The Role of Self-Care Acupressure in Maternal Health Problems to Support the Sustainable Development Goals Program in the Health Sector: A Narrative Review.

Objective: This narrative review discusses several studies that demonstrated the effect of self-care acupressure, especially on maternal-health problems in antenatal, labor, and postpartum times, as well as the mechanism of acupressure, the points used, and treatment strategies to support the Sustainable Development Goals (SDGs) program in the health sector. Methods: PubMed and Google Scholar were searched for randomized controlled trials and systematic reviews/meta-analyses from the date of their inception to February 2022. Results: The 14 studies that were included showed the possibility that acupressure could have a positive impact on maternal health. This self-care can be the main alternative in overcoming the gap in solving health problems in the world. Conclusions: Self-care acupressure at various acupoints has been shown to be feasible to reduce problems during antenatal, labor, and postpartum times. Additional research on the use of acupressure during pregnancy and cross-sectional collaboration to increase the awareness of acupressure techniques are needed.

Combination of electroacupuncture and pharmacological treatment improves insulin resistance in women with polycystic ovary syndrome: Double-blind randomized clinical trial.

Background: Acupuncture is a nonpharmacological treatment which has been known to improve ovulatory function in polycystic ovary syndrome (PCOS) women. Acupuncture modulates the somatic and autonomic nervous systems, which regulate endocrine and metabolic functions to impact ovulatory functions. Objective: To investigate the effectiveness of electroacupuncture (EA) and pharmacological combination therapy on improving insulin resistance in women with PCOS. Materials and Methods: This double-blind, randomized clinical trial was performed on 44 participants from March to September 2018 at Cipto Mangunkusumo National hospital, Jakarta, Indonesia. Participants were randomly allocated to treatment (true EA + medication) and control group (sham EA + medication) in a 1:1 ratio using a web-based computer random-number generator. Randomization was carried out by an independent project manager. Both groups received 12 sessions of acupuncture therapy and metformin as pharmacological therapy. Results: This study showed a significant decrease in the Homeostatic Model Assessment for Insulin Resistance index in the true EA + medication group before and after therapy (p = 0.014). Conclusion: The combination of EA and pharmacological therapy effectively improves insulin sensitivity in women with PCOS.

The role of acupuncture for myofascial pain syndrome (MPS) in interventional pain management.

OBJECTIVES: The aim of this literature review is to describe the role of acupuncture for myofascial pain syndrome in interventional pain management. CONTENT: Myofascial pain syndrome (MPS) can be found at all ages. Approximately 30.0-93.0% of patients with musculoskeletal pain have MPS. Unsuccessful treatment can lead to dysfunction, disability, and a cost burden. We conducted a search of studies published in Google Scholar and PubMed databases from 2016 to 2021. SUMMARY: Acupuncture, combined with other therapies, is effective in reducing pain and improving physical function. Acupuncture can enhance endogenous opioids such as endorphins to relieve pain and enhance the healing process. OUTLOOK: Acupuncture could be considered as one of nonpharmacological options in Interventional Pain Management for MPS. Interventions with acupuncture are safe and have minimal side effects when performed by a trained and competent practitioner.

Reduction of serum level of interleukin-2 and pruritus severity after acupuncture at Quchi (LI11) in hemodialysis patients: a placebo-controlled randomized clinical trial / 针灸推拿医学（英文版）

Objective: To observe the effect of acupuncture at Quchi (LI11) on the serum interleukin-2 (IL-2) level and the severity of uremic pruritus (UP) in hemodialysis patients. Methods: Sixty hemodialysis patients with UP were randomized into an acupuncture group and a control group, with 30 cases in each group. In the acupuncture group, patients were treated with acupuncture at Quchi (LI11) twice a week for six weeks. In the control group, each patient received a placebo treatment (sham acupuncture). Before and after the intervention, the pruritis severity was examined using a 5-D scale, and the serum IL-2 level was measured using an enzyme-linked immunosorbent assay kit. Results: There were no statistically significant differences in the demographic or clinical factors between the control group and the acupuncture group at baseline. The reduction in pruritus severity in patients was more significant in the acupuncture group (P=0.027). Acupuncture therapy also significantly decreased the serum IL-2 level in the patients (P=0.011). Throughout the acupuncture procedures, the incidence of pain and mild bleeding was 3.6％ and 2.5％, respectively. Conclusion: Six-week acupuncture treatment at Quchi (LI11) can effectively decrease the severity of UP and the serum IL-2 level. Large-scale, long-duration, and multi-center studies are needed to fully understand the role of IL-2 in inflammation and neuroimmune stimulation during acupuncture.

Acupuncture for Treating Hypertension and Type 2 Diabetes Mellitus as Comorbidities in Patients with COVID-19.

Objective: The world is experiencing challenging times caused by spread of the Coronavirus Disease 2019 (COVID-19), which is caused by infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Hypertension and type 2 diabetes mellitus are the most prevalent comorbidities of COVID-19. This review discusses several studies that showed the effect of acupuncture on hypertension and type 2 diabetes mellitus, and that discussed the mechanism of acupuncture, points used, and treatment strategies. Method: Literature was searched for studies published from 2016 to 2020 on how acupuncture affects hypertension and type 2 diabetes mellitus on the Google Scholar and PubMed databases using the keywords acupuncture, diabetes mellitus, and hypertension. Randomized clinical trials on human subjects, studies that measured systolic blood pressure (SBP) and diastolic blood pressure (DBP) as outcomes, and studies that measured plasma glucose level as the outcome were included. Studies that did not include clinical effects of acupuncture were excluded. Results: Studies on hypertension (n = 2) and type 2 diabetes mellitus (n = 2) were found. These studies suggested that acupuncture might be able to reduce SBP and DBP, fasting plasma glucose level, oral glucose tolerance, and random blood glucose level. Conclusions: Preliminary studies have suggested that acupuncture might reduce BP in hypertension and reduce blood sugar and insulin resistance in type 2 diabetes mellitus. More research is required to demonstrate if acupuncture is a useful adjunct for treating hypertension and type 2 diabetes mellitus as comorbidities of COVID-19.

The Role of Acupuncture in Interventional Pain Management.

Objective: Interventional pain management has been recognized over the last couple of decades for treating chronic-pain syndromes. Acupuncture is a nonpharmacologic therapeutic option for pain management and may be an option for different patients with contraindications for interventional pain management. This review explores this options. Method: This limited review examines the role of acupuncture for managing head-and-neck pain and lower-back pain, according to interventional pain management. Conclusions: Acupuncture at various points, corresponding to the stellate ganglion, which is ST 10 Shuitu, and corresponding to the splanchnic nerve and the facet joint of the lumbar vertebra-which are Ex-B2 paravertebra-can be applied for pain management in the head-and-neck area and in the lower-back area. According to various research findings, acupuncture is effective and safe for reducing pain in the head and neck area, as well as in the lower back.

Effects of Laser Acupuncture and Dietary Intervention on Key Obesity Parameters.

Objectives: The scope of obesity includes quality of life (QoL); emotions; and financial burdens on individuals, families, and society. Obesity contributes to many diseases, such as coronary heart disease, type 2 diabetes, stroke, osteoarthritis, and cancer. Dietary modifications, lifestyle interventions, pharmacologic agents, and surgical interventions are some ways to address obesity; yet, safer, more-effective options are needed. Laser acupuncture can significantly lower body mass index (BMI) by reducing abdominal and visceral adipose tissue content and regulating lipid metabolism. This study investigated the effects of laser acupuncture + diet modification on fasting blood-glucose level, insulin level, waist:hip ratio, QoL scoring, high-density lipoprotein (HDL) level, triglycerides, BMI, and appetite scoring in obese patients. Materials and Methods: The patients (N = 38) were divided randomly into 2 groups: (1) laser acupuncture + dietary intervention (n = 19) and (2) sham laser acupuncture + dietary intervention (n = 19). Both groups had the same dietary intervention and laser acupuncture sessions, 3 times/week for 4 weeks. All parameters were assessed before and after the interventions. Results: There were statistically significant differences in waist:hip ratio (P = 0.000), QoL scores (P = 0.000), BMI (P = 0.000), and appetite scores (P = 0.000) between the 2 groups after the interventions. There were no differences in levels of blood glucose (P = 0.543), insulin (P = 1.00), HDL (P = 0.208), and triglycerides (P = 0.413) between the 2 groups after the interventions. Conclusions: Combining laser acupuncture and a dietary intervention has good effects on waist:hip ratio, QoL scores, BMI, and appetite scores in obese patients.

Effect of Electroacupuncture on Urea and Creatinine Levels in the Wistar Sepsis Model.

Objective: Sepsis is a life-threatening organ dysfunction caused by dysregulation of a host's response to infections. Sepsis-one of the most common contributing factors to acute kidney injuries in critically ill patients-is caused by bacterial endotoxins that lead to excessive production of proinflammatory cytokines. This condition can be treated with few side-effects by using electroacupuncture (EA) to regulate the neuroendocrine immune system to control the production of these cytokines. A number of studies have proven that EA stimulates the vagus nerve to manage inflammatory responses through the cholinergic pathway, slowing sepsis. This study was conducted to investigate the effect of bilateral EA at ST 36 (Zusanli) on rats' renal function by measuring their levels of plasma urea and creatinine. Materials and Methods: This study was a randomized, double-blinded, laboratory experimental post-test, with both subjects and laboratory investigators blinded. Twenty-eight male Wistar rats were divided randomly into 4 groups of 7 rats each: (1) a control group; (2) a sepsis group; (3) an EA + group; and (4) a sham EA + group. EA and sham EA was applied once for 30 minutes before intraperitoneal administration of live Eschericia coli bacteria ATCC 25922. Six hours after administration of the bacteria the rats' plasma urea and creatinine levels were measured. Results: There was a statistically significant difference in the mean levels of urea (P < 0.001, 95% confidence interval (CI): 57.1-76.6) and creatinine (P = 0.005, 95% CI: 0.14-0.62) between the sepsis and control groups. Conclusions: These findings suggest that EA pretreatment at ST 36 attenuated the induced inflammatory bacteria response and mitigated acute kidney injury.

Electroacupuncture Enhances Number of Mature Oocytes and Fertility Rates for In Vitro Fertilization.

Objective: The increasing prevalence of infertility every year is in line with the increasing need for in vitro fertilization (IVF) programs. Failure of oocyte maturation is an obstacle that often causes low success in IVF. According to several studies, controlled ovarian stimulation (COS) has been reported to increase the risk of granulosa-cell apoptosis associated with inhibition of oocyte maturation. This study was conducted to determine the effect of electroacupuncture (EA) on oocyte maturation; rate of fertilization; granulosa-cell apoptosis; and levels of growth-differentiation factor 9 (GDF9) and bone-morphogenetic protein 15 (BMP15) an IVF program. Materials and Methods: A randomized controlled trial was conducted with 24 subjects who were in the IVF program. Subjects were randomly allocated into verum-EA (n = 12) and sham-EA groups (n = 12). Microscopic assessment of oocyte maturation and rate of fertilization was performed by embryologists, and examinations of granulosa-cell apoptosis index (Bax/Bcl-2 ratio), GDF9, and BMP15 were performed, using real-time quantitative polymerase chain reaction and messenger-RNA techniques. Results: There were significant differences in oocyte maturation (P = 0.02) and fertilization rates (P = 0.03) between the verum-EA and sham-EA groups. There were differences in granulosa-cell apoptosis index between the verum-EA and sham-EA groups (P < 0.001). There were significant differences in Bax-protein expression (P = 0.04) and Bcl-2 (P = 0.03) granulosa cells between the verum-EA and sham-EA groups. There was no significant difference in GDF9 levels (P = 0.34) and BMP15 (p = 0.47) between the verum-EA and sham-EA groups. Conclusions: EA can enhance oocyte maturation and fertilization rate, and reduce the granulosa-cell apoptosis index in an IVF program.