Chinese herbal medicine for chronic heart failure: a multicenter,randomized, double-blind,placebo-controlled trial

ObjectiveThe purpose of this study was to assess the efficacy and safety of Chinese herbal medicine (CHM) in the treatment of chronic heart failure (CHF) patients according to syndrome differentiation.MethodsIn this multicenter, randomized, double-blind, placebo-controlled clinical trial, a total of 220 CHF patients were assigned to receive CHM or placebo granules without decoction according to syndrome differentiation in addition to their standard western treatment for 4 weeks. The change in the left ventricular ejection fraction (LVEF) was the primary outcome, and the changes in the TCM syndrome scores (TCM-SS) and New York Heart Association functional classification (NYHA-FC) were the secondary outcomes.ResultsAfter 4 weeks of treatment, the mean changes in the LVEF (13.1 ± 9.78 vs. 7.34 ± 7.40, P < 0.001) and the TCM syndrome scores (−34.2 ± 24.6 vs. −23.5 ± 25.2, P = 0.002) were better in the CHM group than in the placebo group. After two weeks of treatment, the mean changes in the LVEF (9.26 ± 7.83 vs. 4.72 ± 5.60, P < 0.001) and the TCM syndrome scores (−23.5 ± 18.6 vs. −14.0 ± 15.9, P < 0.001) were better in the CHM group than in the placebo group. In addition, repeated-measures analysis of variance (ANOVA) indicated significant time course effects of CHM versus placebo in the LVEF and TCM syndrome cores (P < 0.001 for all). The distention of the jugular vein (P = 0.021), expectoration (P = 0.044), abdominal distention (P = 0.004), and rib pain (P = 0.005) were significantly less in the CHM group than in the placebo group after two weeks of treatment. Fatigue (P = 0.001), less gas and lazy words (P = 0.001), dizziness (P = 0.003), gasping for breath (P = 0.027), abdominal distention (P = 0.011), nausea (P = 0.001) and emesis (P = 0.012) were significantly less in the CHM group than in the placebo group after treatment for four weeks. After four weeks of treatment, the change in the NYHA functional classification in the CHM group was better than that in the placebo group (P < 0.001). There was one death in the placebo group, and one patient in the CHM group experienced atrial fibrillation.ConclusionCHM treatment according to syndrome differentiation effectively improved the LVEF, TCM-SS, and NYHA-FC in patients with CHF and also appeared to be safe. Thus, CHM treatment could be used as an adjuvant therapy in the treatment of CHF (Clinical trial registration: NCT01939236).     

Effect of Transcutaneous Electrical Nerve Stimulation on the Pain Intensity During Insertion of Needle in Patients Undergoing Spinal Anesthesia: A Randomized Controlled Study

Background and objectivesNeedle insertion pain during spinal anesthesia is an unpleasant experience for patients. This study aimed to investigate the effects of Transcutaneous Electrical Nerve Stimulation (TENS) on the pain intensity during the insertion of spinal needles in patients undergoing spinal anesthesia.Materials and methodsIn a double-blind clinical trial, 60 candidates for elective Trans Ureteral Lithotripsy surgery under spinal anesthesia were randomly divided into intervention and control groups. The electrodes of the TENS device were placed in the space between L3-L4 and L5-S1 vertebrae. The intensity of pain during insertion of the spinal needle by Visual Analog Scale and the frequency of attempts were recorded.ResultsThe mean age of the study samples was 34.26 ± 5.07 and 32.8 ± 5.28 in the control and intervention group, respectively. The pain intensity during insertion of spinal needles was less significant in the intervention group compared to the control group (p = 0.001). The number of attempts to insert the spinal needle between the two groups was not statistically significant (p = 0.51). The duration of spinal anesthesia implementation procedure by physician in the intervention group was significantly shorter than that of the control group (p = 0.001).ConclusionThe use of TENS effectively reduced the pain of spinal needle insertion. Considering these beneficial effects, it is suggested that this procedure be used to relive pain in patients with spinal anesthesia.     

Heart rate responses and oxygen consumption during Tai Chi Chuan practice.

Tai Chi Chuan (TCC) is a popular Chinese conditioning exercise, however, its exercise intensity remains controversial. The objective of this study was to determine the exercise intensity of Yang TCC by measuring heart rate (HR) responses and oxygen consumption (VO2) during practice. Fifteen men aged 39.9 +/- 9.5 yrs (range 26-56 yrs) participated in this study. Subjects had practiced classical Yang TCC for 5.8 +/- 2.4 years. HR responses and VO2 were measured during practice of TCC by using a K4 telemetry system. Blood lactate was measured before and immediately after TCC practice. Additionally, breath-by-breath measurement of cardiorespiratory function and sequential determination of blood lactate were performed during the incremental exercise of leg cycling. Measurements obtained during the TCC practice and exercise testing were compared to determine the exercise intensity of TCC. While performing TCC, the mean HR of subjects was 140 +/- 10 bpm, and the mean VO2 was 21.4 +/- 1.5 mL x kg(-1) min(-1). Compared with the data of the exercise test, the HR during practice was 58% of the heart rate range. Meanwhile, the VO2 during TCC practice was 55% of the VO2peak. Additionally, the level of blood lactate immediately after TCC practice was 3.8 mM, which reflected the level of lactate during TCC, approximated the onset of blood lactate accumulation (OBLA). The results demonstrate that TCC is an exercise with moderate intensity, and is aerobic in nature.     

Acute cardiovascular effects of bitter orange extract (p‐synephrine) consumed alone and in combination with caffeine in human subjects: A placebo‐controlled,double‐blind study

The purpose was to examine cardiovascular responses to supplementation with p‐synephrine alone and in combination with caffeine during quiet sitting. Sixteen subjects were given (in double‐blind manner) either 103 mg of p‐synephrine (S), 233 mg of caffeine +104 mg of p‐synephrine (LC + S), 240 mg of caffeine (LC), 337 mg of caffeine +46 mg of p‐synephrine (HC + S), 325 mg of caffeine (HC), or a placebo. The subjects sat quietly for 3 hr while heart rate (HR) and blood pressure were measured. Only HC + S and HC significantly increased mean systolic blood pressure (SBP) during the second hour and tended to increase mean SBP during the third hour. Mean diastolic blood pressure in S was significantly lower than the other trials during the first and second hours, and mean arterial pressure was significantly lower in S compared to the LC, LC + S, HC, and HC + S trials. No differences were observed in HR. Consumption of p‐synephrine may acutely reduce diastolic blood pressure and mean arterial pressure and not affect SBP or HR during quiet sitting. The addition of p‐synephrine to caffeine did not augment SBP or HR indicating that consumption of up to 104 mg of p‐synephrine does not induce cardiovascular stress during quiet sitting.     

Analgesic effects and hemodynamic mechanisms of perpendicular and transverse needling at Sanyinjiao (SP 6) in patients with primary dysmenorrhea: A randomized controlled trial

ObjectiveTo explore the analgesic effects and uterine hemodynamics of perpendicular needling (PN) and transverse needling (TN) at SP 6 in patients with primary dysmenorrhea (PD).MethodsIn this randomized controlled trial, patients with PD diagnosed with cold-dampness congealing pattern were randomly assigned in a ratio of 1:1 to receive PN or TN at bilateral SP 6 for 10 min. Acupuncture was performed when the menstrual pain score was over 40 mm on the first day of menstruation, as measured using the visual analog scale for pain (VAS-P). The primary outcome was average menstrual pain (VAS-P). Secondary outcomes included the pulsatility index (PI), resistance index (RI), and systolic-diastolic peaks ratio (S/D) in uterine arteries as measured using color Doppler ultrasonography; anxiety as assessed using the Hamilton Anxiety Rating Scale (HAMA), blood pressure (BP), and heart rate (HR).ResultsForty-eight patients completed the study. The TN group exhibited a significant reduction in VAS-P scores (–5.71 mm, 95% confidence interval (CI): –8.78, –2.63, P = .001), RI values (–0.05, 95% CI: –0.09, –0.01, P = .015), and HAMA values (–2.50, 95% CI: –4.78, –0.22, P = .032) when compared with the PN group. No significant differences in PI, S/D, BP, or HR values were observed between the two groups (P > .05).ConclusionTN at SP 6 was superior to PN in alleviating menstrual pain and anxiety in patients with PD. This analgesic effect of TN may be due to its better ability to improve uterine arterial blood flow via decreases in RI values.     

Effect of co-existent components in CO2 supercritical fluid extract of Angelica Sinensis Radix on metabolism of Z-ligustilide after oral administration in rats

ObjectiveTo establish a basis for Angelica Sinensis Radix (ASR) as a dietary supplement for colorectal cancer chemoprevention, the effect of co-existent components in supercritical fluid extract (SFE) of ASR on the pharmacokinetics of Z-ligustilide after oral administration was investigated in vitro and in vivo.MethodsIncubation in gastrointestinal contents and incubation in rat liver tissue homogenates post-mitochondrial supernatant (PMS) experiments were used to study changes in the levels of Z-ligustilide in vitro.ResultsWithin 4 hours, the level of Z-ligustilide in SFE declined at a slower rate than in its pure form. Clearance of Z-ligustilide after administration in its pure form was significantly slower than that of SFE of ASR (CL, 0.96 ± 0.16 mL·min/kg versus 1.24 ± 0.21 mL·min/kg P < 0.05; AUC, 243.37 ± 16.84 versus 176.69 ± 12.59 mg·min/L).ConclusionThese phenomena may be attributed to the interactions between the co-existent components in SFE of ASR and Z-ligustilide enhancing the stability of Z-ligustilide. These results suggest that the bioavailability of Z-ligustilide in SFE of ASR is improved. However, stabilization of plasma concentration was not sustained, so that the efficacy of active components could not be maintained. Thus, further processing of SFE of ASR is required.     

Wet Cupping Therapy Improves the Parameters of Ventricular Repolarization

BackgroundCupping therapy (CT) is an ancient medical treatment since antiquity and is used for the treatment of such various disease states as contagious diseases, chronic or acute inflammatory disease, and autoimmune disorders. Ventricular repolarization is represented by QT and corrected-QT (QTc) intervals from surface electrocardiography.ObjectivesAs novel repolarization parameters, Tpeak-toTend (Tp-Te) interval, and Tp-Te/QT and Tp-Te/QTc ratios are suggested to correlate better with ventricular arrhythmia risk in various clinical conditions than sole QT and QTc intervals. In this study, we aimed to determine whether these parameters changed significantly after CT in healthy individuals.MethodsOne hundred and twenty participants (57 women and 63 men; mean age: 49.0 ± 13.0 years) participated in this study. ECGs strips were recorded 1 hour before and 1 hour after CT from each participant, and relevant ECG parameters were compared.ResultsTp-Te interval [69.51 ± 11.54 msec vs 63.15 ± 10.89 msec, p = 0.001], Tp-Te/QT ratio [0.191 ± 0.030 vs 0.174 ± 0.031, p = 0.002] and Tp-Te/QTc ratio [0.175 ± 0.030 vs 0.159 ± 0.026, p = 0.001] were found to be significantly decreased 1 hour after the procedure compared with the pre-procedure values. However, no statistically significant change was observed in mean heart rate, QT and QTc intervals, QT/QRS and cQT/QRS, and frontal QRS/T angle after the procedure compared with the same parameters before the procedure (p > 0.05).ConclusionsIn accordance with the results of our study, it is plausible to conclude that CT may exert cardioprotective effect. However, larger scale prospective studies are needed to support our findings.     

美洲大蠊粪便提取物对大鼠离体心脏功能的影响研究

[目的]探究美洲大蠊粪便提取物（PAF）对大鼠离体心脏功能的影响。[方法]采用Langendorff灌流装置构建SD大鼠离体心脏灌流模型,检测各组左室收缩压（LVSP）、左心室压力最大上升和下降速率（±dp/dtmax）、心率（HR）等血流动力学指标的变化。[结果] PAF可显著提升正常大鼠离体心脏的LVSP和±dp/dtmax,且呈剂量依赖性,其中0.5 mg/mL的高剂量作用效果最为显著,但PAF对HR并未表现出明显的影响。[结论] PAF升高LVSP,增大±dp/dtmax,对大鼠离体心脏有正性肌力作用,能够增强心肌收缩力。PAF对心率未表现出明显影响,有利于降低心脏耗氧量,可能是其能够发挥心脏保护作用的重要原因。     

Antiplatelet and myocardial protective effect of Shexiang Tongxin Dropping Pill in patients undergoing percutaneous coronary intervention: A randomized controlled trial

BackgroundHigh on-clopidogrel platelet reactivity could be partially explained by loss-of-function alleles of CYP2C19, the enzyme that converts clopidogrel into its active form. Shexiang Tongxin Dropping Pill (STDP) is a traditional Chinese medicine to treat angina pectoris. STDP has been shown to improve blood flow in patients with slow coronary flow and attenuate atherosclerosis in apolipoprotein E-deficient mice. However, whether STDP can affect platelet function remains unknown.ObjectiveThe purpose of this study is to examine the potential effects of STDP on platelet function in patients undergoing percutaneous coronary intervention (PCI) for unstable angina. The interaction between the effects of STDP with polymorphisms of CYP2C19 was also investigated.Design, participants and interventionThis was a single-center, randomized controlled trial in patients undergoing elective PCI for unstable angina. Eligible subjects were randomized to receive STDP (210 mg per day) plus dual antiplatelet therapy (DAPT) with clopidogrel and aspirin or DAPT alone.Main outcome measuresThe primary outcome was platelet function, reflected by adenosine diphosphate (ADP)-induced platelet aggregation and platelet microparticles (PMPs). The secondary outcomes were major adverse cardiovascular events (MACEs) including recurrent ischemia or myocardial infarction, repeat PCI and cardiac death; blood biomarkers for myocardial injury including creatine kinase-MB isoenzyme (CK-MB) and high-sensitive troponin I (hsTnI); and biomarkers for inflammation including intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), monocyte chemoattractant protein-1 (MCP-1) and galectin-3.ResultsA total of 118 subjects (mean age: [66.8 ± 8.9] years; male: 59.8%) were included into analysis: 58 in the control group and 60 in the STDP group. CYP2C19 genotype distribution was comparable between the 2 groups. In comparison to the control group, the STDP group had significantly lower CK-MB (P < 0.05) but similar hsTnI (P > 0.05) at 24 h after PCI, lower ICAM-1, VCAM-1, MCP-1 and galectin-3 at 3 months (all P < 0.05) but not at 7 days after PCI (P > 0.05). At 3 months, the STDP group had lower PMP number ([42.9 ± 37.3] vs. [67.8 ± 53.1] counts/μL in the control group, P = 0.05). Subgroup analysis showed that STDP increased percentage inhibition of ADP-induced platelet aggregation only in slow metabolizers (66.0% ± 20.8% in STDP group vs. 36.0% ± 28.1% in the control group, P < 0.05), but not in intermediate or fast metabolizers. The rate of MACEs during the 3-month follow-up did not differ between the two groups.ConclusionSTDP produced antiplatelet, anti-inflammatory and cardioprotective effects. Subgroup analysis indicated that STDP inhibited residual platelet reactivity in slow metabolizers only.Trial registrationThis study was registered on www.chictr.org.cn: ChiCTR-IPR-16009785.     

Effects of auricular acupuncture on heart rate, oxygen consumption and blood lactic acid for elite basketball athletes

This study investigated the effects of auricular acupuncture on athletes' recovery abilities after exercise. Subjects were selected from twenty-four male elite university basketball players, randomly divided into two groups: auricular acupuncture group (AAG), and normal control group (NCG), each group containing twelve subjects. Auricular acupuncture was experimented to each AAG athlete while no auricular acupuncture was conducted to each NCG athlete. Each subject in both groups performed a ride on the stationary bike until exhausted. The data of heart rate (HR(max)), oxygen consumption (VO(2 max)), and blood lactic acid were measured at four points of time: during the rest period after warm-ups and at the 5th, 30th and 60th minutes post-exercise, respectively. One-way ANOVA and repeated Scheffé methods were used to test the differences of the data between these two groups. The results showed that both HR(max) and blood lactic acid in AAG were significantly lower than those in NCG at the 30th and 60th minutes post-exercise. This suggests that auricular acupuncture can enhance athletes' recovery abilities after aggressive exercise.     

灸药结合治疗慢性心衰疗效观察

目的：观察温和灸结合西药治疗慢性心衰的临床疗效。方法：将60例符合纳入标准的慢性心衰患者随机分为2组,每组30例。治疗组采用温和灸结合常规西药治疗,对照组仅采用常规西药治疗。比较治疗后两组的临床疗效及心功能相关指标。结果：两组治疗后心率（Heart Rate, HR）、心输出量（Cardiac Output,CO）以及左心室射血分数（Left Ventricular Ejection Fraction, LVEF）较治疗前有显著改善（P〈0.01）,治疗组改善情况优于对照组（P〈0.01）。治疗组总有效率也优于对照组（P〈0.05）。提示两种治疗方案对慢性心衰均有效,但治疗组疗效较好。结论：温和灸结合西药治疗慢性心衰临床疗效优于单纯西药治疗。     

浮针治疗膝骨关节炎的临床疗效观察

ObjectiveTo observe and compare the clinical effect on knee osteoarthritis (KOA) between Fu's subcutaneous needling therapy (FSN) and convention acupuncture.MethodsA total of 80 outpatients with KOA were divided into a FSN group (40 cases) and a conventional acupuncture group (40 cases) according to random number table. Within 1 week of treatment, FSN was used once every two days in the FSN group. The needle tip of Fu's subcutaneous needle was inserted toward the affected muscle, about 5 mm in depth, at the angle of 15 to 25°. After the needle body lifted slightly, the needle went forward subcutaneously for 25 to 35 mm in depth and was swiped side to side horizontally with even exertion for about 1 min. According to the distribution of affected muscle, the reperfusion approach was repeated for 3 times consecutively. In the conventional acupuncture group conventional acupuncture was given, once a day, for 6 times totally. The scores of Western Ontario and McMaster universities osteoarthritis index (WOMAC) and Lysholm knee scoring scale (Lysholm) were compared between the two groups before and after 1-week treatment. The clinical effect of the two groups was analyzed statistically and evaluated.ResultsAfter 1-week treatment with FSN, in the FSN group, the score of WOMAC_pain was reduced to be 7.7 ± 1.9 from 18.5 ± 3.2, the score of WOMAC_stiffness to be 1.5 ± 0.7 from 4.5 ± 1.8, WOMAC_function to be 22.7 ± 3.9 from 45.7 ± 2.7 and the score of WOMAC_overall to be 31.9 ± 5.3 from 69.7 ± 6.5. The differences were significant in comparison before and after treatment (all P < 0.05). In the conventional acupuncture group, after 1-week treatment with conventional acupuncture, the score of WOMAC_pain was reduced to be 11.3 ± 2.8 from 18.2 ± 3.0, the score of WOMAC_stiffness to be 3.0 ± 1.6 from 5.6 ± 1.7, WOMAC_function to be 29.8 ± 5.1 from 44.3 ± 2.9 and the score of WOMAC_overall to be 44.1 ± 7.8 from 69.1 ± 7.3. The differences were significant in comparison before and after treatment (all P < 0.05). WOMAC score of every item in the FSN group was lower obviously than that in the conventional acupuncture group (P < 0.01). After 1-week treatment, Lysholm score was increased to be 78.52 ± 18.4 from 59.64 ± 18.3 in the FSN group and it was to be 69.27 ± 11.9 from 58.17 ± 12.5 in the conventional acupuncture group. The differences were significant in comparison before and after treatment in either group (both P < 0.05). Lysholm score in the FSN group was higher than that in the conventional acupuncture group (P < 0.05). The total effective rate was 92.5% in the FSN group, higher than 77.5% in the conventional acupuncture group (P < 0.05).ConclusionFu's subcutaneous needling therapy effectively relieves the clinical symptoms of KOA and improves knee joint function. The therapeutic effect is better than that of the regular acupuncture.     

Effects of the pestle needle therapy,a type of acupoint stimulation,on post-hemorrhoidectomy pain: A randomized controlled trial

BackgroundHemorrhoids are one of the most common conditions that lead to surgery, and until now surgical hemorrhoidectomy has been the major effective treatment. Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation.ObjectiveThis study evaluates the clinical efficacy of the pestle needle therapy, an acupoint stimulation method, for relief of post-hemorrhoidectomy pain.Design, setting, participants and interventionsThis was a single-center, patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery. Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1:1. The treatment group received the pestle needle therapy, with manual stimulation at Yaoshu (DU2), Mingmen (DU4), Changqiang (DU1), Chengshan (BL57), Erbai (EX-UE2) and the perianal points (1, 3, 5, 7, 9, and 11o’clock around the lesion); while the control group received a sham treatment with very light pressure. Three sessions of treatment were performed at 30 min, 4 h and 12 h after the surgery, and each lasted for 15 min.Main outcome measuresThe primary outcome was post-operative pain measured with the visual analogue scale (VAS) at 12 h after surgery. The secondary outcomes included the VAS scores measured at 0.5, 2, 4, 6, 8, 24 and 48 h after surgery, the analgesic dose, the time and the VAS score of the patients’ first defecation after surgery, as well as the Hamilton Rating Scale for Anxiety (HAMA) evaluated before discharge.ResultsThe mean pain score of the treatment group was significantly lower than that of the control group (3.10 ± 1.27 vs 4.82 ± 1.29; P < 0.001) at 12 h after surgery. Compared with the control group, patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery (P = 0.002); and their HAMA scores before discharge were lower (4.07 ± 2.40 vs 5.10 ± 2.45, P = 0.009). Compared to the treatment group, patients in the control group had a greater time to the first defecation after surgery ([52.34 ± 15.72] h vs [27.08 ± 13.68] h; P < 0.001), but there was no difference in their VAS scores at the first defecation (P = 0.092).ConclusionThe pestle needle therapy was effective for relieving pain, reducing anxiety and improving bowel function after hemorrhoidectomy, and it is worthy of clinical application.     

Stimulation of Bladder Acupoints by Cloprostenol for Treating Back Soreness in Athletic Horses

Twenty-five Thoroughbred jumper geldings suffered back soreness with poor performance, and 5 control horses were assessed by archived computer data, clinical examination, and laboratory analyses of complete blood picture, serum enzymes, and cortisol level, before and after cloprostenol-pharmacopuncture. The 25 diseased horses before therapy showed significant increases in aspartate aminotransferase and creatine phosphokinase with clinical pains scored mild in 15 horses, moderate in 9 horses, and severe in one horse, without changes in the hormonal and hematological data. After therapy, they responded by an increase of heart rate (57.8 ± 4.3 bpm), body temperature (38.5 ± 0.7°C), respiration rate (28.3 ± 2.1 bpm), and capillary refilling time (CRT) (1.0 ± 0.0). On the 2^nd day, a significant decrease in the mean levels of aspartate aminotransferase and creatine phosphokinase (P = 0.001) was detected, while on the 4^th day, they mimed the level of the 5 controls, and on the 6^th day, they showed a significant decrease (P = 0.002). The serum cortisol level showed a significant increase on the 6^th day of treatment (P = 0.013). The blood picture showed significant increases in red blood cells, mean corpuscular volume, platelets, white blood cells, hemoglobin, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean platelet volume, platelet distribution width, lymphocytes, plateletcrit, and large platelet concentration ratio (P < 0.05) and nonsignificant changes in hematocrit, granulocytes, and midocytes. The improved blood parameters, enzymes, hormones, and performance progress after cloprostenol-pharmacopuncture proved its effectiveness in treating back soreness in athletic horses.     

Effect of electroacupuncture on knee osteoarthritis and relevant inflammatory factors: A randomized clinical trial: 电针治疗膝骨关节炎以及对相关炎症因子水平的影响

ObjectiveTo explore the treatment effects of electroacupuncture (EA), acupuncture with filiform needle, and western medication for knee osteoarthritis (KOA).MethodsIt was a randomized, controlled trial with the blinding of outcome assessors and statistician. 90 outpatients were diagnosed as KOA in Department of Acupuncture and Moxibustion, the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine. Using the random number table, they were divided into a medication group, an acupuncture group and an EA group, 30 cases in each one. In the medication group, routine medication was provided with oral administration of celebrex for 21 days. Regular acupuncture was applied in the remaining groups, at Liángqiū (梁丘ST34), Xuèh?i (血海SP10), Dúbí (犊鼻ST35), Nèixīy?n (内膝眼EX-LE4), Yánglíngquán (阳陵泉GB34), Hèd?ng (鹤顶EX-LE2) and Sānyīnjiāo (三阴交SP6) and the needles were retained for 30 min. In the EA group, electric stimulation with low-frequency pulse current and dense wave was applied for 30 min on the basis of the treatment of the acupuncture group. The treatment was applied once daily at 1-day intervals after each 6-day treatment for a total of 21 days. Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and visual analogy scale (VAS) scores and levels of serum inflammatory factors (interleukin-1β [IL-1β] and tumor necrosis factor [TNF-α]) were used to assess the clinical therapeutic effect.ResultsFollowing treatment, there were significant differences in the WOMAC score in the medication, acupuncture, and EA groups after treatment (all P < 0.01). In the comparison among groups, after treatment, the WOMAC score in the EA group was lower than that in either the acupuncture or medication group (both P < 0.01). Compared to before treatment, VAS scores were significantly different in the medication group (3.95 ± 0.55 vs 5.75 ± 1.40), the acupuncture group (2.78 ± 0.38 vs 5.78 ± 1.44) and EA group (1.72 ± 0.38 vs 5.78 ± 1.39) separately after treatment (all P < 0.01). In the comparison among groups, after treatment, the VAS score in the EA group was lower than that in either the acupuncture or medication group (both P < 0.01). Compared to before treatment, IL-1β levels were significantly different in the medication group (31.53 ± 6.84 vs 63.33 ± 10.25), acupuncture group (31.70 ± 7.54 vs 63.90 ± 9.96) and the EA groups (23.43 ± 3.94 vs 63.10 ± 10.66) separately after treatment (all P < 0.01). IL-1β levels were significantly lower in the EA group than in the acupuncture and medication groups (both P < 0.01). Compared to before treatment, TNF-α levels were significantly different in the medication group (40.20 ± 6.09 vs 68.77 ± 11.13), the acupuncture group (39.60 ± 7.55 vs 68.33 ± 11.51) and the EA groups (22.17 ± 5.72 vs 68.97 ± 10.52) separately after treatment (all P < 0.01). TNF-α levels were significantly lower in the EA group than in the acupuncture and medication groups (both P < 0.01). After treatment, there were no significant differences in TNF-α and IL-1β levels between the acupuncture and medication groups (both P > 0.05). The total effective rates were 86.67% (26/30), 73.33% (22/30) and 70.00% (21/30) in the EA, acupuncture, and medication groups, respectively. The total effective rate was higher in the EA group than in either the acupuncture or medication group (both P < 0.05). In the whole process of trial, the adverse events occurred in three groups. In consideration of the potential association between these adverse events and acupuncture treatment, the acupuncture physiotherapists and experts classified the adverse events into the treatment relevance or non-treatment relevance within 24 h of occurrence.ConclusionAll three therapeutic methods alleviated clinical symptoms of KOA and reduced levels of relevant inflammatory factors in serum. EA with dense wave is more advantageous than the traditional acupuncture technique and routine medication and is therefore worthy of clinical application.     

艾灸对轻度认知障碍患者认知注意网络功能的影响

ObjectiveTo explore the effect differences between moxibustion and donepezil hydrochloride on the attention network function of patients with mild cognitive impairment (MCI).MethodsA total of 64 patients of MCI were randomly divided into the moxibustion group and donepezil hydrochloride group, 32 cases in each one. On the basis of conventional treatment, the patients in the moxibustion group were given moxibustion, 6 times a week, and the patients in the donepezil hydrochloride group were given donepezil hydrochloride orally, 5 mg / day. The course of treatment was 60 days for both of the groups. Cognitive attention network function and activities of daily living (ADL) score were examined before and after treatment.ResultsThe differences of alerting reaction time (RT), executive control RT, overall mean RT and accuracy of the moxibustion group after treatment were significantly higher than those of the donepezil hydrochloride group [alert: (60.3 ± 3.3) ms vs (48.3 ± 3.7) ms, P < 0.05; executive control: (81.2 ± 3.2) ms vs (91.7 ± 4.2) ms, P < 0.05; total reaction time: (500.4 ± 17.2) ms vs (536.2 ± 20.1) ms, P < 0.05; accuracy: (83.7 ± 4.6)% vs (77.4 ± 4.3)%, P < 0.05]. After treatment, the ADL scores of the both groups were significantly higher than those before treatment [the moxibustion group: (56.47±4.02) points vs (41.53±4.06) points, P < 0.05; the donepezil hydrochloride group: (50.75±4.05) points vs (40.84±3.67) points, P < 0.05], and the ADL score of the moxibustion group was significantly higher than that of the donepezil hydrochloride group [(56.47±4.02) points vs (50.75±4.05) points, P < 0.05].ConclusionCompared with donepezil hydrochloride, moxibustion has a better effect on the cognitive function of MCI patients.     

通腑调神针法治疗便秘型肠易激综合征:随机对照试验（英文）

目的:观察通腑调神针法对便秘型肠易激综合征(const ipat ion-predominant irritable bowel syndrome,IBS-C)患者的便秘、焦虑、抑郁症状及血清神经肽Y (NPY)含量的影响。方法:将42例IBS-C患者随机分为通腑调神针刺组(针刺组)和枸橼酸莫沙必利药物组(药物组),每组21例。治疗过程中,药物组剔除1例,实际观察20例,针刺组实际观察21例。观察两组患者治疗前、治疗后、随访时(治疗后1个月)的便秘量表(CCS)评分、焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分,并比较两组患者治疗前、治疗后血清NPY含量变化。结果:(1)CCS总评分:治疗后,针刺组和药物组的CCS总评分分别为(4.76±2.10)分和(5.60±1.88)分,均低于各自本组治疗前,差异有统计学意义(both P<0.05),而针刺组和药物组比较,差异无统计学意义(P>0.05)。随访时,针刺组和药物组的CCS总评分分别为(4.19±1.69)分和(6.35±2.06)分,药物组高于本组治疗后(P<0.05),而针刺组和药物组比较,差异无统计...     

Efficacy of acupuncture on cardiovascular complications in patients with diabetes mellitus in Korea: A nationwide retrospective cohort

Objective: The main aim of this study is to investigate whether acupuncture could be an effective complementary treatment for reducing the risk of macrovascular complications in diabetic patients currently taking antidiabetic medications using a nationwide population-based database.Methods: We conducted a retrospective cohort study to assess the efficacy of acupuncture on cardiovascular complications in diabetic patients using data from patients between 40 and 79 years of age, newly diagnosed wi...     

Effect of acupuncture at Lièquē ( LU 7) on vertebral-basilar artery hemodynamics in patients with cervical vertigo

ObjectiveTo explore the therapeutic efficacy and mechanism of acupuncture at Lièquē (

LU 7) in treatment of cervical vertigo (CV).MethodsForty CV patients met the inclusion criteria were enrolled and treated with acupuncture at bilateral LU 7 points, once daily with 10 times as a course. The changes of blood flow velocity in bilateral vertebral artery and basilar artery were observed through transcranial doppler sonography (TCD) before treatment, after deqi with acupuncture and after a course of treatment, respectively. The scores and therapeutic efficacy on clinical symptoms were assessed according to CV symptoms and the functional assessment scale as well as the Criteria for Diagnosis and Curative Effect in TCM Syndromes before treatment and after a course of treatment.ResultsBefore treatment, after deqi and after a course of treatment, the blood flow velocity of basilar artery (BA), left vertebral artery (LVA) and right vertebral artery (RVA) in 22 patients with a decreased blood flow velocity were respectively 23.20±4.84 vs 26.30 ±4.17 vs 29.20 ±4.20 (mm/s, BA), 21.65 ± 3.62 vs 24.20 ± 2.89 vs 26.40 ± 3.62 (mm/s, LVA) and 21.90±3.04 vs 24.25±3.01 vs 26.50±3.95 (mm/s, RVA); while in 18 patients with an increased blood flow velocity were respectively 39.94 ± 8.24 vs 35.17 ± 4.84 vs 32.06 ± 3.49 (mm/s, BA), 41.83 ± 5.64 vs 37.28 ± 2.32 vs 35.61 ± 2.09 (mm/s, LVA) and 37.11 ± 9.83 vs 32.22 ± 6.13 vs 28.11 ± 4.12 (mm/s, RVA). Except that the difference of blood flow velocity of RVA was not significant in patients with an increased blood flow velocity before treatment and after deqi (P> 0.05), the Vm of all vessels in 40 patients was improved after deqi with acupuncture and a course of treatment (P<0.01, P<0.05). According to CV symptoms and the functional assessment scale, before treatment and after a course of treatment, the scores were 15.68 ±5.35 and 26.30 ±3.76, respectively, indicating that after a course of treatment, the symptoms were significantly improved (P< 0.01). According to the Criteria for Diagnosis and Curative Effect in TCM Syndromes, after a course of treatment, the total effective rate was 100% (40/40) and the cured rate was 55.0% (22/40).ConclusionAcupuncture at LU 7 not only improves the blood supply of vertebral-basilar artery in CV patients, but also has a significant curative effect on improving the clinical symptoms.     

稳心颗粒与普罗帕酮治疗早搏的疗效比较

目的:比较步长稳心颗粒与普罗帕酮治疗早搏的疗效及临床特点。方法:选择符合入选条件的过早搏动患者共107例(室上性早搏52例、室性早搏55例),完善静息12同步导联心电图,随机分为稳心颗粒组(W组,n=62)、普罗帕酮组(P组,n=45),W组给予稳心颗粒9 g,3次/d,口服;P组给予普罗帕酮150 mg,3次/d,口服。4周后,复查12导联同步心电图和24 h动态心电图,比较治疗前后早搏减少百分率、24 h平均心率、最慢心率及校正的QT间期离散度(QTcd)。结果:稳心颗粒治疗室上性早搏、室性早搏的有效率分别为73.53%,78.57%,总有效率75.81%,与普罗帕酮比较无统计学差异。稳心颗粒组治疗前后24 h平均心率降低不明显[(77.67±5.86)bpm vs(77.42±4.99)bpm]、最慢心率降低不明显[(60.89±5.40)bpm vs(60.55±4.71)bpm];普罗帕酮组治疗前后24 h平均心率明显降低[(78.51±5.42)bpm vs(76.96±5.57)bpm,P<0.05]、最慢心率明显降低[(61.31±5.69)bpm vs(58.53±4.80)bpm,P<0.05]。稳心颗粒能改善糖尿病、冠心病的QTcd。结论:步长稳心颗粒能有效减少早搏,不减慢治疗前后的24 h平均心率及最慢心率,能减小糖尿病、冠心病的QT离散度,适合心率较慢、糖尿病、冠心病患者合并早搏的治疗。