BackgroundScalp acupuncture has shown a remarkable treatment efficacy on motor dysfunction in patients with stroke in China, especially the motor area of Jiao’s scalp acupuncture, which is the most widely used treatment. However, previous studies have summarized that the clinical curative effect of acupuncture treatment for stroke remains uncertain. Meanwhile, no randomized controlled trials on Jiao’s scalp acupuncture have been performed. The aim of this study is to evaluate the efficacy and safety of Jiao’s scalp acupuncture for motor dysfunction in ischemic stroke.Methods/designThis is an assessor- and analyst-blinded, randomized controlled trial. One hundred and eight stroke patients with motor dysfunction meeting the inclusion criteria will be allocated by a 1:1 ratio into either an acupuncture treatment group or a control group. Stroke patients in the control group will receive conventional rehabilitation treatment, whereas a combination of Jiao’s scalp acupuncture and conventional rehabilitation treatment will be applied to the acupuncture group. Forty treatment sessions will be performed over an 8-week period. The Fugl-Meyer Assessment scale will be assessed as the primary outcome measure. The Modified Barthel Index, the Stroke-Specific Quality of Life, and the Stroke Syndrome of Traditional Chinese Medicine scales will be selected as secondary outcome measurements. All assessments will be conducted at baseline, week 4 (treatment 20), week 8 (treatment 40), week 12 (follow-up), and week 16 (follow-up).DiscussionThis is the first trial evaluating the efficacy and safety of Jiao’s scalp acupuncture for motor dysfunction in ischemic stroke. The results of this trial are expected to provide relevant evidence demonstrating that Jiao’s scalp acupuncture can be used as an effective rehabilitation treatment method for improving motor dysfunction in ischemic stroke.Trial registrationClinicalTrials.gov, NCT02871453. Registered on 17 July 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2000-x) contains supplementary material, which is available to authorized users.

Stroke is the leading fatal disease in China. This retrospective study aimed to explore the optimal acupuncture intervention time for long-term efficacy on motor dysfunction in patients suffering from acute ischemic stroke through 1-year of follow-up. Three hundred and nine patients collected at Longhua Hospital from January 2016 to December 2017 were classified into 3 groups based on the acupuncture intervention time, including groups A (within 2 days), B (within 3–7 days) and C (within 8–14 days). All patients had received standard treatment combined with acupuncture therapy. Specifically, acupuncture was performed at the acupoints including LI4 (Hegu), ST40 (Fenglong), DU20 (Baihui), and motor area of the scalp, followed by 2 electroacupuncture protocols based on different muscle tensions once a day for 5 days consecutively. The time-effect relationship was assessed using both the Fugl-Meyer Assessment (FMA) and the modified Barthel index (MBI) on the 90th day and 1st year, respectively. Meanwhile, the modified Rankin scale (mRS), high-sensitivity C-reactive protein (hs-CRP), and fibrinogen (FIB) were also measured during the 1-year follow-up. The favorable outcome rate was 74.4%. One-way univariate analysis of variance (ANOVA) revealed significant differences in FMA and MBI on the 90th day among the 3 groups ([Formula: see text] < 0.05), while no significant differences were observed in FMA, MBI or mRS at the 1st year between groups A and B. The levels of hs-CRP and FIB ([Formula: see text] < 0.05) were markedly reduced. Binary logistic regression analysis suggested that patients with atrial fibrillation (AF) (odds ratio (OR): 3.156), chronic kidney disease (CKD) (OR: 2.563), diabetes mellitus (DM) (OR: 2.174) or stroke history (OR: 1.883) were more inclined to recover poorly from nerve function deficit ([Formula: see text] < 0.05). Earlier acupuncture intervention may have a better long-term effect on motor dysfunction and inflammation during the 1-year follow-up. Moreover, acupuncture within 2 days is probably the optimal treatment time for early recovery on the 90th day.

BackgroundFunctional brain imaging changes have been proven as potential pathophysiological targets in early-stage AD. Current longitudinal neuroimaging studies of AD treated by acupuncture, which is one of the growingly acknowledged non-pharmacological interventions, have neither adopted comprehensive acupuncture protocols, nor explored the changes after a complete treatment duration. Thus, the mechanisms of acupuncture effects remain not fully investigated.ObjectiveThis study aimed to investigate the changes in spontaneous brain activity and functional connectivity and provide evidence for central mechanism of a 12-week acupuncture program on mild-to-moderate AD.MethodsA total of forty-four patients with mild-to-moderate AD and twenty-two age- and education-level-matched healthy subjects were enrolled in this study. The forty-four patients with AD received a 12-week intervention of either acupuncture combined with Donepezil (the treatment group) or Donepezil alone (the control group). The two groups received two functional magnetic resonance imaging (fMRI) scans before and after treatment. The healthy subject group underwent no intervention, and only one fMRI scan was performed after enrollment. The fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) were applied to analyze the imaging data. The correlations between the imaging indicators and the changed score of Alzheimer's Disease Assessment Scale-Cognitive Section (ADAS-cog) were also explored.ResultsAfter the 12-week intervention, compared to those in the control group, patients with AD in the treatment group scored significantly lower on ADAS-cog value. Moreover, compared to healthy subjects, the areas where the fALFF value decreased in patients with AD were mainly located in the right inferior temporal gyrus, middle/inferior frontal gyrus, middle occipital gyrus, left precuneus, and bilateral superior temporal gyrus. Compared with the control group, the right precuneus demonstrated the greatest changed value of fALFF after the intervention in the treatment group. The difference in ADAS-cog after interventions was positively correlated with the difference in fALFF value in the left temporal lobe. Right precuneus-based FC analysis showed that the altered FC by the treatment group compared to the control group was mainly located in the bilateral middle temporal gyrus.ConclusionThe study revealed the key role of precuneus in the effect of the combination of acupuncture and Donepezil on mild-to-moderate AD for cognitive function, as well as its connection with middle temporal gyrus, which provided a potential treating target for AD.Trial Registration Number:NCT03810794 (http://www.clinicaltrials.gov).

Acupuncture has been used to treat ischemic stroke, and mounting evidence demonstrates the neuroprotective and autophagy-mediated actions of electroacupuncture (EA). This review summarizes the evidence that EA affects different stages of autophagy, its neuroprotective action, and effects of different acupoints in treating ischemic stroke. Systematic searches were conducted on English and Chinese databases (MEDLINE, Elsevier, ScienceDirect, Cochrane Library, and China National Knowledge Infrastructure). Studies published up until February 2021 were considered for inclusion, and a final of fifty articles were included in this review. There is evidence that acupuncture promotes neuroprotection by modulating autophagy, and the treatment effectiveness is related to the acupoint selection and timing of treatment administration.

Objective: We evaluated the efficacy and safety of transdermal preparations of Sinomenium acutum (SA) for rheumatoid arthritis (RA).Methods: Randomized controlled trials (RCTs) of SA transdermal preparations for RA were extracted from relevant databases and screened in accordance with the inclusion criteria. The Cochrane System Evaluation Manual (version 5.1.0) was used to assess the quality of the included trials. We used the Cochrane Review Manager (version 5.4) to conduct the meta-analysis.Results: Six trials comprising 436 patients (220 patients in the treatment group and 216 patients in the control group) were analyzed. The meta-analysis indicated that SA transdermal preparations in combination with disease-modifying antirheumatic drugs (DMARDs) enhanced the overall effect (odds ratio [OR] 3.97, 95% confidence interval [CI] [2.25,7.00], P<0.00001), decreased visual analogue scale (VAS) results (mean difference [MD] -0.64, 95% CI [-1.20, -0.09], P=0.02), decreased laboratory indexes including the erythrocyte sedimentation rate (ESR) (MD -4.36, 95% CI [-5.63, -3.08], P<0.00001) and C-reactive protein (CRP) (MD -3.6, 95% CI [ -3.99, -3.21, P<0.00001]), and decreased the Disease Activity Score-28 (DAS28) (MD -0.41, 95% CI [-0.78, -0.03], P=0.03). The results suggest that combination therapy did not shorten the duration of morning stiffness (DMS; standardized MD [SMD] -6.13, 95% CI [-17.33, 5.06], P=0.28) or reduce rheumatoid factor (RF) laboratory indexes (SMD -0.85; 95% CI [-2.19, 0.49], P=0.21). Only one study reported adverse reactions, and thus, it was difficult to determine whether adverse drug reactions in the combination therapy group were significantly different from those in the control group. Conclusion:We found that SA transdermal preparations combined with DMARDs may have greater clinical efficacy than DMARDs for RA. More well-designed and high-quality RCTs are required to verify the findings and determine whether transdermal preparations cause fewer adverse events.