In light of Huangdi Neijing (The Yellow Emperor's Inner Classic), compiled in the name of Qibo, the founder of Chinese medicine, the theory of "relationship between meridians and zangfu" within meridian-collateral system has been systematically refined. Under the guidance of this theory, acupuncture-moxibustion therapy has made an indelible contribution to safeguarding health of the Chinese nation throughout its long historical development. Notably, during nearly the same historical period, Galenus, a representative figure in ancient Greek and Roman medicine, proposed a theory of surface-viscus connection known as "homoeomeria". Although stemming from distinct Eastern and Western cultural and philosophical frameworks, both theories collectively reveal a natural correlation between specific "regions" on the human body surface and their corresponding internal "target organs", and regard these "regional domains" as the key "therapeutic sites" for treating the corresponding diseases. This consensus that transcends cultural and geographical boundaries not only reflects the profound exploration of holistic view of life in ancient medicine, but also demonstrates the collective wisdom of humanity in elucidating patterns between the body and diseases. Furthermore, it provides invaluable historical origins and theoretical foundations for subsequent research in related fields.
Objective:To compare the difference of autonomic responses to transcutaneous auricular vagus nerve stimulation (taVNS) between high-altitude and low-altitude populations, explore the characteristics of neural response under the background of high altitude hypoxia. Methods:A total of 30 border guards stationed in high altitude areas for an extended period were included as the high altitude group. At the same time, 30 healthy subjects were recruited in Beijing as the low altitude group. In both groups, taVNS was applied bilaterally to the auricular branches of the vagus nerve distribution areas (auricular points corresponding to shen[CO10] and xin[CO15]). Using a multimodal wristband, photoplethysmography (PPG) signals were collected during the baseline period, stimulation period, and recovery period. Heart rate (HR) and time-domain and frequency-domain indexes of heart rate variability (HRV) were compared between the two groups. The time-domain indexes included the standard deviation of normal-to-normal intervals (SDNN), the root mean square of successive differences (RMSSD), and the percentage of adjacent normal RR intervals differing by more than 50 ms (pNN50). The frequency-domain indexes included low-frequency power (LF), high-frequency power (HF), and low-frequency/high- frequency (LF/HF). Results:In the high altitude group, HR during the stimulation period was lower than that during the baseline period (P<0.05), and RMSSD was lower than that during the recovery period (P<0.05). In the low altitude group, all indexes showed no statistically significant differences among the baseline, stimulation, and recovery periods (P>0.05). The high altitude group exhibited higher HR, SDNN, RMSSD, pNN50, LF, and HF across all three periods compared to the low altitude group (P<0.05), and lower LF/HF compared to the low altitude group (P<0.05). Conclusion:Under taVNS intervention, the vagal responses in high-altitude populations exhibit a characteristic pattern of delayed activation. This finding suggests that taVNS interventions for high-altitude populations should appropriately extend post-stimulation observation time and optimize stimulation patterns.
Objective:To observe the clinical therapeutic effect of electroacupuncture (EA) on chronic pain in patients with knee osteoarthritis (KOA) and to investigate its influence on serum biomarkers related to central sensitization. Methods:Ninety patients with chronic pain caused by KOA were randomly assigned to an EA group (45 cases, 3 cases dropped out) and a sham-EA group (45 cases, 5 cases dropped out and 1 case was eliminated). The patients in both groups received health education. Additionally, in the EA group, EA was performed at the acupoints such as Neixiyan (EX-LE4), Dubi (ST35), Heding (EX-LE2) and Xuehai (SP10) on the affected side, with dense-disperse wave, at the frequency of 2 Hz/100 Hz and the electric current of 1 mA to 2 mA, it was operated for 30 min in each session, once daily, 6 sessions a week, and for 4 consecutive weeks. In the sham-EA group, sham-EA was operated at the same acupoints as the EA group, with the same duration of interventions, but without electric stimulation exerted. In the baseline (week 0), and week 2, 4, 8 and 16, the score on numerical rating scale (NRS) for pain at rest and during activity, as well as pressure pain thresholds (PPTs) at the local and distal of knee joint were observed in the two groups separately. In week 0, 4, and 16, the Western Ontario and McMaster universities osteoarthritis index (WOMAC) and the 12-item short form health survey (SF-12) were scored. In week 0 and 4, the score on central sensitization inventory (CSI) and the levels of serum biomarkers related to central sensitization, such as glutamate (Glu), glutamine (Gln), substance P (SP), and calcitonin gene-related peptide (CGRP) were observed in the two groups. Results:Compared with the baseline, the EA group showed the decrease in NRS scores at rest and during activity in week 2, 4, 8, and 16, in the scores on subscales and the total score of WOMAC in week 4 and 16, as well as in CSI score and serum levels of Glu, Gln, SP, and CGRP in week 4 (P<0.05); and presented higher PPTs at the local and distal knee joint in week 2, 4, 8 and 16 and the scores on physical and mental health of SF-12 in weeks 4 and 16 (P<0.05). The sham-EA group presented the reduced resting-related NRS scores in week 2, 4, and 8, the activity-related NRS score in week 4, the scores on pain and function subscales and the total score of WOMAC in week 4 and 16, and serum CGRP level in week 4 when compared with the baseline, separately (P<0.05); and PPTs at the center of knee point in week 2 and 4 and the lateral side in week 4 increased (P<0.05). After treatment and at each time point of follow-up visit, NRS scores at rest and during activity, the scores on each subscale and the total score of WOMAC, the score of CSI and serum levels of Glu, Gln, SP, and CGRP in the EA group were lower than those in the sham-EA group (P<0.05); PPTs at each site (except at the lateral side of knee point in week 2 and the deltoid point in week 16) and the scores of SF-12 (except mental health score of SF-12 in week 16) were higher in the EA group when compared with the sham-EA group (P<0.05). Change scores of NRS at rest and during activity were positively correlated with those of CSI in the EA group (P<0.05). Conclusion:Electroacupuncture effectively alleviates chronic pain of KOA, improves joint function and quality of life, which may be achieved through the inhibition of central sensitization.
Objective:To compare the clinical efficacy between herbal cake-separated governor vessel moxibustion combined with conventional medication and conventional medication alone in treating asthenozoospermia infertility of kidney yang deficiency. Methods:A total of 126 patients with asthenozoospermia infertility of kidney yang deficiency were randomized into a herbal cake-separated governor vessel moxibustion group (moxibustion group, 63 cases, 3 cases dropped out) and a medication group (63 cases, 2 cases dropped out, 2 cases were eliminated). The medication group was treated with levocarnitine oral solution and Yougui capsules orally. On the basis of the treatment in the medication group, herbal cake-separated governor vessel moxibustion was applied in the moxibustion group, once every 6 days. Both groups were treated for 90 days. Before and after treatment, the sperm progressive mobility (PR), sperm progressive and non-progressive mobility (PR+NP), sperm deoxyribonucleic acid (DNA) fragmentation index (DFI), seminal plasma levels of malondialdehyde (MDA) and superoxide dismutase (SOD), and TCM syndrome score were observed; the natural pregnancy rate of spouses was recorded during treatment and follow-up of 6 weeks after treatment completion; and the clinical efficacy was evaluated after treatment in the two groups. Results:After treatment, the sperm PR and PR+NP, and seminal plasma SOD levels were increased compared with those before treatment (P<0.05), while the sperm DFI, seminal plasma MDA levels, and TCM syndrome scores were decreased compared with those before treatment (P<0.05) in the two groups. After treatment, the sperm PR and PR+NP, and seminal plasma SOD level in the moxibustion group were higher than those in the medication group (P<0.05), the sperm DFI, seminal plasma MDA level, and TCM syndrome score were lower than those in the medication group (P<0.05). During the treatment and follow-up periods, there were no statistically significant differences in the natural pregnancy rates of spouses in the two groups (P>0.05). The total effective rate in the moxibustion group was 75.0% (45/60), which was higher than 47.5% (28/59) in the medication group (P<0.05). Conclusion:On the basis of conventional medication treatment, herbal cake-separated governor vessel moxibustion can improve the sperm motility, sperm DFI, and seminal plasma SOD and MDA levels, and alleviate TCM clinical symptoms in patients with asthenospermia infertility of kidney yang deficiency. Its clinical efficacy is superior to that of medication treatment alone.
Objective:To observe the clinical efficacy of Tongyuan acupuncture in treatment of postherpetic neuralgia (PHN). Methods:A total of 106 patients with PHN were randomly divided into a Tongyuan electroacupuncture group (53 cases, 3 cases dropped out) and a conventional electroacupuncture group (53 cases, 4 cases dropped out, 2 cases were eliminated). In the Tongyuan electroacupuncture group, Baihui (GV20), Yintang (GV24+), Shuigou (GV26), Qihai (CV6), Guanyuan (CV4), ashi points and bilateral Xinshu (BL15), Geshu (BL17), Ganshu (BL18), Pishu (BL20), Tianshu (ST25) were selected, and 5 to 6 pairs of acupoints were selected to connect the electroacupuncture therapeutic apparatus; in the conventional electroacupuncture group, ashi points and Jiaji points (EX-B2) of the relevant ganglion segments in the affected area were selected, and Jiaji points (EX-B2) and ashi points were connected to the electroacupuncture therapeutic apparatus. In both groups, dense-disperse waves were selected at a frequency of 2 Hz/100 Hz and a current of 2 mA. The needles were retained for 30 min per session, once daily. Five sessions constituted one treatment course, with a 2-day interval between courses. A total of four treatment courses were administered. The simplified McGill pain questionnaire (SF-MPQ) score (including the pain rating index [PRI] score, visual analogue scale [VAS] score, and present pain intensity [PPI] score) of both groups were observed before treatment, after 2 weeks of treatment, and after 4 weeks of treatment. The Pittsburgh sleep quality index (PSQI) score, Hamilton anxiety scale (HAMA) score, and Hamilton depression scale (HAMD) score of both groups were observed before treatment and after 4 weeks of treatment. Clinical efficacy was evaluated after treatment, and pain recurrence was followed up at 3 months after treatment completion. Results:Compared with before treatment, the sub-scores and total scores of the SF-MPQ in both groups decreased after 2 and 4 weeks of treatment (P<0.05), and the scores after 4 weeks of treatment were lower than those after 2 weeks of treatment (P<0.05). After 2 weeks of treatment, the scores of VAS and PPI, and the total score of SF-MPQ in the Tongyuan electroacupuncture group were lower than those in the conventional electroacupuncture group (P<0.05). After 4 weeks of treatment, all sub-scores and total score of the SF-MPQ in the Tongyuan electroacupuncture group were lower than those in the conventional electroacupuncture group (P<0.05). After treatment, the PSQI, HAMA, and HAMD scores in both groups were lower than those before treatment (P<0.05); the PSQI, HAMA, and HAMD scores in the Tongyuan electroacupuncture group were lower than those in the conventional electroacupuncture group (P<0.05). The total effective rate and marked effective rate in the Tongyuan electroacupuncture group were 90.0% (45/50) and 72.0% (36/50), respectively, both higher than those in the conventional electroacupuncture group (74.5% [35/47] and 44.7% [21/47], P<0.05). During follow-up, the pain recurrence rate in the Tongyuan electroacupuncture group was 2.2% (1/45), which was lower than that in the conventional electroacupuncture group (17.1% [6/35], P<0.05). Conclusion:Tongyuan acupuncture can alleviate pain, improve sleep disturbances, and ameliorate emotional comorbidities in patients with PHN, and its short-term and long-term efficacy is superior to that of conventional electroacupuncture.
Objective:To observe the clinical efficacy of ultrasound-guided acupotomy release combined with Tongdu Tiaoshen acupuncture in the treatment of post-stroke talipes varus. Methods:Eighty-four patients with post-stroke talipes varus were randomly divided into a combination group (42 cases, 1 case dropped out) and an acupuncture group (42 cases, 1 case dropped out and 1 case was discontinued). The acupuncture group received Tongdu Tiaoshen acupuncture treatment. On the basis of the acupuncture group, the combination group additionally received ultrasound-guided acupotomy release treatment. The release sites included the tibialis anterior muscle, tibialis posterior muscle, gastrocnemius muscle, achilles tendon, deltoid ligament, calcaneofibular ligament, and anterior talofibular ligament on the affected side. Acupuncture treatment was administered once daily, 5 times per week, and ultrasound-guided acupotomy treatment was administered once weekly. Both groups were treated continuously for 4 weeks. Before and after treatment, the Fugl-Meyer assessment (FMA) score, talipes varus angle, modified Ashworth scale (MAS) grade, Berg balance scale (BBS) score, modified Barthel index (MBI) score, and gait parameters (walking speed and cadence) were observed in both groups. Clinical efficacy was evaluated after treatment. Results:After treatment, FMA scores, BBS scores, and MBI scores were increased compared with those before treatment in both groups (P<0.05), and all three scores in the combination group were higher than those in the acupuncture group (P<0.05). After treatment, the talipes varus angle was decreased compared with that before treatment in both groups (P<0.05), and the talipes varus angle in the combination group was lower than that in the acupuncture group (P<0.05). After treatment, MAS grades were improved compared with those before treatment in both groups (P<0.05), and the improvement in the combination group was superior to that in the acupuncture group (P<0.05). After treatment, walking speed and cadence were increased compared with those before treatment in both groups (P<0.05), and walking speed and cadence in the combination group were faster than those in the acupuncture group (P<0.05). The total effective rate in the combination group was 85.4% (35/41), higher than 75.0% (30/40) in the acupuncture group (P<0.05). Conclusion:Ultrasound-guided acupotomy release combined with Tongdu Tiaoshen acupuncture could reduce the talipes varus angle in patients with post-stroke talipes varus, improve lower limb motor function, and enhance activities of daily living.
Objective:To observe the clinical efficacy and safety of lying needling from Nanjing (Classic of Difficult Issues) in treating malar melasma. Methods:A total of 78 patients with malar melasma were randomized into a lying needling group (39 cases, 1 case dropped out) and a sham acupuncture group (39 cases, 1 case was eliminated). Routine care was adopted in both groups. In the lying needling group, lying needling from Nanjing was applied, the malar melasma area and bilateral Erjian (LI2), Neiting (ST44), Qiangu (SI2), etc. were selected. In the sham acupuncture group, sham acupuncture with blunt-tip needle was applied at the same acupoints. Both groups were treated once daily, 3 times a week for 3 weeks. The scores of melasma area and severity index (MASI), dermatology life quality index (DLQI), skin lesion symptom, and infrared temperature of the melasma area were observed before and after treatment; the clinical efficacy and safety were evaluated after treatment in both groups. Results:After treatment, the MASI and skin lesion symptom scores were decreased compared with those before treatment (P<0.001), and the infrared temperature of the melasma area was increased compared with that before treatment in the lying needling group (P<0.001); the DLQI scores were decreased compared with those before treatment in both groups (P<0.01, P<0.05). The differences in the MASI score, skin lesion symptom score, and infrared temperature of the melasma area before and after treatment in the lying needling group were greater than those in the sham acupuncture group (P<0.001). The total effective rate was 89.5% (34/38) in the lying needling group, which was higher than 31.6% (12/38) in the sham acupuncture group (P<0.05). No adverse events occurred in the two groups. Conclusion:Lying needling from Nanjing can effectively treat malar melasma, improve patients' clinical symptoms and quality of life, with good safety.
Through literature tracing and theoretical analysis, this paper explores the connotation of the important proposition, "better to lose the acupoint than to lose the meridian", and reflects on its significance for clinical guidance, theoretical construction, and examination of acupuncture. First, the paper traces the origin of this proposition and elucidates its original intent of the theory, "interconnection between qi and meridian". Secondly, the paper explores the foundation of this concept formulation and content deepening. From the classical principles of "needling based on meridian" and "pressing the region where the affected meridian runs to adjust" in Huangdi Neijing (The Yellow Emperor's Inner Classic), it gradually evolved into the core epistemological concept of "therapeutic scope of meridians" based on "where meridians pass, where diseases manifest". Based on this, the diagnostic and therapeutic approaches as well as practical value of "therapeutic scope of meridians" were systematically reviewed from two perspectives, "treatment according to meridian running" and "selecting the affected meridian directly". This study examines the dilemma of the weakened status of the principle "not to lose the meridian", in the application of meridian theory, and explores the key scientific questions of acupuncture and moxibustion such as "the continuity and the holisticity of meridian essences".
Objective:To observe the effects of ear holographic scraping therapy combined with repetitive transcranial magnetic stimulation (rTMS) on postoperative delirium and cognitive function in elderly patients undergoing hip fracture surgery. Methods:A total of 138 patients of qi deficiency and blood stagnation undergoing hip fracture surgery were randomly divided into a combined treatment group (46 cases, 1 case dropped out), an rTMS group (46 cases, 1 case dropped out) and a conventional treatment group (46 cases, 2 cases dropped out). The routine measure for delirium prevention was adopted in the conventional treatment group. On the basis of the intervention as the conventional treatment group, the rTMS at 10 Hz was delivered in the rTMS group. In the combined treatment group, the ear holographic scraping therapy was supplemented besides the intervention as the rTMS group. The auricular points included shenmen (TF4), pizhixia (AT4), gan (CO12) and Shen (CO10). The intervention was applied to the auricular points on one side, once daily, then alternated to the other side on the following day. In both the rTMS group and the combined treatment group, the interventions were given on the day before surgery, on the day of surgery, and daily after surgery, for a total of 9 days. The scores of the confusion assessment method (CAM) and the visual analogue scale (VAS) of pain were recorded on the day before surgery and on days 1, 4, and 7 postoperatively in each group. The incidence of postoperative delirium (POD) within 7 days after surgery was calculated, and the scores of delirium rating scale-revised-98 (DRS-R-98) on the delirium and suspected delirium, the length of hospital stay and the average sleep duration during hospitalization were recorded. On the day before surgery and on day 7 after surgery, the number of correct responses in the Stroop color word test, Part C (SCWT-C) and the scores in Montreal cognitive assessment scale (MoCA) were recorded; and the levels of serum C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), and neuron specific enolase (NSE) were measured. Results:The CAM scores at all postoperative time points were higher in all groups compared with preoperative ones (P<0.05). In the combined treatment group, the CAM scores on days 4 and 7 after surgery, the incidence of POD within 7 days after surgery, DRS-R-98 score within 7 days after surgery in patients with delirium and suspected delirium were lower when compared with the other two groups (P<0.05). On day 7 after surgery, the rTMS group showed the lower CAM score in comparison with the conventional treatment group (P<0.05). On days 4 and 7 after surgery, the VAS scores in all groups were lower than those before surgery (P<0.05), and the score in the combined treatment group was lower than the other two groups (P<0.05). On day 4 after surgery, the rTMS group exhibited lower VAS score compared with the conventional treatment group (P<0.05). Both the combined treatment group and the rTMS group had shorter hospital stays when compared with the conventional treatment group (P<0.05). During hospitalization, the rTMS group demonstrated a longer average sleep duration than the conventional treatment group (P<0.05), while the combined treatment group showed a longer sleep duration when compared with the other two groups (P<0.05). On day 7 after surgery, except for MoCA score in the conventional treatment group and NSE level in the combined treatment group, the number of correct responses on SCWT-C, MoCA score, as well as serum NSE and CRP levels in each group were all higher in comparison with the baseline (P<0.05), and PAI-1 level in the combined treatment group and rTMS group was higher when compared with the baseline (P<0.05), while the conventional group exhibited lower level (P<0.05). The combined treatment group demonstrated the higher number of correct responses on SCWT-C and MoCA score in comparison with the conventional treatment group (P<0.05), while the serum CRP and NSE levels were lower and PAI-1 level was higher when compared with the other two groups (P<0.05). In the rTMS group, the number of correct responses on SCWT-C, MoCA score, and serum PAI-1 level were higher than those in the conventional treatment group (P<0.05), while the serum NSE level was lower (P<0.05). Conclusion:The combination of ear holographic scraping therapy and rTMS can effectively reduce the incidence of POD and the duration of delirium. The mechanism may be related to the improvement of cognitive level, postoperative pain relief, circadian rhythms regulation, and neurotransmitter optimization.
Objective:To explore the effect of electroacupuncture (EA) at front-mu and back-shu points of large intestine on autophagy of Cajal interstitial cells (ICCs) in the colon of rats with slow transit constipation (STC), and to analyze the mechanism of EA for mitigating STC. Methods:Thirty-six SD rats were randomly divided into a blank group, a model group, an EA group, a mosapride group, an EA+rapamycin (RAPA) group and an EA+3-methyladenine (3-MA) group, with 6 rats in each group. The STC model was established by intragastric administration with loperamide hydrochloride. In the EA group, the EA+RAPA group and the EA+3-MA group, EA was operated at bilateral "Tianshu" (ST25) and "Dachangshu" (BL25), with dense-disperse waves (2 Hz/15 Hz in frequency), for 15 min each time. In the mosapride group, intragastric administration with mosapride solution was operated. In the EA+RAPA group and the EA+3-MA group, 30 min before acupuncture, the intraperitoneal injection was administered with RAPA and 3-MA solution, respectively. The intervention was delivered once daily and for consecutive 14 days in each group. After model establishment, the defecation time of the first red fecal particle was recorded in each group. After modeling and intervention, the number of fecal particles and fecal quality were recorded in each group over a 24-hour period. After intervention, the small intestinal propulsion rate was calculated in each group. HE staining was used to observe the histological morphology of colonic tissue, transmission electron microscopy was used to observe the ultrastructure of ICCs in the colon tissues, the immunofluorescence assay was used to observe the positive expression of the ICCs marker tyrosine kinase receptor (C-kit) in colonic tissue, the real-time quantitative PCR assay was used to detect C-kit mRNA expression, and Western-blot was used to detect C-kit and autophagy-related protein expression in each group. Results:After modeling, compared with the blank group, the model group exhibited the prolonged defecation time of the first red fecal particle and the reduced number of fecal particles, and the decline of fecal quality and small intestinal propulsion rate (P<0.01). After intervention, compared with the model group, the EA group and the mosapride group showed the increase in the number of fecal particles, fecal quality, and small intestinal propulsion rate (P<0.01). Compared with the EA group, fecal quality and small intestinal propulsion rate were reduced in the EA+RAPA group (P<0.01). Compared with the blank group, the model group showed the impaired colonic mucosal structure and reduced goblet cell count; and autophagosomes and mitochondrial swelling were markedly observed in the cytoplasm of ICCs. The average fluorescence intensity of C-kit, the mRNA expression of C-kit, and the protein expression of C-kit and P62 all decreased, while the protein expression of LC3 and ATG5 increased in the model group (P<0.01). Compared with the model group, all other groups showed the improvements in colonic mucosal structure and ICCs ultrastructure, with the increase in average C-kit fluorescence intensity (P<0.01); the mRNA expression of C-kit and the protein expression of C-kit and P62 were elevated (P<0.01), while the protein expression LC3 and ATG5 were reduced in the EA group (P<0.01). When compared with the EA group, the protein expression of P62 decreased in the EA+3-MA group (P<0.01). Conclusion:Electroacupuncture at front-mu and back-shu point of large intestine can effectively alleviate intestinal motility disorder in rats with slow transit constipation, which may be related to inhibiting excessive autophagy of ICCs and repairing the structure and quantity of ICCs.
Objective:To observe the effects of fire needling with "stomach disease prescription" on inflammatory factors and intestinal flora in rats with gastric ulcer (GU) of spleen-stomach deficiency-cold, and to explore the possible mechanism of fire needling with "stomach disease prescription" in treating GU of spleen-stomach deficiency-cold. Methods:Ten out of 34 SPF-grade male SD rats were randomly selected as the blank group, and the remaining 24 rats were used to establish a GU model of spleen-stomach deficiency-cold by the combined method of "4 ℃ vinegar+absolute ethanol". Twenty successfully modeled rats were randomly divided into a model group and a fire needle group, with 10 rats in each group. The rats in the fire needle group received rapid fire-needle puncture at the acupoints of "stomach disease prescription" ("Zhongwan" [CV12], bilateral "Neiguan" [PC6], and "Zusanli" [ST36]), without needle retention, once every other day, with 5 treatments as one course, for a total of 3 courses. General conditions and body weight of rats in each group were compared. Gastric tissue morphology was observed by naked eye and HE staining, and the gastric mucosal injury index was calculated. ELISA was used to detect serum levels of interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α in rats. 16S rDNA sequencing was used to analyze the structure and composition of intestinal flora. Results:(1) Macroscopic and pathological findings: Compared with the blank group, the rats in the model group showed typical deficiency-cold symptoms, such as mental fatigue and withered hair, and body weight was decreased (P<0.01); spot-like hemorrhagic lesions were observed on the gastric mucosa by naked eye, and HE staining showed gastric mucosal epithelial defects with extensive inflammatory cell infiltration; the gastric mucosal injury index was increased (P<0.01). Compared with the model group, the general condition of rats in the fire needle group improved and body weight was increased (P<0.01); only a small number of petechiae were observed on the gastric mucosa by naked eye, and HE staining showed orderly arrangement of gastric mucosal epithelial cells with reduced inflammatory cell infiltration; the gastric mucosal injury index was decreased (P<0.01). (2) Inflammatory regulation: Compared with the blank group, serum levels of IL-6, IL-1β, and TNF-α in the model group were increased (P<0.01); compared with the model group, serum levels of IL-6, IL-1β, and TNF-α in the fire needle group were decreased (P<0.01). (3) Flora regulation: Compared with the blank group, the Chao1 index, Shannon index, and Simpson index (1-D) of intestinal flora in the model group were decreased (P<0.01, P<0.05); the relative abundance of Bacteroidota, Proteobacteria, and Chloroflexi was decreased (P<0.05), while the relative abundance of Firmicutes was increased (P<0.05); the Firmicutes/Bacteroidota (F/B) ratio increased, and pathways related to xenobiotic biodegradation and metabolism, specific types of cancer, cardiovascular diseases, endocrine and metabolic diseases, and others were relatively enriched. Compared with the model group, the Chao1 index, Shannon index, and Simpson index (1-D) of intestinal flora in the fire needle group were increased (P<0.05, P<0.01); the relative abundance of Bacteroidota, Proteobacteria, and Chloroflexi was increased (P<0.05), while the relative abundance of Firmicutes was decreased (P<0.05); the F/B ratio decreased, and pathways related to cardiovascular diseases, nucleotide metabolism, amino acid metabolism, energy metabolism, and the excretory system were enriched. Conclusion:Fire needling with "stomach disease prescription" may intervene in GU of spleen-stomach deficiency-cold by inhibiting the release of inflammatory factors, correcting metabolic disorders, and restoring the balance of intestinal flora.
The classical statement, "feeling comfortable when acupoint is pressed" in Huangdi Neijing (The Yellow Emperor's Inner Classic ) is regarded as the origin of acupoint theory. "Feeling comfortable" following "acupoint is pressed" refers to the subjective experiences of patient, which reflects a close connection among "acupoint sensitization, mental-physical response and deqi ". Centered on 3 essential links, "acupoint sensitization", "mental-physical response" and "deqi ", this study systematically reviews and comments on the current research of the local manifestations and brain mechanisms of deqi and acupoint sensitization; and it specially focuses on the research progress on acupoint and brain effect. This study aims to propose the idea of brain effect research from the perspective of the relationship among "acupoint sensitization, mental-physical response and deqi ", so as to provide theoretical basis and research framework for revealing the central mechanism and optimizing clinical efficacy of acupuncture intervention.
This paper introduces the clinical experience of Professor LYU Jingshan in the treatment of post-stroke depression with acupuncture and moxibustion. Professor LYU Jingshan believes that this disease results from the damage of brain marrow and dysfunction of mind activity, and was manifested as liver qi stagnation and interaction of phlegm and qi. The treatment emphasizes "treating the mind" as the primary approach, addressing the root causes and symptoms, and establishes the therapeutic principle of regulating the mind and controlling qi. In clinical practice, the acupuncture technique for regulating the mind and controlling qi, and LYU 's umbilical medicine moxibustion are adopted. The paired acupoints, Baihui (GV20) and Shuigou (GV26), Shenmen (HT7) and Neiguan (PC6), are selected to regulate the mind and restore the controlling of qi and the governing of essence; Hegu (LI4) and Taichong (LR3), Fenglong (ST40) and Yinlingquan (SP9) are selected to regulate qi movement and recover the functions of liver and spleen in transportation and free flow of qi. During acupuncture, the needles are manipulated with two hands coordinately to obtain the synchronous therapeutic effect on post-stroke depression. This approach provides a new idea for the treatment of post-stroke depression.
Acupuncture is highly effective on female stress urinary incontinence (SUI), but there remain the limitations such as unclear explanation on its mechanism and the lack of quantitative operation specification. Multimodal imaging, with its advantages in visualization, quantitative analysis, and real-time dynamic imaging, demonstrates the unique value in acupuncture research. This paper systematically elucidates the enhancement of acupuncture diagnosis and treatment for SUI under the assistance of multimodal imaging; and how multimodal imaging, guided by traditional meridian theory, facilitates the transition from empirical approach to standardized operation in acupuncture treatment for SUI, aiming to provide new insights for the modernization of acupuncture.
Objective:To observe the clinical efficacy of acupoint catgut embedding for allergic rhinitis (AR), and to explore its mechanism of action. Methods:Eighty patients with AR were randomly divided into an observation group and a control group, with 40 patients in each group. The observation group received acupoint catgut embedding therapy, with bilateral Yingxiang (LI20) as the main acupoints and additional acupoints according to syndrome differentiation. Catgut embedding was performed once every 2 weeks, for a total of 2 treatments. The control group received oral loratadine tablets. Both groups were treated for 4 weeks. Total nasal symptom scores (TNSS) and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores were observed before treatment, after 2 weeks of treatment, after 4 weeks of treatment, and at 1-month follow-up after treatment in both groups. The levels of immunoglobulin E (IgE), interleukin (IL)-4, interferon-γ (IFN-γ), IL-12, and IL-13 in nasal lavage fluid were detected before and after treatment in both groups. Clinical efficacy was evaluated after treatment. Results:After 2 weeks of treatment, after 4 weeks of treatment, and at follow-up, TNSS and RQLQ scores in both groups were lower than those before treatment (P<0.05). After 4 weeks of treatment and at follow-up, TNSS and RQLQ scores in the observation group were lower than those in the control group (P<0.001). After treatment, the levels of IgE, IL-4, and IL-13 in nasal lavage fluid were decreased compared with those before treatment in both groups (P<0.001, P<0.05, P<0.01), and the levels of IFN-γ and IL-12 were increased compared with those before treatment in both groups (P<0.001, P<0.01, P<0.05); the levels of IgE, IL-4, and IL-13 in nasal lavage fluid in the observation group were lower than those in the control group (P<0.05, P<0.001), and the levels of IFN-γ and IL-12 were higher than those in the control group (P<0.05). The total effective rate in the observation group was 95.0% (38/40), higher than 82.5% (33/40) in the control group (P<0.05). Conclusion:Acupoint catgut embedding could improve clinical symptoms in patients with AR, and may exert its therapeutic effect by modulating immune balance.
Objective:To compare the clinical efficacy of different moxibustion therapies for primary dysmenorrhea (PD) using network Meta-analysis. Methods:A total of 8 databases, including the CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, EMbase, and Web of Science, were searched by computer to collect randomized controlled trials (RCTs) on moxibustion therapy for PD published from database inception to September 1, 2025. The Cochrane risk of bias tool was used to evaluate the quality of the included literature, and R4.1.0 software and Stata15.0 software were used for data analysis. Results:A total of 64 RCTs involving 5 814 PD patients and 11 kinds of moxibustion therapies were finally included. The network Meta-analysis showed that: ① regarding improving the total clinical effective rate, 9 moxibustion therapies (traditional suspended moxibustion, moxibustion with warming devices, herb-partitioned moxibustion, ginger-partitioned moxibustion, warm needling moxibustion, wheat-grain sized cone moxibustion, thunder-fire moxibustion, heat-sensitive moxibustion, and spreading moxibustion) were superior to conventional western medication, and wheat-grain sized cone moxibustion had the best effect [OR=8.91, 95%CI (2.55, 31.14)]; ② regarding improving pain visual analogue scale (VAS) score, 3 moxibustion therapies (herb-partitioned moxibustion, thunder-fire moxibustion, and heat-sensitive moxibustion) were superior to conventional western medication, and herb-partitioned moxibustion had the best effect [MD=-4.19, 95%CI (-6.32, -2.16)]; ③ regarding reducing Cox menstrual symptom scale (CMSS) score, 4 moxibustion therapies (herb-partitioned moxibustion, wheat-grain sized cone moxibustion, thunder-fire moxibustion, and heat-sensitive moxibustion) were superior to conventional western medication, and heat-sensitive moxibustion had the best effect [MD=-11.13, 95%CI (-16.78, -5.42)]; ④ regarding reducing prostaglandin F2α (PGF2α) level, 2 moxibustion therapies (herb-partitioned moxibustion and heat-sensitive moxibustion) were superior to conventional western medication, and heat-sensitive moxibustion had the best effect [MD=-24.94, 95%CI (-42.24, -7.42)]; ⑤ regarding safety, the incidence of adverse events of moxibustion therapies was lower than that of conventional western medication (P<0.05). Conclusion:Based on the current evidence, wheat-grain sized cone moxibustion has the best efficacy in improving the total clinical effective rate, herb-partitioned moxibustion has the best efficacy in improving VAS score, and heat-sensitive moxibustion has the best efficacy in improving CMSS score and PGF2α level. Limited by the quality and quantity of the included original studies and the quality of the current evidence, the conclusions of this study still require further verification by more high-quality RCTs.
Objective:To observe the effects of Tongdu Tiaoshen (unblocking the circulation of the governor vessel and regulating the mind) acupuncture on depressive-like behavior and the expression of microRNA-26a-5p (miR-26a-5p)/ enhancer of zeste homolog 2 (EZH2)/trimethylation of lysine 27 on histone H3 (H3K27me3) proteins and inflammatory factors in chronic unpredictable mild stress (CUMS) rats, and to explore its antidepressant mechanism. Methods:Thirty-two SPF-grade male SD rats were randomly divided into a normal group (8 rats) and a modeling group (24 rats). The modeling group was subjected to CUMS to establish depression model. After successful modeling, the rats were randomized into a model group, an acupuncture group and a fluoxetine group, with 8 rats in each group. In the acupuncture group, Tongdu Tiaoshen acupuncture was operated at "Baihui" (GV20), "Shenting" (GV24), "Shuigou" (GV26) and "Dazhui" (GV14), once daily for 6 consecutive days followed by one day of interval; and the completion of intervention was composed of 24 sessions of acupuncture. The gavage with fluoxetine solution (2.1 mg/kg) was administered in the fluoxetine group; and with 0.9% sodium chloride solution (10 mL/kg) in the other 3 groups, continuously for 28 days. Sucrose preference and the results of the open field test were observed. The hippocampal neuron morphology and Nissl bodies were examined using HE and Nissl staining. The protein expression of hippocampal EZH2 and H3K27me3 was detected using Western blot, and the mRNA expression of hippocampal miR-26a-5p and EZH2 was detected with RT-qPCR. ChIP-qPCR was applied to detect the enrichment levels of H3K27me3 in the promoter regions of interleukin-4 (IL-4), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). ELISA was provided to measure the contents of IL-6, TNF-α, interleukin-1β (IL-1β), and IL-4 in the hippocampus and serum. Results:Compared with the normal group, the model group showed the decrease in sucrose preference (P<0.01), the total distance, the numbers of uprighting and cleaning behavior in the open field test (P<0.01); hippocampal neurons exhibited partial cell dissolution, irregular arrangement, nuclear pyknosis, reduced Nissl bodies (P<0.01), and uneven distribution. The mRNA expression of hippocampal EZH2, and the protein expression of hippocampal EZH2 and H3K27me3 increased (P<0.01), while the mRNA expression of miR-26a-5p decreased (P<0.01). The enrichment levels of H3K27me3 in the promoter regions of IL-6 and TNF-α were elevated (P<0.01), whereas that in IL-4 was reduced (P<0.01). The levels of IL-6, TNF-α and IL-1β in the hippocampus and serum increased (P<0.01), and the levels of IL-4 decreased (P<0.01). Compared with the model group, the acupuncture group and the fluoxetine group showed the increase in sucrose preference (P<0.01), the total distance, the numbers of uprighting and cleaning behavior in the open field test (P<0.01); hippocampal neurons exhibited the reduced cell dissolution, regular arrangement, declined nuclear pyknosis, higher Nissl bodies (P<0.01), and even distribution. The mRNA expression of hippocampal EZH2, the protein expression of hippocampal EZH2 and H3K27me3 decreased (P<0.01), and the mRNA expression of miR-26a-5p increased (P<0.01); and the mRNA expression of miR-26a-5p was negatively correlated with that of EZH2 (P<0.001). The enrichment levels of H3K27me3 in the promoter regions of IL-6 and TNF-α were lower (P<0.01), and that of IL-4 was higher (P<0.01, P<0.05). The levels of IL-6, TNF-α and IL-1β in the hippocampus and serum decreased (P<0.01), and the levels of IL-4 increased (P<0.01). The differences of the above indexes were not statistically significant between the acupuncture group and fluoxetine group (P>0.05). Conclusion:Tongdu Tiaoshen acupuncture can ameliorate depression-like behavior in CUMS rats, with the mechanism potentially related to regulating the miR-26a-5p/EZH2/ H3K27me3 pathway and reducing central neuroinflammation.
The diseases of the six fu organs and the main indications of acupoints are the crucial components of the theories related to meridians, acupoints and zangfu organs. Through analyzing the classic articles in Huangdi Neijing (The Yellow Emperor's Inner Classic) and modern literature, this article elaborates on the pathogenesis, diagnostic criteria and acupoint indications for the diseases of six fu organs. It systematically reviews and summarizes the current research status regarding the diseases of six fu organs and acupoint indications as described in Huangdi Neijing. It is discovered that pathogenic qi enters six fu organs through specific pathways from the medial sides of the limbs and yin meridians, for which, the prerequisite is the abundance and normal functioning of the essence and qi of five zang organs. The diseases of six fu organs are diagnosed in accordance with identifying the syndrome patterns of six fu organs and the characteristics of biao and ben of six yang meridians. In association with the yuan-source points of six fu organs and their corresponding lower he-sea points, the paper analyzes the rationale of the primary acupoints in treatment of diseases of six fu organs, and explains the acupuncture techniques for utilizing these lower he-sea points.
This paper reports a case of Ramsay-Hunt syndrome complicated with incomplete Vernet syndrome caused by otic herpes zoster treated with acupuncture as the main therapy. The pathogenesis of the patient was spleen deficiency with dampness-heat, and blockage of the orifices and collaterals. The combination therapy of flash cupping, fire needling, acupuncture and Chinese materia medica was delivered. Flash cupping was performed on the affected side of the face, fire needling pricking was applied at the herpes zoster area; acupuncture was applied at local acupoints on the face, combined with the "experienced ten acupoints" and the acupuncture method of "ascending on the left and descending on the right" based on the theory of yiqi zhouliu (constant circulatory flowing of qi ), i.e. for the left side, acupoints of the three-yin meridians were selected and treated with twirling reinforcing manipulation, for the right side, acupoints of the three-yang meridians were selected and treated with the twirling reducing manipulation. The treatment was given once every 3 days, twice a week. After 1 month of treatment, the modified Yuebi Jiazhu decoction was given additionally for 14 doses. After 2 weeks of treatment, the herpes zoster resolved and the pain was relieved; after 1 month of treatment, the swallowing function was improved; after 2 months of treatment, the House-Brackmann (H-B) facial nerve function grade was decreased from grade Ⅵ to grade Ⅲ, the Sunnybrook facial grading system score was increased from 21 to 67, and the swallowing, hoarseness, auditory and gustatory functions, as well as the general condition were all improved; at 1 month follow-up, the condition of the patient remained stable.
Since Huangdi Mingtang Jing (Yellow Emperor's Illustrated Manual of Acupuncture Points) proposed the localization of the three preauricular acupoints, namely Ermen (TE21), Tinggong (SI19), and Tinghui (GB2), the textual descriptions of their localization in ancient literature have basically remained unchanged. However, according to the consensus of ancient literature descriptions, the localization combined with anatomy differs from the current national standard for acupoint localization. By systematically collecting and organizing the localization descriptions of the three preauricular acupoints in literature throughout different dynasties, and combining them with the anatomy of the preauricular region, this paper re-localizes the three preauricular acupoints. Based on literature records, acupuncture bronze figures, and Mingtang diagrams, the evolution process of the localization of the three preauricular acupoints is discussed, and the important evolutionary nodes and reasons for their evolution are analyzed. In addition, modern descriptions of the indications of the three preauricular acupoints are basically copied or rewritten from acupuncture literature before the Ming dynasty, and their indications are in fact practical summaries of acupoint localization in ancient literature before the Ming dynasty. In view of this, combined with the anatomical structure of the preauricular region, the localization of the three preauricular acupoints should follow the localization determined by the consensus of ancient literature, namely, Ermen (TE21) is located in the depression anterior to the supratragic notch, Tinggong (SI19) is located on the tragus, and Tinghui (GB2) is located at the pulsation of the superficial temporal artery anterior to the tragus.
