Narrow Results

We investigated the inhibitory pathways that mediate the antinociceptive effects of heterotopic electro-acupuncture (EA) on formalin injection-induced pain in rats. EA (2 ms, 10 Hz, 3 mA) was delivered to heterotopic acupoints HT₇ and PC₇ for 30 min; this was followed immediately by subcutaneous injection of formalin into the left hind paw of rats. Naltrexone (10 mg/kg, i.p.), an opioid receptor antagonist, was administered to evaluate the involvement of endogenous opioids. The dorsolateral funiculus (DLF), which is a descending pathway that inhibits pain, was transected at the ipsilateral T10–11 level of the thoracic spinal cord. EA inhibited behavioral responses to formalin injection-induced pain and prevented the pain-induced increase in cFos expression in the lumbar spinal cord. Pretreatment with naltrexone did not inhibit the antinociceptive effects of EA on formalin injection-induced pain. Transection of the DLF ipsilateral to the acupuncture site eliminated the antinociceptive effects of EA. These results suggest that the antinociceptive effects of heterotopic EA are mediated by the DLF and not by endogenous opioids.

Acupuncture at some specific acupoints of Foot Yangming can regulate gastric activity. However, its precise mechanism remains unknown. In our study, the effects and mechanism of electro-acupuncture (EA) at Tsusanli (ST 36), Shangchuhsu (ST 37) on the regulation of gastric activity were observed. EA at Tsusanli showed that gastric electric change had a significantly higher frequency and wave amplitude as compared to that of the Shangchuhsu group and other groups. EA at Shangchuhsu demonstrated the change of gastric electric was greater than that of the non-acupoint group and the control group. After bilateral vagotomy, the change of electro gastric graph (EGG) of EA at Tsusanlis was not significant compared to the control group. In the mean time, we have observed the electric discharge of the neurons in NTS and DMV. The frequency of electro-physiological activity in nucleus of solitary tract (NTS) and dorsal motor nucleus of the vagus nerve (DMV) in Tsusanli group and Shangchuhsu group were markedly increased compared with that in other groups. The results have indicated that EA at Tsusanli and Shangchuhsu not only regulate gastric activity, but also activate neurons in NTS and DMV significantly. Our study suggests that the effect of EA at Tsusanli and Shangchuhsu on the gastric activity may partially depend upon integrated nerve pathway and related central neurons in dorsal vagal complex.

According to recent evidence, acupuncture at Tsusanli (ST 36) can regulate gastric activity. And this regulation mainly depends upon neural basis or structure and may probably relate to the central neurons in the dorsal vagal complex. However, whether the glias of the dorsal vagal complex participate in the regulation of gastric activity, when electro-acupuncture (EA) at Tsusanli, still remains to be interpreted. In this study, we observed the effect of EA at Tsusanli (ST 36) on regulation of gastric activity. Propentofylline (PPF), a glial metabolic inhibitor, was used to inhibit the function of glial cells. EA at Tsusanli showed that the expressions of glial fibrillary acidic protein (GFAP) and OX42 increased significantly compared to that of the control group, and gastric electric change was obvious, with significantly higher frequency and wave amplitude compared to the control group. The expressions of GFAP and OX42 were decreased markedly when pretreated with PPF group than without PPF pretreatment group. Compared to the Tsusanli group and the control group, the changes of electro gastric graph (EGG) were significantly decreased in PPF pretreatment group. On the other hand, we observed the changes of spontaneous electro-activity of the DVC (dorsal vagal complex) in our previous experiment.

The results indicated that EA at Tsusanli could activate glial cells in the dorsal vagal complex and regulate gastric activity. PPF blocked the function of glia, thus the effect of EA at Tsusanli on gastric activity was weakened. Our study suggested that this electro-acupuncture regulation of gastric activity was possibly related with glia of the dorsal vagal complex.

According to the principles of traditional Chinese medicine, channels and collaterals within the body provide pathways through which qi and blood travel, and each channel or collateral is linked with a specific organ. The Yinlingquan (spleen 9, SP9) and Ququan (liver 8, LR8) acupoints represent the sea points of the spleen and liver meridians, respectively, from which qi and blood flow into their specific visceral organs. The purpose of this study was to investigate the changes in blood flow/perfusion in the liver and spleen resulting from the application of 2 Hz electro-acupuncture (EA) to the Yinlingquan (SP9) or Ququan (LR8) acupoints. A total of 18 Spragrue-Dawley rats were randomly divided into three groups of six rats each as follows: sham group receiving sham EA; Yinlingquan (SP9) group receiving 2 Hz EA, applied at bilateral Yinlingquan (SP9) acupoints; and Ququan (LR8) groups receiving 2 Hz EA, applied at bilateral Ququan (LR8) acupoints. The mean blood flow/perfusion of the spleen and liver was recorded using a laser Doppler blood flow monitor prior to EA (representing the baseline), during EA, and post-EA. Each measurement period lasted ten minutes. Nitric oxide levels were also measured from the right femoral arterial blood, following the conclusion of each series of blood flow/perfusion recordings. The results indicate that the sham EA did not increase the mean blood flow/perfusion in the liver or spleen; 2 Hz EA at bilateral Yinlingquan (SP9) acupoints increased the mean blood flow/perfusion in the spleen, but not in the liver. In contrast, 2 Hz EA at bilateral Ququan (LR8) acupoints increased the mean blood flow/perfusion in the liver, but not in the spleen. Nitric oxide levels showed no significant difference between any of the groups at any stage of the measurements. According to the results, we conclude that EA at the Yinlingquan (SP9) and Ququan (LR8) acupoints can increase the blood flow in the spleen and liver, respectively.

The aim of the study was to investigate the efficacy of electro-acupuncture coupled with conventional treatments and compare it with the efficacy of conventional treatments alone in patients with chronic plantar fasciitis. Thirty patients with chronic refractory plantar fasciitis were randomly assigned to two groups. Subjects in the control group received five weeks of conventional treatments, including stretching exercise, shoe modification and rescue analgesics. Subjects in the acupuncture group received the same treatments plus ten sessions of electro-acupuncture twice weekly. Endpoints included a success rate determined by a minimum of a 50% decrease in Visual Analog Scale (VAS) and Foot Function Index (FFI). At the end of treatment, VAS decreased significantly from 6.00 ± 1.69 to 1.89 ± 1.59 and from 6.27 ± 2.34 to 5.40 ± 2.26 in the acupuncture and control groups, respectively. FFI decreased significantly only in the acupuncture group (p < 0.05). Subjects in the acupuncture group obtained higher success rates than those in control group (80% and 13.3%, respectively). FFI in the acupuncture group was better than those in the control group (p < 0.001). At the sixth week follow-up, subjects in the acupuncture group showed a better FFI and success rate for pain during the day than those in the control group (p < 0.05). Electro-acupuncture coupled with conventional treatments provided a success rate of 80% in chronic planar fasciitis which was more effective than conventional treatments alone. The effects lasted for at least six weeks.

This study aims to examine electro-acupuncture stimulation (EA) assisted therapy with analysis of heart rate variability to understand autonomic nervous activity variability (ANAV) and to track the changes in female patients with constipation. The average ages were 42±12 years old. The participants were divided by a single-blind and randomized trial into two groups: the electro-acupuncture-point group, and the non-electro-acupuncture-point group. Both of the groups had eight treatments, once a week. For the electro-acupuncture (EA) group, needles were inserted into their Zusunli (ST36), Shangiuxu (ST37), Tiensu (ST25), Shueidao (ST28), Guanyuan (CV4) and Qihai (CV6) points. For the sham electro-acupuncture (SA) group, needles were inserted into acu-points that were not the ones mentioned for the EA group. While inserting needles, needles were inserted lightly into the participants' skin and removed quickly (mock Transcutaneous Electrical Nerve Stimulation, TENTS). After an eight-week treatment period, the autonomic nervous system activities of the SA group did not show significant differences in their heart rate variability. However, the autonomic nervous system activities of the EA group had continuously increased after each session. The normalized high frequency powers (nHFP) of their autonomic nervous system activities were 26.79 in the first week, and they increased to 32.28 in the fourth week. In the eighth week, their nHFP had increased to 37.60 (p < 0.05). The normalized low frequency power (nLFP) was 30.81 in the first week. However, it decreased to 25.98 after three weeks of treatment. After the eight-week treatment period, the nLFP decreased to 24.84 (p < 0.05). After the eight-week treatment, the control group did not appear to undergo any physiological change, while the constipation had been improved for the experimental group. It was found that the activation of parasympathetic nervous system in the experimental group increased after the eight-week treatment. The effects of such a result on the enhancement of the activation of parasympathetic nervous system and the improvement of constipation should be further discussed.

We performed this study to examine the effect of electro-acupuncture (EA) on postoperative pain, postoperative nausea and vomiting (PONV) and recovery in patients after a supratentorial tumor resection. Eighty-eight patients requiring a supratentorial tumor resection were anesthetized with sevoflurane and randomly allocated to a no treatment group (Group C) or an EA group (Group A). After anesthesia induction, the patients in Group A received EA at LI4 and SJ5, at BL63 and LR3 and at ST36 and GB40 on the same side as the craniotomy. The stimulation was continued until the end of the operation. Patient-controlled intravenous analgesia (PCIA) was used for the postoperative analgesia. The postoperative pain scores, PONV, the degree of dizziness and appetite were recorded. In the first 6 hours after the operation, the mean total bolus, the effective times of PCIA bolus administrations and the VAS scores were much lower in the EA group (p < 0.05). In the EA group, the incidence of PONV and degree of dizziness and feeling of fullness in the head within the first 24 hours after the operation was much lower than in the control group (p < 0.05). In the EA group, more patients had a better appetite than did the patients in group C (51.2% vs. 27.5%) (p < 0.05). The use of EA in neurosurgery patients improves the quality of postoperative analgesia, promotes appetite recovery and decreases some uncomfortable sensations, such as dizziness and feeling of fullness in the head.

Spinal cord injury is a devastating neurological disease in desperate need of a cure. We have previously shown that overexpression of the adhesion molecule L1 contributes to locomotor recovery after injury and were therefore interested in how electro-acupuncture would influence the expression of this molecule. Here, we investigated the effects of electro-acupuncture at “Jiaji” points (EX-B2), newly established by us, in young adult mice to determine whether improved recovery via electro-acupuncture could be due to enhanced L1 expression. Locomotor function, as evaluated by the Basso Mouse Scale score and by catwalk gait parameters, was improved by electro-acupuncture at different time points after injury in parallel with enhanced levels of L1 expression. Interestingly, the levels of the astrocytic marker glial fibrillary acidic protein (GFAP) were also increased, but only in the early phase after injury, being reduced at later stages during recovery. Acupuncture alone showed less pronounced changes in expression of these molecules. We propose that electro-acupuncture improves regeneration in part by promoting the L1 expression and beneficial activation of stem cells, and by differentially modulating the expression of GFAP by promoting regeneration-conductive astrocytic responses at initial stages and reducing regeneration-adversive activation in the secondary stages. Expression of the stem cell marker nestin was upregulated by electro-acupuncture in the acute stage. The combined observations show for the first time in mice the beneficial functions of electro-acupuncture at Jiaji points in the spinal cord injury mouse model and provide novel insights into some molecular mechanisms underlying electro-acupuncture in spinal cord injury.

Knee osteoarthritis (KOA) is a common chronic degenerative disease of the elderly. Electro-acupuncture (EA) is considered as a beneficial treatment for KOA, but the conclusion is controversial. This systematic review compiled the evidence from 11 randomized controlled trials to objectively assess the effectiveness and safety of EA for KOA. Eight databases including PubMed, Cochrane Library, Clinic trials, Foreign Medical Literature Retrial Service (FMRS), Science Direct, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang Data were extensively searched up to 5 July 2016. The outcomes included the evaluation of effectiveness, pain and physical function. Risk of bias was evaluated according to the Cochrane risk of bias tool. Eleven RCTs with 695 participants were included. Meta-analysis indicated that EA was more effective than pharmacological treatment (RR $=$ 1.14; 95% CI $=$ 1.01,1.28; $P=0.03$) and manual acupuncture (RR $=$ 1.12; 95% CI $=$ 1.02,1.22; $P=0.02$). Also, EA had a more significant effect in reducing the pain intensity (SMD $=-1.11$; 95% CI $=-1.33,-0.88$; $P<0.00001$) and improving the physical function in the perspective of WOMAC (MD $=-9.81$; 95% CI $=-14.05$, 5.56; $P<0.00001$) and LKSS (pharmacological treatment: MD $=5.08$; 95% CI $=3.52$, 6.64; $P<0.00001$). Furthermore, these studies implied that EA should be performed for at least 4 weeks. Conclusively, the results indicate that EA is a great opportunity to remarkably alleviate the pain and improve the physical function of KOA patients with a low risk of adverse reaction. Therefore, more high quality RCTs with rigorous methods of design, measurement and evaluation are needed to confirm the long-term effects of EA for KOA.

The objective of this research is to investigate the potential mechanisms underlying electro-acupuncture intervention in chronic prostatitis (CP). Rats were randomly divided into five groups: a control group, a model group (suffering from CP), an electro-acupuncture group, an inhibitor group, and an activator group. One day post-modeling, electro-acupuncture intervention was conducted on the electro-acupuncture group, inhibitor group, and activator group at the acupoints “Baihuan Shu” (BL 30) and “Huiyang” (BL 35). Relevant indicators were used to evaluate the efficacy. Compared with models, the electro-acupuncture group showed significantly increased horizontal and vertical movement scores and sugar water intake, and significantly decreased prostate wet weight and prostate index. Compared with the electro-acupuncture group, the inhibitor group showed significantly increased horizontal and vertical movement scores and sugar water consumption. In contrast, for the activator group, these scores and consumption levels significantly decreased, while their prostate wet weight and prostate index increased significantly. Compared with models, the expression of TLR4 and p-NF-$\kappa$B/NF-$\kappa$B proteins in the prostate tissue of electro-acupuncture group was significantly lower. In terms of the inhibitor group, they also showed a decrease in TLR4 and p-NF-$\kappa$B/NF-$\kappa$B protein expression, whilst the activator group showed an increase. Therefore, electro-acupuncture at “Baihuan Shu” (BL 30) and “Huiyang” (BL 35) can significantly enhance movement scores, vertical movement scores, and sugar water consumption in rats with CP. Moreover, it can decrease the wet weight and index of the prostate, possibly by regulating the TLR4/NF-$\kappa$B pathway.

Knee osteoarthritis (KOA) is a common chronic degenerative disease of the elderly. Electro-acupuncture (EA) is considered as a beneficial treatment for KOA, but the conclusion is controversial. This systematic review compiled the evidence from 11 randomized controlled trials to objectively assess the effectiveness and safety of EA for KOA. Eight databases including PubMed, Cochrane Library, Clinic trials, Foreign Medical Literature Retrial Service (FMRS), Science Direct, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang Data were extensively searched up to 5 July 2016. The outcomes included the evaluation of effectiveness, pain and physical function. Risk of bias was evaluated according to the Cochrane risk of bias tool. Eleven RCTs with 695 participants were included. Meta-analysis indicated that EA was more effective than pharmacological treatment (RR = 1.14; 95% CI = 1.01,1.28; P = 0:03) and manual acupuncture (RR = 1.12; 95% CI = 1.02,1.22; P = 0:02). Also, EA had a more significant effect in reducing the pain intensity (SMD = − 1:11; 95% CI = − 1:33, − 0:88; P < 0:00001) and improving the physical function in the perspective of WOMAC (MD = − 9:81; 95% CI = − 14:05, 5.56; P < 0:00001) and LKSS (pharmacological treatment: MD = 5:08; 95% CI = 3:52, 6.64; P < 0:00001). Furthermore, these studies implied that EA should be performed for at least 4 weeks. Conclusively, the results indicate that EA is a great opportunity to remarkably alleviate the pain and improve the physical function of KOA patients with a low risk of adverse reaction. Therefore, more high quality RCTs with rigorous methods of design, measurement and evaluation are needed to confirm the long-term effects of EA for KOA.

Electro-Acupuncture therapy is acupuncture based on the standard acupuncture treatment principles of Chinese Medicine. The history of applying Electro-Acupuncture in China was relatively short. Electro-Acupuncture is different from the manual stimulation of acupuncture needling since it is casting its effects to a much wider area. As the development of Electro- Acupuncture equipment continues to progress, basic research has become more serious. There are many types of Electro-Acupuncture equipment, which will be introduced in this chapter.