Research Article2021-12-31

Effect of Dry Cupping Therapy on Pain and Functional Disability in Persistent Non-Specific Low Back Pain: A Randomized Controlled Clinical Trial

Marianna de Melo Salemi^1,*, Vanessa Maria da Silva Alves Gomes¹, Laylla Marjorye Rebouças Bezerra¹, Thania Maion de Souza Melo¹, Geisa Guimarães de Alencar¹, Iracema Hermes Pires de Mélo Montenegro², Alessandra Paula de Melo Calado³, Eduardo José Nepomuceno Montenegro¹, Gisela Rocha de Siqueira¹

J Acupunct Meridian Stud 2021; 14(6): 219-230 https://doi.org/10.51507/j.jams.2021.14.6.219

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Abstract : Background: Cupping therapy is used to treat musculoskeletal conditions, including low back pain.Objectives: The study assessed the effects of dry cupping on pain and functional disability from persistent nonspecific low back pain. Methods: This was a randomized controlled trial, where participants were allocated to a cupping therapy (n = 19) or sham (n = 18) group, for five 10-minute sessions of cupping therapy, twice a week, to stimulate the acupoints related to low back pain (GV4, BL23, BL24, BL25, and BL30, BL40 and BL58) and emotional aspects (HT3 and ST36). All participants were assessed at baseline, post-treatment and follow up (a finalization period of four weeks) using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Groups were compared using the analysis of covariance (ANCOVA) and the effect size was calculated using Cohen̓s d. Results: The cupping therapy group presented a lower mean VAS when compared to the sham, at post-treatment (mean difference: –2.36; standard error [SE]: 0.58; p < 0.001; “large” effect size: –0.94) and follow up (mean difference: –1.71; SE: 0.81; p < 0.042; ‘large’ effect size: –0.83). The cupping therapy group presented a lower mean ODI when compared to the sham post-treatment (mean difference: –4.68; SE: 1.85; p: 0.017; ‘large’ effect size: –0.87), although in follow-up, there was no difference between the groups (mean difference: 4.16; SE: 2.97; p: 0.17; “medium” effect size: –0.70). Conclusion: Dry cupping was more effective in improving pain and functional disability in people with persistent nonspecific low back pain when compared to the sham.

Research Article2021-04-30

Comparison between the Effectiveness of Manual Acupuncture and Laser Acupuncture at EX-B3 Weiwanxiashu in a Rat Model of Type 2 Diabetes

Ahmad Aulia Jusuf¹, Yoshua Viventius^2,3, Wahyuningsih Djaali^2,4,*

2021; 14(2): 75-81 https://doi.org/10.51507/j.jams.2021.14.2.75

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Abstract : Background: Diabetes mellitus (DM) is a chronic metabolic disease characterized by increased blood sugar levels. The current management of DM to date has a target of controlling blood glucose, but the therapy cannot be separated from long-term drug side effects. Acupuncture can be an option as an adjunct therapy for DM. Objectives: The purpose of this study was to compare the effectiveness between manual acupuncture and laser acupuncture. Methods: This study was a randomized control experimental study with a pretest and posttest design using 24 male Sprague-Dawley rats divided into 4 groups: a normal group, a diabetes group, an acupuncture group, and a laser group. Manual acupuncture and laser acupuncture were performed 6 times in two weeks. Fasting blood glucose (FBG) levels, the cell density of Langerhans islets, and side effects were assessed and compared among the 4 groups. Results: The highest mean cell density of Langerhans islets was found in the laser and acupuncture group, and the lowest was found in the diabetes group. In the post hoc analysis, the normal, acupuncture, and the laser groups had a significantly higher mean cell density than the diabetes group. The lowest mean FBG level was in the laser group, followed by the acupuncture group, and the highest was in the diabetes group, but this difference was not significant. There were no serious side effects from the use of manual acupuncture or laser acupuncture. Conclusion: Both manual acupuncture and laser acupuncture can improve the histological findings of Langerhans islets in type 2 diabetic rats, and both are safe to use.

Perspective Article2022-08-31

Correlation Between the Sinew Channels with the Myofascial System, Pathology, and Treatment

Pablo Nava Jaimes*, Alejandro Martínez Reyes, Daniel García Lara, Abel Cristian Patiño Coyuca

J Acupunct Meridian Stud 2022; 15(4): 201-213 https://doi.org/10.51507/j.jams.2022.15.4.201

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Abstract : The sinew channels are a tendon and muscle network, and their description is based on the observation presented on the Huangdi Neijing Ling Shu. However, the myofascial system is an uninterrupted series of connective tissue that is comprised of layers that run in different directions. The similarities on these pathways are compared, such as a brief description on the myofascial pain syndrome and its similitude with the Impediment disorder from the Traditional Chinese Medicine (TCM). Furthermore, we discuss the treatment of these conditions from a Traditional Chinese Medicine perspective.

Review Article2021-04-30

Effect of Acupressure on Primary Dysmenorrhea: Review of Experimental Studies

Aslı Karakuş Selçuk*, Emre Yanikkerem

2021; 14(2): 33-49 https://doi.org/10.51507/j.jams.2021.14.2.33

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Abstract : Primary dysmenorrhea is defined as cramping pain in the lower abdomen with no pelvic diseases, and it has a high prevalence in many countries. Acupressure is a widely used complementary treatment method for primary dysmenorrhea. This review examined experimental studies to determine the effects of acupressure on primary dysmenorrhea using the databases PubMed, Google Scholar, and CINAHL with the keywords “Acupressure” and “Dysmenorrhea”. There were 2227 records in the databases, and 330 articles were published between 1989 and March 2020. Experimental studies in the English language were reviewed according to the PRISMA guidelines. This review included 28 published studies that were assessed using the Jadad score for quality. The studies were categorized as studies of acupressure at the LR3 point (n = 4), at the SP6 point (n = 9), at auricular points (n = 5), at multiple points (n = 8), and with devices (n = 2). Moreover, studies of self-acupressure (n = 9) were identified. The studies demonstrated that acupressure could reduce menstrual symptoms, the severity and duration of menstrual pain, distress, and anxiety. Furthermore, it helped improve the quality of life and well-being of patients and provide psychological support and self-care. Acupressure is an inexpensive, easy-to-apply, and non-pharmacological treatment and is useful for reducing primary dysmenorrhea, and women can apply this method anywhere by themselves. However, high-quality randomized controlled trials with larger samples are necessary to establish the evidence for acupressure as an effective intervention.

Research Article2022-04-30

Trigger Point Acupuncture and Exercise for Chronic Low Back Pain in Older Adult: a Preliminary Randomized Clinical Trial

Yoichi Minakawa^1,2,*, Shogo Miyazaki^1,2, Hideaki Waki^1,2, Naruto Yoshida^1,2, Kaori Iimura³, Kazunori Itoh⁴

J Acupunct Meridian Stud 2022; 15(2): 143-151 https://doi.org/10.51507/j.jams.2022.15.2.143

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Abstract : Background: Exercise therapy is the first choice non-pharmacotherapeutic approach for musculoskeletal pain; however, it often interferes with the implementation and continuation of exercise due to fear-avoidance behaviors. Trigger point acupuncture (TrPAcp) has been reported to reduce musculoskeletal pain.Objectives: To examine the efficacy of exercise combined with TrPAcp compared to exercise alone for older patients with chronic low back pain (CLBP), the most common subjective symptom reported by old people of both sexes in Japan.Methods: In this single-center randomized controlled trial conducted at Teikyo Heisei University, 15 men and women aged ≥ 65 years with low back pain for at least 3 months who met the eligibility criteria were included. The Ex+TrPAcp group received exercise and trigger point acupuncture, while the Ex group received only exercise for 3 months. The main outcome, pain intensity, was measured using the numerical rating scale (NRS). Improvement was defined as a decrease in NRS of ≥ 2 or less than moderate (NRS < 4).Results: The analysis included 7 of 8 cases in the Ex+TrPAcp group and 7 of 7 cases in the Ex group. NRS improved in 6 of 7 and 1 of 7 patients in the intervention and control groups, respectively, with a significant difference between groups (p = 0.03, φ = 0.71). Regarding adverse events due to acupuncture, one patient (14.3%) complained of heaviness after acupuncture. Nothing specific was reported with exercise.Conclusion: Compared with Ex alone, Ex+TrPAcp may be more effective therapy for older people with CLBP who do not have an exercise habit.

Case Report2021-10-31

Role of Acupuncture and Fire Cupping in Reducing the Thyroxine Dose and Improving the Thyroid Function in Hypothyroidism Patients: A Case Series

Pradeep M. K. Nair^1,*, Naga Jyothi²

J Acupunct Meridian Stud 2021; 14(5): 200-205 https://doi.org/10.51507/j.jams.2021.14.5.200

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Abstract : Hypothyroidism is one of the most common endocrine disorders linked to various systemic diseases ranging from obesity to cancers. The present line of management is insufficient as reports suggest that there is persistence of symptoms and poor adherence that makes the management of said disease challenging. Acupuncture and other Traditional Chinese Medicine (TCM) therapies are proven to alleviate endocrine dysfunctions. However, reports on acupuncture and cupping therapy on hypothyroidism are very scarce. Here, we report 5 cases of hypothyroid patients aged between 38-44 yrs who were treated with acupuncture and fire cupping for a period of three months. At the baseline, the patients presented with either a weak, wiry or vacuum pulse which represents spleen Qi deficiency. Further, they presented with elevated levels of Thyroid Stimulating Hormone (TSH), and higher Body Mass Index (BMI). Acupuncture treatment at ST36, LI4, SP6, and BL20 was given bilaterally whilst CV4, LR3, LR4, SP9, ST40, SP10, GV4, KI3, ST12, and SI17 were punctured unilaterally. At the end of the time period of three months, patients progressed to normal levels of TSH, reduction in BMI and had succeeded in tapering their medication doses. Supplementing this, the patients reported marked improvement in other symptoms like fatigue, hair loss, and cold feet post-treatment. The effects were consistent even during the three month follow-up period post-interventions. The results encourage the utilization of acupuncture and fire cupping in the management of hypothyroidism. However, large scale studies are warranted to strengthen this recommendation.

Research Article2021-04-30

Effect of Auricular Acupuncture with Semi-Permanent Ear Needles on Controlling Migraine Symptoms: A Single-Blind Randomized Clinical Trial

Mehran Razvani Habibabadi¹, Fereshteh Ashtari², Iman Raeisi^3,*

2021; 14(2): 58-66 https://doi.org/10.51507/j.jams.2021.14.2.58

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Abstract : Background: Migraine is a very common neurobiological headache disorder caused by an increased irritability of the central nervous system. Acupuncture as a complementary medicine has been suggested as one of the treatments for migraine headaches; however, the findings are conflicting. Objectives: Therefore, the aim of this study was to evaluate the effect of acupuncture with auricular semi-permanent (ASP) needles on migraine headaches. Methods: In this single-blind randomized controlled trial, 80 patients with migraine were selected and divided into two groups. The intervention group was treated with auricular ASP needles in the active points of the ear, and the control group only received routine treatments. Pain score, frequency of migraine headaches, duration of headaches, severity of nausea and vomiting, and patient satisfaction were compared between the two groups for four weeks after the intervention. Results: Our results showed that the level of pain (4.72 ± 2.53, 2.13 ± 1.76 times) and the frequency of migraine headaches (8.98 ± 8.58 hours) from the second week after the intervention in the ASP group were much lower than those in the control group (p < 0.05). However, pain incidence and ear inflammation in the ASP group were negligible and did not differ significantly from those in the control group (p > 0.05). Conclusion: Auricular acupuncture could be considered as a promising complementary therapy along with other standard migraine therapies for the prevention and treatment of migraine headaches.

Research Article2021-06-30

The Effect of Acupressure on Clinical Stress Management in Nursing Students: A Randomised Controlled Study

Dilek Yildirim^1,*, Özlem Akman²

J Acupunct Meridian Stud 2021; 14(3): 95-101 https://doi.org/10.51507/j.jams.2021.14.3.95

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Abstract : Background: Nursing students experience clinical stress frequently and severely. The application of acupressure is reported to be effective in stress management.Objectives: This study was conducted to determine the effects of acupressure on reducing the stress of nursing students in clinical practice. Methods: This study was carried out using a single-blind randomized controlled experimental design. The experimental and control groups were randomly determined by using a previously prepared randomization checklist. A Participant Information Form, VAS, and the State Anxiety Inventory were applied to all students before practice. Acupressure was performed on the HT7 point and Yintang point (EX-HN3), respectively, every five minutes for a total of 30 minutes in the experimental group. Results: The level of stress experienced by the students in the experimental group before the intervention according to VAS was 6.95 ± 1.57, and it was determined as 2.82 ± 1.94 after the third application (p < 0.05). The mean clinical stress score before the application was 46.54 ± 3.81, and after the 3^rd week of application, it was 25.15 ± 5.26 (p < 0.05). It was observed that the students' stress levels decreased in all measurements made after the acupressure intervention. Conclusion: This study determined that acupressure effectively reduces the stress levels of nursing students, and it may be applied in clinical stress management.

Research Article2021-12-31

Mechanisms of Electroacupuncture Pretreatment in Alleviating Myocardial Ischemia Reperfusion Injury: Interactions between the Cerebellar Fastigial Nucleus and Lateral Hypothalamic Area

Qing Yu^1,2, Li-bin Wu¹, Fan Zhang¹, Xiao-tong Wei¹, Pian-pian Chen¹, Shuai-ya Wang¹, Mei-yi Cai¹, Qi Shu¹, Liao-yuan Li¹, Zi-jian Wu^2,3, Rong-lin Cai^2,3,*, Ling Hu^2,3,*

J Acupunct Meridian Stud 2021; 14(6): 207-218 https://doi.org/10.51507/j.jams.2021.14.6.207

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Abstract : Background: Myocardial ischemia reperfusion injury (MIRI) is an important mechanism of post-myocardial infarction injury and a main cause of death in patients with ischemic heart disease. Electroacupuncture (EA) pretreatment is effective for the prevention and treatment of MIRI, but mechanisms mediating the effects of cardiovascular disease EA treatments remain unclear.Objectives: To determine whether the lateral hypothalamus (LHA) and the cerebellar fastigial nucleus (FN) are involved in the protective effects of EA stimulation on MIRI. Methods: EA pretreatment was performed for 7 days before the establishment of the MIRI model. ST-segment changes on electrocardiograms were recorded and the Curtis–Walker arrhythmia score was used to evaluate changes in reperfusion injury. Hematoxylin–eosin staining was applied to evaluate the pathological and morphological changes in myocardial tissue. c-fos expression in the LHA and FN was determined by immunofluorescence staining. Glutamic (Glu) and γ-Aminobutyric acid (GABA) levels were measured using a high-performance liquid chromatography-electrochemical method. Results: EA pretreatment reduced ST-segment elevation, arrhythmia scores, and morphological changes in MIRI myocardial cells in rats, and decreased the c-fos protein expression in LHA/FN nuclei. MIRI was associated with an imbalance between GABA and Glu levels, whereas EA pretreatment increased GABA levels and decreased Glu levels in the LHA/FN. Conclusion: FN and LHA are involved in the EA-mediated attenuation of MIRI. Pretreatment with EA plays a protective role in the myocardium by regulating Glu and GABA release in the LHA and FN.

Review Article2022-02-28

The Cellular Architecture of the Primo Vascular System

Fatma El-Zahraa A. Mustafa^*

J Acupunct Meridian Stud 2022; 15(1): 4-11 https://doi.org/10.51507/j.jams.2022.15.1.4

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Abstract : The primo vascular system (PVS) is of great interest to scientists in the last few years. The PVS plays a role in stem cell migration, immune function, erythropoiesis, tissue regeneration, and cancer metastasis. Discovered by Bong Han Kim in 1960, the PVS was described as a new, independent system that is distributed in the body of different animals. Since then, several cells have been discovered as important constituents of the PVS. Endothelial cells are hallmarks for the identification of the PVS, as they line the sinuses of the primo vessels and are characterized by their arrangement of rod-shaped nuclei in a parallel, broken-line fashion along the primo vessels. Immune cells as mast cells, eosinophils, neutrophils, and lymphocytes are also hallmarks for the identification of the PVS. One of the most interesting cells in the PVS are p-microcells. Primo nodes are a stem cell niche due to their p-microcells content, which express stem cell biomarkers CD133 and Oct 4. Mature erythrocytes and hematopoietic stem cells have also been observed in the PVS. Hematopoietic stem cells were observed in the PVS. Hematopoietic Stem Cells are the source of the cellular component of blood. Additionally, adrenaline and noradrenaline-producing cells, mesothelial cells, and smooth-muscle-like cells have also been described in the PVS.