Analysis of acupoint selection and combinations in acupuncture treatment of asthma based on data mining

Objective: Using data mining, the present study aimed to discover the most effective acupoints and combinations in the acupuncture treatment of asthma. Methods: The main acupoints prescribed in these clinical trials was collected and quantified. A network analysis was performed to uncover the interconnections. Additionally, hierarchical clustering analysis and association rule mining were conducted to discover the potential acupoint combinations. Results: Feishu (BL13), Dingchuan (EX-B1), Dazhui (GV14), Shengshu (BL23), Pishu (BL20), and Fengmen (BL12) appeared to be the most frequently used acupoints for asthma. While the Bladder Meridian of Foot Taiyang, the Governor Vessel, and the Conception Vessel, compared to other meridians, were found to be the more commonly selected meridians. In the acupoint interconnection network, Feishu (BL13), Fengmen (BL12), Dingchuan (EX-B1), and Dazhui (GV14) were defined as key node acupoints. Association rule mining analysis demonstrated that the combination of Pishu, Shenshu, Feishu, and Dingchuan, as well as that of Feishu, Dazhui, and Fengmen were potential acupoint combinations that should be selected with priority in asthma treatment. Conclusion: This study provides valuable information regarding the selection of the most effective acupoints and combinations for clinical acupuncture practice and experimental study aimed at the prevention and treatment of asthma.

Morphological Features of the Acupuncture Points of Bladder Meridian in the Giant Anteater (Myrmecophaga tridactyla)

Background: The acupuncture points are considered a point in the skin of sensitivity to stimulation. The acupuncture meridians represent the communication between acupuncture points and internal organs. The giant anteater (Mirmecophaga tridactyla) is routinely attended in veterinary centers, and is pivotal to know its morphology and therapies such as acupuncture that, probably, can be used in medical practice. Thus, the aim of this study was to evaluate the morphological substrate in regions that correspond to the transposition of acupuncture points of the Bladder Meridian using radiography, ultrasonography, electrical impedance and histology in the giant anteater.Material, Methods & Results: Seven giant anteaters (six males and one female) were used. The animals were from the Center of Medicine and Research in Wild Animals (CEMPAS), School of Veterinary Medicine and Animal Science, UNESP, Botucatu, São Paulo. The acupoints of Bladder Meridian evaluated were Bladder 11 (B-11), Bladder 18 (B-18), Bladder 23 (B-23), Bladder 25 (B-25), and Bladder 28 (B-28). The locations of the acupoints were transposed based on the location of these acupuncture points in dogs. Four animals were live and were used for radiographic, ultrasonographic, and electrical impedance analysis. Three animals were died and the fragments of this acupoints were destined to histological routine with hematoxylin and eosin (HE) and Masson’s Trichrome stains. The giant anteaters studied had fifteen thoracic vertebrae, three lumbar vertebrae, and five sacral vertebrae fused in a single bone. The acupuncture points were characterized by presence of abundant connective tissue at the superficial and intermuscular level, muscular fascia, and many neurovascular bundles in the dermal layer. These bundles consisted of nerves, arteries and veins of various calibers. The spaces between the nerves and blood vessels were filled by loose connective tissue containing adipose cells, capillaries, and sweat glands.Discussion: The network of acupuncture points can be seen as a representation of a network formed by interstitial connective tissue. This hypothesis is supported by ultrasound imaging that demonstrated plans for cleavage of connective tissue at acupuncture points in normal humans. It seems that the anatomical relationship of acupoints and meridians with connective tissue planes is relevant to the mechanism of action of acupuncture and suggests an important integrative role for interstitial connective tissue. The presence of connective tissue was observed in the transposition areas studied in the giant anteater using ultrasound. The main histological structures found in the transposition regions of the acupoints in the giant anteater were the nerve and connective tissue, similar to other studies, who claimed that the nerve is the main histological component of an acupoint. Therefore, there are reports suggesting that the network of acupoints and meridians can be seen as a representation of a network formed by interstitial connective tissue and that this relationship is important for the therapeutic mechanism of acupuncture. Based on the results of this study, it is possible to infer that the studied regions present a morphological substrate that is consistent with the characteristics of an acupuncture point. Thus, it is suggested that there are probably acupuncture points in these regions in the giant anteater, which makes possible the use of this alternative medical therapy for the treatment of these animals.

Local mechanisms for acupoint sensitization in gall bladder meridian of foot shaoyang-a gene chip study

Acupuncture manipulations are clinically important to traditional Chinese medicine, yet the biological mechanisms have not been fully understood. This study aimed to investigate continuous stimulation-induced gene expression changes at stimulated and non-stimulated adjacent acupoints in the same meridian. Catgut embedding into acupoint (CEP) was conducted at acupoint Yanglingquan (gall bladder meridian of foot-shaoyang 34, GB34) of Sprague Dawley rats once or continuously for eight weeks, and gene expression changes at GB34 were assessed by gene chip array analysis 72 h after the last CEP treatment. A total of 688 genes exhibited opposite changes in expression between the two treatments, and 1,336 genes were regulated only by the eight-week CEP treatment. Ingenuity Pathway Analysis revealed that among these differentially regulated genes by one-time and eight-week CEP treatment, insulin-like growth factor-1 pathway and integrin-linked kinase pathway, and Wnt/~ catenin signaling pathway match the observed gene changes to predicted up/down regulation patterns. Upstream analysis further predicted six molecules, namely, tumor necrosis factor, interleukin 1~, interleukin la, kallikrein-related peptidase 5, protein kinase Ca, and catenin ~1. On the other hand, continuous eight-week CEP stimulation at acupoint Xuanzhong (GB39) caused similar changes in the expression of 32 genes at acupoints GB34 and Fengshi (GB31) on the same meridian. Taken together, our results provide the first molecular evidence for the local acupoints' mechanisms for acupoint sensitization theory, and implicate the existence of signaling pathways, either direct or indirect, between acupoints within the meridian GB.

Using Traditional Chinese Medicine to Relieve Asthma Symptoms: A Systematic Review and Meta-Analysis

Studies have demonstrated the effect of acupoint-based interventions in relieving the clinical symptoms of asthma. However, the effect of meridian-based interventions in asthma symptom relief is unknown. This systematic review and meta-analysis determined the effect of multiplex meridian interventions in asthma symptom relief. Eight electronic databases were searched for relevant randomized controlled trials (RCTs) that involved patients with asthma, were published before March 2018, used acupoint stimulation interventions targeting acupoints that correspond to meridians, and considered asthma symptom relief as an outcome. In 204 RCTs that were identified and used in a meta-synthesis, meridians were used 521 times, with the bladder meridian being the most frequently used. Furthermore, 23 RCTs were included in the meta-analysis. Egger’s and inconsistency tests revealed no significant differences among the studies ([Formula: see text]). However, the interventions differed significantly in terms of asthma symptom relief effect, as demonstrated by pairwise (odds ratio [Formula: see text], 95% confidence [Formula: see text]–0.37) and network ([Formula: see text], 95% credibility [Formula: see text]–0.41) meta-analyses. Surface under the cumulative ranking (SUCRA) revealed that the bladder–conception vessel–governor vessel–stomach multiplex meridian intervention was more effective than non-meridian interventions in relieving asthma symptoms. Additionally, either bladder–conception vessel–stomach or bladder–conception vessel–governor vessel–kidney multiplex meridians may be selected in interventions. This study suggests that practitioners target multiplex meridians, especially the meridians of the bladder and conception vessel, to effectively relieve asthma symptoms.