Dissertations / Theses on the topic 'Electro-acupuncture'

The severity of postoperative pain is affected by many factors including the patient’s age, sex, personality, knowledge of and confidence in the procedure, attitude of the staff, and the individual's physiological condition. The same procedure can produce different degrees of postoperative pain in different patients. Even though, in most cases, upper abdominal or thoracic surgery causes severe postoperative pain, superficial operations still cause mild postoperative pain. Patients usually feel the most pain in the first few hours after surgery. Postoperative pain can result in irritability, insomnia, increased heart rate, hypertension, excessive perspiration, overactive metabolism, tachycardia, diaphoresis, mydriasis, pallor and increased myocardial oxygen consumption. In patients with coronary artery disease, postoperative pain can result in myocardial ischemia and possible infarction that in turn may delay postoperative recovery. Intravenous patient-controlled analgesia (PCA) is an accepted method to relieve postoperative pain. Opioids are often used as an analgesic for severe pain management. Possible adverse effects are respiratory depression, constipation, vomiting, gastroparesis, and central nervous system depression including somnolence and consciousness disturbance. Opioid-related side effects often occur post-operatively, and are related to the total dosage of opioid medication. Non-pharmaceutical products can be an alternative in the treatment of post-operative pain and produce less adverse effects. Acupuncture’s ability to control pain has been documented for thousands of years and has become well-accepted in modern Western medicine. Electro-stimulation has a postoperative pain relieving effect when applied as either electro-acupuncture (EA), transcutaneous nerve stimulation (TENS) or Silver Spike Point (SSP) therapy. SSP as needle-free EA and has been shown to have a similar analgesic effect to standard EA, where electrical stimulation is applied to needles that have been inserted into acupuncture points, and a superior effect than TENS. The acupuncture analgesic mechanism remains unclear in spite of successful clinical applications and recognition by WHO. This study investigated SSP needle-free EA's role in managing of postoperative pain and in reducing the adverse side effects of opioids. Acupuncture has generated much interest in western countries like Australia, and is considered a rather safe clinical treatment method for a wide range of disorders. However, in clinical applications, there are some contraindications and complications with using needles. SSP needle-free EA offers many benefits over standard acupuncture treatment such as: reduced hazardous waste, no skin penetration and therefore a reduced risk of infection. SSP EA provides a range of stimulation types that are particularly suitable for sensitive patients including young children and the elderly. A particular advantage of SSP EA is that it can be safely used on acupuncture points all over the body, whereas incorrect acupuncture needling over major organs and the spinal cord can cause serious problems. In this study, we examined the effects of Silver Spike Point (SSP) therapy, also known as needle-free electro-acupuncture (EA), at the classical bilateral acupuncture point Zusanli (ST36) on postoperative pain and opioid-related side effects following hysterectomy. Based on a double blind, sham and different intervention controlled clinical experimental design, four groups of randomised patients were enrolled into the study as subjects. Group 1 was assigned as the control group; Subjects in group 2 were applied SSP electrode at a sham acupuncture point; Group 3 received SSP stimulation at 100 Hz and Group 4 received SSP stimulation by a mixture of at 3 Hz, 10 Hz, and 20 Hz on Zusanli (ST36). It was planned that each group was to consist of 25 women who had undergone hysterectomy. The research evaluated the analgesic effect of SSP needle-free EA for post-operative pain relief of women who had been given a hysterectomy, and comparing the difference between high frequency and low frequency stimulation. The hypothesis was that the groups that received the double treatment of SSP needle-free EA (both pre- and post-surgery) at acupuncture point Zusanli (ST36) would demonstrate increased analgesic relief over a longer period of time, i.e. longer duration before requiring the first PCA dose, fewer PCA doses required, and fewer opioid related side effects compared to the sham and control groups. In addition, the group that received the low frequency treatment would achieve better analgesic relief compared to the high frequency treatment, the sham, and the control groups. The Results were analyzed using a One-way analysis of variance (ANOVA) for Visual Analogue Scale (VAS) of Patient Controlled Analgesia (PCA) doses delivered, and PCA doses demanded by the patients. This method is for testing the differences between means of independent samples. In this case, using SPSS and Student-Newman-Keuls (SNK) and Tukey post-hoc analysis performed a One-way ANOVA. F-tests were also carried out to determine significance between means of the variables, time of first ambulation, bowel movement, total PCA demand and total PCA doses. Statistical significance is based on P value with P < 0.05; clinical beneficial is based on P < 0.10. The results indicated that the means and standard deviations of the four groups were within a close range. Forty-seven women who had hysterectomies met the criteria. The women were randomly allocated to four different groups. Except for those in the control group, treatment was given by an acupuncturist preoperatively and consisted of a course of either sham, low or high frequency stimulation. All groups were assessed during the postoperative period for 24 hours. The Visual Analogue Scale (VAS) was used to determine the amount of perceived pain felt by each subject. It was a 0-10 scale with 0 being no pain and 10 being most severe pain. The data was collected over a 24-hour period commencing post operatively. The significant differences between the groups at each specific time interval were examined. Results showed a clearly decreasing trend in the amount of pain felt over the 24-hour period for all the four groups with respect to the PCA and time. Significant differences or clinical benefits were found between the means at two hours post-operatively with F(3,42) = 2.66 at p<0.10; three hours post-operatively, F(3,42) = 3.68; p<0.05, four hours post-operatively, F(3,42) = 4.33, p<0.05; eight hours post-op, F(3,42) = 3.33, p<0.05; sixteen hours post-op, F(3,42) = 4.25, p<0.05; and twenty-four hours, F(3,42) = 4.67, p<0.01. Further post-hoc analysis showed that at one hour post-operatively, groups one and four were different to each other at the p<0.10 level. At three hours, group 1 (M=6.05) was significantly higher, at the p<0.05 level, than group 4 (M=3.00). This difference was also found at four hours, group 1 (M=5.65) and group four (M=2.71); eight hours, group 1 (M=4.808) and group four (M=2.57); sixteen hours, group 1 (M=4.46) and group 4 (M=2.0); and twenty - four hours, group1 (M= 3.50) and group 4 (M=1.21). Both post-hoc comparison tests indicate that group 4 was significantly different from groups 1, 2, and 3 at twenty-four hours. Differences between the means (M) over the four time intervals for Patient Controlled Analgesia (PCA) doses requirement were also examined. Significant differences were found with F(3,43) = 3.69 at p<0.05, in the Post Operative Room (POR) between the groups. Post-hoc analysis confirmed that group 4 (M=2.30) was significantly lower than groups 2 (M=5.17), and 3 (M=4.58). Post-hoc comparison tests indicate that mean PCA doses in the POR, for group 4 was significantly different from group 2 and 3. Mean PCA doses between groups 1 and 4 have no differences. Differences between the groups between one and eight hours post-operatively were also found with F(3,43)=2.33 at p<0.10. However, post-hoc analysis did not confirm this finding between any of the four groups. To compare the mean amount of Patient Controlled Analgesia (PCA) demands of the four groups over the 24 hours post-operative, a one-way ANOVA with S.N.K and Tukey-HSD post-hoc tests were applied. The results showed that the four groups had a similar trend within 24 hours postoperatively. However, significant differences were found between the means at the Post Operating room with F(3,43) = 4.80 at p<0.01, and 1 to 8 hours postoperative with F(3,43) = 3.49 at p<0.05. Post-hoc analysis confirmed the significant difference between the means at 1 to 8 hours postoperative as group 2 (M=55.75) was significantly higher than group 4 (M=22.30). Post-hoc analysis also confirmed that group 2 (M=30.83) was significantly higher than group 3 (M=13.00) and group 4 (M=5.90) at the POR. No other significance was found between means. The results of PCA doses demanded by subjects indicated that there was no significant difference between the total PCA doses given for the four groups over twenty-four hour period post-operatively. However, a one way ANOVA was applied to compare the groups for total PCA doses demanded and significant differences were found between the groups with F(3,42) = 3.59 at p<0.05. Post-hoc analysis confirmed the difference between groups 1 (M=84.54) and 4 (M=41.60). Moreover, differences were found between the four groups for the amount of analgesia delivered in mg, F(3,43)=2.45, p<0.10. Post-hoc analysis confirmed this finding between group one (M=38.63) and four (M=29.29). The thesis concludes with a discussion of methodological issues related to conducting randomized, placebo-controlled trials of electro-acupuncture and goals for future research in this area of pain management. Treatment outcome of SSP needless electro-acupuncture showed an improvement of the time of first bowel movement and ambulation, opioid related side effects, total amount of PCA demand, and total amount of PCA doses. The clinical significance of this particular study is of great interest, especially for those patients who wish for a non-pharmacological analgesia without side effects. Although further study is needed to ultimately determine whether SSP needle-free electro-acupuncture (EA) has a place in postoperative pain treatment, this study has suggested that SSP needle-free EA does have a place as an adjunct to standard medical care for post-operative surgical pain. Arguably this ‘needle free approach’ has benefits for patients who have difficulties with traditional acupuncture needling and at the same time are interested in a non-pharmacological approach to treating pain.

Objectives: Electro-acupuncture (EA) has been demonstrated to be effective in reducing post-operative acute consumption of opioid-like medications (OLM) by previous studies. This effect has not been examined in patients with chronic pain. In this thesis, a randomised, double-blind, sham acupuncture-controlled study was reported. The trial aimed to evaluate the effect of EA in reducing OLM consumption in patients with chronic non-malignant pain. Methods: Thirty-five patients were recruited from a multidisciplinary pain management clinic in Melbourne. After a two-week baseline assessment, participants were randomly assigned to one of the two groups by a computer generated randomisation sequence: real EA (REA, n = 17) or sham EA (SEA, n = 18). The REA group received 2/100 Hz EA stimulation on two pairs of acupoints (Zusanli ST36 and Fenglong ST40 on one leg and Hegu LI4 and Quchi LI11 on one arm) and manual acupuncture on an additional five chosen acupoints for 30 minutes. The SEA group received superficial needling on non-acupoints without Deqi sensation or electrical stimulation. Both groups received treatment twice a week for six weeks. Participants were followed up for 12 weeks at intervals of four weeks. During the trial, participants were given clear instructions on how to reduce their OLM usage. A researcher telephoned the participants three times during the trial to encourage them to reduce OLM intake. The assessor, researcher and participants were blinded to treatment allocation. Outcome measures: The primary outcome measures included OLM consumption, related side effects, dosage of non-opioid analgesics and the intensity and unpleasantness of pain. These measures were recorded daily for two weeks before the intervention, six weeks during the treatment period and three times during the follow up period. Secondary outcome measures were depression and quality of life as assessed by the Beck Depression Inventory-II (BDI-II) and the Medical Outcome Study 36-Item Short Form (SF-36), respectively. Data were analysed with independent t-tests or analysis of variance (ANOVA) where appropriate and per protocol analysis was employed. Results: Nine participants withdrew from the study. At baseline, the two groups were comparable on all demographic characteristics and major outcome variables except for the average intensity of pain. During the treatment period, the reduction of OLM consumption was more rapid in the REA group (64%) than in the SEA (46%) (ANOVA, p less than 0.05). The effect was maintained for four weeks in the REA group. There were no differences in the improvement of all other measures between the two groups. The incidence of EA-related adverse events (AEs) per treatment was 21% and 10% in the REA and SEA groups, respectively. All AEs were minor. Over 90% of the participants were satisfied with the treatments given and would recommend EA to others. The blinding was successful. Conclusions: EA could be an effective and safe treatment for reducing OLM consumption for patients with chronic pain, and may be used as an adjunct therapy in chronic pain management. Further studies with larger sample sizes are warranted.

Stroke is a serious cerebral vascular event and a leading cause of death and disability worldwide, and ischemic stroke is the most common type. Evidence from animal research in acute cerebral ischemia shows that a combination of neuroprotectants might be more efficacious than the single agent given individually. Both melatonin and electro-acupuncture (EA) have been suggested to be effective treatments against cerebral ischemia. However, it is unknown whether a combination of these two therapies could be beneficial against focal cerebral ischemia. In the first study, the effect of post-treatment with a combination of melatonin and EA on regional cerebral blood flow (rCBF), neurological deficit score and infarct volume was investigated in both permanent and transient middle cerebral artery occlusion (MCAO) models in rats. When compared with the single treatment of melatonin or EA, the combination therapy resulted in a significant improvement of neurological function and a dramatic reduction of infarct volume at 72 hr after transient MCAO. A significant upregulatory effect on rCBF has been exerted by the combined treatment. The effect of a combination of melatonin and EA on inflammatory reaction was investigated in the second study. Post-treatment of the combination therapy effectively inhibited neutrophil infiltration as well as the expression of some pro-inflammatory mediators, and increased the anti-inflammatory protein expression at 72 hr after transient MCAO. This beneficial effect may be due to the respective anti-inflammatory effects of melatonin and EA. In the third study, the effect of a combination of melatonin and EA on apoptosis was examined. When compared with the EA treatment alone, post-treatment of the combination therapy exerted a greater inhibitory effect on tissue apoptosis and expression of the pro-apoptotic proteins as well as an upregulatory effect on the anti-apoptotic protein expression. In the fourth study, the effect of continuous post-treatment of a combination of melatonin and EA on transient MCAO was investigated. The combination treatment significantly improved neurological function and decreased infarct volume at 7 days after transient MCAO. Cell proliferation and expression of the neurotrophic factor were increased by the combined treatment. The effect of pretreatment with a combination of melatonin and EA was examined in the fifth study. Neurological function was improved and infarct volume was reduced by the combination pretreatment at 24 hr after transient MCAO. The inflammatory and apoptotic reaction were inhibited by the combined pretreatment through the modulatory effect of the related proteins. In summary, our results show that, when compared with the single treatment of either melatonin or EA, post-treatment with a combination of melatonin and EA induced a complementary neuroprotective effect on improvement of neurological function and a dramatic reduction of infarct volume after transient MCAO. The complementary protection may be partially mediated via anti-inflammation and anti-apoptosis after transient cerebral ischemia. Pretreatment with a combination of melatonin and EA may be more effective in preventing ischemic brain injury after transient focal cerebral ischemia.
published_or_final_version
Medicine
Doctoral
Doctor of Philosophy

Chronic pelvic pain (CPP) is defined as constant or intermittent lower, cyclical or non-cyclical abdominal pain of at least six months’ duration. In the United Kingdom, over 1 million women suffer from CPP, with an estimated annual healthcare cost above £150 million. The aetiology of CPP is unknown in up to 50% of women, and in the remainder, the symptoms of CPP is associated with endometriosis, pelvic adhesions, irritable bowel syndrome or painful bladder syndrome. CPP is often accompanied by painful periods, pain during sexual intercourse and defaecation. Fatigue, sleep disturbances and depression are also common among this group of women. CPP asserts a heavy emotional, social and economic burden. Standard treatments such as hormonal and analgesic regimens are often associated with unacceptable side effects, even if helpful for the pain, underlining an urgent need for a satisfactory treatment. The meridian balanced method (BM) electro-acupuncture (EA) treatment (acupuncture needling + traditional Chinese medicine health consultation [TCM HC]) may be effective in managing CPP symptoms. Thus, I have completed a pilot study comprising of a three-armed randomised controlled trial (RCT), using a mixed methods research (MMR) approach, to assess the feasibility of a future large-scale RCT to determine the effectiveness of the meridian BMEA treatment on CPP in women. My hypothesis is that it is feasible to conduct such a large-scale RCT for CPP in women. The primary objectives were to determine recruitment and retention rates. The secondary objectives were to evaluate the, acceptability of the methods of recruitment, randomisation, interventions and assessment tools and any signals of effectiveness of the interventions. Thirty (30) women with CPP were randomised into three groups: BMEA treatment, TCM HC, or National Health Service standard care (NHS SC) group. The effects of my interventions were assessed by validated pain, physical and emotional functioning questionnaires, completed at weeks 0, 4, 8 and 12 of the study. Semi-structured telephone interviews and focus group discussions to explore participants’ experience of the study were conducted. Of the 59 women who were referred to the study, 30 women (51%) were randomised. There was a statistically significant difference in retention rates between the three groups. The retention rates were 80% (95% CI 74-96), in the BMEA treatment group, 53 % (95% CI 36- 70) in the TCM HC group and 87% (95% CI 63-90) in the NHS SC group. (Chi-square test, p=0.08) The attendance rates of the BMEA treatment group were 90% compared to 56% in the TCM HC group. There was a statistically significant difference (Mann-Whitney test, p=0.023) in attendance between the two intervention groups. Telephone interviews regarding the acceptability of the methods of recruitment, randomisation, assessment tools and interventions were positive. No adverse effects that were directly related to BMEA treatments were reported or observed. A higher proportion of the BMEA treatment group achieved clinical significance in the VAS-pain, BPI-pain severity, interference, and sleep scores, when compared to the other two groups. Due to small sample sizes, there was insufficient power to show statistically significant difference. (Fishers Exact Test, p=1.0) Analyses of the questionnaire data per group showed statistically significant differences in the following: the BMEA treatment group experienced less in pain at weeks 4 (p=0.01) and 8 (p=0.005); less helplessness (p=0.03) and their anxiety and depression scores declined at week 4 (p=0.04). The NHS SC group also reported less pain at week 4 (p=0.04). However, this group scored higher in anxiety and depression at weeks 8 and 12 (p=0.04). No statistically significant differences were achieved between the three groups at baseline, weeks 4, 8 and 12 in all scores. The therapeutic benefits gained by the TCM HC group were less compared to those of the BMEA treatment group, but better when compared to the NHS SC group. The BMEA treatment and TCM HC groups showed lower scores in anxiety and depression while the NHS SC group showed higher scores in anxiety and depression. The NHS SC group also tended to ruminate and magnify their problems as well as feeling more helpless than the other two groups. The three key themes that emerged from thematic analysis of focus group discussions were the “whole person effects” where participants reported an improvement in pain, sleep and a general sense of wellbeing in the two intervention groups; the “experience of standard care” and “impact of living with CPP”. In conclusion, the results of my pilot study are supportive of the feasibility of a future large-scale study. There were signals of effectiveness of interventions but the sample size was too small to make a definitive conclusion.

碩士
義守大學
電子工程學系
90
Acupuncture has played an important role in pain research. Besides traditional acupuncture and related stimulation, including the filiform needle, intradermal needle, “seven-star” needle, moxa and cups, different forms of acupuncture stimulation have also become popular in recent years. Recently ultrasound and laser, is the newest therapeutic way in the field of acupuncture. Ledergerber found the most gratifying results with TENS (Transcutaneous Electrical Nerve Stimulation) in elderly patients with osteoarthritis. There was not only pain relief, but also decreased joint swelling. Needles tend to have an overall balancing action that can be controlled through manipulation techniques. E.A. stimulates and moves the Ch’i (or Qi), and laser energizes Ch’i and Yang. As in electro acupuncture, diode laser can control the pain relief through endorphin or serotonin release by changing the frequency of pulsation. A specialized laser that has been used effectively for acupuncture is the Neodymium laser for arthritis and operated at infrared (1064nm) wavelength. Acute inflammation was produced by the injection of carrageenan into the principal limb-joint of the rabbit. Immediately after injection, 「Housanli(S36)」 and 「Yangfu(G38)」 were treated with acupuncture, Electro-Acupuncture, Laser stimulation and the Diclofenac. The purpose of the present study was to compare therapeutic effects of the above methods on acute arthritis.

碩士
中國醫藥學院
中國醫學研究所
91
Gait Analysis in Knee Osteoarthritis Patients After Electro-Acupuncture Treatment Po-Hsin Lin Institute of Chinese Medical Sciences, China Medical College, Taiwan, ROC ABSTRACT Osteoarthritis (OA), a common type of arthritis, is mostly seen at the knee joint. Pain caused by OA is a major factor that affects patients’ quality of life and hence convinces patients to seek medical assistance. Clinically, pain relief is the first step in the treatment of OA. OA also has huge impact on patients’ financial and psychological situation. Therefore, accurate diagnosis and effective treatments at early stage can save a lot of unnecessary suffering to patients and resources later used on treatments. The currently prevailing medicine treatments for OA are painkiller and antibiotic prescriptions, including non-steroid anti inflammation drugs（NSAIDs）and new generation cyclooxygenase-2（COX-2）inhibitors. Yet, both prescriptions have inevitable side effects. In addition, these prescriptions do not stop the progression of the disease or help increase or restore the capability and mobility of limbs. Knee joint replacements are thus necessary for advanced OA. In past thirty years, many researches have proved that electro-acupuncture treatments are effective in general pain relief, anesthesia, and treatment of functional disorders. It has also been shown very effective in the treatment of OA with almost no side effects. Gait analysis has been widely used in human ambulation research, contributing to the diagnosis of neuromusculoskeletal pathology and the evaluation of subsequent treatment. Among the measurement equipment in gait analysis, force plates were used to measure the Ground Reaction Forces (GRF) of patients with knee OA during movements before and after treatment, giving quantitative data on the efficacy of the treatment. Sixty-three OA patients were selected as subjects from Department of Acupuncture, Taipei Traditional Chinese Medicine Hospital. The subjects were randomized into electro-acupuncture group（n=37）and sham electro-acupuncture group（n=26）. X-ray was taken for each subject and used to categorize them into 4 K/L grades. A force plate was used to measure changes in the GRF during level walking before and after treatments. The visual analogue scale（VAS）and Pain Index of the Knee（PIK）scores were also used to measure the levels of improvement on pain and movements. Typical curve patterns of the vertical component of the GRF for patients with same K/L grade were first established for all grades. The results showed that the worse the joint as indicated by the K/L grading, the more abnormal the curve pattern. These unique pathological curve patterns can serve as good clinical reference. The abnormal curve patterns of about thirty percent of the subjects became normal after treatment in the electro-acupuncture group. The statistical analysis also showed that the center of the foot pressure (COP) moved more rapidly after the electro-acupuncture treatment. The lower limbs were also more capable of body weight bearing, the stance phase time lasted longer, more body weight sustained, more energy generated, and the capability of joint and muscles to manage sudden changes of forces increases in electro-acupuncture group after treatment. The results of sham electro-acupuncture group did not show any statistically significant difference between before and after treatment. The parameters did not show any regular pattern either. The VAS assessment showed that electro-acupuncture was indeed effective in pain relief. Nevertheless, the psychological influences on patients should be considered when using VAS assessment. PIK measurement results showed that electro-acupuncture was effective in pain relief and the method was more sensitive in less severe joints. In conclusion, the electro-acupuncture has been shown to be capable of easing the pain and stiffness symptoms of the OA patients, improving their gait performance. For patients with more severe symptoms and degeneration, electro-acupuncture seems to be a good choice, but prolonged treatments may be necessary to achieve good outcome. Key words：osteoarthritis (OA), acupuncture, electro-acupuncture, gait analysis, ground reaction force (GRF), knee joint

碩士
中國醫藥學院
中西醫結合研究所
91
Abstract : BACKGROUND : Electrical stimulation of meridian points in the rat inhibits the nociceptive tail withdrawal reflex. It’s pain mechanisms are well documented, but the changes of extracellular glucose and lactate metabolites at cellular level are still unclear. The aim of the study was to evaluate these changes using a rat model in combination with the microdialysis technique for the analysis of extracellular neurochemicals. METHODS: Electrical stimulation was applied in anaesthetized intact rats (n =7) with 2 ms square pulses, 2Hz at the Zusanli points. A second electrical stimulation (2-Hz pulses) was delivered in 2 of them in the same spot. A second electrical stimulation of a different pulse (100-Hz pulses) was delivered. in another 1 in the same spot. A second electrical stimulation of 2-Hz pulses was delivered in another 3 rats in non-acpoints to compare the difference due to the different locations of stimulation. The stimulation lasted for 30 min each time it was delivered. A 90-min recovery period was allowed between the first electrical stimulation and the later treatment to avoid interruption. An automated micro-blood sample collector was used for examining the glucose, pyruvate and lactate value. CONCLUSIONS: electro-acupunctural signal has an influence on the biologic process of energy metabolism by mediating dynamic extracellular neuro-chemical changes. EA on limb acupoints of lower limbs could induce obvious decrease in glucose, increases in lactate metabolites and decrease in lactate/glucose ratio. Moreover, the high lactate/glucose ratio suggests that the cell have an increased anaerobic glucose metabolism.

碩士
國立東華大學
諮商與臨床心理學系
102
Chinese acupuncture has been used to treat a wide range of disease for approximately 3000 years. A clinical study has shown that the acupuncture therapy could elevate the therapeutic effect for the patient with ADHD (Attention Deficit Hyperactivity Disease) (Li, Yu, & Lin, 2010). A study employed the visual attention task showed that electro-acupuncture stimulation resulted in significantly better sustained attention performance (Chen, Thompson, Kropotov, & Gruzelier, 2011). Although these works revealed that the acupuncture can influence the attention, but how it works is still unknown. Posner and Petersen (1990) proposed three attentional networks, alerting, orienting, and executive control, as the underlying mechanisms of visual attention. The Attention Network Test (ANT), propose by Fan, McCandliss, Sommer, Raz, & Posner (2002) became an important paradigm to investigate the attention till now. The aim of the present study is to evaluate the impact of electro-acustimulation and acupuncture on the efficiency of three attention networks. In the experiment 1, 60 participants, age between 20 to 35 years old, divided into two groups, electro-acustimulation (EA) group and sham-electro-acustimulation (SEA) group. In the experiment 2, 75 participants, age between 60 to 80 years old, divided into three groups, acupuncture (A) group, EA group and SEA group. The results of experiment 1 revealed the EA can facilitate the alerting effect but reduced the orienting effect simultaneously during and after the acupoint stimulation, while the SEA can only facilitate the alerting effect during the acupoint stimulation and disappeared immediately after the stimulation. The results of experiment 2 revealed the EA can facilitate the alerting effect of elderly after the acupoint stimulation, while the A and SEA had no effect on the attention network of the elderly.

博士
中國醫藥大學
中醫學系博士班
106
Epileptic seizure can induce inflammation in brain, and this inflammation can enhance neuronal excitation, thus, anti-inflammation became as a ploy for antiepileptic treatment. Three yang meridians of hand and foot connect with ear, and the 7th, 9th and 10th cranial nerve that have parasympathetic components also distribute to ear. Therefore, the purpose of the present study was to investigate: 1) the effect of long-term electric stimulation at ear and electroacupuncture (EA) at Zusanli-Shangjuxu (ST36-ST37) on inflammation; 2) the role of toll-like receptor 4 (TLR4) and nuclear factor-κB (NF-κB) signal pathway in 2 Hz and 15 Hz electric stimulation (ES) at ear. The present study established a kainic acid (KA)-induced epileptic seizure model, ES at ear and EA at ST36-ST37 for 6 weeks, and 2 Hz and 15 Hz ES at ear for 3 weeks. The results indicated: 1) 2 Hz ES at ear and EA at ST36-ST37 for 6 weeks can reduce COX-2 levels of hippocampal CA1, and also can reduce astrocyte and S100-B immunoreactivity cells; 2) 2 Hz and 15 Hz ES at ear for 3 weeks can reduce TLR4, pCaMKIIa??, pERK, pp38 and pJNK, and pNK-kB expression of frontal cortex, hippocampus and cerebral cortex. Based on the mentioned-above results, long-term ES at ear or long-term EA at ST36-ST37 can reduce inflammatory reaction induced by KA-induced epileptic seizures. In addition, the results also indicted 2 Hz or 15 Hz at ear for 3 weeks can reduce inflammation in brain. Thus, suggesting different frequencies or long-term ES at ear or EA at ST-36-ST36 were benefit for epilepsy treatment.

碩士
元智大學
電機工程學系
99
Microcirculation is the most basic and important part of the human body. Acupoints and vessels are the key points for analyzing the characteristics of blood flow. There exists a close relation between health and microcirculation so that improving blood supply has significant meaning on treating early time disease. This research wishes to improve the function of microcirculation by electro-acupuncture, applying resonance theorem and noninvasive instruments to analyze mean blood flux and blood flow wave base on times of heart rate. In this experiment, we stimulate on volunteers'' left Hegu and Quchi by different frequencies: (a) one time of heart rate (b) one point five times of heart rate, and observe the effect after the stimulation. From the result, electro-acupuncture stimulation can both improve the effect and may increase the efficiency of heart working. But we notice that the variability on microcirculation are difference, increase on (a) and decrease on (b). This is possibly that (a) is more close volunteers'' heart rate, heart can use the stimulation easily and deliver this effect to other local sites. While (b) doesn''t, and make heart rate variability increased. Chinese medicine thinks LFS (low frequency stimulation) is supply, though (a) and (b) are both LFS, but the effect are not same. For stimulations to improve microcirculation, like electro-acupuncture, we can use this characteristic, times of heart rate to increase or decrease local blood supply. For clinical treatment and research, we can base on this characteristic to offer a study model for objective estimate the curative effect and investigate physiologic mechanism.

碩士
中國醫藥大學
中國醫學研究所
93
Motion Analysis in Lumbar Myofascial Pain Before and After Electro-Acupuncture Treatment Jia-Hong Li Major professor: Jaung-Geng Lin Institute of Chinese Medical Science, China Medical University, Taiwan, ROC ABSTRACT Chronic low back pain (LBP) is one of the most common medical and social problems in Taiwan. About 60%-90% of the adult population is at risk of developing low back pain at some point in their lives. Therefore, how to cure of the syndrome would be the most important for doctors and patients. The prevalence of myofascial pain ranges from around 85% in patients with chronic low back pain (LBP). Myofascial pain syndrome (MPS) is defined as pain referred from active myofascial trigger points with an associated dysfunction. MPS has huge impact on patients’ financial and psychological situation. Therefore, effective treatments at early stage can save a lot of unnecessary suffering to patients and resources later used on treatments. The current pharmacologic analgesic therapies may be effective for patients with LBP. However, they are unsatisfactory for many patients. The use of pharmacologic therapy can interfere in physical activity and produce inevitable side effects. These concerns have increased interest in nonpharmacologic therapies for LBP, such as electro-acupuncture. Recently, an analgesic effect of acupuncture to alleviate pain is paid much attention by international research workers. Electro-acupuncture is traditional acupuncture needle connected with electrical stimulation. In past thirty years, many researches have proved that electro-acupuncture treatments are effective in pain relief and anesthesia. 3D motion analysis utilized planar trajectories of passive retroreflective markers attached to the skin, which were measured by infrared sterophotogrammetry. The motion analysis system also used the force plates to sense reacting force of the ground and used the novel approach guided by the mathematical model to propose deriving human biomechanical patterns of movements. In clinical application, it can be a useful tool for analysis of functional or therapeutic activities. Besides this, numerous therapies have been compared the relative efficacy of myofascial therapy for LBP by subjective tools, such as VAS et al. But only a few studies have compared the relative efficacy of electro-acupuncture treatment by objective tools. At this writing, a randomized clinical trial has been conducted to evaluate the effectiveness of electro-acupuncture treatment for myofascial pain, which has been discussed about contraction-ischemia vicious cycle promoted by Travell and Simons for more than four decades. Twenty patients diagnosed chronic LBP by certificated doctors, were enrolled in the trial after satisfying the certain criteria. These subjects were randomized into electro-acupuncture (n=11; needling specific acupuncture points BL23, BL25 and BL40; with electrical stimulation 100 Hz) and sham electro-acupuncture group (n=10; needling in the same region without ‘De-Xi’; needle was connected to electro-acupuncture machine without electricity). They were all assessed with visual analogue scale (VAS) and VICON 512 system, during the motion of lumbar flexion-extension, side flexion (L and R), rotation (L and R), sit-to-stand and gait for range of motion and other parameters. The results of study showed that electro-acupuncture treatment improved the velocity and range of motion of lumbar flexion-extension, lateral bending to the left and right and rotation to the left and right remarkably. Besides this, the moment of force of anterior flexion increased, the time of sit-to-stand decreased. The above results of electro-acupuncture group showed statistically significant difference between before and after treatment, but not the results of sham electro-acupuncture group. The VAS assessment also showed that electro-acupuncture was indeed effective in pain relief but not sham electro-acupuncture. Nevertheless, the psychological influences on patients should be considered when using VAS assessment. The author has focused on the efficacy of electro-acupuncture treatment as compared with a sham. In conclusion, the electro-acupuncture has shown to be capable of easing the pain, reducing motion limitation and improving coordinate performance of the chronic LBP patients. The study showed that Electro-acupuncture can contribute to treatment of chronic LBP and prolonged following-up may be necessary for further study. Key words : chronic low back pain, myofascial pain syndrome, electro-acupuncture, motion analysis

碩士
中國醫藥大學
針灸研究所碩士班
99
Neuropathic pain is a chronic pain with high prevalence and few effective therapies. Although acupuncture stimulation can induce endorphin release and has been widely applied for pain control, there is still little known about the effect of acupuncture on neuropathic pain. Electro-acupuncture (EA) can produce greater effect than manual acupuncture has been known. Therefore, the purpose of the present study was to investigate effect and mechanisms of EA on neuropathic pain. We used a 4-0 chromic gut with 4 loose ligatures around the right sciatic nerve proximal to trifurcation in Sprague-Dawley (SD) to establish a neuropathic pain animal model. A total of 24 rats were study, they were divided into 4 groups of 6 rats as follow: 1) Normal Group (NG), without any ligation and EA; 2) sham EA group (SG), sham EA applied to right BL40 and BL57 acupoints; 3) Ipsilateral EA Group (IEAG), 2 Hz EA applied to right BL40 and BL57 acupoints; 4) Contralateral EA group (CEAG), 2Hz EA applied to left BL40 and BL57 acupoins. The behavior was observed, the counts of lifting right hind limb was counted, and radiant heat test was performed daily from first day to 15th days after operation. The level of transient receptor potential vanilloid type 1 (TRPV1) in Par1 area also was measured by western blotting. The results indicated that the counts of lifting hind limb was greater in the SG than in the NG , and the difference score of radiant heat test was smaller in the SG than NG. IEA and CEA treatment can reverse these decreases of the difference score, and reduce the counts of lifting hind limb. Therefore, the level of TRPV1 in Par1 area has no significant difference between them. EA applied to right or left BL40 and BL57 acupoints could reverse the decrease of the difference score, and reduce the counts of lifting hind limb in rats with CCI. However, TRPV1 of Par1 area may not be related to this effect. EA could relief the neuropathic pain in rats induced by chromic gut, suggesting that EA could potentially have similar effect on neuropathic pain relief on human. As regard to the relationship between EA-treating neuropathic pain and TRPV1 needs further study.

碩士
雲林科技大學
光學電子工程研究所
99
This research applied electro-acupuncture stimulation to constipated subjects expecting to improve constipation by enhancing bowel movement,increasing stool frequency, reducing the times of enemata, and lowering the doses of laxatives, as well as to decrease the side effects of drugs and cut down medical expenditure. The research divided 30 qualified subjects,including 35 females with the age of 40±12, into electro-acupuncture group and Sham-acupuncture group by randomized single-blind method. Both groups received 8-week treatment, once every week. In the process of treatment,multi-functional physiological signal acquisition device was utilized to receive the electrocardiograms of the subjects in the first, the fourth and the eighth weeks for analysis. The findings showed that sympathetic nerve system of electro-acupuncture group appeared inactive after 8-week reatment, and their parasympathetic nerve systems turned more active than that of Sham-acupuncture group in the eighth week.

碩士
中國醫藥大學
針灸研究所碩士班
102
Our previous studies had known that both 2 Hz and 15 Hz electro-acupuncture (EA) applied to both Zusanli (ST36) and Shangjuxu (ST37) may increase cerebral blood flow, and EA applied to Baihui (GV20) may reduce neurological deficit and reduce the decrease of long-term potentiation of hippocampus in rats with transient middle cerebral occlusion. Because the development scientific technology, the stem cell like cells have been found in adult brain, and suggests neuronal cells of brain tissue may regenerate in adult. Therefore, the purpose of the present study was to investigate the role in EA treating ischemia-reperfusion injured cerebral infarction. We occluded the cerebral blood flow of right middle cerebral artery for 15 min in Sprgue-Dawley (SD) rats, then reperfusion to establish an ischemia-reperfusion injured cerebral infarction animal model. The neurological deficit score and Rota rod test were assessed at 24 hr after reperfusion, thereafter, 2 Hz and 15 Hz EA were applied to both Zusanli (cathode) and Shangjuxu (anion) points for 15 min at first, 3rd, 5th and 7th day after operation, respectively. The rats were sacrificed at 8th day after operation, and the rat brain was removed for immunohistochemistry stain with nestin. The results showed that both 2 Hz and 15 Hz EA can reduce the neurological deficit score and Rota rod test, but the ischemic area were different from groups by different frequency of EA stimulation. 2Hz EA can reduce cerebral infarction size, whereas 15Hz EA cannot produce similar effect. Both 2 Hz and 15 Hz EA groups were greater effect in reducing nestin stain positive cells than these in control and sham EA groups, suggesting that both 2 Hz and 15 Hz have neuroprotection, but mechanisms need further study.

碩士
中國醫藥大學
中西醫結合研究所碩士班
95
In order to investigate the analgesic effect of 2 Hz electroacupuncture (EA) for postoperative pain after total knee arthroplasty. We selected 34 patients , who have degenerative knee joint arthritis and need treatment with total knee arthroplasty, they were divided into three groups as follows: control group (CP), patient-controlled analgesia only; EA in acupoint group (EAAG), 2 Hz EA applied to Zusanli (St 36) and Yanlinchand (G34) acupoints that were contralateral to operation site for 30 min except PCA; EA in non-acupoint group (EANAG), the method was identical to EAAG, but 2 Hz EA applied to 1 cm lateral to Zusanli and 1 cm lateral to Yanlinchand acupoints. Visual analgesia scale score (VAS), the time of first demanding PCA, the frequency of PCA, total dose of analgesics and incidence of vomiting within 48 hrs after operation were used as indexes for evaluating EA analgesia. The results indicated that the time of first PCA was more prolonger in the EAAG and EANAG than in CG, whereas the total dose of analgesics and incidence of vomiting were no difference among total dose of analgesic and incidence of vomiting were no difference among the CG, EAAG and EANAG. In conclusion, 2 Hz EA applied to Zusanli and Yanlinchand acupoints, and applied to 1 cm lateral to Zusanli and 1 cm lateral to Yanlinchand acupoints contralateral to total knee arthroplasty, both of them can prolong the time of first demanding PCA, suggesting 2 Hz can potentate the analgesic effect of PCA for postoperative pain after total knee arthroplasty. The analgesic effect of 2Hz EA applied to Zusanli and Yanlinchand acupoints was similar to 2 Hz EA applied to 1cm lateral to Zusanli and 1cm lateral to Yanlinchand acupoints, suggesting EA stimulation applied to the acupoint area that belong to the same nerve or nerve segment may obtain similar effect. Because Zusanli acupoint and 1 cm lateral to Zusanli acupoint, Yanlinchand and 1 cm lateral to Yanlinchand acupoint all belong to the distribution area of deep peroneal nerve and 4th lumbar nerve segment.

碩士
中國醫藥大學
針灸研究所
96
Stroke is a common problem that results in neurologic and functional deficits. Approximately 30,000 people per year in Taiwan, aged over 35, suffer a first stroke. 80% of stroke patients experience motor impairments, i.e., hemiparesis, poor coordination and gait disturbance. Abnormal spasticity is considered to be the major factor causing these motor impairments. Acupuncture is one of the main modalities of treatment in traditional Chinese medicine and is a relatively simple, inexpensive and safe treatment. It also has been well-accepted by stroke patients for improving motor, sensation, speech, and other neurological function. Electro-acupuncture (EA) has the same effects as traditional acupuncture. Thirty subjects from the rehabilitation clinics, aged 45 to 75 years who suffer first stroke within 6-24 months, were enrolled in a single blind study and randomly assigned to study and control group in equal number . All subjects (both group) underwent regular rehabilitation programs. Only in the study group, Electro-acupuncture was given .Objective laboratory evaluation, including computerized gait and balance test and dynamic foot pressure analysis is used to compare the effects of EA between these groups. The results show significant differences in the degree of asymmetry in GRF in spastic hemiplegia after electroacupuncture treatment. Since that there is no significant improvement in the functional parameters of gait and balance, the results might provide alternatives for further intervention of rehabilitation program.

碩士
中國醫藥大學
國際針灸碩士學位學程
102
Review: Neuroimaging effects of electro and manual acupuncture on the CNS: a literature review and analysis Scheffold, Brigitte Elisabeth 1 Hsieh, Ching-Liang 2 Litscher, Gerhard 3 1 Graduate Institute of Acupuncture Science, International Master Program, China Medical University, Taichung, Taiwan 2 Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan 3 Biomedical Engineering in Anesthesia at the Medical University of Graz, Austria Key words: Neuroimaging, Acupuncture, Electro Acupuncture, functional magnetic resonance image (fMRI), Positron emission tomography (PET), Electroencephalogram (EEG), Evoked potentials (EP) Background In recent decades numerous studies applied neuroimaging technologies to investigate acupuncture mechanisms and their effects on the brain. Objectives The aim of this review is to provide an overview of the different effects of manual and electro acupuncture on the CNS in studies with the following neuroimaging interventions: fMRI, PET, EEG, EP. Search methods The Database PubMed was searched from 1/1/2000 until 1/6/2014 with restriction to Human studies in English language for all trials. Data collection for fMRI studies was restricted to 1/1/2010 until 1/6/2014 due to a recently published review. Selection criteria This review included all published randomized and non-randomized controlled clinical studies as well as observational studies (cohort and case studies) with control groups, no blinding required. Only studies comparing manual or electro acupuncture as modes of treatment with sham acupuncture were eligible. All participants were healthy adult men and women. Data collection and analysis Trials were selected with restriction to available full texts and data were extracted from these studies by the author. Main results The review includes results of neuroimaging trials (fMRI, PET, EEG or EP) with healthy adult participants. A majority of 25 studies compared manual versus sham, a minority of 7 trials compared electro versus sham and only 1 study compared electro versus manual acupuncture. In 29 out of 33 studies verum acupuncture results were found to present either more or different modulation effects on neurological components measured by fMRI, PET, EEG and EP than sham acupuncture. Only four studies reported no effects of verum in comparison to sham acupuncture. Conclusions Evaluation of the very heterogeneous results shows evidence that verum acupuncture elicits more / different modulation effects on neurological components measured by fMRI, PET, EEG and EP than sham acupuncture. For future studies using neuroimaging technology, more consistent methodology protocols are recommended. Stricter protocols would allow better comparison of results and could accelerate and consolidate advances in the field of acupuncture mechanism research.

碩士
中國醫藥大學
針灸研究所碩士班
97
Non-small cell lung cancer is a affects approximately 80% of all lung malignant primary tumor that responds poorly to both chemotherapy and radiation therapy. In the present study, we investigated the anticancer effect of a honokiol, an active component isolated and purified from the Magnolia officinalis in human lung cells. Honokiol induced cell apoptosis in human lung cancer cell lines (A549 cell). Honokiol also induces upregulation of Bax and Bak, downregulation of Bcl-XL and dysfunction of mitochondrial in lung cancer cells. Importantly, animal studies have revealed a dramatic reduction in tumor volume after 21 days of treatment. Besides, electroacupuncture zusanli acupoint (ST36) combined with intraperitoneal injection of Honokiol inhibits tumour growth in the mouse xenograft model of A549 cells. This study demonstrates that honokiol may be a novel anticancer agent for the treatment of lung cancer cells and electroacupuncture could amplify the chemo-therapeutic effect in lung cancer treatment.

碩士
國立陽明大學
傳統醫藥研究所
101
Acupuncture and electro-acupuncture have been used to improve the brain and motor functions of post-stroke patients, and aspirin is used for the prevention of stroke recurrence in Western medicine. Our hypothesis is that acupuncture or electro-acupuncture may produce an interaction with treatment by aspirin in terms of the drug pharmacokinetics and thereby affect the brain blood flow. The aim of this study is to investigate the potential interactions of acupuncture or electro-acupuncture on the pharmacokinetics of aspirin. The blood flow was measured in rat brain to determine whether acupuncture treatment may disturb the pharmacokinetics of aspirin by affecting blood flow. The parallel study design is divided into three experimental groups: control, acupuncture and electro-acupuncture groups. Two acupoints, namely Quchi (code LI 11) and Zusanli (code ST 36), were needled and stimulated electronically in anaesthetized rats. The blood and brain concentrations of aspirin and its metabolite, salicylic acid were monitored by microdialysis and HPLC analysis after aspirin administration (30 mg/kg, iv). We find that the pharmacokinetic data for both aspirin and salicylic acid in blood and brain did not present a statistically significant interaction (P> 0.05) according to results. The brain blood flow data indicated a short period of change but there was no significantly difference (P> 0.05) in the groups treated with acupuncture and with electro-acupuncture. Our results reveal that there is no significant interaction of aspirin and salicylic acid pharmacokinetic parameters in the control, acupuncture and electro-acupuncture groups. This study may, in part, offer some evidence to support the contention that there is no significant interaction for the combination of aspirin with acupuncture or electro-acupuncture.

碩士
中國醫藥大學
中醫學系
98
The meridian theory of Traditional Chinese medicine considers that twelve meridians belongs to viscera and bowels internally, and connects to limbs and joints externally. Spleen meridian connects to spleen, and liver meridian connects to liver, i.e. so call meridian specificity. Therefore, the purpose of the present study was to investigate specificity of twelve meridians. We applied 2 Hz electroacupuncture（EA）to Yinlingquan（SP9）acupoint that is a sea acupoint of spleen, and Ququan（LR8）acupoint that a sea acupoint of liver meridian, respectively. The blood flow of spleen and liver was recorded simultaneously by a laser Doppler blood flow monitor. The experiment was divided into sham, Yinlingquan, and Ququan groups, and blood flow recordings were divided into before EA period（baseline period）, EA period and post-EA period, each period was 10 min recordings. Nitric oxide levels（NO）were measured at finishing before EA period, EA period and post-EA period recordings from right femoral arterial blood. Results indicated that sham group could not increase the blood flow of liver and spleen; 2 Hz EA applied to bilateral Yinlingquan acupoints could increase the blood flow of spleen, but could not increase the blood flow of liver; In contrast, 2 Hz EA applied to bilateral Ququan acupoints could increase the blood flow of liver, but could not increase the blood flow of spleen; NO levels were not significantly difference among three periods in each group. Based on these results, the sea point of different has specificity to its connecting viscera, these results also proof the qi of meridian is from sea point into meridian and the meridian connects to its viscera.

碩士
國立臺灣大學
獸醫學研究所
93
Veterinary acupuncture is an important part of Chinese traditional animal medicine. The work of many scientists and clinicians over the past 20 years has confirmed the therapeutic values of acupuncture in treating animal diseases. Nowadays, many veterinarians wish to integrate acupuncture therapy into their routine practice. The magnetic resonance imaging (MRI) developed recently may provide a very useful technique to explore the animal body’s confirmation and function. After anesthetized, we used CMR (Cardiac MRI) to gather the cardiac anatomy imaging and functional data in normal cats and acupuncture cats. The acupoint of study is Neiguan, which has been believed to affect cardiovascular function, and used to improve or treat a wide range of health conditions and diseases. Owing to the fast speed and strong data analysis of MRI machine, can establish the basic cardiac function index of cats including cardiac output, major vessel velocity, myocardium thickness and myocardium oxygen consumption phenomenon. And measurement of heart rate, breath rate, electrocardiogram and pulse are performed in the same time to explore the function of autosomal nerve system and cardiovascular system. Results projected the blood pressure values after electroacupuncture are less than single anesthetics and soon recovery to normal. In normal cat, the parameters of heart in anesthetics and one hour later after anesthetics include nEDV(4.26±0.67；2.7±0.37)、nESV(1.75±0.434；0.82±0.08)、EF(0.56±0.058；0.73±0.07)、LVPFR (10.89±0.51；13.19±0.88)、LVPER(-7.26±0.16；-9.94±1.27). EA could shorten the animal’s recovery time: nEDV(2.61±0.46)、nESV(0.83±0.05)、EF(0.71±0.09)、LVPFR (12.27±2.21)、LVPER(-9.75±1.44).Meanwhile, we also showed the special anatomic figures around the points and all data provide very crucial information for feline acupuncture practice. We intend to provide the important platform for further biomedical study related to pharmaceutical and therapeutical fields.

碩士
國立臺灣大學
物理治療學研究所
104
Background: Previous study has found that the off-target low dose irradiation could cause muscle contractile dysfunction which was related to radiation-induced oxidative damage to muscle protein. However, the effect of radiation related chronic oxidative stress on muscle contractile function was not clear. Electro-acupuncture (EA) stimulation has been used to decrease oxidative damage in various injury models but whether EA prior to radiation could ameliorate radiation related muscle contractile dysfunction remains to be determined. Purpose: The aims of this study were to investigate the acute and chronic effect of EA prior to radiation on radiation-induced masseter contractile dysfunction and exploring the potential underlying mechanism in animal model. Methods: Sprague-Dawley rats aged 7-to-8 week-old were used in this study. Whole study was divided into acute phase and chronic phase. In acute phase, rats were randomized into 6 groups (n=4 per group): Ctrl, IR, EA2, EA100, EA2-IR, and EA100-IR. EA stimulation was applied at the masseter muscle belly and temporomandibular joint, 20 minutes per section, for a total of 3 sections in one week (EA2, EA100, EA2-IR, and EA100-IR). Upon the completion of EA interventions, a single dose of 10 Gy radiation was delivered to bilateral masseter muscles (IR, EA2-IR, and EA100-IR). All rats were sacrificed 24 hours post-irradiation and bilateral masseter muscles were removed and analyzed for contractile function, oxidative injury (protein carbonyl), and antioxidant capacity (CuZnSOD and MnSOD mRNA expression). In chronic phase, rats were randomized into 4 groups (n=4 per group):cCtrl, cIR, cEA2-IR, and cEA100-IR. All interventions and assessments were performed identically as those described in acute phase, expect the time points for sacrificing animals were 3-week- post-irradiation. H&E stain, Masson trichrome stain, and TGF-β1 mRNA expression were used to assess fibrotic response. Results: In acute phase, compared to Ctrl, the contractility of masseter muscle was significantly lower (p<0.05), the force-frequency curve showed significant downward shift (p<0.05), and the protein carbonyl concentration was significantly increased in IR (p<0.01). In rats received EA stimulation, the SOD mRNA expression of masseter muscle was upregulation after EA intervention. In rats received EA stimulation before irradiation showed less contractility decline and lower concentration of protein carbonyl of masseter muscle (both p<0.05), compare to no EA group. In chronic phase, compare to cCtrl, the contractility of masseter muscle remained lower and protein carbonyl concentration remained higher in cIR (both p<0.05). The beneficial effects of EA prior to radiation on masseter muscle persisted in chronic phase, including better contractile function and less protein carbonyl concentration. In groups receiving IR (cIR, cEA2-IR, and cEA100-IR), TGF-β1 mRNA was significantly upregulated (all p<0.05) with no apparent evidence of deposition of collagen Conclusion: The present study showed that irradiation could induce acute and chronic masseter muscle contractile dysfunction and EA pre-treatment could attenuate this harmful radiation-induced effect through upregulation muscle’s antioxidant capacity and its role on prevention of fibrosis is inconclusive.

碩士
中國醫藥大學
針灸研究所碩士班
100
Stroke is responsible for one of the main causes to result in patients'' disability and death. Shoulder pain has been reported to be one of the most common complications after stroke. Pain may interfere with ADLs and rehabilitation programs, interrupt sleep, and contribute to depression and fatigue, and cause poor prognosis. Pain alleviation (analgesia) by acupuncture has been accepted by World Health Organization (WHO) and many countries. At 2010 systematic review for acupuncture, the majority (80%) of the randomized clinical trials demonstrate that acupuncture may be effective in the treatment of poststroke rehabilitation, and thus providing a safe and economical method for treating stroke patients. In the past, electric stimulation (ES) were used in pain controled and ROM increased, and its showed positive effect. However, there were no study discussed the difference between electroacupuncture (EA) and ES in pain relief. The aim of this study is to identify the efficacy of EA and TEAS in reducing shoulder pain in stroke patients. The inclusion criteria are (1) Stroke within 6 months from onset, (2) Hemiplegia with shoulder pain in the affected side. We included 48 stroke patients, and randomized to one of the three groups (EA, TEAS, and sham group). Subjects in the EA group or TEAS group received electro-acupuncture or electric stimulation on the Juanyu (Li15) & Jugu (Li16) for 20 minutes. In the sham group, we give Park''s sham devices on the same points. Before and after treatment, we evaluate the muscle tone, pain degree, shoulder pain-free range of motion (ROM), motor ability of upper extremity. Descriptive statistics were provided as mean ± standard deviation for continuous variables while the number of cases and percentages were used for nominal variables. Repeated measures of analysis of variance was used to determine whether a statistically significant difference using SPSS followed by post hoc tests. The between-subjects factor was the "3 groups" and the within-subject factor was the "3 time intervals." A p value <0.05 was considered statistically significant. In our study, the results showed that pain improved in the EA group and TEAS group after 2 weeks treatment, and significantly better than those in the sham group. Shoulder ROM limitation significantly decreased in the EA group and TEAS group, however, only subjects in the EA group improved more than those in the sham group. All subjects got improvement in the ADLs and upper extremity motor function, but no difference between the three groups. According to our study, EA treatment may be a good choice for hemiplegia shoulder pain.

碩士
中國醫藥大學
針灸研究所碩士班
99
(PART 1) BACKGROUND: Hypertension is a kind of disease which the systemic arterial blood pressure is elevated. About 90–95% of cases are termed "spontaneous hypertension", which refers to high blood pressure for no medical cause can be found. It can cause serious heart, brain and kidney dysfunction. Persistent hypertension may cause cardiac fibrosis, left ventricular hypertrophy and cardiac apoptosis, leaving shortened life expectancy. Lots of clinical experiences have shown that puncture Taichong point(LR-3)can effectively lower blood pressure. OBJECTIVE: We punctured LR-3 point to observe the effect of lowering blood pressure and to explore the molecular mechanism of acupuncture treatment for hypertension. Acupuncture treatment for hypertension has less side effect. This is the common point be used in clinic. According to the research, even using the single point of Taicong(LR-3) also can lower hyper-yang activity type hypertension well. We use SHR to make sure whether the effect of electro -acupuncture on the cardiac function of SHR has a positive impact. METHODS: A total of 12 rats with 8-weeks male spontaneously hypertensive rats (SHR)were randomized divided into the acupuncture and sham groups, with 6 animals in each group. Additional 6 male Wistar-Kyoto rats were served as the control group. Rats in the acupuncture group received electro-acupuncture at bilateral Taichong (LR 3) points. Stained with Masson trichrome to observe whether there is myocardial fibrosis.and to observe myocardial cell apoptosis by TUNEL level. The expression of SOD1, FAS, FADD, Bax, cytochromC, Gαq, eNOS, and calcineurin and BNP were detected by Western blot. RESULTS AND CONCLUSION: After treatment for three days, EAT group of blood pressure in rats that have decreased significantly, including systolic(BPs), diastolic(BPd) and mean blood pressure (BPm)were significantly lower than SHR and EAS group. At 19th day , the systolic blood pressure in EAT group was still significantly lower than SHR and EAS group. Electroacupuncture LR-3 has shown that the blood pressure was went down rapidly, but the long-term continuous stimulus, its antihypertensive effects would fade. Electroacupuncture LR-3 can reduce the damage of cardiac hypertrophy and apoptosis and fibrosis caused by hypertension. According to Western blot analysis, we found the eNOS and SOD 1 were increased. In another pathway,, the hypertrophy and apoptosis protein were decreased significantly. (PART Ⅱ ) Background: the persistent high blood pressure might cause myocardial fibrosis and left ventricular hypertrophy and apoptosis. Finally shorten the life. Objective: we learned from the previous experimental Taichong electroacupuncture is effective for reducing blood pressure in spontaneously hypertensive rats, but long-term stimulation will make the effect fade in a row. So we designed a short experimental treatment and join discussions. Methods: the 8-week-old male group randomly divided into Spontaneous hypertensive rat group (SHR), pseudo-point electroacupuncture Group (EAS), electro-acupuncture in the treatment group (EAT), pseudo-acupoint embedding Group (CES), embedding therapy group (CET), for 1 week of treatment. With the 8-week-old male WKY (Wistar-Kyoto) as a control group of rats. Treatment group we chose bilateral Taichongpoint(LR-3) for electro-acupuncture and catgut embedding, and recorded their blood pressure with tail cuff. . After sacrifice we took its heart slices, and observed H&E, Masson '' s trichrome staining with TUNEL assay. Free out of the left ventricle and extraction of proteins, by Western blot to observe the proteins of anti-apoptosis and pro-apoptosis proteins and the proteins about hypertrophy or inflammation. Results and discussion: the treatment of the third day, the blood pressure of rats with has decreased significantly, including systolic, diastolic and mean blood pressure in EAT and CET group were significantly lower than SHR and EAS group, and the blood pressure in EAT group was slightly lower than the CET group , but no significant difference between the two groups. At the treatment of the 7th day EAT blood pressure in CET Group continued to decline, and in CET group blood pressure was less than EAT group but no significant difference between the two groups. We observed from the heart tissue biopsy proofed that the electro-acupuncture or catgut embedding on LR-3 can prevent cardiac hypertrophy and apoptosis and fibrosis from hypertension. Western blot analysis was found that the SOD 1 in CET group was significantly increased and apoptotic protein and hypertrophy and apoptosis protein were decreased significantly, and SOD 1 and the induction of effect of PI3K/pPI3K in CET group were better than EAT group.