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To estimate the minimal clinically important difference (MCID) of the frequency of bowel movement for the patients with chronic severe functional constipation treated with acupuncture so as to provide the evidence for the clinical decision.In this study, 813 patients with chronic severe functional constipation treated with acupuncture in two previous randomized controlled trials were included. Through the anchor-based method (anchored by the item 28 "satisfaction with previous treatment" of the patient assessment of constipation-quality of life [PAC-QOL]) and the distribution-based method, the MCID of the weekly frequency of complete spontaneous bowel movement (CSBM) and spontaneous bowel movement (SBM) was analyzed statistically in the patients.The MCID of the mean weekly frequency of CSBM and SBM was 1.3 times and 1.6 times in patients with chronic severe functional constipation treated with acupuncture, respectively.The mean increase of the weekly CSMB is ≥ 1.3 times and that of SBM is ≥ 1.6 times after treatment when compared with the baseline respectively, suggesting the clinical significance.

To observe the clinical effect of acupuncture on coronavirus disease 2019 (COVID-19) based on the conventional treatment.A total of 35 patients with COVID-19 of mild or ordinary type were involved (3 cases dropped off). Acupuncture was applied on the basis of western medicine and Chinese materia medica treatment. Dazhui (GV 14), Fengchi (GB 20), Kongzui (LU 6), Hegu (LI 4), etc. were selected as the main acupoints, the supplementary acupoints and the reinforcing and reducing manipulations were selected according to syndrome differentiation. Acupuncture treatment was given once a day, 5 times a week. On day 3 and day 7 of acupuncture, relief condition of the main symptoms was observed. Before acupuncture and on day 3 and day 7 of acupuncture, efficacy evaluation scale of TCM on COVID-19 (efficacy evaluation scale) score was recorded. The effects of different intervention time of acupuncture on patients' hospitalization time were compared, the understanding of acupuncture treatment of patients discharged from hospital was recorded, the clinical efficacy and safety of acupuncture treatment were evaluated.On day 3 and day 7 of acupuncture, the symptoms of lung system and non lung system were both relieved; the scores of efficacy evaluation scale were both decreased compared before acupuncture (On the basis of the conventional treatment, acupuncture can effectively relieve the clinical symptoms in patients with COVID-19, early intervention of acupuncture can accelerate the recovery process. Acupuncture has good safety, clinical compliance and recognition of patients.

Based on the data mining technology, the main indications and compatibility rules of Ciliao (BL 32) were analyzed and summarized. The relevant literature was retrieved from the databases of CNKI, Wanfang, VIP, Cochrane Library, SinoMed, Scopus, Web of Science, EMbase and PubMed, from the date of establishment to September 8, 2021. Using the software of SPSS Modeler 18.0 and Gephi0.9.2, the included literature was analyzed by data mining. A total of 218 articles were included, of them, there were 36 articles using single-acupoint prescriptions and 182 articles using compound prescriptions. Acupuncture was the most frequently used intervention of Ciliao (BL 32), followed by electroacupuncture. Dysmenorrhea and labor analgesia were the dominant indications of single-acupoint prescriptions of Ciliao (BL 32), and 9 diseases i.e. dysmenorrhea, urinary incontinence, urinary retention, chronic pelvic inflammatory disease, chronic prostatitis and lumbar disc herniation were the dominant indications of compound prescriptions. The main indications of Ciliao (BL 32) involved diseases of reproductive system, urinary system and waist. There were 92 acupoints in compatibility with Ciliao (BL 32), which were main belonged to the bladder meridian, the conception vessel and the spleen meridian, the most frequently used acupoints were Sanyinjiao (SP 6), Guanyuan (CV 4), Shenshu (BL 23) and Zhongji (CV 3).运用数据挖掘技术分析总结次髎穴的主治病症及腧穴配伍规律。检索自建库至2021年9月8日中国期刊全文数据库（CNKI）、万方数据知识服务平台（Wangfang）、维普资讯中文期刊服务平台（VIP）、Cochrane Library、中国生物医学文献数据库（SinoMed）、Scopus、Web of Science、EMbase及PubMed有关文献资料，运用SPSS Modeler 18.0和Gephi0.9.2软件对纳入文献进行数据挖掘分析。共纳入随机对照试验文献218篇，其中次髎单穴应用文献36篇，配伍他穴应用文献182篇。次髎穴的干预方式以针刺最多，电针次之。单穴主治的优势病症为痛经、分娩镇痛；配伍腧穴主治的优势病症为痛经、尿失禁、尿潴留、慢性盆腔炎、慢性前列腺炎、腰椎间盘突出症等；主治生殖系统疾病、泌尿系统疾病及腰部疾患。次髎配伍腧穴92个，多配伍膀胱经、任脉和脾经的腧穴；其高频配穴为三阴交、关元、肾俞、中极。.

BackgroundChronic Sciatica is a disabling condition causing considerable medical, social and financial implications. Currently, there is no recognised long-term effective treatment to alleviate sciatica. Acupuncture has been widely used for treating chronic pains with persistent analgesic effects. We aim to evaluate the efficacy and safety of acupuncture for chronic sciatica with follow-up in 52 weeks.Methods and analysisThis is a multicenter randomised sham-controlled trial. A total of 216 patients with chronic sciatica will be enrolled and randomly assigned to the acupuncture or sham acupuncture group. There will be 10 treatment sessions applied in 4 weeks with frequency decreased over time. Patients will complete follow-ups during 52 weeks. The primary outcomes are changes in leg pain intensity and disability from baseline to week 4. Secondary outcomes include back pain intensity, frequency and bothersomeness, quality of life, and global perceived effect. Adverse events will be recorded in detail.Ethics and disseminationEthical approval of this trial was granted from the ethics committee of Beijing University of Chinese Medicine and all study centres (No. 2020BZYLL0803). Written informed consent will be obtained from enrolled patients. Trial results will be disseminated in peer-reviewed publications.Trial registration numberChiCTR2100044585 (Chinese Clinical Trial Registry, http://www.chictr.org.cn, registered on 24 March 2021); preresults.

Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders. Although the available evidence for its efficacy is inconclusive, acupuncture is used as an alternative therapy for KOA. The aim of this trial is to determine the efficacy of electro-acupuncture and manual acupuncture versus sham acupuncture for KOA.This is a study protocol for a randomised, three-arm, multicentre, clinical trial. A total of 480 patients with KOA will be randomly assigned to the electro-acupuncture group, the manual acupuncture group or the sham acupuncture group in a 1:1:1 ratio. All patients will receive 24 sessions over 8 weeks. Participants will complete the trial by visiting the research centre at week 26 for a follow-up assessment. The primary outcome is the success rate: the proportion of patients achieving a minimal clinically important improvement, which is defined as ≥2 points on the numerical rating scale and ≥6 points on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score at week 8 compared with baseline. Secondary outcomes include the numerical rating scale, WOMAC score, global patient assessment and quality of life at weeks 4, 8, 16 and 26 after randomisation.This trial may provide high-quality evidence for the efficacy of acupuncture in the treatment of KOA. The results of this study will be published in peer-reviewed journals.ClinicalTrials.gov, NCT03274713 . Registered on 20 November 2017.

To observe the efficacy and safety of electroacupuncture (EA) on improving mini-mental state examination (MMSE) in patients with Alzheimer's disease (AD), and to evaluate the efficacy during follow-up visit.Forty patients were randomly divided into a treatment group and a control group, 20 patients in each one (3 patients dropped off in the treatment group and 4 patients in the control group). The patients in the treatment group were treated with acupuncture at Baihui (GV 20), Fengfu (GV 16), Shenting (GV 24), Taiyang (EX-HN 5), Shangyintang (Extra 3) and Dazhong (KI 14); besides, EA was applied at Taiyang (EX-HN 5), Baihui (GV 20) and Shenting (GV 24) with dilatational wave, 10 Hz/50 Hz in frequency, 0.5 to 5.0 mA in intensity, once every two days, three treatments per week. The patients in the control group were treated with oral administration of donepezil hydrochloride tablets, once a day, taken before sleep. The treatment was given for 12 weeks in the two groups. The MMSE was evaluated before treatment, 12 weeks±3 days into treatment, and 24 weeks±7 days after treatment, respectively.The difference of total score of MMSE before and 12 weeks±3 days into treatment was not significant between the two groups (The effect of EA on improving MMSE in patients with AD is similar to donepezil supported by evidence-based medicine. The effect of EA may have a certain continuous effect, and may have advantages in instantaneous memory. In addition, the EA is safe.

Objective To observe the clinical effect of fire needle combined with Linggui Bafa for post-herpetic neuralgia (PHN). Methods One hundred and twenty patients were randomly divided into an observation group and a control group with 60 cases each. For observation group, fire needle was applied to prick Zusānl ( ST 36), Yanglingquan ( GB 34), Taichōng ( LR 3), Sānyīnjiāo ( SP 6) and partial Ashi points around the lesion, and Linggui Bafa was combined to perform acupuncture therapy, once every other day, 10 times as a course of treatment; for the control group, only fire needle was applied. After 2 courses of treatment, the comparison of the value of visual analogue scale (VAS) and the total effective rate for the two groups were carried out. Results The VAS value of the observation group after treatment was obviously lower than that before treatment (2.28±2.08 vs 6.12±1.96) and that of the control group (2.28±2.08 vs 3.62±2.90), there were significant differences (all P Conclusion The effect of fire needle combined with Linggui Bafa for PHN is obviously superior to that of single fire needle therapy.

Objective To explore the feasibility of electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate. Methods The patients confirmed to the enrolled criteria were randomly divided into an observation group (n=31) and a control group (n=30). In the observation group, electroacupuncture was applied to Sibai ( ST 2), Xiaguān ( ST 7), Hegŭ LI 4) and Zhīgōu( TE 6) on the left side for the anesthesia and the routine local anesthesia was done on the right side. In the control group, the routine local anesthesia was adopted on both sides. The feelings of pain, circulatory index and operation effect were observed and compared between the two groups. Results During radiofrequency ablation, the pain grades of two measurements on the left side and the 2nd measurement on the right in the observation group were all lower than those in the control group (all P Conclusion Electroacupuncture compound anesthesia can meet the analgesia requirement of radiofrequency ablation for hypertrophic inferior turbinate, and would be helpful to prevent cyclic fluctuation during the operation at the same time.

To evaluate preliminarily the efficacy on functional constipation treated with electroacupuncture of different acupoint prescriptions.One hundred and four patients were randomized into a front-mu and back-shu points group (19 cases), a he-sea points group (34 cases), a he-sea, front-mu and back-shu points group (26 cases) and a western medication control group (25 cases). In the front-mu and back-shu points group, electroacupuncture was applied at bilateral Tianshu (ST 25) and Dachangshu (BL 25). In the he-sea points group, electroacupuncture was applied at bilateral Quchi (LI 11) and Shangjuxu (ST 37). In the he-sea, front-mu and back-shu points group, electroacupuncture was applied at unilateral Tianshu (ST 25), Dachangshu (BL 25), Quchi (LI 11) and Shangjuxu (ST 37). In the three groups above, the treatment was given 5 times a week in the first two weeks and 3 times a week in the next two weeks. In the western medication control group, mosapride citrate tablets were prescribed for oral administration, 1 table (5 mg) each time, 3 times a day, continuously for 4 weeks. The period of research was 9 weeks, including 1 week for baseline evaluation, 4 weeks for treatment and 4 weeks for follow-up. The weekly defecation frequency was taken as primary index, while the defecation difficulty and life quality score were taken as the secondary indices for the efficacy evaluation after treatment and in follow-up.According to the intention-to-treat (ITT) analytic principle, 104 cases were all enrolled in the final analysis. (1) After treatment, the weekly frequency of defecation was all increased significantly in the four groups (P0.05, P0.01). The efficacy of the three electroacupuncture groups was similar to that of western medication control group (P0.05). In follow-up, the increasing effect on the weekly frequency of defecation was maintained in the he-sea points group (P0.01), superior to the front-mu and back-shu points group and the western medication control group (P0.05, P0.01); the weekly frequency of defecation was not improved in the rest three groups (P0.05). (2) After treatment, defecation difficulty was relieved in the he-sea points group, the he-sea, front-mu and back-shu points group and the western medication control group (P0.05, P0.01). In follow-up, the improvements were still significant in the he-sea points group and the he-sea, front-mu and back-shu points group (both P0.01). (3) After treatment, the life quality score was significantly improved in the patients of the he-sea points group (P0.05). The difference was not significant in the rest three groups as compared with that before treatment (all P0.05).The weekly frequency of defecation is increased effectively after treatment in the three electroacupuncture groups and the efficacy is similar to mosapride citrate tablets. The bilateral Quchi (LI 11) and Shangjuxu (ST 37) in he-sea acupoints increase significantly the weekly frequency of defecation, relieve defecation difficulty and improve life quality. Acupuncture efficacy is sustained for 4 weeks. This acupoints prescription is the best in the treatment of functional constipation.

To compare efficacy differences between fire filiform needle combined with mild moxibustion and gabapentin combined with sham acupuncture for postherpetic neuralgia (PHN).One hundred cases of PHN were randomly divided into a needle group and a medicine group, 50 cases in each one. In the needle group, pricking method of fire filiform needle was given at the Ashi points, and then mild moxibustion was applied for 15 min. In the medicine group, the oral administration of gabapentin capsule and sham acupuncture at non-acupoints in the distal end of lesions were applied. The treatment was required for 21 days in both groups. The visual analogue score (VAS) was recorded before treatment and on the 1st day, 2nd day, 3rd day, 6th day, 9th day and 12th day of treatment. The most severity of pain within last 24 h, preset severity of pain, immediate analgesia effect and starting time of pain relief were observed, also the efficacy was assessed and improvement of symptoms was observed in the follow-up visit.The total effective rate was 94.0% (47/50) in the fire filiform needle group, which was superior to 86.0% (43/50) in the medicine group (P0.05). Compared with medicine group, the VAS of the most severity of pain within last 24 h was obviously reduced after the 2nd treatment in the fire filiform needle group while that of present severity of pain was relieved after the 1st treatment (both P0.05). The immediate analgesia effect in the fire filiform needle group was obviously superior to that in the medicine group in the first three times of treatment (all P0.05). The average time of pain relief was (3.91 +/- 0.82) days in the fire filiform needle group, which was significantly earlier to (6.53 +/- 1.13) days in the medicine group (P0.05). 26 cases were cured in the fire filiform needle group in the follow-up visit, which was superior to 2 cases in the medicine group (P0.05). The improvement of VAS, pain range and sleep quality in the needle group were also superior to those in the medicine group (all P0.05). The direct medical cost in the fire filiform needle group was (232.32 +/- 48.108) yuan, which was significantly lower than (466.00 +/- 41.09) yuan in the medicine group (P0.05). There was only one case of adverse effect in the medicine group during the treatment.The fire filiform needle combined with mild moxibustion could obviously relieve the pain in PHN patients, which has superior immediate analgesia effect and pain relieving time compared with gabapentin, which also has less adverse effects and cheap cost.

To effectively guarantee quality of randomized controlld trial (RCT) of acupuncture and develop reasonable content and checklist of on-site quality control, influencing factors on quality of acupuncture RCT are analyzed and scientificity of quality control content and feasibility of on-site manipulation are put into overall consideration. Based on content and checklist of on-site quality control in National 11th Five-Year Plan Project Optimization of Comprehensive Treatment Plan for TCM in Prevention and Treatment of Serious Disease and Clinical Assessment on Generic Technology and Quality Control Research, it is proposed that on-site quality control of acupuncture RCT should be conducted with PICOST (patient, intervention, comparison, out come, site and time) as core, especially on quality control of interveners' skills and outcome assessment of blinding, and checklist of on-site quality control is developed to provide references for undertaking groups of the project.

To evaluate the follow-up efficacy and safety on slow transit constipation (STC) treated with individualized deep puncture at Tianshu (ST 25).One hundred and twenty-eight cases of STC were randomized into a deep puncture group (64 cases), a western medication group (31 cases) and a shallow puncture group (33 cases) at the ratio of 2:1:1. In the deep puncture group, electroacupuncture of deep puncture was applied to bilateral Tianshu (ST 25). The needle was inserted perpendicularly and slowly at the acupoint and went deeply till penetrating the peritoneum, about 20 to 65 mm in depth. In the western medication group, lactulose oral liquid was prescribed for oral administration. In the shallow puncture group, electroacupuncture of shallow puncture was done at bilateral Tianshu (ST 25). The needle was inserted perpendicularly and slowly, 5 to 8 mm in depth. The treatment lasted 4 weeks in the three groups and the follow-up visit of 12 weeks and 6 month after treatment was performed respectively. The weekly defecation frequency, patient's satisfaction and safety of deep puncture at Tianshu (ST 25) were assessed before and after treatment in each group.In the deep puncture group, the weekly defecation frequency was (1.79 +/- 1.05) times/week before treatment and was (3.90 +/- 1.43) times/week after 4-week treatment. It was (3.49 +/- 1.46) times/week in 12-week follow-up visit after treatment and was (3.51 +/- 1.42) times/week in 6-month follow-up visit after treatment. In the deep puncture group, the improvements in weekly defecation frequency, patient's satisfaction and short-term efficacy were same as those in the western medication group and the shallow puncture group (all P0.05). The long-term efficacy in follow-up visit was better remarkably than that in the western medication group (P0.05, P0.01). Besides, the combined medication was reduced and no adverse reaction occurred.The individualized deep puncture at Tianshu (ST 25) is effective in the treatment of STC and achieves the satisfactory long-term efficacy. This therapy displays the good effective advantage and deserves to be promoted in clinical practice of acupuncture and moxibustion therapeutic program as compared with the first-tier line of medication, lactulose oral liquid, recommended at home and abroad, in terms of the evidence-based medicine.

Objective: By the systematic evaluation of previous literature, this study was to look for the evidence of evidence-based medicine to objectively evaluate the clinical efficacy, Security. Methods: From 1993 January to 2012 December nearly twenty years of EA in the treatment of functional constipation of domestic and foreign clinical randomized controlled studys, develop quality evaluation and meta analysis. Results: Through strict screening, 16 randomized controlled studies involving 1369 cases were ultimately meet the standards, all of them were Chinese literature. Meta-analysis showed that, after acupuncture treatment of functional constipation, the improvement of efficiency and independent defecation frequency in one week were as good as the oral drug therapy and superior to placebo acupuncture therapy. When the improvement of Cleveland Clinic Score (CCS) acupuncture treatment was as good as oral drug therapy. There into the efficacy of abdominal acupuncture with deep insertion was superior to the shallow insertion. When comparing efficacy in the changes of the constipation symptom scores, the acupuncture treatment was superior to the placebo therapy; None obvious adverse events of acupuncture treatment of functional constipation has been found. Conclusion : Through systematic evaluation, Acupuncture treatment of functional constipation was safe, with efficacy in various aspects as good as the oral drug therapy. The efficacy of acupuncture therapy was relevant to the insertion depth within safety range.

Differences and relations between effects of acupuncture therapy and sham acupuncture are systematically analyzed in this article through the influential factors of acupuncture effect. And it is held that sham acupuncture effect is not exactly equal to placebo effect. The effects of both acupuncture and sham acupuncture are composed by specific effects and non-specific effects, and the differences of non-specific effects between acupunc ture and sham acupuncture can be minimized furthest with blinding and randomized method. Therefore, the difference of acupuncture and sham acupuncture treatment rests with the degree of differences of the specific effects. Only when both of the specific effect of acupuncture and the effect of acupuncture are minimized, can it be applied as the ideal placebo control. Consequently when placebo acupunture are setted up, factors such as the body condition, site of stimulation and stimulation parameters which can influence the specific effect of acupuncture should be taken into consideration to produce the relatively minimum specific effect.

In the present article, the authors made an overview about the existing problems of placebo acupuncture design in accordance with the neurological basis of acupuncture analgesia. The neuron-segmental and systemic mechanisms initiated by local somesthetic stimuli at different intensities are involved in acupuncture analgesia. When the local pain locus and the stimulated point are in the same spinal segmental region, stimuli of either higher intensity or lower intensity may produce an obvious anaIgesia effect. If the stimulation site is far from the pain locus (in remote spinal segment region), only higher intensity stimulation works. From this viewpoint, the placebo acupuncture design in current clinical trials for pain treatment exists some unreasonable aspects. Both pain focus and intensity of acupuncture stimulation should be taken into consideration together. The optimal placebo acupuncture design for the treatment of pain conditions is that lower intensity acupuncture stimulation is given for longer distance between the pain origin locus and the stimulated acupoint.

To observe the therapeutic effect and safety of acupuncture of Back-shu points [Xinshu (BL 15), Pishu (BL 20), etc.] in the treatment of chronic fatigue syndrome (CFS).A total of 120 CFS patients were equally randomized Into acupuncture and control groups. Acupuncture needles were inserted into bilateral Xinshu (BL 15), Pishu (BL 20), and Gaohuang (BL 43) points, once daily for 4 weeks except weekends. For patients of the control group, acupuncture needles were inserted into the shallow layer of the non-acupoints (two mid-points of the horizon lines passing through the crossing-points of the 1st and 2nd branches of the Gallbladder Meridian and the crests of 4th, 5th and 11th thoracic vertebrae). General health scale (SF-20) and Chalder fatigue scale were used to measure the CFS patients' degree of general health. A follow-up survey was carried out 3 months after the last treatment.In comparison with pre-treatment, the scores of Chalder fatigue scale were decreased significantly in both treatment and control groups (P0.01), while the scores of physiological function (PF) and general health (GH) of SF-20 in both acupuncture groups and those of the role function (RF), social function (SF), mental health (MH) and pain sensation (PS) in the treatment group were increased apparently after the treatment (P0.05, P0.01). The scores of Chalder Scale and PF, RF, SF, GH, MH, PS and the CFS patients' satisfication degrees 4 weeks (64.4% and 36.7%) and 3 months (62.3% and 32%) after the treatment in the treatment group were significantly superior to those of the control group (P0.05).Acupuncture at Back-shu point has a good therapeutic effect (including immediate and midterm effect) in the treatment of chronic fatigue syndrome patients.

To explore the feasibility of electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate.The patients confirmed to the enrolled criteria were randomly divided into an observation group (n = 31) and a control group (n = 30). The observation group was treated with electroacupuncture at Sibai (ST 2), Xiaguan (ST 7), Hegu (LI 4) and Zhigou (TE 6) on the left side and routine local anesthesia on the right side. The control group was treated with routine local anesthesia on the both side. The feelings of pain, circulatory index and operation effect were observed and compared.During radiofrequency ablation, the pain grade of two measurements on the left side and the 2nd measurement on the right in the observation group were all lower than those in the control group (all P0.05). In the observation group, the pain grades on the left side were lower than that on the right side (P0.05), and the systolic blood pressure and the heart rate were lower than that in the control group when undergoing the 2nd radiofrequency ablation on the right side and on the left side, respectively (both P0.05). There was no significant difference in operation effect between the two groups.Electroacupuncture compound anesthesia can meet the analgesia requirement of radiofrequency ablation for treatment of hypertrophic inferior turbinate, and would be helpful to prevent cyclic fluctuation during the operation at the same time.

To explore the relationship between the effect of electroacupuncture (EA) and EA of different layer tissues of the acupoint area and different acupoints in upregulating mean arterial pressure (MAP) and heart rate (HR) in hypotension plus bradycardia rats.A total of 200 SD rats were used in the present study. Bradycardia plus hypotension model was established by intravenous injection of 0.4% propranolol (0.4 mg/100 g, maintaining dosage 0.025 mg/100 g per minute). EA (2 Hz/15 Hz, 5 mA) was applied to (1) right "Daling" (PC7) and "Jiexi" (ST 41), "Ximen" (PC 4) and "Housanli" (ST 36), "Quze" (PC 3) and "Dubi" (ST 35) which have a similar tissue structure, and are located in the upper and lower limbs and different meridians, and non-acupoint [3 mm left-superior to the "Tianshu" (ST 25)], (2) skin, muscle layer and periosteum part of "Ximen" (PC4), (3) skin, muscle layer and periosteum of "Housanli" (ST36) for 15 min. The HR and MAP were recorded by using a multi-channel physiological signal sampling-processing system.(1) In comparison with the model group, the percentages of the increased HR and MAP in the "Ximen" (PC4), "Quze" (PC3), "Housanli" (ST 36) and "Jiexi" (ST41) groups, PC 4-skin, PC 4-muscle, PC 4-periosteum, ST 36-skin, ST 36-muscle and ST 36 periosteum groups, and the increased HR in the "Dubi" (ST 35) group were upregulated significantly (P0.05, P0.01). The percentages of the increased HR and MAP were significantly higher in the "Quze" (PC3) and "Ximen" (PC4) groups than in the "Daling" (PC7) group (P0.01), and the increased HR evidently higher in the "Housanli" (ST36) and "Jiexi" (ST41) groups than in the "Dubi" (ST35) group (P0.01), suggesting different effects of EA stimulation of different acupoints in the same one meridian. No significant differences were found among the "Ximen" (PC4), "Quze" (PC3), "Housanli" (ST36) and "Jiexi" (ST 41) groups, and between the "Daling" (PC7) and model groups, and between the non-acupoint and model groups in the rising rates of both HR and MAP (P0.05). (2) Regarding the effects of EA of different tissue layers in "Ximen" (PC4) and "Housanli" (ST36) areas, the rising rates of HR were markedly higher in the PC 4-skin group than in the "Ximen" (PC4), PC4-muscle and PC 4-periosteum groups (P0.01), and considerably higher in the "Housanli" (ST36), ST 36-skin, and ST 36-muscle groups than in ST 36-periosteum group (P0.05). The rising rates of MAP were significantly higher in the PC 4-skin and PC 4-muscle groups than in the "Ximen" (PC4) and PC4-periosteum groups (P0.01), and considerably higher in the ST36-skin group than in the "Housanli" (ST36), ST36-muscle and ST36-periosteum groups (P0.01), suggesting different effects of EA stimulation of different tissue layers in the same one acupoint. No significant differences were found between the "Ximen" (PC 4) and PC 4-muscle groups, among the "Housanli" (ST36), ST36-skin and ST 36-muscle groups in the rising rates of HR, between the "Ximen" (PC 4) and PC4-periosteum groups, and among the "Housanli" (ST36), ST 36-muscle and ST36-periosteum groups in the rising rates of MAP (P0.05). (3) The effect of the PC 4-skin group was significantly superior to that of the ST 36-skin group in increasing HR (P0.01), and the effect of the PC 4-muscle group was obviously stronger than that of the ST 36-muscle group in raising MAP (P0.01), suggesting different therapeutic effects of EA stimulation of the similar tissue in different meridian-acupoints. The effects of the "Ximen"(PC4) and "Housanli" (ST36) groups in raising both HR and MAP, and that of the PC 4-muscle and ST 36-muscle groups in upregulating HR, and that of the PC 4-periosteum and ST 36-periosteum groups in raising MAP were comparable (P0.05).EA of different acupoints of the same one meridian, the similar structure of different meridian acupoints and different tissue layers of the same one acupoint have their own relatively specific effects in upregulating HR and MAP in hypotension plus bradycardia rats.

Based on the optimum clinical evidence, consulting the international guide, the outstanding guidelines of acupuncture clinical practices is formulated in order to promote the process of acupuncture modernization and internationalization. According to consensus of experts, using the questionnaire method, integrating the characteristics and requirements for acupuncture clinical practices, the guidelines reflect the characteristics of acupuncture, for instance, applicability, inheritance, holism, and the discipline characteristics. Thus, the guidelines will standardize the treatments in acupuncture clinical practices, strengthen medical service quality management, control medical costs, and promote the process of acupuncture modernization and internationalization.

To observe the effects of electroacupuncture (EA) of Tianshu (ST 25) and medication on the subjective symptoms and the satisfactory degree of functional constipation (FO) patients, and to evaluate the efficacy of different depth-needling.Single-blind, randomized and parallel-controlled methods were adopted in the present study and a total of 95 FC patients were randomly divided into medication group (Lactulose, 20-30 mL/d, n = 24), deep needling (DN, about 45 mm beneath the skin) of ST 25 group (n = 48), and shallow needling (SN, about 5 mm beneath the skin) of ST 25 group (n = 23). The treatment was given once daily (except weekends) for 4 weeks. The actual number of patients whose defecation frequency was up to 4 times per week, the integrative score of defecation symptoms (defecation exertion degree, abdominal pain, etc.), and the patients' satisfaction degree after the treatment were recorded and evaluated.One, 2, 3 and 4 weeks after the treatment, of the 48, 23 and 24 cases in DN, SN and medication groups, the numbers of FC patients whose defecation was up to 4 times per week were 31 (64.58%), 32 (66.67%), 34 (70.83%) and 37 (77.08%), 9 (39.13%), 16 (69.57%), 15 (65.22%) and 14 (60.87%), and 8 (33.33%), 7 (29.17%), 5 (20.83%) and 4 (16.67%), respectively. The effects of DN and SN groups were significantly superior to those of medication group in increasing the number of FC patients whose defecation was up to 4 times per week, improving constipation symptom integrative score (defecation exertion degree, survival desire for defecation, abdominal distension, etc.) and patients' satisfaction degree (P0.05). Comparison between DN and SN groups showed that the effects of the former group in accelerating the improvement of survival desire for defecation, patients' satisfaction degree were markedly superior to those of the latter group (P0.05).Deep needling-EA of ST 25 has a positive effect in improving functional constipation, being faster in the onset of action and stable efficacy in comparison with shallow needling.

To probe into a better therapeutic method for functional constipation.Ninety-five cases of functional constipation were randomly divided into deep puncture at ST 25 group (48 cases), shallow puncture at ST 25 group (24 cases) and medication group (23 cases). In deep puncture at ST 25 group, Tianshu (ST 25) was punctured deeply to the peritoneum, with electric stimulation. In shallow puncture at ST 25 group, Tianshu (ST 25) was punctured shallowly, 5 mm beneath the skin, with electric stimulation. In medication group, Duphalac was administered orally. These cases were treated continuously for 4 weeks in 3 groups and followed up for 6 months. It was to observe the numbers of person who had defecation 4 times a week, difference in weekly defecation frequency and the difference in the Cleveland Clinic Score (CCS).In deep puncture at ST 25 group, the frequency of weekly defecation and the numbers of person who had defecation 4 times a week increased and CCS decreased, which were similar to the efficacy in shallow puncture at ST 25 group (all P0.05). But the efficacy of both ST 25 groups was superior to that in medication group (both P0.05). In comparison, the deep puncture at ST 25 group acted more quickly than either shallow puncture at ST 25 group or medication group and its efficacy remained much longer.The deep puncture at ST 25 with electric stimulation presents similar efficacy on functional constipation as shallow puncture at ST 25, but it acts more quickly than shallow puncture at ST 25, both of them are more advantageous than medication and the long-term efficacy is better.

To observe the effect of electroacupuncture (EA) at "Ciliao" (BL 32) on detrusor hyperreflexia and c-fos expression in the sacral segment of spinal cord in rats with spinal cord injury (SCI).Thirty-seven adult female Sprague-Dawley rats were randomized into normal control (n=5), SCI model (n=16) and EA (n=16) groups. EA (20 Hz, 3 mA) was applied to bilateral BL 32 for 2 hours, once daily for 14 days. Intravesical pressure was detected by using a pressure transducer and a bioelectric amplifier. The expression of c-fos gene was detected by immunohistochemistry.In comparison with normal control group, the maximum intravesical pressure (MIVP) raised significantly in model group (P0.05), and the compliance of the bladder decreased remarkably (P0.05). While compared with model group, MIVP decreased significantly in SCI rats of EA group after EA intervention (P0.05), and the vesical compliance increased obviously (P0.05). In comparison with normal control group, the mean optical density (OD) value of c-fos immuno-reaction (IR) positive products increased significantly in the sacral cord after SCI in model group (P0.05), while compared with model group, the mean OD value of c-fos IR positive products in EA group declined evidently but still being higher than that of normal control group (P0.05), displaying a downregulation of c-fos expression after EA.Electroacupuncture at "Ciliao" (BL 32) can inhibit the overactivity of bladder in SCI rats and reduce the c-fos expression in the sacral cord, suggesting that the declined C-fibers' activity after EA may be one of its mechanism underlying improving detrusor hyperreflexia in spinal cord injury.

Tianshu (ST 25) is a frequently-used acupoint in acupuncture practice. It is reported that deep acupuncture has a better therapeutic effect than routine depth acupuncture. On the basis of reviewing the available literature, the present paper gives a definition about "deep acupuncture" of Tianshu (ST 25) from the anatomy angle, and makes a summary about its safety. This paper also puts forward a set of operation standards for needling Tianshu (ST 25). Moreover, the authors of the present paper also make a systematic analysis on the factors affecting the safety from the punctured depth, the diameter of the acupuncture needle and the operation technique. These methods and standards have an important significance in guiding clinical practice of acupuncture.

The modernization and internationalization of acupuncture and moxibustion is inevitable trends to develop acupuncture and moxibustion. However, the acupuncture research findings in China are not accepted by the mainstream medicine abroad. The major problems are that the study purposes are not specific and the modern scientific research methods are not rationally used in acupuncture clinical study. Two major issues in acupuncture clinical study in China are the evaluation of the specificity of acupuncture and the overall effect of acupuncture treatment. The core and basis of acupuncture clinical study are the clarity of study purpose, following the law of evidence-based medicine and rational selection of modern scientific methods. On the basis of the characteristics of acupuncture and the specialty of acupuncture clinical study, for instance, the types of trial design, blind methods, the selection of control group and outcome assessment system, the objective of this paper provides research strategies for researchers and to improve the overall level of research in the acupuncture clinical study.

To observe the effect of electroacupuncture (EA) on the related hormones of the hypothalamus-pituitary-adrenal (HPA) axis in rats with cerebral ischemia-reperfusion injury (CI-RI).Ninety Wistar rats were randomly divided into normal control, sham-operation (sham), model, EA acupoint and EA non-acupoint groups. CI-RI model was established by using modified middle cerebral artery occlusion (MCAO) and reperfusion. These rats were further divided into 1 day (d), 3 d and 7 d subgroups, with 6 cases in each. EA (1 mA, 2 Hz/30 Hz) was applied to acupoint "Zusanli" (ST 36) and "Quchi" (LI 11), and non-acupoints (5 mm lateral to ST 36 and 5 mm apart from LI 11 on the radial side respectively) for 30 min, once daily for 1 d, 3 d and 7 d separately. Serum cortisole (CORT) content was assayed by enzyme linked immunosorbent assay (ELISA), and the expression of hypothalamic adrenocorticotropic releasing factor (CRF) mRNA and glucocorticoid receptor (GR) mRNA, and pituitary adrenocorticotrophic hormone (ACTH) mRNA was assayed by reverse transcription polymerase chain reaction (RT-PCR) method.Compared with normal and sham groups, serum CORT levels of model and EA non-acupoint groups on the 1st, 3rd and 7th day increased significantly (P0.05), while compared with model groups, serum CORT level of EA acupoint groups decreased apparently (P0.05). Compared with normal and sham groups, hypothalamic CRF mRNA and pituitary ACTH mRNA expression of model groups were upregulated significantly on the 1st, 3rd and 7th d after CI-RI (P0.01, P0.05), and hypothalamic GR mRNA expression of model groups were obviously downregulated (P0.01, P0.05). In comparison with model groups, hypothalamic CRF mRNA and pituitary ACTH mRNA expression of EA acupoint groups at the 3 time-points, and their expression of EA non-acupoint groups on the 1st and 3rd day were remarkably downregulated (P0.01, P0.05), and hypothalamic GR mRNA expression of EA acupoint groups was upregulated significantly at the 3 time-points (P0.01, P0.05). Comparison between EA acupoint and EA non-acupoint groups showed that the effect of EA acupoint groups was obviously superior to that of EA non-acupoint groups in downregulating CRF mRNA and ACTH mRNA expression and in upregulating GR mRNA expression at the 3 time-points (P0.01, P0.05).EA of meridian-acupoints can effectively downregulate serum CORT content, hypothalamic CRF mRNA and pituitary ACTH mRNA expression and upregulate hypothalamic GR mRNA expression in CI-RI rats, which may contribute to its effect in relieving CI-RI.

To summarize the main electroacupuncture stimulation indexes used in clinical treatment and experimental study on sciatica, and to investigate the optimal stimulation index for sciatica treatment with electroacupuncture.The data was obtained on line from the computerized general and specialized databases such as CBM, VIP, CNKI, and MEDLINE. Data analysis was focused on the different effects of electroacupuncture with different stimulation indexes.(Clinical research suggested that the commonly used electroacupuncture stimulation indexes included frequency of 1-20 Hz, electric current of 0.2-0.8 mA, continuous and dilatational waveform. The intensity of stimulation was endurable for patients. (2) The frequency of electroacupuncture used for animal experimental research was mainly concentrated among 2-20 Hz, which 2 Hz and 5 Hz had better effects for sciatica treatment with electroacupuncture. The scale of electric current was 0. 4-10 mA with intermittent waveform. The intensity of stimulation was decided by a visible muscle contraction occurred during the acupuncture.Different kinds of electroacupuncture stimulation indexes have different effects on the treatment of sciatica. Therefore, it is still needed the more evidence from higher quality clinical trials to investigate the optimal electroacupuncture stimulation indexes on the treatment of sciatica.

The founding of clinical syndrome differentiation treatment system for acu-moxibustion is an important issue for the development of clinical acupuncture practices, and it has attracted extensive attention in the domestic and overseas circles in acu-moxibustion field. At present, the syndrome differentiation treatment system of internal medicine of TCM is literally carried out in clinical acu-moxibustion practices, syndrome differentiation according to zang-fu is used instead of syndrome differentiation according to meridian, hence, it is difficult to reflect the features and advantages of acupuncture and moxibustion. Although the goals of acu-moxibustion and Chinese herbal medicine treatments are consistent, but the methods and approaches of the treatment are different. Therefore, the syndrome differentiation treatment system are not in concordance. Acu-moxibustion has gradually established unique thinking model of treatment based syndrome differentiation including principle, methods, prescription, points and technique which are different from principle, methods, prescription and drugs of internal medicine of TCM.

In order to improve the quality of acupuncture clinical trials, in view of the shortage of design and application of acupuncture clinical trials at present, the authors paper put forward concrete control measures from aspects of subjective factors, objective factors and quality monitoring of acupuncture clinical trials, which are helpful to guarantee the quality of trials and could be reference for other researchers. The results indicate that strict quality control measures are the guarantee of high-quality acupuncture clinical trials.

In Clinical Practice Guideline of Evidence-based Acupuncture and Moxibustion, following principles and methods of evidence-based medicine, in combination with characteristics of acupuncture and moxibustion science, primary literature quality assessment criteria and corresponding scale were stipulated and were repeatedly seeked advice from experts and proved, finally, forming the assessment criteria: (1) Evaluation criteria of literature quality for RCT; (2) Evaluation criteria of literature quality for non-randomly controlled trials; (3) Evaluation criteria of literature quality for cases-study trials.

Acupuncture and moxibustion for treatment of neurogenic bladder dysfunction after spinal cord injuries at home and abroad in recent years is introduced. The acupuncture and moxibustion methods for treatment of this kind of disease are classified and analyzed from body acupuncture, electroacupuncture, acupoint pressure and massage, acupoint-injection, acupoint sticking and so on. Acupuncture and moxibustion are widely applied to treatment of neurogenic bladder dysfunction after spinal cord injuries, with definite therapeutic effect and good safety. The effectiveness of other evaluation indexes of acupuncture and moxibustion for treatment of neurogenic bladder dysfunction after spinal cord injuries needs to be proved by more randomized and controlled trials of high quality with strict design and scientific methods.

To compare the therapeutic effects of evening-electroacupuncture (EA) and morning-EA for insomnia.Sixty cases of simple insomnia patients were randomly divided into evening-EA group and morning-EA group, with 30 cases in each. EA (2/100 Hz, 1-3 mA) was applied to Baihui (GV 20), Shenting (GV 24), Touwei (ST 8), Shenmen (HT 7), Sanyinjiao (SP 6), etc. in the evening (8:00-9:00 pm) and in the morning (8:00-11:00 am) respectively in two groups, once daily for 10 times. Changes of mean global Pittsburgh Sleep Quality Index (PSQI), sleep rate, frequency of hypnotic-taking, etc were observed before and after the treatment.In comparison with pre-treatment, mean PSQI scores in evening-EA and morning-EA groups, and hypnotic-taking frequency in evening-EA group decreased evidently during two weeks after the treatment, and sleep rates of two groups increased significantly from the 1st day on after the treatment in evening-EA group and from the 1st week on in morning-EA group (P0.01). Comparison between two groups showed that the mean PSQI scores at the 1st and 2nd week in evening-EA group were significantly lower, and the sleep rate in evening-EA group on the 2nd week after the treatment was considerably higher than that in morning-EA group (P0.05).Evening-EA can significantly lower insomnia patients' PSQI score, raise sleep rate, and reduce the hypnotic-taking frequency. Evening-EA is superior to morning-EA in the treatment of insomnia.

To assess the quality of literature of clinical studies on acupuncture in treatment of herpes zoster.The literatures between 1994-2006 were searched by means of electronic retrieval. Type and methodology, general condition, diagnosis of diseases and enrolled and excluded criteria, assessment of sample content, treatment condition, criteria for assessment of therapeutic effects, following-up, etc. in clinical studies are evaluated according to principles and methods of clinical epidemiology and evidence-based medicine.Of the 399 literatures enrolled, only 8 were authentic randomized controlled trials (RCTs), 20 quasi-randomized controlled trials, 66 non-randomized concurrent controlled trials and 277 narrative studies, 70 had clear diagnostic criteria, 16 mentioned enrolled or excluded criteria, 287 had clear criteria for therapeutic effects, 107 reported follow-up, 2 had the description of health economical index, 9 reported adverse reaction.At present, correct randomization, concealment, blinding and placebo-control, and the RCTs with generally accepted criteria for assessment of diagnosis and therapeutic effects, safety evaluation and rational design of follow-up are needed. It is indicated by preliminary study of the literatures that blood-letting puncture and cupping at Ashi points are main methods for treatment of herpes zoster.

Clinically, professor TIAN Cong-huo pays attention to treatment based on syndrome differentiation, with acupoint selection based on syndrome differentiation. In this present paper, clinically commonly-used 19 acupoint prescriptions, and relatively fixed indication ranges, manipulation methods, modified acupoint prescriptions, and professor TIAN's experience in application of these acupoints are summarized and introduced.

To probe into the current situation and problems of establishing control group in clinical studies of acupuncture and moxibustion for treatment of periarthritis of shoulder at home.To retrieve the literatures of establishing control groups in clinical studies of acupuncture and moxibustion for treatment of periarthritis of shoulder in magazines at home, and based on key problems in establishment of control group, make a Excel form to take out relative contents in the literatures and classify, summarize and statistically analyze.In establishing control group in clinical studies of acupuncture and moxibustion for treatment of periarthritis of shoulder, a lot of problems exist, most studies do not have the basis of establishing control group, and also do not establish control group for the purpose of the study, making the whole test have error in the stage of program design, and leading to unreliable for the results of clinical control studies.In clinical researches of acupuncture and moxibustion, a standard for guiding establishment of control group is eagerly needed.

To compare therapeutic effects of different needling methods at Tiaokou (ST 38) on periarthritis of shoulder.Eighty cases of periarphritis of shoulder were randomly assigned to four groups. Tiaokou (ST 38) was selected in all the 4 groups. The treatment group were treated with penetration needling, and the control group A, B, C were treated by needling into 40 mm deep, needling into the subcutaneous tissue, sham acupuncture, respectively. Therapeutic effect was evaluated by Constant-Murley shoulder joint scale.The clinical effective rate was 100.0% in the treatment group and 68.4% in the control group A, 52.6% in the control group B, 38.0% in the control group C with significant differences as the treatment group compared with the control groups A, B, C (P0.05 or P0.01). And with no significant difference as the control group A compared with the control group B, C, and the group B with the group C (P0.05).Different needling depths of Tiaokou (ST 38) have different therapeutic effects, the penetration needling being the best and the sham needling being worse which can be used as control method.

Acupuncture and moxibustion have obvious therapeutic effect on spastic paralysis of apoplexy, but there is no common standard for evaluation of therapeutic effects. Available standards for assessment of therapeutic effect of acupuncture and moxibustion on spastic paralysis of apoplexy are not complete. Acupuncture and moxibustion improve clinical symptoms of the patient of spastic paralysis of apoplexy to a considerable degree, a evaluation system for results of clinical symptoms of the patient can be set up, so as to perfect the criteria for evaluation of therapeutic effects of acupuncture and moxibustion on this disease.

To observe the therapeutic effect of He's Santong needling method on neurological functional deficit in the patient of ischemic apoplexy, and search for an effective method for treatment of ischemic apoplexy.According to the randomized and multi-central trial principle, 319 cases enrolled were randomly assigned to an observation group of 161 cases and a control group of 158 cases. The observation group were treated with He's Santong needling method, i. e. blood letting, puncturing with a red-hot needle and filiform needle therapy by stages, and the control group were treated with acupuncture at 12 points of the hand and foot routinely selected in the department, once daily. After treatment of 30 days, changes of neurological functional deficit score were investigated in the two groups.The total effective rate was 91.93% in the observation group and 70. 25% in the control group with a significant difference between the two groups (P0.05); there was no significant difference in changes of the neurological functional deficit score between the patients at the acute stage and the convalescence (P0.05).The therapeutic effect of He's Santong needling method on ischemic apoplexy at acute stage or convalescence is better than that of the routine point selection.

To observe clinical therapeutic effect of electroacupuncture on central vestibular disequilibrium syndrome.Forty-six cases were randomly divided into a treatment group and a control group, 23 cases in each group. The treatment group were treated with electroacupuncture at Baihui (GV 20), Fengfu (GV 16), Fengchi (GB 20) and other points, combined with rehabilitation training, and the control group with the rehabilitation training. After treatment for 4 weeks, the Berg Balance Scale and the parameters of static posturogram were observed to assess the therapeutic effects.The total effective rate was 86.96% in the treatment group and 65.22% in the control group, with a significant difference between the two groups (P0.05); after treatment, the treatment group in the cumulative score for the Berg Balance Scale was superior to the control group (P0.05); and the parameters of static posturogram with opening eyes in the treatment group improved significantly (P0.05 or P0.01).Electroacupuncture plus rehabilitation training is an effective method for central vestibular disequilibrium syndrome.

To assess the effectiveness and safety of various types of acupuncture in treatment of premenstrual syndrome (PMS).Search Chinese and English databases of the Cochrane Library, CENTRAL, MEDLINE, EMBASE, CBM, CNKI and reference lists of correlative academic conference proceedings.Eight controlled studies involving 807 women (range, 61-225) meeting the enrolled criteria. Among them 7 studies showed that therapeutic effects of acupuncture were superior to other methods (i. e. Western medicine or Chinese herbs).Acupuncture can effectively treat PMS. However, more randomized controlled trials are needed to assess the effectiveness and adverse-effect of acupuncture for treatment of PMS.

In Western countries, more and more people select acupuncture and moxibustion as medical ways, and more and more acupuncture and moxibustion research organizations are set up. Britain TCM foundation is such one center for acupuncture research. This center is aimed at promoting acupuncture research. Since 1991, a series of clinical trials and several big research tasks have been completed. The clinical designs in the center are very careful and scientific, being worth to be learnt. In the paper, clinical studies in the center are introduced for increasing levels of acupuncture and moxibustion research at home.

Objective To evaluate the curative effect of electroacupuncture on postapoplectic incontinence of urine.