Acupoint application for postherpetic neuralgia with qi stagnation and blood stasis and its effect on related inflammatory factors and 5-HT

OBJECTIVES

To observe the clinical efficacy of acupoint application in treating postherpetic neuralgia(PHN) with qi stagnation and blood stasis, and its effects on serum inflammatory factors and 5-hydroxytryptamine (5-HT) in patients.

METHODS

A total of 136 PHN patients were randomly divided into an observation group (68 cases, 6 case dropped out) and a control group (68 cases, 5 cases dropped out). In the observation group, the combination of swelling-reducing and pain-relieving patches and acupoint application with herbal powder was used at bilateral Sanyinjiao (SP 6), Shenque (CV 8) and ashi points. Sanyinjiao (SP 6) was applied for 30 min per session, once every 7 days; and Shenque (CV 8) and ashi points were applied for 6-8 h per session, once every 1 day. In the control group, mecobalamin injection was administered at Jiaji (EX-B 2) corresponding to the neural segments governing the painful area, 1 mL per injection, once a day. Each treatment course consisted of 7 days, 4 treatment courses were required in both groups. The visual analog scale (VAS) score for pain, 36-item short form health survey (SF-36) score, traditional Chinese medicine syndrome score, and the serum levels of inflammatory factors (monocyte chemoattractant protein-1 [MCP-1], interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α]) and 5-HT were compared in the patients of the two groups before and after treatment, and the clinical efficacy was evaluated.

RESULTS

After treatment, the VAS scores, traditional Chinese medicine syndrome scores, serum MCP-1, IL-6, TNF-α, and 5-HT levels were decreased compared with those before treatment in both groups (P<0.05), and the results in the observation group were lower than those in the control group (P<0.05). The SF-36 scores were increased compared with those before treatment in the two groups (P<0.05), and the result in the observation group was higher than that in the control group (P<0.05). The total effective rate of the observation group was 74.2% (46/62), which was higher than 52.4% (33/63, P<0.05) of the control group.

CONCLUSIONS

The combination of swelling-reducing and pain-relieving patches and acupoint application with herbal powder has shown better efficacy in treating PHN with qi stagnation and blood stasis, which can significantly alleviate patients symptoms, improve their quality of life, and reduce serum levels of MCP-1, IL-6, TNF-α, and 5-HT.

Efficacy and safety of Buzhongyiqi decoction combined with acupoint application for functional constipation in elderly people: A systematic review and meta-analysis

PURPOSE

This study aimed to evaluate the efficacy and safety of Buzhongyiqi decoction combined with acupoint application in the treatment of functional constipation in elderly people.

METHODS

(1) Four Chinese databases (China National Knowledge Infrastructure, China Science Periodical Database, Chinese Citation Database, China Biology Medicine) and 4 foreign databases (PubMed, Web of Science, Cochrane Library, Embase) were searched, excluded, and included in randomized controlled trials of Buzhongyiqi decoction combined with acupoint application for the treatment of functional constipation in elderly people. (2) Systematic evaluation and meta-analysis using the RevMan 5.3 software. (3) Harbord linear regression and sensitivity analyses were conducted to evaluate publication bias using Stata 14.0. (4) Reliability of the conclusion assessment by sequential test analysis in TSA0.9 software. (5) Quality of evidence evaluation of outcome indicators was evaluated using Gradepro 3.6 software.

RESULTS

Eight randomized controlled trials including 658 case sample sizes were included. Compared with the control group, the intervention group showed improved clinical cure rate and effective rate of functional constipation in elderly people, reduced recurrence rate, and efficacy regulated the levels of defecation-related indices and indices of gastrointestinal function. In addition, trial sequential analysis indicated that the total clinical efficacy rate was conclusive, which showed that the therapeutic efficacy of the intervention group was superior to that of the control group. However, the incidence of adverse effects in intervention group was comparable to that of control group, and trial sequential analysis suggests that this result needs to be supported by additional research.

CONCLUSION

Buzhongyiqi decoction combined with acupoint application has potential value in the treatment of functional constipation in elderly people. Currently, there is insufficient clinical evidence to objectively evaluate safety grades for this combination therapy.

Effectiveness of Acupoint Application in Patients with Pharyngeal Pain: Evidence from CHUNBO, A Prospective Real-World Study

OBJECTIVE

To assess the outcomes after acupoint application in patients with pharyngeal pain in a real-world settings, and analyze the characteristics of effective population and prescription characteristics of acupoint application.

METHODS

Based on CHUNBO platform, patients with pharyngeal pain who were candidates for acupoint application on the basis of physician-evaluation, were enrolled in a nationwide, prospective, 69-week multicenter observational study from August 2020 to February 2022. Propensity score matching (PSM) was used to match the confounding factors and the association rules were used to analyze the characteristics of effective population and prescription characteristics of acupoint application. Outcome assessments included the disappearance rate of pharyngeal pain (within 3, 7, and 14 days), disappearance time of pharyngeal pain, as well as adverse events.

RESULTS

Of 7,699 enrolled participants, 6,693 (86.9%) received acupoint application and 1,450 (21.7%) with non-acupoint application. After PSM, there were 1,004 patients each in the application group (AG) and non-application group (NAG). The disappearance rate of pharyngeal pain in the AG at 3, 7, and 14 days were all higher than those in the NAG (P<0.05). The disappearance time of pharyngeal pain in the AG were shorter than that in the NAG (logrank P<0.001, hazard ratio=1.51, 95% confidence interval: 1.41-1.63). The median age of effective cases was 4 years, mainly 3-6 years old (40.21%). The disappearance rate of pharyngeal pain in the application group with tonsil diseases was 2.19 times higher than that in the NAG (P<0.05). The commonly used acupoints for the effective cases were Tiantu (RN 22), Shenque (RN 8) and Dazhui (DU 14). The commonly used herbs for the effective cases were Natrii sulfas, Radix et Rhizoma Rhei, and Herba Ephedrae. Among them, Natrii sulfas was applied to RN 8 most frequently (support 84.39%). A total of 1,324 (17.2%) patients experienced AEs, and mainly occurred in the AG, with significant difference in the incidence of AEs between goups (P<0.05). All AEs reported were the first grade, and the average regression days of AEs was 2.8 days.

CONCLUSIONS

Acupoint application in patients with pharyngeal pain resulted in improved effective rate and shortened duration, especially children aged 3-6 years old, and those with tonsil diseases. Acupoint of RN 22, RN 8 and DU 14, Natrii sulfas, Radix et Rhizoma Rhei, and Herba Ephedrae were the most commonly used herbs in the treatment of pharyngeal pain.

Clinical effect of acupoint application with turmeric blistering moxibustion plaster on post-stroke hemiplegic shoulder pain

OBJECTIVES

To observe the effects of acupoint application with turmeric blistering moxibustion plaster on pain, shoulder range of motion (ROM) and upper limb motor function in the patients with post-stroke hemiplegic shoulder pain (PSHSP).

METHODS

Eighty-two patients with PSHSP were randomly divided into an observation group (41 cases, 1 case was eliminated, 4 cases dropped out) and a control group (41 cases, 2 cases were eliminated and 2 cases dropped out). The routine treatment, nursing care and rehabilitation training were performed in the control group. On the basis of the intervention as the control group, in the observation group, the turmeric blistering moxibustion plaster was applied to bilateral ashi points, Jianyu (LI 15), Jianliao (TE 14), Binao (LI 14), Shousanli (LI 10) and Hegu (LI 4), once a day, remained for 6 hours each time. This moxibustion therapy was operated 5 times weekly, one course of treatment consisted of 2 weeks and 2 courses were required. Separately, before treatment and after 2 and 4 weeks of treatment, the score of visual analogue scale (VAS), shoulder ROM and the score of upper limbs in Fugl-Meyer assessment (U-FMA) were observed in the two groups.

RESULTS

VAS scores were lower (P<0.05), ROM in shoulder flexion, abduction, internal rotation and external rotation was larger (P<0.05), and U-FMA scores were higher (P<0.05) after 2 and 4 weeks of treatment when compared with those before treatment in the two groups. After 4 weeks of treatment, VAS score decreased (P<0.05), and ROM in shoulder flexion, abduction, internal rotation, external rotation and U-FMA score increased (P<0.05) in comparison with those after 2 weeks of treatment in either group. In the observation group, VAS scores were dropped (P<0.05) after 2 and 4 weeks of treatment respectively, and ROM of shoulder flexion and abduction enlarged after 2 weeks of treatment (P<0.05) when compared with those in the control group. After 4 weeks of treatment, ROM in shoulder flexion, abduction, internal rotation and external rotation in the observation group was larger (P<0.05) and U-FMA score was higher (P<0.05) than those in the control group.

CONCLUSIONS

Acupoint application with turmeric blistering moxibustion plaster may effectively reduce the degree of shoulder pain and improve the shoulder range of motion and the upper limb motor function in the patients with post-stroke hemiplegic shoulder pain.

Efficacy and safety of acupoint application in the treatment of ulcerative colitis: A systematic review and meta-analysis

BACKGROUND

The efficacy of acupoint application in the treatment of ulcerative colitis (UC) is still controversial. The purpose of this study is to systematically evaluate the clinical efficacy and safety of acupoint application in the treatment of ulcerative colitis.

METHODS

The databases of China National Knowledge Infrastructure (CNKI), Chinese Biology Medicine (CBM), VIP, Wanfang, Embase, PubMed, the Cochrane Library and Web of Science were searched. The time limit was from the establishment of the database to July 2022. The published randomized controlled trials of acupoint application in the treatment of UC were analyzed by meta-analysis and trial sequential analysis.

RESULTS

A total of 13 studies were included, with a total sample size of 878 cases. Compared with conventional western medicine, acupoint application can effectively improve the effective rates of clinical comprehensive (risk ratio [RR] 1.13, 95% confidence interval [CI] 1.06-1.20, P = .0003), syndrome (RR 1.13, 95% CI 1.03-1.24, P = .009), and interleukin-4 (IL-4) (mean differences 2.62, 95% CI 1.96-3.28, P < .00001) in the treatment of UC, and reduce interferon-γ (mean differences -5.38, 95% CI -6.81 to -3.94, P < .00001). The effective rates of colonoscopy (RR 0.94, 95% CI 0.84-1.05, P = .25), pathological examination (RR 1.04, 95% CI 0.90-1.20, P = .60) and rate of adverse reaction (RR 0.55, 95% CI 0.25-1.21, P = .14) were the same. Trial sequential analysis indicated that the benefits of effective rates of clinical comprehensive and syndrome, IL-4, and interferon-γ were conclusive. Harbord regression showed no publication bias (P = .98). The evaluation of evidence quality suggested that the evidence quality of effective rates of clinical comprehensive and syndrome was moderate and the evidence quality of other indicators was low or very low.

CONCLUSION

Acupoint application is a safe and effective method for the treatment of UC, and has the prospect of clinical application.

Effectiveness of acupoint application of Xiaozhong Zhitong Tie on diarrhea in patients: a retrospective cohort study in China

OBJECTIVE

To provide the evidence for the efficacy of acupoint application (AA) for patients with diarrhea in a real-world setting.

METHODS

This study is a national multicenter retrospective cohort study. Our study consecutively collected outpatient medical records of patients with diarrhea from hundreds of primary hospitals nationwide registered in Chun Bo Wan Xiang cloud platform from 22nd August, 2020 to 5th November, 2020. The patients were divided into the treatment group and the control group according to patient's condition and willingness. The control group was treated with Western Medicine, oral Chinese Medicine decoction, or both. The treatment group was added with AA based on the control group. Multiple logistic regression was used to evaluate the independent efficacy of AA in diarrheal recovery on the 3rd, 7th, 14th and 28th day. As a next step, we also performed stratified analysis and likelihood ratio test (LRT). Sensitivity analyses included propensity score matching (PSM), four PSM-related analyses and E-value.

RESULTS

The treatment group showed better efficacy than the control group on the 14th and 28th day [the 14th day: = 1.58, 95% (1.15, 2.19), 0.005; the 28th day: = 2.03, 95% (1.43, 2.88), < 0.001]. No difference was observed in efficacy of AA for the treatment of diarrhea among the subgroups ( > 0.05). PSM-related analyses confirmed the efficacy of AA in diarrheal recovery. The findings are unlikely to be nullified by an unmeasured confounding variable according to the results of E-values.

CONCLUSIONS

The efficacy in the treatment group was significantly more improved than that in the control group on the 14th and 28th day.

Effect of oral Xiao-xian decoction combined with acupoint application therapy on pediatric adenoid hypertrophy: A randomized trial

BACKGROUND

This study aimed to observe the clinical effects of Xiao-xian decoction combined with acupoint application therapy (AAT) for treating pediatric adenoid hypertrophy (AH).

METHODS

We randomly divided 93 AH children into 3 groups: AAT alone; Xiao-xian decoction + AAT; control: Montelukast oral therapy. All participants were treated for a month. We used the traditional Chinese medicine syndrome score to evaluate the clinical efficacy and the obstructive sleep apnea-18 scale to evaluate the quality of life.

RESULTS

The major symptoms (nasal congestion, open mouth breathing, snoring, and tongue image) and secondary symptoms of patients treated with Xiao-xian decoction + AAT significantly improved compared to before treatment. The pairwise comparison between groups showed that snoring, tongue, secondary symptoms, and total effective rate of the combined treatment group were better than the control and AAT alone. Additionally, the open-mouth breathing, quality of life, and recurrence rate did not differ after treatment.

CONCLUSION

Oral Xiao-xian decoction combined with AAT significantly improved the symptoms and signs of nasal congestion, open-mouth breathing, snoring, tongue, and quality of life of AH children and may be used as a long-term treatment for AH.

Efficacy and safety of acupoint application for allergic rhinitis: a systematic review and Meta-analysis of randomized controlled trials

OBJECTIVE

To use evidence-based medicine to explore the efficacy of acupoint application (AA) for allergic rhinitis (AR) at different time points and its safety.

METHODS

We searched 7 databases (PubMed, Cochrane, Embase, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, and China Biology Medicine disc) as well as the international clinical trial registration platform from January 2010 to March 2020 for randomized controlled trials (RCTs) comparing the efficacy of AA versus placebo, Western Medicine or other alternative therapies on AR. Risk of bias was assessed according to the Cochrane handbook, and statistical analysis was performed using RevMan 5.3. Outcomes included the total effective rate, recurrence rate, total nasal symptom score (TNSS), visual analogue scale (VAS), quality of life measured by the Rhinitis Quality of Life Questionnaire (RQLQ) or Short Form-36 (SF-36), adverse events, and biomarkers including immunoglobulin E (IgE), peripheral blood eosinophil count (EOS), interleukin-4 (IL-4), and interferon gamma (INF-γ).

RESULTS

Twenty-eight RCTs involving 3282 participants were included. The short-term and long-term efficacy of AA was significantly better than placebo, including better total effective rate [: 3.05, 95% (1.84, 5.07), after treatment; : 9.29, 95% (2.57, 33.66), at 6 months], lower recurrence rate [: 0.55, 95% (0.45, 0.66), at 6 months; : 0.65, 95% (0.57, 0.74), at 1 year], lower TNSS [: -3.09, 95% (-3.58, -2.61), after treatment], and lower RQLQ [: -14.79, 95% (-21.49, -8.10), after treatment; : -11.92, 95% (-17.40, -6.45), at 4-6 months]. Compared with Western Medicine, AA had better long-term total effective rate [: 1.33, 95%CI (1.05, 1.69), at 3 months; : 1.49, 95% 1.22 to 1.81, at 1 year) and lower recurrence rate [: 0.48, 95% (0.39, 0.58), at 6 months; : 0.45, 95% (0.33, 0.60), at 1 year]. AA had better long-term total effective rate versus acupuncture [: 2.06, 95% (1.28, 3.31), at 1 year] or oral Chinese medicine [: 1.21, 95% (1.09, 1.34), ≥ 6 months]. Both AA and Western Medicine can reduce serum levels of IgE, EOS, and IL-4 after treatment. The main adverse event of AA was local skin reaction without systemic side effects.

CONCLUSIONS

The short-term (within one month) and long-term (at 3 months, 6 months and 1 year) efficacy of acupoint application on AR was better than that of placebo. The long-term efficacy of acupoint application was superior to that of Western Medicine (at 3 months, 6 months and 1 year), oral Chinese medicine (at more than 6 months) and acupuncture (at 1 year). AA can reduce serum IgE, EOS, and IL-4 level of AR patients in a short run. Acupoint application is safe, but severe skin reactions can reduce patient compliance.

[Acupoint application for exogenous fever: a multi-central retrospective cohort study]

OBJECTIVE

To explore the effectiveness on exogenous fever and the characteristics of effective population, as well as the specialties of prescription of acupoint application.

METHODS

Using the internet electronic diagnosis and treatment platform (Spring Broadcast Wanxiangyun Clinic Database, and the main TCM suitable technology promoted by this platform is acupoint application therapy), from August 24, 2020 to November 5, 2020, the patients complained with fever and diagnosed as common cold, with a record of initial visit and at least one return visit, were included as the subjects. According to whether acupoint application therapy was received or not, the subjects were divided into an exposure group (with acupoint application therapy, 26 664 cases) and a non-exposure group (without acupoint application therapy, 515 cases). Using the propensity score, the mixed factors, e.g. age and sex, were matched between the two groups. The disappearance rate of fever (within 2 days) and the time for the first fever disappearance were taken as the effect indexes. The association rules extraction was adopted to analyze the characteristics of effective population and acupoint application prescription in treatment of exogenous fever.

RESULTS

After propensity score matching, there were 1 229 cases in the application group and 423 cases in the non-application group. The disappearance rate of fever in the application group was 1.82 times as high as that in the non-application group (P<0.05). The time for the first fever disappearance in the application group was shorter than the non-application group (P<0.01). A total of 5 370 cases were effective with acupoint application therapy, of which, the median age was 2 years old and the proportion of children patients under 6 years old was relatively high. In the effective crowd, the most commonly-used acupoints were Shenque (CV 8), Dazhui (GV 14), Yongquan (KI 1) and Tiantu (CV 22), etc. Shenque (CV 8) and Dazhui (GV 14) were highly associated and the support was 62.57%. The most common herbal materials in the acupoint application therapy included Radix et Rhizoma Rhei, Natrii Sulfas, Radix Scutellariae, Herba Ephedrae and Radix Bupleuri, etc. Radix et Rhizoma Rhei and Natrii Sulfas were most commonly used at Shenque (CV 8) and the supports were 57.49% and 57.21% respectively. Herba Ephedrae was most commonly applied to Shenque (CV 8) and Dazhui (GV 14) and the supports were 48.21% and 43.91% respectively. Radix Bupleuri was the most common herb at Dazhui (GV 14) with the support of 46.61%. Besides, the most commonly combined western drugs included cefixime and keteling in the acupoint application therapy and the supports were 13.07% and 12.72% respectively.

CONCLUSION

Acupoint application is effective on exogenous fever. The common therapy refers to Radix et Rhizoma Rhei and Natrii Sulfas plaster at Shenque (CV 8), while Herba Ephedrae and Radix Bupleuri at Dazhui (GV 14).

Acupoint application therapies for essential hypertension: a systematic review and Meta-analysis

OBJECTIVE

To evaluate the efficacy and safety of acupoint application therapies (AA) for hypertension.

METHODS

We searched PubMed, EMBASE, the Cochrane Center Controlled Trials Register, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wanfang Med Online Database from their inceptions to October 7, 2019. No language restriction was applied. We included randomized clinical trials testing AA against Western Medicine, AA versus placebo, AA combined with Western Medicine versus Western Medicine. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards.

RESULTS

Totally 41 trials with 3772 participants were included. The methodological quality of the included trials was evaluated as generally low. AA plus Western Medicine significantly lowered systolic blood pressure (BP) [weighted mean difference (): -10.36, 95% confidence intervals (): -12.62, -8.10; 0.000 01], diastolic BP (: -5.71, 95% : -7.30, -4.13; 0.000 01), and total effect [risk ratio (): 1.23, 95% : 1.15, 1.32; 0.000 01]. The BP-lowering effect of AA was significantly higher than that of placebo [systolic BP (SBP): -8.05, 95% : -8.67, -7.43; 0.000 01; diastolic BP (DBP): -6.66, 95% : -7.31, -6.01, 0.000 01]. The total effect also improved significantly from baseline with AA than placebo (: 10.85, 95% : 4.71, 24.98; 0.000 01). Traditional Chinese Medicine symptoms score were significantly reduced by AA compared with Western Medicine (: -1.75, 95% : -2.52, -0.99; 0.000 01), 10 trials reported adverse events, indicating that the safety of SSYX Capsule is still uncertain.

CONCLUSIONS

Application therapies may be considered a safe and beneficial for the treatment of hypertension and can reduce BP and improve the total effect. Further well-designed trials are needed to support our conclusions.

[Influence of acupoint application on clinical use of antibiotics: a real world study of 1.23 million primary clinic patients]

OBJECTIVE

To observe the influence of acupoint application on the use of antibiotics in primary clinic practice, and explore the effect of acupoint application and its influence on the use of antibiotics based on common diseases in primary clinic (fever, cough, diarrhea, sore throat).

METHODS

With the help of the internet electronic diagnosis and treatment platform (the main TCM suitable technology promoted by this platform is acupoint application therapy), the diagnosis and treatment data of 1.23 million patients in 2 000 primary clinics from August 24, 2020 to March 31, 2021 were collected. The patients were divided into an application group (acupoint application treatment) and a non-application group (non-acupoint application treatment), and the proportion of antibiotic use in the two groups was compared. The propensity score was used to match age, gender, concomitant symptoms, diagnosed diseases and other confounding factors of treatment, and the disappearance rate of symptoms (fever, cough, diarrhea, sore throat) and the time to first disappearance of symptoms were compared between the two groups.

RESULTS

A total of 1 230 923 patients were analyzed, including 1 048 382 cases in the application group, accounting for 85.2%; 182 541 cases in the non-application group, accounting for 14.8%. The most patients who used acupoint application treatment were 0-2 years old, followed by 3-6 years old, and the patients over 15 years old who did not use acupoint application treatment were the most. The proportion of antibiotic use in the application group was 2.4%, lower than that in the non-application group (44.2%, P<0.001). The proportion of antibiotic use in all ages of patients in the application group was lower than that in the non-application group (P<0.001). Among the common diseases in primary clinic (fever, cough, diarrhea and sore throat), the proportion of antibiotic use in the application group was lower than that in the non-application group (P<0.01); the disappearance rate of symptoms in the application group was higher than that in the non-application group, and the time to first disappearance of symptoms was shorter than that in the non-application group (P<0.001).

CONCLUSION

Acupoint application has a certain influence on the use of antibiotics in primary clinic patients. In the treatment of common diseases, patients treated with acupoint application have better curative effect and lower proportion of antibiotic use.

Successful Intervention with Traditional Chinese Medicine for Severe Coronavirus Disease 2019: A Case Report

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2, is a major public health threat worldwide. However, there are no clinically approved antiviral drugs for COVID-19. Traditional Chinese medicine (TCM) is an important part of complementary and alternative medicine. Based on the TCM principles of pathogenesis, our team proposed “San Tong strategies” (san tong liao fa) and the “Truncation and Reversion strategy” (jie duanniu zhuan ce lve) and developed a Chinese herbal medicine formula to dispel external pathogens, clear heat, drain fire, and detoxify. A 50-year-old man with severe COVID-19 was admitted and received our oral Chinese herbal formula, acupoint plaster application, and moxibustion for 14 days. The computed tomography manifestations of COVID-19 showed marked improvements, and the patient achieved complete remission of fever, cough, fatigue, dizziness, nasal congestion, and rhinorrhea. This case provides a specific TCM treatment plan and effective reference for the treatment of COVID-19.

[Clinical therapeutic effect on bronchial asthma by the observation of skin reaction after acupoint application based on chronic disease management platform of asthma]

OBJECTIVE

To compare the therapeutic effect on bronchial asthma between presence of skin reaction and the absence of skin reaction after acupoint application.

METHODS

Sixty-one patients with bronchial asthma were treated with acupoint application during the hottest periods of summer ("dog days"). The acupoints included Dingchuan (EX-B 1), Feishu (BL 13), Xinshu (BL 15), Pishu (BL 20) and Shenshu (BL 23). The treatment was given once every 7 days, with the herbal plaster remained for 6 h each time, and 4 treatments were required totally. According to the local skin reaction after acupoint application, a skin reaction group (30 cases, 2 cases dropped off) and a non-skin reaction group (31 cases) were divided. Separately, before treatment and 1 year after treatment, using chronic disease management platform of asthma, the number of asthma attacks, the score of asthma control test (ACT) and the score of asthma quality of life questionnaire (AQLQ) were recorded online. Besides, the therapeutic effect was observed in the two groups 1 year after treatment.

RESULTS

One year after treatment, the number of asthma attacks was reduced as compared with that before treatment in the patients of either group (P<0.001), the score of ACT and each domain in AQLQ, i.e. activity limitation, asthma symptoms, psychological state, reactions to stimuli and self-health care as well as the total scores of AQLQ were all increased as compared with those before treatment (P<0.001). The number of asthma attacks in the skin reaction group was less than the non-skin reaction group (P<0.05), the score of ACT and each domain of AQLQ and the total scores of AQLQ were all higher than the non-skin reaction group successively (P<0.05, P<0.01). The total effective rate was 82.1% (23/28) in the skin reaction group, better than 67.7% (21/31) in the non-skin reaction group (P<0.05).

CONCLUSION

In treatment of acupoint application for bronchial asthma, the clinical therapeutic effect is better in the patients with local skin reaction after acupoint application. The chronic disease management platform of asthma is convenient for online evaluation.

[Effect of acupoint application of Zhanjin Huoxue formula combined with local cold compress on swelling and pain after knee arthroscopy in patients with knee osteoarthritis]

OBJECTIVE

To compare the effect between acupoint application of Zhanjin Huoxue formula combined with local cold compress and simple local cold compress on swelling and pain after knee arthroscopy in patients with knee osteoarthritis (KOA).

METHODS

A total of 62 KOA patients with knee swelling after knee arthroscopy were randomly divided into an observation group and a control group, 31 cases in each group. In the control group, cold compress was adopted after surgery, 3 times a day. On the basis of the treatment as the control group, acupoint application of Zhanjin Huoxue formula (angelicae sinensis radix, chuanxiong rhizome, cinnamon twig, poria, etc.) was applied at Liangqiu (ST 34), Xuehai (SP 10), Zusanli (ST 36), Fenglong (ST 40), Sanyinjiao (SP 6), Yinlingquan (SP 9), Yanglingquan (GB 34), Xuanzhong (GB 39) on the affected side in the observation group, 4 h each time, 2 times a day. The treatment was given 7 days in both groups. Before treatment and 1,3,5 and 7 days into treatment, the pain visual analogue scale (VAS) score and swelling value of knee joint (2 cm above the patella upper pole, patella midline, 5 cm below the patella lower pole) were compared in the two groups.

RESULTS

The VAS scores 3, 5 and 7 days into treatment were lower than those before treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). The swelling values of 2 cm above the patella upper pole 3, 5 and 7 days into treatment were lower those before treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). The swelling values of patella midline 1, 3, 5 and 7 days into treatment were lower than those before treatment in the two groups (P<0.05), and except for 1 day into treatment, those in the observation group were lower than the control group (P<0.05). The swelling values of 5 cm below the patella lower pole 1 day into treatment in the observation group and 3, 5 and 7 days into treatment in the two groups were lower those before treatment (P<0.05), and except for 1 day into treatment, those in the observation group were lower than the control group (P<0.05). The total effective rate in the observation group was 93.5% (29/31), which was higher than 74.2% (23/31) in the control group (P<0.05).

CONCLUSION

Acupoint application of Zhanjin Huoxue formula combined with cold compress could effectively improve the knee joint swelling and pain after arthroscopy in KOA patients, and the curative effect is better than simple cold compress.

[Diarrhea-predominant irritable bowel syndrome of spleen deficiency and damp excess treated with fire needling therapy with filiform needle and acupoint application therapy: a randomized controlled trial]

OBJECTIVE

To compare the clinical therapeutic effect on diarrhea-predominant irritable bowel syndrome (IBS-D) of spleen deficiency and damp excess among fire needling therapy with filiform needle combined with acupoint application therapy, simple acupoint application therapy and pinaverium bromide tablets, and explore the mechanism on the improvements in IBS-D.

METHODS

A total of 150 patients with IBS-D of spleen deficiency and damp excess were randomized into a combined treatment group (50 cases, 14 cases dropped off), an acupoint application group (50 cases, 16 cases dropped off ) and a western medication group (50 cases, 13 cases dropped off ). In the western medication group, pinaverium bromide tablets were prescribed for oral administration, 50 mg per time, three times a day. In the acupoint application group, the herbal plaster of shenling baizhu powder mixed with fresh ginger juice was placed on Shenque (CV 8), once every two days. In the combined treatment group, on the base of the treatment as the acupoint application group, the fire needling therapy with filiform needle was exerted at Tianshu (ST 25), Shangjuxu (ST 37), Yinlingquan (SP 9) and Dachangshu (BL 25), once every two days. The duration of treatment in each group was 4 weeks. Separately, before treatment and after 7 and 28 days of treatment, the score of clinical symptoms and the score of quality of life scale for IBS (IBS-QOL) were observed in each group. Before treatment and after 28 days of treatment, the levels of , and T lymphocytes, and the ratio of / in peripheral blood of patients were detected successively; as well as the expressions of 5-HT3R mRNA and 5-HT4R mRNA in colon mucosal tissues in each group separately.

RESULTS

Except the score for abdominal pain in the acupoint application group and the scores for abdominal pain and abdominal distention in the western medication group after 7 days of treatment, the scores for abdominal pain, abdominal distention, defecation frequency, stool form and incomplete bowel movement after 7 and 28 days of treatment were all reduced as compared with those before treatment in each group separately (P<0.05). After 7 days of treatment, the scores for abdominal distention, defecation frequency and stool form in the combined treatment group were all lower than those in the western medication group (P<0.05). After 28 days of treatment, the score of each clinical symptom in the combined treatment group was lower than either of the rest two groups respectively (P<0.05); and the scores for abdominal pain, abdominal distention and incomplete bowel movement in the acupoint application group were lower than those in the western medication group separately (P<0.05). After 7 and 28 days of treatment, the score of each item in IBS-QOL was increased as compared with that before treatment in each group (P<0.05). After 7 days of treatment, except the scores for heterosexual relationship and human relations, scores of the other items, other scores of IBS-QOL in the combined treatment group were higher than those in the western medication group separately (P<0.05); while the scores of anxiety and behavior disorder in the acupoint application group were higher than those in the western medication group (P<0.05). After 28 days of treatment, the each score of IBS-QOL in the combined treatment group was higher than the other two groups respectively (P<0.05), while the scores of anxiety, behavior disorder, dietary control, social reaction and human relations in the acupoint application group were all higher than the western medication group (P<0.05). After treatment, the levels of and T lymphocytes and the ratio of /in peripheral blood, as well as the expressions of 5-HT4R mRNA in colon tissue were all increased in each group (P<0.05), but the levels of T lymphocyte and 5-HT3R mRNA expressions in colon tissue were reduced in each group (P<0.05). After treatment, regarding the levels of and T lymphocytes and the ratio of /in peripheral blood, as well as the expressions of 5-HT4R mRNA in colon tissue, the values in the combined treatment group were all higher than either of the rest two groups respectively (P<0.05), while the values in the acupoint application group were higher than the western medication group (P<0.05). Concerning to the level of T lymphocytes and 5-HT3R mRNA expression, the values in the combined treatment group were lower than the rest two groups respectively (P<0.05), and the values in the acupoint application group were lower than the western medication group (P<0.05).

CONCLUSION

The combined treatment with the fire needling therapy with filiform needle and the acupoint application therapy effectively relieves the clinical symptoms, improves the quality of life and strengthens the immunity in the patients with IBS-D. The therapeutic effect of this combined regimen is better than either simple acupoint application therapy or the oral medication of pinaverium bromide. The mechanism may be related to the regulation of the levels of T lymphocyte subsets and the modulation of the expressions of 5-HT3R and 5-HT4R mRNA in colon tissue.

Effectiveness and Safety of Acupoint Application of Guan Xin Su He Pill () for Patients with Chronic Stable Angina Pectoris: A Multi-Center, Randomized Controlled Trial

OBJECTIVE

To assess the clinical effectiveness of acupoint application (AP) of Guan Xin Su He Pill (, GXSHP) for patients with chronic stable angina pectoris (CSAP).

METHODS

This study was carried out in 3 local hospitals in Chengdu, China. After baseline evaluation, eligible patients were randomly assigned to the placebo application for acupoints (PAA) group or the herbal application for acupoints (HAA) group. Patients in the HAA group underwent AP with herbal powder, which was mainly GXSHP, and patients in the PAA group underwent AP with sham drugs. For each treatment session, unilateral acupoints including Neiguan (PC 6), Danzhong (RN 17), Xinshu (BL 15) and Jueyinshu (BL 14), were stimulated for both groups. AP was performed 3 times a week with a 2-day interval for 4 weeks. The primary outcome was the frequency of angina pectoris attacks per week, while the secondary outcomes included angina pain intensity measured by the Visual Analogue Scale (VAS), dose of rescue oral drugs (nitroglycerin), scores on the Seattle Angina Questionnaire (SAQ), Self-Rating Anxiety Scale scores (SAS) and Self-Rating Depression Scale scores (SDS). Clinical outcomes were measured at week 0, 4 and 8. The safety of AP of GXSHP treatment for CSAP were assessed.

RESULTS

A total of 121 patients were enrolled. Baseline characteristics were comparable across the 2 groups. After treatment, the angina attack numbers in the HAA group were significantly reduced from 11.00 to 4.81 (P<0.05). While, for PAA group, the angina frequency was not significantly improved (baseline 10.55; post-treatment 11.05). The HAA group had significantly fewer angina attacks than the PAA group (P<0.05). Pain intensity measured by VAS in HAA group was significantly reduced from 4.06 to 3.02 (P<0.05). While, for PAA group, the VAS was significantly increased (baseline 3.62; post-treatment 3.96; P<0.05). Clinical outcomes showed better improvement after treatment in the HAA group than in the PAA group in terms of oral administration of rescue drugs, SAS, SDS and SAQ scores (P<0.05). The adverse events were also reported.

CONCLUSION

AP of GXSHP is a safe and effective treatment for CSAP patients (Registration No. NCT02029118).

The effectiveness of acupoint application of traditional Chinese medicine in treating primary dysmenorrhea: A protocol for meta-analysis and data mining

BACKGROUND

Primary dysmenorrhea (PD) is a functional disease of the female reproductive system, which has adverse effects on patients' physical and mental health and quality of life. At present, acupoint application of traditional Chinese medicine (TCM) as adjuvant therapy is undergoing clinical trials in different medical centers. However, there is no systematic review or meta-analysis to evaluate the efficacy of acupoint application of TCM in the treatment of PD. There is also a lack of systematic evaluation and analysis of acupoints and herbs.

METHODS

All randomized controlled trials related to acupoint catgut embedding therapy on PD will be searched in the following electronic databases: Cochrane Central Registry of controlled trials, PubMed, Wed of Science, EMBASE, Science Net, China Biomedical Literature Database, China Science Journal Database, China National Knowledge Infrastructure and Wan-Fang Database, from inception to May, 2021 were searched without language restrictions. The primary outcomes contain visual analog score, The Cox Menstrual Symptom Scale, while the secondary outcomes consist of adverse events and the recurrence rate. Two reviewers will independently perform data selection, data synthesis, and quality assessment. Data meeting the inclusion criteria will be extracted and analyzed by Revman v.5.3 software. Two reviewers will evaluate the study using the Cochrane collaborative bias risk tool. We will use the scoring method to assess the overall quality of the evidence supporting the main results. We will also use Spass software (version 19.0) for complex network analysis to explore the potential core prescription of acupoint application of traditional Chinese medicine in the treatment of PD.

RESULTS

This study will analyze the clinical effective rate, functional outcomes, quality of life, improvement of clinical symptoms of PD, and effective prescriptions of acupoint application for patients with PD.

CONCLUSION

Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupoint application for patients with PD.PROSPERO registration number: CRD 42021244357.

[Observation of acupoint application of gel plaster on insomnia]

OBJECTIVE

To observe the effect of acupoint application of gel plaster on quality of sleep and life in patients with insomnia.

METHODS

A total of 63 patients with insomnia were randomized into a gel plaster group (32 cases, 1 case dropped off) and a placebo plaster group (31 cases). Acupoint application of gel plaster was applied at Yintang (GV 29) and Yongquan (KI 1) in the gel plaster group, placebo plaster was applied at the same acupoints in the placebo plaster group. The treatment was given from bedtime to early moming of the next day, 5 days were as one course, with 2-day interval, totally 4 courses were required in the both groups. Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS) and Flinders fatigue scale were used to evaluate the sleep quality and fatigue level of the patients in the both groups before and after treatment and at 2 weeks of follow-up. The variations of insomnia TCM syndrome score and the 36-item short-form health survey (SF-36) score before and after treatment were observed.

RESULTS

Compared before treatment, the scores of PSQI, ESS and FFS after treatment and at follow-up were decreased in the both groups (P<0.01), and the variations of PSQI total scores and ESS scores in the gel plaster group were larger than those in the placebo plaster group (P<0.05). Compared before treatment, the insomnia TCM syndrome scores were decreased (P<0.01), the scores of physiological function, physiological role, general health, role emotion, mental health of SF-36 were improved after treatment in the both groups (P<0.05), and the social function score after treatment in the gel plaster group was superior to that in the placebo plaster group (P<0.05).

CONCLUSION

Acupoint application of gel plaster can effectively improve the quality of sleep and life in patients with insomnia.

Effectiveness and safety of acupoint application for chronic obstructive pulmonary disease: A protocol for updated systematic review and meta-analysis

BACKGROUND

Acute exacerbation is a primary cause of repeated hospitalization and death in chronic obstructive pulmonary disease (COPD) patients. Therefore, how to control the symptoms of COPD at stable stage and reduce the number of acute exacerbation is a hot spot of medical research. Acupoint application (AA) is a significant part of external treatment of traditional Chinese medicine (TCM), Previous researches have reported that AA can be applied to the treatment of COPD. Nevertheless, its effectiveness is still inconclusive. This systematic review (SR) and meta-analysis is designed to appraise its effectiveness and safety for the treatment of patients with COPD.

METHODS

Eight databases will be systematically retrieved from their inceptions to February 2021. Inclusion criteria are randomized control trials of AA combined with routine western medicine interventions in the treatment of COPD at stable stage. The primary outcomes we focus on comprise clinical effective rate, TCM symptom score, quality of life, dyspnea, exercise capacity, lung function, frequency of acute exacerbation, adverse events. The research screening, data extraction, and risk of bias assessment will be conducted by 2 individuals independently, and divergence will be adjudicated by a third senior investigator. The Stata 13.1 software will be used for meta-analysis. The confidence of evidence will be classified adopting grading of recommendations assessment, development and evaluation (GRADE) algorithm and methodological quality of this SR will be assessed using assessment of multiple systematic reviews-2 (AMSTAR-2) tool.

RESULTS

This SR will provide evidence-based medical proof for the treatment of COPD at stable stage by AA combined with conventional western medicine interventions. The findings of this SR will be presented at relevant conferences and submitted for peer-review publication.

CONCLUSIONS

The findings of this SR will provide up-todated summary proof for evaluating the effectiveness and safety of AA for COPD.

REGISTRATION NUMBER

INPLASY 202140080.

[Acupoint application combined with virtual reality technology to relieve pain after circumcision in children]

OBJECTIVE

To explore the effect of acupoint application combined with virtual reality (VR) technology in relieving pain after circumcision in children.

METHODS

Using a random number table, we divided 106 children undergoing circumcision into a control and an intervention group of an equal number, the former receiving routine nursing care, and the latter acupoint application combined with VR technology. We compared between the two groups the postoperative pain scores with the Changhai pain ruler, the Hamilton Anxiety Scale (HAMA) scores, and the satisfaction of the patients and their families.

RESULTS

Compared with the controls, the patients in the intervention group showed a significantly lower HAMA score (［2.94 ± 0.98］ vs ［1.06 ± 0.92］, P < 0.05) and postoperative pain score (［5.96 ± 1.24］ vs ［3.66 ± 1.18］, P < 0.05), but higher satisfaction in the patients and their families (86.79% vs 98.11%, P < 0.05).

CONCLUSIONS

Acupoint application combined with VR technology for children after circumcision has the advantages of effectively relieving the anxiety of the patients, distracting their attention, increasing the pain perception threshold, reducing the perception of pain, improving the satisfaction of the patients and their family members.

The effect of acupoint application of traditional Chinese medicine for the treatment of chronic obstructive pulmonary disease: A protocol for systematic review and meta-analysis

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a public threat, leading to progressive physical activity and poor quality of life. Although modern medicine has excellent achievement of COPD, the recurrence rate of stable COPD and the mortality of acute exacerbation COPD remain high. As one of the external therapy of traditional Chinese medicine, acupoint application has been treated COPD in China for a long time. Nevertheless, study evaluating the effect of acupoint application for COPD could not satisfy needs for clinic.

METHOD

Randomized controlled trials meeting the inclusion criteria will be collected by the 2 reviewers. We choose the following electronic databases of Web of Science, Pub Med, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wan Fang, Chinese Scientific Journals Database, and Chinese Biomedical Database as our retrieval tool. The retrieval time was from inception to March 2020. The key to evaluation criteria is total clinical efficacy rate and lung function will be measured. Secondary outcomes include assessment scales and adverse reactions. The studies extracted will be assessed. The merging analysis will be carried out by Review Manager Software.

RESULT

A scientific evidence of efficacy and safety of acupoint application for COPD will be found.

CONCLUSION

The evaluation of the efficacy and safety of acupoint application for COPD will be presented.

INPLASY REGISTRATION NUMBER

INPLASY202090023.

Acupoint application for rotavirus diarrhea in infants and children: A protocol for systematic review and meta analysis

BACKGROUND

Diarrheal disease currently claims the lives of approximately 500,000 children each year. Rotaviruses are the pathogens primarily responsible for more severe cases and more than one-third of diarrhea-associated deaths in children under 5 years old globally. At present, commonly used drug therapies for rotavirus diarrhea in Western medicine, such as oral rehydration salts, montmorillonite, probiotics, and nitazoxanide, often cannot achieve satisfactory curative effects. Moreover, infants' and children's compliance with drugs and injections is often lower than their compliance with acupoint application therapy. A large number of studies have shown that acupoint application can increase the clinical cure rate and shorten the duration of diarrhea. However, there is a lack of systematic reviews on the safety and efficacy of acupoint application in the treatment of rotavirus diarrhea. Therefore, we will conduct a study to evaluate the safety and efficacy of acupoint application for rotavirus diarrhea in infants and children.

METHODS

We will search the relevant medical literature using PubMed, EMBASE, Web of Science, Cochrane CENTRAL, China National Knowledge Infrastructure, the Wanfang Database, the Chinese Biomedical Literature Database, and the Chinese Scientific Journal Database from inception to August 2020. Both MeSH and free text terms will be utilized to obtain the maximum numbers of papers. No language restrictions will be applied, and the publication type will be limited to randomized controlled trials. Two teams will independently review and assess the studies for inclusion in the review. RevMan V 5.0 software will be applied for data extraction. The methodological quality of the included studies will be evaluated according to the Cochrane Handbook.

RESULTS

The results of this study will be published in a peer-reviewed journal.

CONCLUSION

The conclusion of this systematic review will provide evidence regarding whether acupoint application is an effective intervention for infants and children with rotavirus diarrhea.

INPLASY REGISTRATION NUMBER

INPLASY202070123.

[Effect of acupoint application therapy at different timing points on gastrointestinal function recovery and heart rate variability after laparoscopic resection of colorectal cancer]

OBJECTIVE

To observe the effect of acupoint application therapy at different timing points on the gastrointestinal function recovery and heart rate variability (HRV) after laparoscopic resection of colorectal cancer under the instruction of enhanced recovery after surgery (ERAS).

METHODS

A total of 105 patients for the selective laparoscopic resection of colorectal cancer were selected and randomized into a preoperative acupoint application group (35 cases, 3 cases dropped off), a postoperative acupoint application group (35 cases, 1 case dropped out) and a control group (35 cases, 2 cases dropped off). In the control group, ERAS interventions were provided, such as health education, fluid supplementation and multi-mode analgesia. On the base of the treatment as the control group, in the preoperative acupoint application group and the postoperative acupoint application group, 3 days before operation and 6 h after operation, the acupoint application therapy was given respectively. The acupoints were Zusanli (ST 36), Shangjuxu (ST 37), Sanyinjiao (SP 6), Neiguan (PC 6) and Xiajuxu (ST 39). The acupoint application was exerted for 6 h each time, once daily till the first postoperative exhaust and defecation presented. It was to observe the time of the first postoperative exhaust, defecation and food intake, the score of visual analogue scale (VAS) 1 to 3 days after operation, the total score of gastrointestinal symptom rating scale (GSRS) before and 1 week after operation, as well as the related indicators of HRV [standard deviation of NN intervals (SDNN) and the ratio of low-frequency power and high frequency power (LF/HF)] in the three groups successively. Besides, the adverse reactions were recorded during intervention in the three groups.

RESULTS

Compared with the control group, the time of the first postoperative exhaust and the time of the first postoperative defecation were all earlier in the preoperative acupoint application group and the postoperative acupoint application group respectively (P<0.05), and VAS scores 1 to 3 days after operation and total GSRS scores 1 week after operation were all reduced (P<0.05); the time of first food intake was earlier after operation (P<0.05), and SDNN and LF/LF were increased 1 day and 3 days after operation in the preoperative acupoint application group (P<0.05). Compared with the postoperative acupoint application group, in the preoperative acupoint application group, the time of the first postoperative exhaust and the time of the first postoperative defecation were all earlier (P<0.05), VAS scores were reduced in 1 to 3 days after operation (P<0.05), and SDNN 1 day and 3 days after operation and LF/HF 1 day after operation were all increased (P<0.05). No adverse reaction was detected in patients of the three groups.

CONCLUSION

Under the instruction of ERAS, the preoperative acupoint application effectively promotes the postoperative gastrointestinal function recovery, improves HRV and autonomous nerve function in the patients after laparoscopic resection of colorectal cancer. The therapeutic effect of this therapy is better than the postoperative acupoint application.

Efficacy of Chinese Medicine Acupoint Application Combined with Montelukast on Children with Perennial Allergic Rhinitis: A Randomized Controlled Trial

OBJECTIVE

To evaluate the efficacy of Chinese medicine acupoint application (CMAA) combined with Western medicine for perennial allergic rhinitis (PAR) in children.

METHODS

In this prospective, parallel, randomized, placebo-controlled and single-blind trial from August to September, 2017, 180 children with PAR were randomly assigned to an integrative group (CMAA and Montelukast), CMAA group (CMAA and placebo tablet), or Montelukast group (placebo CMAA and Montelukast). Participants were applied with CMAA for 6 sessions over 2 weeks, and/or Montelukast Chewable Tablet orally once daily for 12 weeks. The changes in severity of symptoms were measured by Visual Analog Scale (VAS) and rhinitis control assessment test (RCAT) at 0, 2, 4 and 12 weeks of treatment. Blood samples were collected for serum interleukin-4, interferon gamma γ and T helper type 1 (Th1)/Th2 flow cytometric analysis at the time points of 0, 4 and 12 weeks.

RESULTS

Eight cases dropped out from the trial, 3 in the integrative group, 2 in the CMAA group and 3 in the Montelukast group. The VAS scores decreased significantly while the RCAT scores increased significantly in all three groups at 4 and 12 weeks compared with baseline (P<0.01 or P<0.05). The VAS scores were significantly lower while the RCAT scores were significantly higher in the integrative and CMAA groups than the Montelukast group at 2 and 4 weeks (P<0.01 or P<0.05). At 2, 4 and 12 weeks, the scores of nasal congestion, sneezing, sleep problem, and rhinitis symptom control in the integrative and CMAA groups increased significantly compared with baseline (P<0.01 or P<0.05). The least percentages of Th2 and the most alleviated Th2 shift (highest Th1/Th2) were observed in the integrative group at 12 weeks compared with the other two groups (P<0.05).

CONCLUSION

The combination of CMAA with Montelukast might be more effective and appropriate than either option alone for children with PAR. (Registered at Chinese Clinical Trial Register, registration No. ChiCTR-IOR-17012434).

The efficacy and safety of acupoint application combined with western medicine for allergic rhinitis: A protocol for systematic review and meta-analysis

BACKGROUND

Acupoint application combined with western medicine has been used for treating allergic rhinitis widely. However, the efficacy and safety of acupoint application combined with western medicine for allergic rhinitis are unclear. This study aims to evaluate the efficacy and safety of acupoint application combined with western medicine for allergic rhinitis.

METHODS

Randomized controlled trials of acupoint application combined with western medicine for allergic rhinitis will be searched in PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WanFang, the Chongqing VIP Chinese Science and Technology Periodical Database, and China biomedical literature database from inception to July, 2020. And Baidu Scholar, Google Scholar, International Clinical Trials Registry Platform, and Chinese Clinical Trials Registry will be searched to obtain more relevant studies comprehensively. Two researchers will perform data extraction and risk of bias assessment independently. Statistical analysis will be conducted in RevMan 5.3.

RESULTS

This study will summarize the present evidence by exploring the efficacy and safety of acupoint application combined with western medicine for the treatment of allergic rhinitis.

CONCLUSIONS

The findings of the study will provide helpful evidence for the efficacy and safety of acupoint application combined with western medicine in the treatment of allergic rhinitis, facilitating clinical practice and further scientific studies.

ETHICS AND DISSEMINATION

The private information from individuals will not publish. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF REGISTRATION NUMBER

DOI 10.17605/OSF.IO/NSGJH.

[Efficacy of medicinal penetration on acupoint as adjunctive therapy on histiocytic necrotizing lymphadenitis of heat-toxin syndrome: a randomized controlled trial]

OBJECTIVE

To evaluate the clinical efficacy of medicinal penetration on acupoint combined with medication for histiocytic necrotizing lymphadenitis (HNL) of heat-toxin syndrome, and to explore the methods of improving the clinical effect.

METHODS

A total of 72 cases with HNL with heat-toxin syndrome were randomly divided into an observation group and a control group, 36 cases in each group. The patients in the control group were treated with oral administration of prednisone tablets for 40 days (first 5 days: 10 mg, three times a day; since then, reduced by 5 mg every 7 days). In the observation group, on the basis of the medication in the control group, the patients were treated with acupoint application and ultrasonic drug penetration therapy, once a day for 14 days. The acupoints of Waiguan (TE 5), Fengchi (GB 20) of affected side and ashi points were selected. The changes of target lymph node swelling, visual analogue score (VAS), axillary temperature and total score of symptoms and signs were evaluated before treatment and 7, 14, 28 and 40 d into treatment; the changes of white blood cell (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and lactic dehydrogenase (LDH) were evaluated on 14 d and 40 d into treatment; the patients were followed-up for half a year.

RESULTS

① Fourteen days into treatment, the clinical cured rate in the observation group was 38.9% (14/36), which was superior to 16.7% (6/36) in the control group (P<0.01); the clinical cured rates were both 100% in the two groups on 40 d into treatment. ② The VAS score, axillary temperature and the total score 7 d into treatment, as well as node swelling, VAS score, axillary temperature and the total score 14, 28 and 40 d into treatment in the two groups were significantly improved (P<0.01); the total score and VAS score of 7 d into treatment, target lymph node swelling, VAS score and total score of 14 d into treatment in the observation group were significantly improved than those in the control group (P<0.01). ③ Compared before treatment, WBC, CRP, ESR in the two groups were significantly improved 14 d and 40 d into treatment (P<0.01), and LDH in the two groups were decreased 40 d into treatment (P<0.01), but there was no significant difference between the two groups (P>0.05). ④ The recurrence rate in the observation group was 5.6% (2/36), which was similar to 16.7% (6/36) in the control group (P>0.05).

CONCLUSION

The medicinal penetration on acupoint as adjunctive treatment could effectively relieve the discomfort symptoms of HNL patients with syndrome of heat and toxin, improve the clinical cured rate, and provide the research direction for shortening the course of medication.

Effect of acupoint application on T lymphocyte subsets in patients with chronic obstructive pulmonary disease: A meta-analysis

BACKGROUND

The development of chronic obstructive pulmonary disease (COPD) is related to the T lymphocyte mediated inflammatory immune response and immune imbalance. The purpose of this systematic review was to evaluate the clinical efficacy and safety of acupoint application on T lymphocyte subsets in patients with COPD.

METHODS

We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, the Cochrane Library, and EMBASE for studies published as of Oct. 31, 2019. All randomized controlled trials of acupoint application on COPD patients that met the inclusion criteria were included. The Cochrane bias risk assessment tool was used for literature evaluation. RevMan5.3 software was used for meta-analysis.

RESULTS

Eight studies (combined n = 524) qualified based on the inclusion criteria. Compared with routine treatment alone, acupoint application combined with routine treatment can significantly increase the T lymphocyte CD4/CD8 ratio (MD 0.12, 95% CI 0.03-0.21, P < .01, I = 49%), reduce CD8 T-cells (MD-0.99, 95% CI-1.70-0.28, P < .001, I = 37%), reduce the times of acute exacerbations (MD-0.28, 95% CI-0.35-0.21, P < .001, I = 0), and improve the clinical efficacy (MD 1.30, 95% CI 1.14-1.48, P < .001, I = 39%).

CONCLUSION

Acupoint application can improve the CD4/CD8 ratio and CD8 T-cells in patients with COPD and has an auxiliary effect in reducing the times of acute exacerbations and improving clinical efficacy.

A randomized controlled trial for prevention of acute exacerbation of stable chronic obstructive pulmonary disease with acupoint application of traditional Chinese medicine: Study protocol clinical trial (SPIRIT Compliant)

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) is a major public health problem that severely affects the quality of life of patients and may even endanger their lives. Although modern medicine has achieved significant results in relieving the clinical manifestations of COPD, it is difficult to prevent its progression and acute exacerbation entirely. As one of the classic aspects of acupuncture and moxibustion therapy, acupoint application of traditional Chinese medicine (TCM) can improve the clinical efficacy of western medicine in treating COPD. To date, however,there is no high-quality clinical trial to assess the effectiveness of TCM acupoint application directly in preventing acute exacerbation of stable COPD.

METHODS

The study is a randomized, double-blind, placebo-controlled trial, in which 200 stable COPD patients will be randomly and equally divided into the experimental group or control group. Both groups will undergo standard Western medicine treatment; however, the patients in the experimental group will be also treated with TCM acupoint application, while the control group will be given placebo acupoint application. The duration of the treatment will be 1 month and a follow-up for 11 months. The primary outcome will be the number of acute exacerbation episodes of COPD, and the secondary outcomes will include the lung function, St George's Respiratory Questionnaire, COPD Assessment Test, and 6-Minute Walk Test. A safety assessment will also be performed during the trial.

DISCUSSION

The aim of this study is to evaluate the efficacy and safety of TCM acupoint application in preventing acute exacerbation of stable COPD. Our study will provide sound evidence to support the evidence-based medicine of TCM acupoint application as an additional measure in the prevention of acute exacerbation of stable COPD.

TRIAL REGISTRATION

ChiCTR1900026564, Registered 14 October, 2019.

[Moderate and severe persistent allergic rhinitis treated with acupoint application therapy of the different intensity: a randomized controlled trial]

OBJECTIVE

To evaluate the clinical therapeutic effects and safety on moderate and severe persistent allergic rhinitis treated with acupoint application therapy of the different intensity during the dog days.

METHODS

One hundred and sixty patients of moderate and severe persistent allergic rhinitis were randomized into a No.1 treatment group, a No.2 treatment group, a No.3 treatment group and a placebo group, 40 cases in each one. The same acupoints were used in the four groups, named Dazhui (GV 14), Dingchuan (EX-B1), Feishu (BL 13), Pishu (BL 20), Mingmen (GV 4), Gaohuang (BL 43), Shenshu (BL 23) and Qihai (CV 6). In the three treatment groups, the fine powder of the ingredients (semen brassicae, radix angeliceae, asarum sieboldii, rhizome corydalis) of compound baijiezi formula was used. In the No.1 treatment group, the herbal paste (ginger-prepared paste) was prepared with ginger juice and the above herbal powder. In the No.2 and No.3 treatment groups, the herbal paste (honey-prepared paste) was prepared with honey with the above herbal powder. In the placebo group, the pseudo-herbal paste of the same appearance was prepared with millet powder and distilled water. The acupoint application was given for 2 h in the No.1 and No.2 groups and was for 6 h in the No.3 treatment group and the placebo group. The acupoint application therapy was given once every week during the dogdays, continuously for 5 weeks. The total nasal symptom score (TNSS), the score of the rhinoconjunctivitis quality of life questionnaire (RQLQ) and the count of blood eosinophils (EOS) were observed in the patients of the 4 groups before and after treatment. The clinical therapeutic effects were compared among the 4 groups. The incidences of the skin adverse reactions were observed in each treatment group.

RESULTS

After treatment, the scores of TNSS and RQLQ were all reduced as compared with those before treatment in the three treatment groups (P<0.05, P<0.01), in which, the improvements in the No.3 treatment group were better than those in the No.1 treatment group and the No.2 treatment group (both P<0.05). After treatment, the count of EOS was all reduced as compared with that before treatment in the three treatment groups (all P<0.05). The differences were not significant statistically among the three treatment groups (all P>0.05). The total effective rate was 85.0% (34/40) in the No.3 treatment group, better than 76.3% (29/38) in the No.1 treatment group, 71.8% (28/39) in the No.2 treatment group and 5.0% (2/40) in the placebo group (P<0.05, P<0.01). The incidences of the skin adverse reaction in the No.3 treatment group and the No.2 treatment group were lower than those in the No.1 treatment group (both P<0.01).

CONCLUSION

The acupoint application of the different intensity relieves the symptoms and improves the living quality in the patients of moderate and severe persistent allergic rhinitis. The stimulation of the ginger-prepared herbal paste is strong and induces skin blisters after 2 h herbal application. The stimulation of the honey-prepared herbal paste is moderate and does not induce blisters. The 6 h stimulation of the honey-prepared herbal paste is mild and the therapeutic effect is optimal.

[Optimization of acupoint application scheme in the treatment of bronchial asthma based on the orthogonal design method]

OBJECTIVE

To study the primary and secondary factors of the allergic history, the frequency of acupoint application and the time of acupoint application in the treatment of bronchial asthma and optimize its scheme.

METHODS

Eighty patients of bronchial asthma were selected as the subjects in the orthogonal trial. The herbal medicines were the empirical formula of acupoint application (prepared at the ratio as 2:2:1:1:1:1:1:1:1 of semen brassicae, rhizome corydalis, unprocessed radix kansui, asarum sieboldii, ephedra, semen lepidii, syzygium aromaticum, cortex cinnamomi and fructus gleditsiae) and used on bilateral Feishu (BL 13), Xinshu (BL 15), Geshu (BL 17) and Shenshu (BL 23). Firstly, two groups were divided according to allergic history (40 cases with allergic history and 40 cases without allergic history), and then four subgroups were divided on the basis of the two main groups, 10 cases in each one. Through studying three factors and two levels, i.e. allergic history (Factor A:A_Ⅰ:with allergic history; A_Ⅱ:without allergic history), the frequency of acupoint application (Factor B:B_Ⅰ:4 times; B_Ⅱ:10 times, in which, in the group of 4-time applications, the application was given once every 10 days; in the group of 10-time applications, the application was given once every 4 days); and the time of application (Factor C:C_Ⅰ:4 h; C_Ⅱ:8 h), the optimal scheme was screened on the basis of the attack frequency before and after treatment and the score of the asthma quality life questionnaire (AQLQ) before treatment and 6 months after treatment in the patients of each group.

RESULTS

① The orthogonal trial indicated that the best optimal scheme was A_ⅠB_ⅡC_Ⅰ, meaning the patients with allergic history were treated with acupoint application for 10 times, remained for 4 h. ②Factor B (frequency of acupoint application) and C (time of acpoint application) were the significant influential factors of AQLQ scores (both P<0.05). ③The comparison of the attack frequency and AQLQ score before and after treatment in all of the patients showed that the different combinations of factor levels induced the different impacts on the asthma attack frequency and AQLQ scores. Except in the group No.1 and the group No.5, the improvements were all significant in the rest groups, indicating the significant differences (P<0.05, P<0.01).

CONCLUSIONS

Acupoint application reduces apparently the attack frequency of asthma in the patients and improves the living quality. The primary and secondary relationship among the allergic history, the frequency of acupoint application and the time of acupoint application for the impacts on the therapeutic effects are:the frequency of acupoint application > the time of acupoint application > the allergic history. The best optimal scheme is AⅠBⅡCⅠ, meaning the patients with allergic history are treated with acupoint application for 10 times, remained for 4h.

[Point application in literature of Dunhuang stone chamber and its application]

Acupuncture-moxibustion material found in Dunhuang stone chamber shows academic value on research of acupuncture-moxibustion in Tang Dynasty and before. In the paper we summarize its medical prescriptions and the existing acupoint application contents. It is considered that its acupoint application is widely clinically used in dermatological department, cosmetology department, ophthalmology and otorhinolaryngology departments, paediatrics department, gynaecology department, anorectal department, orthopedics and traumatology department. It achieves remarkable effects in dermatological department, orthopedics and traumatology department. Medical literature of Dunhuang is a treasure of TCM with distinctive feature and it deserves to be further explored so as to serve the clinic and promote the inheritance and development of Dunhuang medicine, such as finding out high effect prescription.