[Effect of acupuncture for regulating spleen and stomach on aspirin resistance in patients with type 2 diabetes mellitus: a randomized controlled trial].

OBJECTIVE: To observe the effect of acupuncture for regulating spleen and stomach on aspirin resistance in patients with type 2 diabetes mellitus (T2DM) and explore the effect mechanism. METHODS: A total of 68 T2DM patients complicated with aspirin resistance were randomized into an observation group and a control group, 34 cases in each one. On the base of the conventional treatment for diabetes, aspirin enteric-coated tablets were prescribed for oral administration, 100 mg each time, once daily in the control group. In the observation group, on the basis of the treatment as the control group, acupuncture was used for regulating spleen and stomach at Zhongwan (CV 12), Zusanli (ST 36), Yinlingquan (SP 9), Hegu (LI 4), etc., once daily. The treatment for 1 week was as one course and 4 courses of treatment were required totally in two groups. Before and After treatment, the indexes of platelet function (platelet aggregation rate [PAG] and salicylic acid concentration), the indexes of vascular endothelial function (6-keone prostaglandin F1α[6-keto-PGF1α], thromin B2 [TXB2] and cyclooxysynthase-2 [COX-2]), blood glucose (fasting plasma glucose [FPG], 2 h plasma glucose [2h PG] and glycosylated hemoglobin [HbA1c]), insulin resistance index (HOMA-IR), blood lipid indexes (total cholesterol [TC], triacylglycerol [TG], high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C]) and the total score of TCM symptoms were observed in the patients of two groups. Clinical therapeutic effect and safety was compared in the patients between the two groups after treatment and the recurrence rate of cardiocerebrovascular events was followed up 6 months after treatment. RESULTS: After treatment, PAG, salicylic acid concentration, TXB2, COX-2, FPG, 2h PG, HbA1c, HOMA-IR, LDL-C, TC, TG and the total scores of TCM symptoms were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and 6-keto-PGF1αand HDL-C were increased as compared with those before treatment in the two groups (P<0.01, P<0.05). In comparison with the control group, the aforementioned indexes in the observation group were all improved significantly (P<0.01). The total effective rate was 91.2% (31/34) in the observation group, higher than 70.6% (24/34) in the control group (P<0.05). In follow up visit, the recurrence rate of cardiocerebrovascular events was 14.7% (5/34) in the observation group, lower than 29.4% (10/34) in the control group (P<0.05). The therapies were safe and had no obvious adverse reactions in both two groups. CONCLUSION: Acupuncture for regulating spleen and stomach combined with aspirin enteric-coated tablets relieve insulin resistance and reduces blood glucose and lipid as well as the recurrence rate of cardiocerebrovascular events in the patients with T2DM, which is probably related to the regulation of insulin resistance and the improvement of vascular endothelial function. This combined therapy achieves the better effect on aspirin resistance as compared with simple aspirin enteric-coated tablets.

[Effect of Tiaoli Piwei needling technique on diabetic gastroparesis and transmembrane protein 16A].

OBJECTIVE: To observe the therapeutic effect of Tiaoli Piwei needling technique (acupuncture for regulating spleen and stomach) on diabetic gastroparesis (DGP), and to explore its possible mechanism. METHODS: A total of 128 patients with DGP were randomized into an observation group (64 cases, 4 cases dropped off) and a control group (64 cases, 4 cases dropped off). On the basis of intervention on controlling blood glucose by western medication, Tiaoli Piwei needling technique was adopted at Zhongwan (CV 12), Zusanli (ST 36), Yinlingquan (SP 9), Xuehai (SP 10), Sanyinjiao (SP 6), Diji (SP 8), etc. in the observation group, once a day. Mosapride citrate dispersible tablet 5 mg was given orally 3 times a day in the control group. The treatment was given 6 times a week in the both groups, and totally 4-week treatment was required. Before and after treatment, the DGP symptom score, serum content of transmembrane protein 16A (ANO1) were observed, and the clinical therapeutic effect and the safety were evaluated in the both groups. RESULTS: After treatment, the each subitem score (belching, abdominal distension, inappetence, nausea and vomiting, epigastric pain, abnormal defecation) and the total score of DGP symptom were decreased in both groups (P<0.05), the subitem scores of belching, abdominal distension, inappetence, nausea and vomiting and the total score in the observation group were lower than those in the control group (P<0.05). After treatment, the serum contents of transmembrane protein 16A were reduced in both groups (P<0.05), and that in the observation group was lower than the control group (P<0.05). The total effective rate was 86.7% (52/60) in the observation group, which was superior to 70.0% (42/60) in the control group (P<0.05). Subcutaneous hematoma occurred in 5 cases in the observation group, which was improved after cold compress without other particular intervention. CONCLUSION: The therapeutic effect of Tiaoli Piwei needling technique on improving symptoms in patients with diabetic gastroparesis is superior to mosapride citrate dispersible tablet, its mechanism may be related to alleviating the damage of interstitial cells of Cajal (ICC).

[Research progress on mechanism of gastrodin and p-hydroxybenzyl alcohol on central nervous system].

Gastrodin(GAS) and p-hydroxybenzyl alcohol(HBA) are extracts of dried tubers of Gastrodia elata, which is the material basis for its efficacy and belongs to phenolic compounds. Modern pharmacology studies have shown that they have significant effects on central nervous system diseases, such as insomnia, convulsions, depression, ischemic stroke, anxiety, and cognitive impairment, and these diseases are closely related to neurotransmitters and cytokines. This paper described various mechanisms of GAS and HBA monomer components on the central nervous system. They alleviate hippocampal neuronal toxicity mainly by regulating a variety of neurotransmitters, such as acetylcholine, glutamic acid(GLU), γ-aminobutyric acid(GABA), serotonin(5-HT), dopamine(DA), norepinephrine(NE), 5-indoleacetic acid(5-HIAA), high vanillic acid(HVA) and dihydroxyphenylacetic acid(DOPAC), pro-inflammatory cell growth factors, such as IL-1ß, IL-6 and TNF-α and relevant receptor functions, and exert neuropharmacological effects by effectively increasing mRNA expressions of brain neurotrophic factors, such as BDNF and GDNF, and further inhibiting the apoptosis of damaged neurons. This paper summarized various mechanisms on the central nervous system, which provides a scientific basis for the further research of the neuropharmacological mechanism of GAS and HBA and the development of new drugs and functional food.

Efficacy and safety of pioglitazone for treatment of plaque psoriasis: a systematic review and meta-analysis of randomized controlled trials.

Background: A growing number of studies have shown that thiazolidinediones (TZD) can be antipsoriatic. Pioglitazone is a representative of the class of antidiabetic drugs known as TZD. TZD can activate nuclear peroxisome proliferator-activated receptors (PPAR)-c. PPARs are expressed on epidermal keratinocytes and exert their effects by promoting the terminal differentiation of keratinocytes, inhibiting epidermal growth, and reducing inflammatory responses. These observations suggest that TZD have potential benefits in the treatment of cutaneous and metabolic pathologies associated with psoriasis.Objective: A systematic review and meta-analysis was carried out to evaluate the efficacy of combined pioglitazone treatment. We point out three controversial side effects from administration of pioglitazone in psoriasis: elevated liver enzymes, weight gain, and nausea.Study selection: Randomized, single blind, or double blind, published studies of pioglitazone compared with placebo given to patients with plaque psoriasis for 10 weeks or 12 weeks were considered for inclusion in this review. The primary outcomes were 75% or greater improvement in the Psoriasis Area and Severity Index score from baseline (PASI 75) with pioglitazone.Data collection and analysis: The systematic literature search was conducted in the PubMed, Embase, Google Scholar, and Cochrane databases from inception up to December 20 2018. Data analysis was done using Revman 5.3 Haymarket, London, United Kingdom.Main results: We included six studies (three publications of pioglitazone only; three publications of pioglitazone combination therapy) comprising a total of 294 patients (n = 149 with pioglitazone only and n = 145 with pioglitazone combination therapy) in the analysis. There was a significant PASI 75 response, in the pioglitazone only subgroup as compared to placebo (OR = 8.74, 95% CI 3.76-20.31, p < .00001), and the pioglitazone combination subgroup as compared to placebo (OR = 4.64, 95% CI 2.03-10.60, p < .00001), others, the total of pioglitazone as compared to placebo (OR = 6.37, 95% CI 3.55-11.43, p < .00001), and tests of subgroup differences show: p = .29, I2 = 9.5%. The incidence rate of elevated liver enzymes (OR = 3.70, 95% CI 0.56-24.31, p = .99), weight gain (OR = 1.44, 95% CI 0.60-3.47, p = .41), and nausea (OR = 0.76, 95% CI 0.23-2.49, p = .65) were not significantly different compared with the control group.Conclusion: Pioglitazone has efficacy for the treatment of plaque psoriasis. There is no significant difference between patients treated with pioglitazone only or in combination with other therapies. The incidence rate of side effects associated with pioglitazone treatment such as elevated liver enzymes, weight gain, and nausea were not significantly different compared with the control group.

[Clinical trials of acupuncture treatment of post-stroke shoulder pain].

OBJECTIVE: To observe the clinical therapeutic effect of "Tiaoshen Zhitong" (mental regulating and pain relieving) needling and its influence on serological indicators in the treatment of post-stroke shoulder pain, so as to provide new therapeutic thoughts and approach for post-stroke shoulder pain. METHODS: A total of 80 inpatients with post-stroke shoulder pain were randomly divided into a control group (routine needling, 39 cases) and an observation group ("Tiaoshen Zhitong" needling, 41 cases) according to the random number table. Patients of the two groups accepted basic medication treatment including anticoagulants, hypotensive drugs, hypoglycermic drugs, lipid-lowering drugs, etc. In addition, patients of the control group were also treated by routine acupuncture stimulation (uniform reinforcing-reducing stimulation) of Jianyu (LI15), Jianqian (EX-UE12), Jianhou (Extra), Jianliao (TE14), Waiguan (TE5) and Hegu (LI4) on the affected side, and those of the observation group also treated by "Tiaoshen Zhitong" needling of Ear-Shenmen (MA-TF1), bilateral Neiguan (PC6, lifting-thrusting-reducing method), Shuigou (GV26, lifting-thrusting-reducing method), and Jianyu (LI15), Jianliao(TE14), Jianzhen (SI9) and Yanglingquan (GB34, the latter 4 points were stimulated with uniform reinforcing-reducing method) on the affected side. The treatment was given once every day, 6 days a week for 4 weeks. The pain severity was assessed by using visual analogue scale (VAS), the upper limb function evaluated by using Fugl-Meyer assessment (FMA) scale, the shoulder-joint function evaluated by using Constant-Murley score (CMS) questionnaire, and the daily living ability assessed by using Barthel index (BI) scale. The enzyme linked immunosorbent assay (ELISA) was used to determine the contents of serum beta-endorphin (ß-EP), enkephalin (ENK) and dynorphin (Dyn). The clinical therapeutic effect was evaluated by using Nimodipine scale method. RESULTS: Of the 39 and 41 cases in the control and observation groups, 7(17.95%) and 12(29.27%) were basically cured, 12(30.77%) and 13(31.71%) experienced marked improvement, 8(20.51%) and 11(26.83%) were effective, 12(30.77%) and 5 (12.19%) failed, with the total effective rate being 69.23% and 87.80%, respectively. The effective rate of the observation group was significantly higher than that of the control group (P<0.05). After the treatment, the VAS score was obviously reduced (P<0.01), and the scores of FMA scale, CMS questionnaire and BI scale, and contents of serum ß-EP, ENK and Dyn were all increased obviously in the two groups compared with their own pre-treatment (P<0.01). The therapeutic effect of "Tiaoshen Zhitong" needling was significantly superior to that of the routine needling in lowering VAS, and in raising scores of FMA scale, CMS questionnaire and BI scale and in up-regulating serum ß-EP, ENK and Dyn levels (P<0.01). CONCLUSION: "Tiaoshen Zhitong" needling is effective in reducing post-stroke shoulder pain and improving the motor function of the upper limb and shoulder-joint as well as the quality of daily life in stroke patients with shoulder pain. Its analgesic effect is probably related to the increase of the levels of serum ß-EP, ENK and Dyn.

Efficacy and mechanism of acupuncture for ischemic poststroke depression: Study protocol for a multicenter single-blinded randomized sham-controlled trial.

INTRODUCTION: Poststroke depression is a serious and common complication of stroke, especially the ischemic poststroke depression. Antidepressants are used in poststroke depression, and acupuncture may be an alternative approach. However, the efficacy and mechanism of acupuncture for poststroke depression has not been confirmed. METHODS/DESIGN: This is a multicenter, central-randomized, single-blind, sham-controlled clinical trial. We will allocate 208 subjects aged between 40 and 80 years old, diagnosed with initial poststroke depression (PSD) within 6 months to 2 groups randomly in a ratio of 1:1. Patients in the experimental group will be treated with traditional acupuncture and placebo pills, whereas the others in the control group will be treated with sham-acupoints acupuncture and antidepressant (fluoxetine hydrochloride tablets). All will be given acupuncture and/or medication treatment for 12 weeks, and then received 12-week follow-up. Patients will be evaluated with the 17-item Hamilton Depression Scale and Se1f-rating Depression Scale for depression state, National Institute of Health Stroke Scale for neurological deficit, Modified Barthel Index for activities of daily living, Treatment Emergent Symptom Scale for side effects of treatments, diagnosis and evaluation criteria of traditional Chinese medicine for stroke (try out) for curative effects of stroke, and clinical global impression for synthesize effect before and the 2nd, 4th, 8th, and 12th week of treatment, 24th week of follow-up. Study on mechanisms of acupuncture will be revealed through the diversity of brain metabolites (choline-containing compounds [Cho], N-acetylaspartate [NAA], myoinositol, glutamine and glutamate complex, creatine [Cr], Cho/Cr, Cho/NAA, Cr/NAA) in bilateral dorsolateral prefrontal cortex and anterior cingulate cortex monitored by proton magnetic resonance spectroscopy, and serum monoamine neurotransmitters (5-hydroxytryptamine, norepinephrine, dopamine) and cytokines (brain-derived neurotrophic factor [BDNF], interleukin [IL]-4, IL-6, IL-10, IL-18, IL-1ß, tumor necrosis factor alpha) before and the 12th week of treatment. Baseline characteristics of patients will be summarized by groups and compared with chi-square for categorical variables, and 2-sample t tests or Wilcoxon rank-sum test for the continuous variables. Primary and secondary outcomes according to the measurement times are applicable to univariate repetitive measurement deviation analysis or 2-sample t tests, or Wilcoxon rank-sum test. CONCLUSION: The present research is designed to investigate efficacy and mechanism of traditional acupuncture therapy on ischemic PSD, also to explore the correlation between cerebra metabolic and serologic factors, and ischemic PSD. With this research, we are looking forward to find out an appropriate alternative nondrug therapy for PSD people to alleviate the adverse effects and drug dependence caused by antidepressants.

Tiaolipiwei Acupuncture Reduces Albuminuria by Alleviating Podocyte Lesions in a Rat Model of Diabetic Nephropathy.

BACKGROUND: Diabetic nephropathy is a common and serious complication of diabetes and a major cause of end-stage renal disease. Tiaolipiwei acupuncture is a safe treatment approach that may be effective for lowering albuminuria in diabetic nephropathy. Yet, the exact mechanisms of this therapeutic effect are unclear. METHODS: A rodent model of type 2 diabetic nephropathy (T2DN) was induced by a high-fat diet combined with low-dose streptozotocin. T2DN rats were treated with Tiaolipiwei acupuncture (ACU) for 4, 8, or 12 weeks. At the end of treatment, urinary and blood samples were collected for analysis. Transmission electron microscopy was used to observe morphological changes, and protein expression levels of nephrin, CD2AP, podocalyxin, and desmin were quantified in renal tissue. RESULTS: Compared to the T2DN groups, the T2DN + ACU groups showed significant improvements in 24-hour urinary protein, serum urea, cholesterol, and triglycerides at all time points. ACU treatment also improved the density of slit diaphragms. Simultaneously, ACU promoted the renal expression of nephrin, CD2AP, and podocalyxin and decreased the expression of desmin. CONCLUSION: Our study suggests that Tiaolipiwei acupuncture ameliorates podocyte lesions to reduce albuminuria and prevent the progression of T2DN in a rat model.

[Effect of "Spleen-Stomach Harmonizing" Needling on Insulin Resistance and Expression of Insulin Receptor Substrate-1, -2, and Glucose Transporter-4 in Insulin Resistance Type 2 Diabetes Rats].

OBJECTIVE: To observe the effect of manual acupuncture stimulation of "Quchi" (LI 11), "Hegu" (LI 4), "Zusanli" (ST 36), etc. with "spleen-stomach harmonizing" technique on insulin resistance index (ISI) and the expression of insulin receptor substrate-1 (IRS-1), IRS-2 (two upstream key proteins) and glucose transporter-4 (GluT-4, downstream key protein) of the phosphatidylinositol 3-kinase (PI 3 K)/Akt signaling pathway in insulin resistance type 2 diabetes (IRT 2 D) rats, so as to explore its mechanism underling improvement of type 2 diabetes. METHODS: A total of 35 male Wistar rats were used in the present study. The IRT 2 D model was established by feeding the animal with high-fat and high-sugar diet for 8 weeks, and subsequent intraperitoneal injection (i.p.i.) of a low dose of streptozotocin (25 mg/kg). Using the stratified random sampling method, 20 successful IRT 2 D rats were equally divided into model and acupuncture groups. Ten normal rats were used as the control group. The bilateral acupoints of LI 11, LI 4, ST 36, "Xuehai" (SP 10), "Fenglong" (ST 40), "Yinlingquan" (SP 9), "Diji" (SP 8), "San-yinjiao" (SP 6) and "Taichong" (LR 3) were punctured with filiform needles, followed by manipulating the needles with "spleen-stomach harmonizing" technique. The treatment was given once daily for 4 weeks except the weekends. Fasting blood glucose and serum insulin levels were measured using ELISA. The quadriceps muscle of thigh of each rat was sampled to test the expression levels of IRS-1, IRS-2, and GluT-4 proteins and genes with Western blot and quantitative Real-time PCR, respectively. RESULTS: Following 4 weeks' acupuncture intervention, the modeling-induced remarkable increase of ISI, and considerable down-regulation of expression levels of IRS-1, IRS-2 and GluT-4 proteins and genes in the quadriceps femoris were significantly reversed relevant to the model group (P<0.01), suggesting a possible activation of PI 3 K/Akt signaling after acupuncture administration. CONCLUSIONS: Spleen-stomach regulation needling can improve insulin resistance and up-regulate the expression of IRS-1, IRS-2 and GluT-4 in the quadriceps femoris in type 2 diabetes rats.

[Randomized Controlled Clinical Trial for Analyzing Effect of "Spleen-Stomach Regulation Nee- dling" on Oxidative Stress Level in Patients with Diabetic Nephropathy].

OBJECTIVE: To observe the effect of "spleen-stomach needling" on changes of plasma malondialdehyde. (MDA), protein carbonyl (PCO, an oxidative stress damage biomaker), 8-hydroxyguanine (8-OHdG, an indicator of oxidative DNA damage) and the activity of superoxide dismutase (SOD) levels in patients with diabetic nephropathy, so as to explore its mechanisms underlying improving diabetic nephropathy. METHODS: Diabetic nephropathy patients were randomized into routine acupuncture (control) group (n = 72) and spleen-stomach needling (observation) group (n = 70) according to a random digits table and by using multi-centers, randomized and blind methods in the present study. All the patients were received routine medication. In addition, patients of the control group were treated by acupuncture stimulation of Shenshu (BL 23), Taixi (KI 3), Sanyinjiao (SP 6), Yanglingquan (GB 34), Xuanzhong (GB 39), Guanyuan (CV 4), Shousanli (LI 10), Waiguan (TE 5), Yangxi (LI 5), Liangqiu (ST 34), Shangjuxu (ST 37), Neiting (ST.44), Huaroumen (ST 24), and Dachangshu (BL 25), and those of the observation group treated by acupuncture stimulation of Zhongwan (CV 12), Quchi (LI 11), HQgu (LI 4), Xuehai (SP 10), Zusanli (ST 36), Yinlingquan (SP 9), Fenglong (ST 40), Diji (SP 8), Sanyinjiao (SP 6),Taichong (LR 3), Gaohuang (BL 43), Shenshu (BL 23), Baihuanshu (BL 30) and Zhongji (CV 3) with spleen-stomach needling method. The treatment of both groups was conducted twice a day for six weeks except Sundays. Plasma MDA, PCO and 8-OHdG contents were detected by using ELISA, and SOD detected using xanthine oxidase method. RESULTS: After 3 weeks' treatment, plasma MDA, PCO and 8-OHdG contents were significantly increased in both control and observation groups, and plasma SOD was obviously reduced in both groups (P < 0.05). No significant differences were found between the two groups in the plasma MDA, PCO and 8-OHdG contents (P > 0.05). While after 6 weeks' treatment, plasma MDA, PO and 8-OHdG contents were significantly decreased (turning to the normal levels) and plasma SOD level in the observation group was significantly up-regulated (P < 0.01). Following 3 weeks' treatment, of the 72 and 70 patients in the control and observation groups, 10 and 20 cases experienced marked improvement, 22 and 15 were improved, and 40 and 35 invalid, respectively. After 6 weeks' treatment, of the 72 and 70 patients in the control and observation groups, 12 and 39 experienced marked improvement, 28 and 20 cases were improved, 32 and 11 invalid, respectively. The therapeutic effect of the observation group was obviously superior to that of the control group (P < 0.01). CONCLUSION: Acupuncture treatment with spleen-stomach regulation needling can down-regulate plasma MDA, PCO, 8-OHdG contents and up-regulate SOD activity in diabetic nephropathy patients, which may contribute to its effect in improving the patients' symptoms probably by resisting the oxidative stress damage.

[Clinical observation on repair of lymphocyte injury in patients with diabetic nephropathy treated by regulating spleen-stomach needling].

OBJECTIVE: To explore therapeutic effect and action mechanism of regulating spleen-stomach needling on diabetic nephropathy (DN). METHODS: Using multi-centric, randomized, controlled and blind principles, 144 cases of DN were divided into an observation group and a control group according to random digital tab, 72 cases in each one. Based on regular treatment of diabetes, the regulating spleen-stomach needling was applied at Zhongwan (CV 12), Quchi (LI 11), Hegu (LI 4) and Xuehai (SP 10), etc. in the observation group while Shenshu (BL 23), Taixi (KI 3), Sanyinjiao (SP 6), Yanglingquan (GB 34), etc. were selected in the control group by reference of Acupuncture and moxibustion. The treatment was given twice a day, six days as a treatment session with interval of one day between sessions. Totally six weeks were required. Changes of clinical symptoms and signs, fast blood glucose (FBG), urinary albumin excretion rate (UAER), beta2-microglobulin (beta2-MG), monocyte chemotactic protein-1 (MCP-1), lymphocyte membrane cholesterol, propanediol (MDA), PCO, 8-hydroxydeoxy guanosine (8-OHdG), superoxide dismutase (SOD), CD3+, CD4+, CD8+, and CD4+/CD8+ were observed before and after treatment in two groups. RESULTS: As for improving clinical symptoms and signs, total effective rate was 84.29% (59/70) in the observation group and 55.56% (40/72) in the control group, which had statistical difference between two groups (P<0.01). As for regulating glycometabolism [(6.25 +/- 0.32) mmol/L vs (8.09 +/- 0.63) mmol/L], reducing UAER [(154.43 +/- 55.14) mg/24h vs (268.91 +/- 77.65) mg/24h], restraining over-expression of MCP-1 [(137.59 +/- 36.15) pg/mL vs (166.89 +/- 42.82) pg/mL], regulating level of oxidative stress, prohibiting oxidation of protein and adjusting quantity and activity of T lymphocyte subgroup, the observation group was superior to the control group (P< 0.05, P<0.01). CONCLUSION: The regulating spleen-stomach needling is an effective method for treatment of DN, which cold improve glycometabolism disturbance-induced progressive kidney injury, recover glomerular filtration, reduce urinary albumin excretion rate, restrain overexpression of MCP-1, adjust level of oxidative stress, prohibit oxidation of protein, increase protectiveness of membrane, adjust quantity and activity abnormity of T lymphocyte subgroup, leading to repairing lymphocyte damage and improving immune expression to delay kidney damage.

Acupuncture intervention in ischemic stroke: a randomized controlled prospective study.

Stroke is one of the most common causes of death and few pharmacological therapies show benefits in ischemic stroke. In this study, 290 patients aged 40-75 years old with first onset of acute ischemic stroke (more than 24 hours but within 14 days) were treated with standard treatments, and then were randomly allocated into an intervention group (treated with resuscitating acupuncture) and a control group (treated using sham-acupoints). Primary outcome measures included Barthel Index (BI), relapse and death up to six months. For the 290 patients in both groups, one case in the intervention group died, and two cases in the control group died from the disease (p = 0.558). Six patients of the 144 cases in the intervention group had relapse, whereas 34 of 143 patients had relapse in the control group (p < 0.001). The mean values for BI at six months were 70.25 ± 20.37 and 57.43 ± 19.61 for the two groups, respectively (p < 0.01). Acupuncture resulted in a significant difference between the two groups for the National Institute of Health Stroke Scale (NIHSS), not at two weeks (7.03 ± 3.201 vs. 8.13 ± 3.634; p = 0.067), but at four weeks (4.15 ± 2.032 vs. 6.35 ± 3.131, p < 0.01). The Chinese Stroke Scale (CSS) at four weeks showed more improvement in the intervention group than that in the control group (9.40 ± 4.51 vs. 13.09 ± 5.80, p < 0.001). Stroke Specific Quality of Life Scale (SS-QOL) at six months was higher in the intervention group (166.63 ± 45.70) than the control group (143.60 ± 50.24; p < 0.01). The results of this clinical trial showed a clinically relevant decrease of relapse in patients treated with resuscitating acupuncture intervention by the end of six months, compared with needling at the sham-acupoints. The resuscitating acupuncture intervention could also improve self-care ability and quality of life, evaluated with BI, NIHSS, CSS, Oxford Handicap Scale (OHS), and SS-QOL.

[Randomized controlled study on dysphagia after stroke treated with deep insertion of Chonggu (EX-HN 27) by electroacupuncture].

OBJECTIVE: To explore the therapeutic effect of dysphagia after stroke treated with different depth of Chonggu (EX-HN 27) by electroacupuncture. METHODS: Two hundreds and eighty-three cases of dysphagia after stroke were randomly divided into Chonggu (EX-HN 27) deep insertion group (99 cases), Chonggu (EX-HN 27) shallow insertion group (94 cases) and traditional acupuncture group (90 cases) based on multi-central randomized control and blinding methods. Besides routine therapy, Chonggu (EX-HN 27) and Lianquan (CV 23) were selected in the Chonggu (EX-HN 27) deep insertion group and the Chonggu (EX-HN 27) shallow insertion group; the needles were inserted for 60-75 mm and 30 mm respectively and the electroacupuncture was applied in both groups; in traditional acupuncture group, Fengchi (GB 20), Yifeng (TE 17), Wangu (GB 12) and Lianquan (CV 23), etc. were selected. The needles were retained for 30 min, twice a day and 30 treatments totally in 3 groups. The clinical therapeutic effects were evaluated by Kubota's Water Drinking Test Scale, Standard Swallowing Function Scale and TCM Scale of Dysphagia After Stroke. RESULTS: The total effective rate was 97.0% (96/99) in the Chonggu (EX-HN 27) deep insertion group, superior to that of 64.9% (61/94) in Chonggu (EX-HN 27) shallow insertion group and 70.0% (63/90) in traditional acupuncture group (both P < 0.05). Compared with the scores before and after treatment, significant differences were presented statistically in score reduction of TCM Scale in Chonggu (EX-HN 27) shallow insertion group (P < 0.01); the scores of Kubota's Water Drinking Test Scale, Standard Swallowing Function Scale and TCM Scale of Dysphagia After Stroke were obviously reduced in Chonggu (EX-HN 27) deep insertion group and traditional acupuncture group (all P < 0.01); compared with the scores between groups after treatment, the reduction of scores in Chonggu (EX-HN 27) deep insertion group was superior to those in Chonggu (EX-HN 27) shallow insertion group and traditional acupuncture group ( P < 0.05, P < 0.01) respectively. CONCLUSION: Puncture at Chonggu (EX-HN 27) can improve the dysfunction of swallowing after stroke; it is safe and effective, and the needle should be inserted deeply.

[Knee osteoarthritis treated with acupuncture at the points selected according to syndrome differentiation: a randomized controlled trial].

OBJECTIVE: To compare the efficacy difference between acupuncture and western medication in the treatment of knee osteoarthritis. METHODS: One hundred and twenty cases were randomly divided into an acupunc ture group and a western medication group, 60 cases in each group. In acupuncture group, acupuncture was applied mainly to Neixiyan (EX-LE 4), Dubi (ST 35), Yinlingquan (SP 9) and Yanglingquan (GB 34) and to the other acupoints selected according to syndrome differentiation. In western medication group, Glucosamine Hydrochloride capsules were applied for oral administration, 2 capsules each time, 3 times per day. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)and Medical Outcomes Study 36-Item Short Form Health Survey (SF-36, Chinese version) were used to assess the therapeutic effect before treatment, after 4 weeks treatment and in follow-up visit of 9 weeks after treatment separately. RESULTS: After 4 weeks treatment, the total effective rate was 86.7% (52/60) in acupuncture group and was 88.3% (53/60) in western medication group, indicating no statistical significant difference in the comparison between two groups (P > 0.05). In 9 weeks after treatment, the total effective rate was 83.3% (50/60) in acupuncture group, which was better than 61.7% (37/60, P < 0.05) in western medication group. The scores of WOMAC and SF-36 were all improved after treatment as compared with those before treatment in two groups (P < 0.05, P < 0.01). There were no significant differences in comparison between two groups after 4 weeks treatment (all P > 0.05). But, in follow-up visit of 9 weeks after treatment, the scores of WOMAC and SF-36 in acupuncture group were superior to those in western medication group (P < 0.05, P < 0.01). CONCLUSION: The short-term efficacies on osteoarthritis of knee in acupuncture group according to syndrome differentiation are similar to that of oral adiministration of Glucosamine Hydrochloride, but the long-term efficacy in acupuncture group is better than that in western medication group.

[Research on the clinical significance of theory of the ebb and flow of qi-blood in the twelve meridians].

The sequence of the circulations of the twelve meridians does not follow on the permutation of the yin and yang meridians,whereas it is based on the law of qi-blood circulation. The relative strength of circulation between yin and yang, the ebb and flow of qi-blood goes around and around as cycles. Yin, yang and qi-blood gather in the meridians of the Taiyin and the Yangming, mutually converting in maximum, passing the meridians of the Shaoyin and the Taiyang, and then reaching the meridians of the Jueyin and the Shaoyang in minimum. It reflects not only the running course of the meridians, the sequential and reverse transmission, but also reflects the mutual supporting of yin-yang, and waxing and waning of yin-yang, the relative equilibrium of qi-blood, the transformation of excess and deficiency of disease. Therefore, the clear inspection of the law of qi-blood circulations of the twelve meridians, which is based on the therapy, is the precondition of the comprehensive significance of the sequence.

[Effect of spleen-stomach regulation-needling on nerve conduction activity in patients with diabetic peripheral neuropathy].

OBJECTIVE: To observe the effect of acupuncture on the nerve conduction function in patients with diabetic peripheral neuropathy. METHODS: Eighty diabetic patients were equally randomized into acupuncture group and medication group. Uniform reinforcing and reducing manipulation of acupuncture for regulating both spleen and stomach was applied to bilateral Quchi (LI11), Hegu (LI4), Xuehai (SP10), Diji (SP8), Zhongwan (CV12), Zusanli (ST36), Yinlingquan (SP9), etc., for 30 min, once daily for 4 weeks. Patients of the medication group were treated with intramuscular injection of Mecobalamine (500 microg), once daily for 4 weeks. The sensory conduction velocity (SCV), motor conduction velocity (MCV), the amplitude and latency of the evoked potential of the tibial nerve were detected before and after the treatment by using an Electromyograph and Evoked Potential Equipment. RESULTS: After the treatment, of the two 40 cases in the medication and acupuncture groups, 12 (30.0%) and 24 (60.0%) were cured basically, 12 (30.0%) and 10 (25.0%) experienced marked improvement in their symptoms, 9 (22.5%) and 4 (10.0%) were effective, and 7 (17.5%) and 2 (5.0%) failed in the treatment, with the total effective rates being 82.5% and 95.0% respectively. The therapeutic effect of the acupuncture group was significantly superior to that of the medication group (P < 0.05). In comparison with the ptre-treatment, the SCV, MCV, amplitude and latency of the evoked potential of the tibial nerve in the acupuncture group were improved significantly after the treatment (P < 0.05, P < 0.01). Compared with the medication group, the SCV, the amplitude and the latency of the tibial nerve in the acupuncture group were also improved significantly after the treatment (P < 0.05, P < 0.01). CONCLUSION: Manipulation of acupuncture for regulating spleen-stomach function has a better effect on the conduction function of the tibial nerve than Mecobalamine in the treatment of diabetic patients with peripheral neuropathy.

[Observation on therapeutic effect of nuchal acupuncture and abdominal acupuncture for treatment of stroke patients with spastic hemiplegia].

OBJECTIVE: To probe the effect and mechanism of the nuchal acupuncture and abdominal acupuncture for treatment of stroke patients with spastic hemiplegia. METHODS: Sixty cases were randomly divided into an observation group and a control group, 30 cases in each group. Nuchal acupuncture and abdominal acupuncture treatment was used and Fengfu (GV 16), Fengchi (GB 20), Tianzhu (BL 10), Zhongwan (CV 12) and Guanyuan (CV 4) etc. were selected in observation group, routine acupuncture was applied on Binao (LI 14), Quchi (LI 11), Huantiao (GB 30) and Futu (ST 32) etc. in control group. The scale of Ashworth and score of Fugel-Meyer of the spastic lateral upper and lower limbs and the changes of the EMG F-wave in spastic upper limb of patients in two groups were observed before and after treatment. RESULTS: The Ashworth scale and Fugel-Meyer score of the upper and lower limbs were obviously improved, the amplitude was decreased, the duration was shorten and the threshold of the EMG F-wave of the spastic upper limb was increased (all P < 0.01) in the observation group. The observation group was superior to the control group in Fugel-Meyer score of the upper and lower limbs of the patients the Ashworth scale of the lower limb, and the amplitude, duration and threshold of the EMG F-wave of the spastic upper limb (all P < 0.01). The total effective rate of 90.0% in observation group was superior to that of 50.0% in control group (P < 0.01). CONCLUSION: The nuchal acupuncture and abdominal acupuncture treatment can decrease the muscle tension of the stroke patients with spastic hemiplegia.

[Randomized controlled study on effects of the needling method for regulating spleen-stomach on coronary heart disease complicated by type 2 diabetes mellitus complicated].

OBJECTIVE: To probe into the clinical therapeutic effect of acupuncture on coronary heart disease complicated by type 2 diabetes mellitus (CDM) and the mechanism. METHODS: Using multi-central, randomized, controlled and blind methods, 120 cases of CDM were divided into an observation group and a control group, 60 cases in each group. They were treated by routine therapy for diabetes mellitus, and in the observation group, acupuncture at Quchi (LI 11), Hegu (LI 4), Xuehai (SP 10), Zusanli (ST 36), Yinlingquan (SP 9), Fenglong (ST 40). Diji (SP 8), Sanyinjiao (SP 6), etc. were added with the needling method for regulating spleen-stomach; while in the control group, acupuncture was given at Weiwanxiashu (EX-B 3), Feishu (BL 13), Pishu (BL 20), Shenshu (BL 23), Yanglingquan (GB 34), etc. The treatment was given twice a day in the two groups. Clinical therapeutic effects were assessed according to clinical symptoms and signs, frequency and lasting time of angina pectoris, quantity of taking Glycerol Trinitrate, blood sugar, blood lipids, urinary albumin excretion rate, urinary beta2-microglobulin, urinary monocyte chemotactic protein-1 (MCP-1), ECG, heart color Doppler, etc. RESULTS: The needling method for regulating spleen-stomach not only could improve the symptoms and signs of the patient, but also could improve the degree of ST segment moving down and the function of left artrium relaxation, and had benign regulative effect on glycometabolism, lipids metabolism and urinary albumin level, with significant differences as compared with the control group (P < 0.05 or P < 0.01). The markedly effective rate for improvement of ECG was 50.00% in the observation group and 13.79% in the control group. CONCLUSION: The needling method for regulating spleen-stomach can improve the damage of heart and blood vessels induced by abnormal sugar and lipids, decrease the level of urinary protein, inhibit MCP-1 excessive expression, relieve myocardial load and raise cardiac output in the patient of coronary heart disease complicated by type 2 diabetes mellitus.

[Multi-central controlled study on acupuncture for treatment of cerebral infarction in restoration stage].

OBJECTIVE: To probe into long-term therapeutic effect and safety of Xingnao Kaiqiao acupuncture for treatment of cerebral infarction in restoration stage. METHODS: Two hundred and thirty-four cases of cerebral infarction in restoration stage were randomly assigned to a Xingnao group and a routine group. The Xingnao group (n=116) were treated by Xingnao Kaiqiao acupuncture (once each day, for 4 weeks) and routine treatment of western medicine, and the routine group (n=118) were treated with routine acupuncture and the routine treatment of western medicine. They were followed-up for 6 months. The main indexes living, treatment and recurrence at the end of the following survey and the secondary indexes assessment of nervous functions at the end of the following survey, and the incidence rate of bad events in acupuncture were observed. RESULTS: The death rate was 0.86% and the continuing treatment rate was 36.21% in the Xingnao group, and 1.69% and 36.44% in the routine group, with no significant difference between the two groups (both P>0.05) at the following-up of 6 months; the Xingnao group in decreasing recurrent rate and improving nervous function was better than the routine group (P<0.01); no severe adverse response was found in the 2 groups. CONCLUSION: Xingnao Kaiqiao acupuncture is safe and it is superior to routine acupuncture in long-term therapeutic effect, decreasing recurrence rate, improving nervous function.

[Multi-central randomized controlled trials of electroacupunture at Zhigou (TE 6) for treatment of constipation induced by stagnation or deficiency of qi].

OBJECTIVE: To assess the therapeutic effect and safety of electroacupuncture (EA) at Zhigou (TE 6) on constipation induced by stagnation or deficiency of qi. METHODS: Multi-central randomized controlled trials were adopted and the patients conforming to the criteria for diagnosis, enrolling and excluding were divided into an observation group and a control group according to random number table. The observation group were treated with EA at Zhigou (TE 6) and the control group with EA at non-acupoint for 4 weeks. The cumulative score of clinical symptoms, colon transmission test and various safety indexes were assessed. The following-up was carried out 1 and 3 months after the end of treatment. RESULTS: EA at Zhigou (TE 6) could obviously improve clinical symptoms and colon transmission time, decrease using rate of Kaisailu and cathartics, with an effective rate of 94.4%, which was better than 61.3% in the control group (P < 0.0001). CONCLUSION: EA at Zhigou (TE 6) has a function of regulating qi and relaxing the bowels and it is an effective method for treatment of constipation with safety and no adverse effect.