Effect of acupuncture for diminished ovarian reserve: study protocol for a randomized controlled trial

Background: Diminished ovarian reserve (DOR) is described as reduced fecundity. A satisfactory treatment is lacking despite the upward trend of the prevalence. Acupuncture has been reported as an alternative therapy for female infertility. The purpose of this study is to investigate the effect of acupuncture for women with DOR.Methods/Design: In this randomized controlled trial, a total of 120 women with DOR will be randomized to receive either acupuncture or sham acupuncture for 12 weeks. The primary outcome is the antral follicle counting (AFC).Discussion:This study is expect to investigate the effect of acupuncture versus superficial needling in improving ovarian reserve for women with DOR.Trial registration:Acupuncture-Moxibustion Clinical Trial Registry (ChiCTR1800014988).

Neuroanatomical Characteristics of Deep and Superficial Needling Using Li11 as An Example

Objectives To compare the neuroanatomical characteristics of the deep and superficial tissues at acupuncture point LI11 using a neural tracing technique, in order to examine the neural basis of potential differences between deep and superficial needling techniques. Methods In order to mimic the situations of the deep and superficial needling, the retrograde neural tracer Alexa Fluor 488 conjugate of cholera toxin subunit B (AF488-CTB) was injected into the muscle or subcutaneous tissue, respectively, at acupuncture point LI11 in eight rats (n=4 each). Three days following injection, the distribution of motor and sensory neurons labelled with AF488-CTB was examined in the spinal cord and dorsal root ganglia (DRG) under a fluorescent microscope. Results For both types of injection, labelled motor and sensory neurons were distributed on the side ipsilateral to the injection in the spinal cord and DRG between spinal levels C5 and T1. The number of labelled motor neurons following intramuscular injection was significantly higher than subcutaneous injection. By contrast, the number of labelled sensory neurons following subcutaneous injection was significantly higher in number and extended over a greater number of spinal segments compared to intramuscular injection. Conclusions These data indicate that the motor and sensory innervation of muscle and subcutaneous tissue beneath LI11 differ, and suggest that acupuncture signals induced by deep and superficial needling stimulation may be transmitted through different neural pathways.

Characterizing AcupunctureDe Qiin Mild Cognitive Impairment: Relations with Small-World Efficiency of Functional Brain Networks

As an intermediate state between normal aging and dementia, mild cognitive impairment (MCI) became a hot topic and early treatments can improve disease prognosis. Acupuncture is shown to have possible effect in improving its cognitive defect. However, the underlying neural mechanism of acupuncture and relations betweenDe Qiand different needling depths are still elusive. The present study aimed to explore how acupuncture can exert effect on the reorganization of MCI and to what extent needling depths, associating withDe Qisensations, can influence the acupuncture effects for MCI treatment. Our results presented that MCI patients exhibited losses of small-world attributes indicated by longer characteristic path lengths and larger clustering coefficients, compared with healthy controls. In addition, acupuncture with deep needling can induce much stronger and a wide range ofDe Qisensations both in intensity and prevalence. Acupuncture with deep needling showed modulatory effect to compensate the losses of small-world attributes existed in MCI patients while acupuncture with superficial needling did not. Furthermore, acupuncture with deep needling enhanced the nodal centrality primarily in the abnormal regions of MCI including the hippocampus, postcentral cortex as well as anterior cingulate cortex. This study provides evidence to understand neural mechanism underlying acupuncture and the key role ofDe Qifor MCI treatment.

An Experimental Study on the Self-Report of Acupuncture Needle Sensation during Deep Needling with Bi-Directional Rotation

Background Traditionally, acupuncturists manipulate needles to enhance sensations referred to as de qi or ‘acupuncture needle sensation’. Acupuncture needle sensations are complex and quantifying the experience has been difficult. The aim of this crossover study was to measure self-reported needle sensation during deep and bi-directional rotated needling in 15 healthy volunteers. Methods Each participant received an experimental intervention consisting of superficial needling followed by deep needling and then deep needling with bi-directional rotation. The control intervention consisted of superficial needling, followed by mock deep needling and then mock bi-directional rotation of the needle. The intensity of overall needle sensation was measured using a visual analogue scale (VAS). The subjective acupuncture sensation scale was used to capture component sensations. Results VAS scores were higher during ‘deep’ needle penetration when compared to superficial needling with mock deep insertion (p=0.0002). VAS scores were also higher during deep needling with bi-directional rotation compared to superficial needling with mock bi-directional rotation (p<0.0001). There were higher scores for total component sensation scores and for the sensation of throbbing during the deep needling with bi-directional rotation (p=0.001) when compared to superficial needling with mock bi-directional rotation. Tentative evidence that bi-directional needle rotation generated stabbing, tingling, heaviness, soreness and aching was also found. Conclusion Bi-directional rotation of a needle inserted into deep soft tissue produced higher acupuncture needle sensation intensities when compared to superficial needle insertion with mock deep penetration and bi-directional rotation.