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

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.

Research Article2021-08-31

Heart Rate Variability and Psychometric Analysis in Patients with Hyperactive Heart Fire Syndrome

Oliverio Medina Martínez¹, Ruben Fossion^3,4, Yolanda García Piceno^1,2, Rosa E. Lopez-Gomez^1,2, Emma López-Espinosa^1,2, Ismael Jiménez-Estrada⁵, Salvador Quiroz-González^1,2,*

J Acupunct Meridian Stud 2021; 14(4): 137-148 https://doi.org/10.51507/j.jams.2021.14.4.137

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Abstract : Background: Hyperactive heart fire syndrome is characterized by anxiety, insomnia, dream-disturbed sleep, tongue ulcers, heat in the hands, and palpitations. However, syndrome differentiation is often subjective due to a lack of objective, quantifiable variables. Objectives: To identify changes in heart rate variability (HRV) and psychometric analysis in patients with hyperactive heart fire syndrome. Methods: Healthy controls (n = 33) were compared to patients with hyperactive heart fire syndrome (n = 48) from the Integrative University Clinic of the State University of Ecatepec Valley (CIU-UNEVE). Physiological outcome measures included heart rate (HR), the standard deviation of the normal-to-normal heartbeat intervals (SDNN), low (LF) and high frequency (HF) power, and the LF/HF ratio. Psychometric outcome measures included the Athens Insomnia Scale (AIS) and the Hamilton Anxiety Rating Scale (HARS). Results: Compared to controls, hyperactive heart fire patients had higher HR (9.6 ± 2.62%), LF (22 ± 4.21%) and LF/HF ratio (23 ± 3.14%), and lower SDNN (21 ± 2.33%) and HF (18 ± 4.61%). Patients showed increased anxiety, both with somatic (33 ± 11.2%) and psychic symptoms (39 ± 10.5%) with more difficulty falling asleep (47 ± 9.9%) and diurnal impact of sleep (31 ± 9.6%). Conclusion: Hyperactive heart fire patients may have a sympathovagal imbalance due to a reduced parasympathetic tone and/or adominant sympathetic tone, which may be at the origin of the observed symptoms of insomnia and anxiety.

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.

Research Article2022-04-30

Link Between Electroacupuncture Stimulation near the Sympathetic Trunk and Heart Rate Variability

Kazufumi Takahashi^2,3,*, Xiaoming Wang^2,3, Daiyu Shinohara¹, Kenji Imai^2,3

J Acupunct Meridian Stud 2022; 15(2): 114-120 https://doi.org/10.51507/j.jams.2022.15.2.114

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Abstract : Background: The cardiovascular system and airway smooth muscles are regulated by the autonomic nervous system.Objectives: This study investigated the effect of electrical acupuncture stimulation near the cervical sympathetic ganglia on heart rate variability and respiratory function.Methods: This prospective, single-center study at Teikyo Heisei University recruited 24 healthy adults randomly assigned to no-stimulation and electroacupuncture (EA) groups in a crossover trial with a 2-week washout period. After 5 min of rest, a 5-min rest or acupuncture stimulus was delivered, followed by a further 5 min of rest for both groups. EA, at 2-Hz (level of no pain), was delivered near the left cervical ganglia at the level of the sixth cervical vertebra in the EA group.Results: The high-frequency component of the heart rate variability was significantly higher in the EA group than that in the no-stimulation group. Further, there was a significant increase in the high-frequency component of the heart rate in the EA group during the stimulation compared to before and after stimulation. Heart rate decreased significantly during EA compared to before stimulation in the EA group. Regarding respiratory function, forced vital capacity, forced expiratory volume in 1 s, and peak flow significantly increased in the EA group compared with the no-stimulation group, and after stimulation compared with before stimulation.Conclusion: Stimulation with 2-Hz EA near the cervical sympathetic trunk increased parasympathetic nerve activity and reduced heart rate. However, the respiratory function was activated via increased sympathetic nerve activity. Therefore, 2-Hz EA may be effective for autonomic nerve regulation in bronchial stenosis.

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.

Clinical Study Protocol2021-04-30

A Study on the Effects of Dry Needling in Multiple Sclerosis Patients with Spasticity: Protocol of a Randomized Waitlist-Controlled Trial

Omid Motamedzadeh^1,2, Noureddin Nakhostin Ansari^1,2,3,*, Soofia Naghdi^1,2, Amirreza Azimi⁴, Ashraf Mahmoudzadeh⁵, Sandra Calvo⁶, Pablo Herrero⁷

2021; 14(2): 82-88 https://doi.org/10.51507/j.jams.2021.14.2.82

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Abstract : Background: Spasticity is a common symptom in multiple sclerosis (MS). Dry needling (DN) has been considered a useful method for the treatment of spasticity; however, there are no studies on the effects of DN on spasticity in patients with MS. We propose a study protocol aiming to investigate the effects of DN on spasticity in patients with MS. Methods: MS patients with plantar flexor spasticity will be recruited. Participants will be randomly assigned to the DN group, where they will be receiving a single session of DN, one minute for each head of gastrocnemius muscle, or to the waiting list control group with no intervention. Primary outcome measures are the Modified Ashworth Scale (MAS) for gastrocnemius spasticity, passive resistive torque, and podography for foot pressure distribution. The ankle active and passive range of dorsiflexion and Timed Up and Go tests are the secondary outcome measures. All outcomes will be measured at baseline, immediately after the intervention, and one week later. A mixed-model, general linear model, and two-way repeated-measures ANOVA will be used to compare the quantitative variables between groups and within groups at the measurement time points. The MAS ordinal measure of spasticity will be compared between groups using the Kruskal-Wallis test, and both the Friedman test and Wilcoxon test will be used for within-group changes. Discussion: This study will provide primary evidence on the effects of DN on gastrocnemius muscle spasticity and gait in patients with MS. Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20190617043918N1.

Research Article2022-02-28

GB20 Pharmacopuncture As a Potential Method for Brain Drug Delivery via the Perivascular Spaces

Oxana Semyachkina-Glushkovskaya^1,2,*, Inna Blokhina², Nikita Navolokin^2,3, Arina Evsukova², Georgy Karandin², Alexander Khorovodov², Andrey Terskov², Ivan Fedosov², Alexander Dubrovsky², Maria Tzoy², Vasily Ageev², Ilana Agranovich², Valeria Telnova², Anna Tsven², Jürgen Kurths^1,2,4

J Acupunct Meridian Stud 2022; 15(1): 43-49 https://doi.org/10.51507/j.jams.2022.15.1.43

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Abstract : Background: The development of new methods of drug brain delivery is a crucial step for the effective therapy of the brain diseases. Pharma- and acupuncture are the forms of alternative therapy of the brain pathology, including an increase in the permeability of blood-brain barrier. However, the mechanisms of pharma- and acupuncture-mediated effects on the brain physiology remain not fully understood. Results: This pilot study on healthy mice clearly demonstrates the Evans Blue spreading in the mouse head and in the brain via the perivascular spaces (PVSs) of the trigeminal structure and the cribriform plate after the dye injection into the Feng Chi point (Galbladder 20, GB20). Conclusion: These results suggest that pharmacopuncture at GB20 can be a perspective method for brain drug delivery via PVSs.

Clinical Study Protocol2021-12-31

Effects of Dry Needling on Connectivity of Corticospinal Tract, Spasticity, and Function of Upper Extremity in People with Stroke: Study Protocol for a Randomized Controlled Trial

Masoome Ebrahimzadeh¹, Noureddin Nakhostin Ansari^2,3, Iraj Abdollahi^1,*, Behnam Akhbari¹, Saeideh Monjezi⁴

J Acupunct Meridian Stud 2021; 14(6): 238-243 https://doi.org/10.51507/j.jams.2021.14.6.238

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Abstract : Background: Spasticity is a common motor disorder in adult stroke patients. Injury to the corticospinal tract (CST) is associated with spasticity. Dry needling (DN) has positive impacts on spasticity reduction and improvement in the range of motion (ROM) in stroke patients. This study aims to investigate the effectiveness of DN on the connectivity of the CST and the level of spasticity in adult stroke patients. Methods: This double-blind randomized controlled trial will enroll and randomly assign stroke patients to either the experimental group, for receiving three sessions of DN for the spastic wrist flexors, or the control group, for sham needling. The primary outcome measures will be diffusion tensor imaging and the Modified Modified Ashworth Scale score to assess CST connectivity and wrist flexor spasticity, respectively. The Box and Block Test and standard goniometry are the secondary outcome measures to assess hand dexterity and active and passive wrist ROM, respectively. Measurements will be taken both before and after the intervention. Discussion: The results of this study will provide important evidence of the effects of DN on CST connectivity, spasticity, and arm function in adult stroke patients. Trial registration: This trial is registered in the Iranian Registry of Clinical Trials (IRCT) (https://www.irct.ir; IRCT20191208045649N1).