Objective To observe the effect of acupuncture on the expressions of serum corticotropin-releasing hormone (CRH), pituitary adrenocorticotropic hormone (ACTH) and its mRNA, to discuss the predominant and secondary factors that influence the efficacy of acupuncture, and to explore the optimal combination of acupuncture parameters.Method The rat model of kidney yang deficiency was made by muscular injection with hydrocortisone. Serum CRH, pituitary ACTH and its mRNA expressions were taken as the observation indexes, and 4 influential factors (i.e. selection of acupoints, angle of needle twisting, frequency of needle twisting, and time of needle twisting) plus 3 levels of each factor were arranged to L9(34) orthogonal table. A computer-controlled acupuncture manipulation device was used to treat the kidney yang rats. Serum CRH and pituitary ACTH were detected by enzyme-linked immunosorbent assay (ELISA) and pituitary ACTH mRNA expression by real time fluorescent quantitative PCR, to illustrate the primary and secondary factors that affect the acupuncture effectiveness.Results Regarding the effect on acupuncture effectiveness, the time of needle twisting ranked the top, followed by frequency of needle twisting, angle of needle twisting, and selection of acupoints. Angle of needle twisting, frequency of needle twisting, and time of needle twisting should be the predominant factors or secondary factors in influencing acupuncture effectiveness (P<0.01 orP>0.05). Selection of acupoints should be an important factor or secondary factor in influencing acupuncture effectiveness (P<0.05 orP>0.05).Conclusion For rats with kidney yang deficiency, the optimal acupuncture parameters combination should be acupuncture at Shenshu (BL 23), with twisting angle by 90°, twisting frequency at 180/min, and needle twisting time 120 s. Different factors can produce different effects on the therapeutic efficacy of acupuncture in treating rats with kidney yang deficiency; among the factors, the time of needle twisting produces the most significant effect, followed by frequency of needle twisting, angle of needle twisting, and selection of acupoints.

Objective To investigate the clinical efficacy of mallet needle plus acupuncture in treating stiff neck. Method Eighty patients with stiff neck were randomly allocated to treatment and control groups, 40 cases each. The treatment group received mallet needle therapy plus acupuncture and the control group, acupuncture alone, for three consecutive days. In the two groups, the Pain Rating Index (PRI) score and the Visual Analogue Scale (VAS) score were recorded before and after treatment and the clinical therapeutic effects were evaluated after treatment. Result The PRI score and the VAS score decreased in both groups after treatment compared with before (P<0.05) and decreased more in the treatment group than in the control group at the end of treatment (P<0.05). The total efficacy rate was 95.0% in the treatment group and 87.5% in the control group; there was a statistically significant difference between the two groups (P<0.05). Conclusion Mallet needle therapy plus acupuncture is more effective than acupuncture alone in treating stiff neck.