The Role of Acupuncture Improving Cognitive Deficits due to Alzheimer's Disease or Vascular Diseases through Regulating Neuroplasticity.

Dementia affects millions of elderly worldwide causing remarkable costs to society, but effective treatment is still lacking. Acupuncture is one of the complementary therapies that has been applied to cognitive deficits such as Alzheimer's disease (AD) and vascular cognitive impairment (VCI), while the underlying mechanisms of its therapeutic efficiency remain elusive. Neuroplasticity is defined as the ability of the nervous system to adapt to internal and external environmental changes, which may support some data to clarify mechanisms how acupuncture improves cognitive impairments. This review summarizes the up-to-date and comprehensive information on the effectiveness of acupuncture treatment on neurogenesis and gliogenesis, synaptic plasticity, related regulatory factors, and signaling pathways, as well as brain network connectivity, to lay ground for fully elucidating the potential mechanism of acupuncture on the regulation of neuroplasticity and promoting its clinical application as a complementary therapy for AD and VCI.

Acupuncture Medical Therapy and its Underlying Mechanisms: A Systematic Review.

As a traditional Chinese alternative health care approach, acupuncture is gaining increasing attention and reputation in China and overseas. While becoming increasingly popular globally, some consumers and professionals still know little about the therapy and underlying mechanisms of acupuncture. Due to local superiority, there are large numbers of both clinical applications and mechanistic studies performed in China compared to countries overseas. Herein, this review attempts to give a comprehensive profile of the development, application, and mechanisms of acupuncture in treating major diseases. The number of clinical publications concerning acupuncture-treated neurological diseases, endocrine and metabolic diseases, circulatory diseases, respiratory diseases, etc. is first counted, and then, the application and therapeutic mechanisms of acupuncture on the predominant diseases in each category, including obesity, facial paralysis, sciatica, depression, hypertension, asthma, etc., are specifically discussed in this paper. The evolution of acupuncture tools and the rationality of acupoints are also discussed. This review not only summarizes the mechanisms of acupuncture but also provides useful information, such as specific acupoints and acupuncture procedures, for treating common diseases. Therefore, the current study provides useful information for both investigators and acupuncturists.

Efficacy of Acupuncture/Acupressure in the Prevention and Treatment of Nausea and Vomiting Across Multiple Patient Populations: Implications for Practice.

Nausea and vomiting are complex symptoms related to many disease processes. With many pharmacologic interventions noted to have adverse effects, many patients are turning to alternative therapies, including acupuncture and acupressure. Their efficacy has been proven for nausea and vomiting related to pregnancy, in patients receiving chemotherapy, and in postoperative, pediatric, and female patients. There are minimal to no side effects with the use of acupuncture and acupressure for the treatment of nausea and vomiting. Providers should be encouraged to discuss the efficacy, benefits, and side-effect profile of acupuncture and acupressure with patients who suffer from nausea and vomiting.

Effectiveness comparisons of catgut implantation at acupoint for obese type 2 diabetes: A protocol for systematic review and meta analysis.

BACKGROUND: With the change of people's life style, many more people are suffering from obese type 2 diabetes mellitus (T2DM). Acupoint catgut embedding is one of the acupuncture treatment principles in traditional Chinese medicine, which is widely used in the treatment of obese T2DM. However, there is no systematic review of the therapeutic effect of acupoint catgut embedding on obesity T2DM. Therefore, this article aims at the meta-analysis of acupoint catgut embedding in the treatment of obese T2DM, to clarify its curative effect. METHODS: A structured and systemic literature search was conducted in the following databases up to December 1, 2019: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, EMBASE, CNKI, Wanfang Database. We will use the Review Manager 5.3 software provided by Cochrane collaborative network for statistical analysis. Then we assessed the quality and risk of the included studies and observed the outcome measures. RESULTS: This meta-analysis will further determine the beneficial efficacy of acupoint catgut embedding on obesity T2DM. CONCLUSION: The purpose of this meta-analysis is to explore the effect of acupoint catgut embedding intervention on obese T2DM patients, and provide more options for clinicians and patients to treat obese T2DM. ETHICS AND DISSEMINATION: This systemic review will evaluate the efficacy and safety of acupoint catgut embedding in the treatment of obesity T2DM. Since all the data included are published, the systematic review does not need ethical approval. REGISTRATION NUMBER: CRD42020160801.

Clinical Events Associated with Acupuncture Intervention for the Treatment of Chronic Inflammation Associated Disorders.

Acupuncture is a key component of Chinese medicine. It describes a series of procedures involving the stimulation of skin through penetration of fine, single-use, sterile needles that result in the release of neurotransmitters. Although its use is on the growing trend, considerable controversy surrounds its value as a therapy. Standard randomized controlled trials that adhere to the accepted criteria should be conducted in the future to ensure the effectiveness of acupuncture. This article summarizes the current evidence regarding the use of acupuncture. It includes a description of the history, mode of operation, treatment of a variety of chronic disorders related to inflammation, and future directions for acupuncture use. Published clinical trials support the view that acupuncture is a possible candidate for the treatment of several chronic inflammation-related disorders.

Intractable or persistent hiccups treated with extracranial acupuncture: Two case reports.

RATIONALE: Hiccups are a common clinical symptom, and persistent hiccups and intractable hiccups severely impair the individual's quality of life. To date, there has been no effective treatment specifically for hiccups. Herein, we report 2 cases with intractable or persistent hiccups that were successfully treated with extracranial acupuncture. PATIENT CONCERNS: The first case is a 46-year-old woman who presented with a 7-year history of intractable hiccups that had worsened over the past 3 years. She also complained of chest tightness, dyspnea, palpitations, dreaminess, dysphoria, intolerance of cold, and hypohidrosis. The second case is a 75-year-old man who presented with a 7-day history of persistent hiccups and hematemesis for 3 hours. The patient's persistent hiccups were treated using traditional Chinese acupuncture, but the patient reported no remarkable benefit. DIAGNOSES: They were diagnosed as intractable or persistent hiccups. INTERVENTIONS: They were treated with extracranial acupuncture. OUTCOMES: The hiccups completely disappeared. During the follow-up period, the hiccups did not reappear. LESSONS: According to neural balance theory, an episode of the hiccups is caused by an imbalance of the nervous system. Extracranial acupuncture in the area adjacent to the external occipital protuberance affects the intracranial nervous system, which can effectively control the hiccups. Our study provides a new approach to the treatment of hiccups.

Combined effect of laser acupuncture and electroacupuncture in knee osteoarthritis patients: A protocol for a randomized controlled trial.

BACKGROUND: Knee osteoarthritis (KOA) is a common degenerative joint disorder that affects 250 million people globally. KOA can lead to disability and is often associated with cardiovascular disease, poor quality of life, and mortality. The most common treatment for KOA is non-steroidal anti-inflammatory drug administration. However, the analgesic effect is limited and often accompanied by multiple side effects. Hence, many KOA patients opt for complementary and alternative medicine. Acupuncture is one of the most popular complementary treatments with great analgesic effect and minimal side effect. Electroacupuncture (EA) and laser acupuncture (LA) have been known to reduce pain in KOA patients. However, to date, no study has assessed the benefits of combining these two therapies. METHODS: Fifty participants diagnosed with KOA, aged 50 years or older, and with consistent knee pain for more than 3 months were recruited and randomly assigned to the treatment group (EA plus LA) or control group (EA plus sham LA without laser output). All subjects in the treatment group will undergo a combined EA and LA treatment thrice a week for 4 weeks. The acupuncture will be performed on GB33, GB34, SP9, SP10, and ST36 sites. The treatment group will receive acupuncture with a transcutaneous electrical nerve stimulator at GB33, GB34, SP9, and SP10 sites and with LA at EX-LE5, ST35, and BL40 sites. The subjects in the control group will undergo the same treatment modality as the treatment group, except these subjects will not be exposed to laser output. Outcome measurements will include visual analog scale, Western Ontario McMaster Universities Osteoarthritis Index, Knee injury and osteoarthritis outcome, body composition analysis, knee range of motion, quadriceps muscle stiffness, one-leg standing with eyes open test, and the 30-s chair stand test before and after 4 weeks of intervention. OBJECTIVES: This protocol aims to investigate the combined effect of EA and LA in KOA patients.

The effects of acupuncture and electroacupuncture on Parkinson's disease: Current status and future perspectives for molecular mechanisms.

Among the progressive neurodegenerative disorders, Parkinson's disease (PD) is the second most common. Different factors have critical role in pathophysiology of PD such as apoptosis pathways, inflammatory cytokines, oxidative stress, and neurotransmitters and its receptors abnormalities. Acupuncture and electroacupuncture were considered as nondrug therapies for PD. Although numerous studies has been conducted for assessing the mechanism underlying electroacupuncture and acupuncture, various principal aspects of these treatment procedures remain not well-known. There have also been few investigations on the molecular mechanism of acupuncture and electroacupuncture therapy effects in PD. This review evaluates the effects of electroacupuncture and acupuncture on the molecular mechanism in PD.

The efficacy and safety of acupuncture in women with primary dysmenorrhea: A systematic review and meta-analysis.

BACKGROUND: This systematic review aimed to evaluate the current evidence regarding the efficacy and safety of acupuncture on primary dysmenorrhea. METHODS: Ten electronic databases were searched for relevant articles published before December 2017. This study included randomized controlled trials (RCTs) of women with primary dysmenorrhea; these RCTs compared acupuncture to no treatment, placebo, or medications, and measured menstrual pain intensity and its associated symptoms. Three independent reviewers participated in data extraction and assessment. The risk of bias in each article was assessed, and a meta-analysis was conducted according to the types of acupuncture. The results were expressed as mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CIs). RESULTS: This review included 60 RCTs; the meta-analysis included 49 RCTs. Most studies showed a low or unclear risk of bias. We found that compared to no treatment, manual acupuncture (MA) (SMD = -1.59, 95% CI [-2.12, -1.06]) and electro-acupuncture (EA) was more effective at reducing menstrual pain, and compared to nonsteroidal anti-inflammatory drugs (NSAIDs), MA (SMD = -0.63, 95% CI [-0.88, -0.37]) and warm acupuncture (WA) (SMD = -1.12, 95% CI [-1.81, -0.43]) were more effective at reducing menstrual pain. Some studies showed that the efficacy of acupuncture was maintained after a short-term follow-up. CONCLUSION: The results of this study suggest that acupuncture might reduce menstrual pain and associated symptoms more effectively compared to no treatment or NSAIDs, and the efficacy could be maintained during a short-term follow-up period. Despite limitations due to the low quality and methodological restrictions of the included studies, acupuncture might be used as an effective and safe treatment for females with primary dysmenorrhea.

[Research progress of acupuncture and moxibustion for endometrial receptivity in recent 10 years].

The research of acupuncture and moxibustion for endometrial receptivity in recent 10 years was reviewed. CNKI and PubMed databases were retrieved with "acupuncture" "moxibustion" and "endometrial receptivity" as key words. The retrieving time was from January of 2007 through December of 2016. As a result, 63 relevant papers were collected and 28 papers regarding clinical and experimental researches of acupuncture for endometrial receptivity were included into analysis. It was found that acupuncture and moxibustion could improve endometrial morphology (including the expression of pinopodes, endometrial thickness and the rate of endometrial type A), reduce the endometrial microcirculation (including endometrial pulsatility index, resistance index and hemodynamic index), increase the levels of estrogen and progesterone and the expressions of their receptors, and regulate the expression of molecular biological regulator (such as integrin, leukemia inhibitory factor, vascular endothelial growth factor and HOXA10). As a result, the endometrial receptivity was improved to provide good environment for embryo implantation and improve the pregnancy rate, which had significant advantage in the field of assisted reproductive technology. However, detections of pinopodes and integrin were invasive. Its application for clinical use had limitations. In addition, the evidence of acupuncture improving endometrial receptivity was still insufficient. By reviewing related research result, this paper further summarized and analyzed the action mechanism of acupuncture for endometrial receptivity to provide references for the clinical treatment.

[Progress of fMRI-based deqi research in recent 10 years].

OBJECTIVE: The research regarding the central mechanism of acupuncture deqi (arrival of qi) based on functional magnetic resonance imaging (fMRI) in recent 10 years was analyzed to summarize existing research achievements and experience. METHODS: The literature regarding fMRI-based deqi research published from January of 2007 through December of 2016 in CNKI and PubMed databases was collected. The research content and methods, including research design, inclusion criteria, acupoint selection and deqi evaluation, were analyzed. RESULTS: Totally 18 articles regarding the central mechanism of acupuncture deqi based on fMRI was included. According to research content, the literature was divided into two categories: deqi research and deqi sensation research. In deqi research, the differences of deqi and not deqi on brain functional activity were compared to summarize the central response pattern of deqi; in deqi sensation research, the differences of different sensations and intensities of deqi on central response were compared to explore the effects of different sensations and intensities of deqi on brain functional activity. In recent 10 years, the number of research gradually increased, and the type of design was various, mainly RCT and paired design. The majority of participants was healthy people, and single acupoint was the focus of researches, including Zusanli (ST 36), Waiguan (TE 5), Hegu (LI 4), etc. The evaluation of deqi was based on visual analogue scale (VAS). The research contents were mainly the effects of deqi and not deqi and different deqi sensations on brain function activities. The present studies confirmed that deqi and not deqi as well as different deqi sensations had different impacts on brain functional effects, and different acupoints had specific activated brain areas. There was a positive correlation between the degree of deqi and the intensity of the activation of brain regions. Furthermore, tingling sensation was not included to deqi sensations. CONCLUSION: The number and quality of fMRI-based deqi research need to be improved; the research content is simple, and research method is in exploratory stage. The results obtained in the literature are the phenomena of deqi in the central level, and it is imperative to summarize the essential link between deqi and the central effect through these phenomena to reveal the mechanism of deqi. The specific impact of deqi for brain function needs more clinical exploration.

[Statistics and analysis on acupuncture and moxibustion projects of the National Natural Science Foundation of China of traditional Chinese medicine universities and colleges in recent 10 years: taking the General Program and National Science Fund for Young Scholars as examples].

To analyze statistically the situation of the National Natural Science Foundation of China (NSFC) from 2007 to 2016 in the field of acupuncture and moxibustion for supporting the national Universities colleges of traditional Chinese medicine on the General Program (GP) and the National Science Fund for Young Scholars (NSFYS). In view of five aspects, named fund, supporting units, key words, method, disorder and signal path, the differences were compared between GP and NSFYS, the following characteristics were summarized. ① The fund aid was increased from 2007 through 2013 and down-regulated from 2013 through 2016. In recent ten years, the funding condition was fluctuated, but increasing in tendency generally. ② The relevant projects of the same research direction had been approved continuously for over 3 years in a part of TCM universities, in which, the research continuity was the hot topic. ③ Regarding the therapeutic methods, acupuncture was the chief therapy; electroacupuncture, moxibustion and acupoints were involved as well. ④ The disorders involved in the research were cerebral ischemia, myocardial ischemia and reperfusion injury. It is suggested that the ischemic disorder is predominated in the research. ⑤ The signal path occupied the main research index system, including cell proliferation, metabolism, immune, apoptosis and autophagy. The researches on the other aspects were less.

Trends in use of acupuncture among adults in Taiwan from 2002 to 2011: A nationwide population-based study.

In recent years, acupuncture has gained in popularity worldwide. However, recent epidemiological studies are lacking. We conducted this study to investigate the trends in acupuncture utilization among adults in Taiwan from 2002 to 2011. We analyzed data from the Longitudinal Health Insurance Database 2000 (LHID 2000), which contains all original claims data for 1 million beneficiaries randomly sampled from the registry of all beneficiaries enrolled in the National Health Insurance (NHI) program in 2000. The one-year prevalence of acupuncture use among adults increased from 7.98% in 2002 to 10.9% in 2011. Acupuncture use significantly increased yearly (incidence rate ratio = 1.04, 95% CI = 1.03-1.05, p<0.001). Patients who were female, were middle-aged, resided in highly urbanized areas and suffered from injury or disorders of the musculoskeletal system were prone to more frequent acupuncture use. Our study revealed that the utilization of acupuncture became increasingly popular in Taiwan from 2002 to 2011. Our findings may provide useful information for clinical practice and research as well as for health policy decision making.

Review: Statutory regulation of invasive complementary therapies, such as hijama and acupuncture, is the only effective way of ensuring both patient safety and good practice.

The development of statutory regulation of healthcare professionals first emerged in the 15th century in the UK. However, it was not until the 20th century that statutory regulation of complementary therapies emerged with the Osteopath and Chiropractors Acts. However, during that period, acupuncture failed to gain statutory regulation but was rather subject to the equivalent of trading standards. This review explores the background to this failure and the present need for statutory regulation. It draws comparisons with the need for regulation of hijama, another invasive therapy, for which there is at present no regulation. The benefits of the negative licensing model developed in Australia are considered.

Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis.

Despite wide use in clinical practice, acupuncture remains a controversial treatment for chronic pain. Our objective was to update an individual patient data meta-analysis to determine the effect size of acupuncture for 4 chronic pain conditions. We searched MEDLINE and the Cochrane Central Registry of Controlled Trials randomized trials published up until December 31, 2015. We included randomized trials of acupuncture needling versus either sham acupuncture or no acupuncture control for nonspecific musculoskeletal pain, osteoarthritis, chronic headache, or shoulder pain. Trials were only included if allocation concealment was unambiguously determined to be adequate. Raw data were obtained from study authors and entered into an individual patient data meta-analysis. The main outcome measures were pain and function. An additional 13 trials were identified, with data received for a total of 20,827 patients from 39 trials. Acupuncture was superior to sham as well as no acupuncture control for each pain condition (all P < .001) with differences between groups close to .5 SDs compared with no acupuncture control and close to .2 SDs compared with sham. We also found clear evidence that the effects of acupuncture persist over time with only a small decrease, approximately 15%, in treatment effect at 1 year. In secondary analyses, we found no obvious association between trial outcome and characteristics of acupuncture treatment, but effect sizes of acupuncture were associated with the type of control group, with smaller effects sizes for sham controlled trials that used a penetrating needle for sham, and for trials that had high intensity of intervention in the control arm. We conclude that acupuncture is effective for the treatment of chronic pain, with treatment effects persisting over time. Although factors in addition to the specific effects of needling at correct acupuncture point locations are important contributors to the treatment effect, decreases in pain after acupuncture cannot be explained solely in terms of placebo effects. Variations in the effect size of acupuncture in different trials are driven predominantly by differences in treatments received by the control group rather than by differences in the characteristics of acupuncture treatment. PERSPECTIVE: Acupuncture is effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain.

[Current development of acupuncture-moxibustion in India:a case study of West Bengal].

Acupuncture-moxibustion was introduced to India in mid-20th century and has been legislated in two provinces in India where the registration of acupuncture practitioners is implemented at present. In India, the central government recognizes that acupuncture-moxibustion is an approach of treatment and is permitted by the licensed doctor. Because of the weakness of the basic development of acupuncture-moxibustion in India, the go-vernment put great effort to support and protect their national traditional medicine. Acupuncture-moxibustion development is mainly in the folk and in the progression for the provincial and governmental legislation. In the paper, by taking West Bengal as example, the legislation, clinical application, education and scientific research of acupuncture-moxibustion are analyzed so that an approach is explored for the further development of acupuncture-moxibustion in India.

[The present situation and development of acupuncture and moxibustion in Taiwan].

The development history, present situation, educational institution and association of acupuncture and moxibustion in Taiwan are reviewed. Acupuncture and moxibustion is considered as an invasive treatment in Taiwan, which has been introduced to Taiwan since the late Ming Dynasty and early Qing Dynasty, with a history of less than 400 years. At present, there are two acupuncture-related academic institutions and two educational institutions, which are all private. The acupuncture and moxibustion is applied for various diseases, and the cost is based on whether clinics and treatments are covered by medical insurance, so the differences are significant.