“Governor vessel–unblocking and mind-regulating” acupuncture therapy ameliorates cognitive dysfunction in a rat model of middle cerebral artery occlusion.
Su X, Wu Z, Mai F, Fan Z, Du S, Qian H, Zhu J. Int J Mol Med. 2019;43(1):221–232.
Acupuncture is a Traditional Chinese Medicine modality that is used to ameliorate cognitive dysfunction. This study examined the effectiveness and relevant mechanisms of a kind of therapy known as “Governor Vessel–unblocking and mind-regulating” acupuncture in cognitive dysfunction in rats with ischemia. The researchers used middle cerebral–artery occlusion to induce cognitive dysfunction in the rats. Behavioral changes in the rats were assessed with a Morris water-maze test. Effects of this treatment on the rats' oxidative stress responses and the functioning of mitochondria in their brain tissues were also assessed. Governor Vessel–unblocking and mind-regulating acupuncture improved the rats' cognitive ability markedly.
Production of pro-oxidative stress factors, including nitric oxide (NO) and inducible NO synthase, was also blocked along with amelioration of the rats' cognitive dysfunction. In addition, production of adenosine triphosphate, superoxide dismutase, and cyclo-oxygenase was restored. At the molecular level, accumulation of amyloid β (Aβ) in the rats' mitochondria was suppressed by this form of acupuncture, which might be attributed to inhibition of the functions of translocase of outer mitochondrial membrane 40 (TOMM40) and translocase of inner mitochondrial membrane 17A (TIMM17A).
On the whole, the findings of this study confirmed the effects of Governor Vessel–unblocking and mind-regulating acupuncture on cognitive dysfunction induced by brain ischemia in rats. The study also confirmed that the mechanisms underlying the effects of this treatment might be mediated through inhibition of TOMM40 and TIMM17A synthesis, which can relieve mitochondrial dysfunction caused by an accumulation of Aβ.
Efficacy and safety of thread embedding acupuncture for chronic low back pain: a randomized controlled pilot trial.
Lee HJ, Choi BI, Jun S, et al. Trials. 2018;19(1):680.
This study was conducted to investigate the efficacy and safety of thread-embedding acupuncture (TEA) for treating chronic low-back pain (cLBP) in a randomized, controlled pilot trial. The goal was to prepare a foundation for a large-scale, randomized controlled trial on the effects of TEA in patients with cLBP.
Forty participants were recruited for this 2-arm, assessor-blinded, randomized, controlled pilot trial. The participants were allocated randomly to either a TEA group (experimental group) or an acupuncture group (control group). The TEA group received TEA once every 2 weeks for 8 weeks (a total of 4 sessions), while the acupuncture group received acupuncture twice every week for 8 weeks (a total of 16 sessions). The primary outcome was a visual analogue scale (VAS) score for pain, and the secondary outcomes were Short-Form McGill Pain Questionnaire (SF-MPQ) and Oswestry Disability Index (ODI) scores. Assessments were performed at the initial screening and at 2, 4, 6, 8, and 10 weeks after treatment initiation (the 10-week assessment was conducted 2 weeks after treatment cessation).
Of the 40 original participants, 36 completed the study while 4 dropped out. Both groups had significant improvements in VAS, SF-MPQ, and ODI scores in a time-dependent manner. In addition, on the ODI, a significant interaction between group and time was seen, with the 2 groups having different patterns of change at 8 weeks according to a contrast analysis with Bonferroni's correction. No serious adverse events occurred, and hematologic and biochemical test findings were within normal limits.
The researchers concluded that this pilot study provided the basic data needed for a larger clinical trial to demonstrate the efficacy and safety of TEA for treating cLBP.
Pragmatic combinations of acupuncture points for lateral epicondylalgia are unreliable in the physiotherapy setting.
Alvim DT, Ferreira AS. J Acupunct Meridian Stud. 2018;11(6):367–374.
This study was performed by 2 Brazilian researchers. The goal was to reveal the reliability of pragmatic combinations of acupuncture points for treating lateral epicondylalgia (LE) as prescribed by physiotherapists who were acupuncture experts. Raters (n = 14; 33–59 years) prescribed acupuncture points independently for 30 simulated human patients with LE who were surveyed via a printed questionnaire. The frequency and co-occurrence of acupuncture points prescribed for patients with lateral epicondylitis were assessed. Absolute agreement and Light's kappa (κLight) with 95% confidence intervals (CIs) were used to quantify interrater agreements.
Raters prescribed 103 unique acupuncture points in different combinations with a median (minimum–maximum) of 5 (range: 0–11) acupuncture points. The most-prescribed acupuncture point was LI 11 (297 of 420; 71%), and the most common co-occurring acupuncture points were LI 11 and LI 4 (160 of 420; 38%). The absolute agreement for prescribing the acupuncture points ranged from 70% (GB 20) to 0% (LI 10, SP 6, LI 11, GB 34, LI 12, and LI 4). LR 3 had the highest interrater reliability for prescribing the acupuncture points (κLight = 0.112; 95% CI: 0.055–0.194), whereas LI 4 had the lowest reliability (κLight = −0.003; 95% CI : −0.024 to 0.024).
These findings suggested that pragmatic prescriptions of acupuncture points for LE are unreliable among physiotherapists who are experts in acupuncture. Explicit, high-level evidence-based rules for prescribing and teaching combinations of acupuncture points for LE are warranted.
Acupuncture improves symptoms in patients with mild-to-moderate atopic dermatitis: a randomized, sham-controlled preliminary trial.
Kang S, Kim YK, Yeom M, Lee H, Jang H, Park HJ, Kim K. Complement Ther Med. 2018;41:90–98.
The aim of this study, which was performed by researchers from the Republic of Korea, was to assess the feasibility of a definitive trial to investigate the effects of acupuncture on atopic dermatitis symptoms, including pruritus. A randomized, sham-controlled preliminary trial with three arms, a 4-week intervention period, and a 4-week follow-up was developed. Thirty participants were allocated to 3 groups: verum acupuncture 1 (VA1; 3 times per week for 4 weeks); verum acupuncture 2 (VA2; 2 times per week for 4 weeks); and sham acupuncture (SA; 2 times per week for 4 weeks) at a 1:1:1 ratio. During the study period, the researchers collected scores on the following instruments: visual analogue scale (VAS) for Pruritus and Insomnia; SCORing Atopic Dermatitis (SCORAD) Total and Objective; Eczema Area and Severity Index (EASI); Patient Oriented Eczema Measure (POEM); and Dermatology Life Quality Index (DLQI). Baseline index score (BIS) comparisons, according to general symptoms were also performed.
Scores on the VAS (Pruritus), VAS (Insomnia), SCORAD, EASI, POEM, and DLQI, were significantly improved in both VA groups. Significant BIS mean differences were noted, most predominantly in epigastric tenderness and dyspepsia. There was no significant difference between the VA1 and VA2 groups in all of the main evaluation indices.
For subsequent study, the researchers suggested using SCORAD (Total) as a primary outcome and SCORAD (Objective), VAS (Pruritus), VAS (Insomnia), EASI, POEM, and DLQI as secondary outcomes. It was also recommended that 36 participants should be recruited for the new trial with a 4-week acupuncture period (twice weekly) and a 4-week follow-up. It is necessary to compare differences in the participants' general symptoms with the presence of epigastric tenderness or dyspepsia, when screening participants for the new study.
Is acupuncture effective for improving insulin resistance? a systematic review and meta-analysis.
Song AQ, Zhang YP, Chen R, Liang FX. Curr Med Sci. 2018;38(6):1109–1116.
This study was designed to evaluate the clinical efficacy of acupuncture as an intervention for insulin resistance (IR). The researchers conducted a meta-analysis of related randomized controlled trials (RCTs). Studies published before January 31, 2018, were searched on PubMed, Medline,® Cochrane Library, EMBASE, and Chinese databases. Only RCTs that examined acupuncture as sole or adjunctive treatment for IR-related conditions were included. The primary outcome was homeostasis model assessment for insulin resistance (HOMA-IR). The secondary outcomes were fasting blood glucose (FBG), fasting insulin (FINS), and 2-hour postprandial blood glucose (2h-PBG). The differences between the study groups were reported as mean differences (MDs). All statistical analyses were performed with RevMan software 5.3.
After screening relevant studies carefully, 9 RCTs involving 562 patients (279 in experimental groups and 283 in control groups) were examined in this study. Pooled results showed that acupuncture had significant effects on HOMA-IR (MD: 0.70; 95% confidence interval [CI]: 0.04–1.35; P = 0.04 < 0.05), FINS (MD: 3.35 mU/L; 95% CI 1.99–4.7; P < 0.001), and 2h-PBG (MD: 1.03 mmol/L; 95% CI: 0.25–1.82; P = 0.01). The differences in FBG were not significant (MD: 0.28 mmol/L; 95% CI: −0.28 to 0.84; P = 0.32 > 0.05).
This meta-analysis indicated that acupuncture can help improve IR to a certain extent, which remains to be confirmed by further high-quality RCTs.