16:137. [PMID: 34922567 PMCID: PMC8684198 DOI: 10.1186/s13020-021-00536-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/10/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Acupuncture has shown beneficial effects for seasonal allergic rhinitis (SAR); however, it is time and cost intensive. We investigated feasibility and effects of self-administered body acupressure as a self-care technique that stimulates acupuncture points with manual pressure in SAR patients. METHODS We conducted a two-armed randomized controlled exploratory trial to compare effects of self-administered acupressure over 4 weeks at five acupuncture points plus rescue medication (RM) with cetirizine compared to RM alone in SAR patients. Among other outcome parameters, we assessed disease-related quality of life (Rhinitis Quality of Life Questionnaire [RQLQ]), overall SAR symptoms by a visual analogue scale (VAS) and a rescue medication score (RMS) after 4 and 8 weeks. RESULTS Forty-one SAR patients (mean age 38.5 ± 10.0 years, n = 21, 51.2% women) were randomized. Compared to RM alone (n = 21), acupressure plus RM (n = 20) was associated with relevant improvements after 4 weeks, shown by the difference between groups in adjusted means of RQLQ: - 0.9 points (95% CI - 1.6 to - 0.2; p = 0.011) and VAS overall SAR symptoms: - 21.6 mm (95% CI - 36.3 to - 6.8; p = 0.005). The RMS was lower in the acupressure group than in the control group: 1.9 points (95% CI - 3.8 to - 0.1; p = 0.120). Group differences decreased slightly until week 8. The acupressure was feasible and safe. CONCLUSION Results of this exploratory study indicate that self-applied acupressure is feasible, may improve disease-specific quality of life and reduce disease-related symptoms as well as anti-allergic medication intake in SAR patients. High-quality confirmatory studies including a sham-control group are needed in the future. Trial registration DRKS-ID: DRKS00014310. Date of registration in DRKS: 2018/04/24. Investigator sponsored/initiated trial (IST/IIT): yes. Ethics approval/approval of the ethics committee: Approved (leading) Ethics Committee No. EA1/033/18, Ethik-Kommission der Charité -Universitätsmedizin Berlin. URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00014310.
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Affiliation(s)
- Lukas Israel
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Gabriele Rotter
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Ulrike Förster-Ruhrmann
- Department for Otolaryngology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Platz 1, 10117, Berlin, Germany
| | - Josef Hummelsberger
- Societas Medicinae Sinensis (SMS) e.V. - International Society for Chinese Medicine, Franz-Joseph-Straße 38, 80801, Munich, Germany
| | - Rainer Nögel
- Societas Medicinae Sinensis (SMS) e.V. - International Society for Chinese Medicine, Franz-Joseph-Straße 38, 80801, Munich, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Tatjana Tissen-Diabaté
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany.
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
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Kim KY, Kim JSTW, Tsai AWW, Hsing WT. Acupuncture for the Treatment of Itch: Literature Review and Future Perspectives. Med Acupunct 2021; 33:137-143. [PMID: 33912270 DOI: 10.1089/acu.2020.1445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Chronic pruritus is a prevalent, multifactorial and debilitating condition that is often underestimated. This article reviews current evidence to evaluate the efficacy of acupuncture for the treatment of itch. Results: Although many researchers have conducted observational studies, clinical trials, and systematic reviews on the subject, the lack of more-robust and well-designed studies to prove the effectiveness of acupuncture in the management of itch is evident. Many published studies are of poor quality, with no clear description of randomization methods, and an absence of control groups and measurable clinical outcomes. In addition, a lack of standardization in methods for assessing pruritus and the acupuncture treatment protocols hinders more-comprehensive and higher-quality pooled data analysis. Conclusions: Current evidence cannot fully support acupuncture for the treatment of itch yet.
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Affiliation(s)
- Kevin Yun Kim
- Acupuncture Center of the Orthopedics and Traumatology Institute, University of São Paulo Medical School, São Paulo, Brazil
| | | | - André Wan Wen Tsai
- Acupuncture Center of the Orthopedics and Traumatology Institute, University of São Paulo Medical School, São Paulo, Brazil
| | - Wu Tu Hsing
- Acupuncture Center of the Orthopedics and Traumatology Institute, University of São Paulo Medical School, São Paulo, Brazil
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SACCHELLI L, BOVINA G, GIOVANARDI CM, MAZZANTI U, FERRARA F, PATRIZI A, BARDAZZI F. AcuPru, a pilot study on acupuncture as a viable therapeutic approach to chronic itch: development of two experimental protocols among dermatological adult patients. GIORN ITAL DERMAT V 2021; 155:794-796. [DOI: 10.23736/s0392-0488.18.06158-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Efficacy of Acupuncture in Itch: A Systematic Review and Meta-Analysis of Clinical Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:208690. [PMID: 26064156 PMCID: PMC4430643 DOI: 10.1155/2015/208690] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 03/27/2015] [Accepted: 04/15/2015] [Indexed: 12/11/2022]
Abstract
Background. Itch (pruritus) is a sensitive state that provokes the desire to scratch. It is not only a common symptom of skin diseases but it also occurs in some systemic diseases. Clinical studies on the efficacy of the acupuncture therapy in alleviating itch are increasing, while systematic reviews assessing the efficacy of acupuncture therapy are still lacking. Objective. This systematic review aims to assess the effectiveness of acupuncture therapy for itch. Materials and Methods. A comprehensive literature search of eight databases was performed up to June 2014, and randomized controlled trials which compared acupuncture therapy and placebo acupuncture or no treatment group were identified. Accordingly, a meta-analysis was conducted. Results. This review included three articles of randomized controlled trials (RCTs) from a total of 2530 articles. The results of Meta-analysis showed that acupuncture therapy was effective to alleviate itch compared with placebo acupuncture and no treatment group. Conclusion. Based on the findings of this systematic review, we cautiously suggest that acupuncture therapy could improve the clinical efficacy of itch. However, this conclusion needs more studies on various ethnic samples to confirm our final conclusion.
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Tsai KS, Chen YH, Chen HY, Shen EY, Lee YC, Shen JL, Wu SY, Lin JG, Chen YH, Chen WC. Antipruritic effect of cold stimulation at the Quchi acupoint (LI11) in mice. Altern Ther Health Med 2014; 14:341. [PMID: 25239797 PMCID: PMC4179855 DOI: 10.1186/1472-6882-14-341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 09/16/2014] [Indexed: 12/15/2022]
Abstract
Background Acupuncture and moxibustion are used to treat pruritus and atopic dermatitis. However, whether cold stimulation (defined as that the temperature conducted under skin temperature) of acupoints affects itching in experimental murine models remains unclear. Methods The present study was designed to determine the therapeutic effects of different thermal stimulations at the Quchi acupoint (LI11) in a murine model in which scratching behaviour was elicited by subcutaneous injection with a pruritogenic agent (compound 48/80). Male ICR mice were divided into several groups as follows: control (saline), those receiving compound 48/80 and compound 48/80 with various thermal stimulations (5°C–45°C) at LI11 (n = 6 per group). The scratch response of each animal to these stimulations was recorded for 30 min. The antipruritic effect of the acupoint was further evaluated in LI11 and sham (non-acupoint) groups (n = 6 per group). Results Treatment with lower temperature (20°C) at the LI11 acupoint significantly attenuated compound 48/80-induced scratching; however, this antipruritic effect was not observed with stimulation at the sham point. The expression of c-fos in the neuron of the cervical spine induced by compound 48/80 was suppressed by cold stimulation at LI11. The antipruritic effect of cold stimulation was blocked by ruthium red (RR), a non-selective transient receptor potential (TRP) channel blocker, suggesting that TRP channels may play an important role in the antipruritic effect of cold stimulation at LI11 in mice. Conclusions This study demonstrated that cold stimulation at LI11 attenuated compound 48/80-induced scratching behaviour in mice, possibly by a TRP-related pathway.
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Electroacupuncture Attenuates 5'-Guanidinonaltrindole-Evoked Scratching and Spinal c-Fos Expression in the Mouse. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:319124. [PMID: 23878596 PMCID: PMC3708416 DOI: 10.1155/2013/319124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 04/25/2013] [Accepted: 04/26/2013] [Indexed: 12/13/2022]
Abstract
The present study was undertaken to investigate the influence of electroacupuncture (EA) on compulsive scratching in mice and c-Fos expression elicited by subcutaneous (s.c.) administration of a known puritogen, 5'-guanidinonaltrindole (GNTI) to the neck. Application of EA to Hegu (LI4) and Quchi (LI11) acupoints at 2 Hz, but not 100 Hz, attenuated GNTI-evoked scratching. In mice pretreated with the µ opioid receptor antagonist naloxone, EA 2 Hz did not attenuate GNTI-evoked scratching, whereas EA at 2 Hz did attenuate GNTI-evoked scratching in mice pretreated with the κ opioid receptor antagonist nor-binaltorphimine. Moreover, intradermal (i.d.) administration of the selective µ opioid receptor agonist [d-Ala2, N-Me-Phe4, Gly5-ol]-enkephalin acetate (DAMGO) attenuated GNTI-evoked scratching behavior, while s.c. administration of DAMGO was ineffective. GNTI provoked c-Fos expression on the lateral side of the superficial layer of the dorsal horn of the cervical spinal cord. Application of 2 Hz EA to LI4 and LI11 decreased the number of c-Fos positive nuclei induced by GNTI. It may be concluded that application of 2 Hz EA to LI4 and LI11 attenuates scratching behavior induced by GNTI in mice and that the peripheral µ opioid system is involved, at least in part, in the anti-pruritic effects of EA.
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