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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Abstract : 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 Article2022-08-31

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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Abstract : 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.

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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Abstract : 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.

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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Abstract : 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.

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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Abstract : 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

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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Abstract : 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.

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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Abstract : 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.

Clinical Study Protocol2022-08-31

A Clinical Trial Protocol to Compare the Effect of Dry Needling and Acupoint Dry Needling on Wrist Flexor Spasticity after Stroke

Najmeh Nazari¹, Noureddin Nakhostin Ansari^1,2, Soofia Naghdi^1,2,*, Pablo Herrero Gallego³, Roshanak Honarpisheh¹

J Acupunct Meridian Stud 2022; 15(4): 273-278 https://doi.org/10.51507/j.jams.2022.15.4.273

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Abstract : Background: Stroke is the leading cause of disability in adults worldwide, with spasticity after stroke being one of the more common complications. Dry needling (DN) has been demonstrated to decrease spasticity in stroke patients, although its effects on improving function remain unclear. The purpose of this study protocol is to compare the short-term effects of DN versus acupoint DN on wrist flexor spasticity and upper extremity function in patients with stroke.Methods: A double-blind, randomized clinical trial will be conducted to include patients with stroke and upper extremity spasticity and functional disability. Twenty-four patients with stroke will be randomly assigned to either the DN or acupoint DN (DNap) group. These groups will receive three DN sessions during a one-week period of the wrist flexor muscles or at the LI4 & TE5 acupoints, respectively. The primary outcome measure is the Modified Modified Ashworth Scale (MMAS) of spasticity. The secondary outcomes are the Fugl–Meyer Assessment of motor function (FMA) and the goniometry to assess the active and passive range of motion of the wrist. Data will be collected at baseline, immediately after the end of three sessions DN, and at a one-week follow-up visit.Discussion: The results of this comparative study will help to determine the more effective method for reducing spasticity and improving motor function in patients with stroke.

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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Abstract : 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.