Search

Increasing evidence shows that acupuncture therapy may have a role in promoting fertilization. Authors of the present paper collected the related articles in English published from January 2003 to May 2013 in databases of Ovid Medline, Maternity and Infant Care and Medline (Pubmed), and made an analysis. Results of many randomized controlled clinical trials (RCT) indicated that acupuncture intervention had a positive role in raising pregnancy rate, fetus surviving rate of the transplanted embryo, and increasing the neuropeptide Y content in the ollicular fluid in patients experiencing embryo transplantation, and in raising survival rate of zygote, conception rate of embryo transplantation, and in improving azoospermia in patients undergoing in vitro fertilization. But many systematic reviews and Meta-analysis did not support the above-mentioned conclusion of acupuncture therapy about promoting fertilization. The authors hold that despite of dominated positive outcomes of RCT for acupuncture-assisted fertilization, further well designed RCT are still warranted for providing further definite and convincing evidence.

Objective: To explore the clinical efficacy and action mechanism of acupuncture for premature ovarian failure (POF)., Methods: According to prospective cohort study design, 30 cases were included. Based on theory of regulating Chong and Conception Vessels as well as soothing the liver and calming the nerves, acupuncture at Guanyuan (CV 4), Dahe (KI 12), Taixi (KI 3), Taichong (LR 3), Baihui (GV 20) was applied, three times per week and 3 months were considered as one session. Totally two sessions were performed. The menstruation condition, estradiol (E2), follicle-stimulating hormone (FSH) and scores of the clinical perimenopausal symptoms were taken as treatment outcomes., Results: The total effective rate was 86.7% (26/30) and the cured rate was 16.7% (5/30). The recovery rate of menstruation was 16.7% (5/30) and the regain rate of menstruation was 56.7% (17/30). After the treatment, the level of E2 was significantly increased from (45.41 +/- 18. 09) pmol/L to (59.07 +/- 24.21) pmol/L (P < 0.05), and the score of perimenopausal symptoms was obviously reduced from 14.28 +/- 8. 30 to 4.04 +/- 3.28 (P < 0.01). However, no statistical differences could be seen in FSH before and after treatment (P > 0.05)., Conclusion: Acupuncture has certain effect on improving menstruation and perimenopausal symptoms in POF patients, which is likely to he related with increasing the level of E2.

After searching for literature about the specificity of acupoints from China National Knowledge Infrastructure (CNKI) database (in Chinese) and MEDLINE (in English), published by Chinese scholars from June 2003 to June 2012, the authors made a systemic analysis on the retrieved papers. It was found that most Chinese scholars took a positive viewpoint about the specificity of acupoints in morphological structure, biophysical characters, pathological reactions, acupuncture stimulation-induced responses in different brain regions and therapeutic effects. However, the research methods and comprehensive analysis of abundant research results need being improved, and the conclusion should be validated extensively. Moreover, the research on the affecting factors of specificity of acupoints will be one of the major directions.

Objective: To observe the influence of electroacupuncture (EA) stimulation of "Hegu" (LI 4) and "Sanyinjiao"(SP 6; a classical delivery-facilitating acupoint recipe) at different parameters on endocrine hormone levels of late-stage pregnant rats, so as to find the better stimulation parameters for delivery facilitation., Methods: Ninety-six female Wistar rats were randomly divided into eight groups: normal control (normal), pregnancy (model), EA-15 Hz, EA-30 Hz, EA-50 Hz, EA-2 Hz/ 15 Hz, EA-2 Hz/30 Hz and EA-2 Hz/50 Hz, with 12 rats in each group except EA-30 Hz group (n = 10). EA stimulation (0.2 to 0. 3 mA) was delivered to bilateral LI 4 for 20 min and then bilateral SP 6 for 5 min (25 min). The contents of serum estradiol (E2), progesterone (P) and prostaglandin E2 (PGE2) were detected by ELISA., Results: Compared with the normal group, serum E2, P and PGE2 contents were significantly increased in the pregnancy model group (P<0.01), and E2/ P level was downregulated mildly (P>0.05). Compared with the model group, the contents of serum E2 in the EA-15 Hz, EA-30 Hz, EA-50 Hz, EA-2 Hz/15 Hz and EA-2 Hz/50 Hz groups, serum PGE2 contents in the EA-15 Hz, EA-30 Hz and EA-2 Hz/50 Hz groups, and E2/P levels in the EA-15 Hz, EA-30 Hz, EA-50 Hz and EA-2 Hz/50 Hz groups were significantly increased (P<0.01, P<0.05), whereas serum P contents in the EA-15 Hz, EA-30 Hz, EA-50 Hz and EA-2 Hz/50 Hz groups were significantly down-regulated (P<0. 01, P<0. 05). The effects of EA-2 Hz/50 Hz group were significantly superior to those of EA-2 Hz/15 Hz and EA-2 Hz/ 30 Hz groups in raising serum E2 and E2/P levels (P<0.05, P<0.01). No significant differences were found among the EA-15 Hz, EA-30 Hz, EA-50 Hz and EA-2 Hz/50 Hz groups in raising serum E2, PGE2 and E2/P levels, and among the EA-30 Hz, EA-50 Hz and EA-2 Hz/50 Hz groups in lowering serum P levels (P>0. 05). It displayed that the effects of EA at 15 Hz, 30 Hz and 2 Hz/50 Hz on the abovementioned 4 indexes were relatively better., Conclusion: EA of LI 4 and SP 6 at 15 Hz, 30 Hz and 2 Hz/ 50 Hz can effectively up-regulate serum E2, PGE2 and E2/P levels and down-regulate serum P content in pregnancy rats, which may contribute to its effect in promoting labor.

Objective: To observe the mechanism of the optimized traditional acupuncture prescription for accouchement on cervical ripening based on the molecular biology by observing related indices of cervical ripening in late-stage pregnant rats., Methods: Twenty initial pregnant Wistar rats were randomly divided into an electroacupuncture (EA) group (n = 10) and a model group (n = 10), and other 10 non-pregnancy female rats with same lot were selected as a blank control group. EA group was treated with the optimized traditional acupuncture prescription for accouchement on the 20th day of pregnant, which performed EA at bilateral "Hegu" (LI 4) for 20 min and then at bilateral "Sanyinjiao" (SP 6) for 5 min with 2 Hz/50 Hz sparse-dense wave, while the other groups without acupuncture intervention. The contents of matrix metalloproteinase 9 (MMP-9) and interleukin 8 (IL-8) in cervix tissue were detected by ELISA method., Results: Compared with the blank control group, the contents of MMP-9 and IL-8 in the model group were increased significantly (both P < 0.01). Compared with the model group, the contents of MMP-9 and IL-8 in the EA group were increased significantly (P < or = 0.05)., Conclusion: Optimized traditional acupuncture prescription for accouchement can increase the contents of MMP-9 and IL-8 in cervix tissue of late-stage pregnant rats so as to promote cervical ripening, and the mechanism of EA in promoting cervical ripening is explained from the perspective of molecular biology.

Through CNKI retrieval, 40 articles were selected from Medical Journals published between January 2003 and December 2011, and the study designs, intervention methods and conclusions of the articles were analyzed. It turned out that in the area of clinical research, the main usage of acupuncture was assist treatment of artificial abortion and drug-induced abortion: in artificial abortion, acupuncture can play a role in analgesia, artificial abortion syndrome relieving, and cervix dilating, while in the drug induced abortion, acupuncture can play a role in improving completed abortion rate, accelerating foetal sac release, decreasing side effects and regulating postoperative bleeding. In mechanism research, the effect of acupuncture on uterine tissue was revealed in terms of neuroendocrine. Although the certain role of acupuncture in assisting artificial abortion and drug-induced abortion has been confirmed in numerous clinical trials, its mechanism revealing was limited. The further study should focus on improving research method, acupuncture manipulation standardization and stimulation parameters optimization. What's more, the revealing of acupuncture's role in anti-early pregnancy should be emphasized to improve its effectiveness and scientificalness.

Objective: To observe the effect of electroacupuncture (EA) at different frequencies on serum estradiol (E2), progesterone (P), thromboxance B2 (TXB2), 6-Keton-prostaglandin F 1 alpha (6-keto-PGF1alpha) contents in late pregnancy rats so as to study its mechanisms underlying labor promotion., Methods: A total of 66 late-stage pregnant Wistar rats were randomly divided into 6 groups: normal control, late-pregnancy model (model), 2 Hz-EA, 20 Hz-EA, 50 Hz-EA and 100 Hz-EA groups, with 11 rats in each group. On the 19th day after pregnancy, EA (2 Hz, 20 Hz, 50 Hz, 100 Hz, 0.1 mA) was applied to bilateral "Hegu" (LI 4) for 20 min first and to bilateral "Sanyinjiao" (SP 6) for 5 min afterwards. Serum E2, P, TXB2 and 6-keto-PGF1alpha contents were assayed by radioimmunoassay, and the ratios of E2/P and TXB2/6-keto-PGF1alpha were calculated., Results: Compared to the normal control group, serum E2 contents in 2 Hz-EA, 20 Hz-EA, 50 Hz-EA and 100 Hz-EA groups were increased significantly (P < 0.001, P < 0.01, P < 0.05). Compared to the model group, serum E2 levels in the 2 Hz-EA and 20 Hz-EA groups were up-regulated further significantly (P < 0.05). Comparison among the four EA groups showed that serum P level in the 100 Hz-EA group was significantly higher than those in the 20 Hz-EA and 50 Hz-EA groups (P < 0.05). Compared to the normal control group, the contents of serum TXB2 and the ratios of E2/P in both 2 Hz-EA and 50 Hz-EA groups were significantly higher (P < 0.05, P < 0.001, P< 0.01)., Conclusion: Both 2 Hz and 20 Hz EA can effectively increase serum E2 content, and 2 Hz and 50 Hz EA can raise serum TXB2 and E2/P levels in late pregnancy rats, which may contribute to their effects in strengthening the uterine contractility to promote labor by regulating hormone secretion.

In the present review, the authors sumarrize current situations about application of acupuncture and moxibustion therapies in the maternity department in countries outside China in accordance with 68 articles in English published from 2000 to 2011. The clinical application includes: 1) dilivery processing, 2) lumbo-sacrodynia, 3) dilivery pain, 4) pregnancy problems, 5) problems of post-dilivery, 6) conversion of fetal breech presentation, 7) nausea and vomitting during early pregnancy, 8) safety, 9) depression during pregnancy, and 10) blood supply of fetus. In addition, the retrieved papers include 13 review papers, 4 survey papers and one animal study. Although the purposes of those clinical trials are different, most of them focus on acupuncture analgesia. Despite most of those clinical trials achieved positive results particularly in pain relief, nausea remission, etc., and majority of the pregnant women were willing to accept acupuncture intervention, most systematic reviews or meta-analysis do not show conclusively positive results, and stress that further well designed researches are warranted for providing convincing evidence

Based on the retrieval of literatures at home and abroad from 2000 to 2011, the evaluation indices of acupuncture clinical trials for primary dysmenorrhea (PD) were analyzed. The results indicated that in domestic area the reports were more concerned with the improvement of clinical symptoms and signs while paid less attention on the objective evaluation methodology, on the other hand, the studies abroad generally took many kinds of scales as their evaluation indices and focused on the patients' quality and activity of daily life. The authors suggeste that our clinical research, according to the designed intentions, should combine the general indicators with the specific indicators of diseases to have a more comprehensive evaluation on the effects of acupuncture for PD in clinical practice.

Acupuncture prescription is the key and effectiveness guarantee to acupuncture treatment. Proper selection of acupoint is directly related to the therapeutic effect of acupuncture. Several issues were discussesed, which were acupoint indications, clinical syndrome differentiation and acupoints selection. Acupuncturists should grasp the acupoints characteristic and pay attention to syndrome differentiation. Also they should have flexible selection of acupoints and keep pace with research updates when facing clinical problems in order to maximize the curative effect of acupuncture.

Objective: To select the most effective parameters of electroacupuncture (EA) at Hegu (LI4) and Sanyinjiao (SP6), a traditional acupuncture formula that induces labor, by comparing its effects on uterine contraction in late-stage pregnant rats, so as to improve the effects of acupuncture on induction of labor and its clinical maneuverability and provide the basis for further mechanism research., Methods: One hundred and eight female healthy adult Wistar rats were randomly divided into eight groups including one non-pregnancy control group (normal control group) and seven pregnant groups. Pregnant rats were prepared by free mating and vaginal plugs observation method and were randomly divided into six EA groups and one no EA group (model group) according to the requirements of a 2×3 factorial design. EA parameters included 2 types of waves (continuous wave and sparse-dense wave) and 3 types of frequency (15, 30 and 50 Hz). Rats in treatment groups received EA on bilateral LI4 for 20 min and then bilateral SP6 for 5 min with certain parameters accordingly. Each acupoint and a nearby non-acupoint at the proximal end (2 to 3 mm from the acupoint) were connected with two leads of one EA line. The current intensity of EA was 0.2 to 0.3 mA. A muscle tension transducer and the BL-420 Biological Experimental System were placed on the lower uterine segment of rats for detecting contractility, frequency and lasting-time of contraction wave., Results: Compared with non-pregnancy control group, the amplitude, frequency and lasting time of contraction waves of uterine contraction in all EA groups and model group were significantly increased. Compared with control group, amplitudes of contraction waves of uterine contraction of both EA1 group (15 Hz continuous wave) and EA6 group (2/50 Hz sparse-dense wave) were significantly increased (P<0.01 or P<0.05); frequency of contraction waves of uterine contraction of EA6 group was significantly increased (P<0.01 or P<0.05); lasting time of contraction waves of uterine contraction of EA1 group, EA5 group (2/30 Hz sparse-dense wave) and EA6 group were significantly increased (P<0.01 or P<0.05). Comparisons between EA6 group and the other EA groups showed that, EA6 group had significantly higher levels of amplitude and frequency of contraction waves of uterine contraction than the other EA groups (P<0.01 or P<0.05) except EA1 group, there was no significant difference between EA1 group and EA6 group (P>0.05), but the mean value of EA6 group was higher than that of EA1 group; EA6 group had significantly higher levels of lasting time of contraction waves of uterine contraction than the other EA groups (P<0.01 or P<0.05) except EA1 group and EA5 group, there was no significant difference between EA6 group and EA1 group or EA5 group (P>0.05), but the mean value of EA6 group was higher than EA1 group and EA5 group., Conclusion: EA with sparse-dense wave (2 Hz sparse wave and 50 Hz dense wave, alternately) at LI4 and SP6 was more effective than other EA parameters for increasing uterine contraction amplitude, frequency, and lasting-time of contraction waves in late-stage pregnant rats. This combination of electric wave and frequency for EA at LI4 and SP6, a traditional acupuncture formula for inducing labor, is recommended to be applied in clinical practice for parturition as well as for treatment of uterine atony.

Using literature research in CNKI, VIP, and CBM from 2002 to 2008, sixty-five papers were retrieved. The results reveals that the research of acupuncture application in inducing labor focused on clinical practices, acupuncture has remarkable effectiveness and its advantages in facilitating contractions, shortening birth process, and elevating labor pain. However, the clinical trials demands large sample of multi-center randomized controlled trials, improved standard evaluation system, consistency in research, and further exploration in basic re search. These areas demand further devetions from acupuncture researchers.