Fire acupuncture for plaque psoriasis case series.

OBJECTIVE: To investigate the clinical efficacy of fire acupuncture (FA) on plaque psoriasis (PP), exploring its suitable syndrome types, in order to achieve better therapeutic effects, accelerate the possibility of psoriasis skin lesion recovery, and provide assistance for clinical treatment. METHODS: A total of 8 patients with PP aged between 18 and 60 years were recruited and treated with FA once a week, and the lesion area and severity index (PASI), visual analog scale and pruritus were measured before, 2, 4 and 8 weeks after treatment and at the follow-up period (week 12), respectively. Visual analog scale, and dermoscopy were used for assessment. RESULTS: All patients showed improvement in pruritus after 1 FA treatment, and lesions were reduced to varying degrees after 2 weeks. Except for patients 5 and 8, who only achieved effective results due to severe disease, all other patients with psoriasis achieved significant results at 8 weeks after treatment. CONCLUSION: FA can significantly control the development of lesions, reduce the symptoms of PP lesions and pruritus, and help prevent psoriasis recurrence.

Mechanism of analgesic effect of fire needle on peripheral sensitization in rats with neuropathic pain induced by chemotherapy. / ç«é’ˆå¯¹åŒ–ç–—æ‰€è‡´ç¥žç»ç— ç†æ€§ç–¼ç—›å¤§é¼ å¤–å‘¨æ•åŒ–çš„é•‡ç—›ä½œç”¨æœºåˆ¶.

OBJECTIVES: This study aims to explore the analgesic mechanism of fire needle on peripheral sensitization in rats with neuropathic pain(NP) induced by oxaliplatin, so as to investigate its mechanism in improving peri-pheral sensitization. METHODS: Male SD rats aged 8 weeks were randomly divided into 4 groups：normal group(n=6), model group(n=6), fire needle group(n=6), and medication group(n=6). NP rat model was established by intraperitoneal injection of oxaliplatin(4 mg/kg) on days 1, 2, 8, 9, 15, 16, 22, and 23. For rats in the fire needle group, fire needle treatment was performed at the "Jiaji"(EX-B2) acupoints of the L4-L6 segments on days 24, 26, and 28, ie. 1 day, 3 and 5 days after modeling. The medication group received intraperitoneal injection of pregabalin(100 mg/kg). Mechanical pain thresholds of the rats were measured before modeling, after modeling and intervention. Serum contents of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and chemokine ligand 12(CXCL12) were detected by ELISA. Skin histopathology changes in the acupoint area were observed using HE staining. The number of mast cells in the skin of the acupoints was observed using toluidine blue staining. Immunohistochemical staining was performed to detect the postive expressions of transient receptor potential vanilloid 1(TRPV1), protease-activated receptor 2(PAR2) and tryptase(TPS) in the skin of the acupoint area. Western blot was used to detect the protein expressions of TRPV1 and PAR2 in the dorsal root ganglia(DRG). RESULTS: Compared with the normal group, the model group had decreased paw withdrawal threshold(PWT) after modeling(P<0.05), increased serum contents of IL-6, TNF-α, and CXCL12(P<0.05), increased number of mast cells in the acupoint area(P<0.05), and increased positive protein expressions of TPS, TRPV1, and PAR2 in the skin of the acupoint area(P<0.05). Compared with the model group, the fire needle group and medication group had increased PWT after intervention(P<0.05), decreased serum contents of IL-6, TNF-α, and CXCL12, and postive protein expressions of TPS, TRPV1, and PAR2 in the skin of the acupoint area(P<0.05)；while the medication group had decreased protein expressions of TRPV1 and PAR2 in DRG(P<0.05). HE staining showed thickened epidermis, disordered cellular arrangement, significant intercellular edema, and inflammatory cell infiltration in the model group. In the medication and fire needle groups, the epidermis was thinner, cellular arrangement was clearer, and the extent of tissue edema and inflammatory cell infiltration was reduced compared to the model group. CONCLUSIONS: Fire needle can improve mechanical pain threshold and reduce the contents of peripheral inflammatory factors in rats with oxaliplatin-induced NP. This effect may be related to the inhibition of mast cell activation and the inhibition of TPS, TRPV1 and PAR2 protein expressions, in the local areas of acupoints.

[Clinical efficacy of fire needling combined with cupping therapy on herpes zoster of acute stage and the effect on Th17/Treg cellular immune balance].

OBJECTIVE: To compare the clinical efficacy between the combined therapy of fire needling and cupping, and western medication on herpes zoster of acute stage, as well as the effects on Th17 and Treg cells and inflammatory factors, i.e. IL-10 and IL-17 in the peripheral blood. METHODS: Eighty patients with herpes zoster of acute stage were randomly divided into a combined therapy (fire needling plus cupping) group and a western medication group, 40 cases in each one. In the combined therapy group, the pricking and scattering techniques with fire needle were used at ashi points and Jiaji (EX-B 2) corresponding to the affected spinal segments; afterwards, cupping therapy was delivered. The combined treatment was given once daily. In the western medication group, valaciclovir hydrochloride tablet and vitamin B1 tablet were administered orally. The duration of treatment in each group was 10 days. Before each treatment from day 1 to day 10 and on day 11 , the score of symptoms and physical signs was observed in the two groups separately. Before each treatment from day 1 to day 10 and on day 11, 30, 60, the score of visual analogue scale (VAS) and skin lesion indexes were observed in the two groups. On day 60, the incidence of postherpetic neuralgia was recorded in the two groups. The levels of Th17 and Treg cells, Th17/Treg ratio in the peripheral blood, as well as serum levels of IL-10 and IL-17 were detected before and after treatment in the two groups. The clinical efficacy was compared between the two groups. RESULTS: From day 6 to day 10 during treatment and on day 11, the scores of symptoms and physical signs in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 3, day 6 to day 10 during treatment and day 11, day 30, VAS scores in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 60, the incidence of postherpetic neuralgia in the combined therapy group was lower compared with that in the western medication group (P<0.05). The blister arresting time and scabbing time in the combined therapy group were shorter than those of the western medication group (P<0.05). After treatment, the level of Th17, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 were all lower in comparison with those in the western medication group (P<0.05). The curative and remarkably effective rate was 82.5% (33/40) in the combined therapy group, higher than 62.5% (25/40) in the western medication group (P<0.05). CONCLUSION: The early application of fire needling combined with cupping therapy can effectively treat herpes zoster of acute stage, relieve pain, and reduce the incidence of postherpetic neuralgia, which may be related to reducing the levels of Th17 and Treg cells, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 so that the cellular immune balance is modulated.

Evidence mapping and overview of systematic reviews of the effects of acupuncture therapies.

OBJECTIVE: To provide a route map regarding systematic reviews (SRs) of acupuncture therapies that will meet two goals: (1) to identify areas in which more or better evidence is required and (2) to identify acupuncture applications that, although proven effective, remain underused in practice, and thus warrant more effective knowledge dissemination. ELIGIBILITY CRITERIA: We included SRs that conducted meta-analyses (MAs) of randomised controlled trials (RCTs) for this overview. INFORMATION SOURCES: We searched for SRs without language restrictions from January 2015 to November 2020 in four Chinese electronic databases and Epistemonikos database. And we also searched for newly published RCTs that were eligible for selected best SRs in PubMed, Medline, Cochrane Central Register of Controlled Trials, Embase and four Chinese electronic databases from its lasted search dates to November 2020. SYNTHESIS OF RESULTS: We reanalysed the selected MAs if new primary studies were added. We used random-effect model to calculate the overall effect. RESULTS: Our search identified 120 SRs published in the last 5 years addressing acupuncture therapies across 12 therapeutic areas and 77 diseases and conditions. The SRs included 205 outcomes and involved 138 995 participants from 1402 RCTs. We constructed 77 evidence matrices, including 120 SRs and their included RCTs in the Epistemonikos database. Seventy-seven SRs represented the effect estimate of acupuncture therapies. Finally, we system summarised the areas of possible underutilisation of acupuncture therapies (high or moderate certainty evidence of large or moderate effects), and the areas of warranting additional investigation of acupuncture therapies (low or very low certainty evidence of moderate or large effects). CONCLUSION: The evidence maps and overview of SRs on acupuncture therapies identified both therapies with substantial benefits that may require more assertive evidence dissemination and promising acupuncture therapies that require further investigation.

[Professor LIN Guo-hua's clinical experience in staging treatment for post-stroke dysphagia].

The paper summarizes professor LIN Guo-hua's clinical experience in staging treatment for post-stroke dysphagia. Professor LIN Guo-hua adheres to "essence and marrow deficiency and primary yang decline" as the pathogenesis and "conducting yin from yang " as the treating principle. By regulating the conception vessel and the governor vessel and focusing on yang meridians, in association with meridian differentiation and the location differentiation, professor LIN provides the staging treatment for post-stroke dysphagia. At the oral phase, yangming is dysfunction, manifested as facial paralysis and flaccid tongue. In treatment, reducing method is predominated at yangming meridian specially. At the pharyngeal phase, shaoyang is invaded by pathogens, manifested as pivoting dysfunction. The treatment focuses on communicating the exterior with the interior and promoting shaoyang meridian. At the esophageal phase, yangming meridian is deficiency and the turbid qi fails to descend, thus the reinforcing method is dominated to promote and tonify yangming. Additionally, the kinesiotherapy of acupuncture is assisted and the Lingnan fire needling therapy is used particularly. All of the summaries above provide the reference for the clinical treatment of post-stroke dysphagia.

Acupuncture for improving a case of widespread herpes zoster after non-Hodgkin's lymphoma chemotherapy.

BACKGROUND: Herpes zoster presents as clustered blisters on one side of the body, accompanied by nerve pain. This is caused by reactivation of the varicella zoster virus, and it occurs primarily in people with weakened immunity. Tumor and chemotherapy drugs can impair the patient's immune function, induce herpes zoster and prolong the course of disease.In these patients, skin changes can last for months and blisters can recur and cause serious complications such as postherpetic neuralgia.Acupuncture is a common alternative therapy for herpes zoster in East Asia. CASE PRESENTATION: We report a case of an elderly male patient with widespread herpes zoster in the trunk after non-Hodgkin's lymphoma chemotherapy. The patient had received conventional treatment with valaciclovir and mecobalamin within 24 hours of symptom onset. Because neither the clustered blisters nor the nerve pain were improved a week later, acupuncture and related techniques were applied. These included electro-acupuncture, surrounding acupuncture, fire acupuncture, and cupping. The patient recovered 20 days after the herpes zoster attack, and there were no adverse reactions during the treatment process. CONCLUSIONS: This case suggests that acupuncture and related techniques are effective interventions for this condition.This case report is innovative because it shows that acupuncture as an adjuvant treatment can improve the skin lesions in patients with HZ after tumour chemotherapy, relieve pain, and shorten the course of HZ.

[ZHANG Jia-wei's experience for treating press ulcer with fire-moxibustion].

To summarize ZHANG Jia-wei 's experience for treating press ulcer with fire-moxibustion. Through syndrome differentiation and examined factors, ZHANG Jia-wei believes that the disease is caused by qi deficiency and blood stasis, and advocates that the treatment should be weighed against deficiency and excess, and selection by stages. The cotton-moxibustion is used to diffusing and obstruction-removing qi and blood duingⅠstage of press ulcer. The Lingnan fire-needling is adopted for removing dampness, blood stasis and toxic substance to generate new muscles duringⅡand Ⅲ stage of press ulcer. Stage Ⅳof pressure ulcer and deep pressure ulcer should be treated with Taiyi moxa stick and aconite cake-separated moxibustion combined or alternately to expel toxin and grow muscles.

Auricular acupressure promotes uterine involution after cesarean section: A randomized controlled trial.

BACKGROUND: Postpartum subinvolution of the uterus is a more common condition after cesarean section. Auricular acupressure (AA) is widely used for the treatment of postpartum diseases. However, few studies have explored the effects of AA as a treatment of uterine involution following cesarean section to date. This study aimed to assess the efficacy and safety of AA for uterine involution after cesarean section. METHODS: A total of 109 women who underwent cesarean section participated in this study. They were randomly allocated to either real AA or sham AA in a 1:1 ratio by a computer program. For 3 days, the real AA and sham AA groups received treatment 3 times daily. A series of assessments at 42 days after cesarean section, namely on the uterine size, the incidence of hydrometra, the first anal exsufflation time, bleeding volume at 6 hours, bleeding volume at 6-24 hours along with other general assessments were carried out. RESULTS: A total of 89 women completed the study. The uterine size at 42 days after a cesarean section was 6.3 cm smaller in the real AA group than in the sham AA group (P < 0.01). The incidence of hydrometra on day 42 postpartum was lower in the real AA group than in the sham AA group (P < 0.01). The lochia duration and the first anal exsufflation time after cesarean section were shorter in the real AA group than in the sham AA group (P < 0.05). CONCLUSION: AA improves uterine involution after cesarean section. TRIAL REGISTRATION: ChiCTR1800015569.

[Professor LIN Guo-hua's experience in treating intractable sudden deafness with acupuncture and moxibustion].

Professor LIN Guo-hua's experience and medical record in the treatment of intractable sudden deafness with acupuncture is introduced. Professor LIN believes that this disease is mainly caused by the blockage of shaoyang meridians, and should be treated with acupuncture therapy as soon as possible. According to the root cause and the pathogenesis of shaoyang blockage, the method of "soothing shaoyang, clearing the ear and opening the orifices" is adopted. In the treatment, Tinggong (SI 19) and acupoints in shaoyang meridians are selected as the main acupoints, and other acupoints based on meridian differentiation are selected as assisting acupoints. The manipulatingmethods of "fameng acupuncture" "blowing warm air into ear", and "Lingnan fire needling" are used synthetically. And qi and spirit are also regulated and front mu points are added if necessary to obtain satisfied effect of restore hearing.

[Professor LIN Guo-hua's experience in the new clinical application of Yinjiao (GV 28)].

Yinjiao (GV 28) is generally used in treatment of lumbago and anorectal diseases. Professor LIN Guo-hua believes that Yinjiao (GV 28) is indicated in the disorders related to the sea of marrow and lower jiao by regulating the governor vessel and the conception vessel, promoting qi and blood circulation, tonifying the sea of marrow and adjusting the lower jiao. Based on professor Lin's clinical experience, "three Yinjiao" points are innovated, named Yinjiao (GV 28, upper Yinjiao), external Yinjiao and lower Yinjiao. Acupuncture therapy is generally optioned at Yinjiao (GV 28) and 5 needling principles are emphasized, i.e. accurate acupoint location, strong needling sensation, needling combined with body movement, alternative stimulation and allied stimulation. All of those mentioned above provide a new approach to the clinical treatment for the disorders related to the sea of marrow and lower jiao.

[Analysis of adverse reactions of acupoint catgut embedding therapy].

OBJECTIVE: To objectively evaluate the safety of acupoint catgut embedding therapy. METHODS: A total of 331 patients who received acupoint catgut embedding therapy were enrolled and summarized through the inpatient medical record system, follow-up record and adverse reaction report card. The statistical analysis was performed from the aspects of patients' gender, age, marital status, history of allergy, history of diabetes and the time, symptoms, duration and prognosis of adverse reactions, etc. RESULTS: Among 331 patients who received acupoint catgut embedding therapy, 70 patients had adverse reactions, which were divided into 9 types, including post-treatment discomfort, local hematoma or subcutaneous hemorrhage, local swelling, local induration, severe pain, thread-body rejection, local pruritus, post-treatment body temperature rising, local redness, swelling, fever and pain. The incidence rate of adverse events was 21.15%, and the incidence of serious adverse events was 0. Among the patients with adverse reactions, 58 patients (82.86%) relieved without treatment, and 12 patients (17.14%) received after symptomatic treatment; all patients had no sequelae. CONCLUSION: The acupoint catgut embedding therapy is relatively safe and the incidence of adverse reactions is low.

[Professor LIN Guo-hua's clinical experience of acupuncture for oculomotor nerve paralysis].

Professor LIN Guo-hua's clinical experience of acupuncture for oculomotor nerve palsy was summarized and one typical case was introduced. Professor LIN skillfully applied traditional acupuncture theory and classical acupuncture method, and proposed a diagnosis and treatment system combining meridian syndrome differentiation and specific acupuncture techniques. In addition, Professor LIN combined the yuan-primary and luo-connecting acupoints combination method, theory of "removing the stagnation of blood and qi " and theory of root-stem and origin-end, etc. into the treatment of oculomotor nerve palsy, and achieved good results.

[Professor LIN Guo-hua's experience in treatment of progressive muscular dystrophy with acupuncture].

Professor LIN Guo-hua's experience is introduced in treatment of progressive muscular dystrophy with acupuncture. It is believed that the pathogenesis of this disease is related to spleen and kidney deficiency, qi and blood insufficiency and malnutrition of tendon and muscle. The treatment is determined in terms of the pathogenesis and focuses on the regulation of spleen and kidney functions. The thinking of treatment is summarized as exerting the strong stimulation of acupuncture specially at the acupoints on the head, supplementing the sea of marrow, adjusting simultaneously the three yang meridians, rather than treating particularly yangming meridian and regulating qi in priority and considering the lung function for wei (flaccid) syndrome. Moreover, in clinical treatment, the acupoint thread-embedding therapy is commonly combined to ensure the significant therapeutic effect.

[Systematic review and sequential analysis on treatment of herpes zoster pain mainly by fire needle therapy].

OBJECTIVE: To assess the therapeutic effect and safety of fire needle therapy in the treatment of herpes zoster pain. METHODS: We collected randomized controlled trials about treatment of herpes zoster pain mainly by fire needle therapy (published from the date of establishment of each database to Dec 1 of 2018) from databases of CNKI, Wanfang, VIP, Chinese Biomedical Document Service System (SinoMed), PubMed, Embase, Cochrane Library by using key words of "fire needle" "burnt needle" "red-hot needle" "herpes zoster" "postherpetic neuralgia" and "herpetic neuralgia". Then, we conducted Meta-analysis and sequential analysis about the outcomes of studies met our inclusion criteria using RevMan5.3.5 and TSA0.9.10 Beta softwares and employed GRADE profiler 3.6.1 to grade the quality of evidence. RESULTS: A total of 25 studies including 2 024 patients were brought into the present analysis. Outcomes of the qualitative analysis indicated that the fire needle therapy has a higher effective rate than the western medicine group. Meta-analysis showed that after the treatment mainly with fire needle therapy, 1) the VAS score is evidently lower [WMD=-0.96, 95% CI(-1.22, -0.71), P<0.000 01], 2) the duration of 30% pain relief is obviously shorter [WMD=-1.82, 95% CI (-2.46, -1.18), P<0.000 01], 3) the duration of pain is evidently shorter {fire needle combined with electroacupuncture [WMD=-11.53, 95% CI(-14.57, -8.48), P<0.000 01]; fire needle combined with cupping [WMD=-4.75, 95% CI (-7.99, -1.51), P=0.004]; pure fire needle therapy [WMD=-1.82, 95% CI (-2.46, -1.18), P<0.000 01], and 4) the occurrence rate of post-herpetic neuralgia is considerably lower [RR=0.16, 95% CI (0.09, 0.30), P<0.000 01]. The occurrence and management of adverse events were not mentioned in all the included studies, suggesting no safety problem of the therapy, but the publication bias has not been taken seriously. CONCLUSION: In the treatment of herpes zoster pain, fire needle as the main treatment approach can significantly relieve pain, shorten the pain duration, and reduce the incidence of post-herpetic neuralgia.

[Influence of fire needle stimulation at Sihua acupoints on performance status and Th1/Th2 ba-lance in the patients with advanced non-small cell lung cancer after chemotherapy].

OBJECTIVE: To observe the influence of fire needle stimulation at Sihua acupoints combined with chemotherapy on Th1/Th2 imbalance and performance status in the patients with advanced non-small cell lung cancer (NSCLC) so as to investigate its immunological mechanism underlying the improvement of lung cancer. METHODS: Sixty eligible NSCLC inpatients were randomly assigned to a control group and a treatment group (n＝30 cases in each one). The control group was treated with paclitaxel combined with cisplatin (TP) or gemcitabine plus cisplatin (GP) of chemotherapy, and the treatment group was treated with fire needle stimulation at Sihua acupoints (i.e. bilateral Geshu [BL17] and Danshu [BL19]) and with chemotherapy simultaneously. The fire needle stimulation was given once daily for successive 7 days. One day before and 14 days after chemotherapy, the patients' blood samples were collected for assaying the concentrations of Th1 related cytokines (IL-2, IFN-γ) and Th2 related cytokines (IL-4, IL-10) with ELISA. The Karnofsky performance status (KPS) score was used to assess the patient's physical conditions before and 14 days after chemotherapy. RESULTS: Compared with the results before treatment, the levels of IL-2 and IFN-γ concentration increased obviously and the levels of IL-4 and IL-10 concentration as well as KPS score decreased significantly in the treatment group and the control group after treatment (all P<0.01). After treatment, compared with the control group, the levels of IL-2 and IFN-γ concentration in the treatment group increased and the levels of IL-4 and IL-10 concentration decreased (P<0.01); and the decrease amplitude of KPS score in the treatment group was less than that in the control group (P<0.01). CONCLUSION: Fire needle stimulation at Sihua acupoints improves the function of Th1 cells, and reduces the function of Th2 cells. As a result, the balance between Th1 and Th2 has been modified and the deterioration degree of the performance status been alleviated in the patients after chemotherapy.

Impact evaluation of CONSORT and STRICTA guidelines on reporting quality for randomized controlled trials of acupuncture conducted in China.

OBJECTIVE: To evaluate and compare the reports' qualities of acupuncture randomized controlled trials (RCTs) conducted in China before and after the implementation of two guidelines, i.e., the Consolidated Standards of Reporting Trials (CONSORT) statement and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA). METHODS: Proportions of studies that reported CONSORT and STRICTA items were compared for the years before and after implementation of these two guidelines. In addition, the total score of each item's reporting were calculated and reported differences during different date ranges were compared. RESULTS: For CONSORT items (maximum score 8), there was evidence of a slight improvement in reporting between 1994-1995 and 1999-2000 combined (2.5±0.6) and 2004-2005 and 2009-2010 combined (3.0±0.9; difference 0.4, 95% confidence interval, 0.3 to 0.6, P<0.01). For STRICTA items (maximum score 17), there was evidence that a slight improvement in reporting between 1994-1995 and 1999-2000 combined (8.6±2.1) and 2004-2005 and 2009-2010 combined (10.1±1.8; difference 1.5, 95% confidence interval, 1.1 to 1.9, P<0.01). CONCLUSION: Quality of reporting for RCTs of acupuncture treatment conducted in China have generally improved since the introduction of the STRICTA and CONSORT guidelines.