Anti-nociceptive mechanisms of electroacupuncture in inflammatory pain

Liu, Qing-Ying; Xu, Lingchi; Yi, Ming

doi:10.21037/amj.2017.05.21

Cited by 3 publications

(7 citation statements)

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“…For instance, Cao et al meta-analyzed that neostigmine could effectively improve the symptoms of postoperative urinary retention and neostigmine acupoint injection might achieve a better therapeutic effect ( 34 ). The mechanism of EA in our study may lie in electrical stimulation at BL32 and BL33, which can activate S2 and S3 afferent nerve fibers, promoting detrusor smooth muscle contractions via neural pathways, but more uncertain mechanisms of EA including anti-inflammation require further investigation ( 35 ).…”

Section: Discussionmentioning

confidence: 96%

Effects of electroacupuncture on chronic urinary retention after pelvic or lumbosacral tumor resection surgeries: a retrospective cohort study

Yang,

Zhu,

Yao

et al. 2024

Transl Androl Urol

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Background Chronic urinary retention (CUR) resulting from lower motor neuron lesions (LMNL) is a medical condition secondary to pelvic or lumbosacral tumor resection surgeries. Electroacupuncture (EA) is proved to be effective and safe in treating certain lower urinary tract disorders. However, the clinical benefit and optimal duration of EA treatment for CUR following LMNL remain unknown. Methods Using a retrospective cohort design, 20 eligible patients diagnosed with CUR resulting from LMNL secondary to pelvic or lumbosacral tumor resection surgeries were included from March 1, 2017, to June 30, 2020. The patients were treated by EA three times a week for 2 to 12 weeks and followed up for 24 weeks after treatment. The electric stimulators with a 5-Hz continuous wave (5–10 mA intensity) were separately connected to bilateral Ciliao (BL32), bilateral Zhongliao (BL33), and bilateral Huiyang (BL35), and stimulators with a 10-Hz continuous wave (1–2 mA intensity) were connected to bilateral Sanyinjiao (SP6). Current intensity was adjusted according to the patients’ individual tolerance. The median follow-up was 32 weeks (range, 26–36 weeks). Responders were defined as patients whose post-void residuals (PVR) reduced by 50% or more from baseline. Adverse event was recorded. Results Totally 20 patients [mean (standard deviation) age, 48.1 (15.5) years; 9 men (45.0%); 11 women (55.0%)] were included. Of the 20 patients, 14 (70.0%) had responded to EA treatment and stopped catheterization for achieving satisfactory spontaneous urination (PVR <100 mL without complications), 7 (35.0%) had complete resolution (90–100% reduction in PVR from baseline), and 13 (65.0%) scored 1 (much better) or 2 (moderately better) in the Patient Global Impression of Improvement (PGI-I) assessment. Moreover, 6 (30.0%) patients had responded within 4 weeks of EA treatment. According to Kaplan-Meier survival curve, we found that more than 50% patients could respond to EA treatment within 8 weeks or longer. None of the responders had ever experienced relapse in 24 weeks after EA treatment ended. None of the patients manifested urinary tract infection (UTI), newly diagnosed hydroureter or hydronephrosis. One patient diagnosed with hydronephrosis at baseline recovered after 12-week EA treatment. Two patients with UTI at baseline were prescribed antibiotics and did not present UTI again during the follow-up. Conclusions EA could be a promising treatment option for CUR caused by LMNL following pelvic or lumbosacral tumor resection surgeries, with long-term effects and a good safety profile. The optimal duration of EA should be of 8 weeks at least. But this was a retrospective cohort study of a small sample size, so future studies are needed to investigate EA in larger populations in randomized controlled trials.

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Section: Discussionmentioning

confidence: 96%

Effects of electroacupuncture on chronic urinary retention after pelvic or lumbosacral tumor resection surgeries: a retrospective cohort study

Yang,

Zhu,

Yao

et al. 2024

Transl Androl Urol

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“…Released endogenous opioids plays a major role by desensitizing peripheral nociceptors, decrease cytokines in inflammatory sites, and descending inhibitory system [ 8 ]. Besides opioids, various signal molecules such as cholecystokinin octapeptide, norepinephrine, 5-hydroxytryptamine and glutamate also take part in EA analgesia [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have attempted to elucidating the mechanism by which EA alleviates pain. According to these studies, when EA is performed, bioactive chemicals including opioids that block pain are released through peripheral, spinal, and supraspinal mechanisms [8][9][10][11]. In addition, many studies have suggested that EA provides effective pain management when combined with conventional analgesics, so it may reduce a patient's chance of suffering the side effects of pharmaceuticals [8,12].…”

Section: Introductionmentioning

confidence: 99%

Electroacupuncture for post-thoracotomy pain: A systematic review and meta-analysis

et al. 2021

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Background Thoracotomy is an invasive surgical procedure that produces intense postoperative pain. Electroacupuncture has been used to induce analgesia in various situations, including after surgery. The aim of the following systematic review and meta-analysis was to evaluate the effect of electroacupuncture on post-thoracotomy pain. Methods The studies for the systematic review were searched using the following 9 databases: PubMed, Cochrane Library, EMBASE, MEDLINE Complete, Google Scholar, China National Knowledge Infrastructure (CNKI), Korean Medical Database (KMBASE), Koreanstudies Information Service System (KISS), and OASIS, without language restriction. Randomized controlled trials (RCTs) that met the inclusion criteria were selected. The quality assessment was performed using the Cochrane risk-of-bias tool, and RevMan 5.3 was used for meta-analysis. The review protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) as CRD42019142157. Results Eleven randomized controlled trials were included in the systematic review. The meta-analysis was performed for two outcome measures: pain score 24 hours after surgery and total dose of opioid analgesics. A subgroup analysis was performed according to the control group: sham acupuncture and conventional analgesia group. Pain score 24 hours after surgery of electroacupuncture group showed a standard mean difference of -0.98 (95% CI: -1.62 to -0.35) compared to sham acupuncture. The standard mean difference was -0.94 (95% CI: -1.33 to -0.55) compared to conventional analgesia. The total dose of opioid analgesics of electroacupuncture group showed a standard mean difference values of -0.95 (95% CI: -1.42 to -0.47) compared to sham acupuncture. The standard mean difference was -1.96 (95% CI: -2.82 to -1.10) compared to conventional analgesia. Conclusion Current evidence suggests that electroacupuncture might provide useful pain relieving effect on post-thoracotomy patients. However, due to low quality and high heterogeneity of existing data, further rigorously designed studies should be performed to confirm the safety and efficacy.

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“…(84,85) Pela visão da Medicina Ocidental, acredita-se que a inserção e a estimulação da agulha em um acuponto ativem as fibras musculares aferentes A-delta e C, fazendo com que sejam liberadas endorfinas e monoaminas, o que ativa também os sistemas inibidores de dor endógenos e induz a liberação de mediadores pró-inflamatórios, como as citocinas pró-inflamatórias, gerando como resposta por feedback negativo no hipotálamo a diminuição dos níveis séricos de citocinas pró-inflamatórias e o aumento dos níveis de citocinas anti-inflamatórias. (83,(86)(87)(88)(89)(90) Acrescido a isso, os estudos de imagem demonstram que a analgesia obtida pela acupuntura está associada às interações de ativação e desativação que ocorrem no sistema nervoso autônomo, nas redes sensoriais, límbicas e executivas do córtex, assim como à neuroplasticidade no córtex somatossensorial primário do cérebro. (80,83,(91)(92)(93)(94) A eletroacupuntura (EA), que é a acupuntura acrescida de corrente elétrica, entra nesse cenário com o objetivo de potencializar e prolongar o efeito analgésico da acupuntura manual, mediante diferentes frequências de estimulação elétrica.…”

Section: Acupunturaunclassified

“…(86,88,95) Assim, a baixa frequência (2 Hz) seria responsável pela liberação de β-endorfina, encefalina e endomorfina, já na alta frequência (100 Hz) ocorreria a liberação de dinorfina e colecistoquinina, enquanto que na frequência alternada (modo denso e disperso -DD, com revezamento entre a baixa e a alta frequência) as encefalinas e dinorfinas seriam liberadas. (86,(97)(98)(99)(100)(101)(102)(103) A eletroacupuntura de baixa frequência é descrita como a forma mais efetiva de analgesia em longo prazo (por até 12 meses) nas dores de origem inflamatória e neuropática, pois seus sinais levam a uma depressão no corno dorsal espinhal com aumento da liberação de serotonina na medula espinhal, ativação do eixo hipotálamo-hipófise-adrenal, e, também, possuem capacidade de regulação de expressão gênica mais poderosa do que a EA de alta frequência. (104)(105)(106)(107) Dessa forma, essa faixa de frequência alivia a dor por sua função opiácea, principalmente ao nível da medula espinhal, produzindo efeito antinociceptivo mais longo e mais potente que a alta frequência.…”

Section: Acupunturaunclassified

Efeito de diferentes frequências de eletroacupuntura na dor lombar crônica de idosos: ensaio clínico triplo-cego, controlado e aleatorizado

Torres¹

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Efeito de diferentes frequências de eletroacupuntura na dor lombar crônica de idosos: ensaio clínico triplo-cego, controlado e aleatorizado Tese apresentada à Faculdade de Medicina da Universidade de São Paulo para obtenção do título de doutor em Ciências. Programa: Ciências da Reabilitação Orientadora: Prof. a Dr. a Amélia Pasqual Marques São Paulo 2022 Dedicatória Dedico este trabalho: a Deus, que me carregou no colo em diversos momentos ao longo desta jornada; à minha mãe, Maria, que me ajudou imensamente e de todas as maneiras possíveis; aos meus filhos, Lórien e Thomas, que são o propósito da minha vida; ao meu companheiro Danilo, que sempre me apoiou; à minha orientadora, Prof. a Dr. a Amélia, que partilhou desta experiência comigo com muita sabedoria. AgradecimentosÀ Prof. a Dr. a Amélia Pasqual Marques, pela orientação deste trabalho, por ser um grande exemplo de competência, profissionalismo e ética, pelos ensinamentos, pelo apoio financeiro, pelo acolhimento nos momentos difíceis, por acreditar cegamente na minha proposta de pesquisa e na minha capacidade de finalizá-la, bem como por todo respeito e por toda compreensão que demonstrou após a chegada dos meus filhos.À minha mãe, Maria Francescato, que também foi conselheira, professora, pesquisadora, babá, motorista, médica e terapeuta. Faltam-me palavras para lhe agradecer, pois, além de tudo isso, também foi o pilar para que esse trabalho pudesse ser finalizado.Ao meu companheiro, Danilo Costa e Silva Ferreira, que esteve envolvido neste processo e sempre me ouviu e me apoiou.Às fisioterapeutas e professoras, Dr. a Rubneide Barreto Silva Gallo e Dr. a Ana Carolina Brandt de Macedo, por me proporcionarem a oportunidade de coletar os dados na Universidade Federal do Paraná (UFPR), pela parceria na coleta de dados desta pesquisa e pela carinhosa recepção.Aos alunos de iniciação científica da Dr. a Ana Carolina Brandt de Macedo, Gabriele Cristina Seguro Bressan e Matheus Bieberbach Rodrigues dos Santos, por participarem ativamente, com muita responsabilidade e competência, da coleta de dados dessa pesquisa.Aos queridos amigos, Martin Stephan e Dênis Silveira Martins, pela disponibilidade e imensa ajuda com a coleta de dados na cidade de Pouso Alegre-MG. Eles foram fundamentais nesse processo.

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Anti-nociceptive mechanisms of electroacupuncture in inflammatory pain

Cited by 3 publications

References 0 publications

Effects of electroacupuncture on chronic urinary retention after pelvic or lumbosacral tumor resection surgeries: a retrospective cohort study

Effects of electroacupuncture on chronic urinary retention after pelvic or lumbosacral tumor resection surgeries: a retrospective cohort study

Electroacupuncture for post-thoracotomy pain: A systematic review and meta-analysis

Efeito de diferentes frequências de eletroacupuntura na dor lombar crônica de idosos: ensaio clínico triplo-cego, controlado e aleatorizado

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