Efficacy comparison between acupuncture and other modalities in the treatment of rotator cuff diseases: meta-analysis of randomized controlled trials.

OBJECTIVE: This study aimed to analyze the efficacy of acupuncture alone or combined with physical therapy compared to other treatment interventions for relieving pain and improving function in rotator cuff diseases. METHODS: Our study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After PROSPERO (CRD42023396740) registration, all randomized controlled trials (RCTs) published from the inception of the databases to October 10, 2023, evaluating the efficacy of acupuncture either alone or in combination with physical therapy for treating rotator cuff diseases, were extracted from seven databases, including PubMed, Embase, the Web of Science, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), the VIP Database for Chinese Technical Periodicals (VIP), and the Wanfang Date. Two independent researchers assessed the quality of the included studies and extracted relevant data. Furthermore, a meta-analysis was conducted using Stata 14 software. RESULTS: We included 13 RCTs - 12 published in English and 1 in Chinese - that enrolled 1,371 patients. The meta-analysis results demonstrated that acupuncture alone or in combination with physical therapy was superior to other interventions for short-term shoulder joint function improvement (standardized mean difference [SMD] = -0.82, 95% confidence interval [95% CI]: -1.28 to -0.35, P = 0.001), medium-term shoulder joint function improvement (SMD = -1.00, 95% CI: -1.62 to -0.38, P = 0.002), short-term pain relief (weighted mean difference [WMD] = -1.37, 95% CI: -2.39 to -0.38, P = 0.006), medium-term pain relief (WMD = -1.66, 95% CI: -2.70 to -0.63, P = 0.002), and post-treatment shoulder joint abduction improvements (SMD = 0.68, 95% CI: 0.20 to 1.16, P = 0.005), external rotation (SMD = 0.62, 95% CI: 0.13 to 1.11, P = 0.012), and forward flexion (SMD = 0.71, 95% CI: 0.44 to 0.97, P < 0.001), with significant differences (P < 0.05). CONCLUSION: Based on the current clinical data, meta-analysis showed that acupuncture alone or combined with physical therapy is efficacious for short- and medium-term (< 3 months) pain relief and functional improvements. However, compared to other interventions, the efficacy of the long-term (3 to 12 months) period did not significantly differ. After treatment, these modalities displayed advantages such as improved shoulder joint abduction, external rotation, and forward flexion movements. However, no significant difference was noted in internal rotation movement. Thus, future studies might further investigate whether different acupuncture methods affect the efficacy of treating rotator cuff diseases and improving long-term outcome.

Pediatric tuina for recurrent respiratory tract infection in children: A systematic review and meta-analysis.

BACKGROUND: To evaluate the effects and safety of pediatric tuina for recurrent respiratory tract infections (RRTIs). METHODS: Web of Science, PubMed, Cochrane Library, Embase, CNKI, Wanfang Data, VIP, and CBM databases were searched from inception to September 20 2023. Two authors independently selected studies, collected data, and evaluated methodological quality using the Cochrane Risk of Bias tool. Revman 5.4 was used for the meta-analysis. RESULTS: Fifteen randomized controlled trials involving 1420 pediatric patients were included in this meta-analysis. The meta-analysis indicated that pediatric tuina significantly reduced the incidence of RRTIs [MD -1.11, 95% confidence interval (CI) (-1.77, -0.46)], decreased infection duration (MD -1.16 days, 95% CI [- 1.66, - 0.66]), improved IgA (MD 0.25 g/L, 95% CI [0.09, 0.41]), IgG (MD 1.64 g/L; 95% CI [0.82, 2.45]), CD3+ (MD 3.33%, 95% CI [0.74, 5.92]), CD4+ (MD 4.78%, 95% CI [2.08, 7.48]), CD4+/CD8+ ratio (MD 0.27%, 95% CI [0.08, 0.47]), and total effective rate (RR 1.19, 95% CI [1.13, 1.25]). However, IgM levels (MD 0.26 g/L, 95% CI [-0.26, 0.81]) and CD8+ (MD -1.36%, 95% CI [- 3.12, 0.41]) were not significantly different between the groups. Moreover, no Tuina-linked adverse reactions were observed. CONCLUSION: Pediatric tuina has shown positive effects in RRTIs treatment. However, these results should be interpreted with caution owing to study quality. Further large-scale and high-quality randomized controlled trials are warranted to confirm these findings.

Abdominal Massage Improves the Symptoms of Irritable Bowel Syndrome by Regulating Mast Cells via the Trypase-PAR2-PKCε Pathway in Rats.

Background: Irritable bowel syndrome (IBS) is a clinical disease mainly characterized as a syndrome of abdominal pain and discomfort, which frequently occurs in humans aged 20-50. Abdomen massage is of great medical significance for the health of the human body, including promoting intestinal peristalsis, relieving constipation, and facilitating weight loss. However, its potential benefits in alleviating IBS and the underlying mechanisms remain elusive. Methods: In this study, we established an IBS model in rats to evaluate the effects of abdomen massage. Forty male Sprague Dawley (SD) rats were randomly assigned into 4 groups: the normal (control) group, IBS group, abdominal massage group, and abdominal massage + ketotifen treatment group (n = 10 rats in each group). Abdominal massage was performed once a day for 5 minutes for 14 days. On day 14, the rats were euthanized and the tissues were analyzed by transmission electron microscopy (TEM), immunohistochemistry or immunofluorescence staining, and laser confocal focus to visualize the micromorphology of the intestinal mucosa. The expression of TRPV1 and the release of trypase were determined by RT-qPCR and western blot. Results: We found that compared with the control group, the mast cells in the IBS group were significantly increased and the increased MC was partially decreased by an abdominal massage with or without ketotifen treatment. We also found that TRPV1 was upregulated in the IBS group. Abdominal massage with or without ketotifen treatment could attenuate the upregulation of TRPV1 in IBS. Mechanically, results of IHC and western Blot suggested that abdominal massage reduces the sensitivity of IBS by regulating the trypase-PAR2-PKCε pathway. Conclusion: Overall, our results suggested that abdominal massage produces a beneficial effect in improving the symptoms of IBS through reducing mast cell recruitment and attenuating the trypase-PAR2-PKCε pathway. Ketotifen could promote the effect of abdominal massage on IBS treatment, which can serve as a potential therapeutic strategy for IBS.

Lactobacillus johnsonii BS15 combined with abdominal massage on intestinal permeability in rats with nonalcoholic fatty liver and cell biofilm repair.

This study aimed to analyze the effect of lactobacillus johnsonii BS15 (isolation of homemade yogurt from Ahu Hongyuan Grassland) combined with abdominal massage on intestinal permeability in rats with nonalcoholic fatty liver disease (NAFLD) and cell biofilm repair. Forty-five rats were divided randomly into five groups, four of which were fed with high-fat diet to establish NAFLD models. According to the treatment methods, they were grouped into group A (lactic acid bacteria feeding), group B (abdominal massage), group A + B (a combination of the two methods), model group (distilled water feeding), and normal group (distilled water feeding). Then, the pathological indexes of liver and intestinal permeability were observed. FITC-Dextran content of the model group elevated markedly compared with normal group (P < 0.01), indicating that the intestinal permeability of NAFLD rats fed with high-fat diet increased. The intestinal permeability of groups A, B, and A + B was lower sharply than that of model group (P < 0.01), and the effect of group A + B was the most obvious. HE staining of liver tissues showed that combined treatment could improve structural changes in liver cells caused by modeling and restore the normal structure of intestinal cells. Lactobacillus combined with abdominal massage was better than two treatments alone, further promoting the permeability of intestinal mucosa in NAFLD rats and repair biofilm of hepatocytes. The results initially verified the intervention effect of abdominal massage on intestinal mucosal permeability, and further revealed the mechanism of abdominal massage in treatment of NAFLD by improving intestinal mucosal barrier permeability.

The Combination of Electroacupuncture and Massage Therapy Alleviates Myofibroblast Transdifferentiation and Extracellular Matrix Production in Blunt Trauma-Induced Skeletal Muscle Fibrosis.

Complementary therapies, such as acupuncture and massage, had been previously reported to have therapeutic effects on skeletal muscle contusions. However, the recovery mechanisms on skeletal muscles after blunt trauma via the combination of electroacupuncture (EA) and massage therapy remain unclear. In the present study, a rat model of the skeletal muscle fibrosis following blunt trauma to rat skeletal muscle was established, and the potential molecular mechanisms of EA + massage therapy on the skeletal muscle fibrosis were investigated. The results suggested that EA + massage therapy could significantly decrease inflammatory cells infiltration and collagenous fiber content and ameliorate the disarrangement of sarcomeres within myofibrils compared to the model group. Further analysis revealed that EA + massage therapy could reduce the degree of fibrosis and increase the degree of myofibroblast apoptosis by downregulating the mRNA and protein expression of transforming growth factor- (TGF-) ß1 and connective tissue growth factor (CTGF). Furthermore, the fibrosis of injured skeletal muscle was inhibited after treatment through the normalization of balance between matrix metalloproteinase- (MMP-) 1 and tissue inhibitor of matrix metalloproteinase (TIMP). These findings suggested that the combination of electroacupuncture and massage therapy could alleviate the fibrotic process by regulating TGF ß1-CTGF-induced myofibroblast transdifferentiation and MMP-1/TIMP-1 balance for extracellular matrix production.

Efficacy and safety of warm needle treatment for scapulohumeral periarthritis: A protocol for systematic review and meta-analysis.

BACKGROUND: To evaluate the effectiveness and safety of warm needle acupuncture (WNA) treatment for Scapulohumeral periarthritis. METHODS: Relevant randomized controlled trials will be searched from the databases of Pubmed, the Cochrane Library, Embase, CNKI, Wanfang Database, CBM and VIP Database from their inception to September 2021. The primary outcomes are effective rate, visual analog scale score. The secondary outcomes are Constant-Murley score, Japanese Orthopaedic Association scores, adverse events. Two reviewers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool. The Stata 14.0 will be used for meta-analysis. RESULTS: This study is ongoing and will be submitted to a peer-reviewed journal for publication. CONCLUSION: This study will provide an assessment of the current state of WNA for the scapulohumeral periarthritis, aiming to show the efficacy and safety of WNA treatment. ETHICS AND DISSEMINATION: There is no requirement of ethical approval and informed consent, and it will be in print or published by electronic copies. REGISTRATION: INPLASY2020100049.

Abdominal Massage Reduces Visceral Hypersensitivity via Regulating GDNF and PI3K/AKT Signal Pathway in a Rat Model of Irritable Bowel Syndrome.

Changes in gut motility and visceral hypersensitivity are two major features of irritable bowel syndrome (IBS). Current drug treatments are often poorly efficacious, with many side effects for patients with IBS. Complementary therapies, such as acupuncture or abdominal massage, have received more attention in recent years. In this study, a rat model of IBS with diarrhea (IBS-D) was established by instillation of acetic acid from the colon. The effects of abdominal massage on changes in gut motility, visceral hypersensitivity, and the possible mechanism were investigated. Continuous abdominal massage could decrease the stool consistency score and increase the efflux time of glass beads compared with model groups, while also decreasing mast cell counts in IBS-D rats. The mRNA and protein expressions of neuronal nitric oxide synthase (nNOS), choline acetyl transferase (CHAT), and protein gene product 9.5 (PGP9.5) were significantly upregulated by continuous abdominal massage compared with model groups. Continuous abdominal massage also improved the ultrastructure of enteric glial cells (EGCs) by decreasing the number of mitochondria and increasing the level of the heterochromatin. Meanwhile, continuous abdominal massage could upregulate the expression of glial cell line-derived neurotrophic factor (GDNF) and P-Akt/Akt. Furthermore, it could reduce visceral hypersensitivity and improve the IBS-D symptoms by regulating the phosphoinositide 3-kinase (PI3K)-Akt pathway, which would provide a novel method for the treatment of IBS-D in the clinical setting.

Baduanjin exercise for low back pain: A systematic review and meta-analysis.

INTRODUCTION: Low back pain (LBP) is one of the most common public health concerns worldwide. Baduanjin is very popular and widely practiced for the management of LBP. This study aims to systematically investigate the efficacy and safety of Baduanjin exercise for patients with LBP. METHODS: The PubMed, EMBASE, CENTRAL, Web of Science Core Collection, CBM, CNKI, WANFANG and VIP databases were searched from inception to August 2018 to identify potentially eligible studies. Risk of bias was assessed with the Cochrane collaboration's tool. All statistical analyses were conducted with the RevMan 5.3 software. RESULTS: Nine studies involving 519 patients were included in this systematic review. Our meta-analysis showed that Baduanjin was associated with a small improvement in pain relief compared with general exercise (MD= -0.50, 95% CI: -0.86 to -0.15, P = 0.005). One trial indicated that Baduanjin was superior to routine drug (ibuprofen) in alleviating pain, and the effect was moderate (MD= -1.04, 95% CI: -1.52 to -0.56, P < 0.0001). A descriptive analysis showed that Baduanjin plus other active treatments (such as massage, suspension, or routine drug plus general exercise) had small to moderate effects on low back pain relief compared with active treatments alone. One trial reported that Baduanjin decreased the Oswestry Disability Index (ODI) score compared with routine drug (MD= -4.92, 95% CI= -7.81 to -2.03, P = 0.0009). Another trial found the combination of Baduanjin and electrotherapy offered better improvement than electrotherapy on back-specific function (MD= -6.03, 95% CI= -8.45 to -3.61, P < 0.00001). Three trials suggested that Baduanjin alone or in combination with other treatments achieved greater effects on the Japanese Orthopaedic Association (JOA) score improvement than other treatments. No adverse event was identified in the only study reporting on safety data. CONCLUSIONS: The present study indicated that Baduanjin is effective for LBP. However, evidence supporting the finding is limited due to the small sample size, potential methodological flaws and significant heterogeneity. More large-scale, well-designed RCTs are warranted.

Acupuncture for constipation in patients with stroke: protocol of a systematic review and meta-analysis.

INTRODUCTION: Constipation is one of the most common complications in patients with stroke. Acupuncture has gained increased popularity for the management of constipation. However, there is a lack of supportive evidence on the efficacy of acupuncture for poststroke constipation. This systematic review aims to collect and critically appraise all the available evidence about the efficacy and safety of the acupuncture for constipation in poststroke patients. METHODS AND ANALYSIS: A comprehensive search of Pubmed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, four Chinese databases (National Knowledge Infrastructure (CNKI), Chinese Biomedical Literatures database (CBM), Wanfang Digital Periodicals (WANFANG) and Chinese Science and Technology Periodicals (VIP) database), one Japanese medical database (National Institute of Informatics, CiNii) and one Korean medical database (Oriental Medicine Advanced Searching Integrated System, OASIS) will be conducted to identify randomised controlled trials of acupuncture for constipation in poststroke patients. There is no restriction on language or publication status. The primary outcome measure will be frequency of bowel movement. The risk of bias will be assessed using the approach recommended by Cochrane Handbook for Systematic Reviews of Interventions. We will conduct the meta-analysis to synthesise the evidence for each outcome, if possible. The heterogeneity will be statistically assessed using a χ2 test and I2 statistic. This protocol is developed following the guideline of Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols 2015. ETHICS AND DISSEMINATION: The ethical approval is not required because no primary data are collected. The findings will be presented at scientific conferences or a peer-reviewed scientific journal. PROSPERO REGISTRATION NUMBER: CRD42017076880.

[Bridge role of Jingming (BL 1) for VDT asthenopia and brainfag based on human instinct].

To explore the bridge role of Jingming (BL 1) for video display terminal (VDT) asthenopia and brainfag. Ancient literature and modern scientific research on the acupoint have been analyzed and summarized so as to explore pressing the acupoint the instinct feedback of brain after asthenopia. It is demonstrated that Jingming (BL 1) is a key channel between eyes, brain and the outside world, and it is one of major feedback points of brain after asthenopia. In this paper we try to establish a new research thinking and ascertain it, namely Jingming (BL 1) reflecting the relationship between asthenopia and brainfag. We hope that it can provide some references for further research on cognizing brain through eye.

Chronic fatigue syndrome treated by the traditional Chinese procedure abdominal tuina: a randomized controlled clinical trial.

OBJECTIVE: To evaluate the effect of the traditional Chinese procedure abdominal Tuina (AT) on chronic fatigue syndrome (CFS). METHODS: This randomized, single assessor-blinded clinical trial was carried out from May 2014 to April 2015. Eighty participants in the trial were divided randomly into two groups: experimental group and control. The experimental group (40 cases) was treated by AT and the control group (40 cases) by acupuncture. Each treatment was conducted once a day, 5 d for one course, at an interval of 2 d between each course. The whole treatment course lasted for 4 weeks. To ascertain the effect of AT and acupuncture, Fatigue Scale-14 (FS-14), Self-rating Anxiety Scale (SAS) and Hamilton Rating Scale for Depression (HAMD) scores were used before and after treatment. Patients were followed up for 3 months after treatment. RESULTS: After treatment for 4 weeks, 77 patients (39 cases in the experimental group and 38 cases in the control group) completed the trial. The FS-14, SAS and HAMD scores decreased (P < 0.05) significantly compared with those before treatment in both groups. The FS-14 and HAMD (P < 0.05) scores in the experimental group were much lower than those in the control group. The difference in SAS scores between the two groups was not significant. In the final follow-up, CFS in two cases in the experimental group and three in the control group recurred, but the difference was not significant. The scores for the FS-14, SAS and HAMD in the experimental group were superior to those of the control group, and the difference was significant (P < 0.05). No serious adverse events and few adverse events were observed. CONCLUSION: AT elicited a more efficacious effect than acupuncture alone on CFS.