The influence of different methods of acupuncture on skin surface perfusion

Objective

To compare the effects on the body surface of different kinds of placebo/sham acupuncture with that of traditional needling sensation acupuncture.

Methods

Point Neiguan (PC 6) of 29 healthy subjects, 19 males and 10 females, was stimulated with needling sensation, shallow, placebo and deep acupuncture at the non-acupoint. After stimulation with different methods of acupuncture, the change in perfusion of the micrangium in the skin surface around the elbow joint, with Point Quze (PC 3) as its center, was observed with laser Doppler blood-flow imaging.

Results

Judging from the absolute value of perfusion of the skin surface micrangium, several methods of acupuncture can cause change in blood flow. The ratio of blood-flow perfusion in the meridian area in and around Quze declined before and after needling insertion in needling sensation acupuncture and shallow acupuncture. This observation did not occur in placebo and non-acupoint acupuncture. Needling sensation acupuncture at an acupoint can relatively reduce the perfusion of the micrangium in the projective area of the meridian where the acupoint is located on the body surface (P<0.05), indicating the specificity of meridians.

Conclusions

Stimulation of an acupoint or a point on the body surface with any type of acupuncture can cause change in blood flow in the skin near the needling point. However, the biological mechanism underlying this phenomenon needs to be further explored.     

Needling Sensations following Real and Placebo Acupuncture – a randomised single-blinded two-period cross-over pilot study –

BackgroundPlacebo needles are accepted as the gold standard for the control in acupuncture research. Credibility is one of the essential factors which influence the placebo response. The needling sensations of the real and placebo needles may have a decisive influence on credibility. The aim of the study was therefore to test these sensations from a placebo needle compared to those of real acupuncture.Methods10 healthy volunteers were enrolled in this cross-over pilot study. In each period of the study 5 volunteers were treated with a placebo needle and 5 with a normal acupuncture needle. The LI 4 (Hegu) acupuncture point was selected for bilateral treatment and the needles stayed in place for 15 minutes. Placebo and real needles were manipulated for a short time by rotating the needles in both directions. The interval between the two periods of the study was one week. After each treatment session the volunteers had to guess which treatment condition they had received and filled in a questionnaire which assessed the pricking sensation (intensity), quality and spread of the deqi sensation. The extent of the different sensations was rated on a Verbal Rating Scale (1–10).ResultsThree volunteers receiving real acupuncture and two receiving placebo correctly identified the form of treatment. Four volunteers in the first session and five in the second session could not decide how they had been treated. No significant difference between placebo and real treatments was detected in any of the variables examined which were related to needle sensation (unpaired t-test, p-value > 0.05).ConclusionsBased on the findings of this trial, the tested placebo needle might be a suitable control condition for acupuncture trials.A study with a larger sample size is warrented to confirm the present findings.     

Effect of acupuncture in the treatment of seasonal allergic rhinitis: a randomized controlled clinical trial

The clinical efficacy and safety of acupuncture in the treatment of Seasonal Allergic Rhinitis (SAR) was evaluated by employing a two-phase crossover single-blind clinical trial. Thirty subjects were randomly assigned to two groups with 17 and 13 subjects respectively and treated with real or sham acupuncture (three times per week) for four consecutive weeks and then a crossover for treatments for a further four weeks without a washout period. The administration of real acupuncture treatment was guided by a syndrome differentiation according to Chinese Medicine Theory. Subjects were assessed by various criteria before, during and after the treatments. Outcome measures included subjective symptom scores using a five-point scale (FPS), relief medication scores (RMS) and adverse effect records. Twenty-six (26) subjects completed the study. There was a significant improvement in FPS (nasal and non-nasal symptoms) between the two types of acupuncture treatments. No significant differences were shown in RMS between the real acupuncture treatment group and the sham acupuncture treatment group. No side effects were observed for both groups. The results indicate that acupuncture is an effective and safe alternative treatment for the management of SAR.     

Is sham acupuncture a real placebo: Skeptical for sham acupuncture

Since acupuncture came to western countries, research has been done to try and prove whether or not it is effective. Current Acupuncture research is most often based on the sham needle which was first designed by K Streitberger and J Kleinhenz in 1998. The sham acupuncture needles are developed for the control group and do not penetrate the skin. Sham acupuncture has been used in randomized controlled trial (RCT) for diseases which normally benefit from acupuncture treatment. The sham needle is not the best placebo needle though. Because of the use of sham acupuncture, the result of those research shows acupuncture having no effect or it shows there is no significant difference between real acupuncture (verum) and sham acupuncture (placebo). However, a detailed introduction of the Nine Classical Needles (ancient) and the Nine Modern Needles (SHI's nine needles) shows that the use of sham acupuncture in RCT research is flawed by design. This then casts doubt on the findings and conclusions reached by using sham acupuncture in RCT acupuncture research.     

Deqi sensation between the acupuncture-experienced and the naïve: a Korean study II

Previous experience of acupuncture is believed to affect people's expectation of future treatments. Therefore, subjects who have had acupuncture are generally excluded from sham-controlled acupuncture clinical trials. However, this assumption has not been proven, but just accepted because of the lack of evidence to the contrary. To investigate the difference in frequency and intensity of acupuncture sensation between subjects who have had acupuncture and those who have not, 36 acupuncture-experienced subjects were invited to take part in the study. After informed consent was obtained, participants were asked to complete the acupuncture sensation scale (ASS) according to what they expected needling to feel like. The needling was done at the left Hegu (LI 4) point and consisted of insertion, stimulation for 30 seconds and removal. After needling, the subjects were asked to complete the same ASS according to what they actually experienced. Adverse events were monitored. The frequency of each sensation expected and experienced, as well as acupuncture sensation scores were compared. More than 60% of the subjects expected to feel sensations of penetrating (87.6% to 100%), aching (71.2% to 95.5%), tingling (87.6% to 100%), pricking (79.7% to 99.2%) and throbbing (64.2% to 91.4%). In fact, the subjects experienced sharp (60.9% to 89.1%), intense (60.9% to 89.1%), radiating (71.2% to 95.5%) and heavy (74.8% to 97.4%) sensations just as much. The subjects expected more hurting (p = 0.001), tingling (p < 0.001), pricking (p = 0.010), stinging (p = 0.012), burning (p = 0.001) and pulsing (p = 0.009) than they experienced, while more heaviness (p = 0.011) was experienced than expected. The same outcome measures were also compared between experienced and naive groups. Apart from the fact that the acupuncture-experienced participants expected to feel pricking (p = 0.030) and stinging (p = 0.002), and experienced hurting (p = 0.022) and stinging (p = 0.028) significantly less than those who had not had acupuncture before, there was no significant difference between first time and experienced subjects. The results indicate that previous experience does not affect the people's expectation and does not hinder people from experiencing Deqi. In addition, a constellation of Deqi-related acupuncture-specific sensations is more than just a general pain intensity dimension, which requires a biochemical and physiological exploration.     

ASSOCIATION BETWEEN ACUPUNCTURE NEEDLING SENSATION(DE-QI) AND LOCAL SKIN BLOOD FLOW IN HEALTHY SUBJECTS:A SINGLE-BLIND,RANDOMIZED CONTROLLED TRIAL

Objective: De-qi refers to sensations generated by needle insertion into an acupuncture point.De-qi sensation is believed to be associated with treatment effects of acupuncture with the increase of local blood flow, although some patients may feel these sensations uncomfortable.This study aimed to assess the association between the strength of de-qi sensation and local skin blood flow in healthy subjects.Methods: Forty-five healthy subjects were randomized into real acupuncture(RA) group(n=15), Park-sham acupuncture(SA) group(n=15) and non-needling control(CO) group(n=15).A single acupuncture session was conducted on the right LI4 point with manual stimulation and 10-minute needle retention.De-qi sensation was assessed immediately after the removal of needling by the Southampton needle sensation questionnaire.Local skin blood flow recording within 2 cm in diameter of ipsilateral LI4 area was performed intermittently from just before the intervention to the end of the trial by the laser Doppler blood perfusion imager.Correlation between the change of skin blood flow and strength of De-qi was assessed.Results: Median change of local skin blood flow from baseline to post-treatment was 48.85, 48.20 and 0.59 arbitrary unit(AU) in RA, SA and CO groups, respectively.Median total sensation score was 10, 3 and 0 of 51 points, respectively.No significant correl ation between total sensation score and change of skin blood flow in the RA and SA groups was observed(0.105 9 of Spearman's rho, P=0.57).Conclusion: The data suggest that there is no association between De-qi sensation and local skin blood flow after acupuncture in healthy adults.The role of De-qi sensation for physiological changes and clinical outcomes should be further investigated in future acupuncture trials.     

Minimal Acupuncture is not a Valid Placebo Control in Randomised Controlled Trials of Acupuncture: A Physiologist's Perspective

Placebo-control of acupuncture is used to evaluate and distinguish between the specific effects and the non-specific ones. During ,true' acupuncture treatment in general, the needles are inserted into acupoints and stimulated until deqi is evoked. In contrast, during placebo acupuncture, the needles are inserted into non-acupoints and/or superficially (so-called minimal acupuncture). A sham acupuncture needle with a blunt tip may be used in placebo acupuncture. Both minimal acupuncture and the placebo acupuncture with the sham acupuncture needle touching the skin would evoke activity in cutaneous afferent nerves. This afferent nerve activity has pronounced effects on the functional connectivity in the brain resulting in a ,limbic touch response'. Clinical studies showed that both acupuncture and minimal acupuncture procedures induced significant alleviation of migraine and that both procedures were equally effective. In other conditions such as low back pain and knee osteoarthritis, acupuncture was found to be more potent than minimal acupuncture and conventional non-acupuncture treatment. It is probable that the responses to ,true' acupuncture and minimal acupuncture are dependent on the aetiology of the pain. Furthermore, patients and healthy individuals may have different responses. In this paper, we argue that minimal acupuncture is not valid as an inert placebo-control despite its conceptual brilliance.     

“山幕针”——一种双盲安慰针装置的设计与实践

为临床针刺双盲对照试验提供切实可行且科学的安慰针装置——"山幕针"。其特征是,真/假针具皆由毫针、针管及底座组成,假针具底座下端开口完全封闭,使毫针针尖无法与皮肤接触,从而不产生任何轻微刺激,而外形又与真针具完全相同。假针具内置的填充物可以模拟腧穴内软组织,同时结合试验前暗示诱导,起到降低破盲风险的作用,使针刺双盲试验成为可能。     

Quantification of DeQi sensation by visual analog scales in healthy humans after immunostimulating acupuncture treatment

Acupuncture is the most popular component of traditional Chinese medicine in Western countries. However, the mechanisms of its effects remain unclear. The therapeutic effect of acupuncture appears when a sensation of DeQi is achieved. We previously reported that repeated, but not single acupuncture treatment affected leukocyte circulation and blood pressure in healthy young humans. The objective of this study was to quantify DeQi sensation by using visual analog scales (VASs) and, to test whether DeQi induction is an important factor for the therapeutic effects of acupuncture in the same cohort. After either acupuncture or sham-acupuncture (placebo) treatment, a questionnaire containing five individual VASs was given to subjects to evaluate their DeQi sensation, including numbness, pressure, heaviness, warmth, and radiating paraesthesia, respectively. A separate VAS to measure their levels of anxiety during the treatment was also included. Our results showed that acupuncture significantly induced higher VAS values for numbness, pressure, warmth, and radiating paraesthesia, but not for heaviness than the placebo across three treatment sessions. Additionally, acupuncture did not induce higher anxiety levels than the placebo. These data confirm that VAS is an objective and reliable way to quantify DeQi sensation and, indicate that DeQi is unique to verum acupuncture treatment. Furthermore, either acupuncture-induced therapeutic effects or DeQi sensation should not be attributed to the stress-mediated effects. In summary, the induction of DeQi in each treatment session is an important factor for the physiological outcomes of repeated acupuncture treatment, and VASs offer objective, an easy and reliable way to assess it.     

DISSOCIATION OF THE ACUPUNCTURE EFFECT OF SOMATOSENSORY NEEDLING AND NEEDLING CREDIBILITY ON LOW BACK PAIN PATIENTS USING fMRI

Background: Sham acupuncture as well as real acupuncture, a specific form of needling, is known to reduce low back pain(LBP), but the brain mechanism of placebo effect in sham acupuncture has not been clearly understood.We devised a novel form of sham acupuncture, so called phantom acupuncture which induces needling credibility without somatosensory needling.And we aimed to dissociate the brain correlates with somatosensory needling and needling credibility effect.Methods: Thirty LBP patients were randomized into the real(REAL, n=15) and phantom acupuncture(PHNT, n=15) groups.Sensory threshold and LBP intensity(VAS) were measured before and after the fMRI scanning.During the scanning, two steady state pain sessions were scanned before and after acupuncture stimulation(using low-back extension pain-model) and pain intensity(PAIN) induced by the pain model was collected.In acupuncture session, the REAL group got real acupuncture, while the PHNT group got only the visual stimulation(recorded needling manipulation video) to create needling credibility.Autonomic response of heart rate(HR) and skin conductance(SC), and acupuncture sensation were measured.Results: There was greater SC response, acupuncture sensation, signal increase in sensorimotor network(SMN), periaqueductal grey(PAG) and nucleus accumbense(NAC), and greater signal decrease in default mode network(DMN) in the REAL group.Also increase in vibration detection threshold and decrease in PAIN were observed.The HR decrease and signal increase in salience network(SLN), as well as the decrease in pressure pain threshold and unpleasantness of PAIN were observed both in the REAL and PHNT group.In the PHNT group, decrease in VAS was found.Different correlation between the change in outcome measure and the change in resting state network connectivity was found.Conclusion: Physical information processing and placebo/analgesic brain area were involved in somatosensory needling effect, while cognitive processing was related to the needling credibility effect.     

IMMEDIATE RELIEF OF KNEE PAIN THROUGH THE COMPARISON OF HAND AND EAR ACUPUNCTURE

Objective: The present study aimed to assess the immediate effect of knee pain relief by comparing two techniques, the Koryo Sooji Chim(hand acupuncture) and ear acupuncture.Methods: Forty subjects were included in the present study and randomly divided into 4 groups of 10 subjects in each: real hand acupuncture, sham hand acupuncture, real ear acupuncture and sham ear acupuncture.Each patient was evaluated by Visual Analog Scale(VAS) before and after the stimuli.Results: In group A, subjects who underwent real hand acupuncture showed 50%(5 individuals) improvement in pain and 50%(5 individuals) unchanged; in group B, subjects who underwent sham hand acupuncture showed 100%(10 individuals) unchanged; in group C, subjects who underwent real ear acupuncture showed 90%(9 individuals) improvement in pain and 10%(1 individual) did not change; and in group D, subjects who underwent sham ear acupuncture showed no changes in 100%(10 individuals).Conclusion: From the results, it is clear that the correct application of the stimulus shows better improvement in pain, with the prevalence rates of ear acupuncture that showed better efficacy compared to Korean hand acupuncture.     

DIVERGENT EFFECT OF EXPECTANCY ON TREATMENT RESPONSE BETWEEN REAL AND SHAM ACUPUNCTURE

Background: Expectancy has been hypothesized as a critical component of the placebo response; however, change in expectancy during acupuncture trials has not been previously evaluated.We sought to evaluate the relationship between expectancy and treatment response in both real and sham acupuncture.Methods: We analyzed data from a recently completed randomized controlled trial using real electroacupuncture(EA) and sham acupuncture(SA).The trial was conducted among 67 women with stage I-III breast cancer who experienced joint pain attributable to aromatase inhibitors.Responders were classified as those who reported "much improved" or "very much improved" on the Patient Global Impression of Change instrument at week 8(End of intervention).The Acupuncture Expectancy Scale(AES), a validated instrument, measured expectancy at baseline, week 2, 4, and 8.In this scale, a higher score indicates a greater degree of expectancy.Results: Responders in the SA group had higher expectancy at baseline than non-responders(15.5 vs.12.1, P=0.005).Expectancy remained higher in SA responders through the end of intervention(16.0 vs.11.4, P=0.035).Responders and non-responders in the EA group, by contrast, did not have different expectancy levels at baseline(14.8 vs.15.3, P=0.64).By the end of the intervention, however, EA responders had significantly higher expectancy than non-responders(16.2 vs.11.7, P=0.0038).Conclusion: The relationship between expectancy and treatment response is distinct between real and sham acupuncture.Our findings suggest that while higher outcome expectancy predicts treatment response in sham acupuncture, such a predisposition is not associated with the response to electro-acupuncture.Once patients develop a response to real acupuncture, their expectancy rises significantly.These findings have important implications for both acupuncture research and clinical practice.     

Scientific bases of acupuncture analgesia

The present paper was to review the physiological bases of acupuncture analgesia (AA) on normal subjects, patients, and animals. Effect of acupuncture on pain perception in normal subjects was studied and compared with sham acupuncture. It was shown that the analgesic effect of acupuncture has its physiological basis. Using neurophysiological, neuropharmacological, neurobiochemical and neuromorphological methods, the neurohumoral mechanism of AA was studied from the peripheral neural pathway of acupuncture sensation (De-Qi sensation in Chinese traditional medicine) to the central neuromodulatory effect of AA. It was indicated that needling of acupuncture point could activate the afferent fibers of peripheral nerves to elicit De-Qi sensation, then ascended mainly through the ventro-lateral funiculi, which conducted pain and temperature sensation upward to the brain, activated the antinociceptive system including certain brain nuclei. modulators (opioid peptides), neurotransmitters, through the descending inhibitory pathway resulting in analgesia. Especially the clinical and laboratory results indicated that the endogenous opiate peptides (EOP) participated in AA from the presynaptic level to the receptor sites, which provided a scientific basis for understanding the mechanism of AA. Substantial evidences have been accumulated that acupuncture has prominent analgesic effect; but it fails to give sufficient analgesia during operation. Some effective measures to improve the therapeutic effect of acupuncture, such as the combination of acupuncture with drugs, the selection of suitable EA parameters and optimal time spacing should be adopted.     

ACUPUNCTURE CREDIBILITY SCALE SCORES ASSOCIATED WITH TCM ACUPUNCTURE VERSUS A SHAM ACUPUNCTURE PROCEDURE:IMPLICATION FOR CLINICAL TRIAL DESIGN

Objective: To compare self-reported perceptions of the credibility of traditional Chinese medicine(TCM) acupuncture and a shallowneedling sham procedure, and to explore whether study subjectscan distinguish between real acupuncture and sham acupuncture in controlled clinical trials for headache when they are exposed to both.Methods: Thirty-seven patients with frequent headaches and no prior experience with acupuncture received both a TCM acupuncture treatment and a sham acupuncture procedure in random order.Study participants were not informed that one of the treatments was intended to be a sham procedure.The main outcome measure was patient-perceived credibility of each procedure as assessed by the Acupuncture Credibility Scale.Results: The TCM acupuncture treatment was associated with mean credibility scale scores of 21.2(SD=4.0), whereas the sham acupuncture procedure was associated with a mean scale score of 19.6(SD=4.6).The difference in mean scores associated with the two protocols was 1.6(95% CI: 0.6-2.6; P=0.002).Mean credibility scale scores increased from the first to second treatment for TCM acupuncture, but decreased for the sham acupuncture procedure.Conclusion: The clinical significance of a 1.6-point difference on a 30-point scale is unclear, but the observation that study participants may be able to distinguish between TCM and sham acupuncture protocols after a single exposure to each provides support for the policy of excluding patients with prior experience with acupuncture from participation in clinical trials that involve a sham acupuncture control.     

The effects of Park sham needles: a pilot study

BACKGROUND: When performing clinical trials involving acupuncture, it can be difficult to choose a placebo control. OBJECTIVE: To validate the Park sham needle for use as a double-blind control intervention.DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: Two different methods were employed. First, a researcher blinded to needle type administered the Park sham or a real needle, chosen at random, on the arms of 16 healthy volunteers. The researcher and the volunteers independently recorded which needle type they thought had been applied at each acupuncture point. Second, 19 patients with shoulder impingement syndrome were randomly assigned to receive acupuncture applied with the real needle or the Park sham needle, once a week for 6 weeks alongside a course of physiotherapy. At the end of the 6 sessions the patients recorded which needle type they thought was being used. The results were analyzed with a Fisher's exact test. This study was carried out in the Outpatient Department of Physiotherapy in Charing Cross Hospital, London, UK, on healthy volunteers and patients with shoulder impingement pain. The age range was 23 to 54 and 22 to 74 years respectively.RESULTS: Of the healthy volunteers, there was no difference(P=0.23) between the number of needles that were correctly(n=43) or incorrectly identified(n=53). All patients thought that they had received the real needles. The researcher correctly identified all needles that were applied. CONCLUSION: The researcher delivering the acupuncture recognized the needle type. However, both healthy and patient volunteers were blind to the needle type. This demonstrates that the Park sham needle is an effective single-blind control. It should be noted that the number of patients recruited was small and the study was underpowered to detect an effect of treatment.     

PRELIMINARY FINDINGS OF AN EVALUATION OF THE EFFECTIVENESS OF LASER ACUPUNCTURE ON OSTEOARTHRITIC KNEE PAIN:A RANDOMISED,DOUBLE-BLIND,PLACEBO-CONTROLLED CLINICAL TRIAL

Background: Worldwide, osteoarthritis(OA) is the major cause of musculoskeletal pain and mobility disability in elderly people.Osteo Arthritis Research Society International(OARSI) lists acupuncture among 35 evidence-based consensus recommendations for the management of OA of the knee or hip.Objective: The objective of this randomised, double-blind, placebo-controlled trial is to evaluate the effectiveness of LASER acupuncture on osteoarthritis knee(OAK) pain.The study integrates traditional acupuncture philosophy, treatment principles and techniques with modern LASER technology.A literature review suggests LASER-related OA research has focused primarily on the general condition rather than OAK pain.Little published research is available on LASER acupuncture OAK.Previous OAK research did not use a design that accounts for the TCM model, although 9 out of 10 OAK studies produced positive findings.Methods: Forty participants have been recruited and screened against inclusion/exclusion criteria and randomized into two groups: intervention and placebo.Intervention or placebo will be administered 3 times per week for 4 weeks(12 treatments).Outcome measures will be evaluated before and after the 12 treatments, with 1 and 2 months follow-up.Results will be tested for statistical significance using ANOVA and t tests.This study is differentiating itself from earlier studies by using TCMspecific inclusion criteria in addition to the Kellgren-Lawrence scale.Discussion: Forty participants have taken part in this study, the first of its type in Australia.Whatever the study outcome is, new knowledge will be developed within the field of LASER acupuncture where currently very little information has been published.     

基于CONSORT与TIDieR-Placebo评价安慰针刺治疗膝骨性关节炎随机对照试验文献的报告质量*

目的：评估针对膝骨性关节炎治疗中安慰针刺的随机对照试验（RCT）文献的质量,探讨安慰针刺临床试验设计的思路。方法：计算机检索中国期刊全文数据库（CNKI）、维普中文期刊全文数据数据库（VIP）、万方数据知识服务平台（WF）、中国生物医学文献数据库（SinoMed）、PubMed、Web of Science（WOS）及Embase数据库,收集使用单纯针刺与安慰针刺进行对比的针灸治疗膝骨性关节炎RCT研究,检索时限从建库至2022年12月31日。使用CONSORT与TIDieR-Placebo标准评估文献报告质量,并对结果进行分析讨论。结果：共纳入20篇文献。CONSORT评价结果显示报告率不高于10%的条目为条目3b、 6b、11b、12b、14b、17b、18。TIDieR-Placebo评价结果显示报告率不高于10%的条目为条目6、9、10、11、13。安慰针刺的方式主要为“假穴假刺”“假穴真刺”“假穴浅刺”“非治疗穴真刺”“治疗穴假刺”5种。结论：有关安慰针刺的临床试验尚不严谨,质量有待提高。为推动针灸领域临床研究的标准化,建议未来的研究应更加重视依据这些标准来规范化研究报告。     

WHITE MATTER MICROSTRUCTURE CHANGES IN ACUPUNCTURE FOR PATIENTS WITH STABLE SOMATOSENSORY STROKE:A DIFFUSION TENSOR MAGNETIC RESONANCE IMAGING STUDY

Objective: Acupuncture has been proved to have beneficial effects in the motor recovery process for stroke patients.In spite of its acceptance, the neural mechanism underlying acupuncture for motor recovery is still elusive.The aim of the study was to characterize acupuncture efficacy-related white matter microstructural changes in patients with stable somatosensory stroke.Methods: Twenty-four patients with right hemispheric striatocapsular infarction and stable ischemic stroke were assigned randomly to receive acupuncture or sham treatment for 4 weeks.Twelve age-matched and gender-matched normal subjects were also included.Fractional anisotropy(FA) and mean diffusivity(MD) maps from diffusion tensor imaging(DTI) were obtained for each stroke group before and after acupuncture treatments and for normal subject once.Moreover, mean FA and MD in regions with detected difference after acupuncture treatment were compared in each stroke group and correlations between diffusion quantities and severity of stroke were analyzed.Results: White matter microstructure differences were found between patients and normal subjects primarily in the contralesional primary motor cortex(M1) and insula.The clinical data demonstrated that after 4 weeks of treatment the motricity index(MI) was increased significantly in the acupuncture group but there was no difference between the acupuncture and the sham groups.Only the acupuncture group showed greater activity in the contralesional M1 and non-primary motor cortex(the insula and cingulate cortex) compared with the sham group.The changes were also related significantly with the MI.In the sham group,the activity of the parahippocampus tended to be associated with the increase in the Barthel Index of activities in daily life.Conclusion: Acupuncture and sham intervention have relatively different clinical efficacy and white matter microstructure changes.Acupuncture treatment, which better improves the symptoms and quality of life of stroke patients significantly, enhances the white integrity of both motor network and non-primary motor network.     

平衡针治疗急性咽炎咽痛即时疗效分析

目的:探讨平衡针治疗急性咽炎咽痛的即时疗效。方法:74例病人按就诊号随机分为治疗组和对照组,其中治疗组36人给予平衡针针刺"咽痛穴"治疗,对照组38人给予假穴位针刺,评价治疗后1min视觉模拟评分(VAS)及安全指标。结果:治疗后1min治疗组及对照组VAS分别为(2.11±1.88)分和(3.39±1.94)分,治疗组优于对照组(P<0.05)。治疗组愈显率为44.4%(16/36),优于对照组的10.5%(4/38)。结论:平衡针治疗及假穴位针刺治疗皆能迅速缓解急性咽炎咽痛症状,平衡针疗效优于假穴位针刺疗效。