Efficacy of acupuncture-related therapy in the treatment of primary dysmenorrhea: A network meta-analysis of randomized controlled trials.

Objectives: In order to compare and rank the most effective acupuncture therapy for primary dysmenorrhea and provide evidence-based medical support for clinical treatment of this disease. Methods: A comprehensive search was conducted on China National Knowledge Infrastructure (CNKI), Wanfang Database, Information Chinese Journal Service Platform (VIP), China Biomedical Literature Service System (SinoMed), PubMed, Web of Science, Embase, and Cochrane Library databases from their inception to May 1, 2023. The Cochrane Collaboration Risk of Bias Tool was used to evaluate bias risk, and the GeMTC package of Stata 15.1 software and R 4.3.1 software was used to perform network Meta-analysis. Results: 70 studies were included, including 5772 patients with primary dysmenorrhea, involving 25 kinds of acupuncture techniques commonly used in clinic. The quality of the included literature was low, most of them did not mention the registration information of clinical trial centers, and the specific sample size estimation method was unclear. Some literature did not explain the specific random method, distribution concealment and blindness, so there was a certain publication bias and small sample effect. Results showed that for improving the clinical effective rate, the top three treatments were salt-separated moxibustion, massotherapy + acupoint patching, acupuncture + heat-sensitive moxibustion. In terms of reducing the visual analogue scale(VAS), the top three treatments were massotherapy + acupoint patching, acupuncture + acupoint patching and warm acupuncture. In terms of alleviating cox menstrual symptom scale (CMSS), the top three treatments were acupuncture + acupoint patching, acupoint patching and point embedding. In relieving TCM symptom score, the top three treatments were acupoint patching + heat-sensitive moxibustion, acupoint patching and moxibustion. Conclusion: Different acupuncture therapies have more advantages than oral analgesics in improving the clinical effective rate, reducing VAS score, reducing CMSS score, and alleviating TCM symptom score. Among them, massage therapy + acupoint patching, acupuncture + acupoint patching and acupoint patching may be the best solutions for the treatment of primary dysmenorrhea. However, more large-sample, multi-center and high-quality randomized controlled trials are needed to demonstrate.

Evaluation of vegetation restoration effectiveness along the Yangtze River shoreline and its response to land use changes.

Assessing the effectiveness of vegetation restoration along the Yangtze River shoreline and exploring its relationship with land use changes are imperative for providing recommendations for sustainable management and environmental protection. However, the impact of vegetation restoration post-implementation of the Yangtze River Conservation Project remains uncertain. In this study, utilizing Sentinel-2 satellite imagery and Dynamic World land use data from pre- (2016) and post- (2022) Yangtze River Conservation Project periods, pixel-based binary models, transition matrices, and geographically weighted regression models were employed to analyze the status and evolution of vegetation coverage along the Yangtze River shoreline. The results indicated that there had been an increase in the area covered by high and high-medium vegetation levels. The proportion of vegetation cover shifting to better was 4201.87 km2 (35.68%). Hotspots of vegetation coverage improvement were predominantly located along the Yangtze River. Moreover, areas witnessing enhanced vegetation coverage experienced notable land use changes, notably the conversion of water to crops (126.93 km2, 22.79%), trees to crops (59.93 km2, 10.76%), and crops to built area (59.93 km2, 10.76%). Notably, the conversion between crops and built area emerged as a significant factor influencing vegetation coverage improvement, with average regression coefficients of 0.68 and 0.50, respectively. These outcomes underscore the significance of this study in guiding ecological environmental protection and sustainable management along the Yangtze River shoreline.

Research Hotspots and Trends on Acupuncture for Anti-Inflammation: A Bibliometric Analysis from 2011 to 2021.

Purpose: We here explored the research status, research hotspots, and development trend of acupuncture against inflammation from both quantitative and qualitative aspects through bibliometrics. Methods: We used CiteSpace and VOSviewer to analyze the literature about acupuncture against inflammation from 2011 to 2021 in the Web of Science Core Collection database by using a visual knowledge map. Results: In total, 1479 articles were included, and the number of articles published each year exhibited an upward trend. The largest number of articles were published in China (661), followed by the United States (287) and South Korea (164). The most productive institution is Beijing University of Chinese Medicine (72), while the most influential institution is the Capital Medical University (0.28). Evidence-based Complementary and Alternative Medicine (131) is the journal that published most articles on the topic. Lin Yiwen is the most prolific author, and Borovikova L is the most influential co-cited author. The keywords that have burst in the last 2 years are inflammation and activation. The keywords with the highest frequency of use are electroacupuncture (EA), inflammation, and expression. Conclusion: The number of publications on acupuncture for anti-inflammation research is rapidly increasing. China is a productive country, but the influence of centrality is poor. Research institutions are concentrated in universities, and the whole collaborative network needs to be strengthened. The anti-inflammatory mechanism of acupuncture is the main focus of research in this field. Regulation of immune cell balance by acupuncture may be a hot topic in mechanism research. At present, immune cells, vagus nerve, signal pathway, inflammatory corpuscles, cytokines and neurotransmitters are popular research topics. In the future, the basic research of acupuncture for anti-inflammation transformed into clinical practice may be a trend. EA and bee venom acupuncture may be promising research directions for acupuncture treatment for inflammatory diseases.

Research Hotspots and Trends on Acupuncture for Neuropathic Pain: A Bibliometric Analysis from 2002 to 2021.

Purpose: In this study, we aimed to systematically determine the trend, research hotspots, and directions of the future development of acupuncture for neuropathic pain (NP) by bibliometric analysis. Methods: Based on the relevant literature on acupuncture for NP in the databases of Web of Science from January 2002 to December 2021, Citespace software and VOSviewer were used to determine the use of acupuncture for the treatment of NP. The annual publications, countries, authors, research institutions, keywords, co-cited references, and journals were analyzed to explore the research hotspot and development trends in this field. Results: A total of 1462 records of acupuncture for NP from 2002 to 2021 were obtained. Chingliang Hsieh (20) is the most effective author and Han JS (585 co-citations) is the most influential author. The most productive institutions and countries are Kyung Hee UNIV (88) and China, respectively (480). UNIV Maryland of the USA has the highest centrality (0.12). Evidence-based complementary and alternative medicine (89) is the most prolific journal, and Pain is the most influential journal (4200 co-citations). Ji-sheng Han (2003) is the most frequently cited article (158 co-citations). Electroacupuncture, bee-venom acupuncture, and percutaneous electrical stimulation are the most commonly studied acupuncture types. The analgesic mechanism of acupuncture and acupuncture-neuroimaging was a research hotspot over the years. The clinical evidence of acupuncture for NP should be further studied in the future. Conclusion: The study using bibliometric analysis methods to investigate the publications on acupuncture for NP so as to provide potential research directions in the future.

Acupuncture for patients with mild hypertension: A randomized controlled trial.

Acupuncture may be beneficial for patients with mild hypertension, but the evidence is not convincing. We aimed to examine the effect of acupuncture on blood pressure (BP) reduction in patients with mild hypertension. We conducted a multicenter, single-blind, sham-controlled, randomized trial in eleven hospitals in China. The trial included 428 patients with systolic blood pressure (SBP) from 140 to 159 mm Hg and/or with diastolic blood pressure (DBP) from 90 to 99 mm Hg. The patients were randomly assigned to receive 18 sessions of affected meridian acupuncture (n = 107) or non-affected meridian acupuncture (n = 107) or sham acupuncture (n = 107) during 6 weeks, or to stay in a waiting-list control (n = 107). All patients received 24-hour ambulatory blood pressure monitoring at weeks 6, 9, and 12. We included 415 participants in the intention-to-treat analysis. The two acupuncture groups were pooled in the analysis, since they had no difference in all outcomes. SBP decreased at week 6 in acupuncture group vs sham acupuncture vs waiting-list group (7.2 ± 11.0 mm Hg vs 4.1 ± 11.5 mm Hg vs 4.1 ± 13.2 mm Hg); acupuncture was not superior to sham acupuncture (mean difference 2.7 mm Hg, 95% CI 0.4 to 5.9, adjusted P = 0.103) or waiting-list control (2.9 mm Hg, 95% CI -0.2 to 6.0, adjusted P = 0.078). However, acupuncture was superior to sham acupuncture (3.3 mm Hg, 95% CI 0.2 to 6.3, adjusted P = 0.035) and waiting-list control (4.8 mm Hg, 95% CI 1.8 to 7.8, P < 0.001) at week 9. Acupuncture had a small effect size on the reduction of BP in patients with mild hypertension.

Remote Sensing-Based Extraction and Analysis of Temporal and Spatial Variations of Winter Wheat Planting Areas in the Henan Province of China.

The aim of this study is to assess the winter wheat planting (WWP) area in Henan Province and investigate its temporal and spatial variations by using remote sensing (RS) technology. A spectral angle mapper (SAM) was adopted to identify the WWP area of each district divided by the hierarchical grades of land surface drought index during 2001-2015. The results obtained show the expediency of monitoring the WWP areas at the regional scale via drought regionalization, which provides a goodness-of-fit R2 =0.933, a mean relative error MRE=49,118 ha, and an overall accuracy up to 90.24%. The major WWP areas in Henan Province were located in Zhoukou, Zhumadian, Shangqiu, Nanyang, and Xinxiang prefecture-level cities. Two representative sites are mountainous districts, with rich water resources or high urbanization rate, which have a low probability of WWP. Both sites exhibited a strongly manifested evolution of WWP areas, which could be attributed to extremely cold weather conditions, crop alternation, the popularization of new varieties, and fast expansion of built-up areas. The results of this study are instrumental in the analysis of crop planting variation characteristics, which should be taken into account in the further decision-making process related to the crop planting strategies.

The Long-term Effect of Acupuncture for Migraine Prophylaxis: A Randomized Clinical Trial.

Importance: The long-term prophylactic effects of acupuncture for migraine are uncertain. Objective: To investigate the long-term effects of true acupuncture compared with sham acupuncture and being placed in a waiting-list control group for migraine prophylaxis. Design, Setting, and Participants: This was a 24-week randomized clinical trial (4 weeks of treatment followed by 20 weeks of follow-up). Participants were randomly assigned to true acupuncture, sham acupuncture, or a waiting-list control group. The trial was conducted from October 2012 to September 2014 in outpatient settings at 3 clinical sites in China. A total of 249 participants 18 to 65 years old with migraine without aura based on the criteria of the International Headache Society, with migraine occurring 2 to 8 times per month. Interventions: Participants in the true acupuncture and sham acupuncture groups received treatment 5 days per week for 4 weeks for a total of 20 sessions. Participants in the waiting-list group did not receive acupuncture but were informed that 20 sessions of acupuncture would be provided free of charge at the end of the trial. Main Outcomes and Measures: Participants used diaries to record migraine attacks. The primary outcome was the change in the frequency of migraine attacks from baseline to week 16. Secondary outcome measures included the migraine days, average headache severity, and medication intake every 4 weeks within 24 weeks. Results: A total of 249 participants 18 to 65 years old were enrolled, and 245 were included in the intention-to-treat analyses. One hundred eighty-nine (77.1%) were women. Baseline characteristics were comparable across the 3 groups. The mean (SD) change in frequency of migraine attacks differed significantly among the 3 groups at 16 weeks after randomization (P < .001); the mean (SD) frequency of attacks decreased in the true acupuncture group by 3.2 (2.1), in the sham acupuncture group by 2.1 (2.5), and the waiting-list group by 1.4 (2.5); a greater reduction was observed in the true acupuncture than in the sham acupuncture group (difference of 1.1 attacks; 95% CI, 0.4-1.9; P = .002) and in the true acupuncture vs waiting-list group (difference of 1.8 attacks; 95% CI, 1.1-2.5; P < .001). Sham acupuncture was not statistically different from the waiting-list group (difference of 0.7 attacks; 95% CI, -0.1 to 1.4; P = .07). Conclusions and Relevance: Among patients with migraine without aura, true acupuncture may be associated with long-term reduction in migraine recurrence compared with sham acupuncture or assigned to a waiting list. Trial Registration: clinicaltrials.gov Identifier: NCT01687660.

[A Newly-made Rat Holder for Convenient Acupuncture Needle Insertion].

In the present article, the authors introduce a newly-made rat holder device for easily inserting acupuncture needles into the acupoints at any parts of the body. This device is easy in operation and higher in applicability, being worthy of popularization for researchers engaging in experimental studies.

[Effect of acupuncture along affected meridian on the MME gene expression of migraine patients without aura of gan-yang hyperactivity syndrome].

OBJECTIVE: To observe the effect of acupuncture along affected meridian on the mem- brane metallo-endopeptidase (MME) gene expression of migraine patients without aura (MO) of Gan-yang hyperactivity syndrome (GYHS). METHODS: Totally 20 MO patients of GYHS were randomly assigned to the acupoint group (acupuncture along affected meridian) and the non-acupoint group, 10 cases in each group. Needling was performed once per day for 10 consecutive days. Gene chip technology was used to obtain two sets of gene expression profiles and analyzed using Gene Ontology (GO). RESULTS: In the acupoint group, MME gene expression decreased after needling (P = 0.0023).That gene was rich in the beta-amyloid metabolic process (P = 3.16E-05) and the peptide metabolic process (P = 0.009612). Its expression was not seen in the non-acupoint group. CONCLUSION: The effect of point selection along affected meridian could be achieved possibly by regulating the MME gene expression.

Evaluating the prophylaxis and long-term effectiveness of acupuncture for migraine without aura: study protocol for a randomized controlled trial.

BACKGROUND: The instant-treatment effect of acupuncture for patients with migraines has been corroborated in numerous studies. However, most diseases are chronic and tend to recur, so the long-term effect of acupuncture can verify the existence of sustained efficacy or the placebo effect. Evaluating the efficacy of acupuncture in the prophylaxis of migraine without aura (MWoA) in China is also important because such studies are lacking. METHODS: This trial is a multicenter, prospective, pragmatic randomized controlled clinical trial. We will randomly allocate 249 participants to three groups of 83. Patients in the individualized acupoint group will be treated with individualized acupuncture point prescriptions. The non-acupoint control group will undergo insertion of acupuncture needles at four bilateral non-points in locations not corresponding to acupuncture points. The waiting-list control group will not undergo treatment but instead will receive 20 acupuncture treatments for free after a waiting period of 24 weeks. Participants in the individualized acupoint group and non-acupoint control group will receive 20 sessions over four weeks and then all participants will receive 20 weeks of follow-up. DISCUSSION: The results of our trial will help to supply evidence for the long-term acupuncture effect for MWoA in a long follow-up period, and special attention will be paid to comparison with the placebo effect. TRIAL REGISTRATION: The trial was registered at ClinicalTrials.gov (NCT01687660) on 18 September 2012.

Acupuncture for patients with mild hypertension: study protocol of an open-label multicenter randomized controlled trial.

BACKGROUND: Several studies using acupuncture to treat essential hypertension have been carried out. However, whether acupuncture is efficacious for hypertension is still controversial. Therefore, this trial aims to evaluate the efficacy and safety of acupuncture for patients with mild hypertension. METHODS/DESIGN: This is a large scale, open-label, multicenter, randomized controlled clinical trial with four parallel arms. We will recruit 428 hypertensive patients with systolic blood pressure (SBP) between 140 and 159 mmHg, diastolic blood pressure (DBP) between 90 and 99 mmHg. The participants will be randomly assigned to four different groups (three acupuncture groups and one waiting list group) (1).The affected meridian acupuncture group (n = 107) is treated with acupoints on the affected meridians (2).The non-affected meridian acupuncture group (n = 107) is treated with acupoints on the non-affected meridians (3).The invasive sham acupuncture group (n = 107) is provided with sham acupoints treatment (4).The waiting-list group (n = 107) is not offered any intervention until they complete the trial. Each patient allocated to acupuncture groups will receive 18 sessions of acupuncture treatment over 6 weeks. This trial will be conducted in 11 hospitals in China. The primary endpoint is the change in average 24-hSBP before and 6 weeks after randomization. The secondary endpoints are average SBP and average DBP during the daytime and night-time, and 36-Item Short Form Survey (SF-36), and so on. DISCUSSION: This is the first large scale, multicenter, randomized, sham controlled trial of acupuncture for essential hypertension in China. It may clarify the efficacy of acupuncture as a treatment for mild hypertension. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT01701726.

[Effect of acupuncture on quality of life in post-ischemic stroke patients with dysphagia].

OBJECTIVE: To observe the effect of acupuncture on quality of life (QOL) in post-ischemic stroke patients with dysphagia. METHODS: Sixty-six patients with dysphagia were randomly assigned to 3 groups, the 23 patients in the electro-acupuncture (EA) group treated by EA, 18 in the control group received rehabilitation training combined with acupoint percutaneous electric stimulation, and 25 in the acupoint token puncturing (TP) group received rehabilitation training combined with acupoint TP, once every day for 20 days in total. Changes in QOL scale specified for dysphagia of patients before and after treatment were compared. RESULTS: The total effective rate was 69.6% in the EA group, 50.0% in the control group and 64.0% in the TP group with insignificant difference among them (P > 0.05), but the improvements dealing with patients' general condition, time for taking food, frequency of uneasiness, emotion, appetite, social intercourse ability, fatigue, sleep and mental health, etc. in the EA group were superior to those in the other two groups (P < 0.05). CONCLUSION: Acupuncture could improve the QOL of patients with dysphagia after ischemic stroke.

[Study on the epidemiology and risk factors on dysphagia after ischemic stroke in Chengdu City, China].

OBJECTIVE: To study the incidence and the risk factors of dysphagia after ischemic stroke in Chengdu City, China. METHODS: Review was made with unified questionnaire on dysphagia after ischemic stroke in 563 patients from four hospitals, from January to December 2005. Over 20 risk factors related to dysphagia after ischemic stroke were analyzed by logistic regression. RESULTS: The total incidence of dysphagia after ischemic stroke was 13.3% in Chengdu. Data from logistic regression analysis indicated that gender, morbidity frequency, basal nuclei, periventricular lesion, hypertension, pneumonia, hyperlipemia, cervical spondylosisi, internal carotid artherosclerosis were closely related to dysphagia after ischemic stroke,with OR values as 0.416, 0.489, 0.327, 0.454, 2.187, 2.146, 0.352, 0.242 and 0.273 respectively. CONCLUSION: The total incidence was lower than literature published from home and abroad. Gender, morbidity frequency, basal nuclei, periventricular lesion, hypertension, pneumonia, hyperlipemia, cervical spondylosisi and internal carotid artherosclerosis seemed to be risk factors to dysphagia after ischemic stroke.

[Evaluation and analysis on the methodology of clinical trials of acupuncture treatment of dysphagia due to ischemic stroke].

From the angle of clinical study methodology, the authors of the present paper sum up the related articles on acupuncture treatment of dysphagia caused by ischemic stroke published in the past decade from 1) randomized control trials, 2) non-controlled observation on a group of cases, and 3) case report. The authors point out some defects as lack of description on the random method, lack of united standards for acupoint recipes, acupuncture-needle manipulations, duration of treatment, united and authorized standards for assessing the therapeutic effect, intent-to-treat analysis, etc in the current clinical studies on acupuncture treatment of apoplectic dysphagia, and thus, the rationality and reliability of conclusions about the therapeutic effects of acupuncture for apoplectic dysphagia in many articles are limited. In order to further confirm the effectiveness of acupuncture for dysphagia resulting from ischemic stroke and to provide enough and reliable clinical evidence, it is necessary to adopt the principles and methods of evidence-based medicine to improve our clinical trials and particularly to look for the best model favoring the development of acu-moxibustion study in the coming days.