Participation of Potential Transient Receptors in the Antinociceptive Effect of Pharmacopuncture

Isabella de Paula Ribeiro Argôlo^1,*, Julia Risso Parisi², Josie Resende Torres da Silva¹, Marcelo Lourenço da Silva¹

J Acupunct Meridian Stud 2022; 15(2): 105-113 https://doi.org/10.51507/j.jams.2022.15.2.105

Background: Despite the widespread clinical use of acupuncture in painful situations, the use of this treatment should be further clarified. Nociception is mediated by the activation of nociceptors, such as transient receptor potentials (TRPs). The family of TRPs includes TRPV1, TRPM8, and TRPA1, which can be stimulated by substances such as capsaicin, menthol, and methyl salicylate, respectively.Objectives: This study aimed to investigate the role of TRPs in antinociception via the administration of agonists of these receptors in the Zusanli acupoint (ST36) in models of inflammatory, acute, and neuropathic pain.Methods: Male Wistar rats were used for this experiment. All rats received a subcutaneous injection of TRP agonists (capsaicin, menthol, or methyl salicylate) in ST36; saline was injected as control. Nociception was evaluated using the electronic mechanical threshold test and tail-flick test before the administration of complete Freund’s adjunct or chronic constriction injury of the sciatic nerve and after the administration of TRP agonists. Results: Nociception was found to be attenuated after treatment with TRP agonists. The administration of different doses (0.03, 0.3, and 3.0 μg/20 μL) of capsaicin, menthol, and methyl salicylate in the different pain models (neuropathic, inflammatory, and nociceptive) induced antinociception in most of the evaluated time points.Conclusion: Based on the findings, we suggest that the activation of TRPV1, TRPM8, and TRPA1 receptors results in the antinociceptive effect of the stimulation of the ST36 acupoint. Thus, TRP receptors may present a new therapeutic opportunity for the control of inflammatory and neuropathic pain.

Postoperative Acupuncture is as Effective as Preoperative Acupuncture or Meloxicam in Dogs Undergoing Ovariohysterectomy: a Blind Randomized Study

Ana Carla Zago Basilio Ferro¹, Caroline Cannolas², Juliana Cristianini Reginato², Stelio Pacca Loureiro Luna^1,*

J Acupunct Meridian Stud 2022; 15(3): 181-188 https://doi.org/10.51507/j.jams.2022.15.3.181

Background: Acupuncture has the same analgesic effect as non-steroidal antiinflammatory drugs and opioids. It is challenging to perform preoperative acupuncture in unmanageable animals, while the residual postoperative anesthetic effect facilitates the performance of acupuncture postoperatively.Objectives: To compare preoperative acupuncture or meloxicam versus postoperative acupuncture for postoperative analgesia after ovariohysterectomy.Methods: This is a horizontal prospective positive control blind randomized experimental study. Thirty-six dogs were randomly divided into three groups: GA (preemptive acupuncture), GPA (postoperative acupuncture), and GM (meloxicam 0.2 mg/kg IV preoperatively). After sedation with acepromazine (0.05 mg/kg IM), anesthesia was induced with propofol (5.3 ± 0.3 mg/kg) and maintained with isoflurane/O2. Fentanyl (2 μg/kg, IV) was administered immediately before surgery. Bilateral acupuncture was performed at acupoints Large intestine 4, Spleen 6, and Stomach 36 for 20 minutes, before (GA) or immediately after surgery (GPA). Pain was evaluated by an observer blind to the treatment using the Glasgow scale before and for 24 hours after ovariohysterectomy. Dogs with a score ≥ 6 received rescue analgesia with morphine (0.5 mg/kg IM). Nonparametric data were analyzed by the Kruskal–Wallis test, followed by Dunn’s test and parametric data by ANOVA followed by Tukey’s test.Results: Two GA and one GPA dogs received rescue analgesia once. Two GM dogs received rescue analgesia and one of those was treated again twice. There were no differences in the number of dogs receiving rescue analgesia between groups (p = 0.80).Conclusion: Postoperative acupuncture was as effective as preoperative acupuncture or meloxicam in female dogs undergoing ovariohysterectomy.

Effects of Lidocaine Injection at Acupuncture Points on Perioperative Analgesia in Cats Undergoing Ovariohysterectomy

Camila Menossi Sueza Lima, Camila Zanetti Segatto, Gustavo Ricci Zanelli, Gabriel Montoro Nicácio, Renata Navarro Cassu*

J Acupunct Meridian Stud 2022; 15(4): 255-263 https://doi.org/10.51507/j.jams.2022.15.4.255

Background: Pharmacopuncture is an acupuncture-related technique that has been used to amplify the therapeutic effects of different medications.Objectives: To investigate the analgesic efficacy of a lidocaine injection at acupoints in cats undergoing ovariohysterectomy.Methods: Thirty cats were randomly distributed into two groups (n = 15, per group). The experimental group received a bilateral administration of lidocaine at the following acupoints: Stomach 36 (ST-36) and Spleen 6 (SP-6) (Lido group). The control group did not receive lidocaine (Control group). All cats were sedated with dexmedetomidine and anesthesia was induced with propofol and maintained with isoflurane. Intraoperatively, fentanyl was given to control cardiovascular responses to surgical stimulation. Postoperative pain was assessed at various time points, up to 24 hours after extubation, using the UNESP-Botucatu multidimensional composite pain scale (MCPS) and Glasgow feline composite measure pain scale (CMPS-Feline). Sedation scores were measured at the same time points. Morphine/meloxicam was administered as rescue analgesia. Data were analyzed using t-tests, Fisher´s exact test, the Mann-Whitney test, and the Friedman test (p < 0.05).Results: Intraoperatively, more cats in the Control group required analgesic supplementation than those in the Lido group, but the difference was not significant (p = 0.65). Postoperative pain, sedation scores, and analgesic requirements did not differ between groups. Rescue analgesia was given to 67% (10/15) of the cats in each group.Conclusion: The administration of lidocaine at ST-36 and SP-6 acupuncture points did not provide significant perioperative analgesic benefits in healthy cats undergoing ovariohysterectomy.

Effect of Acupressure at PC6 on Nausea and Vomiting During Pregnancy: a Randomized Controlled Trial

Melike Pündük Yılmaz^1,*, Saadet Yazıcı², İsmail Yılmaz³

J Acupunct Meridian Stud 2023; 16(3): 89-94 https://doi.org/10.51507/j.jams.2023.16.3.89

Background: Nausea and vomiting are among the most common medical problems during pregnancy, affecting 80% of mothers.Objectives: This study was conducted as a randomized controlled experimental study to determine the effect of acupressure applied by a wristband to the pericardium 6 (PC6) point on nausea and vomiting during pregnancy.Methods: The study population consisted of 74 pregnant women between 6-14 weeks of gestation who were experiencing nausea and vomiting. The study data was collected with personal information from the Pregnancy-Unique Quantification of Emesis Scale (PUQE). Experimental and control groups were selected by a simple random method. The experimental group wore acupressure wristbands for one week, while the control group did not use any method to alleviate nausea and vomiting. One week later, the PUQE scale was applied to both groups.Results: The acupressure wristbands decreased the nausea and vomiting scores of the pregnant women in the experimental group without statistical significance but did not change the nausea and vomiting scores of the pregnant women in the control group.Conclusion: Acupressure wristbands can be used to prevent nausea and vomiting during pregnancy.

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

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.

Acupuncture for the Elsberg Syndrome Secondary to Varicella-Zoster Virus Infection: a Case Report and Brief Review

Lian-Sheng Yang^1,*, Kun Zhang¹, Dan-Feng Zhou¹, Shu-Zhen Zheng¹, Jin Zhang²

J Acupunct Meridian Stud 2022; 15(2): 152-156 https://doi.org/10.51507/j.jams.2022.15.2.152

Elsberg syndrome (ES) is an infectious syndrome presenting with variable signs of acute lumbosacral radiculomyelitis. Its low recognition rate leads to misdiagnosis and incorrect treatment. Thus, some ES patients may develop neurological sequelae. This case described a 74-year-old woman complained of urinary retention, constipation, and sacral numbness after herpes zoster in the perianal area. She was diagnosed with ES and accepted conventional drug treatments and urethral catheterization. The treatment was ineffective; therefore, she accepted electroacupuncture six times and her symptoms completely disappeared, with no recurrence of neurological disorders during 1-year follow-up. This shows that acupuncture is a safe and effective alternative therapy for ES. Nonetheless, further prospective studies are necessary to prove its efficacy in ES.