Advanced Search

Journal of Traditional Chinese Medicine >

2026 , Vol. 46 >Issue 3: 674 - 683

DOI: https://doi.org/10.19852/j.cnki.jtcm.2026.03.009

Original Articles

Effect of electro-thumbtack needles on symptoms during high-altitude exposure: a pilot, single-blind, randomized, controlled study

  • WANG Xin ,
  • CAO Xue ,
  • QIN Yuning ,
  • SUN Minglin ,
  • YUE Lihong ,
  • TIAN Yukun ,
  • WANG Guangjun ,
  • LIU Xinglong ,
  • WANG Zirong ,
  • Labasangzhu ,
  • LIU Jia
Expand
  • 1 Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
    2 Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
    3 Xizang Entry-Exit Frontier Inspection Station, National Immigration Administration, Lhasa 850000, China
    4 Department of Logistics and Security, National Immigration Administration, Beijing 100006, China
    5 Department of Preventive Medicine, School of Medicine, Xizang University, Lhasa 850000, China
    6 High Altitude Health Science Research Center, Xizang University, Lhasa 850000, China
Prof. LIU Jia, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medicine Sciences, Beijing 100700, China. marie_liujia@sina.cn;
Prof. Labasangzhu, Department of Preventive Medicine, School of Medicine, Xizang University, Lhasa 850000, China; High Altitude Health Science Research Center, Xizang University, Lhasa 850000, China. lhasam@qq.com

Received date: 2025-01-22

  Accepted date: 2025-09-12

  Online published: 2026-06-08

Supported by

Science and Technology Innovation Project of the China Academy of Chinese Medical Sciences: Registration and Enrollment Study on the Evaluation of the Efficacy of Traditional Chinese Medicine in the Real World(CI2021A05408);Standard Project of Chinese Acupuncture Society: Expert Consensus on Acupuncture and Moxibustion Treatment for High Altitude Sickness(Z0674, surplus funds);Project of China Academy of Chinese Medical Sciences: Research on the Key Technology of the Real-World Case Registry(2022031);Project of the National Key Research and Development Program: Development of International Clinical Research Service Standard for Acupuncture and Moxibustion(2019YFC1712205)

Fold

Abstract

OBJECTIVE: To investigate the efficacy and safety of electro-thumbtack needles (ETN) compared with sham acupuncture (SA) on symptoms during high-altitude exposure.

METHODS: In this pilot, single-blind, randomized, controlled study, we assessed the impact of ETN acupuncture on symptoms associated with high-altitude exposure. Participants were randomized into two groups: an ETN group and a SA group. The intervention involved routine skin disinfection and stimulation of seven acupuncture points: bilateral Neiguan (PC6), bilateral Hegu (LI4), bilateral Taiyang (EX-HN5), and Zhongwan (CV12), with pressure for approximately 1 min on each point. The primary outcome was the Lake Louise Score after intervention. Secondary outcome measures were heart rate, blood pressure, blood oxygen saturation, headache visual analogue scale score, clinical function score, and sleep scale scores after the intervention.

RESULTS: We enrolled 125 patients with high-altitude exposure; 59 in the ETN group and 66 in the SA group. AMS was present in 37.90% of the 125 patients. The Lake Louise Score in the ETN group was significantly lower than that in the SA group 6 h postintervention [P =0.05; adjusted mean difference: 0.56; 95% confidence interval (CI) (0.01, 1.11)]. The changes in blood pressure, blood oxygen saturation, and Groningen Sleep Quality Survey, Stanford Sleepiness Scale, visual analog scale, and clinical functioning scores 48 h postintervention showed no significant differences between the groups. Decreases in cerebral oxygen saturation postintervention differed significantly between the ETN and SA groups [P< 0.05; t = −1.39; 95% CI (3.50, 0.59)].

CONCLUSIONS: This study assessed the feasibility of ETN to address AMS and was a preliminary evaluation of its efficacy. This study provides a basis for the development of intervention programs and scale implementation. ETN is a possible intervention in AMS for special populations, such as those with drug contraindications or pregnant women. This study may guide future research by presenting novel insights, strategic directions, and foundational evidence.

Key words： acupuncture; altitude; randomized controlled trial; altitude sickness; oxygen saturation

Cite this article

WANG Xin , CAO Xue , QIN Yuning , SUN Minglin , YUE Lihong , TIAN Yukun , WANG Guangjun , LIU Xinglong , WANG Zirong , Labasangzhu , LIU Jia . Effect of electro-thumbtack needles on symptoms during high-altitude exposure: a pilot, single-blind, randomized, controlled study[J]. Journal of Traditional Chinese Medicine, 2026 , 46(3) : 674 -683 . DOI: 10.19852/j.cnki.jtcm.2026.03.009

References

1. Trammer RA, Rooney D, Benderoth S, Wittkowski M, Wenzel J, Elmenhorst EM. Effects of moderate alcohol consumption and hypobaric hypoxia: implications for passengers' sleep, oxygen saturation and heart rate on long-haul flights. Thorax 2024; 79: 970-8.
2. Champigneulle B, Brugniaux JV, Stauffer E, et al. Expedition 5300: limits of human adaptations in the highest city in the world. J Physiol 2024; 602: 5449-62.
3. Titz A, Schneider S, Mueller J, Mayer L, Lichtblau M, Ulrich S. Symposium review: high altitude travel with pulmonary vascular disease. J Physiol 2024; 602: 5505-13.
4. Farahani AA, Shahali H. Recurrent unilateral pupillary dilation and transient visual blurring: a clinical challenge during hypoxia exposure in a male fighter pilot. Med J Armed Forces India 2023; 79: S337-337S342.
5. Crawford JE, Amaru R, Song J, et al. Natural selection on genes related to cardiovascular health in high-altitude adapted andeans. Am J Hum Genet 2017; 101: 752-67.
6. Lamichhane S, Ghimire I, Pokhrel A, Sharma NR, Acharya SK. High-altitude illness: menace in himalayas of nepal. Ann Med Surg (Lond) 2022; 81: 104494.
7. Roach RC, Hackett PH, Oelz O, et al. The 2018 lake louise acute mountain sickness score. High Alt Med Biol 2018; 19: 4-6.
8. Berger MM, Hüsing A, Niessen N, et al. Prevalence and knowledge about acute mountain sickness in the Western Alps. PLoS One 2023; 18: e0291060.
9. Hall DP, MacCormick IJ, Phythian-Adams AT, et al. Network analysis reveals distinct clinical syndromes underlying acute mountain sickness. PLoS One 2014; 9: e81229.
10. Burtscher J, Swenson ER, Hackett PH, Millet GP, Burtscher M. Flying to high-altitude destinations: is the risk of acute mountain sickness greater. J Travel Med 2023; 30: taad011.
11. Shen Y, Yang YQ, Liu C, et al. Association between physiological responses after exercise at low altitude and acute mountain sickness upon ascent is sex-dependent. Mil Med Res 2020; 7: 53.
12. Hou YP, Wu JL, Tan C, Chen Y, Guo R, Luo YJ. Sex-based differences in the prevalence of acute mountain sickness: a Meta-analysis. Mil Med Res 2019; 6: 38.
13. Luks AM, Beidleman BA, Freer L, et al. Wilderness medical society clinical practice guidelines for the prevention, diagnosis, and treatment of acute altitude illness: 2024 update. Wilderness Environ Med 2024; 35: 2S-19S.
14. Gao D, Wang Y, Zhang R, Zhang Y. Efficacy of acetazolamide for the prophylaxis of acute mountain sickness: a systematic review, Meta-analysis and trial sequential analysis of randomized clinical trials. Am J Med Sci 2021; 361: 635-45.
15. Chen Y, Guo D. Comparative study of acupuncture-moxibustion and transcranial micro-current stimulation in therapy of altitude hypoxia headache and insomnia. In: Long S, Dhillon BS, editors. Man-Machine-Environment System Engineering. MMESE 2019: Proceedings of the 19th International Conference on Man-Machine-Environment System Engineering; 2019 Oct 19-21; Shanghai, China. Singapore: Springer, 2020: 11-20.
16. Zheng H, Chen M, Wu X, Li Y, Liang FR. Manage migraine with acupuncture: a review of acupuncture protocols in randomized controlled trials. Am J Chin Med 2010; 38: 639-50.
17. Kim HS, Kim YJ, Lee HJ, et al. Development and validation of acupuncture fear scale. Evid Based Complement Alternat Med 2013; 2013: 109704.
18. Lee IS, Jo HJ, Lee SH, et al. Fear of acupuncture enhances sympathetic activation to acupuncture stimulation. Acupunct Med 2013; 31: 276-81.
19. Zhao W, Li J, Wang Y, et al. Efficacy and safety of the "Xingnao Kaiqiao" acupuncture technique via intradermal needling to treat postoperative gastrointestinal dysfunction of laparoscopic surgery: study protocol for a randomized controlled trial. Trials 2017; 18: 567.
20. Hu H, Yuan Z, Han L, Li T, Song F. Intradermal needling and acupuncture in prevention and treatment of leukopenia after chemotherapy with spleen-kidney deficiency: a randomized controlled trial. Zhong Guo Zhen Jiu 2024; 44: 631-6.
21. Li Q. Clinical study on the treatment of perimenopausal insomnia with a new type of thumbtack-needles. Sichuan Zhong Yi 2017; 35: 202-4.
22. Wang X, Wang G, Jia S, Labasangzhu L, Wang Z, Liu J. Safety and efficacy of electro-thumbtack needle for acute mountain sickness patients: a protocol of a randomized, single-blinded, and placebo-controlled study. BMC Complement Med Ther 2024; 24: 355.
23 World Health Organization. WHO standard acupuncture point locations in the Western Pacific region. Regional Office for the Western Pacific, 2022-4-22, cited 2024-11-11; 249. Available from URL: https://iris.who.int/handle/10665/353407.
24. Teare MD, Dimairo M, Shephard N, Hayman A, Whitehead A, Walters SJ. Sample size requirements to estimate key design parameters from external pilot randomised controlled trials: a simulation study. Trials 2014; 15: 264.
25. Meshram I, Boiroju NK, Longvah T. Prevalence of overweight/obesity, hypertension and its associated factors among women from Northeast India. Indian Heart J 2022; 74: 56-62.
26. Kornitzer M, Dramaix M, De Backer G. Epidemiology of risk factors for hypertension: implications for prevention and therapy. Drugs 1999; 57: 695-712.
27. Dubey RK, Oparil S, Imthurn B, Jackson EK. Sex hormones and hypertension. Cardiovasc Res 2002; 53: 688-708.
28. Hou Y, Liang H, Fan C, Liu R, Feng Y. Transcutaneous electrical acupoint stimulation to prevent dizziness after microvascular decompression for hemifacial spasm: a randomized controlled trial. Complement Ther Med 2024; 83: 103055.
29. AlAteeq MA, Alghaihab MM, Marghlani LK, Shamsaddin LA, Alghamdi RK, Alfadley MA. Comparing the prevalence of sleep disorders among underweight, normal, overweight, and obese adults in Riyadh, Saudi Arabia. Cureus 2024; 16: e58858.
30. Bian SZ, Zhang L, Jin J, et al. The onset of sleep disturbances and their associations with anxiety after acute high-altitude exposure at 3700 m. Transl Psychiatry 2019; 9: 175.
31. Zhang J, Tang S, Chen C, et al. A bibliometric analysis of the studies in high-altitude induced sleep disturbances and cognitive impairment research. Front Physiol 2023; 14: 1133059.
32. Xu Y, Xu X, Yang Z, Guo M, Jiang X. Effects of electroacupuncture at "Shuigou" (GV 26) on the expressions of soluble guanylate cyclase and protein kinase G in the cerebral artery vascular smooth muscle of rats with cerebral infarction. Zhen Ci Yan Jiu 2020; 45: 789-92+805.
33. Tao QF, Huang YB, Yuan L, et al. Acupuncture versus tricyclic antidepressants in the prophylactic treatment of tension-type headaches: an indirect treatment comparison Meta-analysis. J Headache Pain 2024; 25: 67.
34. Wu XK, Gao JS, Ma HL, et al. Acupuncture and doxylamine-pyridoxine for nausea and vomiting in pregnancy: a randomized, controlled, 2 × 2 factorial trial. Ann Intern Med 2023; 176: 922-33.
35. Hu L, Wei Z, Wang X, Wu W. Transcranial magnetic stimulation in the assessment of acupuncture effect on exercise-induced fatigue. Brain Behav 2024; 14: e3575.
36. Yin X, Li W, Liang T, et al. Effect of electroacupuncture on insomnia in patients with depression: a randomized clinical trial. JAMA Netw Open 2022; 5: e2220563.
37. Gatterer H, Villafuerte FC, Ulrich S, Bhandari SS, Keyes LE, Burtscher M. Altitude illnesses. Nat Rev Dis Primers 2024; 10: 43.
38. Rattanawong W, Rapoport A, Srikiatkhachorn A, Neurobiology of migraine progression. Neurobiol Pain 2022; 12: 100094.
39. Chen G, Zhang YQ, Qadri YJ, Serhan CN, Ji RR. Microglia in pain: detrimental and protective roles in pathogenesis and resolution of pain. Neuron 2018; 100: 1292-311.
40. Sudershan A, Younis M, Sudershan S, Kumar P. Migraine as an inflammatory disorder with microglial activation as a prime candidate. Neurol Res 2023; 45: 200-15.
41. Zhang Z, Lu T, Li S, et al. Acupuncture extended the thrombolysis window by suppressing blood-brain barrier disruption and regulating autophagy-apoptosis balance after ischemic stroke. Brain Sci 2024; 14: 399.
42. Chavez LM, Huang SS, MacDonald I, Lin JG, Lee YC, Chen YH. Mechanisms of acupuncture therapy in ischemic stroke rehabilitation: a literature review of basic studies. Int J Mol Sci 2017; 18: 2270.
43. Wen CK, Lee TY. Electroacupuncture prevents white adipose tissue inflammation through modulation of hypoxia-inducible factors-1α-dependent pathway in obese mice. BMC Complement Altern Med 2015; 15: 452.
44. Wang C, Li MX, Li YD, Li YP. Bloodletting acupuncture at Jing-well points alleviates myocardial injury in acute altitude hypoxic rats by activating HIF-1α/BNIP3 signaling-mediated mitochondrial autophagy and decreasing oxidative stress. Chin J Integr Med 2023; 29: 170-8.
45. Cui S, Wang K, Wu SB, et al. Electroacupuncture modulates the activity of the hippocampus-nucleus tractus solitarius-vagus nerve pathway to reduce myocardial ischemic injury. Neural Regen Res 2018; 13: 1609-18.
46. Li N, Guo Y, Gong Y, et al. The anti-inflammatory actions and mechanisms of acupuncture from acupoint to target organs via neuro-immune regulation. J Inflamm Res 2021; 14: 7191-224.
47. Fan AY. Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels and targets and is not limited to "driving the vagus-adrenal axis". J Integr Med 2023; 21: 320-3.
48. Pecchio O, Martinelli M, Lupi G, et al. Acupuncture effects on cerebral blood flow during normoxia and normobaric hypoxia: results from a prospective crossover pilot study. Technologies 2021; 9: 102.
49. Amini Rarani S, Rajai N, Sharififar S. Effects of acupressure at the P6 and LI4 points on the anxiety level of soldiers in the Iranian military. BMJ Mil Health 2021; 167: 177-81.
50. Najafi F, Jaafarpour M, Sayehmiri K, Khajavikhan J. An Evaluation of acupressure on the Sanyinjiao (SP6) and Hugo (LI4) points on the pain severity and length of labor: a systematic review and Meta-analysis study. Iran J Nurs Midwifery Res 2018; 23: 1-7.
51. Wang H, Liu WJ, Shen GM, Zhang MT, Huang S, He Y. Neural mechanism of gastric motility regulation by electroacupuncture at RN12 and BL21: a paraventricular hypothalamic nucleus-dorsal vagal complex-vagus nerve-gastric channel pathway. World J Gastroenterol 2015; 21: 13480-9.
52. Small E, Goldberg E, Musi M, et al. Prochlorperazine maleate versus placebo for the prevention of acute mountain sickness: study protocol for a randomized controlled trial. Trials 2024; 25: 785.
53. Schober A, Chinn G, Eichbaum Y, Dudley M, Sall JW; University of California San Francisco AR36 working group. A randomized phase 2 study to evaluate efficacy and safety of AR36 for prevention of acute mountain sickness. Wilderness Environ Med 2023; 34: 498-508.
54. Imray C, Wright A, Subudhi A, Roach R. Acute mountain sickness: pathophysiology, prevention, and treatment. Prog Cardiovasc Dis 2010; 52: 467-84.
55. Zubieta-Calleja G. Redefining chronic mountain sickness: insights from high-altitude research and clinical experience. Med Rev (2021) 2024; 5: 44-65.
Options
Outlines

/

〈 〉