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Kassim MAK, Pantazi AC, Nori W, Tuta LA, Balasa AL, Mihai CM, Mihai L, Frecus CE, Lupu VV, Lupu A, Andrusca A, Iorga AM, Litrin RM, Ion I, Ciciu E, Chirila SI, Chisnoiu T. Non-Pharmacological Interventions for Pain Management in Hemodialysis: A Narrative Review. J Clin Med 2023; 12:5390. [PMID: 37629432 PMCID: PMC10455227 DOI: 10.3390/jcm12165390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
This narrative review aims to summarize non-pharmacological interventions for pain management in hemodialysis patients, assessing their potential benefits and limitations in enhancing patient well-being and quality of life. We reviewed the current literature on five primary non-pharmacological interventions: acupuncture, cognitive behavioral therapy, relaxation techniques, virtual reality, and alternative methods such as transcutaneous electrical nerve stimulation, music therapy, and aromatherapy. We analyzed the evidence regarding their effectiveness, feasibility, and optimal implementation strategies. The existing evidence supports the potential benefits of these interventions in managing pain and improving the well-being of hemodialysis patients. However, further high-quality research is needed to confirm their effectiveness, establish implementation best practices, and assess their long-term impact on patient outcomes. Non-pharmacological interventions hold promise for pain management in hemodialysis patients. Additional research is required to optimize these interventions and validate their effectiveness, contributing to comprehensive pain management strategies for this vulnerable patient population.
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Affiliation(s)
| | | | - Wassan Nori
- College of Medicine, Mustansiriyah University, Baghdad 10052, Iraq
| | - Liliana Ana Tuta
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Adriana Luminita Balasa
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | | | - Larisia Mihai
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Corina Elena Frecus
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Vasile Valeriu Lupu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ancuta Lupu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Antonio Andrusca
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Andra Maria Iorga
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Radu Mihai Litrin
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Irina Ion
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Elena Ciciu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | | | - Tatiana Chisnoiu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
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Maharjan A, Peng M, Cakmak YO. The effects of frequency-specific, non-invasive, median nerve stimulation on food-related attention and appetite. Appetite 2021; 169:105807. [PMID: 34798222 DOI: 10.1016/j.appet.2021.105807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 12/17/2022]
Abstract
Median nerve stimulation (MNS) in the existing literature has been used for treating gastrointestinal disorders and amelioration of nausea and vomiting. Recently, studies have shown that MNS can also exert effects on olfactory performances and corresponding anatomical regions through the activation of vagal pathways. This study aimed to test effects of specific frequencies of MNS on food-related attention and appetite. The experiment used an odourised, dot probe task for testing food-related attention and a combination of behavioural (i.e., visual analogue scales; VAS) and physiological approaches (i.e., electrocardiograph; ECG - root mean square of successive differences between normal heartbeats-RMSSD: parasympathetic nervous system activation (RMSSD), stress index-SI: sympathetic nervous system activation) for measuring hunger, appetite, and satiation. Twenty-four healthy, male adults completed a VAS and dot probe task before and after receiving either 40 Hz-, 80 Hz-, 120 Hz MNS or sham (control) across four different sessions with continuous ECG recording throughout each session. Data from the dot probe task were analysed using repeated-measures ANOVA, while pair-wise tests were used for ECG recordings and VAS. Improvements on the dot probe task, not specific to odour-food congruence were found after 40 Hz MNS (p-value = 0.048; strong effect size (0.308 partial eta squared)) while increased ratings of hunger (VAS) (p-value = 0.03, small effect size (0.47 Cohen-D)) and RMSSD scores (p-value < 0.001; medium effect size (0.76 Cohen-D)) were found after 120 Hz MNS. These findings implore further testing of MNS frequency parameters on improving RMSSD, a characteristic marker of measuring parasympathetic/autonomic nervous system activation pertaining to the vagal network. Furthermore, improving sympathovagal balance is associated with cardiovascular benefits in numerous health-related conditions such as obesity, hypertension and diabetes.
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Affiliation(s)
- Ashim Maharjan
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Mei Peng
- Sensory Neuroscience Laboratory, Department of Food Science, University of Otago, Dunedin, New Zealand
| | - Yusuf O Cakmak
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand; Brain Health Research Centre, Dunedin, New Zealand; Medical Technologies Centre of Research Excellence, Auckland, New Zealand.
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Moreira BR, Duque AP, Massolar CS, de Lima Pimentel R, Mediano MFF, Guimarães TCF, Rodrigues LF. Transcutaneous Electrical Stimulation of PC5 and PC6 Acupoints Modulates Autonomic Balance in Heart Transplant Patients: A Pilot Study. J Acupunct Meridian Stud 2019; 12:84-89. [PMID: 31026520 DOI: 10.1016/j.jams.2019.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 04/16/2019] [Indexed: 02/03/2023] Open
Abstract
The increased resting heart rate (HR) in heart transplant patients is associated with enhanced metabolic demand, the potential for fatigue, and lower quality of life. In the present study, we hypothesized that transcutaneous electrical acupoint stimulation (TEAS) could modulate autonomic balance and reduce resting HR in these patients. A single-arm clinical trial was conducted with patients aged > 18 years, at ambulatorial accompaniment after heart transplantation, who were submitted to a single TEAS (40 minutes at pericardium channel acupoints PC5 and PC6). The arterial blood pressure and RR interval were recorded from 20 minutes before to 20 minutes after TEAS. The RR intervals were used to calculate HR variability (HRV) and the sympathovagal index. Linear mixed models were used for comparing variables before, during, and after TEAS. The significance level was set as P < 0.05. TEAS acutely improved HRV in transplant patients and enhanced the sympathovagal index during its application. Significant increases in systolic and diastolic blood pressure and mean arterial pressure were observed at recovery, such as a slight, but significant, decrease in HR. In conclusion, TEAS at PC5 and PC6 acutely modulates HRV and hemodynamics in transplant patients.
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Affiliation(s)
- Beatriz R Moreira
- Physiotherapy Service, National Institute of Cardiology, 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
| | - Carole S Massolar
- Laboratory of Cardiovascular Biophysics, Department of Physiological Sciences, Biomedical Institute, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - 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
| | - Mauro F F Mediano
- Education and Research Department, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil; Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Tereza C F Guimarães
- Education and Research Department, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil
| | - Luiz F Rodrigues
- Physiotherapy Service, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil; Laboratory of Cardiovascular Biophysics, Department of Physiological Sciences, Biomedical Institute, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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Ribeiro MR, de Carvalho CB, Pereira RH, Nicácio GM, Brinholi RB, Cassu RN. Yamamoto New Scalp Acupuncture for postoperative pain management in cats undergoing ovariohysterectomy. Vet Anaesth Analg 2017; 44:1236-1244. [DOI: 10.1016/j.vaa.2017.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/26/2017] [Accepted: 03/01/2017] [Indexed: 01/26/2023]
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Wang G, Tian Y, Jia S, Wang Z, Zhang W. Laterality and coherence analysis of Laser Doppler Flowmetry signals in bilateral Nèi guān (内关 PC 6): a potential non-invasive method to assess microdrculatory changes of people in different ages. World Journal of Acupuncture - Moxibustion 2017; 27:47-52. [DOI: 10.1016/s1003-5257(17)30099-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Glickman-Simon R. Electroacupuncture Prior to Percutaneous Coronary Intervention May Reduce Risk of Peri-Procedure Myocardial Infarction. Explore (NY) 2016. [DOI: 10.1016/j.explore.2016.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yang Y, Yang X, Dong Y, Chen N, Xiao X, Liu H, Li Z, Chen Y. Transcutaneous electrical acupoint stimulation alleviates adverse cardiac remodeling induced by overload training in rats. J Appl Physiol (1985) 2016; 120:1269-76. [PMID: 27032900 DOI: 10.1152/japplphysiol.00077.2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 03/28/2016] [Indexed: 02/06/2023] Open
Abstract
Electroacupuncture has been shown previously to alleviate cardiac ischemia-reperfusion injury. Overload training (OT) exercise can result in profound cardiac damage and remodeling. In this study, we aimed to examine whether transcutaneous electrical acupoint stimulation (TEAS), a novel noninvasive and low-risk alternative to electroacupuncture, could counteract short-term OT-induced cardiac remodeling, fibrosis, autophagy, and apoptosis. Sixty rats were randomly divided into eight groups (n = 7 or 8/group): control, regular exercise, OT, OT plus low-, moderate- or high-frequency TEAS preconditioning, OT plus moderate-frequency TEAS postconditioning, or transcutaneous electrical nonacupoint stimulation (TENAS) preconditioning. The cardiac weight index (heart weight/body weight) was determined. Left ventricular morphology was examined by hematoxylin and eosin staining. Cardiac fibrosis and apoptosis were determined by Masson's trichrome and TUNEL staining, respectively. The presence of autophagosomes was observed by transmission electron microcopy. The expressions of autophagic markers (LC3 II/I and Beclin-1) were determined by Western blot. The results showed that 1) OT induced adverse cardiac structure changes but did not affect the cardiac weight index; 2) OT increased cardiac fibrosis and apoptosis and induced autophagosome formation with upregulated LC3 II/I and Beclin-1 expression; 3) TEAS preconditioning effectively alleviated OT-induced cardiac structure changes, fibrosis, apoptosis, and autophagy; 4) TEAS preconditioning produced better protective effects than TEAS postconditioning or TENAS preconditioning. Our results demonstrate that TEAS preconditioning protects the heart from OT-induced cardiac injury/remodeling, probably by inhibition of fibrosis, autophagy, and apoptosis.
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Affiliation(s)
- Yi Yang
- College of Health Science, Wuhan Sports University, Wuhan, China
| | - Xi Yang
- College of Health Science, Wuhan Sports University, Wuhan, China
| | - Yuchen Dong
- College of Health Science, Wuhan Sports University, Wuhan, China
| | - Ning Chen
- College of Health Science, Wuhan Sports University, Wuhan, China
| | - Xiang Xiao
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio
| | - Hua Liu
- College of Health Science, Wuhan Sports University, Wuhan, China
| | - Zhanghua Li
- Tongren Hospital of Wuhan University, Wuhan, China; and
| | - Yanfang Chen
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio
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Wang D, Zhang R, Zhou X, Ma S, Qin X, Wang J, Gao H, Wang Q, Li C, Chen Y, Xiong L, Cao F. Electroacupuncture pre-treatment ameliorates myocardial ischaemia/reperfusion injury through regulation of cannabinoid receptor type 2. Eur Heart J Suppl 2015. [DOI: 10.1093/eurheartj/suv050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Shengfeng L, Xin C, Ohara H, Nakamura Y, Izumi-Nakaseko H, Ando K, Wanxin L, Sugiyama A, Bingmei Z. Common parameters of acupuncture for the treatment of hypertension used in animal models. J TRADIT CHIN MED 2015; 35:343-8. [DOI: 10.1016/s0254-6272(15)30108-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Wang Q, Liang D, Wang F, Li W, Han Y, Zhang W, Xie Y, Xin W, Zhou B, Sun D, Cao F, Xiong L. Efficacy of electroacupuncture pretreatment for myocardial injury in patients undergoing percutaneous coronary intervention: A randomized clinical trial with a 2-year follow-up. Int J Cardiol 2015; 194:28-35. [PMID: 26011261 DOI: 10.1016/j.ijcard.2015.05.043] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 05/01/2015] [Accepted: 05/07/2015] [Indexed: 11/25/2022]
Abstract
Electroacupuncture pretreatment (EAP) safely protects the heart from ischemic injury, however, the efficacy of EAP for periprocedural myocardial injury after percutaneous coronary intervention (PCI) remains unclear. Our aim was to investigate whether EAP prior to PCI reduces post-PCI myocardial injury in patients with coronary artery disease (CAD). 388 patients (≥ 18 years old) with CAD, undergoing elective PCI were enrolled and randomized, out of those 204 went through the whole trial. EAP was conducted by 30-minute electrical stimulation through 4 electrodes attached to the Antiguan (PC6) and Ximen (PC4) acupoints in the forearm bilaterally 1-2h prior to PCI. The control group had sham electrodes but no electrical stimulation. The primary end point was the incidence of myocardial infarction type 4a (MI4a) based on serum cTnI values at 24h after PCI. The secondary end points included post-procedural cardiac function and the major adverse cardiac/cerebrovascular event (MACCE) rate. EAP prior to PCI significantly reduced the incidence of MI4a (serum cTnI≥0.20 ng/mL) 24h post-PCI compared to the control group (P=0.004). The echocardiography at 6 months after PCI revealed significant improvement in cardiac function in the EAP group compared with the control group. The MACCE rate was significantly decreased in the EAP group at 24 month follow-up compared to the control group (P=0.0157). Moreover, multivariate logistic regression analysis showed that EAP was associated with decreased likelihood of MACCE (odds ratio 0.327, 95% CI 0.140-0.767, P=0.010). EAP prior to PCI significantly reduced cTnI release and protected patients with CAD from subsequent myocardial injury after PCI procedure.
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Affiliation(s)
- Qiang Wang
- Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Dong Liang
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Feng Wang
- Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Weijie Li
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Yaling Han
- Department of Cardiology, Shenyang PLA General Hospital, Shenyang 110016, China
| | - Wei Zhang
- Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yaning Xie
- Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Weichuan Xin
- Department of Cardiology, Xi'an Central Hospital, Xi'an 710003, China
| | - Baili Zhou
- Department of Cardiology, People's Hospital of Qinghai Province, Xining 810007, China
| | - Dongdong Sun
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Feng Cao
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
| | - Lize Xiong
- Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.
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Gao J, Zhao Y, Wang Y, Xin J, Cui J, Ma S, Lu F, Qin L, Yu X. Anti-arrhythmic effect of acupuncture pretreatment in the rats subjected to simulative global ischemia and reperfusion--involvement of intracellular Ca2+ and connexin 43. BMC Complement Altern Med 2015; 15:5. [PMID: 25651793 PMCID: PMC4323136 DOI: 10.1186/s12906-015-0521-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 01/14/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND The previous study showed that the cardiac arrhythmias induced by myocardial ischemia and reperfusion were attenuated by the pretreatment of acupuncture; however, the related mechanism is not understood. The present study was therefore designed to determine whether intracellular Ca(2+) ([Ca(2+)]i) and connexin 43 (Cx43) are involved in the mediation of the anti-arrhythmic effect of electro-acupuncture (EA) pretreatment in the rats subjected to simulative global ischemia and reperfusion (SGIR). METHODS SGIR was made in the isolated heart by a low flow perfusion followed by a flow restoration. Four groups of animals are involved in the present study, including normal control group, SGIR group, EA group and EA plus 18 beta-glycyrrhetinic acid (EAG) group. For EA pretreatment, bilateral Neiguan acupoints (PC6) of the rats were stimulated for 30 min once a day in 3 consecutive days. Cx43 antagonist was given to the rats in EAG group 30 minutes before the EA pretreatment. The resting [Ca(2+)]i concentration, calcium oscillation, the contents of total Cx43 and non-phosphrylated Cx43 and arrhythmia score were compared among different groups. RESULTS In EA group, the arrhythmic score, the resting [Ca(2+)]i concentration and the number of [Ca(2+)]i oscillations were all significantly less than those in SGIR group (all P < 0.05), and interestingly, after EA pretreatment, the contents of nonphosphated Cx43 in the EA group were significantly lower than that in SGIR group respectively (P < 0.05). However, when the rats were treated with Cx43 antagonist prior to the EA pretreatment, the protection effects induced by EA pretreatment were reversed. CONCLUSIONS The results showed that EA pretreatment could produce anti-arrhythmic effect in the rats subjected to SGIR. The anti-arrhythmic effect of EA pretreatment may be due at least partially to the inhibition of SGIR-induced calcium overload and [Ca(2+)]i oscillations, reduction of non-phosphorylated Cx43 and the enhancement of the corresponding phosphorylated Cx43 in the cardiac cells.
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Affiliation(s)
- Junhong Gao
- Department of Physiology, Institute of Acupuncture, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongcheng District, Beijing, 100700, Dongzhimennei, China.
| | - Yuxue Zhao
- Department of Physiology, Institute of Acupuncture, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongcheng District, Beijing, 100700, Dongzhimennei, China.
| | - Yumin Wang
- Department of Oncology, The Affiliated Hospital of Chifeng University, Chifeng, 024005, Inner Mongolia, China.
| | - Juanjuan Xin
- Department of Physiology, Institute of Acupuncture, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongcheng District, Beijing, 100700, Dongzhimennei, China.
| | - Jingjing Cui
- Department of Physiology, Institute of Acupuncture, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongcheng District, Beijing, 100700, Dongzhimennei, China.
| | - Shuhua Ma
- Department of Physiology, The Experimental Research Center, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongcheng District, Beijing, 100700, Dongzhimennei, China.
| | - Fengyan Lu
- Department of Physiology, Institute of Acupuncture, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongcheng District, Beijing, 100700, Dongzhimennei, China.
| | - Lianping Qin
- Department of Physiology, Institute of Acupuncture, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongcheng District, Beijing, 100700, Dongzhimennei, China.
| | - Xiaochun Yu
- Department of Physiology, Institute of Acupuncture, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongcheng District, Beijing, 100700, Dongzhimennei, China.
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Guangjun W, Yuying T, Shuyong J, Wenting Z, Weibo Z. Bilateral hegu acupoints have the same effect on the heart rate variability of the healthy subjects. Evid Based Complement Alternat Med 2014; 2014:106940. [PMID: 25057272 DOI: 10.1155/2014/106940] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 06/12/2014] [Indexed: 11/21/2022]
Abstract
Background. The specificity of acupuncture points (acupoints) is one of the key concepts in traditional acupuncture theory, but the question of whether there is adequate scientific evidence to prove or disprove specificity has been vigorously debated in recent years. Acupoint laterality is an important aspect of acupoint specificity. Data is particularly scarce regarding the laterality of the same channel, namesake acupoint located on opposite sides of the body. Our previous study results suggest that Neiguan acupoint (PC6) has the laterality. The aim of this study was to investigate whether Hegu (LI4) also has laterality from the perspective of heart rate variability. Methods. A total of twenty-eight healthy female volunteers were recruited for this study and were randomly separated into the group I (n = 14) and the group II (n = 14) according to the register order. In the group I, left LI4 was stimulated in the first epoch and the right LI4 was stimulated in the second epoch. In the group II, right LI4 was stimulated in the first epoch and left LI4 was stimulated in the second epoch. Electrocardiogram was recorded and heart rate variability was analyzed. Results. The results show that there were no significant differences of heart rate variablity between the group I and the group II in the time domain and in the frequency domain. Conclusions. Bilateral Hegu acupoints have the same effect on the heart rate variability of the healthy subjects.
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Wang G, Tian Y, Jia S, Zhou W, Zhang W. Pilot study of acupuncture point laterality: evidence from heart rate variability. Evid Based Complement Alternat Med 2013; 2013:476064. [PMID: 24371461 DOI: 10.1155/2013/476064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/06/2013] [Accepted: 11/06/2013] [Indexed: 11/17/2022]
Abstract
The specificity of acupuncture points (acupoints) is one of the key concepts in traditional acupuncture theory, but the question of whether there is adequate scientific evidence to prove or disprove specificity has been vigorously debated in recent years. Laterality, or the tendency for acupoints on the right or left side of the body to produce different physiological effects, is an important aspect of acupoint specificity. Data is particularly scarce regarding the laterality of the same channel, same-named acupoint located on opposite sides of the body. The aim of this study was to investigate whether Neiguan (PC6) has laterality. A total of eighteen healthy female volunteers were recruited for this study. Electrocardiograms were recorded and heart rate variability was analyzed before, during, and after PC6 was stimulated on either the left or the right side. The results show that during acupuncture, there were significant differences in the standard deviation of RR intervals (STDRR), root mean square of successive differences between RR intervals (RMSSD), and total power between the left PC6 stimulation group and the right PC6 stimulation group, which indicates that PC6 may have laterality.
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Ni X, Xie Y, Wang Q, Zhong H, Chen M, Wang F, Xiong L. Cardioprotective effect of transcutaneous electric acupoint stimulation in the pediatric cardiac patients: a randomized controlled clinical trial. Paediatr Anaesth 2012; 22:805-11. [PMID: 22380768 DOI: 10.1111/j.1460-9592.2012.03822.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Acupuncture pretreatment exerts neuroprotective and cardioprotective effects in animal models and in adult patients underwent cardiac surgery; however, data in pediatric patient are unavailable. OBJECTIVE/AIM To investigate the effects of transcutaneous electric acupoint stimulation (TEAS) on acute myocardial injury from pediatric open-heart surgery. METHODS Children, aged 2-12 years, with congenital heart defects scheduled for surgical repair were enrolled. They were randomized to TEAS (administrated at bilateral P6 acupoint for 30 min after basal anesthesia) and control (an electrode was placed on the arm without stimulus) groups. The primary end point was serum cardiac troponin I (cTnI) over 24 h after aortic unclamping. Furthermore, clinical outcome and serum cytokine and C-reactive protein concentrations were evaluated. RESULTS Seventy eligible children were analyzed, 36 in controls and 34 in TEAS group. Compared with controls, the mean cTnI levels were significantly lower in TEAS group at 8 h (P = 0.043) and 24 h (P = 0.046) after aortic unclamping. The duration of ventilation (P = 0.004) and length of ICU stay (P = 0.032) was significantly longer in controls than in TEAS group. There was a significant difference in the release of C-reactive protein at 8 h (P = 0.039) between two groups, whereas the values for cytokines were not significant. CONCLUSION Transcutaneous electric acupoint stimulation on the bilateral P6 acupoint is effective for attenuation myocardial injury in children undergoing cardiac surgery. The beneficial effects may be partially associated with reduction in cTnI and C-reactive protein level in the early postoperative period.
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Affiliation(s)
- Xinli Ni
- Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Abstract
PC6 is a classic acupuncture point in traditional Chinese medicine. It is considered to be effective when treating cardiovascular disorders. In the present review the authors have focused on the neurophysiological bases of the effects of PC6 stimulation on cardiovascular mechanisms. Experimental studies have shown that the hypothalamic rostral ventrolateral medulla, arcuate nucleus and ventrolateral periaqueductal gray are involved in acupuncture attenuation of sympathoexcitatory cardiovascular reflex responses. This long-loop pathway also appears to contribute to the long-lasting, acupuncture-mediated attenuation of sympathetic premotor outflow and excitatory cardiovascular reflex responses. Acupuncture of PC6 modulates the activity in the cardiovascular system, an effect that may be attributed to attenuation of sympathoexcitatory cardiovascular reflex responses.
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Affiliation(s)
- Jia Li
- Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan, China
| | - Jing Li
- Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zebin Chen
- Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan, China
| | - Fengxia Liang
- Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan, China
| | - Song Wu
- Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan, China
| | - Hua Wang
- Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan, China
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Cheng CH, Yi PL, Lin JG, Chang FC. Endogenous opiates in the nucleus tractus solitarius mediate electroacupuncture-induced sleep activities in rats. Evid Based Complement Alternat Med 2011; 2011:159209. [PMID: 19729491 PMCID: PMC3094708 DOI: 10.1093/ecam/nep132] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Accepted: 08/06/2009] [Indexed: 11/14/2022]
Abstract
Electroacupuncture (EA) possesses various therapeutic effects, including alleviation of pain, reduction of inflammation and improvement of sleep disturbance. The mechanisms of EA on sleep improvement, however, remain to be determined. It has been stated in ancient Chinese literature that the Anmian (EX17) acupoint is one of the trigger points that alleviates insomnia. We previously demonstrated that EA stimulation of Anmian acupoints in rats during the dark period enhances non-rapid eye movement (NREM) sleep, which involves the induction of cholinergic activity in the nucleus tractus solitarius (NTS). In addition to cholinergic activation of the NTS, activation of the endogenous opioidergic system may also be a mechanism by which acupuncture affects sleep. Therefore, this study was designed to investigate the involvement of the NTS opioidergic system in EA-induced alterations in sleep. Our present results indicate that EA of Anmian acupoints increased NREM sleep, but not rapid eye movement sleep, during the dark period in rats. This enhancement in NREM sleep was dose-dependently blocked by microinjection of opioid receptor antagonist, naloxone, and the μ-opioid receptor antagonist, naloxonazine, into the NTS; administrations of δ-receptor antagonist, natrindole, and the κ-receptor antagonist, nor-binaltrophimine, however, did not affect EA-induced alterations in sleep. Furthermore, β-endorphin was significantly increased in both the brainstem and hippocampus after the EA stimuli, an effect blocked by administration of the muscarinic antagonist scopolamine into the NTS. Our findings suggest that mechanisms of EA-induced NREM sleep enhancement may be mediated, in part, by cholinergic activation, stimulation of the opiodergic neurons to increase the concentrations of β-endorphin and the involvement of the μ-opioid receptors.
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Affiliation(s)
- Chiung-Hsiang Cheng
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 106, Taiwan
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17
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He TF, Yang WJ, Zhang SH, Zhang CY, Li LB, Chen YF. Electroacupuncture inhibits inflammation reaction by upregulating vasoactive intestinal Peptide in rats with adjuvant-induced arthritis. Evid Based Complement Alternat Med 2011; 2011:290489. [PMID: 20953422 DOI: 10.1155/2011/290489] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Revised: 07/12/2010] [Accepted: 08/22/2010] [Indexed: 11/29/2022]
Abstract
Acupuncture is emerging as an alternative therapy for rheumatoid arthritis (RA). However, the molecular mechanism underlying this beneficial effect of acupuncture has not been fully understood. Here, we demonstrated that electroacupuncture at acupoints Zusanli (ST36), Xuanzhong (GB39); and Shenshu (BL23) markedly decreased the paw swelling and the histologic scores of inflammation in the synovial tissue, and reduced the body weight loss in an adjuvant-induced arthritis rat model. However, the electrical stimulation at nonacupoint did not produce any beneficial effects against the experimental arthritis. Most interestingly, the electroacupuncture treatment resulted in an enhanced immunostaining for vasoactive intestinal peptide (VIP), a potent anti-inflammatory neuropeptide, in the synovial tissue. Moreover, the VIP-immunostaining intensity was significantly negatively correlated with the scores of inflammation in the synovial tissue (r = −0.483, P = .0026). In conclusion, these findings suggest that electroacupuncture may offer therapeutic benefits for the treatment of RA, at least partially through the induction of VIP expression.
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