This article aimed to discuss the definition of the ancient characterZhen (needle) from three aspects: the origin of the character, the meaning of hexagramXian, and application of interaction in acupuncture. The writers hold thatZhen means feeling, and the definition ofZhen reveals that the key to achieving acupuncture efficacy is needling sensation. In clinic, when practicing acupuncture, the writers should especially pay attention to the use of interactions between the left and the right, the upper and the lower, the anterior and the posterior, and intersections among meridians, which will benefit the enhancement the clinical efficacy of acupuncture-moxibustion therapy.

By studying doctor Sawada's theoretical thought related to clinical experience in "The Essence of Acupuncture", it is found that the data recorded by Daita Bunji according to what he saw and heard provide many returning-to-nature treasures for mining. That plays an important guiding role in expanding the idea of acupuncture treatment and improving clinical therapeutic effects. This article outlines doctor Sawada's thought of acupuncture treatment from the theory of "one original, two opposite, three large, four spiritual and five distributed", the theory of abdominal"卍"symbol, and the development and application of tri-jiao theory. It is intended to make that well known. Posterity is lucky if it can be carried forward.

OBJECTIVETo explore the mechanisms of electro-acupuncture (EA) in improving synaptic plasticity after cerebral ischemic injury.

METHODSFocal cerebral ischemia (FCI) model was established by middle cerebral artery occlusion (MCAO) with heat-coagulation method. The changing rules of synaptic ultrastructure, synaptophysin (P38), growth-associated protein-43 (GAP-43), brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in the ischemic cortex 2 and 5 weeks after FCI and the effects of EA on them were observed.

RESULTSExpression of numerical density (Nv), surface density (Sv), volume density (Vv), post synaptic density (PSD) and P38 in the ischemic cortex significantly decreased after MCAO (P<0.01). Among them, Nv and Sv were raised at the 5th week in FCI rats either treated or untreated with EA (P<0.01), but the increment of Sv was higher in those of the treated rats (P<0.01); PSD in the EA treated rats also showed a significant increase at the 5th week, which was significant higher than that in those untreated; EA showed insignificant influence on Vv and synaptic interfacial curvature; P38 lowered continuously after 2 weeks, but at the 5th week, it was higher in EA treated rats than that in untreated rats (P<0.01), while at the 2nd week, the levels in treated and untreated rats were equal. GAP-43 rose in the 2nd week after modeling, with no difference between EA treated and untreated animals, at the 5th week, it was lowered in untreated rats to near that in sham-operated rats, but maintained at higher level in EA treated rats; NGF and BDNF positive cells significantly increased after modeling (P<0.01), and showed a descending trend with the time going (P<0.01) both in rats treated or untreated with EA.

CONCLUSIONEA can protect synaptic ultrastructure, promote the expression of P38, GAP-43, NGF and BDNF in the ischemic cerebral cortex, and thus improve synaptic plasticity in cerebral ischemic rats.

Acupuncture Therapy ; Animals ; Electroacupuncture ; Female ; Infarction, Middle Cerebral Artery ; physiopathology ; therapy ; Male ; Neuronal Plasticity ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Synapses ; physiology

OBJECTIVETo study the effect of electro-acupuncture (EA) in regulating calcium (Ca2+) content in brain neurocytes of rats with focal cerebral ischemia.

METHODSThe changes of Ca2+ content in ischemic neurocytes were observed by using laser confocal scanning microscope.

RESULTSCa2+ content did not change significantly in cerebral cortex when the brain ischemia occurred for 1 hr, but it raised significantly in striatum neurocytes. Both the Ca2+ contents in striatum and cortex area increased significantly 3 hrs after ischemia occurrence and the content in striatum was higher than that in cortex significantly. Brain Ca2+ content could be reduced significantly after the 3 hrs ischemic brain were treated by EA for 30 min.

CONCLUSIONEA could regulate the content of Ca2+ in the ischemic area of brain, inhibit Ca2+ overload, so as to protect neurons from ischemic injury.

Animals ; Biological Transport, Active ; Brain ; metabolism ; pathology ; Calcium ; metabolism ; Electroacupuncture ; Infarction, Middle Cerebral Artery ; metabolism ; pathology ; Male ; Microscopy, Confocal ; Neurons ; metabolism ; Random Allocation ; Rats ; Rats, Wistar

OBJECTIVETo observe effects of acupuncture and diet on insulin resistance (IR) and to probe the mechanism.

METHODSForty SID rats were equally divided into 5 groups: blank group (group I), model group I (group II), model group II (group III), acupuncture group I (group IV) and acupuncture group II (group V). The groups II, III, N and V were fed with high-fat-sugar-salt forage to made IR model, then the groups I, III and V were fed with normal forage, and the groups II and IV with the high-fat-sugar-salt forage, and the acupuncture groups IV and V received acupuncture treatment. Two weeks later, the fasting blood glucose (FBG), plasma insulin (INS), insulin sensitivity index (ISI), INS antibody and tumor necrosis factor alpha (TNF-alpha) were detected.

RESULTSAs compared with group I, FBG and INS increased, ISI decreased in the group II (all P < 0.01); as compared with the group II , FBG and INS decreased (all P < 0.01) and ISI increased (P < 0.05, P < 0.01) in the group [II, IV, V; no case with INS antibody (+) in all groups; TNF-alpha in the group II increased compared with that of the group I (P < 0.01), and TNF-alpha in the group III, IV, V decreased compared with that of group II (P < 0.01).

CONCLUSIONAcupuncture exerts a reversal effect on insulin resistance, and diet can promotes this effect. The mechanism is carried out possibly through decreasing the secretion of TNF-alpha.

Acupuncture Therapy ; Animals ; Insulin Antibodies ; blood ; Insulin Resistance ; Male ; Medicine, Chinese Traditional ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo observe the effects of electroacupuncture (EA) on the structure parameters of synapse and reactive changes of astrocyte in the marginal zone of focal cerebral ischemia in rats at different time zones so as to further explore its underlying mechanisms in the treatment of cerebral ischemia.

METHODSNinety male Wistar rats were randomly assigned to sham-operation, model, and EA groups, with 30 animals in each group. Each group was subdivided into 1 h, as well as 1, 3, 7, and 21 days post-operation groups, with 6 animals assigned to each time point subgroup. Heat coagulation-induced occlusion of the middle cerebral artery was performed to establish a model of focal cerebral ischemia. EA was applied immediately following surgery to the EA group [4/20 Hz, 2.0-3.0 V, 1-3 mA, to Baihui (GV20) and Dazhui (GV14)] for 30 min. Treatment was performed once a day, and experimental animals were sacrificed at 1 h, as well as 1, 3, 7 and 21 days postoperation. The ultrastructure changes in synapse and astrocytes were observed by using transmission electron microscopy. Glial fibrillary acidic protein (GFAP) expression and Ca(2+) of astrocytes were measured by using laser confocal scanning microscope. Excitatory amino acid transporters-2 (EAAT2) and connexin 43 (CX43) expressions were assayed with immunohistochemical method. Canonical correlation analysis was conducted between structure parameters of synapse and parameters of astrocyte in the same time and group.

RESULTSBroken synapses were observed following cerebral ischemia, and the numbers of synapses were significantly decreased. Compared with the model group, synaptic ultrastructure was significantly improved in the EA group. Compared with the sham-operation group, synaptic number density was significantly decreased, as were postsynaptic density thickness, synaptic cleft width and synaptic interface curvature in the EA and model groups. However, compared with the model group, postsynaptic density thickness was significantly increased in the EA group at the same time points post-operation (P <0.05, P<0.01). In addition, synaptic cleft width, synaptic number density and synaptic interface curvature were significantly increased with the passage of time (P <0.05, P<0.01). The expression of GFAP in the EA group were significantly lower than those in the model group at all the time points (P <0.05, P<0.01). OD values of EAAT2 in the EA group were significantly higher than those in the model group at the same time (P <0.05, P<0.01). Compared with that in the model group, the expressions of CX43 in the EA group increased significantly at 3 days and 7 days (P <0.05, P<0.01). Ca(2+) average fluorescence intensity of astrocytes in the EA group was significantly lower than those in the model group at 1 h, 1 day, 3 days and 7 days (P <0.05, P<0.01). The changes in structure parameters of synapse were closely related to the changes of CX43, EAAT2, GFAP, Ca(2+) of astrocytes by EA treatment at all the time points.

CONCLUSIONSEA is helpful for synaptic reorganization, which may be related to its effect on intervening the activation state of astrocytes and promoting the beneficial interaction between astrocytes and synapses. Acupuncture could start the adjustment of neuron-glial network so as to promote the synaptic reorganization, which may be the key mechanism of treating cerebral ischemia.

Animals ; Astrocytes ; metabolism ; pathology ; Brain Ischemia ; pathology ; therapy ; Calcium ; metabolism ; Connexin 43 ; metabolism ; Electroacupuncture ; methods ; Excitatory Amino Acid Transporter 2 ; metabolism ; Fluorescence ; Glial Fibrillary Acidic Protein ; metabolism ; Male ; Post-Synaptic Density ; metabolism ; Rats ; Rats, Wistar ; Statistics as Topic ; Synapses ; metabolism ; pathology

OBJECTIVETo assess the clinical efficacy of acupuncture and moxibustion on depression in view of the outcome indicators of the patient subjective reports.

METHODSOne hundred and sixty-three cases of depression being in compliance with the inclusive standards were randomized into a soothing-liver and regulating-mind group, an acupoint-shallow-puncturing group and a non-acupoint-shallow-puncturing group. In the soothing-liver and regulating-mind group, the conventional acupuncture was applied to the four-gate points [Hegu (LI 4) and Taichong (LR 3)], Baihui (GV 20) and Yintang (EX-HN 3), the direct moxibustion with moxa cone was applied to the four-flower points [Geshu (BL 17), Danshu (BL 19)]. Finally, the intradermal needling was used at Xinshu (BL 15) and Ganshu (BL 18). In the acupoint-shallow-puncturing group, the acupoints selected were same as those in the soothing-liver and regulating-mind group. But the needle insertion was shallower and the time of moxibustion was shorter. In the non-acupoint-shallow-puncturing group, the spots that were 10 mm lateral to those acupoints in the soothing-liver and regulating-mind group were selected. The operation was same as that in the acupoint-shallow-puncturing group. The treatment was given twice a week in three groups. Totally, 12 weeks of treatment were required. The score of symptom checklist 90 (SCL-90), the self-report symptom inventory was observed before treatment, 1 month and 3 months after treatment separately so as to assess the corresponding short-term, mid-term and long-term efficacies of the program of acupuncture and moxibustion for soothing the liver and regulating the mind.

RESULTSIn each time-point after treatment, for the scores of somatization, obsessive-compulsive symptom, interpersonal sensitivity, depression, anxiety, hostility, paranoid ideation, psychoticism and the other 8 dimensionalities, in comparison between the soothing-liver and regulating-mind group and the non-acupoint-shallow-puncturing group, the differences were significant statistically (all P < 0.05). For the scores of depression, anxiety and hostility, in comparison between the soothing-liver and regulating-mind group and the acupoint-shallow-puncturing group, the differences were significant statistically (all P < 0.05).

CONCLUSIONAcupuncture and moxibustion can improve the scores of SCL-90 scale for the patients with depression. The outcome indicators of the patient subjective reports can accurately assess the clinical efficacy.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Depression ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Self-Assessment ; Treatment Outcome ; Young Adult

Objective To observe the clinical efficacy of Tong Du Tiao Shen needling (unblocking the Governor Vessel and regulating the mind) in treating post-stroke deglutition disorders. Method Sixty patients with post-stroke deglutition disorders were randomized into a treatment group and a control group by the random number table, 30 cases each. In addition to the conventional neurological treatment, the control group was given ordinary acupuncture, and the treatment group was given Tong Du Tiao Shen needling, 3 times a week, 10 sessions as a treatment course. The Water Swallowing Test (WST) and Videofluoroscopic Swallowing Study (VFSS) were observed in the two groups before and after 1 course of treatment. Result The total effective rate was 93.3% in the treatment group, significantly superior to 66.7% in the control group (P<0.05). The VFSS showed that the intra-group differences were statistically significant in comparing oral transit, pharyngeal retention and pharyngeal transit of semi-fluid food in both treatment and control groups by the paired t-test (P<0.05), and the between-group differences after the treatment were also statistically significant (P<0.05). Conclusion Tong Du Tiao Shen needling can produce a more significant efficacy in improving the swallowing function in post-stroke dysphasia compared to ordinary acupuncture.

The research aims to propose the approaches to the clinical trial of acupuncture and moxibustion and provide the methodological guide for the research in this field in terms of the inadequate systematic collection, lack of the specific characteristics of acupuncture-moxibustion treatment and insufficient persuasion in clinical evidences of acupuncture-moxibustion research. Through a systematic review of the registration of acupuncture-moxibustion clinical trials at home and abroad, the distribution of diseases with the recommendation of acupuncture and moxibustion in Cochrane Library database, combined with the evidence grade of the evidence-based medicine and the individual characteristics of clinical practice with acupuncture and moxibustion, some research ideas and framework are proposed for the clinical trial of acupuncture and moxibustion. To take the curative effect as the forerumer, the dominant disease and therapeutic methods of acupuncture and moxibustion should be initially generalized by the case experiences and clinical observation at the first. In view of the potential function of acupuncture and moxibustion in treatment, the rigorous and standardized clinical trial should be carried out to verify their therapeutic effect. Finally, the experimental research is adopted to explore the mechanism of acupuncture and moxibustion. Through the combination of quantitative and qualitative methods, all of the evidences are integrated to form an integrative evidence chain. It is anticipated that the construction of the integrative evidence chain in clinical trial of acupuncture and moxibustion may enhance the promotion of clinical practice with acupuncture and moxibustion and increase the influence of acupuncture-moxibusiton discipline.
Acupuncture Therapy ; Clinical Trials as Topic ; Evidence-Based Medicine ; Medicine, Chinese Traditional ; Moxibustion

's acupuncture technique is a kind of special acupuncture methods developed and improved by . It has unique curative effects on hysterical paralysis, schizophrenia, madness, epilepsy and traumatic paraplegia, etc. This acupuncture technique has the characteristics of "deep" "transparent" "moving" and "sensing". The acupoints selection is different from that of twelve meridian acupoints. The deep insertion of acupuncture needles is applied at acupoints located in the wrist joint, ankle joint and below, while the penetration needling method is applied at acupoints located in the area which has relatively thick muscles, and where meridian and -meridian are symmetric with each other. The horizontal and deep connection of acupoints and the adjustment effect of -blood and - are emphasized during treatment.
Acupuncture Points ; Meridians ; Yin-Yang