RESUMO
OBJECTIVE: To evaluate the effectiveness and safety of acupuncture treatment for dysphagia as a complication of stroke. Methods and Design. This is a multicenter, pragmatic, nonrandomized, self-controlled clinical trial. A total of 39 patients were recruited from several Chinese medicine outpatient clinics and hospital-affiliated speech therapy outpatient clinics in Hong Kong. 26 patients completed all the 24 sessions of acupuncture treatment within two months, and only 12 of them were used as self-control. For the self-control group, the retrospective clinical data was taken from the electronic patient records with patient consent. The descriptive swallowing function data were converted into the quantitative Royal Brisbane Hospital Outcome Measure for Swallowing (RBHOMS) scores by two registered speech therapists through a validation process. And the data were validated by reaching consensus between the two speech therapists. All subjects underwent a baseline assessment before commencement of treatment, and outcome assessments were conducted upon the completion of treatment. The primary outcome measure is the RBHOMS score, which is a swallowing disability rating scale for monitoring difficulties in daily swallowing function. Secondary outcome measures include the Chinese version of the Swallow Quality-of-Life Questionnaire and adverse events. All the primary and secondary outcomes were assessed at baseline as well as at the end of acupuncture treatment (month 2). RESULTS: A total of 39 participants aged 46 to 89 years were enrolled in the study, and the male-to-female ratio was 15 : 11. The mean baseline RBHOMS score of all 39 participants was 5.92 ± 2.23. The mean retrospective RBHOMS score of the 12 subjects who were used as self-control was 5.67 ± 1.72 before enrollment, while the mean RBHOMS score of the 26 participants who completed all the 24 sessions of treatment was 6.92 ± 2.07. There were statistically significant differences between the RBHOMS score at the completion of treatment and baseline (p=0.006), and retrospective data (p=0.042). Moreover, a significant difference was also found in terms of swallow quality-of-life score before and after acupuncture treatment (p < 0.01). CONCLUSIONS: This pilot study provides preliminary evidence for the effectiveness of acupuncture for poststroke dysphagia. The findings from this trial can be used as a foundation for future full-scale randomized controlled clinical trials to assess the efficacy and safety of acupuncture for poststroke dysphagia. Ethics and Dissemination. The ethical approval of the clinical research study was granted by the Research Ethics Committee of both New Territories East and West Cluster of Hong Kong. Written informed consent was obtained from all participants, and the study was undertaken according to the ICH-GCP Guidelines. Trial Registration. This trial is registered with ChiCTR-TRC-12002621 and the registration date is 2012-10-26.
RESUMO
This was a prospective multicenter observational study, aiming to explore the effects of acupuncture on smoking cessation in Hong Kong. From March of 2010 to August of 2015, a total of 5202 smokers were recruited based on inclusion criteria and treated with acupuncture for 8 weeks. As a result, 2940 subjects finished the study with a drop-out rate of 43.48%. The self-reported 7-day point abstinence rate was 34.00% in Week 8 and 18.40% in Week 52. The exhaled carbon monoxide level and the number of cigarettes smoked per day were reduced significantly after treatment. The time to relapse was calculated to be 38.71 days. In addition, "cigarettes smoked per day," "Fagerstrom Test for Nicotine Dependence," "total sessions of acupuncture," "whether finished 8 acupuncture treatments in the first month," and "total sessions of acupuncture" were believed to be essential factors for abstinence success. It was concluded that acupuncture was a safe method for smoking cessation and was effective in helping smokers to quit; therefore, acupuncture could be considered as one of the methods to help smokers quit. Further studies regarding the effect differences between acupuncture and medications were needed to clarify the overall benefits of acupuncture.
RESUMO
Osthole, an active coumarin isolated from Cnidium monnieri (L.) Cusson, has long been used in China as an antipruritic herbal medicine; however, the antipruitic mechanism of osthole is unknown. We studied the molecular mechanism of osthole in histamine-dependent itch by behavioral test, Ca(2+) imaging, and electrophysiological experiments. First, osthole clearly remitted the scratching behaviors of mice induced with histamine, HTMT, and VUF8430. Second, in cultured dorsal root ganglion (DRG) neurons, osthole showed a dose-dependent inhibitory effect to histamine. On the same neurons, osthole also decreased the response to capsaicin and histamine. In further tests, the capsaicin-induced inward currents were inhibited by osthole. These results revealed that osthole inhibited histamine-dependent itch by modulating TRPV1 activity. This study will be helpful in understanding how osthole exerts anti-pruritus effects and suggests that osthole may be a useful treatment medicine for histamine-dependent itch.
Assuntos
Cumarínicos/farmacologia , Ativação do Canal Iônico/efeitos dos fármacos , Prurido/prevenção & controle , Canais de Cátion TRPV/metabolismo , Animais , Antipruriginosos/farmacologia , Cálcio/metabolismo , Bloqueadores dos Canais de Cálcio/farmacologia , Capsaicina/farmacologia , Células Cultivadas , Gânglios Espinais/citologia , Histamina , Masculino , Camundongos Endogâmicos C57BL , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Prurido/induzido quimicamente , Prurido/metabolismoRESUMO
Background. Observational studies of smoking cessation with acupuncture have been reported widely; however, few researchers have focused on its predictors. Objective. This paper attempts to explore the predictors for smoking cessation with acupuncture in a Hong Kong population, aiming to provide references for clinical treatment in the future. Methods. We performed a secondary analysis of data from our observational study "Acupuncture for Smoking Cessation (2011-2014)" in Hong Kong. A total of 23 indexes were selected as possible predictors, and study participants with complete information of 23 indexes were included. By taking 8-week and 52-week smoking cessation results as dependent variables, binary logistic regression method was used to identify the predictors. Additionally, based on an M5P decision-tree algorithm, an equation of "successful rate of smoking cessation with acupuncture" was calculated. Results. (1) 2,051 study participants were included in total. (2) According to the results of binary logistic regression, variables including treatment location, total number of acupuncture sessions received, and whether the study participants received at least 6 sessions of acupuncture were taken as the short-term predictors; gender, treatment location, Fagerstrom Test for Nicotine Dependence (FTND), and total number of acupuncture sessions received were taken as the long-term predictors. (3) According to study participants' FTND, treatment location, and number of cigarettes smoked/day, the equation of "successful rate of smoking cessation with acupuncture" was established. Conclusion. Receiving sufficient and qualified acupuncture is the leading factor for short-term smoking cessation with acupuncture, whereas individual factors and smoking background play a more important role in long-term smoking cessation with acupuncture.