Clinical Effect of Jianpi Huoxue Prescription Combined with Acupuncture on Chronic Atrophic Gastritis with Gastric Blood Stasis and Its Impact on Inflammatory Indicators and Gastric Mucosal Function / 中国实验方剂学杂志

ObjectiveTo explore the application effect of Jianpi Huoxue prescription combined with acupuncture in patients with chronic atrophic gastritis （CAG） of gastric blood stasis type. MethodA total of 86 patients with CAG admitted to Wuhan First Hospital from November 2021 to March 2023 were selected and randomly divided into two groups. The control group was treated with conventional Western medicine， while the observation group was treated with Jianpi Huoxue prescription combined with acupuncture. The clinical efficacy， traditional Chinese medicine （TCM） syndrome score， pathological score， negative conversion rate of Helicobacter pylori （Hp）， inflammatory indicators ［neutrophils/lymphocytes （NLR） and interleukin （IL）-1β］， changes in levels of gastric protease （PG） Ⅰ， PG Ⅰ/PG Ⅱ， and gastrin-17 （G-17）， and drug safety during treatment were observed after treatment in both groups. ResultAfter treatment， the total effective rate of the observation group ［95.35% （41/43）］ was significantly better than that of the control group ［79.07% （34/43）］， and the difference was statistically significant （χ2=5.108， P<0.05）. After treatment， the scores of the primary and secondary TCM syndromes in the observation group and the control group were significantly decreased （P<0.05）. After treatment， the scores of primary and secondary TCM syndromes in the observation group were significantly lower than those in the control group （P<0.05）. After treatment， the pathological scores of gastric mucosa atrophy， activity， chronic inflammation， intestinal metaplasia， and dysplasia were significantly lower in the observation group and control group （P<0.05）. After treatment， the pathological scores of gastric mucosa atrophy， activity， chronic inflammation， intestinal metaplasia， and dysplasia in the observation group were significantly lower than those in the control group （P<0.05）. After treatment， the Hp conversion rate in the observation group was significantly increased compared with the control group （P<0.05）. After treatment， the levels of inflammatory indicators NLR and IL-1β in the observation group and control group were significantly lower （P<0.05）， and the levels of inflammatory indicators NLR and IL-1β in the observation group were significantly lower than those in the control group （P<0.05）. After treatment， the levels of PGI and PGⅠ/PGⅡ in the observation group and control group were significantly higher （P<0.05）， and the levels of PGI and PGⅠ/PGⅡ in the observation group were significantly higher than those in the control group （P<0.05）. After treatment， the G-17 level of the observation group and the control group was different at different time points （P<0.05）， and the G-17 level of the observation group was higher at different time points than that of the control group （P<0.05）. The G-17 level of the observation group had an increasing trend compared with the control group （P<0.05）. There was no significant difference in the risk of adverse reactions between the two groups. ConclusionThe combination of Jianpi Huoxue prescription and acupuncture can effectively alleviate symptoms， increase Hp negative conversion rate， inhibit inflammation， and regulate PG and G-17 levels in CAG patients， thus controlling or even reversing gastric mucosal atrophy and reducing the probability of its progression to gastric cancer.

She Medicine （畲药） Diren Zishen Formula （地稔滋肾方） Combined with Acupuncture as Adjunctive Treatment for 32 Cases of Primary Biliary Cholangitis with Liver and Kidney Yin Deficiency Syndrome / 中医杂志

ObjectiveTo observe the clinical effectiveness and safety of She medicine （畲药） Diren Zishen Formula（地稔滋肾方） combined with acupuncture as adjunctive treatment for primary biliary cholangitis with liver and kidney yin deficiency syndrome. MethodsSeventy patients of primary biliary cholangitis with liver and kidney yin deficiency syndrome were randomly divided into a control group and a treatment group， with 35 patients in each group. The control group received oral ursodeoxycholic acid capsules （250 mg per dose， three times daily）. The treatment group received She medicine Diren Zishen Formula oral decoction （one dose daily， 200 ml per dose in the morning and evening， served warm） and acupuncture ［bilateral Sanyingjiao （SP6）， Taichong （LR3）， Ganshu （BL18）， Zusanli （ST36）， Fenglong （ST17）， once daily， 5 consecutive days per week］ in addition to the same treatment as the control group. The treatment duration was three months for both groups. Comparisons were made between the two groups before and after treatment for the following parameters， which were four traditional Chinese medicine （TCM） symptoms scores （skin itching， fatigue， jaundice， and flank pain）， TCM syndrome scores， liver function indicators including aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， alkaline phosphatase （ALP）， gamma-glutamyl transferase （GGT） and total bilirubin （TBiL）， liver fibrosis markers including serum laminin （LN）， serum hyaluronic acid （HA）， serum type Ⅳ collagen （Ⅳ-C） and serum type Ⅲ procollagen （PC-Ⅲ）， and inflammatory factor indicators including serum interleukin-6 （IL-6） and tumor necrosis factor-alpha （TNF-α）. The effectiveness of TCM syndrome between the two groups was compared and safety evaluations were also conducted after treatment. ResultsA total of 32 cases were finally analyzed in the treatment group， while the control group had 31 cases. The total effective rate of TCM syndrome in the treatment group （87.50%， 28/32） was higher than that in the control group （67.74%， 20/31） （P＜0.05）. After treatment， the TCM symptom scores， syndrome scores， liver function， and liver fibrosis markers in both groups signi-ficantly decreased， while in the treatment group， the inflammatory factor indicators decreased after treatment， and more decreases were found than those in the control group （P＜0.05 or P＜0.01）. Both groups had good safety， and no adverse reactions were observed. ConclusionThe combination of She medicine Diren Zishen Formula and acupuncture as an adjunctive treatment for primary biliary cholangitis can significantly improve the clinical effectiveness， improve liver function， reduce inflammatory response， and alleviate liver fibrosis， with good safety.

Clinical Study of Modified Shenqi Pill （肾气丸） Plus Tongdu Tiaoshen Acupuncture （通督调神针刺） for Neurogenic Bladder After Spinal Cord Injury of Kidney-Yang Deficiency Syndrome / 中医杂志

ObjectiveTo observe the clinical efficacy of modified Shenqi Pill （肾气丸） plus Tongdu Tiaoshen Acupuncture （通督调神针刺） in the treatment of neurogenic bladder after spinal cord injury of kidney-yang deficiency syndrome. MethodsForty-six patients were randomly divided into 23 cases each in the control group and the treatment group. Both groups were given conventional treatment， i.e. oral methylcobalamin tablets （0.5 mg each time， 3 times a day） and paraplegic conventional acupuncture （once a day， 6 consecutive days a week）. The control group was given simple bladder function rehabilitation training on the basis of the conventional treatment； and the treatment group was given modified Shenqi Pill orally （1 dose a day， 150 ml each time， taken warmly in morning and evening） and Tongdu Tiaoshen Acupuncture （once a day， 6 consecutive days per week） in addition to what were given to the control group. The treatment course lasted for 4 weeks. The 24 h urination frequency， 24 h urine leakage frequency， 24 h single urine volume， bladder residual urine volume， international lower urinary tract symptom （LUTS） score， traditional Chinese medicine （TCM） syndrome score were compared between the two groups， and clinical effectiveness and TCM syndrome effectiveness were compared between the two groups after treatment. ResultsTwenty patients in each group were finally analyzed in this study. The number of 24 h urination， the number of 24 h urine leakage， bladder residual urine volume， LUTS score， and the TCM syndrome scores decreased after treatment in both groups， and the 24 h single urine volume increased （P＜0.01）； and much more improvement was found of each index in the treatment group than in the control group （P＜0.05 or P＜0.01）. The total clinical effectiveness and TCM syndrome effectiveness in the treatment group was 85.00% （17/20） respectively， which were statistically significantly higher than 45.00% （the total clinical effectiveness， 9/20） and 60.00% （TCM syndrome effectiveness， 12/20） in the control group （P＜0.01）. ConclusionModified Shenqi Pill plus Tongdu Tiaoshen Acupuncture can signi-ficantly improve the clinical symptoms of neurogenic bladder patients after spinal cord injury of kidney-yang deficiency syndrome， having better effectiveness than simple bladder function rehabilitation training， and its mechanism may be related to the improvement of the injured nerve function innervating the bladder.

Effect of Acupuncture at “Zhibian （BL 54）-to-Shuidao （ST 28）” on Key Factors of Endogenous Exogenous Apoptotic Pathways in Asthenospermia Model Mice / 中医杂志

ObjectiveTo observe the effect of acupuncture “Zhibian （BL 54）-to-Shuidao （ST 28）” on the reproductive function of asthenospermia model mice and to explore the possible mechanism. MethodsForty-two male C57BL/6 mice were randomly divided into blank group， model group， and acupuncture group， with 14 mice in each group. Cyclophosphamide 30 mg/（kg·d） was injected intraperitoneally for 7 days to establish model of asthenospermia for the model group and the acupuncture group， while 0.9% sodium chloride solution 10 ml/（kg·d） was injected intraperitoneally for 7 days in the blank group. After successful modeling， mice in the acupuncture group received acupuncture at “Zhibian （BL 54）-to-Shuidao （ST 28）” once a day for 20 minutes， 6 times a week for 3 weeks； the remaining two groups were fixed without acupuncture. Daily observations were made on the general conditions of mice in all groups， and changes in body weight after intervention were recorded. On the next day after completing the treatment， 6 male mice selected randomly from each group to test the sperm quality as well as testicular and epididymal weights， and calculate the corresponding indices； ELISA was used to test the levels of testosterone （T）， follicle-stimulating hormone （FSH）， and luteinizing hormone （LH） in serum； HE staining and TUNEL staining were performed to observe the pathological morphology and apoptosis of testicular and epididymal tissues； fluorescence quantitative PCR and western blot were used to detect changes in the expression of apoptosis-related factors （Fas）， Fas-associated death domain protein （FADD）， B-cell lymphoma 2 （Bcl-2）， Bcl-2-associated X protein （Bax）， and cysteine-aspartic acid protease （caspase）-3 mRNA and protein in testicular tissue. The remaining 8 male mice in each group were housed with estrus-cycling mice of the same strain at 1∶1 ratio， and the pregnancy rate and number of embryos per litter in each group were determined after mating. ResultsIn comparison with the blank group， mice in the model group exhibited reduced body weight， decreased testicular mass， testicular index， epididymal mass， and epididymal index. Additionally， there was a decrease in total sperm count， sperm motility， and sperm viability. Serum levels of T， FSH， and LH were reduced. The apoptosis rate increased， and the expression levels of Fas， FADD， Bax， and Caspase-3 mRNA and proteins were elevated， while Bcl-2 mRNA and protein expression levels decreased （P＜0.01）. Pathological abnormalities were observed in testicular and epididymal tissues， with disrupted arrangement of seminiferous tubules and a decreased number of spermatogenic cells within the tubular lumen. Furthermore， the pregnancy rate and the number of embryos per litter decreased significantly after mating （P＜0.01）. In comparison with the model group， mice in the acupuncture group showed improvements in testicular mass， testicular index， epididymal mass， epididymal index， total sperm count， sperm motility， and sperm viability. Serum levels of T， FSH， and LH increased. The apoptosis rate decreased， and the expression levels of Fas， FADD， Bax， and Caspase-3 mRNA and proteins decreased， while Bcl-2 mRNA and protein expression levels increased （P＜0.05 or P＜0.01）. Morphological improvements were observed in testicular and epididymal tissues， with a compact arrangement of seminiferous tubules and an increased number of spermatogenic cells within the tubular lumen. Furthermore， the pregnancy rate and the number of embryos per litter increased significantly after mating （P＜0.01）. ConclusionAcupuncture “Zhibian （BL 54）-to-Shuidao （ST 28）” can improve testicular tissue apoptosis and enhance reproductive function in a mouse model of asthenospermia. Its mechanism may be associated with the modulation of key factors in the extrinsic membrane receptor pathway （Fas-mediated pathway） and the intrinsic mitochondrial pathway （Bcl-2/Bax-regulated pathway） in testicular tissue.

Application of proteomics technology in dry eye disease and acupuncture treatment / 国际眼科杂志(Guoji Yanke Zazhi)

Dry eye disease(DED)refers to a condition characterized by reduced stability of the tear film or an imbalance in the microenvironment of the ocular surface, resulting from abnormalities in quality, quantity and kinetics of tear. This condition leads to various ocular discomforts and even visual impairment. The pathogenesis of DED is multifactorial and current treatment mainly focuses on symptom relief and preservation of visual function. Acupuncture has shown effectiveness in treating dry eye, although its underlying mechanism remains incompletely understood. Proteomics technology offers a comprehensive and systematic approach to studying the functions, structures and interactions of proteins. Its application in DED research can provide valuable insights into the dynamic changes in protein levels associated with different etiology or the course of DED and facilitate the identification of potential biomarkers. Furthermore, proteomics can systematically explore the regulatory mechanisms underlying acupuncture treatment for DED, providing a theoretical basis for acupuncture treatment research and contributing to the understanding of its effects at a fundamental level. This paper aims to explore the potential application of proteomics in both clinical and basic research on DED. Ultimately, it strives to offer scientific and effective strategies for the diagnosis and treatment of DED and advance our knowledge of the mechanisms underlying acupuncture therapy.

Acupuncture in the Treatment of a Series of Patients with Chronic Pain Associated with Hip Osteoarthritis / Acupuntura no tratamento de uma série de pacientes com dor crônica associado à osteoartrite de quadril

Abstract Objective Hip osteoarthritis (HO) causes pain and deranges functioning. Surgical treatment is the preferred approach in severe cases, but clinical comorbidities, age and the long waiting list may compromise quality of life. This study aimed to describe the results of acupuncture for the control pain and improvement of functioning in subjects with HO. Method Twelve severe HO patients were treated with ten weekly sessions of a standardized acupuncture point protocol. Pain intensity was assessed with the Visual Analog Pain Scale (VAS) and quality of life with WOMAC Index. Results Pain intensity (VAS) reduced from 75.8 ± 18.8 mm to 20.0 ± 22.6 mm after 10 acupuncture sessions and 48.3 ± 26.6mm in the follow-up (ANOVA F = 7.99; p < 0.001). WOMAC Index values reduced from 74.7 ± 12.7 to 45.7 ± 22.1 and 54.6 ± 22.9 at the same timepoints. Conclusion Acupuncture is an effective conservative rehabilitation strategy to reduce pain and improve quality of life in subjects with severe HO.

Resumo Objetivo A osteoartrite (OA) de quadril causa dor e perda da funcionalidade. O tratamento cirúrgico é a procedimento de escolha nos casos graves, mas as comorbidades clínicas, a idade e a longa lista de espera podem comprometer a qualidade de vida. Este estudo teve como objetivo descrever os resultados da acupuntura no controle da dor e melhora da funcionalidade em indivíduos com OA de quadril. Método Doze pacientes com OA de quadril grave foram tratados com dez sessões semanais de um protocolo padronizado de pontos de acupuntura. A intensidade da dor foi avaliada pela Escala Visual Analógica de Dor (EVA) e a qualidade de vida pelo Índice WOMAC. Resultados A intensidade da dor (EVA) reduziu de 75,8 ± 18,8mm para 20,0 ± 22,6mm após 10 sessões de acupuntura e 48,3 ± 26,6mm no período de seguimento (ANOVA F = 7,99; p < 0,001). Os valores do Índice WOMAC reduziram de 74,7 ± 12,7 para 45,7 ± 22,1 e 54,6 ± 22,9 nos mesmos momentos. Conclusão A acupuntura é uma estratégia de reabilitação conservadora eficaz para reduzir a dor e melhorar a qualidade de vida em indivíduos com OA de quadril grave.

El valor de la acupuntura en la práctica de la medicina tradicional complementaria en el sector salud de México / The value of acupuncture in the practice of complementary traditional medicine in Mexico's health sector

Introduction: Complementary traditional medicine acquires an essential value from the diversity and pluralism of care and therapy. In this logic, it is up to people to search for alternatives when it comes to caring for and improving their own health. Specifically, acupuncture has had rapid growth, largely due to processes derived from globalization, migration and cultural exchange, which in some way force countries to modify their health system towards one that takes into account the transculturality of its population and treatment preferences. Development: With the establishment of a comprehensive health model, physicians can assess the person as a homeodynamic process (information exchange process between environment and man, to keep an internal and external homeostasis to the individual) and pandimensional (spiritual and energetic care) that allows to identify the health problem's origin and thus determine an intervention more in line with the person's needs during the health-disease, life-death processes, with the corresponding conventional or non-conventional therapy. Conclusions: The value and interest of acupuncture in the population derives from the degree of development of a country, its origin and the incorporation of the West as part of the diagnostic and therapeutic arsenal, in order to respond to the population needs by incorporating low-cost complementary treatments with proven effectiveness, without ceasing to consider its unquestionable cultural heritage.

Introducción: la medicina tradicional complementaria adquiere un valor imprescindible desde la diversidad y el pluralismo de la asistencia y la terapéutica. En esa lógica, corresponde a las personas la búsqueda social de alternativas cuando se trata de atender y mejorar la propia salud. En específico la acupuntura ha tenido un rápido crecimiento, en gran parte debido a la globalización, la migración y el intercambio cultural, que de alguna forma obligan a los países a modificar su sistema de salud hacia uno que tome en cuenta la transculturalidad de su población y las preferencias de tratamiento. Desarrollo: con el establecimiento de un modelo de salud integral, los médicos pueden valorar a la persona como un proceso homeodinámico (intercambio de información entre el ambiente y el hombre para mantener una homeostasis interna y externa del individuo) y pandimensional (cuidado espiritual y energético) que permita identificar el origen real del problema de salud y determinar una intervención más acorde a las necesidades de la persona durante los procesos de salud-enfermedad, de vida-muerte, con la terapia convencional o no convencional que corresponda. Conclusiones: el valor e interés de la acupuntura en la población se deriva del grado de desarrollo de un país, de su origen y de la incorporación de occidente como parte del arsenal diagnóstico y terapéutico, para responder a las necesidades de la población al incorporar tratamientos complementarios de bajo costo y con efectividad demostrada, y sin dejar de considerar su herencia cultural incuestionable.

Tratamiento combinado de catgutpuntura y ozonoterapia en la psoriasis vulgar. Hospital Clínico Quirúrgico Lucia Íñiguez Landín. 2019- 2021

Fundamento: la psoriasis afecta aproximadamente al 2 % de la población mundial, con amplias repercusiones biopsicosociales. Objetivo: determinar la efectividad del tratamiento combinado catgutpuntura-ozonoterapia en los pacientes con psoriasis vulgar. Métodos: estudio cuasiexperimental de intervención del tipo antes y después sin grupo de control realizado en el Hospital Lucia Íñiguez Landín, en el período abril 2019 a 2021. La población estuvo constituida por 55 pacientes; la muestra quedó conformada por 29 que cumplieron con los criterios de inclusión. Se realizó un análisis multivariado de frecuencias absolutas y relativas. Para evaluar la efectividad del tratamiento se utilizó la prueba estadística de diferencia de proporciones con un nivel de confianza de 95 %, considerándose estadísticamente significativa. Resultados: predominó el sexo femenino y el grupo de edad de 40 a 49 años. Los síndromes de insuficiencia del Yin de riñón y Xue de hígado constituyeron los más representativos. Se logró disminuir la severidad de la enfermedad en casi la totalidad de estos. Las reacciones adversas a las terapias empleadas fueron mínimas. Conclusiones: el tratamiento combinado fue considerado parcialmente efectivo.

Background: psoriasis affects approximately 2 % of the world population, with extensive biopsychosocial repercussions. Objective: to determine the effectiveness of the combined catgutpuncture-ozone therapy treatment in patients with psoriasis vulgaris. Methods: quasi-experimental intervention study of the type before and after without a control group carried out at the Lucia Íñiguez Landín Hospital, from April 2019 to 2021. 55 patients were the population; 29 patients were the sample who met the inclusion criteria. A multivariate analysis of absolute and relative frequencies was performed. To evaluate the effectiveness of the treatment, the statistical test of proportions' difference was used with a confidence level of 95%, being considered statistically significant. Results: the female sex and the age group of 40 to 49 years old predominated. Kidney Yin and liver Xue insufficiency syndromes was the most representative. It was possible to reduce the severity of the disease in almost all of them. Adverse reactions to the therapies used were minimal. Conclusions: the combined treatment was considered partially effective.

Effect of acupuncture on the molar bite force in women with chronic neck pain / Efecto de la acupuntura sobre la fuerza de mordida en mujeres con cervicalgia crónico

Objetive: To investigate the maximum molar bite force in women with chronic neck pain after treatment with acupuncture. Materials and Methods: Twenty-three women with chronic neck pain participated. Dynamometer was used to measure the right and left maximum molar bite force. Dong Bang acupuncture needles - 0.25 mm x 30 mm was inserted into the integumentary tissue. Treatment was 10 sessions, each 30 minutes long and twice a week. Results: The right (p = 0.01) and left (p = 0.004) molar bite force was assessed after treatment with acupuncture, and showed increased occlusal strength. Conclusions: This study suggests a functional improvement in the stomatognathic system in women with chronic cervical pain after treatment with acupuncture. However, it is important to note that further research is needed to fully elucidate the long-term effects and potential clinical implications of these findings in the field of pain management and rehabilitation.

Objetivo: Investigar la fuerza masticatoria máxima en mujeres con dolor crónico de cuello después del tratamiento con acupuntura. Materiales y Métodos: Participaron veintitrés mujeres con dolor crónico de cuello. Se utilizó un dinamómetro para medir la fuerza máxima de mordida del molar derecho e izquierdo. Agujas de acupuntura Dong Bang se insertaron 0,25 mm x 30 mm en el tejido tegumentario. El tratamiento fue de 10 sesiones, cada una de 30 minutos de duración, dos veces por semana. Resultados: Se observó la fuerza de mordida del molar derecho (p=0.01) e izquierdo (p=0.004) después del tratamiento con acupuntura, que mostró un aumento de la fuerza oclusal. Conclusión: Este estudio sugiere una mejora funcional en el sistema estomatognático en mujeres con dolor cervical crónico después del tratamiento con acupuntura. Sin embargo, es importante señalar que se necesita más investigación para dilucidar por completo los efectos a largo plazo y las posibles implicaciones clínicas de estos hallazgos en el campo del tratamiento y la rehabilitación del dolor.

Behavioral Risk Factors of HBV Infection and its Association with HBs Ag Positivity among Residents of Kaza Sub- division of District Lahaul & Spiti in Himachal Pradesh

Background: Chronic viral hepatitis is a major global public health problem, an important cause of morbidity and mortality. We conducted this study to evaluate the behavioral risk factors of HBV infection and its association with HBsAg positivity among residents of Kaza sub-division of district Lahaul & Spiti in Himachal Pradesh. Material & Methods: The study was carried out by the Gastroenterology, Community Medicine, and Microbiology Department at Indira Gandhi Medical College Shimla at Kaza, a subdivision of Lahaul & Spiti. The cluster sampling technique was used to get the desired sample size of 4000. Forty clusters were chosen using a probability proportionate to size sampling method, and 100 research participants were added to each cluster using a simple random sampling method. The data was gathered using a pre-tested interview plan. A blood sample of 5ml from each study participant was obtained, and its HBsAg content was examined. Results: In our study, 2.7% of the interviewed respondents’ parents were positive for hepatitis B and 3.7% reported one positive family member. Injectable drug use was reported by 1.6 (68/4231). Among these users 8.8% (6/68) shared needles with other IDUs in last 12 months and 35.3% (24/68) used a common container to draw up drug solution. Sexual intercourse was reported to be experienced by 15.5 (655/4231) and 12.2% either did not disclose or were children. Out of those who ever experienced sexual/penetrative intercourse 38.3% (251/655) had reported it with someone else other than a spouse. Majority of these had two partners other than a spouse (30.3%; 76/251). Around 30% (195/655) reported of using a condom in their last intercourse. Body piercings or a tattoo from someone who doesn’t sterilize his or her equipment, including local treatment from lamas, was prevalent among 16.3% of the population (689/4231). Acupuncture was taken as a remedy for any medical condition by 9% of participants. Regression analysis also revealed that one infected family member emerged as an independent factor associated with HBsAg positive test after adjusting for confounders. Conclusion: Our study provided much important information concerning hepatitis B risk factors in this tribal group. Health education about behavioral risk factors among this tribal population should be the main intervention that might help limit the spread of these blood-borne infections.

Effect of acupuncture on heart rate variability in individuals with multiple sclerosis: a protocol for a double-blinded randomized controlled trial / Efeito da acupuntura na variabilidade da frequência cardíaca em indivíduos com esclerose múltipla: um protocolo para ensaio randomizado controlado duplo cego

Introdução: o crescimento de pacientes com esclerose múltipla que procuram tratamento com acupuntura é baseado em relatos clínicos de melhora dos sintomas. Considerando que o comprometimento autonômico, incluindo a disfunção autonômica cardiovascular, não é incomum em pacientes com EM a neuromodulação com acupuntura pode ser uma ferramenta interessante para alterar a variabilidade da frequência cardíaca nessa população.Objetivo: avaliar a variabilidade da frequência cardíaca em pacientes com esclerose múltipla, durante a aplicação da Acupuntura, a fim de analisar o comportamento do sistema nervoso autônomo antes, durante e após a terapia e as mudanças na condição após uma intervenção longitudinal.Métodos: será realizado um ensaio clínico cruzado, randomizado, placebo-controlado, duplo-cego, com proporção de alocação de 1:1, com 40 indivíduos sem doença prévia, que constituirão o grupo controle, e 40 indivíduos com Esclerose Múltipla, que constituirão o grupo experimental. grupo, pareado por idade e sexo. Todos os participantes realizarão sessões de acupuntura ativas ou simuladas.Discussão: de acordo com os estudos encontrados, é esperada disfunção autonômica cardiovascular, com alterações na variabilidade da frequência cardíaca. Embora a neuromodulação com acupuntura possa controlar a dor e a inflamação, ainda há dificuldades em afirmar se o equilíbrio entre os sistemas simpático e parassimpático pode ser alterado pela acupuntura.

Backgroung: the growing of patients with multiple sclerosis seeking acupuncture treatment is based on clinical reports of improvements in symptoms. Considering that autonomic impairment, including cardiovascular autonomic dysfunction, is not uncommon in patients with MS, neuromodulation with acupuncture could be an interesting tool to change heart rate variability in this population.Objective: to evaluate heart rate variability in patients with multiple sclerosis, during the application of acupuncture, in order to analyze the behavior of the autonomic nervous system before, during and after therapy and changes in condition after a longitudinal intervention.Methods: a double-blinded randomized sham-controlled crossover trial with a 1:1 allocation ratio will be conducted, with 40 individuals without a previous illness, who will constitute the control group, and 40 individuals with Multiple Sclerosis, who will constitute the experimental group, paired by age and sex. All participants will undertake active or sham acupuncture sessions.Discussion: according to the studies found, cardiovascular autonomic dysfunction is expected, with alterations in heart rate variability. Although neuromodulation with acupuncture can control pain and inflammation, there are still difficulties in affirming whether the balance between the sympathetic and parasympathetic systems can be changed by acupuncture

Formación médica en la terapéutica no convencional en el mundo (homeopatía y acupuntura) / Medical training in non-conventional therapeutics in the world (homeopathy and acupuncture)

Utilizadas de forma complementaria, alternada o integrada con la medicina convencional, la demanda de la población por las terapias no convencionales se ha incrementado considerablemente en las últimas décadas, requiriendo de los médicos un conocimiento de las nociones básicas de tales enfoques terapéuticos para orientar a sus pacientes en relación con tratamientos distintos a aquellos que suelen prescribir. Entre las mismas, la homeopatía y la acupuntura se han considerado especialidades médicas en Brasil durante varias décadas. Objetivo: Describir el estado actual de la formación médica en terapias no convencionales (homeopatía y acupuntura) alrededor del mundo. Métodos: Actualizamos los datos relacionados con los estudios y revisiones publicados hasta 2013 a través de una revisión de los estudios más recientes incluidos en la base de datos PubMed. Resultados: En todos los países, la enseñanza de terapias no convencionales se considera un tema relevante para la formación de médicos como una función del creciente interés de la población en su uso, con un amplia variedad de enfoques dirigidos a los estudiantes de licenciatura y posgrado, médicos residentes y profesionales con otras especialidades médicas. Conclusiones: Las escuelas brasileñas de medicina deben proporcionar a los estudiantes de licenciatura y posgrado, así como a los médicos residentes, un conocimiento preciso de los supuestos teóricos y enfoques clínico-terapéuticos propios de la homeopatía y la acupuntura, entre otras terapias no convencionales.

Used as complementary to, alternating or integrated with mainstream medicine, the population's demand for non-conventional therapies has substantially increased in the past decades, requiring from doctors knowledge on the basic notions of such therapeutics to orient their patients regarding treatments different to the ones they usually prescribe. Among them, homeopathy and acupuncture are considered medical specialties in Brazil for various decades. Aim: To describe the current state of medical education in non-conventional therapies (homeopathy and acupuncture) around the world. Methods: We updated data resulting from studies and reviews published until 2013 through a review of more recent studies included in database PubMed. Results: In all countries the teaching of non-conventional therapies is considered a relevant topic for the training of doctors as a function of the increasing interest of the population in their use, with a broad range of approaches targeting undergraduate and graduate students, medical residents and doctors from other medical specialties. Conclusions: The Brazilian medical schools must provide undergraduate and graduate students and medical residents accurate knowledge on the theoretical assumptions and clinical-therapeutic approaches proper to homeopathy and acupuncture, among other non-conventional therapies.

Evaluation of acupuncture and auriculotherapy in the control of chemotherapy-induced nausea and vomiting: a Pilot Study / Evaluación de la acupuntura y la auriculoterapia en el control de las náuseas y vómitos inducidos por la quimioterapia: Estudio piloto / Avaliação da acupuntura e auriculoterapia no controle de náuseas e vômitos induzidos por quimioterapia: Estudo Piloto

ABSTRACT Objective: To evaluate the effectiveness of acupuncture and auriculotherapy protocol in relieving chemotherapy-induced nausea and vomiting in cancer patients compared to the antiemetic protocol. Method: Pilot study of a pragmatic two-arm clinical trial: an acupuncture group received systemic acupuncture, auriculotherapy, and antiemetic protocol; a control group used antiemetic protocol. The sample consisted of 42 patients with cancer of the gastrointestinal system or multiple myeloma. The outcome was assessed using the Chemotherapy-Induced Nausea and Vomiting Assessment Tool and the patient's diary. Results: There was no statistically significant difference between groups according to the assessment of the patient's diary and the Assessment Tool of chemotherapy-induced nausea and vomiting. The patients were 60 years old on average and the groups were homogeneous, except for marital status. In the diary, there was no statistical difference between groups and sessions for days of nausea (p = 0.873) and vomiting episodes (p = 0.993). Conclusion: The protocol of acupuncture and auriculotherapy as a complementary treatment of chemotherapy-induced nausea and vomiting was ineffective, considering the limitations of the study.

RESUMEN Objetivo: Evaluar la efectividad del protocolo de acupuntura y auriculoterapia para aliviar las náuseas y los vómitos inducidos por la quimioterapia en pacientes con cáncer en comparación con el protocolo antiemético. Método: Estudio piloto tipo ensayo clínico pragmático con dos brazos: el grupo de acupuntura recibió acupuntura sistémica, auriculoterapia y protocolo antiemético, el grupo control utilizó un protocolo antiemético. La muestra estuvo compuesta por 42 pacientes con cáncer del sistema gastrointestinal o mieloma múltiple. El resultado se evaluó mediante el Instrumento de Evaluación de Náuseas y Vómitos inducidos por quimioterapia y el diario del paciente. Resultados: No hubo diferencias estadísticamente significativas entre los grupos según la evaluación del diario del paciente y el Instrumento de Evaluación de náuseas y vómitos inducidos por quimioterapia. Los pacientes tenían en promedio 60 años y los grupos eran homogéneos, excepto por el estado civil. En el diario no hubo diferencia estadística entre los grupos y sesiones para los días de náuseas (p = 0,873) y episodios de vómitos (p = 0,993). Conclusión: El protocolo de acupuntura y auriculoterapia como tratamiento complementario de las náuseas y vómitos inducidos por la quimioterapia resultó ineficaz, considerando las limitaciones del estudio.

RESUMO Objetivo: Avaliar a efetividade do protocolo de acupuntura e auriculoterapia no alívio de náuseas e vômitos induzidos por quimioterapia em pacientes oncológicos em comparação ao protocolo antiemético. Método: Estudo piloto tipo ensaio clínico pragmático de dois braços: grupo acupuntura recebeu acupuntura sistêmica, auriculoterapia e protocolo antiemético, o grupo controle utilizou protocolo antiemético. A amostra foi composta por 42 pacientes com câncer do sistema gastrointestinal ou mieloma múltiplo. O desfecho foi avaliado pelo Instrumento de Avaliação de náuseas e vômitos induzidos por quimioterapia e diário do paciente. Resultados: Não houve diferença estatística significativa entre os grupos pela avaliação do diário do paciente e Instrumento de Avaliação de náuseas e vômitos induzidos por quimioterapia. Os pacientes apresentavam em média 60 anos e os grupos foram homogêneos, exceto para o estado civil. No diário, não houve diferença estatística entre os grupos e as sessões para os dias de náuseas (p = 0,873) e episódios de vômitos (p = 0,993). Conclusão: O protocolo de acupuntura e auriculoterapia como tratamento complementar de náuseas e vômitos induzidos por quimioterapia foi inefetivo, considerando as limitações do estudo.

Acupuncture regulates the apoptosis of ovarian granulosa cells in polycystic ovarian syndrome-related abnormal follicular development through LncMEG3-mediated inhibition of miR-21-3p

Background The main features of polycystic ovary syndrome (PCOS) are abnormal follicular development and ovulatory dysfunction, which are caused by excessive apoptosis of ovarian granulosa cells. Acupuncture has been shown to improve follicular development abnormalities in patients with PCOS, but its mechanism is unknown. This study hypothesized that the mechanism of acupuncture on follicular development abnormalities in PCOS patients is the inhibition of granulosa cell apoptosis through LncMEG3-mediated regulation of miR-21-3p. Methods A PCOS-like rat model was established using subcutaneous injection of dehydroepiandrosterone (DHEA). Acupuncture was performed on rats for 15 d (CV-4, RN-3, CV-6, SP-6 and EX-CA 1). Ovarian morphology was observed by HE staining, and sex hormone and AMH levels were detected by ELISA. Primary granulosa cells were isolated from each group of rats to assess the association of acupuncture treatment, LncMEG3, miR-21-3p, and granulosa cell apoptosis in rats with PCOS. Results LncMEG3 and miR-21-3p were highly expressed in the ovarian granulosa cells of rats with PCOS, and LncMEG3-mediated regulation of miR-21-3p was involved in the development of PCOS in rats. Silencing of MEG3 attenuated sex hormone dysregulation and ovarian histopathological changes in PCOS rats and promoted follicle cell development and maturation. In addition, silencing MEG3 increased the viability and number of granulosa cells. In addition, silencing MEG3 further inhibited early and late apoptosis of ovarian granulosa cells in PCOS rats. Acupuncture improved polycystic ovarian morphology and sex hormone levels in PCOS rats. Acupuncture intervention increased the viability and number of granulosa cells. Acupuncture intervention inhibited early and late apoptosis of ovarian granulosa cells in PCOS rats by targeting miR-21-3p via LncMEG3. Conclusion These results suggest that acupuncture can downregulate LncMEG3, thereby targeting and regulating miR-21-3p to suppress early and late granulosa cell apoptosis and normalize their proliferation. These factors ultimately compensate for abnormal follicular development. These findings shed light on the clinical potential of acupuncture as a safe treatment for follicular developmental abnormalities in PCOS. Highlights LncMEG3-mediated inhibition of miR-21-3p regulates ovarian granulosa cell apoptosis. LncMEG3 and miR-21-3p are involved in the occurrence and development of PCOS-related abnormal follicular development. CuONPs induce co-occurrence of autophagy activation and autophagic flux blockade. Acupuncture can improve the sex hormone levels and follicular development in the context of PCOS. The underlying mechanism of acupuncture in the treatment of PCOS abnormal follicular development was revealed.

Acupuntura no alívio da dor osteomuscular e a melhora na funcionalidade na pessoa idosa: estudo quase experimental / Acupuncture in the relief of osteomuscular pain and improvement of functionality in older adults: a quasi-experimental study

Resumo Objetivo Avaliar os efeitos da acupuntura no alívio da dor osteomuscular em pessoas idosas e a possibilidade de melhora da funcionalidade para as atividades básicas de vida diária. Método Estudo quase experimental, com avaliação antes e depois da intervenção utilizando a Escala Visual Analógica e o Índice de Katz. Amostra por conveniência, constituída de 31 pessoas idosas. O período de intervenção comportou quatro sessões de atendimentos semanais. A intervenção com acupuntura abordou um protocolo de tratamento sistêmico por intermédio de cinco pares de pontos: IG4 (Hegu), F3 (Taichong), E36 (Zusanli), PC6 (Neiguan) e BP6 (Sanyinjiao). Resultados 100% (31) informando sentir dor, sendo 64,52% (20) em intensidade moderada (3-7); 25,81% (8) dor intensa (8-10); e 9,68% (3) dor leve (0-2). O protocolo de tratamento mostrou-se positivo em 4 sessões, com redução da dor ao grau leve, e média geral reduzida abaixo de 2 no score. A análise dos resultados da Escala Visual Analógica e os do índice de Katz, mostrou possibilidades do uso da acupuntura no alívio da dor osteomuscular e na melhora da funcionalidade da pessoa idosa. Conclusão O uso da técnica de acupuntura sistêmica apontou resultados satisfatórios no alívio da dor osteomuscular e na melhoria da funcionalidade para as atividades básicas de vida diária da pessoa idosa.

Abstract Objective To assess the effects of acupuncture on the relief of osteomuscular pain in older adults and the potential improvement in functionality for activities of daily living. Method A quasi-experimental study, with pre- and post-intervention assessment using the Visual Analog Scale and the Katz Index. Convenience sample comprising 31 older adults. The intervention period consisted of four weekly treatment sessions. Acupuncture intervention targeted a systemic treatment protocol utilizing five pairs of acupoints: LI4 (Hegu), LIV3 (Taichong), ST36 (Zusanli), PC6 (Neiguan), and SP6 (Sanyinjiao). Results 100% (31) reported experiencing pain, with 64.52% (20) reporting moderate pain (3-7), 25.81% (8) reporting severe pain (8-10), and 9.68% (3) reporting mild pain (0-2). The treatment protocol demonstrated positive outcomes after 4 sessions, with a reduction of pain to a mild degree and an overall average score reduced below 2. The analysis of results from the Visual Analog Scale and the Katz Index showed potential for the use of acupuncture in relieving osteomuscular pain and improving the functionality of the older adult. Conclusion The use of systemic acupuncture techniques yielded satisfactory results in the relief of osteomuscular pain and the enhancement of functionality for activities of daily living of the older adult.

Colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic: systematic review and metaanalysis

SUMMARY OBJECTIVE: The aim of this study was to systematically review the colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic and perform a meta-analysis of the available evidence. METHODS: The literature review for this systematic review was conducted between December 2022 and January 2023 using five electronic databases, namely PubMed, CINAHL, Scopus, Web of Science, and ULAKBİM. Published articles were scanned using MeSH-based keywords. Only randomized controlled trials conducted in the past 5 years were included. The data were analyzed using the Review Manager computer program. RESULTS: This meta-analysis included three studies involving a total of 386 infantile colic infants. After nonpharmacological treatment, it was found that infants with infantile colic reduced crying time (standardized mean difference: 0.61; 95%CI 0.29-0.92; Z=3.79; p=0.00002), improved sleep duration (standardized mean difference: 0.22; 95%CI −0.04 to 0.48; Z=1.64; p=0.10), and decreased crying intensity (mean difference: −17.24; 95%CI −20.11 to 14.37; Z=11.77; p<0.000001). CONCLUSION: According to the meta-analysis findings, it was determined that the risk of bias was low in the studies included and that nonpharmacological chiropractic, craniosacral, and acupuncture treatments applied to infantile colic infants in the three included studies reduced crying time and intensity and increased sleep duration.

Clinical efficacy of traditional Chinese medicine therapy for female stress urinary incontinence: a meta-analysis / Eficácia clínica da terapia da medicina tradicional chinesa para a incontinência urinária de esforço feminina: uma meta-análise / Eficacia clínica de la terapia de medicina tradicional china para la incontinencia urinaria de esfuerzo femenina: un metaanálisis

ABSTRACT Objectives: To investigate the efficacy of traditional Chinese medicine (TCM) in the treatment of female stress urinary incontinence (SUI). Method: PubMed, Cochrane, Web of Science, Embase, CNKI, Wanfang, and VIP databases were searched for articles published up to September 2022. Variables were analyzed using weighted mean difference (WMD), standardized mean difference (SMD), odds ratios (OR), and 95% confidence interval (CI). Results: Eight studies containing 744 patients were included in this study. The results demonstrate that TCM therapy had more advantages in improving the clinical outcome of SUI patients (OR = 2.90, 95%CI:1.92-4.37, P = 0.000), reducing the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) score (WMD = -2.41, 95%CI:-2.83- -1.98, P = 0.000), reducing 1-h urinary pad leakage urine volume (WMD = -1.86, 95%CI:-2.23- -1.49, P = 0.000) and increasing Maximum urethral closure pressure (MUCP) (SMD = 0.86, 95%CI: 0.61-1.11, P = 0.000). Conclusion: TCM therapy is effective in improving urinary incontinence symptoms, urodynamics, and quality of life in patients with SUI. This article provides a reference for the application of TCM therapy in women with urinary incontinence.

RESUMEN Objetivo: Investigar la eficacia de la medicina tradicional china (MTC) en el tratamiento de la incontinencia urinaria de esfuerzo (IUE) femenina. Método: Se llevaron a cabo búsquedas de artículos publicados hasta septiembre de 2022 en las bases de datos PubMed, Cochrane, Web of Science, Embase, CNKI, Wanfang y VIP. Las variables se analizaron mediante la diferencia de medias ponderada (DMP), la diferencia de medias estandarizada (DME), la razón de momios (RM) y el intervalo de confianza (IC) del 95%. Resultados: Este estudio incluyó ocho investigaciones con la participación de 744 pacientes. Los resultados indican que la terapia de medicina tradicional china (MTC) presentó mejoras significativas en los resultados clínicos de pacientes con incontinencia urinaria de esfuerzo (IUE) (RM = 2.90, IC del 95%: 1.92-4.37, P = 0.000), al reducir la puntuación del Cuestionario Internacional sobre la Incontinencia y su impacto en la calidad de vida (ICIQ-SF) (DMP = -2.41, IC del 95%: -2.83- -1.98, P = 0.000), así como la disminución del volumen de orina a la 1 hora de fuga de la almohadilla urinaria (DMP = -1.86, IC del 95%: -2.23- -1.49, P = 0.000) y el aumento de la presión de cierre uretral máxima (PCUM) (DME = 0.86, IC del 95%: 0.61-1.11, P = 0.000). Conclusión: La terapia de medicina tradicional china (MTC) resulta efectiva en la mejora de los síntomas de la incontinencia urinaria, la urodinámica y la calidad de vida en pacientes con incontinencia urinaria de esfuerzo (IUE). Este artículo ofrece una referencia para la aplicación de la terapia de MTC en mujeres con incontinencia urinaria.

RESUMO Objetivo: Investigar a eficácia da medicina tradicional chinesa (MTC) no tratamento da incontinência urinária de esforço (IUE) feminina. Método: Foram realizadas pesquisas de artigos publicados até setembro de 2022 nas bases de dados PubMed, Cochrane, Web of Science, Embase, CNKI, Wanfang e VIP. As variáveis foram analisadas por meio da diferença de média ponderada (DMP), da diferença média padronizada (DMP), da razão de chances (RC) e do intervalo de confiança (IC) de 95%. Resultados: Esta pesquisa envolveu oito estudos, contando com a participação de 744 pacientes. Os resultados indicam que a terapia da medicina tradicional chinesa (MTC) apresentou melhorias significativas nos resultados clínicos de pacientes com incontinência urinária de esforço (IUE) (RM = 2.90, IC de 95%: 1.92-4.37, P = 0.000), ao reduzir a pontuação do Questionário Internacional sobre a Incontinência Urinária - Versão Breve (ICIQ-SF) (Diferença de Média Ponderada = -2.41, IC de 95%: -2.83- -1.98, P = 0.000), assim como na diminuição do volume de urina na 1 hora de vazamento do absorvente urinário (Diferença de Média Ponderada = -1.86, IC de 95%: -2.23- -1.49, P = 0.000) e no aumento da pressão máxima de encerramento uretral (PMCU) (Diferença Média Padronizada = 0.86, IC de 95%: 0.61-1.11, P = 0.000). Conclusão: A terapia da medicina tradicional chinesa (MTC) é eficaz na melhoria dos sintomas da incontinência urinária, na urodinâmica e na qualidade de vida em pacientes com incontinência urinária de esforço (IUE). Este artigo fornece uma referência para a aplicação da terapia da MTC em mulheres com incontinência urinária.

Treatment duration of wrist-ankle acupuncture for relieving post-thyroidectomy pain: A randomized controlled trial / 中西医结合学报

BACKGROUND@#Treatment duration of wrist-ankle acupuncture (WAA) is uncertain for post-thyroidectomy pain relief.@*OBJECTIVE@#This study evaluated the effect of different WAA treatment duration on post-operative pain relief and other discomforts associated with thyroidectomy.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This randomized controlled trial was conducted at a single research site in Guangzhou, China. A total of 132 patients receiving thyroidectomy were randomly divided into the control group (sham WAA, 30 min) and three intervention groups (group 1: WAA, 30 min; group 2: WAA, 45 min; group 3: WAA, 60 min), with group allocation ratio of 1:1:1:1. Acupuncture was administered within 1 hour of leaving the operating room.@*OUTCOMES AND MEASURES@#Primary outcome was patients' pain at the surgical site assessed by visual analogue scale (VAS) at the moment after acupuncture treatment (post-intervention). Secondary outcomes included the patients' pain VAS scores at 6, 12, 24, 48 and 72 h after the thyroidectomy, the 40-item Quality of Recovery (QoR-40) score, the grade of post-operative nausea and vomiting (PONV), and the use of additional analgesic therapy.@*RESULTS@#The adjusted mean difference (AMD) in VAS scores from baseline to post-intervention in group 1 was -0.89 (95% confidence interval [CI], -1.02 to -0.76). The decrease in VAS score at post-intervention was statistically significant in group 1 compared to the control group (AMD, -0.43; 95% CI, -0.58 to -0.28; P < 0.001), and in groups 2 and 3 compared to group 1 (group 2 vs group 1: AMD, -0.65; 95% CI, -0.81 to -0.48; P < 0.001; group 3 vs group 1: AMD, -0.66; 95% CI, -0.86 to -0.47; P < 0.001). The VAS scores in the four groups converged beyond 24 h after the operation. Fewer patients in group 2 and group 3 experienced PONV in the first 24 h after operation. No statistical differences were measured in QoR-40 score and the number of patients with additional analgesic therapy.@*CONCLUSION@#Compared with the 30 min intervention, WAA treatment with longer needle retention time (45 or 60 min) had an advantage in pain relief within 6 h after surgery. WAA's analgesic effect lasted for 6-12 h post-operatively. Please cite this article as: Han XR, Yue W, Chen HC, He W, Luo JH, Chen SX, Liu N, Yang M. Treatment duration of wrist-ankle acupuncture for relieving post-thyroidectomy pain: A randomized controlled trial. J Integr Med. 2023; 21(2): 168-175.

Efficacy of acupuncture on cardiovascular complications in patients with diabetes mellitus in Korea: A nationwide retrospective cohort / 中西医结合学报

OBJECTIVE@#The main aim of this study is to investigate whether acupuncture could be an effective complementary treatment for reducing the risk of macrovascular complications in diabetic patients currently taking antidiabetic medications using a nationwide population-based database.@*METHODS@#We conducted a retrospective cohort study to assess the efficacy of acupuncture on cardiovascular complications in diabetic patients using data from patients between 40 and 79 years of age, newly diagnosed with diabetes between 2003 and 2006, found in the National Health Insurance Service-National Sample Cohort (NHIS-NSC) in Korea. From the data, we identified 21,232 diabetic patients who were taking antidiabetic medication between 2003 and 2006. The selected patients were divided into two groups-those who received acupuncture at least three times and those who received no acupuncture (non-acupuncture) in the year following their diagnosis of diabetes. After 1:1 propensity score matching (PSM), each group had 3350 patients, and the observation ceased at the occurrence of a major adverse cardiovascular event (MACE), which was defined as either myocardial infarction, stroke, or death due to cardiovascular cause.@*RESULTS@#After PSM, the acupuncture group had a lower incidence of MACE (hazard ratio [HR]: 0.87; 95% confidence interval [CI]: 0.81-0.94; P = 0.0003) and all-cause mortality (HR: 0.77; 95% CI: 0.70-0.84; P < 0.0001) than the non-acupuncture group; the HRs for stroke-related mortality (HR: 0.75; 95% CI: 0.56-1.00; P = 0.0485), ischemic heart disease mortality (HR: 0.53; 95% CI: 0.34-0.84; P = 0.006) and circulatory system disease mortality (HR: 0.67; 95% CI: 0.55-0.82; P < 0.0001) were lower in the acupuncture group than in the non-acupuncture group in the secondary analysis.@*CONCLUSION@#Our results indicate that diabetic patients receiving acupuncture treatment might have a lower risk of MACE, all-cause mortality and cardiovascular mortality. This population-based retrospective study suggests beneficial effects of acupuncture in preventing macrovascular complications associated with diabetes. These findings call for further prospective cohort or experimental studies on acupuncture treatment for cardiovascular complications of diabetes. Please cite this article as: Jung H, Won T, Kim GY, Jang J, Yeo S, Lim S. Efficacy of acupuncture on cardiovascular complications in patients with diabetes mellitus in Korea: A nationwide retrospective cohort. J Integr Med. 2023; 21(2): 176-183.

Efficacy and safety of acupuncture for polycystic ovary syndrome: An overview of systematic reviews / 中西医结合学报

BACKGROUND@#Polycystic ovary syndrome (PCOS) is the primary cause of anovulatory infertility, bringing serious harm to women's physical and mental health. Acupuncture may be an effective treatment for PCOS. However, systematic reviews (SRs) on the efficacy and safety of acupuncture for PCOS have reported inconsistent results, and the quality of these studies has not been adequately assessed.@*OBJECTIVE@#To summarize and evaluate the current evidence on the efficacy and safety of acupuncture for PCOS, as well as to assess the quality and risks of bias of the available SRs.@*SEARCH STRATEGY@#Nine electronic databases (Cochrane Library, MEDLINE, Embase, PsycINFO, CINAHL, Chinese National Knowledge Infrastructure, Wanfang Data, Chongqing VIP Chinese Science and Technology Periodical Database, and China Biology Medicine disc) were searched from their establishment to July 27, 2022. Based on the principle of combining subject words with text words, the search strategy was constructed around search terms for "acupuncture," "polycystic ovary syndrome," and "systematic review."@*INCLUSION CRITERIA@#SRs of randomized controlled trials that explored the efficacy and (or) safety of acupuncture for treating patients with PCOS were included.@*DATA EXTRACTION AND ANALYSIS@#Two authors independently extracted study data according to a predesigned form. Tools for evaluating the methodological quality, risk of bias, reporting quality, and confidence in study outcomes, including A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Risk of Bias in Systematic Reviews (ROBIS), Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A), and the Grading of Recommendations Assessment, Development and Evaluation (GRADE), were used to score the included SRs.@*RESULTS@#A total of 885 studies were retrieved, and 11 eligible SRs were finally included in this review. The methodological quality of 2 SRs (18.18%) was low, while the other 9 SRs (81.82%) were scored as extremely low. Four SRs (36.36%) were considered to be of low risk of bias. As for reporting quality, the reporting completeness of 9 SRs (81.82%) was more than 70%. Concerning the confidence in study results, 2 study results were considered to have a high quality of evidence (3.13%), 14 (21.88%) a "moderate" quality, 28 (43.75%) a "low" quality, and 20 (31.24%) considered a "very low" quality. Descriptive analyses suggested that combining acupuncture with other medicines can effectively improve the clinical pregnancy rate (CPR) and ovulation rate, and reduce luteinizing hormone/follicle-stimulating hormone ratio, homeostasis model assessment of insulin resistance, and body mass index (BMI). When compared with medicine alone, acupuncture alone also can improve CPR. Further, when compared with no intervention, acupuncture had a better effect in promoting the recovery of menstrual cycle and reducing BMI. Acupuncture was reported to cause no adverse events or some adverse events without serious harm.@*CONCLUSION@#The efficacy and safety of acupuncture for PCOS remains uncertain due to the limitations and inconsistencies of current evidence. More high-quality studies are needed to support the use of acupuncture in PCOS.