Acupuncture at Back-Shu point improves insomnia by reducing inflammation and inhibiting the ERK/NF-κB signaling pathway.

BACKGROUND: Insomnia is a disease where individuals cannot maintain a steady and stable sleep state or fail to fall asleep. Western medicine mainly uses sedatives and hypnotic drugs to treat insomnia, and long-term use is prone to drug resistance and other adverse reactions. Acupuncture has a good curative effect and unique advantages in the treatment of insomnia. AIM: To explore the molecular mechanism of acupuncture at Back-Shu point for the treatment of insomnia. METHODS: We first prepared a rat model of insomnia, and then carried out acupuncture for 7 consecutive days. After treatment, the sleep time and general behavior of the rats were determined. The Morris water maze test was used to assess the learning ability and spatial memory ability of the rats. The expression levels of inflammatory cytokines in serum and the hippocampus were detected by ELISA. qRT-PCR was used to detect the mRNA expression changes in the ERK/NF-κB signaling pathway. Western blot and immunohistochemistry were carried out to evaluate the protein expression levels of RAF-1, MEK-2, ERK1/2 and NF-κB. RESULTS: Acupuncture can prolong sleep duration, and improve mental state, activity, diet volume, learning ability and spatial memory. In addition, acupuncture increased the release of 1L-1ß, 1L-6 and TNF-α in serum and the hippocampus and inhibited the mRNA and protein expression of the ERK/NF-κB signaling pathway. CONCLUSION: These findings suggest that acupuncture at Back-Shu point can inhibit the ERK/NF-κB signaling pathway and treat insomnia by increasing the release of inflammatory cytokines in the hippo-campus.

[Adjuvant treatment of penetrating moxibustion at governor vessel for persistent allergic rhinitis of deficiency-cold syndrome].

OBJECTIVE: To explore the efficacy and action mechanism of penetrating moxibustion at governor vessel for persistent allergic rhinitis of deficiency-cold syndrome. METHODS: Ninety patients with persistent allergic rhinitis of deficiency-cold syndrome were randomly divided into an observation group (n = 45) and a control group (n = 45). The patients in the control group were treated with momethasone furoate nasal spray, 2 sprays per side per time, once a day. On the basis of treatment in the control group, the patients in the observation group were additionally treated with penetrating moxibustion at governor vessel, 2 h per treatment, once a week. Both groups were treated for 4 weeks. The TCM symptom score, visual analogue scale (VAS) score and rhinoconjunctivitis quality of life questionnaire (RQLQ) score were observed in the two groups before and after treatment. The serum level of immunoglobulin E (IgE) and complete blood count of eosinophil (EOS) were measured before and after treatment, and the clinical effects were compared. RESULTS: Compared before treatment, the TCM symptom scores, VAS scores, RQLQ scores, serum levels of IgE and complete blood count of EOS in the two groups were all reduced after treatment (P<0.05), and those in the observation group were lower than those in the control group (P<0.05). The total effective rate in the observation group was 95.6% (43/45), which was higher than 82.2% (37/45) in the control group (P<0.05). CONCLUSION: Based on the momethasone furoate nasal spray, the adjuvant treatment of penetrating moxibustion at governor vessel could significantly improve the clinical symptoms in patients with persistent allergic rhinitis of deficiency-cold syndrome, and its mechanism may be related to the regulation of immune disorder.

[Design and application of Baihui moxibustion box].

On the base of the principle of penetrating moxibustion and in combination with free adjustment devices such as movable U-shaped moxa stick holder and movable clamp, a new type of moxibustion box exerted on the head is designed, with precise positioning and sufficient heat intensity. Baihui moxibustion box is composed of two sections, i.e. body section and pillow section, which is as one structure. There are several vertical bar-shaped holes distributed evenly on the movable door outside moxa box. The U-shaped moxa stick holder on the inner side of the bar-shaped hole is connected with the fixed clamp on the outside, which is movable up and down, forward and backward for height adjustment. Such moxibustion box is characterized as accurate positioning, energy saving, temperature control and manpower saving.

Effect and Safety of Penetrating Moxibustion in Treatment of Migraine without Aura: A Randomized Controlled Trial.

OBJECTIVE: To observe the clinical effect of penetrating moxibustion on migraine without aura (MO) patients. METHODS: Totally 60 MO patients from the Acupuncture Clinic of the Third Affiliated Hospital of Henan University of Chinese Medicine were collected from November 2015 to February 2017. All patients were assigned to a treatment group and a control group using a random number table, 30 cases in each group. The treatment group was treated with penetrating moxibustion, and the control group was treated with mild moxibustion, thrice a week for 4 consecutive weeks. The total effective rate, Visual Analogue Scale (VAS) scores, headache intensity, and Migraine Specific Quality of Life Questionnaire (MSQ) scores of patients after treatment were compared between the two groups. The moxibustion sensation and reaction after moxibustion were observed, and the adverse reactions were evaluated. All patients were followed up at 4 and 16 weeks after treatment. RESULTS: The total effective rate of the treatment group was significantly higher than that of the control group (93.33% vs. 80.00%, P<0.05). The improvement of VAS scores, headache intensity, and the role restrictive and role preventive scores in MSQ in the treatment group was better than those in the control group (P<0.05). The person-time of moxibustion sensations of itching, numbness and cold as well as flushing and sweating after moxibustion in the treatment group was all significantly higher than that in the control group (P<0.01). There was no significant difference in safety evaluation between the two groups (P>0.05). CONCLUSIONS: Penetrating moxibustion can significantly relieve pain and improve quality of life of MO patients. After penetrating moxibustion, flushing and sweating of patients were obvious, and the curative effect was superior to the mild moxibustion.

[Exploration and practice of micro-video teaching of Characteristic Clinical Technology of Acupuncture and Moxibustion].

In this paper, the micro-video teaching mode was explored in the course construction of Characteristic Clinical Technology of Acupuncture and Moxibustion. The micro-video teaching contents include the academic thought, experience in diagnosis and treatment, characteristic technology and clinical manipulation of famous acupuncture experts in the Henan University of CM. Each micro-video film is designed within 15-18 min, including three sections of knowledge, i.e. basic theory, technological application and clinical manipulation. Each section is designed within 5-6 min. The construction of the teaching course of Characteristic Clinical Technology of Acupuncture and Moxibustion is the innovation of practice mode of TCM and the new approach to the inheritance of the experience of experts. The construction of micro-video teaching course propels the reform of teaching mode, improves the learning initiative of students and clinical manipulative ability so as to improve the teaching effect and quality.

[Clinical characteristics of ZHU Dan-xi's acupuncture and moxibustion].

The clinical characteristics of ZHU Dan-xi 's acupuncture and moxibustion in the aspects of syndrome differentiation based on meridian and collateral and the techniques of acupuncture and moxibustion were explored by analyzing and summarizing ZHU Dan-xi's clinical experience in acupuncture and moxibustion practice. ZHU Dan-xi pointed out a compound symptoms with the three yin and three yang of hand and foot meridians, which enriches the connotation of the diagnosis and treatment on base of the meridian-collateral theory. In clinical practice, the therapeutic method with acupuncture and moxibustion is combined with herbal medicine. He believed that acupuncture is mostly used for reducing rather than reinforcing purpose. Hence, the bloodletting technique of acupuncture is commonly used. The moxibustion therapy is applicable for all of the conditions of deficiency, excess, cold and heat. In clinical practice, moxibustion is used for heat syndrome and acute syndrome by reducing heat, removing toxin and regaining consciousness. The timing of moxibustion should be considered specifically in the treatment for tonifying yang, generating yin, reducing heat and removing toxin. The unique characteristics of ZHU Dan-xi 's experience provide the reference for the clinical practice of acupuncture and moxibustion in the later generations.

[Clinical trial of treatment of frozen shoulder by intensive moxibustion plus acupuncture].

OBJECTIVE: To compare the clinical therapeutic effect of intensive moxibustion plus acupuncture and simple acupuncture therapy in the treatment of frozen shoulder so as to provide a reference for clinical practice. METHODS: A total of 60 patients with frozen shoulder were randomly divided into intensive moxibustion plus acupuncture group and simple acupuncture group (n＝30 per group). Acupoints Jianyu (LI15), Jianzhen (SI9), Jianliao (TE14), Tiaokou (ST38), Chengshan (BL57) and Ashi points (Extra) were punctured with filiform needles which were manipulated till the patients experienced feelings of soreness and distension in the local region, followed by retaining the needles for 40 min. For patients of the moxibustion plus acupuncture group, after acupuncture, an ignited moxa-stick segment was applied to the affected shoulder for 40－50 min. After the treatment, all patients were ordered to make a shoulder exercise (anteflexion, rear protraction, abduction and upthrow movements, etc.). The visual analogue scale (VAS) was used to assess the pain severity, and the Constant-Murley shoulder assessment scale (the total score is 100 points, including 15 points in pain severity and 20 points in daily living activities, 40 points in joint motion range, and 25 points in myodynamia) used to assess the functional state of the shoulder, and the "Standards for Diagnosis and Therapeutic Effect Evaluation of Diseases of Traditional Chinese Medicine"(1994) were employed to evaluate the therapeutic effect. RESULTS: Following the treatment, intra-group comparison showed that the VAS score was significantly reduced in both groups in comparison with their own pre-treatment (P<0.05), and the total scores of Constant-Murley scale, the scores of activities of daily living and active motion range, as well as the scores of pain integration and myodynamia, were all considerably increased in the two groups in comparison with their own pre-treatment (all P<0.05). The therapeutic effect of the moxibustion plus acupuncture was significantly superior to that of the simple acupuncture in reducing VAS score and increasing total score of Constant-Murley scale, and scores of activities of daily living and active motion range, as well as the scores of pain integration (P<0.05). Of the two 29 cases in the moxibustion plus acupuncture and simple acupuncture groups, 19 (65.52%) and 10 (34.48%) were cured, 8 (27.58%) and 12 (41.38%) experienced improvement, 2 (6.90%) and 7 (24.14%) were failed, with the effective rate being 93.10% and 75.86%, respectively. The therapeutic effective rate of the moxibustion plus acupuncture was evidently higher than that of the simple acupuncture (P<0.05)．. CONCLUSION: The therapeutic effect of intensive moxibustion plus acupuncture is superior to that of simple acupuncture in improving symptoms of frozen shoulder in patients.

[Discussion on professor SHAO Jing-Ming's academic opinion of focusing spirit].

During professor SHAO Jing-ming's academic research and medical practice, his academic opinion of focusing spirit is gradually developed. In terms of nurturing the spirit, attention should be paid on persistence as well as everyday health maintenance and exercise to nurture the spirit of physician. In terms of clinical diagnosis and treatment, patients' psychology, employment and life status should be observed and experienced, which could bring more methods to take essential care of patients' spirit. The treatment should work with psychological counseling, advocating that based on patients' qi and spirit, various forms of treatment methods should be properly used, such as acupuncture or moxibustion or combination of acupuncture and medicine, along with simple acupoint selection and harmony medication. Before clinical treatment of acupuncture, calming the mind is critically emphasized to make a clear diagnosis. During the acupuncture, calming and focusing the mind is necessary as well as emphasizing the details, so acupuncture could be integrated with Chi Gong to create a new warming-sensation technique. In a word, the academic opinion of focusing spirit is shedding an inspiring light upon further study.

[Research and practice on basic skill training and technique improving of acupuncture and tuina major].

In order to summarize and perfect the basic skill practicing method in acupuncture teaching and form a characteristic teaching, the research on skill training and technique improving of acupuncture and tuina major was carried out. The undergraduate students in acupuncture and tuina major from College of Acupuncture-Moxibustion and Tuina were randomly divided into an experimental group and a control group. Students from both groups received the basic courses of acupuncture-moxibustion and tuina as requested in the syllabus and the special teaching was added to the experimental group, namely "three practice" (strength practice, coordination practice, targeted practice of acupuncture basic skills) and "three enlightenment" (technique enlightenment, mind and qi enlightenment, efficacy enlightenment). During and after the courses, the teaching effectiveness was evaluated on the basis of needling manipulation. The peacetime score in the experimental group was superior to that in the control group (38.03 +/- 1.14 vs 33.25 +/- 1.31, P < 0.05), the total score in the experimental group was superior to that in the control group (84.03 +/- 6.30 vs 78.05 +/- 6.55, P < 0.05). The special teaching method of "three practice" and "three enlightenment" can improve the effect of skill training teaching method. It highlights the unique feature of central plains by integrating the essence of Shaolin internal qigong and Chen-style Taiji, it can also provide new ideas for the practical teaching of TCM professional courses and the construction of characteristic professionals.

[Asthma at acute attack stage treated with "Shao's five needling therapy": a multi-central randomized controlled study].

OBJECTIVE: To evaluate the clinical efficacy of asthma at acute attack stage treated with "Shao's five needling therapy". METHODS: The randomized controlled method was applied to divide 210 cases into an observation group and a control group, 105 cases in each one. In the observation group, "Shao's five needling therapy" [Feishu (BL 13), Dazhui (GV 14), Fengmen (BL 12)] and the combined therapy were adopted, including oxygen uptake, aerosol inhalation and oral administration of prednisone. In the control group, the oral administration of theophylline sustained release tablet and the combined therapy were applied. The treatment was continued for 7 days. The clinical symptoms and physical signs such as wheezing, cough, expectoration, chest stuffiness, wheezing rale and shortness of breath, as well as lung function indices such as forced expiratory volume one second (FEV1) and peak expiratory flow (PEF) were observed before and after treatment in the two groups. METHODS: In the observation group, 69 cases were cured clinically, 20 cases effective remarkably, 7 cases effective and 0 case failed. In the control group, 49 cases were cured clinically, 31 cases effective remarkably, 15 cases effective and 0 case failed. The difference in the efficacy was significant in comparison of the two groups (P < 0.05). The therapeutic effect in the observation group was better than that in the control group. The total score of the symptoms and physical signs, FEV1 and PEF after treatment were all improved significantly in the two groups (all P < 0.01). And the results in the observation group were better than those in the control group (all P < 0.01). CONCLUSION: "Shao's five needling therapy" achieves the significant efficacy on asthma at acute attack stage. It significantly relieves the symptoms and physical signs of the patients and improves lung functions. The effect is better than that of theophylline sustained release tablet.

[Design and application of hand-wrist caring moxibustion box].

A hand-wrist moxibustion box is designed to effectively solve difficulty to have moxibustion at handwrist joint and problem of bad moxibustion effect as well as improve heat efficiency of moxibustion. The device is consisted of a box and protective screening. The box is hollow with opening on top and bottom. A reversible cover is fixed on the top of the box and support frames are put in the inner-middle. On the side wall there is a hole that is at the same horizontal level of support frames, and horizontal protective screening is put on the bottom. The design of this moxibustion box is novel and unique, simple and reasonable, which could give moxibustion on hand and wrist at the same time. Also it is easily made with low cost, easy to use and favorable effect. It is an innovation on moxibustion box.

[Discussion on WANG Guo-rui's acupuncture academy thought].

Through study on Bianque Shenying Zhenjiu Yulong Jing (Bianque's Classic of Effective Acupuncture Prescriptions), acupuncture experiences and ideology of WANG Guo-rui, an acupuncture physician of the Yuan Dynasty (1271-1368), is discussed in this article. Inherited and carried forward DOU's acupuncture theory, WANG Guo-rui encouraged to use experiential points and to expand extra points. Penetrating needling method was created, and the application of acupoints according to needling opportunities and seasonal factors were enriched by him. Great importance was also attached on treatment according to differentiation of syndromes, which including the simultaneous acupuncture and moxibustion, simultaneous reinforcing and reducing, reducing after reinforcing, reinforcing after reducing, predomination of reducing and predomination of reinforcing. The flexible treating methods are still extensively adopted in clinic nowadays. WANG Guo-rui is a master of clinical acupuncture who made great contribution to the development of acupuncture and moxibustion.

[Effect of acupuncture at different acupoints on expression of hypothalamic GABA and GABA(A) receptor proteins in insomnia rats].

OBJECTIVE: To observe the effect of acupuncture of "Shenmai" (BL 62) and "Zhaohai" (KI 6), "Shenmen" (HT 7), etc. on the expression of hypothalamic gamma-aminobutyric acid (GABA) and GABA(A) receptor (GABA(A)R) proteins in experimental insomnia rats so as to explore its mechanism underlying improving sleeping. METHODS: Seventy Wistar rats were randomly divided into normal control, model, "Sanyinjiao" (SP6), "Neiguan" (PC 6), "Zusanli" (ST 36), "Shenmen" (HT7), and "Shenmai" (BL 62)-Zhaohai (KI 6, BL 62-KI 6) groups, with 10 rats in each group. Insomnia model was established by intraperitoneal injection of chlorophenylalanine solution (PCPA, 1 mL/100 g). An acupuncture needle was inserted into each of the bilateral HT 7, PC 6, SP 6, ST 36 and BL 62-KI 6 respectively and manipulated for about 1 min, once daily for 7 days. Hypothamic GABA and GABA(A)R protein expressions were detected by immunohistochemistry. The animals' physical ability was evaluated by using pole-climbing test in a water tank. RESULTS: In comparison with the normal control group, the numbers of hypothalamic GABA immunoreaction (IR)- and GABA(A)R IR-positive neurons and the pole-climbing time were reduced significantly in the model group (P < 0.05). While in comparison with the model group, the numbers of hypothalamic GABA IR-positive neurons and those of hypothalamic GABA(A)R IR-positive neurons in the HT 7, PC 6, SP 6, ST 36 and BL 62-KI 6 groups, as well as the pole-climbing duration in the SP 6, ST 36 and BL 62-KI 6 groups were increased considerably (P < 0.05, P < 0.01). The effects of HT 7 and BL 62-KI 6 groups were significantly superior to those of PC 6, ST 36 and SP 6 groups in up-regulating GABA and GABA(A)R expression, and the effect of BL 62-KI 6 group was remarkably better than those of HT 7, PC 6, SP 6 and ST 36 groups in lengthening the pole-climbing time (P < 0.05). CONCLUSION: Acupuncture can effectively suppress insomnia induced down-regulation of hypothalamic GABA and GABA(A)R in rats and lengthen pole-climbing time, which may contribute to its effect in relieving insomnia.

[Discussion on operating technique of ancient moxibustion].

To summarize and discuss the operating technique of ancient moxibustion with the consulting of some relevant literatures. In the ancient, the dosage of the moxibustion was based on the size and the number of moxa cones, the feelings of patients and their reaction after the treatment. Of them, the size and the number of moxa cones were estimated by doctors own experience, and it would be more objective and suitable for patients' needs if the dose was additionally decided on the reactions of patients (pain, post-moxibustion sore, sweating, spots and so on). It could have significance for improving clinical effects if attention is paid to the feelings and reactions of patients, the size and the number of moxa cones and the time of moxibustion.

[Professor LI Ding's understanding on the eight extra meridians].

Through his long-term acupuncture-moxibustion teaching and academic research, professor LI Ding from Shanghai University of TCM had conducted a profound research on the theory of the eight extra meridians, named Governor Vessel, Conception Vessel, Thoroughfare Vessel, Belt Vessel, Link Vessels and Heel Vessels, as well as their relationship with the regular meridians. He rectified the miss-understanding on the courses of Governor Vessel and Conception Vessel determined by the ancient medical masters, and had a further analysis on some different views, such as the running course of Governor Vessel and the flowing direction of meridian qi in Governor Vessel and Conception Vessel. He proposed that the nutrient qi flew up to down in Governor Vessel and down to up in Conception Vessel. His research and discovery much perfected the theory of the eight extra meridians and provided a significant instruction for the research on the eight extra meridians in the later generations.

[DOU Han-qing's academic thought of acupuncture and moxibustion].

DOU Han-qing's academic thought of acupuncture and moxibustion are analyzed, which include "eight confluence points", sensation of qi arrival, 14 manipulations for promotion of qi sensation, point selection, needling technique and observation of the psychological condition of patients. DOU's inheritance and development of Huangdi Neijing (Internal Classic) and Nanjing (Classics on Medical Problems) as well as his influences on the later schools are approved to have great value and significance on the enhancement of clinical effect and development of acupuncture and moxibustion sciences.