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Factors and Their Impact on Treatment Effect of Acupuncture in Different Outcomes:A Meta-Regression of Acupuncture Randomized Controlled Trials

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Chinese Journal of Integrative Medicine 2024年第3期30卷 260-266页

作者： XIU Wen-cui GANG Wei-juan ZHOU Qi SHI Lan-jun HU xiang-yu MING Tian-yu LUO Zhen ZHANG Yu-qing jing xiang-hong Institute of Acupuncture and Moxibustion China Academy of Chinese Medical SciencesBeijing100700China China Center for Evidence-Based Traditional Chinese Medicine China Academy of Chinese Medical SciencesBeijing100700China Department of Health Research Methods Evidenceand ImpactMcMaster UniversityHamiltonOntarioL8S 4L8Canada Center for Evidence-Based Integrative Medicine-Clarity Collaboration Guang’anmen HospitalChina Academy of Chinese Medical SciencesBeijing100053China

Background:The effects of acupuncture have varied in different randomized controlled trials(RCTs),and there are many factors that influence treatment effect of acupuncture in different outcomes,with conflicting ***:To identify factors and their impact on the treatment effect of acupuncture in different ***:Acupuncture RCTs were searched from 7 databases including Medline(Pub Med),Embase,Cochrane Central Register of Controlled Trials,China National Knowledge Infrastructure,Wanfang Database,VIP Database,and China Biology Medicine disc between January 1st,2015 and December 31st,*** studies must compare acupuncture to no acupuncture,sham acupuncture,or waiting lists,and report at least 1patient-important outcome.A multi-level meta-regression was conducted using a 3-level robust mixed model and univariate analyses were performed for all independent variables,even those excluded from the multivariable model due to *** used thresholds of 0.2 and 0.4 for the difference of standardized mean differences(SMDs),categorising them as small(0.4) ***:The pain construct analysis involved 211 effect estimates from 153 studies and 14 independent ***-frequency acupuncture treatment sessions produced larger effects compared to low-frequency sessions [large magnitude,the difference of adjusted SMDs 0.46,95% confidence interval(CI) 0.07 to 0.84;P=0.02].The non-pain symptoms construct analysis comprised 323 effect estimates from 231 studies and 15 independent *** acupuncture showed moderately larger effects when compared to non-penetrating acupuncture(0.30,95% CI 0.06 to 0.53;P=0.01).The function construct analysis included 495 effect estimates from 274 studies and 14 independent *** acupuncture and the flexible acupuncture regimen showed moderately larger effects,compared to non-penetrating acupuncture and fixed regimen,respectively(0.40,95% CI 0

关键词： acupuncture randomized controlled trial patient-important outcome meta-regression

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Use of Evidence-Based Research Approach in RCTs of Acupuncture-Related Therapies for Primary Dysmenorrhea: A Meta-Research

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Chinese Journal of Integrative Medicine 2024年第6期30卷 551-558页

作者： HU Xiao-yi TIAN Zi-yu CHEN Huan HU xiang-yu MING Tian-yu PENG Hao-xuan JIAO Rui-min SHI Lan-jun XIU Wen-cui YANG Ji-wei GANG Wei-juan jing xiang-hong Institute of Acupuncture and Moxibustion China Academy of Chinese Medical SciencesBeijingChina Department of Traditional Chinese Medicine Beijing Puren HospitalBeijing100062China

Objective To assess the use of evidence-based research(EBR)approach in randomized controlled trials(RCTs)of acupuncture-related therapies for primary dysmenorrhea(PD).Methods PubMed,EMBASE,Cochrane Library,China National Knowledge Infrastructure,Wanfang Database,Chinese Biomedical Database,and China Science and Technology Journal Database were searched from January 2013 to December 2022 for RCTs of acupuncture on *** full text and references of each RCT were read to assess whether systematic reviews(SRs)or other types of studies with similar research questions and end-users’perspectives were cited to justify and design the *** addition,the discussion section were analyzed to evaluate whether trials placed the new result in the existing SRs to draw a *** logistic regression was used to find variables that associated with 3 aspects of EBR approach:(1)citing clinical studies for justification,(2)citing relevant studies that obtain the perspectives of end users,and(3)citing clinical studies for results *** Of 473 RCTs included,45.67%(216)of the trials cited relevant similar studies,21.56%(102)referenced to the studies that collected end-users’perspectives,and 10.99%(52)placed result in the context of the previous *** RCTs appropriately applied EBR *** all the included studies,3.17%(15)of the trials used SRs to inform study questions but none of them used updated SRs with acceptable quality;1.05%(5)of the trials cited SRs of end-user’s perspectives in the justification and design of the study,and only 1 trial added results in existing SR to draw a *** of publication,language,funding,registration,ethical approval and number of sites were significantly associated with 1 of the 3 aspects of EBR *** Few RCTs in acupuncture-related therapies for PD used the EBR approach to minimize research ***,research institutes,funding agencies,ethics committees,journals and peer

关键词： evidence-based research acupuncture therapy primary dysmenorrhea randomized controlled trial systematic review end-usersperspective meta-research

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推进针灸学科的高质量发展

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针刺研究 2024年第1期49卷 1-5页

作者：景向红宿杨帅高昕妍朱兵中国中医科学院针灸研究所北京100700

近20年来,针灸学科在临床研究、方法构建、标准制定、指南推广及学科基础理论和关键科学问题研究等多方面,取得了长足的进步。国际针灸发展从关注临床证据,逐渐开始关注学科本身的基础问题。美国国立卫生研究院聚焦穴位知识库和数据库... 详细信息

近20年来,针灸学科在临床研究、方法构建、标准制定、指南推广及学科基础理论和关键科学问题研究等多方面,取得了长足的进步。国际针灸发展从关注临床证据,逐渐开始关注学科本身的基础问题。美国国立卫生研究院聚焦穴位知识库和数据库的建设及外周神经刺激装备的转化,是针灸学科发展的机遇和挑战。本文分析目前中医针灸学科发展的短板,提出未来高质量发展策略:梳理针灸学科基本科学问题,形成针灸学术共识;用现代科学语言表达针灸理论的科学内涵,构建开放、自洽的现代针灸理论体系;吸引多学科人才融合创新,开辟针灸基础科研成果转化新局面;创立以针灸为代表的“体表医学”理论体系,引领针灸学对现代生命科学和未来医学的原创性贡献。

关键词：针灸学科发展学术共识理论体系科研成果转化体表医学

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穴位不同层次和强度电刺激缓解肌肉炎性痛及对脊髓背角广动力神经元的抑制作用

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针刺研究 2024年第2期49卷 103-109页

作者：孙小月陈李圳万红叶王晓宇张知云宿杨帅于清泉曹婉萦景向红中国中医科学院针灸研究所北京100700

目的:观察在痛源局部穴区不同层次和强度电刺激的镇痛作用及对脊髓背角广动力(WDR)神经元诱发电活动的影响,为选择合理的电针刺激参数提供依据。方法:Wistar大鼠用于3部分实验。采用弗氏完全佐剂(CFA)建立腓肠肌炎性痛模型,造模后随机选... 详细信息

目的:观察在痛源局部穴区不同层次和强度电刺激的镇痛作用及对脊髓背角广动力(WDR)神经元诱发电活动的影响,为选择合理的电针刺激参数提供依据。方法:Wistar大鼠用于3部分实验。采用弗氏完全佐剂(CFA)建立腓肠肌炎性痛模型,造模后随机选取6只大鼠进行WDR神经元电活动多通道细胞外电生理记录,用于确定激活A-成分的电刺激阈值Ta和C-成分的电刺激阈值Tc,以此作为经皮穴位电刺激(TEAS)或电针的干预强度;选取36只大鼠随机分为正常组、模型组、TEAS-Ta组、TEAS-Tc组、EA-Ta组和EA-Tc组,每组6只,在痛源局部“承山”采用Ta或Tc强度的TEAS或电针干预,每次30 min,1次/d,连续3 d,采用小动物压痛测量仪检测大鼠腓肠肌的机械压痛阈值,Von Frey丝测量足底机械痛阈值;随机选择13只肌肉炎性痛大鼠用于观察Ta/Tc强度电针或TEAS“承山”即刻WDR神经元的反应性。结果:TEAS皮肤激活WDR神经元A-成分或C-成分的阈值分别为(2.43±0.57)mA和(7.00±1.34)mA,电针激活肌肉WDR神经元的A-成分或C-成分的阈值分别为(0.72±0.34)mA和(1.58±0.35)mA。大鼠腓肠肌注射CFA后腓肠肌和足底机械痛阈值较正常组明显降低(P<0.001),在“承山”给予TEAS-Ta、TEAS-Tc或EA-Ta干预后,其腓肠肌和足底机械痛阈值较模型组明显升高(P<0.05,P<0.001)。模型组大鼠伤害性电刺激诱发WDR神经元C-成分放电阈值较正常组降低(P<0.001);与模型组比较,TEAS-Ta、TEAS-Tc或EA-Ta干预后阈值明显升高(P<0.01)。TEAS-Ta、TEAS-Tc或EA-Ta即刻干预后,肌肉WDR神经元诱发放电频率较干预前明显降低(P<0.01,P<0.05)。EA-Tc对WDR神经元的诱发电活动和痛行为均无显著改善。结论:TEAS-Ta、TEAS-Tc或EA-Ta均可减轻肌肉炎性痛大鼠痛源局部及足底机械痛,并抑制WDR神经元的反应性,提示在痛源局部穴位的不同层次镇痛作用需要的电刺激强度不同。

关键词：电针刺激强度刺激层次经皮穴位电刺激广动力神经元肌肉炎性痛

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不同强度电针对大鼠脊髓背角广动力神经元伤害性放电的抑制作用

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针刺研究 2024年第5期49卷 448-455页

作者：于清泉袁咪孙小月张妮楠王晓宇宿杨帅张知云景向红中国中医科学院针灸研究所北京100700

目的:观察不同强度电针对大鼠脊髓背角广动力(WDR)神经元伤害性电活动的作用,探讨电针在脊髓背角水平调控伤害性信号的效应特征。方法:采用多通道在体电生理技术记录25只正常雄性SD大鼠脊髓背角WDR神经元的电活动,在神经元的足底感受野(... 详细信息

目的:观察不同强度电针对大鼠脊髓背角广动力(WDR)神经元伤害性电活动的作用,探讨电针在脊髓背角水平调控伤害性信号的效应特征。方法:采用多通道在体电生理技术记录25只正常雄性SD大鼠脊髓背角WDR神经元的电活动,在神经元的足底感受野(RF)给予连续高强度电刺激诱发神经元的windup,而后于大鼠同侧“足三里”穴区进行不同强度(1 mA或2 mA)的电针(EA1 mA、EA2 mA)干预10 min,刺激频率为2 Hz/15 Hz,然后再次以相同条件诱发WDR神经元的windup。比较不同强度电针干预前后,WDR神经元伤害性放电成分的总数量及windup现象的变化。结果:EA1 mA和EA2 mA均显著减少了WDR神经元Aδ和C成分及后放电的数量(P<0.01,P<0.001),且EA2 mA对C成分的抑制率显著高于EA1 mA(P<0.05);EA1 mA和EA2 mA干预减弱了WDR神经元的windup现象(P<0.05,P<0.01),且EA2 mA的效应要强于EA1 mA(P<0.05)。EA1 mA和EA2 mA作用于WDR神经元的非感受野(non-RF)和RF均明显减少了其Aδ成分、C成分和后放电的数量(P<0.05,P<0.01);对于WDR神经元windup现象,EA2 mA作用于non-RF和RF均能发挥显著的抑制作用(P<0.01,P<0.05),而EA1 mA只有作用于non-RF时才能显著抑制(P<0.01)。结论:电针可以抑制大鼠脊髓背角WDR神经元的伤害性电活动,抑制效应与EA干预的强度和部位直接相关,2 mA的抑制效应要强于1 mA。

关键词：电针刺激强度镇痛伤害性信号广动力神经元

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Mechanism of Acupuncture and Moxibustion on Promoting Mucosal Healing in Ulcerative Colitis

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Chinese Journal of Integrative Medicine 2023年第9期29卷 847-856页

作者： LI Han YE Xiao-feng SU Yang-shuai HE Wei ZHANG Jian-bin ZHANG Qi ZHAN Li-bin jing xiang-hong Department of Acupuncture and Moxibustion Changzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese MedicineChangzhouJiangsu Province213002China Nanjing University of Chinese Medicine Nanjing210023China Research Center of Meridians Institute of Acupuncture and MoxibustionChina Academy of Chinese Medical SciencesBeijing100700China Department of Acupuncture and Moxibustion the Second Affiliated Hospital of Nanjing University of Chinese MedicineNanjing211005China Liaoning University of Chinese Medicine Shenyang116600China

The latest guideline about ulcerative colitis(UC) clinical practice stresses that mucosal healing, rather than anti-inflammation, is the main target in UC clinical management. Current mucosal dysfunction mainly closely relates to the endoscopic intestinal wall(mechanical barrier) injury with the imbalance between intestinal epithelial cells(IECs) regeneration and death, as well as tight junction(TJ) dysfunction. It is suggested that biological barrier(gut microbiota), chemical barrier(mucus protein layer, MUC) and immune barrier(immune cells) all take part in the imbalance, leading to mechanical barrier injury. Lots of experimental studies reported that acupuncture and moxibustion on UC recovery by adjusting the gut microbiota, MUC and immune cells on multiple targets and pathways, which contributes to the balance of IEC regeneration and death, as well as TJ structure recovery in animals. Moreover, the validity and superiority of acupuncture and moxibustion were also demonstrated in clinic. This paper aims to review the achievements of acupuncture and moxibustion on mucosal healing and analyse the underlying mechanisms.

关键词： acupuncture and moxibustion ulcerative colitis mucosal healing intestinal epithelial cells regeneration and death tight junction function gut microbiota review

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Approach to Assess Adequacy of Acupuncture in Randomized Controlled Trials:A Systematic Review

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Chinese Journal of Integrative Medicine 2023年第8期29卷 730-737页

作者： SHI Lan-jun TIAN Zi-yu HU Xiao-yi XIU Wen-cui JIAO Rui-min HU xiang-yu Nicola Robinson GANG Wei-juan jing xiang-hong Institute of Acupuncture and Moxibustion China Academy of Chinese Medical SciencesBeijing(100700)China Centre for Evidence-Based Chinese Medicine Beijing University of Chinese MedicineBeijing(100029)China School of Health and Social Care London South Bank UniversityLondon(SE1OAA)United Kingdom

Objective To summarize and identify the available instruments/methods assessing the adequacy of acupuncture in randomized controlled trials(RCTs)for proposing a new improved *** A systematic literature search was carried out in 7 electronic databases from inception until 21st November *** study evaluating the adequacy or quality of acupuncture,specifying specific acupuncture treatment-related factors as criteria of subgroup analysis,or developing an instrument/tool to assess the adequacy or quality of acupuncture in an RCT was *** information,characteristics and contents of acupuncture adequacy assessment were presented as frequencies and *** Forty studies were included in this systematic ***-five studies(87.50%)were systematic reviews,none of which used formal methods to develop the assessment instruments/methods of acupuncture adequacy;of 5 methodological studies,only 1 study used a relatively formal ***-two studies(82.05%)assessed the components of acupuncture,while 7(17.95%)assessed the overall quality of *** independent assessment instrument/method was used to assess acupuncture adequacy in 29 studies(74.35%),whereas as one part of a methodological quality assessment scale in 10(25.65%).Only 9(23.00%)studies used the assessment results for subgroup analysis,sensitivity analysis or the criteria for inclusion in the *** Assessment contents for adequacy or quality of acupuncture in RCTs hadn’t still reached consensus and no widely used assessment tools *** methodology of available assessment instruments/scales is far from formal and rigorous.A new instrument/tool assessing adequacy of acupuncture should be developed using a formal method.

关键词： acupuncture adequacy assessment quality randomized clinical trial systematic review

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Effect of Acupuncture on Outcomes of in vitro Fertilisation:A Scoping Review

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Chinese Journal of Integrative Medicine 2022年第5期28卷 472-480页

作者： XIU Wen-cui GANG Wei-juan JIAO Rui-min SHI Lan-jun YANG Ji-wei jing xiang-hong SHI Xiao-shuang Institute of Acupuncture and Moxibustion China Academy of Chinese Medical SciencesBeijing(100700)China

Objectives:To identify,examine and summarize the available evidence on the effectiveness and safety of acupuncture for in vitro fertilisation(IVF)***:Eight electronic databases,including Pub Med,EMBASE,Cochrane Database of Systematic Review,Cochrane Central Register of Controlled Trials,China National Knowledge Infrastructure,Wanfang Database,Chinese Biomedical Database and VIP Database,were searched,supplemented by manual *** researchers independently conducted the literature screening,data extraction,and methodological quality assessments.A narrative description was provided to show the general information and specific characteristics of the included studies.A bubble plot was used to visually display the overall effects of acupuncture on IVF ***:Eighty-two studies were identified,including 64 primary studies and 18 systematic *** electrical acupoint stimulation,electric acupuncture and manual acupuncture were applied in most studies and compared with no acupuncture,sham acupuncture and placebo acupuncture control ***-three(98.4%)primary studies reported clinical pregnancy rate,and positive effects of acupuncture were found in 34 studies(54.0%).Live birth rate was reported in only 18(28.1%)primary studies,of which 10(55.6%)showed positive *** addition,only 8 and 2 systematic reviews showed that acupuncture could increase clinical pregnancy events and live birth events,***,none of these reviews was of high methodological ***:Available evidence suggests that acupuncture therapy could improve clinical pregnancy ***,whether acupuncture could increase live birth events was difficult to determine based on the few studies that have reported this outcome ***,the methodological quality of most systematic reviews was assessed as critically low or *** with a rigorous design and standardized implementation should be performed to refine the

关键词： acupuncture in vitro fertilisation clinical pregnancy rate live birth rate scoping review

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Acupuncture Enhances Signalsat Sensitized Acupoints to Elevate Pressure Pain Thresholdin Knee Osteoarthritis Patients

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Chinese Journal of Integrative Medicine 2022年第12期28卷 1105-1110页

作者： WANG Xiao-yu NIE Zhong-yi YU Qing-quan CHEN Wei ZHANG Xiao-ning WAN hong-ye SUYang-shuai HE Wei Li Ru-ya jing xiang-hong Institute of Acupuncture and Moxibustion China Academy of Chinese Medical SciencesBeijing 100700China Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education Beijing Advanced Innovation Center for Biomedical EngineeringSchool of Biological Science and Medical EngineeringBeihang UniversityBeijing 100083China

Objective:To observe the pressure pain threshold(PPT),skin conductance(SC)and blood perfusion(BP)of the sensitized acupoints in patients with knee osteoarthritis(KOA),and explore the mechanism of acupuncture at the sensitized acupoints for treating ***:Eleven healthy subjects and 11 unilateral KOA patients were recruited from July 2020 to March 2021 in this *** PPT,SC and BP of control acupoints in healthy controls,and non-sensitized and sensitized acupoints in KOA patients were measured and compared between baseline and after manual acupuncture(MA)***:Before MA treatment,lower PPT was observed at the sensitized acupoints comparedwith non-sensitized andcontrol acupoints(P0.05).Compared with the control and non-sensitized acupoints,there were significant increases of SC and BP in sensitized acupoints of KOA patients after MA treatment(P<0.05 or P<0.01).Conclusion:MA at sensitized acupoints could elevate PPT of KOA patients,which may be associated with the increment of SC and BP.

关键词： sensitized acupoint pain manual acupuncture skin conductance blood perfusion

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Studies on the Rice LEAF INCLINATION1 （LC1）, an IAA-amido Synthetase, Reveal the Effects of Auxin in Leaf Inclination Control

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Molecular Plant 2013年第1期6卷 174-187页

作者： Shu-Qing Zhao jing-jing xiang hong-Wei Xue National Key Laboratory of Plant Molecular Genetics institute of Plant Physiology and Ecology Shanghai Institutes for Biological Sciences ChineseAcademy of Sciences Shanghai 200032 China

The angle of rice leaf inclination is an important agronomic trait and closely related to the yields and archi- tecture of crops. Although few mutants with altered leaf angles have been reported, the molecular mechanism remains to be elucidated, especially whether hormones are involved in this process. Through genetic screening, a rice gain-of- function mutant leaf inclination1, Icl-D, was identified from the Shanghai T-DNA Insertion Population （SHIP）. Phenotypic analysis confirmed the exaggerated leaf angles of Icl-D due to the stimulated cell elongation at the lamina joint. LC1 is transcribed in various tissues and encodes OsGH3-1, an indole-3-acetic acid （IAA） amido synthetase, whose homolog of Arabidopsis functions in maintaining the auxin homeostasis by conjugating excess IAA to various amino acids. Indeed, recombinant LC1 can catalyze the conjugation of IAA to Ala, Asp, and Asn in vitro, which is consistent with the decreased free IAA amount in Icl-D mutant. Icl-D is insensitive to IAA and hypersensitive to exogenous BR, in agreement with the microarray analysis that reveals the altered transcriptions of genes involved in auxin signaling and BR biosynthesis. These results indicate the crucial roles of auxin homeostasis in the leaf inclination control.

关键词： rice leaf inclination auxin GH3.

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