[Exploration of GAO Shu-zhong's academic thought of acupuncture and moxibustion].

This paper summarizes professor GAO Shu-zhong's academic thought of acupuncture and moxibustion. Professor GAO studies classic literature and clarifies the authentic Chinese medicine from the origin. He provides the unique understandings on the theories, e.g "four passes", gaohuang, the flowing rule of nutrient and defensive qi, lung governing management and regulation and moxibustion for sinking of qi. By analyzing the differences in diagnosis and treatment between acupuncture and herbal medication therapies and exploring the syndrome/pattern differentiation, he advocates the rules of disorder differentiation and treatment in clinical practice of acupuncture and moxibustion, creates GAO 's three-promotion theory and summarizes the characteristic diagnostic methods. He proposes novel statement, perfects theoretic system and creates GAO's extra points. He puts forward that the human acupoint system should be reconstructed to compose of two systems, i.e. meridian acupoints and collateral acupoints systems. Professor GAO pays the attention to acupuncture techniques, proposes a trinity needling technique, "pulse diagnosis, acupoint detection and qi differentiation under needle", and applies different needling techniques in treatment accordingly. He thinks highly of moxibustion, especially umbilicus moxibustion therapy, which has been used widely in practice. Besides, professor GAO provides the comprehensive methods flexibly, with acupuncture, moxibustion and herbal medication in combination.

[GAO Shu-zhong's clinical experience in "seeking yin from yang needling method" based on "qi street" and "four seas" theories].

The paper introduces professor GAO Shu-zhong's understanding on "seeking yin from yang needling method" and its clinical application on the basis of "qi street" and "four seas" theories. Through professor GAO's clinical practice for years, he integrates and extendes the theories of "seeking yin from yang", "qi street" and "four seas" in Huangdi Neijing (The Yellow Emperor's Inner Classic). In this specific acupuncture method, in reference with the theories of "qi street" and "four seas", acupuncture is exerted on yang part of body, e.g. the back and lumber region to treat the diseases of yin parts, e.g. the chest and abdomen, which is differentiated as yin-yang imbalance in pathogenesis. In order to fully explain the clinical curative effect of "seeking yin from yang needling method", the common diseases in clinic, e.g. the disorders of heart, spleen and stomach systems, as well as the gynecology are taken as examples in the paper.

[Brief analysis on GAO Shu-zhong's qiguan theory and its clinical application].

The paper introduces professor GAO Shu-zhong's experience in qiguan (umbilicus pass) theory and its clinical application. Professor GAO believes that the umbilicus is the "pass" where the primary qi of sanjiao transported from the lower jiao to the middle jiao. It is the general pivot of qi transformation of yin and yang, as well as the place for qi ascending, descending, exiting and entering in the human body. Hence, the umbilicus is called qiguan (umbilicus pass). In clinical practice, associated with observation, palpation and pulse diagnosis, the qiguan theory is conductive to disease diagnosis. Moreover, the therapeutic methods for promoting qiguan is generated, i.e. umbilicus-acupuncture therapy and umbilicus-moxibustion therapy. In the umbilicus-acupuncture therapy, Gao 's umbilicus five points (umbilicus heart, umbilicus stomach, umbilicus liver, umbilicus kidney and umbilicus lung) are commonly selected. With the umbilicus- moxibustion therapy, the isolated moxibustion with different herbal materials is exerted at the umbilicus, in which, the herbal materials with drastic medical action, pungent and fragrant in flavor and warm in property are specially selected.

[Herb-separated moxibustion on navel combined with Ningmitai capsule for non-liquefaction semen with dampness and heat diffusing downward: a randomized controlled trial].

OBJECTIVE: To compare the clinical therapeutic effect between herb-separated moxibustion on navel combined with Ningmitai capsule and simple Ningmitai capsule for non-liquefaction semen with dampness and heat diffusing downward. METHODS: A total of 66 patients with non-liquefaction semen of dampness and heat diffusing downward were randomized into an observation group (33 cases, 2 cases dropped off) and a control group (33 cases, 2 cases dropped off). In the control group, Ningmitai capsule was given orally 3 times a day. On the basis of the control group, herb-separated moxibustion on navel was applied in the observation group, 5 moxa-cones each time, once a week. The 4-time treatment was as one course and totally 3 courses were required in the both groups. Before and after treatment, the semen quality indexes (time of semen liquefaction, sperm viability, total sperm motility, number of progressive motility sperms, sperm concentration and semen volume) and TCM syndrome score were observed, the clinical therapeutic efficacy and spouse pregnancy rate were evaluated in the two groups. RESULTS: After treatment, the time of semen liquefaction was shortened (P<0.05), the sperm viability, total sperm motility, number of progressive motility sperms, sperm concentration and semen volume were increased in the both groups (P<0.05); the time of semen liquefaction in the observation group was shorter than the control group (P<0.05), the sperm viability, total sperm motility and number of progressive motility sperms in the observation group were superior to the control group (P<0.05). After treatment, the TCM syndrome score was decreased compared before treatment in the observation group (P<0.05), and that in the observation group was lower than the control group (P<0.05). The total therapeutic effect rate and spouse pregnancy rate were 93.5% (29/31) and 67.7% (21/31) in the observation group, which were higher than 71.0% (22/31) and 41.9% (13/31) in the control group respectively (P<0.05). CONCLUSION: Herb-separated moxibustion on navel combined with Ningmitai capsule can effectively treat non-liquefaction semen with dampness and heat diffusing downward, improve the clinical symptoms, semen quality and spouse pregnancy rate, the therapeutic effect is superior to simple oral Ningmitai capsule.

Adjuvant therapeutic effects of moxibustion on COVID-19: A protocol for systematic review and meta-analysis.

BACKGROUND: COVID-9 has become a global pandemic with severe health issues around the world. However, there is still no effective drug to treat the disease, and many studies have shown that moxibustion plays a positive role in adjuvant treatment of COVID-19. Therefore, this meta-analysis is designed to evaluate the efficacy of moxibustion for COVID-19. METHODS: The relevant randomized controlled trials will be systematically retrieved from the electronic database, including PubMed, Embase, Cochrane Clinical Trials Database, Web of Science, and China National Knowledge Infrastructure, without restrictions on publication status and language. Two reviewers will independently review all included studies and assess the risk of bias. Two reviewers will independently extract data from the included studies based on a pre-designed standardized form. Any disagreements will be resolved by consensus. The meta-analysis will be performed with RevMan (V5.3.5) software. RESULT: The results of this study will be published in a peer-reviewed journal. CONCLUSION: This ongoing meta-analysis will provide up-to-date evidence of the efficacy of moxibustion for patients with COVID-19. REGISTRATION: The meta-analysis has been prospectively registered in PROSPERO (CRD42020211910).

Effects of fatty and lean fish intake on stroke risk: a meta-analysis of prospective cohort studies.

BACKGROUND: Fish intake has been postulated to reduce the risk of stroke. However, whether the beneficial effect of fish are mainly linked to fat content, as a source of omega-3 polyunsaturated fatty acids, remains unclear. We conducted a meta-analysis to compare the effect of fatty and lean fish intake on stroke risk. METHODS: We performed a literature search on four database (PubMed, Embase, Scopus, and Cochrane Library) through February 1, 2018 to identify prospective studies of fatty and lean fish in relation to stroke risk. A random-effects model was used to calculate the summary estimates. RESULTS: We identified five prospective studies, including 7 comparisons for fatty fish intake and 5 comparisons for lean fish intake. Compared with the highest category of intake with lowest category, the summary relative risk was 0.88 [95% confidence interval (CI), 0.74-1.04] for fatty fish intake and 0.81 (95% CI, 0.67-0.99) for lean fish intake. No heterogeneity across studies and publication bias were observed. CONCLUSION: Our findings demonstrated that fatty and lean fish intake has beneficial effects on stroke risk, especially lean fish intake. Additional prospective studies are necessary to confirm these observations.

Research of Herb-Partitioned Moxibustion for Primary Dysmenorrhea Patients Based on the LC-MS Metabonomics.

Objective. To explore the efficacy and mechanism of primary dysmenorrhea patients were treated with herb-partitioned moxibustion through metabonomics. Methods. 20 patients with primary dysmenorrhea were randomized into two groups, separately treated with herb-partitioned moxibustion at CV8 (shenque) and acupuncture at SP6 (sanyinjiao). After three menstrual cycles' treatment, the intensity of menstrual pain using VAS and the changes of metabolites of plasma using LC-MS were observed. Results. The VAS of two groups decreased with different descending range. Herb-partitioned moxibustion upregulated 20α-dihydroprogesterone, pregnenolone, prostaglandin E2 and γ-aminobutyric acid and downregulated the content of estrone and prostaglandin H2, while acupuncture upregulated pregnenolone and 20α-dihydroprogesterone and downregulated 2-methoxyestradiol-3-methylether, 15-hydroxyeicosatrienoic acid and 6-keto-prostaglandin. Discussion. It was effective in relieving the abdominal pain by these two therapies. Herb-partitioned moxibustion is superior to acupuncture for primary dysmenorrhea, which could be related to regulating the endocrine hormone.

[Ancient clinical application of herb-participated moxibustion on umbilicus].

In order to further improve the curative effect of the herb-participated moxibustion on umbilicus, we collected a wide range of literature on herb-participated moxibustion on umbilicus and then systematically arranged them to analyze and summarize the technology and operating methods of herb-participated moxibustion on umbilicus. We also briefly discussed issues on application of medicine, locust tree skin and ginger, the method of kneading dough for medical uses, and the appropriate size of moxa cone and its using frequency in order to form clear concepts and standardized operations to provide theories and operational basis for the clinical application of modern herb-participated moxibustion on umbilicus.

[The herbal-partitioned moxibustion for primary dysmenorrhea and it's impact on reproductive endocrinal function of patients].

OBJECTIVE: To explore the efficacy and the reproductive endocrinal mechanism of herbal-partitioned moxibustion in the treatment of primary dysmenorrhea. METHODS: One hundred and seventy-one cases of primary dysmenorrhea were randomized into an herbal-partitioned moxibustion group (group A), an starch-partitioned moxibustion group (group B) and an acupuncture group (group C), 57 cases in each one. In the group A, moxibustion isolated with herbal medicine was applied to Shenque (CV 8). In the group B, moxibustion isolated with starch was used at Shenque (CV 8). In the group C, acupuncture was given at Sanyinjiao (SP 6). The changes of estradiol (E2), progesterone (P) and prostaglandin levels (PGF2alpha) were observed before and after treatment, and the therapeutic effects were compared among the 3 groups. RESULTS: The therapeutic effect in the group A was better than those in the other two groups [compared the cured rate: 89.8% (44/49) vs 60.0% (30/50), 60.4% (32/53), both P < 0.05]. In the group A, E2 level [(110.99 +/- 12.90) pg/mL vs (83.94 +/- 8.91) pg/mL, P < 0.05] and PGF2alpha level [(24.58 +/- 3.01) pg/mL vs (14.34 +/- 1.48) pg/mL, P < 0.01] were decreased and P level was increased [(4.65 +/- 0.68) ng/mL vs (6.68 +/- 0.95) pg/mL, P < 0.05]. In the group B and C, PGF2alpha level were reduced. Concerning to the regulating of E2 and PGF2alpha levels, the results in the group A were better than those in the group B and C [(-30.16 +/- 10.20) pg/mL vs (10.79 +/- 15.01) pg/mL, (22.81 +/- 12.22) pg/mL; (-13.10 +/- 2.40) pg/mL vs (-6.52 +/- 1.88) pg/mL, (-3.14 +/- 1.19) pg/mL, (see text) P < 0.05]. Concerning to the regulation of P level, the results in the group A and B were better than that in the group C (all P < 0.05). CONCLUSION: The herbal-partitioned moxibustion achieves the significant efficacy on primary dysmenorrhea, which could be related to regulating the reproductive endocrinal level. It decreases E2 and PGF2alpha levels and increases P level.

A clinical trial of acupuncture about time-varying treatment and points selection in primary dysmenorrhea.

OBJECTIVE: To observe the clinical therapeutic effects of acupuncture at single point Shiqizhui (EX-B8) and multi-points in time-varying treatment for primary dysmenorrhea. METHODS: 600 patients with primary dysmenorrhea were randomly assigned to the single point group (n=200) including group A (treating before the menstruation, n=100) and group B (immediately treating as soon as pain occurrence, n=100), the multi-points group (n=200) including group C (treating before the menstruation, n=100) and group D (immediately treating as soon as pain occurrence, n=100), or the control group, group E (n=200, no treatment). The therapeutic effects were analyzed after treatment for three menstrual cycles and interviewed for three follow-up periods. RESULTS: Acupuncture could effectively relieve menstrual pain for primary dysmenorrhea compared with the control group (P<0.05, P<0.01). Immediate pain relief occurred following acupuncture within 5 min in group B (P<0.01) and group D (P<0.01), and the two groups obviously relieved menstrual pain for VAS scores. Both group A and group C obviously relieved menstrual pain (P<0.01), and group C was better than group A (P<0.05). Compared with group D, Group C was much better for CMSS scores in cycle 1. CONCLUSION: Treating before the menstruation is better than immediately treating as soon as pain occurrence at the improvement in symptoms of dysmenorrheal at multi-points. And single point is better than multi-points when immediately treating as soon as pain occurrence. The present trial suggest Shiqizhui (EX-B8) should be chosen as a convenient point.

Randomized clinical trial: the clinical effects of herb-partitioned moxibustion in patients with diarrhoea-predominant irritable bowel syndrome.

Objective. To explore the efficacy of Herb-partitioned moxibustion in treating IBS-D patients. Method. 210 IBS-D patients were randomly assigned on a 3 : 3 : 2 basis to group HM, group FM, or group PB for 4-week treatment. The change of GSRS total score at weeks 4 and 8, the changes of GSRS specific scores, and adverse events were evaluated. Results. Patients in group HM and group FM had lower GSRS total score at week 4 (1.98 ± 0.303, 2.93 ± 0.302 versus 3.73 ± 0.449) and at week 8 (2.75 ± 0.306, 3.56 ± 0.329 versus 4.39 ± 2.48) as compared with patients' score in group PB. However, there was no significant difference of GSRS total score between group HM and group FM. The effect of HM was significantly greater than that of orally taking PB in ameliorating the symptoms of rugitus (0.38 versus 0.59, P < 0.05), abdominal pain (0.28 versus 0.57, P < 0.01), abdominal distension (0.4 versus 0.7, P < 0.01), and increased passage of stools (0.06 versus 0.25, P < 0.01) at the end of treatment period. In the follow-up period, patients' therapeutic effect in group HM remained greater than that in group FM (in abdominal pain, abdominal distension, and increased passage of stools) and that in group PB (in loose stools). Conclusions. HM appears to be a promising, efficacious, and well-tolerated treatment for patients with IBS-D.

[Analysis on the status of vitamin A deficiency among children under 5 years old in poor rural areas of 6 Western Chinese provinces in 2009].

OBJECTIVE: To analyze the status of vitamin A deficiency among children under 5 years old in poor rural areas of 6 Western Chinese provinces in 2009. METHODS: The study subjects involved 2091 children from a program - 'Appropriate measurements in improving children under-nutrition in poor rural areas'. RESULTS: In 2009, prevalence of vitamin A deficiency among children under 5 years old from the poor rural areas of 6 western Chinese provinces was 20.2%, with boys as 20.6% and girls as 19.7%. Prevalence rates of vitamin A deficiency among children under 5 years old in the highest and lowest areas were seen in Gansu (25.5%) and Guangxi (12.2%) provinces, respectively. The peak of vitamin A deficiency prevalence fell in the 6 - 11 months age group. The prevalence of vitamin A deficiency declined along with the increase of age. RESULTS: from this study demonstrated that vitamin A deficiency among children under 5 years old appeared to be a serious public health problem in the poor rural areas of 6 Western Chinese provinces. Education on reasonable ways of feeding and provision of complementary nutrients to children with vitamin A deficiency, should be the key points in the prevention and control programs on this problem.

Immediate effect of acupuncture at Sanyinjiao (SP6) and Xuanzhong (GB39) on uterine arterial blood flow in primary dysmenorrhea.

OBJECTIVE: The objective of this study was to compare immediate effect of acupuncture at SP6 on uterine arterial blood flow in primary dysmenorrhea with that of GB39. DESIGN: This was a prospective, randomized clinical trial. SETTING: Sixty-six (66) patients with primary dysmenorrhea from the Affiliated Hospital of Shangdong University of Traditional Chinese Medicine were recruited. INTERVENTIONS: The SP6 group (n =32) was treated with manual acupuncture at bilateral SP6 for 5 minutes after obtaining needling sensation (de qi) during the period of menstrual pain, whereas the control group (n = 34) was needled at GB39 of both sides for 5 minutes when they suffered menstrual pain. MAIN OUTCOME MEASURES: Differences in pulsatility index (PI), resistance index (RI), and ratio of systolic peak and diastolic peak (A/B) in uterine arteries were the main outcome measures. RESULTS: Highly significant reductions were observed in the SP6 treatment group 5 minutes after treatment in menstrual pain scores (8.17 ± 1.90 versus 11.20 ± 2.66; p < 0.001), values of PI (1.75 ± 0.48 versus 2.32 ± 0.70; p < 0.001), RI (0.72 ± 0.11 versus 0.78 ± 0.07; p < 0.001), and A/B (4.33 ± 1.37 versus 5.23 ± 1.67; p < 0.001). Compared with the GB39 control group, patients in the SP6 treatment group showed significant reductions in 5 minutes after treatment in the changes of menstrual pain scores (3.03 ± 2.36 versus 0.00 ± 0.29; p < 0.001), values of PI (0.57 ± 0.42 versus -0.10 ± 0.58; p < 0.001), RI (0.06 ± 0.08 versus -0.03 ± 0.15; p < 0.01), and A/B (0.90 ± 0.87 versus 0.23 ± 1.02; p < 0.01). There were no significant changes in menstrual pain scores, values of PI, RI, or A/B before and after treatment in the GB39 control group (p > 0.05). No adverse events from treatment were reported. CONCLUSIONS: This study suggests that needling at SP6 can immediately improve uterine arterial blood flow of patients with primary dysmenorrhea, while GB39 does not have these effects.

A comparative study on the immediate effects of electroacupuncture at Sanyinjiao (SP6), Xuanzhong (GB39) and a non-meridian point, on menstrual pain and uterine arterial blood flow, in primary dysmenorrhea patients.

OBJECTIVE: The objective of this study was to compare the effects of Sanyinjiao (SP6), Xuanzhong (GB39), and an adjacent non-meridian point on menstrual pain and uterine arterial blood flow in primary dysmenorrhea patients. DESIGN: The design of the study was a prospective, randomized controlled trial. SETTING: The setting of the study was the Shandong Institute of Medical Imaging, Jinan, China. PATIENTS: The patients were 52 women with primary dysmenorrhea. INTERVENTIONS: Women received electroacupuncture (EA) at SP6 (n=13), GB39 (n=14), and an adjacent non-meridian point (n=12), respectively, for 10 minutes when scored ≥40 on a 100-mm visual analog scale (VAS), and for 30 minutes on the next 2 days. There was no EA in the waiting list group (n=13). OUTCOME MEASURES: Primary outcomes were menstrual pain, resistance index (RI), and the ratio between peak systolic to end-diastolic flow velocity (S/D) in uterine arteries. Secondary outcomes included verbal rating scale (VRS) and retrospective symptom scale (RSS). RESULTS: The SP6 group had a highly significant reduction in VAS scores compared with the waiting list group (-23.19mm, 95% confidence interval [CI]-32.06 to -14.33, P<0.0001), GB39 group (-18.58mm, 95% CI -27.29 to -9.88, P<0.0001) and the non-meridian point group (-20.78mm, 95% CI -29.82 to -11.73, P<0.0001), respectively. A significant reduction in VRS scores was found in the SP6 group compared with the GB39 group (P=0.034) and the non-meridian point group (P=0.038). There were no significant differences of RI, S/D-values and RSS scores among the four groups (P>0.05). CONCLUSIONS: EA at SP6 can immediately relieve menstrual pain and minimize the influence of pain on daily life compared with GB39 and an adjacent non-meridian point. The data preliminarily show the specificity of SP6 for the immediate pain relief of primary dysmenorrhea.