Review Article2022-08-31

Discovering Influential Core-Keywords, Researcher Networks and Research Trends of Acupuncture on Depression Using Bibliometric Analysis

Jae-Ha Ahn^1,2, Mi-Yeon Song^3,*, Hi-Joon Park^1,2,*

J Acupunct Meridian Stud 2022; 15(4): 227-237 https://doi.org/10.51507/j.jams.2022.15.4.227

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Depression is a common illness worldwide. Acupuncture is used as an alternative to non-pharmacological therapy. This study aimed to identify the development and global trends in the study of acupuncture therapy for depression over the past two decades using a bibliometric analysis. Articles published between 2001 and 2020 on acupuncture for depression were retrieved from the Web of Science database. Extracted information included authors, organizations, countries, keywords, and journals. The VOSviewer program was used to visualize the impacts and network hubs of the keywords, authors, and affiliations. Analyses of 871 original and review articles revealed that the number of publications has continually increased over the past 20 years. China has published the maximum number of articles, followed by the United States and South Korea. As for research areas, integrative complementary medicine was most well represented in terms of the number of articles. Co-occurrence analysis of keywords indicated that each five sub-group cluster (including “pain related to depressive symptoms,” “CAM therapies of depression,” “comorbid disease or symptoms of depression,” “clinical trials of depression,” and “mechanism of acupuncture on depression”) has its own impact keyword. The most recent keywords were “protocol” and “systematic review,” whereas early keywords were “acupuncture analgesia” and “St john’s wort.” Co-authorship analysis of authors and organizations revealed 4 influential authors and 2 organizations in the field of acupuncture for depression. The present study provided influential keywords that show comorbid symptoms, treatments, and mechanism. Additionally, it revealed the influential persons or groups related to acupuncture therapy for depression.

Research Article2022-08-31

The Adjunctive Effects of Acupuncture for Hospitalized COVID-19 Patients: a Single-Blinded Randomized Clinical Study

Dwi Rachma Helianthi¹, Atikah C. Barasila^1,2, Salim Harris³, Robert Sinto⁴, Yordan Khaedir², Irman^1,*

J Acupunct Meridian Stud 2022; 15(4): 247-254 https://doi.org/10.51507/j.jams.2022.15.4.247

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Background: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a coronavirus (SARS-CoV-2) that can induce cytokine storm. To this point, no specific drug has been effective for curing COVID-19.Objectives: The aim of this study was to determine the effects of a combination of acupuncture intervention and pharmacologic treatment in hospitalized COVID-19 patients with mild-moderate symptoms.Methods: A single-blinded randomized controlled clinical trial of hospitalized COVID-19 patients confirmed by RT-PCR examination with mild-moderate symptoms was conducted from August to September 2020. Participants were assigned to the treatment group (receiving pharmacologic treatment and manual acupuncture intervention) or the control group (receiving only pharmacologic treatment). Laboratory outcomes, including complete blood count, C-reactive protein (CRP) and ferritin levels, and erythrocyte sedimentation rate (ESR), were measured before and after the intervention. For clinical outcomes, we evaluated the duration of the cough symptom.Results: We found that participants in the treatment group had a shorter duration of the cough symptom compared to the control group, and the difference was statistically significant. In the treatment group, we found an increase in the percentage of lymphocyte count and ESR, while in the control group, both parameters were decreased; however, the differences were not statistically significant. There was a decrease in the mean of CRP and ferritin levels in both groups, and the differences were not statistically significant.Conclusion: Our study has shown promising results for the effects of combined treatment of acupuncture and pharmacologic treatment on the duration of the cough symptom in hospitalized COVID-19 patients with mild-moderate symptoms. Further large-scale studies with rigorous design are needed to examine these preliminary results.

Case Report2023-04-30

Integrative Strategy with Ayurveda and Electro-Acupuncture in Hemifacial Spasm: a Case Report

Akshatha K Bhat^1,*, Venugopalan Krishna kumar², Jim Daniel Johnson³

J Acupunct Meridian Stud 2023; 16(2): 65-69 https://doi.org/10.51507/j.jams.2023.16.2.65

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We report a primary hemifacial spasm that started four years ago with sudden twitching of the face towards the right side. It was diagnosed as a hemifacial spasm by a neurologist and prescribed with Zeptol 100 mg 0.5 tablet BID for two weeks, followed by two sittings of Botox injection in a gap of 1 year. A year later, it reappeared more severely, driving her towards an integrative treatment modality. Ayurveda treatments including Nasya, Ksheera dhooma, internal medications, and Rasona navaneetha prayoga were administered. GV20, GB14, EX-HN5, ST3, ST4, ST6, TE17, LI4, and GB34 were selected for electro-acupuncture. The scores of hemifacial spasm grading and quality of life scale were 9 and 20 (before), 6 and 16 (after treatment), and 4 and 10 (follow-up after six months), respectively. This integrative approach was safe and has shown an improvement in hemifacial spasm.

Research Article2023-04-30

The Effects of Manual Acupuncture on Mitochondrial Fusion and Fission Gene Expression in Rat Spleen

Yu-Mi Lee^1,†, Dong-Hee Choi^2,†, Jeong-Hye Park², Min-Woo Cheon³, Jae Gwan Kim¹, Jeong-Sang Kim², Taejin Choi⁴, Hye-Ran Kim², Daehwan Youn^2,*

J Acupunct Meridian Stud 2023; 16(2): 49-55 https://doi.org/10.51507/j.jams.2023.16.2.49

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Background: A significant amount of research has been conducted to establish the validity of acupuncture, and it has been demonstrated through animal disease model studies that acupuncture influences mitochondrial changes. However, to more accurately examine the mechanisms of acupuncture treatment effectiveness in pathological models, it is crucial to investigate changes in disease-free animals. Among various hypotheses regarding the effects of acupuncture on the body, we focused on the result that acupuncture stimulation is related to mitochondria.Objectives: We examined the effects of acupuncture mitochondrial fission and fusionrelated mediators in disease-free Sprague Dawley (SD) rats' spleen meridian acupoints.Methods: SD rats were divided into control, SP1, SP2, SP3, SP5, and SP9 acupuncture groups. Acupuncture was performed at each point for 10 minutes daily for four days. Peroxisome proliferator-activated receptor-gamma coactivator 1-α (PGC-1α) and fission protein 1 (Fis1) levels were evaluated using quantitative real-time polymerase chain reaction (qRT-PCR), while dynamin-related protein 1 (DRP1), optic atrophy-1 (OPA1), mitofusin-1 (MFN1), and mitofusin-2 (MFN2) levels were assessed via western blotting. Mitochondria protein concentrations and NADH dehydrogenase activity in spleen tissues were measured using enzyme-linked immunosorbent assay (ELISA).Results: PGC-1α expression decreased in the SP1 (p < 0.01), SP5 (p < 0.05), and SP9 (p < 0.05) groups, while Fis1 expression increased in the SP1 (p < 0.01), SP5 (p < 0.01), and SP9 (p < 0.05) groups. DRP1, OPA1, MFN1, and MFN2 levels exhibited no significant changes. Mitochondrial protein concentrations decreased in the SP2 (p < 0.01), SP3 (p < 0.01), SP5 (p < 0.01), and SP9 (p < 0.01) groups, while NADH dehydrogenase activity decreased in the SP2 (p < 0.05) and SP9 (p < 0.05) groups.Conclusion: Acupuncture at the SP9 acupoint influenced the mitochondrial fission pathway by modulating PGC-1α and Fis1 mediators in the rat spleen under non-disease conditions.

Perspective Article2022-12-31

Sham Acupuncture Is Not Just a Placebo

Tae-Hun Kim^1,*, Myeong Soo Lee², Hyangsook Lee³

J Acupunct Meridian Stud 2022; 15(6): 333-335 https://doi.org/10.51507/j.jams.2022.15.6.333

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Sham acupuncture should have two distinct features: first, it must be morphologically similar to verum acupuncture for blinding purposes, and second, it must not exert physiologically expected effects of verum acupuncture. While several types of sham acupuncture are currently used, there are on-going debates on which sham acupuncture can meet the criteria for being an appropriate control intervention in acupuncture research. In view of this situation, it is unreasonable to regard the use of sham acupuncture in acupuncture research as the same as the use of placebo drugs in drug research. Given the current research evidence that sham acupuncture can exert not only the originally expected non-specific effects but also sham acupuncture-specific effects, it would be misleading to simply regard sham acupuncture as the same as placebo. Therefore, researchers should be cautious when using the term sham acupuncture in clinical investigations.

Review Article2022-10-31

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

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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.

Research Article2023-04-30

Abdominal Acupuncture for Non-Responding TMD Patients: a Retrospective Observational Study in General Practice

Emanuela Serritella*, Gabriella Galluccio, Carlo Di Paolo

J Acupunct Meridian Stud 2023; 16(2): 56-64 https://doi.org/10.51507/j.jams.2023.16.2.56

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Background: Pain related to Temporomandibular Disorders (TMD) is severe, negatively affecting patients' quality of life, and often resistant to conventional treatments. Abdominal Acupuncture (AA) is known to be particularly effective for pain, especially chronic and musculoskeletal pain, but it is still poorly studied and never investigated in TMD patients.Objectives: To analyze the efficacy of AA for the treatment of patients with subacute and chronic pain related to TMD and non-responding to previous conventional therapies (occlusal splint, medications, physical therapy).Methods: Twenty-eight patients, 24 F and four M (mean age 49.36 years), were recruited from January 2019-February 2021. All patients underwent AA treatment: two sessions per week for four weeks, for a total of eight sessions. At the beginning of therapy (T0) and at the end of the cycle (T1) the following data were evaluated: maximum mouth opening (MMO); cranio-facial pain related to TMD (verbal numeric scale, VNS); pain interference with normal activities and quality of life of patients (Brief Pain Inventory, BPI); oral functioning (Oral Behavior Checklist, OBC); impression of treatment effectiveness (Patients' Global Impression of Improvement, PGI-I Scale). Statistical comparison of data before and after the AA treatment was performed by Wilcoxon's signed-rank test (significance level p < 0.05).Results: The MMO values were significantly improved after one cycle of AA (p = 0.0002). In addition, TMD-related pain had a statistically significant decline following AA treatment (all p < 0.001). Patients’ general activity and quality of life (BPI) were described as improved following a course of AA, with statistically significant values for all aspects considered (all p < 0.05).Conclusion: Abdominal acupuncture resulted in effective treatment of subacute/chronic-resistant pain related to TMD, capable of improving mandibular function and facial pain, and reduced the interference of pain affecting patients' quality of life.

Review Article2023-02-28

Acupuncture for Management of Endodontic Emergencies: a Review

Gaurav Kumar^1,†, Sanjay Tewari^2,*,†

J Acupunct Meridian Stud 2023; 16(1): 1-10 https://doi.org/10.51507/j.jams.2023.16.1.1

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Root canal treatment (RCT) employed for painful endodontic conditions like apical periodontitis and irreversible pulpitis is associated with a high incidence of postoperative pain. Pharmacological management for this purpose is effective, but not entirely free from side effects and in some cases may fail to provide adequate relief. Furthermore, concerns have been raised regarding the transmission of coronavirus disease-2019 (COVID-19) as a result of the aerosols generated and prolonged chair side time required for RCT. Acupuncture is a traditional Chinese therapy commonly employed as an alternative for the treatment of pain. And what’s more, the use of acupuncture has been recently reported as treatment for the management of endodontic pain as well as on the anesthetic success in patients with irreversible pulpitis. This review aims to evaluate the current evidence for acupuncture in endodontics and its potential role in emergency pain relief and management for patients. To combat this, a thorough search for literature within the field was performed in five electronic databases. Retrieved studies were screened according to the pre-defined eligibility criteria. After both an electronic and manual search, five studies were selected for review. These studies reported the beneficial effects of acupuncture in reducing the failure of nerve block in patients with irreversible pulpitis and in controlling both intraoperative and postoperative pain following RCT. In addition, it was also reported to reduce anxiety surrounding the dental procedure and minimized the intake of analgesics after the endodontic procedure, which can result in some unwanted side effects. However, more in depth clinical research is required before any recommendation regarding the application of acupuncture in endodontic patients can be made.

Research Article2022-10-31

Effects of Preoperative Acupuncture on Prevention of Nausea and Vomiting and Plasma Serotonin Values in the Hysterectomy Postoperative Period: a Randomized Clinical Trial

Michelle Catarina Pires, Guilherme Antonio Moreira de Barros*, Lucas Guimarães Ferreira Fonseca, Murilo Moreira Thom, Paulo do Nascimento Junior, Norma Sueli Pinheiro Módolo

J Acupunct Meridian Stud 2022; 15(5): 300-306 https://doi.org/10.51507/j.jams.2022.15.5.300

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Background: Nausea and vomiting are frequent complications of anesthesia in the postoperative period. Acupuncture at the pericardium point 6 (PC6) is known to be effective in preventing postoperative nausea and vomiting (PONV).Objectives: The objective of the present study is to investigate the effects of acupuncture performed at the PC6 point in the prevention of PONV in women undergoing elective open hysterectomy under general inhalational anesthesia and to assess its association with plasma serotonin levels.Methods: 97 patients undergoing elective open hysterectomy were randomly divided into two groups: acupuncture group (bilateral acupuncture at PC6, n = 49), and a control group (no acupuncture, n = 48). All patients prophylactically received ondansetron and dexamethasone and, as rescue medication, metoclopramide in case of occurrence of PONV. The primary outcome evaluated was occurrence of nausea and vomiting within 24 hours after surgery. Serotonin plasma levels were measured before and after acupuncture prior to anesthesia induction. For the control group, the repeat measurement was performed 30 minutes after admission to the preoperative unit.Results: Acupuncture at PC6 significantly reduced the incidence of nausea (29.2% vs. 6.1%; p > 0.003), and the need of rescue medication (metoclopramide) (33.3% vs. 10.2%; p > 0.006), but not vomiting (4.2 vs. 4.1; p > 0.98). The plasma serotonin levels between control and acupuncture groups did not differ.Conclusion: This study shows that acupuncture at PC6 resulted in a lower incidence of postoperative nausea in patients undergoing hysterectomy.