[Effect of acupuncture on patients with cancer-related fatigue and serum levels of CRP, IL-6, TNF-α and sTNF-R1].

OBJECTIVE: To observe the therapeutic effect of acupuncture on cancer-related fatigue (CRF) and to explore its possible mechanism. METHODS: A total of 80 patients with CRF were randomized into an observation group and a control group, and finally 67 patients completed the trial (36 patients in the observation group, 31 patients in the control group). Patients in the control group were treated with conventional chemoradiotherapy and symptomatic treatment, while no particular anti-fatigue intervention was adopted. On the basis of treatment in the control group, acupuncture was applied at Baihui (GV 20), Guanyuan (CV 4), Qihai (CV 6), Fengchi (GB 20), Zusanli (ST 36), Sanyinjiao (SP 6) in the observation group, once a day, 5 times as one course, with 2 days interval between each course, totally 4 courses were required. Before and after treatment, scores of functional assessment of cancer therapy-fatigue (FACT-F) in Chinese and McGill quality of life questionnaire (MQOL), serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and soluble TNF receptor-1 (sTNF-R1) were observed in the two groups. RESULTS: ①Compared before treatment, the FACT-F score was decreased after treatment in the observation group (P<0.05), while there was no significant difference in the control group (P<0.05). The change of the FACT-F score in the observation group was larger than that in the control group (P<0.05). ②In the observation group, scores of physiological and psychological dimension were decreased (P<0.05), score of social support dimension was increased after the treatment (P<0.05). The score changes of physiological, psychological and social support dimension in the observation group were larger than those in the control group (all P<0.05). ③After treatment, the serum levels of IL-6, TNF-α and sTNF-R1 were decreased in the observation group (P<0.05), while the serum levels of CPR and IL-6 were increased in the control group (P<0.05). The serum levels of CPR, IL-6 and TNF-α in the observation were lower than those in the control group (P<0.05). CONCLUSION: ①Acupuncture can improve the related symptoms of depression, weakness and headache in patients with CRF, strengthen their cognition of the support from society and family, and boost the confidence in curing the disease. ②Acupuncture can effectively down-regulate serum levels of the relative inflammatory factors, which may be its possible mechanism on treating CRF.

[Effect of Electroacupuncture Combined with Rehabilitation Training on Neurological Function and Expression of Neuronal Growth Associated Protein 43 and Synaptophysin in Rats with Focal Cerebral Ischemia/Reperfusion Injury].

OBJECTIVE: To observe the effect of electroacupuncture (EA) combined with rehabilitation training on motor function and expression of neuronal growth associated protein 43 (GAP-43) and synaptophysin (SYP) in hippocampal CA 3 region in rats with focal cerebral ischemia/reperfusion injury (CI/RI). METHODS: A total of 46 SD rats were randomized into normal control, CI/RI model, rehabilitation training (RT), paralysis-side (unilateral)-EA+RT, and bilateral-EA+RT groups (n=6 in the normal control group, and n=10 in each of the other group). The CI/RI model was established by occlusion of the middle cerebral artery (MCAO) and reperfusion. EA (5 Hz/10 Hz, 2 mA) was applied to the unilateral "Quchi" (LI 11) and "Housanli" (ST 36) on the affected side or bilateral LI 11 and ST 36 for 30 min, once daily for two weeks except the Sunday. The neurological deficit severity (Zea Longa score) was assessed 24 h, 7 and 14 days after modeling. The immunoactivity of GAP-43 and SYP in the CA 3 region of the hippocampus was detected using immunohistochemistry. Pathological changes of the prefrontal cortex was observed after H.E. staining. RESULTS: Following modeling, the neurological deficit scores of the model, RT, unilateral-EA+RT and bilateral-EA+RT groups were gradually decreased, and were significantly lower on day 7 and 14 in the bilateral-EA+RT group and on day 14 in the unilateral-EA+RT group than in the model group (P<0.05). The effect of the bilateral-EA+RT group was obviously superior to those of both RT and unilateral EA+RT groups in improving neurological function (P<0.05). Results of immunohistochemical staining displayed that the expression levels of GAP-43 and SYP in the CA 3 region of hippocampus were significantly up-regulated in the model group than in the normal control group (P<0.05), and further obviously up-regulated in both unilateral-and bilateral-EA+RT groups (P<0.05). No significant changes of GAP-43 and SYP protein expression in the RT group compared with the model group (P>0.05), and the expression levels of GAP-43 and SYP protein in the bilateral-EA+RT were significantly higher than those in the unilateral EA+RT group (P<0.05). H.E. staining showed that the ischemic injury of cells (neuronal apoptosis and enlargement of intercellular space) of the prefrontal cortex was relatively milder in the EA+RT groups. CONCLUSIONS: EA plus RT can promote the recovery of motor function in CI/RI rats, which may be associated with its function in increasing the expression of GAP-43 and SYP in hippocampal CA 3 region. The effects of bilateral-EA+RT is obviously better than those of unilateral EA+RT.

A 6-week randomized controlled trial with 4-week follow-up of acupuncture combined with paroxetine in patients with major depressive disorder.

Acupuncture possesses the antidepressant potential. In this 6-week randomized controlled trial with 4-week follow-up, 160 patients with major depressive disorder (MDD) were randomly assigned to paroxetine (PRX) alone (n = 48) or combined with 18 sessions of manual acupuncture (MA, n = 54) or electrical acupuncture (EA, n = 58). Treatment outcomes were measured mainly using the 17-item Hamilton Depression Rating Scale (HAMD-17), Self-rating Depression Scale (SDS), clinical response and remission rates. Average PRX dose taken and proportion of patients who required an increased PRX dose due to symptom aggravation were also obtained. Both additional MA and EA produced a significantly greater reduction from baseline in score on HAMD-17 and SDS at most measure points from week 1 through week 6 compared to PRX alone. The clinical response was markedly greater in MA (69.8%) and EA (69.6%) groups than the group treated with PRX alone (41.7%, P = 0.004). The proportion of patients who required an increase dose of PRX due to symptom aggravation was significantly lower with MA (5.7%) and EA (8.9%) than PRX alone (22.9%, P = 0.019). At 4 weeks follow-up after completion of acupuncture treatment, patients with EA, but not MA, continued to show significantly greater clinical improvement. Incidence of adverse events was not different in the three groups. Our study indicates that acupuncture can accelerate the clinical response to selective serotonin reuptake inhibitors (SSRIs) and prevent the aggravation of depression. Electrical acupuncture may have a long-lasting enhancement of the antidepressant effects (Trial Registration: ChiCTR-TRC-08000278).