Acupuncture therapy and cognitive dysfunction in patients with type 2 diabetes: A protocol for systematic review

Background:With the aging of society, the incidence of type 2 diabetes (T2DM) is increasing every year, and there is a clear correlation between T2DM and cognitive dysfunction. Acupuncture therapy has been widely used in the treatment of T2DM, but there is no systematic review on the treatment of T2DM associated with cognitive impairment. Therefore, this study aimed to conduct a meta-analysis of acupuncture in the treatment of T2DM with cognitive impairment to clarify its efficacy.Methods:A structured and systematic literature search will be conducted in the following databases up to April 26, 2021: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (WOS), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Chinese Scientific and Journal Database (VIP), and Wan Fang database (Wanfang). We will use the Review Manager 5.4 software provided by the Cochrane Collaborative Network for statistical analysis. We then assessed the quality and risk of the included studies and observed the outcome measures.Results:This meta-analysis further determined the beneficial effects of acupuncture on T2DM with cognitive impairment.Conclusion:The purpose of this meta-analysis was to explore the effect of acupuncture on patients T2DM with and cognitive impairment patients, and provide more options for clinicians and patients to treat T2DM with cognitive impairment.Ethics and dissemination:This systematics review will evaluate the efficacy and safety of acupuncture in the treatment of T2DM with cognitive impairment. Since all the data included were published, the systematic review did not require ethical approval.Registration number:CRD42021245681.     

Study on acupuncture improving insomnia comorbid with depression and anxiety based on rs-fMRI: A protocol for systematic review and meta-analysis

Background:Long term insomnia and low sleep quality often lead to depression, anxiety and other negative emotions, and often interact with each other. Many studies have confirmed the effectiveness of acupuncture in the treatment of insomnia comorbid with emotional disorders, but its specific mechanism needs to be further explored. Resting-state functional magnetic resonance (rsfMRI) is an important means to study the changes of brain activity. However, the results are inconsistent and lack of systematic evaluation and analysis.Methods:Nine databases will be searched, including PubMed, EMBASE, EBSCOhost-medline, Web of Science, Cochrane Library, China National Knowledge Infrastructure, VIP Database and Wan-Fang Database, Chinese Biomedical Literature Database from inception to January 2021. And screening clinical registration platform related research, in order to obtain more relevant studies. The outcomes include the change of rs-fMRI, sleep quality, depression, and anxiety. Quality assessment of the included studies will be performed according to the Cochrane Risk of Bias tool. Evidence quality will be assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. RevMan software (Version 5.3) and stata13.1will be used for statistical analyses. Subgroup analysis will be performed if necessary. If the data is insufficient, qualitative synthesis will be conducted instead of quantitative synthesis.Results:This study will analyze the effect of acupuncture on the brain activity changes, improvement of sleep quality and clinical symptoms of anxiety and depression with insomnia comorbid with emotional disorders.Conclusion:This study used meta-analysis method to explore the characteristics of acupuncture on brain activity changes in insomnia comorbid with emotional disorders, so as to provide effective evidence for clarifying its pathogenesis.     

Comparison between acupuncture and antidepressant therapy for the treatment of poststroke depression: Systematic review and meta-analysis

Background:In this paper, a systematic review and meta-analysis of published randomized controlled trials (RCTs) was conducted to compare the efficacies of acupuncture and antidepressant therapy for the treatment of poststroke depression (PSD).Methods:The research team searched RCTs published on PubMed; Medline; Cochrane library; Chinese National Knowledge Infrastructure (CNKI); Wanfang; Embase; Scopus, and Sinomed from their respective establishments to January 2019. We evaluated the Hamilton Depression Rating Scale (HAMD) scores, Treatment Emergent Symptom Scale (TESS) scores, National Institute of Health Stroke Scale (NIHSS) scores, and total clinical efficacy using fixed effects models.Results:Fourteen RCTs, representing a total of 1124 patients, were studied. Results showed that acupuncture was more effective in improving HAMD scores at 3 weeks after administration (mean difference [MD] = −1.17, 95%CI = −2.18 to −0.16), at 4 weeks (MD = −4.44, 95% CI = −5.64 to −3.23), at 6 weeks (MD = −1.02, 95% CI = −1.68 to −0.36), and at 8 weeks (MD = −4.33, 95% CI = −4.96 to −3.70). Similarly, acupuncture more dramatically decreased NIHSS scores (MD = −2.31, 95% CI = −2.53 to −2.09), and TESS scores (MD = −4.70, 95% CI = −4.93 to −4.48) than conventional Western medicinal therapy. Further, the total clinical efficacy in the acupuncture group was significantly higher than in the antidepressants group (risk ratio [RR] = 1.15, 95% CI = 1.08–1.21).Conclusions:The results of this study suggest that acupuncture not only can reduce the severity of PSD, but also has significant effects on decreasing the appearance of other adverse events.     

Local cutaneous nerve terminal and mast cell responses to manual acupuncture in acupoint LI4 area of the rats

Previous studies have shown that the effects of manual acupuncture (MA) are contributed by collagen fibers and mast cells in local acupoints, at which acupuncture stimulation causes various afferent fiber groups to be excited. However what happens in local nerve fibers and mast cells after MA remains unclear. The aim of this study was to examine the response of cutaneous nerve fibers and mast cells to MA stimulation in acupoint Hegu (LI4). The contralateral LI4 of the same rat was used as a non-stimulated control. Immnohistochemistry analysis were carried out to observe the expression of histamine (HA), serotonin (5-HT) and nociceptive neuropeptides, calcitonin gene-related peptide (CGRP) and substance P (SP), in the LI4 area. Mast cells were labeled with anti-mast cell tryptase antibody and simultaneously with HA or 5-HT primary antibodies to observe their co-expression. Our results showed that SP and CGRP were expressed more highly on the cutaneous nerve fibers of LI4 after MA stimulation than that of the control. Mast cells aggregated in close proximity to the blood vessels in intra-epidermis and dermis and some of them with degranulation in the lower dermis and subcutaneous tissue of LI4. Both mast cells and their granules appeared with HA (+) and 5-HT (+) expression at stimulated L14 sites, while a few intact mast cells with a little expression of 5-HT and HA were distributed in areas of non-stimulated L14. The results indicated that local cutaneous nerve terminals and mast cells responded to MA with higher expression of SP and CGRP in nerve fibers, as well as with aggregation and degranulation of mast cells with HA and 5-HT granules at acupoint LI4. These neuroactive substances may convey signals to certain pathways that contribute to the effects of acupuncture.     

针刺太溪、复溜治疗神经根型颈椎病疗效观察

目的观察针刺太溪、复溜穴治疗神经根型颈椎病的临床疗效。方法将80例神经根型颈椎病患者分为治疗组40例和对照组40例,治疗组选择针刺太溪、复溜穴进行治疗,对照组则选取与病变椎体相对应的双侧颈夹脊穴进行治疗。结果治疗组与对照组近期疗效与远期疗效差异不明显。结论针刺太溪、复溜穴治疗神经根型颈椎病疗效与针刺局部颈夹脊穴作用相当,但取穴少而精,有利于临床推广应用。     

针灸药合用治疗膝骨关节炎疗效观察

目的观察针刺、雷火灸为主治疗膝骨关节炎的疗效。方法将84例患者随机分为两组。治疗组采用针刺、雷火灸结合硫酸氨基葡萄糖胶囊治疗,对照组单纯口服硫酸氨基葡萄糖胶囊。1周为1疗程,1疗程后进行疗效评定。结果治疗组总有效率优于对照组(P0.05);膝关节疼痛及功能评分比较,治疗组优于对照组(P0.05)。结论针刺、雷火灸为主治疗膝骨关节炎疗效显著。     

针灸联合三阶药物疗法对原发性肝癌疼痛镇痛作用的疗效观察

目的观察针灸联合三阶药物疗法治疗肝癌疼痛的疼痛缓解情况及不良反应的发生率。方法 54例原发性肝癌疼痛患者随机分为3组,联合治疗组采用针灸与三阶梯药物止痛法联合治疗;针灸治疗组取双曲泉、双肝俞、双心俞、大椎7穴进行阻滞针法治疗;药物对照组采用三阶梯药物止痛法进行治疗。结果 3组的总有效率比较差异有统计学意义(P0.05);联合治疗组与针灸治疗组不良反应发生率较药物对照组低,差异有统计学意义(P0.05)。结论针灸联合三阶药物治疗肝癌疼痛疗效良好,明显优于单独使用三阶药物疗法治疗或针灸疗法治疗,且不良反应较单纯应用三阶药物疗法小。     

醒脑开窍针刺法联合脑络通方治疗急性脑梗死的临床研究

【目的】观察醒脑开窍针刺法联合中药脑络通方治疗急性脑梗死的临床疗效。【方法】将70例患者随机分为针药组和对照组各35例。对照组给予西医常规+香丹注射液治疗,针药组在对照组治疗基础上予以醒脑开窍针刺法和脑络通方联合治疗。治疗后进行神经功能缺损评分(NIHSS)和独立生活能力量表(BI)评价。【结果】（1） NIHSS评分疗效方面：治疗后,针药组总有效率为93．3%,对照组为72．4%,针药组的疗效优于对照组（P<0．01）。（2）基于BI评分的残疾率方面：治疗后,针药组残疾率为43．33%,对照组为75．86%,针药组的残疾率低于对照组(P<0．01)。（3）治疗后,2组NIHSS评分均显著降低, BI评分均显著提高,与治疗前比较,差异均有统计学意义（P<0．05）;且针药组对NIHSS、 BI评分的改善作用均优于对照组（P<0．05）。【结论】醒脑开窍针刺法与中药脑络通方联合治疗方案能显著改善急性脑梗死患者的神经功能,降低致残率,其疗效优于单纯西医常规治疗。     

针灸治疗干眼症

目的 总结近5年针灸治疗干眼症的临床研究进展,并提出存在问题与研究展望.方法 检索2008年1月-2013年6月发表的针灸治疗干眼症的临床研究文献,从临床疗效、临床操作、诊疗标准及作用机制角度进行探讨.结果 针灸治疗干眼症以眼周局部取穴为主,常用穴位有睛明、攒竹、太阳等,配穴以局部和远端取穴相结合为主,但诊疗标准缺乏统一,机制研究较少,有待进一步完善.结论 针灸通过刺激神经兴奋,促进泪腺、睑板腺主动分泌泪液,双向调节性激素水平等环节起到缓解眼部症状的功效.