Points - Recent Research
Acupuncture for the Postcholecystectomy Syndrome
Mechanism of Traditional Chinese Medicine in Treating Knee Osteoarthritis
Chinese Massage, Tui Na, Combined With Herbs Improves Clinical Symptoms And Regulates Sex Hormones In Patients With Mammary Gland Hyperplasia

Acupuncture for the Postcholecystectomy Syndrome

Zihan Yin, et al.

Postcholecystectomy syndrome (PCS) has become a common postoperative syndrome that requires systematic and comprehensive therapy to achieve adequate clinical control. Acupuncture and related therapies have shown clinical effects for PCS in many studies. However, systematic reviews/meta-analyses (SRs/MAs) for them are lacking.
Objective: To evaluate the efficacy and safety of acupuncture in the treatment of PCS using randomized controlled trials (RCTs).
Methods: Potentially eligible studies were searched in the following electronic databases up to 1 February 2020: PubMed, Embase, Cochrane Library, Web of Science (WoS), Chinese databases (Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), WanFang Database (WF), and China Science and Technology Journal Database (VIP)), and other sources (WHO ICTRP, ChiCTR, Clinical Trials, and Grey Literature Database). The RevMan 5.3 was employed for analyses. The Cochrane Collaboration' risk of bias tool was used to assess the risk of bias (ROB). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of the evidence.
Results: A total of 14 RCTs with 1593 participants were included in this SR. MA showed that acupuncture in combination with conventional medicine (CM) did not show statistical differences in reduction in pain. However, acupuncture in combination with CM significantly reduced the incidence of postoperative nausea and vomiting (PONV) (RR, 0.71; 95% CI, 0.550.92) and improved gastrointestinal function recovery compared to the CM group. Acupuncture combined with traditional Chinese medicine and CM, and acupuncture as monotherapy may improve gastrointestinal function recovery with acceptable adverse events.
Conclusion: Acupuncture may be an effective and safe treatment for PCS. However, this study lacks conclusive evidence due to poor quality evidence, limited data, and clinical heterogeneity of acupuncture methods in the included studies.

Evid Based Complement Alternat Med. 2020; 2020: 7509481. Published online 2020 Jul 30. doi: 10.1155/2020/7509481 [Epub ahead of print]

Source: PubMed


Mechanism of Traditional Chinese Medicine in Treating Knee Osteoarthritis

Mina Wang, et al.

Knee osteoarthritis (KOA) is a degenerative disease, making a unique contribution to chronic pain, edema, and limited mobility of knee joint. Traditional Chinese Medicine (TCM) is a common complementary therapy for KOA and has been found effective. The aim of this review is to consolidate the current knowledge about the mechanism of four interventions of TCM: acupuncture, moxibustion, herbs, and massage in treating KOA, and how they alleviate symptoms such as pain, swelling, and dysfunction. Furthermore, this review highlights that four therapies have different mechanisms but all of them can manage KOA through inhibiting inflammation, which indicates that alternative therapies should be considered as a viable complementary treatment for pain management in clinical practice./p>

This review focuses on the mechanism of four classical types of Traditional Chinese Medicine in treating with KOA: acupuncture, moxibustion, herbs, and massage have different mechanism but all of them are associated with mediating inflammatory factors to alleviate KOA. Acupuncture inhibits KOA-related signaling pathways (MAPK, Wnt, Notch, SDF-1/CXCR4, TLRs, Hippo-YAP OPG-RANK-RANKL, and TGFβ pathway) and hypertrophic differentiation of chondrocytes, but promotes the release of antioxidants. Moxibustion affects NF-κB signaling pathway and the activation and expression of COX-2. Herbs modulate Wnt/β-catenin signaling pathway and p38-MAPK signaling pathway as well as protect articular cartilage through preventing losses of proteoglycans and collagen II and promoting proliferation of chondrocytes. Massage changes the expression of RANTES and MCP-1 and harmonizes musculature. It has been confirmed in clinical doctors or scientists that acupuncture, moxibustion, herbs, and massage are beneficial to KOA, but most studies pay attention to individual side that TCM affects. The potential mechanism is more complicated because of interaction among diverse factors within knee joint. Therefore, the crosstalk between various factors should not be neglected in future studies. Overall, different interventions of TCM have their own aspects in treating with KOA, but they all suppress inflammation of knee joint to relieve pain and make up for the abuse of acesodyne.

J Pain Res.2020; 13: 14211429. Published online 2020 Jun 15. doi: 10.2147/JPR.S247827

Source: PubMed


Chinese Massage, Tui Na, Combined With Herbs Improves Clinical Symptoms And Regulates Sex Hormones In Patients With Mammary Gland Hyperplasia

Dandan Li, BA, et al.

To study the effects of Tui Na therapy on patients with mammary gland hyperplasia.

A total of 68 female patients with mammary gland hyperplasia were included in this retrospective study from May 2016 to May 2017 and assigned into control group (N = 34) treated with Rupixiao only (a proprietary Chinese medicine) or Tui Na group (N = 34) treated with Tui Na (Chinese massage) combined with Rupixiao. The pain intensity (visual analogous scale, VAS) and serum levels of luteinizing hormone (LH), estradiol (E2), prolactin (PRL), and progesterone (P) were examined before and after the treatment.

The efficacies were 94.1% (32/34) in the Tui Na group and 76.5% (26/34) in the control group (P = .04). After treatment, VAS in Tui Na groups was significantly lower than that in control group (2.1  1.1 vs 3.1  1.1, P < .05). After follow-up for five months, the recurrence rates were 12.5% (4/32) in the Tui Na group and 23.1% (6/26) in the control group (P = .01). The levels of all 4 hormones in the Tui Na group increased significantly after treatment. In control group, only LH and E2 levels were significantly increased after treatment.

In patients with mammary gland hyperplasia, Tui Na combined with Rupixiao could improve clinical symptoms, regulate sex hormone levels, and decrease the recurrence rate than Rupixiao alone. Our finding suggests that Tui Na can be potentially used for the treatment of mammary gland hyperplasia.

Medicine (Baltimore). 2020 May 22; 99(21): e20300. Published online 2020 May 22. doi: 10.1097/MD.0000000000020300

Source: PubMed


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