[Effect of nape cluster acupuncture on swallowing function and respiratory function in patients with post-stroke dysphagia].

OBJECTIVE: To observe the effect of nape cluster acupuncture on swallowing function and respiratory function in patients with post-stroke dysphagia, and to explore its relationship to cerebral arterial flow and neurotrophic factors. METHODS: A total of 120 patients with post-stroke dysphagia were randomized into an observation group and a control group, 60 patients in each one. The conventional swallowing rehabilitation therapy and respiratory function training were adopted in the control group. On the basis of treatment in the control group, nape cluster acupuncture was applied at Fengchi (GB 20), Tianzhu (BL 10), Wangu (GB 12), Lianquan (CV 23), Panglianquan (Extra), once a day; pricking blood was applied at Jinjin (EX-HN 12) and Yuye (EX-HN 13), once every 2 days. Both groups were treated for 2 weeks. The therapeutic efficacy was compared between the two groups, and the swallowing function (scores of Kubota water swallowing test, standardized swallowing assessment [SSA] and video fluoroscopic swallowing study [VFSS]), the respiratory function indexes (forced vital capacity [FVC], maximal voluntary ventilation [MVV] and maximal expiratory time), the bilateral cerebral arterial hemodynamics parameters (systolic peak velocity [Vs], mean flow velocity [Vm] and vascular resistance index [RI]) and the serology indexes (brain-derived neurotrophic factor [BDNF], nerve growth factor [NGF] and insulin-like growth factors-1 [IGF-1]) before and after treatment were observed in the both groups. RESULTS: The total effective rate was 80.0% (48/60) in the observation group, which was superior to 60.0% (36/60) in the control group (P<0.05). After treatment, the scores of Kubota water swallowing test and SSA in the observation group were lower than the control group (P<0.05), the VFSS score, FVC, MVV and maximal expiratory time were higher than the control group (P<0.05). After treatment, the Vs and Vm of bilateral cerebral artery and serum levels of BDNF, NGF and IGF-1 in the observation group were higher than the control group (P<0.05), the RI of bilateral cerebral artery was lower than the control group (P<0.05). CONCLUSION: On the basis of the conventional rehabilitation training, nape cluster acupuncture can effectively improve the swallowing function and respiratory function in patients with post-stroke dysphagia, its mechanism may be related to the improvement of cerebral hemodynamics and the regulation of neurotrophic factors.

[Analysis on regional homogeneity of resting brain during balance acupuncture-induced analgesic effect in migraine patients without aura].

OBJECTIVE: To observe the relationship between the analgesic effect of balance acupuncture and functional changes in brain in patients with migraine without aura. METHODS: A total of 40 cases of migraine without aura were equally randomized into a headache-acupoint group and a sham-acupoint group. When acupuncture given, a filiform needle was inserted into the headache-acupoint (the midpoint of the depression region anterior to the juncture of the first and second metatarsal bones on the dorsum of the foot) or the sham point (the midpoint of the depression region anterior to the juncture site between the 3rd and 4th metatarsal joints of the dorsum of the foot) about 25-40 mm deep and manipulated for a while till the patient experienced feelings of electric shock and numbness, then withdrawn immediately. The treatment was conducted once daily for 4 weeks. The visual analogue scale (VAS) was used to evaluate the severity of pain, and the regional homogeneity (ReHo) analysis of resting state functional magnetic resonance imaging (fMRI) was used to assess changes of the spontaneous brain activity. RESULTS: After acupuncture, the analgesic effect of headache-acupoint was better than that of the sham-acupoint in both intervention stage and the follow-up stage (P< 0.05), and was also stronger in the intervention stage than in the follow-up stage (P<0.05). There was no significant difference in the analgesic effect between the intervention stage and the follow-up stage in the sham-acupoint group (P>0.05). Compared with pre-intervention, 4-weeks' intervention at the headache-acupoint showed an increase of ReHo values in the anterior cingulate gyrus, anterior central gyrus, superior orbital frontal gyrus, insula, inferior lobule, left anterior cingulate gyrus, ventral lateral nucleus and ventral posteromedial nucleus of the thalamus, pontine nucleus, cerebellar tonsils and orbital frontal inferior gyrus of the brain (P<0.05), and a decrease of ReHo values in the right brain bridge, central posterior gyrus, posterior cingulate gyrus, left central anterior gyrus, posterolateral nucleus of thalamus, and hippocampus (P<0.05), separately. In the sham-acupoint group, the ReHo value was increased in the right tongue gyrus, the left anterior lobe, the anterior cingulate gyrus and the lower occipital gyrus of the brain (P<0.05), and reduced in the left ventral posterolateral nucleus of the thalamus, separately (P<0.05). CONCLUSION: Balance acupuncture stimulation of headache acupoint has an analgesic effect in migraine patients without aura, which may be related to its effect in regulating resting state brain function of the limbic-system-dominated multiple brain regions.

[Randomized controlled trails for "equilibrium-acupuncture" treatment of lumbar pain in patients with lumbar intervertebral disc prolapse].

OBJECTIVE: To observe the effect of "equilibrium-acupuncture" intervention on lumbar pain in lumbar intervertebral disc prolapse patients. METHODS: A total of 287 patients with lumbar intervertebral disc prolapse syndrome were randomly assigned to equilibrium acupuncture group (n = 143) and routine acupuncture group (n = 144) using SAS (Statistical Analysis System) Software. Patients of the equilibrium acupuncture group were treated by acupuncture stimulation of bilateral "Yaotong" point (at the middle site of the forehead) and those of the routine acupuncture group treated by acupuncture stimulation of Ashi-points, Weizhong (BL 40), Jiaji (EX-B 2), Shenshu (BL 23), etc. The treatment was conducted once daily for 20 days, then, 3 months' follow-up was given. Pain scores including pain rating index (PRI) and visual analogue scale (VAS) were given to the patients before and after the treatment using Chinese version of Short-Form of McGill Pain Questionnaire. Present pain intensity (PPI) was evaluated after the treatment. RESULTS: Before the treatment, no significant differences were found between the equilibrium acupuncture group and the routine acupuncture group in PRI and VAS scores (P > 0.05). Following the treatment, the pain symptom was apparently improved in both groups, and the rates of pain improvement (including excellent, good and moderate improvement rates) of the equilibrium acupuncture group were significantly higher than those of the routine acupuncture group from the 1st to the 4th treatment sessions, in the 20th treatment session and the 2nd follow-up (P < 0.05); and the PRI and VAS scores of the equilibrium acupuncture group were significantly lower than those of the routine acupuncture group after the 18th and 20th sessions of treatment and the 3 months' follow-up (P < 0.05). The cases and percentages of patients without pain (PPI rating) were significantly more in the equilibrium acupuncture group than in the routine acupuncture group in the 18th and 20th treatment sessions and the 2nd follow-up (P < 0.05). The "equilibrium-acupuncture" is relatively superior to routine acupuncture in the instant effect and long-term effect. CONCLUSION: "Equilibrium-acupuncture" has a faster and stable long-term analgesic effect for lumbar intervertebral disc prolapse patients.

[Effects of balance-acupuncture stimulation of "back pain" and "hip pain" points on plasma beta-endorphin and ACTH contents in rats with lumbar disc herniation].

OBJECTIVE: To observe the effect of balance acupuncture on the thermal pain threshold and plasma beta-endorphin (beta-EP) and adrenocorticotrophic hormone (ACTH) levels in lumbar disc herniation rats so as to research its mechanisms underlying improvement of lumbar disc protrusion. METHODS: A total of 120 male rats were randomly divided into blank control (control) group, model group, sham-operation(sham)group, and acupuncture group (n=30) which were further divided into 7-days (d) and 14-d subgroups. Rats in the acupuncture group were treated with balance acupuncture of "Back Pain" point (the midpoint between two eyes) and "Hip Pain"point (the midpoint between the acromial process and the axillary furrow). Thermal pain threshold was detected by using radiant heat detector. Plasma beta-EP and ACTH levels were determined by radioimmunoassay. RESULTS: Compared with the control group and pre-operation and sham group, the thermal pain reaction was increased significantly in the model group (P < 0.05). In comparison with the model group, the thermal pain reaction was decreased obviously from day 10 after acupuncture treatment in the acupuncture group (P < 0.05). Compared to the control group, plasma beta-EP contents on day 7 and 14 and ACTH level on day 14 in the model group were increased significantly (P < 0.05), while in comparison with the model group, plasma beta-EP contents on day 7 and 14 and ACTH level on day 14 in the acupuncture group were down-regulated markedly (P < 0.05). No significant difference were found between the control and sham groups in plasma beta-EP contents and ACTH levels on day 7 and 14 (P > 0.05). CONCLUSION: Balance acupuncture treatment can lower plasma ACTH level in lumbar disc herniation rats, which may contribute to its effect in easing lumbar disc herniation pain in clinic practice.

[Analgesic and anti-inflammatory effects of balance acupuncture on experimental scapulohumeral periarthritis in rabbits].

OBJECTIVE: To investigate therapeutic effects of balance acupuncture on scapulohumeral periarthritis (SP)and the mechanisms. METHODS: Thirty male New Zealand rabbits were randomly divided into a blank group (group B), a model group (group M) and a balance acupuncture group (group BA) with 10 rabbits in each group. SP model was established by using persistent mechanical strain and ice compress. Balance acupuncture at "Jiantong" point was applied in the animals in group BA, but not in the rabbits of the other two groups. Joint movement and pathological changes in tissues around the affected shoulder joint were observed, and interleukin-1beta (IL-1beta), 5-hydroxytryptamine (5-HT) in plasma and the affected surrounding tissues, and DNA contents in tendon of supraspinatus muscle were measured. RESULTS: The content of plasma 5-HT in group BA [(18.16 +/- 4.44) ng/mL] was significantly lower than that in group M [(23.28 +/- 5.89) ng/mL] (P < 0.05), but without obvious difference in IL-1beta content between the two groups (P > 0.05). Compared with group M, the contents of IL-1beta, 5-HT in affected surrounding tissues, and DNA expression in tendon of supraspinatus muscle were significantly lowered to va rious extent in group BA (P < 0.01, P < 0.05). CONCLUSION: Balance acupuncture can effectively improve local and systemic pathological situation induced by SP by way of reducing pain-producing factors, inflammatory factors and DNA expression to alleviate local organization and adhesions in rabbits with experimental SP.

["First regulating vitality" is core of acupuncture].

In combination with long-term clinical practice of acupuncture and moxibustion, and repeatedly learn, comprehend and probe theoretical intension about "essence" and "vitality" of acupuncture in Neijing (Internal Classic) to guide clinical practice. By the regulative mechanisms of needling "target points" of the peripheral nerve and central "target location", form single point therapy, rapid acupuncture, taking effect in three seconds, safety and other technique characteristics. Confirm that Deqi (needling sensation) is concrete reflection of "essence of acupuncture", regulating vitality (center) is the key of "first treating the vitality". The classical theory, "First treating vitality is essence for acupuncture" in Neijing, is correct and it is theoretical core of scientific acupuncture, which is of wide practical significance and profound historic significance for guiding clinical practice of acupuncture and moxibustion.