[Visual analysis of the acupoint prescription characteristics of acupuncture and moxibustion in treatment of rheumatoid arthritis].
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Using the complex network technology, the characteristics of the core acupoint prescriptions and the application of acupuncture-moxibustion techniques were analyzed in treatment of rheumatoid arthritis (RA) so as to provide the evidences for acupoint selection and therapeutic methods for RA treated with acupuncture and moxibustion. The articles of acupuncture and moxibustion for treatment of RA in recent 20 years were collated and imported, and the database of the acupoint prescriptions was developed. Using Cytoscape 3.9.2 software, the acupoints in the prescriptions were visualized for the common occurrence network analysis. The association rule analysis was performed with IBM SPSS Modeler 18.0 software and the complex network analysis was by Gephi 0.9.2 software. A total of 798 articles were screened, in which, 3 258 prescriptions were extracted with 253 acupoints involved. The analysis of acupoint selection was conducted in terms of syndrome/pattern differentiation, acupoint locations and main acupoints, and therapeutic methods. The results showed that the most common TCM syndromes of RA included painful bi syndrome, wandering bi syndrome, fixed bi syndrome and bi syndrome due to wind, damp and heat. Regarding the core combination of acupoints, painful bi syndrome: Guanyuan (CV 4) and Shenshu (BL 23); fixed bi syndrome: Yinlingquan (SP 9), Sanyinjiao (SP 6), Zusanli (ST 36), Pishu (BL 20) and Fenglong (ST 40); wandering bi syndrome: Fengchi (GB 20), Geshu (BL 17), Fengmen (BL 12), Xuehai (SP 10) and Waiguan (TE 5); bi syndrome due to wind, damp and heat: Dazhui (GV 14), Quchi (LI 11) and Hegu (LI 4). Regarding the acupoint locations, the acupoints located in the upper limbs, lower limbs and spinal region were generally selected. Quchi (LI 11) was one of the main acupoints in prescriptions with the highest use frequency. Zusanli (ST 36) and Shenshu (BL 23) presented the highest co-occurrence intensity, while Zusanli (ST 36) and Quchi (LI 11) indicated the highest correlation. The treatment of acupuncture-moxibustion for RA is generally complied with the principle as "the synthesis of main acupoints, supplementary acupoints in local affected area and those based on syndrome differentiation". Warm needling and the combination of acupuncture and herbal medication are the most common therapeutic methods for RA.利用复杂网络技术分析针灸治疗类风湿关节炎的核心腧穴处方以及刺灸法应用特点，为临床针灸治疗类风湿关节炎提供选穴、治法依据。对近20年针灸治疗类风湿关节炎的文献进行收集、整理、录入，建立针灸处方数据库，对处方中的腧穴运用Cytoscape3.9.0进行共现网络可视化、运用IBM SPSS Modeler 18.0进行关联规则分析、利用Gephi0.9.2软件进行复杂网络分析。共筛选出798篇文献，提取3 258条针灸处方，涉及253个腧穴，主要从辨证分型选穴、分部选穴、主穴处方及疗法进行分析。结果表明最常见的中医证型为痛痹、行痹、着痹及风湿热痹；辨证选穴核心腧穴组合为痛痹：关元、肾俞；着痹：阴陵泉、三阴交、足三里、脾俞、丰隆；行痹：风池、膈俞、风门、血海、外关；风湿热痹：大椎、曲池、合谷。分部选穴以上肢部、下肢部、脊柱部腧穴多见。曲池在主穴处方中使用频次最高，足三里-肾俞的共现强度最高；相关性最高的腧穴组合为足三里-曲池。针灸治疗类风湿关节炎选穴多遵循“主穴-局部配穴-辨证配穴”的原则，温针灸及针药联合为最常用的施治方法。.Keywords:
Zusanli
Moxibustion
Objective: To observe the effects of warm acupuncture on “Dinghui Acupoint” and “Heart Acupoint” in Traditional Mongolian Medicine on behavior and hypothalamic inflammatory cytokines IL-1β, IL-6 and IFN-r in Rats with Chronic Fatigue Syndrome. Methods: SD rats were randomly divided into normal group, model group, warm acupuncture group and moxibustion positive control group. The latter three groups of rats were used to establish a model of rats with chronic fatigue syndrome (CFS) using a combination of physical fatigue and mental fatigue. When establishing the model of warm acupuncture group, “Dinghui Acupoint” and “Heart Acupoint” intervention was carried out; when establishing the model of moxibustion positive control group, “Zusanli Acupoint” intervention was carried out on both sides. Behavioral observations (body weight, exhaustive swimming time, tail suspension experiment, water maze) were performed before and after modeling. The hypothalamic inflammatory cytokines IL-1β, IL-6 and IFN-r were detected by ELISA method after warm acupuncture and moxibustion intervention. Results: After 21 days of modeling, the body weight of the rats in each group was significantly lower than that in the normal group, and there was a significant difference (P<0.01); Compared with the model group, the weight of the rats in the warm acupuncture group increased significantly, and there was a significant difference (P<0.01); Compared with the model group, the exhaustive swimming time of the rats in the warm acupuncture group was significantly prolonged, and there was a significant difference (P<0.01); Compared with the moxibustion group, the exhaustion time of the rats in the warm acupuncture group was relatively prolonged, and there was a significant difference (P<0.05); Compared with the normal group, the tail suspension time of the model group was significantly prolonged, and there was a significant difference (P<0.05); Compared with the model group, there was a significant difference in the duration of the suspension of the warm acupuncture group and the moxibustion group (P<0.01); Compared with the normal group, the total distance of the water maze test was shorter in the model group, and there was a significant difference (P<0.01); Compared with the model group, both the warm acupuncture group and the moxibustion group were prolonged, and there was a significant difference (P<0.05); Compared with the moxibustion group, the distance between the rats in the warm acupuncture group was relatively longer, but there was no significant difference (P>0.05); Compared with the normal group, IL-1β, IL-6 and IFN-r increased significantly in the model group and there was a significant difference (P<0.05); Compared with the model group, IL-1β and IL-6 in the warm acupuncture group was significantly decreased (P<0.05), and the IL-6 in the moxibustion group was significantly different (P<0.05); Compared with the model group, there was no significant difference between the IFN-r group and the moxibustion group (P>0.05); Compared with the moxibustion group, the levels of IL-1β, IL-6 and IFN-r were not significantly different (P>0.05). Conclusion: Warm acupuncture on “Dinghui Acupoint” and “Heart Acupoint” in Traditional Mongolian Medicine has the ability to improve the body’s defense and self-healing ability, improve chronic fatigue syndrome (CFS), and thus play a preventive role. The results of this research indicate that the warm acupuncture group and the moxibustion group have the same effect.
Zusanli
Moxibustion
Rat model
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Objectives : The aim of this study was to describe the details and to assess the clinical evidence of acupuncture and moxibustion for non-specific chronic neck pain. Methods : We searched seven databases including Korean, English, and Chinese databases through July 2016. Studies using acupuncture, moxibustion, pharmacopuncture, electroacupuncture, auricular-acupuncture, acupressure for non-specific chronic neck pain were included. Only controlled clinical trials or randomized clinical trials were assessed. Study design, number of subject, inclusion criteria, intervention, and results were extracted. In addition, details of intervention including needle type, retention time, acupoints were analyzed. Results : Total 64 studies(39 acupuncture, 9 laser, 6 pharmaco-acupuncture, 3 electro-acupuncture, 3 auricular-acupuncture, 3 moxibustion, 1 acupressure) were included. Among 39 acupuncture studies, 35 used acupuncture as sole intervention. Sham treatment was the most common intervention for control group, followed by no intervention. Various outcome including pain, disability, quality of life, range of motion was used as outcome measurement. The effect of acupuncture and moxibustion was different depending on the type of control and outcome measurement. The most commonly used method in acupuncture for neck pain was GB21, SI3, GB20, LI4, BL11 acupoints, 10∼30 mm insertion depth, 20∼30 retention time, and 1∼2 times per week. Conclusions : Analyzing the details of acupuncture and moxibustion treatment could be helpful for researches and clinics. Further studies should consider the characteristics of study design, intervention, and outcome to assess the effect of TKM.
Moxibustion
Acupressure
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Objective: To observe the effect of electroacupuncture at Guanyuan,Zusanli and Sanyinjiao in the treatment of climacteric syndrome.Methods: 90 patients were randomly divided into three groups,each group with 30 cases,and were given acupuncture therapy,30min each time,one time each day,10 times as a course,a total of three courses of treatment.Results: After treatment for three courses,the total efficiency in Sanyinjiao group was 90%,which was significantly better than the other two groups(P 0.05).Conclusion: Electroacupuncture at Sanyinjiao in the treatment of climacteric syndrome has a satisfactory effect and provides evidence based medicine for the treatment of such disease.
Zusanli
Moxibustion
Climacteric
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Objective To investigate the quantitative relationship between the intensity of acupuncture effect and the functional state and ascertain the regularity of acupuncture effect generation.Methods Thirty cerebral thrombosis patients were enrolled as subjects.Fifteen patients were given electroacupuncture at 9-11 am and the other 15,at 1-3 pm.The main points selected were Zusanli(ST 36),Fenglong(ST 40),Sanyinjiao(SP 6),Taixi(KI 3),Quchi(LI 11),Neiguan(PC 6) and Hegu(LI 4) on the affected side.The adjunct points were selected according to different affected parts.A G6805 health device was connected after arrival of qi following needle insertion.Treatment was administered 30 min once daily,5 consecutive times as a course.A summary was made after 3 courses of treatment.In all the patients,5 ml venous blood was drawn at 8:00-8:10 on the day before acupuncture and after 3 courses of acupuncture treatment.Serum was separated by centrifugation and kept by refrigeration at ultralow temperature for the examination of thromboxane B2(TXB2) and prostaglandin F1α(PGF1α).TXB2,PGF1α and TXB2/PGF1α all improved markedly in the patients after 3 courses of acupuncture treatment.The degrees of improvements in TXB2,PGF1α and TXB2/PGF1α by electroacupuncture therapy had very close linear quantitative relationships with the basic levels of them before acupuncture.The three correlation coefficients were r=0.752r0.01(28),P0.01;r=0.652r0.01(28),P0.01;r=0.773r0.01(28),P0.01,respectively.Conclusion The results indicate that in a certain range,the more obviously the functional state deviates from the normal level,the more marked regulating effect acupuncture produces.
Zusanli
Thromboxane B2
Moxibustion
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Objective:To investigate the protection BBB by using electro-acupuncture and moxibustion after acute cerebral ischemia reperfusion in rats and the dynamic changes of S100 βprotein level in serum.Method:Use middle cerebral artery occlusion/reperfusion(MCAO/R)rat model.30 minutes later the Baihui and Shuigou points were stimulated by electro-acupuncture and Zusanli point was stimulated by moxbustion.To investigate and evaluate the S100 βprotein level in blood serum after 6h,12 h,24 h,48h of the treatment.Then observe the ultramicrostmcture change of the BBB of each phase before and after the treatment.Results:(1)H-600 transmission electron microscope shows that damage of the BBB system in electro-acupuncture and moxibustion phase are lighter than that in model phase.(2) ELISA results show that S100β protein level in electro-acupuncture and moxibustion group is lower than that in model group(P0.05).Conclusions:Electro-acupuncture and moxibustion can protect the BBB system and cut down the S100 βprotein level in blood serum,keeping the normal physiologic function.
Zusanli
Moxibustion
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To observe the therapeutic effect of acupuncture and moxibustion interventions in the treatment of chronic fatigue syndrome (CFS).A total of 133 CFS patients were randomized into acupuncture group (47 cases), warm-needling group (44 cases) and non-acupoint group (42 cases). Manual acupuncture (MA) stimulation was applied to Baihui (GV 20), Danzhong (CV 17), Qihai (CV 6), Guanyuan (CV 4), bilateral Zusanli (ST 36), Hegu (LI 4), Taichong (LR 3) and Sanyinjiao (SP 6) for patients in the acupuncture group. For patients in the warm-needling group, moxa-heated needle was applied to Baihui (GV 20), Qihai (CV 6), Guanyuan (CV 4) and bilateral Zusanli (ST 36). Non-acupoints were located about 1-2 cm beside the Baihui (GV 20), Danzhong (CV 17), Qihai (CV 6), Guanyuan (CV 4), Zusanli (ST 36), Taichong (LR 3), Sanyinjiao (SP 6) and Hegu (LI 4). The treatment was given once daily for 20 days. The Chalder Fatigue Scale (14-item fatigue scale) was adopted to evaluate the changes of CFS before and after the treatment.In comparison with pre-treatment, the scores of Chalder Fatigue Scale including physical and mental fatigue and total score were significantly decreased in both acupuncture and warm-needling groups (P < 0.05, P < 0.01), but not in the non-acupoint group (P > 0.05) except physical score (P < 0.05). The physical, mental and total scores of the acupuncture and warm-needling groups were significantly lower than those of the non-acupoint group (P < 0.05, P < 0.01), while the physical and total scores of the warm-needling group were markedly lower than those of the acupuncture group (P < 0.05). After the treatment, the CFS patients' satisfactory rates of the acupuncture, warm-needling and non-acupoint groups were 36.2% (17/47), 72.7% (32/44) and 35.7% (15/42), respectively.Both MA and warm-needling interventions have a good therapeutic effect in the treatment of CFS patients, while the latter is obviously better.
Zusanli
Moxibustion
Dry Needling
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Objective: The purpose of this study is to examine the tendency of experimental studies on the physiological effects of acupuncture at ST36(Zusanli). Methods: We investigated 69 theses (10 Korean and 59 international) which were searched by the keyword `Zusanli` tough PubMed website, and that were experimented with manual acupuncture or electroacupuncture on healthy human subjects or normal animals. Results: The 69 theses were classified into four groups based on the main topic which is related with the influence of acupuncture stimulation at ST36(Zusanli), such as digestive system, nervous system, immune system, and cardiovascular system. The main results found in this study are: 1. Acupuncture at ST36(Zusanli) increases gastric mobility. Arid such effect is related with vagal nerve and opioid pathway. 2. Acupuncture at ST36(Zusanli) is valuably related with cerebral cortex. And it influences on the cerebrum activities. 3. Acupuncture at ST36(Zusanli) has noticeable analgesic effect, which is related with Opioid mechanism, Gate control and SP. 4. Acupuncture at ST36(Zusanli) increases immunity. Conclusion: Acupuncture at ST36(Zusanli) has many effects on digestive system, nervous system, immune system, and cardiovascular system.
Zusanli
Moxibustion
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To compare the clinical efficacy of acupuncture, electroacupuncture (EA) and moxibustion in the treatment of knee osteoarthritis (KOA).A total of eight-four patients with KOA were randomly and equally divided into acupuncture group, EA group and moxibustion group. Neixiyan (EX-LE40), Dubi (ST35), Heding (EX-LE2), Liangqiu (ST34), Xuehai (SP10), Zusanli (ST36) and Ashi-point on the affected side of the body were punctured with filiform needles or EA (2 Hz/100 Hz) for 30 min. In the moxibustion group, moxibustion was applied to the surrounding area of the affected joint for 60 min. The treatment was conducted once every other day for 4 weeks. The pain degree was assessed by using numerical rating scale (NRS) and the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scale (0－240 points) was used to evaluate the severity of KOA. The "Minimal Clinically Important Improvement (MCII)" was used to assess the therapeutic effect after the treatment.After the treatment, the scores of NRS, and the pain, stiffness, motor function and total scores of WOMAC were significantly decreased in the three groups compared with their own pre-treatment (P<0.05), and were obviously lower in the EA and moxibustion groups than in the acupuncture group (P<0.05), and those of the moxibustion group was notably lower than those of the acupuncture group (P<0.05). Of the 28 cases in the acupuncture, EA and moxibustion groups, 11, 17 and 22 were effective, with the effective rate being 39.29%, 60.71% and 78.57%, respectively. The comprehensive therapeutic effect of the moxibustion group was significantly superior to that of the acupuncture and EA groups (P<0.05).All the three different kinds of acupuncture and moxibustion methods have positively regulatory effect on KOA, and moxibustion is the best for reducing the joint pain and stiffness, and improving the motor function.
Zusanli
Moxibustion
WOMAC
Therapeutic effect
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Objective To objectively reflect indications for and the efficacy of point Tianshu by making a statistical analysis and assessment of papers on point Tianshu acupuncture and moxibustion published from 1949 to 2010. Methods A statistical analysis of the data from Traditional Chinese Medical Acupuncture-Moxibustion Information Databank was made using bibliometric methods. Results and conclusions Point Tianshu-treated disease spectrum was involved in 1431 pieces of literature with a total of 101376 cases and included 151 kinds of diseases. Of these cases, 94795 were effectively treated, the mean efficacy rate being 93.5%. Treatment with point Tianshu can regulate qi to remove stagnation and reinforce the spleen to harmonize the stomach. The indications are intestinal diseases, obesity and so on. This point is often combined with Zusanli, Zhongwan And Qihai and given acupuncture, moxibustion, and electroacupuncture.
Zusanli
Moxibustion
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Objective To compare the therapeutic effects of tug-of-war needling method versus conventional electroacupuncture on knee osteoarthritis, seek a better method for treating this disease and prove the importance of needling and moxibustion techniques. Method One hundred patients meeting the criteria of knee osteoarthritis were allocated, in order of visits, to an electroacupuncture group of 50 cases and a tug-of-war needling group of 50 cases. In the tug-of-war needling group of patients, points Zusanli(ST36) and Heding(EX-LE2) were mainly selected and after the arrival of qi following needle insertion, forward pushing or backward pulling was repeatedly made like tug of war to strengthen or eliminate the needling sensation. In the electroacupuncture group, local points were mainly selected according to the routine, and after the arrival of qi, a G6805-1 type electric acupuncture therapeutic instrument was connected and sparse-dense waves were used. Reactions were recorded in the two groups of patients after two courses of treatment. Joint function was assessed using the VAS and the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC). Result Both groups of patients were followed up at six months after the end of treatment. There were statistically significant pre-/post-treatment differences in the VAS score and the WOMAC sub-scores and total score in the two groups(P0.01). The VAS score and the WOMAC sub-scores and total score decreased more in the tug-of-war needling group of patients than in the electroacupuncture group(P0.01). The total efficacy rates in the tug-of-war needling and electroacupuncture groups were 92.0% and 90.0%, respectively, at the end of treatment and 94.0% and 92.0%, respectively, at the follow-up; there was no statistically significant difference between the two groups and between at the end of treatment and at the follow-up in the two groups(P0.05). However, the cure and marked efficacy rates in the two groups of patients were 68.0% and 52.0%, respectively, at the end of treatment and 68.0% and 54.0%, respectively, at the follow-up. It was statistically higher in the tug-of-war needling group than in the electroacupuncture group(P0.05). Conclusion Both tug-of-war needling and electroacupuncture have a good and very stable therapeutic effect on knee osteoarthritis. Tug-of-war needling is better than electroacupuncture in improving the clinical symptoms.
Dry Needling
Zusanli
WOMAC
Moxibustion
Therapeutic effect
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