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      Acupoint-Specific, Frequency-Dependent, and Improved Insulin Sensitivity Hypoglycemic Effect of Electroacupuncture Applied to Drug-Combined Therapy Studied by a Randomized Control Clinical Trial

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          Abstract

          The application of electroacupuncture (EA) to specific acupoints can induce a hypoglycemic effect in streptozotocin-induced rats, normal rats, and rats with steroid-induced insulin resistance. EA combined with the oral insulin sensitizer rosiglitazone improved insulin sensitivity in rats and humans with type II diabetes mellitus (DM). There are different hypoglycemic mechanisms between Zhongwan and Zusanli acupoints by EA stimulation. On low-frequency (2 Hz) stimulation at bilateral Zusanli acupoints, serotonin was involved in the hypoglycemic effect in normal rats. Moreover, after 15 Hz EA stimulation at the bilateral Zusanli acupoints, although enhanced insulin activity mainly acts on the insulin-sensitive target organs, the muscles must be considered. In addition, 15 Hz EA stimulation at the bilateral Zusanli acupoints has the combined effect of enhancing cholinergic nerve activity and increasing nitric oxide synthase (NOS) activity to enhance insulin activity. Despite the well-documented effect of pain control by EA in many systemic diseases, there are few high-quality long-term clinical trials on the hypoglycemic effect of EA in DM. Combination treatment with EA and other medications seems to be an alternative treatment to achieve better therapeutic goals that merit future investigation.

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          Most cited references49

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          Transcutaneous electrical nerve stimulation: basic science mechanisms and clinical effectiveness.

          Transcutaneous electrical nerve stimulation (TENS) is used clinically by a variety of health care professionals for the reduction of pain. Clinical effectiveness of TENS is controversial, with some studies supporting whereas others refute its clinical use. Although used by health professionals for decades, the mechanisms by which TENS produces analgesia or reduces pain are only recently being elucidated. This article describes the basic science mechanisms behind different frequencies of TENS stimulation. Specifically, we describe the literature that supports the use of different frequencies and intensities of TENS. We further describe theories that support the use of TENS such as the gate control theory and the release of endogenous opioids. The literature that supports or refutes each of these theories is described. We also review the clinical literature on TENS effectiveness and elucidate the problems with clinical research studies to date. In conclusion, TENS is a noninvasive modality that is easy to apply with relatively few contraindications. However, the clinical efficacy of TENS will remain equivocal until the publication of sufficient numbers of high quality, randomized, controlled clinical trials.
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            Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies

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              Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial.

              Evidence on the efficacy of acupuncture for reducing the pain and dysfunction of osteoarthritis is equivocal. To determine whether acupuncture provides greater pain relief and improved function compared with sham acupuncture or education in patients with osteoarthritis of the knee. Randomized, controlled trial. Two outpatient clinics (an integrative medicine facility and a rheumatology facility) located in academic teaching hospitals and 1 clinical trials facility. 570 patients with osteoarthritis of the knee (mean age [+/-SD], 65.5 +/- 8.4 years). 23 true acupuncture sessions over 26 weeks. Controls received 6 two-hour sessions over 12 weeks or 23 sham acupuncture sessions over 26 weeks. Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores at 8 and 26 weeks. Secondary outcomes were patient global assessment, 6-minute walk distance, and physical health scores of the 36-Item Short-Form Health Survey (SF-36). Participants in the true acupuncture group experienced greater improvement in WOMAC function scores than the sham acupuncture group at 8 weeks (mean difference, -2.9 [95% CI, -5.0 to -0.8]; P = 0.01) but not in WOMAC pain score (mean difference, -0.5 [CI, -1.2 to 0.2]; P = 0.18) or the patient global assessment (mean difference, 0.16 [CI, -0.02 to 0.34]; P > 0.2). At 26 weeks, the true acupuncture group experienced significantly greater improvement than the sham group in the WOMAC function score (mean difference, -2.5 [CI, -4.7 to -0.4]; P = 0.01), WOMAC pain score (mean difference, -0.87 [CI, -1.58 to -0.16];P = 0.003), and patient global assessment (mean difference, 0.26 [CI, 0.07 to 0.45]; P = 0.02). At 26 weeks, 43% of the participants in the education group and 25% in each of the true and sham acupuncture groups were not available for analysis. Acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.
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                Author and article information

                Journal
                Evid Based Complement Alternat Med
                Evid Based Complement Alternat Med
                ECAM
                Evidence-based Complementary and Alternative Medicine : eCAM
                Hindawi Publishing Corporation
                1741-427X
                1741-4288
                2014
                16 June 2014
                16 June 2014
                : 2014
                : 371475
                Affiliations
                1Department of Internal Medicine and Emergency Medicine, Division of Endocrinology and Metabolism, Tungs' Taichung Metro Harbor Hospital, Taichung County 43503, Taiwan
                2Department of Occupational Safety and Health, Jen-Teh Junior College of Medicine, Nursing and Management, Houlong, Miaoli County 35664, Taiwan
                3Department of Orthopedics, Taichung Veterans General Hospital, Taichung 40705, Taiwan
                4Institute of Molecular Medicine, College of Life Science, National Tsing Hua University, Hsinchu 30013, Taiwan
                5Department of Acupuncture, China Medical University Hospital, Taichung 40402, Taiwan
                6Department of Medicinal Botanicals and Health Application, Da-Yeh University, No. 168, University Road, Dacun, Changhua County 51591, Taiwan
                7School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
                Author notes
                *Jaung-Geng Lin: jglin@ 123456mail.cmu.edu.tw and
                *Shih-Liang Chang: slc0124@ 123456gmail.com

                Academic Editor: Xin-Yan Gao

                Article
                10.1155/2014/371475
                4082841
                25024728
                150ef603-1a3f-4658-a4ad-2e7bd4578ade
                Copyright © 2014 Rong-Tsung Lin et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 March 2014
                : 28 April 2014
                : 6 May 2014
                Categories
                Review Article

                Complementary & Alternative medicine
                Complementary & Alternative medicine

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