Journal of cachexia, sarcopenia and muscleRuoxin Chen, Qinqin Qian, Bin Wang, Ruoyang Chen, Liuping Zhang, Hui Jin, Jun Zhu, Zuolin Li, Jianyun Gao, Hong Liu
BACKGROUND: Electroacupuncture (EA) treatment has been utilized for recovery from neuromuscular-related diseases and may play a significant role in the treatment of sarcopenia. This interventional, randomized controlled clinical study aims to explore the efficacy of EA treatment in maintenance haemodialysis (MHD) patients with sarcopenia. METHODS: Thirty-six participants with sarcopenia undergoing MHD were randomly divided into the control group and the EA group. The participants in the EA group received a total of 24 treatments, each lasting 30 min, and were administered three times per week. Participants in the control group were instructed to continue their current lifestyle and treatment plans. The assessments were conducted at baseline and after 8 weeks. Statistical analysis was performed using two-way analysis of covariance (ANCOVA) adjusted according to gender and baseline values. Repeated measures analysis of variance (ANOVA) was used to assess EA effects, reporting main effects and the time × group interaction with partial eta squared (η2p) effect sizes. The primary outcome was 6-m gait speed; the secondary outcomes were skeletal muscle mass index (SMI) and handgrip strength. Fasting blood samples were collected, and serum metabolomics using the liquid chromatography-mass spectrometry method was employed to reveal metabolic changes. RESULTS: One participant from the EA group dropped out, and 35 participants were included in the analysis, aged (59.06 ± 11.69) years, including 22 men and 13 women. After intervention, the 6-m gait speed of the EA group increased (Δ = 0.10 ± 0.08; p < 0.001), whereas that of the control group decreased (Δ = -0.06 ± 0.09; p = 0.018). The handgrip strength of the EA group increased (Δ = 0.68 ± 0.98; p = 0.011), whereas that of the control group decreased (Δ = -0.76 ± 1.19; p = 0.015). The SMI in the EA group increased (Δ = 0.19 ± 0.22; p = 0.003), although there was no significant difference in the control group. No serious adverse events were observed during the EA treatment. The results of serum metabolomics indicated that a total of 127 differentially expressed metabolites were identified (p < 0.05, VIP > 1), including 35 up-regulated metabolites and 92 down-regulated metabolites. KEGG pathway enrichment analysis showed that glycerophospholipid metabolism, linoleic acid metabolism and other pathways related to lipid metabolism were significantly changed. CONCLUSIONS: EA treatment was an effective therapy for sarcopenia in patients undergoing MHD. Its therapeutic effect may be related to the positive regulation of systemic metabolism (including amino acid and lipid profiles).
MedicineYuan Zhou, Yanru Wang, Xiaoming Wu, Xi Zhou, Linjia Wang, Jingxin Mao
BACKGROUND: Facial spastic synkinesis (FSS) is a disabling sequela of facial nerve palsy, with current treatments limited by transient efficacy, severe side effects, poor precision, and lack of quantifiable targets/objective evaluation. This study used ultrasound shear wave elastography combined with Canggui Tanxue needling to precisely locate lesioned muscles, exploring a safer, more effective targeted strategy to address the gap of insufficient precision and quantitative evidence in clinical practice. METHODS: A single-blind randomized controlled trial was conducted at Chongqing Traditional Chinese Medicine Hospital's Acupuncture Department (June 2022 to May 2023), enrolling 64 FSS patients randomized into an ultrasound-guided group (n = 31) and a control group (n = 33). The former received Canggui Tanxue needling at hypertonic muscles (Young modulus > 10 kPa) under real-time shear wave elastography, the latter received traditional syndrome differentiation-based acupuncture. Both groups had 6 sessions (twice weekly for 3 weeks). Outcome measures included primary (Young modulus of target muscles) and secondary (House-Brackmann grading, Facial Disability Index, and total effective rate) indicators. SPSS 26.0 was used for statistical analysis. RESULTS: A total of 64 patients aged 27 to 66 years were enrolled, including 25 males (39.06%) and 39 females (60.94%). Baseline characteristics were comparable between groups (P > .05). Post-intervention, the ultrasound-guided group had significantly larger reductions in Young modulus of depressor anguli oris (3.00 vs 1.10 kPa) and levator labii superioris (5.60 vs 1.00 kPa) versus controls (P < .001). It also showed superior facial nerve recovery (House-Brackmann grading: P = .013), a higher total effective rate (87.1% vs 42.4%, P < .001), and greater improvement in physical function scores (74.84 ± 8.42 vs 68.94 ± 13.68, P = .04). Psychosocial function scores decreased in both groups (P = .92). Only 2 mild subcutaneous hematomas occurred in the ultrasound-guided group, confirming good safety. CONCLUSIONS: Ultrasound-guided Canggui Tanxue needling precisely targets hypertonic muscles, reduces pathological tension, improves FSS patients' facial function, and is safe, offering an effective targeted strategy. Clinical promotion of this precise acupuncture technology is recommended, especially for late-stage facial nerve palsy patients with abnormal muscle tension. Future studies should extend follow-up to assess long-term efficacy/recurrence and combine neurophysiological/multimodal imaging to clarify its mechanism.
Physiological researchS-N Zhang, C-C Zhang, L-H Jiang, G Ouyang
This study investigated the effects of acupuncture on bone and lipid metabolism in a rat model of postmenopausal osteoporosis (PMOP). Thirty-two female Sprague-Dawley rats were randomly assigned to four groups: blank control, sham-operated, model (ovariectomy), and acupuncture treatment (ovariectomy plus acupuncture). Following treatment, bone mineral density (BMD), bone tissue morphological changes with quantitative histomorphometry, serum bone metabolism markers, estradiol (E2) levels at multiple time points, body mass index (BMI), blood lipid indicators, inflammatory factors, and gut microbiota composition were measured in each group. Acupuncture increased femoral BMD after adjusting for femoral shaft thickness (P<0.05) and improved trabecular bone structure, with significant rises in trabecular number, thickness, and bone volume fraction (P<0.05). Serum osteoprotegerin levels increased and osteoclast markers decreased. Serial E2 measurements showed progressive restoration from week 4. Acupuncture reduced BMI (P<0.05), with BMI changes negatively correlating with BMD improvements (r=-0.68, P<0.01). Lipid metabolism and inflammatory markers were significantly improved (P<0.05). Gut microbiota analysis indicated increased abundance of Lactobacillus and Bifidobacterium and decreased pathogenic bacteria (P<0.05). Liquid chromatography-mass spectrometry suggested acupuncture may promote osteogenic differentiation via upregulation of the cAMP-PKA-CREB pathway. Overall, acupuncture effectively enhances bone and lipid metabolism in PMOP rats through hormonal regulation, metabolic modulation, and gut microbiota optimization. Key words Acupuncture " Postmenopausal osteoporosis " Bone metabolism " Lipid metabolism " Estradiol " Gut microbiota " cAMP-PKA-CREB pathway.
Brain research bulletinYi Gao, Weimin Li, Qi Ma, Xuechong Zhao, Qiujun Wang
Electroacupuncture (EA) has been identified as an effective intervention for mitigating postoperative cognitive dysfunction in the elderly; however, its underlying mechanisms remain inadequately understood. This study aimed to elucidate the neuroprotective effects of EA on anesthesia/surgery-induced cognitive impairment in aged rats through a combination of behavioral testing, RNA sequencing analysis, Golgi-Cox staining, dendritic spine analysis, Sholl analysis, immunofluorescence assays, and western blot analysis. The findings demonstrated that EA ameliorates anesthesia/surgery-induced cognitive decline by inhibiting hippocampal synaptic dysfunction, with a notable enrichment in the downregulation of IL-17A signaling and upregulation of ERK signaling. Furthermore, the study confirmed that an exogenous increase in IL-17A expression can induce hippocampal synaptic dysfunction and partially negate the neuroprotective effects of EA by inhibiting the expression of the ERK/CREB signaling pathway. In conclusion, EA attenuates anesthesia/surgery-induced cognitive impairment in aged rats by inhibiting IL-17A-mediated hippocampal synaptic dysfunction via the ERK/CREB signaling pathway.
Although electroacupuncture (EA) yields favorable clinical outcomes for vascular dementia (VD), its mechanisms remain poorly understood. This study aimed to investigate the protective effects of EA on VD by regulating growth hormone (GH). A rat VD model was induced by multiple microinfarction (MMI). EA was applied at Baihui (GV20) and Shenting (GV24), and its effects on cognitive function and synaptic lesions were assessed. Hippocampal synaptic morphology and synaptic protein expression, as well as GH level were detected using transmission electron microscopy and biochemical methods. Finally, GH and PGC-1α agonists were used for mechanistic validation. Our results showed that MMI rats presented severe cognitive deficits and synaptic dysfunction relative to sham rats, and EA successfully alleviated these abnormalities. The expression of GH-related and mitochondrial proteins in the hippocampus continuously decreased on D7, D14 and D21 post-modeling, and EA significantly prevented such reductions. EA also increased hippocampal GH level and repaired damaged mitochondria in VD rats. Of note, GH receptor and PGC-1α agonists exerted similar beneficial effects as EA, validating the proposed mechanism. Collectively, EA at GV20 and GV24 increases hippocampal GH levels, rescues mitochondrial and synaptic dysfunction in VD rats, and possesses great potential for clinical application.
Photobiomodulation, photomedicine, and laser surgeryYongqing Ma, Miaomiao Yang, Jiang Sun
BACKGROUND: Inferior alveolar nerve (IAN) sensory disturbance after mandibular third molar extraction can persist and affect speech, mastication, and quality of life. Photobiomodulation (PBM) has been used to promote peripheral nerve recovery, but the most suitable irradiation strategy remains unclear. Laser acupuncture (LA) delivers PBM to predefined acupoints and may provide both local and central neuromodulatory effects. OBJECTIVE: To compare standardized LA with direct nerve-trajectory PBM for post-extraction IAN hypoesthesia in a randomized, double-blind, sham-controlled trial. METHODS: Adults aged 18-60 years with unilateral IAN hypoesthesia lasting ≥7 days and ≤12 weeks were randomized (1:1:1) to LA, direct PBM along the external IAN projection, or sham treatment. All participants received mecobalamin (0.5 mg, three times daily) for 30 days. PBM was delivered using an 808-nm diode laser (continuous wave, 100 mW; beam area 1.0 cm2), 90 s/site (9 J; 9 J/cm2), every other day for 15 sessions. LA used a fixed 5 + 2 prescription: ST4, ST6, ST7, CV24, Jiachengjiang (EX-HN19), plus LI4 and PC6. Primary outcomes were two-point discrimination (TPD) and Semmes-Weinstein monofilament examination (SWME) at day 30. Secondary outcomes included Visual Analog Scale (VAS) numbness, additional sensory tests, and day-60 follow-up. RESULTS: Sixty participants completed the intervention. Both active groups improved more than sham for TPD and SWME (group × time p < 0.01). Mean TPD change at day 30 was -3.2 ± 1.8 mm (LA) and -2.6 ± 1.7 mm (direct PBM) versus -0.8 ± 1.1 mm (sham). SWME improved by ≥1 grade in 85%, 80%, and 25%, respectively. VAS numbness decreased by 60%, 48%, and 12%, respectively, and the improvement was largely maintained at day 60. No treatment-related adverse events occurred. CONCLUSIONS: Under matched PBM dosimetry, both irradiation strategies improved sensory recovery compared with sham. LA produced comparable results and was associated with greater improvement in patient-reported numbness.
Journal of investigative surgery : the official journal of the Academy of Surgical ResearchHao Gao, Chunlan Hu, Xi Chen, Lili Li, Xiaohui Wu, Haoliang Cai, Hai Zhu, Wenting Chen, Jiangang Song
OBJECTIVE: This study evaluated whether moxibustion at the Dazhui point (GV14) reduces intraoperative hypothermia during cesarean delivery under spinal anesthesia. METHODS: Sixty - four parturients (32/group) scheduled for cesarean section were randomly assigned 30 min before surgery to receive either moxibustion at Dazhui or sham moxibustion (pre-combusted cooled moxa pack); both groups received standard blanket warming. The primary outcome was hypothermia incidence (core temperature <36.0 °C). Secondary outcomes included shivering, thermal comfort (0-100 scale), Apgar scores, hospital stay, and postoperative complications (fever, blood loss, infection). RESULTS: Baseline characteristics were similar between groups. Hypothermia incidence was significantly lower in the intervention group (62.50%) than in the sham group (84.38%; p = 0.048). From 10 min after surgery start until operating room departure, core temperature remained consistently higher in the moxibustion group (p < 0.05). Shivering occurred less often in the intervention group (43.75% vs. 68.75%, p < 0.05). Thermal comfort scores were higher in the intervention group (87.19 ± 9.24 vs. 78.75 ± 10.08, p < 0.05). No significant differences were found in Apgar scores, hospital stay, or postoperative complications. CONCLUSION: Preoperative moxibustion at Dazhui reduces intraoperative hypothermia and improves maternal comfort during cesarean delivery without adverse neonatal effects. Although it cannot completely eliminate hypothermia or shivering, it may serve as an effective non - pharmacological adjunct for thermoregulation in obstetric anesthesia.
OBJECTIVES: Electroacupuncture, a therapeutic modality integrating electrical stimulation with traditional acupuncture, has emerged as a promising intervention for intracerebral hemorrhage (ICH). This study aimed to elucidate the potential mechanisms underlying electroacupuncture's therapeutic effects in a mouse model of ICH. METHODS: The mice were injected autologous blood into basal ganglia region of brain to establish an ICH model. The study comprised two parts. First, we evaluated the therapeutic efficacy of electroacupuncture at Baihui (GV20) and Dazhui (GV14) points using the ICH model by neurological deficit score, Fluoro-Jade C (FJC) staining, and ELISA. Subsequently, based on the observed therapeutic benefits, we further explored the underlying mechanisms via neurological deficit and adhesive removal score, immunofluorescence staining, immunohistochemical staining, ELISA, and Western blot assays. RESULTS: The first part of the study showed that electroacupuncture treatment alleviated the expression of proinflammatory cytokines [tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β)], neuronal degeneration, and neurological deficits. The second part of the study showed that electroacupuncture treatment upregulated the expression of the α7 nicotinic acetylcholine receptor (α7nAChR), downregulated Janus kinase-2 (JAK2) and signal transducer and activator of transcription 3 (STAT3) phosphorylation, promoted M2 microglia/macrophage polarization, and reduced IL-1β and TNF-α expression, contributing to improved neurobehavioral function. CONCLUSION: Electroacupuncture treatment can alleviate neuroinflammation and improve neurobehavioral function in ICH mice, which might be modulated by the α7nAChR/JAK2/STAT3 pathway, providing a new molecular mechanism of electroacupuncture treatment on ICH.
OBJECTIVE: To observe the effects of moxibustion on paw appearance and serum levels of interleukin-1β (IL-1β), interleukin-18 (IL-18) and matrix metalloproteinase-3 (MMP-3) in model rats of rheumatoid arthritis (RA), and to explore the regulatory mechanism of moxibustion on gasdermin D (GSDMD)-mediated cell pyroptosis. METHODS: Fifty SD rats were randomly divided into 5 groups, with 10 rats in each group, including a control group, a model group, a moxibustion group, a GSDMD overexpression group, and a GSDMD overexpression combined with moxibustion treatment group (GSDMD overexpression + moxibustion group). Except for the control group, RA rat models were established in the other groups using Freund's complete adjuvant (FCA). In the GSDMD overexpression group and the GSDMD overexpression + moxibustion group, the rats received a GSDMD lentiviral vector to induce GSDMD overexpression. In the moxibustion group and the GSDMD overexpression + moxibustion group, moxibustion was performed at "Shenshu" (BL23) and "Zusanli" (ST36) alternately on both sides, with 5 moxa cones at each point and in each session, for 6 consecutive days followed by 1 day of rest. The intervention completion covered 18 sessions. The general conditions of rats and the changes in right paw volume were observed before modeling, 7 days after modeling, 7 days after lentiviral injection and after intervention completion. After intervention completion, using ELISA, serum levels of IL-1β, IL-18, and MMP-3 were measured. RESULTS: Compared with the control group, the model group showed the increase in the right paw volume (P<0.05) and serum levels of IL-1β, IL-18 and MMP-3 (P<0.05). Compared with the model group, the moxibustion group exhibited the decrease in the right paw volume (P<0.05) and serum levels of IL-1β, IL-18 and MMP-3 (P<0.05); and in the GSDMD overexpression group, the volume of right paw was higher (P<0.05) and the serum levels of IL-1β, IL-18 and MMP-3 were elevated (P<0.05). In the moxibustion group, the volume of right paw and the serum levels of IL-1β, IL-18 and MMP-3 were all lower when compared with the GSDMD overexpression + moxibustion group (P<0.05). CONCLUSION: Moxibustion can alleviate paw swelling and mitigate the serum inflammatory response in RA rats, which may be obtained by regulating GSDMD-mediated pyroptosis.
Zhongguo zhen jiu = Chinese acupuncture & moxibustionJuanjuan Li, Xi Wang, Ping Yin, Yuelai Chen
Acupuncture is highly effective on female stress urinary incontinence (SUI), but there remain the limitations such as unclear explanation on its mechanism and the lack of quantitative operation specification. Multimodal imaging, with its advantages in visualization, quantitative analysis, and real-time dynamic imaging, demonstrates the unique value in acupuncture research. This paper systematically elucidates the enhancement of acupuncture diagnosis and treatment for SUI under the assistance of multimodal imaging; and how multimodal imaging, guided by traditional meridian theory, facilitates the transition from empirical approach to standardized operation in acupuncture treatment for SUI, aiming to provide new insights for the modernization of acupuncture.
Zhongguo zhen jiu = Chinese acupuncture & moxibustionLing Yin, Yuxiang Li, Feng Zhong, Rong Luo
OBJECTIVE: To explore the effect of electroacupuncture (EA) at front-mu and back-shu points of large intestine on autophagy of Cajal interstitial cells (ICCs) in the colon of rats with slow transit constipation (STC), and to analyze the mechanism of EA for mitigating STC. METHODS: Thirty-six SD rats were randomly divided into a blank group, a model group, an EA group, a mosapride group, an EA+rapamycin (RAPA) group and an EA+3-methyladenine (3-MA) group, with 6 rats in each group. The STC model was established by intragastric administration with loperamide hydrochloride. In the EA group, the EA+RAPA group and the EA+3-MA group, EA was operated at bilateral "Tianshu" (ST25) and "Dachangshu" (BL25), with dense-disperse waves (2 Hz/15 Hz in frequency), for 15 min each time. In the mosapride group, intragastric administration with mosapride solution was operated. In the EA+RAPA group and the EA+3-MA group, 30 min before acupuncture, the intraperitoneal injection was administered with RAPA and 3-MA solution, respectively. The intervention was delivered once daily and for consecutive 14 days in each group. After model establishment, the defecation time of the first red fecal particle was recorded in each group. After modeling and intervention, the number of fecal particles and fecal quality were recorded in each group over a 24-hour period. After intervention, the small intestinal propulsion rate was calculated in each group. HE staining was used to observe the histological morphology of colonic tissue, transmission electron microscopy was used to observe the ultrastructure of ICCs in the colon tissues, the immunofluorescence assay was used to observe the positive expression of the ICCs marker tyrosine kinase receptor (C-kit) in colonic tissue, the real-time quantitative PCR assay was used to detect C-kit mRNA expression, and Western-blot was used to detect C-kit and autophagy-related protein expression in each group. RESULTS: After modeling, compared with the blank group, the model group exhibited the prolonged defecation time of the first red fecal particle and the reduced number of fecal particles, and the decline of fecal quality and small intestinal propulsion rate (P<0.01). After intervention, compared with the model group, the EA group and the mosapride group showed the increase in the number of fecal particles, fecal quality, and small intestinal propulsion rate (P<0.01). Compared with the EA group, fecal quality and small intestinal propulsion rate were reduced in the EA+RAPA group (P<0.01). Compared with the blank group, the model group showed the impaired colonic mucosal structure and reduced goblet cell count; and autophagosomes and mitochondrial swelling were markedly observed in the cytoplasm of ICCs. The average fluorescence intensity of C-kit, the mRNA expression of C-kit, and the protein expression of C-kit and P62 all decreased, while the protein expression of LC3 and ATG5 increased in the model group (P<0.01). Compared with the model group, all other groups showed the improvements in colonic mucosal structure and ICCs ultrastructure, with the increase in average C-kit fluorescence intensity (P<0.01); the mRNA expression of C-kit and the protein expression of C-kit and P62 were elevated (P<0.01), while the protein expression LC3 and ATG5 were reduced in the EA group (P<0.01). When compared with the EA group, the protein expression of P62 decreased in the EA+3-MA group (P<0.01). CONCLUSION: Electroacupuncture at front-mu and back-shu point of large intestine can effectively alleviate intestinal motility disorder in rats with slow transit constipation, which may be related to inhibiting excessive autophagy of ICCs and repairing the structure and quantity of ICCs.
The diseases of the six fu organs and the main indications of acupoints are the crucial components of the theories related to meridians, acupoints and zangfu organs. Through analyzing the classic articles in Huangdi Neijing (The Yellow Emperor's Inner Classic) and modern literature, this article elaborates on the pathogenesis, diagnostic criteria and acupoint indications for the diseases of six fu organs. It systematically reviews and summarizes the current research status regarding the diseases of six fu organs and acupoint indications as described in Huangdi Neijing. It is discovered that pathogenic qi enters six fu organs through specific pathways from the medial sides of the limbs and yin meridians, for which, the prerequisite is the abundance and normal functioning of the essence and qi of five zang organs. The diseases of six fu organs are diagnosed in accordance with identifying the syndrome patterns of six fu organs and the characteristics of biao and ben of six yang meridians. In association with the yuan-source points of six fu organs and their corresponding lower he-sea points, the paper analyzes the rationale of the primary acupoints in treatment of diseases of six fu organs, and explains the acupuncture techniques for utilizing these lower he-sea points.
This paper introduces the clinical experience of Professor LYU Jingshan in the treatment of post-stroke depression with acupuncture and moxibustion. Professor LYU Jingshan believes that this disease results from the damage of brain marrow and dysfunction of mind activity, and was manifested as liver qi stagnation and interaction of phlegm and qi. The treatment emphasizes "treating the mind" as the primary approach, addressing the root causes and symptoms, and establishes the therapeutic principle of regulating the mind and controlling qi. In clinical practice, the acupuncture technique for regulating the mind and controlling qi, and LYU 's umbilical medicine moxibustion are adopted. The paired acupoints, Baihui (GV20) and Shuigou (GV26), Shenmen (HT7) and Neiguan (PC6), are selected to regulate the mind and restore the controlling of qi and the governing of essence; Hegu (LI4) and Taichong (LR3), Fenglong (ST40) and Yinlingquan (SP9) are selected to regulate qi movement and recover the functions of liver and spleen in transportation and free flow of qi. During acupuncture, the needles are manipulated with two hands coordinately to obtain the synchronous therapeutic effect on post-stroke depression. This approach provides a new idea for the treatment of post-stroke depression.
Zhongguo zhen jiu = Chinese acupuncture & moxibustionYangjing Duan, Xu Jin, Qianqian Liu, Yanlin Zhang, Yuxia Cao, Haijun Wang
OBJECTIVE: To observe the effects of fire needling with "stomach disease prescription" on inflammatory factors and intestinal flora in rats with gastric ulcer (GU) of spleen-stomach deficiency-cold, and to explore the possible mechanism of fire needling with "stomach disease prescription" in treating GU of spleen-stomach deficiency-cold. METHODS: Ten out of 34 SPF-grade male SD rats were randomly selected as the blank group, and the remaining 24 rats were used to establish a GU model of spleen-stomach deficiency-cold by the combined method of "4 ℃ vinegar+absolute ethanol". Twenty successfully modeled rats were randomly divided into a model group and a fire needle group, with 10 rats in each group. The rats in the fire needle group received rapid fire-needle puncture at the acupoints of "stomach disease prescription" ("Zhongwan" [CV12], bilateral "Neiguan" [PC6], and "Zusanli" [ST36]), without needle retention, once every other day, with 5 treatments as one course, for a total of 3 courses. General conditions and body weight of rats in each group were compared. Gastric tissue morphology was observed by naked eye and HE staining, and the gastric mucosal injury index was calculated. ELISA was used to detect serum levels of interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α in rats. 16S rDNA sequencing was used to analyze the structure and composition of intestinal flora. RESULTS: (1) Macroscopic and pathological findings: Compared with the blank group, the rats in the model group showed typical deficiency-cold symptoms, such as mental fatigue and withered hair, and body weight was decreased (P<0.01); spot-like hemorrhagic lesions were observed on the gastric mucosa by naked eye, and HE staining showed gastric mucosal epithelial defects with extensive inflammatory cell infiltration; the gastric mucosal injury index was increased (P<0.01). Compared with the model group, the general condition of rats in the fire needle group improved and body weight was increased (P<0.01); only a small number of petechiae were observed on the gastric mucosa by naked eye, and HE staining showed orderly arrangement of gastric mucosal epithelial cells with reduced inflammatory cell infiltration; the gastric mucosal injury index was decreased (P<0.01). (2) Inflammatory regulation: Compared with the blank group, serum levels of IL-6, IL-1β, and TNF-α in the model group were increased (P<0.01); compared with the model group, serum levels of IL-6, IL-1β, and TNF-α in the fire needle group were decreased (P<0.01). (3) Flora regulation: Compared with the blank group, the Chao1 index, Shannon index, and Simpson index (1-D) of intestinal flora in the model group were decreased (P<0.01, P<0.05); the relative abundance of Bacteroidota, Proteobacteria, and Chloroflexi was decreased (P<0.05), while the relative abundance of Firmicutes was increased (P<0.05); the Firmicutes/Bacteroidota (F/B) ratio increased, and pathways related to xenobiotic biodegradation and metabolism, specific types of cancer, cardiovascular diseases, endocrine and metabolic diseases, and others were relatively enriched. Compared with the model group, the Chao1 index, Shannon index, and Simpson index (1-D) of intestinal flora in the fire needle group were increased (P<0.05, P<0.01); the relative abundance of Bacteroidota, Proteobacteria, and Chloroflexi was increased (P<0.05), while the relative abundance of Firmicutes was decreased (P<0.05); the F/B ratio decreased, and pathways related to cardiovascular diseases, nucleotide metabolism, amino acid metabolism, energy metabolism, and the excretory system were enriched. CONCLUSION: Fire needling with "stomach disease prescription" may intervene in GU of spleen-stomach deficiency-cold by inhibiting the release of inflammatory factors, correcting metabolic disorders, and restoring the balance of intestinal flora.
Zhongguo zhen jiu = Chinese acupuncture & moxibustionChengming Huang, Wen Lai, Jing Luo, Zhigang Zhou, Jianyu You
OBJECTIVE: To compare the clinical efficacy of different moxibustion therapies for primary dysmenorrhea (PD) using network Meta-analysis. METHODS: A total of 8 databases, including the CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, EMbase, and Web of Science, were searched by computer to collect randomized controlled trials (RCTs) on moxibustion therapy for PD published from database inception to September 1, 2025. The Cochrane risk of bias tool was used to evaluate the quality of the included literature, and R4.1.0 software and Stata15.0 software were used for data analysis. RESULTS: A total of 64 RCTs involving 5 814 PD patients and 11 kinds of moxibustion therapies were finally included. The network Meta-analysis showed that: ① regarding improving the total clinical effective rate, 9 moxibustion therapies (traditional suspended moxibustion, moxibustion with warming devices, herb-partitioned moxibustion, ginger-partitioned moxibustion, warm needling moxibustion, wheat-grain sized cone moxibustion, thunder-fire moxibustion, heat-sensitive moxibustion, and spreading moxibustion) were superior to conventional western medication, and wheat-grain sized cone moxibustion had the best effect [OR=8.91, 95%CI (2.55, 31.14)]; ② regarding improving pain visual analogue scale (VAS) score, 3 moxibustion therapies (herb-partitioned moxibustion, thunder-fire moxibustion, and heat-sensitive moxibustion) were superior to conventional western medication, and herb-partitioned moxibustion had the best effect [MD=-4.19, 95%CI (-6.32, -2.16)]; ③ regarding reducing Cox menstrual symptom scale (CMSS) score, 4 moxibustion therapies (herb-partitioned moxibustion, wheat-grain sized cone moxibustion, thunder-fire moxibustion, and heat-sensitive moxibustion) were superior to conventional western medication, and heat-sensitive moxibustion had the best effect [MD=-11.13, 95%CI (-16.78, -5.42)]; ④ regarding reducing prostaglandin F2α (PGF2α) level, 2 moxibustion therapies (herb-partitioned moxibustion and heat-sensitive moxibustion) were superior to conventional western medication, and heat-sensitive moxibustion had the best effect [MD=-24.94, 95%CI (-42.24, -7.42)]; ⑤ regarding safety, the incidence of adverse events of moxibustion therapies was lower than that of conventional western medication (P<0.05). CONCLUSION: Based on the current evidence, wheat-grain sized cone moxibustion has the best efficacy in improving the total clinical effective rate, herb-partitioned moxibustion has the best efficacy in improving VAS score, and heat-sensitive moxibustion has the best efficacy in improving CMSS score and PGF2α level. Limited by the quality and quantity of the included original studies and the quality of the current evidence, the conclusions of this study still require further verification by more high-quality RCTs.
Since Huangdi Mingtang Jing (Yellow Emperor's Illustrated Manual of Acupuncture Points) proposed the localization of the three preauricular acupoints, namely Ermen (TE21), Tinggong (SI19), and Tinghui (GB2), the textual descriptions of their localization in ancient literature have basically remained unchanged. However, according to the consensus of ancient literature descriptions, the localization combined with anatomy differs from the current national standard for acupoint localization. By systematically collecting and organizing the localization descriptions of the three preauricular acupoints in literature throughout different dynasties, and combining them with the anatomy of the preauricular region, this paper re-localizes the three preauricular acupoints. Based on literature records, acupuncture bronze figures, and Mingtang diagrams, the evolution process of the localization of the three preauricular acupoints is discussed, and the important evolutionary nodes and reasons for their evolution are analyzed. In addition, modern descriptions of the indications of the three preauricular acupoints are basically copied or rewritten from acupuncture literature before the Ming dynasty, and their indications are in fact practical summaries of acupoint localization in ancient literature before the Ming dynasty. In view of this, combined with the anatomical structure of the preauricular region, the localization of the three preauricular acupoints should follow the localization determined by the consensus of ancient literature, namely, Ermen (TE21) is located in the depression anterior to the supratragic notch, Tinggong (SI19) is located on the tragus, and Tinghui (GB2) is located at the pulsation of the superficial temporal artery anterior to the tragus.
OBJECTIVE: To observe the effects of Tongdu Tiaoshen (unblocking the circulation of the governor vessel and regulating the mind) acupuncture on depressive-like behavior and the expression of microRNA-26a-5p (miR-26a-5p)/ enhancer of zeste homolog 2 (EZH2)/trimethylation of lysine 27 on histone H3 (H3K27me3) proteins and inflammatory factors in chronic unpredictable mild stress (CUMS) rats, and to explore its antidepressant mechanism. METHODS: Thirty-two SPF-grade male SD rats were randomly divided into a normal group (8 rats) and a modeling group (24 rats). The modeling group was subjected to CUMS to establish depression model. After successful modeling, the rats were randomized into a model group, an acupuncture group and a fluoxetine group, with 8 rats in each group. In the acupuncture group, Tongdu Tiaoshen acupuncture was operated at "Baihui" (GV20), "Shenting" (GV24), "Shuigou" (GV26) and "Dazhui" (GV14), once daily for 6 consecutive days followed by one day of interval; and the completion of intervention was composed of 24 sessions of acupuncture. The gavage with fluoxetine solution (2.1 mg/kg) was administered in the fluoxetine group; and with 0.9% sodium chloride solution (10 mL/kg) in the other 3 groups, continuously for 28 days. Sucrose preference and the results of the open field test were observed. The hippocampal neuron morphology and Nissl bodies were examined using HE and Nissl staining. The protein expression of hippocampal EZH2 and H3K27me3 was detected using Western blot, and the mRNA expression of hippocampal miR-26a-5p and EZH2 was detected with RT-qPCR. ChIP-qPCR was applied to detect the enrichment levels of H3K27me3 in the promoter regions of interleukin-4 (IL-4), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). ELISA was provided to measure the contents of IL-6, TNF-α, interleukin-1β (IL-1β), and IL-4 in the hippocampus and serum. RESULTS: Compared with the normal group, the model group showed the decrease in sucrose preference (P<0.01), the total distance, the numbers of uprighting and cleaning behavior in the open field test (P<0.01); hippocampal neurons exhibited partial cell dissolution, irregular arrangement, nuclear pyknosis, reduced Nissl bodies (P<0.01), and uneven distribution. The mRNA expression of hippocampal EZH2, and the protein expression of hippocampal EZH2 and H3K27me3 increased (P<0.01), while the mRNA expression of miR-26a-5p decreased (P<0.01). The enrichment levels of H3K27me3 in the promoter regions of IL-6 and TNF-α were elevated (P<0.01), whereas that in IL-4 was reduced (P<0.01). The levels of IL-6, TNF-α and IL-1β in the hippocampus and serum increased (P<0.01), and the levels of IL-4 decreased (P<0.01). Compared with the model group, the acupuncture group and the fluoxetine group showed the increase in sucrose preference (P<0.01), the total distance, the numbers of uprighting and cleaning behavior in the open field test (P<0.01); hippocampal neurons exhibited the reduced cell dissolution, regular arrangement, declined nuclear pyknosis, higher Nissl bodies (P<0.01), and even distribution. The mRNA expression of hippocampal EZH2, the protein expression of hippocampal EZH2 and H3K27me3 decreased (P<0.01), and the mRNA expression of miR-26a-5p increased (P<0.01); and the mRNA expression of miR-26a-5p was negatively correlated with that of EZH2 (P<0.001). The enrichment levels of H3K27me3 in the promoter regions of IL-6 and TNF-α were lower (P<0.01), and that of IL-4 was higher (P<0.01, P<0.05). The levels of IL-6, TNF-α and IL-1β in the hippocampus and serum decreased (P<0.01), and the levels of IL-4 increased (P<0.01). The differences of the above indexes were not statistically significant between the acupuncture group and fluoxetine group (P>0.05). CONCLUSION: Tongdu Tiaoshen acupuncture can ameliorate depression-like behavior in CUMS rats, with the mechanism potentially related to regulating the miR-26a-5p/EZH2/ H3K27me3 pathway and reducing central neuroinflammation.
Zhongguo zhen jiu = Chinese acupuncture & moxibustionRong Hua, Bing Liu
Through literature tracing and theoretical analysis, this paper explores the connotation of the important proposition, "better to lose the acupoint than to lose the meridian", and reflects on its significance for clinical guidance, theoretical construction, and examination of acupuncture. First, the paper traces the origin of this proposition and elucidates its original intent of the theory, "interconnection between qi and meridian". Secondly, the paper explores the foundation of this concept formulation and content deepening. From the classical principles of "needling based on meridian" and "pressing the region where the affected meridian runs to adjust" in Huangdi Neijing (The Yellow Emperor's Inner Classic), it gradually evolved into the core epistemological concept of "therapeutic scope of meridians" based on "where meridians pass, where diseases manifest". Based on this, the diagnostic and therapeutic approaches as well as practical value of "therapeutic scope of meridians" were systematically reviewed from two perspectives, "treatment according to meridian running" and "selecting the affected meridian directly". This study examines the dilemma of the weakened status of the principle "not to lose the meridian", in the application of meridian theory, and explores the key scientific questions of acupuncture and moxibustion such as "the continuity and the holisticity of meridian essences".
Zhongguo zhen jiu = Chinese acupuncture & moxibustionWeidong Tao, Bang Zhan, Lei Ji, Chuanliang Ruan
The xi-cleft points of Qiao and Wei meridians (heel and link vessels), were first described in Zhenjiu Jiayi Jing (The Systematic Classic of Acupuncture and Moxibustion), and their conceptual framework remain consistently elusive. During the development of meridian theory, the intrinsic meridian attribution of xi-cleft points of Qiao and Wei meridians gradually disappeared, and these points were subsequently reassigned to the various regular meridians distributed in the lower limbs. This study explores the commonness of Qiao and Wei meridians with regular meridians from the perspective of meridian evolution, and verifies the therapeutic content of xi-cleft points, so as to attempt reconstructing the system of xi-cleft points in Zhenjiu Jiayi Jing. It is proposed that the changes in meridian tropism of these xi-cleft points are based on meridian distribution and clinical manifestations, and such changes result from both the constraints of numerological system of meridian, and the requirement to establish the circulatory theory of fourteen meridians. It is summarized that the evolution of meridian tropism reflects the ancients' need to integrate meridian theory, and reveals the unique value of Qiao and Wei meridians as the early framework of meridian theory, thereby reevaluating the academic status of Qiao and Wei meridian that had been marginalized in history.
Zhongguo zhen jiu = Chinese acupuncture & moxibustionZhijie Xu, Sixian Wu, Fan Xu, Sihan Sun, Qian Song, Guiping Li, Yan Shen, Shu Wang
The classical statement, "feeling comfortable when acupoint is pressed" in Huangdi Neijing (The Yellow Emperor's Inner Classic ) is regarded as the origin of acupoint theory. "Feeling comfortable" following "acupoint is pressed" refers to the subjective experiences of patient, which reflects a close connection among "acupoint sensitization, mental-physical response and deqi ". Centered on 3 essential links, "acupoint sensitization", "mental-physical response" and "deqi ", this study systematically reviews and comments on the current research of the local manifestations and brain mechanisms of deqi and acupoint sensitization; and it specially focuses on the research progress on acupoint and brain effect. This study aims to propose the idea of brain effect research from the perspective of the relationship among "acupoint sensitization, mental-physical response and deqi ", so as to provide theoretical basis and research framework for revealing the central mechanism and optimizing clinical efficacy of acupuncture intervention.