Comparison of efficacy of acupuncture-related therapy in the treatment of herpes zoster: A network meta-analysis of randomized controlled trials.

OBJECTIVE: A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to evaluate the efficacy and safety of acupuncture-related therapy in the treatment of herpes zoster (HZ) and to provide a reference for the clinical treatment of herpes zoster. METHODS: PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, VIP database, Wanfang Database, and SinoMED Chinese and English databases were systematically searched for RCTs on acupuncture-related therapy for HZ until February 2023. Literature screening, data extraction, and risk of bias assessment were performed independently by 2 researchers. R4.2.1 and Stata15.1 software were used for data analysis. RESULTS: A total of 26 RCTs involving 1929 HZ patients were included, and the network meta-analysis results showed that acupotomy appeared to be most effective in terms of improving VAS scores and the time of incrustation; SUCRA cumulative probability ranking showed the best efficacy of bloodletting in improving efficiency and the time of ceasing new blisters, acupuncture in improving the time of decrustation, and moxibustion in reducing the incidence of postherpetic neuralgia (PHN). CONCLUSIONS: Through a comprehensive comparison of 9 different acupuncture therapies, acupotomy was the optimal treatment to improve VAS pain scores and the time of incrustation; bloodletting, acupuncture, fire needle, and moxibustion could be effective intervention measures to improve the time of ceasing new blisters and decrustation and reduce the incidence of PHN; Western medicine was closely related to adverse reactions. The conclusions need to be further verified due to the limitations of the study.

Role of SIRT5 in the analgesic effectiveness of moxibustion at ST36 in mice with inflammatory pain.

Sirtuine5 (SIRT5) is an important molecule involved in the pathology of inflammatory diseases. To investigate the impact of SIRT5 on the analgesic effectiveness of moxibustion, we established a complete Freund's adjuvant- (CFA-) induced inflammatory pain in mice model. Moxibustion was applied at the Zusanli (ST36) acupoint in mice with inflammatory pain. The analgesic effectiveness was evaluated by thermal hyperalgesia and mechanical allodynia tests in the right paws after CFA injection. The expression of inflammatory cytokines, including the pro-inflammatory factors IL-1ß and TNF-α, and the anti-inflammatory factors IL-4 and TGF-ß expressions, was evaluated using by ELISA. Furthermore, SIRT5 was evaluated by immunofluorescence and western blotting. The results showed that, compared with the CFA group, both thermal and mechanical pain thresholds increased with moxibustion and the SIRT5 inhibitor MC3482 intervention at ST36. Additionally, compared to the CFA-induced group, the inflammatory mediators, including IL-1ß and TNF-α, decreased, while the anti-inflammatory cytokines IL-4 and TGF-ß increased with moxibustion and MC3482 ST36 acupoint injection. Western blot results showed a decreased expression of SIRT5 at the ST36 site with moxibustion and MC3482 injection, compared to the CFA-induced group. SIRT5 expression in the right paw of mice injected with moxibustion and MC3482 was higher than that in the CFA-induced group. This study revealed that SIRT5 expression is involved in moxibustion analgesia and may be a potential mediator in the regulation of analgesia.

[Dynamic Changes of Ultrasonographic Images of Zusanli (ST 36) Region During Deqi of Acupuncture Needle Stimulation].

OBJECTIVE: To observe the dynamic changes of ultrosonographic images of Zusanli (ST 36) area during Deqi after inserting acupuncture needles, so as to provide objective evidence for clinical Deqi. METHODS: Sixty healthy volunteers (30 men and 30 women) were recruited in the present study. The subjects were asked to take a supine position on a test-bed, sterilized disposable filiform needles were perpendicularly inserted into bilateral ST 36 till Deqi (without lifting, thrusting and twirling), when, high-resolution ultrasound scanning was conducted over the regional skeletal muscles by using a radio-frequency (5-12 MHz) coil probe (Philips IU Elite Ultrasound Diagnostic Instrument) after smearing a layer of gel at the skin of ST 36. RESULTS: Among these 120 points of the 60 volunteer subjects, a marked Deqi was obtained from 108 points (consisting of 90%) including 52 points in men and 56 in women, and 53 at the left ST 36 and 56 at the right ST 36. Ultrosonographic scanning displayed that when a strongest Deqi feeling was obtained from bilateral ST 36 in these 60 volunteers, the acupuncture needle-tip was about (25.32±5.82) mm in the vertical depth, and was (5.45±0.55) mm lateral to the tibia, involving the anterior tibial muscle near the deep fascia in 46 acupoints, and the intersection fascia of anterior tibial muscle and extensor digitorum longus in 62 acupoints. CONCLUSIONS: The anterior tibial muscle near the deep fascia and the intersection fascia of anterior tibial muscle and extensor digitorum longus around ST 36 are involved in strongest Deqi. There are no significant differences in the gender and location (left and right).

Clinical curative effect of electric acupuncture on acute cerebral infarction: a randomized controlled multicenter trial.

OBJECTIVE: To examine whether electric acupuncture can improve the daily life of patients with ischemic cerebral apoplexy at acute stage. METHODS: A stratified-block randomized controlled multicenter trial was designed for this study. Totally 340 patients with acute ischemic cerebral apoplexy were randomly divided into an electric acupuncture group and a control group. In the electric acupuncture group, 170 patients were treated with electric acupuncture and routine therapy, and 170 patients in the control group with routine therapy alone. Major indexes for judging curative effect were Barthel index at 3- and 6- months follow-up visits and number of re-hospitalized patients. Minor indexes for judging curative effect were change in the score for nervous dysfunction at 4 and 12 weeks follow-up visits and number of patients persisting in rehabilitation treatment with acupuncture during follow-up visit. RESULTS: Baseline data at the time of case selection between the two groups were similar. The odds ratio (OR) was 0.92, and the 95% confidence interval (CI) was 0.49-1.73 in disabled rate and 0.73 and 0.51-1.05 in the number of re-hospitalized patients in the electric acupuncture group at 6-month follow up visit compared with the control group. There was no difference in the score for nervous dysfunction at the end of 12-week follow-up visit between the two groups. The score for nervous dysfunction at the end of 4-week treatment in the electric acupuncture group was significantly higher than that in the control group (P < 0.05). The number of patients discharged from hospital who persisted in rehabilitation treatment with acupuncture in the acupuncture group was significantly higher than that in the control group. CONCLUSION: Using electric acupuncture to treat patients with acute ischemic cerebral apoplexy can effectively improve the nervous dysfunction scores after 4-week treatment and their ability to deal with daily life after 6-month follow-up visit. Systematic treatment with acupuncture may also reduce the number of patients with secondary apoplexy.

[Controlled observation on Guan-moxibustion and suspended moxibustion for treatment of herpes simplex virus facial neuritis].

OBJECTIVE: To evaluate clinical therapeutic effect of Guan-moxibustion on herpes simplex virus facial neuritis. METHODS: One hundred and sixty cases were enrolled in 3 centers and 157 cases were completed the study. All he patients were randomly divided into 2 groups, a Guan-moxibustion group and a suspended moxibustion plus acupuncture group. All of them were treated with basic acupuncture, and the Guan-moxibustion group were added with Guan-moxibustion and the suspended moxibustion group with suspended moxibustion. They were treated for 8 weeks, and facial disability index (FDI) and House-Brackmann facial nerve grading system were used to assess therapeutic effects. RESULTS: The effective rate was 91.0% in the Guan-moxibustion group and 72.2% in the suspended moxibustion group with a significant difference between the two groups (P < 0.05), the Guan-moxibustion being better than the suspended moxibustion group. CONCLUSION: The therapeutic effect of Guan-moxibustion plus acupuncture on herpes simplex virus facial neuritis is better than that of suspended moxibustion plus acupuncture.