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Zhongguo Zhen Jiu = Chinese Acupuncture... Jun 2024To observe the clinical effect of acupuncture (acupuncture for promoting the circulation of the governor vessel and regulating the spirit) for subjective tinnitus, and... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To observe the clinical effect of acupuncture (acupuncture for promoting the circulation of the governor vessel and regulating the spirit) for subjective tinnitus, and explore its potential mechanism.
METHODS
A total of 92 patients with subjective tinnitus were randomly divided into an acupuncture group (46 cases, 5 cases dropped out) and a medication group (46 cases, 2 cases dropped out). The acupuncture group received acupuncture at Shuigou (GV 26), Yintang (GV 24), Shenting (GV 24), Baihui (GV 20), Fengfu (GV 16), Dazhui (GV 14) and Zhongzhu (TE 3), Tinghui (GB 2), Yifeng (TE 17) on the affected side, 30 min each time, once every other day, 3 times a week. The medication group was orally administered ginkgo biloba leaves tablets (40 mg each time) and mecobalamin tablets (0.5 mg each time), 3 times a day. Both groups were treated for 4 weeks. The scores of tinnitus severity, tinnitus loudness visual analogue scale (VAS) and depression anxiety stress scale-21(DASS-21) before and after treatment were observed in the two groups, serum level of brain-derived neurotrophic factor (BDNF) before and after treatment in the two groups was detected, and the clinical effect was evaluated in the two groups.
RESULTS
After treatment,the scores of tinnitus severity, tinnitus loudness VAS and DASS-21 were decreased compared with those before treatment in the two groups (<0.01), and the scores in the acupuncture group were lower than those in the medication group (<0.05). After treatment, the serum level of BDNF was decreased compared with that before treatment in the two groups (<0.01), and the serum level of BDNF in the acupuncture group was lower than that in the medication group (<0.05). The total effective rate of the acupuncture group was 82.9% (34/41), which was higher than 70.5% (31/44) in the medication group (<0.05).
CONCLUSION
acupuncture could improve the severity of tinnitus, tinnitus loudness and negative emotion in patients with subjective tinnitus. Its mechanism may be related to the regulation of serum level of BDNF and thus affect auditory central plasticity.
Topics: Humans; Tinnitus; Male; Female; Acupuncture Therapy; Middle Aged; Adult; Acupuncture Points; Aged; Brain-Derived Neurotrophic Factor; Treatment Outcome; Young Adult
PubMed: 38867626
DOI: 10.13703/j.0255-2930.20230808-k0001 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Jun 2024To observe the clinical efficacy of acupuncture combined with therapy for stiff neck with levator scapula injury type. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To observe the clinical efficacy of acupuncture combined with therapy for stiff neck with levator scapula injury type.
METHODS
A total of 162 patients with stiff neck of levator scapula injury type were randomly divided into an acupuncture combined with tuina group (combined group, 52 patients), a tuina group (55 patients), and an acupuncture group (55 patients). The patients in the acupuncture group received acupuncture on the affected side's Houxi (SI 3), inserting the needle 10 to 20 mm towards Laogong (PC 8) with strong or moderate stimulation, and patients were instructed to move their neck, shoulders, and upper limbs during the process, with the needle retained for 2 to 3 min. The patients in the tuina group received strong stimulation pressing on tender points to release the starting and ending points of the trapezius muscle with modified techniques. The combined group first received therapy, followed immediately by acupuncture treatment at the Houxi (SI 3). Treatments were administered every other day for a total of three sessions. Before treatment and on 1, 3, and 7 days after treatment, the simple McGill pain questionnaire (SF-MPQ) scores [including the pain rating index (PRI), visual analogue scale (VAS), and present pain intensity (PPI) scores] of the head, neck and shoulder, cervical spine mobility scores were observed, and the clinical efficacy and safety of each group were evaluated.
RESULTS
On the 1, 3, and 7 days after treatment, the SF-MPQ, PRI, VAS, and PPI scores of the head, neck, and shoulder in all groups were significantly reduced (<0.01). On the 1 and 3 days after treatment, the above scores in the combined group were lower than those in the tuina group and the acupuncture group (<0.05, <0.01). On the 7 days after treatment, the above scores in the combined group were lower than those in the acupuncture group (<0.01). On the 3 days after treatment, the SF-MPQ, PRI, and VAS scores in the tuina group were lower than those in the acupuncture group (<0.01). On the 7 days after treatment, the SF-MPQ, PRI, VAS, and PPI scores in the tuina group were lower than those in the acupuncture group (<0.01, <0.05). On the 1, 3, and 7 days after treatment, the cervical spine mobility scores in each group were decreased compared to those before treatment (<0.01). On the 3 days after treatment, the cervical spine mobility score in the combined group was lower than that in the acupuncture group and the tuina group (<0.01). On the 1, 3, and 7 days after treatment, the cured rate in the combined group was higher than that in the tuina group and the acupuncture group (<0.01). During the treatment period, no serious adverse reactions occurred in any group.
CONCLUSION
Acupuncture combined with therapy could effectively improve stiff neck with levator scapula injury type, alleviate patient pain, restore cervical spine mobility, and clinically outperform both and acupuncture therapy alone.
Topics: Humans; Male; Female; Adult; Scapula; Acupuncture Therapy; Middle Aged; Young Adult; Massage; Treatment Outcome; Combined Modality Therapy; Acupuncture Points
PubMed: 38867624
DOI: 10.13703/j.0255-2930.20231206-k0007 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Jun 2024To compare the clinical effect of intradermal needling and acupuncture in prevention and treatment of leukopenia after chemotherapy with spleen-kidney deficiency. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To compare the clinical effect of intradermal needling and acupuncture in prevention and treatment of leukopenia after chemotherapy with spleen-kidney deficiency.
METHODS
A total of 90 patients with malignant tumor who received chemotherapy were randomly divided into a intradermal needling group (30 cases, 1 case dropped out), an acupuncture group (30 cases, 2 cases dropped out, 1 case was eliminated) and a control group (30 cases). The control group received conventional symptomatic treatment after chemotherapy. On the basis of the treatment in the control group, the intradermal needling group received intradermal needling at Guanyuan (CV 4), Dazhui (GV 14) and bilateral Geshu (BL 17), Zusanli (ST 36),Shenshu (BL 23), the needles were retained for 48 h, once every other day. On the basis of the treatment in the control group, the acupuncture group received conventional acupuncture at the same acupoints as the intradermal needling group, once every other day. The treatment started from the first day of chemotherapy, for a total of 2 weeks in the three groups. The white blood cell count, neutrophil count, hemoglobin content, platelet count and Karnofsky performance status (KPS) score before treatment and on 3rd, 7th, 14th, and 21st days after treatment were compared among the three groups. The incidence and grading of leukopenia and the usage of leukocyte-boosting drug during chemotherapy cycle was recorded.
RESULTS
On 7th day after treatment, the white blood cell count in the intradermal needling group and the acupuncture group was higher than that in the control group (<0.01, <0.05). On the 14th day after treatment, the hemoglobin content in the intradermal needling group and the acupuncture group was higher than that in the control group (<0.01). On the 7th, 14th, and 21st days after treatment, the platelet count in the acupuncture group was higher than that in the control group (<0.01), on the 14th and 21st days after treatment, the platelet count in the intradermal needling group was higher than that in the control group (<0.01). There was no statistically significant difference among the three groups after treatment in terms of neutrophil count, KPS score, incidence and grading of leukopenia, and the usage of leukocyte-boosting drug (>0.05).
CONCLUSION
Both intradermal needling and acupuncture can effectively increase peripheral blood white blood cell count, hemoglobin content and platelet count during chemotherapy cycle, reduce the toxicity of chemotherapy drug to bone marrow hematopoietic function, and alleviate bone marrow suppression after chemotherapy. The two treatments are equally effective.
Topics: Humans; Leukopenia; Acupuncture Therapy; Male; Female; Middle Aged; Adult; Aged; Spleen; Young Adult; Neoplasms; Antineoplastic Agents; Kidney; Acupuncture Points
PubMed: 38867623
DOI: 10.13703/j.0255-2930.20231031-0003 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Jun 2024To observe the effect of acupuncture on gastroesophageal reflux disease (GERD) based on the "heart-stomach connection" theory, and to explore its possible mechanisms. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To observe the effect of acupuncture on gastroesophageal reflux disease (GERD) based on the "heart-stomach connection" theory, and to explore its possible mechanisms.
METHODS
Seventy patients with GERD were randomly divided into an acupuncture group (35 cases, 2 cases dropped out) and a medication group (35 cases, 1 case dropped out). The patients in the acupuncture group received acupuncture at bilateral Shenmen (HT 7), Neiguan (PC 6), Burong (ST 19), Tianshu (ST 25), Zusanli (ST 36), Gongsun (SP 4), and Zhongwan (CV 12), with needles retained for 30 min, every other day, three times a week. The patients in the medication group were treated with oral omeprazole capsules, once daily, 20 mg each time. Both groups were treated for 8 weeks. Before and after treatment, the GERD questionnaire (GERDQ), GERD-quality of life scale (GERD-QOL), Hamilton depression scale-24 (HAMD-24), Zung self-rating depression scale (SDS), and Zung self-rating anxiety scale (SAS) scores were observed. Serum levels of gastrointestinal hormones (gastrin [GAS], motilin [MTL], and vasoactive intestinal peptide [VIP]) were measured, and the clinical efficacy of both groups was evaluated. Correlation between pre-treatment GERDQ score and GERD-QOL score, HAMD-24 score, SDS score, and SAS score was analyzed.
RESULTS
After treatment, the scores of GERDQ, HAMD-24, SDS, and SAS were decreased (<0.001) and the scores of GERD-QOL were increased (<0.001), serum levels of GAS and MTL were increased (<0.001) in both groups, while the serum level of VIP in the acupuncture group was decreased (<0.001) compared with those before treatment. The acupuncture group had higher GERD-QOL score and lower SAS score than the medication group (<0.05), with lower serum VIP level (<0.05). The total effective rate was 75.8% (25/33) in the acupuncture group, and 76.5% (26/34) in the medication group, with no significant difference between the two groups (>0.05). GERDQ score was negatively correlated with GERD-QOL scores ( =-0.762, <0.01) and positively correlated with HAMD-24 score, SDS score, and SAS score ( =0.709, 0.649, 0.689, <0.01) before treatment.
CONCLUSION
Based on the "heart-stomach connection" theory, acupuncture could effectively improve clinical symptoms, quality of life, and negative emotions in patients with GERD. Its mechanism may be related to the regulation of gastrointestinal hormone levels, thereby promoting the contraction of the lower esophageal sphincter.
Topics: Humans; Gastroesophageal Reflux; Acupuncture Therapy; Male; Female; Middle Aged; Adult; Aged; Gastrointestinal Hormones; Acupuncture Points; Young Adult; Stomach; Heart; Motilin
PubMed: 38867622
DOI: 10.13703/j.0255-2930.20230818-0004 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Jun 2024To explore the interaction between emotional and insomnia symptom improvement in comorbid depression and insomnia patients treated with optimized acupuncture. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To explore the interaction between emotional and insomnia symptom improvement in comorbid depression and insomnia patients treated with optimized acupuncture.
METHODS
A secondary analysis was conducted on a multicenter randomized controlled trial of acupuncture treatment for comorbid depression and insomnia. One hundred and forty patients with comorbid depression and insomnia were randomly assigned to an optimized acupuncture group (70 cases, 8 cases dropped out) and a conventional acupuncture group (70 cases, 8 cases dropped out). The patients in the conventional acupuncture group were treated with acupuncture at Yintang (GV 24), Baihui (GV 20), bilateral Hegu (LI 4) and Taichong (LR 3); the patients in the optimized acupuncture group were treated with additional acupuncture at bilateral Lieque (LU 7), Zhaohai (KI 6), and intradermal needling was applied alternately at bilateral Xinshu (BL 15) and Danshu (BL 19), Shenshu (BL 23) and Anmian (Extra). Both groups received treatments twice a week for six weeks. The Hamilton depression scale-24 (HAMD-24) and Pittsburgh sleep quality index (PSQI) scores were observed before and after treatment for both groups. Mediation analysis was used to assess the mesomeric effect of PSQI and HAMD-24 emotional factors, and latent profile analysis categorized patients into subgroups based on HAMD-24 scores, followed by between-group efficacy comparisons.
RESULTS
The indirect effect of the optimized acupuncture on improving depression emotions through PSQI was 3.052 (95% [1.407, 4.697]), accounting for 77.5% of the total effect. Conversely, the indirect effect of improving PSQI through the optimized protocol on depression emotions was 0.479 (95% [0.024, 0.935]), representing 14.8% of the total effect. Latent profile analysis identified 3 categories based on emotional and insomnia symptoms, and statistically significant differences in efficacy favoring the optimized acupuncture protocol over the conventional acupuncture protocol were observed only in the subgroup with relatively mild depression and insomnia symptoms (PSQI: 95% [-10.98, -5.44], <0.001; HAMD-24: 95% [-12.31, -3.73], =0.001).
CONCLUSION
The optimized acupuncture protocol primarily improves insomnia symptoms and further improves depression emotions. Its efficacy advantages are more evident in patients with mild symptoms compared with the conventional acupuncture protocol.
Topics: Humans; Acupuncture Therapy; Sleep Initiation and Maintenance Disorders; Male; Female; Adult; Middle Aged; Depression; Treatment Outcome; Acupuncture Points; Aged; Young Adult; Sleep Quality
PubMed: 38867621
DOI: 10.13703/j.0255-2930.20230822-k0001 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Jun 2024To observe the clinical effect of prophylaxis on migraine without aura differentiated as liver hyperactivity undergoing acupuncture at the points selected using the... (Randomized Controlled Trial)
Randomized Controlled Trial
[Prophylaxis of migraine without aura of liver hyperactivity treated with acupuncture at the points selected using the "seven lines of the neck" method: a randomized controlled trial].
OBJECTIVE
To observe the clinical effect of prophylaxis on migraine without aura differentiated as liver hyperactivity undergoing acupuncture at the points selected using the "seven lines of the neck" method.
METHODS
Fifty-eight patients with migraine without aura of liver hyperactivity at remission stage were randomly divided into an observation group (29 cases, 3 cases dropped out) and a control group (29 cases, 4 cases dropped out). In the observation group, acupuncture was delivered at Dazhui (GV 14), Fengfu (GV 16), bilateral Fengchi (GB 20), Gongxue (Extra), etc., selected using the "seven lines of the neck" method. In the control group, conventional acupuncture was applied to point, Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5) and others on the affected side. The treatment was given once every other day or every two days, 3 interventions weekly, for consecutive 8 weeks. Before treatment, after 4 and 8 weeks of treatment, and after 4 weeks of treatment completion (follow-up visit), the days of migraine episodes, the frequency of migraine episodes, the score of visual analogue scale (VAS) for pain intensity, and the score of migraine specific quality of life questionnaire (MSQ) were observed in the patients of the two groups. Before treatment and after 8 weeks of treatment, the score of TCM syndrome was observed. After 4 and 8 weeks of treatment and after 4 weeks of treatment completion (follow-up visit), the response rates of 50% reduction in the days and the frequency of migraine episodes were calculated in the two groups.
RESULTS
After 4 and 8 weeks of treatment and during follow-up visit, the days and the frequency of migraine episodes were decreased (<0.01) and VAS scores were declined (<0.01) when compared with those before treatment in the two groups. The days and the frequency of migraine episodes in the observation group were lower during the follow-up visit (<0.05) and VAS scores were lower after 8 weeks of treatment and during the follow-up visit (<0.05) when compared with those in the control group. After 4 and 8 weeks of treatment, and during follow-up visit, the scores of "role function-preventive" and "emotional function" of MSQ were increased in comparison with those before treatment in the observation group (<0.05). After 8 weeks of treatment and during the follow-up visit, the scores of "role function-restrictive" of MSQ were increased in comparison with those before treatment in the observation group (<0.05), and the scores of "role function-restrictive" "role function-preventive" and "emotional function" were higher when compared with those before treatment in the control group (<0.05). After 8 weeks of treatment, the scores of TCM syndrome were decreased in comparison with those before treatment in the two groups (<0.01). In the observation group, the response rate of 50% reduction in the days of migraine episodes after 8 weeks of treatment and that of the frequency of migraine episodes during the follow-up visit were higher than those of the control group (<0.05).
CONCLUSION
Acupuncture at the points selected using the "seven lines of the neck" method can reduce the days and frequency of migraine episodes and pain intensity, ameliorate the syndrome of TCM and improve the quality of life of the patients with migraine without aura of liver hyperactivity.
Topics: Humans; Female; Male; Acupuncture Therapy; Adult; Middle Aged; Acupuncture Points; Migraine without Aura; Treatment Outcome; Liver; Young Adult; Aged; Quality of Life
PubMed: 38867620
DOI: 10.13703/j.0255-2930.20231105-k0006 -
BMJ Open Jun 2024Primary dysmenorrhoea (PD) is a common menstrual concern with significant physical and psychosocial impacts. The effectiveness and safety of transcutaneous electrical... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Primary dysmenorrhoea (PD) is a common menstrual concern with significant physical and psychosocial impacts. The effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) in alleviating PD symptoms remain uncertain due to insufficient evidence. This single-centre, parallel, randomised controlled study intends to evaluate the efficacy and safety of TEAS for PD management.
METHODS AND ANALYSIS
60 participants aged 18-40 years diagnosed with moderate to severe PD will be recruited from Tai'an Hospital of Traditional Chinese Medicine (TCM) and randomly assigned to either a TEAS group or a TEAS-sham group (1:1). The TEAS group will undergo 12 sessions of TEAS treatment over two menstrual cycles, with 30 min per session, three sessions weekly. Participants in the TEAS-sham group will receive TEAS stimulation using identical devices and protocols but without current output. The primary outcome is the Visual Analogue Scale (VAS) for pain assessment. Secondary outcomes are Short-Form McGill Pain Questionnaire, total effective rate, uterine artery haemodynamics, prostaglandin and β-endorphin level, mental well-being and quality of life. Adverse events and their potential reasons and the use of analgesics will also be recorded.
ETHICS AND DISSEMINATION
This study was approved by the Medical Ethics Committee of Tai'an Hospital of TCM. Written informed consent will be obtained from each participant. The results will be submitted for publication in a peer-reviewed journal.
TRIAL REGISTRATION NUMBER
ChiCTR2300071686.
Topics: Humans; Dysmenorrhea; Female; Transcutaneous Electric Nerve Stimulation; Acupuncture Points; Adult; Young Adult; China; Adolescent; Pain Measurement; Treatment Outcome; Randomized Controlled Trials as Topic; Quality of Life
PubMed: 38866569
DOI: 10.1136/bmjopen-2023-078895 -
Frontiers in Neurology 2024Post-stroke dysphagia (PSD) affects the efficacy and safety of swallowing, causing serious complications. Acupuncture is a promising and cost-effective treatment for...
BACKGROUND
Post-stroke dysphagia (PSD) affects the efficacy and safety of swallowing, causing serious complications. Acupuncture is a promising and cost-effective treatment for PSD; however, as the number of randomized controlled trials increases, scientific analysis of the parameters and acupoint prescription is required. Therefore, this study aimed to explore the effects of acupuncture on parameters related to post-stroke dysphagia (PSD).
METHODS
We searched the Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature, and Chongqing VIP Database for randomized controlled trials of acupuncture for PSD in the last 15 years and relevant parameters were analyzed using data mining techniques.
RESULTS
In total, 3,205 records were identified, of which 3,507 patients with PSD were included in 39 studies. The comprehensive analysis demonstrated that the closest parameter combinations of acupuncture on PSD were 0.25 mm × 40 mm needle size, 30 min retention time, five treatments per week, and a 4-week total course of treatment. Additionally, the gallbladder and nontraditional meridians, crossing points, and head and neck sites are the most commonly used acupoint parameters. The core acupoints identified were GB20, RN23, EX-HN14, Gongxue, MS6, SJ17, EX-HN12, EX-HN13, and the commonly used combination of EX-HN12, EX-HN13, GB20, and RN23.
CONCLUSION
This study analyzed the patterns of PSD-related needling and acupoint parameters to provide evidence-based guidelines for clinical acupuncturists in treating PSD, potentially benefitting affected patients.
PubMed: 38854959
DOI: 10.3389/fneur.2024.1394348 -
Medical Science Monitor : International... Jun 2024BACKGROUND This study embarked on an innovative exploration to elucidate the effects of integrating electroacupuncture (EA) with motor training (MT) on enhancing...
BACKGROUND This study embarked on an innovative exploration to elucidate the effects of integrating electroacupuncture (EA) with motor training (MT) on enhancing corticospinal excitability and motor learning. Central to this investigation is the interplay between homeostatic and non-homeostatic metaplasticity processes, providing insights into how these combined interventions may influence neural plasticity and motor skill acquisition. MATERIAL AND METHODS The investigation enrolled 20 healthy volunteers, subjecting them to 4 distinct interventions to parse out the individual and combined effects of EA and MT. These interventions were EA alone, MT alone, EA-priming followed by MT, and MT-priming followed by EA. The assessment of changes in primary motor cortex (M1) excitability was conducted through motor-evoked potentials (MEPs), while the grooved pegboard test (GPT) was used to evaluate alterations in motor performance. RESULTS The findings revealed that EA and MT independently contributed to enhanced M1 excitability and motor performance. However, the additional priming with EA or MT did not yield further modulation in MEPs amplitudes. Notably, EA-priming was associated with improved GPT completion times, underscoring its potential in facilitating motor learning. CONCLUSIONS The study underscores that while EA and MT individually augment motor cortex excitability and performance, their synergistic application does not further enhance or inhibit cortical excitability. This points to the involvement of non-homeostatic metaplasticity mechanisms. Nonetheless, EA emerges as a critical tool in preventing M1 overstimulation, thereby continuously fostering motor learning. The findings call for further research into the strategic application of EA, whether in isolation or with MT, within clinical settings to optimize rehabilitation outcomes.
Topics: Humans; Electroacupuncture; Male; Motor Cortex; Learning; Female; Evoked Potentials, Motor; Adult; Healthy Volunteers; Transcranial Magnetic Stimulation; Neuronal Plasticity; Young Adult; Motor Skills; Pyramidal Tracts
PubMed: 38853414
DOI: 10.12659/MSM.943748 -
Medicine Jun 2024Since ancient times, acupuncture has been utilized in the treatment of lots of diseases, as a part of Traditional Chinese Medicine. Acupoint embedding (AEM) therapy,... (Review)
Review
Since ancient times, acupuncture has been utilized in the treatment of lots of diseases, as a part of Traditional Chinese Medicine. Acupoint embedding (AEM) therapy, known as catgut embedding, is a development of acupuncture that consists of inserting catgut or surgical threads into specific acupoints to produce continuous acupoint stimulation based on the theory of Traditional Chinese Medicine. The remaining thread in the acupoint works as a semi-permanent acupuncture needle that results in decreasing the total time of the treatment which is required for continuous manual acupuncture sessions and increasing the treatment efficacy and patients' satisfaction. In each session of AEM about twenty 1 to 2 cm-long threads-natural origin, synthetic polymer, or bioactive threads-will be inserted at the target acupoints and this process will be repeated every 3 to 4 weeks. Indications of AEM are somehow similar to manual acupuncture including obesity, pain, musculoskeletal inflammations, infertility, etc, and it cannot be performed on pregnant women and pediatrics. AEM demonstrates its therapeutic effects via modulating immune system function, alleviating body inflammatory conditions, affecting the neurohormonal system, and other mechanisms. Subcutaneous indurations, redness, bleeding, hematoma, and bruising are some adverse events reported following the AEM. In conclusion, the scientific literature suggests that AEM is a relatively safe and convenient therapy if performed by a professional skilled practitioner.
Topics: Humans; Acupuncture Therapy; Acupuncture Points; Catgut; Medicine, Chinese Traditional
PubMed: 38847703
DOI: 10.1097/MD.0000000000038314