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.

Discussion on acupuncture analgesia from the perspective of acupuncture regulating mind / 中国针灸

To explore the regulating effect of acupuncture on pain based on the three dimensions of pain (pain sensation, pain emotion and pain cognition). The pain sensation is related to the body, the pain emotion is related to the seven emotions, the pain cognition is related to the mind of the five zang, and the three dimensions of pain interact with each other. Through the two ways of "regulating qi to treat mind" and "treating mind to regulate qi ", acupuncture comprehensively acts on pain sensation, pain emotion and pain cognition to achieve comprehensive regulation of pain.

Tratamento imediato da dor e limitação de abertura bucal nas disfunções temporomandibulares, através da Medicina Tradicional Chinesa (MTC) / Immediate treatment of pain and limitation of mouth opening in temporomandibular disorders through Traditional Chinese Medicine (TCM)

Disfunção Temporomandibular (DTM) apresenta-se como principal causa de dores orofaciais de origem não dentária. A acupuntura é indicada para o alívio de da dor em casos de DTM muscular, baseada em propriedades anti-inflamatórias com efeitos neuro-hormonais. Objetivou-se nesta pesquisa a avaliação da eficácia da acupuntura como um método válido para redução imediata da sintomatologia dolorosa e limitação de abertura bucal nos casos de DTM. Realizou-se terapia acupuntural em 30 pacientes com DTM, avaliando-se a dor, a partir da Escala Verbal (EV) e da Escala Analógica Visual (EAV) e a limitação de abertura bucal com o auxílio de paquímetro digital antes e após a terapia para registro da análise. O aumento da média de abertura bucal foi de 9,2% no total de participantes. Quanto à sintomatologia dolorosa, apresentou redução média em 63%. Na EV, 27 dos pacientes tiveram resposta "moderada" e "intensa" para sensação dolorosa. Contudo, após a terapia, observou-se ausência de sensação dolorosa intensa. Os dados apontaram significância da terapia acupuntural para redução dor e limitação de abertura bucal, de forma imediata, em pacientes com DTM... (AU)

Temporomandibular Disorder (TMD) is the main cause of orofacial pain of non-dental origin. Acupuncture is indicated for pain relief in cases of muscle TMD, based on anti-inflammatory properties with neuro hormonal effects. The aim of this research was to evaluate the effectiveness of the acupuncture as a valid method for immediate reduction of painful symptoms and mouth opening limitation in TMD cases. Acupuncture therapy was performed in 30 patients with TMD, evaluating pain from the Verbal Scale (VE) and Visual Analog Scale (VAS) and mouth opening limitation with the aid of a digital caliper before and after therapy to record the analysis. The increase in the average mouth opening was 9.2% in the total number of participants. As for painful symptoms, an average reduction of 63%. In IV, 27 of the patients had "moderate" and "intense" responses to painful sensation. However, after therapy, the absence of intense painful sensation was observed. The data showed the significance of acupuncture therapy for immediate pain reduction and mouth opening limitation in patients with TMD... (AU)

Initiation of Acupoint Molecular Mechanisms for Manual Acupuncture Analgesia-Nuclear Factor κB Signaling Pathway / 中国结合医学杂志

OBJECTIVE@#To identify the prominent molecular signaling in acupoints and explore their roles in initiating the analgesia effect of manual acupuncture (MA).@*METHOD@#A three-step study was conducted, the experiment 1 was a genome-wide analysis of the tissue at acupoint Zusanli (ST 36), including 12 Wistar rats which were divided into control, control+MA1, and control+MA7 groups. In the experiment 2, the paw withdrawal latency (PWL), immunohistochemistry and Western blot analysis of phospho-nuclear factor kappa B (NFκB) p65 (p-p65), phospho-NFκB p50 (p-p50) at ST 36 were performed on rats of saline, saline+MA, and complete Freund's adjuvant (CFA)+MA groups (n=6). In experiment 3, 24 rats were divided into saline+DMSO, CFA+DMSO, CFA+DMSO+MA, and CFA+BAY 11-7082+MA groups, the PWL and immunofluorescence assay of NFκB p65 at ST 36 was conducted.@*RESULT@#(1) The gene: inhibitor of NFκB (Nfkbia), interleukin-1β (Il1b), interleukin-6 (Il6), chemokine c-x-c motif ligand 1 (Cxcl1), monocyte chemoattractant protein-1 (MCP-1/Ccl2) expressions in the control+MA7 group were significantly increased (P<0.05 or P<0.01), and the expression of NFκB p65 (Rela), NFκB p50 (Nfkb1) were increased in the control+MA7 group (P<0.05). (2) CFA+MA groups showed increased PWL from day 1 to 7 (P<0.01 vs. CFA), and the Western blot results were consistent with immunohistochemistry, the expression of NFκB p-p65 and NFκB p-p50 were significantly increased in the MA-related groups compared with control and CFA groups (P<0.05). (3) Compared with the CFA+DMSO+MA group, the PWL of the CFA+ BAY 11-7082+MA group decreased significantly and continued until day 5 and 7 (P<0.05 and P<0.01, respectively), and the NFκB p65 expression of CFA+BAY 11-7082+MA was significantly reduced compared with CFA+DMSO+MA (P<0.01).@*CONCLUSION@#Local NFκB signaling cascade in acupoint caused by MA is an important step in initiating the analgesic effect, which would provide new evidence for the initiation of MA-effect and improve the understanding of the scientific basis of acupuncture analgesia.

Profesionalización de la acupuntura y sus implicaciones en la salud de los pacientes / Acupuncture professionalisation and patients health implications

Introducción: la acupuntura humana es una terapia complementaria en la atención para la salud. Derivado de su alta demanda en gran parte del mundo la OMS fijo su postura a favor de la Medicina Tradicional y Complementaria (MTC) con la publicación "Estrategia sobre medicina tradicional 2014-2023", ésta se centra en dos objetivos: brindar apoyo a los Estados Miembros en la contribución de la MTC en la salud, bienestar y atención centrada en las personas y promover su utilización de forma segura y eficaz; mediante la reglamentación de productos, prácticas y profesionales capacitados. Desarrollo: la estrategia plantea la necesidad de que toda práctica de MTC sea realizada con formación universitaria, sin embargo, solo el 30% de los países miembros (39) cuentan con ella universitaria y 56% (72) tienen reglamentos para su práctica en acupuntura. En México se imparten diversos cursos y diplomados de MTC, a nivel técnico, licenciatura, especialidad y posgrado, con diferentes horas curriculares. Asimismo, cuenta con políticas de regulación sobre acupuntura y sus técnicas. Conclusión: la acupuntura tiene sustento científico en la anatomía y neurofisiología. Debe ser aplicada por profesionales del área de salud y con formación certificada por una institución de reconocido prestigio.

Efectividad de la analgesia quirúrgica acupuntural en pacientes operados de catarata / Effectiveness of the acupunctural surgical analgesia in patients operated for cataract

Introducción: La catarata constituye una de las principales causas de ceguera a escala mundial. Es más frecuente en los ancianos y el tratamiento de elección es el quirúrgico. Objetivo: Evaluar la efectividad de la analgesia acupuntural en pacientes operados de catarata. Métodos: Se realizó un estudio de intervención terapéutica en 136 pacientes mayores de 40 años con diagnóstico de catarata, operados en el Servicio de Oftalmología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba en el período 2016-2018. La muestra se dividió aleatoriamente en 2 grupos (de estudio y de control), con 68 integrantes cada uno. Resultados: Predominaron los pacientes de 70 años y más y del sexo femenino. Las variables hemodinámicas no sufrieron modificaciones significativas con el proceder terapéutico. Conclusiones: La analgesia quirúrgica acupuntural fue más efectiva que la convencional, pues se logró una sedación mayor en casi la totalidad de los pacientes durante la operación, así como mayor permanencia de su efecto durante el período posoperatorio; asimismo, hubo menor número de afectados con edema y hemorragia.

Introduction: The cataract constitutes one of the main causes of blindness worldwide. It is more frequent in the elderly and the election treatment is the surgical one. Objective: To evaluate the effectiveness of the acupunctural analgesia in patients operated for cataract. Methods: A study of therapeutic intervention was carried out in 136 patients older than 40 years with diagnosis of cataract, operated in the Ophthalmology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba in the period 2016-2018. The sample was divided at random in 2 groups (study and control), with 68 members each one. Results: The 70 years and over patients of the female sex prevailed. The hemodynamic variables didn't suffer significant modifications with the therapeutical procedure. Conclusions: The acupunctural surgical analgesia was more effective than the conventional one, because a higher sedation was achieved in almost all the patients during the operation, as well as higher permanency of its effect during the postoperatory period; also, there was smaller number of patients affected with edema and hemorrhages.

Efeito da acupuntura para alívio dos desconfortos físicos e emocionais na gestação / The effect of acupuncture on the relief of physical and emotional discomfort during pregnancy / Efecto de la acupuntura para alivio de los desconfortos fisicos y emocionales en la gestión

Objetivo: analisar os efeitos da acupuntura nos desconfortos físicos e emocionais presentes na gestação. Método: estudo transversal realizado com 45 gestantes do segundo e terceiro trimestre gestacional, atendidas no pré-natal de risco habitual e que realizaram sessões de acupuntura. Cada gestante fazia duas sessões por semana com duração de 30 minutos cada uma. Resultados: evidenciou-se que, após seis sessões de acupuntura, utilizando os pontos sistêmicos B57, B40, VB30, B23, B60, VG20 e pontos de auriculoterapia: Shemen, lombar e ciático, houve uma significativa melhoria de diversas queixas comuns na gestação, relatadas pelas participantes, como: relaxamento do corpo (97,8%); mudança do estresse (82,2%); sono (86,7%); estado de humor (82,2%); paciência (80%); energia (77,8); ansiedade (66,7%), dentre outros. Conclusão: a acupuntura contribuiu positivamente na melhoria de sintomas físicos e emocionais referidos pelas gestantes, podendo ser usada como alternativa para a promoção da saúde gestacional

Objective: to analyze the effects of acupuncture on physical and emotional discomfort present during gestation. Method: cross-sectional study carried out with 45 pregnant women in the second and third gestational trimesters receiving prenatal care for pregnancy of normal risk who underwent acupuncture sessions. Each pregnant woman attended two sessions per week with a duration of 30 minutes each. Results: after six sessions of acupuncture using the B57, B40, VB30, B23, B60, VG20 systemic points and the Shemen, lumbar and sciatic auriculotherapy points, there was a significant improvement in several common gestational complaints reported by the participants, such as: body relaxation (97.8%); change in stress levels (82.2%); sleep (86.7%); mood (82.2%); patience (80%); energy (77.8); anxiety (66.7%), among others. Conclusion: acupuncture contributed positively to the improvement of the physical and emotional symptoms mentioned by the pregnant women and can be used as an alternative for the promotion of gestational health

Objetivo: analizar los efectos de la acupuntura en las molestias físicas y emocionales presentes en la gestación. Método: estudio transversal realizado con 45 gestantes del segundo y tercer trismestre gestacional, atendidas en el pre natal de riesgo habitual y que realizaron sesiones de acupuntura. Cada gestante hacía dos sesiones por semana con una duración de 30 minutos cada una. Resultados: en la mayoría de los casos, se observó que, después de seis sesiones de acupuntura, utilizando los puntos sistémicos B57, B40, VB30, B23, B60, VG20 y puntos de auriculoterapia: Shemen, lumbar y ciático, hubo una significativa mejora de diversas quejas comunes en la gestación, de las participantes, como: relajación del cuerpo (97,8%); cambio del estrés (82,2%); (86,7%); estado de humor (82,2%); (80%); energía (77,8); la ansiedad (66,7%), entre otros. Conclusión: la acupuntura contribuyó positivamente en la mejora de los síntomas físicos y emocionales referidos por las gestantes, pudiendo ser usada como alternativa para la promoción de la salud gestacional

Perioperative acupuncture medicine: a novel concept instead of acupuncture anesthesia / 中华医学杂志(英文版)

OBJECTIVE@#To confirm that acupuncture applied to patients would improve the clinical curative effect and accelerate the patient's recovery by introducing the application of acupuncture in pre-operation, during operation, and post-operation.@*DATA SOURCES@#Literature cited in this review was retrieved from PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) and was primarily published in English or Chinese from 2010 to 2018, with keywords of "acupuncture," "electroacupuncture," "perioperative period," "sedation," "analgesia," and "recovery." Relevant citations in the retrieved articles were also screened to include more data.@*STUDY SELECTION@#All retrieved literature was scrutinized, most typical articles related on perioperative acupuncture application in clinical study were reviewed.@*RESULTS@#Acupuncture could relieve anxiety and stress during the preoperative stage. It reduces the usage of narcotics and stress response, and maintains the respiratory stability and homeostasis during surgery. It also exerts a protective effect on vital organs, and during the postoperative stages, enhances the recovery while effectively alleviating the postoperative pain. This phenomenon prevents common postoperative discomforts such as nausea and vomiting. In addition, it might improve the patients' long-term prognosis.@*CONCLUSIONS@#The novel concept "perioperative acupuncture medicine" is to focus on the optimal treatment in the perioperative period of surgical patients. The review reveals the important role of acupuncture in enhancing rapid recovery of patients during the perioperative period.

Systematic review and analysis on the appropriate diseases in clinical treatment with 's subcutaneous needling therapy / 中国针灸

The clinical research articles relevant with 's subcutaneous needling therapy (FSN) were retrieved from CNKI, WANFANG, CBM and PubMed databases till January 2018 since the establishment of database. According to the general international criteria of disease classification, the diseases involved in the articles were classified and summarized. In terms of the clinical application and research of FSN, the questions were extracted and commented through expert's consultation. As a result, 412 articles were included. The statistical results of disease spectrum indicated that FSN was adopted in 65 kinds of diseases in 11 systems. Of these diseases, the relevant somatic pain disorders in the musculoskeletal system were the most appropriate. Professor explained that the clinical physicians of FSN should select the muscle-related disorders as the clinical research subject and treat them with normalized manipulation of FSN. The research on FSN is still at the preliminary stage. It needs more high-quality clinical and basic researches to provide the evidences for the therapeutic effects of FSN.

Wrist-ankle needle combined with opioid drugs on refractory cancer pain: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect of wrist-ankle needle combined with opioid drugs and opioid drugs alone in treating refractory cancer pain.@*METHODS@#Sixty patients were randomly divided into an observation group and a control group, 30 cases in each one. The opioid drugs in accordance with the three-step analgesic principle and other auxiliary drugs were treated in the control group. On the basis of the treatment in the control group, wrist-ankle needle was added in the observation group, and acupoints were selected according to the pain site and the primary focus, the treatment was given once a day for 10 days. The visual analogue scale (VAS) score, the times of pain outbreaks and the incidence of adverse reactions were compared at the 2nd, 4th, 6th, 8th and 10th days of treatment and the 3rd and 7th days after treatment. The therapeutic effect in the two groups were compared after treatment.@*RESULTS@#Compared with the control group, the VAS scores in the observation group were significantly reduced from the 2nd day of wrist-ankle needle treatment, and continued to the 3rd day after the end of the treatment (0.05); compared with the control group, the times of pain outbreaks in the observation group decreased from the 2nd day to the 10th day of treatment (all <0.05); the incidence of nausea, vomiting and constipation in the observation group was significantly reduced compared with the control group (<0.05); the total effective rate in the observation group was 86.7% (26/30), which was higher than 76.7% (23/30) in the control group (<0.05).@*CONCLUSION@#Wrist-ankle needle combined with opioid drugs can increase the efficacy of the refractory cancer pain and reduce the adverse reactions of opioid drugs.

Efectividad de la acupuntura con microsistema de cara como tratamiento de pacientes con cefalea migrañosa / Effectiveness of Acupuncture with a Facial Microsystem as a Treatment for Patients with Migraine Headache

RESUMEN Introducción: La cefalea es uno de los trastornos más comunes del sistema nervioso en todo el mundo, frecuentemente es signo de otras enfermedades. Mientras la medicina occidental trata los síntomas con medicamentos, los médicos alternativos tratan la causa con acupuntura para proporcionar alivio duradero. Objetivo: Evaluar la efectividad de la acupuntura con microsistema de cara como tratamiento de pacientes con cefalea migrañosa. Métodos: Estudio cuasiexperimental de tipo casos-controles con 100 pacientes que asistieron a la Clínica del Dolor del Hospital "Dr. Ambrosio Grillo Portuondo", en Santiago de Cuba, con diagnóstico de cefalea migrañosa, desde enero de 2014 a noviembre de 2015. Al grupo estudio se aplicó acupuntura con microsistema de cara; al grupo control, medicamentos. La información se obtuvo de las historias clínicas, el dolor se valoró con la escala analógica visual del dolor. Se aplicó Ji cuadrado de homogeneidad para la identificar diferencias significativas entre las proporciones de efectividad de uno y otro tratamiento, con un nivel de significación (α;= 0,05). Resultados: Predominó el sexo femenino (70,00 por ciento), el grupo etareo 18-39 años, de ellos 40 en el grupo estudio (80,00 por ciento), 43 en el control (86,00 por ciento). En el grupo estudio el 82,00 por ciento de los pacientes quedó sin dolor desde la primera sesión del tratamiento, el 18,00 por ciento con dolor disminuido. Al final del tratamiento el 98,00 por ciento del grupo estudio quedó sin dolor contra el 96,00 por ciento del grupo control. Conclusión: La acupuntura con microsistema de cara es un método alternativo efectivo en el tratamiento de la cefalea migrañosa(AU)

ABSTRACT Introduction: Headache is one of the most common nervous system disorders worldwide. It is frequently a sign of other diseases. While Western medicine treats symptoms with medications, alternative practitioners treat the cause with acupuncture to provide long-lasting relief. Objective: To evaluate the effectiveness of acupuncture with a facial microsystem as a treatment for patients with migraine headache. Methods: Quasiexperimental case-control study with 100 patients who attended the Pain Clinic at Dr. Ambrosio Grillo Portuondo Hospital in Santiago de Cuba, with a diagnosis of migraine headache, from January 2014 to November 2015. The study group was applied acupuncture with a facial microsystem. The control group was treated with medicines. The information was obtained from the medical records. The pain was assessed using the Visual Analogue Scale. Chi-square test of homogeneity was applied in order to identify significant differences between the proportions of effectiveness of one treatment and another, with a level of significance α =0.05. Results: There was predominance of the female sex (70.00 percent), age group 18-39 years, among them 40 in the study group (80.00 percent) and 43 in the control group (86.00 percent). In the study group, 82.00 percent of patients remained without pain from the first session of treatment and 18.00 percent with pain decreased. At the end of the treatment, 98.00 percent of the study group remained without pain in opposition to 96.00 percent of the control group. Conclusion: Acupuncture with a facial microsystem is an effective alternative method in the treatment of migraine headache(AU)

Avaliação da dor frente à técnica de eletroacupuntura em crianças com disfunções miccionais / Pain evaluation in relation to the electroacupuncture in children with voiding dysfunctions

Introdução: as disfunções miccionais possuem alta incidência entre as crianças, com potencial de afetar a qualidade devida destes indivíduos. É necessária a avaliação das terapêuticas utilizadas para tratar este problema quanto a sua capacidade de gerar dor. Objetivo: Avaliar a existência de dor nas crianças com distúrbios miccionais submetidas à técnica de eletroacupuntura.Método: Estudo avaliativo de abordagem quantitativa realizado em abril e maio de 2011 com 24 crianças em tratamento com eletroacupuntura em um Centro de Distúrbios Miccionais na Infância da cidade de Salvador-BA. Resultados: Em todas as sessões foi constatada presença de dor, contudo esta foi predominantemente caracterizada como leve e sua prevalência foi maior na primeira sessão e no momento inicial desta. Conclusão: O procedimento tem potencial de gerar dor em crianças e é necessária a adoção de medidas que atenuem este sintoma, de forma a melhorar a assistência e promover maior aceitação do tratamento.

Introduction: the miccional dysfunctions have high incidence among children, with potential of affecting thequality of life of these patients. It’s necessary the evaluation of therapeutic used to treat this problem regarding the ability toproduce pain. Objective: To evaluate the existence of pain in children with miccional dysfunctions submitted to the technique of electoacupuncture. Method: Evaluative study with quantitative approach carried on in April and May 2011 with 24 children intreatment with electoacupuncture in a Center of Miccional Disorders in Childhood in the city of Salvador-BA. Results: In all sessionspresence of pain was observed, however it was predominantly characterized as mild pain and its prevalence was higher in the firstsession and in the beginning of this. Conclusion: The procedure has the potential to generate pain in children and it’s necessary to adopt measures that decrease the pain, improving care and the acceptance of the treatment.

Objetivo: identificar los factores que ocasionan la caída en los ancianos, considerando consecuencias, y describiendocambios ocurridos en la vida diaria de los ancianos que son asistidos por la Estrategia Salud de la Familia. Método: se trata de unainvestigación descriptiva exploratoria, con abordaje cuantitativo con corte transversal. Se realizó con ancianos con 60 o más de edad.Ancianos atendidos en la Estrategia Salud de la Familia, en el período de octubre / 2017. En la mayoría de los casos, se observó queel 43,59% (n=17) tenía una edad comprendida entre 60 a 69 años incompletos, cuando se observó la variable acceso a la Unidadde Salud se observó que el 64,10% (n=25) se refiere a tener buen acceso, cuando se verifica la variable ya cayó se observó que el84,62% (n=33) respondieron sí. Conclusión: La caída es un evento de causa multifactorial, con factores extrínsecos e intrínsecosrelacionados de alta complejidad terapéutica y de difícil prevención, exigiendo de esa forma un abordaje multidisciplinario y unaasistencia continúa la salud de anciano por medio de estrategia.

Extracción dentaria con analgesia acupuntural / Dental extraction acupuntural analgesia

Se realizó un estudio de intervención terapéutica durante el periodo comprendido de junio de 2015 a junio de 2016 en 29 pacientes que presentaron necesidad de extracción dentaria en la Clínica Estomatológica "Ramón Guevara Montano" de Baracoa, Guantánamo, con la finalidad de evaluar la evolución clínica de dichos pacientes con esta técnica de tratamiento. Los pacientes fueron incluidos en la muestra según el orden de recepción luego de su consentimiento informado. Se utilizaron las variables: dolor, limpieza del campo operatorio, complicaciones post extracción dentaria y reparación tisular. La evolución clínica de los pacientes fue satisfactoria(AU)

A study of therapeutic intervention was conducted during the period from June 2015 to June 2016 in 29 patients who presented a need for tooth extraction at the "Ramón Guevara Montano" Stomatology Clinic in Baracoa, Guantanamo, The patients were included in the sample according to the reception order after their informed consent. The variables were used: pain, cleaning of the operative field, complications after tooth extraction and tissue repair. The clinical evolution of the patients was satisfactory(AU)

Acupoint selection for acupuncture analgesia based on the relationship of "the opening-closing- pivoting theory" with meridians and organs / 中国针灸

"The opening-closing-pivoting theory" recorded in () visualizes the activity of six meridians and indicates the relationship among the six meridians in physiology and pathology. Through the analysis on the classic medical works and modern literature of TCM by the modern medical masters, a specific relationship is discovered among the hand and foot meridians of the same name and among the organs. The is corresponded and interacted among the hand and foot meridians of the same name. Except the exterior and interior relationship among the organs, the related communication is also existing. Both meridians and organs are closely related to "the opening-closing- pivoting" theory. This discovery is the inheritance and development of "the opening-closing-pivoting theory" and plays the important role in the guidance of the acupoint selection of clinical acupuncture analgesia.

Analgesia acupuntural en la actividad quirúrgica. Realidad práctica alternativa / Acupunctural analgesia in surgical activity. Alternative practical reality

La acupuntura es un método de tratamiento basado en la estimulación neural periférica, la cual actúa en tres niveles del sistema nervioso central: espinal, tronco encefálico y diencéfalo, en los que se involucran núcleos cerebrales (reticular del bulbo y magno de rafe), áreas del sistema límbico, neurotransmisores como serotonina, noradrenalina y acetilcolina que favorecen la liberación de neuropéptidos como las encefalinas y endorfinas las que juega un papel fundamental en la modulación de la transmisión del estímulo doloroso, lo que permite elevar el umbral del dolor; el cual constituye la base de la analgesia quirúrgica acupuntural, teniendo en cuenta las principales teorías occidentales que tratan de explicar los mecanismos de supresión de dolor se abordan las bases neurofisiológicas de esta técnica milenaria.

Acupuncture is a treatment method based on peripheral neural stimulation, which acts on three levels of the central nervous system: spinal, brain stem and diencephalon, involving brain nuclei (reticular bulb and magne of raphe), areas of the limbic system, neurotransmitters such as serotonin, noradrenaline and acetylcholine, favoring the release of neuropeptides such as enkephalins and endorphins, which plays a key role in modulating the transmission of painful stimuli, thus raising the pain threshold; Which is the basis of acupuncture surgical analgesia, taking into account the main western theories that try to explain the mechanisms of pain suppression, the neurophysiological bases of this millenarian technique are approached.

Golpe del espolón calcáneo complementado con electroacupuntura / Calcaneal spur shockwave complemented with electroacupuncture

El síntoma más importante del espolón calcáneo es el dolor, que se agrava con la carga estando el paciente parado o caminando; localizado en la zona del talón y de rara irra­diación. Se hace presentación de caso: mujer de 47 años de edad, sobrepeso, larga estancia de pie laborando en una cafetería, con espolón calcáneo y la descripción técnica de un único golpe en región plantar, complementado con electroacupuntura por su efecto analgésico y antiinflamatorio. La técnica se aplica por personal calificado y especializado de salud pública(AU)

The most important symptom of the calcaneal spur is pain, which worsening with the weight charge as the patients is standing up or walking; located in the heel area and of rare irradiation. Case presentation: women of 47 years of age, overweight, long time standing up as she works in a cafeteria, with a calcaneal spur and the technical description of an only plantar region shockwave, complemented with electroacupuncture for its analgesic and anti-inflammatory effect. The technique was applied by the qualified and specialized public health personal(AU)

Uso de Terapias Complementarias en el Tratamiento de Pacientes con Lumbalgia Crónica del Seguro Social de Salud. La Libertad, 2009 / Use of complementary therapies in the treatment of chronic low back pain in patients from Peruvian Health Insurance (EsSalud). La Libertad, 2009

Objetivo: Describir las variaciones en el consumo de analgésicos en pacientes con lumbalgia crónica que recibieron terapias con medicina complementaria. Materiales y métodos: Estudio descriptivo. Se realizó en el Centro de Atención de Medicina Complementaria (CAMEC) ­ La Libertad en el periodo marzo-mayo de 2009, de seis semanas de seguimiento en 45 pacientes que recibieron terapias con medicina complementaria. Se incluyeron pacientes con diagnóstico de lumbalgia mayor de 12 semanas y tratamiento farmacológico activo. Se evaluaron características clínico-epidemiológicas, factores de riesgo asociados (obesidad, estrés, sedentarismo, polifarmacia), tiempo de enfermedad, terapia utilizada, disminución del consumo de analgésicos y el grado de satisfacción. Resultados: Un 77,8% presentó el diagnóstico de lumbalgia crónica inespecífica. Las terapias complementarias más indicadas fueron acupuntura, masoterapia y fitoterapia; en su mayoría de modo combinado. En seis semanas de seguimiento el 93,3% de la población redujo, en alguna medida, la dosis habitual de analgésicos; mientras que el 40% suspendió totalmente su consumo. El 86,7% de los pacientes manifestaron haber obtenido resultados excelentes o buenos después de la aplicación de terapias alternativas. Conclusiones: El uso de terapias complementarias en el tratamiento de la lumbalgia crónica disminuye el uso de analgésicos y brinda una percepción de satisfacción en los pacientes.

Improving the synergy of muscle movement is one of the important mechanisms in acupuncture analgesia / 中国针灸

The efficacy of acupuncture for pain diseases is significant, however, the unified understanding re garding mechanisms of acupuncture analgesia has not been fully reached. In this paper, it is believed that uncoordi nated muscle movement is one of the important causes for pain, while acupuncture could enhance the contact of nerve cells and improve the synergy of muscle movement, so as to achieve the aim of pain relief and even cure.

Analgesic and Sedative Effect of Acupuncture Combined with Medicine on Patients Undergiong Cardiac Surgery / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe analgesic and sedative effect of acupuncture combined with medicine (ACM) on patients undergiong cardiac surgery.</p><p><b>METHODS</b>A total of 50 patients with cardiac surgery from January 2012 to October 2014 were randomly assigned to the conventional analgesia group (group A) and the ACM analgesia group (group B), 25 in each group. Patients in group A were subjected to analgesia and sedation by injecting dexmedetomidine, while patients in group B were subjected to analgesia and sedation by electro-acupuncture [EA, Shenting (GV24); Yintang (EX-HN3)] combined with injection of dexmedetomidine. Morphine hydrochloride injection was performed when analgesia and sedation effect was ineffective in the two groups. The indicators of patients at different time points in the two groups were observed, such as static and dynamic VAS scores, SAS scores, mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2). The injection dosage of dexmedetomidine and morphine hydrochloride, analgesia satisfaction rate, sedation satisfaction rate, the incidences of adverse reactions during treatment such as bradycardia and low blood pressure, mechanical ventilation time, ICU time, and hospitalization expense were observed and recorded in the two groups.</p><p><b>RESULTS</b>There was no statistical difference in static and dynamic VAS scores, SAS score, MAP, HR and SpO2 between the two groups at different time points (P > 0.05). The injection dosage of dexmedetomidine and morphine hydrochloride was significantly reduced in group B than in group A (P < 0.05). The analgesia satisfaction rate of patients in group B was much higher than that in group A (P < 0.05). The incidence of bradycardia also obviously decreased more in group B than in group A (P < 0.05). There was no statistical difference in patients' sedation satisfaction rate, incidences of low blood pressure, delirium, vomiting; mechanical ventilation time, ICU time, or hospitalization expense between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>The analgesia method of ACM could reduce the dosage of traditional analgesic drugs and the occurrence of partial adverse reactions.</p>