1
|
Qu LL, Zhao WP, Li JP, Zhang W. Predictive value of diaphragm ultrasound for mechanical ventilation outcome in patients with acute exacerbation of chronic obstructive pulmonary disease. World J Clin Cases 2024; 12:5893-5900. [DOI: 10.12998/wjcc.v12.i26.5893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/07/2024] [Accepted: 07/01/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is often combined with respiratory failure, which increases the patient's morbidity and mortality. Diaphragm ultrasound (DUS) has developed rapidly in the field of critical care in recent years. Studies with DUS monitoring diaphragm-related rapid shallow breathing index have demonstrated important results in guiding intensive care unit patients out of the ventilator. Early prediction of the indications for withdrawal of non-invasive ventilator and early evaluation of patients to avoid or reduce disease progression are very important.
AIM To explore the predictive value of DUS indexes for non-invasive ventilation outcome in patients with AECOPD.
METHODS Ninety-four patients with AECOPD who received mechanical ventilation in our hospital from January 2022 to December 2023 were retrospectively analyzed, and they were divided into a successful ventilation group (68 cases) and a failed ventilation group (26 cases) according to the outcome of ventilation. The clinical data of patients with successful and failed noninvasive ventilation were compared, and the independent predictors of noninvasive ventilation outcomes in AECOPD patients were identified by multivariate logistic regression analysis.
RESULTS There were no significant differences in gender, age, body mass index, complications, systolic pressure, heart rate, mean arterial pressure, respiratory rate, oxygen saturation, partial pressure of oxygen, oxygenation index, or time of inspiration between patients with successful and failed mechanical ventilation (P > 0.05). The patients with successful noninvasive ventilation had shorter hospital stays and lower partial pressure of carbon dioxide (PaCO2) than those with failed treatment, while potential of hydrogen (pH), diaphragm thickening fraction (DTF), diaphragm activity, and diaphragm movement time were significantly higher than those with failed treatment (P < 0.05). pH [odds ratio (OR) = 0.005, P < 0.05], PaCO2 (OR = 0.430, P < 0.05), and DTF (OR = 0.570, P < 0.05) were identified to be independent factors influencing the outcome of mechanical ventilation in AECOPD patients.
CONCLUSION The DUS index DTF can better predict the outcome of non-invasive ventilation in AECOPD patients.
Collapse
Affiliation(s)
- Lei-Lei Qu
- The First Department of Respiratory and Critical Care Medical Center, The First People's Hospital of Baiyin City, Baiyin 730900, Gansu Province, China
| | - Wen-Ping Zhao
- Department of Nursing, The First People's Hospital of Baiyin City, Baiyin 730900, Gansu Province, China
| | - Ji-Ping Li
- The First Department of Respiratory and Critical Care Medical Center, The First People's Hospital of Baiyin City, Baiyin 730900, Gansu Province, China
| | - Wei Zhang
- The First Department of Respiratory and Critical Care Medical Center, The First People's Hospital of Baiyin City, Baiyin 730900, Gansu Province, China
| |
Collapse
|
2
|
Zeng Q, Liu L, Chen Y, Chen D, Zhou Z, Hu W, Gong S, He B, Qi W, Wang C, Yang Z, Yu S, Zhao L. Efficacy and Safety of Acupuncture in Managing COPD: An Overview of Systematic Reviews. Int J Chron Obstruct Pulmon Dis 2024; 19:1721-1739. [PMID: 39081776 PMCID: PMC11288361 DOI: 10.2147/copd.s464546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 06/18/2024] [Indexed: 08/02/2024] Open
Abstract
Background Acupuncture has been used as an adjuvant therapy for Chronic obstructive pulmonary disease (COPD). However, systematic reviews (SRs) and meta-analyses (MAs) have reported inconsistent results and unknown quality. This overview aimed to summarize the current SRs/MAs to provide evidence for the effectiveness and safety of acupuncture in the treatment of COPD. Methods SRs/MAs were searched via eight databases from their establishment to December 31, 2023. The methodological quality was assessed by A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). The risk of bias was assessed using the Risk of Bias in Systematic Review (ROBIS) tool. The Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A) to evaluate the reporting quality. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to determine the strength of evidence. In addition, we also conducted an analysis of the acupuncture points used in the primary RCTs. Results Twenty-two SRs/MAs were included in this overview. Based on the assessment using AMSTAR 2, nineteen SRs/MAs were "critically low". Eight SRs/MAs had a low risk of bias. Based on PRISMA-A, the reporting completeness of eighteen SRs/MAs were more than 70%. As for GRADE assessment, only three outcome measures were of high quality. COPD patients can benefit from moxibustion, acupoint application, acupoint catgut embedding, manual acupuncture, and electroacupuncture, as indicated by effectiveness in measures including lung function, 6MWD, mMRC, CAT, and acute exacerbation. In addition, the efficacy of TENS needed to be further demonstrated. The commonly used acupuncture points in the RCTs include BL13, BL23, and EX-B1. Conclusion Evidence from SRs showed that acupuncture is beneficial to lung function, acute exacerbation, 6MWD, mMRC and CAT. For SGRQ and brog scale, acupuncture should be used selectively, but this finding should still be taken with caution.
Collapse
Affiliation(s)
- Qian Zeng
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Lu Liu
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Ying Chen
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Daohong Chen
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Ziyang Zhou
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Wenjiao Hu
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Siyao Gong
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Bin He
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Wenchuan Qi
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
- Key Laboratory of Acupuncture for Senile Disease, Chengdu University of Traditional Chinese Medicine, Ministry of Education, Chengdu, People’s Republic of China
| | - Chao Wang
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
- Sub-health Management Center, Sichuan Integrative Medicine Hospital, Chengdu, People’s Republic of China
| | - Zuoqin Yang
- Department of Acupuncture and Tuina, Chengdu Pidu District Hospital of Traditional Chinese Medicine, Sichuan, People’s Republic of China
| | - Shuguang Yu
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
- Key Laboratory of Acupuncture for Senile Disease, Chengdu University of Traditional Chinese Medicine, Ministry of Education, Chengdu, People’s Republic of China
| | - Ling Zhao
- Department of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
- Key Laboratory of Acupuncture for Senile Disease, Chengdu University of Traditional Chinese Medicine, Ministry of Education, Chengdu, People’s Republic of China
| |
Collapse
|
3
|
Yang C, Tian H, Xu G, Luo Q, Sun M, Liang F. Efficacy of Acupuncture in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. Int J Chron Obstruct Pulmon Dis 2024; 19:707-720. [PMID: 38495215 PMCID: PMC10942019 DOI: 10.2147/copd.s450257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
Purpose The effect of acupuncture as adjunctive therapy for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) was controversial. Thus, we aimed to evaluate the effects of acupuncture for treating AECOPD. Methods Eight databases were searched from database inception to July 30, 2023. All RCTs compared acupuncture plus conventional western medicine with conventional western medicine alone were included. Outcomes were quality of life, lung function, blood oxygen condition, exercise capacity, daily symptoms, duration of hospitalization, and adverse events. The statistical analyses were conducted using Stata 17.0, and methodological quality was measured by the Cochrane bias risk assessment tool. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. Results Twelve studies including 915 patients were included. Compared with conventional western medicine alone, acupuncture combined with conventional western therapy significantly improved quality of life (CAT: MD: -3.25; 95% CI: -3.73 to -2.78, P<0.001) and arterial blood gas (PaCO2: MD: -1.85; 95% CI: -2.74 to -0.95, P<0.001; PaO2: MD: 5.15; 95% CI: 1.22 to 9.07, P = 0.01). And for lung function, statistical benefits were found in FEV1/FVC (MD: 4.66; 95% CI: 2.21 to 7.12, P<0.001), but no difference was seen for FEV1% (MD: 1.83; 95% CI: -0.17 to 3.83, P = 0.073). There was no significant improvement in exercise capacity (6MWD: MD: 96.69; 95% CI: -0.60 to 193.98, P = 0.051), hospitalization duration (MD: -5.70; 95% CI: -11.97 to 0.58, P = 0.075), and dyspnea (mMRC: MD: -0.19; 95% CI: -0.61 to 0.63, P = 0.376) between two groups. Overall bias for CAT and mMRC was in "high" risk, FEV1%, FEV1/FVC, PaCO2, and PaO2 was in "some concern" and 1 RCT assessing hospitalization duration was in "low" risk. And the overall assessments were either moderate, low or very low certainty. Seven trials performed safety assessment of acupuncture, and no serious adverse events were reported. Conclusion Acupuncture might have auxiliary effects on AECOPD. However, the quality of the evidence is limited, and more high-quality RCTs are needed to be performed in the future.
Collapse
Affiliation(s)
- Chunyan Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People’s Republic of China
| | - Hao Tian
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People’s Republic of China
| | - Guixing Xu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People’s Republic of China
| | - Qin Luo
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People’s Republic of China
| | - Mingsheng Sun
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People’s Republic of China
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People’s Republic of China
| |
Collapse
|
4
|
Shi F, Cao J, Zhou D, Wang X, Yang H, Liu T, Chen Z, Zeng J, Du S, Yang L, Jia R, Zhang S, Zhang M, Guo Y, Lin X. Revealing the clinical effect and biological mechanism of acupuncture in COPD: A review. Biomed Pharmacother 2024; 170:115926. [PMID: 38035864 DOI: 10.1016/j.biopha.2023.115926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/12/2023] [Accepted: 11/20/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND To provide new ideas for the clinical and mechanism research of acupuncture in the treatment of chronic obstructive pulmonary disease (COPD), this study systematically reviews clinical research and the progress of basic research of acupuncture in the treatment of COPD. METHODS PubMed and Web of Science databases were searched using acupuncture and COPD as keywords in the last 10 years, and the included literature was determined according to exclusion criteria. FINDINGS Acupuncture can relieve clinical symptoms, improve exercise tolerance, anxiety, and nutritional status, as well as hemorheological changes (blood viscosity), reduce the inflammatory response, and reduce the duration and frequency of COPD in patients with COPD. Mechanistically, acupuncture inhibits M1 macrophage activity, reduces neutrophil infiltration, reduces inflammatory factor production in alveolar type II epithelial cells, inhibits mucus hypersecretion of airway epithelial cells, inhibits the development of chronic inflammation in COPD, and slows tissue structure destruction. Acupuncture may control pulmonary COPD inflammation through the vagal-cholinergic anti-inflammatory, vagal-adrenomedullary-dopamine, vagal-dual-sensory nerve fiber-pulmonary, and CNS-hypothalamus-orexin pathways. Furthermore, acupuncture can increase endogenous cortisol levels by inhibiting the HPA axis, thus improving airway antioxidant capacity and reducing airway inflammation in COPD. In conclusion, the inhibition of the chronic inflammatory response is the key mechanism of acupuncture treatment for COPD.
Collapse
Affiliation(s)
- Fangyuan Shi
- Tianjin Key Laboratory of Modern Chinese Medicine Theory of Innovation and Application, School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Jiaojiao Cao
- Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Dan Zhou
- Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Xue Wang
- Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Haitao Yang
- Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Tingting Liu
- Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Zhihan Chen
- Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Jiaming Zeng
- Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Simin Du
- Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Lin Yang
- Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Ruo Jia
- Tianjin Key Laboratory of Modern Chinese Medicine Theory of Innovation and Application, School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Siqi Zhang
- Ministry of Education, and State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, China
| | - Mingxing Zhang
- School of Intergrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Yi Guo
- Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Xiaowei Lin
- Tianjin Key Laboratory of Modern Chinese Medicine Theory of Innovation and Application, School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| |
Collapse
|
5
|
Yang ZH, Hao JW, Liu JP, Bao B, Li TL, Wu QX, He MG, Bi HS, Guo DD. Electroacupuncture alleviates ciliary muscle cell apoptosis in lens-induced myopic guinea pigs through inhibiting the mitochondrial signaling pathway. Int J Ophthalmol 2023; 16:1942-1951. [PMID: 38111935 PMCID: PMC10700068 DOI: 10.18240/ijo.2023.12.05] [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: 04/10/2023] [Accepted: 10/19/2023] [Indexed: 12/20/2023] Open
Abstract
AIM To investigate the effect of electroacupuncture (EA) on the mitochondria-dependent apoptotic signaling pathway in the ciliary muscle of guinea pigs with negative lens-induced myopia (LIM). METHODS Guinea pigs were randomly divided into normal control (NC) group, LIM group, LIM+SHAM acupoint (LIM+SHAM) group, and LIM+EA group. Animals in the NC group received no intervention, while those in other three groups were covered with -6.0 diopter (D) lenses on right eyes. Meanwhile, animals in the LIM+EA group received EA at Hegu (LI4) combined with Taiyang (EX-HN5) acupoints, while those in the LIM+SHAM group were treated at sham points. After treatments for 1, 2, and 4wk, morphological changes in ciliary muscles were observed with hematoxylin and eosin (H&E) staining and nick end labeling (TUNEL), and the expression of the mitochondrial apoptotic signaling pathway-related molecules in ciliary muscles was measured by real-time quantitative polymerase chain reaction (qPCR) and Western blot. Additionally, the adenosine triphosphate (ATP) contents were also determined in ciliary muscles. RESULTS Axial length increased significantly in the LIM and LIM+SHAM groups and decreased in the LIM+EA group. The ciliary muscle fibers were broken and destroyed in both LIM and LIM+SHAM groups, whereas those in the LIM+EA group improved significantly. TUNEL assay showed the number of apoptotic cells increased in the LIM and LIM+SHAM groups, whereas reduced in the LIM+EA group. ATP contents showed a significant decrease in the LIM and LIM+SHAM groups, whereas increased after EA treatment. Compared with the NC group, the dynamin-related protein 1 (DRP1), Caspase3, and apoptotic protease activator 1 (APAF1) levels were significantly increased in the LIM group and decreased in the LIM+EA group. CONCLUSION The results provide evidence of EA inhibiting the development of myopia by regulating the mitochondrial apoptotic signaling pathway.
Collapse
Affiliation(s)
- Zhao-Hui Yang
- Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Jia-Wen Hao
- Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Jin-Peng Liu
- Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Bo Bao
- Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Tu-Ling Li
- Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Qiu-Xin Wu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Provincial Clinical Medical Research Center of Optometry and Adolescent Low Vision Prevention and Control, Jinan 250002, Shandong Province, China
| | - Ming-Guang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Hong-Sheng Bi
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Provincial Clinical Medical Research Center of Optometry and Adolescent Low Vision Prevention and Control, Jinan 250002, Shandong Province, China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Academy of Eye Disease Prevention and Therapy, Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
| | - Da-Dong Guo
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Academy of Eye Disease Prevention and Therapy, Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
| |
Collapse
|
6
|
Xu K, Ma J, Lu R, Shao X, Zhao Y, Cui L, Qiu Z, Tian Y, Li J. Effective-compound combination of Bufei Yishen formula III combined with ER suppress airway mucus hypersecretion in COPD rats: via EGFR/MAPK signaling. Biosci Rep 2023; 43:BSR20222669. [PMID: 36799253 PMCID: PMC10643050 DOI: 10.1042/bsr20222669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/08/2023] [Accepted: 02/16/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The aim of this study was to explore the combined efficacy ofeffective-component compatibility of Bufei Yishen formula III (ECC-BYF III) and exercise rehabilitation (ER) in inhibiting airway mucus hypersecretion in a chronic obstructive pulmonary disease (COPD) rat model. METHODS A total of 48 SD rats were divided into control, model, acetylcysteine (NAC), ECC-BYF III, ER, and ECC-BYF III + ER groups (n=8). COPD rats were exposed to cigarette smoke and bacteria for 8 weeks and administered various treatments over the next eight weeks. Rats were euthanized at week 17 after pulmonary function testing. Pathological examination of lung tissues was performed. IL-6 and IL-10 levels were measured in bronchoalveolar lavage fluid (BALF) and protein levels of MUC5AC, MUC5B, AQP-5, EGFR, ERK, JNK, and p38 were measured in lung tissues. RESULTS Improved pulmonary function and pathological changes were observed in ECC-BYF III, ECC-BYF III + ER, and NAC groups. ECC-BYF III and ECC-BYF III + ER had greater mean alveolar number (MAN) compared with NAC. Lung inflammation and goblet cell generation were reduced and MUC5AC, MUC5B and AQP-5 expressions were lower in all treatment groups. ECC-BYF III has more significant effect on MUC5AC than ER and NAC. ECC-BYFIII + ER had a greater effect on suppressing IL-6 in BALF compared with other treatments. ECC-BYFIII, ER, and ECC-BYF III + ER reduced EGFR, ERK, JNK, and p38 phosphorylated protein levels. ECC-BYFIII+ER had a greater effect on p-JNK and p-p38 than ECC-BYFIII and NAC. CONCLUSION ECC-BYF III, ER, and ECC-BYF III + ER have efficacy in inhibiting airway mucus hypersecretion with improved pulmonary function and pathological changes. ECC-BYF III had a greater effect in improving MAN and MUC5AC in lung tissue. ECC-BYF III+ER had a greater effect in alleviating pulmonary pathology and inflammation. These effects may be mediated by inhibition of the EGFR/MAPK pathway.
Collapse
Affiliation(s)
- Kexin Xu
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou, Henan 450046, China
| | - Jindi Ma
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou, Henan 450046, China
- Traditional Chinese Medicine (ZHONG JING) School, Henan University of Chines Medicine, Zhengzhou, Henan 450046, China
| | - Ruilong Lu
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou, Henan 450046, China
| | - Xuejie Shao
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou, Henan 450046, China
| | - Yakun Zhao
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou, Henan 450046, China
| | - Lili Cui
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou, Henan 450046, China
| | - Zhiguang Qiu
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou, Henan 450046, China
| | - Yange Tian
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou, Henan 450046, China
| | - Jiansheng Li
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou, Henan 450046, China
- Institute for Respiratory Diseases, The First Affiliated Hospital, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan 450008, China
| |
Collapse
|
7
|
Yang C, Sun M, Xu G, Luo Q, Huang L, Tian H, Gong S, Li Q, Yu X, Chen M, Huang D, Liu Y, Zhou Z, Huang F, Liu Y, Tang J, Yang S, Zeng F, Liang F. Acupuncture as adjunctive therapy for patients with AECOPD: study protocol for a multicenter, randomized controlled trial. Front Public Health 2023; 11:1235672. [PMID: 37849714 PMCID: PMC10578458 DOI: 10.3389/fpubh.2023.1235672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/07/2023] [Indexed: 10/19/2023] Open
Abstract
Background The acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common respiratory disease among older adults, which imposes a significant burden on individuals and society and poses a major challenge to the global public health system due to its high morbidity and mortality. Acupuncture is effective for AECOPD, but its efficacy has been questioned due to the limited methodological quality. Thus, we aim to investigate the efficacy of acupuncture as adjunctive therapy for AECOPD and determine whether the efficacy of acupuncture differs with the type of acupoint combinations. Methods and analysis This study proposes a prospective, multicenter randomized controlled trial that will comprise four groups, including two acupuncture treatment groups, one sham acupuncture group, and one basic treatment group. The acupuncture treatment groups will be distinguished by their focus on different patterns of acupoint combination, namely the Xi-cleft and He-sea acupoint combination and the Eight Confluence points acupoint combination, which may vary in clinical efficacy based on traditional acupuncture theories. The study aims to randomize 556 patients in a 1:1:1:1 ratio across the four groups. Each patient in acupuncture group or sham acupuncture group will receive routine drug therapy and 7 sessions of acupuncture treatment over 1 week. Participants in the basic treatment group will only receive routine drug therapy. The trial will be conducted in seven hospitals located in China. The primary outcomes in this trial will include differences in the Breathlessness, Cough, and Sputum Scale (BCSS) before randomization, 7 days after randomization, 5 and 9 weeks after randomization. Ethics and dissemination Ethical approval was obtained from the Sichuan Regional Ethics Review of Committee on Traditional Chinese Medicine (Approval ID: 2022KL-068). The results of this study will be distributed through peer-reviewed journals.Clinical Trial Registration: ClinicalTrials.gov, identifier ChiCTR2200064484.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sha Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Fang Zeng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| |
Collapse
|
8
|
He J, Li X. Relationship between chronic obstructive pulmonary disease and adiponectin concentrations: An updated meta-analysis and single-cell RNA sequencing. Medicine (Baltimore) 2023; 102:e34825. [PMID: 37603523 PMCID: PMC10443756 DOI: 10.1097/md.0000000000034825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/28/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Adipose tissue, being an organ of the endocrine system, can influence the severity of chronic obstructive pulmonary disease (COPD). Even though several inflammatory markers can potentially significantly influence lung function, the precise function of adipokines, like adiponectin, in COPD is still disputed. To analyze the association of COPD with adiponectin concentrations, a meta-analysis of the most recent literature and single-cell sequencing data were conducted. METHODS Studies in Embase, PubMed, Cochrane Library, and Web of Science were browsed to obtain relevant data, which were then assessed with the aid of R 4.1.3 and STATA 11.0 software. Standardized mean differences and correlation coefficients aided the analysis of effect values. Moreover, a single-cell sequencing GSE136831 dataset was retrieved to ascertain the mRNA expression of adiponectin gene (ADIPOQ) in the lung tissue of COPD patients to confirm the difference in the expression of adiponectin between the case and control groups. RESULTS This meta-analysis comprised 18 publications involving 24 studies. The overall combined data established the concentration of plasma/serum adiponectin as significantly higher in patients with COPD compared to healthy subjects. Subgroup analyses based on disease status, specimen type, ethnicity, study design method, measurement method, and age of COPD patients demonstrated that all patients with COPD had elevated levels of adiponectin compared to healthy controls. When subgroup analysis was performed for gender alone, the results depicted that male COPD patients had significantly higher adiponectin than healthy males, while female patients of COPD had elevated adiponectin compared to healthy females. Furthermore, it was found that plasma/serum adiponectin appeared to be positively correlated with tumor necrosis factor-α, and it was negatively correlated with FEV1% and FEV1/FVC. The results of single-cell sequencing data suggested that ADIPOQ mRNA was mainly expressed in alveolar epithelial cells, and the level of ADIPOQ mRNA was higher in lung tissues of patients with COPD than in lung tissues of healthy subjects. CONCLUSION This meta-analysis suggests that the levels of plasma/serum adiponectin are significantly elevated in patients with COPD versus controls. Tumor necrosis factor-α, FEV1/FVC, and FEV1% may all be associated with the concentrations of adiponectin.
Collapse
Affiliation(s)
- Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes, Chengdu, China
| | - Xuemei Li
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Neurosurgery department, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| |
Collapse
|
9
|
Fang L, Zhu RR, Sang Z, Xu XT, Zheng LY, Xiang Y, Guo C, Li Z, Espinosa SA, Zhang Q, Shan C. World Health Organization survey on the level of integration of traditional Chinese medicine in Chinese health system rehabilitation services. Integr Med Res 2023; 12:100945. [PMID: 37122485 PMCID: PMC10134443 DOI: 10.1016/j.imr.2023.100945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Background To meet the growing global demand for rehabilitation services, the World Health Organization (WHO) launched Rehabilitation 2030. This study was commissioned by the WHO to investigate the integration degree of traditional Chinese medicine (TCM) in Chinese health system rehabilitation services and the demand for TCM rehabilitation in China. Methods Twenty TCM rehabilitation experts and relevant government administrators were invited to complete the questionnaire between September 2019 and January 2022. The development of traditional, complementary, and integrative medicine (TCI) rehabilitation in China was assessed primarily based on six different health system components. Results 26 policies, regulations, and national strategic plans related to TCI rehabilitation were issued by relevant government departments since 2002; notably, 14 policies related to TCI rehabilitation development were intensively introduced from 2016 to 2021. These policies cover the three main areas of financing, infrastructure development, and service delivery. The National Administration of Traditional Chinese Medicine's investment in TCM clinical capacity infrastructure and scientific research in 2019-2021 increased by 66% compared to 2010-2012, and the average number of TCM hospitals with rehabilitation departments in 2020 increased by 6.5% compared to 2018. The proportion of community health service centers providing TCM services in primary medical and health institutions has increased by 30.8% over the past 10 years. Conclusion Long-term continuous policies, substantial financial investment, and expansion of the scope of TCI rehabilitation services in primary care institutions have effectively contributed to the rapid development of TCI rehabilitation. However, human resources and financing mechanisms for TCI rehabilitation need further improvement.
Collapse
Affiliation(s)
- Lei Fang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ran-ran Zhu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhen Sang
- Institute of TCM International Standardization, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-ting Xu
- Institute of TCM International Standardization, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lin-yun Zheng
- WHO Collaborating Centre for Traditional Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanwei Xiang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Chaoyang Guo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhenrui Li
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Stéphane Alexandre Espinosa
- Traditional, Complementary and Integrative Medicine Governmental Agencies of Service Delivery and Safety, World Health Organization, Geneva, Switzerland
| | - Qi Zhang
- Traditional, Complementary and Integrative Medicine, Integrated Health Services Department, World Health Organization, Geneva, Switzerland
| | - Chunlei Shan
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
10
|
Correia de Carvalho M, Nunes de Azevedo J, Azevedo P, Pires C, Machado JP, Laranjeira M. Effectiveness of Acupuncture on Health-Related Quality of Life in Patients Receiving Maintenance Hemodialysis. Healthcare (Basel) 2023; 11:healthcare11091355. [PMID: 37174896 PMCID: PMC10178503 DOI: 10.3390/healthcare11091355] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/24/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
Patients with kidney failure (KF) receiving maintenance hemodialysis (HD) experience numerous symptoms that impair their health-related quality of life (HRQOL) and contribute to high mortality rates. Acupuncture is often used for symptom enhancement and HRQOL. This blinded, randomized, controlled patient-assessor trial evaluated the effectiveness of acupuncture compared with sham acupuncture on patients' HRQOL receiving maintenance HD as a secondary analysis. Seventy-two participants were randomly assigned to verum acupuncture (VA), sham acupuncture (SA), or waiting-list (WL) groups. The outcome was an improvement in HRQOL, assessed using the Kidney Disease Quality of Life-Short Form, version 1.3 (KDQOL-SF™ v1.3) at baseline, after treatment, and at 12-week follow-up. Non-parametric tests were used for statistical analysis. Of the 72 randomized patients, 67 were included in the complete analysis set. As for the changes between baseline and after treatment, the VA group showed significantly increased scores on most of the KDQOL-SF™ v1.3 scales compared to SA or WL groups (p < 0.05). No statistically significant differences between groups were observed in the changes from baseline to follow-up (p > 0.05). Compared to the sham treatment, acupuncture improved the HRQOL in patients receiving maintenance HD after treatment but not at follow-up.
Collapse
Affiliation(s)
| | | | - Pedro Azevedo
- TECSAM-Tecnologia e Serviços Médicos SA, 5370-530 Mirandela, Portugal
| | - Carlos Pires
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Jorge Pereira Machado
- ICBAS, School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- CBSin, Center of BioSciences in Integrative Health, 4000-105 Porto, Portugal
| | - Manuel Laranjeira
- ICBAS, School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- INC, Instituto de Neurociências, 4100-141 Porto, Portugal
| |
Collapse
|
11
|
Fan S, Zhang Z, Wang Q. Efficacy of acupuncture therapy for stable chronic obstructive pulmonary disease: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33537. [PMID: 37058051 PMCID: PMC10101258 DOI: 10.1097/md.0000000000033537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/24/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Acupuncture therapy (AT) is a widely used, alternative medicine in China. AT is an effective treatment for many diseases, but its efficacy in stable chronic obstructive pulmonary disease (COPD) remains controversial. Therefore, we performed the present meta-analysis to evaluate the efficacy of AT in stable COPD patients. METHODS Randomized controlled trials (RCTs) for AT efficacy in stable COPD patients were searched in literature databases from the inception to December 31, 2021. Pooled effect sizes of outcome measurements with respect to lung function (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1 in predicted value [FEV1%], FEV1/FVC), quality of life (St. George respiratory questionnaire [SGRQ]), exercise capacity (6-minute walking distance [6MWD]) and effective rate were estimated by calculating weighted mean difference (WMD) or odds ratio (OR) with corresponding 95% confidence interval (95% CI), respectively, by a random-effect model. RESULTS A total of 28 RCTs with 2130 COPD patients were included. AT group had significant improvement in FVC (WMD = 0.29 L, 95% CI: 0.22-0.36, P < .001), FEV1 (WMD = 0.33 L, 95% CI: 0.23-0.43, P < .001), FEV1% (WMD = 3.30%, 95% CI: 3.30-4.64, P < .001), FEV1/FVC (WMD = 5.45%, 95% CI: 4.41-6.49, P < .001), 6MWD (WMD = 45.48 m, 95% CI: 28.21-62.16, P < .001), SGRQ (WMD = -7.79, 95% CI: -12.34 to -3.24, P < .001), and a higher effective rate (OR = 3.71, 95% CI: 2.50-5.52, P < .001) compared to the control group. Subgroup analysis stratified by comparison model (AT combined with other treatments vs other treatments, AT alone vs sham AT) and treatment duration (≥8 weeks, <8 weeks) also showed more improvement in AT arm than control arm without significant between-subgroup difference. Adverse events were reported in a few studies and only mild reactions were observed. CONCLUSION AT is effective in improving lung function, quality of life and exercise capacity, and can be used as an adjunctive treatment in patients with stable COPD.
Collapse
Affiliation(s)
- Su Fan
- Special Treatment Center, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhenyu Zhang
- Special Treatment Center, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qinglin Wang
- Department of Vascular Surgery, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
12
|
Effects of Ipratropium Bromide Combined with Traditional Chinese Medicine Intervention on the Pulmonary Function and Psychological Status of Patients with Chronic Obstructive Pulmonary Disease. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2023; 2023:6483785. [PMID: 36798728 PMCID: PMC9928514 DOI: 10.1155/2023/6483785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/28/2022] [Accepted: 10/09/2022] [Indexed: 02/10/2023]
Abstract
Recently, most scholars have advocated multidisciplinary comprehensive intervention measures for chronic obstructive pulmonary disease (COPD) to improve lung function, relieve symptoms of dyspnea, and improve quality of life. Traditional Chinese medicine (TCM) has rich experience in the treatment of various respiratory system diseases and the rehabilitation of their syndrome differentiation. In this study, total 68 patients with COPD from November 2019 to November 2021 in the hospitals were divided into the control group, ipratropium bromide (IB)-treated group, and IB + TCM-treated group for clinical efficacy observation and to explore the effect of IB combined with TCM on the pulmonary function and psychological status of COPD patients. Patients in the control group were subjected to routine oxygen inhalation, cough and expectorant, and antiviral treatments, while the patients in the IB-treated group were treated with IB and those received in the control group. Patients in the IB + TCM-treated group were treated with IB and TCM intervention. All patients were treated for a month. The results showed that after different interventions, the levels of FEV1, FEV1% pred, FVC, and PEF (P < 0.05) were significantly increased in all the groups, while levels of TNF-α, IL-6, IL-8, and CRP in serum as well as Hamilton Anxiety Scale and Hamilton Depression scores were significantly decreased. Compared with the control group and IB-treated group, the IB + TCM-treated group presented the greatest changes on all abovementioned indicators and the lowest total incidence of adverse reactions, indicating the biggest improvement of IB + TCM on the symptoms of COPD patients. Therefore, the combination of IB and TCM intervention effectively improved the pulmonary function and psychological status of COPD patients and could be used as an important adjunct for COPD treatment.
Collapse
|
13
|
Lee S, Kim SN. The Effect of Acupuncture on Modulating Inflammatory Cytokines in Rodent Animal Models of Respiratory Disease: A Systematic Review and Meta-Analysis. Front Immunol 2022; 13:878463. [PMID: 35784312 PMCID: PMC9241441 DOI: 10.3389/fimmu.2022.878463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeAlthough respiratory diseases (RD) are rapidly becoming a global health issue due to their high mortality and prevalence, there are limitations to the currently available treatments. Acupuncture has been recognized to mitigate many diseases by reducing inflammation and modulating cytokines. However, no systematic analysis has been performed to examine the effects of acupuncture on RD. We aimed to evaluate the effects of acupuncture on rodent animal models of RD.MethodsPubMed, EMBASE, MEDLINE, and the Research Information Service System were searched to retrieve studies that met our inclusion/exclusion criteria. The quality of each included study was evaluated using a 10-item checklist modified from the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies. With adequate data extracted, meta-analysis was performed using RevMan software.ResultsA total of 18 studies were included, and the mean quality assessment was 5.7. The meta-analysis revealed that acupuncture had a significant effect on changing the cytokine levels, including pro-/anti-inflammatory, Th1-, Th2- and Th17- specific cytokines.ConclusionAlthough there were limitations in the number of included studies, the results suggest that acupuncture can be a possible treatment for RD through its modulation of various cytokines, leading to reduced inflammation.
Collapse
|
14
|
Effect of Acupuncture on Diaphragm Function in Healthy Volunteers: A Pilot Clinical Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6608200. [PMID: 35677369 PMCID: PMC9168091 DOI: 10.1155/2022/6608200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/28/2022] [Accepted: 05/14/2022] [Indexed: 11/18/2022]
Abstract
Introduction In western medicine, the diaphragm is the main inspiratory muscle. It is involved in the postural control of the trunk and contributes to balance performance. In traditional Chinese medicine (TCM), the diaphragm represents a gateway between the lower and upper parts of the body, and it regulates the descending and ascending functions of the whole organism. The aim of this study was to assess the effect of acupuncture on diaphragm function. Methods A proof-of-concept, prospective, controlled, pilot trial in healthy volunteers. Respiratory rate, inspired volume, diaphragm excursion, and thickening were measured during tidal and maximal breathing at baseline and after sham or real acupuncture. Acupuncture was performed on Yanglingquan (GB34), Tai Chong (LV3), Danzhong (CV17), Geshu (BL17), and Geguan (BL46). Results Ten participants were enrolled (6 males, weight 71 ± 12 kg, height 173 ± 9 cm, BMI 21 ± 1.3 kg/m2). During tidal breathing, tidal volume, diaphragm displacement, and end-expiratory diaphragm thickness did not change with sham or real acupuncture as compared to baseline; thickening ratio was 43.5 ± 16.6 vs. 31.3 ± 14.9 (sham) vs. 30.8 ± 15.3% (baseline), p=0.1066. During breaths at vital capacity, the acupuncture group, as compared to both baseline and sham acupuncture, had a trend toward a larger tidal volume (3840 ± 690 vs. 3110 ± 880 vs. 3230 ± 750 ml, p=0.1247) and showed a significantly higher thickening ratio (270.6 ± 136.4 vs. 172.4 ± 57.4 vs. 188.6 ± 41.7%, p=0.0414). Conclusions Acupuncture significantly influenced diaphragm function in healthy volunteers, improving its inspiratory thickening fraction during breaths at vital capacity, as compared to no or sham acupuncture.
Collapse
|
15
|
Levy I, Elimeleh Y, Gavrieli S, Attias S, Schiff A, Oliven A, Schiff E. Treatment of acute exacerbations of chronic obstructive pulmonary disease with acupuncture during hospitalization: a three-arm double-blinded randomized sham-controlled trial. Acupunct Med 2022; 40:505-515. [PMID: 35579025 PMCID: PMC9597160 DOI: 10.1177/09645284221086293] [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] [Indexed: 11/17/2022]
Abstract
Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a
healthcare burden. Acupuncture improves dyspnea in patients with chronic
obstructive pulmonary disease (COPD) but, to the best of our knowledge, has
not been tested in AECOPD. Here, we evaluated the efficacy and safety of
true acupuncture added to standard of care (SOC), as compared with both sham
procedure plus SOC and SOC only, for the treatment of AECOPD among
inpatients. Methods: This double-blinded randomized sham-controlled trial was set in a tertiary
hospital in Israel. Patients with a clinical diagnosis of AECOPD were
assigned to true acupuncture with SOC, sham procedure with SOC or SOC only.
The primary outcome was dyspnea improvement as measured daily by the
validated modified Borg (mBorg) scale. Secondary outcomes included
improvement of other patient-reported outcomes and physiologic features, as
well as duration of hospitalization and treatment failure.
Acupuncture-related side effects were evaluated by the validated Acup-AE
questionnaire. Results: Seventy-two patients were randomized: 26 to acupuncture treatment, 24 to sham
and 22 to SOC only arms. Baseline characteristics were similar in the three
groups. A statistically significant difference in dyspnea intensity was
found from the first day of evaluation after treatment (p = 0.014) until day
3 after treatment. Similar results were found for sputum production, but no
statistical significance was found when comparing physiologic features
between the three arms. Acupuncture was not associated with adverse
events. Conclusion: Acupuncture seems to be efficacious in the treatment of AECOPD among
inpatients hospitalized in internal medicine departments. Trial registration number: NCT03398213 (ClinicalTrials.gov)
Collapse
Affiliation(s)
- Ilana Levy
- Internal Medicine B Department, Bnai Zion Medical Center, Haifa, Israel.,Complementary and Integrative Medicine Service, Bnai Zion Medical Center, Haifa, Israel.,Rappaport Faculty of Medicine, Technion, Haifa, Israel.,Hematology Unit, Bnai Zion Medical Center, Haifa, Israel
| | - Yotam Elimeleh
- Internal Medicine B Department, Bnai Zion Medical Center, Haifa, Israel
| | - Sagi Gavrieli
- Complementary and Integrative Medicine Service, Bnai Zion Medical Center, Haifa, Israel
| | - Samuel Attias
- Complementary and Integrative Medicine Service, Bnai Zion Medical Center, Haifa, Israel.,School of Public Health, University of Haifa, Haifa, Israel
| | - Ariel Schiff
- Faculty of Medicine, Ben-Gurion University, Beer-Sheva, Israel
| | - Arie Oliven
- Internal Medicine B Department, Bnai Zion Medical Center, Haifa, Israel.,Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Elad Schiff
- Internal Medicine B Department, Bnai Zion Medical Center, Haifa, Israel.,Complementary and Integrative Medicine Service, Bnai Zion Medical Center, Haifa, Israel.,Rappaport Faculty of Medicine, Technion, Haifa, Israel
| |
Collapse
|
16
|
Publication Trends in Rehabilitative Effects of Acupuncture: A Visual Analysis of the Literature. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7705256. [PMID: 35449821 PMCID: PMC9017514 DOI: 10.1155/2022/7705256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/23/2022] [Indexed: 12/04/2022]
Abstract
Objectives To conduct a comprehensive analysis of scientific outputs in 2011–2021 regarding the rehabilitative effects of acupuncture on diseases. Methods The study was conducted in the form of knowledge graph and data visualization, with data being drawn from the Web of Science Core Collection database. Results Articles and reviews were the dominant types; China, Guangzhou University of Chinese Medicine and Medicine ranked was the active country, institution, and journal, respectively, in terms of issued articles. Systematic reviews and the meta-analyses of stroke and pain were extensively carried out in the past decade, whose principal interventions were manual acupuncture, electroacupuncture, scalp acupuncture, and dry needling correspondingly at Baihui (DU20) and Zusanli (ST36). And most frequently utilized rehabilitation assessment criteria were the Fugl-Meyer Assessment Scale and the Barthel Index. More recently, motor function and chronic obstructive pulmonary disease have captured researchers' attention, which might be the futuristic frontier. Conclusions This article provided a relatively panoramic picture of the scientific outputs in acupuncture for disease rehabilitation, which may help readers embrace the heated topic and grasp the recent research focus on this field.
Collapse
|
17
|
Litscher G. Literature Watch. Med Acupunct 2021. [DOI: 10.1089/acu.2021.29181.lit] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|