[Observation of the therapeutic effect on acute ankle sprain treated with surrounding needling and cold compression].

OBJECTIVE: To observe the difference in the therapeutic effect on acute ankle sprain treated with the combination of surrounding needling and cold compression in comparison of the conventional cold compression. METHODS: The patients with acute ankle sprain were randomly divided into control group (33 cases) and observation group (35 cases). In the first 3 days of treatment, the conventional cold compression was used in the control group, while the surrounding needling technique of acupuncture was combined with cold compression in the observation group. Separately, along the distal-lateral side of the leg, and the lateral sides of the heel and the dorsal part of the foot, 3 or 4 needles were inserted in each part，total 9 to 12 needles, toward the center of swelling and pain site, and distributed in a fan shape. The needles were retained for 30 min and the acupuncture therapy was delivered once daily. Since the 4th day of treatment, the hot compress and the static stretching exercise of the ankle joint were adopted in the two groups, once daily for 1 week. The visual analogue scale (VAS) score for ankle pain and ankle swelling degree were compared between the two groups before and after 3-day treatment, as well as the score of American orthopedic foot and ankle society (AOFAS) ankle-hindfoot scale was evaluated. RESULTS: After 3-day treatment, VAS score was decreased in both groups (P<0.01), and the score in the observation group was lower than that of the control group (P<0.01). Ankle swelling degree was relieved in both groups (P<0.01), and there was no significant difference between the two groups. After 1 week of treatment, the scores of AOFAS ankle-hindfoot scale were improved in both groups (P<0.01), and the score in the observation group was higher than the control group (P<0.05). CONCLUSION: Either the combined therapy of surrounding needling and cold compression or the conventional cold compression can effectively relieve pain and swelling induced by acute ankle sprain. The therapeutic effect of the combined therapy is superior to the conventional cold compression for the motor function improvement of ankle joint.

[Acupuncture for dysarthria: systematic review].

OBJECTIVE: To systematically evaluate the clinical efficacy of acupuncture for dysarthria, and to explore the rules of acupoints selection for dysarthria. METHODS: The clinical randomized control trial literature regarding acupuncture for dysarthria published before January of 2018 were searched in databases, including CNKI, Wanfang, VIP, CBM, PubMed, Ebsco, Science Direct and Cochrane Library. The information of included studies was extract and the quality was assessed. The Meta analysis was performed by using RevMan 5.3 software. The frequency of acupoints was calculated by using Excel software to analyzed the rules of acupoints selection. RESULTS: Totally 21 papers were included, involving 1651 patients. The pooled effects of clinical efficacy: heterogeneity test P =0.74, I 2=0%, OR =6.36, 95% CI: 4.55, 8.88, Z =10.84 (P<0.01), indicating the efficacy in the treatment group was significantly higher than that in the control group. The pooled effects of the symptom score in Frenchay scale: heterogeneity test P =0.56, I 2=0%, WMD =3.20, 95% CI: 1.38, 5.02, Z =3.45 (P<0.01), indicating the efficacy in the treatment group was significantly higher than that in the control group. The acupoints with frequency of more than 5 times were Fengchi (GB 20), Yuye (EX-HN 13), Jinjin (EX-HN 12), Lianquan (CV 23), Baihui (GV 20), tongue-three needles and Yamen (GV15). The meridians with frequency of more than 5 times were the extra channels, governor vessel, gallbladder channel, conception vessel and stomach channel. CONCLUSION: The clinical efficacy of acupuncture combined with speech training/regular treatment is significantly superior to that of control group (speech training, medication, regular treatment); acupuncture is safe and effective for dysarthria; the majority of selected acupoint is local acupoints around tongue, throat and neck, as well as extra points and empirical points. However, high-quality randomized controlled trials with large sample sizes are still needed to provide further evidence.

[Electroacupuncture Relieves Visceral Hypersensitivity by Down-regulating Mast Cell Number，PAR-2/TRPV 1 Signaling, etc. in Colonic Tissue of Rats with Irritable Bowel Syndrome].

OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Shangjuxu" (ST 37, Lower Confluent point) and "Tianshu" (ST 25, Front-Mu point) on visceral pain and expression of colonic tryptase(Try), proteinase-activated receptor 2(PAR-2)，transient receptor potential channel vanilloid subfamily member 1 (TPRV 1)，substance P (SP) and calcitonin gene-related peptide (CGRP) in rats with irritable bowel syndrome (IBS), so as to explore its mechanisms underlying improvement of IBS. METHODS: Forty male Sprague Dawley rats were equally randomized into normal control (control), model, medication and EA groups (n＝10 in each). The IBS model was established by chronic acute combining stress (CACS, water deprivation, fasting, tail clamping, forced swimming in ice water, restraint, etc.) for 21 days. Rats of the medication group were treated by gavage of Pinaverium Bromide (1 mg/mL, 15 mg/kg), once daily for 14 d. EA (10 Hz/50 Hz, 0.2－0.3 mA) was applied to bilateral ST 37 and ST 25 for 30 min, once daily for 14 d. The muscular withdrawal reflex (AWR) of both abdomen and buttock was detected by colorectal distension (CRD) with a water-filled balloon for examining the visceral hypersensitivity. The number of mast cells in the colonic tissue was counted after toluidine blue stain. The immunoactivity of colonic Try was determined by immunochemistry and the expression of colonic PAR-2, TRVP 1, SP and CGRP proteins detected by Western blot. RESULTS: After modeling, the body weight was significantly decreased in IBS rats of the model, medication and EA groups compared with their own individual pre-treatment and with the control group (P<0.01), and markedly higher in both medication and EA groups than in the model group (P<0.05, P<0.01). The intra-colonic volume thresholds for inducing abdominal and hip AWR were significantly lower in the model group than in the normal control group (P<0.01), and obviously higher in both medication and EA groups than in the model group (P<0.05，P<0.01). The AWR scores of intra-colorectal balloon at volumes of 0.5, 1.0 and 1.5 mL of water were significantly higher in the model group than in the control group (P<0.01), and considerably lower in the EA and medication groups than in the model group (P<0.01). The number of colonic MC and the expression levels of colonic Try, PAR-2, TRPV 1, SP and CGRP proteins were significantly higher in the model group than in the control group (P<0.01), and obviously decreased in both medication and EA groups relevant to the model group (P<0.01). Comparison between the medication and EA groups showed that the decreased expression levels of colonic PAR-2, TRPV 1, SP and CGRP proteins were significantly lower in the EA group than in the medication group (P<0.05), but no significant differences were found between the two groups in intra-colonic volumes for inducing AWR, AWR scores, body weight, and colonic MC number and Try immunoactivity levels (P>0.05)．. CONCLUSION: EA of ST 37 and ST 25 can relieve visceral hypersensitivity in IBS rats, which may be associated with its effects in down-regulating the number of MC and the expression of PAR-2, TRVP 1, SP, CGRP and Try proteins in the colonic tissue.

[Effect of Catgut Implantation on Spatial Learning-memory Ability, Expression of Hippocampal Protein Kinase C Interacting Protein 1 and GluR 2 and Ca2+ Content in Rats with Chronic Ischemic Cognitive Impairment].

OBJECTIVE: To observe the effect of catgut embedment at "Baihui" (GV 20), "Dazhui" (GV 14), etc. on learning-memory ability, expression of hippocampal protein kinase C interacting protein 1 (PICK 1) and glutamate receptor 2 (GluR 2) proteins and level of calcium ions, so as to explore its mechanism underlying improvement of vascular cognitive impairment. METHODS: A total of 56 male SD rats were randomly divided into sham operation, model, catgut embedment and medication groups (n=14 in each). The chronic ischemic cognitive impairment model was established by permanent occlusion of bilate-ral common carotid arteries. The catgut embedment was applied to GV 20, GV 14, "Shenshu" (BL 23) and "Xuanzhong" (GB 39), once a week, for 4 weeks. Rats of the medication group received intraperitoneal injection of monosialate tetrahexose ganglioside sodium (GM-1, 0.33 mg/kg), once daily for 4 weeks. The rats' learning-memory ability was detected by Morris water maze tasks, pathological changes of hippocampal Nissl's bodies were tested by Nissl staining. The expression levels of PICK 1 and GluR 2 proteins in the hippocampus were detected by Western bolt (WB), and the concentration of calcium ions in the hippocampus tissue was measured by Bicinchoninic acid (BCA) assay. RESULTS: After modeling, the mean escape latencies of place navigation test were significantly increased while the crossing times of target platform quadrant of space probing test notably decreased in the model, catgut embedment and medication groups compared with their own individual pre-modeling (P<0.01). Following the treatment, the increased mean escape latencies and decreased crossing times were markedly reversed in both catgut embedment and medication groups relevant to the model group (P<0.01, P<0.05). Nissl staining showed that after mode-ling, a smaller amount of Nissl bodies with dispersing arrangement, reduction in cellular volume, and loss of large amount of cells with vague structure, and hyperchromatic nuclear pyknosis were found in the hippocampus tissue, which was relatively milder in both catgut embedment and medication groups. The hippocampal PICK 1 protein expression and the calcium ion concentration were obviously higher in the model group than in the sham operation group (P<0.01), and significantly lower in both embedment and medication groups than in the model group (P<0.01, P<0.05), while hippocampal GluR 2 protein expression was obviously lower in the model group than in the sham operation group (P<0.01), and markedly higher in both embedment and medication groups than in the model group (P<0.05, P<0.01). No significant differences were found between the embedment and medication groups in the abovementioned indexes (P>0.05). CONCLUSION: Catgut implantation at GV 20 etc. can effectively improve the learning-memory ability in rats with chronic ischemic cognitive impairment, which may be related to its effects in down-regulating the expression of PICK 1 and calcium ion concentration and up-regulating the expression of AMPA receptor subunit GluR 2 protein in the hippocampus.

[Acupuncture for diarrhea-predominant irritable bowel syndrome:a meta-analysis].

OBJECTIVE: To systematically evaluate the efficacy and safety of acupuncture on diarrhea-predominant irritable bowel syndrome (IBS) in the past five years. METHODS: Online databases, including CNKI, VIP, WANFANG, PubMed, CBM, ScienceDirect OnSite, Cochrane Library, etc. were searched for randomized controlled trials (RCTs) of acupuncture for diarrhea-predominant IBS. Retrieval time was from January of 2011 to January of 2016. According to modified Jadad standard, the bias risk and quality assessment of each RCT included were evaluated by two researchers. RevMan 5.3 software was adopted for the meta-analysis. RESULTS: Totally 17 RCTs were included with 1 333 patients. The result of meta-analysis indicated the total effective rate of clinical symptoms improvement in the acupuncture group or acupuncture combined with western medicine group was superior to that in the western medicine group (OR=3.92, 95% CI:2.83~5.43, P<0.01), and the funnel plot was basically symmetry. The result of meta-analysis showed 3-month recurrence rate:OR=0.22, 95% CI:0.12~0.41 (P<0.01), indicating the recurrence rate in the acupuncture group was lower than that in the western medicine group in three month. CONCLUSIONS: Acupuncture for diarrhea-predominant irritable bowel syndrome is superior to conventional treatment of western medication, which can improve the clinical symptoms and reduce the recurrence rate of patients.