Using a consensus acupoints regimen to explore the relationship between acupuncture sensation and lumbar spinal postoperative analgesia: A retrospective analysis of prospective clinical cooperation / 中西医结合学报

OBJECTIVE@#This study evaluated the effectiveness of acupuncture treatment on postoperative pain in patients with degenerative lumbar spine disease, and explored the relationship between the postoperative analgesic effect of acupuncture and the sensation of acupuncture experienced by the patients.@*METHODS@#This retrospective study analyzed the medical records of 97 patients who had undergone an operation by the same surgeon due to degenerative lumbar disease. These patients were divided into acupuncture group (n = 32), patient-controlled analgesia (PCA) group (n = 27), and oral analgesia group (n = 38) according to the different postoperative analgesic methods. During their hospitalization, patients completed daily evaluations of their pain using a visual analogue scale (VAS), and injection times of supplemental meperidine were recorded. Also, the Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale (C-MASS) was used in the acupuncture group.@*RESULTS@#Each of the three treatment groups showed significant reductions in postoperative pain, as shown by reduced VAS scores. The acupuncture group, however, had less rebound pain (P < 0.05) than the other two groups. Both the acupuncture and PCA groups experienced acute analgesic effects that were superior to those in the oral analgesia group. In addition, the higher the C-MASS index on the second day after surgery, the lower the VAS score on the fourth day after surgery. There was also a significant difference in the "dull pain" in the acupuncture sensation.@*CONCLUSION@#The results demonstrated that acupuncture was beneficial for postoperative pain and discomfort after simple surgery for degenerative spinal disease. It is worth noting that there was a disproportionate relevance between the patient's acupuncture sensation and the improvement of pain VAS score.

Analysis on "the essence of tuina, arrival of qi ensuring curative effect" / 中国针灸

In reference with the systematic review of the thought of deqi (arrival of qi) put forward in Huangdi Neijing (Internal Classic of Yellow Emperor) and other classic books of traditional Chinese medicine, in view of detecting qi and identifying qi before treatment, as well as the prerequisites of deqi in tuina, meaning the accurate syndrome differentiation and manipulations, the importance of deqi in treatment with tuina is expounded. In association with clinical experience, the specific manifestations of deqi in patients during tuina are summarized, e.g. soreness, distention, pain, numbness, warm feeling and slight sweating, local changes in intestinal sound and skin color, as well as mind regulation. It is anticipated that deqi of tuina may be drawn the attention in clinical practice, and the relevant study be expanded.

Preliminary research of / 中国针灸

OBJECTIVE@#To explore the impacts on weight reduction effect treated with acupoint thread embedding therapy at different tissue levels under ultrasonic guidance.@*METHODS@#A total of 70 patients with overweight or obesity were randomized into a shallow-tissue thread embedding group (35 cases, 5 cases dropped off) and a deep-tissue thread embedding group (35 cases, 4 cases dropped off). Under ultrasonic guidance, the thread was embedded in the shallow tissue level and the deep tissue level respectively. The acupoints were Zhongwan (CV 12), Xiawan (CV 10), Shuifen (CV 9), Zhongji (CV 3), etc. The thread embedding therapy was exerted once every 2 weeks, totally for 3 times. Before and 2 weeks after treatment, body mass, body mass index (BMI), waist circumference and hip circumference were recorded in the patients of the two groups separately. After each treatment, the number and the property of blood vessels under each acupoint were detected by ultrasound. Besides, the needling sensation and the intensity were scored and the adverse events were observed after thread embedding therapy.@*RESULTS@#After treatment, the reduction range of body mass, BMI and waist circumference in the deep-tissue thread embedding group were larger than those in the shallow-tissue thread embedding group successively (@*CONCLUSION@#The deep-tissue thread embedding therapy achieves the stronger

Effects of Three Needling Manipulations of Zusanli (ST 36) on Deqi Sensations and Surface Myoelectricity in Healthy Participants / 中国结合医学杂志

OBJECTIVE@#To investigate the effects of different acupuncture manipulations on Deqi sensations and surface myoelectricity, and explore the correlation between Deqi sensations and needling manipulations.@*METHODS@#Forty-five healthy participants accepted twirling, lifting-thrusting, and twirling plus lifting-thrusting manipulanions at right Zusanli (ST 36), respectively. The acupuncturist's and participants' Deqi sensations were collected by MGH Acupuncture Sensation Scale (MASS). The intensity and occurrence rate of soreness, dull pain, pressure, heaviness, fullness, numbness, sharp pain, warmth, coolness, and throbbing feelings of participants, and tightness, smooth, and tangle feelings of acupuncturist were measured. The correlation between the acupuncturist's and participant's Deqi sensations was analyzed. Surface electromyogram (EMG) were recorded before, during and after needling in 30 participants. The integrated EMG (iEMG), mean power frequency (MPF) and media frequency (MF) were analyzed.@*RESULT@#Both fullness and soreness of participants and tightness of acupuncturist were the most frequently occurred ones. A positive correlation between participants' fullness and acupuncturist's tightness was observed during the three aforementioned needling manipulations (P1). Almost all the needling sensations measured in the present study could be induced by the three needling manipulations. However, strength of Deqi sensations was exhibited as lifting-thrusting > twirling plus lifting-thrusting > twirling according to MASS index. The iEMG values were increased and MPF, MF values were decreased during needling compaired to those before needling, especially during lifting-thrusting (P<0.01).@*CONCLUSIONS@#The intensity and occurrence rate of the different Deqi sensations induced by different needling manipulations were basically similar. The fullness and soreness were both the most frequently induced Deqi sensations. The strongest Deqi sensation could be induced by lifting-thrusting manipulation. There is a positive correlation between participants' fullness and acupuncturist's tightness during the three needling manipulations. The myoelectricity around the acupoint is related to Deqi responses. (Registration No. AMCTR-IOR-20000314).

On the in moxibustion / 中国针灸

The original connotation of in () was explored to provide the reference for the clinical application of moxibustion. The relevant items of the original definition of in were traced aligning with the achievements in the clinical researches on the heat-sensitive phenomena and its rule, and thus, the characteristics of in moxibustion and its inducing approaches were analyzed. A new viewpoint of the connotation of in was put forward. It is believed that is not only a somatic response to acupuncture, but also a kind of comfortable mental-physical reaction related to curative effect. On this basis, it was discussed that moxibustion on heat-sensitive acupoints could induce which conforms to the original definition described in . Additionally, the method of moxibustion for stimulating , the screening of the items on in moxibustion as well as the preliminary evaluation were introduced in the paper. It is suggested that the in moxibustion is the comprehensive responses of the mental-physical-curative effect.

Relationship between acupuncture sensations of and different organizational structures of acupoint area / 中国针灸

Acupuncture sensation, as one of the essential signs of (arrival of ), is closely associated with curative effect. With systematically reviewing the literature regarding relationship between acupuncture sensations of and different organizational structures of acupoint area (skin, connective tissue, muscles, nerves and blood vessels), it is believed that acupuncture sensation of is the product of various organizational structures in acupoint area, which is closely related to the nervous system. The sensations sensed by the hands of acupuncturists, which is called sense of needle stagnation, maybe caused by the contraction of muscles in the acupoint area during the process of needle manipulation. By system review, this paper puts forward a new research idea to explore the role of different manipulations of needling in generating the sense of -generating needle based on different acupoint structure and brain function response system, which could provide some reference for clarifying the scientific mechanism and clinical application of acupuncture sensations of .

Progress of fMRI Research on "Deqi" of Acupuncture and Our Considerations About Further Studies / 针刺研究

The objectification of "Deqi" of acupuncture is a hot topic in acupuncture research at present, and functional magnetic resonance imaging (fMRI) is one of the most frequently-used techniques for revealing its brain responses. We searched literature about "Deqi" from PubMed in recent 10 years by using key words "Deqi""acupuncture sensation""needling sensation" and fMRI, trying to expound the central mechanism of "Deqi" and to put forward our understandings. Acupuncture "Deqi" evoked deactivation of the limbic-paralimbic-neocortical network (LPNN)/ default mode network (DMN), including medial prefrontal cortex (frontal pole, anterior cingulate), temporal lobe (amygdala, hippocampus, parahippocampus gyrus, temporal pole), and apparent activation of brain regions as the somatosensory cortex, thalamic-somatosensory area-insular lobe, orbitofrontal cortex, etc., which may enhance the connectivity of brain networks and function in analgesia, anti-anxiety, anti-depression, etc., but the activated and deactivated brain regions are different from study to study possibly due to the stimulated different acupoints, subjects' psychophysical conditions, scanning parameters, image acquiring sequences, etc. It is recommended that the coming stu-dies should pay more attention to the influence of acupuncture "Deqi" on brain functions in subjects suffering from diseases, the brain response characteristics of the longer post-effects and the accumulated effects of acupuncture treatment.

Development and initial evaluation of sensation scale of heat-sensitive moxibustion / 中国针灸

Based on heat-sensitive moxibustion (HSM) theory, a widely applicable scale was developed to reflect the (arrival of ) sensation of HSM. By documentary method and interviewing method, the items of describing sensation of HSM were collected to establish the pool of candidate items. With expert questionnaire, patient questionnaire and core expert discussion, the items were screened and quantified by method of subjective evaluation to develop the initial draft of the scale. A total of 121 patients were pre-surveyed with the initial draft, and the structural validity of the scale was examined by exploratory factor analysis (principal component) and its internal consistency was assessed by Cronbach's coefficient. As a result, the items in the scale was reduced from 36 to 9; 110 effective questionnaires were reclaimed for statistical analysis. Finally, the scale (Version 1.0) contained 9 items and 4 dimensions, of which, 3 items highlighted the comfort emotional experience, 3 items highlighted autonomic response, 2 items highlighted heat sensation, and 1 item highlighted non-heat sensation. In conclusion, the sensation scale of HSM containes 9 items, which has fair content and structure validity. It is in line with the current clinical understanding of sensation of HSM and has strong clinical operability and wide adaptability.

Progress of fMRI-based research in recent 10 years / 中国针灸

<p><b>OBJECTIVE</b>The research regarding the central mechanism of acupuncture (arrival of ) based on functional magnetic resonance imaging (fMRI) in recent 10 years was analyzed to summarize existing research achievements and experience.</p><p><b>METHODS</b>The literature regarding fMRI-based research published from January of 2007 through December of 2016 in CNKI and PubMed databases was collected. The research content and methods, including research design, inclusion criteria, acupoint selection and evaluation, were analyzed.</p><p><b>RESULTS</b>Totally 18 articles regarding the central mechanism of acupuncture based on fMRI was included. According to research content, the literature was divided into two categories: research and sensation research. In research, the differences of and not on brain functional activity were compared to summarize the central response pattern of ; in sensation research, the differences of different sensations and intensities of on central response were compared to explore the effects of different sensations and intensities of on brain functional activity. In recent 10 years, the number of research gradually increased, and the type of design was various, mainly RCT and paired design. The majority of participants was healthy people, and single acupoint was the focus of researches, including Zusanli (ST 36), Waiguan (TE 5), Hegu (LI 4), etc. The evaluation of was based on visual analogue scale (VAS). The research contents were mainly the effects of and not and different sensations on brain function activities. The present studies confirmed that and not as well as different sensations had different impacts on brain functional effects, and different acupoints had specific activated brain areas. There was a positive correlation between the degree of and the intensity of the activation of brain regions. Furthermore, tingling sensation was not included to sensations.</p><p><b>CONCLUSION</b>The number and quality of fMRI-based research need to be improved; the research content is simple, and research method is in exploratory stage. The results obtained in the literature are the phenomena of in the central level, and it is imperative to summarize the essential link between and the central effect through these phenomena to reveal the mechanism of . The specific impact of for brain function needs more clinical exploration.</p>

(arrival) theory in ancient TCM books / 中国针灸

Acupuncturists in all ages emphasize(arrival). We arranged and analyzed contents onandarrival electronic texts in 1156 ancient medical books through, the major electronic series of books on TCM, with medical classics as well as acupuncture-moxibustion andparts as the emphasis. It is found thatis a standard for traditional acupuncture effect evaluation. Meanwhile, it acts on regulating body cold, heat, insufficiency and excess, guiding reinforce-reducing manipulation, determining needle depth, retaining and withdrawing, as well as prognosis, etc.takes the priority in clinical and scientific research.

Application of data mining on the relationship betweenand effect / 中国针灸

<p><b>OBJECTIVE</b>To analyze the relationship betweenand effect by data mining technique with retrieving clinical literature about acupuncturesince the founding of the country.</p><p><b>METHODS</b>The modern computerization and data mining technologies were adopted to set up clinical literature about acupuncturedatabase. The relevant clinical literature was collected, screened, extracted, and statistical and correlation analyses were used so as to explore the relationship betweenand effect.</p><p><b>RESULTS</b>82.1% (46/56) of the studies considered thatwas related to the effect; 17.9% (10/56) of the studies considered thatwas unrelated to the effect. The support ofrelated to the effect is 100% on dysmenorrhea and facial paralysis. 72% (18/25) of the the articles of pain syndrome considered thatwas related to the effect; 28% (7/25)of the studies considered thatwas unrelated to the effect. In the research of the relationship between the features ofand effect, 60.7% of the studies suggested that the sense of conduction was positively correlated with the effect. There were 21 studies on the relationship between the intensity ofand effect, involving a variety of diseases, which was related to the type of the disease. 58.3% (7/12) of the articles on dysmenorrhea and 63% (34/54) on pain syndrome supported conduction positively correlated to effect, showing the highest frequencies. 50% (3/6) of the papers on facial paralysis supported weaksensation positively correlated to effect, which was the highest frequency.</p><p><b>CONCLUSIONS</b>Most studies considered thatcan improve clinical efficacy. The relationship between different features ofand effect is closely related to the disease. Further study may focus on high quality research on the relationship betweenand the obvious effect achieved by acupuncture so as to summarize the law of.</p>

Impact ofon acupoint effects in patients with primary dysmenorrhea:a systematic review of randomized controlled trials / 中国针灸

The effects of(arrival of) on acupoint effects in patients with primary dysmenorrhea (PD) were evaluated.Ten literature databases,including China National Knowledge Infrastructure (CNKI),VIP Database,Wanfang Database,Chinese Biomedical Literature Database (CBM),Cochrane Library CENTRAL,MEDLINE,Embase,AMED, CINAHL Plus,PsycINFO were selected.In addition,5 registers of ongoing trials,the reference lists of included articles and grey literature website OpenGrey were added.The search time was from date of database establishment to August 2016;no restrictions were made on language or status of publication.All randomized controlled trials (RCTs) and quasi-randomized controlled trials (q-RCTs) which compared the effects ofand non-on PD or compared the effects of differentelements on PD were included.The research quality was assessed according to Cochrane bias risk evaluation tool 5.1.0.The RevMan 5.3.5 was applied for quantitative analysis if insignificant clinical heterogenicity with≤ 75%,otherwise the results was summarized by qualitative analysis.As a result,6 RCTs involving 645 patients were included.Because of considerable clinical heterogeneity,only qualitative analysis was performed,which indicated ① acupuncture could reduce pain and anxiety regardless of,and the effects ofon pain relief were superior or equivalent to that of none-,and the effects ofon anxiety relief were similar to that of none-;② the more intensity ofand higher number of acupoints selected,the better effects on pain alleviation,symptom relief and pain duration;③ the higher rate ofhad a better acupoint effect on alleviating anxiety,but was not on pain relief;④appeared early and propagated to affected area could lead to faster onset on pain relief;⑤ the effects on relieving pain and symptoms was better when warm sensation inorreaching affected area.Due to the few number,low quality and potential bias of included studies,it was not sufficient to draw clear conclusion regarding the effects ofon PD patients.This study protocol was registered in PROSPERO (CRD42016038518).

Is sham acupuncture as effective as traditional Chinese acupuncture? It's too early to say / 中国结合医学杂志

Many clinical trials and experimental studies claim that sham acupuncture is as effective as traditional Chinese acupuncture. However, these studies have no standard sham acupuncture control and many other factors can affect the clinical effect. These factors include needle retention time, treatment frequency, and the total number of treatments needed for satisfactory results, and all can change the clinical effect. The majority of existing acupuncture treatment studies do not consider these factors and lack standard dosage criteria. Therefore, it is still too early to conclude that sham acupuncture is as effective as traditional Chinese acupuncture. This article investigates the factors that influence the curative effect of acupuncture as to help set a standard for acupuncture studies in the future.

Quantification of Deqi (arrival of qi) by Short-latency Somatosensory Evoked Potentials：A Randomized Crossover Controlled Trial Plan / 上海针灸杂志

Objective To explore the feasibility of using short-latency somatosensory evoked potentials (SLSEP) to quantitate Deqi.Methods A randomized crossover controlled trial was carried out. Healthy subjects were enrolled and allocated to treatment (thick needle, deep insertion and manipulation for Deqi) and control (thin needle, shallow insertion and no manipulation without Deqi) groups. Somatosensory evoked potentials were recorded before, during and after acupuncture. Deqi was assessed using the score scale in the subjets. The effects of Deqi and no Deqi at point Sanyinjiao (SP 6) on the potentials were observed.Results The preliminary exploration of the feasibility by the trial test showed that the effect of Deqi on short-latency somatosensory evoked potentials had certain regularity. It was worthy to be observed.Conclusion The plan is feasible. The formal test can be conducted.

Hemodynamic Change of Anterior Tibial Artery during Acupuncture at Zusanli (ST36) / 中国康复理论与实践

@#Objective To study physiological foundation of acupunctureDeqi.Methods 28 healthy volunteers who never experienced acupuncture were recruited. The right Zusanli (ST36) and a site 1.5 cm beside Zusanli (ST36) (nominated as A) were acupunctured at different time. Shallow and deep acupuncturing was inserted at Zusanli (ST36). Only deep acupuncturing was inserted at A. Hemodynamic parameters of the anterior tibial artery including the peak value in the systolic phase (Vmax), the average blood flow velocity (Vm), and the inner diameter of vessels (Dist) were observed with colored Doppler ultrasound before, at the end of acupuncture, and 3 min afterDeqi response. Results There was significant difference in those parameters between before acupuncture and 3 min after deqi response when deep acupuncturing at Zusanli (ST36) (P＜0.05), but was not significant difference when shallow acupuncturing (P＞0.05). There was significant difference in ΔVmax and ΔVm between acupuncture at Zusanli (ST36) and A points (P＜0.05). Conclusion Arterial haemodynamics variation seems to be associated with acupunctureDeqi.

Effects of Needle Retaining on Haemodynamics of Anterior Tibial Artery During Acupuncture / 中国康复理论与实践

@# Objective To study the relationship between needle retaining anddeqi. Methods Manual acupuncture was performed at the left ST36 of 26 naive healthy adult volunteers. Half of them retained the needles for 6 min and others were put the needle out immediately afterdeqi. Hemodynamic parameters of the anterior tibial artery were observed with color Doppler ultrasonography before and at 0, 1, 2, 3, 4, 5 min after acupuncture. Results There was significant difference in Vmax、Vm、Pi and Dist in anterior tibial artery before and 3 min after acupuncture, but wasn't between needle remaining and not. Conclusion Needle retaining cannot change the regional haemodynamics during acupuncture, which suggest it cannot strengthendeqi.