Search

To observe the effect of electroacupuncture (EA) on pain behavior, synovial inflammatory response and demyelination of saphenous nerve in the rats modeled with knee osteoarthritis (KOA) and explore the effect mechanism of EA for reliving allodynia.Eighty-four male SD rats were randomly divided into a control group, a model group and an EA group, 28 rats in each one. Intra-articular injection of sodium monoiodoacetate (MIA) was administered in right knee joint of each rat in the model group and the EA group to establish the KOA model. In the EA group, separately, on day 5, 7 and 9 after modeling, EA was applied at "Zusanli" (ST 36) and "Yanglingquan" (GB 34) on the right side, with disperse-dense wave (2 Hz/15 Hz), 1 mA in current intensity, for 30 min in one intervention, once a day, and 3 interventions were required. On the 9th day after modeling, the weight-bearing rate was calculated for the affected limbs of the rats in each group, the synovial morphological changes were observed using HE and Masson staining, flow cytometry was adopted to detect the synovial immunocyte counts, and MSD multi-spot assay was used to detected the synovial inflammatory cytokine content. On the 14th day after modeling, the hind-paw mechanical withdrawal threshold was observed in each group and the ultrastructure of the saphenous nerve was observed under transmission electron microscopy.On the 9th day after modeling, compared with the control group, the weight-bearing rate of the affected limb was reduced (The intervention with EA may attenuate the synovial inflammatory response and the injury of saphenous nerve in the affected limb of the rat with KOA, so that the spontaneous pain during the synovial inflammatory response stage and allodynia at the later stage are relieved.

Somatosensory autonomic reflexes allow electroacupuncture stimulation (ES) to modulate body physiology at distant sites1–6 (for example, suppressing severe systemic inflammation6–9). Since the 1970s, an emerging organizational rule about these reflexes has been the presence of body-region specificity1–6. For example, ES at the hindlimb ST36 acupoint but not the abdominal ST25 acupoint can drive the vagal–adrenal anti-inflammatory axis in mice10,11. The neuroanatomical basis of this somatotopic organization is, however, unknown. Here we show that PROKR2Cre-marked sensory neurons, which innervate the deep hindlimb fascia (for example, the periosteum) but not abdominal fascia (for example, the peritoneum), are crucial for driving the vagal–adrenal axis. Low-intensity ES at the ST36 site in mice with ablated PROKR2Cre-marked sensory neurons failed to activate hindbrain vagal efferent neurons or to drive catecholamine release from adrenal glands. As a result, ES no longer suppressed systemic inflammation induced by bacterial endotoxins. By contrast, spinal sympathetic reflexes evoked by high-intensity ES at both ST25 and ST36 sites were unaffected. We also show that optogenetic stimulation of PROKR2Cre-marked nerve terminals through the ST36 site is sufficient to drive the vagal–adrenal axis but not sympathetic reflexes. Furthermore, the distribution patterns of PROKR2Cre nerve fibres can retrospectively predict body regions at which low-intensity ES will or will not effectively produce anti-inflammatory effects. Our studies provide a neuroanatomical basis for the selectivity and specificity of acupoints in driving specific autonomic pathways. Neuroanatomical findings demonstrate why electroactupuncture at only specific acupoints can drive the vagal–adrenal axis and treat inflammation in mice.

To investigate the mechanism of electroacupuncture (EA) "Zusanli" (ST36) in delaying colon "inflammation-cancer transformation" in mice by anti-inflammatory.C57BL/6J mice were randomly divided into normal, model and EA groups, with 12 mice in each group. The mouse model of colorectal cancer (CRC) was established by intrape-ritoneal injection of azomethane (AOM) and feeding dextran sodium sulfate (DSS). At the beginning of the 2Compared with the normal group, the colon length was significantly shortened (Electroacupuncture at ST36 can inhibit the inflammatory response of AOM/DSS inflammatory associated CRC mice and delay the "inflammation-cancer transformation" of colon.

In the view of the controversy that there is no efficacy difference between true and sham acupuncture in acupuncture randomized controlled trials (RCTs), it is analyzed that one of the reasons is that many clinical studies do not properly understand the design of RCT research and interpret the research results. Starting from the concept and coverage of explanatory RCT and pragmatic RCT, this study lists the application examples of two types of RCTs in the field of acupuncture from five aspects: research purpose and trial environment, subject selection, intervention measures, control measures and outcome evaluation, so as to provide some ideas for their application in clinical trials.针对针刺随机对照试验（RCT）中真假针刺疗效无差异的结论引发的争议，分析其原因之一是很多临床研究对RCT研究设计理解与研究结果解读的不恰当。本文从解释性RCT与实用性RCT的概念与涵盖范畴出发，从研究目的与试验环境、受试者选择、干预措施、对照措施及结局评价5个方面列举两种RCT在针刺领域的应用实例，为其在临床试验中的应用提供一定的思路。.

ObjectiveThe aim of this study was to evaluate the efficacy of acupuncture, an alternative medicine therapy, as a preventive treatment for menstruation-related migraine (MRM).Patients and methodsThis was a prospective, multicenter, double-dummy, participant-blinded, randomized controlled clinical trial conducted in China between 1 April 2013, and 30 April 2014. The participants were enrolled from four study centers and randomized to into either the acupuncture group, which received 24 sessions of acupuncture at traditional acupoints plus placebo, or the medication group, which received sham acupuncture plus naproxen. The primary endpoint was change from the baseline average number of migraine days per perimenstrual period over cycles 1−3. The secondary endpoints included changes from the baseline average number of migraine days outside the perimenstrual period, mean number of migraine hours during and outside the perimenstrual period, mean visual analog scale score during and outside the perimenstrual period, ≥50% migraine responder rate, and the proportion of participants who used acute pain medication over cycles 1−3 and 4−6.ResultsA total of 172 women with MRM were enrolled; 170 in the intention-to-treat analyses. Our primary outcome reported a significant between-group difference that favored the acupuncture group (95% CI, 0.17–0.50; P < 0.001), with the average reduction of migraine days per perimenstrual period from the baseline was 0.94 (95% CI, 0.82–1.07) in the acupuncture group and 0.61 (95% CI, 0.50–0.71) in the medication group over cycles 1−3.ConclusionThis study showed that compared to medication, acupuncture reduces the number of migraine days experienced by patients with MRM. For patients who received the acupuncture treatment over three cycles, the preventive effect of the therapy was sustained for six cycles.Clinical trial registration[https://www.isrctn.com/ISRCTN57133712], identifier [ISRCTN15663606].

To investigate the changes of skin temperature, blood infusion and inflammatory cytokines of cutaneous tissue in the sensitized area of colitis model rats, as well as the relationship between sensory and sympathetic nerves and the formation of sensitized area, and to initially reveal the partial physicalThirty-five male SD rats were randomly divided into a control group (Sensitization occurred at the TThe sensitized areas on the body surface of colitis rats are mainly distributed in the L

The systematic reviews (SRs) of acupuncture published before December 31 of 2020 in PubMed, Cochrane and EMbase databases were searched, and the publication overview of international acupuncture SRs were analyzed. As a result, a total of 717 SRs were included, and the overall number of published SRs showed a fluctuating upward trend. A total of 15 categories of diseases were involved, of which 113 SRs suggested that acupuncture was effective, and 12 SRs did not support acupuncture, and the remaining SRs showed uncertain conclusions. It is suggested that the standard of evidence-based medicine should be adopted to standardize the design of acupuncture trial and improve the level of clinical research; SRs should include high-quality literature that met the standards according to the principles and methods of PRISMA, so as to provide reliable clinical evidence for acupuncture.检索并分析PubMed、Cochrane和EMbase数据库从建库起至2020年12月31日发表的针灸系统评价（SR）文献，分析国际针灸SR的发表现状。共纳入717篇针灸SR文献，总体发文数量呈波动式上升趋势。共涉及15大类疾病，其中113篇认为针灸治疗有效，12篇不支持针灸治疗，其他结论尚不确定。建议采用循证医学标准规范针灸试验设计，提高临床研究水平；SR研究应参照PRISMA报告的原则和方法筛选符合标准的优质文献，为针灸疗法提供可靠的临床证据。.

To explore the influencing factors of acupuncture curative effect in literature of experts' experience. The journal literature of experts' experience was retrieved from China National Knowledge Infrastructure (CNKI) and PubMed, starting from inception to September 4, 2020, and the influencing factors of acupuncture curative effect were extracted and analyzed. A total of 499 articles were included, involving 495 articles in Chinese and 4 articles in English. The influencing factors of acupuncture curative effect mainly include five aspects: diagnostic method, acupoint selection of acupuncture, acupuncture manipulation, regulating mind of acupuncture and acupuncture time, and provide reference for acupuncture protocol design in clinical trials.探讨专家经验类文献中提及的针刺疗效的影响因素。通过检索中国期刊全文数据库（CNKI）和PubMed从建库至2020年9月4日收录的专家经验类期刊文献，提取针刺疗效的影响因素进行归纳分析。结果共纳入499篇文献，包括495篇中文和4篇英文文献。针刺疗效影响因素主要包括诊断方式、针刺取穴、针刺操作、针刺调神、针刺时间5个方面，为临床试验中针刺方案设计提供参考。.

To observe the pressure pain threshold (PPT), skin conductance (SC) and blood perfusion (BP) of the sensitized acupoints in patients with knee osteoarthritis (KOA), and explore the mechanism of acupuncture at the sensitized acupoints for treating diseases.Eleven healthy subjects and 11 unilateral KOA patients were recruited from July 2020 to March 2021 in this study. The PPT, SC and BP of control acupoints in healthy controls, and non-sensitized and sensitized acupoints in KOA patients were measured and compared between baseline and after manual acupuncture (MA) treatment.Before MA treatment, lower PPT was observed at the sensitized acupoints compared with non-sensitized and control acupoints (P0.05). After MA treatment, PPT at the sensitized acupoints increased significantly in KOA patients (P0.05). Before MA treatment, there was no statistical difference in SC and BP among control, non-sensitized and sensitized acupoints (P0.05). Compared with the control and non-sensitized acupoints, there were significant increases of SC and BP in sensitized acupoints of KOA patients after MA treatment (P0.05 or P0.01).MA at sensitized acupoints could elevate PPT of KOA patients, which may be associated with the increment of SC and BP.

Acetylcholine (ACh) is found not only in cholinergic nerve termini but also in the nonneuronal cholinergic system (NNCS). ACh is released from cholinergic nerves by vesicular ACh transporter (VAChT), but ACh release from the NNCS is mediated by organic cation transporter (OCT). Recent studies have suggested that components of the NNCS are located in intestinal epithelial cells (IECs), crypt-villus organoids, immune cells, intestinal stem cells (ISCs), and vascular endothelial cells (VECs). When ACh enters the interstitial space, its self-modulation or effects on adjacent tissues are part of the range of its biological functions. This review focuses on the current understanding of the mechanisms of ACh synthesis and release in the NNCS. Furthermore, studies on ACh functions in colonic disorders suggest that ACh from the NNCS contributes to immune regulation, IEC and VEC repair, ISC differentiation, colonic movement, and colonic tumor development. As indicated by the features of some colonic disorders, ACh and the NNCS have positive and negative effects on these disorders. Furthermore, the NNCS is located in multiple colonic organs, and the specific effects and cross-talk involving ACh from the NNCS in different colonic tissues are explored.

The clinical evidences on acupuncture and moxibustion for the treatment of frozen shoulder were sorted and summarized systematically. The relevant articles of frozen shoulder treated with acupuncture and moxibustion were searched from PubMed, EMbase, Cochrane database of systematic review (CDSR), Cochrane database of controlled trials register (CENTRAL), China national knowledge infrastructure (CNKI), Wanfang, VIP, and Chinese biomedical literature databases (SinoMed), from database inception to May 31, 2021. Using AMSTAR-2, the methodological quality of the included systematic reviews was evaluated. With evidence map, the current status of clinical evidence was summarized on acupuncture and moxibustion in treatment of frozen shoulder. A total of 266 original studies and 6 systematic reviews were included finally. At present, many randomized controlled trials are designed with small sample size and the simple acupuncture and moxibustion therapy is dominant as the intervention, e.g. warm acupuncture, acupuncture with filiform needle, acupotomy and electroacupuncture. The outcomes considered in the current trials focus on clinical effective rate, the score of shoulder pain, the score of shoulder function and the score of quality of life. Most of the studies have shown that acupuncture and moxibustion is advantageous as an adjunctive therapy for frozen shoulder, but its clinical evidence is few in terms of the recurrence rate and safety. Moreover, it needs to improve the evidence quality of the relevant studies on acupuncture and moxibustion for frozen shoulder.梳理和总结针灸治疗肩周炎的临床研究证据。计算机检索PubMed、EMbase、Cochrane系统评价数据库（CDSR）、Cochrane对照试验注册数据库（CENTRAL）、中国期刊全文数据库（CNKI）、万方数据知识服务平台（Wanfang）、维普资讯中文期刊服务平台（VIP）和中国生物医学文献数据库（SinoMed）中针灸治疗肩周炎文献，检索时限为建库至2021年5月31日。采用AMSTAR-2评价纳入系统评价的方法学质量，并以证据图的形式总结针灸治疗肩周炎临床研究证据现况。共纳入原始研究文献266篇，系统评价文献6篇。目前小样本随机对照试验居多，干预措施以温针灸、毫针、针刀和电针等单一针灸疗法为主，临床有效率、肩关节疼痛评分、肩关节功能评分和生活质量评分是现有临床研究关注较多的结局指标。大多数研究结果显示了针灸作为肩周炎辅助治疗措施的优势，在疾病复发率以及安全性方面的临床证据较少。此外，针灸治疗肩周炎相关研究的证据质量也有待提高。.

October 2021,《自然》杂志于2021年10月刊登“电针驱动迷走-肾上腺轴的神经解剖学机制”一文，引起了针灸学术界的广泛关注和讨论。在前期工作的基础上，该研究证实PROKR2-Cre神经纤维在躯体不同部位和层次的差异性分布是电针低强度刺激“足三里”或“手三里”穴，通过“迷走-肾上腺轴”产生抗炎效应的关键。该研究成果是针灸基础科研领域的里程碑事件，是针灸学科与神经-免疫学科交叉相互碰撞融合的代表作，揭示了针刺起效的部分因素构成和穴位结构相对特异性的神经解剖学基础，对未来针灸科研模式的变革和针灸科研成果的转化具有一定指导意义，其研究思路、方法和结论值得针灸科研工作者学习和借鉴。.

Knee osteoarthritis (KOA) is a degenerative disease, making a unique contribution to chronic pain, edema, and limited mobility of knee joint. Traditional Chinese Medicine (TCM) is a common complementary therapy for KOA and has been found effective. The aim of this review is to consolidate the current knowledge about the mechanism of four interventions of TCM: acupuncture, moxibustion, herbs, and massage in treating KOA, and how they alleviate symptoms such as pain, swelling, and dysfunction. Furthermore, this review highlights that four therapies have different mechanisms but all of them can manage KOA through inhibiting inflammation, which indicates that alternative therapies should be considered as a viable complementary treatment for pain management in clinical practice.

Objective The aim of this study was to compare the microstructure of blood vessels and nerve fibers between different acupoints in the rat skin from the perspective of histology. Methods The skin tissue at “Qūze” (曲泽 PC3)” “Daling (大陵 PC7)” and “Zhōngchōng (中冲 PC9)” regions was taken from the rat forelimb along the pericardium meridian, and cut sagittally with a freezing microtome. After that, the skin sections were stained by fluorescent histochemistry and immunohistochemistry with phalloidin and calcitonin gene-related peptide (CGRP) to reveal the microstructure of blood vessels and nerve fibers respectively, and then examined under a laser scanning confocal microscope. Results The microstructure of blood vessels and nerve fibers was clearly labeled with phalloidin and CGRP, respectively. The blood vessels and nerve fibers were observed in the dermis of “PC3” “PC7” and “PC9” regions, where the bundle of nerve fibers distribute in parallel to the blood vessels, and sent out thin branches to surround the wall of the blood vessels. In contrast, the density of blood vessels and nerve fibers in “PC3” “PC7” and “PC9” were presented orderly in an increased tendency. Conclusion The results of present study demonstrate the differences of the neurovascular microstructure among “PC3” “PC7” and “PC9” in the rat, providing a histological view to insight into the specificity of different acupoints.

Objective Acupuncture has a therapeutic effect similar to that of prophylactic drugs and can be considered a treatment option for migraineurs. However, the mechanism of acupuncture treatment's effect on migraine is uncertain. An approach based on anti-inflammatory effects is an important treatment strategy for migraine because non-steroidal anti-inflammatory drugs (NSAIDs) are usually used during migraine attacks. Meningeal inflammation is thought to be responsible for the activation of the trigeminovascular system. Our previous study found that electroacupuncture (EA) decreased neurogenic inflammation mediator expression in the trigeminal ganglion (TG) and alleviated hyperalgesia. The present study examined whether EA would inhibit hyperalgesia by alleviating neurogenic inflammatory factors. Methods A rat model of migraine was established using dural electrical stimulation (DES). Five groups were analyzed in this study. The Model group received DES three times to mimic migraine attacks, a Control group had sham DES, and three groups received electroacupuncture after DES: a Non-Acu group at a non-acupuncture point, a GB20 group at GB20, and a GB20/34 group at GB20 and GB34 acupuncture points. We evaluated mechanical hyperalgesia using an electronic von Frey esthesiometer in the awake state. After sacrifice, the dura mater was analyzed using immunofluorescence. Serum calcitonin gene-related peptide, cyclooxygenase-2, brain-derived neurotrophic factor, IL-1β, IL-6, and TNF levels were determined using enzyme-linked immunosorbent assays to evaluate the anti-inflammatory effect of acupuncture. Results After repeated DES, we observed facial and hind paw mechanical hyperalgesia, which was inhibited by electroacupuncture. Electrical stimulation increased the number of mast cells and macrophages and serum levels of inflammatory factors. GB20 and GB20/34 electroacupuncture significantly decreased the number of mast cells and macrophages and serum levels of inflammatory factors. Moreover, electroacupuncture at GB20/34 was superior to that at GB20 alone in inhibiting hyperalgesia and alleviating inflammatory factors. Conclusion Electroacupuncture inhibits DES-induced hyperalgesia by alleviating inflammatory factors. Inhibition of dural mast cells, macrophages, and serum inflammatory factors may be one of the mechanisms involved in acupuncture treatment's effect on migraine.

Zhengyang Qu, 1 Lu Liu, 1, 2 Luopeng Zhao, 1, 3 Xiaobai Xu, 1 Zhijuan Li, 1 Yupu Zhu, 1 Chen Zhang, 4 Xianghong Jing, 2 Xiaoyu Wang, 2 Bin Li, 1 Claire Suiqing Zhang, 5 Marc Fisher, 6 Linpeng Wang 1 1Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People’s Republic of China; 2Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; 3Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, People’s Republic of China; 4Acupuncture and Moxibustion Department, Beijing Massage Hospital, Beijing, People’s Republic of China; 5School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia; 6Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USACorrespondence: Linpeng WangAcupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, No. 23 Meishuguanhou Street, Dongcheng District, Beijing 100010, People’s Republic of ChinaTel +86 1052176644Email wlp5558@sina.comPurpose: This rat experiment aims to demonstrate the efficacy of electrical acupuncture in preventing migraine attacks by stimulating the acupoint GB20.Introduction: Migraine, which takes 2ed at level four causes of GBD’s disease hierarchy, becomes a public health issue. It is important for physicians to supplement their knowledge of its treatment and consider alternative methods of therapy, such as acupuncture. However, the neurobiological and pathophysiological mechanisms of this prophylactic effect were unclear. The trigeminocervical complex is thought to be an important relay station in migraine pathophysiology as the key nuclei of the trigeminovascular system and the brainstem descending pain modulation system.Methods: There were six groups involved in this study: control, model, electroacupuncture, non-acupoint electroacupuncture, saline+electroacupuncture and saline+non-acupoint electroacupuncture. We injected saline or inflammatory soup into dura mater to induce control or migraine in the rats. The mechanical pain threshold and the single-cell extraneural neurophysiology of the C1 spinal dorsal horn neurons in the trigeminocervical complex were detected.Results: Pre-electroacupuncture could significantly increase the mechanical pain threshold of the periorbital region receptive field of the trigeminal nerve and decrease the discharges of neurons in the trigeminocervical complex. Acupuncture also reversed the abnormal skin pain response of the periorbital region receptive field of the trigeminal nerve caused by low-intensity stimulation.Discussion: We believe that our study makes a significant contribution to the literature because it is the first of its kind to use GB20 to provide relief from migraine attacks and mechanical cephalic cutaneous hypersensitivity by regulating the neuronal discharge from trigeminocervical complex.Keywords: acupuncture, headache prevention, hypersensitivity, electrophysiology, the trigeminocervical complex, inflammatory soup

With the worldwide spread of acupuncture as a therapeutic modality and the rapid development of acupuncture clinical research, the number of acupuncture randomized controlled trial (RCT) studies is steadily increasing in China and around the world. However, the results of these studies seem to come from two different worlds indeed. Chinese RCT studies overwhelmingly demonstrate positive outcomes from acupuncture, whereas Western-based studies generally conclude that there is no discernible difference between acupuncture and a placebo. Why should there be such different outcomes when the same scientific method is being used? This paper analyzes factors that may be contributing to the different outcomes between China-based and Western-based RCT studies by considering and comparing starting points, purpose, study design, investigators, acupuncture treatment regimen, methodological quality, results, conclusions, and deficiencies in acupuncture RCT. Based on these comparisons, this paper examines the value of acupuncture RCT in general, and the methodological confusion which seems to have propagated from study to study. We propose the following suggestions to remediate the acupuncture clinical research paradigm: First, acupuncture clinical researches should be carried out step-by-step according to universal, agreed-upon research protocols. Second, norms for reporting outcome metrics need to be standardized for each stage of a study.随着针灸的国际传播及针灸临床研究的迅速发展，中西方针刺随机对照试验（RCT）研究数量持续增长。然而，西方针刺RCT研究得出针刺效应相当于安慰剂的结果，与中国针刺RCT研究几乎全部是阳性结果形成鲜明对比。为什么同一种方法产生如此不同的结果？本文从针刺RCT研究的缘起与国内外针刺RCT研究现状出发，系统比较中西方针刺RCT在需求与起点、研究目的、研究设计、研究者、针刺治疗方案、研究的方法学质量、研究结果、研究结论及研究不足等方面的差异。在此基础上重新思考针刺RCT的价值及针刺临床研究中的方法学困惑，对针刺临床研究范式提出以下建议：根据研究方案成熟度，开展阶梯递进的临床研究；在不同研究阶段设置明确的实施指导和报告规范。.

Under the situation of the rapid expansion of hospital, the dilemma of acupuncture-moxibustion department, as well as the relevant solutions are explored. The main reasons for the shrinking situation of the service in acupuncture-moxibustion department include: the disease-based department division trends to divert many diseases suitably treated in acupuncture-moxibustion department; the environment pursuing economic benefits restricts the development of acupuncture-moxibustion therapy characterized by "simple and low-cost operation". There are three important approaches for breaking through the dilemma of acupuncture and moxibustion therapy. First, modifying the traditional service mode as waiting for patients in acupuncture-moxibustion department and promoting acupuncture and moxibustion technology to be adopted in other departments rather than limited only in acupuncture-moxibustion department. Second, increasing the charges of acupuncture and moxibustion technology rationally. Third, positioning accurately the role of acupuncture and moxibustion technology in health services based on its own characteristics and advantages and promoting it in community medical institutions. All of these solutions require the guidance of supporting policies.探讨医院急剧扩张情势下针灸科面临的困境及解决方法。针灸科的服务阵地不断萎缩的主要原因为：以病分科的趋势分流了针灸科的许多适宜病种；追求经济效益的大环境导致以“简便验廉”为特点的针灸疗法发展受到制约。针灸疗法突破困境的重要途径有三：一是改变传统针灸科坐等患者上门的服务模式，推动针灸技术走出针灸科，向其他科室渗透；二是合理提升针灸技术收费价格；三是根据针灸技术的自身特点与优势，准确定位自身在健康服务中的作用，并在社区医疗机构推广。但这都需要配套的政策引导。.

Objective: To determine whether electroacupuncture (EA) or moxibustion-like stimulation (MLS) can affect the cutaneous and/or systemic hypothalamic–pituitary–adrenal (HPA) axes. Methods: Rats were divided into Control, EA, 37°C MLS and 43.5°C MLS groups. EA and MLS were performed at bilateral ST36 or LI4. The expression of corticotropin-releasing factor (CRF), adrenocorticotropic hormone (ACTH) and the glucocorticoid receptor (GR) was detected in local cutaneous tissues at the site of ST36 and LI4 by immunohistochemical staining. In addition, levels of CRF, ACTH and corticosterone (CORT) in cutaneous tissue and plasma were determined. Results: Cutaneous expression of CRF, ACTH and GR significantly increased after EA at ST36, while only GR increased after 43.5°C MLS at ST36. The results of EA and MLS at LI4 were in parallel with those at ST36. In plasma, compared with the control group, the level of CORT increased after EA at ST36, while both ACTH and CORT were markedly increased after 43.5°C MLS. For LI4, plasma CRF and CORT increased after EA, while the levels of all three hormones increased following 43.5°C MLS. Notably, compared with the effect of EA, 43.5°C MLS at ST36 produced a more substantial increase in plasma CORT, and 43.5°C MLS at LI4 induced a more dramatic increase in plasma CRF and CORT. Conclusion: Both EA and 43.5°C MLS can activate the cutaneous and systemic HPA axes of the rat. EA tended to activate the local cutaneous HPA, while 43.5°C MLS was more likely to activate the systemic HPA axis.

The latest guideline about ulcerative colitis (UC) clinical practice stresses that mucosal healing, rather than anti-inflammation, is the main target in UC clinical management. Current mucosal dysfunction mainly closely relates to the endoscopic intestinal wall (mechanical barrier) injury with the imbalance between intestinal epithelial cells (IECs) regeneration and death, as well as tight junction (TJ) dysfunction. It is suggested that biological barrier (gut microbiota), chemical barrier (mucus protein layer, MUC) and immune barrier (immune cells) all take part in the imbalance, leading to mechanical barrier injury. Lots of experimental studies reported that acupuncture and moxibustion on UC recovery by adjusting the gut microbiota, MUC and immune cells on multiple targets and pathways, which contributes to the balance of IEC regeneration and death, as well as TJ structure recovery in animals. Moreover, the validity and superiority of acupuncture and moxibustion were also demonstrated in clinic. This study aims to review the achievements of acupuncture and moxibustion on mucosal healing and analyse the underlying mechanisms.

In recent years, many studies have confirmed the positive effect of acupuncture and moxibustion in the treatment of irritable bowel syndrome (IBS), and a lot of researches have been made to explore its neurobiological mechanisms. The neurobiological mechanisms include two aspects 1) remission of visceral hypersensitivity via peripheral and central pathways (spinal cord and brain), and 2) improvement of intestinal motility via vagus nerve and enteric nervous system (ENS)- interstitial cells of Cajal (ICC)-smooth muscle cells (ENS-ICC-SMC) network, and 5-HT, vasoactive intestinal peptide (VIP), neuropeptide Y, etc.. At the same time, we also discussed the existing problems in the research of the underlying neurobiological mechanisms of acupuncture and moxibustion for IBS. The existing problems in this field mainly include 1) fragmentization or lack of integrity in researches, and 2) limitation of the reductionism method. For this reason, we should draw lessons from the research methods of systematic science to study the neurobiological mechanisms of acupuncture and moxibustion in the treatment of IBS, including the detailed links of peripheral and central nervous transmission of acupoint stimulation signals, and the interactive action modes (two-way benign regulation, multi-target regulation, saturation regulation, etc.).近年来研究证实，针灸治疗肠易激综合征(IBS)有肯定的疗效，并对针灸治疗本病的神经生物学机制进行了大量探索。本文对此进行了综述，一是回顾了针灸调控IBS内脏高敏痛的神经生物学机制的研究，涉及外周水平的机制、脊髓水平的机制、脑水平的机制；二是回顾了针灸调节IBS肠运动功能的神经生物学机制的研究，涉及迷走神经和肠神经—Cajal间质细胞—平滑肌细胞网络发挥的作用。同时，本文还就针灸治疗IBS的神经生物学机制研究存在的问题进行了讨论，针对这一领域的研究所存在的碎片化问题和既往相关机制研究所依赖的还原论方法的局限性，提出针灸治疗IBS的神经生物学机制的研究有必要借鉴系统科学的研究方法。.

ObjectiveTo identify factors and assess to what extent they impact the magnitude of the treatment effect of acupuncture therapies across therapeutic areas.Data sourceMedline, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc, between 2015 and 2019.Study selectionThe inclusion criteria were trials with a total number of randomised patients larger than 100, at least one patient-important outcome and one of two sets of comparisons.Data analysisThe potential independent variables were identified by reviewing relevant literature and consulting with experts. We conducted meta-regression analyses with standardised mean difference (SMD) as effect estimate for the dependent variable. The analyses included univariable meta-regression and multivariable meta-regression using a three-level robust mixed model.Results1304 effect estimates from 584 acupuncture randomised controlled trials (RCTs) were analysed. The multivariable analyses contained 15 independent variables . In the multivariable analysis, the following produced larger treatment effects of large magnitude (>0.4): quality of life (difference of adjusted SMDs 0.51, 95% CI 0.24 to 0.77), or pain (0.48, 95% CI 0.27 to 0.69), or function (0.41, 95% CI 0.21 to 0.61) vs major events. The following produced larger treatment effects of moderate magnitude (0.2–0.4): single-centred vs multicentred RCTs (0.38, 95% CI 0.10 to 0.66); penetration acupuncture vs non-penetration types of acupuncture (0.34, 95% CI 0.15 to 0.53); non-pain symptoms vs major events (0.32, 95% CI 0.12 to 0.52). The following produced larger treatment effects of small magnitude (ConclusionPatients, clinicians and policy-makers should consider penetrating over non-penetrating acupuncture and more frequent treatment sessions when feasible and acceptable. When designing future acupuncture RCTs, trialists should consider factors that impact acupuncture treatment effects.

Acupuncture is an effective alternative therapy for pain management. Evidence suggests that acupuncture relieves pain by exciting somatic afferent nerve fibers. However, the mechanism underlying the interaction between neurons in different layers of the spinal dorsal horn induced by electroacupuncture (EA) remains unclear. The aim of this study was to explore the mechanism of EA relieving inflammatory muscle pain, which was associated with activation of the spontaneous firing of low-threshold mechanoreceptor (LTM) neurons and inhibition of wide dynamic range (WDR) neuronal activities in the spinal dorsal horn of rats. Inflammatory muscle pain was induced by injecting complete Freund’s adjuvant into the right biceps femoris muscle. EA with intensity of threshold of A fibers (Ta) in Liangqiu (ST34) muscle considerably inhibited the abnormal spontaneous activities of electromyography (EMG) due to muscle inflammation. While EA with intensity of C-fiber threshold (Tc) increased the abnormal activities of EMG. EA with Ta also ameliorated the imbalance of weight-bearing behavior. A microelectrode array with 750-μm depth covering 32 channels was used to record the neuronal activities of WDR and LTM in different layers of the spinal dorsal horn. The spontaneous firing of LTM neurons was enhanced by EA-Ta, while the spontaneous firing of WDR neurons was inhibited. Moreover, EA-Ta led to a significant inverse correlation between changes in the frequency of WDR and LTM neurons (r = −0.64, p < 0.05). In conclusion, the results indicated that EA could alleviate inflammatory muscle pain, which was associated with facilitation of the spontaneous firing of LTM neurons and inhibition of WDR neuronal activities. This provides a promising evidence that EA-Ta could be applied to relieve muscular inflammatory pain in clinical practice.

Recent studies have shown that both superficial and deep acupuncture produced clinically relevant and persistent effect on chronic pain, and several subtypes of somatic primary afferents played critical roles in acupuncture and moxibustion analgesia. However, which kind of primary afferents in the superficial and deep tissue of the acupoint is activated by acupuncture or moxibustion to relieve pain persistently remains unclear. The aim of this study is to investigate the roles of distinct peripheral afferents in different layers of the tissue (muscle or skin) in the acupoint for pain relief. Muscular A-fibers activated by deep electroacupuncture (dEA) with lower intensity (approximately 1 mA) persistently alleviated inflammatory muscle pain. Meanwhile, cutaneous C-nociceptors excited by noxious moxibustion-like stimulation (MS) and topical application of capsaicin (CAP) on local acupoint area produced durable analgesic effect. Additionally, spontaneous activity of C-fibers caused by muscular inflammation was also inhibited by dEA and CAP. Furthermore, decreases in pain behavior induced by dEA disappeared after deep A-fibers were demyelinated by cobra venom, whereas CAP failed to relieve pain following cutaneous denervation. Collectively, these results indicate that dEA and MS ameliorate inflammatory muscle pain through distinct primary afferents in different layers of somatic tissue; the former is achieved by activating muscular A-fibers, while the latter is mediated by activating cutaneous C-fibers.

To review systematically the effectiveness and safety ofThe articles on functional constipation treated withA total of 16 articles were included, with 1424 cases involved. Meta analysis results showed: ①The total effective rate in the treatment group was higher than that in the control group

To compare the effect of electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS) of skin and muscle layers of "Liangqiu" (ST34) area on inflammatory muscular pain in rats, so as to study the role of different-layer afferent nerve fibers in acupuncture analgesia.A total of 120 male SD rats were used in the present study, including 8 rats used for determining the excitatory threshold of Aδ(Ta) and C (Tc) afferent nerve fibers, 48 employed for comparing the analgesic effect of EA and TEAS at intensities of Ta and Tc, and 64 for observing the effect of EA and TAES stimulation of ipsilateral (Ipsi), contralateral (Contra) ST34 and ipsilateral LI4 at Ta and Tc intensities. Inflammatory muscle pain was induced by injection of complete Freund's adjuvant (CFA) into the right biceps femoris muscle. In the second part of the present study, 48 rats were randomly and equally divided into control, model, TEAS-Ta, TEAS-Tc, EA-Ta and EA-Tc groups, while in the 3rd part, 64 rats were randomly and equally divided into control, model, Ipsi-ST34-TEAS, Contra-ST34-TEAS, Ipsi-ST34-EA, Contra-ST34-EA, Ipsi-LI4-TEAS and Ipsi-LI4-EA groups. TEAS or EA was applied to the skin and muscle layers, respectively. Before and after modeling, the animal was forced to stand on a bipedal equilibrator, the difference in body mass distribution of both feet (bearing difference) was used to assess the pain severity. The frequency of myoelectrical discharges of the right bicep femoris muscle in responding to electrical stimulation of the spot between the 41) The bearing difference between the bilateral hindlimbs was markedly higher in the model group than in the control group (TEAS-ST34 at Tc and EA-ST34 at both Ta and Tc can alleviate pain behavior in inflammatory pain rats, which may be related to its effect in activating the afferent nerve fiber in different layers of ST34 area.

This paper analyzes the severe challenges posed by the localization process in the internationalization of Chinese acupuncture and moxibustion to Chinese traditional acupuncture and moxibustion, and the ways to deal with the challenges. It is believed that the lack of deep understanding of the challenges in the process of internationalization of acupuncture and moxibustion is mainly due to the lack of knowledge structure of acupuncture and moxibustion, and the innovation of acupuncture and moxibustion teaching materials is the basis of effectively adjusting the knowledge structure. The direction of the reform of acupuncture and moxibustion teaching materials should separate the modern version of acupuncture and moxibustion that conforms to the nature of science and teach it in parallel with the traditional version of acupuncture and moxibustion. The development of modern acupuncture and moxibustion in line with the nature of science is not only an urgent need to meet the challenges of western acupuncture and moxibustion, but also an internal requirement for the development of acupuncture and moxibustion itself.分析中国针灸学国际化中的本土化进程对中国传统针灸学构成的严峻挑战，以及应对挑战的办法。认为对于针灸国际化过程中出现的挑战缺乏深刻认识，主要是由于针灸队伍知识结构的欠缺造成的，而针灸学教材的革新是有效调整知识结构的基础；针灸学教材改革的方向应当是分离出符合科学本质的现代针灸学版本，并与传统针灸学版本并行施教。发展符合科学本质的现代针灸学既是应对西方针灸学挑战的迫切需要，也是针灸学自身发展的内在要求。.

To observe the effect of electroacupuncture (EA) at sensitized acupoints on choline acetyltransferase positive (ChATA total of 79 male SD rats were randomized into five groups, i.e. a normal group (20 rats), a normal plus sensitized acupoint group (5 rats), a model group (34 rats), an EAThe EB extravasating areas were distributed in the segments from TThe segmental dominance (acupoints) from T

To observe and compare the ameliorate effects of electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS) with different intensities on inflammatory muscle pain, so as to confirm the role of different afferent nerve fibers in different layers (skin or muscle) in pain relief of acupuncture.The intensities of the thresholds of A (Ta) and C (Tc) were selected for TEAS and EA. TEAS and EA were applied on the layer of skin and muscle of "Liangqiu" (ST34), respectively. Forty-eight rats were randomly divided into control, model, TEAS-Ta, TEAS-Tc, EA-Ta and EA-Tc groups (After modeling, the weight difference between the hind limbs was increased markedly in the model group relevant to the control group (TEAS with Tc or EA with Ta in the muscle layer can alleviate the pain and inhibit the abnormal EMG in inflammatory muscle pain rats. It is indicated that local pain relief by acupuncture was related to the afferent nerve fiber in different layer with different intensities.