1
|
Fan AY. Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels and targets and is not limited to "driving the vagus-adrenal axis". JOURNAL OF INTEGRATIVE MEDICINE 2023:S2095-4964(23)00043-2. [PMID: 37331861 DOI: 10.1016/j.joim.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/04/2023] [Indexed: 06/20/2023]
Abstract
In October 2021, an international collaborative study on the use of electroacupuncture (EA) to treat inflammation was published in the journal Nature by Dr. Qiufu Ma's team. Based on the results of EA on inflammation in the mouse model of lipopolysaccharide inflammatory storm, the study showed that the distal effect of acupuncture can be achieved by "driving the vagus-adrenal axis (through the adrenal medulla, by releasing catecholamines)." PROKR2Cre-marked sensory neurons, which innervate the deep hindlimb fascia but not the abdominal fascia, are crucial for driving this axis. The study suggests the existence of specificity distribution of acupoints, that different EA stimulation intensities or different needle penetration depths have different therapeutic effects, that photosensitive stimulation may be a substitute for needle acupuncture, and that massage, stretching and body movements may also activate PROKR2Cre-markable dorsal root ganglion sensory neurons and elicit anti-inflammatory effects. However, results of some other studies are contrary to the conclusions of Ma's team. For examples: low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation, which is more relevant to the real daily acupuncture practice, and this effect was partly related to the adrenal cortex and associated with the stimulation of corticosterone and adrenocorticotropic hormone; manual acupuncture (similar to the low-intensity EA) at KI3, Zhichuan point (an extra point), etc. was effective in a severe COVID-19 patient with sepsis; stimulating ST25 with low-intensity EA or manual acupuncture was effective against gastrointestinal inflammations; the above mentioned points are not in an area enriched with PROKR2Cre-marked sensory nerve endings. Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems, multi-levels and multi-targets, which does not limit to "driving the vagus-adrenal axis." Please cite this article as: Fan AY. Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels and targets and is not limited to "driving the vagus-adrenal axis." J Integr Med. 2023; Epub ahead of print.
Collapse
Affiliation(s)
- Arthur Yin Fan
- American TCM Association, Vienna, VA 22182, USA; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA 22182, USA.
| |
Collapse
|
2
|
Zhu F, Yin S, Zhu X, Che D, Li Z, Zhong Y, Yan H, Gan D, Yang L, Wu X, Li L. Acupuncture for Relieving Abdominal Pain and Distension in Acute Pancreatitis: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:786401. [PMID: 34925110 PMCID: PMC8678533 DOI: 10.3389/fpsyt.2021.786401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Clinical evidence suggests that acupuncture is effective for relieving abdominal pain and distension in acute pancreatitis (AP). However, there is a lack of systematic reviews and meta-analyses that provide high-quality evidence of the efficacy and safety of acupuncture in this context. Aim: To assess the efficacy and safety of acupuncture for relieving abdominal pain and distension in AP. Methods: We searched the PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, VIP, and China Biomedical Literature databases. Randomized controlled trials of acupuncture plus routine treatment (RT) vs. RT alone or RT plus sham/placebo acupuncture were included. Primary outcomes included total effectiveness rate, VAS scores for abdominal pain and distension, and time until relief of abdominal pain and distension. Secondary outcomes included time until recovery of bowel sound, time until first defecation, length of hospital stay, and APACHE II score. Results: Nineteen eligible original studies (n = 1,503) were included. The results showed that acupuncture in combination with RT had a significant advantage in terms of increasing the total effectiveness rate [risk ratio: 1.15; 95% confidence interval (CI): 1.06-1.24; P = 0.001]. Acupuncture also reduced the VAS score for abdominal pain [weighted mean difference (WMD): -1.45; 95% CI: -1.71 to -1.19; P < 0.0001] and the VAS score for abdominal distension (WMD: -0.71; 95% CI: -1.04 to -0.37; P < 0.0001) in patients with AP. Other results also showed the efficacy of acupuncture. One study reported adverse events after acupuncture. Conclusion: Acupuncture in combination with RT has a better effect than RT alone for relieving abdominal pain and distension in AP. More rigorous studies are needed to confirm this result. Systematic Review Registration: PROSPERO CRD42019147503 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=147503).
Collapse
Affiliation(s)
- Fengya Zhu
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
| | - Shao Yin
- Clinical Medical School, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinyun Zhu
- Traditional Chinese Medicine Department, The People's Hospital of Leshan, Leshan, China
| | - Deya Che
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
| | - Zimeng Li
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yue Zhong
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
| | - Hui Yan
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
| | - Daohui Gan
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
| | - Lanying Yang
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
| | - Xiaohan Wu
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
| | - Liuying Li
- Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, China
| |
Collapse
|
3
|
Xu T, Yu Z, Liu Y, Lu M, Gong M, Li Q, Xia Y, Xu B. Hypoglycemic Effect of Electroacupuncture at ST25 Through Neural Regulation of the Pancreatic Intrinsic Nervous System. Mol Neurobiol 2021; 59:703-716. [PMID: 34757591 PMCID: PMC8786791 DOI: 10.1007/s12035-021-02609-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/19/2021] [Indexed: 02/06/2023]
Abstract
Electroacupuncture (EA) is considered to have potential antidiabetic effects; however, the role of the pancreatic intrinsic nervous system (PINS) in EA-induced amelioration of type 2 diabetes (T2DM) remains unclear. Therefore, we investigated whether EA at ST25 exerts any beneficial effects on insulin resistance (IR), inflammation severity, and pancreatic β cell function via the PINS in a rat model of a high-fat diet-streptozotocin (HFD/STZ)-induced diabetes. To this end, Sprague Dawley rats were fed with HFD to induce IR, followed by STZ (35 mg/kg, i.p.) injection to establish the T2DM model. After hyperglycemia was confirmed as fasting glucose level > 16.7 mmol/L, the rats were treated with EA (2 mA, 2/15 Hz) for the next 28 days. Model rats showed increased serum glucose, insulin, IR, and TNF-α levels with a concomitant decrease in β cell function. Microscopy examination of the pancreas revealed pathological changes in islets, which reverted to near-normal levels after EA at ST25. EA improved islet cell morphology by increasing islet area and reducing vacuolation. EA at ST25 decreased transient receptor potential vanilloid 1 (TRPV1) and increased substance P (SP) and calcitonin gene-related peptide (CGRP) expression. Subsequently, insulin secretion decreased and impaired pancreatic endocrine function was restored through the TRPV1 channel (SP/CGRP)-insulin circuit. EA increased choline acetyltransferase and neuropeptide Y expression and controlled inflammation. It also enhanced the cocaine and amphetamine-regulated transcript prepropeptide expression and promoted glucagon-like peptide-1 secretion. Additionally, the electrophysiological activity of PINS during acupuncture (2.71 ± 1.72 Hz) was significantly increased compared to the pre-acupuncture frequency (0.32 ± 0.37 Hz, P < 0.05). Thus, our study demonstrated the beneficial effect of EA on β cell dysfunction via the PINS in rat models of HFD-STZ-induced T2DM.
Collapse
Affiliation(s)
- Tiancheng Xu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Zhi Yu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Yun Liu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Mengjiang Lu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Meirong Gong
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Qian Li
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Youbing Xia
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, 210023, China. .,Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, 221004, China.
| | - Bin Xu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
| |
Collapse
|
4
|
Acupuncture at Back-Shu and Front-Mu Acupoints Prevents Gastric Ulcer by Regulating the TLR4/MyD88/NF- κB Signaling Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8214052. [PMID: 33628315 PMCID: PMC7886517 DOI: 10.1155/2021/8214052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 12/22/2022]
Abstract
Purpose To assess the preventive effects of acupuncture at back-shu and front-mu acupoints on rats with restraint water-immersion stress (RWIS)-induced gastric ulcer. Methods Thirty-six rats were randomly divided into four groups for 10 days of treatment as follows: the normal group received no treatment; the model group received RWIS-induced gastric ulcer; the omeprazole group was administered omeprazole orally every 2 days; and the electroacupuncture group received electroacupuncture at the RN12 and BL21 acupoints every 2 days. After 10 days of treatment, except for the normal group, all rats were induced with gastric ulcer by RWIS for 3 h. The ulcer index (UI), ulcer inhibition rate, and histopathological score were calculated. We determined the levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6 in serum, and the activities of myeloperoxidase (MPO), malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO), and glutathione peroxidase (GSH-Px) in serum and gastric tissues. Protein expression of MyD88, nuclear factor (NF)-κB (p65), and toll-like receptor (TLR) 4 was quantified in gastric tissues. Results The electroacupuncture and omeprazole groups were equivalent in terms of UI, ulcer inhibition rate, and histopathological score. The serum levels of TNF-α and IL-6 were significantly lower in the electroacupuncture group compared with the omeprazole group (P < 0.05). Compared with the model group, there were significant changes in the levels of NO, MPO, GSH-Px, and MDA in all other groups, while the expression of TLR4, MyD88, and NF-κB p65 in gastric tissue decreased significantly in the electroacupuncture group. The expression of TLR4 was substantially lower in the electroacupuncture group compared with the omeprazole group. Conclusion Acupuncture at back-shu and front-mu acupoints played a role in preventing gastric ulcer by inhibiting extracellular signals, stimulating kinases in serum and gastric tissues, and activating the inhibition of the TLR4 signaling pathway.
Collapse
|
5
|
Efficacy of Acupuncture and Moxibustion as a Subsequent Treatment after Second-Line Chemotherapy in Advanced Gastric Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:8274021. [PMID: 33144870 PMCID: PMC7599393 DOI: 10.1155/2020/8274021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 05/18/2020] [Indexed: 02/06/2023]
Abstract
Objective To explore whether acupuncture and moxibustion can prevent disease progression of advanced gastric cancer patients completing second-line chemotherapy and, if so, the related mechanism. Method Progression-free survival (PFS) and overall survival (OS) were main outcome measures. The real-time quantitative PCR was used to detect the expression of genes including T-bet, IFN-γ, GATA3, and IL-4 in peripheral blood mononuclear cells (PBMCs). IL-4, IL-6, Ca199, CRP, and IFN-γ in plasma levels were checked. Results 170 patients were randomly assigned in a 3 : 2 ratio to receive either acupuncture and moxibustion or sham acupuncture until progression. 135 patients were included in the primary analysis. Both PFS and OS in treatment group were proven to be better than control group. Acupuncture and moxibustion promoted typical Th1 cells drifting, as confirmed by increased T-bet/IFN-γ and decreased GATA3/IL-4 in mRNA levels from PBMCs, as well as upregulating IFN-γ and downregulating IL-4 in plasma levels. IL-6, Ca199, and CRP in plasma levels were also reduced by acupuncture and moxibustion. Conclusions Acupuncture and moxibustion can prolong PFS and OS of advanced gastric cancer patients completing second-line chemotherapy by reversing Th1/Th2 shift and attenuating inflammatory responses.
Collapse
|
6
|
Ramires CC, Balbinot DT, Cidral-Filho FJ, Dias DV, Dos Santos AR, da Silva MD. Acupuncture reduces peripheral and brainstem cytokines in rats subjected to lipopolysaccharide-induced inflammation. Acupunct Med 2020; 39:376-384. [PMID: 32744055 DOI: 10.1177/0964528420938379] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Lipopolysaccharide (LPS) endotoxins are activators of innate immunity inducing infection and inflammatory responses. Anti-inflammatory drugs can have undesirable side effects. Acupuncture may be an alternative for the treatment of inflammatory processes. OBJECTIVE We investigated the potential anti-inflammatory effect of manual acupuncture (MA) at SP6 upon LPS-induced peritonitis in rats. METHODS Peritonitis was induced in rats with an intraperitoneal injection of LPS (0.002, 0.02, 0.2 or 2 µg/kg) in four experimental groups (n = 6 each). A fifth group was injected with sterile saline solution (saline group, n = 6). Four hours after the procedure, peritoneal fluid was collected to determine total cell counts for inflammatory cells, differential leukocyte counts and peritoneal capillary permeability. The LPS dose of 0.02 µg/kg was used in the subsequent experiments as it most successfully induced peritoneal inflammation. Subsequently, five experimental groups (n = 12 rats each) were used: (1) saline, (2) control (untreated LPS group), (3) indomethacin (LPS group treated with indomethacin), (4) NA (LPS group treated with MA at a location not corresponding to any traditional acupuncture point), and (5) SP6 (LPS group treated with verum MA at SP6). Ten minutes after MA or 30 min after indomethacin treatment, the rats received an intraperitoneal injection of LPS. After 4 h, total leukocyte and differential cell counts, myeloperoxidase (MPO) activity, vascular permeability and cytokine levels were evaluated in the peritoneal fluid. Cytokine levels were additionally evaluated in the brainstem. RESULTS SP6 MA and indomethacin treatments reduced inflammatory cell infiltration, vascular permeability and MPO activity in the LPS-exposed rats. Pre-treatment with indomethacin and SP6 MA decreased tumor necrosis factor (TNF)-α levels and preserved interleukin (IL)-10 in the peritoneal fluid. Indomethacin also reduced IL-6 in the peritoneal fluid. In the brainstem, indomethacin reduced IL-1β, IL-6, TNFα and IL-10, whereas SP6 MA reduced only TNFα and IL-6 levels. CONCLUSIONS This study clearly demonstrates the anti-inflammatory effect of acupuncture, which we believe may involve the activation of anti-inflammatory neural reflexes in the regulation of peritonitis.
Collapse
Affiliation(s)
- Caroline C Ramires
- Multicentric Post-graduation Program in Physiological Sciences, Federal University of Pampa, Rio Grande do Sul, Brazil
| | - Daniela Tl Balbinot
- Department of Physiological Sciences, Center for Biological Sciences, Laboratory of Neurobiology of Pain and Inflammation, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Francisco J Cidral-Filho
- Department of Physiological Sciences, Center for Biological Sciences, Laboratory of Neurobiology of Pain and Inflammation, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Daniel Ventura Dias
- Laboratory of Anatomy, Federal University of Pampa, Rio Grande do Sul, Brazil
| | - Adair Rs Dos Santos
- Department of Physiological Sciences, Center for Biological Sciences, Laboratory of Neurobiology of Pain and Inflammation, Federal University of Santa Catarina, Florianópolis, Brazil.,Neurosciences Post-Graduation Program, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Morgana Duarte da Silva
- Multicentric Post-graduation Program in Physiological Sciences, Federal University of Pampa, Rio Grande do Sul, Brazil.,Department of Physiological Sciences, Center for Biological Sciences, Laboratory of Neurobiology of Pain and Inflammation, Federal University of Santa Catarina, Florianópolis, Brazil
| |
Collapse
|
7
|
Crosstalk between Acupuncture and NF- κB in Inflammatory Diseases. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:7924985. [PMID: 32595736 PMCID: PMC7301242 DOI: 10.1155/2020/7924985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 02/07/2023]
Abstract
Acupuncture has been used in China for thousands of years and concerned as a typical alternative medicine in inflammatory diseases nowadays. The nuclear factor-κB (NF-κB) transcription factor is an important regulator of inflammation. In this article, we discuss the role of acupuncture in NF-κB pathways and also present the acupoints selection, acupuncture administration, and related inflammation diseases and models from previous studies to bring readers close to a more complete understanding of the mechanisms between acupuncture and NF-κB in inflammatory diseases.
Collapse
|
8
|
Zhu X, Yang L, Li X, Zhu F, Li Z, Craemer A, Xiong Y, Lan Y, Zhao Y, Wu J. Efficacy and safety of acupuncture on relieving abdominal pain and distension for acute pancreatitis: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e19044. [PMID: 32080079 PMCID: PMC7034659 DOI: 10.1097/md.0000000000019044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The purpose of this study is to evaluate the efficacy and safety of acupuncture on relieving abdominal pain and distension in acute pancreatitis. METHODS AND ANALYSIS We will electronically search PubMed, MEDLINE, Embase, Web of Science, the Cochrane Central Register of Controlled Trial, China National Knowledge Infrastructure, China Biomedical Literature Database, China Science Journal Database, and Wanfang Database from their inception. Furthermore, we will manually retrieve other resources, including reference lists of identified publications, conference articles, and gray literature. The clinical randomized controlled trials or quasi-randomized controlled trials related to acupuncture treating acute pancreatitis will be included in the study. The language is limited to Chinese and English. Research selection, data extraction, and research quality assessment will be independently completed by 2 researchers. Data will be synthesized using a fixed effects model or random effects model depending on the heterogeneity test. The overall response rate and the visual analog scale score will be the primary outcomes. The time of first bowel sound, the time of first defecation, the length of hospitalization, acute physiology and chronic health evaluation II score, and the adverse events will also be assessed as secondary outcomes. RevMan 5 (version 5.3) statistical software will be used for meta-analysis, and the level of evidence will be assessed by Grading of Recommendations Assessment, Development, and Evaluation. Continuous data will be expressed in the form of weighted mean difference or standardized mean difference with 95% confidence intervals, whereas dichotomous data will be expressed in the form of risk ratios with 95% confidence intervals. ETHICS AND DISSEMINATION The protocol of this systematic review does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and present at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42019147503.
Collapse
Affiliation(s)
- Xinyun Zhu
- Acupuncture and Moxibustion School, Chengdu University of Traditional Chinese Medicine
| | - Lijie Yang
- Hospital of Chengdu University of Traditional Chinese Medicine, Jinniu District, Chengdu, Sichuan
| | - Xianglei Li
- The Second Affiliated Hospital of Xingtai Medical College, Qiaoxi District, Xingtai, Hebei
| | - Fengya Zhu
- Acupuncture and Moxibustion School, Chengdu University of Traditional Chinese Medicine
| | - Zimeng Li
- Acupuncture and Moxibustion School, Chengdu University of Traditional Chinese Medicine
| | - Andrea Craemer
- School of Basic Medical Science, Chengdu University of Traditional Chinese Medicine, Jinniu District, Chengdu, Sichuan, China
| | - Yueheng Xiong
- Acupuncture and Moxibustion School, Chengdu University of Traditional Chinese Medicine
| | - Ying Lan
- Hospital of Chengdu University of Traditional Chinese Medicine, Jinniu District, Chengdu, Sichuan
| | - Yuemeng Zhao
- Acupuncture and Moxibustion School, Chengdu University of Traditional Chinese Medicine
| | - Jie Wu
- Hospital of Chengdu University of Traditional Chinese Medicine, Jinniu District, Chengdu, Sichuan
| |
Collapse
|
9
|
Zhang K, Li C, Gao C, Zhao C, Tang Q, Zhai J, Li Y. Efficacy and safety of acupuncture as an adjuvant treatment for acute pancreatitis: a protocol of systematic review and meta-analysis. BMJ Open 2019; 9:e029327. [PMID: 31278104 PMCID: PMC6615812 DOI: 10.1136/bmjopen-2019-029327] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/09/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Acupuncture may be effective for acute pancreatitis (AP). This systematic review aims to assess the efficacy and safety of acupuncture as an adjuvant treatment for AP. METHODS AND ANALYSIS We will search PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, China National Knowledge Infrastructure, Wan Fang Data and Chinese Science Journal Database from inception to 30 June 2019 to identify any eligible study. Only randomised controlled trials will be included. The selection of studies, data extraction and management will be completed by two reviewers independently. The primary outcomes include the overall response rate, mortality during the treatment, the proportion of patients with severe acute pancreatitis transferred to the intensive care unit or scheduled for surgery, gastrointestinal function and the acute physiology and chronic health evaluation II scores. The secondary outcomes include visual analogue scale, the use of analgesics, the recovery time of blood amylase becoming normal, tumour necrosis factor α counts, IL-6 counts, IL-10 counts, length of hospital stay and adverse events related to acupuncture (such as fainting, nausea, haematoma and local infection). Review Manager V.5.3 software will be used for statistical analyses. The risk of bias of included studies will be assessed by the Cochrane 'risk of bias' tool. ETHICS AND DISSEMINATION This study will not involve personal information. The ethical approval will not be required. The results will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER CRD42018115099.
Collapse
Affiliation(s)
- Kai Zhang
- Department of Acupuncture and Moxibustion, Tianjin Gong An Hospital, Tianjin, China
| | - Chengyu Li
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Chao Gao
- Tianjin Institute of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Chen Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qilin Tang
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jingbo Zhai
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yan Li
- Department of Acupuncture and Moxibustion, Tianjin Gong An Hospital, Tianjin, China
| |
Collapse
|
10
|
Sun L, Li Y, Luo H, Wang K, Li L, Zeng Y. Effects of Toll‑like receptor 9 and CpG oligodeoxynucleotides 1826 on sodium taurocholate‑induced acute pancreatitis rats. Mol Med Rep 2018; 18:3818-3824. [PMID: 30106134 PMCID: PMC6131499 DOI: 10.3892/mmr.2018.9346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 05/25/2017] [Indexed: 01/06/2023] Open
Abstract
The aim of the present study was to investigate the effects of Toll-like receptor (TLR) 9 and CpG oligodeoxynucleotide (CpG-ODN)1826 on sodium taurocholate-induced acute pancreatitis (AP) rats at different time points. Pathological examination indicated that the severity of pancreatic tissue damage following AP increased with time. Additionally, TLR9 protein levels were upregulated after AP, and were higher at 6 h compared with at 3 h. Subsequently, the TLR9 protein levels were downregulated at 12 h, but remained higher than the control group. In rats subjected to AP, tumor necrosis factor (TNF-α protein expression levels and serum amylase (AMS) in the serum were increased until 12 h. The expression level of TNF-α protein in the AP 12 h group was higher than that in the AP 3 and 6 h groups. In addition, following CpG-ODN1826 administration, the morphology of pancreatic tissue appeared worse compared with that in the AP only groups. Furthermore, CpG-ODN1826 administration induced an increase in TLR9 expression levels compared with the AP alone group at 0, 3, 6 and 12 h. TNF-α in the CpG + AP 12 h group was upregulated compared with that in the CpG + AP 3 and 6 h groups; however, no change was observed between 3 and 6 h. Thus, these data indicate that CpG-ODN1826 aggravates sodium taurocholate-induced pancreas damage in rats.
Collapse
Affiliation(s)
- Liang Sun
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650031, P.R. China
| | - Yuanhua Li
- Department of Anesthesiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650031, P.R. China
| | - Huayou Luo
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650031, P.R. China
| | - Kunhua Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650031, P.R. China
| | - Li Li
- Department of Hepatobiliary Surgery, The Affiliated Ganmei Hospital of Kunming Medical University, Kunming, Yunnan 650011, P.R. China
| | - Yujian Zeng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650031, P.R. China
| |
Collapse
|
11
|
Jie X, Li X, Song JQ, Wang D, Wang JH. Anti-inflammatory and autonomic effects of electroacupuncture in a rat model of diet-induced obesity. Acupunct Med 2018; 36:103-109. [PMID: 29487062 DOI: 10.1136/acupmed-2016-011223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To study the effect of electroacupuncture (EA) on the cholinergic anti-inflammatory pathway (CAP) by measurement of vagal activity in rats with high-fat diet (HFD)-induced obesity. METHODS Diet-induced obesity (DIO) was induced in 30 rats by feeding them a HFD for 12 weeks. A further 10 rats fed normal food comprised the lean diet (LD) control group. DIO rats were further subdivided into three groups that received a HFD only (HFD group, n=10), a HFD plus electroacupuncture (HFD+EA group, n=10) or a HFD plus minimal acupuncture (HFD+MA group, n=10). EA and MA treatments were continued for 8 weeks. Heart rate variability (HRV) was used to measure the function of the autonomic nervous system before and after treatment. ELISA was used to determine acetylcholine (ACh) and tumour necrosis factor (TNF)-α levels in the serum. Real-time PCR was used to assess the mRNA expression of α7-subtype nicotinic acetylcholine cholinergic receptors (α7nAChRs) and TNF-α in the mesenteric white adipose tissues (MWAT). RESULTS EA but not MA significantly reduced rats' bodyweight. No difference was found in the low frequency (LF), high frequency (HF) and the balance between LF and HF (LF/HF) components of HRV before treatment. After the EA intervention, HF was elevated and LF/HF was reduced in the HFD+EA group comparedwith the HFD group. TNF-α in the serum and MWAT were increased in the HFD group, but were reduced in the HFD+EA group. Furthermore, EA promoted expression of α7nAChRs and ACh in the MWAT. There was no difference between the HFD and HFD+MA groups for any indices. CONCLUSIONS EA enhanced vagal activity, promoted ACh release and activated α7nAChRs in the MWAT, leading to inhibition of proinflammatory cytokine production.
Collapse
Affiliation(s)
- Xiaoyan Jie
- Department of Neurosurgical Intensive Care Unit, Nanyang Second General Hospital, Nanyang, Henan, China
| | - Xu Li
- Department of Medicine, Nanyang Second General Hospital, Nanyang, Henan, China
| | - Jian-Qing Song
- Department of Neurosurgical Intensive Care Unit, Nanyang Second General Hospital, Nanyang, Henan, China
| | - Dan Wang
- Department of Neurosurgical Intensive Care Unit, Nanyang Second General Hospital, Nanyang, Henan, China
| | - Jian-Hua Wang
- Department of Neurosurgical Intensive Care Unit, Nanyang Second General Hospital, Nanyang, Henan, China
| |
Collapse
|
12
|
Liang Y, Lenon GB, Yang AWH. Acupressure for respiratory allergic diseases: a systematic review of randomised controlled trials. Acupunct Med 2017; 35:413-420. [PMID: 29113981 DOI: 10.1136/acupmed-2016-011354] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2017] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To evaluate the effects and safety of acupressure for the management of respiratory allergic diseases by systematically reviewing randomised controlled trials (RCTs). METHODS A total of 13 electronic English and Chinese databases were searched until July 2017. Two authors extracted data and evaluated risk of bias independently. Review Manager V.5.3 was employed for data analysis. RESULTS The literature search identified 186 papers, of which only four of met the inclusion criteria: two for allergic rhinitis (AR) and two for asthma. High and unclear risk of bias existed across all the included studies. The findings demonstrated that acupressure greater effects on the relief of nasal symptoms of AR compared with 1% ephedrine nasal drop plus thermal therapy. With either Western medicine or Chinese herbal medicine as a cointervention, one study indicated that acupressure plus salbutamol was led to a significantly greater improvement of pulmonary function for patients with asthma compared with salbutamol only. However, the remaining two studies indentified no significant differences in any outcome measures between the two groups. CONCLUSIONS No reliable conclusions regarding the effects of acupressure on AR and asthma could be drawn by this review due to the small number of available trials with significant heterogeneity of study design and high/unclear risk of bias. Further, more rigorously designed RCTs are needed. Acupressure seems safe for symptomatic relief of AR and asthma, although larger studies are required to be able to robustly confirm its safety. TRIAL REGISTRATION NUMBER ACTRN12617001106325; Pre-results.
Collapse
Affiliation(s)
- Yaqun Liang
- Discipline of Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - George Binh Lenon
- Discipline of Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Angela Wei Hong Yang
- Discipline of Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| |
Collapse
|
13
|
Multimodal Care in the Management of a Patient With Chronic Tendinopathy of the Biceps Femoris: A Case Report. J Chiropr Med 2017; 16:156-162. [PMID: 28559756 DOI: 10.1016/j.jcm.2017.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 01/09/2017] [Accepted: 01/24/2017] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The purpose of this case report was to describe the use of dry needling in conjunction with auricular acupuncture, core exercises, and light aerobic activity for treating chronic tendinopathy of the biceps femoris. CLINICAL FEATURES A 30-year-old white female presented with chronic biceps femoris tendinopathy. The injury had occurred 18 months prior while training for a triathlon. Active stretching of her right biceps femoris while standing with her feet 6 inches apart aggravated the pain at the origin in the right tendon of the biceps femoris at 0 degrees of movement. INTERVENTION/OUTCOME The combination of dry needling and auricular acupuncture with core rehabilitation exercises and light activity was employed. Alleviation of pain with full range of motion was achieved during hip extension, knee flexion, and standing biceps femoris stretch at the 11th, 16th, and 18th treatments. In addition, the patient also reported improvement in her symptoms, including night sweats, insomnia, anxiety, tension, and constipation. CONCLUSIONS This patient's symptoms and function improved after 18 treatments of multimodal care. Dry needling employed simultaneously with auricular acupuncture, core exercises, and light activity could be considered a possible strategy for treating chronic tendinopathy.
Collapse
|
14
|
Liu W, Yuan Q, Guo S, Fu Z. Emodin in Severe Acute Pancreatitis Treatment. Chin Med 2017. [DOI: 10.4236/cm.2017.84008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
15
|
dos Santos Maciel LY, dos Santos Leite PM, Neto MLP, Mendonça ACR, de Araujo CCA, da Hora Santos Souza J, DeSantana JM. Comparison of the placebo effect between different non-penetrating acupuncture devices and real acupuncture in healthy subjects: a randomized clinical trial. Altern Ther Health Med 2016; 16:518. [PMID: 27978834 PMCID: PMC5159982 DOI: 10.1186/s12906-016-1477-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 11/07/2016] [Indexed: 11/11/2022]
Abstract
Background Several studies have used placebo acupuncture methods in recent years as a way for blinding therapeutic effect of acupuncture, however placebo method selection has not followed enough methodological criteria to the point of stabilishing a consensus of what should be the best method to be used. This study aimed to evaluate the effectiveness of three different placebo acupuncture methods for blinding applied in healthy subjects. Methods This study was approved by the Ethics Committee of the Federal University of Sergipe with the number 47193015.5.0000.5546 and all individuals participating in the study signed a free and informed consent. For this study, 321 healthy volunteers were randomly divided into seven groups using the abdominal point stomach (ST) 25 and seven groups using the lumbar point bladder (Bl) 52 for stimulation. For real acupuncture procedure, three different methods of placebo acupuncture plus a mix between real acupuncture and placebo applied in the same individual, totaling fourteen groups in this study. Outcome assessments were performed before and immediately after applying the technique. Investigator who assessed variables had no knowledgement about the method was applied. Identification, weight and height were measured before puncture by using. At the end, subjects were asked if they believed they were receiving real or placebo acupuncture. Results There was no significant difference between groups for the perception about the type o stimulation (wheter real or placebo puncture). Percentage of subjects who reported to have received real acupuncture in the abdominal point was 69.56% in real group, 86.95% in group Park Sham, 82.60% in needle + foam, 91.30% in insertion and removal, 78.26% in real + Park Sham, 86.36% in real + needle and foam, 86.95% in real + insertion and removal, and for the lumbar point was 86.36% in real group, 86.95% in group Park Sham, 69.56% in needle + foam, 72% in insertion and removal, 86.95% in real + Park Sham, 81.81% in real + needle and foam and 78.26% in real + insertion and removal. Conclusion All placebo acupuncture methods proposed in this study were equally effective for bliding the study participants using either abdominal or lumbar acupoints, and none of the placebo methods presented benefit compared to the other to be used in future clinical trials. Ethics Committee Federal University of Sergipe (UFS), number of approval: 47193015.5.0000.5546 Trial registration ensaiosclinicos.gov.br RBR-3w2p32 Registered in 28th January 2016.
Collapse
|