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Ma J, Zhang Y, Ge Q, Wu K. The effect of auricular acupuncture on preoperative blood pressure across age groups: a prospective randomized controlled trial. Clin Exp Hypertens 2023; 45:2169452. [PMID: 36681906 DOI: 10.1080/10641963.2023.2169452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE To determine the effect of auricular acupuncture on preoperative blood pressure (BP) elevation in different age groups. MATERIALS AND METHODS Auricular acupuncture treats elevated BP among patients before surgery. This prospective, randomized clinical trial was performed at Li Huili Hospital of Ningbo Medical Center, China, from January to June 2021. We prospectively enrolled 120 patients with elevated BP aged 45 to 75 and observed them in the inpatient department. Patients were randomly assigned in a 1:1 ratio to undergo auricular acupuncture or sham control groups. In addition to usual care, the study group underwent auricular acupuncture bilaterally at HX6 7i-Ear apex, TF4-Shen men, TF1-Superior triangular fossa, and CO15-Heart. RESULTS A total of 120 patients completed the study, 60 in the study group and 60 in the control group. Of these, 76 (63.3%) were men, and the mean (standard deviation) was 64.55 (9.48) years. The differences in systolic BP comparisons after intervention were significant (7.88 mmHg; 95% confidence interval [CI], 2.94 to 12.81; P = .002). Diastolic BP also showed statistical significance (5.85 mmHg; 95% CI, 3.05 to 8.64; P < .01. Neither AA-related adverse events nor serious adverse events occurred. Stratified by age, the differences comparisons of systolic BP (-10.13 mmHg; 95% confidence interval [CI], -16.69 to -3.57; P < .01) and diastolic BP (-7.65 mmHg; 95% confidence interval [CI], -11.17 to -4.14; P < .01) were statistically significant for participants aged 60-75 years; The differences comparison of systolic BP (-2.37 mmHg; 95% confidence interval [CI], -8.04 to 3.31; P = .40) and diastolic BP (-1.46 mmHg; 95% confidence interval [CI], -5.68 to 2.76; P = .48) were not significant aged 45-59. CONCLUSION Auricular acupuncture can reduce BP before procedures. However, further research is needed on the antihypertensive effect on people aged 45-59. These findings provide clinicians with evidence of auricular acupuncture as a standard adjunctive therapy targeting this patient population.
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Affiliation(s)
- Jingjing Ma
- Department of Nursing, Ningbo Medical Center LiHuili Hospital, Ningbo, China
| | - Yiqing Zhang
- Department of Nursing, Ningbo Medical Center LiHuili Hospital, Ningbo, China
| | - Qingqing Ge
- Department of Nursing, Ningbo Medical Center LiHuili Hospital, Ningbo, China
| | - Keer Wu
- Department of Nursing, Ningbo Medical Center LiHuili Hospital, Ningbo, China
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2
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Peng Y, Wu J, Wu Y, Chen F. Abdominal acupuncture therapy for cervical spondylotic radiculopathy: A systematic review and metaanalysis. Asian J Surg 2023; 46:5776-5778. [PMID: 37648543 DOI: 10.1016/j.asjsur.2023.08.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023] Open
Affiliation(s)
- Yong Peng
- Ningbo Municipal Hospital of Traditional Chinese Medicine(TCM) Affiliated Hospital of Zhejiang Chinese Medical University, China.
| | - Jun Wu
- Ningbo Municipal Hospital of Traditional Chinese Medicine(TCM) Affiliated Hospital of Zhejiang Chinese Medical University, China.
| | - Yunzhou Wu
- Ningbo Municipal Hospital of Traditional Chinese Medicine(TCM) Affiliated Hospital of Zhejiang Chinese Medical University, China.
| | - Furong Chen
- Ningbo Municipal Hospital of Traditional Chinese Medicine(TCM) Affiliated Hospital of Zhejiang Chinese Medical University, China.
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3
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Dong P, Wang LF, Zhang LX, Li F, Yin HS, Dou ZX, Huang XJ, Xu R, Zhang WL. Clinical study of acupuncture combined with surface anesthesia using proparacaine in geriatric cataract phacoemulsification. World J Clin Cases 2023; 11:5073-5082. [PMID: 37583853 PMCID: PMC10424011 DOI: 10.12998/wjcc.v11.i21.5073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/28/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND During anesthesia administration for cataract surgery, low pH of proparacaine may induce pain or complications such as corneal damage and poor wound healing, with the use of additional drops intraoperatively increasing the risk of complications. Accordingly, there is a clinical need for adjuncts to local anesthesia needs to improve the efficiency of anesthesia and reduce the required amount of intraoperative proparacaine. AIM To identify a method of anesthesia for geriatric cataract phacoemulsification that provides more efficient analgesia and improves clinical efficacy. METHODS A total of 130 geriatric patients with cataracts who attended Hebei Eye Hospital from December 2020 to December 2022 were included in the present study. Patients were divided into the proparacaine surface anesthesia (SA) group (65 cases) and the compound acupuncture-medicine anesthesia group (CAMA group, 65 cases). Patients in the CAMA group were provided acupuncture analgesia in addition to SA. Preoperative anxiety [Self-Rating Anxiety Scale (SAS) score and state anxiety inventory (SAI) score], intraoperative stress, vital signs, analgesia, and cooperation, as well as postoperative adverse events, were compared between groups. RESULTS More marked reductions in anxiety were observed among patients in the CAMA group, with corresponding reductions in SAS and SAI scores. During the operation, no change in the secretion of E, NE, or Cor group compared to the preoperative period was observed in the CAMA, which was markedly lower than that in the SA group. Heart rate, blood pressure, and respiratory rate were more stable intraoperatively in the CAMA group. In addition, the incidence of intraoperative pain and the number of additional doses of anesthesia required in the CAMA group were markedly lower than in the SA group. Accordingly, patients in the CAMA group were able to avoid eye movements and eyelid closing leading to greater cooperation with surgeons during surgery. Furthermore, marked reductions in intraoperative adverse effects were observed in the CAMA group, indicating greater overall safety. CONCLUSION Proparacaine SA combined with acupuncture as an analgesic provides improved analgesia with greater safety compared to surface anesthesia with proparacaine during geriatric cataract phacoemulsification.
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Affiliation(s)
- Ping Dong
- Department of Acupuncture and Rehabilitation, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Li-Fang Wang
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Li-Xiang Zhang
- Department of Pediatrics, Hebei General Hospital For Veterans, Xingtai 054000, Hebei Province, China
| | - Fang Li
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Hui-Su Yin
- Department of Science and Education, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Zhi-Xia Dou
- Department of Ocular Trauma, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Xiu-Ju Huang
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Rui Xu
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Wu-Lin Zhang
- Department of Cataract, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
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Wang C, Wang P, Qi G. A new use of transcutaneous electrical nerve stimulation: Role of bioelectric technology in resistant hypertension (Review). Biomed Rep 2023; 18:38. [PMID: 37168651 PMCID: PMC10165504 DOI: 10.3892/br.2023.1621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/21/2023] [Indexed: 05/13/2023] Open
Abstract
Hypertension is an important risk factor for cardiovascular and cerebrovascular disease-associated death. Hypertension and its complications are the main problems that have an impact on public health at present. A portion of adults with hypertension fail to meet the recommended blood pressure (BP) treatment goals, despite strict clinical management. Those individuals requiring at least three types of antihypertensive drugs to achieve their BP goal may be classified as patients with resistant hypertension (RH). Bioelectric technology is an emerging method that functions with the help of the human body's own bioelectric system. It is widely used in auxiliary examination, pain relief and organ function rehabilitation. Bioelectrical technology, as an effective treatment for RH, has developed rapidly in recent years and mainly includes renal sympathetic denervation, carotid baroreflex activation therapy, Traditional Chinese Medicine electroacupuncture and transcutaneous electrical nerve stimulation (TENS). The present review describes the pathogenesis of hypertension and provides an understanding of bioelectrical technology as a treatment. In particular, the development of the application of TENS in RH is introduced. The aim is to provide a basis for the clinical treatment of RH and a new idea for further clinical trials in this field.
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Affiliation(s)
- Chenghua Wang
- The Third Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050030, P.R. China
| | - Pu Wang
- The Third Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050030, P.R. China
| | - Guoqing Qi
- The Third Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050030, P.R. China
- Correspondence to: Dr Guoqing Qi, The Third Department of Cardiology, The First Hospital of Hebei Medical University, 89 Donggang Road, Shijiazhuang, Hebei 050030, P.R. China
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Mao Y, Yang L. Clinical application of electroacupuncture in enhanced recovery after surgery. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1135618. [PMID: 37292427 PMCID: PMC10244595 DOI: 10.3389/fresc.2023.1135618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 05/02/2023] [Indexed: 06/10/2023]
Abstract
Enhanced recovery after surgery (ERAS) is currently the recommended surgical strategy, the main content of which is to reduce perioperative stress response and postoperative complications through perioperative multimodal analgesia and intensive surgery. Since ERAS was introduced, many rehabilitation medicine teams have been deeply involved, including physical therapy, occupational therapy, nutrition therapy and psychological counseling. However, ERAS lacks several powerful means to address perioperative prognostic issues. Therefore, how to further improve the effects of ERAS, reduce perioperative complications and protect vital organ functions has become an urgent problem. With the continuous development of traditional Chinese medicine, electroacupuncture (EA) has been widely used in various clinical applications, and its efficacy and safety have been fully proved. Recent studies have shown that the application of EA in ERAS has had an important impact on rehabilitation researches. In terms of reducing complications, the therapeutic effects of EA treatment mainly include: reducing pain and the use of analgesics; Improvement of postoperative nausea and vomiting; Postoperative immune function treatment; Relieve anxiety and depression. In addition, EA also protects the recovery of physiological functions, including cardiovascular function, cerebrovascular function and gastrointestinal function, etc. To sum up, the complementary strengths of EA and ERAS will allow them to develop and combine. This review discusses the potential value and feasibility of EA in ERAS from the aspects of improving perioperative efficacy and protecting organ functions.
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Affiliation(s)
- Yu Mao
- Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi’an, China
| | - Lifang Yang
- Department of Anesthesiology, Xi'an Children Hospital, Xi'an, China
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Yuan M, Lu W, Lan Y, Yang J, Yin J, Wang D. Current role and future perspectives of electroacupuncture in circadian rhythm regulation. Heliyon 2023; 9:e15986. [PMID: 37205998 PMCID: PMC10189514 DOI: 10.1016/j.heliyon.2023.e15986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/02/2023] [Accepted: 04/28/2023] [Indexed: 05/21/2023] Open
Abstract
In recent years, in-depth research on chronobiology has been conducted, and the circadian rhythm has become a new target for the treatment of diseases. Circadian rhythms are closely related to the normal physiological functions of organisms. Increasing evidence indicates that circadian rhythm disorders are the pathological basis of diseases such as sleep disorders, depression, cardiovascular diseases, and cancer. As an economical, safe, and effective treatment method, electroacupuncture has been widely used in clinical practice. In this paper, we summarize the current literature on electroacupuncture's regulation of circadian rhythm disorders and circadian clock genes. In addition, we briefly explore the optimization of electroacupuncture intervention programmes and the feasibility of implementing electroacupuncture intervention programmes at selected times in clinical practice. We conclude that electroacupuncture may have good application prospects in circadian rhythm regulation, but this conclusion needs to be confirmed by clinical trials.
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Affiliation(s)
- Min Yuan
- Department of Rehabilitation Medicine, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, China
| | - Wei Lu
- Department of Rehabilitation Medicine, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, China
| | - Ying Lan
- Department of Intensive Care Unit, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, China
| | - Jiaen Yang
- Department of TCM Rehabilitation Medicine, Affiliated Foshan Gaoming Hospital of Guangdong Medical University, Foshan, China
| | - Jun Yin
- Department of Rehabilitation Medicine, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, China
| | - Dong Wang
- Department of Rehabilitation Medicine, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, China
- Corresponding author.
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7
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Hu WS, Lin CL. Acupuncture decreases risk of stroke among patients with atrial fibrillation: A nationwide investigation. Medicine (Baltimore) 2022; 101:e31889. [PMID: 36482554 PMCID: PMC9726288 DOI: 10.1097/md.0000000000031889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The authors aim to investigate retrospectively the association between acupuncture and risk of stroke in patients with atrial fibrillation (AF). Using the Taiwan National Health Insurance Research Database, AF patients without any acupuncture treatment record were classified as non-acupuncture cohort and 1:1 matching with acupuncture cohort by age, gender, and all comorbidities. To calculate the risk of stroke in case and control groups, cox proportional hazard models were used and presented by hazard ratios, adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Two equally distributed groups of AF individuals with and without acupuncture were included. After adjusting for risk factors, AF subjects with acupuncture conferred a lower risk of stroke (aHR = 0.46, 95% confidence intervals [CI] = 0.38-0.54), ischemic stroke (aHR = 0.47, 95% CI = 0.39-0.56) and hemorrhagic stroke (aHR = 0.35, 95% CI = 0.19-0.67), compared to the controls. AF patients receiving acupuncture was associated with a decreased risk of stroke.
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Affiliation(s)
- Wei-Syun Hu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- * Correspondence: Wei-Syun Hu, Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung 40447, Taiwan (e-mail: )
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
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Randomized controlled trials of acupuncture for the treatment of essential hypertension: a meta-analysis. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2022. [DOI: 10.1007/s11726-022-1330-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Objective
To systematically assess the efficacy and safety of acupuncture therapy for essential hypertension.
Methods
A computerized literature search of the Chinese National Knowledge Infrastructure (CNKI), Chongqing VIP Database (CQVIP), Wanfang Academic Journal Full-text Database (Wanfang), China Biology Medicine Disc (CBM), PubMed, EMBASE, and Cochrane Library was conducted to retrieve randomized controlled clinical trials on acupuncture as the main intervention for the treatment of essential hypertension published from the inception of the database to 30 January 2021. The risk-of-bias assessment was carried out for each included study according to the Cochrane Handbook. Data analysis was performed using Review Manager 5.4.1 and Stata 15.0.
Results
After the screening, 46 randomized controlled trials involving a total of 3 859 subjects were included. Primary outcomes included changes in the diastolic blood pressure after intervention [eight studies showed that the acupuncture plus antihypertensive drug group was better than the antihypertensive drug monotherapy group [mean difference (MD)=1.45, 95% confidence interval (CI) (0.48, 2.43), P=0.004, fixed effects model; I2=39%] and changes in the systolic blood pressure after intervention {11 studies showed that the acupuncture plus antihypertensive drug group was better than the antihypertensive drug monotherapy group [MD=8.60, 95%CI (7.12, 10.07), P<0.00001, fixed effects model; I2=26%]}. The secondary outcome was antihypertensive efficacy, 12 studies of acupuncture monotherapy group [risk ratio (RR)=1.20, 95%CI (1.12, 1.28), P<0.00001, fixed effects model; I2=36%] and 15 studies of acupuncture combined with antihypertensive drug group [RR=1.27, 95%CI (1.20, 1.34), P<0.00001, fixed effects model; I2=6%] showed better results than the antihypertensive drug monotherapy group in antihypertensive efficacy. In terms of the adverse events, four studies showed that the acupuncture monotherapy group had fewer adverse events than the antihypertensive drug monotherapy group [RR=0.10, 95%CI (0.04, 0.25), P<0.00001, fixed effects model; I2=0%].
Conclusion
Acupuncture combined with antihypertensive drugs is superior to antihypertensive drugs alone in reducing blood pressure, and acupuncture therapy is effective and safe for the treatment of essential hypertension with fewer side effects. However, there is still a lack of high-quality multicenter randomized double-blinded controlled trials in this field. Rigorous large-sample clinical trials are needed to validate these findings.
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Li X, Yin Z, Ling F, Zheng Q, Li X, Qi W, Liang F. The application of acupuncture in cardiopathy: A bibliometric analysis based on Web of Science across ten recent years. Front Cardiovasc Med 2022; 9:920491. [PMID: 36148057 PMCID: PMC9485815 DOI: 10.3389/fcvm.2022.920491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background With high morbidity and mortality, cardiopathy is a major component of cardiovascular disease, causing a huge burden of disease to public health worldwide. In recent years, research on acupuncture treatment of cardiopathies has been increasing. However, no bibliometric analysis has been conducted to systematically describe the research progress and hotspots in this field. Therefore, this study aimed to conduct a bibliometric analysis of the relevant literature to explore the current status and future development of acupuncture for cardiopathies. Methods The Web of Science (WoS) Core Collection Database was searched for literature related to acupuncture therapies for cardiopathies from 2011 to 2021. Using CiteSpace 5.8 R3, cooperation network diagrams of authors, institutions, countries and journals, keyword co-occurrences, and clustering were performed and analyzed. Results A total of 321 studies were included. Overall, the number of annual publications increased yearly. These publications came from 31 countries or regions, of which China and the United States made the greatest contributions. In total, 333 authors from 258 institutions participated in this field, and Beijing University of Chinese Medicine and Professor Fanrong Liang were the most published institution and author, respectively. Evidence-based Complementary and Alternative Medicine published the largest number of articles, and CIRCULATION was the most commonly cited journal. Based on co-occurrences and cluster analysis of 257 keywords, three research frontiers and hotspots were identified: acupuncture for blood pressure regulation, acupuncture for coronary heart disease, and acupuncture for regulation of heart rate. In these three research frontiers, the rostral ventrolateral medulla (RVLM) and autonomic nervous system (ANS) are the most popular mechanisms. Conclusion A stable development trend has formed in this field. Further research should focus on the role of acupuncture therapies in the treatment of hypertension or hypertensive heart disease, coronary heart disease, and arrhythmia based on the mechanisms related to the RVLM and ANS.
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Affiliation(s)
- Xiao Li
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zihan Yin
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Acupuncture and Tuina School/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, Sichuan, China
| | - Fayang Ling
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qianhua Zheng
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xiang Li
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- *Correspondence: Xiang Li,
| | - Wenchuan Qi
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Wenchuan Qi,
| | - Fanrong Liang
- School of Acu-Mox and Tuina/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Acupuncture and Tuina School/The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, Sichuan, China
- Fanrong Liang,
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Zhang P, Chen Y, Zhang F, Pei H, Sun M, Qu Y, Chen J, Du T, He X, Liang F, Jia W, Yang M. Effect of Acupuncture on Blood Pressure and Metabolic Profile Among Patients With Essential Hypertension: Protocol of a Randomized Clinical Trial. Front Cardiovasc Med 2022; 9:888569. [PMID: 35800160 PMCID: PMC9253512 DOI: 10.3389/fcvm.2022.888569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Essential hypertension is a polygenic cardiovascular disease that is associated with maladaptive metabolic changes. Acupuncture as a non-pharmacologic intervention is used to lower blood pressure and improve metabolic dysfunction. However, such effects have not been clinically characterized. We will conduct a randomized clinical trial to evaluate the antihypertensive effect of acupuncture among patients with essential hypertension and determine the associated metabolic improvements. This study is a phase II, two-arm, randomized, sham-controlled trial (Trial registration: ChiCTR2100043737), in which biospecimens will be collected for metabolic profiling. A total of 64 patients with a clinical diagnosis of essential hypertension will be randomly assigned to either the acupuncture or the sham acupuncture group in a 1:1 ratio. All participants will receive 10 treatments over 4 weeks, with three sessions per week for the first 2 weeks and two sessions per week for the remaining weeks. The primary outcome is the change of the systolic and diastolic blood pressure measured by the 24-h ambulatory blood pressure monitoring from baseline to 4 weeks. Secondary outcomes include the circadian rhythm of blood pressure, sleep quality measured by the Insomnia Severity Index, cognitive function measured by the Montreal Cognitive Assessment, and others. Fasting blood serum and urine samples will be collected at baseline and 4 weeks for targeted and untargeted metabolomics analysis. We will use the mixed-effects model and other related bioinformatics approaches to analyze the clinical and metabolome data. This metabolomic-based trial will provide important clinical data regarding the efficacy of acupuncture for essential hypertension to better inform evidence-based care delivery for hypertension patients. Moreover, the findings will offer important insights into the mechanism of action of acupuncture for hypertension by revealing its effect on metabolism. The results of this study will be used to inform the design of a statistically powered, multicenter, randomized trial. We will publish the study findings in peer-reviewed journals. The ethical approval of this study has been reviewed and approved by the Sichuan Regional Ethics Review Committee on Traditional Chinese Medicine (ID: 2021KL-006). The outcomes of the trial will be disseminated through peer-reviewed publications.
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Affiliation(s)
- Pan Zhang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yalan Chen
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Furong Zhang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hong Pei
- Department of Chinese Medicine, Geriatric Hospital of Sichuan Province, Chengdu, China
| | - Mingsheng Sun
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuzhu Qu
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiyao Chen
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ting Du
- Department of Rehabilitation Medicine, Xishan People's Hospital, Wuxi, China
| | - Xiaoguo He
- Department of Chinese Medicine, Geriatric Hospital of Sichuan Province, Chengdu, China
| | - Fanrong Liang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Weiguo Jia
- The Center of Gerontology and Geriatrics of West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Weiguo Jia
| | - Mingxiao Yang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Mingxiao Yang ;
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EEG and ECG Power Spectrum Analysis of Sedative Effects on Propofol-Anesthetized Rats with Electroacupuncture. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2440609. [PMID: 35668776 PMCID: PMC9167085 DOI: 10.1155/2022/2440609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 05/11/2022] [Indexed: 11/29/2022]
Abstract
Background In previous studies, electroacupuncture (EA) with 2/15 Hz has been shown to enhance the sedative effects in general anesthesia patients. Central lateral thalamic stimulation of 50 Hz showed an arousal effect in macaques. Therefore, it is worth studying the sedative effect of EA at peripheral acupoints with different frequencies, especially the frequency of around 50 Hz. Methods Rats were anesthetized under the constant infusion of propofol and EA at Zusanli (ST36) and Neiguan (PC6) locations. Electroencephalography (EEG) and heart rate were continuously recorded before and after the intervention by EA in the C group (control), LEA group (low-frequency group, 2/15 Hz diffuse/dense wave EA stimulation), and HEA group (high-frequency group, 50 Hz stimulation). Results In the LEA group, a significant increase in the power of the delta component with a decrease in the alpha component (p < 0.05) was observed after EA stimulation. In the HEA group, significant increases in the powers of alpha and beta components of EEG (p < 0.05) and a decrease in the delta component of EEG were observed (p < 0.05). The phenomenon is also shown in full-frequency waves. In addition, a significant decrease in the low-frequency/high-frequency ratio parameter was observed in the LEA group. Conclusions EA at bilateral ST36 and PC6 can enhance the sedative effects of propofol anesthesia in low-frequency stimulation but lighten the sedative effects in high-frequency (50 Hz) stimulation. The sympathetic-vagal balance was affected due to low-frequency EA.
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Acupuncture Attenuates Blood Pressure via Inducing the Expression of nNOS. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9945277. [PMID: 34239595 PMCID: PMC8235963 DOI: 10.1155/2021/9945277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/04/2021] [Indexed: 11/17/2022]
Abstract
Background Sympathetic activation leads to elevated blood pressure. Neuronal nitric oxide synthase (nNOS) inhibits sympathetic nervous system activity, thereby decreasing blood pressure (BP). nNOS is highly expressed in the arcuate nucleus (ARC) and ventrolateral periaqueductal gray (vlPAG), which play essential roles in the regulation of the cardiovascular and sympathetic nervous systems. Objective This study was designed to verify the hypothesis that acupuncture exerts an antihypertensive effect via increasing the expression of nNOS in ARC and vlPAG of spontaneously hypertensive (SHR) rats. Methods Rats without anesthesia were subject to daily acupuncture for 2 weeks. BP was monitored by the tail-cuff method. nNOS expressions in the ARC and vlPAG were detected by western blot and immunofluorescence. BP was measured after 7-Nitroindazole (7-NI), a specific nNOS inhibitor, was microinjected into ARC or vlPAG in SHR rats treated with acupuncture. Results Acupuncture for 14 days significantly attenuated BP, and the Taichong (LR3) acupoint was superior to Zusanli (ST36) and Fengchi (GB20) in lowering BP. In addition, acupuncture at Taichong (LR3) induced an increase of nNOS expression in ARC and vlPAG, whereas microinjection of 7-NI into ARC or vlPAG reversed the antihypertensive effect of acupuncture. Conclusions This study indicates that acupuncture at Taichong (LR3) induces a better antihypertensive effect than at Zusanli (ST36) or at Fengchi (GB20) in SHR rats, and enhancement of nNOS in ARC and vlPAG probably contributes to the antihypertensive effect of acupuncture.
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Effects of Acupuncture on Lowering Blood Pressure in Postmenopausal Women with Prehypertension or Stage 1 Hypertension: A Propensity Score-Matched Analysis. J Clin Med 2021; 10:jcm10071426. [PMID: 33916003 PMCID: PMC8038045 DOI: 10.3390/jcm10071426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022] Open
Abstract
Postmenopausal women have a higher prevalence of hypertension compared to premenopausal women. Hypertension is a risk factor for cardiovascular diseases, the prevalence of which is ever increasing. This study investigated the effects of long-term acupuncture on lowering the blood pressure of postmenopausal women with prehypertension and stage 1 hypertension. Participants were 122 postmenopausal women aged less than 65 years, diagnosed with prehypertension or stage 1 hypertension (systolic blood pressure 120–159 mmHg or diastolic blood pressure 80–99 mmHg). We used a propensity score-matched design. The experimental group (n = 61) received acupuncture for four weeks every six months over a period of two years. The control group (n = 61) received no intervention. An Analysis of covariance (ANCOVA) was performed for the primary efficacy analysis. Relative risk ratios were used to compare group differences in treatment effects. Acupuncture significantly reduced the participants’ diastolic blood pressure (−9.92 mmHg; p < 0.001) and systolic blood pressure (−10.34 mmHg; p < 0.001) from baseline to follow-up. The results indicate that acupuncture alleviates hypertension in postmenopausal women, reducing their risk of developing cardiovascular diseases and improving their health and quality of life.
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Micalos PS, Pak SC, Jesulola E, Cannon J, Hale M, Koo BS. Does Acupuncture Enhance Muscle Strength and Performance? Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Verma N, Rastogi S, Chia YC, Siddique S, Turana Y, Cheng HM, Sogunuru GP, Tay JC, Teo BW, Wang TD, Tsoi KKF, Kario K. Non-pharmacological management of hypertension. J Clin Hypertens (Greenwich) 2021; 23:1275-1283. [PMID: 33738923 PMCID: PMC8678745 DOI: 10.1111/jch.14236] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/01/2021] [Accepted: 01/19/2021] [Indexed: 12/12/2022]
Abstract
Hypertension is an insidious disease which predisposes to cardiovascular complications and if not treated properly can lead to various serious complications. Economic limitations, having additional benefits with few or almost no side effects have made non-pharmacological management of hypertension an attractive approach for dealing with hypertension, in developed and developing countries alike. A MEDLINE search was done for relevant references with emphasis on original studies, randomized controlled trials, and meta-analyses for this review paper. Lifestyle modifications including changes in the dietary pattern, adopting special diets with low sodium, saturated fat and high calcium, magnesium and potassium and trying the new methods like time restricted meal intake which work in tandem with the circadian rhythm are opening new vistas in the field of non-pharmacological management of hypertension. Lifestyle modifications that effectively lower blood pressure are increased physical activity, weight loss, limited alcohol consumption, relaxation techniques of Yoga, Acupuncture, Tai chi, mindfulness-based stress-reduction program, and Transcendental Meditation. Air pollution of the surrounding air is linked with poor health outcomes and is a major contributor to the global burden of disease. Fine particulate matter <2.5 μm in diameter (PM2.5) is strongly associated with cardiovascular morbidity and mortality. Short-term PM exposure (hours to weeks) increases the likelihood of adverse cardiovascular events including myocardial infarction, stroke, and heart failure, and longer-term exposure multiplies that risk. Non-pharmacological methods should be initiated early phase of disease and should be continued with medication.
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Affiliation(s)
- Narsingh Verma
- Department of Physiology, King George's Medical University, Lucknow, India
| | - Smriti Rastogi
- Department of Physiology, King George's Medical University, Lucknow, India
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia
| | - Saulat Siddique
- Department of Cardiology, Fatima Memorial Hospital, Lahore, Pakistan
| | - Yuda Turana
- Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia
| | - Hao-Min Cheng
- Department of Medicine, Taipei Veterans General Hospital, Medical Education and Research, National Yang-ming University, Taipei, Taiwan
| | | | - Jam Chin Tay
- Department of General Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Boon Wee Teo
- Department of Medicine division of Nephrology Wang, National University Singapore Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Tzung-Dau Wang
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kelvin Kam Fai Tsoi
- Faculty of Medicine, JC School of Public Health and Primary Care, JC Institute of Ageing, SH Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
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Jeon SR, Nam D, Kim TH. Dropouts in randomized clinical trials of Korean medicine interventions: a systematic review and meta-analysis. Trials 2021; 22:176. [PMID: 33648566 PMCID: PMC7923634 DOI: 10.1186/s13063-021-05114-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 02/09/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The dropout rate is an important determinant of outcomes in randomized controlled trials (RCTs) and should be carefully controlled. This study explored the current dropout rate in studies of Korean medicine (KM) interventions by systematic evaluation of RCTs conducted in the past 10 years. METHODS Three clinical trial registries (Clinical Research Information Service, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform) were searched to identify RCT protocols for KM interventions, such as acupuncture, herbal medicine, moxibustion, or cupping, and studies of mixed interventions, registered in Korea from 2009 to 2019. The PubMed, Embase, and OASIS databases were searched for the full reports of these RCTs, including published journal articles and theses. Dropout rates and the reasons for dropping out were analyzed in each report. The risk of bias in each of the included studies was assessed using the Cochrane risk of bias tool. The risk difference for dropping out between the treatment and control groups was calculated with the 95% confidence interval in a random effects model. RESULTS Forty-nine published studies were included in the review. The median dropout rate was 10% in the treatment group (interquartile range 6.7%, 17.0%) and 14% in the control group (interquartile range 5.4%, 16.3%) and was highest in acupuncture studies (12%), followed by herbal medicine (10%), moxibustion (8%), and cupping (7%). Loss to follow-up was the most common reason for dropping out. The risk difference for dropping out between the intervention and control groups was estimated to be 0.01 (95% confidence interval - 0.02, 0.03) in KM intervention studies. CONCLUSIONS This review found no significant difference in the dropout rate between studies according to the type of KM intervention. We recommend allowance for a minimum dropout rate of 15% in future RCTs of KM interventions. REVIEW PROTOCOL REGISTRATION PROSPERO CRD42020141011.
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Affiliation(s)
- Sae-rom Jeon
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyung Heedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Dongwoo Nam
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyung Heedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Tae-Hun Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyung Heedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
- Department of Korea8n Medicine Clinical Trial Center, College of Korean Medicine, Kyung Hee University, 23 Kyung Heedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
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Kimura K, Kitagawa Y, Tajima F. Effects of a Single Session of Acupuncture Treatment on Blood Pressure and Heart Rate Variability in Patients with Mild Hypertension. J Altern Complement Med 2021; 27:342-348. [PMID: 33512256 DOI: 10.1089/acm.2020.0324] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of the present study was to compare the effects of acupuncture treatment on arterial blood pressure (BP) and heart rate (HR) in patients with mild hypertension with high sympathetic tone with those of normotensive patients and to examine the effects on cardiac sympathetic nerve activity (CSNA) and vagal activity using heart rate variability (HRV) analysis. Design: Eight male patients with prehypertension or stage I hypertension and eight normotensive age-matched patients were included in this study. All patients had their systolic BP (SBP), diastolic BP (DBP), HR, and HRV measured. In addition, the ratio of low-frequency (LF) to high-frequency (HF) HRV and the power of the HF of the HRV were recorded. The study was conducted at Kansai University of Health Sciences in Japan. Interventions: Each patient underwent a single, 15-min-long acupuncture session. Acupuncture was applied to PC6, LI4, ST36, LR3 on both sides, and GV20. Results: SBP and HR decreased significantly in the hypertensive group during and after acupuncture compared with the baseline SBP and HR (p < 0.05). LF/HF was significantly reduced during acupuncture (p < 0.05), and HF was significantly increased after acupuncture in the hypertensive group (p < 0.05). However, there were no significant changes in LF/HF or HF in the control group. Conclusions: Acupuncture may reduce the BP and HR in patients with mild hypertension. An HRV analysis suggests that acupuncture may suppress the enhanced basal CSNA activity and increase the vagal nerve activity in patients with mild hypertension. Clinical Trial Registration number: UMIN000041249.
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Affiliation(s)
- Kenichi Kimura
- Department of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
| | - Yoji Kitagawa
- Department of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
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Wang JM, Yang MX, Wu QF, Chen J, Deng SF, Chen L, Wei DN, Liang FR. Improvement of intestinal flora: accompany with the antihypertensive effect of electroacupuncture on stage 1 hypertension. Chin Med 2021; 16:7. [PMID: 33413552 PMCID: PMC7792359 DOI: 10.1186/s13020-020-00417-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 12/22/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Increasing evidence have indicated the relationship between intestinal dysbiosis and hypertension. We aimed to evaluate the effect of the electroacupuncture (EA) on intestinal microbiota in patients with stage 1 hypertension. METHODS 93 hypertensive patients and 15 healthy subjects were enrolled in this study. Applying a highly accurate oscillometric device to evaluate the antihypertensive effect of EA. 16S rRNA sequencing was used to profile stool microbial communities from Healthy group, Before treatment (BT) group and After treatment (AT) group, and various multivariate analysis approaches were used to assess diversity, composition and abundance of intestinal microbiota. RESULTS In this study, EA significantly decreased the blood pressure (BP) of hypertensive patients. Higher abundance of Firmicutes and lower Bacteroidetes abundance were observed in the BT group compared to the Healthy group. And EA treatment significantly decreased the Firmicutes/Bacteroidetes ratio compared to the BT group. Moreover, at the genus level, there was an increased abundance of Escherichia-Shigella in patients with hypertension, while Blautia were decreased, and EA reversed these changes. CONCLUSIONS Our study indicates that EA can effectively lower BP and improve the structure of intestinal microbiota which are correlate with the alteration of blood pressure by electroacupuncture. TRIAL REGISTRATION Clinicaltrial.gov, NCT01701726. Registered 5 October 2012, https://clinicaltrials.gov/ct2/show/study/NCT01701726.
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Affiliation(s)
- Jun-Meng Wang
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China
| | - Ming-Xiao Yang
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, SAR, China.,Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Hai yuan Road, Futian District, Shenzhen, 518053, Guangdong, China
| | - Qiao-Feng Wu
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China. .,Institute of Acupuncture and Homeostasis Regulation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
| | - Ji Chen
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China
| | - Shu-Fang Deng
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China
| | - Lin Chen
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China
| | - Da-Neng Wei
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China
| | - Fan-Rong Liang
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China.
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Biçer S, Ünsal A, Taşcı S, Demir G, Ceyhan YŞ. The Effect of Acupressure on Blood Pressure Level and Pulse Rate in Individuals With Essential Hypertension: A Randomized Controlled Trial. Holist Nurs Pract 2021; 35:40-48. [PMID: 33492879 DOI: 10.1097/hnp.0000000000000384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A total of 91 people including 47 in the intervention group and 44 in the placebo group were included to a randomized controlled study. It can be asserted that acupressure, applied to the Neiguan (PC 6) acupuncture point in individuals with essential hypertension, provides blood pressure regulation and is effective for management of numerous hypertension-related symptoms.
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Affiliation(s)
- Sevil Biçer
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey (Drs Biçer and Taşcı); and Department of Nursing, School of Health, Ahi Evran University, Kırşehir, Turkey (Drs Ünsal, Demir, and Ceyhan)
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Huang KY, Huang CJ, Hsu CH. Efficacy of Acupuncture in the Treatment of Elderly Patients with Hypertension in Home Health Care: A Randomized Controlled Trial. J Altern Complement Med 2020; 26:273-281. [PMID: 32045259 DOI: 10.1089/acm.2019.0172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objective: To evaluate the efficacy of acupuncture in helping antihypertensive drugs lower the hypertension of elderly patients in home health care. Design: Randomized controlled trial. Setting: Subjects were recruited from Branch of Linsen, Chinese Medicine, and Kunming, Taipei City Hospital, Taipei, Taiwan. Subjects: A total of 70 participants with hypertension in home health care were assigned randomly to the acupuncture group (35 participants) or the control group (35 participants). Interventions: The acupuncture group received antihypertensive drugs plus acupuncture twice a week for 12 weeks, and the control group received antihypertensive drugs only. Acupuncture points SP10, SP6, LR3, ST36, and LI4 were used bilaterally. Each acupuncture treatment session lasted 30 min. All the subjects were instructed not to alter their diet, physical activity, or use of drugs. Outcome measurements: Blood pressure (BP), heart rate variability, and the Constitution in Chinese Medicine Questionnaire (CCMQ) were assessed at baseline and at 6 and 12 weeks from the baseline between 9 am and 10 am in all subjects. Results: A total of 31 participants in each group completed the study. Within-group differences were observed in systolic BP (SBP) (p < 0.001), diastolic BP (p < 0.001), standard deviation of normal sinus beat intervals (SDNN) (p = 0.01), low frequency (p = 0.05), high frequency (p = 0.01), total power (TP) (p = 0.01), percentage of successive intervals that differ by more than 50 msec (PNN50) (p = 0.01), qi deficiency (p = 0.003), blood stasis (p = 0.02), and qi depression (p = 0.03) constitution. Significant between-group differences were observed in SBP (p = 0.001), SDNN (p = 0.008), and TP (p = 0.04). Conclusions: This study suggested that in the home health care hypertension population, antihypertensive drugs plus acupuncture may be more beneficial in lowering BP and in regulating autonomic nervous system activity than drugs alone. A longer follow-up and larger sample size should be considered in future studies to reveal the precise effect of acupuncture followed by evidence-based practice.
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Affiliation(s)
- Kuei-Yu Huang
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Chinese Medicine, Branch of Taipei, China Medical University Hospital, Taipei, Taiwan
| | - Chien-Jung Huang
- Division of Endocrinology and Metabolism, Branch of Linsen, Chinese Medicine, and Kunming, Taipei City Hospital, Taipei, Taiwan
| | - Chung-Hua Hsu
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Chinese Medicine, Branch of Linsen, Chinese Medicine, and Kunming, Taipei City Hospital, Taipei, Taiwan
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21
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Sun J, Ashley J, Kellawan JM. Can Acupuncture Treatment of Hypertension Improve Brain Health? A Mini Review. Front Aging Neurosci 2019; 11:240. [PMID: 31572163 PMCID: PMC6753179 DOI: 10.3389/fnagi.2019.00240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/19/2019] [Indexed: 12/29/2022] Open
Abstract
With age, cerebrovascular and neurodegenerative diseases (e.g., dementia and Alzheimer’s) are some of the leading causes of death in the United States. Related to these outcomes is the increased prevalence of hypertension, which independently increases the development of cerebrovascular and neurodegenerative diseases. While a direct mechanistic link between hypertension and poor brain health is unknown, many hypothesize that the etiology stems from poor blood pressure (BP) and cerebrovascular regulation. This dysfunction fosters hypoperfusion of the brain, causing stress to the tissue through a nutrient mismatch, subtly damaging the brain over many years. Current Western medical treatment relies on pharmacological treatment (mainly beta-blockers, angiotensin-converting enzyme inhibitors, or a combination of the two). However, Western treatments have not been successful in mitigating brain health outcomes and are burdened with unwanted side effects and non-adherence issues. Alternatively, traditional East Asia medicine has used acupuncture as a treatment for hypertension and may offer a promising approach in response to the limitations of conventional therapy. While detailed clinical and mechanistic experimental evidence is lacking, acupuncture has been observed to reduce BP and improve endothelial function in hypertensive adults. Further, acupuncture has been shown to have specific cerebrovascular effects, increasing cerebrovascular reactivity in healthy adults, highlighting possible neuroprotective properties. Therefore, our review is aimed at evaluating acupuncture as a treatment for hypertension and the potential impact on brain health. We will interrogate the current literature as well as discuss the proposed neural and vascular mechanisms by which acupuncture acts.
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Affiliation(s)
- Jongjoo Sun
- Human Circulation Research Laboratory, Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - John Ashley
- Human Circulation Research Laboratory, Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - J Mikhail Kellawan
- Human Circulation Research Laboratory, Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
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Abstract
Objective: To confirm that acupuncture applied to patients would improve the clinical curative effect and accelerate the patient's recovery by introducing the application of acupuncture in pre-operation, during operation, and post-operation. Data sources: Literature cited in this review was retrieved from PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) and was primarily published in English or Chinese from 2010 to 2018, with keywords of “acupuncture,” “electroacupuncture,” “perioperative period,” “sedation,” “analgesia,” and “recovery.” Relevant citations in the retrieved articles were also screened to include more data. Study selection: All retrieved literature was scrutinized, most typical articles related on perioperative acupuncture application in clinical study were reviewed. Results: Acupuncture could relieve anxiety and stress during the preoperative stage. It reduces the usage of narcotics and stress response, and maintains the respiratory stability and homeostasis during surgery. It also exerts a protective effect on vital organs, and during the postoperative stages, enhances the recovery while effectively alleviating the postoperative pain. This phenomenon prevents common postoperative discomforts such as nausea and vomiting. In addition, it might improve the patients’ long-term prognosis. Conclusions: The novel concept “perioperative acupuncture medicine” is to focus on the optimal treatment in the perioperative period of surgical patients. The review reveals the important role of acupuncture in enhancing rapid recovery of patients during the perioperative period.
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Tan X, Pan Y, Su W, Gong S, Zhu H, Chen H, Lu S. Acupuncture therapy for essential hypertension: a network meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:266. [PMID: 31355233 DOI: 10.21037/atm.2019.05.59] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background To evaluate the efficacy and safety of acupuncture therapies for the treatment of essential hypertension. Methods We performed a systematic electronic search of PubMed, Embase, the Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), and Wan-fang Data Database. The main outcome indicators measured were the amount of major adverse cardiovascular events (MACE), a change of blood pressure, and the response rate. STATA15.0 software was used for the network meta-analysis. Results A total of 31 trials with 2,649 patients were included. Patients were allocated to 15 kinds of interventions. These including acupuncture types were electroacupuncture, moxibustion, warm needle therapy, sham acupuncture, behavioral therapy, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium channel blocker (CCB), beta-blocker, acupuncture combined ACEI, acupuncture combined CCB, acupuncture combined behavior, electroacupuncture combined CCB, and non-treatment. The results of the network meta-analysis showed that there was no significant clinical or statistic difference in systolic blood pressure (SBP) change magnitude between acupuncture treatment and the other 14 therapies. Moxibustion may be better than acupuncture in reducing diastolic blood pressure (DBP) [mean difference (MD): 15.9, 95% confidence interval (CI): 5.96-25.85]. There was no significant difference in reducing DBP between acupuncture and the other 13 interventions. The effective rate of acupuncture combined with AECI [odds ratio (OR) =7.96, 95% CI: 1.11-56.92] and acupuncture combined with behavioral therapy (OR =3.53, 95% CI: 1.08-11.51) in treating hypertension was better than that of acupuncture alone, and there was no statistically significant difference in the effective rate between acupuncture and the other therapies. Conclusions The existing evidence shows that acupuncture could be used for treating hypertension, and it may have the same effects as common medication. However, due to the low qualities of the original studies, the quality of this evidence is poor. Therefore, it is recommended that more scientific research be performed to confirm the efficacy of acupuncture.
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Affiliation(s)
- Xiaodong Tan
- The Graduate School, Nanjing University of Chinese Medicine, Nanjing 210023, China.,Department of Cardiology, Wuxi Hospital of Traditional Chinese Medicine, Wuxi 214071, China
| | - Yujing Pan
- The Graduate School, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Wei Su
- Department of Cardiology, Wuxi Hospital of Traditional Chinese Medicine, Wuxi 214071, China
| | - Shaoyu Gong
- Department of Cardiology, Wuxi Hospital of Traditional Chinese Medicine, Wuxi 214071, China
| | - Hongjun Zhu
- Department of Cardiology, Wuxi Hospital of Traditional Chinese Medicine, Wuxi 214071, China
| | - Hao Chen
- The Graduate School, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Shu Lu
- Department of Cardiology, Wuxi Hospital of Traditional Chinese Medicine, Wuxi 214071, China
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Zhang M, Du Q, Yang F, Guo Y, Hou Y, Zhu P. Acupuncture at PC6 prevents cardiac hypertrophy in isoproterenol-treated mice. Acupunct Med 2019; 37:55-63. [PMID: 30843422 DOI: 10.1136/acupmed-2017-011418] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To investigate the effect of acupuncture at PC6 on cardiac hypertrophy in isoproterenol (ISO)-treated mice. METHODS 48 male C57BL/6 mice underwent subcutaneous injection of ISO for 14 days and were randomly divided into four groups (n=12 each) that remained untreated (ISO group), received verum manual acupuncture (MA) treatment at PC6 (ISO+MA(PC6) group), sham MA at location on the tail not corresponding to any traditional acupuncture point (ISO+MA(tail) group), or propranolol (ISO+PR group). An additional 12 mice were given an injection of phosphate-buffered saline (PBS) and formed a healthy control (Normal) group. After performing echocardiography and measuring the ratio of heart weight (HW)/tibia length (TL) at 14 days, all mice were euthanased. Morphological examination was performed following haematoxylin and eosin and Masson's staining of heart tissues. Ultrastructural changes were observed by electron microscopy. Cardiac protein expression of atrial natriuretic peptide (ANP) and tumour necrosis factor α (TNFα) were measured by immunohistochemical (IHC) staining and Western blotting. RESULTS Compared with the untreated model group, acupuncture at PC6 lowered the heart rate, reduced the ratio of HW/TL, improved the left ventricular (LV) anterior wall thickness (LVAWd), LV end-diastolic anterior wall thickness (LVAWs), LV end-systolic posterior wall thickness (LVPWd), LV end-diastolic posterior wall thickness (LVPWs), and fractional shortening (FS) as observed by echocardiography (ISO+MA(PC6) vs. ISO groups: P<0.05). Moreover, evidence from morphological studies demonstrated that acupuncture at PC6 inhibited myocardial hypertrophy and collagen deposition, and normalised the ultrastructural changes. In addition, ANP and TNFα expression were attenuated in the verum acupuncture group compared with the untreated model group (ISO+MA(PC6) vs. ISO groups: P<0.05). CONCLUSIONS The results demonstrated that acupuncture at PC6 attenuates sympathetic overactivity. Additionally, it may improve cardiac performance by reversing adverse cardiac remodelling. Acupuncture has potential as a treatment for sympathetic hypertension.
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Affiliation(s)
- Miao Zhang
- 1 Second Affiliated Hospital of Heilongjiang TCM University, Harbin, China
| | - Qigen Du
- 1 Second Affiliated Hospital of Heilongjiang TCM University, Harbin, China
| | - Fubiao Yang
- 2 Department of Medical Affairs, Heilongjiang TCM University, Harbin, China
| | - Ying Guo
- 1 Second Affiliated Hospital of Heilongjiang TCM University, Harbin, China
| | - Yunlong Hou
- 3 Department of Pharmacology, Harbin Medical University, Harbin, China
| | - Pengyu Zhu
- 1 Second Affiliated Hospital of Heilongjiang TCM University, Harbin, China
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The Mechanism of Acupuncture in Treating Essential Hypertension: A Narrative Review. Int J Hypertens 2019; 2019:8676490. [PMID: 30984420 PMCID: PMC6431462 DOI: 10.1155/2019/8676490] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/14/2019] [Indexed: 01/13/2023] Open
Abstract
Essential hypertension has a high incidence worldwide, and patients with essential hypertension endure a lifetime of medication, leading to a heavy economic burden on the patient's family and causing serious impacts on the patient's quality of life. Much evidence has demonstrated that acupuncture as an adjunctive therapy can lower blood pressure in patients with hypertension, but the mechanism of its action is unclear. This article reviews the research from 2000 to 2018 regarding the mechanism of acupuncture for hypertension, and we summarize the current knowledge about using acupuncture for hypertension. We found that the mechanism whereby acupuncture lowers blood pressure is related to the regulation of renin-angiotensin-aldosterone system, vascular endothelium, oxidative stress, neuroendocrine system, and so on. Besides, there may be cross-talk between multiple systems and multiple targets. We also investigate the influence factors of acupuncture for hypertension. These results may provide evidence and research ideas for the treatment of hypertension via acupuncture.
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Shin KM, Park JE, Yook TH, Kim JU, Kwon O, Choi SM. Moxibustion for prehypertension and stage I hypertension: a pilot randomized controlled trial. Integr Med Res 2019; 8:1-7. [PMID: 30596012 PMCID: PMC6309023 DOI: 10.1016/j.imr.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/06/2018] [Accepted: 11/19/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Prehypertension and hypertension are associated with cardiovascular disease, ischemic heart disease, and stroke morbidity. The purpose of this study is to evaluate the effectiveness and safety of moxibustion in patients with prehypertension or hypertension. METHODS Forty-five subjects with prehypertension or stage I hypertension were randomized into three groups: moxibustion treatment group A (2 sessions/week for 4 weeks), moxibustion treatment group B (3 sessions/week for 4 weeks), and control group (nontreated group). The primary outcome measure was the change in blood pressure after 4 weeks of treatment. Safety was assessed at every visit. RESULTS There were no significant differences in systolic blood pressure (SBP) or diastolic blood pressure (DBP) among three groups after 4 weeks of treatment (p = 0.4798 and p = 0.3252, respectively). In treatment group B, there was a significant decrease in SBP and DBP from baseline to 4 weeks of treatment (mean difference (MD) -9.55; p = 0.0225, MD -7.55; p = 0.0098, respectively). There were no significant differences among groups in secondary outcome measures after 4 weeks of treatment. Six adverse events (AEs) in the treatment group A and 12 AEs in the treatment group B occurred related to the moxibustion treatment. CONCLUSION In conclusion, the results of this study show that moxibustion (3 sessions/week for 4 weeks) might lower blood pressure in patients with prehypertension or stage I hypertension and treatment frequency might affect effectiveness of moxibustion in BP regulation. Further randomized controlled trials with a large sample size on prehypertension and hypertension should be conducted. TRIAL REGISTRATION This study was registered with the 'Clinical Research Information Service (CRIS)', Republic of Korea (KCT0000469), and the protocol for this study was presented orally at the 15th International Council of Medical Acupuncture and Related Techniques (ICMART) in Athens, 25-27 May 2012.
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Key Words
- AE, adverse event
- BMI, body mass index
- BP, blood pressure
- CI, confidence interval
- DBP, diastolic blood pressure
- EQ-5D, EuroQol-5 Dimensions
- FSS, Fatigue Severity Scale
- HRV, heart rate variability
- Hypertension
- MD, mean difference
- Moxibustion
- NDI, neck disability index
- PSQI, Pittsburgh Sleep Quality Index
- Prehypertension
- RCT, randomized controlled trial
- SAE, serious adverse event
- SBP, systolic blood pressure
- SRI-MF, Modified Form of the Stress Response Inventory
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Affiliation(s)
- Kyung-Min Shin
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ji-Eun Park
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Tae-Han Yook
- Department of Acupuncture & Moxibustion Medicine, Korean Medicine Hospital of Woosuk University, Jeonju, South Korea
| | - Jong-Uk Kim
- Department of Acupuncture & Moxibustion Medicine, Korean Medicine Hospital of Woosuk University, Jeonju, South Korea
| | - Ojin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Sun-Mi Choi
- Korea Institute of Oriental Medicine, Daejeon, South Korea
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Fan H, Lu F, Yang A, Dong Y, Liu P, Wang Y. A Review on the Nonpharmacological Therapy of Traditional Chinese Medicine with Antihypertensive Effects. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:1317842. [PMID: 30719053 PMCID: PMC6334369 DOI: 10.1155/2019/1317842] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 10/09/2018] [Accepted: 11/12/2018] [Indexed: 12/28/2022]
Abstract
Hypertension is a global health concern. Although the pharmacological treatment has obvious antihypertensive effects, there are still some limitations on management of hypertension by drug therapy alone. In recent years, the nonpharmacological therapy of traditional Chinese medicine (TCM) has gradually become an important mean to help the prevention and treatment of hypertension in some Eastern countries. In this review, the nonpharmacological TCM therapies, including acupuncture, tuina, Tai Chi, and auricular-plaster, are covered along with the mechanism.
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Affiliation(s)
- Hua Fan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, China
| | - Feng Lu
- The Affiliated Hospital of Shandong University of TCM, Shandong Provincial Hospital of Traditional Chinese Medicine, China
| | - Ailing Yang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, China
| | - Yidan Dong
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, China
| | - Ping Liu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, China
| | - Youhua Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, China
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28
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Yang M, Yu Z, Chen X, Guo Z, Deng S, Chen L, Wu Q, Liang F. Active Acupoints Differ from Inactive Acupoints in Modulating Key Plasmatic Metabolites of Hypertension: A Targeted Metabolomics Study. Sci Rep 2018; 8:17824. [PMID: 30546033 PMCID: PMC6292875 DOI: 10.1038/s41598-018-36199-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 11/15/2018] [Indexed: 11/09/2022] Open
Abstract
The effect of active acupoints versus inactive acupoints in treating hypertension is not well documented. Metabolic phenotypes, depicted by metabolomics analysis, reflect the influence of external exposures, nutrition, and lifestyle on the integrated system of the human body. Therefore, we utilized high-performance liquid chromatography tandem mass spectrometry to compare the targeted metabolic phenotype changes induced by two different acupoint treatments. The clinical outcomes show that active acupoint treatment significantly lowers 24-hour systolic blood pressure but not diastolic blood pressure, as compared with inactive acupoint treatment. Furthermore, distinctive changes are observed between the metabolomics data of the two groups. Multivariate analysis shows that only in the active acupoint treatment group can the follow-up plasma be clearly separated from the baseline plasma. Moreover, the follow-up plasma of these two groups can be clearly separated, indicating two different post-treatment metabolic phenotypes. Three metabolites, sucrose, cellobiose, and hypoxanthine, are shown to be the most important features of active acupoint treatment. This study demonstrates that metabolomic analysis is a potential tool that can be used to efficiently differentiate the effect of active acupoints from inactive acupoints in treating hypertension. Possible mechanisms are the alternation of hypothalamic microinflammation and the restoration of host-gut microbiota interactions induced by acupuncture.
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Affiliation(s)
- Mingxiao Yang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China.,School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong SAR, China.,Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan Road, Futian District, Shenzhen, 518053, Guangdong, China
| | - Zheng Yu
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China
| | - Xiaomin Chen
- Metabolomics, Scientific Technology Department, BGI, Beishan Industrial Zone, Yantian District, Shenzhen, 518083, Guangdong, China
| | - Zhenyu Guo
- Metabolomics, Scientific Technology Department, BGI, Beishan Industrial Zone, Yantian District, Shenzhen, 518083, Guangdong, China
| | - Shufang Deng
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China
| | - Lin Chen
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China
| | - Qiaofeng Wu
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China.
| | - Fanrong Liang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Jinniu Street, Chengdu, 610075, Sichuan, China.
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29
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Sibbritt D, Peng W, Lauche R, Ferguson C, Frawley J, Adams J. Efficacy of acupuncture for lifestyle risk factors for stroke: A systematic review. PLoS One 2018; 13:e0206288. [PMID: 30365567 PMCID: PMC6203376 DOI: 10.1371/journal.pone.0206288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 10/10/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Modifications to lifestyle risk factors for stroke may help prevent stroke events. This systematic review aimed to identify and summarise the evidence of acupuncture interventions for those people with lifestyle risk factors for stroke, including alcohol-dependence, smoking-dependence, hypertension, and obesity. METHODS MEDLINE, CINAHL/EBSCO, SCOPUS, and Cochrane Database were searched from January 1996 to December 2016. Only randomised controlled trials (RCTs) with empirical research findings were included. PRISMA guidelines were followed and risk of bias was assessed via the Cochrane Collaboration risk of bias assessment tool. The systematic review reported in this paper has been registered on the PROSPERO (#CRD42017060490). RESULTS A total of 59 RCTs (5,650 participants) examining the use of acupuncture in treating lifestyle risk factors for stroke met the inclusion criteria. The seven RCTs focusing on alcohol-dependence showed substantial heterogeneity regarding intervention details. No evidence from meta-analysis has been found regarding post-intervention or long-term effect on blood pressure control for acupuncture compared to sham intervention. Relative to sham acupuncture, individuals receiving auricular acupressure for smoking-dependence reported lower numbers of consumed cigarettes per day (two RCTs, mean difference (MD) = -2.75 cigarettes/day; 95% confidence interval (CI) = -5.33, -0.17; p = 0.04). Compared to sham acupuncture those receiving acupuncture for obesity reported lower waist circumference (five RCTs, MD = -2.79 cm; 95% CI: -4.13, -1.46; p<0.001). Overall, only few trials were considered of low risk of bias for smoking-dependence and obesity, and as such none of the significant effects in favour of acupuncture interventions were robust against potential selection, performance, and detection bias. CONCLUSIONS This review found no convincing evidence for effects of acupuncture interventions for improving lifestyle risk factors for stroke.
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Affiliation(s)
- David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Wenbo Peng
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Caleb Ferguson
- Nursing Research Centre, Western Sydney University & Western Sydney Local Health District, Blacktown Clinical & Research School, Blacktown Hospital, Sydney, New South Wales, Australia
| | - Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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de Lima Pimentel R, Duque AP, Moreira BR, Rodrigues LF. Acupuncture for the Treatment of Cardiovascular Diseases: A Systematic Review. J Acupunct Meridian Stud 2018; 12:43-51. [PMID: 30059774 DOI: 10.1016/j.jams.2018.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/16/2018] [Accepted: 07/23/2018] [Indexed: 11/18/2022] Open
Abstract
Acupuncture, for the westerns countries, is an innovative and low-cost therapy for treatment and prevention of cardiovascular diseases (CVDs). However, most of its effects and mechanisms are poorly understood. Thus, the objective of this work was to systematically review the literature regarding the clinical effects of acupuncture for the treatment and prevention of CVDs. A search for papers published in English or Portuguese in the past 20 years was conducted at PubMed, SciELO, and PEDro databases. Clinical trials conducted on the effects of acupuncture were included in this review. Two reviewers extracted the data independently from the remaining 17 articles after screening. The most used acupoint was PC6 (10 studies, 64.7%), followed by ST36 (6 studies, 35.3%) and auricular acupoints (4 studies, 23.5%). Among the clinical applications, hypertension was the most studied CVD, with acupuncture being the most reported method among the studies (70.6%). Only three articles reported no benefit in the treatment of CVDs for the methodology used. We conclude that although several studies indicated an improvement in the response of the cardiovascular system in CVDs by acupuncture, electroacupuncture, or electrostimulation treatment, the heterogeneity of the studies does not allow a standardization of its application for each specific disease, making further studies necessary for its use to become a reality.
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Affiliation(s)
- Rodrigo de Lima Pimentel
- Laboratory of Cardiovascular Biophysics, Department of Physiological Sciences, Biomedical Institute, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Alice P Duque
- Laboratory of Cardiovascular Biophysics, Department of Physiological Sciences, Biomedical Institute, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Beatriz R Moreira
- Technical Support Division, Physiotherapy Service, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil
| | - Luiz F Rodrigues
- Laboratory of Cardiovascular Biophysics, Department of Physiological Sciences, Biomedical Institute, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Technical Support Division, Physiotherapy Service, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil.
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31
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Qiulei G, Qingguo L, Dongmei S, Binbin N. Twirling reinforcing-reducing manipulation — central mechanism underlying antihypertensive effect on spontaneous hypertension in rats. J TRADIT CHIN MED 2018. [DOI: 10.1016/s0254-6272(18)30629-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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Chen H, Shen FE, Tan XD, Jiang WB, Gu YH. Efficacy and Safety of Acupuncture for Essential Hypertension: A Meta-Analysis. Med Sci Monit 2018; 24:2946-2969. [PMID: 29735972 PMCID: PMC5963739 DOI: 10.12659/msm.909995] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background The aim of this study was to assess the efficacy and safety of acupuncture therapy for patients with hypertension. Material/Methods We searched PubMed, Embase, the Cochrane Library, the Chinese Biomedical Literature Database, the Chinese National Knowledge Infrastructure, and the Wan-fang Data Database from inception through 29 April 2017. Randomized controlled trials investigating acupuncture therapy for hypertension were included. Review Manager 5.3 software was used for the data analysis. Results A total of 30 RCTs involving 2107 patients were included. The overall methodological quality of the included studies was low. Pooled results demonstrate that acupuncture plus anti-hypertensive drugs is better than anti-hypertensive drugs alone at reducing systolic and diastolic blood pressure (SBP and DBP). The same result was observed for pooled data from experiments that compared acupuncture plus medication to sham acupuncture plus medication at reducing SBP and DBP. However, studies reveal that using acupuncture alone or anti-hypertensive drugs alone do not differ in the effect on lowering blood pressure. Similarly, acupuncture alone also did not differ from sham acupuncture alone, and electroacupuncture versus anti-hypertensive drugs was not significantly different at reducing SBP and DBP. Conclusions Our systematic review indicates there is inadequate high quality evidence that acupuncture therapy is useful in treating hypertension, as the exact effect and safety of acupuncture therapy for hypertension is still unclear. Therefore, research with larger sample sizes and higher-quality RCTs is still needed.
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Affiliation(s)
- Hao Chen
- The Second Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China (mainland)
| | - Fei-Er Shen
- The Second Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China (mainland)
| | - Xiao-Dong Tan
- The Second Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China (mainland)
| | - Wen-Bo Jiang
- The Second Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China (mainland)
| | - Yi-Huang Gu
- The Second Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China (mainland)
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33
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Seo BN, Park JE, Kim YE, Kang KW, Seol IC, Choi SM. Effects of acupuncture in postmenopausal women with prehypertension or stage 1 hypertension: study protocol for a prospective, comparative, interventional cohort study. Integr Med Res 2018; 7:95-102. [PMID: 29629296 PMCID: PMC5883999 DOI: 10.1016/j.imr.2017.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/24/2017] [Accepted: 11/07/2017] [Indexed: 11/16/2022] Open
Abstract
Background Hypertension is a major cause of cardiovascular disease and associated mortality, and postmenopausal women are at a high risk of hypertension. We aim to investigate the hypotensive effect and safety of acupuncture, focusing on postmenopausal women with prehypertension and stage 1 hypertension. In addition, we aim to investigate whether the effect of acupuncture treatment differed, depending on Sasang Constitution and cold-heat pattern. Methods This study is designed as an intervention cohort study. Two hundred postmenopausal women aged <65 years with prehypertension or stage 1 hypertension living in Daejeon city in Korea will be recruited, and randomly assigned to either an acupuncture or no-treatment control group. The intervention will consist of four sessions; one session will include acupuncture performed 10 times for 4 weeks. There will be a 20-week observation period after each session, and the total study duration will be 96 weeks. Acupuncture will be applied at the bilateral Fengchi (GB20), Quchi (LI11), Zusanli (ST36), and Sameumgyo (SP6) acupoints. The effect of acupuncture will be evaluated by comparing the change in systolic and diastolic blood pressure between the acupuncture and control groups every 4 weeks until the end of the study. Discussion To evaluate the success of blood pressure management, long-term observation is required, but no long-term studies have been conducted to evaluate the effect of acupuncture on blood pressure in postmenopausal women. To our knowledge, this study will be the first long-term study to investigate this issue for more than 6-8 weeks.
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Affiliation(s)
- Bok-Nam Seo
- Department of Mibyeong Research Center, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Ji-Eun Park
- Department of Mibyeong Research Center, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Young-Eun Kim
- Department of Mibyeong Research Center, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Kyung-Won Kang
- Hoseo University Institutional Review Board, Daejeon, Korea
| | - In-Chan Seol
- Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Korea
| | - Sun-Mi Choi
- KM Standards Center, Korea Institute of Oriental Medicine, Daejeon, Korea
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Wang XR, Yang JW, Ji CS, Zeng XH, Shi GX, Fisher M, Liu CZ. Inhibition of NADPH Oxidase-Dependent Oxidative Stress in the Rostral Ventrolateral Medulla Mediates the Antihypertensive Effects of Acupuncture in Spontaneously Hypertensive Rats. Hypertension 2017; 71:356-365. [PMID: 29229746 DOI: 10.1161/hypertensionaha.117.09759] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 06/01/2017] [Accepted: 10/19/2017] [Indexed: 01/06/2023]
Abstract
Oxidative stress in the rostral ventrolateral medulla (RVLM), where the sympathetic nervous control center is located, contributes to neural mechanisms of hypertension. Acupuncture was previously reported to favorably affect high blood pressure. However, little is known about the effect of acupuncture on oxidative stress-modulated mechanisms in hypertension. This study was designed to evaluate the hypothesis that acupuncture exerts an antihypertensive effect via ameliorating oxidative stress and the redox-sensitive pathway in the RVLM of spontaneously hypertensive rats. Two weeks of acupuncture reduced blood pressure and sympathetic nervous system activity in spontaneously hypertensive rats. Oxidative stress in the RVLM was alleviated by acupuncture, accompanied by a decrease in nicotinamide adenine dinucleotide phosphate oxidase activity and expression of its subunits. Acupuncture significantly altered the mitogen-activated protein kinases signaling pathway as assessed by pathway enrichment analysis in a gene chip assay. The phosphorylation of p38 mitogen-activated protein kinases and extracellular signal-regulated protein kinase 1/2, but not Jun N-terminal kinase, was downregulated by acupuncture. Microinjection bilaterally of the superoxide dismutase mimetic tempol, nicotinamide adenine dinucleotide phosphate oxidase inhibitor apocynin, or diphenyleneiodonium chloride into the RVLM mimicked the antihypertensive effect of acupuncture. In contrast, the nicotinamide adenine dinucleotide phosphate oxidase agonist tetrabromocinnamic acid abolished the beneficial effects of acupuncture. Furthermore, injection of capsaicin or surgical sectioning of the sciatic nerve abolished the antihypertensive effect of acupuncture. We conclude that acupuncture decreases high blood pressure and nicotinamide adenine dinucleotide phosphate oxidase in the RVLM of spontaneously hypertensive rats. The mitogen-activated protein kinases and the sciatic nerve are involved in the mechanism of acupuncture's amelioration of hypertension.
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Affiliation(s)
- Xue-Rui Wang
- From the Department of Acupuncture and Moxibustion (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.) and Beijing Institute of Tradition Chinese Medicine (X.-R.W.), Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University; Beijing Key Laboratory of Acupuncture Neuromodulation, China (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.); and the Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA (M.F.)
| | - Jing-Wen Yang
- From the Department of Acupuncture and Moxibustion (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.) and Beijing Institute of Tradition Chinese Medicine (X.-R.W.), Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University; Beijing Key Laboratory of Acupuncture Neuromodulation, China (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.); and the Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA (M.F.)
| | - Cai-Shuo Ji
- From the Department of Acupuncture and Moxibustion (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.) and Beijing Institute of Tradition Chinese Medicine (X.-R.W.), Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University; Beijing Key Laboratory of Acupuncture Neuromodulation, China (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.); and the Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA (M.F.)
| | - Xiang-Hong Zeng
- From the Department of Acupuncture and Moxibustion (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.) and Beijing Institute of Tradition Chinese Medicine (X.-R.W.), Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University; Beijing Key Laboratory of Acupuncture Neuromodulation, China (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.); and the Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA (M.F.)
| | - Guang-Xia Shi
- From the Department of Acupuncture and Moxibustion (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.) and Beijing Institute of Tradition Chinese Medicine (X.-R.W.), Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University; Beijing Key Laboratory of Acupuncture Neuromodulation, China (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.); and the Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA (M.F.)
| | - Marc Fisher
- From the Department of Acupuncture and Moxibustion (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.) and Beijing Institute of Tradition Chinese Medicine (X.-R.W.), Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University; Beijing Key Laboratory of Acupuncture Neuromodulation, China (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.); and the Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA (M.F.)
| | - Cun-Zhi Liu
- From the Department of Acupuncture and Moxibustion (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.) and Beijing Institute of Tradition Chinese Medicine (X.-R.W.), Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University; Beijing Key Laboratory of Acupuncture Neuromodulation, China (X.-R.W., J.-W.Y., C.-S.J., X.-H.Z., G.-X.S., C.-Z.L.); and the Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA (M.F.).
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Terenteva N, Chernykh O, Sanchez-Gonzalez MA, Wong A. Acupuncture therapy improves vascular hemodynamics and stiffness in middle-age hypertensive individuals. Complement Ther Clin Pract 2017; 30:14-18. [PMID: 29389472 DOI: 10.1016/j.ctcp.2017.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 11/07/2017] [Indexed: 12/20/2022]
Abstract
Acupuncture (ACU) is becoming a more common practice among hypertensive individuals. However, the reported therapeutic effects of ACU in lowering brachial blood pressure (BP) are ambiguous. Therefore, evaluating more sensitive markers of arterial functioning might unveil the protective effects of ACU on hypertension. We examined the effects of an 8-week ACU therapy intervention on vascular hemodynamics and stiffness in middle-age hypertensive individuals. Participants were randomly assigned to either ACU (n = 23) or a control group (n = 22). Brachial and aortic BP, wave reflection (AIx) and arterial stiffness (SI) were measured before and after 8 weeks. There was a significant group x time interaction (P < 0.05) for brachial and aortic BP, AIx and SI which significantly decreased (P < 0.05) following ACU but not after control. ACU led to reductions in brachial and aortic BP, wave reflection and arterial stiffness in middle-age hypertensive individuals. ACU might be effective in the prevention and treatment of hypertension.
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Affiliation(s)
- Nina Terenteva
- Department of Industrial Ecology and Life Safety, Nosov Magnitogorsk State Technical University, Magnitogorsk, Chelyabinsk Region, Russia
| | - Oksana Chernykh
- Department of Economics and Management, Moscow Financial and Law University, Moscow, Russia
| | | | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, USA.
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Du YZ, Gao XX, Wang CT, Zheng HZ, Lei Y, Wu MH, Shi XM, Ban HP, Gu WL, Meng XG, Wei MT, Hu CX. Acupuncture lowering blood pressure for secondary prevention of stroke: a study protocol for a multicenter randomized controlled trial. Trials 2017; 18:428. [PMID: 28915826 PMCID: PMC5603044 DOI: 10.1186/s13063-017-2171-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 07/03/2017] [Indexed: 01/19/2023] Open
Abstract
Background Stroke is the prime cause of morbidity and mortality in the general population, and hypertension will increase the recurrence and mortality of stroke. We report a protocol of a pragmatic randomized controlled trial (RCT) using blood pressure (BP)-lowering acupuncture add-on treatment to treat patients with hypertension and stroke. Methods This is a large-scale, multicenter, subject-, assessor- and analyst-blinded, pragmatic RCT. A total of 480 patients with hypertension and ischemic stroke will be randomly assigned to two groups: an experimental group and a control group. The experimental group will receive “HuoXueSanFeng” acupuncture combined with one antihypertensive medication in addition to routine ischemic stroke treatment. The control group will only receive one antihypertensive medication and basic treatments for ischemic stroke. HuoXueSanFeng acupuncture will be given for six sessions weekly for the first 6 weeks and three times weekly for the next 6 weeks. A 9-month follow-up will, thereafter, be conducted. Antihypertensive medication will be adjusted based on BP levels. The primary outcome will be the recurrence of stroke. The secondary outcomes including 24-h ambulatory BP, the TCM syndrome score, the Short Form 36-item Health Survey (SF-36), the National Institute of Health Stroke Scale (NIHSS), as well as the Barthel Index (BI) scale will be assessed at baseline, 6 weeks and 12 weeks post initiating treatments; cardiac ultrasound, carotid artery ultrasound, transcranial Doppler, and lower extremity ultrasound will be evaluated at baseline and 12 weeks after treatment. The safety of acupuncture will also be assessed. Discussion We aim to determine the clinical effects of controlling BP for secondary prevention of stroke with acupuncture add-on treatment. Trial registration ClinicalTrials.gov, ID: NCT02967484. Registered on 13 February 2017; last updated on 27 June 2017. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2171-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yu-Zheng Du
- Acupuncture and Moxibustion Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88, Changling Road, Xiqing District, Tianjin, 300000, China.
| | - Xin-Xin Gao
- Emergency Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Cheng-Ting Wang
- Acupuncture and Moxibustion Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88, Changling Road, Xiqing District, Tianjin, 300000, China.,Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hai-Zhen Zheng
- Acupuncture and Moxibustion Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88, Changling Road, Xiqing District, Tianjin, 300000, China.,Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yun Lei
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Meng-Han Wu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xue-Min Shi
- Acupuncture and Moxibustion Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88, Changling Road, Xiqing District, Tianjin, 300000, China
| | - Hai-Peng Ban
- Acupuncture and Moxibustion Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88, Changling Road, Xiqing District, Tianjin, 300000, China
| | - Wen-Long Gu
- Acupuncture and Moxibustion Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88, Changling Road, Xiqing District, Tianjin, 300000, China
| | - Xiang-Gang Meng
- Acupuncture and Moxibustion Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88, Changling Road, Xiqing District, Tianjin, 300000, China
| | - Mao-Ti Wei
- Department of Epidemiology, Logistics College of Chinese People's Armed Police Forces, Tianjin, China
| | - Chun-Xiao Hu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Kimura K, Ishida K, Takahashi N, Toge Y, Tajima F. Effects of acupuncture at the ST-36 point on muscle sympathetic nerve activity and blood pressure in normal adults. Auton Neurosci 2017; 208:131-136. [PMID: 28887003 DOI: 10.1016/j.autneu.2017.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/25/2017] [Accepted: 08/29/2017] [Indexed: 12/16/2022]
Abstract
The aim of the present study was to determine the effects of acupuncture on post-ganglionic muscle sympathetic nerve activity (MSNA) in humans. MSNA was measured in 8 healthy adult males by microneurography evaluation of the left peroneal nerve. Blood pressure (BP) and heart rate (HR) were simultaneously recorded. MSNA was evaluated as the burst rate, with total MSNA, BP and HR normalized to their respective baseline values. After 10min of rest in the supine position, acupuncture was applied to the right ST-36 point in the tibialis anterior muscle for 15min, with recovery then monitored over a 20-min period. While the burst rate and total MSNA remained constant throughout the study, there was a significant decrease in BP during the real but not sham acupuncture procedure (p<0.05). HR did not significantly change throughout the study. The results rule out the role of MSNA in the BP fall during acupuncture at the ST-36 point, and suggest possible involvement of other factors in the fall of BP.
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Affiliation(s)
- Kenichi Kimura
- Department of Health Sciences, Kansai University of Health Sciences, Osaka 590-0482, Japan.
| | - Kazuya Ishida
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Noriyo Takahashi
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Yasushi Toge
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
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Lee H, Kim H, Kim J, Oh HS, Park YJ, Park YB. Feasibility study of transfer function model on electrocardiogram change caused by acupuncture. Altern Ther Health Med 2017; 17:101. [PMID: 28178964 PMCID: PMC5299648 DOI: 10.1186/s12906-017-1615-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 01/31/2017] [Indexed: 11/25/2022]
Abstract
Background Acupuncture treatments that regulate the heart are used to treat various clinical disorders and conditions. Although many studies have been conducted to measure quantitatively the effects of acupuncture, thus far, models that describe these effects have not been established. The purpose of this study was to derive a transfer function model of acupuncture stimulation within the electrocardiograms based on the periods before, during, and after acupuncture. Methods Fourteen healthy subjects were included in this clinical trial. Five-minute electrocardiograms were captured before, during, and after acupuncture at HT7. For each period, signal-averaged electrocardiograms were created from all of the subjects’ 5-min electrocardiograms for that period. Individual transfer functions, which has the highest average goodness of fit, were derived for each period pair. By averaging individual transfer functions, generalized transfer functions were derived. Results The transfer function with the highest average goodness of fit was a fraction with 4th order numerator and 5th order denominator. Fourteen individual transfer functions were derived separately for each pair of periods: before and during acupuncture, during and after acupuncture, and before and after acupuncture. Three generalized transfer functions were derived by averaging individual transfer functions for each period pair. Conclusion The three generalized transfer functions that were derived may reflect the electrocardiogram changes caused by acupuncture. However, this clinical trial included only 14 subjects. Further studies with control groups and more subjects are needed. This clinical trial has been registered on the Clinical Research Information Service, Republic of Korea (No. KCT0001944). The first enrolment of subject started at 2 June 2015 and this trial was retrospectively registered at 14 June 2016
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Abdominal and auricular acupuncture reduces blood pressure in hypertensive patients. Complement Ther Med 2017; 31:20-26. [PMID: 28434467 DOI: 10.1016/j.ctim.2017.01.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 12/27/2016] [Accepted: 01/16/2017] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Hypertension is an important risk factor of cardiovascular disease (CVD), which is associated with premature death, myocardial infarction, stroke, peripheral vascular disease, and renal disease. The goal of the present study was to use a randomized controlled clinical trial to explore and compare the effectiveness of abdominal and auricular acupuncture on blood pressure in 440 subjects with and without obesity. METHODS Four hundred participants were recruited and randomized to one of four groups: cases and controls receiving auricular acupuncture (204 subjects) and cases and controls receiving abdominal electroacupuncture (196 subjects). Blood pressure and anthropometric parameters were measured before and after the intervention period. In order to match the initial diet of the groups, participants were required to follow an isocaloric diet for two weeks before the trial, and a low-calorie diet for 6 weeks during the intervention period. RESULTS We observed a significant time dependent improvement in the systolic blood pressure measurements in the abdominal intervention group, although this improvement was more pronounce in the first period of study. Of note, in the auricular intervention group, a significant increasing in the level of SBP was detected. Importantly no statistically significant changes were found in the corresponding sham groups. CONCLUSIONS Our findings demonstrated that abdominal electro-acupuncture for 6 weeks reduced both systolic and diastolic blood pressure and auricular acupuncture had a short-term adverse effect on both SBP and DBP.
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Wang HQ, Bao CL, Jiao ZH, Dong GR. Efficacy and safety of penetration acupuncture on head for acute intracerebral hemorrhage: A randomized controlled study. Medicine (Baltimore) 2016; 95:e5562. [PMID: 27902622 PMCID: PMC5134766 DOI: 10.1097/md.0000000000005562] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Acupuncture, especially acupuncture treatment on head for acute intracerebral hemorrhage (ICH), has long been disputable. The aim of this study was to evaluate the efficacy and safety of penetration acupuncture on head in patients with acute ICH. METHODS Eighty-two patients with acute ICH were randomized to receive penetration acupuncture treatment on head combined with conventional treatment (treatment group [TG]) or conventional treatment only (control group [CG]). Acupuncture treatments were given in 24 sessions over 4 weeks, with 3-month follow-up period. Measures included Clinical Neurological Function Deficit Scale (CNFDS), Barthel Index (BI), vital signs (respiration, heart rate, blood pressure, and oxygen saturation), and hematoma absorption ratio. RESULTS Both groups showed a progressively improvement in CNFDS and BI scores from day 7 to 90. The TG showed a significantly greater improvement in CNFDS than CG over time (P < 0.05). However, BI failed to show significant difference between the 2 groups (P > 0.05). The vital signs were stable and no expansion of hematoma occurred over the course of acupuncture treatment. CONCLUSION Penetration acupuncture treatment on head appeared to be safe over the course of treatment on acute ICH and may result in additional functional improvements detected in the CNFDS but not reflected in the BI. A larger-scale clinical trial with longer follow-up assessments is required to confirm these findings.
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Affiliation(s)
- Hai-Qiao Wang
- Department of Traditional Chinese Medicine, South Campus, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University
| | - Chun-Ling Bao
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhi-Hua Jiao
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Gui-Rong Dong
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Acupuncture to treat hypertension: a recent systematic review and implications for subsequent research. Integr Med Res 2015; 5:69-71. [PMID: 28462100 PMCID: PMC5381419 DOI: 10.1016/j.imr.2015.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 12/01/2015] [Accepted: 12/03/2015] [Indexed: 11/29/2022] Open
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Chang Lee SN, Ho TJ, Shibu MA, Day CH, Viswanadha VP, Lai CH, Chen YL, Hsieh DJY, Chen YS, Huang CY. Protective effects of electroacupuncture at LR3 on cardiac hypertrophy and apoptosis in hypertensive rats. Acupunct Med 2015; 34:201-8. [PMID: 26566622 DOI: 10.1136/acupmed-2015-010782] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2015] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To investigate the effect of electroacupuncture (EA) at LR3 on blood pressure (BP) and cardiovascular remodelling and hypertrophy in male spontaneously hypertensive rats (SHRs). METHODS Healthy Wistar-Kyoto rats were used as normotensive controls (control group, n=9). SHRs either remained untreated (SHR group, n=9) or received EA treatment at LR3 (SHR+LR3 group, n=9) or a nearby non-acupuncture point (SHR+sham group, n=9) for 3 weeks. BP was measured on day 3 and day 19. Samples of left ventricle were stained with haematoxylin and eosin or subjected to terminal deoxynucleotidyl transferase dUTP (deoxyuridine triphosphate) nick end labelling (TUNEL) to assess histology and apoptosis, respectively (n=3 per group). Western blotting was used to determine the relative expression of antioxidants and molecular markers of detoxification capacity, cardiac hypertrophy, and apoptosis (n=5 per group). RESULTS By day 3, the systolic BP, mean BP, and diastolic BP in the untreated SHRs increased from 169.5±14, 131.6±14, and 112.2±15 mm Hg (at baseline) to 179.6±1, 137.6±4, and 118.7±5 mm Hg, respectively (p<0.001 vs control group). BP in the SHR+LR3 rats was approximately 15 mm Hg lower than the SHR and SHR+sham groups (p<0.05). SHRs also exhibited cardiac hypertrophy (evident from histological and Western blot analyses). However, SHR+LR3 rats showed significant reductions in markers of cardiac hypertrophy and apoptosis, as well as elevated expression of antioxidant enzymes including superoxide dismutase-1 (SOD1). CONCLUSIONS EA at LR3 reduced BP and had positive effects on markers of cardiac apoptosis and hypertrophy in a rat model of hypertension. Thus, EA is a potentially promising intervention to treat cardiovascular remodelling secondary to hypertension.
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Affiliation(s)
- Shu-Nu Chang Lee
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Tsung-Jung Ho
- Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan Chinese Medicine Department, China Medical University Beigang Hospital, Taichung, Taiwan
| | | | | | | | - Chao-Hung Lai
- Division of Cardiology, Department of Internal Medicine, Armed Force Taichung General Hospital, Taichung, Taiwan
| | - Yi-Li Chen
- Graduate Institute of Acupuncture Science, China Medical University, Taichung Taiwan
| | - Dennis Jine-Yuan Hsieh
- Department of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung, Taiwan
| | - Yueh-Sheng Chen
- Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chih-Yang Huang
- Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan
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