Chinese medicine for idiopathic Parkinson's disease: A meta analysis of randomized controlled trials.

OBJECTIVE: To evaluate the efficacy of Chinese medicine (CM) adjunct to conventional medications for idiopathic Parkinson's disease (PD). METHODS: Electronic English and Chinese databases including PubMed, Cochrane Library, Web of Science, Chinese Medical Current Contents, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Med Database, and Traditional Chinese Medical Database System were used for key words searching in a highly sensitive search strategy. The extracted data was analyzed by the Review Manager 5.0. RESULTS: Twelve trials involving 869 participants were included in the meta-analysis. Unified PD Rating Scale (UPDRS) I, II, III, IV scores and UPDRS V-IV total scores were used to be the primary outcomes, Parkinson Disease Question-39 (PDQ-39) and Scores of Chinese Medical Symptoms were the secondary outcomes. CM adjunct therapy had greater improvement in UPDRS I [2 trials; standardized mean difference (SMD)-0.40, 95% confidence interval (CI)-0.71 to-0.09; Z=2.49 (P=0.01)], II [5 trials; SMD-0.47, 95% CI-0.69 to-0.25; Z=4.20 (P<0.01)], III [5 trials; SMD-0.35, 95% CI-0.57 to-0.13; Z=3.16 (P=0.002)], IV scores [3 trials; SMD-0.32, 95% CI-0.60 to-0.03; Z=2.17 (P=0.03)], UPDRS I-IV total scores [7 trials; SMD-0.36, 95%CI-0.53 to-0.20; Z=4.24 (P<0.05)]. PDQ-39 and Chinese medical symptoms compared to the conventional medication only. CONCLUSION: CM adjunct therapy has potential therapeutic benefits by decreasing UPDRS scores and reducing adverse effect.

Induction of Hyperalgesia in Pigs through Blocking Low Hydraulic Resistance Channels and Reduction of the Resistance through Acupuncture: A Mechanism of Action of Acupuncture.

According to the classic theory of Chinese medicine, pain is due to the blockage in meridian channels, and acupuncture was invented to treat pain by "dredging" the channels. To test the theory, a hyperalgesia model was made by injecting hydrogel into low hydraulic resistance channel (LHRC) in 12 anaesthetized minipigs. Tail-flick threshold and ear-flick threshold were measured using a thermal radiation dolorimeter, and relative flick threshold (RFT) was calculated. Hydraulic resistance (HR) was measured with a biological HR measuring instrument on low HR points on LHRC and on control points with higher HR located outside LHRC; readings were recorded before, during, and after acupuncture treatment. RFT decreased after blocking the LRHC and was still significantly decreased 2 days and 4 days afterwards. No significant changes occurred when injecting saline into the same points or injecting gel into points outside the channel. Subsequent acupuncture reduced HR on LRHC along meridians but had no significant effect on sites with higher HR located outside LHRC. One of the mechanisms of action of acupuncture treatment for chronic pain may be that acupuncture affects peripheral tissue by reducing the HR in LHRC along meridians, improving the flow of interstitial fluid and removing algogenic substances and thereby relieving pain.

[Influence of mechanical pressure on the change of acupuncture-induced transcutaneous CO2 emission].

OBJECTIVE: To investigate conduction of acupuncture effect and the influence of mechanical pressing meridians on it. METHODS: In twenty healthy volunteers (8 males and 12 females, aged 29 years on average), by using a Frewil Q. F. apparatus, transcutaneous CO2 emission (TCE) was measured before, during and after acupuncture at Neiguan (PC 6), respectively. The locations being measured were Quze (PC 3) and four points including two non-acupoints along the Pricardium Meridian (Point A and B) and two non-acupoints apart from the Pericardium Meridian (Point C and D). Point A was located at the lower one fourth of the line connecting Tianquan (PC 2) and Quze (PC 3), and Point B located at the middle of the line connecting Ximen (PC 4) and Quze (PC 3). Point C was located 2 cm lateral on the ulnar side to Point A, and Point D located 2 cm lateral on the ulnar side to Point B. The above results were compared with those obtained after mechanical pressure of 1 kg (area 1 cm X 2 cm) applied on Ximen (PC 4) and Daling (PC 7), respectively, to observe their effect on TCE. RESULTS: During and after acupuncture at Neiguan (PC 6) without mechanical pressure, TCE at Quze (PC 3), point A and B increased significantly (P < 0.05), but not at point C and D (P > 0.05). While applying mechanical pressure at Ximen (PC 4), no significant increase was found on the three points during and after acupuncture. When applying pressure at Daling (PC 7), significant increases of TCE were also found at Quze (PC 3) and point A during acupuncture (P < 0.05), and a significant increase of TCE was found at point B after acupuncture with pressure keeping (P < 0.05). CONCLUSION: Acupuncture can enhance energy metabolism along meridians, and this effect can be blocked by mechanical pressure.

[Some misunderstandings of deqi phenomenon: from historic review to experimental study].

In this paper, the authors trace back to the historic source of deqi and needling sensation, and probe the misunderstanding course of the feeling of sourness, numbness, distension, aching or heaviness used as synonym of deqi, and explore and introduce the modern significance and experimental studies of deqi. Although there are arguments in relationship between the feeling of sourness, numbness, distension, aching or heaviness after acupuncture and effect of acupuncture at home and abroad, in fact, this is a misunderstanding of needling sensation replacing deqi. Sometimes acupuncture possibly does not induce sourness, numbness, distension, aching or heaviness, but it also induces patient's comfortable sensation and at the same time acupuncture practitioners possibly have a sensation under the hand, which is at the state of deqi. The two states will be detected by fMRI in experimental studies, so as to have indexes to be followed for deqi or needling sensation.

A discovery of low hydraulic resistance channel along meridians.

A hydro-mechanic model was put forward to study the fundamental nature of acupuncture meridians. The basic state of low hydraulic resistance was tested on humans and mini pigs using three methods. The first, a modified Guyton's method, proved that there was lower hydraulic resistance on meridians compared with nonmeridians. The second scanning method involved a single pressure transducer that can find the lowest resistance point in tissue, and the third method used two transducers and provided a more stable measurement. Using the latter method, low hydraulic resistance points were found very close to low impedance points along meridians. The transmission of artificial interstitial fluid pressure waves was measured to examine their connection to the low resistance points, with the result that a good connection between the points was confirmed. This means the points form channels along the meridians that we refer to as low hydraulic resistance channels. The channel was imaged through isotopic tracing and a migration of isotope (99m)Te could be found along the channel. The layer of the channel was detected by injecting Alcian blue and the track was found beneath the skin. All of the above experiments suggest the existence of a new type of channel in living tissues that has not yet been described in modern science, but coincides quite well with the Qi channel theory of traditional Chinese medicine.

[Experimental verification of "treating lumbar-back problems by puncturing Weizhong (BL 40)" with blood perfusion imaging technique].

OBJECTIVE: To verify the classic saying of "Treating lumbar-back problems by puncturing Weizhong (BL 40)" in acu-moxibustion learning and to explore its underlying mechanism. METHODS: Forty volunteer sublects were asked to accept twice tests respectively, i.e., acupuncture of Weizhong (BL 40) and Yanglingquan (GB 34), for observing changes of skin blood perfusion (SBP) at the low back part of the body by using a laser Doppler perfusion imager. The whole observed area (lower back) was divided into five sub-areas, left and right areas involving Line-one and Line-two of the Bladder Meridian. RESULTS: In comparison with pre-acupuncture, SBP of both BL40 and GB34 groups increased significantly from 4 minutes' retention of needles on to 12 mm after withdrawing acupuncture needle (P < 0.01), but no significant difference was found between two groups in SBP (P > 0.05). The change rates of SBP at Line-one and Line-two of the Bladder Meridian on the same side of the stimulated Weizhong (BL 40) were significantly higher than those of Yanglingquan (GB 34) (P < 0.05), but no significant changes were found on the opposite side (both Line-one and Line-two) of the Bladder Meridian. CONCLUSION: Acupuncture of both BL4O and GB34 can increase SBP at the low back of the body (involving the Bladder Meridian) on the same side, but the changing rate of SBP of BL4O is hiaher than that of GB34.