Case Report2022-06-30

Laser Acupuncture as a Treatment Option for Carpal Tunnel Syndrome Management: a Case Series

Iwan Limanjaya¹, Salim Haris², Irma Nareswari^1,3,*

J Acupunct Meridian Stud 2022; 15(3): 189-193 https://doi.org/10.51507/j.jams.2022.15.3.189

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Carpal tunnel syndrome (CTS) is disease that gives burdens for many countries, with a few choices for the management such as drugs or surgery, each has side effects that decrease the quality of life. Acupuncture is proven to be an effective treatment for pain and can restore nerve functions, and laser acupuncture is one of the modalities. This study aims to assess the effectiveness of laser acupuncture with total sample of 3 patients (6 wrists) mostly with tingling sensations and the outcomes are Boston questionnaire (BCTQ), visual analogue scale (VAS), Tinel sign, Phalen sign, and parameters of nerve conduction study (NCS). Acupuncture points used here are PC6, PC7, EXUE9, and LI4. The results show a decrease in NCS grades for 3 wrists, all wrists have BCTQ score improvements, a decrease in VAS, but no significant improvement in Tinel and Phalen signs. It is concluded that laser acupuncture can be used as a treatment option for the management of carpal tunnel syndrome.

Research Article2022-12-31

Comparison of the Effects of Myofascial Meridian Stretching Exercises and Acupuncture in Patients with Low Back Pain

Dilek Eker Büyükşireci^1,*, Nesrin Demirsoy¹, Setenay Mit², Ersel Geçioğlu², İlknur Onurlu¹, Zafer Günendi¹

J Acupunct Meridian Stud 2022; 15(6): 347-355 https://doi.org/10.51507/j.jams.2022.15.6.347

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Background: Acupuncture and myofascial meridians show great anatomical and clinical compatibility.Objectives: We aimed to compare the effects of myofascial meridian stretching exercises and acupuncture in patients with low back pain.Methods: We randomized 81 subjects with acute/subacute low back pain into three groups: an acupuncture (A) group, a myofascial meridian stretching (MMS) group, and a control (C) group. We recorded the Numerical Rating Scale (NRS) and Roland- Morris Disability Questionnaire (RMQ) scores at baseline and weeks two and six. We evaluated posterior pelvic tilt and transversus abdominis muscle strenghth with a pressure biofeedback unit, back extensor muscle strength by the Sorenson test, and lumbar range of motion (ROM) with an inclinometer. Group A received acupuncture (BL 57 and BL 62 acupoints) and stretching exercises according to the posterior superficial line were applied to the MMS group.Results: Improvements in the NRS score were more prominent in group A than in group C (p = 0.004). The RMQ score improvement between baseline and weeks two and six was more prominent in groups A and MMS (p < 0.001, p = 0.001, respectively). The Sorenson test showed significant improvement between the baseline and week two in groups A and MMS (p = 0.004, p < 0.001, respectively). The increase in lumbar ROM measurement in the MMS group between baseline and week two was significantly higher than in groups A and C (p = 0.009, p < 0.001, respectively).Conclusion: Stretching exercises according to the myofascial meridian system and acupuncture contributed to improved symptoms in the first two weeks in patients with acute/subacute low-back pain.

Research Article2022-02-28

Injection Effect of Anti-CD3 Monoclonal Antibody on Primo Vessel in Lymph Vessel of Rabbit with Lipopolysaccharide-Induced Inflammation

Sang-Heon Choi , Jong-Gu Choi , Sang-Suk Lee ^*

J Acupunct Meridian Stud 2022; 15(1): 37-42 https://doi.org/10.51507/j.jams.2022.15.1.37

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Background: The primo vascular system can be viewed as a circulatory system that plays a therapeutic function in regenerating the body tissue. The anti-CD3 monoclonal antibody was used as an immunotherapeutic agent to treat the novel coronavirus infection (COVID-19). Objectives: In this study, we observed the effect of injecting lymph nodes with Foralumab, an anti- human CD3 epsilon therapeutic monoclonal antibody, on primo vessels. Methods: The structure and atomic stoichiometry of the antibody were determined by transmission electron microscopy and energy dispersive spectroscopy. Alcian blue dying solution was injected into the lymph nodes of the abdominal vena cava of rabbits, and the solution further flowed into the lymph vessels. Results: A primo vessel with primo nodes stained with Alcian blue was clearly visible in the lymph vessel. By injecting Foralumab into lymph nodes of rabbits with lipopolysaccharide-induced inflammation, the floating primo vessel in the lymph vessel appeared thicker and was distinctly visible. Conclusion: The observation of the primo vessel post-treated with Foralumab in the inflamed lymphatic system suggests the possibility of a functional role of the primo vascular circulatory system in pathophysiological conditions.

Case Report2022-06-30

Warm Cupping of the Posterior Thorax in Combination with Standard Conventional Therapy for ARDS in COVID-19 Patients in ICU: a Case Series

Mehrdad Karimi¹, Amir Hooman Kazemi^1,2, Asma Asadi³, Azadeh Zarei¹, Arman Zargaran⁴, Seyed Ali Al-hadi Moravej⁵, Seyede Ferdos Jazayeri⁵, Omid Nabavian⁶, Seyedeh Aida Ahmadi⁶, Reihane Alipour^1,*

J Acupunct Meridian Stud 2022; 15(3): 194-200 https://doi.org/10.51507/j.jams.2022.15.3.194

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Acute respiratory distress syndrome (ARDS) is commonly found in critically ill patients with coronavirus disease 2019 (COVID-19). As a non-pharmacological treatment of complementary and alternative medicine (CAM), cupping has been clinically used for respiratory symptoms. We sequentially identified a series of patients with COVID-19 with ARDS who were admitted to the intensive care unit (ICU). Warm cupping of the posterior thorax was performed for seven days. We collected longitudinal severity scores on cough, breathlessness, chest tightness, type of oxygen therapy, and oxygen saturation (SpO₂). We hereby report the changes in the severity scores in a series of eight patients who received 21 sessions of cupping in addition to conventional treatments. All patients reported improvement in symptom scores that was matched by an increase in SpO₂ by as much as 3.16%. All patients were discharged and did not require the use of a mechanical ventilator. The results suggest that combining cupping with conventional treatment may provide a good prognosis for patients with COVID-19 with ARDS.

Research Article2022-06-30

Comparison of an Iranian Traditional Massage (Fateh Method) with Physiotherapy and Acupuncture for Patients with Chronic Low Back Pain: a Randomized Controlled Trial

Parva Namiranian¹, Mehrdad Karimi¹, Seyede Zahra Emami Razavi², Ahmad Fateh Garoos¹, Mohammad Hossein Ayati^1,*

J Acupunct Meridian Stud 2022; 15(3): 163-173 https://doi.org/10.51507/j.jams.2022.15.3.163

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Background: Low back pain (LBP) is currently a major reason for disability worldwide. Therapeutic massage is one of the most popular non-pharmacological methods for managing chronic LBP (CLBP), and the Fateh method is a massage technique based on Iranian Traditional Medicine.Objectives: The current study aimed to compare the effects of Fateh massage with those of acupuncture and physiotherapy on relieving pain and disability in CLBP.Methods: Eighty-four patients with CLBP were categorized into groups that received Fateh massage, acupuncture, or physiotherapy. Each group included 28 randomly assigned patients who completed 10 sessions of therapy. Visual analogue scale (VAS) scores and Roland–Morris disability scores were evaluated at baseline, after intervention, and four weeks later. The findings were analyzed with SPSS software.Results: The baseline VAS and Roland–Morris scores of the three study groups did not indicate significant differences (p > 0.05). All three groups showed significant pre-post improvements in both scores (p < 0.05). At the end of the treatment sessions, the three groups showed no significant difference in the reductions in pain intensity and disability score (p > 0.05). Improvements in disability and pain between the first and third time points were significant in all three groups (p < 0.05 for each group). In addition, the results of massage, physiotherapy, and acupuncture groups were not significantly different (p > 0.05). No adverse events occurred in the patients.Conclusion: The effects of Fateh massage were comparable to those of acupuncture and physiotherapy in reducing pain and disability in patients with CLBP.

Research Article2023-02-28

Lipid Profile Response to Acupuncture in Obese Patients with Subjective Tinnitus: a Randomized Controlled Trial

Ali Mohamed Ali Ismail*

J Acupunct Meridian Stud 2023; 16(1): 11-19 https://doi.org/10.51507/j.jams.2023.16.1.11

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Background: Blood lipid levels have been reported as novel biomarkers for chronic subjective tinnitus (CST), with their levels being higher in patients with CST.Objectives: This trial aimed to determine the change in lipid profile and tinnitus-related quality of life (TR-QoL) responses to 8-week acupuncture treatment in patients with CST.Methods: Sixty obese patients with CST were randomly assigned to group A (treatment group; n = 30; mean age = 44.10 ± 3.69 years) or group B (sham group; n = 30; mean age = 45.53 ± 3.62 years). Patients in group A (n = 30) received manual stimulation at the TE3, TE5, TE17, TE18, TE19, TE20, TE21, TE22, GB2, GB8, GB20, LI4, LI11, KI3, SP6, ST36, CV4, CV9, and CV12 acupoints through in-site acupuncture needles thrice weekly. Furthermore, the bilateral abdominal ST25 and GB28 acupoints were electrically stimulated through in-site acupuncture needles. Group B (n = 30) received the same acupuncture protocol as group A but the insertion of needles was a sham insertion. Anthropometrics such as body mass index (BMI) and waist circumference (WC), TR-QoL (assessed via tinnitus handicap inventory), blood lipid levels such as high-density lipoprotein (HDL_s), low-density lipoprotein (LDL_s), cholesterol (C), and triglycerides (TG_s), and the visual analogue scale (VAS) score for tinnitus severity, were assessed prospectively.Results: Only group A showed significant within-group improvements. Except for HDL_s, BMI, and WC, unpaired between-group comparisons showed significantly greater improvements in other outcome measures of all patients with tinnitus (TR-QoL, LDL_s, TG_s, C, and VAS) in group A than in group B.Conclusion: Safe acupuncture treatment not only improves anthropometrics and TR-QoL, but also helps resolve hyperlipidemia and reduces the severity of tinnitus in obese patients with CST.

Research Article2022-02-28

Adrenergic Control of Primo Tissue Size in Rats

Yiming Shen , Yu Jeong Kim , Pan Dong Ryu ^*

J Acupunct Meridian Stud 2022; 15(1): 25-36 https://doi.org/10.51507/j.jams.2022.15.1.25

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Background: Hyperplastic morphological changes associated with erythropoiesis have been reported in the primo vascular system (PVS) tissue on the surface of abdominal organs in rats with heart failure (HF) or hemolytic anemia (HA). Objectives: Since adrenergic activity is commonly activated in both HF and HA, we investigated whether adrenergic signaling mediates the abovementioned morphological changes. Methods: We compared the effects of adrenolytic treatments (exercise training and 6-hydroxydopamine) on the gross morphology of the PVS tissues isolated from organ surfaces in HF or HA rats. HF and HA were induced by ligating the left coronary artery and injecting phenylhydrazine, respectively. We further compared the effects of norepinephrine and norepinephrine plus α- or β-adrenoceptor blockers. Results: The number of samples per rat, PN size, and proportion of red-colored samples in the PVS tissue increased in the HF and HA rats. These changes were reversed by adrenolytic treatments. Interestingly, 6-hydroxydopamine also reversed phenylhydrazineinduced hemolytic changes in erythrocytes. Subcutaneous administration of norepinephrine (3 mg/kg/d) increased the sampling frequency per rat and the PN size, but these effects were blunted at a higher dose (10 mg/kg/d). Norepinephrine administration had little effect on the proportion of red-colored tissues. Norepinephrine-induced morphological changes were completely blocked by a β-adrenoceptor antagonist (propranolol) but increased slightly by an α-adrenoceptor antagonist (phentolamine). Conclusion: Adrenergic signaling controls hyperplastic changes in the organ surface PVS in rats. These findings may explain the morphological dynamics of the PVS tissues proposed by Bong Han Kim and further clarify the pathophysiological roles of the PVS.

Research Article2022-10-31

Sedative Effect of Ketamin-Midazolam Administered at Acupoint GV20 Compared to Intramuscular Route in Blue-Fronted Amazon (Amazona aestiva): a Pilot Study

Aricia Noelli Brega Monteiro^1,*, Bruno Simões Sérgio Petri², Haroldo Furuya², Liliane Milanelo², Márcia Valéria Rizzo Scognamillo³, Ayne Murata Hayashi⁴

J Acupunct Meridian Stud 2022; 15(5): 314-321 https://doi.org/10.51507/j.jams.2022.15.5.314

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Background: The growth of exotic pet medicine is leading to fast developments in clinical investigations on birds. Acupuncture, specifically pharmacopuncture, offers safe chemical restraint options.Objectives: To investigate pharmacopuncture at acupoint GV20 in blue-fronted Amazon parrots (Amazona aestiva) using ketamine and midazolam.Methods: Sixteen healthy birds were distributed into four groups (C: intramuscular control; 1/2 C: 1/2 dose intramuscular control; 1/2 GV20: 1/2 dose at acupoint GV20; 1/5 GV20: 1/5 dose at acupoint GV20). Degree of sedation, latency, recuperation time, heart and respiratory rate, and body temperature were measured. Quantitative data were analyzed by a Student’s t-test.Results: The C, 1/2 C, and 1/2 GV20 groups showed the same degree of sedation. The 1/2 GV20 group showed longer latency times (6 ± 2.1) than the 1/2 C (2.5 ± 0.5) group. Sedation time did not differ between the C (28 ± 9.8), 1/2 C (30.5 ± 8.6), and 1/2 GV20 (41 ± 22.24) groups. The 1/2 GV20 group recuperated faster (13.7 ± 3.7) than the C group (64.2 ± 3.5). The C and 1/2 C groups showed tremors and slow and unstable recovery. Two animals in the C group showed mild hypothermia (38°C).Conclusion: The use of 1/2 GV20 was effective and safe to sedate blue-fronted Amazon parrots without side effects, providing easy, stable, and fast recovery. The use of 1/5 GV20 had a shorter sedation time. These findings show that the combination of acupuncture and drugs provides new possibilities for efficient anesthetic protocols with fewer side effects in birds.