A bibliometric study on trends in chiropractic research from 1920 to 2023.

OBJECTIVE: An increasing body of evidence suggests a positive role of chiropractic in the treatment of neuro-musculoskeletal disorders. This study aims to explore current research hotspots and trends, providing insights into the broad prospects of this field. METHODS: A bibliometric review was conducted on all chiropractic articles included in the Web of Science Core Collection before December 31, 2023. RESULTS: Over the past century, the volume of research in the field of chiropractic has been fluctuating annually, with four peaks observed in total. The United States, Canada, Australia, and the United Kingdom are leading countries. Chu, Eric Chun-Pu is the author with the most publications, while Bronfort, Gert has the highest total citation count. The University of Southern Denmark has produced the most publications, while Queens University - Canada is the most central institution. The Journal of Manipulative and Physiological Therapeutics is the journal with the most publications and citations, while the Journal of the American Medical Association is the most central journal. The two most-cited articles were both authored by Eisenberg DM. Emerging keywords include "chronic pain" and "skills". The theoretical mechanisms and scientific basis of chiropractic, its clinical practice and safety, education and training, integration with other disciplines, and patient experiences and satisfaction are the frontiers and hotspots of research. CONCLUSION: This study integrates bibliometric analysis to summarize the current state of research and global network centers in the field of chiropractic, further highlighting the hotspots and trends in this field. However, Individual and national rankings should be interpreted with caution due to our focus on Web of Science rather than PubMed.

[Effect of oblique needling at Ashi-point on expression of MyoD1/Pax7 in mice with quadriceps femoris injury].

OBJECTIVE: To observe the effect of oblique needling at Ashi-point on behavior, and cell morphology, myogenic differentiation antigen (MyoD1) and paired box transcription factor Pax7 (Pax7) of quadriceps femoris tissue in quadriceps femoris injured mice. METHODS: A total of 24 C57BL/6 male mice were randomly divided into control, model, shallow insertion and deep insertion groups, with 6 mice in each group. The quadriceps femoris injury model was established by single intramuscular injection of 0.5% bupivacaine (BPVC). Twenty-four hours after modeling, mice of the two acupuncture groups were received oblique needling on the surface or through the muscle belly of quadriceps femoris for once, the oblique needling was lifted and inserted 3 times. The climbing pole test was conducted 24 h after modeling and 24 h after EA. Histopathological changes of quadriceps femoris was observed by H.E. staining. The expressions of MyoD1 and Pax7 were detected by immunohistochemistry. RESULTS: Compared with the control group, the score of climbing pole test was lower (P<0.01), and the expressions of MyoD1 and Pax7 significantly increased (P<0.01) in the model group. After the intervention and compared with the model group, the score of climbing pole test was higher (P<0.01), and the expressions of MyoD1 and Pax7 obviously increased (P<0.01) in the two acupuncture groups. The therapeutic effect of deep insertion group was apparently superior to that of shallow insertion group in up-regulating the climbing pole test score and expressions of MyoD1 and Pax7 (P<0.05, P<0.01). H.E. stain showed large areas of inflammatory infiltration, muscle cells swelling, atrophy, rupture, degeneration and necrosis, different cell sizes and morphologies, enlarged intervals, nuclear aggregation, deep nuclear staining, nuclear pyknosis, and hemorrhage in the model group, which was relatively milder in both needling groups. CONCLUSION: Oblique needling at Ashi-point can effectively promote the benign repair of injured quadriceps muscle and promote the recovery of exercise ability in mice, which may be associated with its effect in up-regulating the expression of MyoD1 and Pax7 protein. The role of deep insertion is superior to that of shallow insertion.

[Comparison of therapeutic effect of soft-tissue relaxing needling and electroacupuncture for knee osteoarthritis].

OBJECTIVE: To compare the clinical efficacy of soft-tissue relaxing needling and electroacupuncture (EA) in the treatment of knee osteoarthritis (KOA), so as to explore a new and more effective therapy for KOA. METHODS: Forty patients with KOA who met our diagnostic criteria were randomly and equally divided into acupuncture group and soft-tissue relaxing needling (relaxing-needling) group. EA (20 Hz, a tolerable strength and duration of 20 min) was applied to the unilateral Neixiyan(EX-LE5) and Waixiyan(EX-LE5), and manual acupuncture stimulation was applied to Heding(EX-LE2), Xuehai (SP10), Xiyangguan (GB33), Liangqiu(ST34), Yanglingquan(GB34) and Yinlingquan(SP9) on the affected side by using uniform reinforcing-reducing technique. In the relaxing-needling group, after identifying the tender point and nodule-like or stiff-strip-muscle spot at the affected limb by palpation, we used filiform needles to insert into them, then, made a longitudinal separation or point-like pricking. The visual analog scale (VAS) pain score, knee flexion activity (range of motion, ROM), and the knee osteoarthritis severity (Lequesne index, composed of daily living, walking distance and pain) were measured before and after the treatment. The therapeutic effect was assessed by consulting the Guiding Principles for Researching New Drugs of Traditional Chinese Medicine (2002) and Criteria for Diagnosis and Assessment of Therapeutic Effect of Syndromes or Illnesses of Traditional Chinese Medicine (1994). RESULTS: After the treatment, the VAS score and Lequesne index were significantly decreased in both acupuncture and relaxing-needling groups (P<0.001), and the ROM score was considerably increased in both groups in comparison with their own pre-treatment (P<0.001). The difference values of VAS score and Lequesne index between pre- and post-treatment were significantly higher in the relaxing-needling group than in the acupuncture group (P<0.05). Of the two 20 cases in the relaxing-needling and acupuncture groups, 8 and 3 experienced a remarkable improvement in their symptoms, 10 and 13 were effective, 2 and 4 failed, with the effective rate being 90.0% and 80.0%, respectively. No significant difference was found between the two groups in the difference value of ROM score and the effective rate (P>0.05)．. CONCLUSION: Both relaxing-needling and EA therapies are comparable in the therapeutic effect for KOA, and the former is superior to the latter in reducing the joint pain and improving the knee joint locomotor function, thus being worthy of clinical application.

[The effect of acupuncture stimulation of Ashi-point on hepatocyte growth factor expression in the soft tissue in acute contusion rats].

OBJECTIVE: To observe the effect of acupuncture stimulation of Ashi-point on hepatocyte growth factor (HGF) protein expression in gastrocnemius muscle (GM) in rats with traumatic injury of GM, so as to reveal its mechanism underlying improvement of traumatic injury of skeletal muscle. METHODS: A total of 80 SD rats were randomly divided into normal control (n = 8), model, acupuncture control, and acupuncture treatment groups, and the latter 3 groups were further allocated to 0 h, 24 h and 48 h subgroups (n = 8 in each subgroup). The acute soft tissue contusion model was established by using 500 g-counterweight free falling hitting at the GM of the right leg (height 30 cm). The Ashi-point was punctured with a piece of filiform needle by penetrating the site beside the injured GM, and stimulated for about 5 seconds. For acupuncture control group, acupuncture was performed in the same Ashi-point in normal rats. Pathological changes of the focal GM were observed by H. E. staining and HGF protein expression of GM was detected by Western blot. RESULTS: H.E. staining showed that different degrees of injury of GM tissue including broken muscle fibers with cellular swelling, inflammatory cell infiltration, muscle fibrinolysis, atrophy, degeneration and necrosis, etc., were found at each time-point after modeling, while in the acupuncture treatment group, the severity of muscle injury was relatively milder particularly at the time-points of 24 h and 48 h. Compared with the normal control group, HGF protein expression levels of GM at the 3 time-points in the model group, and at 48 h in the acupuncture control group were markedly increased (P<0.05, P<0.01); while in comparison with the model group, HGF protein expression levels were remarkably down-regulated at 24 h and 48 h after acupuncture treatment (P<0.01, P<0.05). CONCLUSION: Acupuncture stimulation of Ashi-point can significantly down-regulate HGF protein expression in the GM in soft tissue contusion rats, which may contribute to its effects in relieving contusion injury of skeletal muscle.

[Effects of electroacupuncture and manual acupuncture interventions on contents of serum inflammatory cytokines in rats with chronic adjuvant arthritis].

OBJECTIVE: To observe the effect of electroacupuncture (EA) or manual acupuncture of unilateral or bilateral "Zusanli" (ST 36) on the contents of serum inflammatory factors interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha), and anti-inflammatory factors interleukin 2 (IL-2), interleukin 4 (IL-4) and interleukin 10 (IL-10), so as to reveal their mechanism underlying improvement of chronic arthritis. METHODS: Sixty SD rats were randomly divided into normal control, model, electroacupuncture (EA)-left (L) Zusanli (ST 36), EA-bilateral (Bi)-ST 36,and manual acupuncture (MA)-L-ST 36 groups (12 rats/group). Arthritis model was established by subcutaneous injection of complete Freund's adjuvant (0.1 mL)into the hindpaw. EA (2 Hz/100 Hz, 1-3 mA, pulse duration: 0.6 ms/0.2 ms) or manual needle stimulation was applied to the left or bilateral "Zusanli" (ST 36) for 30 min, twice every week for 4 weeks. Enzyme linked immunosorbent assay (ELISA) was used to detect the contents of serum IL-1beta, TNF-alpha, IL-2, IL-4 and IL-10, respectively. RESULTS: Compared with the normal control group, the contents of serum inflammatory factors IL-1beta and TNF-alpha, anti-inflammatory factors IL-4 and IL-10 were increased significantly in the model group (P < 0.001). In comparison with the model group, serum IL-1beta, TNF-alpha, IL-4 and IL-10 contents were down-regulated considerably in the EA-L-ST 36, EA-Bi-ST 36 and MA-L-ST 36 groups (P < 0.001, P < 0.005). Serum IL-2 content had no apparent changes after modeling in comparison with the normal group (P > 0.05). While serum IL-2 contents were markedly higher in the EA-L-ST 36, EA-Bi-ST 36 and MA-L-ST 36 groups than in the model group (P < 0.05). No significant differences were found among the EA-L-ST 36, EA-Bi-ST 36 and MA-L-ST 36 groups in serum IL-1beta, TNF-alpha, IL-2, IL-4 and IL-10 contents (P > 0.05). CONCLUSION: EA or manual acupuncture stimulation of single or bilateral ST 36 can effectively down-regulate serum inflammatory factors IL-1beta and TNF-alpha levels, and upregulate anti-inflammatory factor IL-2 level in chronic arthritis rats, which may contribute to their effects in relieving chronic arthritis.

[Effect of electroacupuncture on hippocampal NO-cGMP signaling pathway in depression rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on hippocampal nitric oxide (NO)-cyclic guanosine 3,5-monophosphate (cGMP) signaling pathway in depression rats in order to explore the underlying mechanism of EA in improving depression. METHODS: Thirty male SD rats were equally randomized into control, model and EA groups. Depression model was established by using chronic unpredictable mild stress stimulation (forced ice-water swimming, electric shock, tail-clamping, etc.) combined with lonely raising for 21 days. EA (2 Hz, 0.6 mA, 20 min) was applied to "Baihui" (GV 20) and "Yintang" (EX-HN 3), once daily for 21 days. The expression of neuronal nitric oxide synthase (nNOS) and the content of cGMP in the hippocampus were determined by immuno-histochemistry and radioimmunoassay separately. RESULTS: Many nNOS immuno-reaction (IR)-positive granular cells were observed in the hippocampus in control group, fewer found in EA group and fewest in model group. Image analysis showed that the grey value of model group was significantly higher than that of control group (P < 0.01), and that of EA group was obviously lower than that of model group (P < 0.01), suggesting upregulation of nNOS expression after EA. Compared with control group the content of cGMP in hippocampus in model group showed a decreasing trend, but without significant difference between two groups (P > 0.05). In comparison with model group, hippocampal cGMP content of EA group increased considerably (P < 0.01), being comparable to that of control group (P > 0.05). CONCLUSION: Electroacupuncture of "Baihui" (GV 20) and "Yintang" (EX-HN 3) can upregulate the expression of nNOS and the content of cGMP in the hippocampus in depression rats, maintaining a normal activity of the NO/cGMP signaling pathway, which may contribute to its effect in relieving depression.