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Zheng JY, Zhu J, Wang Y, Tian ZZ. Effects of acupuncture on hypothalamic-pituitary-adrenal axis: Current status and future perspectives. JOURNAL OF INTEGRATIVE MEDICINE 2024; 22:445-458. [PMID: 38955651 DOI: 10.1016/j.joim.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/08/2024] [Indexed: 07/04/2024]
Abstract
The hypothalamic-pituitary-adrenal (HPA) axis is a critical component of the neuroendocrine system, playing a central role in regulating the body's stress response and modulating various physiological processes. Dysregulation of HPA axis function disrupts the neuroendocrine equilibrium, resulting in impaired physiological functions. Acupuncture is recognized as a non-pharmacological type of therapy which has been confirmed to play an important role in modulating the HPA axis and thus favorably targets diseases with abnormal activation of the HPA axis. With numerous studies reporting the promising efficacy of acupuncture for neuroendocrine disorders, a comprehensive review in terms of the underlying molecular mechanism for acupuncture, especially in regulating the HPA axis, is currently in need. This review fills the need and summarizes recent breakthroughs, from the basic principles and the pathological changes of HPA axis dysfunction, to the molecular mechanisms by which acupuncture regulates the HPA axis. These mechanisms include the modulation of multiple neurotransmitters and their receptors, neuropeptides and their receptors, and microRNAs in the paraventricular nucleus, hippocampus, amygdala and pituitary gland, which alleviate the hyperfunctioning of the HPA axis. This review comprehensively summarizes the mechanism of acupuncture in regulating HPA axis dysfunction for the first time, providing new targets and prospects for further exploration of acupuncture. Please cite this article as: Zheng JY, Zhu J, Wang Y, Tian ZZ. Effects of acupuncture on hypothalamic-pituitary-adrenal axis: Current status and future perspectives. J Integr Med. 2024; 22(4): 446-459.
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Affiliation(s)
- Jia-Yuan Zheng
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science, Institute of Acupuncture Research, Academy of Integrative Medicine, Shanghai Key Laboratory for Acupuncture Mechanism and Acupoint Function, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Jing Zhu
- Department of Human Anatomy, School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yu Wang
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science, Institute of Acupuncture Research, Academy of Integrative Medicine, Shanghai Key Laboratory for Acupuncture Mechanism and Acupoint Function, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Zhan-Zhuang Tian
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science, Institute of Acupuncture Research, Academy of Integrative Medicine, Shanghai Key Laboratory for Acupuncture Mechanism and Acupoint Function, Shanghai Medical College, Fudan University, Shanghai 200032, China.
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2
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Wu XD, Yan HJ, Xu YM, Zhao SY, Zhang XD, Lv L, Zhu KL. Effect and mechanism of needleless transcutaneous neuromodulation on gastrointestinal function after pancreaticoduodenectomy. Scand J Gastroenterol 2024; 59:133-141. [PMID: 37752679 DOI: 10.1080/00365521.2023.2261060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Gastrointestinal motility disorders tend to develop after pancreaticoduodenectomy (PD). The objectives of this study were: (1) to investigate the impact of needleless transcutaneous neuromodulation (TN) on the postoperative recuperation following pancreaticoduodenectomy (PD), and (2) to explore the underlying mechanisms by which TN facilitates the recovery of gastrointestinal function after PD. METHODS A total of 41 patients scheduled for PD were randomized into two groups: the TN group (n = 21) and the Sham-TN group (n = 20). TN was performed at acupoints ST-36 and PC-6 twice daily for 1 h from the postoperative day 1 (POD1) to day 7. Sham-TN was performed at non-acupoints. Subsequent assessments incorporated both heart rate variation and dynamic electrogastrography to quantify alterations in vagal activity (HF) and gastric pacing activity. RESULTS 1)TN significantly decreased the duration of the first passage of flatus (p < 0.001) and defecation (p < 0.01) as well as the time required to resume diet (p < 0.001) when compared to sham-TN;2)Compared with sham-TN, TN increased the proportion of regular gastric pacing activity (p < 0.01);3) From POD1 to POD7, there was a discernible augmentation in HF induced by TN stimulation(p < 0.01);4) TN significantly decreased serum IL-6 levels from POD1 to POD7 (p < 0.001);5) TN was an independent predictor of shortened hospital stay(β = - 0.349, p = 0.035). CONCLUSION Needleless TN accelerates the recovery of gastrointestinal function and reduces the risk of delayed gastric emptying in patients after PD by enhancing vagal activity and controlling the inflammatory response.
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Affiliation(s)
- Xu-Dong Wu
- Hepatopancreatobiliary Surgery, The Affiliated People's Hospital of Ningbo University, Ningbo University, Ningbo, China
| | - Huan-Jun Yan
- Hepatopancreatobiliary Surgery, The Affiliated People's Hospital of Ningbo University, Ningbo University, Ningbo, China
| | - Yue-Mei Xu
- Gastroenterology, The Affiliated People's Hospital of Ningbo University, Ningbo University, Ningbo, China
| | - Shuang-Ying Zhao
- Hepatopancreatobiliary Surgery, The Affiliated People's Hospital of Ningbo University, Ningbo University, Ningbo, China
| | - Xiao-Dong Zhang
- Hepatopancreatobiliary Surgery, The Affiliated People's Hospital of Ningbo University, Ningbo University, Ningbo, China
| | - Li- Lv
- Department of Infectious Diseases, Zhejiang University School of Medicine, Hangzhou, China
| | - Ke-Lei Zhu
- Hepatopancreatobiliary Surgery, The Affiliated People's Hospital of Ningbo University, Ningbo University, Ningbo, China
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3
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Seibold JM, Abeykoon SW, Ross AE, White RJ. Development of an Electrochemical, Aptamer-Based Sensor for Dynamic Detection of Neuropeptide Y. ACS Sens 2023; 8:4504-4511. [PMID: 38033269 PMCID: PMC11214579 DOI: 10.1021/acssensors.3c00855] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
The ability to monitor dynamic changes in neuropeptide Y (NPY) levels in complex environments can have an impact on many fields, including neuroscience and immunology. Here, we describe the development of an electrochemical, aptamer-based (E-AB) sensor for the dynamic (reversible) measurement of physiologically relevant (nanomolar) concentrations of neuropeptide Y. The E-AB sensors are fabricated using a previously described 80 nucleotide aptamer1 reported to specifically bind NPY with a binding affinity Kd = 0.3 ± 0.2 uM. We investigated two redox tag placement locations on the aptamer sequence (terminal vs internal) and various sensor fabrication and interrogation parameters to tune the performance of the resulting sensor. The best-performing sensor architecture displayed a physiologically relevant dynamic range (nM) and low limit of detection and is selective among competitors and similar molecules. The development of this sensor accomplishes two breakthroughs: first, the development of a nonmicrofluidic aptamer-based electrochemical sensor that can detect NPY on a physiologically relevant (seconds to minutes) time scale and across a relevant concentration range; second, the expansion of the range of molecules for which an electrochemical, aptamer-based sensor can be used.
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Affiliation(s)
- Jordan M. Seibold
- University of Cincinnati Department of Chemistry 312 College Dr. 404 Crosley Tower Cincinnati, OH 45221-0172
| | - Sanduni W. Abeykoon
- University of Cincinnati Department of Chemistry 312 College Dr. 404 Crosley Tower Cincinnati, OH 45221-0172
| | - Ashley E. Ross
- University of Cincinnati Department of Chemistry 312 College Dr. 404 Crosley Tower Cincinnati, OH 45221-0172
| | - Ryan J. White
- University of Cincinnati Department of Chemistry 312 College Dr. 404 Crosley Tower Cincinnati, OH 45221-0172
- Department of Electrical and Computer Engineering
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4
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Yu L, Wang Y, Zhang H, Li M, Chen G, Hao J, Xie M. Involvement of purinergic P2Y1R in antidepressant-like effects of electroacupuncture treatment on social isolation stress mice. Purinergic Signal 2023; 19:55-68. [PMID: 35094240 PMCID: PMC9984636 DOI: 10.1007/s11302-021-09827-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 10/31/2021] [Indexed: 12/28/2022] Open
Abstract
Depression is a common neuropsychiatric disorder with high incidence and disability. Electroacupuncture (EA) is effective in the treatment of depression. However, the underlying mechanisms are not fully understood. Social isolation stress during post-weaning period can impair purinergic signaling in the brain of rodents and has emerged as a major risk factor for depression. The purpose of this study was to investigate the involvement of P2Y1 receptor (P2Y1R) in the antidepressant-like effects of EA. In this study, C57BL/6 mice were randomly assigned to group-housed (GH) or social isolated (SI) groups at post-natal day 21. After 6 weeks of social isolation, EA was performed on acupoints "Bai-hui" (GV20) and "Yin-tang" (GV29), or non-acupoints for 4 weeks. The SI mice received either intracerebroventricular injection of a selective P2Y1R agonist, MRS2365 (1 nmol); or a selective P2Y1R antagonist, MRS2179 (2 μmol), before and after EA. We found that SI mice exhibited depression-like behaviors accompanied with anxiety-like behaviors. The expressions of P2Y1R were well co-localized with GFAP-positive astrocytes and increased in the prefrontal cortex and hippocampus of SI mice. After treated with MRS2179, the depression-like behaviors of SI mice were attenuated, but not with MRS2365. Meanwhile, we found that EA could attenuate social isolation caused depression- and anxiety-like behaviors, and inhibited the up-regulation of P2Y1R in the prefrontal cortex and hippocampus of SI mice. Notably, the positive effects of EA on depression-like behaviors of SI mice could be reversed by MRS2365, while MRS2365 had no effect on the anxiolytic-like effects of EA. Therefore, we provide new evidence that EA could ameliorate depression- and anxiety-like behaviors in social isolation stress mice, and P2Y1R was involved in the antidepressant-like effects of EA.
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Affiliation(s)
- Lingling Yu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan, China.,Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yao Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hong Zhang
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Man Li
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guang Chen
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan, China
| | - Jiahuan Hao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Minjie Xie
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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5
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Abanes JJ, Ridner SH, Dietrich MS, Hiers C, Rhoten B. Acupuncture for Sleep Disturbances in Post-Deployment Military Service Members: A Randomized Controlled Trial. Clin Nurs Res 2021; 31:239-250. [PMID: 34229475 DOI: 10.1177/10547738211030602] [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: 11/17/2022]
Abstract
This RCT and mixed-methods study examined the difference between two groups receiving the following interventions: (1) brief manual standardized stress acupuncture (MSSA) combined with an abbreviated Cognitive Behavioral Therapy (ACBT) versus (2) ACBT alone. Three study aims: Aim (1): Insomnia Severity Index (ISI) and Pittsburg Sleep Quality Index (PSQI) scores were analyzed using descriptive summaries, linear regression, and reliable change index (RCI). Aim (2): Journal entries were analyzed using content analysis. Aim (3): Acupuncture Expectancy Scale (AES) scores were analyzed using paired t-test and RCI. Aim (1): Both groups demonstrated similar improvements in the ISI scores (p = .480). Aim (2): The ACBT/MSSA group reported greater benefits in sleep and in other life areas including mental, physical, and social functioning. Aim (3): The AES showed that 21.6% had a clinically meaningful increase in expectations in the effect of acupuncture for stress (p = .965). The study was registered in ClinicalTrials.gov (NCT04031365) at https://clinicaltrials.gov/ct2/show/NCT04031365 on July 24, 2019.
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Affiliation(s)
| | | | - Mary S Dietrich
- Vanderbilt University School of Nursing, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Cynthia Hiers
- James H. Quillen VA Medical Center, Sevierville, TN, USA
| | - Bethany Rhoten
- Vanderbilt University School of Nursing, Nashville, TN, USA
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6
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Jung J, Lee SM, Lee MJ, Ryu JS, Song JH, Lee JE, Kang G, Kwon OS, Park JY. Lipidomics reveals that acupuncture modulates the lipid metabolism and inflammatory interaction in a mouse model of depression. Brain Behav Immun 2021; 94:424-436. [PMID: 33607237 DOI: 10.1016/j.bbi.2021.02.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Depression is a serious disease that has considerable impact on lipid metabolism and inflammatory responses. Recent studies have shown that leptin, which is well known as a mediator of energy homeostasis and is a cytokine in inflammatory response, plays an important role in depression. Acupuncture is widely used to treat depression; however, the underlying mechanisms and the effect of acupuncture on depression remain poorly understood. In this study, we utilized the chronic restraint stress (CRS) induced depression model and acupuncture treatment was performed at KI10, LR8, LU8, LR4 (AP) or non-acupoint (NP). Then, lipidomics was applied to investigate the effects of acupuncture on lipid metabolism and analyze leptin signals in the brain and changes of immune markers. Acupuncture treatment at AP improved depression-like behavior in an open-field test, forced swimming test, and marble burying test. Concurrently, CRS mice treated with AP acupuncture (CRS + AP) had significantly lower levels of aspartate aminotransaminase (AST, liver injury markers) and exhibited different lipid patterns in liver lipidomic profiles. In particular, triglycerides (TGs) contributed the change of lipid patterns. Compared to the CRS mice, TGs with relatively high degrees of unsaturated fatty acids increased in the CRS + AP mice, but did not change in CRS mice treated with NP acupuncture (CRS + NP). The levels of leptin in plasma and leptin receptor positive cells in the brain (hypothalamus and hippocampus) decreased and increased, respectively, in the CRS + AP mice, while opposite patterns were exhibited in the CRS and CRS + NP mice. These results indicated that acupuncture treatment at AP attenuated leptin insensitivity in CRS mice. Additionally, expression of pro-inflammatory cytokines such as interleukin-1 beta and tumor necrosis factor-alpha were decreased in the spleen, plasma, and liver of CRS + AP mice, which was one of results of alleviation of leptin resistance. In conclusion, these results show that AP acupuncture treatment effectively alleviated the depression-like behavior, affected immune responses, and altered hepatic lipid metabolism through the attenuation of leptin insensitivity.
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Affiliation(s)
- Jeeyoun Jung
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054, Republic of Korea.
| | - So Min Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054, Republic of Korea
| | - Min-Ju Lee
- College of Korean Medicine, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea
| | - Jae-Sang Ryu
- College of Korean Medicine, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea
| | - Ji-Hye Song
- College of Korean Medicine, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea
| | - Jung-Eun Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054, Republic of Korea
| | - Geonhui Kang
- Clinical Trial Center, Wonkwang University Gwangju Hospital, 1140-23 Hoejae-ro, Nam-Gu, Gwangju 16729, Republic of Korea
| | - O Sang Kwon
- Department of Meridian and Acupuncture Points, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea
| | - Ji-Yeun Park
- College of Korean Medicine, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea.
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7
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Abanes J, Ridner SH, Rhoten B. Perceived benefits of a brief acupuncture for sleep disturbances in post-deployment military service members. J Clin Sleep Med 2021; 17:1533-1543. [PMID: 33687323 DOI: 10.5664/jcsm.9222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The purpose of this study was to describe the perceived benefits of a manual standardized stress acupuncture (MSSA) for sleep disturbances (SD) in service members with deployment exposure. METHODS This qualitative study was imbedded in a two-arm randomized controlled trial, mixed-methods research that evaluated the effect of weekly MSSA for four weeks as an adjunct treatment with an abbreviated cognitive behavioral therapy for insomnia (CBTi) for SD in service members. Participants were randomized to either the experimental group (CBTi and MSSA) and control group (CBTi only). CBTi consisted of one group psychotherapy for 60 minutes, a follow-up telephone therapy for 30 minutes, and additional four 30-minute follow-up sessions via telephone. Participants provided written journal entries by answering five open-ended questions about their treatment experiences at week five during the posttreatment assessment. Journal log entries were transcribed verbatim in the Dedoose software. A thematic content analysis method was used to code emerging themes. RESULTS Three overarching categories were found from the qualitative data: personal challenges in implementing the CBTi sleep strategies, no perception of improvement from treatment, and perceived benefits of treatment. The CBTi/MSSA group reported greater benefits in sleep and in other life areas including mental, physical, and social functioning using thematic content analysis. CONCLUSIONS Findings of this study showed greater improvements in participants' sleep, mood, physical health, and occupational and social functioning after receiving the combination of CBTi and MSSA. Future research that investigates the long-term effects of CBTi and MSSA may be beneficial among post-deployment service members. CLINICAL TRIAL REGISTRATION Our study was conducted as part of a mixed-methods study registered with clinicaltrials.gov identifier: NCT04031365.
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Affiliation(s)
| | - Sheila H Ridner
- Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Bethany Rhoten
- Vanderbilt University School of Nursing, Nashville, Tennessee
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8
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Mooventhan A, Ningombam R, Nivethitha L. Effect of bilateral needling at an acupuncture point, ST-36 (Zusanli) on blood glucose levels in type 2 diabetes mellitus patients: A pilot randomized placebo controlled trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 17:jcim-2019-0100. [PMID: 32406384 DOI: 10.1515/jcim-2019-0100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 10/14/2019] [Indexed: 11/15/2022]
Abstract
Background Diabetes mellitus is one of the major current public health problems. Electro-acupuncture at ST-36 showed a significant reduction in plasma glucose levels in diabetic rats. There are lacks of studies reporting its hypoglycemic effect in humans and thus, the present study was conducted to evaluate the effect of needling at ST-36 (Zusanli) on blood glucose levels in patients with type 2 diabetes mellitus (T2DM). Methods Sixty T2DM participants were recruited and randomized into acupuncture group (n=30) and placebo control group (n=30). The participants of the acupuncture group received needling at ST-36 (one finger breadth lateral to the inferior border of the tibial tuberosity), and the participants those in the placebo control group received needling at placebo point (midpoint between the apex of the patella and tibial tuberosity). For both the groups, needles were retained for 30 min. Baseline and post-test assessments were performed prior to and after each intervention. Statistical analysis was performed using SPSS version 16. Results The present study showed a significant reduction in random blood glucose levels in the acupuncture group compared to the placebo control group. Conclusion This study suggests that 30 min of bilateral acupuncture needling at ST-36 with manual stimulation is effective in reducing blood glucose levels in T2DM patients.
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Affiliation(s)
- A Mooventhan
- Department of Research and Development, Government Yoga and Naturopathy Medical College, Arumbakkam,Chennai-600106, India
| | - Reema Ningombam
- Division of Yoga and Life Sciences, The School of Yoga and Naturopathic Medicine, S-VYASA (Deemed to be University), Bengaluru, India
| | - L Nivethitha
- Department of Naturopathy, Government Yoga and Naturopathy Medical College, Arumbakkam,Chennai-600106, India
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9
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Zhang S, Liu Y, Li S, Ye F, Foreman RD, Chen JDZ. Effects of electroacupuncture on stress-induced gastric dysrhythmia and mechanisms involving autonomic and central nervous systems in functional dyspepsia. Am J Physiol Regul Integr Comp Physiol 2020; 319:R106-R113. [PMID: 32493036 DOI: 10.1152/ajpregu.00256.2019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Electroacupuncture (EA) is widely used as an effective method to treat stress-related disorders. However, its mechanisms remain largely unknown. The aim of this study was to investigate the effects and mechanisms of EA on gastric slow wave (GSW) dysrhythmia and c-Fos expression in the nucleus of the solitary tract (NTS) induced by stress in a rodent model of functional dyspepsia (FD). Rats in the neonatal stage were treated using intragastric iodoacetamide. Eight weeks later, the rats were implanted with electrodes in the stomach for the measurement of GSW and electrodes into accupoints ST36 for EA. Autonomic functions were assessed by spectral analysis of heart rate variability. Rats were placed for 30 min in a cylindrical plastic tube for acute restraint stress. The involvement of a central afferent pathway was assessed by measuring c-Fos-immunoreactive cells in the NTS. 1) EA normalized restraint stress-induced impairment of GSW in FD rats. 2) EA significantly increased vagal activity (P = 0.002) and improved sympathovagal balance (P = 0.004) under stress in FD rats. 3) In FD rats under restraint stress, plasma norepinephrine concentration was increased substantially (P < 0.01), which was suppressed with EA. 4) The EA group showed increased c-Fos-positive cell counts in the NTS compared with the sham EA group (P < 0.05) in FD rats. Acute restraint stress induces gastric dysrhythmia in a rodent model of FD. EA at ST36 improves GSW under stress in FD rats mediated via the central and autonomic pathways, involving the NTS and vagal efferent pathway.
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Affiliation(s)
- Sujuan Zhang
- Veterans Research and Education Foundation, Veterans Affairs Medical Center, Oklahoma City, Oklahoma.,Department of Physiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma.,Department of Gastroenterology, No. 983 Hospital of Chinese People's Liberation Army, Tianjin, China
| | - Yi Liu
- Veterans Research and Education Foundation, Veterans Affairs Medical Center, Oklahoma City, Oklahoma.,Department of Physiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma.,Department of Traditional Chinese Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi, China
| | - Shiying Li
- Veterans Research and Education Foundation, Veterans Affairs Medical Center, Oklahoma City, Oklahoma.,Division of Gastroenterology and Hepatology, The Johns Hopkins University, Baltimore, Maryland
| | - Feng Ye
- Veterans Research and Education Foundation, Veterans Affairs Medical Center, Oklahoma City, Oklahoma.,Department of Physiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma.,Department of Hepatology, 1st Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi, China
| | - Robert D Foreman
- Department of Physiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Jiande D Z Chen
- Veterans Research and Education Foundation, Veterans Affairs Medical Center, Oklahoma City, Oklahoma.,Division of Gastroenterology and Hepatology, The Johns Hopkins University, Baltimore, Maryland
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10
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Lin JCF, Lin TC, Cheng CF, Lin YJ, Liang S, Chang YJ, Liang WM. Lower rates of mortality, readmission and reoperation in patients receiving acupuncture after hip fracture: a population-based analysis. Acupunct Med 2020; 38:352-360. [PMID: 32429674 DOI: 10.1177/0964528420911664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Studies on the effects of acupuncture on mortality and complication rates in hip fracture patients are limited by small sample size and short follow-up time. We aimed to assess the associations of acupuncture use with mortality, readmission and reoperation rates in hip fracture patients using a longitudinal population-based database. METHODS A retrospective matched cohort study was conducted using data for the years 1996-2012 from Taiwan's National Health Insurance Research Database. Hip fracture patients were divided into an acupuncture group consisting of 292 subjects who received at least 6 acupuncture treatments within 183 days of hip fracture, and a propensity score matched "no acupuncture" group of 876 subjects who did not receive any acupuncture treatment and who functioned as controls. The two groups were compared using survival analysis and competing risk analysis. RESULTS Compared to non-treated subjects, subjects treated with acupuncture had a lower risk of overall death (hazard ratio (HR): 0.41, 95% confidence interval (CI): 0.24-0.73, p = 0.002), a lower risk of readmission due to medical complications (subdistribution HR (sHR): 0.64, 95% CI: 0.44-0.93, p = 0.019) and a lower risk of reoperation due to surgical complications (sHR: 0.62, 95% CI: 0.40-0.96, p = 0.034). CONCLUSION This is the first study to suggest that postoperative acupuncture in hip fracture patients is associated with significantly lower mortality, readmission and reoperation rates compared with those of matched controls.
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Affiliation(s)
- Jeff Chien-Fu Lin
- Department of Statistics, National Taipei University, Taipei, Taiwan.,Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Chieh Lin
- Department of Public Health, China Medical University, Taichung, Taiwan.,Division of Traumatology, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chi-Fung Cheng
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Ying-Ju Lin
- School of Chinese Medicine, China Medical University, Taichung.,Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Sophia Liang
- Sophie Davis Biomedical Education Program, CUNY School of Medicine, New York, NY, USA
| | - Yu-Jun Chang
- Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Wen-Miin Liang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
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11
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Abanes J, Hiers C, Rhoten B, Dietrich MS, Ridner SH. Feasibility and Acceptability of a Brief Acupuncture Intervention for Service Members with Perceived Stress. Mil Med 2020; 185:e17-e22. [PMID: 31247110 DOI: 10.1093/milmed/usz132] [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] [Received: 03/06/2019] [Revised: 04/23/2019] [Accepted: 05/22/2019] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Given the role of perceived stress in disability and suicidality in the military, intervening early before service members become at risk for severe injuries, hospitalizations, and chronic disability could improve health outcomes. The purpose of this study was to explore the feasibility and acceptability of a standardized stress acupuncture (SSA) approach on perceived stress in U.S. military personnel. This study had the following aims: examine feasibility of recruitment for SSA and implementation of study procedures in preparation for a methodologically rigorous study; examine acceptability of SSA treatment in a sample of military personnel with perceived stress; and examine change in perceived stress and general health before and after SSA. MATERIALS AND METHODS This was a single-arm, single-site study protocol which assessed the feasibility of SSA in 16 patients with perceived stress. Upon IRB approval and written informed consent, the participants received 4 weekly sessions of SSA which consisted of 6 acupuncture points. RESULTS This study showed that recruitment and implementation of SSA is feasible in service members. Service members found SSA to be acceptable. Statistically significant increases were found on the energy/fatigue, well-being, and social functioning components of the Short Form Health Survey (SF 36) (reliable change: 50%, 56%, and 25% respectively, Cohen's d = 0.72-0.78, all p < 0.05). A statistically significant decrease in perceived stress based was found on the Perceived Stress Scale (PSS) (reliable change 63%, Cohen's d = 1.03, p = 0.001). CONCLUSION These results suggest that SSA is a feasible and acceptable treatment for perceived stress in military personnel. Preliminary findings suggest that SSA may be useful in improving energy/fatigue, social functioning, and perceived stress of service members.
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Affiliation(s)
- Jane Abanes
- Department Head, Mental Health, Naval Hospital, Camp Pendleton, CA, PSC 482 BOX 2903, FPO, AP 96362
| | - Cynthia Hiers
- James H. Quillen, VA Medical Center, 130 Burning Oaks Dr., Sevierville, TN 37876
| | - Bethany Rhoten
- Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240
| | - Mary S Dietrich
- Vanderbilt University School of Medicine, Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240
| | - Sheila H Ridner
- Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240
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Hu Y, Zhang B, Shi X, Ning B, Shi J, Zeng X, Liu F, Chen JD, Xie WF. Ameliorating Effects and Autonomic Mechanisms of Transcutaneous Electrical Acustimulation in Patients With Gastroesophageal Reflux Disease. Neuromodulation 2019; 23:1207-1214. [PMID: 31859433 DOI: 10.1111/ner.13082] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 09/22/2019] [Accepted: 10/30/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND/AIM Gastric dysmotility is one of pathophysiologies of gastroesophageal reflux disease (GERD). The aim of this study was to investigate the effects of transcutaneous electrical acustimulation (TEA) on gastric accommodation and gastric slow waves, and evaluate possible mechanisms in patients with GERD. METHODS Thirty patients were studied in two randomized sessions of sham-TEA and TEA with the measurements of esophageal high-resolution manometry (HRM), gastric accommodation assessed by a nutrient-drinking test, electrogastrogram (EGG), electrocardiogram (ECG), and postprandial dyspeptic symptoms. RESULTS Compared with sham-TEA, TEA improved nutrient drinking-induced fullness (42.0 ± 3.3 vs. 31.0 ± 3.5, P = 0.003) at 10 min after the drink, and belching right after the drink (22.0 ± 4.6 vs. 11.7 ± 3.1, P = 0.012) and at 10 min (16.0 ± 3.8 vs. 3.0 ± 1.5, P = 0.002) after the drink. TEA also improved gastric accommodation (954 ± 37 mL vs. 857 ± 47 mL, P = 0.001) and normalized maximal drink-induced impairment in gastric slow waves. Concurrently, TEA enhanced vagal activity assessed from spectral analysis of heart rate variability in the postprandial state (0.42 ± 0.03 vs. 0.49 ± 0.04, P = 0.039). The vagal activity was positively correlated with the percentage of normal slow waves (r = 0.528; P = 0.003) and negatively correlated with the regurgitation score (r = -0.408, P = 0.025). CONCLUSIONS Acute TEA increases gastric accommodation, improves gastric slow waves, and reduces postprandial fullness and belching, possibly mediated via the vagal mechanisms.
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Affiliation(s)
- Yedong Hu
- Department of Gastroenterology, Shanghai East Hospital Affiliated Tongji University, Shanghai, China
| | - Bo Zhang
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xiaodan Shi
- Department of Gastroenterology, Shanghai East Hospital Affiliated Tongji University, Shanghai, China
| | - Beifang Ning
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jian Shi
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xin Zeng
- Department of Gastroenterology, Shanghai East Hospital Affiliated Tongji University, Shanghai, China
| | - Fei Liu
- Department of Gastroenterology, Shanghai East Hospital Affiliated Tongji University, Shanghai, China
| | - Jiande Dz Chen
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
| | - Wei-Fen Xie
- Department of Gastroenterology, Shanghai East Hospital Affiliated Tongji University, Shanghai, China.,Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Lee MJ, Ryu JS, Won SK, Namgung U, Jung J, Lee SM, Park JY. Effects of Acupuncture on Chronic Stress-Induced Depression-Like Behavior and Its Central Neural Mechanism. Front Psychol 2019; 10:1353. [PMID: 31333523 PMCID: PMC6625224 DOI: 10.3389/fpsyg.2019.01353] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/24/2019] [Indexed: 12/17/2022] Open
Abstract
Depression is a serious psychiatric disorder with an enormous socioeconomic burden, and it is commonly comorbid with pain, chronic fatigue, or other inflammatory diseases. Recent studies have shown that acupuncture is an effective therapeutic method for reducing depressive symptoms; however, the underlying mechanism remains unknown. In this study, we investigated the effects of acupuncture on chronic stress-induced depression-like behavior and its central neural mechanisms in the brain. We induced chronic restraint stress (CRS) in male C57BL/6 mice for 14 or 28 consecutive days. Acupuncture treatment was performed at KI10·LR8·LU8·LR4 or control points for 7 or 14 days. Depression-like behavior was assessed with the open field test. Then, brain neural activity involving c-Fos and serotonin-related mechanisms via the 5-HT1A and 5-HT1B receptors were investigated. Acupuncture treatment at KI10·LR8·LU8·LR4 points rescued the depressive-like behavior, while control points (LU8·LR4·HT8·LR2) and non-acupoints on the hips did not. Brain neural activity was changed in the hippocampus, cingulate cortex, motor cortex, insular cortex, thalamus, and the hypothalamus after acupuncture treatment. Acupuncture treatment increased expression of 5-HT1A receptor in the cortex, hippocampus, thalamus, and the hypothalamus, and of 5-HT1B in the cortex and thalamus. In conclusion, acupuncture treatment at KI10·LR8·LU8·LR4 was effective in alleviating the depressive-like behavior in mice, and this therapeutic effect was produced through central brain neural activity and serotonin receptor modulation.
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Affiliation(s)
- Min-Ju Lee
- Department of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Jae-Sang Ryu
- Department of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Seul-Ki Won
- Department of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Uk Namgung
- Department of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Jeeyoun Jung
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - So-Min Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ji-Yeun Park
- Department of Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
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Effect of Electroacupuncture on Hyperalgesia and Vasoactive Neurotransmitters in a Rat Model of Conscious Recurrent Migraine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:9512875. [PMID: 31217804 PMCID: PMC6537014 DOI: 10.1155/2019/9512875] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/13/2019] [Accepted: 05/02/2019] [Indexed: 12/24/2022]
Abstract
Migraine onset is associated with the abnormal release of vasoactive neurotransmitters from perivascular nerves, and these neurotransmitters are involved in the pathophysiology of migraine. Hyperalgesia is a key feature of migraine, and accumulating evidence indicates that electroacupuncture (EA) at the single acupuncture point (Fengchi [GB20]) is effective in ameliorating hyperalgesia. In clinical practice, multiple acupuncture points are widely used, especially GB20 and Yanglingquan (GB34). However, the role played by vasoactive neurotransmitters in acupuncture antihyperalgesic effect at the single or multiple acupuncture points remains unknown. We aimed to determine whether EA would exert its antihyperalgesic effects by modulating vasoactive neurotransmitter release from the perivascular nerves. Furthermore, we examined whether targeting multiple acupuncture points would be more effective than targeting a single point in reducing hyperalgesia. The mechanical and thermal hyperalgesia were evaluated by measuring the facial and hind-paw mechanical withdrawal thresholds, tail-flick and hot-plate latencies. Plasma concentrations of vasoactive neurotransmitters were determined using rat-specific ELISA kits from jugular vein, including calcitonin gene-related peptide (CGRP), substance P (SP), vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), pituitary adenylate cyclase-activating polypeptide (PACAP), nitric oxide (NO), and endothelin-1 (ET-1). The result suggested that EA significantly ameliorated the mechanical and thermal hyperalgesia, reduced c-Fos levels in the trigeminal ganglion, and attenuated plasma and dural levels of vasoactive neurotransmitters, especially in the multiple acupuncture points group (GB20+GB34). In conclusion, EA exerts antihyperalgesic effect in a rat model of conscious recurrent migraine, possibly via modulation of the vasoactive neurotransmitters. Furthermore, targeting multiple acupuncture points is more effective than targeting a single point in reducing hyperalgesia.
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15
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Zhang M, Du Q, Yang F, Guo Y, Hou Y, Zhu P. Acupuncture at PC6 prevents cardiac hypertrophy in isoproterenol-treated mice. Acupunct Med 2019; 37:55-63. [PMID: 30843422 DOI: 10.1136/acupmed-2017-011418] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To investigate the effect of acupuncture at PC6 on cardiac hypertrophy in isoproterenol (ISO)-treated mice. METHODS 48 male C57BL/6 mice underwent subcutaneous injection of ISO for 14 days and were randomly divided into four groups (n=12 each) that remained untreated (ISO group), received verum manual acupuncture (MA) treatment at PC6 (ISO+MA(PC6) group), sham MA at location on the tail not corresponding to any traditional acupuncture point (ISO+MA(tail) group), or propranolol (ISO+PR group). An additional 12 mice were given an injection of phosphate-buffered saline (PBS) and formed a healthy control (Normal) group. After performing echocardiography and measuring the ratio of heart weight (HW)/tibia length (TL) at 14 days, all mice were euthanased. Morphological examination was performed following haematoxylin and eosin and Masson's staining of heart tissues. Ultrastructural changes were observed by electron microscopy. Cardiac protein expression of atrial natriuretic peptide (ANP) and tumour necrosis factor α (TNFα) were measured by immunohistochemical (IHC) staining and Western blotting. RESULTS Compared with the untreated model group, acupuncture at PC6 lowered the heart rate, reduced the ratio of HW/TL, improved the left ventricular (LV) anterior wall thickness (LVAWd), LV end-diastolic anterior wall thickness (LVAWs), LV end-systolic posterior wall thickness (LVPWd), LV end-diastolic posterior wall thickness (LVPWs), and fractional shortening (FS) as observed by echocardiography (ISO+MA(PC6) vs. ISO groups: P<0.05). Moreover, evidence from morphological studies demonstrated that acupuncture at PC6 inhibited myocardial hypertrophy and collagen deposition, and normalised the ultrastructural changes. In addition, ANP and TNFα expression were attenuated in the verum acupuncture group compared with the untreated model group (ISO+MA(PC6) vs. ISO groups: P<0.05). CONCLUSIONS The results demonstrated that acupuncture at PC6 attenuates sympathetic overactivity. Additionally, it may improve cardiac performance by reversing adverse cardiac remodelling. Acupuncture has potential as a treatment for sympathetic hypertension.
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Affiliation(s)
- Miao Zhang
- 1 Second Affiliated Hospital of Heilongjiang TCM University, Harbin, China
| | - Qigen Du
- 1 Second Affiliated Hospital of Heilongjiang TCM University, Harbin, China
| | - Fubiao Yang
- 2 Department of Medical Affairs, Heilongjiang TCM University, Harbin, China
| | - Ying Guo
- 1 Second Affiliated Hospital of Heilongjiang TCM University, Harbin, China
| | - Yunlong Hou
- 3 Department of Pharmacology, Harbin Medical University, Harbin, China
| | - Pengyu Zhu
- 1 Second Affiliated Hospital of Heilongjiang TCM University, Harbin, China
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16
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Zhang B, Xu F, Hu P, Zhang M, Tong K, Ma G, Xu Y, Zhu L, Chen JDZ. Needleless Transcutaneous Electrical Acustimulation: A Pilot Study Evaluating Improvement in Post-Operative Recovery. Am J Gastroenterol 2018; 113:1026-1035. [PMID: 29925916 DOI: 10.1038/s41395-018-0156-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/30/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Functional gastrointestinal disturbance occurs after abdominal surgeries and could last for an extended period of time in some cases. This study was designed (1) to evaluate the effects of needleless transcutaneous electrical acustimulation (TEA) on postoperative recovery, and (2) to investigate the mechanisms involving autonomic function in postoperative patients after removal of gastrointestinal cancers. METHODS Forty-two patients (33 male, age: 69.5 ± 1.5 years) scheduled for abdominal surgical removal of gastrointestinal cancers were randomized to TEA (n = 21) and sham-TEA (n = 21). TEA was performed via acupoints ST36 and PC6 1 h twice daily from the postoperative day (POD) 1 to day 3. Sham-TEA was performed at non-acupoints. RESULTS (1) TEA improved major postoperative symptoms by about 30%, including a reduction in time to defecation by 31.7% (P < 0.01 vs. sham-TEA), time to first flatus by 35.9% (P < 0.001), time to ambulation by 42.8% (P < 0.01), time to resuming diet by 26.5% (P < 0.01) and hospital stay by 30% (P < 0.05) as well as pain score by 50% (P < 0.01). (2) TEA significantly increased vagal activity (P < 0.001) and decreased sympathetic activity on POD 4 (P < 0.001) compared with POD 1 as well as the serum level of NE (P < 0.05). (3) The vagal activity, high frequency assessed from the spectral analysis of heart rate variability, was negatively correlated with time to resuming diet, whereas the sympathetic measurement, serum norepinephrine was positively correlated with time to resuming diet and time to flatus. (4) TEA but not sham-TEA decreased TNF-α by 17.4% from POD 1 to POD 4. (5) TEA was an independent predictor of a shorter hospital stay. CONCLUSIONS Needleless TEA improves major postoperative symptoms by enhancing vagal and suppressing sympathetic activities.
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Affiliation(s)
- Bo Zhang
- Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu.,Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu
| | - Feng Xu
- Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu
| | - Pingping Hu
- Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu
| | - Mingyuan Zhang
- Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu
| | - Kehui Tong
- Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu
| | - Gang Ma
- Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu.,Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu
| | - Yuemei Xu
- Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu
| | - Liang Zhu
- Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu
| | - Jiande D Z Chen
- Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu.,Department of Gastroenterology, Changzheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China. Ningbo Pace Translational Medical Research Center, Ningbo, Zhejiang, China. Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Gastroenterology Surgical Department, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China. Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China. Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA. These authors contributed equally: Bo Zhang, Feng Xu
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Yang Y, Babygirija R, Zheng J, Shi B, Sun W, Zheng X, Zhang F, Cao Y. Central Neuropeptide Y Plays an Important Role in Mediating the Adaptation Mechanism Against Chronic Stress in Male Rats. Endocrinology 2018; 159:1525-1536. [PMID: 29425286 DOI: 10.1210/en.2018-00045] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/17/2018] [Indexed: 12/31/2022]
Abstract
Exposure to continuous life stress often causes gastrointestinal (GI) symptoms. Studies have shown that neuropeptide Y (NPY) counteracts the biological actions of corticotrophin-releasing factor (CRF) and is involved in the termination of the stress response. However, in chronic repeated restraint stress (CRS) conditions, the actions of NPY on GI motility remain controversial. To evaluate the role of NPY in mediation of the adaptation mechanism and GI motility in CRS conditions, a CRS rat model was set up. Central CRF and NPY expression levels were analyzed, serum corticosterone and NPY concentrations were measured, and GI motor function was evaluated. The NPY Y1 receptor antagonist BIBP-3226 was centrally administered before stress loading, and on days 1 through 5 of repeated stress, the central CRF and the serum corticosterone concentrations were measured. In addition, gastric and colonic motor functions were evaluated. The elevated central CRF expression and corticosterone concentration caused by acute stress began to fall after 3 days of stress loading, whereas central NPY expression and serum NPY began to increase. GI dysmotility also returned to a normal level. Pretreatment with BIBP-3226 abolished the adaptation mechanism and significantly increased CRF expression and the corticosterone concentration, which resulted in delayed gastric emptying and accelerated fecal pellet output. Inhibited gastric motility and enhanced distal colonic motility were also recorded. CRS-produced adaptation, overexpressed central CRF, and GI dysmotility observed in acute restraint stress were restored to normal levels. Central NPY via the Y1 receptor plays an important role in mediating the adaptation mechanism against chronic stress.
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Affiliation(s)
- Yu Yang
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Reji Babygirija
- Department of Surgery, Medical College of Wisconsin and Zablocki VA Medical Center, Milwaukee, Wisconsin
| | - Jun Zheng
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Bei Shi
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Weinan Sun
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Xiaojiao Zheng
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Fan Zhang
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
| | - Yu Cao
- Department of Physiology, College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, China
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Maccariello CEM, Franzini de Souza CC, Morena L, Dias DPM, Medeiros MAD. Effects of acupuncture on the heart rate variability, cortisol levels and behavioural response induced by thunder sound in beagles. Physiol Behav 2018; 186:37-44. [DOI: 10.1016/j.physbeh.2018.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/20/2017] [Accepted: 01/08/2018] [Indexed: 12/30/2022]
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Ko SJ, Kuo B, Kim SK, Lee H, Kim J, Han G, Kim J, Kim SY, Jang S, Son J, Kim M, Lee H, Yeo I, Joo KR, Park JW. Individualized Acupuncture for Symptom Relief in Functional Dyspepsia: A Randomized Controlled Trial. J Altern Complement Med 2016; 22:997-1006. [PMID: 27732083 DOI: 10.1089/acm.2016.0208] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES This study was implemented to evaluate the effect of individualized acupuncture treatment (AT) on functional dyspepsia (FD). METHODS A randomized, waitlist-controlled, two-center trial was performed. Seventy-six patients with FD were enrolled in the trial with partially individualized AT in a more realistic clinical setting performed twice a week for 15 minutes a session over 4 weeks. The participants were randomly allocated to a group receiving 8 sessions of AT for 4 weeks or a waitlist control group. After 4 consecutive weeks, the AT group was followed up without AT and the control group received the identical AT. The proportion of responders with adequate symptom relief, Nepean Dyspepsia Index (NDI), FD-related quality of life, Beck Depression Inventory, State-Trait Anxiety Inventory, Acupuncture Belief Scale, and acupuncture credibility test were assessed. RESULTS After the first 4 weeks, the proportion of responders significantly improved (59% in AT group [n = 37] versus 3% in control group [n = 39]; p < 0.001). The difference was no longer significant at 8 weeks, at which point the waitlist control group showed similar improvement after receiving AT (68% in the AT group versus 79% in the control group). Total NDI scores were significantly reduced in the AT group compared with the waitlist group (p = 0.03). Among NDI items, discomfort (p = 0.01), burning (p = 0.02), fullness after eating (p = 0.02), and burping (p = 0.02) were significantly improved in the AT group compared with the control group. No significant differences were observed between groups in other secondary variables. CONCLUSION Individualized AT adequately relieves symptoms in patients with FD, and this effect may persist up to 8 weeks.
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Affiliation(s)
- Seok-Jae Ko
- 1 Department of Gastroenterology, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Braden Kuo
- 2 Department of Gastroenterology, Center for Neurointestinal Health , Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Seul-Ki Kim
- 1 Department of Gastroenterology, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Hyangsook Lee
- 3 Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Jinsung Kim
- 1 Department of Gastroenterology, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Gajin Han
- 1 Department of Gastroenterology, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Juyeon Kim
- 1 Department of Gastroenterology, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Song-Yi Kim
- 3 Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Seungwon Jang
- 1 Department of Gastroenterology, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Jiyoung Son
- 1 Department of Gastroenterology, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Minji Kim
- 1 Department of Gastroenterology, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Hyejung Lee
- 3 Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Inkwon Yeo
- 4 Department of Statistics, Sookmyung Women's University , Seoul, Republic of Korea
| | - Kwang Ro Joo
- 5 Department of Gastroenterology, School of Medicine, Kyung Hee University , Seoul, Republic of Korea
| | - Jae-Woo Park
- 1 Department of Gastroenterology, College of Korean Medicine, Kyung Hee University , Seoul, Republic of Korea
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Zhang N, Song G, Chen J, Xu F, Yin J, Wu Q, Lin L, Chen JDZ. Ameliorating effects and autonomic mechanisms of needle-less transcutaneous electrical stimulation at ST36 on stress-induced impairment in gastric slow waves. J Gastroenterol Hepatol 2015; 30:1574-81. [PMID: 25974066 DOI: 10.1111/jgh.12995] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIM Stress has long been documented to alter gastrointestinal motility. The effects of electroacupuncture (EA) on stress and gastric motility are relatively well known; however, whether EA has an ameliorating effect on stress-induced dysmotility remained unclear. This study aims to investigate the effects and mechanisms of needle-less transcutaneous electroacupuncture (TEA) on stress-induced impairment in gastric slow waves. METHODS A watch-size digital stimulator was developed. Ten healthy volunteers were involved in a four-session study (control, cold stress, TEA, and sham TEA). Electrogastrograpy was used to assess gastric slow waves, and electrocardiogram was recorded for the assessment of autonomic functions. The recordings were made in each session with/without stress and with TEA at ST36 or sham points. RESULTS The results are as follows: (i) Cold stress-induced gastric dysrhythmia and impaired normal slow waves (P < 0.01). TEA showed a preventive effect on cold stress-induced impairment in gastric slow waves. TEA at ST36, but not sham TEA, normalized slow waves (P = 0.03 vs stress; P = 0.44 vs control), attributed to the suppression of gastric dysrhythmia; (ii) Postprandially, there was a decrease in vagal activity in both control (P = 0.004) and stress (P = 0.002) sessions; this decrease was prevented with TEA (P < 0.05). Similarly, there was a postprandial increase in sympathetic activity in both control (P = 0.01) and stress (P = 0.002) sessions, and this increase was suppressed with TEA. CONCLUSIONS Needle-less TEA at ST36 using a watch-size stimulator is able to improve stress-induced impairment in gastric slow waves, possibly mediated via the autonomic mechanism. Home-based needle-less TEA may be a viable therapy for stress-induced impairment in gastric motility functions.
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Affiliation(s)
- Nina Zhang
- Division of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Ningbo Pace Translational Medical Research Center, Ningbo, China
| | - Gengqing Song
- Ningbo Pace Translational Medical Research Center, Ningbo, China
| | | | - Feng Xu
- Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical College of Ningbo University, Ningbo, China
| | - Jieyun Yin
- Ningbo Pace Translational Medical Research Center, Ningbo, China
| | - Qiong Wu
- Ningbo Pace Translational Medical Research Center, Ningbo, China
| | - Lin Lin
- Division of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiande D Z Chen
- Ningbo Pace Translational Medical Research Center, Ningbo, China.,Division of Gastroenterology and Hepatology, Johns Hopkins Center of Neurogastroenterology, Baltimore, MD, USA
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Eshkevari L, Mulroney SE, Egan R, Lao L. Effects of Acupuncture, RU-486 on the Hypothalamic-Pituitary-Adrenal Axis in Chronically Stressed Adult Male Rats. Endocrinology 2015. [PMID: 26196540 DOI: 10.1210/en.2015-1018] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We have recently reported that pretreatment with electroacupuncture (EA) at stomach meridian point 36 (St36) prevents the chronic cold-stress increase in the hypothalamus-pituitary-adrenal axis (HPA), an action that may be under central control. Given that treatment for stress-related symptoms usually begins after onset of the stress responses, the objectives of the present study were to determine the efficacy of EA St36 on HPA hormones when EA St36 is given after stress was initiated, if the results are long lasting, and if blocking the glucocorticoid receptor (GR) using RU-486 had the same effects as EA St36. Adult male rats were placed in 4 groups of animals, 3 of which were exposed to cold and 1 of which was a nontreatment control group. After exposure to the cold stress, 2 groups were treated with either EA St36 or sham-EA, repeated over 10 days. The increase in ACTH and corticosterone observed in stress-only rats was prevented in EA St36 animals, and the effects remained intact 4 days after withdrawal of EA but continuation of cold stress. When the GR was blocked with RU-486, the efficacy of EA St36 remained unchanged. GR blockade did significantly elevate ACTH, which is not seen with EA St36, suggesting that EA St36 does act centrally. The elevated HPA hormones in stress-only rats were associated with a significant increase in depressive and anxious behavior; this was not observed in the stressed EA St36 animals. The results indicate that EA specifically at St36 vs sham-EA is effective in treating chronic poststress exposure.
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Affiliation(s)
- Ladan Eshkevari
- School of Nursing and Health Studies (L.E.), Department of Pharmacology and Physiology (L.E., S.E.M., R.E.), Georgetown University Medical Center, Washington, DC 20007; and School of Chinese Medicine (L.L.), The University of Hong Kong, Pokfulam, Hong Kong
| | - Susan E Mulroney
- School of Nursing and Health Studies (L.E.), Department of Pharmacology and Physiology (L.E., S.E.M., R.E.), Georgetown University Medical Center, Washington, DC 20007; and School of Chinese Medicine (L.L.), The University of Hong Kong, Pokfulam, Hong Kong
| | - Rupert Egan
- School of Nursing and Health Studies (L.E.), Department of Pharmacology and Physiology (L.E., S.E.M., R.E.), Georgetown University Medical Center, Washington, DC 20007; and School of Chinese Medicine (L.L.), The University of Hong Kong, Pokfulam, Hong Kong
| | - Lixing Lao
- School of Nursing and Health Studies (L.E.), Department of Pharmacology and Physiology (L.E., S.E.M., R.E.), Georgetown University Medical Center, Washington, DC 20007; and School of Chinese Medicine (L.L.), The University of Hong Kong, Pokfulam, Hong Kong
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Acupuncture Affects Autonomic and Endocrine but Not Behavioural Responses Induced by Startle in Horses. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:219579. [PMID: 26413116 PMCID: PMC4568046 DOI: 10.1155/2015/219579] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 07/20/2015] [Accepted: 08/04/2015] [Indexed: 12/12/2022]
Abstract
Startle is a fast response elicited by sudden acoustic, tactile, or visual stimuli in a variety of animals and in humans. As the magnitude of startle response can be modulated by external and internal variables, it can be a useful tool to study reaction to stress. Our study evaluated whether acupuncture can change cardiac autonomic modulation (heart rate variability); and behavioural (reactivity) and endocrine (cortisol levels) parameters in response to startle. Brazilian Sport horses (n = 6) were subjected to a model of startle in which an umbrella was abruptly opened near the horse. Before startle, the horses were subjected to a 20-minute session of acupuncture in acupoints GV1, HT7, GV20, and BL52 (ACUP) and in nonpoints (NP) or left undisturbed (CTL). For analysis of the heart rate variability, ultrashort-term (64 s) heart rate series were interpolated (4 Hz) and divided into 256-point segments and the spectra integrated into low (LF; 0.01–0.07 Hz; index of sympathetic modulation) and high (HF; 0.07–0.50 Hz; index of parasympathetic modulation) frequency bands. Acupuncture (ACUP) changed the sympathovagal balance with a shift towards parasympathetic modulation, reducing the prompt startle-induced increase in LF/HF and reducing cortisol levels 30 min after startle. However, acupuncture elicited no changes in behavioural parameters.
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Kim SK, Sun B, Yoon H, Lee JH, Lee G, Sohn SH, Kim H, Quan FS, Shim I, Ha J, Min BI, Bae H. Expression levels of the hypothalamic AMPK gene determines the responsiveness of the rats to electroacupuncture-induced analgesia. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:211. [PMID: 24980520 PMCID: PMC4096532 DOI: 10.1186/1472-6882-14-211] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 06/25/2014] [Indexed: 01/10/2023]
Abstract
BACKGROUND Although electroacupuncture (EA) relieves various types of pain, individual differences in the sensitivity to EA analgesia have been reported, causing experimental and clinical difficulties. Our functional genomic study using cDNA microarray identified that 5'-AMP-activated protein kinase (AMPK), a well-known factor in the regulation of energy homeostasis, is the most highly expressed gene in the hypothalamus of the rats that were sensitive to EA analgesia ("responder"), as compared to the rats that were insensitive to EA analgesia ("non-responder"). In this study, we investigated the causal relationship between the hypothalamic AMPK and the individual variation in EA analgesia. METHODS Sprague-Dawley (SD) rats were divided into the responder and the non-responder groups, based on EA-induced analgesic effects in the tail flick latency (TFL) test, which measures the latency of the tail flick response elicited by radiant heat applied to the tail. Real-time reverse transcription-polymerase chain reaction (RT-PCR) was performed to quantify the expression levels of AMPK mRNA in the hypothalamus of the responder and non-responder rats. Further, we examined whether viral manipulation of the AMPK expression in the hypothalamus modulates EA analgesia in rats. RESULTS The real-time RT-PCR analysis showed that mRNA expression levels of AMPK in the hypothalamus of the responder rats are significantly higher than those of the non-responder rats, validating the previous microarray results. Microinjection of dominant negative (DN) AMPK adenovirus, which inhibits AMPK activity, into the rat hypothalamus significantly attenuates EA analgesia (p < 0.05), whereas wild type (WT) AMPK virus did not affect EA analgesia (p > 0.05). CONCLUSIONS The present results demonstrated that levels of AMPK gene expression in the rat hypothalamus determine the individual differences in the sensitivity to EA analgesia. Thus, our findings provide a clinically useful evidence for the application of acupuncture or EA for analgesia.
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Affiliation(s)
- Sun Kwang Kim
- Department of Physiology, College of Korean Medicine, Kyung Hee University, 130-701 Seoul, Republic of Korea
| | - Boram Sun
- Department of East-West Medicine, Graduate School, Kyung Hee University, 130-701 Seoul, Republic of Korea
| | - Heera Yoon
- Department of Physiology, College of Korean Medicine, Kyung Hee University, 130-701 Seoul, Republic of Korea
| | - Ji Hwan Lee
- Department of Physiology, College of Korean Medicine, Kyung Hee University, 130-701 Seoul, Republic of Korea
- Department of Microbiology, Pusan National University, 609-735 Busan, Republic of Korea
| | - Giseog Lee
- Department of Physiology, College of Korean Medicine, Kyung Hee University, 130-701 Seoul, Republic of Korea
- Department of East-West Medicine, Graduate School, Kyung Hee University, 130-701 Seoul, Republic of Korea
| | - Sung-Hwa Sohn
- Department of Physiology, College of Korean Medicine, Kyung Hee University, 130-701 Seoul, Republic of Korea
- Department of Physiology, School of Medicine, Ajou University, 443-721 Suwon, Republic of Korea
| | - Hyunseong Kim
- Department of Physiology, College of Korean Medicine, Kyung Hee University, 130-701 Seoul, Republic of Korea
| | - Fu Shi Quan
- Department of Medical Zoology, School of Medicine, Kyung Hee University, 130-701 Seoul, Republic of Korea
| | - Insop Shim
- Acupuncture & Meridian Science Research Center, Kyung Hee University, 130-701 Seoul, Republic of Korea
| | - Joohun Ha
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, 130-701 Seoul, Republic of Korea
| | - Byung-Il Min
- Department of East-West Medicine, Graduate School, Kyung Hee University, 130-701 Seoul, Republic of Korea
- Department of Physiology, School of Medicine, Kyung Hee University, 130-701 Seoul, Republic of Korea
| | - Hyunsu Bae
- Department of Physiology, College of Korean Medicine, Kyung Hee University, 130-701 Seoul, Republic of Korea
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Abstract
As a nonspecific physical stimulation, the effect of acupuncture on diseases is produced by motivating the inherent regulatory system in the body, having the characteristics of whole regulation, dual directional regulation, etc. Modern scientific researches show that body's inherent regulatory system is neuro-endocrine-immune (NEI) network. Hence, we speculate that the regulatory effect of acupuncture may be produced through its regulation of NEI network. In this article, we reviewed the recent researches about acupuncture's effect on the NEI network, to find out the evidence of acupuncture adjusting NEI network and provide some evidences for revealing the mechanism of acupuncture.
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Affiliation(s)
- S S Ding
- College of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, No. 312 Anshan West Road, Nankai District, Tianjin 300193, China.
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Meyer RM, Barber BA, Kobylecka M, Gold JI. Examining the Association Between Parental Stress Related to Child Illness and Child Pain Across Acupuncture Treatments. Med Acupunct 2014. [DOI: 10.1089/acu.2013.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Rika M.L. Meyer
- Pediatric Pain Management Clinic, Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA
| | - Beth A. Barber
- Departments of Pediatrics, University Center for Excellence in Developmental Disabilities, University of Southern California, Los Angeles, CA
| | - Monika Kobylecka
- Pediatric Pain Management Clinic, Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA
| | - Jeffrey I. Gold
- Pediatric Pain Management Clinic, Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA
- Departments of Pediatrics, University Center for Excellence in Developmental Disabilities, University of Southern California, Los Angeles, CA
- Departments of Anesthesiology and Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Kondo T, Kawamoto M. Acupuncture and moxibustion for stress-related disorders. Biopsychosoc Med 2014; 8:7. [PMID: 24456818 PMCID: PMC3903561 DOI: 10.1186/1751-0759-8-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 01/20/2014] [Indexed: 12/29/2022] Open
Abstract
Acupuncture and moxibustion, which medical doctors are licensed by the government of Japan to perform, can improve the psychological relationship between doctors and patients, especially when it is disturbed by a “game”, a dysfunctional interpersonal interaction that is repeated unintentionally. This advantage is due to the essential properties of acupuncture and moxibustion. Acupuncture and moxibustion are helpful in treating somatoform disorders, especially musculoskeletal symptoms. In Japan, a holistic acupuncture and moxibustion therapy called Sawada-style has been developed. This is based on fundamental meridian points that are considered to have effects on central, autonomic nervous, immune, metabolic, and endocrine systems to regulate the whole body balance. In addition, some of the fundamental points have effects on Qi, blood, and water patterns associated with major depression, generalized anxiety disorder, eating disorders, and somatoform disorders. The fixed protocol of Sawada-style would be suitable for large-scale, randomized, controlled studies in the future. Recent systematic reviews indicate that electroacupuncture would be a useful addition to antidepressant therapy for some symptoms accompanying fibromyalgia. Acupuncture and moxibustion are also recommended for irritable bowel syndrome, instead of Western drug therapy. Surprisingly, the dorsal prefrontal cerebral cortex, which is associated with a method of scalp acupuncture applied for gastrointestinal disorders, has been found to be activated in patients with irritable bowel syndrome. It is quite possible that regulation of this cortical area is related to the effect of scalp acupuncture. This acupuncture method can be effective not only for irritable bowel syndrome but also for other stress-related gastrointestinal disorders.
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Affiliation(s)
- Tetsuya Kondo
- Kansai University of Health Sciences, 2-11-1, Wakaba, Kumatori-cho, Sennan-gun 590-0482, Japan.
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Abstract
The field of anatomic pathology has changed significantly over the last decades and, as a result of the technological developments in molecular pathology and genetics, has had increasing pressures put on it to become quantitative and to provide more information about protein expression on a cellular level in tissue sections. Multispectral imaging (MSI) has a long history as an advanced imaging modality and has been used for over a decade now in pathology to improve quantitative accuracy, enable the analysis of multicolor immunohistochemistry, and drastically reduce the impact of contrast-robbing tissue autofluorescence common in formalin-fixed, paraffin-embedded tissues. When combined with advanced software for the automated segmentation of different tissue morphologies (eg, tumor vs stroma) and cellular and subcellular segmentation, MSI can enable the per-cell quantitation of many markers simultaneously. This article covers the role that MSI has played in anatomic pathology in the analysis of formalin-fixed, paraffin-embedded tissue sections, discusses the technological aspects of why MSI has been adopted, and provides a review of the literature of the application of MSI in anatomic pathology.
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Acupuncture effect and central autonomic regulation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:267959. [PMID: 23762116 PMCID: PMC3677642 DOI: 10.1155/2013/267959] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 04/03/2013] [Accepted: 04/03/2013] [Indexed: 02/07/2023]
Abstract
Acupuncture is a therapeutic technique and part of traditional Chinese medicine (TCM). Acupuncture has clinical efficacy on various autonomic nerve-related disorders, such as cardiovascular diseases, epilepsy, anxiety and nervousness, circadian rhythm disorders, polycystic ovary syndrome (PCOS) and subfertility. An increasing number of studies have demonstrated that acupuncture can control autonomic nerve system (ANS) functions including blood pressure, pupil size, skin conductance, skin temperature, muscle sympathetic nerve activities, heart rate and/or pulse rate, and heart rate variability. Emerging evidence indicates that acupuncture treatment not only activates distinct brain regions in different kinds of diseases caused by imbalance between the sympathetic and parasympathetic activities, but also modulates adaptive neurotransmitter in related brain regions to alleviate autonomic response. This review focused on the central mechanism of acupuncture in modulating various autonomic responses, which might provide neurobiological foundations for acupuncture effects.
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Eshkevari L, Permaul E, Mulroney SE. Acupuncture blocks cold stress-induced increases in the hypothalamus-pituitary-adrenal axis in the rat. J Endocrinol 2013; 217:95-104. [PMID: 23386059 DOI: 10.1530/joe-12-0404] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Electroacupuncture (EA) is used to treat chronic stress; however, its mechanism(s) of action in allaying stress remains unclear. The interplay of stress hormones of the hypothalamus-pituitary-adrenal axis (HPA) and the sympathetic nervous system (SNS) is critical in the stress response. Our objective was to determine whether EA at acupoint, stomach 36 (EA St₃₆) is effective in preventing chronic cold stress-induced increased hormone levels in the rat by examining four groups of animals, three of which were exposed to cold and one of which was a non-treatment control group. Before exposure to the cold, two groups were treated with either EA St₃₆, or Sham-EA, before 10 days of cold stress. The EA St₃₆ animals demonstrated a significant decrease in peripheral HP hormones (ACTH and CORT) compared with stress animals (P<0.05). These effects were specific; rats receiving Sham-EA had elevation of these hormones, similar to the stress-only animals. These effects were mirrored centrally in the brain; CRH levels were significantly (P<0.05) reduced in EA St₃₆ animals compared with the other animals. Finally, EA effect on peripheral and adrenal SNS hormones (norepinephrine (NE) and neuropeptide Y (NPY) respectively) was examined, with no significant difference noted in adrenal tyrosine hydroxylase or circulating NE in any of the groups. However, EA St₃₆ was effective in preventing stress-induced elevation is adrenal Npy mRNA. These results indicate that EA St₃₆ blocks the chronic stress-induced elevations in the HPA and the sympathetic NPY pathway, which may be a mechanism for its specific stress-allaying effects.
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Affiliation(s)
- Ladan Eshkevari
- School of Nursing and Health Studies, Georgetown University Medical Center, 421 St Mary's Hall, 3700 Reservoir Road NW, Washington, DC 20007, USA.
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Silberstein M. Is acupuncture "stimulation" a misnomer? A case for using the term "blockade". Altern Ther Health Med 2013; 13:68. [PMID: 23530528 PMCID: PMC3614535 DOI: 10.1186/1472-6882-13-68] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 03/19/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND The term used most frequently in the literature to describe acupuncture's effects is "stimulation" which may be used to describe either (or both) the direct stimulus applied to a needle as well as putative stimulation of the nervous system, despite little published evidence describing what is actually being stimulated. In contrast, recent published work has suggested that acupuncture may, in fact be inhibitory at a peripheral level, acting by blocking neural transmission. DISCUSSION The suggestion that acupuncture exerts its effects through peripheral neural blockade is supported by recent evidence explaining related techniques including low level laser and capsaicin at acupoints. It also explains acupuncture's effect on painful and non-painful conditions and both Eastern and Western concepts of acupuncture. There is a need for additional work to elucidate acupuncture's mechanism of action, and the suggestion that it acts through neural blockade should prompt further research in this direction. SUMMARY If the term "blockade" were applied to acupuncture, this would, likely, be expected to promote this minimally invasive technique, and, potentially, bring it into mainstream clinical practice for pain management as well as other therapeutic applications.
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Acupuncture for posttraumatic stress disorder: a systematic review of randomized controlled trials and prospective clinical trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:615857. [PMID: 23476697 PMCID: PMC3580897 DOI: 10.1155/2013/615857] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 10/15/2012] [Indexed: 01/08/2023]
Abstract
To evaluate the current evidence for effectiveness of acupuncture for posttraumatic stress disorder (PTSD) in the form of a systematic review, a systematic literature search was conducted in 23 electronic databases. Grey literature was also searched. The key search terms were “acupuncture” and “PTSD.” No language restrictions were imposed. We included all randomized or prospective clinical trials that evaluated acupuncture and its variants against a waitlist, sham acupuncture, conventional therapy control for PTSD, or without control. Four randomized controlled trials (RCTs) and 2 uncontrolled clinical trials (UCTs) out of 136 articles in total were systematically reviewed. One high-quality RCT reported that acupuncture was superior to waitlist control and therapeutic effects of acupuncture and cognitive-behavioral therapy (CBT) were similar based on the effect sizes. One RCT showed no statistical difference between acupuncture and selective serotonin reuptake inhibitors (SSRIs). One RCT reported a favorable effect of acupoint stimulation plus CBT against CBT alone. A meta-analysis of acupuncture plus moxibustion versus SSRI favored acupuncture plus moxibustion in three outcomes. This systematic review and meta-analysis suggest that the evidence of effectiveness of acupuncture for PTSD is encouraging but not cogent. Further qualified trials are needed to confirm whether acupuncture is effective for PTSD.
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