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Dong P, Wang LF, Zhang LX, Li F, Yin HS, Dou ZX, Huang XJ, Xu R, Zhang WL. Clinical study of acupuncture combined with surface anesthesia using proparacaine in geriatric cataract phacoemulsification. World J Clin Cases 2023; 11:5073-5082. [PMID: 37583853 PMCID: PMC10424011 DOI: 10.12998/wjcc.v11.i21.5073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/28/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND During anesthesia administration for cataract surgery, low pH of proparacaine may induce pain or complications such as corneal damage and poor wound healing, with the use of additional drops intraoperatively increasing the risk of complications. Accordingly, there is a clinical need for adjuncts to local anesthesia needs to improve the efficiency of anesthesia and reduce the required amount of intraoperative proparacaine. AIM To identify a method of anesthesia for geriatric cataract phacoemulsification that provides more efficient analgesia and improves clinical efficacy. METHODS A total of 130 geriatric patients with cataracts who attended Hebei Eye Hospital from December 2020 to December 2022 were included in the present study. Patients were divided into the proparacaine surface anesthesia (SA) group (65 cases) and the compound acupuncture-medicine anesthesia group (CAMA group, 65 cases). Patients in the CAMA group were provided acupuncture analgesia in addition to SA. Preoperative anxiety [Self-Rating Anxiety Scale (SAS) score and state anxiety inventory (SAI) score], intraoperative stress, vital signs, analgesia, and cooperation, as well as postoperative adverse events, were compared between groups. RESULTS More marked reductions in anxiety were observed among patients in the CAMA group, with corresponding reductions in SAS and SAI scores. During the operation, no change in the secretion of E, NE, or Cor group compared to the preoperative period was observed in the CAMA, which was markedly lower than that in the SA group. Heart rate, blood pressure, and respiratory rate were more stable intraoperatively in the CAMA group. In addition, the incidence of intraoperative pain and the number of additional doses of anesthesia required in the CAMA group were markedly lower than in the SA group. Accordingly, patients in the CAMA group were able to avoid eye movements and eyelid closing leading to greater cooperation with surgeons during surgery. Furthermore, marked reductions in intraoperative adverse effects were observed in the CAMA group, indicating greater overall safety. CONCLUSION Proparacaine SA combined with acupuncture as an analgesic provides improved analgesia with greater safety compared to surface anesthesia with proparacaine during geriatric cataract phacoemulsification.
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Affiliation(s)
- Ping Dong
- Department of Acupuncture and Rehabilitation, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Li-Fang Wang
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Li-Xiang Zhang
- Department of Pediatrics, Hebei General Hospital For Veterans, Xingtai 054000, Hebei Province, China
| | - Fang Li
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Hui-Su Yin
- Department of Science and Education, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Zhi-Xia Dou
- Department of Ocular Trauma, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Xiu-Ju Huang
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Rui Xu
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Wu-Lin Zhang
- Department of Cataract, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
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Yin X, Yu B, Hazlewood PJ, Xu K, Yue H, Mi Y, Xu S. Effect of electroacupuncture on discomfort during gastroscopy: A randomised controlled trial. Complement Ther Med 2023; 73:102936. [PMID: 36858243 DOI: 10.1016/j.ctim.2023.102936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Gastrointestinal reactions, pain and discomfort are inevitable in patients undergoing common gastroscopy. Acupuncture is an effective therapy that assists in the perioperative period; however, evidence of it relieving discomfort is limited. We conducted this trial to observe the effect of electroacupuncture (EA) on discomfort caused by gastroscopy without sedatives. METHODS This was a single-centre, patient-assessor blind, randomised controlled trial. Sixty patients requiring gastroscopy were randomly assigned to the EA and control groups (sham acupuncture, SA, group) in a 1:1 ratio. Patients in the EA group underwent treatment at acupoints LI4 (Hegu), PC6 (Neiguan), ST36 (Zusanli), and ST34 (Liangqiu) for 30 min before gastroscopy, whereas patients in the SA group underwent superficial acupuncture at non-acupoints. The patients' nausea level, throat discomfort, bucking, and agitation were evaluated using a visual analogue scale (VAS) within 30 min after gastroscopy. The mean VAS score was the primary outcome. Secondary outcomes were the Amsterdam Preoperative Anxiety and Information Inventory Scale, used to evaluate patients' preoperative anxiety levels, and the 6-item State-Trait Anxiety Inventory (STAI-S6), used to assess anxiety before and after gastroscopy. The patients' vital signs, including heart rate, blood pressure, and pulse oxygen saturation, were recorded before, during, and after gastroscopy. RESULTS At 30 min after gastroscopy, the mean VAS score in the EA group (4.20 ± 0.63) was lower than that in the control group (5.14 ± 0.70, mean difference (MD): - 0.94, 95% confidence interval (CI): - 1.28, - 0.59, P < 0.001). There were statistically significant between-group differences in the nausea and vomiting, throat discomfort and agitation VAS scores (all P < 0.01), whereas no difference was found in the bucking VAS score (P = 0.692). Compared with the SA group, patients in the EA group had a 6.90-point lower in STAI-S6 (95% CI: -12.98, -0.81, P = 0.027) after gastroscopy. Patients in the EA group had a slower heart rate and lower blood pressure than those in the SA group. Serious adverse events were not observed during the trial. CONCLUSION EA can help relieve patients' anxiety, and improve their nausea and vomiting, throat discomfort, and agitation during gastroscopy. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR) ID: ChiCTR2000040726.
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Affiliation(s)
- Xuan Yin
- Department of Acupuncture and Moxibustion, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
| | - Bingyu Yu
- Department of Acupuncture and Moxibustion, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
| | - Philippa Jemma Hazlewood
- International Education College, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Kun Xu
- Department of Acupuncture and Moxibustion, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
| | - Hongyu Yue
- Department of Acupuncture and Moxibustion, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
| | - Yiqun Mi
- Department of Acupuncture and Moxibustion, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
| | - Shifen Xu
- Department of Acupuncture and Moxibustion, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
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Man TM, Wu L, Zhang JY, Dong YT, Sun YT, Luo L. Research trends of acupuncture therapy for hypertension over the past two decades: a bibliometric analysis. Cardiovasc Diagn Ther 2023; 13:67-82. [PMID: 36864974 PMCID: PMC9971308 DOI: 10.21037/cdt-22-480] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022]
Abstract
Acupuncture has already been extensively utilized to treat high blood pressure (hypertension) in several nations. Nevertheless, the bibliometric research on the worldwide usage of acupuncture for hypertension is mostly unclear. As a result, our objective for the research aimed to investigate the present state as well as developments in the global usage of acupuncture on hypertension during the last 20 years using CiteSpace (5.8.R2). The Web of Science (WOS) database examined papers on acupuncture treatment of hypertension from 2002 to 2021. We examined the number of publications, cited journals, nations/regions, organizations, authors, cited authors, cited references, and keywords utilizing CiteSpace. The record of 296 documents was obtained between 2002 and 2021. The quantity and frequency of annual publications rose gradually. Regarding frequency and centrality of citations, Circulation and Clin Exp Hypertens (Clinical and Experimental Hypertension) scored top and second respectively. China had the most publications among countries/regions, as well as the five largest institutions were also in China. Cunzhi Liu was the most productive author, while P Li was the most referenced author. XF Zhao produced the first article inside the quantity of cited references classification. 'Electroacupuncture' had a significant frequency with centrality for the keywords, which suggested electroacupuncture is a popular treatment in this field. In the treatment of hypertension, electroacupuncture has a beneficial effect on reducing blood pressure. However, because of the many different applications of electroacupuncture frequencies in research, whether the electroacupuncture frequency is connected to the therapeutic impact should be given more significant consideration. The findings of this bibliometric analysis give an overview of the present state as well as developments of clinical studies on acupuncture for hypertensive patients during the last two decades, which could assist researchers in identifying hot subjects and exploring novel directions in further study within the field.
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Affiliation(s)
- Tian-Ming Man
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liu Wu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing-Yi Zhang
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yu-Ting Dong
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yi-Tao Sun
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ling Luo
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Liang J, Wu J, Zhang X, Hao X, Zeng T, Sun J, Ji Z, Park K, Li K, Liu Q. Proteomics analysis of the hypothalamus in spontaneously hypertensive rats treated with twirling reinforcing manipulation, twirling reducing manipulation or electroacupuncture. Exp Ther Med 2021; 21:381. [PMID: 33680103 PMCID: PMC7918484 DOI: 10.3892/etm.2021.9812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/17/2020] [Indexed: 12/12/2022] Open
Abstract
Hypertension is one of the primary risk factors for cardiovascular diseases. Numerous proteins serve a critical role in hypertension. Acupuncture has been widely used as a treatment for hypertension in China. The results of the current study suggested that electroacupuncture (EA), twirling reinforcing manipulation (TRFM) and twirling reducing manipulation (TRDM) may be useful in the treatment of hypertension. Additionally, proteome analysis of spontaneously hypertensive rats treated with EA, TRFM and TRDM was performed. There were 117 (EA group), 61 (TRFM group) and 86 (TRDM group) differentially expressed proteins (DEPs) identified in the respective experimental groups compared with the model group. Moreover, parallel reaction monitoring assays were used to validate the reliability of the DEPs. The majority of the results were consistent with previous proteomics results, in particular that for expression of neudesin neurotrophic factor (NENF). NENF may potentially represent an antihypertensive drug target.
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Affiliation(s)
- Jingrong Liang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
| | - Jiaojuan Wu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
| | - Xudong Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
| | - Xiaomin Hao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
| | - Tianxiao Zeng
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
| | - Jiao Sun
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
| | - Zhi Ji
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
| | - Kibeum Park
- Shenzhen New Element Clinic, Shenzhen Bay Ecological Science and Technology Park, Shenzhen, Guangdong 518000, P.R. China
| | - Kaimin Li
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, P.R. China
| | - Qingguo Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
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Tang H, Qin S, Li W, Chen X, Ulloa L, Zhu Q, Liu B, Gong Y, Zhao Y, Wang S, Li S, Guo Y, Xu Z, Guo Y. P2RX7 in Dopaminergic Neurons of Ventral Periaqueductal Gray Mediates HTWP Acupuncture-Induced Consciousness in Traumatic Brain Injury. Front Cell Neurosci 2021; 14:598198. [PMID: 33519382 PMCID: PMC7838360 DOI: 10.3389/fncel.2020.598198] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/04/2020] [Indexed: 11/13/2022] Open
Abstract
The induction of a coma by traumatic brain injury (TBI) is a crucial factor for poor clinical prognoses. We report that acupuncture at the hand 12 Jing-Well points (HTWP) improved consciousness and neurologic function in TBI rats. Gene chip analyses showed that HTWP acupuncture mostly activated genes modulating neuronal projections (P2rx7, P2rx3, Trpv1, Tacr1, and Cacna1d), protein secretion (Exoc1, Exoc3l1, Fgb, and Fgr), and dopamine (DA) receptor D3 (Drd3) in the ventral periaqueductal gray (vPAG), among which the expression rate of P2rx7 was the most obviously increased. Acupuncture also increased the expression and excitability of DA and P2RX7 neurons, and the DA neurons expressed P2RX7, P2RX3, and TRPV1 in the vPAG. Intracerebroventricular administration of P2RX7, P2RX3, or TRPV1 antagonists blocked acupuncture-induced consciousness, and the subsequent injection of a P2RX7 antagonist into the vPAG nucleus also inhibited this effect. Our findings provide evidence that acupuncture alleviates TBI-induced comas via DA neurons expressing P2RX7 in the vPAG, so as to reveal the cellular and molecular mechanisms of the improvement of TBI clinical outcomes by HTWP acupuncture.
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Affiliation(s)
- Huiling Tang
- Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Siru Qin
- Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wei Li
- Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuyi Chen
- Department of Neurosurgery, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China.,Institution of Brain Trauma and Neurology Disease of People's Armed Police Forces, Tianjin, China.,Tianjin Key Laboratory of Neurotrauma Repair, Tianjin, China
| | - Luis Ulloa
- Department of Anesthesiology, Center of Perioperative Organ Protection, Duke University Medical Center, Durham, NC, United States
| | - Qiumei Zhu
- Luoding Hospital of Traditional Chinese Medicine, Guangdong, China
| | - Baohu Liu
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yinan Gong
- Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yadan Zhao
- Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Songtao Wang
- Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shanshan Li
- Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yongming Guo
- Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,School of Acupuncture & Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhifang Xu
- Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,School of Acupuncture & Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yi Guo
- Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Peroxisome proliferator-activated receptor-γ mediates the antihypertensive effects of acupuncture in spontaneously hypertensive rats. Neuroreport 2020; 31:952-958. [PMID: 32568773 DOI: 10.1097/wnr.0000000000001496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We investigated a central antihypertensive effect of acupuncture in rostral ventrolateral medulla (RVLM) in spontaneously hypertensive rats (SHRs). In total, 56 rats were randomly divided into seven groups as follows: the SHR group, SHR+acupuncture (SHR+Acu) group, SHR+nonacupuncture (SHR+Non-acu) group, GW9662+acupuncture (GW9662+Acu) group, GW9662+GW1929 group, GW9662 group, and 2% DMSO group (n = 8 per group). The whole eight Wistar-Kyoto rats were assigned to the WKY group. The acupuncture treatment lasting for 14 days was performed at the Taichong acupoint (LR3) or at a nonacupoint (non-acu) once daily. The peroxisome proliferator-activated receptor (PPAR)-γ agonist GW1929 and the PPAR-γ inhibitor GW9662 were microinjected by the brain stereotactic technique. Blood pressure was measured by the tail-cuff method. Sympathetic vasomotor activity was determined by implanting in a telemetry electrocardiogram radio transmitter. The expression of PPARs in the RVLM of the rats was detected using Western blot. We demonstrated that acupuncture attenuated blood pressure, heart rate, and sympathetic vasomotor activity in SHRs. The protein expression of PPAR-γ was significantly increased in SHRs treated with acupuncture. The antihypertensive effects of acupuncture in SHRs were abrogated by microinjection bilaterally into RVLM of GW9662. Microinjection of GW1929 mimicked the antihypertensive effect of acupuncture. PPAR-γ expression was negatively correlated with blood pressure and sympathetic vasomotor activity in SHRs treated with acupuncture. These results suggested that acupuncture promoted a central antihypertensive effect by increasing the expression of PPAR-γ in RVLM of SHRs.
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Jung H, Yeo S, Lim S. Effects of acupuncture on cardiovascular risks in patients with hypertension: a Korean cohort study. Acupunct Med 2020; 39:116-125. [PMID: 32567334 DOI: 10.1177/0964528420920290] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the effects of acupuncture on major adverse cardiovascular events (MACE), myocardial infarction, stroke and death in hypertensive patients taking anti-hypertensives. METHODS Using the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) database, this study identified 59,370 patients taking anti-hypertensives who had been diagnosed with hypertension between 2003 and 2006. They were divided into acupuncture and non-acupuncture groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke or death. After propensity score matching (PSM), there were 18,011 patients each in the non-acupuncture and acupuncture groups. We calculated the incidence rate, hazard ratio (HR) and 95% confidence interval (CI) for MACE, myocardial infarction, stroke and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. RESULTS After PSM, the HRs for MACE (0.83, 95% CI 0.80-0.86), all-cause mortality (0.73, 95% CI 0.70-0.76) and myocardial infarction (0.85, 95% CI 0.79-0.92) were significantly lower in the acupuncture group than in the non-acupuncture group. Moreover, the HRs for stroke-related mortality, hemorrhage stroke-related mortality, ischemic stroke-related mortality, ischemic heart disease-related mortality and circulatory system disease-related mortality were significantly lower in the acupuncture group than in the non-acupuncture group. CONCLUSION This observational study with long-term follow-up extends the evidence base in support of the effectiveness of acupuncture for the management of hypertension and potentially reduce the burden of cardiovascular disease.
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Affiliation(s)
- Hyejin Jung
- Research Group of Pain and Neuroscience, East-West Medical Research Institute, 26723Kyung Hee University and WHO Collaborating Center for Traditional Medicine, Seoul, South Korea.,Department of Meridian & Acupoint, College of Korean Medicine, 26723Kyung Hee University, Seoul, South Korea
| | - Sujung Yeo
- Department of Meridian & Acupoint, College of Korean Medicine, 35004Sangji University, Wonju, South Korea
| | - Sabina Lim
- Research Group of Pain and Neuroscience, East-West Medical Research Institute, 26723Kyung Hee University and WHO Collaborating Center for Traditional Medicine, Seoul, South Korea.,Department of Meridian & Acupoint, College of Korean Medicine, 26723Kyung Hee University, Seoul, South Korea
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Fan H, Yang JW, Wang LQ, Huang J, Lin LL, Wang Y, Zhang N, Liu CZ. The Hypotensive Role of Acupuncture in Hypertension: Clinical Study and Mechanistic Study. Front Aging Neurosci 2020; 12:138. [PMID: 32523527 PMCID: PMC7261879 DOI: 10.3389/fnagi.2020.00138] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/23/2020] [Indexed: 01/03/2023] Open
Abstract
As a component of traditional Chinese medicine (TCM), acupuncture has the potential to lower blood pressure (BP) in patients with hypertension. Emerging evidence indicates that the acupuncture-induced inhibition of high BP occurs through the activation of the pathway in the afferent, central, and efferent pathways. An increasing number of studies have demonstrated that acupuncture not only activates distinct brain regions under conditions of hypertension caused by an imbalance between the sympathetic and parasympathetic systems but also modulates neurotransmitters in related brain regions to alleviate the autonomic response. The activity of these pathways can be assessed by injecting agonists or inhibitors or by performing neurotomy. This review focuses on the clinical and mechanistic studies of acupuncture in modulating BP, which might provide a neurobiological foundation for the effects of acupuncture. Although many mechanisms underlying the effects of acupuncture on cardiovascular function have been identified, further investigation is warranted.
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Affiliation(s)
- Hao Fan
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.,Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Jing-Wen Yang
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Li-Qiong Wang
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jin Huang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Lu-Lu Lin
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Na Zhang
- School of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Cun-Zhi Liu
- Acupuncture Research Center, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Abstract
Objective: To confirm that acupuncture applied to patients would improve the clinical curative effect and accelerate the patient's recovery by introducing the application of acupuncture in pre-operation, during operation, and post-operation. Data sources: Literature cited in this review was retrieved from PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) and was primarily published in English or Chinese from 2010 to 2018, with keywords of “acupuncture,” “electroacupuncture,” “perioperative period,” “sedation,” “analgesia,” and “recovery.” Relevant citations in the retrieved articles were also screened to include more data. Study selection: All retrieved literature was scrutinized, most typical articles related on perioperative acupuncture application in clinical study were reviewed. Results: Acupuncture could relieve anxiety and stress during the preoperative stage. It reduces the usage of narcotics and stress response, and maintains the respiratory stability and homeostasis during surgery. It also exerts a protective effect on vital organs, and during the postoperative stages, enhances the recovery while effectively alleviating the postoperative pain. This phenomenon prevents common postoperative discomforts such as nausea and vomiting. In addition, it might improve the patients’ long-term prognosis. Conclusions: The novel concept “perioperative acupuncture medicine” is to focus on the optimal treatment in the perioperative period of surgical patients. The review reveals the important role of acupuncture in enhancing rapid recovery of patients during the perioperative period.
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Tan YY, Fang L, Yao FR, Cao DY, Zhang Q. Orexin Receptor-1 in the Rostral Ventrolateral Medulla Mediates the Antihypertensive Effects of Electroacupuncture. Front Neurosci 2019; 13:282. [PMID: 30971886 PMCID: PMC6443850 DOI: 10.3389/fnins.2019.00282] [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: 12/05/2018] [Accepted: 03/11/2019] [Indexed: 12/15/2022] Open
Abstract
Electroacupuncture (EA) has been used to treat numerous diseases, including hypertension. This study aimed to investigate the long-term effect and underlying mechanisms of EA stimulation at the LI11 point on the hypertension and sympathetic nerve activity in two-kidney, one-clip (2K1C) hypertensive rats. EA (0.1–0.4 mA, 2 and 15 Hz) was applied to the acupoints LI11 overlying the deep radial nerve once a day for 6 weeks. The mean arterial pressure (MAP) and heart rate (HR) were determined by radiotelemetry, and the sympathetic nerve activity was evaluated by telemetric analyses of the low-frequency component of blood pressure (BP) and by plasma epinephrine and norepinephrine levels. The results showed 6 weeks of EA significantly lowered the increased BP effectively, inhibited the enhanced sympathetic nerve activities and attenuated cardiac hypertrophy in 2K1C hypertensive rats. The level of orexin receptor-1 (OX1R) in the rostral ventrolateral medulla (RVLM) after EA treatment was markedly reduced in 2K1C rats, while there was no difference in the RVLM expression of orexin receptor-2 (OX2R) in 2K1C and 2K1C+EA rats. Moreover, the increased pressor and depressor responses to microinjection of orexin A or OX1R antagonist SB408124 into the RVLM of 2K1C rats were significantly blunted by the EA treatment. These findings suggest that BP-lowering effect of EA on renovascular hypertension may be through inhibition of central sympathetic activities and modulation of functional orexin receptors in the RVLM.
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Affiliation(s)
- Ying-Ying Tan
- Shaanxi Key Laboratory of Chinese Medicine Encephalopathy, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Ling Fang
- Shaanxi Key Laboratory of Chinese Medicine Encephalopathy, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Fan-Rong Yao
- Department of Biochemistry and Molecular Biology, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Dong-Yuan Cao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, China
| | - Qi Zhang
- Shaanxi Key Laboratory of Chinese Medicine Encephalopathy, Shaanxi University of Chinese Medicine, Xianyang, China
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Li J, Peng C, Lai D, He K, Wang Y, Zhang G, Wu Y, Nie B, Shan B, Tang C, Lai X. Changes in cerebral glucose metabolism after acupuncture at KI3 in spontaneously hypertensive rats: a positron emission tomography study. Acupunct Med 2019; 37:107-115. [DOI: 10.1177/0964528419828733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: The aim of this study was to explore the effect of acupuncture stimulation at KI3 on brain glucose metabolism in spontaneously hypertensive rats (SHRs). Methods: Brain glucose metabolism in SHRs after acupuncture stimulation at KI3 was detected using 18F-2-fluorodeoxy-D-glucose positron emission tomography (18F-FDG-PET). SHRs were randomly divided into three groups: no treatment (SHR group); acupuncture at KI3 (KI3 group); and sham acupuncture (Sham group). Wistar Kyoto (WKY) rats were used as a normal blood pressure (BP) control group. Rats were subjected to 10 min of acupuncture once a day for 7 days. BP and positron emission tomography–computed tomography (PET-CT) were measured after the first acupuncture session and after 7 days of treatment. Results: The results showed that BP was lower in the KI3 group than in the SHR group, both 30–60 min after the first acupuncture session and 24–48 h after the 7-day treatment. Compared with the WKY group, the SHR group had lower glucose metabolism in the motor cortex, sensory cortex, basal ganglia, corpus callosum, caudate putamen, and visual cortex. Compared with the untreated/sham-treated SHR control groups, cerebral glucose metabolism was lower in the medulla oblongata, thalamus, dorsal thalamus, orbital cortex, and hypothalamus after acupuncture at KI3, while it was higher in the olfactory cortex and inferior phrenic muscle. Conclusion: Our results show that, in SHRs, needling at KI3 reduces high BP, most likely by altering the activation of cerebral regions.
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Affiliation(s)
- Jing Li
- Clinical School of Acupuncture and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chong Peng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dongjian Lai
- Department of Rehabilitation, Yuexiu District Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Kejie He
- Clinical School of Acupuncture and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yumei Wang
- Clinical School of Acupuncture and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Gaochuan Zhang
- Clinical School of Acupuncture and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuwen Wu
- Clinical School of Acupuncture and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Binbin Nie
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
| | - Baoci Shan
- Division of Nuclear Technology and Applications, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
| | - Chunzhi Tang
- Clinical School of Acupuncture and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinsheng Lai
- Clinical School of Acupuncture and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
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Lin TJ, Ko HC, Wu JYW, Oei TP, Lane HY, Chen CH. The Effectiveness of Dialectical Behavior Therapy Skills Training Group vs. Cognitive Therapy Group on Reducing Depression and Suicide Attempts for Borderline Personality Disorder in Taiwan. Arch Suicide Res 2019. [PMID: 29528807 DOI: 10.1080/13811118.2018.1436104] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In this study the effectiveness of the condensed Dialectical Behavior Therapy Skills Training Group (DBTSTG) was compared to the Cognitive Therapy Group (CTG) in reducing depression and suicide reattempt and modifying emotion regulation strategies among those with borderline personality disorder (BPD). A total of 82 depressed BPD college students with a suicidal history within the past 6-months were randomly allocated to DBTSTG or CTG. Both groups had similar reductions in suicide reattempts and depression after the intervention and 6-month follow-ups. However, the CTG showed improvements in cognitive errors, but the DBTSTG revealed increases in acceptance and decreases in suppression scores. Both groups were effective in decreasing depression and suicide reattempt in BPD college students, probably through increasing adaptive antecedent-focused or response-focused strategies of emotion regulation, respectively.
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Electroacupuncture Improves Baroreflex and γ-Aminobutyric Acid Type B Receptor-Mediated Responses in the Nucleus Tractus Solitarii of Hypertensive Rats. Neural Plast 2018; 2018:8919347. [PMID: 30363902 PMCID: PMC6186317 DOI: 10.1155/2018/8919347] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/12/2018] [Indexed: 01/09/2023] Open
Abstract
Electroacupuncture (EA) has been reported to benefit hypertension, but the underlying mechanisms are still unclear. We hypothesized that EA attenuates hypertension, in part, through modulation of γ-aminobutyric acid (GABA) receptor function in the nucleus tractus solitarii (NTS). In the present study, the long-term effect of EA on GABA receptor function and expression was examined in the NTS of two-kidney, one-clip (2K1C) renovascular hypertensive rats. EA (0.1-0.4 mA, 2 and 15 Hz) was applied at Zusanli (ST36) acupoints overlying the deep fibular nerve for 30 min once a day for two weeks. The results showed that long-term EA treatment improved blood pressure (BP) and markedly restored the baroreflex response in 2K1C hypertensive rats. The increased pressor and depressor responses to microinjection of GABAB receptor agonist and antagonist into the NTS in the hypertensive rats were blunted by the EA treatment. Moreover, EA treatment attenuated the increased GABAB receptor expression in the NTS of hypertensive rats. In contrast, EA had no significant effect on the GABAA receptor function and expression in the NTS of 2K1C hypertensive rats. These findings suggest that the beneficial effects of EA on renovascular hypertension may be through modulation of functional GABAB receptors in the NTS.
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14
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Magden ER. Spotlight on acupuncture in laboratory animal medicine. VETERINARY MEDICINE-RESEARCH AND REPORTS 2017; 8:53-58. [PMID: 30050856 PMCID: PMC6042487 DOI: 10.2147/vmrr.s125609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Acupuncture has been practiced for thousands of years, although it is only in the past century that science has worked to unravel the mechanisms behind its use. Literature supporting the efficacious use of acupuncture to treat a variety of conditions has been and continues to be published, including the randomized controlled studies we all appreciate when practicing evidence-based medicine. The use of acupuncture in veterinary medicine has paralleled the trends observed in people, with an increasingly common use to remedy specific medical conditions. These conditions are commonly related to neurological dysfunction or orthopedic pain. Although pain relief is the most common use of acupuncture, numerous other conditions have been shown to improve with this therapy. Laboratory animals are also benefiting from acupuncture. Its use is starting to be incorporated into research settings, although there is still further progress to be made in this field. Acupuncture has been shown to improve clinical conditions and quality of life in laboratory animals, and should be considered as a tool to treat laboratory animals with conditions known to benefit from therapy. Here we review the history, mechanisms of action, and use of acupuncture to treat veterinary patients and laboratory animals.
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Affiliation(s)
- Elizabeth R Magden
- Department of Veterinary Sciences, Michale E Keeling Center for Comparative Medicine and Research, University of Texas MD Anderson Cancer Center, Bastrop, TX, USA,
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15
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Abdominal and auricular acupuncture reduces blood pressure in hypertensive patients. Complement Ther Med 2017; 31:20-26. [PMID: 28434467 DOI: 10.1016/j.ctim.2017.01.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 12/27/2016] [Accepted: 01/16/2017] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Hypertension is an important risk factor of cardiovascular disease (CVD), which is associated with premature death, myocardial infarction, stroke, peripheral vascular disease, and renal disease. The goal of the present study was to use a randomized controlled clinical trial to explore and compare the effectiveness of abdominal and auricular acupuncture on blood pressure in 440 subjects with and without obesity. METHODS Four hundred participants were recruited and randomized to one of four groups: cases and controls receiving auricular acupuncture (204 subjects) and cases and controls receiving abdominal electroacupuncture (196 subjects). Blood pressure and anthropometric parameters were measured before and after the intervention period. In order to match the initial diet of the groups, participants were required to follow an isocaloric diet for two weeks before the trial, and a low-calorie diet for 6 weeks during the intervention period. RESULTS We observed a significant time dependent improvement in the systolic blood pressure measurements in the abdominal intervention group, although this improvement was more pronounce in the first period of study. Of note, in the auricular intervention group, a significant increasing in the level of SBP was detected. Importantly no statistically significant changes were found in the corresponding sham groups. CONCLUSIONS Our findings demonstrated that abdominal electro-acupuncture for 6 weeks reduced both systolic and diastolic blood pressure and auricular acupuncture had a short-term adverse effect on both SBP and DBP.
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Hubkova T. Lifestyle Approaches to White Coat Hypertension. Am J Lifestyle Med 2017; 11:29-32. [DOI: 10.1177/1559827616673024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This case presentation illustrates the importance of 24 hour ambulatory blood pressure monitoring in patients with white coat hypertension, as many progress into sustained hypertension over time. Also, it serves as a reminder not to overlook a possible underlying sleep breathing disorder in patients who are not obese or fatigued. Finally, the case provides an opportunity to review the value of non-pharmacological and lifestyle approaches to the treatment of both white coat hypertension and sustained hypertension.
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Affiliation(s)
- Tereza Hubkova
- Medical Department, Canyon Ranch in Lenox, Lenox, Massachusetts
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