[Clinical trials of acupuncture treatment of post-stroke shoulder pain].

OBJECTIVE: To observe the clinical therapeutic effect of "Tiaoshen Zhitong" (mental regulating and pain relieving) needling and its influence on serological indicators in the treatment of post-stroke shoulder pain, so as to provide new therapeutic thoughts and approach for post-stroke shoulder pain. METHODS: A total of 80 inpatients with post-stroke shoulder pain were randomly divided into a control group (routine needling, 39 cases) and an observation group ("Tiaoshen Zhitong" needling, 41 cases) according to the random number table. Patients of the two groups accepted basic medication treatment including anticoagulants, hypotensive drugs, hypoglycermic drugs, lipid-lowering drugs, etc. In addition, patients of the control group were also treated by routine acupuncture stimulation (uniform reinforcing-reducing stimulation) of Jianyu (LI15), Jianqian (EX-UE12), Jianhou (Extra), Jianliao (TE14), Waiguan (TE5) and Hegu (LI4) on the affected side, and those of the observation group also treated by "Tiaoshen Zhitong" needling of Ear-Shenmen (MA-TF1), bilateral Neiguan (PC6, lifting-thrusting-reducing method), Shuigou (GV26, lifting-thrusting-reducing method), and Jianyu (LI15), Jianliao(TE14), Jianzhen (SI9) and Yanglingquan (GB34, the latter 4 points were stimulated with uniform reinforcing-reducing method) on the affected side. The treatment was given once every day, 6 days a week for 4 weeks. The pain severity was assessed by using visual analogue scale (VAS), the upper limb function evaluated by using Fugl-Meyer assessment (FMA) scale, the shoulder-joint function evaluated by using Constant-Murley score (CMS) questionnaire, and the daily living ability assessed by using Barthel index (BI) scale. The enzyme linked immunosorbent assay (ELISA) was used to determine the contents of serum beta-endorphin (ß-EP), enkephalin (ENK) and dynorphin (Dyn). The clinical therapeutic effect was evaluated by using Nimodipine scale method. RESULTS: Of the 39 and 41 cases in the control and observation groups, 7(17.95%) and 12(29.27%) were basically cured, 12(30.77%) and 13(31.71%) experienced marked improvement, 8(20.51%) and 11(26.83%) were effective, 12(30.77%) and 5 (12.19%) failed, with the total effective rate being 69.23% and 87.80%, respectively. The effective rate of the observation group was significantly higher than that of the control group (P<0.05). After the treatment, the VAS score was obviously reduced (P<0.01), and the scores of FMA scale, CMS questionnaire and BI scale, and contents of serum ß-EP, ENK and Dyn were all increased obviously in the two groups compared with their own pre-treatment (P<0.01). The therapeutic effect of "Tiaoshen Zhitong" needling was significantly superior to that of the routine needling in lowering VAS, and in raising scores of FMA scale, CMS questionnaire and BI scale and in up-regulating serum ß-EP, ENK and Dyn levels (P<0.01). CONCLUSION: "Tiaoshen Zhitong" needling is effective in reducing post-stroke shoulder pain and improving the motor function of the upper limb and shoulder-joint as well as the quality of daily life in stroke patients with shoulder pain. Its analgesic effect is probably related to the increase of the levels of serum ß-EP, ENK and Dyn.

[Randomized Controlled Clinical Trial for Analyzing Effect of "Spleen-Stomach Regulation Nee- dling" on Oxidative Stress Level in Patients with Diabetic Nephropathy].

OBJECTIVE: To observe the effect of "spleen-stomach needling" on changes of plasma malondialdehyde. (MDA), protein carbonyl (PCO, an oxidative stress damage biomaker), 8-hydroxyguanine (8-OHdG, an indicator of oxidative DNA damage) and the activity of superoxide dismutase (SOD) levels in patients with diabetic nephropathy, so as to explore its mechanisms underlying improving diabetic nephropathy. METHODS: Diabetic nephropathy patients were randomized into routine acupuncture (control) group (n = 72) and spleen-stomach needling (observation) group (n = 70) according to a random digits table and by using multi-centers, randomized and blind methods in the present study. All the patients were received routine medication. In addition, patients of the control group were treated by acupuncture stimulation of Shenshu (BL 23), Taixi (KI 3), Sanyinjiao (SP 6), Yanglingquan (GB 34), Xuanzhong (GB 39), Guanyuan (CV 4), Shousanli (LI 10), Waiguan (TE 5), Yangxi (LI 5), Liangqiu (ST 34), Shangjuxu (ST 37), Neiting (ST.44), Huaroumen (ST 24), and Dachangshu (BL 25), and those of the observation group treated by acupuncture stimulation of Zhongwan (CV 12), Quchi (LI 11), HQgu (LI 4), Xuehai (SP 10), Zusanli (ST 36), Yinlingquan (SP 9), Fenglong (ST 40), Diji (SP 8), Sanyinjiao (SP 6),Taichong (LR 3), Gaohuang (BL 43), Shenshu (BL 23), Baihuanshu (BL 30) and Zhongji (CV 3) with spleen-stomach needling method. The treatment of both groups was conducted twice a day for six weeks except Sundays. Plasma MDA, PCO and 8-OHdG contents were detected by using ELISA, and SOD detected using xanthine oxidase method. RESULTS: After 3 weeks' treatment, plasma MDA, PCO and 8-OHdG contents were significantly increased in both control and observation groups, and plasma SOD was obviously reduced in both groups (P < 0.05). No significant differences were found between the two groups in the plasma MDA, PCO and 8-OHdG contents (P > 0.05). While after 6 weeks' treatment, plasma MDA, PO and 8-OHdG contents were significantly decreased (turning to the normal levels) and plasma SOD level in the observation group was significantly up-regulated (P < 0.01). Following 3 weeks' treatment, of the 72 and 70 patients in the control and observation groups, 10 and 20 cases experienced marked improvement, 22 and 15 were improved, and 40 and 35 invalid, respectively. After 6 weeks' treatment, of the 72 and 70 patients in the control and observation groups, 12 and 39 experienced marked improvement, 28 and 20 cases were improved, 32 and 11 invalid, respectively. The therapeutic effect of the observation group was obviously superior to that of the control group (P < 0.01). CONCLUSION: Acupuncture treatment with spleen-stomach regulation needling can down-regulate plasma MDA, PCO, 8-OHdG contents and up-regulate SOD activity in diabetic nephropathy patients, which may contribute to its effect in improving the patients' symptoms probably by resisting the oxidative stress damage.

[Randomized controlled study on dysphagia after stroke treated with deep insertion of Chonggu (EX-HN 27) by electroacupuncture].

OBJECTIVE: To explore the therapeutic effect of dysphagia after stroke treated with different depth of Chonggu (EX-HN 27) by electroacupuncture. METHODS: Two hundreds and eighty-three cases of dysphagia after stroke were randomly divided into Chonggu (EX-HN 27) deep insertion group (99 cases), Chonggu (EX-HN 27) shallow insertion group (94 cases) and traditional acupuncture group (90 cases) based on multi-central randomized control and blinding methods. Besides routine therapy, Chonggu (EX-HN 27) and Lianquan (CV 23) were selected in the Chonggu (EX-HN 27) deep insertion group and the Chonggu (EX-HN 27) shallow insertion group; the needles were inserted for 60-75 mm and 30 mm respectively and the electroacupuncture was applied in both groups; in traditional acupuncture group, Fengchi (GB 20), Yifeng (TE 17), Wangu (GB 12) and Lianquan (CV 23), etc. were selected. The needles were retained for 30 min, twice a day and 30 treatments totally in 3 groups. The clinical therapeutic effects were evaluated by Kubota's Water Drinking Test Scale, Standard Swallowing Function Scale and TCM Scale of Dysphagia After Stroke. RESULTS: The total effective rate was 97.0% (96/99) in the Chonggu (EX-HN 27) deep insertion group, superior to that of 64.9% (61/94) in Chonggu (EX-HN 27) shallow insertion group and 70.0% (63/90) in traditional acupuncture group (both P < 0.05). Compared with the scores before and after treatment, significant differences were presented statistically in score reduction of TCM Scale in Chonggu (EX-HN 27) shallow insertion group (P < 0.01); the scores of Kubota's Water Drinking Test Scale, Standard Swallowing Function Scale and TCM Scale of Dysphagia After Stroke were obviously reduced in Chonggu (EX-HN 27) deep insertion group and traditional acupuncture group (all P < 0.01); compared with the scores between groups after treatment, the reduction of scores in Chonggu (EX-HN 27) deep insertion group was superior to those in Chonggu (EX-HN 27) shallow insertion group and traditional acupuncture group ( P < 0.05, P < 0.01) respectively. CONCLUSION: Puncture at Chonggu (EX-HN 27) can improve the dysfunction of swallowing after stroke; it is safe and effective, and the needle should be inserted deeply.

[Effect of spleen-stomach regulation-needling on nerve conduction activity in patients with diabetic peripheral neuropathy].

OBJECTIVE: To observe the effect of acupuncture on the nerve conduction function in patients with diabetic peripheral neuropathy. METHODS: Eighty diabetic patients were equally randomized into acupuncture group and medication group. Uniform reinforcing and reducing manipulation of acupuncture for regulating both spleen and stomach was applied to bilateral Quchi (LI11), Hegu (LI4), Xuehai (SP10), Diji (SP8), Zhongwan (CV12), Zusanli (ST36), Yinlingquan (SP9), etc., for 30 min, once daily for 4 weeks. Patients of the medication group were treated with intramuscular injection of Mecobalamine (500 microg), once daily for 4 weeks. The sensory conduction velocity (SCV), motor conduction velocity (MCV), the amplitude and latency of the evoked potential of the tibial nerve were detected before and after the treatment by using an Electromyograph and Evoked Potential Equipment. RESULTS: After the treatment, of the two 40 cases in the medication and acupuncture groups, 12 (30.0%) and 24 (60.0%) were cured basically, 12 (30.0%) and 10 (25.0%) experienced marked improvement in their symptoms, 9 (22.5%) and 4 (10.0%) were effective, and 7 (17.5%) and 2 (5.0%) failed in the treatment, with the total effective rates being 82.5% and 95.0% respectively. The therapeutic effect of the acupuncture group was significantly superior to that of the medication group (P < 0.05). In comparison with the ptre-treatment, the SCV, MCV, amplitude and latency of the evoked potential of the tibial nerve in the acupuncture group were improved significantly after the treatment (P < 0.05, P < 0.01). Compared with the medication group, the SCV, the amplitude and the latency of the tibial nerve in the acupuncture group were also improved significantly after the treatment (P < 0.05, P < 0.01). CONCLUSION: Manipulation of acupuncture for regulating spleen-stomach function has a better effect on the conduction function of the tibial nerve than Mecobalamine in the treatment of diabetic patients with peripheral neuropathy.

[Observation on therapeutic effect of nuchal acupuncture and abdominal acupuncture for treatment of stroke patients with spastic hemiplegia].

OBJECTIVE: To probe the effect and mechanism of the nuchal acupuncture and abdominal acupuncture for treatment of stroke patients with spastic hemiplegia. METHODS: Sixty cases were randomly divided into an observation group and a control group, 30 cases in each group. Nuchal acupuncture and abdominal acupuncture treatment was used and Fengfu (GV 16), Fengchi (GB 20), Tianzhu (BL 10), Zhongwan (CV 12) and Guanyuan (CV 4) etc. were selected in observation group, routine acupuncture was applied on Binao (LI 14), Quchi (LI 11), Huantiao (GB 30) and Futu (ST 32) etc. in control group. The scale of Ashworth and score of Fugel-Meyer of the spastic lateral upper and lower limbs and the changes of the EMG F-wave in spastic upper limb of patients in two groups were observed before and after treatment. RESULTS: The Ashworth scale and Fugel-Meyer score of the upper and lower limbs were obviously improved, the amplitude was decreased, the duration was shorten and the threshold of the EMG F-wave of the spastic upper limb was increased (all P < 0.01) in the observation group. The observation group was superior to the control group in Fugel-Meyer score of the upper and lower limbs of the patients the Ashworth scale of the lower limb, and the amplitude, duration and threshold of the EMG F-wave of the spastic upper limb (all P < 0.01). The total effective rate of 90.0% in observation group was superior to that of 50.0% in control group (P < 0.01). CONCLUSION: The nuchal acupuncture and abdominal acupuncture treatment can decrease the muscle tension of the stroke patients with spastic hemiplegia.

[Randomized controlled study on effects of the needling method for regulating spleen-stomach on coronary heart disease complicated by type 2 diabetes mellitus complicated].

OBJECTIVE: To probe into the clinical therapeutic effect of acupuncture on coronary heart disease complicated by type 2 diabetes mellitus (CDM) and the mechanism. METHODS: Using multi-central, randomized, controlled and blind methods, 120 cases of CDM were divided into an observation group and a control group, 60 cases in each group. They were treated by routine therapy for diabetes mellitus, and in the observation group, acupuncture at Quchi (LI 11), Hegu (LI 4), Xuehai (SP 10), Zusanli (ST 36), Yinlingquan (SP 9), Fenglong (ST 40). Diji (SP 8), Sanyinjiao (SP 6), etc. were added with the needling method for regulating spleen-stomach; while in the control group, acupuncture was given at Weiwanxiashu (EX-B 3), Feishu (BL 13), Pishu (BL 20), Shenshu (BL 23), Yanglingquan (GB 34), etc. The treatment was given twice a day in the two groups. Clinical therapeutic effects were assessed according to clinical symptoms and signs, frequency and lasting time of angina pectoris, quantity of taking Glycerol Trinitrate, blood sugar, blood lipids, urinary albumin excretion rate, urinary beta2-microglobulin, urinary monocyte chemotactic protein-1 (MCP-1), ECG, heart color Doppler, etc. RESULTS: The needling method for regulating spleen-stomach not only could improve the symptoms and signs of the patient, but also could improve the degree of ST segment moving down and the function of left artrium relaxation, and had benign regulative effect on glycometabolism, lipids metabolism and urinary albumin level, with significant differences as compared with the control group (P < 0.05 or P < 0.01). The markedly effective rate for improvement of ECG was 50.00% in the observation group and 13.79% in the control group. CONCLUSION: The needling method for regulating spleen-stomach can improve the damage of heart and blood vessels induced by abnormal sugar and lipids, decrease the level of urinary protein, inhibit MCP-1 excessive expression, relieve myocardial load and raise cardiac output in the patient of coronary heart disease complicated by type 2 diabetes mellitus.

[Multi-central randomized controlled trials of electroacupunture at Zhigou (TE 6) for treatment of constipation induced by stagnation or deficiency of qi].

OBJECTIVE: To assess the therapeutic effect and safety of electroacupuncture (EA) at Zhigou (TE 6) on constipation induced by stagnation or deficiency of qi. METHODS: Multi-central randomized controlled trials were adopted and the patients conforming to the criteria for diagnosis, enrolling and excluding were divided into an observation group and a control group according to random number table. The observation group were treated with EA at Zhigou (TE 6) and the control group with EA at non-acupoint for 4 weeks. The cumulative score of clinical symptoms, colon transmission test and various safety indexes were assessed. The following-up was carried out 1 and 3 months after the end of treatment. RESULTS: EA at Zhigou (TE 6) could obviously improve clinical symptoms and colon transmission time, decrease using rate of Kaisailu and cathartics, with an effective rate of 94.4%, which was better than 61.3% in the control group (P < 0.0001). CONCLUSION: EA at Zhigou (TE 6) has a function of regulating qi and relaxing the bowels and it is an effective method for treatment of constipation with safety and no adverse effect.

[Randomized and controlled study on needling method of harmonizing spleen-stomach for early intervention of diabetic nephropathies and the mechanism of protecting kidney].

OBJECTIVE: To probe into clinical therapeutic effect of acupuncture on diabetic nephropathies and the mechanism. METHODS: Using multi-central, randomized and blind methods, 130 cases of diabetic nephropathy were divided into an observation group and a control group, 65 cases in each group. They were treated by routine diabetic therapy, and in the observation group, acupuncture at Quchi (LI 11), Zhigou (TE 6), Hegu (LI 4), Xuehai (SP 10), Zusanli (ST 36), Yinlingquan (SP 9), Fenglong (ST 40), Diji (SP 8), Sanyinjiao (SP 6), Taichong (LR 3), Tianshu (ST 25), Gaohuang (BL 43), Shenshu (BL 23), Zhongwan (CV 12), Zhongji (CV 3) were added with needling method of harmonizing spleen-stomach. While in the control group, acupuncture at Shenshu (BL 23), Taixi (KI 3), Sanyingjiao (SP 6), Yanglingquan (GB 34), Xuanzhong (GB 39), Guanyuan (CV 4), Shousanli (LI 10), Waiguan (TE 5), Yangxi (LI 5), Liangqiu (ST 34), Shangjuxu (ST 37), Neiting (ST 44), Huaroumen (ST 24), Dachangshu (BL 25). The treatment was given twice a day in the two groups. Clinical therapeutic effects were assessed according to clinical symptoms and signs, blood sugar, blood lipids, urinary albumin excretion rate, urinary monocyte chemotactic protein-1 (MCP-1), glomerular filtration rate (GFR), renal blood flow, etc.. RESULTS: The needling method of harmonizing spleen-stomach not only could improve symptoms and signs of the patients, and also had benign regulative action on metabolism of blood sugar and lipids, and GFR, renal blood flow and urinary albumin level, with significant or very significant differences as compared with the control group ( P < 0.05 or P < 0.01). CONCLUSION: The needling method of harmonizing spleen-stomach is an effective method for diabetic nephropathies, which can improve progressive renal lesion induced by abnormal metabolism of blood sugar and lipids, improve renal blood flow and GFR, decrease urinary albumin secretion, inhibit over expression of MCP-1, protect glomerulus and renal tubules, so as to improve renal function and delay renal lesion.

[Controlled study on the needling method for regulating the spleen and stomach for treatment of diabetic retinopathy].

OBJECTIVE: To probe clinical therapeutic effect of acupuncture on diabetic retinopathy and the mechanism. METHODS: One hundred and twenty cases of diabetic retinopathy were randomly divided into an observed group and a control group, 60 cases in each group. On the basis of routine diabetic treatment, the observation group were treated with the acupoints for regulating the spleen and stomach, and the control group with the acupoints around eye mainly. Clinical therapeutic effect was evaluated by eye fundus condition, blood glucose, blood lipids, nitric oxide (NO) and endothelin (ET) levels. RESULTS: The needling method for regulating the spleen and stomach not only can improve the eye fundus condition, but also has benign regulative action on metabolism of blood glucose and blood lipids, and NO and ET levels, with significant differences as compared with those in the control group (P < 0.05, P < 0.01). CONCLUSION: The needling method for regulating the spleen and stomach is an effective therapy for diabetic retinopathy, and the mechanism is possibly related with the regulation of levels of vascular active substances, NO and ET.

[Clinical observation on acupuncture for treatment of bronchial asthma at acute stage].

OBJECTIVE: To observe effect of acupuncture on asthma at acute stage. METHODS: Ninety cases of asthma at acute stage were randomly divided into an observation group of 60 cases and a control group of 30 cases. Clinical therapeutic effect and the mechanisms were studied from symptoms and signs, pulmonary function and serum interleukin -4 (IL-4), gamma-interferon (INF-gamma). RESULTS: The pulmonary function was improved, the vital capacity was increased and attack of asthma was reduced in both the observation group and the control group, but the observation group was better than the control group in the pulmonary function improving degree (P < 0.05). CONCLUSION: Acupuncture can strengthen the relieving action of medicine on asthma and it is one of effective methods for bronchial asthma.