Purpose To investigate the required sample size for and feasibility of a full-scale randomized controlled trial examining the impact of the "dose" effect of acupuncture in treating sciatica. Patients and methods Fifty-seven patients with sciatica, aged 35-70 years, were recruited and screened. Thirty-one participants were randomly assigned to receive "low-dose" manual acupuncture (MAL) (n= 15) or "high-dose" manual acupuncture (MAH) (n=16). The acupuncture treatment was administered twice weekly for 4 weeks. The primary outcome was the visual analog scale (VAS) score at baseline and after 4 weeks of acupuncture treatment. Secondary outcomes included the Roland Disability Questionnaire for Sciatica (RDQS), the Sciatica Bothersomeness Index (SBI), and the World Health Organization Quality of Life in the Brief Edition (WHOQOL-BREF) scores at baseline and after 4 weeks of acupuncture treatment. Results Thirty patients completed the study. For all patients, acupuncture achieved significant improvement in the VAS (5.48±2.0, p<0.001), RDQS (3.18±2.83, p=0.004), and SBI (2.85±3.23, p=0.008) scores, but not in the WHOQOL-BREF scores. In the between-group analysis, the assessed scales showed no significant differences between the MAL and MAH groups. However, based on the level of chronicity, the MAH group demonstrated greater improvement in the outcomes and a significant benefit in the physical subscale of the WHOQOL-BREF (p<0.05). Conclusion Results of this pilot study indicate that acupuncture is safe and may effectively relieve symptoms and disability in patients with non-acute sciatica. MAL was as effective as MAH in treating sciatica. A subsequent trial with a larger sample size (estimated at n=96) is required to confirm whether patients with a high level of chronicity would benefit from MAH treatment. Trial registration NCT03489681.

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Therapeutic Efficacy and the Impact of the "Dose" Effect of Acupuncture to Treat Sciatica: A Randomized Controlled Pilot Study

This study was to explore the value of data mining model in evaluating the treatment effect of acupuncture on patients with cervical spondylosis (CS) and neck pain. A total of 270 patients with CS and neck pain recruited in the acupuncture clinic of Shanxi Provincial People’s Hospital were selected as the research objects in this study and were divided into an acupuncture needle group (group A), an acupoint latent acupuncture group (group B), and a puncture bloodletting group (group C) randomly, with 90 cases in each group. The Northwick Park Questionnaire (NPQ), McGill Pain Questionnaire (MPQ), and Role-Physical (RP), Physiological Function (PF), General Health (GH), and Body Pain (BP) of all patients were recorded before treatment, at the completion of the fifth acupuncture, at the end of treatment, one-month follow-up, two-month follow-up, and three-month follow-up to analyse the clinical treatment effect. Based on the artificial neural network (ANN) algorithm, a curative effect evaluation method and data mining model was further established to compare the accuracy rate of data processing by different data models, and the data processed by the data mining model were compared with the clinical data to analyse the feasibility of the data mining model. The test results found that the NPQ and MPQ values of patients in group B were significantly lower than those in groups A and C (P < 0.05). At the end of treatment, the PF and BP values of patients in groups B and C were significantly higher than those of group A (P < 0.05). The RP value of patients in group B was significantly higher than that in groups A and C after treatment and during follow-up (P < 0.05). The GH value of patients in group B was significantly higher than that in groups A and C (P < 0.05). The clinical treatment efficiency in group B was significantly higher than that in the other two groups (P < 0.05). Different sample sizes of decision tree (DT-1), clustering algorithm (CA-1), and support vector machines (SVM-1) had no effect on the accuracy rate of efficacy judgement of the model. Moreover, the accuracy rate of DT-2, CA-2, and SVM-2 using the neighbourhood learning algorithm increased as increase of the sample size. The correct rate of treatment efficiency judgement of the SVM model and the data mining model reached the maximum value of 81.48% and 82.64%, respectively. It suggested that the data mining model based on the ANN algorithm could accurately estimate and evaluate the overall efficacy data of patients with CS and neck pain.

Analysis of treatment effect of acupuncture on cervical spondylosis and neck pain with the data mining technology under deep learning

Background. Mongolian medical warm acupuncture has a desirable therapeutic effect on sciatica. Apoptosis of the nucleus pulposus cells is considered to play an important role in sciatica. Evidence has demonstrated that oxidative stress and its induced activation of the signaling pathways play important roles in sciatica. However, further research is expected to reveal whether Mongolian medical warm acupuncture can inhibit the apoptosis of nucleus pulposus cells and oxidative stress. Objective. To study the effect of the p38 MAPK pathway activated by the generated ROS on apoptosis and the expression of the genes related to the balance of the extracellular matrix metabolism during treatment of sciatica with Mongolian medical warm acupuncture. Method. The volume of the active oxygen generated in the nucleus pulposus cells was detected following intervention of Mongolian medical warm acupuncture. The p38 MAPK phosphorylation level was detected with Western blot. The genes are related to the metabolism of the nucleus pulposus extracellular matrix. Result. Mongolian medical warm acupuncture reduced the active oxygen within the nucleus pulposus cells and inhibited the activation of the p38 MAPK pathway (P=0.013). Meanwhile, it upregulated the gene expression of Type II collagen, aggrecan, Sox-9, and tissue matrix metalloproteinase reagent 1 (P-0.015; P=0.025; P=0.031; P=0.045) and downregulated the gene expression of matrix metalloproteinase 3 (P=0.015). Conclusion. Mongolian medical warm acupuncture may inhibit apoptosis of nucleus pulposus cells and activation of the extracellular matrix decomposition metabolism pathway and promote its anabolism. This process may rely on the oxidative stress matrix of the p38 MAPK pathway.

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Research on Roles of Mongolian Medical Warm Acupuncture in Inhibiting p38 MAPK Activation and Apoptosis of Nucleus Pulposus Cells

Effectiveness and safety of warm needle acupuncture for sciatica: A protocol for systematic review and meta-analysis.

Postpartum body pain is women,in the puerperium,having aches,stiffness,and numbness in the limbs or joints.If left untreated may become chronic and difficult to heal,which seriously affects female both physical and psychological health.This article summarizes and analyzes the recent research about the traditional Chinese medicine therapy on postpartum body pain,including pathogenesis differentiation and treatment,chinese pattern medicine therapy,external therapy and combined modality therapy.The curative effect of TCM on postpartum body pain is very outstanding,however,more research is still necessary.

Yang Li

Papers

Preliminary Clinical Evaluation of Acupuncture Therapy in Patients With Postpartum Sciatica