Meta-Analysis of Acupuncture Treatment for Cervicogenic Headache.

OBJECTIVE: To analyze and evaluate the clinical effect of acupuncture on cervicogenic headache (CEH), and provide evidence-based basis for clinical selection of acupuncture for CEH. METHODS: Databases including China Knowledge Network, Wanfang, VIP Chinese sci-tech journals, Chinese Biomedical, and PubMed were searched to collect clinical randomized controlled trials on the effectiveness of acupuncture in the treatment of CEH until November 2023. Statistical analysis was performed using the RevMan 5.4.1 software, and heterogeneity was assessed using the Q test (P value), allowing for the calculation of the combined effect odds ratio through either the fixed or random-effect model. Sensitivity analysis will be conducted by excluding articles with the highest weight, while the validity of the literature will be evaluated through the creation of a funnel plot to identify any potential biases. RESULTS: A total of 400 articles were retrieved, and eventually, 20 clinical randomized controlled trials were included in the analysis. Comparing with control, acupuncture exhibited a higher total effective rate in treating CEH. The cure rate was also higher in the experimental group, and improvements in short-term and long-term visual analogue scale scores outcomes were significantly greater than those in the control group. The quality-of-life scores were higher in CEH patients treated with acupuncture. Sensitivity analysis confirmed the stability and reliability of the pooled effect size results. The results of the funnel plot indicated the presence of publication bias. CONCLUSIONS: Acupuncture treatment is effective for CEH relief and worthy of clinical application.

[Clinical effect of plum-blossom needle tapping at three yin meridians of wrist on wrist joint contracture after stroke].

OBJECTIVE: To compare the therapeutic effect of plum-blossom needle tapping at three yin meridians of wrist combined with rehabilitation training and simple rehabilitation training on wrist joint contracture after stroke. METHODS: A total of 72 patients with wrist joint contracture after stroke were randomized into an observation group and a control group, 36 cases in each one. In the control group, simple rehabilitation training was applied, 5 times a week, 3 weeks as one course and totally 3 courses were required. On the basis of the treatment in the control group, plum-blossom needle tapping at three yin meridians of wrist was adopted in the observation group. The tapping regions were wrist traveling parts of three yin meridians of hand, ranging from up 3 cun to below 1 cun of wrist crease, 3 times a week, 3 weeks as one course and totally 3 courses were required. The active range of motion (AROM) of active wrist extension, Fugl-Meyer score (FMA) and Barthel index (BI) score were observed before and after treatment in the two groups. RESULTS: The AROM, FMA scores and BI scores after treatment in the two groups were superior to before treatment (P<0.05), and the improvements of 3 indexes in the observation group were superior to the control group (P<0.05). CONCLUSION: The therapeutic effect of plum-blossom needle tapping at three yin meridians of wrist combined with rehabilitation training is superior to simple rehabilitation training on wrist joint contracture after stroke.

[Clinical observation on plum-blossom needle combined with rehabilitation training for hand spasm after stroke].

OBJECTIVE: To observe the effect difference between plum-blossom needle combined with rehabilitation training and conventional rehabilitation training for hand spasm after stroke. METHODS: A total of 61 patients were randomly divided into a comprehensive treatment group (30 cases) and a rehabilitation training group (31 cases). In the rehabilitation training group, Bobath occupational therapy, OT training, and hand function training were adopted, once every day; on the basis of treatment in the rehabilitation group, plum-blossom needle was applied at the lung meridian of hand-taiyin, heart meridian of hand-shaoyin, pericardium meridian of hand-jueyin in the comprehensive treatment group. The treatment was given once every two days, three weeks as one course in the two gnoups. After 3 courses of treatment, clinical efficacy evaluation was performed, and the modified Ashworth scale and Fugl-Meyer (FMA) motor function scores were assessed before and after treatment. RESULTS: After treatment, the grade for Ashworth scale and FMA scores in the comprehensive treatment group and the rehabilitation trainning group were better than those before treatment (all P<0.05), and the improvements in hand spasm and hand fuction in the comprehensive treatment group were superior apparently to those in the rehabilitation trainning group (both P<0.05) The total effective rate of hand function was 93.3% (28/30) in the comprehensive treatment group, which was better than 74.2% (23/31) in the rehabilitation training group (P<0.05). CONCLUSION: Plum-blossom needle combined with rehabilitation training are more effective than simple rehabilitation training for hand spasm after stroke.

Early use of noninvasive techniques for clearing respiratory secretions during noninvasive positive-pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease and hypercapnic encephalopathy: A prospective cohort study.

Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China.A total of 74 patients received NPPV and 90 patients received CMV. Inclusion criteria included the following: physician-diagnosed AECOPD, spontaneous airway clearance of excessive secretions, arterial blood gas analysis requiring intensive care, moderate-to-severe dyspnea, and a Kelly-Matthay scale score of 3 to 5. Exclusion criteria included the following: preexisting psychiatric/neurological disorders unrelated to HE, upper gastrointestinal bleeding, upper airway obstruction, acute coronary syndromes, preadmission tracheostomy or endotracheal intubation, and urgent endotracheal intubation for cardiovascular, psychomotor agitation, or severe hemodynamic conditions.Intensive care unit participants were managed by NPPV. Participants received standard treatment consisting of controlled oxygen therapy during NPPV-free periods; antibiotics, intravenous doxofylline, corticosteroids (e.g., salbutamol and ambroxol), and subcutaneous low-molecular-weight heparin; and therapy for comorbidities if necessary. Nasogastric tubes were inserted only in participants who developed gastric distension. No pharmacological sedation was administered.The primary and secondary outcome measures included comparative complication rates, durations of ventilation and hospitalization, number of invasive devices/patient, and in-hospital and 1-year mortality rates.Arterial blood gases and sensorium levels improved significantly within 2 hours in the NPPV group with lower hospital mortality, fewer complications and invasive devices/patient, and superior weaning off mechanical ventilation. Mechanical ventilation duration, hospital stay, or 1-year mortality was similar between groups.NPPV combined with a noninvasive strategy to clear secretions during the first 2 hours may offer advantages over CMV in treating AECOPD patients complicated by HE.

[Analysis of death risk factors for nosocomial infection patients in an ICU: a retrospective review of 864 patients from 2009 to 2015].

OBJECTIVE: To investigate the mortality risk factors of nosocomial infection patients in intensive care unit (ICU), and to guide clinicians to take effective control measures. METHODS: A retrospectively cohort study was conducted. The relevant information of patients with nosocomial infection treated in ICU of Hengshui Harrison International Peace Hospital Affiliated to Hebei Medical University from June 2009 to December 2015 was analyzed. The patients who admitted to ICU again, with length of ICU stay less than 48 hours, without first etiology of screening within 48 hours of ICU admission, or without complete pathogenic information were excluded. The gender, age, diagnosis, length of ICU stay, invasive operation, nutritional status, acute physiology and chronic health evaluation II (APACHEII) score, sequential organ failure assessment (SOFA) score, distribution and drug resistance of the pathogens, and procalcitonin (PCT) levels at 7 days after nosocomial infection were recorded. The risk factors leading to death in patients with nosocomial infection were analyzed by logistic regression, and the receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of all risk factors on the outcome of patients with nosocomial infection. RESULTS: In 864 enrolled patients with male of 54.75% and mean age of (63.50±15.80) years, 732 (84.72%) patients survived and 132 (15.28%) died. Compared with survivors, the non-survivors had higher age (years: 65.47±15.32 vs. 58.15±13.27), incidence of urgent trachea intubation (32.58% vs. 22.81%), deep venous catheterization (83.33% vs. 63.25%), and multiple drug-resistant infection (65.91% vs. 33.20%), longer length of ICU stay (days: 13.56±4.29 vs. 10.29±4.32) and duration of coma (days: 7.36±2.46 vs. 5.48±2.14), lower albumin (g/L: 23.64±8.47 vs. 26.36±12.84), higher APACHEII score (19.28±5.16 vs. 17.56±5.62), SOFA score (8.55±1.34 vs. 6.43±2.65), and PCT (µg/L: 3.06±1.36 vs. 2.53±0.87, all P < 0.05). There was no significant difference in gender and urinary tract catheterization between survivors and non-survivors (both P > 0.05). The low respiratory tract was the most common site of infection followed by urinary tract and bloodstream in both groups. It was shown by logistic regression analysis that prolonged ICU stay [odds ratio (OR) = 2.039, 95% confidence interval (95%CI) = 1.231-3.473, P = 0.002], APACHEII score (OR = 1.683, 95%CI = 1.002-9.376, P = 0.000), SOFA score (OR = 2.060, 95%CI = 1.208 -14.309, P = 0.041), PCT (OR = 2.090, 95%CI = 1.706-13.098, P = 0.004), and multi-drug resistant pathogens infection (OR = 5.245, 95%CI = 2.213-35.098, P = 0.027) were independent risk factors for ICU mortality in patients with nosocomial infection. The area under ROC curve (AUC) of length of ICU stay, APACHEII score, SOFA score, and PCT level for predicting death of nosocomial infection patients was 0.854, 0.738, 0.786, and 0.849, respectively, the best cut-off value was 16.50 days, 22.45, 6.37 and 3.38 µg/L, respectively, the sensitivity was 83.6%, 90.0%, 81.1%, and 89.6%, and the specificity was 70.3%, 75.6%, 71.3%, and 85.4%, respectively. CONCLUSIONS: Prolonged ICU stay, nosocomial infection with secondary sepsis and multiple organ dysfunction syndrome were the leading causes of death for nosocomial infection patients in ICU. Prolonged ICU stay, APACHE II score, SOFA score, and PCT level could effectively predict death risks for nosocomial infection patients.

[Effects of acupuncture on body mass index and waist-hip ratio in the patient of simple obesity].

OBJECTIVE: To observe the therapeutic effect of acupuncture for slimming. METHODS: Eighty cases of simple obesity were randomly divided into an acupuncture group and a medication group, 40 cases in each group. The acupuncture group were treated with body acupuncture, electroacupuncture and auricular acupoint taping and pressing, with Tianshu (ST 25), Guanyuan (CV 4), Sanyinjiao (SP 6) etc. selected for body acupuncture, and auricular acupoints Shenmen, Neifenmi (endocrine), Pi (spleen) etc. selected for ear acupoint taping and pressing. And the medication group were treated with oral administration of Sibutramine. Body weight, body mass index, waist and hip circumferences and waist-hip ratio were determined before and after treatment to evaluate therapeutic effect of slimming. RESULTS: The total effective rate of 87.5% in the acupuncture group was similar to 82.5% in the medication group (P > 0.05). After treatment, body weight, body mass index, waist and hip circumferences and waist-hip ratio significantly decreased in the two groups, but the improvement of waist circumferences and waist-hip ratio in the acupuncture group was better than that in the medication group (P < 0. 05). CONCLUSION: Acupuncture has a definite therapeutic effect in slimming and it can effectively improve body weight, body mass index, waist and hip circumferences and waist-hip ratio in the patient of simple obesity.

[Effect of acupuncture on serum insulin level in the patient of simple obesity].

OBJECTIVE: To compare therapeutic effects of acupuncture plus ear point tapping and pressing therapy and simple medicine for slimming and to probe the mechanism. METHODS: Fifty cases of simple obesity were randomly divided into an acupuncture group and a medication group, 25 cases in each group. The acupuncture group were treated with body acupuncture and electroacupuncture at Tianshu (ST 25), Guanyuan (CV 4), Sanyinjiao (SP 6), Feng-long (ST 40), Zusanli (ST 36), etc., combined with ear point sticking and pressing at Shenmen, Nei-fenmi (endocrine), Pi (spleen), Wei (stomach), Sanjiao (triple energy), Dachang (large intestine), etc.. The medication group were treated with oral administration of Sibutramine, once each day, 10 mg each time. Serum insulin contents before and after treatment were detected, and the therapeutic effect for slimming was assessed. RESULTS: The total effective rate was 88.0% in the acupuncture group and 80.0% in the medication group, with no significant difference between the two groups (P > 0.05); after treatment, the serum insulin levels in the two groups significantly decreased (P < 0.01), and the decrease of insulin level in the acupuncture group was significantly better than that in the medication group (P < 0.05). CONCLUSION: Acupuncture combined with ear point tapping and pressing therapy has a similar therapeutic effect to western medicine for slimming, but the former is better than the later in improving serum insulin level.

[Acupuncture for treatment of simple obesity and its effect on serum leptin level of the patient].

OBJECTIVE: To explore the therapeutic effect and the mechanism of acupuncture in reducing body weight. METHODS: Fifty cases of simple obesity were randomly divided into an acupuncture group and a drug control group, 25 cases in each group. The patients in the acupuncture group were treated with body acupuncture at Tianshu (ST 25), Guanyuan (CV 4), etc, electroacupuncture and ear point tapping and pressing therapy (Shenmen, Endocrine, etc. were selected); the patients in the control group were treated with oral administration of sibutramine. The serum leptin level before and after treatment were determined and the therapeutic effect in reducing body weight was assessed. RESULTS: The total effective rate was 88.0% in the acupuncture group and 80. 0% in the control group, with no significant difference between the two groups (P>0.05); after treatment, the serum leptin level in both the two groups decreased significantly (P<0.01), and the decreasing amplitude in the acupuncture group was superior to that in the control group (P<0.05). CONCLUSION: Acupuncture therapy has a definite therapeutic effect in reducing body weight, and the improvement of serum leptin level of the patient is possibly one of the mechanisms of acupuncture in reducing body weight.

[Intervention effect of tongfei mixture on nocturnal hypoxia in patients with chronic obstructive pulmonary disease].

OBJECTIVE: To study the effect of tongfei mixture (TFM, a Chinese recipe mainly consisted of angelica and rehmannia root) on nocturnal hypoxia in patients with chronic obstructive pulmonary disease (COPD). METHODS: Sixty patients with COPD of remission phase were randomly divided into 3 groups, 20 in each group. Group A was the control group; Group B, the group simply treated with oxygen; Group C, treated with oxygen and TFM. Changes of pulmonary function, diaphragm muscle mobility (DMM), 6 min walk distance (6MWD), morning arterial blood gas, nocturnal lowest oxygen saturation (LSaO2), mean blood oxygen saturation (MSaO2), the percentage of saturation lower than 90% time account for total sleeping time (SLT90%) and ultrasonocardiogram before and after treatment were observed. RESULTS: Levels of LSaO2, MSaO2 and SLT90% in Groups B and C were significantly higher than those in Group A (P<0.05, P<0.01). The lowering of PaCO2 in Group C was more significant than that in Group B (P<0.05). The mPAP level in Group C was lower, FEV1, 6MWD and DMM were improved than those in Group A and B, showing significant difference (P<0.05). CONCLUSION: Combined use of oxygen therapy and TFM could not only improve the nocturnal hypoxia, but also lower PaCO2. TFM is an important supplement of oxygen therapy.