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1.
Medicine (Baltimore) ; 102(1): e32582, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36607887

RESUMO

BACKGROUND: Combined acupuncture-medicine anesthesia (CAMA) is extensively used in thyroid surgery in China. We conducted a systematic review and meta-analysis to assess the efficacy and safety of CAMA. METHODS: We searched the China National Knowledge Infrastructure (CNKI), VIP database, WanFang database, PubMed, EMBASE, and the Cochrane Library for relevant literature. The term of literature was published before April 18, 2020, and there were no restrictions on publication language, region, or publication year. The inclusion criteria included a randomized controlled trial (RCT) of acupuncture combined with cervical plexus anesthesia. We used RevMan5.3 software for data analysis. If the chi-square test showed no significant heterogeneity (P > .10, I2 < 50%), we used the fixed-effect model to calculate risk ratio (RR) and mean difference. Otherwise, the random-effects model was used. RESULTS: Overall, 18 RCTs involving 1211 patients were included in the study. The anesthesia significant rate (ASR) in the transcutaneous electrical acupoint stimulation (TEAS) plus cervical plexus block anesthesia (CPBA) and electroacupuncture (EA) plus CPBA groups was significantly higher compared with the CPBA group (TEAS + CPBA: P < .001; EA + CPBA: P < .001). The pooled effect values of the intraoperative heart rate (HR) and mean arterial pressure (MAP) were significantly lower in both the TEAS + CPBA and EA + CPBA groups relative to the control group (HR: P = .05, P < .001; the MAP: P = .002, P < .001; respectively). Moreover, the postoperative adverse reaction was markedly lower in the experimental group than in the control group (RR = 0.30, P < .001), and there was no heterogeneity between the two groups (P = .71, I2 = 0%). CONCLUSION: Combined acupuncture-medicine anesthesia significantly increases the anesthesia significance rate, reduces the intraoperative heart rate, and blood pressure, and reduces the incidence of postoperative adverse reactions. However, more high-quality future studies should be conducted to validate the efficacy and safety of acupuncture combined anesthesia further.


Assuntos
Analgesia por Acupuntura , Terapia por Acupuntura , Anestesia , Eletroacupuntura , Humanos , Glândula Tireoide , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
Mol Pain ; 18: 17448069221128667, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-36196847

RESUMO

Acupuncture is a complex treatment comprising multisensory stimulation, including visual and tactile sensations and experiences of body ownership. The purpose of this study was to investigate the role of these three components of acupuncture stimulation in acupuncture analgesia. 40 healthy volunteers participated in the study and received acupuncture treatment under three different conditions (real-hand, rubber-hand synchronous, and rubber-hand asynchronous). The tolerance for heat pain stimuli was measured before and after treatment. Brain oscillation changes were also measured using electroencephalography (EEG). The pain tolerance was significantly increased after acupuncture treatment under all three conditions. Noticeable deqi (needle) sensations in response to acupuncture stimulation of the rubber hand were found under both rubber-hand synchronous and rubber-hand asynchronous conditions. Deqi sensations were significantly correlated with acupuncture analgesia only under the rubber-hand synchronous condition. Increased delta and decreased theta, alpha, beta, and gamma waves were observed after acupuncture treatment under all three conditions. Our findings clarified the role of cognitive components of acupuncture treatment in acupuncture analgesia through the rubber-hand illusion. This study is a first step toward separating various components of acupuncture analgesia, i.e. visual, tactile, and body ownership, and utilizing those components to maximize analgesic effects.


Assuntos
Analgesia por Acupuntura , Ilusões , Percepção do Tato , Analgésicos , Eletroencefalografia , Humanos , Ilusões/fisiologia , Motivação , Dor , Tato , Percepção do Tato/fisiologia
3.
Zhen Ci Yan Jiu ; 47(6): 559-64, 2022 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-35764526

RESUMO

The paper reviewed the relevant studies on dyspnea treated with acupuncture over the past 20 years, as well as the underlying neuroendocrine mechanism from the perspective of central and peripheral vagus nerves, neurotransmitter, respiratory muscle function and anti-depression-anxiety function. It revealed that the central response area was regulated by acupuncture in treatment of dyspnea, which is similar to the area affected in acupuncture analgesia. Additionally, acupuncture generates its therapeutic effects on dyspnea through promoting the release of endogenous opioid peptides and the regulation of autonomic nerve, amygdale and hypothalamic-pituitary-adrenal axis.


Assuntos
Analgesia por Acupuntura , Terapia por Acupuntura , Dispneia/terapia , Humanos , Sistema Hipotálamo-Hipofisário , Sistema Hipófise-Suprarrenal
4.
Cells ; 11(5)2022 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-35269483

RESUMO

Mast cells are widely distributed in various parts of the human body and play a vital role in the progression of many diseases. Recently, the close relationship between mast cells and acupoints was elucidated, and the role of mast cells in acupuncture analgesia has attracted the attention of researchers worldwide. Using mast cells, acupuncture analgesia and acupoint as key words to search CNKI, PubMed, Web of Science and other databases, combining the representative articles in these databases with the published research papers of our group, we summarized: The enrichment of mast cells and the dense arrangement of collagen fibers, microvessels, and nerves form the basis for acupoints as the reaction sites of acupuncture; acupuncture can cause the deformation of collagen fibers and activate TRPV channels on mast cells membrane, so as to stimulate mast cells to release bioactive substances and activate nerve receptors to generate analgesic effect; system biology models are set up to explain the quantitative process of information initiation and transmission at acupuncture points, and indicate that the acupuncture effect depends on the local mast cells density. In a conclusion, this review will give a scientific explanation of acupuncture analgesia from the material basis of acupoints, the local initiation, and afferent biological mechanism.


Assuntos
Analgesia por Acupuntura , Terapia por Acupuntura , Pontos de Acupuntura , Colágeno , Humanos , Mastócitos/fisiologia
5.
Zhen Ci Yan Jiu ; 47(3): 268-73, 2022 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-35319846

RESUMO

Relief of the chronic pain, as the negative reinforcement of pain, is recognized as a reward and it activates related brain's reward circultries. Brian's reward circuits not only relate to rewards, but also participate in pain process. Currently, the reward effect of acupuncture on chronic pain relief and the mechanism of brain's reward circuits involved in acupuncture analgeisa have not been revealed adequately yet. This paper reviewed the conceptual features of analgesia reward and the new progression of brain's reward circuits and function, expounded the valuable clinical and scientific significance of the researches for the reward effect of acupuncture analgesia and related brain's reward circuits, proposed the ideas and suggestions on many questions in the study of reward effect of acupuncture analgesia and related brain's reward circuits, and then, determined the multi-dimensional characteristis and positive regulation of acupuncture analgesia. Focusing on the reward effect of acupuncture and related brain's reward circuits for chronic pain relief, the research on the regulatory effect of acupuncture analgesia will be conductive to deepen the understanding of acupuncture analgies in clinical practice and innovate a research concept of acupuncture analgeis. Eventually, a new approach can be provided to further elaborate neurobiolgical mechanism of acupuncture analgesia.


Assuntos
Analgesia por Acupuntura , Dor Crônica , Encéfalo , Dor Crônica/terapia , Humanos , Manejo da Dor , Recompensa
6.
JNCI Cancer Spectr ; 5(6)2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34901744

RESUMO

Background: Almost one-half of aromatase inhibitor (AI)-treated breast cancer patients experience AI-associated musculoskeletal symptoms (AIMSS); 20%-30% discontinue treatment because of severe symptoms. We hypothesized that we could identify predictors of pain reduction in AIMSS intervention trials by combining data from previously conducted trials. Methods: We pooled patient-level data from 3 randomized trials testing interventions (omega-3 fatty acids, acupuncture, and duloxetine) for AIMSS that had similar eligibility criteria and the same patient-reported outcome measures. Only patients with a baseline Brief Pain Inventory average pain score of at least 4 of 10 were included. The primary outcome examined was 2-point reduction in average pain from baseline to week 12. Variable cut-point selection and logistic regression were used. Risk models were built by summing the number of factors statistically significantly associated with pain reduction. Analyses were stratified by study and adjusted for treatment arm. Results: For the 583 analyzed patients, the 4 factors statistically significantly associated with pain reduction were Functional Assessment of Cancer Therapy Functional Well-Being greater than 24 and Physical Well-Being greater than 14 (higher scores reflect better function), and Western Ontario and McMaster Universities Osteoarthritis Index less than 50 and Modified Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands less than 33 (lower scores reflect less pain). Patients with all 4 factors were greater than 6 times more likely to experience at least a 2-point pain reduction (odds ratio = 6.37, 95% confidence interval = 2.31 to 17.53, 2-sided P < .001); similar results were found for secondary 30% and 50% pain reduction endpoints. Conclusions: Patients with AIMSS who have lower symptom and functional distress at study entry on AIMSS intervention trials are more likely to experience meaningful pain reduction. Baseline symptom and functional status should be considered as stratification factors in future interventional trials.


Assuntos
Analgesia por Acupuntura , Analgésicos/uso terapêutico , Inibidores da Aromatase/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Cloridrato de Duloxetina/uso terapêutico , Ácidos Graxos Ômega-3/uso terapêutico , Dor Musculoesquelética/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Dor Musculoesquelética/induzido quimicamente , Manejo da Dor/métodos , Medição da Dor/efeitos dos fármacos , Medidas de Resultados Relatados pelo Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
Int J Mol Sci ; 22(16)2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34445280

RESUMO

Diabetic neuropathy, a major complication of diabetes mellitus, refers to a collection of clinically diverse disorders affecting the nervous system that may present with pain. Although the number of patients suffering from severe neuropathy is increasing, no optimal treatment method has been developed yet. Acupuncture is well known for its ability to reduce various kinds of pain, and a number of studies have also reported its effect on diabetes mellitus; however, its effect and underlying mechanism against diabetic neuropathy are not yet clearly understood. In this review, ten and five studies performed in humans and animals, respectively, were analyzed. All studies reported that acupuncture significantly relieved diabetic neuropathy. ST36, BL13, BL20, SP6, and SP9 were the most widely used acupoints. Five studies used electro-acupuncture, whereas other studies used manual acupuncture. Furthermore, the effect of acupuncture was shown to be mediated through the various molecules present in the peripheral nerves and spinal cord, such as P65, GPR78, and TRPV1. Five studies reported side effects, such as swelling, numbness, and nausea, but none were reported to be serious. Based on these results, we suggest that acupuncture should be considered as a treatment option for diabetic neuropathy.


Assuntos
Analgesia por Acupuntura , Pontos de Acupuntura , Neuropatias Diabéticas , Animais , Neuropatias Diabéticas/fisiopatologia , Neuropatias Diabéticas/terapia , Chaperona BiP do Retículo Endoplasmático , Humanos
10.
Zhen Ci Yan Jiu ; 46(6): 505-9, 2021 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-34190455

RESUMO

Acupuncture is effective for the management and treatment of pain related diseases. At present, the patients'subjective evaluations were often used to measure the effect of acupuncture analgesia in clinical research, but it lacks objectivity and accuracy. In recent years, some studies had tried to analyze the magnetic resonance images of patients' brains using magne-tic resonance imaging and machine learning methods before and after acupuncture intervention, so as to identify specific neural markers. These markers not only helped explain the brain mechanism of acupuncture analgesia, but also provided objective indicators for the analgesic effect of acupuncture. This article analyzes the significance and feasibility of pain biomarkers research based on magnetic resonance imaging and machine learning technology, summarizes its research status in acupuncture analgesia, and makes suggestions in the future study.


Assuntos
Analgesia por Acupuntura , Terapia por Acupuntura , Biomarcadores , Encéfalo/diagnóstico por imagem , Humanos , Aprendizado de Máquina , Imageamento por Ressonância Magnética
11.
J Pain ; 22(12): 1560-1577, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34182104

RESUMO

While mast cells (MCs) are previously well-known as a pathological indicator of pain, their role in alleviating pain is recently emerged in acupuncture research. Thus, this study systematically reviews the role of MC in acupuncture analgesia. Animal studies on MC changes associated with the acupuncture analgesia were searched in PubMed and EMBASE. The MC number, degranulation ratio and pain threshold changes were collected as outcome measures for meta-analyses. Twenty studies were included with 13 suitable for meta-analysis, most with a moderate risk of bias. A significant MC degranulation after acupuncture was indicated in the normal and was significantly higher in the pain model. In the subgroup analysis by acupuncture type, manual (MA) and electrical (EA, each P < .00001) but not sham acupuncture had significant MC degranulation. Meta-regression revealed the linear proportionality between MC degranulation and acupuncture-induced analgesia (P < .001), which was found essential in MA (P < .00001), but not in EA (P = .45). MC mediators, such as adenosine and histamine, are involved in its mechanism. Taken together, skin MC is an essential factor for acupuncture-induced analgesia, which reveals a new aspect of MC as a pain alleviator. However, its molecular mechanism requires further study. PERSPECTIVE: This systematic review synthesizes data from studies that examined the contribution of skin MC in acupuncture analgesia. Current reports suggest a new role for skin MC and its mediators in pain alleviation and explain a peripheral mechanism of acupuncture analgesia, with suggesting the need of further studies to confirm these findings.


Assuntos
Analgesia por Acupuntura , Degranulação Celular/fisiologia , Mastócitos/fisiologia , Fenômenos Fisiológicos da Pele , Pele/citologia , Animais
12.
Acta Neurol Scand ; 144(2): 115-131, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33982803

RESUMO

Among the various non-motor symptoms of Parkinson's disease (PD), pain is often cited as the most common and debilitating feature. Currently, the literature contains gaps in knowledge with respect to the various forms of treatment available, particularly non-pharmacological therapies. Thus, the purpose of this systematic review is to provide an examination of the literature on non-pharmacological therapies for pain in PD. We compared the findings of research articles indexed within various literature databases related to non-pharmacological treatments of pain in PD patients. Our review identified five major non-pharmacological methods of pain therapy in PD: acupuncture, hydrotherapy, massage therapy, neuromodulation, and exercise. Treatments such as exercise therapy found a reduction in pain perception due to various factors, including the analgesic effects of neurotransmitter release during exercise and increased activity leading to a decrease in musculoskeletal rigidity and stiffness. By the same token, hydrotherapy has been shown to reduce pain perception within PD patients, with authors often citing a combined treatment of exercise and hydrotherapy as an effective treatment for pain management. Multiple methods of neurostimulation were also observed, including deep brain stimulation and spinal cord stimulation. Deep brain stimulation showed efficacy in alleviating certain pain types (dystonic and central), while not others (musculoskeletal). Hence, patients may consider deep brain stimulation as an additive procedure for their current treatment protocol. On the other hand, spinal cord stimulation showed significant improvement in reducing VAS scores for pain. Finally, although the literature on massage therapy and acupuncture effectiveness on pain management is limited, both have demonstrated a reduction in pain perception, with common reasons such as tactile stimulation and release of anti-nociceptive molecules in the body. Although literature pertaining to non-pharmacological treatments of pain in PD is sparse, there is copious support for these treatments as beneficial to pain management. Further exploration in the form of clinical trials is warranted to assess the efficacy of such therapies.


Assuntos
Manejo da Dor/métodos , Dor/etiologia , Doença de Parkinson/complicações , Analgesia por Acupuntura/métodos , Terapia por Exercício/métodos , Humanos , Hidroterapia/métodos , Massagem/métodos , Estimulação Elétrica Nervosa Transcutânea/métodos
13.
Odontol. Clín.-Cient ; 20(3): 36-40, jul.-set. 2021. ilus, tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1372314

RESUMO

Disfunção Temporomandibular (DTM) apresenta-se como principal causa de dores orofaciais de origem não dentária. A acupuntura é indicada para o alívio de da dor em casos de DTM muscular, baseada em propriedades anti-inflamatórias com efeitos neuro-hormonais. Objetivou-se nesta pesquisa a avaliação da eficácia da acupuntura como um método válido para redução imediata da sintomatologia dolorosa e limitação de abertura bucal nos casos de DTM. Realizou-se terapia acupuntural em 30 pacientes com DTM, avaliando-se a dor, a partir da Escala Verbal (EV) e da Escala Analógica Visual (EAV) e a limitação de abertura bucal com o auxílio de paquímetro digital antes e após a terapia para registro da análise. O aumento da média de abertura bucal foi de 9,2% no total de participantes. Quanto à sintomatologia dolorosa, apresentou redução média em 63%. Na EV, 27 dos pacientes tiveram resposta "moderada" e "intensa" para sensação dolorosa. Contudo, após a terapia, observou-se ausência de sensação dolorosa intensa. Os dados apontaram significância da terapia acupuntural para redução dor e limitação de abertura bucal, de forma imediata, em pacientes com DTM... (AU)


Temporomandibular Disorder (TMD) is the main cause of orofacial pain of non-dental origin. Acupuncture is indicated for pain relief in cases of muscle TMD, based on anti-inflammatory properties with neuro hormonal effects. The aim of this research was to evaluate the effectiveness of the acupuncture as a valid method for immediate reduction of painful symptoms and mouth opening limitation in TMD cases. Acupuncture therapy was performed in 30 patients with TMD, evaluating pain from the Verbal Scale (VE) and Visual Analog Scale (VAS) and mouth opening limitation with the aid of a digital caliper before and after therapy to record the analysis. The increase in the average mouth opening was 9.2% in the total number of participants. As for painful symptoms, an average reduction of 63%. In IV, 27 of the patients had "moderate" and "intense" responses to painful sensation. However, after therapy, the absence of intense painful sensation was observed. The data showed the significance of acupuncture therapy for immediate pain reduction and mouth opening limitation in patients with TMD... (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Dor Facial , Transtornos da Articulação Temporomandibular , Síndrome da Disfunção da Articulação Temporomandibular , Analgesia por Acupuntura , Terapia por Acupuntura , Acupuntura , Medicina Tradicional Chinesa , Boca , Músculos
14.
Open Vet J ; 11(1): 52-60, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33898284

RESUMO

Background: The objective of the study to evaluate the effect of electroacupuncture during laparotomy in goats. Aim: To study the abdominal anesthesia in goats by electroacupuncture using the physiological variables, vital parameters, hematological, biochemical, cortisol hormone, pain threshold, and wound healing for laparotomy in goats. Methods: Fifteen healthy adult bucks were used to receive electroacupuncture in 10 newly selected acupoints. The data (M ± SD) were assessed at intervals (0 minutes) before induction (control group), (5 minutes), (10 minutes), (15 minutes), and (20 minutes) during induction, (30 minutes), (45 minutes), and (60 minutes) throughout surgery and (24 hours) after surgery, cortisol levels in serum at (0), (24 hours), and (72 hours) throughout laparotomy. Results: The goats of the study showed improvement in the rates of eyelid closure, head, and neck relaxation, rumen motility, and tympany which were graded into mild (+), moderate (++), and severe (+++) degrees. The respiratory rates, body temperatures, and capillary fill times were not significantly different. The total mean of hematocrit was (19.9 ± 2.68), the total mean of hemoglobin was (9.9 ± 0.94), the total mean of red blood cells was (7.9 ± 0.8), the total mean of platelets was (244,861.3 ± 138,444.8) and the total mean of SPO2 was (70.5 ± 4.6). ALT and AST showed no significance. The significant mean cortisol level was (2.6 ± 2.01) and the significant mean pain threshold level was (0.02 ± 0.03). The results proved that electroacupuncture had a lot of significant parameters. The wound healing was improved by early epithelization and immature granulation tissue (at 7 days). Thick keratinized epithelization and collagen deposition in the dermal tissue with enhanced angiogenesis (at 14 days). Mild restoration of skin and the dermal tissue was well-organized (at 21 days). Besides, well-formed scar tissue covering a highly cellular organized dermal tissue (at 28 days). Conclusions: Electroacupuncture had been considered a powerful anesthetic for abdominal surgery in goats. Moreover, wound healing proved excellent and better healing.


Assuntos
Analgesia por Acupuntura/veterinária , Eletroacupuntura/veterinária , Cabras/cirurgia , Laparotomia/veterinária , Analgesia por Acupuntura/efeitos adversos , Animais , Eletroacupuntura/efeitos adversos , Hidrocortisona/sangue , Laparotomia/efeitos adversos , Masculino , Limiar da Dor , Sinais Vitais/fisiologia , Cicatrização
15.
Acupunct Med ; 39(6): 673-680, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33706560

RESUMO

BACKGROUND: Inflammatory pain is the most common type of pain encountered clinically. The analgesic effect of acupuncture has been well-documented. OBJECTIVE: The aim of this study was to investigate the involvement of chemokine CXCL1 in the serum on manual acupuncture (MA)-induced antinociception. METHODS: Rats with inflammatory pain of the right hind paw were induced by intraplantar (i.pl.) administration of complete Freund's adjuvant (CFA). After wards, the CFA-injected rats were treated daily with MA at ST36 from Day 1 to Day 7, and thermal nociceptive thresholds (paw withdrawal latency; PWL) were analyzed. The concentration of CXCL1 in the serum of the rats was measured by enzyme-linked immunosorbent assay (ELISA) after the first and the last MA treatment. Subsequently, the rats were injected with two doses (5 or 10 µg) of recombinant CXCL1 through the tail vein daily from Day 1 to Day 7 or injected with two doses (6.4 or 16 µg) of anti-CXCL1 antibody using the same methods and course at 30 min before MA, and the PWLs were measured again. Finally, naloxone (500 µg, 0.1 mL) was administered by i.pl. injection into the inflamed paw 5 min before the last MA treatment or last injection of recombinant CXCL1. RESULTS: MA significantly increased the PWLs and upregulated the expression of serum CXCL1 in the CFA-injected rats. Without acupuncture, repeated tail vein injection of recombinant CXCL1 showed an analgesic effect on CFA-induced inflammatory pain. Conversely, the neutralization of serum CXCL1 by anti-CXCL1 antibody decreased MA-induced antinociception in a time-dependent manner. Anti-CXCL1 antibody injected just once before the first MA did not affect MA-induced antinociception. The analgesic effects of MA and recombinant CXCL1 were reversed by an i.pl. injection of naloxone. CONCLUSION: This study indicates MA at ST36 had an analgesic effect on inflammatory pain and found a novel function of CXCL1. Increased serum CXCL1 had an antinociceptive effect on inflammatory pain induced by CFA. CXCL1 in serum appeared to be a key molecule involved in the peripheral mechanism of MA-induced antinociception. The analgesic effect of MA or recombinant CXCL1 on inflammatory pain might be mediated through a peripheral opioid pathway, which needs further investigation.


Assuntos
Pontos de Acupuntura , Terapia por Acupuntura , Quimiocina CXCL1/sangue , Inflamação/terapia , Analgesia por Acupuntura , Animais , Humanos , Inflamação/sangue , Masculino , Medição da Dor , Ratos , Ratos Wistar
16.
Zhen Ci Yan Jiu ; 46(2): 168-71, 2021 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-33788440

RESUMO

This article reviews the clinical studies on the application of acupuncture anesthesia in thyroid surgery over the past 5 years. Starting from the principle of acupuncture anesthesia, the authors explore the application of acupuncture anesthesia in thyroid surgery, its advantages and development. The summarized findings showed that acupuncture anesthesia has a better analgesic effect in thyroid surgery, which can reduce the occurrence of stress reactions, adverse reactions and complications, and is conducive to postoperative recovery. However, there is a lack of standardized operations. In the future, standardized operations can make acupuncture anesthesia more widely used and popularized.


Assuntos
Analgesia por Acupuntura , Glândula Tireoide
17.
Am J Chin Med ; 49(3): 645-659, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33641652

RESUMO

Acupuncture is a therapeutic treatment that is well recognized in many countries. However, the initiation mechanisms of acupuncture are not well understood. Purinergic signaling has been considered a key signaling pathway in acupuncture in recent years. Acupuncture-induced ATP is mainly produced by mast cells and fibroblasts, and ATP is gradually hydrolyzed into adenosine. ATP and adenosine further participate in the process of acupuncture information transmission to the nervous and immune systems through specific purine receptors. Acupuncture initiates analgesia via the down-regulation of the expression of P2 receptors or up-regulation of the expression of adenosine A1 receptors on nerve fibers. ATP also promotes the proliferation of immune cells through P2 receptors and A3 receptors, causing inflammation. In contrast, adenosine activates A2 receptors, promotes the production and infiltration of immunosuppressive cells, and causes an anti-inflammatory response. In summary, we described the role of purinergic signaling as a general signaling pathway in the initiation of acupuncture and the influence of purinergic signaling on the neuroimmune network to lay the foundation for future systematic research on the mechanisms of acupuncture therapeutics.


Assuntos
Terapia por Acupuntura , Purinas/metabolismo , Transdução de Sinais/genética , Transdução de Sinais/fisiologia , Analgesia por Acupuntura , Adenosina/metabolismo , Trifosfato de Adenosina/metabolismo , Regulação para Baixo , Fibroblastos/metabolismo , Expressão Gênica , Humanos , Hidrólise , Mastócitos/metabolismo , Neuroimunomodulação , Receptor A1 de Adenosina/genética , Receptor A1 de Adenosina/metabolismo , Receptores Purinérgicos/metabolismo , Receptores Purinérgicos P2/genética , Receptores Purinérgicos P2/metabolismo , Regulação para Cima
18.
Neural Plast ; 2021: 8881557, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33531894

RESUMO

Although pain is regarded as a global public health priority, analgesic therapy remains a significant challenge. Pain is a hypersensitivity state caused by peripheral and central sensitization, with the latter considered the culprit for chronic pain. This study summarizes the pathogenesis of central sensitization from the perspective of neuroglial crosstalk and synaptic plasticity and underlines the related analgesic mechanisms of acupuncture. Central sensitization is modulated by the neurotransmitters and neuropeptides involved in the ascending excitatory pathway and the descending pain modulatory system. Acupuncture analgesia is associated with downregulating glutamate in the ascending excitatory pathway and upregulating opioids, 𝛾-aminobutyric acid, norepinephrine, and 5-hydroxytryptamine in the descending pain modulatory system. Furthermore, it is increasingly appreciated that neurotransmitters, cytokines, and chemokines are implicated in neuroglial crosstalk and associated plasticity, thus contributing to central sensitization. Acupuncture produces its analgesic action by inhibiting cytokines, such as interleukin-1ß, interleukin-6, and tumor necrosis factor-α, and upregulating interleukin-10, as well as modulating chemokines and their receptors such as CX3CL1/CX3CR1, CXCL12/CXCR4, CCL2/CCR2, and CXCL1/CXCR2. These factors are regulated by acupuncture through the activation of multiple signaling pathways, including mitogen-activated protein kinase signaling (e.g., the p38, extracellular signal-regulated kinases, and c-Jun-N-terminal kinase pathways), which contribute to the activation of nociceptive neurons. However, the responses of chemokines to acupuncture vary among the types of pain models, acupuncture methods, and stimulation parameters. Thus, the exact mechanisms require future clarification. Taken together, inhibition of central sensitization modulated by neuroglial plasticity is central in acupuncture analgesia, providing a novel insight for the clinical application of acupuncture analgesia.


Assuntos
Analgesia por Acupuntura/métodos , Neuroglia/metabolismo , Plasticidade Neuronal/fisiologia , Manejo da Dor/métodos , Dor/metabolismo , Analgesia por Acupuntura/tendências , Animais , Citocinas/imunologia , Citocinas/metabolismo , Humanos , Neuroglia/imunologia , Dor/imunologia
19.
Fisioterapia (Madr., Ed. impr.) ; 43(1): 5-11, ene.-feb. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-202433

RESUMO

La dismenorrea es el conjunto de síntomas que se pueden padecer durante la menstruación, siendo el más característico un dolor intenso. El síndrome de dolor miofascial es el conjunto de signos y síntomas que producen los puntos gatillo miofasciales (PGM) tanto en su localización como a distancia, entre otros el dolor. Por lo tanto, el objetivo del estudio es estudiar la eficacia del tratamiento fisioterápico de los PGM en musculatura abdominal, aductora y del suelo pélvico para con la afectación de las variables de dolor, función sexual, calidad de vida, fuerza y movimiento en pacientes con dismenorrea. MATERIAL Y MÉTODOS: Estudio piloto aleatorizado. Se dividió a las participantes entre un grupo A (n = 6) donde se aplicó punción seca y terapia manual en musculatura abdominal, aductora de la cadera y suelo pélvico y grupo B (n = 7) donde se aplicó termoterapia y estiramientos en la misma musculatura. Las variables estudiadas fueron: dolor menstrual, función sexual, calidad de vida, rango de abducción de cadera, fuerza muscular, resistencia del suelo pélvico y existencia de puntos gatillo miofasciales. Una fisioterapeuta realizó los tratamientos y otra las valoraciones, estando cegada la segunda. RESULTADOS: el grupo A obtuvo una diferencia clínica (1,6 puntos menos en EVA) y estadísticamente significativa del dolor (p = 0,018), frente al otro grupo (0,4 puntos, p > 0,05), así como una mejora en la calidad de vida (p < 0,05) del grupo A. No se hallaron cambios significativos en el resto de las variables. CONCLUSIÓN: existe un alivio significativo del dolor y mejora de la calidad de vida del grupo A. Se considera así que el tratamiento específico del síndrome de dolor miofascial puede presentar mayor eficacia clínica. Se concluye la necesidad de continuar esta investigación con una mayor muestra de participantes, con el fin de esclarecer la eficacia del tratamiento de fisioterapia para el resto de las variables estudiadas


The term dysmenorrhoea defines different symptoms that women can feel during menstruation, the most common being intense pain. Myofascial pain syndrome (MPS) is the combination of signs and symptoms caused by myofascial trigger points (MTP), at their site or at a distance. Therefore, the objective of this study is to evaluate the efficacy of a treatment for MTP in the abdominal, hip adductor and pelvic floor muscles, from a physiotherapeutic approach, regarding the following outcome measures: pain, sexual function, quality of life, strength and mobility in patients suffering from dysmenorrhoea. MATERIALS AND METHODS: Randomized pilot study. Participants were divided into two groups: A (n = 6), where dry needling and manual therapy was applied to the abdominal, hip adductor and pelvic floor muscles; and B (n = 7), where the participants received thermotherapy and stretching of these muscles. The outcome measures studied were menstrual pain, sexual function, quality of life, hip abduction range of motion, strength of the affected muscles, pelvic floor muscle endurance and finding myofascial trigger points. All the treatments were provided by the same physiotherapist, while a different physiotherapist carried out the evaluations blinded to each patient's group. RESULTS: in group A, a clinically (1.6 less in VAS) and statistically significant reduction (p = 0.018) in pain was observed in comparison with group B (.4 in VAS, p > 0.05). Quality of life also improved in the first group (p< 0.05). No further significant differences were found in the remaining outcome measures. CONCLUSIONS: a significant improvement was observed with regards to pain and quality of life in group A. Thus, we consider that specific treatment for MPS could be more clinically effective. We conclude that this research should be continued with a larger sample of participants, in order to clarify the efficacy of the physiotherapy treatment suggested for the remaining outcome measures


Assuntos
Humanos , Feminino , Adulto , Dismenorreia/terapia , Síndromes da Dor Miofascial/terapia , Pontos-Gatilho , Modalidades de Fisioterapia , Dismenorreia/epidemiologia , Síndromes da Dor Miofascial/epidemiologia , Analgesia por Acupuntura/métodos , Exercícios de Alongamento Muscular/métodos , Hipertermia Induzida/métodos
20.
Pflugers Arch ; 473(4): 573-593, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33474636

RESUMO

The present study aims to describe state-of-the-art of preclinical studies that have investigated peripheral receptors and neuromediators involved in the antihyperalgesic effects of acupuncture. The PubMed, Scopus, and Web of Science databases were searched using the integrative review method. Preclinical articles that involved the study of peripheral receptors and neuromediators on the pain control effects of acupuncture in rats or mice were selected using a predefined search strategy. From this search, 456 articles were found, and 29 of them met the inclusion criteria of the study. The selected articles addressed the following peripheral receptors: opioid (n = 9), adenosine (n = 5), cannabinoid (n = 5), transient receptor potential vanilloid (TRPV) (n = 3), histamine (n = 2), adrenergic (n = 1), muscarinic (n = 1), corticotrophin-releasing factor (CRF) (n = 2), IL-1 (n = 1), and endothelin (n = 1) receptors. The peripheral neuromediators correlated with the peripheral pain control effect were as follows: opioid peptides (n = 4), adenosine (n = 3), histamine (n = 1), substance P (n = 1) calcitonin gene-related peptide (CGRP) (n = 1), anandamide (n = 1), nitric oxide (n = 1), and norepinephrine (n = 1). This review summarizes the methods used to investigate the peripheral effects of acupuncture and discusses the main findings on each family of receptors and neuromediators. Ten families of peripheral receptors and 8 types of neuromediators were correlated with the antihyperalgesic effects of acupuncture in preclinical studies. Considering the benefits of a better understanding of the role of peripheral receptors and neuromediators in the context pain management, the findings of the present study highlight the importance of deepening the exploration of the peripheral mechanisms of acupuncture.


Assuntos
Analgesia por Acupuntura/métodos , Neurotransmissores/metabolismo , Receptores de Neurotransmissores/metabolismo , Analgesia por Acupuntura/efeitos adversos , Animais , Humanos , Nociceptividade , Receptores Acoplados a Proteínas G/metabolismo
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