Acupuncture combined with cognitive-behavioural therapy for insomnia (CBT-I) in patients with insomnia: study protocol for a randomised controlled trial.

INTRODUCTION: Insomnia affects physical and mental health due to the lack of continuous and complete sleep architecture. Polysomnograms (PSGs) are used to record electrical information to perform sleep architecture using deep learning. Although acupuncture combined with cognitive-behavioural therapy for insomnia (CBT-I) could not only improve sleep quality, solve anxiety, depression but also ameliorate poor sleep habits and detrimental cognition. Therefore, this study will focus on the effects of electroacupuncture combined with CBT-I on sleep architecture with deep learning. METHODS AND ANALYSIS: This randomised controlled trial will evaluate the efficacy and effectiveness of electroacupuncture combined with CBT-I in patients with insomnia. Participants will be randomised to receive either electroacupuncture combined with CBT-I or sham acupuncture combined with CBT-I and followed up for 4 weeks. The primary outcome is sleep quality, which is evaluated by the Pittsburgh Sleep Quality Index. The secondary outcome measures include a measurement of depression severity, anxiety, maladaptive cognitions associated with sleep and adverse events. Sleep architecture will be assessed using deep learning on PSGs. ETHICS AND DISSEMINATION: This trial has been approved by the institutional review boards and ethics committees of the First Affiliated Hospital of Sun Yat-sun University (2021763). The results will be disseminated through peer-reviewed journals. The results of this trial will be disseminated through peer-reviewed publications and conference abstracts or posters. TRIAL REGISTRATION NUMBER: CTR2100052502.

Electroacupuncture promotes the survival and synaptic plasticity of hippocampal neurons and improvement of sleep deprivation-induced spatial memory impairment.

AIMS: This study aimed to investigate whether electroacupuncture (EA) promotes the survival and synaptic plasticity of hippocampal neurons by activating brain-derived neurotrophic factor (BDNF)/tyrosine receptor kinase (TrkB)/extracellular signal-regulated kinase (Erk) signaling, thereby improving spatial memory deficits in rats under SD. METHODS: In vivo, Morris water maze (MWM) was used to detect the effect of EA on learning and memory, at the same time Western blotting (WB), immunofluorescence (IF), and transmission electron microscopy (TEM) were used to explore the plasticity of hippocampal neurons and synapses, and the expression of BDNF/TrkB/Erk signaling. In vitro, cultured hippocampal neurons were treated with exogenous BDNF and the TrkB inhibitor K252a to confirm the relationship between BDNF/TrkB/Erk signaling and synaptic plasticity. RESULTS: Our results showed that EA mitigated the loss of hippocampal neurons and synapses, stimulated hippocampal neurogenesis, and improved learning and memory of rats under SD accompanied by upregulation of BDNF and increased phosphorylation of TrkB and Erk. In cultured hippocampal neurons, exogenous BDNF enhanced the expression of synaptic proteins, the frequency of the postsynaptic currents, and the phosphorylation of TrkB and Erk; these effects were reversed by treatment with K252a. CONCLUSIONS: Electroacupuncture alleviates SD-induced spatial memory impairment by promoting hippocampal neurogenesis and synaptic plasticity via activation of BDNF/TrkB/Erk signaling, which provided evidence for EA as a therapeutic strategy for countering the adverse effects of SD on cognition.

The Effects of Electrical Acupuncture and Essential Amino Acid Supplementation on Sarcopenic Obesity in Male Older Adults: A Randomized Control Study.

OBJECTIVE: Aging which is accompanied by loss of skeletal muscle and increase of body fat in some adults older than 60 years does not only result in remarkable influences on daily life function but also increases the risk of cardiovascular events. This study used electrical acupuncture together with essential amino acid supplementation to treat sarcopenic obesity (SO) in male older adults. METHODS: A total of 48 male participants with SO (>60 years old) were randomized to electrical acupuncture with oral essential amino acids (EA + AA) or oral essential amino acids alone (AA). Acupuncture points on the limbs were punctured and stimulated electrically once every 3 days for 12 weeks. All participants received essential amino acids orally, twice per day for 28 weeks. Body fat percentage (BFP) and appendicular skeletal muscle index (ASM/H2) was determined by bioelectrical impedance analysis. RESULTS: Both groups exhibited significant changes in BFP after 12, 20, and 28 weeks compared with baseline values; for ASM/H2, there were significant differences to baseline values after 12, 20, and 28 weeks in the EA + AA group, but only after 28 weeks in the AA group. Between the two groups, there were significant differences in BFP after 12, 20, and 28 weeks, and in ASM/H2 after 20 and 28 weeks. CONCLUSION: Both methods decrease BFP and increase ASM/H2. In male older adults, electrical acupuncture with oral essential amino acids is more effective and can increase muscle mass in a shorter time than oral essential amino acids alone.

[Analysis on the atypical clinical accidents of acupuncture based on the individual factors in patients].

The hidden risk of acupuncture has become the factor of the high incidence of adverse reaction of acupuncture in clinical practice. The retrospective analysis and the typical cases analysis are especially important for the prevention from the hidden risk of acupuncture. In the paper, the relevant literatures were reviewed, the basic diseases were listed such as diabetes, hypertension and digestive gastric ulcer that were neglected by the physicians, and the adverse reactions induced by the therapeutic history and the body constitutions were analyzed. It was stated in the paper that because of the individual factors of patient, the risks of the atypical clinical accidents of acupuncture were extremely serious and easily neglected by the clinical acupuncture physicians. It is very necessary to remind the clinical acupuncture physicians to understand the basic diseases, basic treatment as well as the peculiarity of body constitution of the patients besides their chief complaints. Moreover, acupuncture should be applied very carefully after identifying the pulse condition and the contraindication so as to ensure the patient's safety and obtain the optimal efficacy.

Improvement in acupoint selection for acupuncture of nerves surrounding the injury site: electro-acupuncture with Governor vessel with local meridian acupoints.

Peripheral nerve injury not only affects the site of the injury, but can also induce neuronal apoptosis at the spinal cord. However, many acupuncture clinicians still focus only on the injury site, selecting acupoints entirely along the injured nerve trunk and neglecting other regions; this may delay onset of treatment efficacy and rehabilitation. Therefore, in the present study, we compared the clinical efficacy of acupuncture at Governor vessel and local meridian acupoints combined (GV/LM group) with acupuncture at local meridian acupoints alone (LM group) in the treatment of patients with peripheral nerve injury. In the GV/LM group (n = 15), in addition to meridian acupoints at the injury site, the following acupoints on the Governor vessel were stimulated: Baihui (GV20), Fengfu (GV16), Dazhui (GV14), and Shenzhu (GV12), selected to treat nerve injury of the upper limb, and Jizhong (GV6), Mingmen (GV4), Yaoyangguan (GV3), and Yaoshu (GV2) to treat nerve injury of the lower limb. In the LM group (n = 15), only meridian acupoints along the injured nerve were selected. Both groups had electroacupuncture treatment for 30 minutes, once a day, 5 times per week, for 6 weeks. Two cases dropped out of the LM group. A good or excellent clinical response was obtained in 80% of the patients in the GV/LM group and 38.5% of the LM group. In a second study, an additional 20 patients underwent acupuncture with the same prescription as the GV/LM group. Electomyographic nerve conduction tests were performed before and after acupuncture to explore the mechanism of action of the treatment. An effective response was observed in 80.0% of the patients, with greater motor nerve conduction velocity and amplitude after treatment, indicating that electroacupuncture on specific Governor vessel acupoints promotes functional motor nerve repair after peripheral nerve injury. In addition, electromyography was performed before, during and after electroacupuncture in one patient with radial nerve injury. After a single session, the patient's motor nerve conduction velocity increased by 23.2%, indicating that electroacupuncture at Governor vessel acupoints has an immediate therapeutic effect on peripheral nerve injury. Our results indicate that Governor vessel and local meridian acupoints used simultaneously promote functional repair after peripheral nerve injury. The mechanism of action may arise from an improvement of the local microenvironment in injured nervous tissue, as well as immediate effects of Governor vessel and local meridian acupoint stimulation to ensure the continuity between the peripheral and central nervous systems.

[Uterine involution after cesarean section promoted with acupuncture: a randomized controlled trial].

OBJECTIVE: To explore the effect and feasibility of acupuncture in uterine involution after cesarean section. METHODS: Seventy cases of cesarean section in primipara were randomized into an observation group (33 cases) and a control group (37 cases). In the control group, the conventional treatment was adopted after cesarean section. In the observation group, on the basic treatment as the control group, acupuncture was applied at Sanyinjiao (SP 6), Hegu (LI 4), Qihai (CV 6) and Guanyuan (CV 4). In 2 h after operation, acupuncture started, once a day, continuously for five times. The daily height of uterine fundus, daily uterine fundus decreasing degree, postpartum blood loss, lochia duration and ultrasonic B test in 42 days of postpartum were compared between the two groups. RESULTS: The therapeutic methods of the two groups all promoted uterine contraction. The postpartum height of uterine fundus in the observation group was lower than that in the control group (all P<0.05) and the uterine fundus decreasing degree was higher than that in the control group (all P<0.05). The blood loss in 2 h, 6 to 12 h and 24 to 48 h of postpartum was less than that in the control group (all P<0.05). The lochia duration in the observation group was shorter than that in the control group (P<0.05). CONCLUSION: Acupuncture promotes uterine contraction, reduces postpartum blood loss and lochia duration and benefits uterine involution after cesarean section.