Far-infrared stimulation of Neiguan acupoints improves heart rate variability and ameliorate fatigue in hemodialysis patients: A randomized trial.

BACKGROUND: In 2018, 84 615 patients in Taiwan received hemodialysis, of which about 62% to 97% suffered from fatigue. Fatigue caused by hemodialysis may be mental or physical. However, the detailed mechanism remains unclear. This study aimed to evaluate whether far-infrared stimulation of the Neiguan acupoint (P6) could effectively reduce fatigue and improve heart rate variability (HRV) in hemodialysis patients. METHODS: We conducted a two-arm, randomized trial in a hemodialysis center between March 2015 and March 2016. A total of 73 hemodialysis patients were included and were randomly assigned to an experimental group (n = 37) and a control group (n = 36). The experimental group received far-infrared radiation on Neiguan acupoint during hemodialysis for 12 weeks. The outcomes were fatigue level and HRV. RESULTS: All patients showed moderate fatigue ( M = 26.00 ± 13.01, range = 0-78) at baseline. Far-infrared stimulation on Neiguan acupoint significantly reduced overall fatigue ( ß = 24, p < 0.001) and improved HRV ( ß = 74.36, p < 0.001). Compared to the control group, the experiment group had significantly reduced fatigue levels in all aspects such as reduced energy and motivation ( ß = -2.97, p < 0.001), reduced physical strength ( ß = -1.28, p < 0.01), reduced mental capability ( ß = -2.38, p < 0.001), reduction in daily activities ( ß = -1.48, p < 0.01), depressed mood and loss of control ( ß = -1.21, p < 0.05) as well as increased autonomous nervous system activity ( ß = 14.71, p < 0.01) in the third month of stimulation. CONCLUSION: Far-infrared stimulation of the Neiguan acupoints effectively reduces fatigue and increases autonomic nervous system activity in hemodialysis patients.

Moxibustion for Managing Postoperative Urinary Retention After Hemorrhoidectomy and Anorectal Surgeries: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

PURPOSE: Common surgical procedures for conditions affecting the anus and rectum such as hemorrhoidectomy are associated with high risks of postoperative urinary retention (POUR). Little is known about the efficacy of moxibustion in managing POUR after such surgical procedures. This systematic review and meta-analysis aimed to review the related literature and synthesize data on the effectiveness of moxibustion in managing POUR after common anorectal surgeries. DESIGN: A systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS: PubMed, EMBASE, CENTRAL, Chinese National Knowledge Infrastructure (CNKI), VIP information, and Wanfang databases were searched to October 1, 2021 using the keywords urinary retention, moxibustion, and moxa. Randomized controlled trials (RCTs) investigating patients who had developed POUR after hemorrhoidectomy or other anorectal surgeries were eligible for inclusion. Patients receiving moxibustion formed the intervention group and the control group received usual care alone. Primary outcomes were markedly effective rate, defined as spontaneous voiding with complete symptom relief within 30 to 60 minutes after treatment; and total effective rate (ie, markedly effective rate plus effective rate, defined as spontaneous voiding with partial relief of symptoms within 60 minutes to 4 hours after treatment). Secondary outcome was time to first urination after treatment. FINDINGS: Thirty-four RCTs met the eligibility criteria. Pooled analysis revealed that the markedly effective rate was significantly higher in the moxibustion group than that in the control group (pooled RR = 2.53, 95% CI = 2.17-2.95), and the total effective rate in the moxibustion group was also higher than that in the control group (pooled RR = 5.02, 95% CI = 4.01-6.28). The intervention group had significantly shorter times to first urination than controls (pooled effect = -2.81, 95% CI = -2.06 to -3.56). CONCLUSIONS: Moxibustion appears superior to usual care in relieving POUR after common anorectal surgeries. Future studies are still warranted to confirm these findings.

Efficacy of acupuncture in children with asthma: a systematic review.

BACKGROUND: We performed a systematic review of the efficacy of various types of acupuncture in the treatment of asthma in children. METHODS: We searched the MEDLINE, Embase, and Cochrane Library databases up to October 20, 2014. Randomized controlled trials (RCTs) of children and adolescents (<18 years of age) with asthma were included. Data extraction was applied, and methodologic quality was assessed. RESULTS: A total of 32 articles were assessed for eligibility, and seven studies comprising 410 patients were included in the systematic review. Two RCTs showed significant improvement in peak expiratory flow (PEF) variability for acupuncture (traditional and laser) vs. control, with one showing significant improvement in asthma-specific anxiety level, but no significant differences in other lung function parameters or quality of life. Another RCT reported significant benefits of laser acupuncture on lung function parameters but did not describe or report statistical analyses. One crossover RCT showed significant improvements in response to both acupuncture and placebo acupuncture, with better improvements with acupuncture compared to placebo acupuncture (forced exhaled volume in 1 s [FEV1], PEF). Two additional crossover RCTs showed no significant differences between single sessions of laser acupuncture and placebo acupuncture on baseline, postacupuncture, and postinduced bronchoconstriction values (% predicted FEV1, maximum expiratory flow). A recent study showed a significant effect of acupuncture paired with acupressure on medication use and symptoms in preschool-age children. Methodologic and reporting variability remains an issue. However, the results suggest that acupuncture may have a beneficial effect on PEF or PEF variability in children with asthma. CONCLUSIONS: The efficacy of acupuncture on other outcome measures is unclear. Large-scale RCTs are needed to further assess the efficacy of acupuncture in the treatment of asthma in children.

Correlation of electrical conductance in meridian and autonomic nervous activity after auricular acupressure in middle-aged women.

BACKGROUND: This study aimed to examine the correlation of heart rate variability (HRV) and meridian electrical conductance among middle-aged women during an 8-week period of auricular acupressure (AA) treatment for weight reduction. METHODS: Sixty (60) subjects were randomized either to a control group (n=30) or to a treatment group with AA (n=30). Anthropometric parameters, HRV indices, and meridian levels were measured before treatment, at the 5th week, and 1 week after the 8-week treatment period. RESULTS: Although no significant changes were observed in body weight (BW) and body-mass index (BMI) from baseline to 1 week after AA treatment, a significant decrease in Waist Circumference (WC) was observed in the acupressure group. In contrast, the subjects' BW, BMI, and WC were significantly increased from baseline to the 9th week in the control group. With adjustment for baseline low frequencies (LF) of HRV, the LF at the 5th and 9th weeks in the acupressure groups was generally lower than that in the control group, with a p-value=0.027 using the mixed linear model. The meridian levels for Spleen, Bladder, and Gallbladder were significantly lower in the group subjected to acupressure than in the control group at the 5th week. CONCLUSIONS: The results of the present study indicate that AA tends to inactivate the sympathetic nervous activity demonstrated by both HRV and meridian electrical conductance changes. As a result, AA may modulate the autonomic nervous system to exert its physiological effect through the pathway of the meridian system.

Acupuncture or Acupressure at the Sanyinjiao (SP6) Acupoint for the Treatment of Primary Dysmenorrhea: A Meta-Analysis.

This meta-analysis aimed to evaluate the effectiveness of acupuncture or acupressure at the Sanyinjiao (SP6) acupoint in relieving pain associated with primary dysmenorrhea. We searched the scientific literature databases to identify randomized controlled trials. The primary outcome was visual analogue scale (VAS) pain score. Three acupuncture and four acupressure trials were included in the meta-analyses. For the acupuncture analysis, there was no difference in the mean VAS score reduction between the SP6 acupoint and control (GB39 acupoint) groups (-4.935; lower limit = -15.757, upper limit = 5.887; P = 0.371). For the acupressure analysis, there was a significant difference in the mean VAS score after intervention between the SP6 acupoint and control (rest/light touch at SP6/nonacupoint acupressure) groups, favoring the SP6 acupoint group (-1.011; lower limit = -1.622, upper limit = -0.400; P = 0.001). Sensitivity analyses demonstrated good reliability of the meta-analyses findings. These findings suggest that acupuncture at SP6 is not more effective than acupuncture at an unrelated acupoint in the relief from primary dysmenorrhea. Acupressure at SP6 may be effective in the relief from primary dysmenorrhea. High-quality randomized controlled trials are needed to confirm these findings.

Effect of yoga on serum homocysteine and nitric oxide levels in adolescent women with and without dysmenorrhea.

BACKGROUND: The purpose of the present study is to explore the effect of yoga on the serum levels of homocysteine and nitric oxide (NO) in a cohort of women with primary dysmenorrhea and normal healthy controls. METHODS: A prospective controlled trial was conducted in 35 women with primary dysmenorrhea and 35 healthy controls in a community-based study. Short-form Menstrual Distress Questionnaires (MDQs) were administered to assess the menstrual symptoms. All participants were provided yoga intervention, twice a week at 30 minutes/session, consecutively for 8 weeks. Blood samples were drawn from each woman on the third day of the menstrual cycle. Assessments of MDQs and blood samples for the determination of homocysteine and NO concentrations were performed at baseline and within the first 3 days of their next menses after completion of yoga intervention. RESULTS: A total of 30 women from the dysmenorrheal group and 30 from the control group completed the study. Homocysteine levels were higher in those with dysmenorrhea when compared with healthy controls before yoga intervention (Mann-Whitney U test, p<0.05); however, no statistically significant differences were found between the two groups after 8 weeks of yoga training (p<0.05). The concentrations of homocysteine in both the dysmenorrheal and control groups after 8 weeks decreased by 51.37% and 46.46%, respectively (p<0.001). There were no statistically significant differences in NO levels between the two groups at baseline and after intervention. The total scores on the MDQs decreased significantly after yoga intervention in the dysmenorrheal group (p<0.05). CONCLUSIONS: Yoga intervention was found to be associated with reductions in severity of dysmenorrhea and may be effective in lowering serum homocysteine levels after an intervention period of 8 weeks. These observations suggest that yoga may have therapeutic effects in women by restoring endothelial function.

The effect of lavender aromatherapy on autonomic nervous system in midlife women with insomnia.

The objective of this study is to determine the effects of 12 weeks of lavender aromatherapy on self-reported sleep and heart rate variability (HRV) in the midlife women with insomnia. Sixty-seven women aged 45-55 years, with a CPSQI (Chinese version of Pittsburgh Sleep Quality Index) greater than 5, were recruited from communities in Taiwan. The experimental group (n = 34) received lavender inhalation, 20 min each time, twice per week, for 12 weeks, with a total of 24 times. The control group (n = 33) received health education program for sleep hygiene with no intervention. The study of HRV was analyzed by time- and frequency-domain methods. Significant decrease in mean heart rate (HR) and increases in SDNN (standard deviation of the normal-to-normal (NN) intervals), RMSDD (square root of the mean squared differences of successive NN intervals), and HF (high frequency) of spectral powers analysis after lavender inhalation were observed in the 4th and 12th weeks of aromatherapy. The total CPSQI score of study subjects was significantly decreased in the experimental group (P < 0.001), while no significant difference was observed across the same time period (P = 0.776) in the control group. Resting HR and HRV measurements at baseline 1 month and 3 months after allocation showed no significant difference between the experimental and control groups. The study demonstrated that lavender inhalation may have a persistent short-term effect on HRV with an increase in parasympathetic modulation. Women receiving aromatherapy experienced a significant improvement in sleep quality after intervention. However, lavender aromatherapy does not appear to confer benefit on HRV in the long-term followup.

Local thermal therapy effects on menopausal symptoms and bone mineral density.

OBJECTIVES: The aim of this study was to evaluate the effects of local thermal therapy with far-infrared rays (FIR) on menopausal symptoms and bone mineral density (BMD) in postmenopausal women. SUBJECTS AND METHODS: A prospective randomized, controlled trial was conducted in female volunteers from communities in Northern Taiwan. The intervention group (n=22) received local thermal therapy with the help of FIR from an FIR emitter, for approximately 20 minutes per day, twice a week, for 20 sessions. They received the therapy on their backs while lying in a supine position. The control group (n=21) received no treatment. The primary outcome was the change in the Perceived Perimenopausal Disturbances Scale, designed for the measurement of menopause-related symptoms (MRS) before and after completion of treatment in a 10-week period. Secondary outcome parameters included serum levels of estradiol (E2) with osteocalcin (OC), and calcaneal BMD by quantitative ultrasound. RESULTS: After 10 weeks of intervention, MRS determined by the scale decreased in mean total scores and mean scores for vasomotor, musculoskeletal, urologic, reproductive, and psychologic domains (p<0.05), except for reproductive (sexuality-related) symptoms. In the control group, mean total scores and scores of each domain had no significant difference between baseline and follow-up examination after 10 weeks. There was no significant difference between the quantitative ultrasound parameters in the calcaneus, serum E2, and OC levels either at the baseline or in the changes from the baseline between the intervention and control groups of women (p>0.05). CONCLUSIONS: Local thermal therapy with FIR results in a significant reduction of MRS in postmenopausal women. Serum E2, OC levels, and calcaneal BMD showed no significant changes between the two groups. These results suggest that FIR local thermal therapy may be a potential alternative for the management of postmenopausal symptoms.

Transcutaneous electrical stimulation of acupoints changes body composition and heart rate variability in postmenopausal women with obesity.

This study aimed to evaluate the effect of transcutaneous electric acupoint stimulations (TEAS) on body composition and heart rate variability (HRV) in postmenopausal women with obesity. In this prospective study, 49 postmenopausal women were recruited in Taiwan. Body composition was used as a screening test for obesity (percentage body fat > 30%, waist circumference > 80 cm). The experimental group (n = 24) received TEAS treatment 30 min twice per week for 12 weeks at the Zusanli (ST 36) and Sanyinjiao (SP 6) acupoints. The control group (n = 25) did not receive any intervention. The study of HRV was analyzed by time (standard deviation of the normal-to-normal (NN) intervals (SDNN) and square root of the mean squared differences of successive NN intervals (RMSSD) indices) and frequency domain methods. Power spectral components were obtained at low (LF) and high (HF) frequencies. Body composition and HRV values were measured at the 4th, 8th, and 12th weeks. A total of 40 subjects completed this study. Waist circumference and percentage body fat in the experimental group (n = 20) were significantly less than those of the control group (n = 20) at the 8th and 12th weeks (all P < .05). Additionally, at the same time points, percentage lean body mass in the experimental group was significantly greater than that in the control group (P < .05). SDNN values increased significantly at the 4th and 8th weeks when compared with the control group (all P < .05). At 12 weeks, SDNN value was not significantly different from that of the control group (P = .105). TEAS treatment improves body composition, and has a transient effect on the HRV in postmenopausal women with obesity.

Effects of auricular acupressure on menstrual symptoms and nitric oxide for women with primary dysmenorrhea.

OBJECTIVES: The aim of this study was to evaluate the effects of auricular acupressure on relieving menstrual symptoms and decreasing nitric oxide (NO) for women with primary dysmenorrhea. DESIGN: This was a randomized clinical trial comparing the effects of auricular acupressure by seed-pressure method and placebo adhesive patch. SETTING: Settings included colleges in northern and central Taiwan. SUBJECTS: Serum CA-125 testing was used as a screening test for primary dysmenorrhea (<35 mg/dL). The study included 36 college females randomized to acupressure group, 35 to control group. INTERVENTIONS: The acupressure group received auricular acupressure by seed-pressure method on liver (CO12), kidney (CO10), and endocrine (CO18) acupoints. The control group had a plain adhesive patch placed on the same acupoints with no seed attached. Acupressure protocol included massaging 15 times on each acupoint, 3 times a day, for a total of 20 days. OUTCOME MEASURES: Primary: Short-form Menstrual Distress Questionnaire (MDQs). Secondary: blood sample of NO. Assessments of MDQs and NO were performed at baseline and within the first 2 days of their next menses (after completion of 20 days of acupressure). RESULTS: In the acupressure group, the overall menstrual symptoms (95% confidence interval [CI] = -49.8 to -6.5, effect size [ES] = 0.43, p = 0.01) and two subscales, menstrual pain (95% CI = -16.4 -to -2.2, ES = 0.45, p = 0.01) and negative affects (95% CI = -11.9-2.0, ES = 0.38, p = 0.04), revealed that menstrual symptoms decreased significantly after auricular acupressure by the seed-pressure method. The ES for the MDQs were in favor of the auricular acupressure by seed-pressure method. NO level increased in the acupressure group, although this difference did not achieve statistical significance (p > 0.05). CONCLUSIONS: This study supports the effects of auricular acupressure by seed-pressure method in improving menstrual symptoms, and offers a noninvasive complementary therapy for women with primary dysmenorrhea.