[Therapeutic effect of Fanzhen Jieci needling on discogenic sciatica: a randomized controlled trial].

OBJECTIVE: To compare the therapeutic effect between Fanzhen Jieci (warming acupuncture plus fast needling) combined with conventional acupuncture and simple conventional acupuncture on discogenic sciatica. METHODS: A total of 76 patients with discogenic sciatica were randomized into a Fanzhen Jieci group and a conventional acupuncture group, 38 cases in each one. Conventional acupuncture was applied at Shenshu (BL 23), Dachangshu (BL 25), L1-L5 Jiaji (EX-B 2) and Huantiao (GB 30) on the affected side, etc. in the conventional acupuncture group. On the basis of the treatment in the conventional acupuncture group, Fanzhen Jieci was applied at L1-L5 Jiaji (EX-B 2) and Huantiao (GB 30) on the affected side in the Fanzhen Jieci group, i.e. warming acupuncture was applied at L1-L5 Jiaji (EX-B 2), and fast needling was applied at Huantiao (GB 30) on the affected side for a depth of 40-60 mm, so as to introduce a sensation of electric shock transmitting to lower limb, and then the needle was immediately withdrawn. The treatment was given once every other day, 3 times a week for 3 weeks in both groups. The visual analogue scale (VAS) score of leg and low back pain, the Oswestry disability index (ODI) score and the 36-item short form health survey (SF-36) score before and after treatment were compared between the two groups. RESULTS: Compared before treatment, the VAS scores of leg and low back pain and the ODI scores after treatment were decreased in both groups (P<0.001), the changes of the VAS scores of leg and low back pain in the Fanzhen Jieci group were larger than those in the conventional acupuncture group (P<0.05). After treatment, except for the role emotional and health transition scores, the various scores of SF-36 were increased compared before treatment in the Fanzhen Jieci group (P<0.01); except for the role physical, role emotional and health transition scores, the various scores of SF-36 were increased compared before treatment in the conventional acupuncture group (P<0.01). After treatment, the physical functioning, role physical, bodily pain, mental health and general health scores of SF-36 in the Fanzhen Jieci group were higher than those in the conventional acupuncture group (P<0.05). CONCLUSION: Fanzhen Jieci combined with conventional acupuncture can effectively relieve the pain and improve the mental state in patients with discogenic sciatica, its therapeutic effect is superior to simple conventional acupuncture.

[Progress on acupuncture intervention for perioperative stress response].

To summarize the application value of acupuncture in perioperative stress response. Perioperative acupuncture can not only effectively relieve pain and stress response during operation, but also relieve psychological stress response represented by preoperative anxiety before operation, and regulate adaptive immune response after operation. Acupuncture, as a safe non-drug therapy, shows its core advantage of participating in the multidisciplinary intervention of enhance recovery after surgery (ERAS). The future studies need to explore and evaluate the role of acupuncture during perioperative period from multiple dimensions, and gradually reveal the mechanism of acupuncture while establishing the evidence-based basis for acupuncture during perioperative period.

[Acupuncture at xing-spring point, shu-stream point and lower he-sea point for type-2 diabetic peripheral neuropathy].

OBJECTIVE: To observe the effect of acupuncture at xing-spring point, shu-stream point and lower he-sea point on neurological function and clinical symptoms in patients with type-2 diabetic peripheral neuropathy. METHODS: Sixty patients with type-2 diabetic peripheral neuropathy were randomly divided into an observation group and a control group, 30 cases in each one. Both groups were treated with basic treatment, and the observation group was additionally treated with acupuncture at Neiting (ST 44), Xiangu (ST 43), Dadu (SP 2), Taibai (SP 3), Zusanli (ST 36), etc. once every other day, 3 times a week for 4 weeks. The changes of TCM symptom score, Toronto clinical assessment (TCSS) score, visual analogue scale (VAS) score of pain and serum tumor necrosis factor α(TNF-α) level were observed before and after treatment in the two groups, and the clinical effects of the two groups were evaluated. RESULTS: Compared before treatment, the TCM syndrome score and the TCSS score in the two groups were reduced after treatment (P<0.05), and the TCM syndrome score after treatment in the observation group was lower than that in the control group (P<0.05). After treatment, the VAS in the observation group was reduced (P<0.05), and the VAS score of pain in the observation group was lower than that in the control group (P<0.05). There was no significant difference in the level of serum TNF-α within and between the two groups (P>0.05). The total effective rate was 76.7% (23/30) in the observation group, which was superior to 33.3% (10/30) in the control group (P<0.05). CONCLUSION: Acupuncture at xing-spring point, shu-stream point and lower he-sea point could effectively improve the neurological function and clinical symptoms in patients with type-2 diabetic peripheral neuropathy.

"Fan-zhen Jie-ci" acupuncture therapy for treatment of discogenic sciatica: protocol for a single-blind, randomized controlled clinical trial.

BACKGROUND: Curative medical treatment for patients with discogenic sciatica is limited. Acupuncture is an important non-pharmacological therapy reported to have positive therapeutic effects on discogenic sciatica. According to traditional Chinese acupuncture theory, discogenic sciatica is a channel tendon disease which can be treated by a special "Fan-zhen Jie-ci (FZJC)" method. Our recent preliminary clinical evidence indicated that the FZJC method had a positive treatment effect on the disease. This study will further evaluate the efficacy and safety of FZJC on patients with discogenic sciatica. METHODS: A single-blind randomized controlled clinical trial will be conducted, assigning 76 participants with discogenic sciatica to a randomly assigned FZJC group or a control group. Acupuncture treatment combined with the FZJC method will be applied in the FZJC group while routine acupuncture treatment only will be applied in the control group. Treatments will be administered three times a week for a total of 3 consecutive weeks. The primary outcome of this trial is change in the visual analogue scale of leg pain (VAS-LP), and the secondary outcomes are changes in the visual analogue scale of back pain (VAS-BP), the Brief Pain Inventory (BPI), the Oswestry Disability Index (ODI), the 36-Item Short Form Health Survey (SF-36), and serum concentrations of mitochondrial DNA (mtDNA) and high sensitivity C reactive protein (hsCRP). DISCUSSION: The results of this study will provide insight into the efficacy and safety of FZJC acupuncture as a treatment for discogenic sciatica. TRIAL REGISTRAION: The trial has been registered at the Chinese Clinical Trial Registry (ChiCTR1900026272) and the Acupuncture-Moxibustion Clinical Trial Registry (AMCTR-IOR-19000275).

[Therapeutic effects on rheumatoid arthritis treated with shu-deep needling and bloodletting techniques].

OBJECTIVE: To observe the difference in the therapeutic effects on rheumatoid arthritis (RA) between the combined shu-deep needling and bloodletting technique and the regular needling technique. METHODS: A total of 70 patients were randomized into an observation group (35 cases) and a control group (35 cases, 4 cases dropped-out). Dazhui (GV 14), Shenzhu (GV 12), Zhiyang (GV 9), Jinsuo (GV 8), Ganshu (BL 18), Shenshu (BL 23), Zhibian (BL 54), Weizhong (BL 40), Taixi (KI 3) and Tianzong (SI 11), etc. were selected in the two groups. Additionally, in the observation group the shu-deep needling technique was adopted at Tianzong (SI 11) and Zhibian (BL 54), the bloodletting technique at the local swollen area and the even-needling technique at the rest acupoints. In the control group, the even-needling technique was applied to all of the acupoints. Acupuncture treatment was given once every two days, 3 times a week and for 12 weeks totally. The numbers of tender points at the knee joint, the numbers of swollen sites at the knee joint, the visual analogue scale (VAS) score and the American health assessment questionnaire (HAQ) score were observed in the two groups before and after treatment, as well as the changes in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The American College of Rheumatology (ACR) criteria was adopted to evaluate the therapeutic effects of the two groups. RESULTS: After treatment, the numbers of tender points, the numbers of swollen sites, VAS score and HAQ score were all improved as compared with those before treatment in the two groups (all P<0.01), and the results in the observation group were better than those in the control group (all P<0.05). After treatment, ESR and CRP levels were all reduced as compared with those before treatment in the two groups (all P<0.01), but there was no significant differences between the two groups (both P>0.05). The standard-reaching rates of ACR 20 and ACR 50 in the observation group were 94.3% (33/35) and 31.4% (11/35) respectively, which were better than 67.7% (21/31) and 6.5% (2/31) in the control group (P<0.01, P<0.05). CONCLUSION: The acupuncture with the shu-deep and bloodletting techniques and the acupuncture with regular needling technique are all effective on RA. The therapeutic effects of the acupuncture treatment with the shu-deep and bloodletting techniques are better than that with regular needling technique.

[Electroacupuncture Relieves Pain by Down-regulating Expression of Hippocampal High Mobility Group Protein 1 and Contents of TNF-α and IL-1 ß in Rats with Chronic Neuropathic Pain].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on expression of high mobility group protein 1 (HMGB 1) and related downstream effectors of proinflammatory cytokines in the hippocampus in chronic neuropathic pain rats, so as to investigate its mechanism underlying neuropathic pain relief. METHODS: Male SD rats were randomized into sham, model, and EA groups, with 12 rats in each group. The neuropathic pain model was established by ligature of the left sciatic nerve to induce chronic constriction injury (CCI). EA was applied to bilateral "Zusanli"(ST 36) and "Yanglingquan"(GB 34) for 30 min, once daily for 7 days. The mechanical withdrawal threshold (WMT) was detected using an electronic von Frey anesthesiometer. The expression level of HMGB 1 in the hippocampus was determined using quantitative RT-PCR and Western blot, separately, and the contents of hippocampal TNF-α and IL-1 ß were detected by ELISA. RESULTS: Compared with the sham group, the MWT values were markedly decreased on day 7, 10 and 14 after modeling in the model group (P<0.001). On day 10 and 14 after modeling, the MWT values were significantly up-regulated in the EA group relevant to those of the model group (P<0.05, P<0.01). The expression levels of HMGB1 mRNA and protein, and the contents of hippocampal TNF-α and IL-1 ß were markedly increased in the model group relevant to the sham group (P<0.001), and significantly down-regulated in the EA group relevant to the model group (P<0.001, P<0.01, P<0.05). CONCLUSION: EA stimulation of ST 36-GB 34 can relieve pain in chronic neuropathic pain rats, which may be related to its actions in down-regulating the levels of HMGB 1 and its downstream proinflammatory cytokines TNF-α and IL-1 ß in the hippocampus.

The effects of acupuncture on bladder interstitial cells of cajal excitability in rats with overactive bladder.

It is well known that acupuncture treatment has an effect on patients with an overactive bladder, but the mechanism of its action remains to be clarified. This study was aimed to investigate the effects of acupuncture on bladder overactivity, and the excitability of interstitial cells of Cajal of the bladder in a rat model of partial bladder outlet obstruction. Electroacupuncture (continuous wave, 30 Hz, 1 mA) was applied to stimulate the Ciliao point (BL32) and the Huiyang point (BL35) of rats for 20 min, 3 days. Results showed that acupuncture suppressed detrusor unstable contraction frequency and decreased detrusor maximum pressure in the bladder filling period. Compared with the normal control rats, HCN2 mRNA and protein expression within the bladder were upregulated and were reversed by electroacupuncture in overactive bladder rats as determined by RT-PCR, western blotting and immunohistochemistry. Moreover, in-vitro cell-cultured OAB rats bladder interstitial cells of Cajal intracellular Ca(2+) concentration were higher than normal control rats, which were lowered after acupuncture treatment. These findings suggest that acupuncture stimulation can suppress bladder overactivity, and regulate the excitability of bladder interstitial cells of Cajal in treatment of overactive bladder myogenic mechanism.

[Observation on therapeutic effects of elongated needle therapy on dysuria induced by benign prostatic hyperplasia].

OBJECTIVE: To compare therapeutic effects of elongated needle therapy and routine acupuncture therapy on dysuria induced by benign prostatic hyperplasia (BPH). METHODS: Randomized, controlled, multi-central method was adopted and 150 cases confirmed to the enrolled criteria were divided into two groups by odd or even number, an elongated needle group (n = 72) and a routine acupuncture group (n = 78). Acupuncture was given at bilateral Zhibian (BL 54) and Zhongji (CV 3) in the two groups, once daily, 5 sessions constituting one course, with a 2-day interval between two courses. The treatment was given for 2 courses. Changes of I-PSS symptom cumulative score, urine flowing rate, residual urine in bladder before and after the treatment were observed. RESULTS: The effective rate was 83.3% in the elongated needle group and 44.9% in the routine acupuncture group. There were significant differences between the two groups in improvemet of I-PSS score, increase of urine flowing rate and reduction of residual urine in bladder (all P < 0.05). CONCLUSION: The elongated needle therapy has a definite therapeutic effect on dysuria induced by benign prostatic hyperplasia.

[Effects of electroacupuncture treatment on nitrergic neurotransmitter in bladder neck and detrusor of rats with unstable bladder].

OBJECTIVE: To observe the effects of electroacupuncture treatment on nitrergic neurotransmitter in bladder neck and detrusor of rats with unstable bladder. METHODS: Rat models of unstable bladder were established by operation to induce urethral obstruction. Electroacupuncture treatment was given by acupuncturing Huiyang and Zhonglushu points for a week. Then the neuronal nitric oxide synthase (nNOS)-, endothelial nitric oxide synthase (eNOS)- and inducible nitric oxide synthase (iNOS)-positive cells in bladder neck and detrusor of the rats were observed. RESULTS: The nitrergic neurotransmitter in bladder neck and detrusor were obviously decreased in rats with unstable bladder. The electroacupuncture treatment could significantly increase the contains of NOS in bladder tissue. CONCLUSION: To promote the synthesis and secretion of nitrergic neurotransmitter in bladder tissue may be one of the mechanisms of acupuncture in adjusting bladder function.

[Comparative observation on therapeutic effects of electroacupuncture and manual acupuncture on female urethral syndrome].

OBJECTIVE: To evaluate objectively clinical effects of different needling methods on urethral syndrome. METHODS: Eighty-nine cases of female urethral syndrome were randomly divided into an electroacupuncture group and a hand-acupuncture group. The scores were evaluated with I-PSS of International Urine-Controlled Association and life quality before and after treatment, and their therapeutic effects were compared. RESULTS: The abnormal symptoms of urination alliviated in the both groups (P < 0.05); the short-term cured rate was 51.8% in the electroacupuncture group, which was higher than 17.1% in the hand-acupuncture group (P < 0.05). CONCLUSION: The therapeutic effect of electroacupuncture on female urethral syndrome is better than that of the hand-acupuncture.