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Introduction: Primary dysmenorrhea (PDM) is a common condition among women of reproductive age, characterized by menstrual pain in the absence of any organic causes. Previous research has established a link between the A118G polymorphism in the mu-opioid receptor (OPRM1) gene and pain experience in PDM. Specifically, carriers of the G allele have been found to exhibit maladaptive functional connectivity between the descending pain modulatory system and the motor system in young women with PDM. This study aims to explore the potential relationship between the OPRM1 A118G polymorphism and changes in white matter in young women with PDM. Methods: The study enrolled 43 individuals with PDM, including 13 AA homozygotes and 30 G allele carriers. Diffusion tensor imaging (DTI) scans were performed during both the menstrual and peri-ovulatory phases, and tract-based spatial statistics (TBSS) and probabilistic tractography were used to explore variations in white matter microstructure related to the OPRM1 A118G polymorphism. The short-form McGill Pain Questionnaire (MPQ) was used to access participants' pain experience during the MEN phase. Results: Two-way ANOVA on TBSS analysis revealed a significant main effect of genotype, with no phase effect or phase-gene interaction detected. Planned contrast analysis showed that during the menstrual phase, G allele carriers had higher fractional anisotropy (FA) and lower radial diffusivity in the corpus callosum and the left corona radiata compared to AA homozygotes. Tractographic analysis indicated the involvement of the left internal capsule, left corticospinal tract, and bilateral medial motor cortex. Additionally, the mean FA of the corpus callosum and the corona radiata was negatively correlated with MPQ scales in AA homozygotes, but this correlation was not observed in G allele carriers. No significant genotype difference was found during the pain-free peri-ovulary phase. Discussion: OPRM1 A118G polymorphism may influence the connection between structural integrity and dysmenorrheic pain, where the G allele could impede the pain-regulating effects of the A allele. These novel findings shed light on the underlying mechanisms of both adaptive and maladaptive structural neuroplasticity in PDM, depending on the specific OPRM1 polymorphism.
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Background: Stroke leads to tremendous impacts on patients and the healthcare system. It is crucial to explore the potential management of rehabilitation. Acupuncture and traditional Chinese herbal medicine (TCHM) integrated with conventional rehabilitation benefit post-stroke functional recovery. Methods: We retrospectively reviewed the medical records of all patients included in the Integrated Traditional Chinese-Western Medicine care program for stroke (ITCWM-stroke care program) in 2019 in Taipei Tzu Chi Hospital to investigate the effects of acupuncture and TCHM integrated with conventional rehabilitation on National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI) scores before and after the program. Results: A total of 255 stroke inpatients were retrieved and divided into acupuncture and acupuncture + TCHM group by hemorrhagic and ischemic stroke types, respectively. All the patients were recruited in the program at the early subacute phase after stroke onset. Of the hemorrhagic and ischemic stroke subjects, the NIHSS and BI total scores were significantly improved in the acupuncture and acupuncture + TCHM groups. The subgroup analysis results showed that in subjects with a baseline BI score ≤ 40, the acupuncture + TCHM group significantly improved BI total score better than the acupuncture group in both hemorrhagic (p < 0.05) and ischemic (p < 0.05) stroke subjects. Conclusion: Acupuncture and TCHM integrated with conventional rehabilitation significantly improve stroke patients' functional recovery at the early subacute phase. Acupuncture + TCHM contributes to better activities of daily living (ADL) improvements in stroke patients with a baseline BI score ≤ 40. We suggest integrating acupuncture and TCHM into the post-stroke rehabilitation strategy, especially for stroke patients with poor ADL function.
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Background: Chronic obstructive pulmonary disease (COPD), which is a disease characterized by dyspnea, cough, and respiratory symptoms, leading to impaired health-related quality of life (HRQL) and exercise capacity, is highly prevalent worldwide. Some studies demonstrated that acupuncture point stimulation treatments (APSTs) are effective and safe in treating patients with COPD. The aim of this systematic review and network meta-analysis is to analyze the effects on HRQL and FEV1% predicted of diverse APSTs in treating patients with COPD. Materials and Methods: We searched seven electronic databases. Randomized controlled trials (RCTs) with stable COPD patients comparing APSTs and conventional treatment (Tx) were included. The primary outcome was HRQL measured by COPD Assessment Test or St. George's Respiratory Questionnaire. The secondary outcome was FEV1% predicted. We performed random effect network meta-analysis using a consistency model. Results: This network meta-analysis analyzed 21 RCTs with 1,577 stable COPD participants. In comparison with Tx, acupressure massage (AM) + Tx [-5.11; 95% confidence interval (CI), -6.65 to -3.57] was the most effective intervention in improving HRQL, followed by moxibustion (Mx) + Tx (-2.86; 95% CI, -3.86 to -1.86). Moreover, in comparison with Tx, Mx + Tx (7.79; 95% CI, 2.16 to 13.42) was the most effective intervention in improving FEV1% predicted, followed by acupuncture (A) + Tx (5.79; 95% CI, 2.90 to 8.68). Conclusions: Combined interventions (APSTs + Tx) are more effective than single intervention in improving both HRQL and FEV1% predicted. AM, Mx, and A can be considered effective non-pharmacological complementary interventions in treating patients with COPD under Tx.
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Chronic obstructive pulmonary disease (COPD) is highly prevalent and a major burden on the healthcare system worldwide. It has a severe impact on patients due to poor health-related quality of life (HRQL), dyspnea, and exertional intolerance. Our previous meta-analysis revealed that body acupuncture therapy had adjuvant benefits of improving HRQL in COPD patients undergoing optimal medical treatment. Previous studies indicated that treatment with combinations of acupoints was more effective than single acupoint treatment. The association rule analysis has been widely used to explore relationships in acupoint combination. Therefore, we aimed to investigate the potential core acupoint combination in COPD treatment by mining the association rules from the retrieved randomized control trials (RCTs) of the previous meta-analyses. This study was conducted based on Apriori algorithm-based association rule analysis, which is a popular data mining method available in software R. We extracted acupoints as binary data from the 12 included RCTs for analysis. There were 27 acupoints extracted from 12 RCTs. The top 10 frequently selected acupoints were BL12, BL13, BL20, BL23, BL43, CV17, EXB1, LU5, LU7, and ST36. We investigated 2444 association rules, and the results showed that {ST36, BL12} ≥ {CV17}, {ST36, BL12} ≥ {EXB1}, {CV17, BL12} ≥ {ST36}, and {EXB1, BL12} ≥ {ST36} were the most associated rules in the retrieved RCTs. The acupoint combinations of ST36, BL12, and CV17 and ST36, BL12, and EXB1 could be considered as the core of acupoint combination for further acupuncture treatment of COPD.
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Traditional Chinese medicine (TCM) practitioners assess body constitution (BC) as a treatment basis for maintaining body homeostasis. We investigated patterns in spontaneous brain activity in different BC groups using resting-state functional magnetic resonance imaging (rsfMRI) and determined the relationship between these patterns and quality of life (QOL). Thirty-two healthy individuals divided into two groups (body constitution questionnaire (BCQ)-gentleness [BCQ-G] and BCQ-deficiency [BCQ-D]) based on the body constitution questionnaire (BCQ) underwent rsfMRI to analyze regional homogeneity (ReHo) and the amplitude of low-frequency fluctuation (ALFF). The World Health Organization Quality of Life Instruments (brief edition) scale was used to evaluate the QOL. The BCQ-G group (n = 18) had significantly greater ReHo values in the right postcentral gyrus and lower ALFF values in the brainstem than the BCQ-D group (n = 14). In the BCQ-D group, decreased ReHo of the postcentral gyrus correlated with better physiological functioning; increased ALFF in the brainstem correlated with poor QOL. BCQ-subgroup analysis revealed a nonsignificant correlation between ReHo and Yang deficiency/phlegm and stasis (Phl & STA). Nonetheless, the BCQ-D group showed a positive correlation between ALFF and Phl & STA in the parahippocampus. This study identified differences between BCQ-G and BCQ-D types of healthy adults based on the rsfMRI analysis. The different BCQ types with varied brain endophenotypes may elucidate individualized TCM treatment strategies.
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BACKGROUND: Chronic obstructive pulmonary disease (COPD) is highly prevalent around the world and has a large impact on its patients, leading to a poor health-related quality of life (HRQL) and exercise capacity. Even under optimal medications, there are still many patients with poor HRQL. Body acupuncture therapy (BAT) is a non-invasive and a popular therapy. Therefore, we aimed to comprehensively analyze the effects of BAT in COPD. MATERIALS AND METHODS: Eight electronic databases were searched. We included randomized controlled trials (RCTs) that evaluated the effect of BAT, medication (M), and pulmonary rehabilitation (PR). The primary outcome was HRQL evaluated by St. George's respiratory questionnaire (SGRQ) or COPD assessment test (CAT). RESULTS: Of the 922 articles, 12 studies were included with attesting a total of 798 participants. The result obtained indicated a significant improvement that favored the BAT + M group over the M group in CAT scores (MD: -4.77; 95% CI: -6.53 to -3.01; p < 0.00001). CONCLUSIONS: BAT is an effective adjunctive non-pharmacological treatment to improve HRQL in patients under medical treatment for COPD. We suggested that BAT should be considered as one of the methods of management in patients with COPD.