Professor GAO Wei-bin's clinical experience of using electroacupuncture for dry eye. / 高维滨电针治疗干眼临床经验撷要.

The academic thoughts of professor GAO Wei-bin regarding the use of electroacupuncture in the treatment of dry eye are introduced. Professor GAO believes that the occurrence of dry eye is mainly related to the stagnation of qi and blood in the eye meridians, leading to inadequate nourishment of the eyes. The acupuncture treatment principle focuses on promoting blood circulation, clearing and benefiting the eye orifices. By integrating traditional acupuncture theory with modern neuroanatomy, the treatment approach centers on stimulating the lacrimal gland, emphasizing the importance of promoting, addressing symptoms as a priority, and considering both the root cause and symptoms.The precise acupoint selection is emphasized. Acupoints of periocular region, such as Taiyang (EX-HN 5) and Leixian point are selected along with Fengchi (GB 20) and Gongxue point to treat dry eye. Attention is also given to the use of electroacupuncture and the selection of its frequencies, emphasizing specific needling techniques based on the severity and classification of the disease.

Trends and hotspots of acupuncture for allergic rhinitis: A bibliometric analysis from 2002 to 2022.

OBJECTIVE: The study aims to investigate and visualize the hotspots of acupuncture for Allergic rhinitis (AR) over the past two decades and pinpoint future trends in this field. METHOD: We conducted a systematic search of English-language articles or reviews on acupuncture for AR in the Web of Science Core Collection from 2002 to 2022. Using Citespace, VOSviewer, and Bibliometrix, we analyzed and visualized the publications, countries, institutions, authors, journals, and keywords from various angles. RESULT: The study identified 197 documents, 80 journals, 458 keywords, and 928 authors associated with acupuncture for AR. Although article publication fluctuated over the past 20 years, an overall upward trend emerged, with rapid growth during the second decade. China contributed the most to acupuncture research on AR and had the closest collaborations with the United States and Germany. China Medical University was the most prolific institution, and Benno Brinkhaus was the most productive and influential author. The most published journal was Medicine, while the Journal of Allergy and Clinical Immunology was the most frequently cited journal. The highest frequency keywords included acupuncture, allergic rhinitis, and asthma. Randomized controlled trials and alternative & complementary medicine remained significant research hotspots, while rhinoconjunctivitis is expected to be the emerging focus of future investigations. CONCLUSION: acupuncture has experienced robust development for the treatment of allergic rhinitis over the last two decades, with rhinoconjunctivitis and clinical research being the anticipated trends and frontiers of future research.

[Research progress on the effect mechanism of acupuncture-moxibustion for pressure injuries].

Evidence shows that acupuncture-moxibustion could promote the healing of pressure injuries (PI), but its action mechanism is not fully understood. This review summarizes the basic research literature of acupuncture-moxibustion for PI and identifies that the mechanism of acupuncture-moxibustion for PI is related with regulation of related signaling pathway target proteins, improvement of inflammatory response, modulation of vascular microenvironment, attenuation of oxidative stress damage, and inhibition of cell apoptosis. The review also points out the current limitations and future research directions. It emphasizes the need for further exploration of the upstream regulatory mechanism, specific cellular molecules, and the interactions among these molecules. A multi-level, multi-target, and multi-dimensional approach is required to fully understand the mechanism underlying the promotion of PI healing by acupuncture-moxibustion.

Efficacy of acupuncture on acute pharynx infections: A systematic review and meta-analysis.

BACKGROUND: Several clinical reports have focused on acupuncture for the treatment of acute pharyngeal infections. However, the efficacy and safety of acupuncture for the treatment of acute pharyngeal infections are controversial. To systematically assess the efficacy and safety of acupuncture in treating acute pharynx infections, thus providing a reference for clinical decision-making. METHODS: We searched PubMed, CENTRAL, Embase, Web of Science, China National Knowledge Infrastructure, China Biomedical, clinical research registration platforms, gray literature, and reference lists of the selected studies from inception to October 30, 2022. The risk of bias assessment was performed using RevMan. The meta-analysis was performed using STATA with the Hedges' g value. We also performed a subgroup analysis, meta-regression, and publication bias detection using Harbord's and Egger's tests. RESULTS: We included 19 randomized controlled trials comprising 1701 patients, of which only one study had a high risk of bias. The primary outcome, i.e., the response rate, revealed that acupuncture was more effective than antibiotics. The secondary results revealed that the differences in the reduction of VAS scores, sore throat duration, and white blood cell counts were statistically significant in the acupuncture group compared with the antibiotic group. However, the difference in the modulation of the neutrophil percentage and C-reactive protein levels was insignificant. Moreover, the acupuncture treatment resulted in a lower incidence of adverse events than the antibiotic treatment. CONCLUSIONS: Thus, acupuncture therapy for acute pharyngeal infections is safe and its response rate is superior to that of antibiotics. Acupuncture showed positive outcomes for alleviating the sore throat symptoms, shortening the sore throat duration, and improving the immune inflammation index. Nevertheless, owing to the limitations of this study, our conclusions should be interpreted with caution. More high-quality trials are warranted in the future for improving the methodology and reporting quality.

[Progress of researches on acupuncture treatment of allergic rhinitis].

Acupuncture therapy has been widely used in clinical treatment of allergic rhinitis (AR), and can induce a positive therapeutic effect through multi-targets and multi-aspects. In recent 10 years, the research on the mechanisms of acupuncture in treating AR mainly focused on humoral immunity, cellular immunity, cell apoptosis, inflammatory mediators and factors, neuropeptides, etc. By regulating the level of immunoglobulin in the blood, acupuncture intervention can restore the relative balance of cellular immune response, reduce the accumulation of eosinophils and promote apoptosis, down-regulate the expression of related inflammatory mediators and factors, regulate the excitability of related nerves, modulate the release of neuropeptides and other ways to diminish the inflammatory reaction of nasal mucosa, and enhance the repair and protection of nasal mucosa, relieve the nasal symptoms at last. On the basis of the existing studies, the follow-up research should make use of the advantages of acupuncture intervention, refine the treatment process, and deeply explore the feasibility of acupuncture treatment of AR, further promote the combination of mechanism study and clinical practice, provide references for clinical application. Moreover, some shortcomings exist, for example, the unknown correlation between the therapeutic effect and duration of treatment, the unknown correlation between the effect of acupuncture and various targets, and disconnection between experimental research achievements and clinical application, etc.

[GAO Wei-bin's clinical experience of electric eye acupuncture and stagnant-moving needling for ophthalmopathy].

Professor GAO Wei-bin's clinical experience of electric eye acupuncture and stagnant-moving needling for ophthalmopathy was introduced. The indications of electric eye acupuncture and stagnant-moving needling include external ophtalmoplegia and visual impairment. Professor GAO has proposed new acupoints at the ocular muscles attachment of eyeball, and put forward five experience points: Shangming point, Neiming point, Xiaming point, Waiming point and Tijian point. The points are selected according to different pathological changes of ocular muscles. In the treatment of ophthalmopathy, the tendons and vessels are often regulated at the same time. Neiming point, Shangming point, Xiaming point and Qiuhou point are the main points, with Fengchi (GB 20) and Gongxue (Extra) as the matching points. In addition, attention is paid to the application of stagnant-moving needling and electroacupuncture (continuous dense wave, frequency of 50 Hz).

Does electroacupuncture benefit mixed urinary incontinence? A systematic review and meta-analysis with trial sequential analysis.

INTRODUCTIN AND HYPOTHESIS: Mixed urinary incontinence (MUI) comprises a combination of urgency and stress. The efficacy and safety of electroacupuncture (EA) for the treatment of MUI remain unclear. OBJECTIVE: To assess the efficacy and safety of EA in treating MUI. METHODS: We searched PubMed, CENTRAL, Embase, Web of Science, four Chinese databases, clinical research registration platforms, grey literature, and the reference lists of the selected studies. Risk of bias and quality were evaluated using the Revman 5.4 and Jadad scores. Meta-analysis was performed using Stata 15.1 software. Trial sequential analysis (TSA) was used to assess the stability of the results. RESULTS: Eight randomized controlled trials comprising 847 patients were included. The meta-analysis results showed that compared with antimuscarinic drugs plus pelvic floor muscle training, EA resulted in significantly less pad weight on the 1-h pad test and statistically significantly lower severity scores on the International Consultation on Incontinence Questionnaire Short Form. The change in the 72-h incontinence episode frequency difference was not statistically significant, and there was no outcome of overall response rate and quality of life in this meta-analysis. Few adverse events occurred in the EA group. The TSA results suggested that the result of change from baseline in the 1-h pad test was stable and the evidence was conclusive. CONCLUSIONS: EA could be a potential treatment option for MUI and is relatively safe. Nevertheless, because of the limitations of this study, our conclusions should be interpreted with caution, and further studies are needed to confirm the comprehensive clinical efficacy and placebo effect of EA.

Efficacy of different acupuncture therapies on postherpetic neuralgia: A Bayesian network meta-analysis.

Background: Postherpetic neuralgia (PHN) is a common, complex, and refractory type of neuropathic pain. Several systematic reviews support the efficacy of acupuncture and related treatments for PHN. Nevertheless, the efficacy of various acupuncture-related treatments for PHN remains debatable. Objective: We aimed to assess the efficacy and safety of acupuncture-related treatments for PHN, identify the most effective acupuncture-related treatments, and expound on the current inadequacies and prospects in the applications of acupuncture-related therapies. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, Google Scholar, four Chinese databases (China National Knowledge Infrastructure, China Biomedical, Chongqing VIP, and Wan Fang databases), clinical research registration platform (World Health Organization International Clinical Trial Registration platform, China Clinical Trial Registration Center) for relevant studies. We also examined previous meta-analyses; gray literature; and reference lists of the selected studies. We then evaluated the risk of bias in the included studies and performed a Bayesian multiple network meta-analysis. Results: We included 29 randomized controlled trials comprising 1,973 patients, of which five studies showed a high risk of bias. The pairwise meta-analysis results revealed that the efficacy of all acupuncture-related treatments for pain relief related to PHN was significantly better than antiepileptics. The network meta-analysis results showed that pricking and cupping plus antiepileptics were the most effective treatment, followed by electroacupuncture (EA) plus antiepileptics for pain relief in patients with PHN. EA plus antiepileptics ranked the best regarding reduced Pittsburgh Sleep Quality Index (PSQI) and Self-Rating Depression Scale (SDS) scores in patients with PHN. No results were found regarding the total response rate or quality of life in this study. Acupuncture-related treatments showed a lower incidence of adverse events than that of antiepileptics. Conclusion: Acupuncture-related therapies are potential treatment options for PHN and are safe. Pricking and cupping plus antiepileptics, are the most effective acupuncture-related techniques for pain relief, while EA plus antiepileptics is the best acupuncture-related technique for improving PHN-related insomnia and depression symptoms. However, owing to the limitations of this study, these conclusions should be cautiously interpreted, and future high-quality studies are needed. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021226422, identifier CRD42021226422.

[Progress of researches on mechanisms of acupuncture in treatment of Parkinson's disease].

Parkinson's disease (PD) is a common neurodegenerative disease, and acupuncture has shown potential advantages in the treatment. By analyzing the experimental researches on acupuncture therapy of PD over the past 10 years, the authors find that acupuncture can play a therapeutic role by regulating multiple targets such as basal ganglia neurotransmitter disorder, oxidative stress, abnormal protein folding, immune inflammatory response, apoptosis, neural stem cells and calcium homeostasis. Although the mechanism of acupuncture in the treatment of PD is widely studied, there is still a lack of systematic, in-depth and high-quality research, and the mechanism of acupuncture therapy has not reached a consensus. In the future, the potential mechanisms including mitochondrial dysfunction and intestinal flora should be further studied.

[Network Meta-analysis of acupuncture and moxibustion for allergic rhinitis].

OBJECTIVE: To review the therapeutic effect of acupuncture and moxibustion on allergic rhinitis based on the network Meta-analysis. METHODS: The randomized controlled trials of acupuncture and moxibustion for allergic rhinitis were retrieved from the databases, starting from the date of establishment to August 17, 2020, i.e. the PubMed, EMbase, Cochrane Library, CNKI, Wanfang and VIP. The traditional Meta-analysis and network Meta-analysis were performed by RevMan5.3 and GeMTC0.14.3. RESULTS: A total of 50 RCTs were included, including 4260 patients, involving 5 kinds of acupuncture and moxibustion therapies, such as acupuncture, moxibustion, acupoint application, acupoint thread-embedding and auricular point therapy.①In term of total effective rate, acupuncture, moxibustion and acupoint thread-embedding were superior to western medication and auricular point therapy (P<0.05); moxibustion was superior to acupoint application (P<0.05); acupoint thread-embedding was superior to acupoint application (P<0.05). Acupoint thread-embedding was most likely to be the best treatment (P<0.05). ②In term of total effective rate in follow-up, acupuncture, moxibustion, acupoint thread-embedding and auricular point therapy were superior to western medication (P<0.05); acupuncture and moxibustion were superior to acupoint application (P<0.05). Moxibustion was most likely to be the best treatment (P<0.05). ③In term of total score of nasal symptom, moxibustion and acupoint thread-embedding were superior to acupuncture (P<0.05). CONCLUSION: The therapeutic effect of acupuncture and moxibustion on allergic rhinitis is better than western medication, and acupoint thread-embedding has the best curative effect.

[Research progress in the integration of machine learning and acupunctology].

Machine learning is a newly emerged discipline. It develops rapidly and has been penetrated into all walks of life and made great achievements in medical field. The introduction of machine learning in the field of acupuncture and moxibustion should fully play the advantages of targeted therapy of acupuncture and moxibustion, optimize the resource allocation of traditional Chinese medicine and accurately serve the clinic rather than only limited to data mining and analysis. In the paper, through the analysis of the relevant literature in recent years, the combination of acupuncture-moxibustion with machine learning was discussed from the aspects of acupoint selection and prescription, clinical teaching application of acupuncture and moxibustion, the prediction on acupuncture curative effect, etc. Moreover, on the base of multidisciplinary intersection and by means of machine learning, the exploration was given on the future direction of acupuncture and moxibustion.

[Progress of Researches on Mechanisms of Acupuncture Therapy in Regulating Brain Plasticity].

Brain plasticity is referred to the ability of the brain to change in structure and functional activities from microscopic aspects (synapses) in individual neurons to larger-scale aspects such as cortical remapping, neuronal remodeling, etc. in response to injury. Acupuncture has a positive effect in the treatment of cerebral diseases, thus leading to an increasing research on its underlying mechanisms in regulating brain plasticity. The present paper reviewed recent development of studies on acupuncture treatment of Alzheimer's disease, vascular dementia, cerebral ischemia, bone cancer pain, autism, etc. from 1) regulating synaptic plasticity (up-regulating the proportion of hippocampal synapses, increasing synaptic curvature, post-synaptic density, and numerical density, areal density, and lowering synaptic cleft); 2) increasing hippocampal post-synaptic potential slop, peak and peak area of population spikes to evoke long-term potentiation (LTP) by regulating the expression of glutamate N-methyl-D-aspartate (NMDA) and alpha amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors, and growth associated protein (GAP-43); 3) down-regulating the expression of glial fibrillary acidic protein (GFAP) to suppress the activity of astrocytes in the ischemic cerebral area and hippocampus in cerebral ischemia rats, and in the spinal cord dorsal horns of bone cancer rats, etc. and promoting vimentin and connexin 43 expression; and 4) promoting neuronal remodeling, and repair and regeneration of the injured nerve in the central nervous system via regulating neuron-glia network, expression of nerve growth factor, brain derived neurotrophic factor, etc. The future studies should pay more attention to 1) the contribution of acupuncture intervention to the correlation between the initiation of the endogenous protective effect and the brain plasticity during the onset of nerve injury and repair of the injured nerve, and 2) standarization of stimulating quantity, manipulation and duration of acupuncture treatment, as well as the relationship between the stimulating quantity and efficacy.

Evidence for the Use of Acupuncture in Treating Parkinson's Disease: Update of Information From the Past 5 Years, a Mini Review of the Literature.

Acupuncture is an alternative therapy for Parkinson's disease (PD), but its efficacy and safety are controversial. Our previous study, which reviewed the literature from 1974 to 2012, could not find enough evidence from rigorously designed randomized, controlled trials (RCTs) to make a conclusion about the efficacy of acupuncture. Recently, more RCTs and meta-analyses have been conducted to evaluate the efficacy of acupuncture. The aim of our current study is to provide updated information in brief on this topic. In this study, we analyzed and summarized seven RCTs and four meta-analyses. Although all included studies were not of high quality, we found that there has been a tremendous progress in acupuncture research in treating Parkinson's disease (PD) during the past 5 years, based on our experience and insights into the behavioral assessments of PD. First, the numbers of RCTs and meta-analyses based on RCTs are increasing. Second, non-motor symptoms are increasingly emphasized. Third, objective behavioral assessment tools are being employed. Although recent studies can provide limited evidence for the efficacy of acupuncture, we make the following recommendations for the future investigation: First, large, multicenter, well-designed RCTs should be organized for evaluation of the efficacy of acupuncture. Second, objective assessments using novel computerized technologies should be considered. Third, target symptoms should be selected and evaluated instead of only performing global evaluations. Fourth, attention should be paid to the efficacy of scalp acupuncture. Fifth, the safety of acupuncture should be evaluated and reported.

[Effects of Electroacupuncture Intervention on Oxygen Free Radicals and Expression of Apoptosis-related Proteins in Rats with Ischemic Learning and Memory Disorder].

OBJECTIVE: To observe the effect of electroacupuncture (EA) therapy on levels of oxygen free radicals (OFR) and hippocampal apoptosis-related protein expression in ischemic learning-memory disorder rats so as to investigate its mechanisms underlying improvement of ischemic learning-memory impairment. METHODS: A total of 60 SD rats were randomly divided into sham operation (sham), model, medication, and EA groups, with 15 rats in each group. The learning-memory disorder model was made by occlusion of bilateral carotid arteries. EA (2- 3 Hz, 2 mA) was applied to "Zhi San Zhen" ["Shenting" (GV 24) and bilateral "Benshen" (GB 13)] for 30 min, once a day for 3 weeks. The rats of the medication group were treated by lavage of Aricept (0.03 mg . kg(-1) . d(-1)), once daily for 3 weeks. The rats' learning-memory ability was detected by Morris water maze tests and the state of hippocampal apoptosis cells was observed by light microscope after TUNEL staining and the expression of hippocampal Bcl-2, Bax and Caspase-3 proteins was detected by immunohistochemistry. Serum and hippocampal superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activity and malondialdehyde (MDA) contents were detected by chemical colorimetric analysis. RESULTS: Compared with the sham group, the escape latencies (place-navigation) after modeling were evidently prolonged, and the times of target-platform crossing in 90 sec (spatial probe test) considerably reduced in the model group (P<0.01), suggesting an impairment of learning-memory ability. After the treatment for 21 d, the increased escape latency and the reduced target-platform crossing time in both EA and medication groups were reversed in comparison with the model group (P<0.01), suggesting an improvement of memory ability, and the effect of the EA group was significantly superior to that of the medication group (P<0.05). Compared with the sham group, the number of apoptotic cells in hippocampal CA 1- CA 3 regions, and the expression levels of hippocampal Bcl-2, Bax and Caspase-3 proteins, and serum and hippocampal MDA contents were significantly increased in the model group (P<0.01), while serum and hippocampal SOD and GSH-Px levels obviously decreased in the model group (P<0.01). After the treatment for 21 days, compared to the model group, the number of the apoptotic cells, the expression levels of hippocampal Bax and Caspase--3 proteins, and the contents of serum and hippocampal MDA were notably decreased in the EA and medication groups (P<0.01), whereas, Bcl-2 protein expression levels, and serum and hippocampal SOD and GSH-Px activity were notably up-regulated in the EA and medication groups (P<0.01). The effects of EA group were obviously superior to those of medication group in increasing hippocampal Bcl-2 immunoactivity, serum SOD and GSH-Px and hippocampal GSH-Px activity and in down-regulating serum MDA level (P<0.01, P<0.05). CONCLUSION: Electroacupuncture intervention can improve learning-memory ability in ischemic learning-memory disorder rats which may be associated with its effects in reducing blood and hippocampal OFR contents and hippocampal cellular apoptosis.