A protocol for systematic review and meta-analysis of the effect of acupoint therapy for essential hypertension.

BACKGROUND: Essential hypertension remains an enormous public health concern, imposing a major burden of morbidity and mortality worldwide. Relevant studies showed that acupuncture therapy might be effective in treating essential hypertension. However, there is no consistent conclusion so far. The aim of this study was to assess the efficacy and safety of acupuncture therapy for patients with essential hypertension. METHODS: We searched the PubMed, Embase, the Cochrane Library, Web of Science, the Chinese National Knowledge Infrastructure (CNKI), and the Wan-fang databases from inception through November 29, 2019. Randomized controlled trials investigating acupuncture therapy for hypertension were included. We will use Endnote software X8 for studies selection, Review Manager software 5.3 for the data analysis. RESULTS: We will synthesize current studies to evaluate the safeties and effectiveness of acupuncture for essential hypertension. CONCLUSIONS: Our study will provide the evidence of acupuncture therapy for essential hypertension.

[Exploration into the simplex reinforcing-reducing manipulation of acupuncture].

Four controversial types of simplex reinforcing-reducing manipulation of acupuncture and their possible meanings were summarized to explore several key elements of reinforcing-reducing manipulation of acupuncture, in addition, the simplex reinforcing-reducing manipulation of acupuncture was classified by single factor. It is concluded that the definition of simplex reinforcing-reducing manipulation of acupuncture should try not to include other non-manipulative elements. According to single factor, it can be divided into: needle-oriented reinforcing-reducing manipulation, twisting reinforcing-reducing manipulation, lifting and interpolating reinforcing-reducing manipulation, fast and slow reinforcing-reducing manipulation, breathing reinforcing-reducing manipulation, opening and closing reinforcing-reducing manipulation. In addition, after considering the effect and principle of number reinforcing-reducing manipulation, it can be considered.

[Regulating effect of electroacupuncture on left ventricular function and autophagy-specific proteins in spontaneously hypertension rats].

OBJECTIVE: To investigate the effect of electroacupuncture (EA) on cardiac hypertrophy and expression of myocardial autophagy-specific proteins in spontaneously hypertensive rats (SHRs). METHODS: Twelve male Wistar Kyoto (WKY) rats were selected as the normal control group, and 24 male SHRs were randomized into model and EA groups (n＝12 in each). EA (2 Hz /15 Hz, 1 mA) was applied to "Taichong" (LR3) and "Baihui" (GV20) for 20 min, once a day for successive 30 days. The other two groups only received the same grasping and fixation procedures. The systolic blood pressure (SBP) was measured using a non-invasive blood detector, and the left ventricular function including the left ventricular anterior wall diameter (LVAWd), left ventricular posterior wall diameter (LVPWd) and left ventricular internal diameter at end-diastolic dimension (LVIDd) was detected using a real-time echocardiography imaging system, and the left ventricular mass index (left ventricle weight / body weight, LVMI) was calculated. The expression of Beclin-1 and LC3 proteins in the left ventricle tissue was detected by Western blot. Pathological changes of the myocardial tissue were observed by Masson staining and transmission electron microscope (TEM). RESULTS: After the intervention, the elevated SBP was significantly lowered in the EA group relevant to the model group (P<0.01) and the increased LVAWd, LVPWd and LVMI were markedly decreased in the EA group (P<0.01, P<0.05), while the reduced LVIDd was significantly ameliorated in the EA group (P<0.01). Masson staining showed that in SHRs, disorder of arrangement of cardiac myofibers, swelling of cardiomyocytes, widened space among myocardial cells with a large number of collagenous fibers were observed, and under TEM, aggregation and unequal size of myocardial mitochondria with vacuolation and rupture, autophagosomes and autophagic lysosomes were seen. These changes were relatively milder in the EA group. Western blot showed that hypertension induced up-regulation of Beclin-1 and LC3-II and ratio of LC3-II/LC3-I, and down-regulation of LC3-I were significantly suppressed in the EA group (P<0.01, P<0.05). CONCLUSION: EA at LR3 and GV20 may improve the left cardiac function, myocardial morphological changes and the degree of autophagy in SHRs, which is related to its effects in down-regulating the expression of myocardial Beclin-1 and LC3-II and in up-regulating expression of LC3-I.

[Effect of Electroacupuncture at "Neiguan" (PC 6) on Skin Microcirculation Blood Perfusion Volume of Heart-related Acupoints and Heart-irrelevant Acupoints in Myocardial Ischemia Rats].

OBJECTIVE: To observe the effect of low-frequency or high-frequency electroacupuncture (EA) stimulation of "Neiguan" (PC 6) on changes of skin blood perfusion volume of heart-related and heart-irrelevant acupoints in rats with normal or ischemic myocardium. METHODS: Wistar rats were randomly divided into the control, sham-operation, model, low-frequency EA and high-frequency EA groups (n=8 in each group). The myocardial ischemic (MI) model was established by occlusion of the anterior descending branch of the left coronary artery. 2 Hz and 100 Hz EA was respectively applied to left PC 6 for 20 min, once daily, a total of three times. Electrocardiogram (ECG) was recorded after the last treatment. Serum cardiac troponin T (cTnT) contents were assayed by ELISA. The skin blood perfusion volumes of bilateral PC 6, "Zusanli" (ST 36) and "Yanglingquan" (GB 34) were observed by laser speckle contrast imaging. RESULTS: In comparison with the control and sham-operation groups, the differences of "J point" and contents of serum cTnT were significantly increased in the model group (P<0.01). After EA, the differences of "J point" and contents of serum cTnT were significantly decreased in both low-frequency and high-frequency EA groups (P<0.01, P<0.05). Compared with the control group, the skin blood perfusion volumes of bilateral PC 6 and ST 36 decreased obviously in rats of the model group (P<0.01). After EA, the skin blood perfusion volumes were markedly up-regulated in the areas of PC 6 and ST 36 (P<0.01). There were no significant changes in that of GB 34 among the 5 groups (P<0.05). CONCLUSIONS: Skin blood perfusion volumes around PC 6 and ST 36 can specifically reflect the change of the myocardial state.