Effects of acupressure at the P6 and LI4 points on the anxiety level of soldiers in the Iranian military.

INTRODUCTION: Military service is a stressful environment. Methods to reduce stress may result in the mental health promotion of military forces. There are various methods for relieving anxiety. Acupressure is one of them. Hence, this study was carried out to explore effects of acupressure at the P6 and LI4 acupressure points on the anxiety level of army soldiers. METHODS: A randomised double-blind design was undertaken. A total of 120 Iranian army soldiers were randomly assigned to three groups, namely P6, LI4 and control. The P6 and LI4 acupressure points are effective in lowering the anxiety level. In the intervention groups, acupressure was applied at the P6 and LI4 points three times for 10 min at 30 min intervals. In the control group, the thumb pad, which is not an acupressure point, was pressed. The anxiety level of the subjects was measured before the intervention and 30 min after the last intervention. The instruments included a demographics questionnaire and the State-Trait Anxiety Inventory. RESULTS: There was no significant difference between the three groups with respect to the anxiety level in the preintervention phase. However, the mean anxiety score in the P6 group decreased significantly from 53.35±9.7 to 49.02±9.3 (p=0.005). The mean anxiety score in the LI4 group also decreased significantly from 53.37±8.39 to 45.47±8.16 (p<0.001). In the control group, there was no significant difference between the preintervention and postintervention phases (p=0.16). In the postintervention phase, the analysis of variance test showed a significant difference between the three groups in terms of the anxiety level (p=0.04). CONCLUSIONS: Acupressure can reduce soldiers' anxiety at the acupressure points, especially at the LI4 point. It is recommended that this simple and cost-effective intervention be used to relieve soldiers' anxiety in stressful situations. TRIAL REGISTRATION NUMBER: 20150715023216N4.

Eletrodiagnóstico e perfil energético com o Ryodoraku em medicina tradicional chinesa: revisão integrativa / Eletrodiagnostic and energy profile with Ryodoraku in chinese traditional medicine: integrative review / Eletrodiagnóstico y perfil energético con el Ryodoraku en medicina tradicional china: revisión integrativa

Objective: To synthesize the evidence in the literature on the applicability of the Ryodoraku system in the energy diagnosis based on the precepts of Traditional Chinese Medicine. Method: integrative review, carried out by independent reviewers in databases. Results: we found 324 studies. After exclusion, eight were analyzed, with a predominance of descriptive studies. There was agreement about the 24 points selected for the application of Ryodoraku; however, there is disagreement as to their location. Conclusions: Ryodoraku still does not present consistent evidence on its use, limiting the evaluation of its applicability

Objetivo: Sintetizar as evidências disponíveis na literatura sobre a aplicabilidade do sistema Ryodoraku no diagnóstico energético baseado nos preceitos da Medicina Tradicional Chinesa. Método: revisão integrativa, realizada por revisores independentes em bases de dados. Resultados: encontrou-se 324 estudos. Após exclusões, oito foram analisados, com predomínio de estudos descritivos. Houve concordância acerca dos 24 pontos selecionados para a aplicação do Ryodoraku; entretanto, há divergência quanto à localização dos mesmos. Conclusões: o Ryodoraku ainda não apresenta evidências consistentes sobre sua utilização, limitando a avaliação de sua aplicabilidade.

Objetivo: Sintetizar las evidencias de la literatura sobre la aplicabilidad del sistema Ryodoraku en el diagnóstico energético basado en los preceptos de la Medicina Tradicional China. Método: revisión integrativa, realizada por revisores independientes en bases de datos. Resultados: se han encontrado 324 estudios. Después de exclusiones, ocho fueron analizados, con predominio de estudios descriptivos. Hubo concordancia sobre los 24 puntos seleccionados para la aplicación del Ryodoraku; sin embargo, hay divergencia en cuanto a la localización de los mismos. Conclusión: el Ryodoraku todavía no presenta evidencias consistentes sobre su utilización, limitando la evaluación de su aplicabilidad

Effectiveness comparisons of catgut implantation at acupoint for obese type 2 diabetes: A protocol for systematic review and meta analysis.

BACKGROUND: With the change of people's life style, many more people are suffering from obese type 2 diabetes mellitus (T2DM). Acupoint catgut embedding is one of the acupuncture treatment principles in traditional Chinese medicine, which is widely used in the treatment of obese T2DM. However, there is no systematic review of the therapeutic effect of acupoint catgut embedding on obesity T2DM. Therefore, this article aims at the meta-analysis of acupoint catgut embedding in the treatment of obese T2DM, to clarify its curative effect. METHODS: A structured and systemic literature search was conducted in the following databases up to December 1, 2019: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, EMBASE, CNKI, Wanfang Database. We will use the Review Manager 5.3 software provided by Cochrane collaborative network for statistical analysis. Then we assessed the quality and risk of the included studies and observed the outcome measures. RESULTS: This meta-analysis will further determine the beneficial efficacy of acupoint catgut embedding on obesity T2DM. CONCLUSION: The purpose of this meta-analysis is to explore the effect of acupoint catgut embedding intervention on obese T2DM patients, and provide more options for clinicians and patients to treat obese T2DM. ETHICS AND DISSEMINATION: This systemic review will evaluate the efficacy and safety of acupoint catgut embedding in the treatment of obesity T2DM. Since all the data included are published, the systematic review does not need ethical approval. REGISTRATION NUMBER: CRD42020160801.

Electroacupuncture at Zusanli and at Neiguan characterized point specificity in the brain by metabolomic analysis.

Different point stimulations can induce brain activity in specific regions, and however whether these stimulations affect unique neurotransmitter transmission remains unknown. Therefore, we aimed to investigate the effect of point specificity to the brain by resolving the metabolite profiles. Eighteen Sprague-Dawley rats were randomly divided into three groups: (1) the sham group: sham acupuncture at Zusanli (ST36) without electric stimulation; (2) the Zusanli (ST36) group: electroacupuncture (EA) at ST36; and (3) the Neiguan (PC6) group: EA at PC6. Then, the metabolites from rat brain samples were measured by LC-ESI-MS. The results of a partial least squares discriminant analysis revealed the differences among the sham, ST36, and PC6 groups regarding the relative content of metabolites in the cerebral cortex, hippocampus, and hypothalamus. EA at PC6 resulted in downregulation of adenosine, adrenaline, γ-aminobutyric acid, glycine, and glutamate majorly in hippocampus, and then in cerebral cortex. Otherwise, EA at ST6 resulted in upregulation of adrenaline and arginine in hippocampus, and all stimulations showed barely change of identified neurotransmitters in hypothalamus. These differential metabolite and neurotransmitter profiles prove that brain areas can be modulated by point specificity and may provide a maneuver to understand more details of meridian.

Efficacy of compatible acupoints and single acupoint versus sham acupuncture for functional dyspepsia: study protocol for a randomized controlled trial.

BACKGROUND: Acupoint selection is a key factor in the treatment of diseases and has not been well studied. The aim of this trial is to explore the differences in efficacy between compatible acupoints and a single acupoint for patients with functional dyspepsia (FD). METHODS: This randomized controlled trial will be conducted in the First Affiliated Hospital of Changchun University of Chinese Medicine in China. Two hundred and sixteen FD patients will be randomly assigned to the compatible acupoints group, single acupoint group, or sham acupuncture group. This trial will include a 1-week baseline period, a 4-week treatment period, and a 4-week follow-up period. During the 4-week treatment period, patients will receive 20 sessions of acupuncture (weekly cycles of one session per day for 5 consecutive days followed by a 2-day break). The primary outcome will be a change in the Nepean Dyspepsia Life Quality Index from baseline to after the 4-week treatment period. Secondary outcome measures will include the dyspeptic symptom sum score, Overall Treatment Effect questionnaire, and 36-item Short Form survey. Adverse events also will be recorded. Ultraweak photon emission and metabolomics tests will be performed at baseline and at the end of treatment to explore the mechanisms of the differences between compatible acupoints and a single acupoint. DISCUSSION: The results of this trial will allow us to compare the difference in efficacy between compatible acupoints and a single acupoint. The findings from this trial will be published in peer-reviewed journals. TRIAL REGISTRATION: Acupuncture-Moxibustion Clinical Trial Registry, AMCTR-IPC-18000176, registered on 4 March 2019; Chinese Clinical Trial Registry, ChiCTR1900023983, registered on 23 June 2019.

[Discussion on the classification of acupoints].

This paper discusses the existing classification of acupoints and puts forward a new classification method of acupoints. Through the definition of 3 kinds of acupoints and the analysis of the original meaning of ashi points, it is pointed out that the existing classification of acupoints has overlapping among different categories. The acupoints are reclassified based on the characteristics of acupoints in reflecting and treating disease as well as the application of acupoints in clinic. Acupoints can be divided into traditional acupoints and modern holographic acupoints, among which traditional acupoints can be divided into meridian system points and extra points. According to their structure and function features, meridian system points can be divided into meridian points, collateral points, meridian-muscles points and cutaneous region points. The new classification method of acupoints highlights the importance of channel-collateral theory in acupuncture clinic and the feature of acupuncture in the diagnosis and treatment of disease.

[Discussion on locating of back-shu points].

Back-shu points were firstly discussed in Lingshu (the Miraculous Pivot), and various location methods of back-shu points had been proposed by acupuncturists until conclusive method was made in Song dynasty. In this paper, the different location methods of back-shu points were reviewed; based on this, the reasons of divergences among each theory on location methods were discussed, and the theoretical background and reference of the original establishment of back-shu points were further explored. Therefore, it was proposed that the standardized location of back-shu points should be just considered as the center of possible distribution range, and adjustment should be made during clinical application according to the variability of individual combined with finger pressing.

[Acupoint selection thought for post-stroke anxiety disorder in terms of heart and brain differentiation].

To explore the relativity between heart-brain and post-stroke anxiety disorder by analyzing the pathogenesis of post-stroke anxiety disorder combined with the physiology and pathology of organs. The acupoint selection thought was explored by its selection rule according to literature. Post-stroke anxiety belongs to the brain organic anxiety disorder, whose basic pathogenesis is mind injury. The crucial cause is heart and brain disorder at the same time. Thus, Baihui (GV 20), Fengfu (GV 16) for brain and Xinshu (BL 15), Shenmen (HT 7) for heart can improve anxiety disorder according to the theories such as five organ, qijie (qi thoroughfare), sihai (four seas), meridian and collateral.

The Analysis of Normalized Effects on Meridian Current Level After the Photoluminescent Bioceramic Treatment on Acupuncture Points.

OBJECTIVE: This study investigated the advantage of photoluminescent bioceramic (PLB) irradiation on meridian channels of abnormal meridian currents, as well as the normalization of meridian current levels that may represent the participants' physiologic conditions. DESIGN: Statistical analysis of survey data. PARTICIPANTS: Forty-six patients with abnormal meridian current in the gallbladder (GB). INTERVENTIONS: The effects on the meridian currents were measured by an electrodermal instrument after PLB irradiation was applied to the GB and other specific acupuncture points. Each meridian was categorized into six physiologic levels to evaluate effectiveness after the PLB irradiation: 1, extremely low; 2, moderately low; 3, normally low; 4, normally high; 5, moderately high; and 6, extremely high level. The positive effect of PLB treatment for each meridian could be defined as the normalized ability of the meridian level from the extreme values (1, 2, 5, or 6) approaching the normal levels (3 or 4). RESULTS: Participants with higher average meridian current (Amc >36 µA) calculated from the currents of 24 Ryodoraku points could be significantly normalized after the PLB treatment (p=0.0241). A significant positive effect was seen in comparison with the negative effect of PLB on the GB meridian (McNemar test, p=0.00004) (n=46×2 for left and right GB meridians). A patient with benign facial tremor was treated by PLB for 1 month; PLB improved the facial tremor and normalized effects on Amc and meridian current levels at the GB, lung, small intestine, bladder, and kidney. CONCLUSION: A method was proposed to evaluate the normalization effect of a noninvasive PLB technique on the 12 meridians. PLB acupuncture on the specific meridian points could show the normalization ability of Amc and GB meridian for the participants.

What is the Acupoint? A preliminary review of Acupoints.

BACKGROUND: According to traditional Chinese medicine (TCM) theory, acupoints are specifically chosen sites of acupuncture manipulation, and also the basis for studying the mechanism of acupuncture. Stimulating different acupoints on the body surface could provide various therapeutic benefits. However, what is the acupoint? This question is not clear. REVIEW SUMMARY: We focuse on examining the function of acupoints from different perspectives, including the local and the systemic effects of stimulating acupoints. For example, acupoints may release certain substances or incur some changes, which could adjust the function of organs, maintain homeostasis. Furthermore, the therapeutic effects of verum acupoints versus sham acupoints were discussed. However, due to insufficience in evidence and in current methodologies, research into mechanisms of acupuncture is still incomplete. CONCLUSION: This review might explain, to some extent, what an acupoint is. Further research into the identity of acupoints is warranted, and multidisciplinary methods using novel technologies may yield significant advances over existing knowledge.

Development and evaluation of a multi-frequency bioelectrical impedance analysis analyzer for estimating acupoint composition.

The purpose of this study was to suggest a new method of estimating acupoint compositions by using a multi-frequency bioelectrical impedance analysis (MF-BIA) method at 5 kHz, 50 kHz and 200 kHz within 2 cm of acupoints divided into local segments. To verify the system developed, we confirmed the stable occurrence of a constant current at every frequency, regardless of the impedance connected to the electrodes. Moreover, we found left and right distal bicep brachii aponeurosis to be identical by using ultrasound imaging, and we analyzed the repeatability of the findings by making 10 consecutive sets of measurements (p > 0.05). To evaluate the practical use of the acupoint composition, we used the MF-BIA analyzer to measure the left and right LU3, LU4, and LU9 at the lung meridian. We confirmed that the potentials generated were equal to the changes in the cell membrane function, which were caused by the applied frequency (p < 0.01). We also verified that the MF-BIA analyzer measurements corresponded to the acupoint components by comparing the left and right potentials generated (p > 0.05). Hence, we conclude that the MF-BIA analyzer can be used to estimate the acupoint composition based on the acupoint state.

Categorial structure of acupuncture points for terminological resources.

Recent increase in the number of clinical reports of acupuncture requires terminological resources based on conceptual frameworks for knowledge management. For this purpose, we developed a categorial structure for acupuncture points based on ISO 17115.

Auricular acupuncture effectively reduces state anxiety before dental treatment--a randomised controlled trial.

OBJECTIVES: The objective of this study was to analyse whether auricular acupuncture, acupuncture at the outer ear, could reduce state anxiety before dental treatment. METHODS: This prospective, randomised patient-blinded study with 182 patients compared anxiety before dental treatment following auricular acupuncture at the relaxation-, tranquillizer- and master cerebral points (auricular acupuncture group) versus acupuncture at sham points (finger-, shoulder- and tonsil points; sham group) and a non-intervention control group. Anxiety was assessed using the Spielberger State Trait Anxiety Inventory (German version) before auricular acupuncture and 20 min thereafter, immediately before dental treatment. RESULTS: Auricular acupuncture reduced state anxiety score more effectively from 54.7 ± 10.8 to 46.9 ± 10.4 (mean ± SD) than sham acupuncture from 51.9 ± 10.2 to 48.4 ± 10.0. In contrast, state anxiety in the control group increased from 51.0 ± 11.7 to 54.0 ± 11.6 (mean increase +3.0; CI +4.7 to +1.2). The decrease in state anxiety in both intervention groups was statistically significant (p < 0.001) when compared to the non-intervention control group. After correcting for group differences in baseline state anxiety, the reduction in anxiety was -7.3 score points (CI -9.0 to -5.6) in the auricular acupuncture group and -3.7 score points (CI -5.4 to -1.9) in the sham group (p = 0.008). CONCLUSION: Auricular acupuncture, a minimally invasive method, effectively reduces state anxiety before dental treatment. CLINICAL RELEVANCE: Auricular acupuncture could be an option for patients scheduled for dental treatment, who experience an uncomfortable degree of anxiety and request an acute intervention for their anxiety.

Ensayo no aleatorizado del tratamiento con acupuntura de la cefalea resistente a terapias convencionales / Acupuncture treatment in headache refractory to conventional therapies

Objetivos. Valorar la efectividad global de la acupuntura como terapia complementaria en la reducción del dolor crónico en las cefaleas resistentes a terapias habituales en grupos apareados de pacientes en condiciones de práctica clínica real. Conocer en qué proporción disminuye el consumo de analgésicos en estos pacientes tras un ciclo de acupuntura. Determinar las reacciones adversas debidas a la acupuntura. Material y métodos. Estudio cuasi-experimental en 56 pacientes ambulatorios con cefalea refractaria a tratamiento farmacológico convencional. Medición con una escala múltiple de valoración del dolor antes de iniciar el ciclo de tratamiento con acupuntura, después de realizar diagnóstico según la medicina tradicional china, y al terminar. Resultados. Se ha obtenido un nivel de significación p<0,001 para el valor total de la escala de dolor y para cada una de sus variables (intensidad, frecuencia, consumo de analgésicos, discapacidad y sueño) antes y después del tratamiento con acupuntura. Tras la aplicación de un ciclo de acupuntura, el total de la escala de dolor disminuyó en un 50,8%; la intensidad, en un 48,3%; la frecuencia, en un 45%; el consumo de analgésicos, en un 48,5%; la discapacidad, en un 47%; el sueño mejoró en un 66,8%. No se observaron efectos adversos de la acupuntura. El 56% de las cefaleas fueron migrañas. El 14% de los sujetos presentaba intolerancia a fármacos. Conclusiones. La acupuntura es un procedimiento que consume escasos recursos y es altamente efectiva en el tratamiento complementario de la cefalea crónica refractaria a tratamiento. La reducción en la ingesta de fármacos en pacientes con dolor se traduce en un incremento de la calidad de vida, disminución de efectos secundarios, reducción del coste para el sistema sanitario y aumento de la satisfacción del usuario en pacientes con cefalea crónica refractaria (AU)

Objectives. To evaluate the overall effectiveness of acupuncture as a complementary therapy in relieving chronic pain in paired groups (before-after) of patients with headache refractory to conventional therapies in a real life clinical setting. To determine the extent to which analgesic consumption is reduced in these patients after an acupuncture cycle. To determine the adverse reactions due to acupuncture. Material and methods. We performed a quasi-experimental study in 56 outpatients with headache refractory to conventional pharmacological treatment. Pain was measured using a multiple-item pain scale before the acupuncture cycle was started, after the traditional Chinese medicine diagnosis was made, and when the treatment cycle was complete. Results. Significant differences (p<001) before and after acupuncture treatment were obtained for the overall pain score and for each of its variables (intensity, frequency, analgesic consumption, disability, and sleep). After the acupuncture cycle, the total pain score decreased by 50.8%, intensity by 48.3%, frequency by 45%, analgesic consumption by 48.5%, disability by 47%, and sleep improved by 66.8%. No adverse effects of acupuncture were observed. Fifty-six percent were migraine. Fourteen percent of the patients showed drug intolerance. Conclusions. Acupuncture consumes few resources and is highly effective in the complementary treatment of chronic refractory headache. The reduction in analgesic consumption in patients with pain increases quality of life and patient satisfaction, and reduces adverse effects and healthcare costs in patients with chronic refractory headache (AU)

Brain imaging of acupuncture: comparing superficial with deep needling.

The difference between superficial and deep needling at acupuncture points has yet to be mapped with functional magnetic resonance imaging (fMRI). Using a 3T MRI, echo planar imaging data were acquired for 17 right-handed healthy volunteer participants. Two fMRI scans of acupuncture needling were taken in random order in a block design, one for superficial and one for deep needling on the right hand at the acupuncture point LI-4 (Hegu), with the participant blind to the order. For both scans needle stimulation was used. Brain image analysis tools were used to explore within-group and between-group differences in the blood oxygen level dependent (BOLD) responses. The study demonstrated marked similarities in BOLD signal responses between superficial and deep needling, with no significant differences in either activations (increases in BOLD signal) or deactivations (decreases in BOLD signal) above the voxel Z score of 2.3 with corrected cluster significance of P=0.05. For both types of needling, deactivations predominated over activations. These fMRI data suggest that acupuncture needle stimulation at two different depths of needling, superficial and deep, do not elicit significantly different BOLD responses. This data is consistent with the equivalent therapeutic outcomes that are claimed by proponents of Japanese and Chinese styles of acupuncture that utilise superficial and deep needling, respectively.

A comparison of effects on regional pressure pain threshold produced by deep needling of LI4 and LI11, individually and in combination.

OBJECTIVES: To compare the effects of unilateral and bilateral needling of the same acupoint, and the effects of individual and combined needling of two distinct acupoints on pressure pain threshold (PPT). DESIGN: 22 subjects completed the randomised, dual blind (subject and evaluator) repeated measures study. PPT was measured before and after each intervention at ten sites (acupoints and nonacupoints) across the body with an algometer. INTERVENTIONS: The same manual acupuncture techniques were applied to four interventions of large intestine 4 (LI4) unilaterally; LI4 bilaterally; large intestine 11 (LI 11) unilaterally; and LI4 in conjunction with LI11, both unilaterally. MAIN OUTCOME MEASURES: (1) Percentage change in PPT from preintervention baseline measured at the 10 regional sites following every intervention; (2) participants' perceptions of pain; needling sensations; tension during, and anxiety prior to, each intervention; and changes in practitioner behaviour. RESULTS: Following all four interventions, statistically significant increases in mean PPT were observed. These occurred at nine sites following the LI4 intervention either unilaterally or bilaterally; at six sites for LI11 intervention; and at five sites following the combined LI11 and LI4 intervention. These increases were significantly greater for the bilateral LI4 intervention than the unilateral LI4 intervention at only two sites (p < 0.02 and p < 0.0001). There were no statistically significant differences in the subjective perceptions among the four interventions. CONCLUSION: The enhanced effects on PPT by the bilateral compared with the unilateral intervention at LI4 although limited, do provide some support for the traditional Chinese medicine (TCM) assumption that bilateral needling of the same point enhances the treatment effect. There was no support for the assumption that combined needling of points from the same channel should enhance the treatment effect and failure to obtain better effects by combined needling of points from the same channel could result from the interaction occurring during the combined needling.

Study on the microcirculatory blood velocity of acupoint monitored by laser Doppler signal.

Meridian system composed of acupoints is the most fundamental concept to build oriental medicine. In this study, we employ LDF measurement to compare the microcirculatory blood velocity of acupuncture point and its surrounding tissues. Measurements were performed around an important acupoint in oriental medicine, Hoh-Ku (Li4, on the hand), in healthy volunteers. The study presented has shown that the acupoints have significantly slower mean blood velocity than their surrounding tissues (p all < 0.005). This finding facilitates the detection of the position of acupuncture point and helps us to provide a possible connection between microcirculatory physiology and the underlying mechanism of acupoints.