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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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 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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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.

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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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.

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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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 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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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.

Brief Report2022-12-31

Acupuncture Treatment of a Patient with Bradycardia and Idioventricular Rhythm

Oksana Strakhova*, Alexey Ryzhov*

J Acupunct Meridian Stud 2022; 15(6): 356-360 https://doi.org/10.51507/j.jams.2022.15.6.356

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A patient with bradycardia and an idioventricular rhythm was observed. According to cardiologists, there is no reliable drug treatment for bradycardia with an idioventricular rhythm; instead, the sole treatment is a pacemaker. In the course of this case, it was shown that acupuncture can restore the heart rhythm from bradycardia to normocardia, and from idioventricular with third-degree atrioventricular node block and an average heart rate of 34 BPM, to normal sinus rhythm with a heart rate of 71 BPM. Additionally, at the end of the treatment, the patient’s number of episodes of ventricular extrasystole decreased 36 times (3289 versus 91 episodes). These results show that research on this technique should be continued.

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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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.

Research Article2021-12-31

Effects of Joint Mobilization Versus Acupuncture on Pain and Functional Ability in People with Chronic Neck Pain: A Randomized Controlled Trial of Comparative Effectiveness

Petros Voulgarakis, Paris Iakovidis, Dimitrios Lytras*, Ioanna P. Chatziprodromidou, Anastasios Kottaras, Thomas Apostolou

J Acupunct Meridian Stud 2021; 14(6): 231-237 https://doi.org/10.51507/j.jams.2021.14.6.231

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Background: Chronic Neck Pain (CNP) is one of the main contributing factors to disability in people of working age.Objectives: The aim of this randomized clinical trial was to compare the efficacy between acupuncture and joint mobilization on pain and disability in patients with CNP. Methods: The study involved 45 men and women with CNP, divided into three groups of 15 each. The first group followed a manual therapy protocol with joint mobilization for eight weeks three times per week. The second group followed an acupuncture protocol of equal duration and frequency, while the third group did not follow any treatment. Pain with the Visual Analog Scale (VAS) for pain and functional limitations with the Neck Disability Index (NDI) questionnaire were assessed before and after an 8-week intervention. Analysis of variance was applied while post-hoc comparisons were made to determine the differences among the groups at each time of measurement. Results: Both intervention groups showed statistically significant differences compared to the control group after the end of the intervention in both the VAS and the NDI scores (p< .001). Furthermore, the acupuncture group showed a statistically significant improvement compared to the joint mobilization team after the end of the intervention in the VAS score (p< .001) and the NDI score (p< .05). Conclusion: Both joint mobilization and acupuncture appear to be effective interventions in reducing pain and improving functional ability in people with CNP. However, acupuncture appears to have a greater analgesic effect than joint mobilization.

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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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).

Research Article2021-10-31

Comparison of the Effects of Electroacupuncture and Melatonin on Nerve Regeneration in Experimentally Nerve-Damaged Rats

Yasemin Özkan^1,*, Mehmet Turgut², Yasemin Turan¹, Mehmet Dinçer Bilgin³, Sinem Sari⁴, Mustafa Yilmaz³, Yiğit Uyanikgil⁵, Mahmut Alp Kiliç³, Derya Tanriöver⁵, Zehra Seznur Kasar¹

J Acupunct Meridian Stud 2021; 14(5): 176-182 https://doi.org/10.51507/j.jams.2021.14.5.176

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Background: Development of methods to accelerate nerve regeneration in peripheral nerve damage is important. Electroacupuncture is a new therapeutic method that combines traditional acupuncture with modern electrotherapy. Melatonin has been shown to reduce nerve damage. Objectives: In this study, we aimed to determine and compare the therapeutic effects of electroacupuncture and melatonin on rat sciatic nerve injury. Methods: A total of 56 adult male Wistar Albino rats were divided into four study groups with 14 animals in each group: intact control (group I), subcutaneous saline (group II), subcutaneous melatonin (group III), and electroacupuncture (group IV). Surgical procedure including unilateral (right) sciatic nerve injury was applied to groups II, III, and IV. Saline and melatonin started immediately after surgery for six weeks, while electroacupuncture was given two weeks after surgery for 3 weeks. Functional and histological assessments were used as outcome measurements. Results: Sciatic nerve damage caused a significant decrease in nerve conduction velocity. Both electroacupuncture treatment and melatonin treatment significantly increased the nerve conduction velocity. Both sciatic functional recovery and histological regeneration were faster in these treatment groups compared to the saline. However, no significant difference was observed between the two treatment groups. Conclusion: Electroacupuncture and melatonin are promising alternative treatment strategies for peripheral nerve damage and can be examined in detail in future studies.