Article

Observation on therapeutic effect of electroacupuncture at Chengshan (BL 57) and Changqiang (GV 1) on hemorrhoidal pain

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Abstract

To assess the clinical effect of combination of far with near acupoints, Chengshan (BL 57) and Changqiang (GV 1), for acupuncture treatment of hemorrhoidal pain. One hundred and twenty cases of hemorrhoids with pain were randomly divided into 2 groups, an electroacupuncture group and a medication group, 60 cases in each group. The electroacupuncture group were treated by electroacupuncture at Changqiang (GV 1) and Chengshan (BL 57) with sparse-dense wave, frequency 2/100 Hz; and the medication group with oral administration of Tramadol and rectal application of Mayinglong Shexiang Zhichuang Suppository. The two group were treated for five days. Changes of pain were assessed by Visual Analogue Scale (VAS) scores at the defecation each day. In the electroacupuncture group, VAS score was 6.64 +/- 3.66 before treatment and 5.65 +/- 2.21 on the second day of treatment with a significant decrease (P < 0.05), and 1.85 +/- 1.24 on the fifth day after treatment end. In the medication group, VAS score was 6.58 +/- 3.18 before treatment and 4.86 +/- 2.04 on the third day after treatment with significant decrease compared with that before treatment, and 2.24 +/- 1.46 on the fifth day. There was no significant difference between the two groups in the pain score on the fifth day after the treatment end. Combination of Chengshan (BL 57) with Changqiang (GV 1) is effective for improvement of hemorrhoidal pain in defecation.

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... Acupuncture has been a major part of healthcare in China for centuries and was also used even as a primary Chinese researchers have started to assess acupuncture as a method for pain relief after haemorrhoidal surgery. Recently, three clinical trials found acupuncture to have analgesic effects in posthaemorrhoidectomy patients [8][9][10]. Chinese researchers, however, often do not adhere to well-established methodological standards when performing or reporting randomized clinical trials [11,12]. ...
... A comparison of the present study with previous Chinese studies shows that the selection of acupuncture points for perianal analgesia is not as straightforward as for other conditions. For example, the acupuncture point Du 2 (yao shu) was used by Xu et al. [8,10,15]. Other groups have suggested that the point BL 54 (zhi bian) may also be connected to perianal pain perception [16]. ...
Article
Haemorrhoidectomy usually causes moderate to strong postoperative pain. Chinese studies have found that acupuncture may have an analgesic effect in posthaemorrhoidectomy patients. This is the first Western study aiming assess the efficacy of acupuncture as an adjunct analgesic therapy after stapled haemorrhoidopexy. In a randomized controlled trial, 50 patients were allocated to three groups. Conventional drug therapy (oral diclofenac and metamizol, local lidocaine) served as baseline analgesia. In the control group (n = 17) only this regimen was used. In addition to baseline analgesia, 17 patients received verum acupuncture. Sham acupuncture was performed on 16 patients. Being the primary outcome measure, pain was measured twice daily using the numerical rating scale (NRS) and compared statistically by repeated-measures analysis of variance. The study was registered (DRKS00003116). Results  After verum acupuncture, pain intensity was not significantly lower when compared with conventional analgesia (primary hypothesis, P = 0.057), but was when compared to sham acupuncture (P = 0.007). In the afternoon of postoperative day 1, for example, NRS was 2.7 (SD 1.5) in the verum group, but 4.0 (1.0) in the sham group and 4.1 (1.9) under conventional analgesia. Furthermore, significantly fewer rescue analgesics were necessary if verum acupuncture was applied. Cardiovascular parameters were stable in all three groups, and no complications were recorded. In posthaemorrhoidectomy patients, acupuncture appears to be an effective adjunct to conventional analgesia. Further studies are necessary to confirm these observations and to refine the acupuncture technique.
... GV-1 is an acupuncture point located on the midline, midway between tip of the coccyx and anus that is also purported to alleviate pain along the centerline and back. 8,14 Traditionally, GV-26 is used for emergency and resuscitation. GV-26 is an acupuncture point located on midline below the nares that is used to aid the in the treatment of shock, cardiopulmonary arrest, and apnea. ...
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Intramuscular administration of anesthetic agents in chelonians may result in a prolonged (≥1 hr) return of spontaneous movement and breathing, which increases the probability for peri- and postoperative complications. The acupuncture point governing vessel (GV)-26 has been demonstrated to reduce anesthetic recovery times from inhalant anesthesia in other species. In this study, 30 eastern box turtles (EBT;Terrapene carolina carolina), presented to the Turtle Rescue Team at North Carolina State University's College of Veterinary Medicine for treatment of aural abscess, were divided into four groups: control (no treatment); GV-26 acupuncture; GV-1 and GV-26 acupuncture; or GV-1 and GV-26 electroacupuncture. Turtles receiving either GV-1 and GV-26 acupuncture or GV-1 and GV-26 electroacupuncture had a significantly reduced time to return of voluntary movement (P= 0.012 and P= 0.006, respectively), a significantly reduced time to response of limb extension (P= 0.03 and P< 0.001, respectively), and a significantly reduced time to anesthetic recovery (P< 0.05 and P< 0.01, respectively). Therefore, the use of either GV-1 and GV-26 acupuncture or GV-1 and GV-26 electroacupuncture produces significant reductions in anesthetic recovery time in EBTs that have received injectable anesthetics.
... A combination of acupuncture and electric current, electroacupuncture (EA), has been widely used for treatment of various diseases and for analgesia. [12][13][14][15] Evidence suggests that acupuncture activates C-afferent fibers and A-d fibers, altering transmission of pain signals at the spinal cord, midbrain, and hypothalamus. Stimulation of A-d and C-afferent fibers in the muscle depresses nociception in the spinal cord. ...
Article
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... In poem Baizheng Fu ( 《百症赋》A Verse for Treating Diseases with Acup-Mox) Chángqiáng (长强 GV 1) and Chéngshān (承山 BL 57) were described as benefi cial for dispelling blood from intestine. The initial purpose for prescribing Chéngshān (承山 BL 57) with electroacupuncture stimulation emerges from three aspects: ① Combination of Chángqiáng (长强 GV 1) and Chéngshān (承山 BL 57) is a typical prescription in acupuncture treatment, as they combined points from remote area with local regions [6] . ② Chéngshān (承山 BL 57) has definite effects in promoting circulation in meridians and collaterals, eliminating dampness, strengthening functions of spleen and kidney [10] , moreover the point can be easily located, it is less painful and more acceptable by the patients. ...
Article
Full-text available
To discuss the effect of electroacupuncture at Chengshan (BL 57) on postoperative pain of mixed hemorrhoids. One hundred and twenty cases with postoperative pain of mixed hemorrhoids were divided into an electroacupuncture group (60 cases) and a medication group (60 cases) randomly. The disperse-dense wave in frequency of 2Hz/100Hz at Chengshan (BL 57) were used in the electroacupuncture group. Its first treatment was in 30 min after the operation, and then it was given once a day after hip bath in the morning. 2 tablets of Naproxen Sunstained Release Capsule were taken in 30 min after operation in the medication group, and then it was taken 2 tablets a day before dressing change. After 4 times of treatment, evaluate the changing condition of Visual Analogue Scale (VAS) at 5 h, 24 h, 48 h and 72 h after operation. The VAS at 5 h, 24 h, 48 h and 72 h after operation in the electroacupuncture group (6.78 +/- 2.12, 5.56 +/- 1.87, 4.34 +/- 2.23 and 3.15 +/- 2.11) were all lower than those in the medication group (7.56 +/- 2.01, 6.23 +/- 1.15, 5.57 +/- 2.21 and 4.34 +/- 2.12), and the difference was statistically significant (all P < 0.05). Electroacupuncture at Chengshan (BL 57) can reduce the postoperative pain of mixed hemorrhoids.
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Hemorrhoid refers to soft vein mass formed by varicosity of submucosal veins around the end of the rectum and subcutanceous veins of the anal canal. It is the most common anorectal disease. This article summarized the regular patterns, features and advantages of Professor Yu Hai-Bo’s acupuncture-moxibustion therapy for hemorrhoids, in order to guide the acupuncture treatment for hemorrhoids.
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Treatment for enlarged hemorrhoids is necessary when the patient experiences symptoms. The type of treatment depends on the severity of the disease. The Goligher classification assigns hemorrhoids to 4 degrees of severity, depending on their size, tendency to prolapse, and the likelihood of spontaneous or manual reduction of a prolapse. For optimal treatment of hemorrhoids, a 3-level approach with the following stages has been proposed: (1) conservative therapy, (2) minimally invasive/interventional therapy, (3) and surgical therapy. Independently of the severity of the disease, conservative procedures (stage 1) represent the foundation for every form of hemorrhoid treatment. Even in more severe conditions, conservative treatment often leads to symptomatic improvement. If this does not occur, then inter-ventional and minimally invasive procedures (stage 2) represent a reasonable option for treating less severe hemorrhoids (degrees 1 and 2). Surgery should be performed in third- or fourth-degree hemorrhoids that present with specific symptoms, as conservative and minimally invasive/interventional treatment options are not sufficient in such cases.
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Current research has confirmed certain therapeutic benefits of AC and EA. In musculoskeletal disorders, the success rate of the treatment was nearly 100% for thoracolumbar pain. For this type of disorder, AC, EA, aquapuncture, or laser AC can be used with no significant difference in their therapeutic efficacy. For treating nerve-associated disorders, EA seems to be the best method, and electrical stimulation has been shown to be essential to promote nerve repair, remyelination, and neuronal plasticity. Little modern research on equine arthritis has been conducted, and clinical application of AC and EA to treat equine arthritis is still based on empiric and personal experience. However, results from human research seem promising, and research on their therapeutic effects for treating equine arthritis may be worthwhile. For ophthalmic treatment, local acupoints around the eyes are appropriate for ocular pain and inflammation. Possible therapeutic mechanisms include opioid analgesia and antiinflammation. Using AC and EA for ocular hypertension also is promising. The therapeutic mechanism is thought to be opioid dependent, which requires intact sympathetic innervation. In the field of reproductive disorders, AC and EA therapeutic mechanisms are thought to be governed by the ability of AC and EA to restore hormonal balance of the hypothalamic pituitary gonadal axis and promote uterine tone by the central inhibition of the sympathetic nerve activity. Current available research data were obtained from studies on humans. Interpretation of results should be done with care, because the positive results of treatments on humans may by attributable to the placebo effect. Additional studies in animals may eliminate this positive psychologic effect, and the true effects of AC and EA can be demonstrated. To date, scientific scrutiny of the mechanisms of AC and EA for treating reproductive problems in horses has been limited to studies on mares. AC and EA provide mild to moderate visceral analgesia and are not the treatments of choice when surgical intervention is required. Therefore, all cases of colic presented to veterinarians are likely to be treated first with conventional medicine, and the clinical benefits of AC and EA are rarely investigated in conventional equine practice. However, for chronic gastrointestinal disorders, treatment efficacy of both AC and EA has been demonstrated. Treatment benefit was thought to be attributable party to an activation of the cholinergic antiinflammatory pathway, which leads to a downregulation of inflammatory cytokines such as IL1-β, IL-6, and TNF-α. In respiratory disorders, EA might be beneficial for treating RAO. Results from laboratory animals suggested that the possible treatment mechanisms include antiinflammation, bronchodilation, and increased mucociliary clearance. Anhidrosis is another internal medical problem in which AC and EA can improve clinical signs. This result is important because TCVM seems to be a treatment of choice, and it is second only to the rather undesirable relocation of the affected horses to a temperate zone. Finally, diagnostic and therapeutic values of trigger points have been confirmed, and, for some of them, the increase in sensitivity is positively correlated with a suspected disorder. Even though previous research supports using AC and EA for veterinary medicine, more carefully controlled research in every aspect of equine TCVM is necessary.
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