The lower He-sea points playing a significant role in postoperative ileus in colorectal cancer treated with acupuncture: based on machine-learning

Progress of traditional Chinese medicine in the prevention and treatment of colorectal cancer

Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide, ranking among the highest in both incidence and mortality rates. Traditional Chinese medicine, with a history spanning thousands of years, has demonstrated unique efficacy and advantages in the prevention and treatment of CRC, playing a pivotal role at all levels of China’s healthcare system. This article provides a comprehensive analysis and summary of traditional Chinese medicine’s contributions to CRC prevention, antitumor therapy, palliative care for advanced tumors, perioperative rehabilitation, and postoperative functional recovery.

Study protocol for a prospective, investigator-initiated clinical trial on the vascular effects of acupuncture in the abdomen and lower limbs for patients with diarrhea-predominant irritable bowel syndrome

BACKGROUND

Physicians classify irritable bowel syndrome with diarrhea symptoms under the label IBS-D which represents a gastrointestinal disorder that meets specific functional diagnostic criteria. Studies show acupuncture helps manage IBS-D symptoms though researchers do not understand if specific treatment points in the abdomen provide better outcomes than standard acupuncture points in the lower body regions. The study investigates the effects acupuncture treatments using local and systemic needling techniques have on IBS-D symptom expression and gut microbial diversity features.

METHODS

The study employs a randomized controlled single-blinded exploratory clinical trial design which includes 36 participants diagnosed with IBS-D via Rome IV criteria. Participants are randomly allocated to one of three groups: abdominal acupuncture, lower limb acupuncture, or standard treatment. Participants who receive acupuncture treatment receive eight sessions which are distributed throughout 4 weeks as clinicians activate specific points connected to gastrointestinal function. Lifestyle education and approved medications with symptom management make up the standard treatment provided to participants. The main outcome measures assess IBS Symptom Severity Scale (IBS-SSS) score changes from baseline at Week 5. Additional evaluation measures in this study comprise stool consistency examination alongside patient global assessments and cold-heat surveys along with EQ-5D-5L quality of life assessment and gut microbiota examination as secondary outcomes.

RESULTS

Research has been designed to evaluate how abdominal and lower limb acupuncture techniques compare in symptom relief and microbiota adaptation outcomes. The preliminary data is expected to reveal distinct patterns between local and wide-reaching effects which suggests that IBS-D treatment should be tailored on a personal basis.

CONCLUSION

The comparison of abdominal and lower limb acupuncture treatment efficacy adds to our understanding of acupuncture therapy benefit for IBS-D. The results will help guide clinical practice and support the creation of tailored acupuncture treatments.

Effectiveness of Acupuncture in Improving Quality of Life for Patients with Advanced Cancer: A Systematic Review and Meta-Analysis

OBJECTIVE

To investigate the effect of acupuncture on advanced cancer patients by meta-analysis.

METHODS

Nine databases (the Cochrane Central Register of Controlled Trials, MEDLINE, Web of Science, Embase, China National Knowledge Infrastructure, the Cumulative Index to Nursing and Allied Health Literature, Chinese Biomedical Literature Database, China Science and Technology Journal Database, and WanFang Data) were searched for randomized controlled trials (RCTs) on acupuncture in advanced cancer patients published from inception to February 13, 2023 and updated to June 1, 2023. Primary outcomes were quality of life (QOL), while secondary outcomes were pain, fatigue, and adverse events (side effects). Data synthesis was performed using RevMan V.5.3 to calculate pooled effect sizes. RoB-2 was used for the risk of bias, and the quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool.

RESULTS

Totally 17 RCTs involving 1,178 participants were included, 15 of which were pooled for meta-analysis. Most studies demonstrated some concern for the overall risk of bias. The pooled data indicated that acupuncture was associated with improved QOL [mean difference (MD)=6.67, 95% confidence interval (CI): 5.09 to 8.26], pain (MD=-1.18, 95% CI -2.28 to -0.08), and adverse events (risk ratio=0.30, 95% CI: 0.26 to 0.57) compared with control groups. Fatigue outcome was not included. Heterogeneity was substantial, and GRADE evidence was very low for both QOL and pain.

CONCLUSIONS

Acupuncture could benefit patients with advanced cancer and is considered safe compared with usual care. However, the evidence regarding QOL and pain outcomes requires further validation. It is crucial to encourage the development of high-quality studies to strengthen this evidence. (Registry No. CRD42023423539).

Acupuncture for postoperative ileus: Advancement and underlying mechanisms

Postoperative ileus (POI) remains a prevalent and significant challenge following abdominal surgeries, precipitating patient distress, prolonged hospital stays, and escalated medical expenditures. Conventionally addressed via pharmacological interventions, POI is increasingly being explored through adjunctive therapeutic strategies, with acupuncture gaining recognition as a promising option. Acupuncture has demonstrated encouraging potential in promoting gastrointestinal motility in patients with POI. Moreover, recent research has shed light on the therapeutic mechanisms underlying its efficacy. This article aims to present a comprehensive overview of acupuncture as a treatment for POI, highlighting advancements in clinical research and recent elucidations of its mechanistic underpinnings. It aspires to contribute a pivotal reference point for scholars and enthusiasts keen on garnering a deeper understanding of acupuncture’s role in managing POI.

Electroacupuncture promotes gastrointestinal functional recovery after radical colorectal cancer surgery: a protocol of multicenter randomized controlled trial (CORRECT trial)

INTRODUCTION

The incidence of postoperative gastrointestinal dysfunction (POGD) is notably high among patients following colorectal cancer surgery, highlighting the urgency for the prompt development of efficacious preventive and therapeutic approaches. Electroacupuncture (EA) represents an intervention modality that holds promise for the management of POGD. However, the existing empirical evidence substantiating its efficacy remains scarce. The aim of this study is to evaluate the efficacy and safety of EA as a treatment for POGD in patients undergoing colorectal cancer surgery.

METHODS

This study is a multicenter, parallel-group, randomized controlled trial, named as CORRECT. CORRECT trial will recruit 300 participants diagnosed with colorectal cancer and about to undergo radical surgery across four sub-centers. The participants will be randomly assigned to one of three groups: the EA group, sham-electroacupuncture group, or control group, with a randomization ratio of 2:2:1. All groups will follow a standardized Enhanced Recovery After Surgery (ERAS) protocol. The EA group will receive EA at acupoints LI4, SJ6, ST36, and ST37, while the SA group will undergo sham-electroacupuncture. The treatments will be administered twice daily from the day of surgery until the fourth day after the operation. The primary endpoint is the time to first flatus, while secondary endpoints encompass time to first defecation, bowel sound emergence, initial water intake, duration of postoperative hospitalization, nausea and vomiting, pain levels, and blinded evaluations. Additional outcomes include medication usage and complication rates, et al. DISCUSSION: The CORRECT trial aims to provide high-quality evidence for the role of EA in the treatment of POGD following colorectal cancer surgery. It will contribute data towards the integration of acupuncture into ERAS protocols. Insights from the trial could help in tailoring treatment plans based on individual patient responses to EA, optimizing care on a case-by-case basis.

TRIAL REGISTRATION

Clinical Trial Registry registration was approved by the ClinicalTrials.gov committee on November 2023 with the ClinicalTrials.gov Identifier: NCT06128785. URL: https://clinicaltrials.gov/study/NCT06128785?tab=history&a=1#study-details-card .

The effectiveness of acupuncture in cancer pain treatment

Introduction

In recent years, pain has been recognized as a primary factor significantly diminishing the quality of life in cancer patients. Recent data have prompted the establishment and increased application of non-pharmacological interventions in pain management, such as acupuncture.

Objectives

This review assesses literature from 2018 to 2023 on the impact of acupuncture on pain management and quality of life in cancer patients, with a particular focus on reducing pain intensity. The effectiveness of acupuncture therapy was compared with the traditional treatment of pain symptoms, with a focus on the patients' quality of life.

Conclusions

Although no conclusive scientific evidence confirms the effectiveness of acupuncture in treating cancer pain symptoms, numerous studies have demonstrated its ability to reduce pain, better control pain, decrease analgesic intake, and significantly improve patients' quality of life. Further research is needed to unequivocally confirm the clinical benefits of acupuncture.

Acupuncture's Emergence as A Promising Non-Pharmacological Therapy for Appetite Management in Cancer Chemotherapy

OBJECTIVE

The primary objective of this investigation was to assess the impact of acupuncture intervention and explore the intricacies of acupoint selection as a therapeutic strategy for chemotherapy-induced Anorexia (CIA).

METHOD

Eight electronic databases were searched to identify relevant studies on the use of acupuncture for the treatment of CIA to conduct a comprehensive meta-analysis. Following this, the Apriori algorithm, correlation analysis, and cluster analysis were performed to identify correlations between the selection of acupoints.

RESULTS

Acupuncture significantly reduced the incidence of anorexia (RR = 0.76, 95%CI: 0.65, 0.90; I2=63%; p = 0.001; n = 503) and anorexia score (SMD=-0.33, 95%CI: -0.53, -0.14; I2=22%; p = 0.0008; n = 419), as well as preserved body mass (MD = 2.70, 95%CI: 1.08, 4.32; I2=0%; p = 0.001; n = 187) and enhanced physical strength (MD = 4.23, 95%CI: 1.90, 6.55; I2=58%; p = 0.0004; n = 377). Moreover, subgroup analysis highlighted its efficacy in managing anorexia associated with non-gastrointestinal tumors and mitigating the severity of cisplatin-induced anorexia. Meanwhile, Zusanli (ST36), Neiguan (PC6), Tianshu (ST25), Zhongwan (RN12), and Qihai (RN6) were identified as crucial acupoints in CIA management.

CONCLUSION

Acupuncture holds promise as a potential non-pharmacological approach for managing anorexia during cancer chemotherapy. To provide robust evidence of its effectiveness, well-designed Randomized Controlled Trials (RCTs) with larger participant cohorts, and consistent core outcome measures are essential.

Acupuncture indication knowledge bases: meridian entity recognition and classification based on ACUBERT

In acupuncture diagnosis and treatment, non-quantitative clinical descriptions have limited the development of standardized treatment methods. This study explores the effectiveness and the reasons for discrepancies in the entity recognition and classification of meridians in acupuncture indication using the Acupuncture Bidirectional Encoder Representations from Transformers (ACUBERT) model. During the research process, we selected 54 593 different entities from 82 acupuncture medical books as the pretraining corpus for medical literature, conducting classification research on Chinese medical literature using the BERT model. Additionally, we employed the support vector machine and Random Forest models as comparative benchmarks and optimized them through parameter tuning, ultimately leading to the development of the ACUBERT model. The results show that the ACUBERT model outperforms other baseline models in classification effectiveness, achieving the best performance at Epoch = 5. The model's "precision," "recall," and F1 scores reached above 0.8. Moreover, our study has a unique feature: it trains the meridian differentiation model based on the eight principles of differentiation and zang-fu differentiation as foundational labels. It establishes an acupuncture-indication knowledge base (ACU-IKD) and ACUBERT model with traditional Chinese medicine characteristics. In summary, the ACUBERT model significantly enhances the classification effectiveness of meridian attribution in the acupuncture indication database and also demonstrates the classification advantages of deep learning methods based on BERT in multi-category, large-scale training sets. Database URL: http://acuai.njucm.edu.cn:8081/#/user/login?tenantUrl=default.