Therapeutic observation of Tui-pushing Wujing plus Chinese patent medicine for infantile diarrhea due to spleen deficiency Abstract Objective: To observe the therapeutic efficacy of pediatric tuina plus Chinese patent medicine for preschool kids with diarrhea due to spleen deficiency. Methods: Ninety-two eligible kids were divided into a tuina plus Chinese patent medicine and a Chinese patent medicine group by the random number table, with 46 cases in each group. The Chinese patent medicine group was intervened by oral administration of Qi Wei Bai Zhu San (Seven-ingredient Atractylodes Macrocephala Powder); the tuina plus Chinese patent medicine group was additionally given pediatric tuina therapy once a day, 20 min each time. Efficacy and safety were evaluated after 7-day treatment in both groups, and a 14-day follow-up was conducted. Results: After treatment, the symptom scores all changed significantly in the two groups (all P<0.05). After intervention, the symptom scores in the tuina plus Chinese patent medicine group were significantly different from those in the Chinese patent medicine group (all P<0.05). The total effective rate was 78.3% in the Chinese patent medicine group, versus 89.1% in the tuina plus Chinese patent medicine group, and the between-group difference was statistically significant (P<0.05). Three cases got a relapse in the Chinese patent medicine group, versus one case in the tuina plus Chinese patent medicine group, and the between-group difference was statistically insignificant (P>0.05). The two groups each had one case of vomiting, which were treated properly and turned better. No other adverse reactions occurred. Conclusion: Tuina plus Chinese patent medicine and Chinese patent medicine alone both are effective for diarrhea due to spleen deficiency in kids, but the combined therapy can produce more significant efficacy.

Effects of moxibustion on serum IL-6, IL-8 and TNF-α in rats with experimental rheumatoid arthritis Abstract Objective: To observe the effects of moxibustion on serum levels of interleukin (IL)-6, IL-8 and tumor necrosis factor-α (TNF-α), and to explore the effects of moxibustion on inflammatory damaging factors in experimental rheumatoid arthritis (RA) model rats; the relationship between the therapeutic effect of moxibustion on RA and the change in the Toll-like receptor (TLR) signaling pathway was analyzed using Toll-like receptor 4 (TLR4) antagonists and agonists. Methods: Fifty Sprague-Dawley (SD) rats were divided into a normal group, a model group, a moxibustion group, a moxibustion plus TLR4 agonist group (agonist group) and a moxibustion plus TLR4 antagonist group (antagonist group) according to the random number table, with 10 rats in each group. Except the normal group, rats in the other four groups were subjected to model preparation with the wind, cold and wet environmental factors plus Freund’s complete adjuvant (FCA). Rats in the normal and model groups were not treated; rats in the moxibustion, agonist and antagonist groups started to be treated with the moxibustion (cigarette-type moxa) at bilateral Shenshu (BL 23) and Zusanli (ST 36) from the 4th day after the successful modeling, for 20 min each time with a total of 10 d. Rats in the agonist and the antagonist groups were injected with TLR4 agonist or antagonist [0.1 mg/(kg•bw)] via the tail vein 30 min before moxibustion. The concentrations of serum IL-6, IL-8 and TNF-α in each group were determined by enzyme-linked immunosorbent assay (ELISA). Results: Compared with the normal group, in the model group, the rat’s right hind paw swelling was significantly obvious (P<0.01), there was a lot of inflammatory infiltration in the synovial tissues, the surface of the synovial membrane was unsmooth, the synovial membrane was hyperplasia and thicker, and the serum IL-6, IL-8 and TNF-α concentrations increased significantly (P<0.05). Compared with the model group, the paw swelling degrees of the rats in the moxibustion, the agonist and the antagonist groups reduced significantly (all P<0.01); the swelling degree in the antagonist group was milder than that in the agonist group, but the between-group difference was not statistically significant (P>0.05); inflammatory infiltration and synovial membrane hyperplasia in the synovial tissues of the moxibustion group and the antagonist group were all relieved differently; the decrease of synovial layer number in the moxibustion group was more obvious, and there were no obvious improvements in inflammatory infiltration and synovial thickness in the agonist group; the concentrations of IL-6, IL-8 and TNF-α in the moxibustion group were decreased, and the differences in the IL-6 and TNF-α concentrations were statistically significant (all P<0.01); there was no significant between-group difference in the IL-8 concentration (P>0.05); the concentrations of serum IL-8 and TNF-α in the agonist group increased significantly (both P<0.01), while the IL-6 concentration decreased without significant difference (P>0.05); the concentrations of IL-6 and IL-8 in the antagonist group decreased but the between-group differences were statistically insignificant (both P>0.05), and the TNF-α concentration significantly increased (P<0.05). Compared with the moxibustion group, IL-6, IL-8 and TNF-α concentrations increased in the agonist group, and the differences in the IL-8 and TNF-α concentrations were statistically significant (both P<0.01); the concentrations of IL-6, IL-8 and TNF-α increased in the antagonist group, and the differences in the IL-6 and TNF-α concentrations were statistically significant (both P<0.01); there was no significant difference in the IL-8 concentration between the groups (P>0.05). The serum levels of IL-6, IL-8 and TNF-α in the antagonist group were lower than those in the agonist group (all P<0.05). Conclusion: Moxibustion at Shenshu (BL 23) and Zusanli (ST 36) can reduce the joint swelling degree and inflammation in synovial tissue of RA model rats, decrease the serum levels of IL-6, IL-8 and TNF-α in RA model rats; the decreases of IL-6 and TNF-α are more significant than the decrease of IL-8; TLR4 agonist and antagonist can significantly attenuate the effect of moxibustion in inhibiting releases of IL-6, IL-8 and TNF-α, so that the change in TLR signaling pathway affects the effect of moxibustion in inhibiting the releases of IL-6, IL-8 and TNF-α.

Exploration on acupoint-selection patterns based on data mining for the treatment of chronic atrophic gastritis Abstract Objective: To analyze the features and patterns of acupoint selection in acupuncture-moxibustion treatment of chronic atrophic gastritis (CAG) by data mining technique. Methods: Relevant clinical studies published before 25 June, 2017 were searched in databases including PubMed, EMBASE, Cochrane library, Chinese Biomedical Literature Database (CBM), China National Knowledge infrastructure (CNKI), and Wanfang Academic Journal Full-text Database (Wanfang). Results: A total of 122 papers were included, involving 69 points. It was found that the top three points on the frequency list were Zusanli (ST 36), Zhongwan (CV 12) and Weishu (BL 21). The points selected were distributed in 11 meridians, in which the Stomach Meridian of Foot Yangming, Conception Vessel, and Bladder Meridian of Foot Taiyang ranked the top and accounted for 74.0% of the total frequency. Of the involved specific points, Five Shu-Transmitting points, crossing points and Back-Shu points ranked the top, accounting for 47.1%. The analysis of association pattern has shown that Zusanli (ST 36) and Zhongwan (CV 12) won the highest support rate in the paired groups; Zusanli (ST 36), Weishu (BL 21) and Zhongwan (CV 12) had the highest support rate among the point groups. The Five Shu-Transmitting points and the Lower He-Sea points had the highest support rate among the specific point groups. Conclusion: The data mining results of the studies on acupuncture-moxibustion for CAG are substantially in line with the acupuncture-moxibustion treatment theories in traditional Chinese medicine. The results can reflect the acupoint selection patterns in treatment of CAG and provide reference for acupuncture-moxibustion treatment of CAG in clinic.

Is fire needle superior to Western medication for herpes zoster? A systematic review and meta-analysis Abstract Objective: To compare the effectiveness of fire needle versus Western medicine in the treatment of herpes zoster. Methods: Randomized controlled trials comparing fire needle with Western medicine in the treatment of herpes zoster were identified using 8 databases. A meta-analysis was performed using RevMan 5.3 software. Results: Eight trials involving 569 patients were included in this meta-analysis, and the results showed that fire needle was superior to Western medicine comparing the effective rate [risk ratio (RR)=1.13, 95% confidence interval (CI): 1.06 to 1.20; P=0.0002], the visual analog scale (VAS) score [mean difference (MD)=−7.95, 95% CI: −10.71 to −5.20; P<0.00001], time of pain disappearance (MD=−7.61, 95%CI: −9.38 to −5.84; P<0.00001), time of blister-stop (MD=−1.34, 95%CI: −1.51 to −1.18; P<0.00001), time of crusted scab (MD=−2.92, 95%CI: −3.62 to −2.23; P<0.00001), and time of scab off (MD=−4.64, 95%CI: −5.83 to −3.46; P<0.00001). In addition, a significantly lower incidence of postherpetic neuralgia was found in the fire needle group in 30 d (RR=0.23, 95%CI: 0.11 to 0.51; P=0.0002) and 60 d (RR=0.33, 95%CI: 0.12 to 0.91; P=0.03) after treatment. Conclusion: Fire needle has a favorable effect in increasing the effective rate, relieving pain, recovering skin lesions and decreasing incidence of postherpetic neuralgia in the treatment of herpes zoster. However, considering the limitations in this study, the findings should be interpreted cautiously.

Effect of electroacupuncture pretreatment on adenine nucleotides in myocardial tissues of rats with myocardial ischemia-reperfusion injury detected by high performance liquid chromatography (HPLC) Abstract Objective: To observe the effect of electroacupuncture (EA) pretreatment on adenine nucleotides in the myocardial tissues of the myocardial ischemia-reperfusion injury (MIRI) rats, and to explore the mechanism of EA pretreatment on myocardial prevention and protection in MIRI rats. Methods: Forty SPF male Sprague-Dawley (SD) rats were randomly divided into 5 groups: a blank group, a sham operation group, a model group, an EA at Neiguan (PC 6) group and an EA at Hegu (LI 4) group, with 8 rats in each group. Rats in the blank group only received binding to the rat plate, 30 min/time, once a day for 7 d; on the 7th day, rats in the sham operation group were subjected to threading for 40 min at the left anterior descending coronary artery without ligation, and then the rats were allowed to stand for 60 min before collection of the specimens; on the 7th day, rats in the model group were subjected to threading at the left anterior descending coronary artery with ligation, for 40 min before the blood flow was restored, and then the rats were allowed to stand for 60 min before collection of the specimens; on the 7th day of pretreatment with EA at Neiguan (PC 6) or Hegu (LI 4) for 30 min per day (once a day for 7 d), rats in the EA at Neiguan (PC 6) group and EA at Hegu (LI 4) group were subjected to modeling and sample collection same as in the model group. The left ventricular myocardium of the lower left anterior descending coronary artery was collected from rats in all 5 groups. Hematoxylin-eosin (HE) staining and transmission electron microscope (TEM) were used to observe the changes in myocardial pathological morphology. The change in the adenine nucleotide level of myocardial tissue was measured by high performance liquid chromatography (HPLC). Results: The HE staining and ultrastructure showed that the myocardial injury was severer in the model group compared with the sham operation group. Compared with the model group, the myocardial injury in the EA at Neiguan (PC 6) and the EA at Hegu (LI 4) groups was mild or hardly any. The adenine nucleotide levels in the sham operation group and the model group were all decreased compared with the blank group (all P<0.05); compared with the sham operation group, the adenine nucleotide level of the model group was also decreased, but the difference was not statistically significant (P>0.05); compared with the model group, the adenine nucleotide level in the EA at Neiguan (PC 6) group was increased (P<0.05), and the adenine nucleotide level in the EA at Hegu (LI 4) group was significantly increased (P<0.01). The adenine nucleotide level in the EA at Hegu (LI 4) group was higher than that in the EA at Neiguan (PC 6) group, but the difference was not statistically significant (P>0.05). Compared with the EA at Neiguan (PC 6) group, the levels of adenosine triphosphate (ATP), adenosine diphosphate (ADP) and adenosine monophosphate (AMP) in the EA at Hegu (LI 4) group were significantly increased (all P<0.01). Conclusion: Both EA at Neiguan (PC 6) and Hegu (LI 4) can alleviate the pathological damage to myocardium in MIRI rats, and increase the adenine nucleotide level in myocardial tissues, and thus protect MIRI rats. EA at Hegu (LI 4) has a better protective effect than Neiguan (PC 6).

Clinical study of optimizing acupoint combining in treatment of bronchial asthma with acupoint application Abstract Objective: To observe the therapeutic efficacy of acupoint application at different groups of acupoints in treating bronchial asthma in remission stage. Methods: A total of 120 patients with bronchial asthma in remission stage were recruited and divided by the random number table method into acupoint application group 1, acupoint application group 2 and acupoint application group 3, with 40 cases in each group. In all the three groups, Tiantu (CV 22), Dazhui (GV 14) and Feishu (BL 13) were selected, with Dingchuan (EX-B 1) added in acupoint application group 1, Shenshu (BL 23) added in acupoint application group 2, and Gaohuang (BL 43) added in acupoint application group 3. Before intervention, one month and 3 months after intervention, clinical symptoms, peak expiratory flow (PEF) and forced expiratory volume in 1 second percentage of predicted value (FEV1%) of the three groups were observed, and their clinical efficacies were evaluated. Results: Comparing the therapeutic efficacy regarding traditional Chinese medicine symptoms and signs, after 1-month treatment, the total effective rate was 87.5% in acupoint application group 1, versus 62.5% in acupoint application group 2 and 55.0% in acupoint application group 3, and the between-group differences were statistically significant. After 3-month treatment, the total effective rate was 95.0% in acupoint application group 1, versus 70.0% in acupoint application group 2 and 65.0% in acupoint application group 3, and the between-group differences were statistically significant. After intervention, the three groups all showed significant improvements in pulmonary function with statistical significance; among the three groups, the improvement in acupoint application group 1 was more significant than that in the other two groups. Conclusion: Tiantu (CV 22), Dazhui (GV 14) and Feishu (BL 13) as basic prescription plus Dingchuan (EX-B 1) can improve symptoms of bronchial asthma in remission stage, and it works better in improving pulmonary function than the basic prescription plus Shenshu (BL 23) or Gaohuang (BL 43).

Clinical observation of treatment of infantile diarrhea due to spleen deficiency using five-step pediatric tuina of Huxiang school Abstract Objective: To observe the clinical efficacy of treating infantile diarrhea due to spleen deficiency with five-step pediatric tuina of Huxiang school. Methods: Using a randomized controlled trial design, sixty eligible kids with diarrhea due to spleen deficiency were randomized into an observation group and a control group, with 30 cases in each group. The observation group was intervened by the five-step pediatric tuina method of Huxiang school, and the control group received conventional tuina treatment. The intervention was conducted once a day, consecutive 5-day treatment as 1 course, at a 2-day interval between courses, successively for a total of 4 courses. Changes in the primary and secondary symptoms of diarrhea due to spleen deficiency were observed, and the clinical efficacy was evaluated. Results: After treatment, the scores of primary and secondary symptoms and the general score of diarrhea due to spleen deficiency were improved; the improvements in fecal form and frequency, decreased appetite, bloating after meals and fatigue and sluggishness were more significant in the observation group than in the control group. Conclusion: The five-step pediatric tuina method of Huxiang school and conventional tuina both can improve the primary and secondary symptoms in infantile diarrhea due to spleen deficiency, while the former one can produce more significant efficacy.

Therapeutic observation on tuina at head and abdomen for headache due to phlegm turbidity Abstract Objective: To observe the clinical efficacy of tuina at head and abdomen for headache due to phlegm turbidity. Methods: A total of 56 patients with headache due to phlegm turbidity were randomized into a tuina group and a Chinese medicine group by the random number table, with 28 cases in each group. The tuina group was treated mainly with tuina at the head and abdomen, while the Chinese medicine group was treated with oral administration of Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes Macrocephala and Gastrodia Decoction). The course of treatment was 30 d. The scores of headache index, traditional Chinese medicine syndrome scale, and the therapeutic efficacy were observed. Results: There were 2 dropouts in each group during treatment. The total effective rate was 92.3% in the tuina group, significantly higher than 76.9% in the Chinese medicine group (P<0.05). The scores of headache index and traditional Chinese medicine syndrome scale in both groups decreased after treatment (both P<0.05), and scores in the tuina group were lower than those in the Chinese medicine group (both P<0.05). Conclusion: Tuina mainly at head and abdomen is effective in treating headache due to phlegm turbidity, and has a better effect than Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes Macrocephala and Gastrodia Decoction).

Effects of needling acupoints at different nerve segments on oxytocin neurons in rat’s hypothalamic paraventricular nucleus and intragastric pressure Abstract Objective: To compare and explore the effects of needling acupoints at different nerve segments on the oxytocin (OT) neurons in the paraventricular nucleus of hypothalamus (PVN) and the intragastric pressure, and discuss the possible mechanisms. Methods: Thirty-two healthy adult Sprague-Dawley (SD) rats were numbered and divided into 4 groups according to the random number table, a Zusanli (ST 36) group, a Neiguan (PC 6) group, a Weishu (BL 21) group and a control group, with 8 rats in each group. Except the control group, rats in the other three groups received acupuncture at the corresponding acupoints. To observe the differences in double-labeled OT neurons and c-fos neurons of the hypothalamic PVN and the intragastric pressure after acupuncture among the three groups of needling acupoints at different nerve segments. Results: Compared with the control group, the numbers of double-labeled cells in the PVN of the Zusanli (ST 36) group and the Neiguan (PC 6) group decreased significantly, while the intragastric pressure increased significantly (all P<0.05), and the inter-group differences were statistically significant (P<0.05). The intragastric pressure in the Weishu (BL 21) group decreased significantly, and the inter-group difference was statistically significant (P<0.05). Compared with the Weishu (BL 21) group, the numbers of OT/c-fos double-labeled cells in PVN of the Zusanli (ST 36) group and the Neiguan (PC 6) group decreased significantly, and the intragastric pressure increased significantly, the inter-group differences were statistically significant (all P<0.01). Conclusion: Acupoints at different nerve segments have different regulation effects on intragastric pressure. The difference may be related to the different nerve conduction pathways by acupoints at different nerve segments in regulating the intragastric pressure. The PVN may be one common integration center for the regulation of gastric function in the three acupoints [Zusanli (ST 36), Neiguan (PC 6) and Weishu (BL 21)] at different nerve segments.

Effect of acupuncture plus exercise on pain and motor function in patients with knee osteoarthritis Abstract Objective: To observe the effects of acupuncture combined with isokinetic eccentric exercise on pain and motor function in patients with knee osteoarthritis (KOA). Methods: Sixty-four patients with KOA were randomly divided into an observation group and a control group, with 32 cases in each group. The observation group received acupuncture and isokinetic eccentric exercise, and the control group received isokinetic eccentric exercise and oral intake of meloxicam tablets. Both groups were treated for 4 weeks. Before and after treatment, the visual analog scale (VAS) score, the lysholm knee scale (LKS) score, and the quadriceps peak torque (PT) were evaluated. Results: The total effective rate was 93.8% in the observation group, versus 81.3% in the control group. The difference between the two groups was statistically significant (P<0.05). After treatment, the VAS scores of the two groups were lower than those before the treatment; both LKS score and quadriceps PT were higher than those before treatment, and the differences were statistically significant (all P<0.05). The VAS score, LKS score and quadriceps PT (angular velocity was 60°/s) of the observation group were significantly different from those of the control group (all P<0.05). Conclusion: Acupuncture plus isokinetic eccentric exercise is effective in treating KOA. The combined treatment can reduce the pain of KOA patients, improve joint function, strengthen quadriceps, improve joint stability, and its curative effect is better than isokinetic eccentric exercise plus oral intake of meloxicam tablets.