Effect of Acupressure on Pain during Inferior Alveolar Nerve Block Injection in Children Aged 5-10 Years Old - An Experimental Study

Ayushi Shashikant Gurharikar, Devendra Nagpal*, Prabhat Singh Yadav, Purva Chaudhari, Kavita Hotwani, Gagandeep Lamba

J Acupunct Meridian Stud 2023; 16(4): 127-132 https://doi.org/10.51507/j.jams.2023.16.4.127

Background: Acupressure, which is related to acupuncture, is a noninvasive therapy suitable for use in children. However, data examining acupressure’s effects on the pain of local anesthetic injection in children are sparse.Objectives: The purpose of this study was to evaluate acupressure’s effects on the pain of local anesthetic injection in children.Methods: This randomized, double-blind, parallel-group clinical study included 37 5- to 10-year-olds who had an inferior alveolar nerve block (IANB) for a mandibular extraction and were randomized to one of two groups: acupressure (study group) or non-acupressure (control group). The Wong-Baker FACES Pain Rating Scale (WBFPS) and the Sound, Eye, Motor (SEM) scale were utilized for subjective and objective pain assessment during injection.Results: The objective and subjective assessment of pain during injection significantly differed between the groups, with the acupressure group displaying lower scores.Conclusion: Acupressure at the extra one point (EX-HN1) reduced pain during IANB injection in 5- to 10-year-olds and can be used as an adjunct to conventional measures like topical anesthesia to reduce pain.

Investigation of the Effects of Acupuncture on Post-Operative Chest Pain after Open Heart Surgery

Sharareh Roshanzamir¹, Yas Haririan¹, Rezvan Ghaderpanah², Leila Sadat Mohamadi Jahromi^1,*, Alireza Dabbaghmanesh³

J Acupunct Meridian Stud 2023; 16(4): 133-138 https://doi.org/10.51507/j.jams.2023.16.4.133

Background: Coronary artery bypass grafting (CABG) accounts for more than half of all adult cardiac surgeries worldwide. Post-operative chest pain is a common CABG complication and can cause significant discomfort.Objectives: Because taking large amounts of analgesics can have many side effects, we evaluated whether acupuncture effectively reduces pain and the use of analgesics by CABG patients.Methods: In this clinical trial, 30 patients who had recently undergone CABG were randomly allocated to two groups. For both groups, exercise therapy and routine analgesics were recommended. The intervention group underwent bilateral acupuncture in distinct acupoints, including the HT3, HT4, HT5, HT6, HT7, PC3, PC5, PC6, and PC7 for 10 daily sessions constantly. Visual analog scale (VAS) and analgesic use were evaluated in both groups at baseline and after completing the 10-day treatment.Results: Our analysis revealed significant decreases in the mean VAS scores in both the intervention and the control group, and that the reduction was more significant in the acupuncture group (p < 0.001). Moreover, analgesic use was significantly lower in the acupuncture group when compared with the control group (p < 0.001).Conclusion: Our findings highlight acupuncture as an alternative method of controlling CABG-associated post-operative chest pain and reducing the use of analgesics, which might have many side effects.

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

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.

Acupuncture in the Anesthetic Recovery of Bitches Submitted to Ovariohysterectomy

Amanda Caroline Gomes Graboschii^1,*, Carolina Carvalho dos Santos Lira¹, Jackellyne Laís Ferreira Lins², Marcia Kikuyo Notomi³, Pierre Barnabé Escodro¹

J Acupunct Meridian Stud 2023; 16(3): 95-100 https://doi.org/10.51507/j.jams.2023.16.3.95

Background: Cardiorespiratory depression caused by anesthesia decreases the quality and increases the time of postoperative recovery. The acupoint Governor Vessel 26 (GV26) is a resuscitation point that can reverse this depression and can be safely used without side effects.Objectives: The objective of this study was to evaluate the stimulation and anesthetic recovery time of GV26 in bitches submitted to ovariohysterectomy (OH) under dissociative anesthesia.Methods: As pre-anesthetic protocol, acepromazine 0.2% (0.1 mg/kg) and tramadol hydrochloride (2 mg/kg) was used, and induction was performed using midazolam (0.5 mg/kg) and ketamine (10 mg/kg). For the control group, standard procedure was performed for OH, with anesthetic recovery and post-surgical procedures. For the acupuncture group (AP), the stimulation of acupoint GV26 was performed 20 minutes after the anesthetic induction and maintained for 5 minutes. Respiratory rate, amplitude (superficial, normal or deep), type of respiratory movement (abdominal, abdominocostal or thoracoabdominal), heart rate, capillary filling time, temperature, presence or absence of laryngotracheal reflex, presence or absence of interdigital reflexes were assessed immediately before PAM application, and 2 (T1), 5 (T2), 10 (T3), 15 (T4), 20 (T5), 25 (T6) and 30 (T7) minutes after treatment. The results were tabulated and statistically analyzed.Results: When comparing the AP group with the control group, an improvement in amplitude of the chest cage was observed at all times, where the animals remained in normal or deep respiratory amplitude. The heart rate was significantly higher for the AP group (155.5 ± 34.4 bpm) than the control group at T1 (105.1 ± 15.4 bpm), while recovery time was lower for the AP group (54.1 ± 14.9 min) when compared to control group (79.9 ± 17.9 min).Conclusion: The present paper demonstrated the efficacy of GV26 in maintaining adequate respiratory amplitude and decreasing the anesthetic recovery time.

Effectiveness of Pharmacopuncture Therapy in Adhesive Capsulitis: a Study Protocol for a Pragmatic Randomized Controlled Trial

Hui Yan Zhao^1,2,†, Chang-Hyun Han^1,2,†, Changsop Yang², Yoon Jae Lee³, In-Hyuk Ha³, Kyoung Sun Park^4,*

J Acupunct Meridian Stud 2023; 16(2): 70-78 https://doi.org/10.51507/j.jams.2023.16.2.70

Background: Adhesive capsulitis is a progressive, idiopathic disorder that significantly impacts individuals̓ daily lives and increases their medical burden. Pharmacopuncture therapy, which combines acupuncture techniques with herbal medicine, involves injecting herbal extracts into specific acupoints. This study aims to determine the effectiveness and safety of pharmacopuncture therapy in comparison to physiotherapy (PT) for treating adhesive capsulitis.Methods: This research protocol outlines a two-arm, parallel, multi-center, pragmatic randomized controlled trial. Fifty participants will be randomly allocated to either the pharmacopuncture therapy or PT group, and they will receive 12 sessions of their respective therapies over a 6-week period. The primary outcome measure is the numeric rating scale for shoulder pain. Secondary outcomes include the visual analog scale score for shoulder pain, Shoulder Pain and Disability Index, Patients̓ Global Impression of Change score, Short Form-12 Health Survey Version 2 score, and EuroQol-5 Dimension. Statistical analysis will be conducted based on the intention-to-treat principle.Discussion: This trial may offer high-quality and reliable clinical evidence for evaluating the effectiveness and safety of pharmacopuncture therapy compared to PT in the treatment of adhesive capsulitis. Furthermore, this study will serve as a valuable guideline for practitioners when making clinical decisions and managing adhesive capsulitis.

Influence of Psychological Factors in Primary Dysmenorrhea Patients on De qi: a Secondary Analysis of a Randomized Controlled Trial

Ni-juan Hu¹, Chun-hua Li¹, Pei Wang², Gui-wen Wu³, Liang-xiao Ma^4,*, Jiang Zhu^4,*

J Acupunct Meridian Stud 2023; 16(1): 20-29 https://doi.org/10.51507/j.jams.2023.16.1.20

Background: De qi , the needling sensation, is important in acupuncture treatment. Almost all studies believe that deep needling and manipulation could achieve a significant de qi sensation. However, relatively few studies have examined the effect of psychological factors on de qi, and those that did often reached different conclusions.Objectives: To explore the influence of psychologic factors on de qi in patients with primary dysmenorrhea (PD).Methods: Sixty-eight PD patients with cold and dampness stagnation were randomly allocated to de qi (deep insertion using thick needles, with manipulation, n=17) and non-de qi groups (shallow insertion using thin needles, without manipulation, n=51). Both groups received bilateral needling at Sanyinjiao (SP6) for 30 min. De qi was assessed using the Acupuncture De qi Clinical Assessment Scale (ADCAS). The patients’ acupuncture-related anxiety and their expectations of the relationship between needle sensation and curative effect were evaluated using a five-point and four-point scale, respectively.Results: Within the de qi group, all patients experienced the de qi sensation, although anxiety levels were unrelated to de qi. Patients’ expectations correlated negatively with de qi timing, and positively with electric sensation. Within the non-de qi group, 59.5% of patients experienced de qi. Between those who experienced it and those who did not, no significant differences were found in anxiety levels, although patients’ expectations differed significantly. Among patients who experienced de qi sensations in the non-de qi group, anxiety and throbbing were positively correlated. Additionally, patients’ expectations correlated positively with de qi intensity, as well as coldness, and numbness.Conclusion: Psychological factors should be considered when studying de qi since PD patients’ expectations could influence the de qi sensation at SP6.