Electroacupuncture promotes gastrointestinal function recovery in patients undergoing laparoscopic gastrectomy : a randomized controlled trial

OBJECTIVES

To explore the clinical effect of electroacupuncture (EA) on promoting gastrointestinal function recovery in patients undergoing laparoscopic gastrectomy.

METHODS

One hundred and twenty patients undergoing laparoscopic gastrectomy were randomly divided into an EA group (40 cases, 1 case was eliminated), a placebo EA (PEA) group (40 cases, 1 case dropped out) and a conventional treatment group (40 cases, 1 case dropped out). The patients in the conventional treatment group received perioperative routine treatment. On the basis of routine treatment, patients in the EA group and the PEA group were given electroacupuncture or placebo electroacupuncture stimulation at 24,48 and 72 h after anesthesia recovery. Bilateral Neiguan (PC 6), Zusanli (ST 36) and Shangjuxu (ST 37) were selected, and the electrodes of SDV-Z electroacupuncture instrument were connected to Zusanli (ST 36) and Shangjuxu (ST 37) on the same side respectively. Continuous wave was selected, the frequency was 5 Hz, and the needles were retained for 30 min each time. The postoperative gastrointestinal-2 ( GI-2 ) time, the incidence of grade A/B delayed gastric emptying were compared among the three groups, and the safety of acupuncture was evaluated.

RESULTS

The GI-2 time of the EA group was significantly shorter than that of the PEA group and the conventional treatment group (P<0.05). The incidence of grade A and grade B of delayed gastric emptying in the EA group was lower than that in the PEA group and the conventional treatment group (P<0.05). No acupuncture-related adverse reactions occurred.

CONCLUSIONS

EA can promote the recovery of gastrointestinal function in patients undergoing laparoscopic gastrectomy, and the treatment plan is safe, which is worthy of promotion and application into the enhanced recovery surgery program.

Visual analysis on clinical randomized controlled trial of fire needle based on VOSviewer and CiteSpace

To analyze the research hotspots, frontiers and trends of fire needle clinical randomized controlled trial (RCT) literature in the past 10 years by using bibliometrics and knowledge mapping methods. Six Chinese and English databases including CNKI, Wanfang, VIP, SinoMed, PubMed and Web of Science ( WOS ) were searched for RCT research literature on fire needle. CiteSpace V6.1.R6 and VOSviewer V1.6.18 software were used to analyze the cooperation network, keyword co-occurrence, keyword clustering, keyword timeline, keyword emergence, etc., and to draw a visual knowledge map. A total of 1 973 Chinese articles and 3 English articles were included. The top three institutions that publish articles were Guangzhou University of CM, Heilongjiang University of CM and Beijing Hospital of TCM Affiliated to Capital Medical University. The fire needle was often combined with acupuncture, cupping and bloodletting therapy in the treatment of acne, vitiligo, lumbar disc herniation, herpes zoster, stroke sequelae, facial paralysis, knee osteoarthritis and so on. The research frontiers included the combined application of fire needle and other therapies, clinical mechanism research and efficacy evaluation index research. In the future, we should expand the dominant diseases, optimize the research design, strengthen the cooperation between the teams, and carry out high-level clinical research.

Interactive scalp acupuncture combined with suspension digital occupational therapy for upper limb motor dysfunction after stroke: a multi-center randomized controlled trial

OBJECTIVES

To observe the effects of interactive scalp acupuncture on upper limb motor function and activities of daily living in patients with upper limb motor dysfunction after stroke.

METHODS

One hundred and twenty patients with upper limb motor dysfunction after stroke were randomly divided into an observation group(60 cases, 2 cases dropped out)and a control group(60 cases, 1 case dropped out). Both groups were treated with routine medication and rehabilitation. The observation group was treated with interactive scalp acupuncture combined with suspension digital occupational therapy, interactive scalp acupuncture was applied at middle 2/5 of the parietal and temporal anterior oblique line, middle 2/5 of the parietal and temporal posterior oblique line and second lateral line of parietal of the hemiparalysis contralateral side, 30 min each time.The control group was treated with suspension digital occupational therapy alone. The treatment was given once a day, 5 times a week for 4 weeks in the two groups. The scores of Fugl-Meyer assessment scale of upper extremity(FMA-UE), action research arm test(ARAT), the modified Barthel index (MBI) and surface electromyography(sEMG)signal of the biceps and triceps on the affected side were observed before and after treatment in the two groups, and the clinical efficacy was evaluated.

RESULTS

After treatment, the FMA-UE, ARAT and MBI scores were increased compared with those before treatment in both groups(P<0.05), the changes of the observation group were greater than those in the control group(P<0.05). After treatment, the integrated electromyography(iEMG)value and root mean square(RMS)value of the biceps and triceps on the affected side during elbow flexion and extension were increased compared with those before treatment in both groups(P<0.05), the changes of the observation group were greater than those in the control group(P<0.05). The total effective rate was 94.8%(55/58) in the observation group, which was higher than 83.1%(49/59) in the control group(P<0.05).

CONCLUSIONS

Interactive scalp acupuncture could improve upper limb motor function and activities of daily living in patients with upper limb motor dysfunction after stroke.

Acupuncture for postpartum diastasis recti abdominis and its effects on abdominal circumference, separation distance of rectus abdominis

OBJECTIVES

To observe the therapeutic efficacy of acupuncture and its effects on abdominal circumference, separation distance of rectus abdominis and quality of life in patients with postpartum diastasis recti abdominis on the basis of diastasis recti abdominis exercise.

METHODS

A total of 87 postpartum women with diastasis recti abdominis were randomly divided into an observation group (44 cases) and a control group (43 cases) . The control group was treated with conventional diastasis recti abdominis rehabilitation exercise, including abdominal breathing training and supine leg lifting training, 3 times a day for 2 weeks. On the basis of the treatment in the control group, the observation group was treated with acupuncture at Zhongwan(CV 12), Qihai(CV 6)and bilateral Shenshu(BL 23), Daimai(GB 26), Daheng(SP 15), Zusanli (ST 36), etc., 30 min each time, once a day for 2 weeks. Before and after treatment, the separation distance of rectus abdominis, low back pain visual analogue scale (VAS) score, abdominal circumference and 36-item short form health survey questionnaire (SF-36) score in the two groups were compared, and the clinical effect was evaluated.

RESULTS

After treatment, the separation distance of rectus abdominis, low back pain VAS scores, abdominal circumference of the two groups were lower than those before treatment(P<0.05), and the physiological function, physiological role, pain, mental health, emotional role, social function, energy, general health scores and total scores of SF-36 were higher than those before treatment(P<0.05); the separation distance of rectus abdominis, low back pain VAS score, abdominal circumference of the observation group were lower than those in the control group(P<0.05), the sub-item scores and total score of SF-36 of the observation group were higher than those in the control group(P<0.05).The effective rate of the observation group was 95.5% (42/44), which was higher than 79.1% (34/43) in the control group(P<0.05).

CONCLUSIONS

Acupuncture combined with diastasis recti abdominis exercise can effectively relieve the low back pain of postpartum diastasis recti abdominis patients, promote the recovery of recti abdominis function, and improve the quality of life. The clinical effect is superior to diastasis recti abdominis exercise alone.

[Evidence mapping of clinical research on traditional Chinese medicine in treatment of diabetic foot]

The present study comprehensively summarized the clinical randomized controlled trials(RCTs) and systematic reviews/Meta-analyses of traditional Chinese medicine(TCM) in the treatment of diabetic foot by evidence mapping and clarified the distribution of evidence in this field.CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Web of Science were searched for clinical RCTs and systematic reviews on TCM in the treatment of diabetic foot published in the past ten years.The evidence was analyzed and displayed in the form of text combined with figures and tables.AMSTAR was used for the quality evaluation of systematic reviews.A total of 1 037 clinical RCTs and 20 systematic reviews/Meta-analyses were included.The overall publishing trend was stable, and the scale of RCTs was small.TCM interventions for diabetic foot mainly included external application and foot bath.Much attention was paid to the outcome indicators including total effective rate, ankle brachial index(ABI), and TCM syndromes, while less attention to neuropathy scores, emotional psychology, and long-term prognosis.The overall quality of systematic reviews was low, and the majority of studies indicated that TCM had potential efficacy in treating diabetic foot, and there was still a lack of clear clinical evidence of efficacy.TCM has both advantages and problems in the treatment of diabetic foot.At present, there is still a lack of high-quality research, suggesting that more large-sample, multi-center RCTs should be launched in the future, and the quality of related systematic reviews/Meta-analyses should be improved to fully explore and give full play to the advantages of TCM in the treatment of diabetic foot, and promote the development of the clinical and evidence-based medicine of TCM in the treatment of diabetic foot.

[Clinical evidence analysis report of Chinese patent medicine in 2020]

The present study collected, collated, analyzed, and evaluated randomized controlled trial(RCT) of Chinese patent medicine published in Chinese and English journals in 2020, and summarized clinical evidence of Chinese patent medicine in stages, providing references for follow-up clinical research and evidence transformation and application. On the basis of the collection in the Traditional Chinese Medicine(TCM) Clinical Evidence Database System(EVDS), CNKI, Wanfang, SinoMed, Cochrane Library, PubMed, and EMbase were searched for RCTs of Chinese patent medicine published in 2020, and their research characteristics and methodological quality were analyzed and evaluated. A total of 1 285 research papers on Chinese patent medicine(1 257 in Chinese/28 in English) were included, involving 146 054 patients and 639 Chinese patent medicines, including 526 oral drugs, 68 injections, and 45 external drugs. A total of 412 diseases in 23 types were involved, which were dominated by circulatory system diseases and respiratory system diseases, specifically, cerebral infarction and angina pectoris. The sample size ranged from 20 cases to 2 673 cases, and 57.67% of RCTs had samples sizes less than 100. Single-center trials were the main ones, and multi-center trials only accounted for 4.75%(n=61). In terms of methodological quality, 52.91% of the RCTs had unclear descriptions or incorrect application of randomization methods, and the implementation of allocation concealment and blinding methods has not been paid much attention. In conclusion, compared with the conditions in 2019, the number of RCTs published in 2020 has decreased, and the research interest in respiratory diseases has increased, while the quality control in the process of research design and implementation has not been improved. Therefore, it is necessary to strengthen the methodological training of researchers and promote the output of high-quality research evidence.

[Randomized double-blind placebo-controlled trial of Jingfang Granules in treatment of common cold(wind-cold syndrome)]

Jingfang Granules have the effects of inducing sweating to releasing exterior, dispersing wind and dispelling dampness. Modern studies have demonstrated that it has antipyretic and antiviral activities. Therefore, this trial was conducted to evaluate the efficacy and safety of Jingfang Granules in the treatment of common cold(wind-cold syndrome). A total of 138 common cold(wind-cold syndrome) patients meeting the inclusion and exclusion criteria were randomly assigned into the experimental group(n=92) and the placebo group(n=46) at a ratio of 2∶1 and respectively received Jingfang Granules and Jingfang Granules simulation agent. The treatment lasted for 5 d, and the follow-up time was 8 d. Recovery time was employed as the main indicator of efficacy. The median reco-very time of the experimental group was 3.33 d, shorter than that 7.00 d of the placebo group. The efficacy of the experimental group was better than that of the placebo group(P&lt;0.000 1). The major symptom severity score-time AUC of the experimental group was 489.90±206.95, which was smaller than that of the placebo group(763.50±339.53). The recovery rate and marked effective rate of the experimental group were higher than those of the placebo group, The above outcomes were statistically significant between the two groups(P&lt;0.05). The disappearance time and rate of single symptoms including aversion to cold, nasal congestion, runny nose, cough, headache, pharyngeal itching/pain, white sputum, and somatalgia also had significant differences between the two groups(P&lt;0.05), indicating that Jingfang Granules had good performance in alleviating the above symptoms. During the study period, one case of the experimental group had a slight increase in serum creatinine, which returned to the normal level after re-examination. The incidence of adverse reactions was 1.10%, and no serious adverse reaction was found. The two groups had no significant difference in the incidence of adverse reactions. In conclusion, Jingfang Granules can significantly shorten the course of common cold(wind-cold syndrome) and quickly alleviate the clinical symptoms, demonstrating good safety and clinical advantages.

[Systematic review of efficacy and safety of Ginkgo biloba extract 50 in treatment of ischemic stroke]

The present study aimed to systematically evaluate the efficacy and safety of Ginkgo biloba extract 50(GBE50) in the treatment of ischemic stroke. The databases including CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library were searched for randomized controlled trial(RCT) of GBE50 for the treatment of ischemic stroke reported between database inception and May 2020. The methodological quality of the included RCTs was evaluated via the Cochrane risk of bias tool. The RevMan 5.4 was used for Meta-analysis. Sixteen RCTs were included, involving 1 615 patients with acute ischemic stroke. Most of the included RCTs reported the methods of random sequence generation, but only two performed the concealment of random sequence. All RCTs failed in blinding. Two RCTs reported the information of cases lost to follow-up and drop-outs. Since the number was small, the baselines of groups remained balanced. All RCTs reported key outcomes of ischemic stroke, which made selective reporting bias in a low risk. Meta-analysis results revealed that GBE50 combined with routine therapies could effectively lower the score of the National Institutes of Health stroke scale(NIHSS) and restore cognitive function and daily activity in ischemic stroke patients. Compared with routine therapies, the combination is advantageous in treating patients with ischemic stroke. However, high-quality multicenter RCTs with large sample sizes are still required for verification.

[Randomized controlled trial outcome indicators of postmenopausal osteoporosis treated by traditional Chinese medicine]

This study evaluated the outcome indicators of the randomized controlled trials(RCTs) of traditional Chinese medicine(TCM) in the treatment of postmenopausal osteoporosis(PMOP) to provide a reference for the related research. Four Chinese databa-ses(CNKI, VIP, Wanfang and CBM) and three English databases(Cochrane Library, EMbase and PubMed) were searched syste-matically to screen RCTs of TCM in the treatment of PMOP according to the pre-set criteria, and the quality of the included trials was evaluated by the Cochrane risk-of-bias tool. A total of 29 627 articles were initially retrieved, and finally, 43 articles were included, including 34 in Chinese and 9 in English. As revealed by the results, the outcome indicators of 43 RCTs were mainly divided into six categories, with biochemical indicators accounting for 54.59%, bone mineral density(BMD) for 26.57%, quality of life for 6.28%, fracture for 1.94%, safety for 5.31%(including adverse reactions or events) and others for 5.31%. Biochemical indicators showed the maximum occurrence, followed by BMD. Many problems were found in the selection of outcome indicators of the TCM RCTs in the treatment of PMOP, such as the confusion of primary and secondary outcome indicators, the lack of endpoint criteria and vital clinical outcome indicators substituted by intermediate indicators, inconsistent evaluation standard of syndrome curative efficacy and neglected blinding in the measurement of subjective outcome indicators. The problems also included importance given to the efficacy indicators instead of the adverse outcome indicators, unnormalized indicator name, large quantitative range of the indicators, unconventional application of TCM efficacy criteria, seldom used confidence interval, relative effect indicator and absolute effect indicator.

[Acupuncture expectation and its clinical evaluation]

Acupuncture expectation refers to the subjective estimation for the effect of acupuncture to be applied. As sham acupuncture is usually used in acupuncture randomized clinical trials,there exists the effect of acupuncture expectation on subjects. It is necessary to evaluate and standardize it. The factors that influence the evaluation standard of acupuncture expectations are different acupuncture expectation value evaluations,evaluation criterions and time points. They will affect the evaluation of clinical efficacy. It is urgent to establish a unified evaluation standard to improve its reliability.

[Warm acupuncture for chronic atrophic gastritis with spleen-stomach deficiency cold]

OBJECTIVE

To observe the clinical effect of warm acupuncture at Zhongwan(CV 12) for chronic atrophic gastritis(CAG) with spleen-stomach deficiency cold by the comparison with conventional acupuncture.

METHODS

Sixty-two patients were randomly assigned into a warm acupuncture group and a conventional acupuncture group,31 cases in each one. The acupoints in the two groups were Zhongwan(CV 12),Zusanli(ST 36),Neiguan(PC 6),Gongsun(SP 4),Qihai(CV 6),Pishu(BL 20) and Weishu(BL 21). Warm acupuncture was intervened at Zhongwan(CV 12) in the warm acupuncture group. Twirling reinforcing was applied at Zhongwan(CV 12) in the conventional acupuncture group. All the treatment was given for 3 courses continuously,5 days as one course,once a day. TCM syndrome score and symptom rating scale were observed before and after treatment in the two groups,and the effects were compared.

RESULTS

The total effective rate was 93.5%(29/31) in the warm acupuncture group,which was better than 87.0%(27/31) in the conventional acupuncture group(P<0.05). The TCM syndrome score and symptom rating score were improved in the two groups after treatment(P<0.01, P<0.05),with more apparent improvement in the warm acupuncture group(P<0.01,P<0.05).

CONCLUSIONS

Warm acupuncture at Zhongwan(CV 12) can improve gastrointestinal discomfort,which is better than twirling reinforcing at Zhongwan(CV 12) for CAG with spleen-stomach deficiency cold.

[Infraoccipital needle-knife for cervical vertigo]

OBJECTIVE

To observe the clinical effect differences between infraoccipital needle-knife and massage for cervical vertigo.

METHODS

A total of 366 patients with cervical vertigo were randomly assigned into a needle-knife group (186 cases) and a massage group (180 cases). With cases dropping excluded, 183 cases in the needle-knife group and 176 cases in the massage group were included. Needle-knife was used at Fengchi (GB 20), infraoccipital ashi point, etc. in the needle-knife group. The treatment was given for one course, once three days, 5 times as one course. The traditional massage was applied in the massage group for one course, including systematic stroking, kneading, and the application of pressure and plucking, etc., once every two days and 7 times as one course. The dizziness handicap inventory (DHI) score was observed before and after treatment, as well as 3, 6, and 12 months after treatment. The effects were also evaluated.

RESULTS

The total effective rate was 92.3% (169/183) in the needle-knife group, which was better than 85.2% (150/176) in the massage group (P<0.05). Compared with those before treatment, the DHI scores at all the observation time points after treatment were improved in the two groups (all P<0.05), with better improvements after treatment as well as 3 and 6 months after treatment in the needle-knife group (all P<0.05). There was no significant difference in the improvement of DHI scores between the two groups 12 months after treatment (P>0.05). The recurrence rate was 10.3% (12/117) in the needle-knife group, and it was 10.7% (11/103) in the massage group 12 months after treatment (P>0.05).

CONCLUSIONS

Infraoccipital needle-knife achieves apparent effect for cervical vertigo, which is superior to massage in short period.

[Clinical observation of dysphagia after cerebral infarction treated with awn-like needle at Tiantu(CV 22)]

OBJECTIVE

To observe the effect difference between awn-like needle at Tiantu(CV 22) and filiform needle for dysphagia after cerebral infarction.

METHODS

One hundred patients were randomly assigned into an awn-like needle group and a filiform needle group,50 cases in each one. Based on the conventional western medicine for all the patients,awn-like needle was applied at Tiantu(CV 22) in the awn-like needle group;while acupuncture was used at Fengchi(GB 20),Shanglianquan(Extra),Shuigou(GV 26) and Tongli(HT 5) in the filiform needle group,combined with pricking at Jinjin(EX-HN 12), Yuye(EX-HN 13),posterior pharyngeal wall with three-edged needle method. All the treatment was given once a day for two weeks. Standard swallowing assessment scale(SSA) and modified Bathel index for daily life ability(MBI) were used and the efficacy was calculated after treatment.

RESULTS

The scores of SSA and MBI were improved after treatment in the two groups(all P<0.01),and the results were better in the awn-like needle group than those in the filiform needle group(both P<0.05). The cured and effective rate of the awn-like needle group was 56.0%(28/50), which was obviously better than 30.0%(15/50) of the filiform needle group(P<0.05).

CONCLUSIONS

Based on the conventional western treatment,awn-like needle and filiform needle can both improve dysphagia and daily life after cerebral infarction. But awn-like needle achieves better effect.

[Acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages:a clinical randomized controlled trial]

OBJECTIVE

To compare the efficacy difference between acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages.

METHODS

The randomized controlled prospective study method was adopted. Sixty cases of avascular necrosis of femoral head at Ficat-ArletⅠto Ⅱ stages were randomized into an acupotomy group (32 cases) and an acupuncture group (28 cases) by the third part. In the acupotomy group, the acupotomy was adopted for the loose solution at the treatment sites of hip joint, once every two weeks, totally for 3 times. In the acupuncture group, ashi points around the hip joint were selected and stimulated with warm acupuncture therapy, once every day, for 6 weeks. Harris hip score was observed before and after treatment. The efficacy was evaluated in the two groups.

RESULTS

Harris hip score was improved significantly after treatment in the two groups (both P<0.05). The result in acupotomy group was better than that in the acupuncture group (P<0.05). The effective rate was 90.6% (29/32) in the acupotomy group, better than 75.0% (21/28) in the acupuncture group after treatment (P<0.05).

CONCLUSIONS

Harris hip score and the effective rate in the acupotomy group are better than those in the treatment with routine acupuncture for avascular necrosis of femoral head at the early and middle stages.

[Acupuncture with smoothing liver and regulating qi for post-stroke slow transit constipation and its gastrointestinal hormone level]

OBJECTIVE

To compare the efficacy between acupuncture with smoothing liver and regulating qi and lactulose for post-stroke slow transit constipation(STC) and to explore the mechanism.

METHODS

Sixty patients were randomized into an acupuncture group and a medication group,30 cases in each one. Based on the comprehensive stroke unit care,acupuncture with smoothing liver and regulating qi was used at Danzhong(CV 17),Qihai(CV 6),Tianshu(ST 25),Neiguan(PC 6),Gongsun(SP 4) and Taichong(LR 3) in the acupuncture group,once a day. Lactulose oral liquid was taken at a draught in the morning in the medication group,20 to 30 mL a time,once a day. The study period was 11 weeks,including 1-week baseline evaluation,6-week treatment and 4-week follow-up. We recorded the time of the first independent defecation,constipation symptom score,and gastrointestinal hormone level,including somatostatin(SS),motilin(MTL),P substance(SP) and vasoactive intestinal peptide(VIP). Also,the side effects were recorded at any time.

RESULTS

The time of the first independent defecation was (30.18±16.14) h in the acupuncture group,which was significantly different from (43.22±28.42) h in the medication group(P<0.05). The constipation scores after 6-week treatment and at follow-up were lower than those before treatment in the two groups (all P<0.05),with better results in the acupuncture group(both P<0.05). MTL and SP increased,as well as SS and VIP decreased after treatment in the two groups(all P<0.05). The changes were better in the acupuncture group(all P<0.05). The side effect was not observed in the two groups.

CONCLUSIONS

Acupuncture with smoothing liver and regulating qi achieves better effect than lactulose for post-stroke STC in terms of efficacy onset,extent,and long term. The mechanism may relate to increasing excitatory regulatory peptide and reducing inhibitory regulatory peptide.

[Penetration acupuncture at Baxie(EX-UE 9) combined with rehabilitation for swelling hand of post-stroke shoulder-hand syndrome]

OBJECTIVE

To compare the effects between penetration acupuncture at Baxie (EX-UE 9) combined with rehabilitation and simple rehabilitation for swelling hand in post-stroke shoulder-hand syndrome.

METHODS

Sixty patients were randomly assigned into an observation group and a control group,30 cases in each one. Penetration acupuncture at Baxie (EX-UE 9) combined with rehabilitation were used in the observation group,and the acupoints were the affected Baxie (EX-UE 9) and Wailaogong (EX-UE 8). Simple rehabilitation was used in the control group. All the treatment was given for 3 weeks,5 days a week with 2 days at the interval,once a day. The swelling degree and motor function of the affected hand were assessed before and after treatment in the two groups. Also,the effects were compared.

RESULTS

The swelling and motor function scores after treatment were improved compared with those before treatment in the two groups(all P<0.01),with better effects in the observation group(both P<0.01). The total effective rate was 93.3%(28/30) in the observation group,which was better than 73.3%(22/30) in the control group(P<0.01).

CONCLUSIONS

Penetration acupuncture at Baxie (EX-UE 9) combined with rehabilitation can effectively and timely alleviate the swelling hand and motor function of post-stroke shoulder-hand syndrome,which are better than simple rehabilitation.

[Clinical observation of ankylosing spondylitis treated with moxibustion along the governor vessel and the conception vessel and salazosulfapyridine]

OBJECTIVE

To observe the difference in the clinical efficacy on ankylosing spondylitis (AS) between the combined therapy of moxibustion along the governor vessel and the conception vessel and salazosulfapyridine (SASP) and the routine moxibustion.

METHODS

Sixty-two patients of AS were randomized into two groups, 31 cases in each one with one case dnopping separately. In the two groups, SASP was prescribed for oral administration. In the observation group, the self-prepared moxa powder, ginger granules and moxa wool were placed on the back, from Dazhui (GV 14) to Yaoshu (GV 2) and on the abdomen, from the inferior of the xiphoid process to the upper border of symphsis pubis, covering the running of the governor vessel and the conception vessel. In the control group, the routine moxibustion therapy was used, in which, the moxa box was placed on the back and abdomen alternatively. Each treatment lasted 2 h, once every 7 days, 3 treatments as one session. After 3 sessions of treatment, the symptom score, visual analogue scale (VAS) score, time of morning stiffness, Schober test, occiput-to-wall distance and thoracic mobility were observed before and after treatment. The clinical efficacy was evaluated in the two groups.

RESULTS

The total effective rate was 86.7% (26/30) in the observation group, better than 73.3% (22/30) in the control group. The efficacy in the observation group was better than that in the control group (P<0.05). All of the observation indices after treatment were improved apparently as compared with those before treatment in the two groups (all P<0.01). After treatment, the improvements in the symptom score, VAS score, time of morning stiffness and Schober test in the observation group were better apparently than those in the control group (all P<0.01).

CONCLUSIONS

On the basis of treatment with SASP, moxibustion along the governor vessel and the conception vessel achieves the definite efficacy on AS, better than the routine moxibustion therapy.

[Clinical observation of gastrointestinal dysfunction after vascular surgery prevented by electroacupuncture]

OBJECTIVE

To evaluate the preventative efficacy of preoperative electroacupuncture(EA) for gastrointestinal dysfunction after vascular surgery.

METHODS

Sixty patients with the same general anesthesia before vascular surgery were randomly assigned to an observation group and a control group,30 cases in each one. In the observation group,acupuncture was used at bilateral Neiguan(PC 6),Zusanli(ST 36) and Shangjuxu(ST 37) in the forenoon and afternoon one day before surgery,with EA(continuous wave,15 Hz) at Zusanli(ST 36) and Shangjuxu(ST 37) for 20 min. The abdominal distension rate and degree as well as the length of stay in hospital after surgery were recorded.

RESULTS

There was no statistic difference about the rate of abdominal distension between the two groups[16.7%(5/30) vs 36.7%(11/30),P>0.05)],but it was lighter in the observation group 72 hours after surgery(P<0.05). The length of stay in hospital in the observation group was shorter than that in the control group[(5.33±1.30) d vs (7.33±1.71) d,P<0.05].

CONCLUSIONS

Acupuncture at Neiguan(PC 6),Zusanli(ST 36) and Shangjuxu(ST 37) one day before surgery can improve gastrointestinal function after vascular surgery with general anesthesia,and it has some efficacy as to shorting the length of stay in hospital.

[Efficacy on the range of motion of the lower limbs in patients of post-stroke spasmodic paralysis regulated with multi-directional stimulation technique]

OBJECTIVE

To compare the efficacy between the multi-directional stimulation technique and routine needling technique in the range of motion (ROM) of the lower limbs in patients of post-stroke spasmodic paralysis.

METHODS

Sixty patients were randomized into a multi-directional stimulation technique group and a routine needling technique group, 30 cases in each one. In the two groups, Biguan (ST 31), Fengshi (GB 31), Yang-lingquan (GB 34), Xiyangguan (GB 33), Zhongfeng (LR 4), Jiexi (ST 41), Qiuxu (GB 40), Kunlun (BL 60) and Xuanzhong (GB 39) on the affected side, scalp acupuncture sites and the acupoints on the upper limb of the affected side were selected. The even needling technique was used in the routine needling technique group and the multi-directional stimulation technique was used in the multi-directional stimulation technique group. The treatment was given once daily, 5 days a week, for 4 weeks totally. Before and after treatment, Fugl-Meyer function and Berg balance were scored. The three-dimensional gait analysis was adopted to analyze ROM of hip, knee and ankle joints.

RESULTS

Fugl-Meyer function score and Berg balance score were improved significantly after treatment as compared with those before treatment in the two groups (all P<0.01). The scores in the multi-directional stimulation technique group were all higher than those in the routine needling technique group (P<0.01, P<0.05). The abduction and adduction of hip joints and flexion-extension ROM were all improved after treatment as comparedwith those before treatment in the two groups (all P<0.05). The maximum flexibility and flexion extension ROM of knee joint were improved after treatment as compared with those before treatment in the two groups (all P<0.05), and the changes in extension of knee joint were not apparent (both P>0.05). After treatment, the maximal flexion and the flexion-extension ROM of knee joint in the multi-directional stimulation technique group were improved significantly as compared with those in the routine needling technique group (both P<0.05). The maximal dorsal flexion of ankle joint in the multi-directional stimulation technique group after treatment was increased as compared with that before treatment (P<0.05), and the change was better than that in the routine needling technique group (P<0.05).

CONCLUSIONS

Acupuncture effectively increases the maximal adduction angle and flexion-extension ROM of hip joint, and reduces abduction of hip joint. The multi-directional stimulation technique contributes to the flexion of knee joint and dorsal flexion of ankle joint and the maintenance of limb balance. The efficacy of it is better than that of routine acupuncture stimulation technique.

["Dredging governor vessel" for cervical vertigo with deficiency of qi and blood:a randomized controlled trial]

OBJECTIVE

To compare the effect differences of acupuncture of dredging the governor vessel (GV) and conception vessel (CV) for cervical vertigo with deficiency of qi and blood so as to provide Objective evaluation and guide for clinical treatment.

METHODS

A total of 60 patients were randomly divided assigned into an observation group and a control group, 30 cases in each one. The acupoints of the observation group were mainly in the GV, namely Shenting (GV 24), Baihui (GV 20), Fengfu (GV 16), Dazhui (GV 14), Shenzhu (GV 12), Jiaji (EX-B 2) of C₆ and C₇, Zusanli (ST 36) and Sanyinjiao (SP 6). The acupoints of the control group were mainly in the CV, including Danzhong (CV 17), Zhongwan (CV 12), Xiawan (CV 10), Guanyan (CV 4), Qihai (CV 6), Jiaji (EX-B 2) of C₆ and C₇, Zusanli (ST 36) and Sanyinjiao (SP 6). Acupuncture was given once every other day and 10 treatments were taken as one course. After 2-course treatment, the changes before and after treatment of the scores of symptoms of cervical vertigo and functional evaluation scale, the scores of symptoms of deficiency of qi and blood, the mean blood flow rate of vertebral-basilar artery were observed. Also, the effects were evaluated.

RESULTS

(1) The cured and effective rate and total effective rate of the observation group were 76.7% (23/30) and 93.3% (28/30), which were better than 46.7% (14/30) and 70.0% (21/30) of the control group (both P<0.05). (2) As for the scores of symptoms of cervical vertigo and functional evaluation scale and the mean blood flow rate, the results were obviously improved after treatment in the two groups (all P<0.05), with superiority in the observation group (all P<0.01). (3) After treatment,the scores of the symptoms of deficiency of qi and blood were decreased obviously in the two groups (all P<0.05). As to fatigue,facial expression,tongue and pulse condition,there was no statistical significance between the two groups after treatment (all P>0.05),but treatment for palpitation and shortness of breath achieved better effect in the control group(P<0.01).

CONCLUSIONS

The effect of dredging the GV for cervical vertigo with deficiency of qi and blood is superior to that of acupuncture mainly in the CV,which can improve the symptoms of cervical vertigo and the mean blood flow rate of vertebral-besilar better. But acupuncture at acupoints both in the GV and CV may be better for the patients with syndrome of deficiency of qi and blood seriously.

[Effect of governor moxibustion for restless legs syndrome of maintenance hemodialysis:a rando-mized controlled trial]

OBJECTIVE

To observe the effect of governor moxibustion for restless legs syndrome(RLS) of maintenance hemodialysis.

METHODS

Sixty-nine patients with RLS of maintenance hemodialysis were randomly divided into an observation group(34 cases) and a control group(35 cases). Conventional hemodialysis was applied in the two groups. Moxibustion was used at the governor vessel from Dazhui(GV 14) to Yaoshu(GV 2) separated by governor moxibustion powder and ginger mud in the observation group. Treatment was given once two weeks and continuous eight times were taken as a course. One course was adopted. Scores of international restless legs syndrome(IRLS) and Pittsburgh sleep quality index(PSQI) were observed before and after treatment and comprehensive effects were evaluated in the two groups.

RESULTS

The total scores of IRLS and PSQI were decreased after treatment in the two groups(all P<0.01). And the above two scores after treatment of the observation group were apparently lower than those of the control group(both P<0.05). The cured and effective rate of the observation group was 58.8%(20/34),and that of the control group was 22.9%(8/35),with statistical difference(P<0.01).

CONCLUSIONS

Governor moxibustion can effectively improve the symptoms and sleep quality of RLS of maintenance hemodialysis.

[Acupuncture and moxibustion based on meridian differentiation for cervical spondylosis radiculopathy:a randomized controlled trial]

OBJECTIVE

To observe the difference of clinical effects of acupoints selected based on meridian differen-tiation and conventional method for cervical spondylosis radiculopathy(CSR) treated with acupuncture and moxibustion.

METHODS

Sixty patients with CSR were randomly divided into an observation group and a control group,30 cases in each one. Ashi points of the injured meridians in the neck,namely six-he points,were selected in the observation group,matched with luo-connecting points of the injured meridians on the same side and the interiorly-exteriorly correlated meridians on the opposite side. Conventional acupuncture was used on Fengchi(GB 20),Jiaji(EX-B 2) of the neck,Tianzhu(BL 10),Jianjing(GB 21),Houxi(SI 3),Hegu(LI 4) and Waiguan(TE 5) on the affected side in the control group. Treatment was given once every other day,three times a week and total 12 times in the two groups. Twenty subscales for CSR and visual analogue scale(VAS) were observed before and after treatment,and total effects were evaluated after treatment.

RESULTS

The effective rate of the observation group was 93.3%(28/30),which was better than 66.7%(20/30) of the control group(P<0.05). The scores of 20 subscales and VAS after treatment were all improved compared with those before treatment in the two groups(all P<0.01),with more apparent change in the observation group(both P<0.05).

CONCLUSIONS

The effect of acupuncture and moxibustion based on meridian differentiation is obvious,and superior to that of conventional acupoints selection.

[Vascular cognitive impairment with no dementia treated with auricular acupuncture and acupuncture:a randomized controlled trial]

OBJECTIVE

To compare the clinical efficacy on vascular cognitive impairment with no dementia (VCIND) between the combined therapy of auricular acupuncture and acupuncture and the simple acupuncture.

METHODS

One hundred patients of VCIND were randomized into a combined therapy of auricular acupuncture and acupuncture group (a combined therapy group) and an acupuncture group, 50 cases in each one. The basic internal medicine treatment was applied in the two groups. Additionally, in the combined therapy group, auricular acupuncture and JIN's three needling therapy were used. pizhixia (AT₄), xin (CO₁₅), shen (CO₁₀), gan (CO₁₂), erzhong (HX₁) were selected in auricular acupuncture, once every Monday, Wednesday and Friday; Niesanzhen, Zhisanzhen and Sishenzhen were selected in JIN's three needling therapy, once a day. In the acupuncture group, JIN's three needling therapy was just provided, once a day. The treatment was given for 4 weeks in the two groups. Montreal cognitive assessment (MoCA) and social function activities questionnaire (FAQ) were adopted for the evaluation comparison before treatment and in 2 weeks and 4 weeks after treatment in patients of the two groups.

RESULTS

Compared with those before treatment, the total scores of MoCA were improved in 2 and 4 weeks after treatment in the two groups (all P<0.01). The score in the combined therapy group was improved more apparently as compared with that in the acupuncture group (P<0.01). FAQ score was reduced in the two groups (all P<0.05). The score in the combined therapy group was reduced more apparently as compared with that in the acupuncture group (P<0.05). As compared with the result in 2 weeks of treatment, MoCA score was improved in the two groups in 4 weeks of treatment (both P<0.01), the improvements in the combined therapygroup were more obvious than those in the acupuncture group (P<0.05) and FAQ score was reduced in the two groups (P<0.05), but the difference was not significant between the two groups (P>0.05).

CONCLUSIONS

The combined therapy of auricular acupuncture and acupuncture effectively improve the cognitive function and social function, which are better than the effects of simple acupuncture in VCIND. The improvement of the combined therapy in social function is more advantageous in the treatment of the first two weeks.