Comparative efficacy of acupuncture, venesection, and physical therapy on chronic low back pain outcomes: a randomized clinical trial.

Objective: Chronic low back pain (CLBP) imposes considerable financial and social burden with poor response to medical and surgical treatments. Alternatively, acupuncture and venesection(Fasd) are traditionally used to alleviate nociceptive and musculoskeletal pains. This study aimed to evaluate the effectiveness and the safety of acupuncture and venesection on CLBP and patient functionality. Methods: The current study was a single-blinded, randomized clinical trial with balanced allocation, conducted in the Department of Physical Medicine & Rehabilitation Medicine, in 2022. One hundred five CLBP patients who had no back pain-attributable structural or major diseases were randomly allocated into three parallel arms and received either physical therapy (PTG), acupuncture (APG), or venesection (VSG). Pain severity and functional aspects were evaluated using the visual analogue scale (VAS) and Oswestry disability index (ODI) during the study. VAS and ODI scores were defined as the primary outcomes. Results: Ninety-five patients were reviewed in the final analysis (PTG=33, APG=30, VSG=31). Demographic data showed equal group distribution. Statistical analysis showed all procedures had reduced VAS score immediately after the first session, after the last session, and after follow-up; however, APG and VSG values were significantly lower (P<0.05). Pain reduction results in follow-up period were more sustainable in APG and VSG as compared to PTG (P<0.01). ODI results revealed global improvement after the last session of the treatment in all groups, while APG had more significant results (P<0.05). During the follow-up period, ODI still tended to decrease in VSG, non-significantly increased in APG, and significantly increased in PTG. Only two patients reported fainting after receiving venesection. Conclusion: Considering the pain and functional scores, both acupuncture and venesection can reproduce reliable results. Acupuncture and venesection both have sustained effects on pain and daily function of the patients even after treatment termination, while physical therapy had more relapse in pain and functional limitations.

Efficacy and safety comparison of infrared laser moxibustion and traditional moxibustion in knee osteoarthritis: study protocol for a Zelen-design randomized controlled non-inferiority clinical trial.

BACKGROUND: Knee osteoarthritis (KOA) is the most common chronic degenerative joint disease and places a substantial burden on the public health resources in China. The purpose of this study is to preliminarily evaluate whether infrared laser moxibustion (ILM) is non-inferior to traditional moxibustion (TM) in the treatment of KOA. MATERIALS AND METHODS: In the designed Zelen-design randomized controlled non-inferiority clinical trial, a total of 74 patients with KOA will be randomly allocated to one of two interventions: ILM treatment or TM treatment. All participants will receive a 6-week treatment and a follow-up 4 weeks after treatment. The primary outcomes will be the mean change in pain scores on the numeric rating scale (NRS) measured at baseline and the end of last treatment at week 6. The secondary outcomes will be the pain scores on the NRS from weeks 1 to 5 after the start of treatment and the changes from baseline to endpoints (weeks 6 and 10) in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), SF-36, knee circumference, and 6-min walking test. In addition, safety assessment will be performed throughout the trial. CONCLUSION: The results of our study will help determine whether a 6-week treatment with ILM is non-inferior to TM in patients with KOA, therefore providing evidence to verify if ILM can become a safer alternative for TM in clinical applications in the future. TRIAL REGISTRATION: Clinical Trial Registration Platform (ChiCTR2200065264); Pre-results. Registered on 1 November 2022.

[Effect of electroacupuncture on morphological changes and myocardial metabolism in rats undergoing simulated weightlessness].

OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Neiguan" (PC 6) and "Sanyinjiao" (SP 6) on morphological changes, myocardial energy metabolism in rats undergoing simulated weightlessness. METHODS: A total of 40 male Wistar rats were randomly divided into normal control, weightlessness model, Neiguan (PC 6) and Sanyinjiao (SP 6) groups (10 rats/group). EA was applied to PC 6 and SP 6 acupoints for 30 min, once every other day. The morphological changes were observed by light microscopy after H. E. staining. Lactate dehydrogenase (LDH), succinate dehydrogenase (SDH) and ATPase activities in the left ventricular myocardium were measured by colorimetry. RESULTS: In weightlessness rats, myocardial pathological changes as loose arrangement, breakage and lytic necrosis of myocardial fibers were found, these changes were obviously improved in rats of both PC 6 and SP 6 groups. Compared with the control group, the ATPase activity was significantly decreased, while the LDH activity was significantly increased in the model group (P<0.05). After EA intervention, the ATPase activity was obviously increased in the SP 6 group (P<0. 05), and LDH activity was apparently reduced in both PC 6 and SP 6 groups (P<0. 05). No significant changes were found in myocardial SDH activity after modeling and EA of the two acupoints (P>0. 05). CONCLUSION: EA intervention has functions in up-regulating ATP activity and suppressing the myocardial LDH activity in weightlessness rats, which may be related to its effect in improving myocardial pathological changes.

Moxibustion inhibits interleukin-12 and tumor necrosis factor alpha and modulates intestinal flora in rat with ulcerative colitis.

AIM: To investigate the effect of moxibustion on intestinal flora and release of interleukin-12 (IL-12) and tumor necrosis factor-α (TNF-α) from the colon in rat with ulcerative colitis (UC). METHODS: A rat model of UC was established by local stimulation of the intestine with supernatant from colonic contents harvested from human UC patients. A total of 40 male Sprague-Dawley rats were randomly divided into the following groups: normal (sham), model (UC), herb-partition moxibustion (HPM-treated), and positive control sulfasalazine (SA-treated). Rats treated with HPM received HPM at acupuncture points ST25 and RN6, once a day for 15 min, for a total of 8 d. Rats in the SA group were perfused with SA twice a day for 8 d. The colonic histopathology was observed by hematoxylin-eosin. The levels of intestinal flora, including Bifidobacterium, Lactobacillus, Escherichia coli (E. coli), and Bacteroides fragilis (B. fragilis), were tested by real-time quantitative polymerase chain reaction to detect bacterial 16S rRNA/DNA in order to determine DNA copy numbers of each specific species. Immunohistochemical assays were used to observe the expression of TNF-α and IL-12 in the rat colons. RESULTS: HPM treatment inhibited immunopathology in colonic tissues of UC rats; the general morphological score and the immunopathological score were significantly decreased in the HPM and SA groups compared with the model group [3.5 (2.0-4.0), 3.0 (1.5-3.5) vs 6.0 (5.5-7.0), P < 0.05 for the general morphological score, and 3.00 (2.00-3.50), 3.00 (2.50-3.50) vs 5.00 (4.50-5.50), P < 0.01 for the immunopathological score]. As measured by DNA copy number, we found that Bifidobacterium and Lactobacillus, which are associated with a healthy colon, were significantly higher in the HPM and SA groups than in the model group (1.395 ± 1.339, 1.461 ± 1.152 vs 0.045 ± 0.036, P < 0.01 for Bifidobacterium, and 0.395 ± 0.325, 0.851 ± 0.651 vs 0.0015 ± 0.0014, P < 0.01 for Lactobacillus). On the other hand, E. coli and B. fragilis, which are associated with an inflamed colon, were significantly lower in the HPM and SA groups than in the model group (0.244 ± 0.107, 0.628 ± 0.257 vs 1.691 ± 0.683, P < 0.01 for E. coli, and 0.351 ± 0.181, 0.416 ± 0.329 vs 1.285 ± 1.039, P < 0.01 for B. fragilis). The expression of TNF-α and IL-12 was decreased after HPM and SA treatment as compared to UC model alone (4970.81 ± 959.78, 6635.45 ± 1135.16 vs 12333.81 ± 680.79, P < 0.01 for TNF-α, and 5528.75 ± 1245.72, 7477.38 ± 1259.16 vs 12550.29 ± 1973.30, P < 0.01 for IL-12). CONCLUSION: HPM treatment can regulate intestinal flora and inhibit the expression of TNF-α and IL-12 in the colon tissues of UC rats, indicating that HPM can improve colonic immune response.

[Changes of electrical property of the twelve source-points in encephaloma patients before and after surgery].

OBJECTIVE: To observe the changes of electrical property of the 12 Source-points in encephaloma patients undergoing surgery. METHODS: A total of 116 encephaloma patients and 60 healthy people who signed the informed consent were enlisted in the present study. The regional cutaneous electric resistance (CER) of the bilateral 12 Yuan (Source)-points was measured in the afternoon (14:00-16:00) before and one week after surgery under room temperature [(22 +/- 3) degrees C, (55 +/- 10)% in humidity] by using "Meridian Energy Analysis Device". RESULTS: In comparison with normal subjects, CER values of the 12 Source-points on both sides of the body in encephaloma patients were significantly lower (P < 0.01). Before surgery, CER values of Wangu (SI 4), Taibai (SP 3), Taichong (LR 3) and Chongyang (ST 42) on the left side were significantly higher than those of the isonym points on the right side (P < 0.01, P < 0.05), suggesting an imbalance of the bilateral Small Intestine, Spleen, Liver and Stomach Meridians. After surgery, CER values of Shenmen (HT 7), Wangu (SI 4), Yangchi (SJ 4) and Taibai (SP 3) on the left side were markedly higher than those of the isonym points on the right side (P < 0.05, P < 0.01), suggesting an imbalance of the bilateral Heart, Small Intestine, Trienergizer and Spleen Meridians. Comparison between pre- and post-surgery showed that CER values of Taiyuan (LU 9), Daling (PC 7), Taibai (SP 3), Taichong (LR 3), Taixi (KI 3), Jinggu (BL 64), Qiuxu (GB 40) and Chongyang (ST 42) on both sides, and Wangu (SI 4) on the right side lessened obviously post-surgery (P < 0.01, P < 0.05), suggesting an imbalance of the bilateral meridians found in more meridians, including yang meridians entering the brain as the Bladder, Gallbladder, Stomach Meridians. CONCLUSION: In encephaloma patients, the CER values of some Source-points on the left side are significantly higher than those on the right side, suggesting an imbalance of the bilateral meridians in functional activities.