Efficacy of acupuncture and pharmacological therapies for vascular cognitive impairment with no dementia: a network meta-analysis.

Background and objective: Vascular cognitive impairment with no dementia (VCIND) is considered to be the prodromal stage of vascular dementia, characterized by insidious onset. Although acupuncture and drug therapies are effective, the optimal therapy for VCIND remains to be further determined. Therefore, we conducted a network meta-analysis to compare the effectiveness of acupuncture therapies and current common medicines for VCIND. Methods: We searched eight electronic databases to identify eligible randomized controlled trials of patients with VCIND treated by acupuncture or drug therapies. The primary outcome was Montreal Cognitive Assessment, and the secondary outcome was Mini-Mental State Examination. We conducted the network meta-analysis within a Bayesian framework. Weighted mean difference with 95% confidence intervals were applied as effect sizes to continuous data for all outcomes. Sensitivity analysis was done to assess the robustness of the findings, and we also carried out a subgroup analysis based on age. We assessed the risk of bias using the Risk of Bias 2.0 tool and applied the Grade of Recommendation Assessment, Development and Evaluation (GRADE) to assess the quality of the outcomes. This study was registered with PROSPERO, number CRD42022331718. Results: A total of 33 studies with 14 interventions were included, including 2603 participants. In terms of the primary outcome, manual acupuncture plus herbal decoction was considered to be the most effective intervention (P = 91.41%), followed by electroacupuncture (P = 60.77%) and manual acupuncture plus piracetam (P = 42.58%), whereas donepezil hydrochloride ranked the least efficacious intervention (P = 54.19%). For the secondary outcome, electroacupuncture plus nimodipine was considered to be the most effective intervention (P = 42.70%), followed by manual acupuncture plus nimodipine (P = 30.62%) and manual acupuncture (P = 28.89%), whereas nimodipine ranked the least efficacious intervention (P = 44.56%). Conclusion: Manual acupuncture plus herbal decoction might be the most effective intervention for VCIND. The combination of acupuncture and drug therapy had a tendency to perform better than monotherapy in terms of clinical outcomes. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=331718, identifier: CRD42022331718.

[Observation on therapeutic effect and mechanism research of acupuncture on headache in the recovery phase of ischemic stroke].

OBJECTIVE: To explore the clinical therapeutic effect and mechanism of acupuncture on headache in the recovery phase of ischemic stroke. METHODS: A total of 97 patients with headache in the recovery phase of ischemic stroke were randomized into an acupuncture group (57 cases) and a western medication group (40 cases). In the western medication group, flunarizine hydrochloride capsule was taken orally 5 mg each time, once a day. In the acupuncture group, acupuncture was applied at Qiuxu (GB 40), Zulinqi (GB 41), Xuanli (GB 6), Shuaigu (GB 8), Fengchi (GB 20) and Baihui (GV 20) for migraine; Chongyang (ST 42), Neiting (ST 44), Jiexi (ST 41), Zusanli (ST 36), Hegu (LI 4), Cuanzhu (BL 2) and Baihui (GV 20) for forehead pain; Jinggu (BL 64), Kunlun (BL 60), Tianzhu (BL 10), Fengchi (GB 20), Baihui (GV 20) and Sishencong (EX-HN 1) for occipital headache; Taichong (LR 3), Yongquan (KI 1), Sanyinjiao (SP 6), Fengchi (GB 20), Baihui (GV 20) and Sishencong (EX-HN 1) for parietal headache. The needles were retained for 30 min each time, once a day and 5 times a week. Both of the two groups were given consecutive treatment for 14 days. The visual analogue scale (VAS) and the headache scores before and after treatment and the recurrence rate 1 month after treatment were observed to evaluate the therapeutic effect, before and after treatment, the contents of substance P (SP), dopamine (DA), serotonin (5-HT), alpha-endorphin (α-EP) and beta-endorphin (ß-EP) in plasma were determined by ELISA in the two groups. RESULTS: Compared before treatment, the VAS scores, the headache scores and the contents of SP, DA and 5-HT in plasma were reduced and the contents ofα-EP andß-EP in plasma were increased in the two groups (all P<0.01). After treatment, the changes of the VAS score, the headache score and the contents of pain-related factors and endogenous opioid peptides in plasma in the acupuncture group were larger than the western medication group (all P<0.05). The total effective rate in the acupuncture group was 84.2% (48/57), which was superior to 62.5% (25/40) in the western medication group, and the recurrence rate in the acupuncture group was lower than the western medication group (both P<0.01). CONCLUSION: The therapeutic effect of acupuncture on headache in the recovery phase of ischemic stroke is superior to flunarizine hydrochloride capsule, and the mechanism may relate to down-regulate the pain-related factors and up-regulate endogenous opioid peptides in plasma.

[Using bioinformatics tools to explore cellular biological mechanisms of "Triple Energizer Acupuncture Method" in treating senile dementia].

OBJECTIVE: To observe the effect of needling "Danzhong" (CV17), "Zhongwan"(CV12), "Qihai" (CV6), "Xuehai"(SP10)and "Zusanli"(ST36) (Triple Energizer Acupuncture Method) on the learning-memory ability and profile of hippocampal differentially-expressed genes and proteins of SAMP8 mice (rapid aging mice), so as to explore its underlying mechanisms in improving Alzheimer's disease (AD)．. METHODS: A total of 60 SAMP8 were used as the dementia model and randomly divided into blank control, acupoint and non-acupoint groups (n＝20 per group). The 5 acupuncture points and non-acupoints (subcostal region) on the bilateral sides were needled with filiform needles and manipulated manually for 30 s at each one，once daily, 6 times a week for 4 weeks. The Morris water maze tests (location navigation tests and space probing trials) were used to evaluate the mouse's learning-memory ability. The hippocampal tissue was extracted to detect differentially expressed genes and proteins related to acupuncture intervention by gene chip and isobaric tags for relative and absolute quantitation (iTRAQ) techniques as well as bioinformatic analysis, separately. The information is analyzed through bioinformatics database tools. Finally, immunofluorescence staining was used to verify theresults of microarray analysis. RESULTS: Compared with mice of the control and non-acupoint groups, the escape latency of location navigation task of Morris water maze tests on 4th and 5th day of training was significantly shortened in mice of the acupoint group, and the duration of stay in the original safe-platform quadrant was significantly increased in the acupoint group (P<0.05). Gene microarray displayed that in comparison with the control group, 898 differentially expressed genes were up-regulated, 418 genes were down-regulated in the hippocampus of acupoint group. The iTRAQ analysis indicated that in the acupoint and non-acupoint groups, 286 and 299 differentially expressed proteins were up-regulated, 319 and 179 proteins down-regulated, respectively. Of the 34 terms containing 47 proteins up-regulated by acupoint needling, including intermediate filament, keratin filament, myelin sheath, postsynaptic density, neuron projection were related with neurite and cytoskele-ton. While in the non-acupoint group, of the 24 terms were listed by the system, only the myelin sheath involving 11 differentially expressed proteins functions in activities of neurite and cytoskeleton. Immunofluorescence staining of the hippocampal tissue showed that the high-density distribution areas of neurons and neurite fibers were characterized by decentralization and disordering, with the highlighted areas being mainly near the cell body parts in control mice, but in mice of the acupoint group, the highlighted areas at the neurite were relatively dense, the morphology of hippocampal cells was complete, the fiber structure was clear, dense and orderly, and the neurites were closely arranged and in order, indicating an improvement of the distribution and arrangement of nerve fibers after acupuncture. The height of neurite highlight area of the acupoint group was significantly higher than that of the non-acupoint group (P<0.05)．. CONCLUSION: The "Triple Energizer Acupuncture" of acupoints is able to improve the learning-memory ability in SAMP8, which may be related to its effects in regulating the expression and function of hippocampal genes and proteins related to neurite and cytoskeleton.

Acupuncture Administration Improves Cognitive Functions and Alleviates Inflammation and Nuclear Damage by Regulating Phosphatidylinositol 3 Kinase (PI3K)/Phosphoinositol-Dependent Kinase 1 (PDK1)/Novel Protein Kinase C (nPKC)/Rac 1 Signaling Pathway in Senescence-Accelerated Prone 8 (SAM-P8) Mice.

BACKGROUND Alzheimer's disease (AD) is an age-associated neurodegenerative disorder. This study aimed to investigate effects of acupuncture administration on cognitive function and associated mechanisms. MATERIAL AND METHODS Senescence-accelerated prone 8 (SAM-P8) mice were randomly divided into 3 groups: the SAM-P8 group (P8-CN), the SAM-P8 administrating with acupuncture (P8-Acup) group, and the SAM-P8 administrating without acupuncture (P8-Sham) group. Morris water maze test was conducted to evaluate cognitive functions (memory and learning ability). PDK1, nPKC, and Rac1 inhibitors were used to treat SAM-P8 mice. Transmission electron microscope analysis was used to examine nuclear damage hippocampal tissues. Hematoxylin and eosin (H&E) staining was employed to evaluate inflammation. Western blot was used to detect PI3K, PDK1, nPKC, and Rac 1 expression in hippocampal tissues. RESULTS Acupuncture administration significantly reduced PI3K, PDK1, nPKC, and Rac 1 levels compared to P8-CN group (P<0.05). Both acupuncture and enzyme inhibitors (NSC23766, Rottlerin, OSU03012) significantly improved cognitive functions, reduced inflammation, and alleviated nuclear damages of SAM-P8 mice compared to P8-CN group (P<0.05). Acupuncture significantly enhanced effects of inhibitors on inflammation and nuclear damages compared to inhibitor treatment single (P<0.05). Acupuncture significantly enhanced down-regulative effects of OSU03012 on PI3K and PDK1 levels, increased down-regulative effects of Rottlerin on nPKC and Rac 1 levels and enhanced effects of Rottlerin on Rac 1 compared to P8-CN group (P<0.05). CONCLUSIONS Acupuncture administration improved cognitive functions and alleviated inflammatory response and nuclear damage of SAM-P8 mice, by downregulating PI3K/PDK1/nPKC/Rac 1 signaling pathway. This study could provide potential insight for treating cognitive dysfunction and aging of AD patients.

[Effect of Acupuncture Plus Moxibustion on Immune Function in Patients with Bra-chiocephalic Takayasu Arteritis].

OBJECTIVE: To observe the influence of acupuncture and moxibustion on humoral immunity and cellular immunity related indexes in patients with bra-chiocephalic Takayasu arteritis (BCTA), so as to explore its underlying mechanisms in the treatment of Takayasu arteritis (TA). METHODS: A total of 31 BCTA patients (9 men and 22 women at age of 16-70 years) were treated by manual acupuncture stimulation of main acupoint Renying(ST 9)and auxillary acupoints as Jiquan (HT 1), Chize (LU 5), Fengchi (GB 20), bilateral Xinshu (BL15), Feishu (BL 13) and Geshu (BL 17), Jingming (BL 1), etc. according to clinical symptoms, with the needles retained for 20 min. Additionally, moxibustion was applied to Taiyuan (LU 9), BL 15, BL 13 and BL 17. The treatment was conducted twice daily for 4 weeks. Serum IgG, IgA, IgM, IgE, C3 , C4 contents, and CD 3＋， CD 4＋， CD 8＋ T lymphocytes contents were assayed by using immue turbidimetry and cell counting. RESULTS: Before the treatment and in these 31 BCTA patients, an abnormal increase was found in serum IgG content in 10 cases, IgM in 3 cases, IgE in 3 cases, C3 in 11 cases, CD 4＋ in 6 cases, and CD 8＋ in 9 cases, and an abnormal decrease was found in serum CD 3＋ level in 11 cases, CD 4＋ in 7 cases, as well as CD 8＋ in 4 cases. After the treatment, the increased levels of IgG, IgM, C3, CD 4＋ and CD 8＋ in patients with abnormally higher values were considerably down-regulated (P<0.05), the decreased levels of CD 3＋， CD 4＋ and CD 8＋ in patients with abnormally lower values were evidently up-regulated (P<0.05). No significant changes were found in IgG, IgA, IgM, IgE, C3 and C4, CD 3＋ and CD 8＋ in patients with normal values of these indexes after the treatment (P>0.05). The CD 4＋ level in patients with normal value was significantly deun-regulated after the treatment (P<0.05), but still in the range of normal value. CONCLUSION: Acupuncture plus moxibustion can regulate some of the abnormally elevated and lowered humoral immunity and cellular immunity related indexes in BCTA patients, possibly having a favorable role in the treatment of BCTA.

Acupuncture improves dendritic structure and spatial learning and memory ability of Alzheimer's disease mice.

Acupuncture can improve the cognitive state of Alzheimer's disease, but its mechanism is not clear. Dendritic atrophy and synaptic loss in Alzheimer's disease brain are positively correlated with cognitive damage. Therefore, we speculated that the effect of acupuncture on improving cognitive function may be associated with reduced dendritic damage in the brain. Acupuncture at Qihai (CV6), Zhongwan (CV12), Danzhong (CV17), bilateral Zusanli (ST36), and bilateral Xuehai (SP10) acupoints was performed once a day (1-day rest after 6-day treatment) for 14 consecutive days. Senescence-accelerated mouse prone 8 (SAMP8) mice without acupuncture and senescence-accelerated mouse resistant 1 (SAMR1) mice were used as normal controls. After 14 days of treatment, spatial learning and memory ability of mice was assessed in each group using the Morris water maze. Dendritic changes of pyramidal cells in the hippocampal CA1 region were analyzed by quantitative Golgi staining. Our results showed that acupuncture shortened escape latency and lengthened retention time of the former platform quadrant in SAMP8 mice. Further, SAMP8 mice exhibited a significant increase in the number of apical and basal dendritic branches and total length of apical and basal dendrites after acupuncture. These results suggest that acupuncture improves spatial learning and memory ability of middle-aged SAMP8 mice by ameliorating dendritic structure.

Combined acupuncture and HuangDiSan treatment affects behavior and synaptophysin levels in the hippocampus of senescence-accelerated mouse prone 8 after neural stem cell transplantation.

Sanjiao acupuncture and HuangDiSan can promote the proliferation, migration and differentiation of exogenous neural stem cells in senescence-accelerated mouse prone 8 (SAMP8) mice and can improve learning and memory impairment and behavioral function in dementia-model mice. Thus, we sought to determine whether Sanjiao acupuncture and HuangDiSan can elevate the effect of neural stem cell transplantation in Alzheimer's disease model mice. Sanjiao acupuncture was used to stimulate Danzhong (CV17), Zhongwan (CV12), Qihai (CV6), bilateral Xuehai (SP10) and bilateral Zusanli (ST36) 15 days before and after implantation of neural stem cells (5 × 105) into the hippocampal dentate gyrus of SAMP8 mice. Simultaneously, 0.2 mL HuangDiSan, containing Rehmannia Root and Chinese Angelica, was intragastrically administered. Our results demonstrated that compared with mice undergoing neural stem cell transplantation alone, learning ability was significantly improved and synaptophysin mRNA and protein levels were greatly increased in the hippocampus of mice undergoing both Sanjiao acupuncture and intragastric administration of HuangDiSan. We conclude that the combination of Sanjiao acupuncture and HuangDiSan can effectively improve dementia symptoms in mice, and the mechanism of this action might be related to the regulation of synaptophysin expression.

Acupuncture for patients with mild to moderate Alzheimer's disease: a randomized controlled trial.

BACKGROUND: Alzheimer's disease (AD) is the most common cause of dementia. However, none of medical treatment can stop or reverse the underlying neurodegenerative of AD at present. Acupuncture has attracted more and more attention in recent years due to its efficacy and very few side effects. Lately, a systematic review has thought that the evidence on the effectiveness of acupuncture in improving the cognitive function of AD patients was not powerful enough. Therefore, the aim of this study is to explore the efficacy and safety of acupuncture in patients with mild to moderate AD. METHODS: This was a randomized, controlled, parallel-group, exploratory study with 4-week baseline (T0), 12-week treatment phase (T1) and 12-week follow-up period (T2). Patients with mild to moderate AD meeting the included criteria were randomly allocated into either acupuncture or donepezil hydrochloride groups. The acupuncture group(AG) was given acupuncture treatment three times per week and the donepezil hydrochloride group(DG) group was administered donepezil hydrochloride once daily (5 mg/day for the first 4 weeks and 10 mg/day thereafter). Primary efficacy was measured using Alzheimer's disease Assessment Scale-Cognitive (ADAS-cog) and Clinician's Interview-Based Impression of Change-Plus (CIBIC-Plus). The second outcomes were measured with 23-Item Alzheimer's disease Cooperative Study Activities of Daily Living Scales (ADAS-ADL23) and Neuropsychiatric Index (NPI). RESULTS: Of 87 participants enrolled in the study, 79 patients finished their treatment and follow-up processes. The ADAS-cog scores for AG group showed obvious decreases at T2 and ∆(T2-T0)when compared with DG group, and significant between-group differences were detected (all p < 0.05). The mean CIBIC-Plus values for the AG group at T1 and T2 were much lower than that for the DG group, and there were significant differences between the two groups (푃<0.05). There were no significant between-group differences in the scores of ADAS-ADL23 and NPI during the study period. Treatment discontinuations due to adverse events were 0 (0%) and 4 (9.09%) for the AG and DG groups, respectively. CONCLUSIONS: Acupuncture is safe, well tolerated and effective in improving the cognitive function, global clinical status of AD. TRIAL REGISTRATION: ChiCTR-IOR-17010465 (Retroactively registered on 18 JAN 2017).

Acupuncture upregulates G protein coupled activity in SAMP8 mice.

BACKGROUND: Transmembrane and intracellular signal transduction of G protein is closely related to the pathophysiology of Alzheimer's disease (AD). OBJECTIVE: To explore the effects of Sanjiao acupuncture on G protein signal transduction pathways in the pathogenesis of AD. METHODS: 36 senescence-accelerated (SAM) prone 8 mice were divided into three groups that remained untreated (SAMP8, n=12) or received Sanjiao acupuncture (SAMP8+SA, n=12) or control acupuncture (SAMP8+CA, n=12). An additional control group of SAM resistant 1 mice was included (SAMR1 group, n=12). Morris water maze tests were used to investigate learning and memory abilities. Immunoprecipitation and Western blotting were used to study expression of G protein subunits and their activities in the cortex/hippocampus. RESULTS: Behavioural analysis showed that acupuncture attenuated the severe cognitive deficits observed in untreated/CA-treated SAMP8 mice. The findings of the G protein activation assays via immunoprecipitation and Western blots were that the physiologically coupled activation rate (PCAR) and maximal coupled activation rate (MCAR) of Gαs and Gαi were decreased in the cortex of SAMP8 vs SAMR1 mice. Sanjiao acupuncture induced an upregulation in the PCAR of Gαs and Gαi. In the hippocampus of untreated SAMP8 mice, the PCAR of Gαs and MCAR of both Gαs and Gαi declined, and Sanjiao acupuncture was associated with an upregulation in the MCAR of Gαs and Gαi. There were no significant differences in Gαs and Gαi expression between the groups. CONCLUSIONS: Sanjiao acupuncture attenuates cognitive deficits in a mouse model of AD via upregulation of G protein activity and stabilisation of the cellular signal.

Acupuncture Improves Cerebral Microenvironment in Mice with Alzheimer's Disease Treated with Hippocampal Neural Stem Cells.

Transplantation with neural stem cells (NSCs) is a promising clinical therapy for Alzheimer's disease (AD). However, the final fate of grafted NSCs is mainly determined by the host microenvironment. Therefore, this study investigated the role of Sanjiao acupuncture in the NSCs-treated hippocampus of a mouse model, senescence-accelerated mouse prone 8 (SAMP8) using Western blot, real-time fluorescent PCR, and immunofluorescence techniques. Meanwhile, we developed a co-culture model of hippocampal tissue specimens and NSCs in vitro, to observe the effects of acupuncture on survival, proliferation and differentiation of grafted NSCs using flow cytometry. Results showed that acupuncture pre- and post-NSCs transplantation significantly improved senescence-induced cognitive dysfunction (P < 0.05); upregulated the expression of basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), and brain-derived neurotrophic factor (BDNF) (P < 0.05); and also increased the count of neuron-specific nuclear protein (NeuN)- and glial fibrillary acidic protein (GFAP)-positive cells (P < 0.05). Therapeutic acupuncture may regulate the cytokine levels associated with survival, proliferation, and differentiation of NSCs in hippocampal microenvironment, to promote the repair of damaged cells, resulting in improved cognitive performance in mice.

[Clinical research of electroacupuncture at acupoints of qijie area combined with spine balance-regulating massage on posterior circulation ischemia].

OBJECTIVE: To compare the clinical efficacy difference between electroacupuncture (EA) at qijie area combined with spine balance-regulating massage and medication for posterior circulation ischemia (PCI). METHODS: One hundred cases of PCI were randomly divided into a treatment group (50 cases) and a medication group (50 cases). The treatment group was treated with EA at Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Shenshu (BL 23), Danzhong (CV 17), etc. in qijie area combined with spine muscle-relieving massage and comprehensive chiropractic. The medication group was treated with oral administration of nimodipine (30 mg per time, three treatments per day) and vinpocetine injection with 500 mL of glucose injection or intravenous drip of 500 mL 0.9% sodium chloride injection, once a day. Ten treatments were taken as one course in both groups, and two courses were given. The symptom score, mean resistance index (RI) of vertebral artery (VA) and basilar artery (BA), mean velocity of blood flow (Vm) and comprehensive clinical efficacy were compared before and after treatment in two groups. RESULTS: The cured and markedly effective rate was 79.6% (39/49) in the treatment group, which was superior to 54.7% (23/42) in the medication group (P<0.05). The symptom score was both significantly improved after treatment in two groups (both P<0.05), which was more obvious in the treatment group (P<0.05). The RI of VA and BA, Vm of VA and BA were significantly improved after treatment in two groups (all P<0.05), which were more obvious in the treatment group (all P<0.05). CONCLUSION: The electroacupuncture combined with spine balance-regulating massage has superior effect on improving mean velocity of blood flow and resistance index of vertebral artery and basilar artery as well as symptom score to medication, and is believed to be a safe and effective treatment for posterior circulation ischemia.

[Clinical research of primary trigeminal neuralgia treated with electroacupuncture at qi streets acupoints combined with spinal regulation therapy].

OBJECTIVE: To compare the difference in the clinical efficacy on primary trigeminal neuralgia (PTN) between the comprehensive therapy of electroacupuncture (EA) at qi streets acupoints combined with spinal regulation method and medication with carbamazepine (CBZ). METHODS: Sixty patients were randomized into a comprehensive therapy group (30 cases) and a medication group (30 cases). In the comprehensive therapy group, the acupoints at qi streets on the head such as Taiyang (EX-HN 5) and Sishencong (EX-HN 1) and those at qi streets on the chest and abdomen such as Shenshu (BL 23), Zhongwan (CV 12) and Guanyuan (CV 4), etc. were selected. After arrival of qi, EA was attached on 2 to 4 groups of acupoints. After acupuncture, the spinal regulation method was applied. This comprehensive therapy was given once a day. In the medication group, CBZ was used for oral administration, 100 mg at the first time, twice a day, and 400 to 600 mg each day as the maintenance dose. Separately, before and after treatment, in 2 and 6 months in follow-up, pain rating index (PRI), life satisfaction index B (LSI-B) and hamilton depression scale (HAMD) were adopted to evaluate comprehensively the clinical efficacy in the two groups and compare the adverse reaction during the treatment between the two groups. RESULTS: After treatment, the curative and markedly effective rate in the comprehensive therapy group was 76.7% (23/30), which was better than 63.3% (19/30) in the medication group (P < 0.01). The difference in PRI was not significant after treatment between the two groups (all P > 0.05). In 2 and 6 months follow-up, PRI grade in the comprehensive therapy group was superior to that of the medication group (both P<0. 05). After treatment and in follow-up, HAMD score was all reduced in the two groups (P < 0.01, P < 0.05) and the result in follow-up in the comprehensive therapy group was significant as compared with that in the medication group (all P<0. 05). After treatment, LSI-B score was increased obviously in the two groups (all P < 0.05) and the result in the comprehensive therapy group was better than that in the medication group (P < 0.05). The incidence of adverse reaction in the comprehensive therapy group was 16.7% (5/30), which was lower than 30.0% (9/30, P < 0.01) in the medication group. CONCLUSION: The comprehensive therapy of EA at qi streets acpoints combined with spinal regulation method achieves the long-term efficacy on PTN as compared with oral administration of CBZ in terms of the improvement of psychological condition, analgesia and life quality. It is the safe, effective and stable therapy.

[Effect of acupuncture on transmembrane signal pathway in AD mice: an analysis based on lipid-raft proteomics].

OBJECTIVE: To reveal the transmembrane signal pathway participating in regulating neuron functions of treating Alzheimer's disease (AD) by acupuncture. METHODS: SAMP8 mice was used for AD animal model. The effect of acupuncture method for qi benefiting, blood regulating, health supporting, and root strengthening on the amount and varieties of transmembrane signal proteins from hippocampal lipid rafts in SAMP8 mice was detected using HPLC MS/MS proteomics method. RESULTS: Compared with the control group, acupuncture increased 39 transmembrane signal proteins from hippocampal lipid rafts in SAMP8 mice, of them, 14 belonged to ionophorous protein, 8 to G protein, 8 to transmembrane signal receptor, and 9 to kinase protein. Totally 3 main cell signal pathways were involved, including G-protein-coupled receptors signal, enzyme linked receptor signal, and ion-channel mediated signal. Compared with the sham-acupuncture group, acupuncture resulted in significant increase of kinase signal protein amount. From the aspect of functions, they were dominant in regulating synapse functions relevant to cytoskeleton and secreting neurotransmitters. CONCLUSION: The cell biological mechanism for treating AD by acupuncture might be achieved by improving synapse functions and promoting the secretion of neurotransmitters through transmembrane signal transduction, thus improving cognitive function of AD patients.

[Effect of acupuncture intervention on hippocampal neuron loss and astrocytosis in SAMP 8 mice].

OBJECTIVE: To observe the effect of "Sanjiao Acupuncture Therapy" on hippocampal selective neuron loss and astrocytosis in senile accelerated mice (SAM) so as to reveal its mechanism underlying improvement of Alzheimer's disease (AD). METHODS: A total of 18 seven-month old male SAM prone 8 (SAMP 8) were selected and randomly allocated into model group, acupuncture group, and non-acupoint group. Moreover, 6 age- and sex-matched SAM resistant 1 (SAMR 1) were enrolled as the homology normal control group. For mice of the acupuncture group, "Sanjiao Acupuncture Therapy" [manual acupuncture stimulation of "Danzhong" (CV 17), "Zhongwan" (CV 12), "Qihai" (CV 6), "Zusanli" (ST 36) and "Xuehai"(SP 10)] was given, and for rats of the non-acupoint group, manual acupuncture stimulation was applied to bilateral costal region (non-acupoints, below the costal region and 10 and 15 mm superior to the iliac crest). The treatment was conducted once daily for 14 days. At the end of each experiment, the mouse's hippocampus tissue was taken out after routine perfusion and fixing for paraffin sections which were stained by toluidine blue technique for observing changes of neurons and by immunohistochemistry for analyzing glial fibrillary acidic protein (GFAP) immunoactivity of astrocytes. RESULTS: Compared with the control group, a marked neuron loss was found in the model, acupuncture and non-acupoint groups (P < 0.01). The numbers of neurons of hippocampal CA 1 and CA 3 regions in the acupuncture group were significantly more than those in the model group (P < 0.05). Compared with the control group, the expression level of hippocampal GFAP was markedly increased in the model group (P < 0.01). In comparison with the control group, the average expression area, optical density values and the number of GFAP-labeled astocytes were significantly upregulated in the model group (P < 0.01). While in comparison with the model group, these 3 indexes were apparently downregulated in the acupuncture group (P < 0.01) but not in the non-acupoint group except the average expression area, suggesting a reduction of hippocampal astrocyte activity after acupuncture intervention. A negative correlation was found between the expression level of GFAP and the number of astrocytes. CONCLUSION: "Sanjiao Acupuncture Therapy" can lower or delay neuron loss, suppress astrocytosis, and regulate the relationship between neuron and astrocyte, which may contribute to its function in relieving AD.

[Cumulative analgesic effects of EA stimulation of sanyinjiao (SP 6) in primary dysmenorrhea patients: a multicenter randomized controlled clinical trial].

OBJECTIVE: To compare the cumulative analgesic effect of electroacupuncture (EA) stimulation of Sanyinjiao (SP 6), Xuanzhong (GB 39) and non-acupoint for primary dysmenorrhea patients. METHODS: A total of 200 patients with primary dysmenorrhea were randomly assigned to Sanyinjiao (SP 6, a dysmenorrheal-relieving related acupoint) group, Xuanzhong (GB 39, an unrelated acupoint) group, non-acupoint group and control group, with 50 cases in each group. The participants were administered with EA (2 Hz/100 Hz, 0.5-1.6 mA) at SP 6, GB 39 and non-acupoint for 30 min, once daily for 3 consecutive days. The intensity of the pain was ranked from 0 (no pain) to 100 (intolerable) using visual analogue scale (VAS) and RSS (Cox retrospective symptom scale) severity rating scores (RSS-COX 2) before and after three interventions. RESULTS: In comparison with the control group, VAS and RSS-COX 2 scores were significantly lower in the SP 36, GB 39 and non-acupoint groups (P < 0.001, P < 0.05), suggesting an alleviation of the pain severity after EA treatment. No significant differences were found among the three treatment groups in both VAS and RSS-COX 2 scores (P > 0.05). CONCLUSION: EA stimulation of SP 6, GB 39 and non-acupoint has a good cumulative analgesic effect in patients with primary dysmenorrhea.

[Treatment of cervical spondylosis by spinal balancing combined with intervention of pathway of qi: a randomized controlled study].

OBJECTIVE: To compare the difference in the efficacy of cervical spondylosis between the combined therapy of spinal balancing and the intervention of pathway of qi and the conventional acupuncture and massage therapy. METHODS: Two hundred and seventy-four cases of cervical spondylosis were randomized into a spinal balancing group and a conventional acupuncture group, 137 cases in each one. In the spinal balancing group, the points on the pathway of qi on the head and on the abdomen were selected [the pathway of qi on the head: Baihui (GV 20), Tianzhu (BL 10), Wangu (GB 12) and the others; the pathway of qi on the abdomen: Shenshu (BL 23), Guanyuan (CV 4), Zhongji (CV 3) and the others]. The bimanual needling technique was applied in combination with spinal balancing therapy. In the conventional acupuncture group, the points were Jiaji (EX-B 2) (C3-C7), Fengchi (GB 20), Wangu (GB 12), Baihui (GV 20), etc. The conventional acupuncture technique and massage therapy were adopted. The neck pain questionnaire (NPQ) was adopted to assess the clinical efficacy of the two groups before and after treatment. RESULTS: NPQ score was all improved significantly after treatment in the two groups (all P < 0.05). The result in the spinal balancing group was superior to the conventional acupuncture group (P < 0.05). The curative and effective rate was 83.2% (114/137) in the spinal balancing group, which was better than 69.3% (95/137) in the conventional acupuncture group (P < 0.05). In terms of the types of cervical spondylosis, from high to low, the efficacy sequence was cervical type, nerve root type, vertebral artery type, sympathetic nerve type and spinal cord type. CONCLUSION: The combined therapy of spinal balancing and the intervention of pathway of qi achieves the superior efficacy on various types of cervical spondylosis as compared with the conventional acupuncture and massage therapy. It apparently relieves the symptoms and improves the life quality of the patients.

[Lumbar disc herniation treated with qi pathway intervention and spinal adjustment: a randomized controlled trial].

OBJECTIVE: To compare the efficacy difference in the treatment of lumbar disc herniation (LDH) between the comprehensive therapy of qi pathway intervention and the spinal adjustment and the conventional therapy of acupuncture and Tuina and explore the analgesic mechanism. METHODS: Seventy-one cases were randomized into a comprehensive therapy group (36 cases) and a conventional therapy group (35 cases). In the comprehensive therapy group, the acupoints in the region of abdominal qi pathway were selected and stimulated manually with both hands. In combination, the spinal adjustment therapy was applied. In the conventional therapy group, Shenshu (BL 23), Dachangshu (BL 25), Huantiao (GB 30) and Chengfu (BL 36) on the affected side were selected and stimulated with the conventional needling technique. Additionally, the routine Tuina therapy was applied. Before and after treatment, the visual analogue scale (VAS), Oswestry disability index (ODI) questionnaire, the health related quality of life (SF-36) questionnaire and the level of serum tumor necrosis factor (TNF-alpha) were adopted to determine analgesic effect and clinical efficacy. RESULTS: In the comprehensive therapy group, the curative and effective rate was 91.7% (33/36), which was apparently superior to 77.1% (27/35) in the conventional therapy group (P < 0.05). The analgesic effect in the first 10 treatments in the comprehensive therapy group was apparently superior to that in the conventional therapy group (P < 0.05). ODI after treatment was improved significantly in both groups (both P < 0.05), in which the result in the comprehensive therapy group was superior to that in the conventional therapy group (P < 0.05). After treatment, the SF-36 values of gener al health, bodily pain, physiological functioning, social functioning and emotional functioning in the comprehensive therapy group were superior to that in the conventional therapy group (all P < 0.05). After 15 treatments, the level of serum TNF-alpha in the comprehensive therapy group was lowered as compared with that before treatment and lower apparently than that in the conventional therapy group (P < 0.05); after 30 treatments, it was also lower than that in conventional therapy group (P < 0.05). CONCLUSION: In the guide of the theory of qi pathway, the comprehensive therapy of acupuncture and spinal adjustment intervention achieves the quick and good efficacy on LDH as compared with the conventional acupuncture and Tuina and improves the quality of life for the patients to certain extent. The analgesic effect of this therapy is relevant with the decrease of serum TNF-alpha.

Aging-related changes of triose phosphate isomerase in hippocampus of senescence accelerated mouse and the intervention of acupuncture.

Glycometabolism disorder induced by triose phosphate isomerase (TPI) is closely related to Alzheimer's disease (AD). Senescence accelerated mouse (SAM) is often employed as an AD model characteristic of early cognitive impairment. In order to investigate the variation of TPI with aging, SAM prone 8 (SAMP8) and SAM resistant 1 (SAMR1) were divided into 2-month, 6-month, 8-month and 12-month group. For the analysis of acupuncture intervention, SAMP8 were divided into SAMP8 control group (Pc), SAMP8 acupoint group (Pa), SAMP8 non-acupoint group (Pn) and SAMR1 control group (Rc). Grading score of senescence and Morris water maze results showed that SAMP8 presented aging-related deterioration of learning and memory, and that acupuncture could improve the learning and memory ability of SAMP8. TPI activity and expression were detected by colorimetric method and Western blot analysis, respectively. When compared to SAMR1, TPI activity in 6-, 8- and 12-month SAMP8 decreased significantly. However, acupuncture intervention markedly up-regulated TPI activity in hippocampus of Pa. These findings suggested that the learning and memory deterioration of SAMP8 with aging might be associated with the lower TPI activity and that acupuncture could improve the cognitive impairment by increasing TPI activity, thus correcting the abnormal glycolysis metabolism and maintaining the brain homeostasis and internal environment.