CLINICAL OBSERVATION ON THE TREATMENT OF ACUTE CEREBRAL INFARCTION WITH SCALP-ACUPUNCTURE

With the rapid development of research onthe treatment of cerebrovascular diseases withscalp acupuncture, ear1y or earlier treatment ofacute cerebral infarction with acupuncture thera-py has become a common endeavor direction forall the medical workers in the field of acupunc-ture and moxibustion. In accordance with thescalppoint. distribution in different meridiansand 'their clinical indications and combing thedistributive area of blood flow of the cerebral an-terior and middle arteries and ce…     

CLINICAL SIGNIFICANCE OF“TREATING VITALITY” AND “RESERVING VITALITY”

"Treating vitality"and"reserving vitality"are very important manipulations during acupuncture treatment of diseases. "Treating vitality" comprises adjusting and treating both the acupuncture doctor's and the patient's vitality; while "reserving vitality" demands the acupuncture doctor carefully to experience the sensations of 'excess' or 'deficiency' under the needle, wait for the arrival of qi, observe the patient's responses, and then perform reducing or reinforcing needling manipulations in accordance with the state of excess- or deficiency- syndrome. "Treating vitality" and "reserving vitality" impenetrate the whole process of acupuncture treatment all along. Through years' clinical practice, the author of the present paper discusses the functions of the two aspects in every stage of acupuncture treatment, including before acupuncture, during needle insertion, during retention and withdrawal of the needle. The purpose of this paper is to explain the clinical significance of treating and reserving vitality and arouse many acupuncture doctors' attention.     

COMMENTS ON THE STUDY OF ACUPOINT COMBINATION AND REMEDIES FOR TREATMENT OF DIABETES MELLITUS WITH ACUPUNCTURE AND MOXIBUSTION

In the present paper, the author reviews the progresses in the study on acumoxi (acupuncture-moxi-bustion) treatment of diabetes mellitus (DM) from Chinese ancient classical works, Chinese and foreign journals. The therapeutic results reveal that acupuncture treatment of DM is effective in improving DM patients' symptoms via vagal-nerve reflex, regulation of neuroendocrine and immune functions. The author holds that ① correct selection of acupoints in accordance with syndrome differentiation and the related meridians and combined application of acupuncture and Chinese herbal medicines (for oral administration) are the key points for raising the therapeutic effect; and ②acupoint combination and curative methods need to be researched further.     

COMMENTS ON THE STUDY OF ACUPOINT COMBINATION AND REMEDIES FOR TREATMENT OF DIABETES MELLTIUS WITH ACUPUNCTURE AND MOXIBUSTION

In the present pater ,the author reviews the progresses in the study on acumoxi(acupuncture-moxi-bustion)treatment of diabets mellitus(DM) from Chinese ancient classical works.Chinese and foreign journals.The therapeutic results reveal that acupuncture treatment of DM is effective in improving DM patients‘ symptoms via vagal-nerve reflex,regulation of neuroendocrine and immune functions,The author holds that （1） correct selection of acupoints in accordance with syndrome differentiation and the related meridians and combined application of acupuncture and Chinese herbal medicaines (for oral administration)are the key points for raising the therapeutic effect;and (2) acupoint combinaton and curative methods need to be researched further.     

针刺加刺络与卡马西平治疗偏头痛效应差异的观察（英文）

Objective:To observe the clinical therapeutic effect on migraine treated with acupuncture combined with blood-letting therapy.Methods:A total of 90 patients of migraine were included in compliance with the requirement and divided into a blood-letting therapy group,a western medication group,an acupuncture plus blood-letting therapy group,30 cases in each one according to the random number table.In the two control groups,the simple blood-letting therapy was exerted at Dazhui(大椎 GV14) and the oral administration with carbamazepine were provided respectively.In the acupuncture plus blood-letting therapy group,acupuncture was exerted at Baihui(百会 GV20) and other points,with blood-letting therapy combined.The treatment was given once daily and 12 treatments were as one course.After 2 courses of treatment,the score of therapeutic effect on symptoms and signs,pain score of visual analogue scale(VAS) and clinical therapeutic effect were compared among the three groups before and after treatment.Results:At the end of treatment,the scores for symptoms and signs and VAS score were reduced obviously as compared with those before treatment in the three groups(all P 0.01).Compared with the blood-letting therapy group and the medication group,the scores for symptoms and signs and VAS score were all reduced more obviously in the acupuncture plus blood-letting therapy group respectively(all P0.01) and the differences were not significant between the blood-letting therapy group and the medication group(P 0.05).The total effective rate in the acupuncture plus blood-letting therapy group was higher obviously than either the blood-letting therapy group or the medication group(both P 0.05).Conclusion:Acupuncture combined with blood-letting therapy achieves a better clinical therapeutic effect on migraine as compared with either simple blood-letting therapy or medication.Such combined treatment obtains a satisfactory therapeutic results and deserves to be promoted in clinical application.     

Survey： Use of Acupuncture for the Treatment of Acute Low Back Pain by Physicians and Physiotherapists in Ontario

Objective: To determine the prevalence of the use of acupuncture treatment for acute low back pain (LBP) among acupuncture practitioners, and investigate acupuncture practitioners’ perceptions on the effectiveness of this treatment modality and the costs associated with its use in Canada.     

EFFICACY OF ACUPUNCTURE FOR MOTION SICKNESS:A RANDOMIZED CONTROLLED CLINICAL TRIAL

Objective: In this randomized, controlled study, we observed the efficacy of acupuncture in motion sickness.Methods: We did a randomized and controlled trial of acupuncture in volunteers with motion sickness.A total of 60 patients were randomly assigned to acupuncture or standard care group.The acupuncture group received treatments on acupuncture points including GV20(Baihui), EX-HN1(Sishencong), bilateral PC6(Neiguan) and ST36(Zusanli), twice per week for 5 weeks.The control group received only usual care during the same period.The two experimental groups received tests with motion sickness device in the same environment.Graybiel score and the degrees of discomfort were used to evaluate the degree of motion sickness.Car trials were used for the evaluation of clinical efficacy.Analysis was performed on the last score except patients who were dropped out before completion.Results: The Graybiel scores were 10.12±3.37 and 9.95±2.60 in the acupuncture group and the control group respectively with no significant difference(P0.05) before treatment.The Graybiel scores were 0.92±0.40 and 9.86±2.53 in the acupuncture group and the control group respectively with significant differences(P0.05) after treatment.The motion sickness degree distribution in the acupuncture group was N, 0;I, 0; IIB, 0; IIA, 7; III, 16; and F, 2 before treatment; and N, 3; I, 22; IIB, 0; IIA, 0; III, 0; and F, 0 after treatment.The distribution of the control group was N, 0; I, 0; IIB, 0; IIA, 5; III, 16; and F, 1 before and after treatment.After the experiment, the degrees of discomfort in the acupuncture group significantly decreased(P0.01).Total effective rates of the acupuncture group and the control group were 96% and 0% respectively with significant differences(P0.05).No adverse effects of acupuncture were reported.Conclusion: These data suggest that acupuncture is an effective therapy for patients with motion sickness.The anti-motion sickness capabilities are improved and the sufferings of patients with motion sickness were alleviated after acupuncture treatment.     

Effects of moxibustion and acupuncture at Zusanli(ST 36) and Zhongwan(CV 12) on chronic atrophic gastritis in rats

OBJECTIVE: To evaluate the effects of moxibustion and acupuncture of Zusanli(ST 36) and Zhongwan(CV 12) acupoints on chronic atrophic gastritis(CAG) in rats, and to study the mechanisms behind their actions.METHODS: Forty-four male Sprague-Dawley rats were induced with CAG by intragastric administration of 40% ethanol combined with free drinking of N-methyl-N′-nitro-N-nitrosoguanidine and irregular feeding for 12 weeks, followed by daily treatment with moxibustion or acupuncture for 2 weeks. Histopathologic examination, Western blotting of cytokines [epidermal growth factor(EGF),EGF receptor(EGFR), extracellular signal-regulated kinase(ERK), phosphorylated ERK(p-ERK)], and1 H NMR-based metabolic profiling of gastric tissues were used to measure changes related to CAG modeling and treatment.RESULTS: Moxibustion and acupuncture at Zusanli(ST 36) and Zhongwan(CV 12) each relieved CAG-induced abnormalities in histopathology and cytokine expression of ERK and p-ERK. Only moxibustion treatment regulated the expression of EGF and EGFR. Metabolites that were increased in gastric tissue by CAG induction(alanine, nicotinamide adenine dinucleotide phosphate, uracil DNA glycosylase, lactate, glycerol and adenosine) were restored to normal levels after moxibustion treatment; acupuncture treatment only normalized the levels of adenosine monophosphate and glycerol.CONCLUSION: Our findings suggest that moxibustion or acupuncture at Zusanli(ST 36) and Zhongwan(CV 12) can significantly improve the condition of CAG in rats. These treatments exert their effects on CAG through different mechanisms.     

THE EFFECT OF ACUPUNCTURE ON PREVENTION AND TREATMENT OF ISCHEMIC ARRHYTHMIA AND THE RELATION BETWEEN EFFECT OF ACUPUNCTURE AND CHOLINERGIC MUSCARINE-LIKE RECEPTORS

For investigating the effect of acupuncture on ischemic arrhythmia and its mech-anism, adult albino rats with ligated anterior descending branch of coronary artery as experimentalmodel were treated with or without acupuncture, and others with imitative operation but without bothcoronary artery ligation and acupuncture treatment were used as control. It was found in acupuncturegroup that the fibrillation-liability of ischemic myocardium was efficiently decreased, the affinity ofAch-M receptors on membranes of ischemic myocardium was markedly increased, and the tolerance ofischemic myocardium to atropine was elevated in the experiment of atropine inducing fibrillation.These results indicate that acupuncture may play a therapeutic role on ischemic arrhythmia throughactivating the activity of muscarine-like receptors of cholinergic nervous system.     

ACUPUNCTURE AND KETAMINE IN TREATING CHRONIC BACKACHE

Purpose: The primary aim of this research was to determin whether the use of oral ketamine is effective, safe, and acceptable fo patients presenting with low-back pain.It was used in conjunctio with acupuncture treatment to reduce the number of the seat(when treating a patient with acupuncture, they receive treatment over a series of days—this may mean every day or every othe day for a period of 10 d, for example, this is called a "seat") o acupuncture.Results: The results showed that(1) 58%(29/50) of the patients became pain-free;(2) 26%(13/50) of the patients experienced a decrease in pain by one half.They continued on acupuncture only, without ketamine;(3) The remaining 16%(8/50) had no response during the 1st course.Among these eight participants, six requested ketamine in combination with acupuncture, and two required surgery.The result of this study is compared with other studies in which acupuncture alone was used in treatment of the 30 patients in the control group.Thirty percent were pain-free after the 1st course of acupuncture, 50% of the patients had pain reduced by one half, and only 20% showed no response during the first course.     

Clinical Practice Guideline of Acupuncture for Bell’s Palsy

Backgroud: Acupuncture is common used for Bell’s palsy in clinic, however, recent systematic reviews all shows that there is no sufficient evidence to support the effectiveness of acupuncture for Bell’s palsy because ofthe poor quality and heterogeneity. It’s urgently necessary to develop a guideline of acupuncture for Bell’s palsy based on principles of evidence-based medicine to optimize acupuncture treating, standardize outcomes evaluating and to improve the quality of acupuncture for patients with Bell’s palsy under general circumstances. Objective: To improve the accuracy of diagnosing and managing Bell’s palsy, optimize acupuncture treating and outcomes evaluating for patients with Bell’s palsy, and to improve the quality of acupuncture for patients with Bell’s palsy in most instances. Methods: This guideline was developed using an explicit and transparent a priori protocol based on supporting evidences and experts’ consensus. The guideline developing Group followed the protocol through all stages of the development process: proposed clinical questions, searched clinical evidences, evaluated levels of evidences, developed recommendations, peer reviewed and consummated, and finally formed the draft of this guideline. Results: (1)The guideline development group made a Grade A recommendation that ①With a course of Bell’s palsy within 3 months, the patients with mild facial palsy may be treated with any one of acupuncture, western drugs, or acupuncture combing with western drugs, whereas the patients with severe facial palsy may be treated with acupuncture or acupuncture combing with western drugs. With a course of more than 3 months, acupuncture is more suitable. ②Acupuncture should be applied as early as possible for Bell’s palsy. ③The principle of selecting acupoints for Bell’s palsy is to select local points, points of corresponding meridians and those according to differentiation. Generally, the points of yangming meridians are the main ones. ④The various methods of acupuncture and moxibustion are adopted for Bell’s palsy, including filiform needling, moxibustion, electro-acupuncture, etc. Two or more methods are usually used together in clinical practice. (2) The development group formed expert consensus on the principles of acupuncture treatment for Bell’ palsy. Bell’s palsy is suitably treated according to the stages, differentiation and symptoms.     

黑龙江针灸临床创新研究头雁团队介绍

Heilongjiang Clinical Acupuncture Innovation & Research Leading Team is a main research team of Heilongjiang provincial acupuncture discipline with Professor SUN Zhongren as the academic leader.The team is a first-class research one specialized in treatment of encephalopathy diseases that is composed of academic leaders and core discipline researchers and based on the acupuncture discipline of Heilongjiang University of Chinese Medicine.     

INFLUENCE OF “WARMING YANG AND NOURISHING QI” ACUPUNCTURE TREATMENT ON SERUM IL-12 AND IL-18 EXPRESSION LEVELS IN RATS WITH EXPERIMENTAL AUTOIMMUNE MYASTHENIA GRAVIS AND ITS MECHANISM

Objective: To observe the influence of the "Warming yang and Nourishing qi" acupuncture treatment on the serum interleukin-12(IL-12) and interleukin-18(IL-18) expression levels in rats with experimental autoimmune myasthenia gravis(EAMG) and to analyze the mechanism of acupuncture in treatment of myasthenia gravis(MG).Methods: AchRα1 129-145 peptide fragments were used to immune the female Lewis rats to establish EAMG rat models.Thirty EAMG model rats were randomly divided into acupuncture treatment group, drug control group and model control group(n=10); the unmodeled 10 rats purchased at the same period were used as the blank control group.The rats in acupuncture treatment group were treated by "Warming yang and Nourishing qi" acupuncture treatment, 30 min, once a day, 7 d for a period, 1 d rest between two periods, and two periods of continuous treatment.The rats in drug control group were treated by the pyridostigmine lavaged treatment, 18.5 mg/(kg·d), continuous treatment for 15 d.The rats in the other two groups had no any special treatments.After treatment, the blood samples from the vein of tail root of the rats in 4 groups were collected, and the serum expression levels of IL-12 and IL-18 were detected with ELISA method.Results: After treatment, compared with the model control group, the serum IL-12 and IL-18 expression levels of the EAMG rats in the acupuncture treatment group and the drugcontrol group were significantly decreased(P0.05 or P0.01).Compared between the acupuncture treatment group and the drug control group, the serum IL-12 and IL-18 expression levels of the EAMG rats were not significantly different(P0.05).Conclusion: "Warming yang and Nourishing qi" acupuncture treatment can reduce the serum IL-12 and IL-18 expression levels of EAMG rats.For the treatment of MG, the effect of acupuncture was similar to pyridostigmine.     

Survey on Treatment of Cerebral Palsy by Scalp Acupuncture

Infantile cerebral palsy （cerebral palsy） refers to the syndrome of the motor and posture developing disturbance, caused by non-progressive injury in the developing fetus or infant. Acupuncture therapy can be used to improve various clinical manifestations of the infants with cerebral palsy, and in the treatment of the functional disturbance and accompanying symptoms of cerebral palsy; the satisfactory therapeutic results have been achieved. In this article, the literature on the treatment of cerebral palsy by scalp acupuncture in the recent years has been surveyed and assessed.     

Effect of individualized needling on gross motor function in cerebral palsy infants

Objective: To observe the effect of individualized needling protocol (on the basis of functional brain mapping and standardized syndrome differentiation in Chinese medicine) on gross motor functions of infants with cerebral palsy (CP) and thus study the innovative means of combining acupuncture with rehabilitation management technique. Methods: A total of 74 CP infants were randomized into a treatment group and a control group, 37 in each group. Combined individualized needling and rehabilitation training were used in the treatment group, versus combined Jin’s needling (16 brain-benefiting points) and rehabilitation training in the control group. For both groups, acupuncture treatment was conducted once every other day and rehabilitation training every day. The dynamic changes of gross motor functions before treatment and after every 1-month treatment were measured and assessed using the Gross Motor Function Measure (GMFM)-66. Results: After treatment, the GMFM scores were significantly increased in both groups (P<0.01); there were no between-group statistical differences in increase range of the GMFM scores (P>0.05); the treatment protocol was not interacted with the treatment time; and the GMFM scores for spastic CP infants were better in the treatment group than that in the control group (P<0.05). Conclusion: Combined scalp acupuncture and rehabilitation training can produce positive effects on gross motor functions of CP infants. Individualized needling can obtain better effects than 16 brain-benefiting points in improving the gross motor functions of spastic CP infants.     

CASE STUDIES OF THE TREATMENT OF HYPOTHYROIDISM BY MERIDIAN THEORY OF CHINESE MEDICINE

Some patients with hypothyroidism still remain symptom after prolonged treatment with thyroxine. Alternative treatment needs to be explored. The treatment is described as overlapof acupunture, supplemented with electric acupuncture, magnetic acupuncture, ear acupuncture, herbaltreatment, and acupressure of thyroid. The result of two case studies will be discussed in the presentation.The theoretical basis for the approach will also be explored.In Chinese medicine, hypothyroidismis often defined as spleen deficiency in the early stage and can be treated with ISRQ recipes (Invigorating the Spleen and Replenishing the Qi). In the chronic stage, hypothyroidism can be seen as kidneydeficiency and can be treated with KRR (Kidney Reinforcing Regimen). Hypthyroidism symptoms aresometimes diffcult to treat. However, TCM (Traditional Chinese Medicine) diagnosis and treatmentare based on an overall analysis of the illness according to patients' condition. After successful treamentof TCM, patients can stop taking Thy     

Efficacy of acupuncture on fibromyalgia syndrome：a Meta-analysis

OBJECTIVE：To comprehensively evaluate the effectiveness of acupuncture as a treatment for fibromyalgiasyndrome.METHODS： Two review authors independently selected the trials for the Meta-analysis, assessed their methodological quality and extracted relevant data. A quality assessment was conducted according to the Cochrane Review Handbook 5.0.RevMan 5.0.20 software was used in the statistical analysis.RESULTS： A total of 523 trials were reviewed and 9trials were selected for Meta-analysis.（a） Compared acupuncture with sham acupuncture, there was a significant difference in the visual analogue scale,but no difference in the pressure pain threshold.Additionally,and there was a difference in the fibromyalgia impact questionnaire and the multidisciplinary pain inventory after 4 weeks of treatment,but no difference after 7 weeks of therapy. There was no difference in the numerical rating scale in weeks 3, 8 and 13.（b） Acupuncture versus drugs.There were differences in the VAS after 20 days of acupuncture and moxibustion treatment comparing with the drug amitriptyline, and after 4 weeks of acupuncture and moxibustion treatment comparing with the drug fluoxetine and amitriptyline.There were also differences in the number of tender points when comparing acupuncture with amitriptyline or fluoxetine. There was no difference in total efficiency when comparing acupuncture with amitriptyline after 4 weeks of treatment, but there were differences between the two groups 45 days after treatment.There were also differences in total efficiency comparing acupuncture with fluoxetine,and when comparing 4 weeks post-treatment of acupuncture with a combination of amitriptyline,oryzanol and vitamin B.（c） A comparison of acupuncture, drugs and exercise with drugs and exercise showed PPT differences in months 3 and 6.There was no difference between the two comparison groups after follow-up visits in months 12 and 24.CONCLUSION： Compared with sham acupuncture,there was not enough evidence to prove the efficacy of acupunc     

OBSERVATION ON CLINICAL THERAPEUTIC EFFECT OF MRI-AIDED ENCLOSURE NEEDLING IN THE TREATMENT OF STROKE AND ITS INFLUENCE ON BLOOD RHEOLOGY

Objective: To observe clinical therapeutic effect of magnetic resonance imaging (MRl)-aided enclosure needling in the treatment of stroke patients and changes of the related blood rheology. Methods: A total of 61stroke patients were randomized into MR I-aided enclosure needling group (MRI-aided acupuncture group) (n = 31 ) and conventional acupuncture group (n= 30). For patients of MRl-aided acupuncture group, acupuncture needles were inserted into the subcutaneous tissues around the focus-projection scalp area displayed by MRI, with the needle tips toward the center of the projection region and with two needles being about 2 crn apart, combined with other acupoints according to the concrete syndromes or symptoms. For patients of conventional acupuncture group, Motor Area (MS 6)and Sensory Area (MS 7) on the contralateral side of the focus were punctured. The treatment was conducted once daily, continuously for 30 days. Results: After treatment, of the 31 cases in MRl-aided acupuncture group, 20 werecured basically, 10 responded with significant improvement of symptoms and signs, one case had some improvement.While in conventional acupuncture group, of the 30 cases, 11 were cured basically, 15 responded with striking amelioration of symptoms and signs and 4 had some amelioration. Ridit analysis showed that the therapeutic effect of MRI-aided acupuncture group was significantly superior to that of conventional acupuncture group (P ＜ 0.05). After treatment,the whole blood viscosity, plasma viscosity, hematocrit, whole blood reduction viscosity, hemagglutination index, and the total score of the two groups all decreased significantly in comparison with those of pre-treatment of each group,while whole blood viscosity, hematocrit, vascular sclerosis index and the total score of MRl-aided acupuncture group were obviously lower than those of conventional acupuncture group ( P＜ 0.05- 0.01 ), suggesting that the effect of theformer group in bettering blood rheology was pronouncedly superior to that of conventional acupuncture group. Conclusion: MRl-aided acupuncture group is obviously superior to that of conventional acupuncture group in improving clinicalsymptoms and signs and blood rheology in stroke patients.     

Moxibustion on Shenque （CV 8） Improves Effect of Acupuncture for Diarrhea-predominant Irritable Bowel Syndrome

Objective： To observe the clinical effect of acupuncture and moxibustion on diarrhea-predominant irritable bowel syndrome （IBS-D）. Methods： A total of 60 IBS-D patients were randomly allocated into a treatment group and a control group, 30 in each group. Patients in the treatment group were treated with acupuncture combined with ginger and salt-partitioned moxibustion on Shenque （CV 8）, whereas patients in the control group only received acupuncture treatment. Six days made up a course of treatment, and the clinical effects were statistically analyzed after 4 courses. Results： The overall response rate in the treatment group was 96.7%, versus 76.7% in the control group, showing a statistical significance （P〈0.05）. In the intra-group comparison of the symptom scores after treatment, there were statistical differences in both groups （both P〈0.01）, and in the inter-group comparison, the difference was statistically significant （P〈0.05）. Conclusion： Acupuncture combined with ginger and salt-partitioned moxibustion on Shenque （CV 8） can obtain better effect for ISB-D than acupuncture alone.     

DEVELOPMENT OF CLINICAL STUDIES ON ACUPUNCTURE TREATMENT OF SHOULDER PAIN IN PATIENTS WITH WIND STROKE

In the present paper, the authors review some new results of acupuncture treatment of shoulder pain in stroke patients from ① application of filiform needle with different needling manipulations, ② selection and combination of acupoints, and ③ some special needling methods including point-injection. Generally, if acupuncture therapy is used in combination with other rehabilitation methods, the therapeutic effect of shoulder-pain-relief will be much better. Regarding the acupoint selection, both local acupoints and those of the yang meridians are primarily used in clinical practice. Further studies on treating shoulder pain of hemiplegia based upon the basic theory of TOM are necessary.