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bloodletting puncture in the treatment of acute ischemic stroke:protocol for a mixed-method study of a multi-center randomized controlled trial and focus group

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Journal of Traditional Chinese Medicine 2023年第6期43卷 1259-1267页

作者： DAI Zeqi LIAO Xing GUAN Yueyue ZENG Zixiu TANG Jun HU Jing Center for Evidence Based Chinese Medicine Institute of Basic Research in Clinical MedicineChina Academy of Chinese Medical SciencesBeijing 100700China Department of Encephalopathy Chongqing Hospital of Traditional Chinese MedicineChongqing 400021China Evidence-based Medicine Center Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijing Institute of Traditional Chinese MedicineBeijing 100010China

This study is to investigate the effectiveness and safety of bloodletting puncture(BP)for acute ischemic stroke(AIS)when used in combination with standard treatment,as well as the patients'feelings and attitudes toward the *** is a mixed method research which includes a multi-center,superiority,randomized controlled clinical trial,and focus group interview.A total of 360 AIS participants will be *** will be randomized into one of the following two groups for 7 d:(a)BP with standard treatment group(n=180);(b)standard treatment group(n=180).The primary outcome will be National Institute of Health stroke scale(NIHSS)score at day 7 after *** outcomes will be changes of Glasgow Coma Scale score,NIHSS score,mRS and Traditional Chinese Medicine syndrome score from baseline to 7,14,and 30 d after treatment,recurrence rate and all-cause mortality rate within 30 d,and the safety *** focus group will be conducted with a purposive sample of 1-2 acupuncturists and 1-2 patients respectively at each center at 7 and 30 d after *** designed a mixed method study to evaluate the effect of BP,an acupuncture therapy for patients with *** the findings of this study confirm the effectiveness of BP to reduce the NIHSS score and other related outcomes and patients are willing to accept the therapy,we believe this study will help the implementation of this therapy in clinical practice,and provide new evidence for the treatment of AIS.

关键词： bloodletting punctures ischemic stroke equivalence trial randomized controlled trial focus groups clinical protocols

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bloodletting at Jing-well points decreases interstitial fluid flow in the thalamus of rats

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Journal of Traditional Chinese Medicine 2016年第1期36卷 107-112页

作者： FuYu LiYuliang GuoJia Liu Bin Liu Huipo Zhang Weibo Sun Wanli GaoYajuan Ren Qiushi Han Haojun Department of Neurology Peking University Third Hospital Beijing 100191 China Beijing Key Lab of Magnetic Resonance Imaging Device and Technique Beijing 100191 China Department of Biomedical Engineering College of engineering of Peking University Beijing 100191 China Department of Interventional Medicine The Second Hospital of Shandong University Jinan 250033China Institute of Applied Physics and Computational Mathematics Beijing 100094 China Institute of Acupuncture and Moxibustion China Academy of Chinese Medical Sciences Beijing 100700China Beijing Key Lab of Magnetic Resonance Imaging Device and Technique Department of Biomedical Engineering College of engineering of Peking University Department of Radiology Peking University Third Hospital Beijing 100191 China Chang Zhi Medical College Chang Zhi 046000 China

OBJECTIVE：To investigate the changes in the neuronal microenvironment of the middle cerebral artery （MCA） territory induced by Jing-well points bloodletting acupuncture （WPBA） and to explore the neuroprotective mechanism of WPBA in stroke. METHODS： Adult male Sprague Dawley （n = 32） rats were randomly divided into four groups of eight animals each： WPBA-thalamus group （WT）, WPBA-caudate nucleus group （WC）, sham-control thalamus group （ST） and sham-control caudate nucleus group （SC）. Animals in the WT and WC groups received 2 I-μL of the extracellular tracer gadolinium-diethylene triamine pentaacetic acid （Gd-DTPA） injected into the thalamus or caudate nucleus, respectively, and 12 Jing-well points in the distal ends of the rats＇ digits were used for WPBA. Although 2 μL of Gd-DTPA was injected into the thalamus or caudate nucleus, respectively, for animals in the two sham groups （ST and SC）, no acupuncture or bloodletting was performed. Brain extracellular space and interstitial fluid flow parameters were measured using Gd-DTPA-enhanced magnetic reso- nance imaging. RESULTS： The brain interstitial fluid flow speed was decreased in the thalamus after WPBA, with a significantly lower Gd-DTPA clearance rate and longer half-life of Gd-DTPA in the thalamus of treated rats than those in sham-control rats [WPBA-treated rats＇clearance rate, （7.47 ± 3.15） x 10^-5/s （P = 0.009）; half-life, （1.52 ± 0.13） h, P = 0.000]. By contrast, no significant changes in brain extracellular space and interstitial fluid flow parameters were detected in the caudate nucleus after WPBA （P = 0.649）. In addi- tion, no differences in the morphology of the brain extracellular space or the final distribution of the traced brain interstitial fluid were demonstrated be- tween theWT and WC groups （P = 0.631, P = 0.970, respectively）. CONCLUSION： The WPBA decreased the speed of the local thalamic ISF flow in rats, which is assumed to be a beneficial protection by down-modulated the metabolic rate of the

关键词： bloodletting Extracellular space Gado-linium ethoxybenzyl DTPA Interstitial fluid Magnetic resonance imaging

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Effectiveness and safety of auricular acupoint bloodletting in treatment of insomnia:an assessor-blinded pilot randomized controlled trial

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Journal of Traditional Chinese Medicine 2018年第5期38卷 763-768页

作者： Ni Jing Wang Bin Wang Fuzhuang Zhou Hongwei Shi Huaxin Zhang Ninan Zhao Hong Xie Qi Department of traditional Chinese medicine Fuxing Hospital Affiliated to Captial Medical University of Yuetan Community Health Service CenterBeijing 100053China Clinical Evaluation Center Institute of Basic Research in Clinical MedicineChina Academy of Chinese Medical SciencesBeijing 100700China TCM data center China Academy of Chinese Medical SciencesBeijing 100700China The acupuncture and moxibustion hospital of China Academy of Chinese Medical Sciences Beijing 100700China

OBJECTIVE: To evaluate the effectiveness and safety of auricular acupoint bloodletting in treatment of insomniaMETHODS: Participants(n = 60) with insomnia were randomized into two groups to receive treatment of auricular acupoint bloodletting: low frequency group, 1 times/week for five weeks(n = 30);high frequency group, 2 times/week for two weeks(n = 30). The following outcomes were measured blindly at baseline, after first treatment, 4 weeks,and 8 weeks: Pittsburgh sleep quality index scale(PSQI).RESULTS: The groups were balanced at baseline for insomnia and demographic characteristics. There were no significant differences between the groups in terms of any of the outcomes, at the first follow-up time point. However, the therapeutic effect of LFG(once per week) is obviously lower than that of HFG(twice per week). In addition, there was no significant difference in the side effects between the two ***: The treatment of insomnia with different frequencies of auricular acupoint bloodletting is effective and has less side effects. More reasonable treatment frequencies are worth further study.

关键词： insomnia Auricular acupoint bloodletting Randomized controlled trials Frequency

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Effect of bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji(EX-B 2) points on upper back myofascial pain syndrome: a randomized controlled trial

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Journal of Traditional Chinese Medicine 2016年第1期36卷 26-31页

作者： Jiang Guimei Jia Chao Lin Mode Physiotherapy Department Guangdong Provincial Hospital of Traditional Chinese Medicine Tuina Department No.1 Affiliated Hospital of Guangzhou University of TCM Department of Acupuncture and Moxibustion Guangdong Provincial Hospital of TCM

OBJECTIVE： To observe the clinical efficacy of bloodletting therapy and acupuncture at Jiaji points for treating upper back myofascial pain syndrome （MPS）, and compare this with lidocaine block therapy. METHODS： A total of 66 were randomly assigned upper back MPS patients to either the treatment group or the control group in a 1 ： 1 ratio. The treatment group （n = 33） were treated with bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji （EX-B 2） points; one treatment course consisted of five, single 20-min-treatments with a 2-day break between each treatment. The control group （n = 33） were treated with a lidocaine block at trigger points; one treatment course consisted of five sessions of lidocaine block therapy with a 2-day break between each session. The simplified McGill Scale （SF-MPQ） and tenderness threshold determination were used to assess pain before and after a course of treatment. RESULTS： After the third and fifth treatment, the SF-MPQ values were significantly decreased （P 〈 0.01） and the tenderness thresholds were significantly increased （P 〈 0.01） in both groups compared with before treatment. There were no significant differences in pain assessments between the two groups after three and five treatments （P 〉 0.05）. There were five cases with minor adverse reactions reported in the control patients, while no adverse reactions were reported in the treatment group. CONCLUSION： bloodletting therapy at local myo- fascial trigger points and acupuncture at Jiaji points was effective in treating upper back MPS. Clinically, bloodletting and acupuncture therapy had the same efficacy as the lidocaine block therapy, with fewer adverse reactions.

关键词： Myofascial pain syndromes Acupuncture bloodletting Treatment outcome Randomized controlled trial

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Wake-Promoting Effect of bloodletting Puncture at Hand Twelve Jing-Well Points in Acute Stroke Patients:A Multi-center Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2021年第8期27卷 570-577页

作者： YU Nan-nan XU Zhi-fang GAO Yang ZHOU Zhi-liang ZHAO Xue ZHOU Dan WANG Zhen-guo CHEN Ze-lin PAN Xing-fang GUO Yi Department of Traditional Chinese Medicine Xijing Hospitalthe Air Force Medical UniversityXi’an710032China Acupuncture Research Center Tianjin University of traditional Chinese MedicineTianjin301617China Acu-moxibustion and Tuina Department Tianjin University of Traditional Chinese MedicineTianjin301617China Department of Acupuncture and Moxibustion the First Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjin300193China Department of Acupuncture and Moxibustion the Second Affiliated Hospital of Tianjin University of Traditional Chinese MedicineTianjin300150China The Third Department of Encephalopathy Xi’an Encephalopathy Hospital of Traditional Chinese MedicineXi’an710032China Department of Traditional Chinese Medicine Tianjin University of Traditional Chinese MedicineTianjin301617China

Objective To assess the effect and safety of bloodletting puncture at hand twelve Jing-Well points(HTWPs)in acute stroke patients with conscious *** In this multi-center and randomized controlled trial,360 patients suffered from ischemic or hemorrhagic stroke with conscious disturbance within 48 h from the onset of symptom were divided into bloodletting(180 cases)and control(180 cases)groups using a block *** in both groups received routine Western medicine,and patients in the bloodletting group received additional bloodletting puncture at HTWPs on admission immediately before conventional *** primary outcome measure was Glasgow Coma Scale(GCS)score and the secondary outcomes included blood pressure,respiratory rate and pulse *** variables were evaluated at baseline(before bloodletting),0(after bloodletting immediately),15,30,50 and 80 min post *** At 80 min post bloodletting,the proportion of patients with improved consciousness in the bloodletting group was greater than the control group(Pbloodletting therapy benefited ischemic patients,and improved the eye and language response of GCS score at 15,30,50,80 min post bloodletting(P0.05).Conclusion The bloodletting puncture at HTWPs was safe and could improve conscious levels of ischemic stroke patients,highlighting a first-aid intervention for acute stroke.

关键词： acute stroke bloodletting Jing-Well point conscious disturbance randomized controlled trial

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bloodletting-cupping for 169 cases of pes anserinus myotenositis

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World Journal of Acupuncture-Moxibustion 2019年第3期29卷 231-234页

作者： Shaoren CAI Yong JIN Wanyu ZHANG Zhongtang LIAO Department of Disease Prevention Pingle Hospital of Orthopedics and Traumatology Shenzhen 518010 Guangdong Province China

Objective:To observe the clinical effect of bloodletting-cupping for pes anserinus ***:A total of 169 patients of pes anserinus myotenositis were *** tapping or bloodletting with plum-blossom needle or the syringe needle was adopted at the local Ashi points to induce bleeding and the cupping was *** cup was retained for 10-15 *** treatment was given once a week and continued till the clinical symptoms disappeared or the patients were unwilling to continue the *** maximal treatment was 10 *** and after treatment,the score of visual analogue scale(VAS)and Lysholm knee score,as well as the clinical effects were observed of the ***:Of 169 cases,137 cases were cured,20 cases improved and 12 cases *** effective rate was 92.89%.Of the 137 cured cases,10 cases were cured after 1 time of treatment,5 cases were cured after 10 times of treatment and the rest 122 cases were cured between 2 and 9 times of *** score was reduced to be(1.10±0.32)after treatment from(4.35±0.60)before treatment and Lysholm score was increased to be(92.74±5.04)from(65.42±6.38).Conclusion:The bloodletting-cupping alleviates knee pain,or even cure it completely and improves the motor function of knee joints in the 169 patients of pes anserinus *** clinical effect is satisfactory.

关键词： Pes anserinus myotenositis bloodletting Bleeding Cupping

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Effects of bloodletting puncture at Jing-Well points in distal ends of finger and toe on survival rate and brain edema in cerebral ischemic rats

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Journal of Traditional Chinese Medicine 2012年第3期32卷 471-476页

作者： Liang Gao Zelin Chen Lixin Tian Zhongzheng Li Yi Guo First Teaching Hospital of Tianjin University ofTraditional Chinese Medicine Tianjin 300192 China Tianjin University of Traditional Chinese Medicine Tianjin 300193 China

OBJECTIVE:To observe the effects of bloodletting puncture at Jing-Well points in the distal ends of the finger and toe on survival rate,survival time,and brain edema in rats with cerebral ***:Fifty-four male Sprague-Dawley rats were randomly divided into five groups:normal,sham operation,model,bloodletting puncture at Jing-Well points in distal ends of finger and toe,and puncture without bloodletting at these *** cerebral artery occlusion models were established according to Longa's *** brains were taken 48 h after the model was *** water content,brain density,brain coefficient,survival rate,and survival time in each group were ***:After bloodletting puncture,the survival time of the rats was prolonged,their brain water content and brain coefficient were reduced,and brain density was ***:bloodletting puncture at Jing-Well points in the distal ends of the finger and toe can improve function in ischemic brain edema.

关键词： bloodletting Brain ischemia Brain edema Acupuncture therapy Points,Jing-Well(Five Shu) Survival rate

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Heated Moxibustion and bloodletting in Tibetan Medical Literature of Dunhuang Heritage

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Chinese Journal of Integrative Medicine 2012年第3期18卷 230-232页

作者：赵琪吴墨政赵吉平 Department of Acupuncture and Moxibustion Dongzhimen Hospital Affiliated to Beijing University of Chinese and Moxibustion Medicine Institute of Acupuncture and Moxibusti0n China Academy of Chinese Medical Sciences

The paper introduces the heated moxibustion and bloodletting in Tibetan medical literature of Dunhuang *** proves that the external therapies in Tibetan medicine such as heated moxibustion and bloodletting are of very high level since the 8th century,which inspires current clinical *** also shows that the extensive exchange between Tibetan medicine and various kinds of medicine such as Chinese medicine promoted the development of Tibetan medicine.

关键词： Dunhuang Heritage Tibetan medicine heated moxibustion bloodletting

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Fire needling and bloodletting at cleft points in treatment of 35 patients with acute gouty arthritis

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World Journal of Acupuncture-Moxibustion 2016年第2期26卷 73-78页

作者：许素瑜涂云王志花湛江中心人民医院中医科广东湛江524000

Objective To observe the clinical efficacy of fire needling and bloodletting at cleft points for acute gouty arthritis, and to explore its functional mechanism. Methods Thirty-five patients with acute gouty arthritis were enrolled into this study, and fire needling and bloodletting with 10 mL/ time were applied at cleft points of corresponding meridians and collaterals at the affected side. The treatment was conducted for once every other day, and treatment for three consecutive times was needed. Serum uric acid （UA） and pain score were tested in patients before treatment and on the 6th day after treatment, follow-up visit for 3 months was performed in patients who stopped treatment, and recurrence rate was calculated. Results Budzyuski 6-point behavioral rating scale was applied to score pain. T-test was conducted on mean and standard deviation of pain score before treatment （4.09 ＋ 0.82） and after treatment （1.14 ＋ 1.33）, showing that the difference was significant （P〈0.05）; t-test was also conducted on mean and standard deviation of serum UA before treatment [（555.34 ＋ 53.09） pmol/L] and after treatment [（414.23 ＋ 67.04） pmol/L], showing that the difference was significant （P〈0.05）; among the 35 patients with acute gouty arthritis, 14 patients were cured （40.0%）, improvement was found in 19 patients （54.3%）, and effectiveness was found in 33 patients （94.3%）. Based on follow-up visit for 3 months in 33 patients with efficacy, recurrence was found in 3 patients （9.1%）. Conclusion Fire needling and bloodletting at cleft points is an effective method in treatment of acute gouty arthritis with significant analgesic effect, efficacy of reducing serum UA, high cure rate and low recurrence rate, which is worth of being generalized clinically.

关键词： acute gouty arthritis cleft point fire needling bloodletting

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Clinical observation of acupuncture bloodletting at Ashi points on local swelling and pain after snakebite

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World Journal of Acupuncture-Moxibustion 2021年第3期31卷 197-201页

作者： Lin-sheng ZENG Zhong-yi ZENG Yu-xiang LIU Cong-cong ZHANG Jian-hua GAO Qiang LIU Lin-hua LIU Yan ZHANG Cheng-bin LI Shenzhen Traditional Chinese Medicine Hospital Shenzhen 518033China The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine Shenzhen 518033China

Objective:To evaluate the clinical therapeutic effect of acupuncture bloodletting therapy on local swelling and pain of snakebite in the patients bitten by ***:A total of 106 patients with trimeresurus stejnegeri bite were randomly divided into two groups,a conventional treatment group and a conventional treatment combined with bloodletting therapy group,53 cases in each *** the conventional treatment group,the convention treatment of western medicine was *** the conventional treatment combined with bloodletting therapy group,on the base of the conventional treatment,bloodletting therapy was applied at Ashi points selected at the tender points around the *** intervention and observation were performed not less than 7 days in two *** and after treatment,swelling and pain degrees were measured and remission time of both the limb swelling and pain were recorded in the ***:Compared with the values on day 1 of treatment,swelling degree and visual analogue scale(VAS) score of the upper and lower limbs were all lower on day 3 and day 7 of treatment in the patients of the two groups(all P bloodletting therapy group on day 3 and day 7 of treatment respectively(all P bloodletting therapy group was shorter than the conventional treatment group respectively(both P bloodletting therapy can effectively relieve the local swelling and pain caused by snakebite,promote the recovery of limb function,shorten the treatment course and improve the clinical therapeutic effect.

关键词： Acupuncture bloodletting Snakebite Swelling and pain Ashi points

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