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Sodders MD, Deshpande SJ, Dusek JA, Bradley R, Vavilala MS. Acupuncture knowledge, attitudes, beliefs and health service needs after traumatic brain injury: a cross-sectional survey. Acupunct Med 2024; 42:194-208. [PMID: 38721741 DOI: 10.1177/09645284241249197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
BACKGROUND Acupuncture is a promising treatment for common symptoms after traumatic brain injury (TBI). Our objectives were to explore knowledge, attitudes and beliefs about acupuncture, identify health service needs and assess the perceived feasibility of weekly acupuncture visits among individuals with TBI. METHODS We surveyed adults 18 years of age and older with TBI who received care at the University of Washington. Respondents were asked to complete 143 questions regarding acupuncture knowledge, attitudes and beliefs, injury-related symptoms and comorbidities, and to describe their interest in weekly acupuncture. RESULTS Respondents (n = 136) reported a high degree of knowledge about acupuncture as a component of Traditional Chinese Medicine, needle use and safety, but were less knowledgeable regarding that the fact that most conditions require multiple acupuncture treatments to achieve optimal therapeutic benefit. Respondents were comfortable talking with healthcare providers about acupuncture (63.4%), open to acupuncture concurrent with conventional treatments (80.6%) and identified lack of insurance coverage as a barrier (50.8%). Beliefs varied, but respondents were generally receptive to using acupuncture as therapy. Unsurprisingly, respondents with a history of acupuncture (n = 60) had more acupuncture knowledge than those without such a history (n = 66) and were more likely to pursue acupuncture without insurance (60%), for serious health conditions (63.3%) or alongside conventional medical therapy (85.0%). Half of all respondents expressed interest in participating in weekly acupuncture for up to 12 months and would expect almost a 50% improvement in symptoms by participating. CONCLUSION Adults with TBI were receptive and interested in participating in weekly acupuncture to address health concerns. These results provide support for exploring the integration of acupuncture into the care of individuals with TBI.
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Affiliation(s)
- Mark D Sodders
- Department of Anesthesiology & Pain Medicine, School of Medicine, University of Washington, Seattle, WA, USA
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA
| | - Shyam J Deshpande
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Jeffery A Dusek
- Susan Samueli Integrative Health Institute, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Monica S Vavilala
- Department of Anesthesiology & Pain Medicine, School of Medicine, University of Washington, Seattle, WA, USA
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA
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2
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Fu TC, Wang GR, Li YX, Xu ZF, Wang C, Zhang RC, Ma QT, Ma YJ, Guo Y, Dai XY, Guo Y. Mobilizing endogenous neuroprotection: the mechanism of the protective effect of acupuncture on the brain after stroke. Front Neurosci 2024; 18:1181670. [PMID: 38737099 PMCID: PMC11084281 DOI: 10.3389/fnins.2024.1181670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/04/2024] [Indexed: 05/14/2024] Open
Abstract
Given its high morbidity, disability, and mortality rates, ischemic stroke (IS) is a severe disease posing a substantial public health threat. Although early thrombolytic therapy is effective in IS treatment, the limited time frame for its administration presents a formidable challenge. Upon occurrence, IS triggers an ischemic cascade response, inducing the brain to generate endogenous protective mechanisms against excitotoxicity and inflammation, among other pathological processes. Stroke patients often experience limited recovery stages. As a result, activating their innate self-protective capacity [endogenous brain protection (EBP)] is essential for neurological function recovery. Acupuncture has exhibited clinical efficacy in cerebral ischemic stroke (CIS) treatment by promoting the human body's self-preservation and "Zheng Qi" (a term in traditional Chinese medicine (TCM) describing positive capabilities such as self-immunity, self-recovery, and disease prevention). According to research, acupuncture can modulate astrocyte activity, decrease oxidative stress (OS), and protect neurons by inhibiting excitotoxicity, inflammation, and apoptosis via activating endogenous protective mechanisms within the brain. Furthermore, acupuncture was found to modulate microglia transformation, thereby reducing inflammation and autoimmune responses, as well as promoting blood flow restoration by regulating the vasculature or the blood-brain barrier (BBB). However, the precise mechanism underlying these processes remains unclear. Consequently, this review aims to shed light on the potential acupuncture-induced endogenous neuroprotective mechanisms by critically examining experimental evidence on the preventive and therapeutic effects exerted by acupuncture on CIS. This review offers a theoretical foundation for acupuncture-based stroke treatment.
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Affiliation(s)
- Tian-cong Fu
- Tianjin Key Laboratory of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Guan-ran Wang
- Tianjin Key Laboratory of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yu-xuan Li
- Tianjin Key Laboratory of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zhi-fang Xu
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Can Wang
- Tianjin Key Laboratory of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Run-chen Zhang
- Tianjin Key Laboratory of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Qing-tao Ma
- Tianjin Key Laboratory of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Ya-jing Ma
- Tianjin Key Laboratory of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yi Guo
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiao-yu Dai
- Tianjin Key Laboratory of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yang Guo
- Tianjin Key Laboratory of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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3
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Bai L, Zou W, Wang L, Yu X, Lou H, Dai X, Teng W, Yu W, Li M, Cao H, Zheng L. Effect of "Tiaoshen" acupuncture technique on mild depression and its underlying mechanism: A randomized controlled trial study protocol. Heliyon 2024; 10:e28889. [PMID: 38596088 PMCID: PMC11002658 DOI: 10.1016/j.heliyon.2024.e28889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 03/14/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
Background Mild depression is not just a mental disease, but also a serious and long-term public health issue. It affects the quality of life of patients and can quickly develop into major depression. There are currently no effective drug treatments with high efficacy and few adverse reactions. Acupuncture may be an alternative treatment option. Preliminary experiments and practices have demonstrated that "Tiaoshen" acupuncture improves symptoms in patients who have depression, however the underlying data and method remain unclear at present. Methods This is a prospective, single-center, single-blind, randomized controlled trial. We plan to recruit 70 participants and randomly assign them to receive "Tiaoshen" acupuncture or traditional acupuncture at a ratio of 1:1. Then, all the participants will receive the appropriate acupuncture treatment for four weeks. The results of the Hamilton Depression Rating Scale (HDSR-24) will serve as the primary outcome, while the results of the Patient Health Questionnaire-9 (PHQ-9) and the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) will serve as secondary outcomes. Evaluations will be conducted at baseline, 1, 2, and 4 weeks after treatment initiation, and 1 and 3 months after treatment completion. The safety of the intervention will be evaluated every week using the Columbia-Suicide Severity Rating Scale (C-SSRS) and the Treatment Emergent Symptoms Scale (TESS). Serum levels of oxidative stress markers 8-iso-prostaglandin F2α (8-iso-PGF2α), superoxide dismutase (SOD), uric acid (UA), and total bilirubin (TBIL) will be measured at baseline and the end of the treatment. We will conduct a statistical analysis of intention to treat (ITT) and conformance to protocol set (PPS) data. Discussion This research aims to provide high-quality evidence for the efficacy and safety of "Tiaoshen" acupuncture as a treatment for mild depression. In addition, the mechanism through which acupuncture heals mild depression will be investigated.
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Affiliation(s)
- Lu Bai
- Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Wei Zou
- The third department of Acupuncture, the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China
- Clinical Key Laboratory of Integrated Traditional Chinese and Western Medicine, Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Long Wang
- The first Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Xueping Yu
- The third department of Acupuncture, the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Hongjun Lou
- The first Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Xiaohong Dai
- Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Wei Teng
- Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Weiwei Yu
- The third department of Acupuncture, the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Mingyue Li
- The third department of Acupuncture, the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Hongtao Cao
- The third department of Acupuncture, the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Lei Zheng
- The third department of Acupuncture, the First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China
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4
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Duffy KEM, Simmonds-Buckley M, Haake R, Delgadillo J, Barkham M. The efficacy of individual humanistic-experiential therapies for the treatment of depression: A systematic review and meta-analysis of randomized controlled trials. Psychother Res 2024; 34:323-338. [PMID: 37406243 DOI: 10.1080/10503307.2023.2227757] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE Conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the efficacy of individual humanistic-experiential therapies (HEPs) for depression. METHOD Database searches (Scopus, Medline, and PsycINFO) identified RCTs comparing any HEP intervention with a treatment-as-usual (TAU) control or active alternative intervention for the treatment of depression. Included studies were assessed using the Risk of Bias 2 tool and narratively synthesized. Post-treatment and follow-up effect sizes were aggregated using random-effects meta-analysis and moderators of treatment effect were explored (PROSPERO: CRD42021240485). RESULTS Seventeen RCTs, synthesized across four meta-analyzes, indicated HEP depression outcomes were significantly better than TAU controls at post-treatment (g = 0.41, 95% CI [0.18, 0.65], n = 735), but not significantly different at follow-up (g = 0.14, 95% CI [-0.30, 0.58], n = 631). HEP depression outcomes were comparable to active treatments at post-treatment (g = -0.09, 95% CI [-0.26, 0.08], n = 2131), but significantly favored non-HEP alternative interventions at follow-up (g = -0.21, 95% CI [-0.35, -0.07], n = 1196). CONCLUSION Relative to usual care, HEPs are effective in the short-term and comparable to non-HEP alternative interventions at post-treatment, but not at follow-up. However, imprecision, inconsistency, and risk of bias concerns were identified as limitations of the evidence included. Future large-scale trials of HEPs with equipoise between comparator conditions are required.
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Affiliation(s)
- Kate E M Duffy
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Melanie Simmonds-Buckley
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
- Rotherham Doncaster and South Humber NHS Foundation Trust, Doncaster, UK
| | - Rinda Haake
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Jaime Delgadillo
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
- Rotherham Doncaster and South Humber NHS Foundation Trust, Doncaster, UK
| | - Michael Barkham
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
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5
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Lin SS, Zhou B, Chen BJ, Jiang RT, Li B, Illes P, Semyanov A, Tang Y, Verkhratsky A. Electroacupuncture prevents astrocyte atrophy to alleviate depression. Cell Death Dis 2023; 14:343. [PMID: 37248211 DOI: 10.1038/s41419-023-05839-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/16/2023] [Accepted: 04/26/2023] [Indexed: 05/31/2023]
Abstract
Astrocyte atrophy is the main histopathological hallmark of major depressive disorder (MDD) in humans and in animal models of depression. Here we show that electroacupuncture prevents astrocyte atrophy in the prefrontal cortex and alleviates depressive-like behaviour in mice subjected to chronic unpredictable mild stress (CUMS). Treatment of mice with CUMS induced depressive-like phenotypes as confirmed by sucrose preference test, tail suspension test, and forced swimming test. These behavioural changes were paralleled with morphological atrophy of astrocytes in the prefrontal cortex, revealed by analysis of 3D reconstructions of confocal Z-stack images of mCherry expressing astrocytes. This morphological atrophy was accompanied by a decrease in the expression of cytoskeletal linker Ezrin, associated with formation of astrocytic leaflets, which form astroglial synaptic cradle. Electroacupuncture at the acupoint ST36, as well as treatment with anti-depressant fluoxetine, prevented depressive-like behaviours, astrocytic atrophy, and down-regulation of astrocytic ezrin. In conclusion, our data further strengthen the notion of a primary role of astrocytic atrophy in depression and reveal astrocytes as cellular target for electroacupuncture in treatment of depressive disorders.
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Affiliation(s)
- Si-Si Lin
- International Joint Research Centre on Purinergic Signalling of Sichuan Province /Research Centre on TCM-Rehabilitation and Neural Circuit, School of Acupuncture and Tuina/Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Bin Zhou
- Laboratory of Anaesthesia and Critical Care Medicine, Department of Anaesthesiology, Translational Neuroscience Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Bin-Jie Chen
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
| | - Ruo-Tian Jiang
- Laboratory of Anaesthesia and Critical Care Medicine, Department of Anaesthesiology, Translational Neuroscience Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Baoman Li
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
| | - Peter Illes
- International Joint Research Centre on Purinergic Signalling of Sichuan Province /Research Centre on TCM-Rehabilitation and Neural Circuit, School of Acupuncture and Tuina/Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Rudolf Boehm Institute for Pharmacology and Toxicology, University of Leipzig, Leipzig, Germany
| | - Alexey Semyanov
- College of Medicine, Jiaxing University, Jiaxing, China
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, Russia
| | - Yong Tang
- International Joint Research Centre on Purinergic Signalling of Sichuan Province /Research Centre on TCM-Rehabilitation and Neural Circuit, School of Acupuncture and Tuina/Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
- Acupuncture and Chronobiology Key Laboratory of Sichuan Province, Chengdu, China.
| | - Alexei Verkhratsky
- International Joint Research Centre on Purinergic Signalling of Sichuan Province /Research Centre on TCM-Rehabilitation and Neural Circuit, School of Acupuncture and Tuina/Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China.
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
- Achucarro Centre for Neuroscience, IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.
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6
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Chen B, Wang CC, Lee KH, Xia JC, Luo Z. Efficacy and safety of acupuncture for depression: A systematic review and meta-analysis. Res Nurs Health 2023; 46:48-67. [PMID: 36509453 PMCID: PMC10108109 DOI: 10.1002/nur.22284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 10/27/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022]
Abstract
Acupuncture is widely accepted as a therapeutic option for managing depression. However, evidence from clinical trials remains controversial. This review aims to synthesize the best available evidence on the efficacy and safety of acupuncture in managing depression. The review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Five databases and the relevant trial registries were searched from the inception to October 2021. Randomized clinical trials of acupuncture for managing depression, published in English, were selected for inclusion. The quality of included studies was assessed using the Cochrane risk of bias tool. Netmeta and dmetar of R packages were used to conduct a network meta-analysis. Twenty-two trials with 2391 participants were eligible and included in the analysis. This review found evidence that electroacupuncture (EA) plus antidepressant achieved superior outcomes compared with the waitlist (standardized mean difference = -8.86, 95% confidence interval: -14.78 to -2.93). The treatment ranking of different interventions in improving depression symptoms indicated that EA plus antidepressant with a probability of 0.8294, followed by manual acupuncture (MA) plus antidepressant (0.6470) and MA (0.5232). Acupuncture, either in isolation or as an adjunct to pharmacological treatment, has clinical benefits and can be considered a safe option for managing depression.
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Affiliation(s)
- Binglei Chen
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Carol Chunfeng Wang
- National School of Nursing, Midwifery, Health Science & PhysiotherapyThe University of Notre Dame AustraliaFremantleWestern AustraliaAustralia
| | - Khui Hung Lee
- School of ScienceEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Jianhong Cecilia Xia
- School of Earth and Planetary SciencesCurtin UniversityPerthWestern AustraliaAustralia
| | - Zongting Luo
- School of NursingFujian University of Traditional Chinese MedicineFuzhouChina
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7
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Matsuura Y, Hongo S, Taniguchi H, Yasuno F, Sakai T. Effect of Acupuncture on Physical Symptoms and Quality of Life in Treatment-Resistant Major Depressive Disorder and Bipolar Disorder: a Single-Arm Longitudinal Study. J Acupunct Meridian Stud 2022; 15:336-346. [DOI: 10.51507/j.jams.2022.15.6.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/22/2022] [Accepted: 10/04/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Yuto Matsuura
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Seiji Hongo
- Himorogi Psychiatric Institute, Tokyo, Japan
| | - Hiroshi Taniguchi
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Fumiko Yasuno
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Tomomi Sakai
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
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8
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Giraudeau B, Caille A, Eldridge SM, Weijer C, Zwarenstein M, Taljaard M. Heterogeneity in pragmatic randomised trials: sources and management. BMC Med 2022; 20:372. [PMID: 36303153 PMCID: PMC9615398 DOI: 10.1186/s12916-022-02569-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Pragmatic trials aim to generate evidence to directly inform patient, caregiver and health-system manager policies and decisions. Heterogeneity in patient characteristics contributes to heterogeneity in their response to the intervention. However, there are many other sources of heterogeneity in outcomes. Based on the expertise and judgements of the authors, we identify different sources of clinical and methodological heterogeneity, which translate into heterogeneity in patient responses-some we consider as desirable and some as undesirable. For each of them, we discuss and, using real-world trial examples, illustrate how heterogeneity should be managed over the whole course of the trial. MAIN TEXT Heterogeneity in centres and patients should be welcomed rather than limited. Interventions can be flexible or tailored and control interventions are expected to reflect usual care, avoiding use of a placebo. Co-interventions should be allowed; adherence should not be enforced. All these elements introduce heterogeneity in interventions (experimental or control), which has to be welcomed because it mimics reality. Outcomes should be objective and possibly routinely collected; standardised assessment, blinding and adjudication should be avoided as much as possible because this is not how assessment would be done outside a trial setting. The statistical analysis strategy must be guided by the objective to inform decision-making, thus favouring the intention-to-treat principle. Pragmatic trials should consider including process analyses to inform an understanding of the trial results. Needed data to conduct these analyses should be collected unobtrusively. Finally, ethical principles must be respected, even though this may seem to conflict with goals of pragmatism; consent procedures could be incorporated in the flow of care.
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Affiliation(s)
- Bruno Giraudeau
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, 2 Bd Tonnellé, 37044, Tours cedex 9, France.
- INSERM CIC1415, CHRU de Tours, Tours, France.
| | - Agnès Caille
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, 2 Bd Tonnellé, 37044, Tours cedex 9, France
- INSERM CIC1415, CHRU de Tours, Tours, France
| | - Sandra M Eldridge
- Centre for Primary Care and Public Health, Queen Mary University of London, 58 Turner Street, London, E1 2AB, UK
| | - Charles Weijer
- Departments of Medicine and Philosophy, Western University, Stevenson Hall 4130, 1151 Richmond Street, London, ON, N6A 5B7, Canada
| | - Merrick Zwarenstein
- Centre for Studies in Family Medicine, Department of Family Medicine Schulich School of Medicine & Dentistry Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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9
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Duan D, He L, Chen H, Lei Y, Wu W, Li T. Efficacy of auricular plaster therapy for sleep disorders in preschool children with autism spectrum disorders: Study protocol for a randomized controlled trial. Front Neurol 2022; 13:973609. [PMID: 36262834 PMCID: PMC9574001 DOI: 10.3389/fneur.2022.973609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Children with autism spectrum disorders (ASDs) suffer from sleep disorders to a considerable degree; however, there is no safe and effective treatment available in clinical practice. The objective of the trial is to assess the clinical effectiveness of auricular plaster therapy (APT) in treating sleep disorders in children with ASD. Method This is a single-center, patient-assessor blind, randomized controlled trial. A total of 44 preschool children with sleep disorders with ASD will be included in this study. Eligible participants will be randomly assigned to either the auricular plaster group or the sham auricular plaster group in a 1:1 ratio. Participants in the different groups will receive APT or sham APT, respectively, for a total of 30 sessions over 30 days. The primary outcome includes the Children's Sleep Habits Questionnaire (CSHQ), while secondary outcomes include the Autism Behavior Checklist (ABC) and polysomnography (PSG) for total sleep time, sleep latency, awakening duration, and sleep structures. The CSHQ and ABC will be assessed at baseline, 10, 20, 30, 60, 90, and 120 days after randomization, whereas PSG will be assessed at baseline and 30 days after randomization. The follow-up period will be scheduled to be 60, 90, and 120 days after randomization. Discussion The results of this study may provide evidence of the efficacy of APT, as well as offer new alternatives for the treatment of sleep disorders in children with ASD. Trial registration CHiCTR.org.cn (ChiCTR2100048257). Registered on July 5, 2021.
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Affiliation(s)
- Duoxi Duan
- Department of Integrated Traditional Chinese and Western Medicine, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, China
| | - Lin He
- Foreign Language School, Southwest Medical University, Luzhou, China
| | - Hong Chen
- Department of Integrated Traditional Chinese and Western Medicine, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, China
| | - Ying Lei
- Department of Integrated Traditional Chinese and Western Medicine, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, China
| | - Wei Wu
- Department of Anesthesiology, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, China
| | - Tao Li
- Department of Integrated Traditional Chinese and Western Medicine, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, China
- *Correspondence: Tao Li
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Electroacupuncture-Regulated miR-34a-3p/PDCD6 Axis Promotes Post-Spinal Cord Injury Recovery in Both In Vitro and In Vivo Settings. J Immunol Res 2022; 2022:9329494. [PMID: 36132985 PMCID: PMC9484976 DOI: 10.1155/2022/9329494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/04/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
Electroacupuncture (EA) could enhance neuroregeneration and posttraumatic conditions; however, the underlying regulatory mechanisms remain ambiguous. PDCD6 (programmed cell death 6) is an established proapoptotic regulator which is responsible for motoneuronal death. However, its potential regulatory role in post-spinal cord injury (SCI) regeneration has remained largely unknown. Further investigations are warranted to clarify the involvement of PDCD6 post-SCI recovery and the underlying mechanisms. In our study, based on bioinformatics prediction, we found that miR-34a-3p might be an upstream regulator miRNA for PDCD6, which was subsequently validated through combined utilization of the qRT-PCR, western blot, and dual-luciferase reporter system. Our in vitro results showed that miR-34a-3p might promote the in vitro differentiation of neural stem cell (NSC) through suppressing PDCD6 and regulating other important neural markers such as fibroblast growth factor receptor 1 (FGFR1), MAP1/2 (MAP kinase kinases 1/2), myelin basic protein (MBP), βIII-tubulin Class III β-tubulin (βIII tubulin), and glial fibrillary acidic protein (GFAP). Notably, in the post-SCI rat model, exogenous miR-34a-3p agomir obviously inhibited the expression of PDCD6 at the protein level and promoted neuronal proliferation, motoneurons regeneration, and axonal myelination. The restorations at cellular level might contribute to the improved hindlimbs functions of post-SCI rats, which was manifested by the Basso-Beattie-Bresnahan (BBB) locomotor test. The impact of miR-34a-3p was further promoted by EA treatment in vivo. Conclusively, this paper argues that a miR-34a-3p/PDCD6 axis might be a candidate therapeutic target for treating SCI and that the therapeutic effect of EA is driven through this pathway.
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Ahn JH, Song MY, Park HJ. Discovering Influential Core-Keywords, Researcher Networks and Research Trends of Acupuncture on Depression Using Bibliometric Analysis. J Acupunct Meridian Stud 2022; 15:227-237. [PMID: 36521771 DOI: 10.51507/j.jams.2022.15.4.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/29/2021] [Accepted: 03/23/2022] [Indexed: 01/26/2023] Open
Abstract
Depression is a common illness worldwide. Acupuncture is used as an alternative to non-pharmacological therapy. This study aimed to identify the development and global trends in the study of acupuncture therapy for depression over the past two decades using a bibliometric analysis. Articles published between 2001 and 2020 on acupuncture for depression were retrieved from the Web of Science database. Extracted information included authors, organizations, countries, keywords, and journals. The VOSviewer program was used to visualize the impacts and network hubs of the keywords, authors, and affiliations. Analyses of 871 original and review articles revealed that the number of publications has continually increased over the past 20 years. China has published the maximum number of articles, followed by the United States and South Korea. As for research areas, integrative complementary medicine was most well represented in terms of the number of articles. Co-occurrence analysis of keywords indicated that each five sub-group cluster (including "pain related to depressive symptoms," "CAM therapies of depression," "comorbid disease or symptoms of depression," "clinical trials of depression," and "mechanism of acupuncture on depression") has its own impact keyword. The most recent keywords were "protocol" and "systematic review," whereas early keywords were "acupuncture analgesia" and "St john's wort." Co-authorship analysis of authors and organizations revealed 4 influential authors and 2 organizations in the field of acupuncture for depression. The present study provided influential keywords that show comorbid symptoms, treatments, and mechanism. Additionally, it revealed the influential persons or groups related to acupuncture therapy for depression.
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Affiliation(s)
- Jae-Ha Ahn
- Department of Meridian Medical Science, School of Medicine, Kyung Hee University, Seoul, Korea.,Acupuncture and Meridian Science Research Center (AMSRC), College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Mi-Yeon Song
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Hi-Joon Park
- Department of Meridian Medical Science, School of Medicine, Kyung Hee University, Seoul, Korea.,Acupuncture and Meridian Science Research Center (AMSRC), College of Korean Medicine, Kyung Hee University, Seoul, Korea
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Graca S, Citkovitz C. From Bench to Bedside and Back Again: Developments in the Evidence-Informed Practice (and Practice-Informed Research) of Acupuncture. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:613-617. [PMID: 35862030 DOI: 10.1089/jicm.2022.0630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Sandro Graca
- Department of Research, Northern College of Acupuncture, York, United Kingdom
| | - Claudia Citkovitz
- Massachusetts College of Pharmacy and Health Sciences, New England College of Acupuncture, Worcester, MA, USA
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Xu MM, Guo P, Ma QY, Zhou X, Wei YL, Wang L, Chen Y, Guo Y. Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:305-320. [PMID: 35595611 DOI: 10.1016/j.joim.2022.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Some depressed patients receive acupuncture as an adjunct to their conventional medications. OBJECTIVE This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants. SEARCH STRATEGY English and Chinese databases were searched for randomized controlled trials (RCTs) published until December 1, 2021. INCLUSION CRITERIA RCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone. DATA EXTRACTION AND ANALYSIS Meta-analysis was performed, and statistical heterogeneity was assessed based on Cochran's Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to evaluate the overall quality of evidence in the included studies. RESULTS This review included 16 studies (with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17 (HAMD-17) scores (standard mean difference [SMD] -0.44, 95% confidence interval [CI] -0.55 to -0.33, P < 0.01; I2 = 14%), Self-rating Depression Scale (SDS) scores (SMD -0.53, 95% CI -0.84 to -0.23, P < 0.01; I2 = 79%), and the Side Effect Rating Scale (SERS) scores (SMD -1.11, 95% CI -1.56 to -0.66, P < 0.01; I2 = 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores (SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01; I2 = 15%), decreased the number of participants who increased their antidepressant dosages (relative risk [RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01; I2 = 0%), and resulted in significantly higher remission rates (RR 1.52, 95% CI 1.26 to 1.83, P < 0.01; I2 = 0%) and treatment responses (RR 1.35, 95% CI 1.24 to 1.47, P < 0.01; I2 = 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality. CONCLUSION Acupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control. SYSTEMATIC REVIEW REGISTRATION INPLASY202150008.
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Affiliation(s)
- Ming-Min Xu
- School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China; Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
| | - Pei Guo
- School of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
| | - Qing-Yu Ma
- School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China; Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Xuan Zhou
- School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China; Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Yu-Long Wei
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Lu Wang
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
| | - Yue Chen
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yu Guo
- School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China; Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-Pattern Research Center, Jinan University, Guangzhou 510632, Guangdong Province, China.
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Kim M, Choi EJ, Kwon OJ, Park HJ, Kim AR, Seo BN, Chung SY, Lee JH, Kim JH. Electroacupuncture plus moxibustion for major depressive disorder: A randomized, sham-controlled, pilot clinical trial. Integr Med Res 2022; 11:100802. [PMID: 34840949 PMCID: PMC8605331 DOI: 10.1016/j.imr.2021.100802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/14/2021] [Accepted: 10/21/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The first treatment option for major depressive disorder (MDD) is antidepressants, however, there is substantial demand for alternative therapies due to its low compliance and remission rates. This study was aimed to explore the effectiveness, safety, and feasibility of electroacupuncture plus moxibustion therapy for MDD. METHODS Thirty adults with MDD were randomly assigned to the treatment group (TG) or control group (CG). The TG was treated with electroacupuncture plus moxibustion, and the CG received sham interventions at non-acupoints for 8 weeks. The primary outcome measure was the intergroup difference of the mean change of total score of the Hamilton rating scale for depression (HRSD) between baseline and week 9. Secondary outcome measures were Beck's depression inventory, insomnia severity index, the state-trait anxiety inventory, the EuroQol-5 dimension index, the measure yourself medical outcome profile version 2, and frontal alpha asymmetry measured by electroencephalography. Adverse events (AEs) were monitored for safety assessment. RESULTS The primary outcome measure was not significantly different between the two groups (p=0.2641), although the scores of HRSD in both groups improved significantly after treatment. No significant difference was identified between groups in secondary outcome measures. The incidence of AE was not significantly different between the two groups (p=0.1067). CONCLUSION A clinical trial using electroacupuncture plus moxibustion for MDD seems feasible. However, further studies with the larger size, adopting ideal controls are warranted to provide a confirmative conclusion to the efficacy and safety of electroacupuncture plus moxibustion for MDD. TRIAL REGISTRATION The protocol was registered at Korean Clinical Trial Registry (CRIS-KCT0001810).
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Affiliation(s)
- Mikyung Kim
- Department of Internal Medicine, College of Korean Medicine, Sangji University, Wonju, Republic of Korea
| | - Eun-Ji Choi
- Haneum Neuropsychiatry Clinic of Korean Medicine, Cheonan, Republic of Korea
| | - O-Jin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Deajeon, Republic of Korea
| | - Hyo-Ju Park
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Deajeon, Republic of Korea
| | - Ae-Ran Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Deajeon, Republic of Korea
| | - Bok-Nam Seo
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Deajeon, Republic of Korea
| | - Sun-Yong Chung
- Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Deajeon, Republic of Korea
- Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Joo-Hee Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Sangji University, Wonju, Republic of Korea
- Research institute of Korean medicine, Sangji University, Wonju, Republic of Korea
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Zhang Y, Liu Y, Ning B, Yan L, Wu L, Zhang D, Li C, Ouyang W, Su S, Jiang S, Zhang G, Xu J, Wang Z, Zheng Z, Zheng D, Chen S, Sun L, Fu W. Efficacy of the Integrative Acupuncture and Moxibustion Treatment in Patients With Major Depressive Disorder: The Study Protocol for a Multicenter, Single-Blinded, Randomized Trial in China. Front Med (Lausanne) 2022; 9:761419. [PMID: 35707522 PMCID: PMC9189311 DOI: 10.3389/fmed.2022.761419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Antidepressants are the front-line treatments for major depressive disorder (MDD), but remain unsatisfactory in outcome. An increasing number of patients are interested in acupuncture and moxibustion treatment as complementary therapies. This study aims to evaluate the efficacy and safety of integrative acupuncture and moxibustion (iAM) treatment in patients with MDD. Methods and Analysis This multicenter, single-blind, 2 × 2 factorial randomized trial will enroll 592 patients with MDD of moderate severity from nine hospitals. All patients will be randomized, in a ratio of 2:2:2:1, through a computerized central randomization system, into four groups (the combined, iAM-only, sertraline-only, and placebo groups). Participants will undergo a 12-week intervention with either 50 mg of sertraline or a placebo once a day and active/sham iAM treatment three times per week. The primary outcome is depression severity, assessed using the Hamilton Depression Scale-17. The secondary outcomes include self-rated depression severity, anxiety, and sleep quality. The primary and secondary outcomes will be measured at weeks 0, 4, 8, 12, and the 8th week posttreatment. Safety will be evaluated through liver and kidney function tests conducted before and after treatment and through monitoring of daily adverse events. An intent-to-treat principle will be followed for the outcome analyses. Conclusion This trial will provide sufficient evidence to ascertain whether iAM is effective and safe for treating MDD and provides a suitable combination strategy for treating MDD. Clinical Trial Registration [www.chictr.org.cn], identifier [ChiCTR2100042841].
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Affiliation(s)
- Yuan Zhang
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yamin Liu
- Shenzhen Bao’an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Baile Ning
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Luda Yan
- Shenzhen Bao’an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Lihua Wu
- Shenzhen Bao’an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Delong Zhang
- School of Psychology, South China Normal University, Guangzhou, China
| | - Changhong Li
- College of Teacher Education, Guangdong University of Education, Guangzhou, China
| | - Wenwei Ouyang
- Key Unit of Methodology in Clinical Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shengyong Su
- The First Affiliated Hospital of Guangxi Chinese Medical University, Nanning, China
| | - Shuo Jiang
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Guangcai Zhang
- Hainan Provincial Hospital of Chinese Medicine, Haikou, China
| | - Junfeng Xu
- The First Affiliated Hospital of Tianjin Chinese Medical University, Tianjin, China
| | - Zhen Wang
- The Second Affiliated Hospital of Anhui Chinese Medical University, Hefei, China
| | - Zhong Zheng
- Sleep Medical Center, West China Hospital of Sichuan University, Chengdu, China
| | - Dong Zheng
- Brain Hospital Affiliated Guangzhou Medical University, Guangzhou, China
| | - Shan Chen
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lu Sun
- Department of Psychosomatic Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Lu Sun,
| | - Wenbin Fu
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Wenbin Fu,
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Efficacy and Safety of Acupuncture in the Treatment of Poststroke Insomnia: A Systematic Review and Meta-Analysis of Twenty-Six Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5188311. [PMID: 35345621 PMCID: PMC8957466 DOI: 10.1155/2022/5188311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/27/2021] [Accepted: 01/27/2022] [Indexed: 12/03/2022]
Abstract
Objective To evaluate the efficacy and safety of acupuncture in the treatment of poststroke insomnia. Methods PubMed, the Cochrane Library, Embase, Web of Science, China Biology Medicine (CBM), CNKI, VIP, and Wanfang databases were searched by computer from their inception to April 29, 2021, for collecting all randomized controlled trials of acupuncture in the treatment of poststroke insomnia. After two reviewers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies, the data were analyzed by RevMan 5.3 and STATA 16.0. The quality of outcomes was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results A total of 26 studies with 1874 cases were included, which had 942 cases in the treatment group and 932 cases in the control group. Meta-analysis results showed that, compared with oral medications alone, acupuncture alone or acupuncture combined with oral medications could improve the clinical effective rate and the sleep quality of patients, and the combined effects were RR = 1.21; 95% CI: 1.15, 1.27; P < 0.00001 and MD = 3.41; 95% CI: 2.40, 4.41; P < 0.00001, respectively. As for adverse reactions, the incidence of acupuncture alone or acupuncture combined with oral drugs was lower than that of oral drugs alone, which was safer and the combined effect was RR = 0.21; 95% CI: 0.09, 0.48; P=0.0002. Sensitivity analysis showed that the results were stable. We evaluated the quality of evidence with the GRADE system; the clinical effective rate was rated as “LOW,” the evidence grade of PSQI score was “LOW,” and the evidence grade of adverse reactions was “Very LOW.” Conclusion Acupuncture alone or acupuncture combined with oral drugs is more effective and safer than oral drugs alone in the treatment of poststroke insomnia, which is suitable to promote in clinical practice.
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Zhu X, Yan L, Dou X, Zheng Y, He G, Liao M, Fu W. Acupuncture treatment of hypertension with insomnia: A protocol for randomized, double-blind, placebo controlled trial research. Medicine (Baltimore) 2022; 101:e28455. [PMID: 35029187 PMCID: PMC8757932 DOI: 10.1097/md.0000000000028455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Hypertension patients often suffered from insomnia problems which lowered the quality of life. Studies have shown that acupuncture is effective to treat perimenopausal and cancer-related insomnia. However, there is a lack of randomized controlled trials to support the effectiveness of acupuncture on insomnia of hypertension patients. METHODS AND ANALYSIS This study is a randomized, double-blind (patients and evaluators), and placebo-controlled clinical trial to investigate the effect of acupuncture in hypertension patients' insomnia management. We will recruit 158 hypertension patients suffering from insomnia in Bao'an People's Hospital, Shenzhen and randomly assign them into treatment group (antihypertensive drugs + acupuncture) and control group (antihypertensive drugs + sham acupuncture) in a 1:1 ratio. The patients will receive acupuncture 3 times a week for 12 weeks, and then a 6-months follow-up will be conducted after the treatment. The primary outcome is the Pittsburgh Sleep Quality Index. The secondary outcomes include sleep parameters, blood pressure dropping, sleeping pill dosage, Rating Depression Scale score, and Self-Rating Anxiety Scale score. The primary outcome will be evaluated at baseline, 4, 8, and 12 weeks, and 1, 3, and 6 months following the end of treatment. The secondary outcomes will be assessed at baseline and 12 weeks of the treatment period.
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Affiliation(s)
- Xun Zhu
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, P.R China
- Department of General Practice, Bao’an People's Hospital, Shenzhen, P.R. China
| | - Luda Yan
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, P.R China
- Department of Acupuncture and Moxibustion, Bao’an Traditional Chinese Medicine Hospital, Shenzhen, P.R. China
| | - Xuejiao Dou
- Department of General Practice, Bao’an People's Hospital, Shenzhen, P.R. China
| | - Yanping Zheng
- Department of General Practice, Bao’an Traditional Chinese Medicine Hospital, Shenzhen, P.R. China
| | - Guanglin He
- Department of General Practice, Bao’an People's Hospital, Shenzhen, P.R. China
| | - Meiyan Liao
- Department of General Practice, Bao’an People's Hospital, Shenzhen, P.R. China
| | - Wenbin Fu
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, P.R. China
- Innovative Research Team of Acupuncture for Depression and Related Disorders, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, P.R. China
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Cheng WJ, Li P, Huang WY, Huang Y, Chen WJ, Chen YP, Shen JL, Chen JK, Long NS, Meng XJ. Acupuncture Relieves Stress-Induced Depressive Behavior by Reducing Oxidative Stress and Neuroapoptosis in Rats. Front Behav Neurosci 2022; 15:783056. [PMID: 35058758 PMCID: PMC8763975 DOI: 10.3389/fnbeh.2021.783056] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Oxidative stress is closely related to the occurrence of depression. Acupuncture has been proved to be an effective method for treating depression. In order to explore the mechanism of the antidepressant effect of acupuncture, this study performed acupuncture prevention on chronic unpredictable mild stress (CUMS) depression model rats, and observed the effect of acupuncture on hippocampal oxidative stress and Nrf2 signaling pathway. Male SD rats were randomly divided into control group, CUMS group, acupuncture group, and fluoxetine group (n = 10/group). Fluoxetine, a common antidepressant, was used as a positive control drug in this study. In the fluoxetine group, rats were given fluoxetine (2.1 mg/kg) intragastrically once a day for 28 days. The acupoints of Shangxing (GV23) and Fengfu (GV16) were applied in acupuncture group, once every other day for 14 times in total. Behavioral tests and biological detections were used to evaluate the effects of the interventions and the changes of factors related to oxidative stress, Nrf2 pathway, and neuronal apoptosis. The results showed that both acupuncture and fluoxetine could increase sugar preference rate in SPT and decrease immobility time in FST in depression model rats. It also significantly decreased oxidative stress products such as ROS and H2O2, and elevated the protein and mRNA expressions of Nrf2 and HO-1. From Nissl’s staining, there were more abundant nerve cells in two intervention groups compared with CUMS group. Plus, acupuncture down-regulated the expression levels of Bax and caspase-3 and up-regulated the expression of Bcl-2. Our findings indicate that acupuncture improved depression-like behaviors of CUMS rats. And CUMS-induced depression-like behaviors in rats were related to oxidative stress and neuronal apoptosis in hippocampus. Acupuncture showed antidepressant effects in reducing oxidative stress products via regulating the Nrf2/HO-1 signaling pathway so that prevented neuronal apoptosis.
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Affiliation(s)
- Wen-Jing Cheng
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, China
- Shenzhen Research Institute of Xiamen University, Shenzhen, China
| | - Peng Li
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen-Ya Huang
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, China
- Institute of TCM-Related Comorbid Depression, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yang Huang
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, China
| | - Wen-Jie Chen
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, China
| | - Yi-Ping Chen
- Third Clinical College, Shanxi University of Traditional Chinese Medicine, Taiyuan, China
| | - Jun-Liang Shen
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, China
| | - Jian-Kun Chen
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, China
| | - Na-Sha Long
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, China
| | - Xian-Jun Meng
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, China
- Shenzhen Research Institute of Xiamen University, Shenzhen, China
- *Correspondence: Xian-Jun Meng,
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Electroacupuncture Ameliorates Depression-Like Behaviour in Rats by Enhancing Synaptic Plasticity via the GluN2B/CaMKII/CREB Signalling Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:2146001. [PMID: 34777532 PMCID: PMC8580672 DOI: 10.1155/2021/2146001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/11/2021] [Indexed: 12/27/2022]
Abstract
Background Hippocampal synaptic plasticity during the pathological process of depression has received increasing attention. Hippocampal neuron atrophy and the reduction in synaptic density induced by chronic stress are important pathological mechanisms of depression. Electroacupuncture (EA) exerts beneficial effects on depression, but the mechanism is unclear. This study explored the effect of EA on synaptic plasticity and the potential mechanism. Methods Forty-eight SD rats were randomly divided into the control, chronic unpredictable mild stress (CUMS), EA, and fluoxetine (FLX) groups, and each group consisted of 12 rats. The sucrose preference test, open field test, and forced swimming test were used for the evaluation of depression-like behaviour, and Golgi and Nissl staining were used for the assessment of synaptic plasticity. Western blotting and immunofluorescence were conducted to detect proteins related to synaptic plasticity and to determine their effects on signalling pathways. Results We found that CUMS led to depression-like behaviours, including a reduced preference for sucrose, a prolonged immobility time, and reduced exploration activity. The dendritic spine densities and neuron numbers and the protein levels of MAP-2, PSD-95, and SYN were decreased in the hippocampi of rats with CUMS-induced depression, and these trends were reversed by EA. The molecular mechanism regulating this plasticity may involve the GluN2B/CaMKII/CREB signalling pathway. Conclusion These results suggest that EA can improve depression-like behaviour and hippocampal plasticity induced by CUMS, and the mechanism may be related to the GluN2B/CaMKII/CREB pathway.
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Xiang H, Li J, Li B, Tan Q, Cai G. Trends of Acupuncture Therapy on Depression From 2011 to 2020: A Bibliometric Analysis. Front Psychol 2021; 12:721872. [PMID: 34721179 PMCID: PMC8549834 DOI: 10.3389/fpsyg.2021.721872] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/06/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives: The purpose of this study was to explore the current status and trends of acupuncture for depression in the last decade and provide new insights for researchers in future studies. Methods: The articles regarding acupuncture treatment for depression published between 2011 and 2020 were extracted from the Web of Science Core Collection. We used CiteSpace to analyze data on publications, countries, institutions, cited journals, cited authors, cited references, keywords, and citation bursts about acupuncture and depression. Results: A total of 1,032 publications were obtained from 2011 to 2020. We identified the most prolific journals, countries, institutions, and authors in the field of acupuncture for depression in the last decade. The most prolific country and institutions were the People's Republic of China and KyungHee University, respectively. Evidence-based Complementary and Alternative Medicine was the most prolific and cited journal. The author with the highest centrality was Zhangjin Zhang, and the author with the most publications was Park Hi-Joon. The keyword “cognitive behavioral therapy” was first for research developments with the highest citation burst. The five hot topics in acupuncture on depression were “acupuncture,” “depression,” “electro-acupuncture,” “quality of life,” and “anxiety.” Conclusions: The results from this bibliometric study provide insight into the research trends in acupuncture therapy for depression, and the current status and trends of the past decade, which may help researchers determine the current status, hotspots, and frontier trends in this field.
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Affiliation(s)
- Hongchun Xiang
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Li
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bocun Li
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Tan
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guowei Cai
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Choi Y, Park IH, Kim JE, Kwon O, Kim AR, Park HJ, Lee JH, Kim JH. Acupuncture for Psychosomatic Symptoms of Hwa-byung, an Anger Syndrome: A Feasibility Randomized Controlled Trial. Front Psychol 2021; 12:651649. [PMID: 34630196 PMCID: PMC8498113 DOI: 10.3389/fpsyg.2021.651649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/19/2021] [Indexed: 12/24/2022] Open
Abstract
Objectives: Emerging studies found the potential effects of acupuncture for treating chronic pain and mental disorders, namely, depressive and anxiety disorders. Acupuncture is widely used for treating culture-related anger syndrome, Hwa-byung. This pilot trial aimed to investigate the feasibility of a clinical trial testing acupuncture for the psychosomatic symptoms of Hwa-byung. Methods: A total of 26 patients with Hwa-byung planned to be randomly assigned to the acupuncture or sham acupuncture groups. About 10 treatment sessions were applied over 4 weeks. The 100-mm visual analog scale was used to measure the six major Hwa-byung symptoms: stuffiness in the chest, heat sensations, pushing-up in the chest, feeling a mass in the throat, feelings of unfairness, and hard feelings. The criteria for assessing the success of this pilot trial were defined as improvement in three or more of the six Hwa-byung symptoms after treatment, with an effect size >0.2. Results: A total of 15 patients were finally included and randomly assigned to the acupuncture group (n = 7) or the sham acupuncture group (n = 8). After 10 treatment sessions, the Cohen's d effect sizes for acupuncture compared to sham acupuncture were >0.2 for each one of the six major Hwa-byung symptoms, which met our a priori criteria for success. Also, the effect size for the somatic symptoms of “stuffiness in the chest” was 0.81 (95% CI −0.40, 2.20), referring to a large effect size. Conclusions: Our results suggest that acupuncture treatment would be regarded as an acceptable intervention for a full-scale study of psychosomatic symptoms in patients with Hwa-byung. Trial Registration:cris.nih.go.kr, identifier: KCT0001732.
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Affiliation(s)
- Yujin Choi
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - In-Hye Park
- Department of Korean Medicine, College of Korean Medicine, Sangji University, Wonju, South Korea
| | - Jung-Eun Kim
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ojin Kwon
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ae-Ran Kim
- R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Hyo-Ju Park
- R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jun-Hwan Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea.,Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Joo-Hee Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Sangji University, Wonju, South Korea.,Research Institute of Korean Medicine, Sangji University, Wonju, South Korea
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Kim M, Choi EJ, Kwon OJ, Park HJ, Kim AR, Seo BN, Chung SY, Lee JH, Kim JH. Electroacupuncture plus moxibustion for major depressive disorder: A randomized, sham-controlled, pilot clinical trial. Integr Med Res 2021; 10:100727. [PMID: 34307020 PMCID: PMC8296085 DOI: 10.1016/j.imr.2021.100727] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The first treatment option for major depressive disorder (MDD) is antidepressants, however, there is substantial demand for alternative therapies due to its low compliance and remission rates. This study was aimed to explore the effectiveness, safety, and feasibility of electroacupuncture plus moxibustion therapy for MDD. METHODS Thirty adults with MDD were randomly assigned to the treatment group (TG) or control group (CG). The TG was treated with electroacupuncture plus moxibustion, and the CG received sham interventions at non-acupoints for 8 weeks. The primary outcome measure was the intergroup difference of the mean change of total score of the Hamilton rating scale for depression (HRSD) between baseline and week 9. Secondary outcome measures were Beck's depression inventory, insomnia severity index, the state-trait anxiety inventory, the EuroQol-5 dimension index, the measure yourself medical outcome profile version 2, and frontal alpha asymmetry measured by electroencephalography. Adverse events (AEs) were monitored for safety assessment. RESULTS The primary outcome measure was not significantly different between the two groups (p=0.2641), although the scores of HRSD in both groups improved significantly after treatment. No significant difference was identified between groups in secondary outcome measures. The incidence of AE was not significantly different between the two groups (p=0.1067). CONCLUSION A clinical trial using electroacupuncture plus moxibustion for MDD seems feasible. However, further studies with the larger size, adopting ideal controls are warranted to provide a confirmative conclusion to the efficacy and safety of electroacupuncture plus moxibustion for MDD.
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Affiliation(s)
- Mikyung Kim
- Department of Internal Medicine, College of Korean Medicine, Sangji University, Wonju, Republic of Korea
| | - Eun-Ji Choi
- Haneum Neuropsychiatry Clinic of Korean Medicine, Cheonan, Republic of Korea
| | - O-Jin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hyo-Ju Park
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ae-Ran Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Bok-Nam Seo
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sun-Yong Chung
- Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Joo-Hee Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Sangji University, Wonju, Republic of Korea
- Research institute of Korean medicine, Sangji University, Wonju, Republic of Korea
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Kao L, Hui KK, Hui E. A Patient-Centered Integrative Approach Improves Visual Field Defect: A Case Report. Glob Adv Health Med 2021; 10:21649561211021081. [PMID: 34104579 PMCID: PMC8168048 DOI: 10.1177/21649561211021081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 12/02/2022] Open
Abstract
We present a case involving a patient with a complicated visual field defect preventing her from renewing her driver license. It highlights the underappreciated role of chronic stress in the genesis and perpetuation of ill health and the potential of Chinese medicine (CM) to complement biomedicine in the treatment of an intractable visual disorder. The patient experienced impaired vision from age 15, and ophthalmologists considered various diagnoses including optic neuritis and acute zonal occult outer retinopathy (AZOOR)-complex disorder with acute macular neuroretinopathy. She was treated with an integrative East-West medical approach incorporating acupuncture, cupping, trigger point injections, guidance on self-care and lifestyle modification. Although the eye disorder was not cured, there was visual improvement as demonstrated by various objective ophthalmologic tests, and the patient was able to renew her driver license. Visual improvement remained stable upon follow-up examination three years after the treatment intervention. Other concomitant health issues reported by the patient also improved including amelioration of neck pain, a more regular menstrual cycle, and decreased anxiety. This case demonstrates how a patient with an intractable complex eye disorder can have objective visual improvement when treated with an integrative patient-centered approach.
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Affiliation(s)
- Lan Kao
- UCLA Department of Medicine, UCLA Center for East-West Medicine, University of California Los Angeles, Los Angeles, California
| | - Ka-Kit Hui
- UCLA Department of Medicine, UCLA Center for East-West Medicine, University of California Los Angeles, Los Angeles, California
- UCLA Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Edward Hui
- UCLA Department of Medicine, UCLA Center for East-West Medicine, University of California Los Angeles, Los Angeles, California
- UCLA Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
- Edward Hui, UCLA Department of Medicine, UCLA Center for East-West Medicine, University of California Los Angeles, 1015 Gayley Avenue, Suite 301, Los Angeles, CA 90024, USA.
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Matsuura Y, Watanabe Y, Taniguchi H, Koga Y, Yasuno F, Sakai T. Acupuncture for the Treatment of Depression and Physical Symptoms in Chronic Bipolar Disorder: A Case Report. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2020; 13:1179547620967379. [PMID: 33192114 PMCID: PMC7597561 DOI: 10.1177/1179547620967379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/23/2020] [Indexed: 12/31/2022]
Abstract
Introduction Bipolar disorder (BD) is typically treated by pharmacotherapy. However, pharmacotherapy alone is often not adequate to cope with the variety of symptoms associated with BD. The present case report describes the therapeutic effects of manual acupuncture on a patient with chronic BD, and multiple concurrent physical symptoms, that did not improve with standard pharmacotherapy. Case A 41-year-old woman with type II BD presented with depression, anxiety, and multiple physical symptoms. Her symptoms had first appeared 12 years prior, and she was diagnosed with type II BD 3 years after symptom onset. Although she received standard treatment, including medication and psychotherapy, her symptoms did not improve. Acupuncture treatment aimed at improving psychiatric and physical symptoms was performed weekly for 12 weeks. Depression and anxiety symptoms were evaluated using the Himorogi Self-Rating Depression Scale (HSDS) and Himorogi Self-Rating Anxiety Scale (HSAS) respectively. A visual analog scale (VAS) was used to evaluate physical symptoms including diarrhea, insomnia, and general malaise. Outcome measures were evaluated before each treatment. Results Throughout the course of the acupuncture intervention, no changes were made to the patient's psychotropic medication regimen. HSDS and HSAS scores decreased after 12 weeks of acupuncture treatment and improvements in all physical symptoms, as measured by the VAS, were observed. Furthermore, psychiatric symptoms with hypomanic or mixed features were not exacerbated. Conclusions In this patient, acupuncture was effective in improving psychiatric and physical symptoms of type II BD. This non-pharmacological intervention may be a viable option for the treatment of BD-associated symptoms.
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Affiliation(s)
- Yuto Matsuura
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Yoshinori Watanabe
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan.,Himorogi Psychiatric Institute, Tokyo, Japan
| | - Hiroshi Taniguchi
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Yoshihisa Koga
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Fumiko Yasuno
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Tomomi Sakai
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
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Xu M, Guo Y, Wei Y, Wang L, Feng X, Chen Y, Yan J. Non-pharmacological interventions for depressive disorder in patients after traumatic brain injury: A protocol for a systematic review and network meta-analysis. Medicine (Baltimore) 2020; 99:e22375. [PMID: 32991457 PMCID: PMC7523874 DOI: 10.1097/md.0000000000022375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Depressive disorder has gradually become one of the most commonly reported disabling psychiatric complication that occurs after traumatic brain injury (TBI). Currently classical antidepressant medications may not have the same effectiveness in patients with TBI as in patients without TBI. Non-pharmacological interventions have been considered to be effective for managing depressive symptoms or treating depressive disorder. But to date the comparative effectiveness of various types of non-pharmacological interventions has been synthesized in few studies, the evidence remains inconclusive. Thus, the purpose of this systematic review and network meta-analyses is to summarize high-quality evidence and identify the most effective non-pharmacological intervention when applied to treat the depressive disorder in patients after TBI. METHODS The comprehensive literature search in electronic database including PubMed, Ovid Medline, Cochrane Library, Web of Science database, Embase Database, China National Knowledge Infrastructure (CNKI), and Wanfang Data Chinese database from inception to the search date. Only high-quality randomized controlled trials (RCTs) that have used non-pharmacological interventions to treat depressive disorder after TBI will be considered. Two independent reviewers will identify eligible studies, extract and manage data information, and then determine methodical quality of included studies. Overall efficacy will be assessed as primary outcome. Secondary outcomes involved treatment response, remission rate, overall acceptability, tolerability of treatment, social functioning, occurrence of adverse events, and suicide-related outcome. Cochrane risk of bias assessment tool will be adopted to assess the risk of bias. Study heterogeneity will be measured by the I statistic. Traditional pairwise meta-analyses will be performed using STATA, while WinBUGS with GeMTC package of R software will be used to carry out network meta-analysis. RESULTS This systematic review will examine the relative efficacy, effectiveness, safety, tolerability and acceptability of non-pharmacological interventions, and then to identify the most effective non-pharmacological intervention for depressive disorder after TBI. EXPECTED CONCLUSION Our work could be used to give clinical recommendations for practice guideline developers, psychiatrist, neurologist, policymakers, researchers as well as individual with depressive disorder after TBI, and will also identify gaps in knowledge that could be the subject of future research. ETHICS AND DISSEMINATION Neither ethics approval nor patient informed consent is necessary since this protocol was designed based on the existing literature. The results will be disseminated electronically or in print through publications in peer-reviewed scientific journal. INPLASY REGISTRATION INPLASY202080022.
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Affiliation(s)
- Mingmin Xu
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Yu Guo
- Teaching and Research Section of Acupuncture
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou
| | - Yulong Wei
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Lu Wang
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Xiumei Feng
- School of Acupuncture-Moxibustion and Tuina/The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Yue Chen
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jian Yan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Manzoor S, Hoda N. A comprehensive review of monoamine oxidase inhibitors as Anti-Alzheimer's disease agents: A review. Eur J Med Chem 2020; 206:112787. [PMID: 32942081 DOI: 10.1016/j.ejmech.2020.112787] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 07/22/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023]
Abstract
Monoamine oxidases (MAO-A and MAO-B) are mammalian flavoenzyme, which catalyze the oxidative deamination of several neurotransmitters like norepinephrine, dopamine, tyramine, serotonin, and some other amines. The oxidative deamination produces several harmful side products like ammonia, peroxides, and aldehydes during the biochemical reaction. The concentration of biochemical neurotransmitter alteration in the brain by MAO is directly related with several neurological disorders like Alzheimer's disease and Parkinson's disease (PD). Activated MAO also contributes to the amyloid beta (Aβ) aggregation by two successive cleft β-secretase and γ-secretase of amyloid precursor protein (APP). Additionally, activated MAO is also involved in aggregation of neurofibrillary tangles and cognitive destruction through the cholinergic neuronal damage and disorder of the cholinergic system. MAO inhibition has general anti-Alzheimer's disease effect as a consequence of oxidative stress reduction prompted by MAO enzymes. In this review, we outlined and addressed recent understanding on MAO enzymes such as their structure, physiological function, catalytic mechanism, and possible therapeutic goals in AD. In addition, it also highlights the current development and discovery of potential MAO inhibitors (MAOIs) from various chemical scaffolds.
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Affiliation(s)
- Shoaib Manzoor
- Drug Design and Synthesis Laboratory, Department of Chemistry, Jamia Millia Islamia, New Delhi, 110025, India
| | - Nasimul Hoda
- Drug Design and Synthesis Laboratory, Department of Chemistry, Jamia Millia Islamia, New Delhi, 110025, India.
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Effect of Acupuncture on Chronic Pain with Depression: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:7479459. [PMID: 32714417 PMCID: PMC7334776 DOI: 10.1155/2020/7479459] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/10/2020] [Indexed: 01/09/2023]
Abstract
Background Numerous studies suggested that chronic pain and depression were closely related and widespread in the population. When patients have symptoms of chronic pain and depression, the corresponding treatment will become difficult. Acupuncture, a unique therapeutic method of traditional Chinese medicine, has been reported to potentially serve as an alternative treatment for patients with comorbid chronic pain and depression by many research studies. Methods A comprehensive search was conducted through the online database, including the Cochrane Library, PubMed, EMBASE, SinoMed, CNKI, and Wanfang database. Trials were RCTs published in the English or Chinese language, recruiting participants with chronic pain and depression comorbidity. The primary outcomes were the Visual Analogue Scale (VAS) and Hamilton Depression Scale (HAMD). Statistical analyses were conducted using Review Manager 5.3. Each trail was quality appraised with the five-point Jadad Score. Results 7 eligible RCTs involving 535 patients were included. Better therapeutic effect and safety could be observed in the experimental group compared with the control group. There was a significant decrease in the VAS (mean difference (MD) = −0.68 (−1.24, −0.12), P=0.02) and HAMD (MD = −2.18 (−3.09, −1.26), P < 0.00001) scores and the incidence of adverse events between two groups. Conclusion In the treatment of chronic pain with depression, acupuncture could not only get better clinical efficacy, but also have higher security compared with medicine therapy, which can be used in patients with poorer response to the conventional medication or suffering from serious side effects.
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Molassiotis A, Suen L, Lai C, Chan B, Wat KHY, Tang J, To KL, Leung CO, Lee S, Lee P, Chien WT. The effectiveness of acupressure in the management of depressive symptoms and in improving quality of life in older people living in the community: a randomised sham-controlled trial. Aging Ment Health 2020; 24:1001-1009. [PMID: 30869991 DOI: 10.1080/13607863.2019.1584789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: The primary aim of the current trial was to assess the clinical effectiveness of acupressure in the management of depression in elderly people compared to patients receiving sham acupressure or standard care alone.Methods: Randomized sham-controlled trial of acupressure, sham acupressure and standard care alone in older patients with depression living in the community. Patients with a score>/=8 in the Geriatric Depression Scale were recruited for this study. Intervention/sham treatments were provided four times/week for three months. Assessments related to depressive symptoms (primary outcome), well-being, resilience, spirituality and quality of life domains were carried out at baseline, end of the intervention and three-months after the intervention.Results: 118 patients were randomized to intervention (n = 40), sham (n = 40) or control arm (n = 38), with 84 patients providing final analysis data. Significant reduction in mean score of depressive symptoms was found in the acupressure group (from 10.6 (sd = 0.03) to 7.7 (sd = 0.07), p < 0.001 at end of intervention and 8.7 (sd = 0.8), p = 0.002 at follow-up) and the sham acupressure group (from 10.5 (sd = 0.3) to 8.4 (sd = 0.8), p = 0.005) at end of intervention and 8.4 (sd = 0.8), p = 0.006 at follow-up but not in the control group (from 10.8 to 9.9, p = 0.20). Resilience (p = 0.02) and spirituality (p = 0.02) were also improved in the intervention group at the end of intervention assessment but this change was not sustained at follow-up. Mind-body-spirit well-being and social functioning were improved both at the end of intervention and follow-up in the experimental as well as sham group. The sham group showed additional improvements in daily functioning and environmental quality of life.Conclusions: Although acupressure improved outcomes, a placebo effect was evident. Acupressure may be an effective approach to manage depression in elderly patients, but more evidence is needed in the future before it can be recommended for practice as well as more clear elucidation of any placebo effects.
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Affiliation(s)
- Alex Molassiotis
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR
| | - Lorna Suen
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR
| | - Claudia Lai
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR
| | - Ben Chan
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR
| | | | - Jenny Tang
- Psychogeriatrics team, Kwai Chung Hospital, Hong Kong SAR
| | - Kui-Lung To
- Psychogeriatrics team, Kwai Chung Hospital, Hong Kong SAR
| | | | - Sara Lee
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR
| | - Paul Lee
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR
| | - Wai Tong Chien
- School of Nursing, Chinese University of Hong Kong, Hong Kong SAR
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Hunter J, Armour M. Stop, Listen, and Learn: Using Mixed Methods to Add Value to Clinical Trials. J Evid Based Integr Med 2020; 24:2515690X19857073. [PMID: 31232083 PMCID: PMC6591665 DOI: 10.1177/2515690x19857073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This commentary discusses the concept of value-based or value-focused health care as a
rationale for researchers to incorporate mixed methods study designs a priori into
clinical trials evaluating traditional, complementary, alternative, and integrative
medicine (TCAIM). Along with assessing patient outcomes, information about patients’
experiences and preferences are needed to determine the value of an intervention.
Incorporating a mixed-methods approach can improve the quality of clinical trials and
provide important information about the potential value of the intervention.
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Affiliation(s)
- Jennifer Hunter
- 1 Western Sydney University, Sydney, New South Wales, Australia.,2 The University of Sydney, Sydney, New South Wales, Australia
| | - Mike Armour
- 1 Western Sydney University, Sydney, New South Wales, Australia
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Zhukova M, Talantseva O, Logvinenko T, Titova O, Grigorenko E. Complementary and Alternative Treatments for Autism Spectrum Disorders: A Review for Parents and Clinicians. КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2020. [DOI: 10.17759/cpse.2020090310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Complementary and alternative therapy (CAT) methods for children with autism spectrum disorders (ASD) are widespread in European countries and the Russian Federation; however, their efficacy and safety is not routinely considered by parents and clinicians when recommended or used. The current narrative review presents the most widely known CAT interventions for children with ASD synthesizing data from meta-analyses, systematic reviews, and randomized controlled trials obtained from the PubMed database based on the safety-efficacy model. We have found that, of the reviewed CATs, only the melatonin intervention can be considered safe and effective for children with ASD with comorbid sleep problems. The methods that were classified as safe but had inconclusive efficacy are recommended to be implemented only when they do not interfere with front line treatment for ASD, Applied Behavior Analysis (ABA). Methods with the lack of current evidence for the efficacy such as auditory integration therapies, bioacoustic correction, sensory integration therapy, micropolarization, animal assisted therapy, and dietary interventions should not be recommended as alternative treatments and can only be used as complimentary to ABA-based interventions. We advise against the use of chelation, hyperbaric oxygen therapy, and holding therapy due their documented harmful psychological and physical effects. When considering CAT for ASD we recommend parents and clinicians use the criteria suggested by Lofthouse and colleagues [59]: only the therapies that are safe, easy, cheap, and sensible can be recommended and used, as opposed to therapies that are risky, unrealistic, difficult, or expensive that should not be recommended or utilized.
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Hwangbo Y, Son GM, Kim KH, Kwon MS, Kim KH. Colorectal cancer survivors’ willingness to participate in a hypothetical clinical trial of Korean medicine: A cross-sectional study. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2019.101033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Acupuncture and moxibustion for the elderly patients with depression: A randomized controlled trial. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2019. [DOI: 10.1016/j.wjam.2019.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Armour M, Smith CA, Wang LQ, Naidoo D, Yang GY, MacPherson H, Lee MS, Hay P. Acupuncture for Depression: A Systematic Review and Meta-Analysis. J Clin Med 2019; 8:jcm8081140. [PMID: 31370200 PMCID: PMC6722678 DOI: 10.3390/jcm8081140] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/22/2019] [Accepted: 07/27/2019] [Indexed: 12/29/2022] Open
Abstract
Background: Depression is commonly treated with anti-depressant medication and/or psychological interventions. Patients with depression are common users of complementary therapies, such as acupuncture, either as a replacement for, or adjunct to, their conventional treatments. This systematic review and meta-analysis examined the effectiveness of acupuncture in major depressive disorder. Methods: A search of English (Medline, PsychINFO, Google Scholar, and CINAL), Chinese (China National Knowledge Infrastructure Database (CNKI) and Wanfang Database), and Korean databases was undertaken from 1980 to November 2018 for clinical trials using manual, electro, or laser acupuncture. Results: Twenty-nine studies including 2268 participants were eligible and included in the meta-analysis. Twenty-two trials were undertaken in China and seven outside of China. Acupuncture showed clinically significant reductions in the severity of depression compared to usual care (Hedges (g) = 0.41, 95% confidence interval (CI) 0.18 to 0.63), sham acupuncture (g = 0.55, 95% CI 0.31 to 0.79), and as an adjunct to anti-depressant medication (g = 0.84, 95% CI 0.61 to 1.07). A significant correlation between an increase in the number of acupuncture treatments delivered and reduction in the severity of depression (p = 0.015) was found. Limitations: The majority of the included trials were at a high risk of bias for performance blinding. The applicability of findings in Chinese populations to other populations is unclear, due to the use of a higher treatment frequency and number of treatments in China. The majority of trials did not report any post-trial follow-up and safety reporting was poor. Conclusions: Acupuncture may be a suitable adjunct to usual care and standard anti-depressant medication.
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Affiliation(s)
- Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia.
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia.
| | - Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia
| | - Li-Qiong Wang
- School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Dhevaksha Naidoo
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
| | - Guo-Yan Yang
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
| | - Hugh MacPherson
- Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia
- Campbelltown Hospital, South West Sydney Local Health District, Campbelltown, NSW 5074, Australia
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Kligler B, Nielsen A, Kohrherr C, Schmid T, Waltermaurer E, Perez E, Merrell W. Acupuncture Therapy in a Group Setting for Chronic Pain. PAIN MEDICINE 2019; 19:393-403. [PMID: 28595273 DOI: 10.1093/pm/pnx134] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective This project was designed to test the feasibility and effectiveness of acupuncture therapy given in a group setting for chronic pain. Design Nonrandomized, repeated measures quasi-experimental trial. Setting Care was delivered in a primary care clinic waiting area after clinic hours. Subjects Included were primary care patients (≥18 years old) with chronic pain of the neck, back, shoulder, or osteoarthritis of any site of at least three months' duration. Methods Subjects received eight weekly acupuncture therapy sessions in a group setting. Acupuncture therapy included a combination of palpation, acupuncture needling, Tui na, Gua sha, and auricular treatment. Baseline pain levels were established in a two- to four-week run-in; assessment of the intervention impact on pain intensity, mood, and functional status were made at the end of the treatment period (eight weeks) and 16 weeks after completion of intervention (24 weeks). Results Of the total 113 participants recruited for the trial, 96 completed the 24-week protocol. We found a statistically and clinically significant decrease in pain severity, pain interference, and depression in our study population. There were no serious adverse events. Conclusions Acupuncture therapy offered in the group setting was effective in reducing pain severity, pain interference, and depression in patients with chronic neck, back, or shoulder pain or osteoarthritis. Benefit persisted through the 24-week measure despite no additional treatment. This finding has potentially important implications for improving access to effective acupuncture treatment for patients with limited financial resources.
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Affiliation(s)
- Benjamin Kligler
- Department of Family Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Arya Nielsen
- Department of Family Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.,Mount Sinai Beth Israel Medical Center, New York, New York
| | - Corinne Kohrherr
- Mount Sinai Beth Israel Medical Center, New York, New York.,Hunter-Bellevue School of Nursing, New York, New York, USA
| | - Tracy Schmid
- Mount Sinai Beth Israel Medical Center, New York, New York
| | - Eve Waltermaurer
- Department of Family Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Elidania Perez
- Department of Family Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.,Mount Sinai Beth Israel Medical Center, New York, New York
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Patel A. Practicing in Both Worlds: Why two General Practitioners Decided to Become Traditional Chinese Medicine Practitioners. Am J Lifestyle Med 2019; 15:257-259. [PMID: 34025317 DOI: 10.1177/1559827619829691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/07/2019] [Accepted: 01/18/2019] [Indexed: 11/16/2022] Open
Abstract
In New Zealand, little is known about Western medicine practitioners, such as general practitioners (GPs), who have also trained in traditional Chinese medicine (TCM). The aim was to identify the reasons why two GPs decided to study TCM and become integrated health care practitioners. Data from two Auckland-based integrated (combined GP and TCM) health care practitioners were analyzed for the present study. Individual face-to-face interviews were conducted. An inductive thematic approach was used to analyze the data. One main theme emerged. Both participants discussed how they perceived certain limitations in relation to their practice within the Western medicine model and that TCM allowed them to provide a holistic form of treatment. Being an integrated health care practitioner was perceived by participants as allowing them to treat the whole person rather than just the symptoms of a condition. TCM was also perceived to be beneficial as it allowed participants to provide alternative methods in treating their patients.
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Affiliation(s)
- Asmita Patel
- New Zealand College of Chinese Medicine, Auckland, New Zealand, and School of Public Health and Psychosocial Studies, Faculty Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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Current Tracking on Effectiveness and Mechanisms of Acupuncture Therapy: A Literature Review of High-Quality Studies. Chin J Integr Med 2019; 26:310-320. [DOI: 10.1007/s11655-019-3150-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Indexed: 02/07/2023]
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Arvidsdotter T, Kylén S, Bäck-Pettersson S. Experiences of Living with Stress-Related Exhaustion Disorder and Participating in a Tailor-Made AntiStress Program in Primary Care. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/psych.2019.1011096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Affiliation(s)
- Hugh MacPherson
- Dr Hugh MacPherson, Department of Health Sciences, University of York, York YO24 1DG, UK
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Huang W, Liao X, Tian J, Wu J, Shan Y, Zhou W. Traditional Chinese medicine for post-stroke depression: A systematic review and network meta-analysis (Protocol). Medicine (Baltimore) 2018; 97:e13840. [PMID: 30593181 PMCID: PMC6314659 DOI: 10.1097/md.0000000000013840] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Post-stroke depression (PSD) is common in stroke survivors, with significantly negative effects and serious impairments in terms of personal and social functioning. While both pharmacological and traditional Chinese medicine (TCM) interventions have been administered for PSD, there is still uncertainty about the balance between these and what treatment strategy should be preferred in clinical practice. Therefore, we aim to compare and rank, describing the protocol of a systematic review and network meta-analysis (NMA), the commonly used TCM interventions for PSD. METHODS AND ANALYSIS We will search CENTRAL (the Cochrane Central Register of Controlled Trials), CINAHL, Embase, PubMed, CBM and PsycINFO, the US National Institutes of Health and the World Health Organisation International Trials Registry Platform search portal from inception to November 2018. There will be no restrictions on language, publication year or publication type. Only randomized clinical trials (RCTs) accessing any TCM treatments against active comparator or other controls for PSD will be included. The primary outcomes will be efficacy (the total number of participants, declining more than 50% on the total score between baseline) and acceptability of treatment (dropout rate due to any cause). A Bayesian NMA will be performed to compare all relative outcome of different TCM interventions. we will conduct the network meta-regression meta-analyses of data on the sex ratio, the types of stroke and the treatment duration of TCM interventions. Potential explanations in extra subgroup analyses according to the results of heterogeneity and inconsistency will be explored, and sensitivity analyses will be conducted to assess the robustness of the findings. TRIALS REGISTRATION NUMBER PROSPERO CRD42018082400. CONCLUSION Our study will generate evidence for TCM in the treatment of PSD and help to reduce the uncertainty about the effectiveness of PSD management, which will encourage further suggestions for TCM clinical practice or guideline.
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Affiliation(s)
- Wanlin Huang
- Shanghai University of Traditional Chinese Medicine, Shanghai
| | - Xiaoqin Liao
- Shanghai University of Traditional Chinese Medicine, Shanghai
| | - Jinhui Tian
- Lanzhou University, Centre of Evidence Based Medicine, Lanzhou City, Gansu, China
| | - Jing Wu
- Shanghai University of Traditional Chinese Medicine, Shanghai
| | - Yawei Shan
- Shanghai University of Traditional Chinese Medicine, Shanghai
| | - Weini Zhou
- Shanghai University of Traditional Chinese Medicine, Shanghai
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Mayor DF, McClure LS, Clayton McClure JH. Individual Differences in Responsiveness to Acupuncture: An Exploratory Survey of Practitioner Opinion. MEDICINES 2018; 5:medicines5030085. [PMID: 30082630 PMCID: PMC6163768 DOI: 10.3390/medicines5030085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 07/28/2018] [Accepted: 07/31/2018] [Indexed: 12/30/2022]
Abstract
Background: Previous research has considered the impact of personal and situational factors on treatment responses. This article documents the first phase of a four-stage project on patient characteristics that may influence responsiveness to acupuncture treatment, reporting results from an exploratory practitioner survey. Methods: Acupuncture practitioners from various medical professions were recruited through professional organisations to complete an online survey about their demographics and attitudes as well as 60 questions on specific factors that might influence treatment. They gave categorical (“Yes”, “No”, and “Don’t know”) and free-text responses. Quantitative and qualitative (thematic) analyses were then conducted. Results: There were more affirmative than negative or uncertain responses overall. Certain characteristics, including ability to relax, exercise and diet, were most often considered relevant. Younger and male practitioners were more likely to respond negatively. Limited support was found for groupings between characteristics. Qualitative data provide explanatory depth. Response fatigue was evident over the course of the survey. Conclusions: Targeting and reminders may benefit uptake when conducting survey research. Practitioner characteristics influence their appreciation of patient characteristics. Factors consistently viewed as important included ability to relax, exercise and diet. Acupuncture practitioners may benefit from additional training in certain areas. Surveys may produce more informative results if reduced in length and complexity.
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Affiliation(s)
- David F Mayor
- Department of Allied Health Professions and Midwifery, School of Health and Social Work, University of Hertfordshire, Hatfield AL10 9AB, UK.
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Chang CC, Chen TL, Lin CS, Chung CL, Yeh CC, Hu CJ, Lane HL, Liao CC, Shih CC. Decreased risk of pneumonia in stroke patients receiving acupuncture: A nationwide matched-pair retrospective cohort study. PLoS One 2018; 13:e0196094. [PMID: 29782526 PMCID: PMC5962082 DOI: 10.1371/journal.pone.0196094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/07/2018] [Indexed: 11/29/2022] Open
Abstract
Background Acupuncture treatment is common among stroke patients, but there is limited information available on whether acupuncture effectively prevents post-stroke pneumonia. The aim of this study was to analyze the differential risk of pneumonia after stroke between patients who did and did not receive acupuncture after discharge. Methods We used the Taiwan National Health Insurance Research Database to conduct a retrospective cohort study using propensity score matched-pairs of new stroke patients in 2000–2004 who did and did not receive acupuncture post-stroke. Both cohorts were followed up until the end of 2009 for new-onset pneumonia. After correcting for immortal time bias, the incidence and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of pneumonia associated with acupuncture use were calculated using multivariate Cox proportional hazard models. Results Overall, 12557 stroke patients with 12557 paired controls were included in the analysis; pneumonia was diagnosed in 6796 (27.1%). Stroke patients receiving acupuncture had a lower incidence of pneumonia than those without acupuncture (53.4 vs. 58.9 per 1000 person-years), with an adjusted HR of 0.86 (95% CI 0.82–0.90). The association between pneumonia risk and acupuncture use was significant in men (HR 0.92, 95% CI 0.86–0.98) and women (HR 0.79, 95% 0.70–0.82) and was also observed in every age group from 20–79 years. Conclusion Stroke patients receiving acupuncture had a lower risk of pneumonia than those who did not. Further randomized control studies are needed to validate the protective effect of acupuncture on the risk of pneumonia among stroke patients.
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Affiliation(s)
- Chuen-Chau Chang
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ta-Liang Chen
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chao-Shun Lin
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Li Chung
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chun-Chieh Yeh
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan
- Department of Surgery, University of Illinois, Chicago, IL, United States of America
| | - Chaur-Jong Hu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hsin-Long Lane
- School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chien-Chang Liao
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Anesthesiology, Shuan Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chuan Shih
- School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Ph.D. Program for Clinical Drug Discovery from Botanical Herbs, Taipei Medical University, Taipei, Taiwan
- * E-mail: ,
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Critical roles of TRPV2 channels, histamine H1 and adenosine A1 receptors in the initiation of acupoint signals for acupuncture analgesia. Sci Rep 2018; 8:6523. [PMID: 29695862 PMCID: PMC5916903 DOI: 10.1038/s41598-018-24654-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 04/03/2018] [Indexed: 12/31/2022] Open
Abstract
Acupuncture is one of the most promising modalities in complimentary medicine. However, the underlying mechanisms are not well understood yet. We found that in TRPV2 knockout male mice, acupuncture-induced analgesia was suppressed with a decreased activation of mast cells in the acupoints stimulated. The mast cell stabilizer sodium cromolyn could suppress the release of adenosine in the acupoints on male rats. A direct injection of adenosine A1 receptor agonist or histamine H1 receptor agonist increased β-endorphin in the cerebral-spinal fluid in the acute adjuvant arthritis male rats and thus replicated the analgesic effect of acupuncture. These observations suggest that the mast cell is the central structure of acupoints and is activated by acupuncture through TRPV2 channels. The mast cell transduces the mechanical stimuli to acupuncture signal by activating either H1 or A1 receptors, therefore triggering the acupuncture effect in the subject. These findings might open new frontiers for acupuncture research.
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Complementary and alternative therapies for restless legs syndrome: An evidence-based systematic review. Sleep Med Rev 2018; 38:158-167. [DOI: 10.1016/j.smrv.2017.06.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/23/2017] [Accepted: 06/09/2017] [Indexed: 12/19/2022]
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Abstract
BACKGROUND Depression is recognised as a major public health problem that has a substantial impact on individuals and on society. People with depression may consider using complementary therapies such as acupuncture, and an increasing body of research has been undertaken to assess the effectiveness of acupuncture for treatment of individuals with depression. This is the second update of this review. OBJECTIVES To examine the effectiveness and adverse effects of acupuncture for treatment of individuals with depression.To determine:• Whether acupuncture is more effective than treatment as usual/no treatment/wait list control for treating and improving quality of life for individuals with depression.• Whether acupuncture is more effective than control acupuncture for treating and improving quality of life for individuals with depression.• Whether acupuncture is more effective than pharmacological therapies for treating and improving quality of life for individuals with depression.• Whether acupuncture plus pharmacological therapy is more effective than pharmacological therapy alone for treating and improving quality of life for individuals with depression.• Whether acupuncture is more effective than psychological therapies for treating and improving quality of life for individuals with depression.• Adverse effects of acupuncture compared with treatment as usual/no treatment/wait list control, control acupuncture, pharmacological therapies, and psychological therapies for treatment of individuals with depression. SEARCH METHODS We searched the following databases to June 2016: Cochrane Common Mental Disorders Group Controlled Trials Register (CCMD-CTR), Korean Studies Information Service System (KISS), DBPIA (Korean article database website), Korea Institute of Science and Technology Information, Research Information Service System (RISS), Korea Med, Korean Medical Database (KM base), and Oriental Medicine Advanced Searching Integrated System (OASIS), as well as several Korean medical journals. SELECTION CRITERIA Review criteria called for inclusion of all published and unpublished randomised controlled trials comparing acupuncture versus control acupuncture, no treatment, medication, other structured psychotherapies (cognitive-behavioural therapy, psychotherapy, or counselling), or standard care. Modes of treatment included acupuncture, electro-acupuncture, and laser acupuncture. Participants included adult men and women with depression diagnosed by Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), Research Diagnostic Criteria (RDC), International Statistical Classification of Diseases and Related Health Problems (ICD), or Chinese Classification of Mental Disorders Third Edition Revised (CCMD-3-R). If necessary, we used trial authors' definitions of depressive disorder. DATA COLLECTION AND ANALYSIS We performed meta-analyses using risk ratios (RRs) for dichotomous outcomes and standardised mean differences (SMDs) for continuous outcomes, with 95% confidence intervals (CIs). Primary outcomes were reduction in the severity of depression, measured by self-rating scales or by clinician-rated scales, and improvement in depression, defined as remission versus no remission. We assessed evidence quality using the GRADE method. MAIN RESULTS This review is an update of previous versions and includes 64 studies (7104 participants). Most studies were at high risk of performance bias, at high or unclear risk of detection bias, and at low or unclear risk of selection bias, attrition bias, reporting bias, and other bias.Acupuncture versus no treatment/wait list/treatment as usualWe found low-quality evidence suggesting that acupuncture (manual and electro-) may moderately reduce the severity of depression by end of treatment (SMD -0.66, 95% CI -1.06 to -0.25, five trials, 488 participants). It is unclear whether data show differences between groups in the risk of adverse events (RR 0.89, 95% CI 0.35 to 2.24, one trial, 302 participants; low-quality evidence).Acupuncture versus control acupuncture (invasive, non-invasive sham controls)Acupuncture may be associated with a small reduction in the severity of depression of 1.69 points on the Hamilton Depression Rating Scale (HAMD) by end of treatment (95% CI -3.33 to -0.05, 14 trials, 841 participants; low-quality evidence). It is unclear whether data show differences between groups in the risk of adverse events (RR 1.63, 95% CI 0.93 to 2.86, five trials, 300 participants; moderate-quality evidence).Acupuncture versus medicationWe found very low-quality evidence suggesting that acupuncture may confer small benefit in reducing the severity of depression by end of treatment (SMD -0.23, 95% CI -0.40 to -0.05, 31 trials, 3127 participants). Studies show substantial variation resulting from use of different classes of medications and different modes of acupuncture stimulation. Very low-quality evidence suggests lower ratings of adverse events following acupuncture compared with medication alone, as measured by the Montgomery-Asberg Depression Rating Scale (MADRS) (mean difference (MD) -4.32, 95% CI -7.41 to -1.23, three trials, 481 participants).Acupuncture plus medication versus medication aloneWe found very low-quality evidence suggesting that acupuncture is highly beneficial in reducing the severity of depression by end of treatment (SMD -1.15, 95% CI -1.63 to -0.66, 11 trials, 775 participants). Studies show substantial variation resulting from use of different modes of acupuncture stimulation. It is unclear whether differences in adverse events are associated with different modes of acupuncture (SMD -1.32, 95% CI -2.86 to 0.23, three trials, 200 participants; very low-quality evidence).Acupuncture versus psychological therapyIt is unclear whether data show differences between acupuncture and psychological therapy in the severity of depression by end of treatment (SMD -0.5, 95% CI -1.33 to 0.33, two trials, 497 participants; low-quality evidence). Low-quality evidence suggests no differences between groups in rates of adverse events (RR 0.62, 95% CI 0.29 to 1.33, one trial, 452 participants). AUTHORS' CONCLUSIONS The reduction in severity of depression was less when acupuncture was compared with control acupuncture than when acupuncture was compared with no treatment control, although in both cases, results were rated as providing low-quality evidence. The reduction in severity of depression with acupuncture given alone or in conjunction with medication versus medication alone is uncertain owing to the very low quality of evidence. The effect of acupuncture compared with psychological therapy is unclear. The risk of adverse events with acupuncture is also unclear, as most trials did not report adverse events adequately. Few studies included follow-up periods or assessed important outcomes such as quality of life. High-quality randomised controlled trials are urgently needed to examine the clinical efficacy and acceptability of acupuncture, as well as its effectiveness, compared with acupuncture controls, medication, or psychological therapies.
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Affiliation(s)
- Caroline A Smith
- Western Sydney UniversityNational Institute of Complementary Medicine (NICM)Locked Bag 1797PenrithNew South WalesAustralia2751
| | - Mike Armour
- Western Sydney UniversityNational Institute of Complementary Medicine (NICM)Locked Bag 1797PenrithNew South WalesAustralia2751
| | - Myeong Soo Lee
- Korea Institute of Oriental MedicineClinical Research Division461‐24 Jeonmin‐dong, Yuseong‐guDaejeonKorea, South34054
| | - Li‐Qiong Wang
- Beijing University of Chinese MedicineCentre for Evidence‐Based Chinese MedicineNo.11 East Road of North 3rd Ring, Chaoyang DistrictBeijingChina100029
| | - Phillipa J Hay
- Western Sydney UniversityCentre for Health ResearchPenrithNew South WalesAustralia2751
- James Cook UniversityTownsvilleQueenslandAustralia
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Yang Z, Zhao L, Xie X, Xu T, Zhang Y, Wang X, Du J, Wang Z, Zhou M, Li Y, Zhou S. The effectiveness of acupuncture for chronic pain with depression: A systematic review protocol. Medicine (Baltimore) 2017; 96:e8800. [PMID: 29381981 PMCID: PMC5708980 DOI: 10.1097/md.0000000000008800] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Chronic pain is a major public health problem and 30% to 45% of sufferers experience severe depression. Acupuncture is often used to treat both depression and a range of pain disorders. We aim to conduct a systematic review of randomized controlled trials (RCTs) to evaluate the efficacy of acupuncture for patients experiencing chronic pain with depression. METHODS To identify relevant RCTs, the following databases will be searched electronically from their inception to July 1, 2017: PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, the Allied and Complementary Medicine Database, the Cumulative Index to Nursing and Allied Health Literature, Chinese medical databases, and others. Manual retrieval will also be conducted. RCTs that evaluated acupuncture as the sole or adjunct treatment for patients with chronic pain and depression will be included. The primary outcomes will be based on a visual analog pain measurement scale and the Hamilton Depression Scale. The secondary outcomes will include scores on a numerical rating scale, verbal rating scale, and the Hospital Anxiety and Depression Scale. The study selection, data extraction, and study quality evaluation will be performed independently by 2 researchers. If the data permit, meta-analysis will be performed using RevMan V5.3 statistical software. If the data are not appropriate for meta-analysis, descriptive analysis or subgroup analysis will be conducted. The methodological quality of the included trials will be assessed using the Cochrane risk-of-bias criteria and the Standards for Reporting Interventions in Controlled Trials of Acupuncture checklist. RESULTS This study will provide a high-quality synthesis of current evidence of acupuncture for chronic pain with depression from several scales including visual analog pain measurement scale, the Hamilton Depression Scale, a numerical rating scale, verbal rating scale and the Hospital Anxiety and Depression Scale. CONCLUSION The conclusion of our study will provide updated evidence to judge whether acupuncture is an effective intervention for patients suffered from chronic pain with depression.
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Affiliation(s)
- Ziyi Yang
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
| | - Ling Zhao
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
| | - Xianze Xie
- College of Foreign Language & Cultures, Chengdu University of Technology, Chengdu, Sichuan, China
| | - Tao Xu
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
| | - Yutong Zhang
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
| | - Xing Wang
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
| | - Jiarong Du
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
| | - Ziwen Wang
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
| | - Mengyuan Zhou
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
| | - Ying Li
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
| | - Siyuan Zhou
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
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The Role of MAPK and Dopaminergic Synapse Signaling Pathways in Antidepressant Effect of Electroacupuncture Pretreatment in Chronic Restraint Stress Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:2357653. [PMID: 29234374 PMCID: PMC5664199 DOI: 10.1155/2017/2357653] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/17/2017] [Accepted: 08/03/2017] [Indexed: 12/21/2022]
Abstract
Acupuncture has demonstrated the function in ameliorating depressive-like behaviors via modulating PKA/CREB signaling pathway. To further confirm the antidepressant mechanism of EA on the mitogen-activated protein kinase (MAPK) and dopaminergic synapse signaling pathways, 4 target proteins were detected based on our previous iTRAQ analysis. Rats were randomly divided into control group, model group, and electroacupuncture (EA) group. Except for the control group, all rats were subjected to 28 days of chronic restraint stress (CRS) protocols to induce depression. In the EA group, EA pretreatment at Baihui (GV20) and Yintang (GV29) was performed daily (1 mA, 2 Hz, discontinuous wave, 20 minutes) prior to restraint. The antidepressant-like effect of EA was measured by body weight and open-field test. The protein levels of DAT, Th, Mapt, and Prkc in the hippocampus were examined by using Western blot. The results showed EA could ameliorate the depression-like behaviors and regulate the expression levels of Prkc and Mapt in CRS rats. The effect of EA on DAT and Th expression was minimal. These findings implied that EA pretreatment could alleviate depression through modulating MAPK signaling pathway. The role of EA on dopaminergic synapse signaling pathways needs to be further explored.
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Acupuncture for behavioral changes of experimental depressive disorder: a systematic review and meta-analysis. Sci Rep 2017; 7:9669. [PMID: 28851961 PMCID: PMC5575352 DOI: 10.1038/s41598-017-09712-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/28/2017] [Indexed: 01/28/2023] Open
Abstract
Acupuncture is considered to be a promising alternative therapy for depression. Nevertheless, up to now, it remains controversial on the effects exerted by acupuncture on behavioral changes in depression models. Consequently, it’s necessary to develop a systematic review and meta-analysis to assess the effect of acupuncture for model rats of depression. Ultimately, 90 studies involving 1861 models were identified. Behavioral indicators including the number of crossings (NC) and the number of rearings (NR) in open field test (OFT), the capacity of sucrose intake (CSI) and the rate of sucrose intake (RSI) in sucrose intake test (SIT), final weight (FW) and gain weight (GW) were employed as main outcomes in depression model rats. The pooled results showed that acupuncture had not less effect than western medicine on improving NC, NR, FW, GW, RSI (P > 0.05). However, the CSI improvement was poorer compared with west medicine (P < 0.05). In conclusion, acupuncture has not less effect on behavior changes than western medicine, including improving NC, NR, RSI, FW and GW in depression models.
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Wu X, Zhang W, Qin Y, Liu X, Wang Z. Effect of acupuncture and its influence on cerebral activity in perimenopausal insomniacs: study protocol for a randomized controlled trial. Trials 2017; 18:377. [PMID: 28806907 PMCID: PMC5557519 DOI: 10.1186/s13063-017-2072-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 06/28/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Perimenopausal insomnia is one of the core symptoms of the menopausal transition. Acupuncture is considered to exert a positive effect on restoring the normal sleep-wake cycle. However, there is little intuitive evidence besides evaluation using clinical effectiveness scales. We therefore designed this study, aiming to use more intuitive and reliable detection techniques such as functional magnetic resonance imaging before and after applying acupuncture to provide neuroimaging evidence, as well as to verify the effectiveness with other curative effect indicators. METHODS/DESIGN This study is a randomized, assessor-statistician-blinded, positive medicine controlled trial involving 40 participants. A total of 40 eligible patients with perimenopausal insomnia will be randomly assigned to two groups in a 1:1 ratio as an intervention group using acupuncture and a control group taking estazolam. Participants in the intervention group will receive six acupuncture treatment sessions per week for 4 consecutive weeks, for a total of 24 sessions during the study. Meanwhile, the medicine control group will be prescribed estazolam 1-2 mg/day to be taken 30 minutes before sleep for 4 weeks. The primary outcome is the Pittsburgh Sleep Quality Index. Secondary outcomes are the micro-movement sensitive mattress-type sleep monitoring system, the Hamilton Depression Scale, and the Hamilton Anxiety Scale. All outcomes will be evaluated before and after treatment. The safety of interventions will be assessed at every visit. DISCUSSION The results of this trial, which will be available in 2018, will investigate the impact of acupuncture treating perimenopausal insomnia from assessment of the sleep architecture, hormone level, and emotional-circuit neurological function, and will uncover the effective mechanism of acupuncture regulating the emotional center integrated effect. TRIAL REGISTRATION Chinese Clinical Trials Register, ChCTR-IPC-16007832 . Registered on 26 January 2016.
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Affiliation(s)
- Xiao Wu
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610072 People’s Republic of China
- Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, 16 Chunhui Road, Longmatan District, Luzhou, Sichuan 646000 People’s Republic of China
| | - Wei Zhang
- Sichuan Integrative Medicine Hospital, 51 4th section of Renmin South Road, Wuhou District, Chengdu, Sichuan 610041 People’s Republic of China
| | - Yuanyuan Qin
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610072 People’s Republic of China
| | - Xuguang Liu
- Chengdu University of Traditional Chinese Medicine, 37 Shi’er Qiao Road, Jinniu District, Chengdu, Sichuan 610072 People’s Republic of China
| | - Zhengyan Wang
- Sichuan Integrative Medicine Hospital, 51 4th section of Renmin South Road, Wuhou District, Chengdu, Sichuan 610041 People’s Republic of China
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Shih CC, Yeh CC, Hu CJ, Lane HL, Tsai CC, Chen TL, Liao CC. Risk of dementia in patients with non-haemorrhagic stroke receiving acupuncture treatment: a nationwide matched cohort study from Taiwan's National Health Insurance Research Database. BMJ Open 2017; 7:e013638. [PMID: 28679673 PMCID: PMC5734214 DOI: 10.1136/bmjopen-2016-013638] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the risk of dementia in patients with stroke who did and did not receive acupuncture treatment. DESIGN Retrospective cohort study. SETTING This study was based on Taiwan's National Health Insurance Research Database that included patients with stroke hospitalised between 1 January 2000 and 31 December 2004. PARTICIPANTS We identified 11 220 patients aged 50 years and older with newly diagnosed stroke hospitalisation. PRIMARY AND SECONDARY OUTCOME MEASURES We compared the incident dementia during the follow-up period until the end of 2009 in patients with stroke who did and did not receive acupuncture. The adjusted HRs and 95% CIs of dementia associated with acupuncture were calculated in multivariate Cox proportional hazard regressions. RESULTS Acupuncture treatment was associated with a decreased risk of dementia with multivariate adjustment (HR, 0.73; 95% CI 0.66 to 0.80), and the association was significant in both sexes and every age group, as well as in groups with ischaemic stroke, with fewer medical conditions and those hospitalised after stroke. Patients with stroke received acupuncture treatment, and conventional rehabilitation was associated with a significantly reduced risk of poststroke dementia (HR, 0.64; 95% CI 0.56 to 0.74). CONCLUSIONS This study raises the possibility that patients with non-haemorrhagic stroke who received acupuncture had a reduced risk of dementia. The results suggest the need for prospective sham-controlled and randomised trials to establish the efficacy of acupuncture in preventing dementia.
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Affiliation(s)
- Chun-Chuan Shih
- School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Ph.D. Program for Clinical Drug Discovery from Botanical Herbs, Taipei Medical University, Taipei, Taiwan
- Taipei Chinese Medical Association, Taipei, Taiwan
| | - Chun-Chieh Yeh
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan
- Department of Surgery, University of Illinois, Chicago, Illinois, USA
| | - Chaur-Jong Hu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hsin-Long Lane
- School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chin-Chuan Tsai
- School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ta-Liang Chen
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chien-Chang Liao
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
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