The phrase "wood element characterized by spreading harmony" from the Huangdi Neijing five-phase theory summarizes the fundamental nature and functions of the wood element, emphasizing the crucial significance of the harmonious virtue of wood in promoting the generation and transformation of all things. In human physiology, "wood element characterized by spreading harmony" corresponds to the harmonious spreading of liver-gallbladder qi, ensuring smooth liver qi regulation and proper functioning of the ascending-descending movement mechanisms. Bipolar disorder, categorized in traditional Chinese medicine as "depression" or "manic depressive psychosis," primarily arises from hepatic wood dysfunction. Insufficient wood qi dispersion typically manifests as a depressive phase, whereas excessive dispersion leads to a manic phase, with alternating manic-depressive phase indicating qi movement disorder. By integrating wood qi characteristics, disease pathogenesis of bipolar disorder, and our team′s clinical experience in treating emotional disorders, this study developed an integrated acupuncture and moxibustion diagnosis and treatment approach for bipolar disorder, focusing on soothing the liver and regulating spirit, structured as "acupuncture-moxibustion-consolidation." Based on the physiological characteristics of "wood element characterized by spreading harmony," from liver failing to controll conveyance and dispersion: depressive phase should apply warm-nourishing growth method, manic phase should suppress hyperactive liver for tranquillizing mind method, and alternating manic-depressive phase should apply harmonized rigidity-flexibility method. These methods aim to regulate the spirit of the heart and brain, harmonize the qi movement of the spleen and stomach, and replenish the essence and blood of the liver and kidney. Clinical application through syndrome differentiation has demonstrated satisfactory therapeutic outcomes.
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Open Access
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This paper introduces FU Wenbin's clinical experience in treatment of post-stroke depression with holistic therapy of acupuncture and moxibusiton for Shugan Tiaoshen (soothing the liver and regulating the mind). In pathogenesis, post-stroke depression is associated with the loss of the mind control and the failure of the liver in maintaining the free flow of qi. In treating principle, soothing the liver qi and regulating the mind are equally important, and the holistic regulation is applicable with the combination of multiple therapies. During treatment, the four-gate points are stimulated at first to promote liver qi flowing, the acupoints of the conception vessel and the governor vessel (e.g. Zhongwan [CV12], Guanyuan [CV4], Baihui [GV20], Yintang [GV24+]) are combined to regulate the mind and regain the consciousness. The conditions of illness are differentiated in terms of excess and deficiency, and the point prescription is modified accordingly. Refined moxibustion is applied specially at Fengchi (GB20), Fengfu (GV16) and Wangu (GB12) to warm meridians, strengthen yang and nourish the mind. In the last step of treatment, shallow needling techniques, such as the pricking and bloodletting, intradermal needling and auricular acupuncture, are used to consolidate the curative effect.
Open Access
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To observe the effect of acupuncture and moxibustion on arterial elasticity in patients with early carotid atherosclerosis.
A total of 62 patients with early carotid atherosclerosis were randomly divided into a blank group (12 cases, 1 cases dropped-off), a sham-acupuncture group (25 cases, 5 cases dropped-off) and an acupuncture group (25 cases, 3 cases dropped-off). Patients in the acupuncture group received acupuncture treatment, including ① acupuncture: Baihui (GV20), Yintang (GV24+), Renying (ST9), Neiguan (PC6), Yanglingquan (GB34); ② moxibustion: Yinqiguiyuan (Zhongwan [CV12], Xiawan [CV10], Qihai [CV6], Guanyuan [CV4]), Sihua (Geshu [BL17], Danshu [BL19]); ③Intradermal needle: Xinshu (BL15), Danshu (BL19). Patients in the sham acupuncture group received placebo acupuncture, moxibustion, an intradermal needle, and the acupoints were the same as the acupuncture group. The above treatments were performed twice a week for 12 weeks. No intervention was given to the patients in the blank group. Diet and lifestyle education was given to the three groups. The ultrafast pulse wave velocity, including beginning-systolic pulse wave velocity (BS) and end-systolic pulse wave velocity (ES), was observed before treatment and 1, 2, 3 months after treatment in the three groups. The blood lipid level and platelet count (PLT) at each time point were observed. The safety of the treatments was also evaluated.
Compared with those before treatment, the BS and ES values of both sides in the acupuncture group decreased at 2and 3 months after treatment (P＜0.05). Compared with the blank group, the bilateral ES of the acupuncture group were decreased at 2 months after treatment (P＜0.05), and the bilateral BS and ES were decreased at 3 months (P＜0.05). Compared with the sham-acupuncture group, the acupuncture group showed a decrease in left BS and left ES after 3months of treatment (P＜0.05), and the overall decrease on the left side of the acupuncture group was better than that on the right side. There were no significant differences between three groups in the levels of blood lipid and PLT at each time point. No serious adverse safety events occurred in the three groups during the treatment.
Acupuncture and moxibustion therapy can improve arterial elasticity in patients with early carotid atherosclerosis, and it is safe and effective.
Open Access
Issue
To observe the effect of electroacupuncture (EA) preconditioning on podocytes and phosphatase and tension homologous protein (PTEN)/phosphoinositide-3-kinase (PI3K) signaling pathway in rats with type 2 diabetic kidney injury, so as to explore its potential mechanisms.
Fifty male Wistar rats were randomly divided into control, model, EA, inhibitor, and sham EA groups, with 10 rats in each group. Diabetes model was established by high-fat and high-sugar diet and intraperitoneal injection of streptozotocin (40 mg/kg). For rats in the EA group, EA (2 Hz, 1 mA) preconditioning was applied to “Guanyuan” (CV4), “Zhongwan” (CV12), and bilateral “Zusanli” (ST36), “Fenglong” (ST40) for 15 min, once every other day for 8 weeks. And rats in the sham EA group were given acupuncture at the subcutaneous areas of the same acupoints without EA stimulation. Rats of the inhibitor group were given intraperitoneal injection of BPV (HOpic, 0.6 mg/kg, 0.5 mg/mL) combined with the same EA stimulation as EA group once a week for 8 weeks. The blood glucose level of rats was recorded. Urinary albumin (ALB) content in rats was detected by ELISA. The contents of serum urea (Urea), creatinine (Crea), total cholesterol (TC) and triglyceride (TG) were detected by automatic biochemical analyzer. HE staining, PAS staining and Masson staining were used to observe the pathological changes of renal tissues. The ultrastructural changes of podocytes were observed by transmission electron microscopy. The relative expression levels of Synaptopodin, microtubule-associated protein light chain 3 Ⅱ (LC3-Ⅱ ), PTEN and PI3K proteins in kidney were detected by Western blot.
Compared with the control group, the blood glucose, content of serum ALB, Urea, Crea, TC, TG and renal PI3K protein expression in the model group were significantly increased (P＜0.01), while the expression levels of renal Synaptopodin, LC3-Ⅱ and PTEN proteins were decreased (P＜0.01). Compared with the model group, the blood glucose, content of serum ALB, Urea, Crea, TC, TG and renal PI3K protein expression in the EA group decreased (P＜0.01, P＜0.05), while the expression levels of renal Synaptopodin, LC3-Ⅱ and PTEN proteins increased (P＜0.01). In comparison with the EA group, the blood glucose, ALB, Urea, Crea, TC, TG content and PI3K protein expression level were increased (P＜0.05, P＜0.01), while the expression levels of Synaptopodin, LC3-Ⅱ and PTEN proteins were decreased (P＜0.01) in the inhibitor group; whereas, the blood glucose, ALB, Urea, TC, TG content and PI3K protein expression level were increased (P＜0.05, P＜0.01), while the expression levels of Synaptopodin, LC3-Ⅱ and PTEN proteins were decreased (P＜0.01) in the sham EA group. HE staining and PAS staining showed glomerular hypertrophy and glomerular glycogen deposition; and Masson staining displayed an enhancement of glomerular fibrosis; and electron microscope revealed foot process fusion, basement membrane thickening and autophagosomes reduction in the rat’s kidney of the model, inhibitor and sham EA groups, which were relatively milder in the EA group.
EA promotes the expression of PTEN gene-encoded protein in the kidneys of type 2 diabetic rats, thereby inhibiting the activation of PI3K, increasing the autophagy level and protecting the podocytes.
To explore the interaction between emotional and insomnia symptom improvement in comorbid depression and insomnia patients treated with optimized acupuncture.
A secondary analysis was conducted on a multicenter randomized controlled trial of acupuncture treatment for comorbid depression and insomnia. One hundred and forty patients with comorbid depression and insomnia were randomly assigned to an optimized acupuncture group (70 cases, 8 cases dropped out) and a conventional acupuncture group (70 cases, 8 cases dropped out). The patients in the conventional acupuncture group were treated with acupuncture at Yintang (GV 24+), Baihui (GV 20), bilateral Hegu (LI 4) and Taichong (LR 3); the patients in the optimized acupuncture group were treated with additional acupuncture at bilateral Lieque (LU 7), Zhaohai (KI 6), and intradermal needling was applied alternately at bilateral Xinshu (BL 15) and Danshu (BL 19), Shenshu (BL 23) and Anmian (Extra). Both groups received treatments twice a week for six weeks. The Hamilton depression scale-24 (HAMD-24) and Pittsburgh sleep quality index (PSQI) scores were observed before and after treatment for both groups.Mediation analysis was used to assess the mesomeric effect of PSQI and HAMD-24 emotional factors, and latent profile analysis categorized patients into subgroups based on HAMD-24 scores, followed by between-group efficacy comparisons.
The indirect effect of the optimized acupuncture on improving depression emotions through PSQI was 3.052 (95%CI [1.407, 4.697]), accounting for 77.5% of the total effect. Conversely, the indirect effect of improving PSQI through the optimized protocol on depression emotions was 0.479 (95%CI [0.024, 0.935]), representing 14.8% of the total effect. Latent profile analysis identified 3 categories based on emotional and insomnia symptoms, and statistically significant differences in efficacy favoring the optimized acupuncture protocol over the conventional acupuncture protocol were observed only in the subgroup with relatively mild depression and insomnia symptoms (PSQI: 95%CI [-10.98, -5.44], P<0.001; HAMD-24:95%CI [-12.31, -3.73], P=0.001).
The optimized acupuncture protocol primarily improves insomnia symptoms and further improves depression emotions. Its efficacy advantages are more evident in patients with mild symptoms compared with the conventional acupuncture protocol.
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