Effect of Dry Cupping Therapy on Pain and Functional Disability in Persistent Non-Specific Low Back Pain: A Randomized Controlled Clinical Trial

Marianna de Melo Salemi^1,*, Vanessa Maria da Silva Alves Gomes¹, Laylla Marjorye Rebouças Bezerra¹, Thania Maion de Souza Melo¹, Geisa Guimarães de Alencar¹, Iracema Hermes Pires de Mélo Montenegro², Alessandra Paula de Melo Calado³, Eduardo José Nepomuceno Montenegro¹, Gisela Rocha de Siqueira¹

J Acupunct Meridian Stud 2021; 14(6): 219-230 https://doi.org/10.51507/j.jams.2021.14.6.219

Background: Cupping therapy is used to treat musculoskeletal conditions, including low back pain.Objectives: The study assessed the effects of dry cupping on pain and functional disability from persistent nonspecific low back pain. Methods: This was a randomized controlled trial, where participants were allocated to a cupping therapy (n = 19) or sham (n = 18) group, for five 10-minute sessions of cupping therapy, twice a week, to stimulate the acupoints related to low back pain (GV4, BL23, BL24, BL25, and BL30, BL40 and BL58) and emotional aspects (HT3 and ST36). All participants were assessed at baseline, post-treatment and follow up (a finalization period of four weeks) using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Groups were compared using the analysis of covariance (ANCOVA) and the effect size was calculated using Cohen̓s d. Results: The cupping therapy group presented a lower mean VAS when compared to the sham, at post-treatment (mean difference: –2.36; standard error [SE]: 0.58; p < 0.001; “large” effect size: –0.94) and follow up (mean difference: –1.71; SE: 0.81; p < 0.042; ‘large’ effect size: –0.83). The cupping therapy group presented a lower mean ODI when compared to the sham post-treatment (mean difference: –4.68; SE: 1.85; p: 0.017; ‘large’ effect size: –0.87), although in follow-up, there was no difference between the groups (mean difference: 4.16; SE: 2.97; p: 0.17; “medium” effect size: –0.70). Conclusion: Dry cupping was more effective in improving pain and functional disability in people with persistent nonspecific low back pain when compared to the sham.

Link Between Electroacupuncture Stimulation near the Sympathetic Trunk and Heart Rate Variability

Kazufumi Takahashi^2,3,*, Xiaoming Wang^2,3, Daiyu Shinohara¹, Kenji Imai^2,3

J Acupunct Meridian Stud 2022; 15(2): 114-120 https://doi.org/10.51507/j.jams.2022.15.2.114

Background: The cardiovascular system and airway smooth muscles are regulated by the autonomic nervous system.Objectives: This study investigated the effect of electrical acupuncture stimulation near the cervical sympathetic ganglia on heart rate variability and respiratory function.Methods: This prospective, single-center study at Teikyo Heisei University recruited 24 healthy adults randomly assigned to no-stimulation and electroacupuncture (EA) groups in a crossover trial with a 2-week washout period. After 5 min of rest, a 5-min rest or acupuncture stimulus was delivered, followed by a further 5 min of rest for both groups. EA, at 2-Hz (level of no pain), was delivered near the left cervical ganglia at the level of the sixth cervical vertebra in the EA group.Results: The high-frequency component of the heart rate variability was significantly higher in the EA group than that in the no-stimulation group. Further, there was a significant increase in the high-frequency component of the heart rate in the EA group during the stimulation compared to before and after stimulation. Heart rate decreased significantly during EA compared to before stimulation in the EA group. Regarding respiratory function, forced vital capacity, forced expiratory volume in 1 s, and peak flow significantly increased in the EA group compared with the no-stimulation group, and after stimulation compared with before stimulation.Conclusion: Stimulation with 2-Hz EA near the cervical sympathetic trunk increased parasympathetic nerve activity and reduced heart rate. However, the respiratory function was activated via increased sympathetic nerve activity. Therefore, 2-Hz EA may be effective for autonomic nerve regulation in bronchial stenosis.

Acupuncture Treatment of a Patient with Bradycardia and Idioventricular Rhythm

Oksana Strakhova*, Alexey Ryzhov*

J Acupunct Meridian Stud 2022; 15(6): 356-360 https://doi.org/10.51507/j.jams.2022.15.6.356

A patient with bradycardia and an idioventricular rhythm was observed. According to cardiologists, there is no reliable drug treatment for bradycardia with an idioventricular rhythm; instead, the sole treatment is a pacemaker. In the course of this case, it was shown that acupuncture can restore the heart rhythm from bradycardia to normocardia, and from idioventricular with third-degree atrioventricular node block and an average heart rate of 34 BPM, to normal sinus rhythm with a heart rate of 71 BPM. Additionally, at the end of the treatment, the patient’s number of episodes of ventricular extrasystole decreased 36 times (3289 versus 91 episodes). These results show that research on this technique should be continued.

Role of Acupuncture and Fire Cupping in Reducing the Thyroxine Dose and Improving the Thyroid Function in Hypothyroidism Patients: A Case Series

Pradeep M. K. Nair^1,*, Naga Jyothi²

J Acupunct Meridian Stud 2021; 14(5): 200-205 https://doi.org/10.51507/j.jams.2021.14.5.200

Hypothyroidism is one of the most common endocrine disorders linked to various systemic diseases ranging from obesity to cancers. The present line of management is insufficient as reports suggest that there is persistence of symptoms and poor adherence that makes the management of said disease challenging. Acupuncture and other Traditional Chinese Medicine (TCM) therapies are proven to alleviate endocrine dysfunctions. However, reports on acupuncture and cupping therapy on hypothyroidism are very scarce. Here, we report 5 cases of hypothyroid patients aged between 38-44 yrs who were treated with acupuncture and fire cupping for a period of three months. At the baseline, the patients presented with either a weak, wiry or vacuum pulse which represents spleen Qi deficiency. Further, they presented with elevated levels of Thyroid Stimulating Hormone (TSH), and higher Body Mass Index (BMI). Acupuncture treatment at ST36, LI4, SP6, and BL20 was given bilaterally whilst CV4, LR3, LR4, SP9, ST40, SP10, GV4, KI3, ST12, and SI17 were punctured unilaterally. At the end of the time period of three months, patients progressed to normal levels of TSH, reduction in BMI and had succeeded in tapering their medication doses. Supplementing this, the patients reported marked improvement in other symptoms like fatigue, hair loss, and cold feet post-treatment. The effects were consistent even during the three month follow-up period post-interventions. The results encourage the utilization of acupuncture and fire cupping in the management of hypothyroidism. However, large scale studies are warranted to strengthen this recommendation.

Acupuncture for Osteoporosis: a Review of Its Clinical and Preclinical Studies

Yimiao Tian^1,†, Lili Wang^2,†, Tianshu Xu¹, Rui Li¹, Ruyuan Zhu¹, Beibei Chen¹, Hao Zhang¹, Bingke Xia¹, Yiwen Che³, Dandan Zhao^1,*, Dongwei Zhang^1,*

J Acupunct Meridian Stud 2022; 15(5): 281-299 https://doi.org/10.51507/j.jams.2022.15.5.281

Acupuncture has gained growing attention in the management of osteoporosis (OP). However, a comprehensive review has not yet been conducted on the efficacy and challenges of acupuncture in preliminary research and clinical trials. Therefore, an extensive literature search was conducted using electronic databases, including PubMed (www.ncbi.nlm.nih.gov/pubmed), CNKI (www.cnki.net), and Web of Science, for studies published from the beginning of 2000 to the end of May 2022. Combinations of synonyms for OP, acupuncture, traditional Chinese medicine, clinical trial, preclinical study, and animal experiments were searched. A total of 290 papers were consulted, including 115 reviews, 109 clinical observations, and 66 preclinical studies. There is accumulating evidence to support the beneficial role of acupuncture in preserving bone quality and relieving clinical symptoms based on clinical and preclinical investigations. The top ten most commonly used acupoints are BL23, ST36, BL20, BL11, CV4, GV4, SP 6, KI3, BL18, and GB39. The underlying mechanisms behind the benefits of acupuncture may be linked with the regulation of the hypothalamic-pituitary-gonadal (adrenal) axis and activation of the Wnt/β-catenin and OPG/RANKL/RANK signaling pathways. In summary, strong evidence may still come from prospective and well-designed clinical trials to shed light on the potential role of acupuncture in preserving bone loss. Future investigations are needed to explore the potential underlying mechanisms, long-term clinical efficacy, and compliance of acupuncture in OP management.

Exploring Acupuncture Actions in the Body and Brain

In-Seon Lee, Younbyoung Chae^*

J Acupunct Meridian Stud 2022; 15(3): 157-162 https://doi.org/10.51507/j.jams.2022.15.3.157

Acupuncture’s actions have been explained by biomedical research. However, the meridian system used in acupuncture needs further clarification. This review describes how acupuncture affects the body and brain. From the perspective of traditional East Asian medicine, the meridian system is closely connected with acupuncture’s treatment effects. In the body, the indications of acupoints, primarily established based on the meridian system, have spatial symptom patterns. Spatial patterns of acupoint indications are distant from the stimulated sites and strongly associated with the corresponding meridian’s route. Understanding how acupuncture works based on the original meridian system is important. From a neuroscience perspective, an acupuncture-induced sensation originates from the bottom-up action of simple needling in the peripheral receptor and the reciprocal interaction with top-down brain modulation. In the brain, enhanced bodily attention triggered by acupuncture stimulation can activate the salience network and deactivate the default mode network regardless of the actual stimulation. The application of data science technology to acupuncture research may provide new tools to uncover the principles of acupoint selection and enhance the clinical efficacy of acupuncture treatment in various diseases.