Antihistamine promotes electroacupuncture analgesia in healthy human subjects: A pilot study

Yu-Chen Lee, Cheng-Hao Tu, Hsin-Yi Chung, Sih-Ting Luo, Yu-Ting Chu, Iona J MacDonald, Peddanna Kotha, Chien-Chen Huang, Hsien-Yuan Lane, Jaung-Geng Lin, Yi-Hung Chen, Yu-Chen Lee, Cheng-Hao Tu, Hsin-Yi Chung, Sih-Ting Luo, Yu-Ting Chu, Iona J MacDonald, Peddanna Kotha, Chien-Chen Huang, Hsien-Yuan Lane, Jaung-Geng Lin, Yi-Hung Chen

Abstract

Background and aim: We have previously reported that histamine H1 receptor antagonists facilitate electroacupuncture (EA) analgesia in experimental animals. In this pilot study, we sought to determine whether the histamine H1 receptor antagonist dexchlorpheniramine (DCPA) facilitates EA analgesia in healthy human subjects.

Experimental procedure: Forty healthy subjects aged 20-30 years were randomly allocated to 1 of 4 groups: (1) sham EA at acupoints Zusanli (ST36) and Yanglingquan (GB34) (sham EA; n = 10); (2) EA at ST36 and GB34 (n = 10); (3) EA at ST36 and GB34 plus low-dose DCPA (2 mg, n = 10); (4) EA at ST36 and GB34 plus high-dose DCPA (4 mg, n = 10). Before and after acupuncture treatment, pain thresholds were determined by transcutaneous electrical stimuli on the glabrous skin of the left upper arm.

Results: After the acupuncture session, subjects in the EA plus high-dose DCPA group had a significantly higher pain threshold elevation compared with the other 3 study groups. The change from baseline in pain threshold in the EA plus high-dose DCPA group was significantly greater than the change in pain threshold with EA only, indicating that DCPA 4 mg facilitated EA analgesia.

Conclusion: The results suggest that combining H1 receptor antagonist treatment with EA appears to relieve pain to a greater extent compared with EA alone. This study is registered with ClinicalTrials.gov (https://ichgcp.net/clinical-trials-registry/NCT03805035" title="See in ClinicalTrials.gov">NCT03805035 (https://ichgcp.net/clinical-trials-registry/NCT03805035).

Keywords: Dexchlorpheniramine; Electroacupuncture; H1 receptor antagonists; Pain threshold; Pilot study.

Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

© 2022 Center for Food and Biomolecules, National Taiwan University. Production and hosting by Elsevier Taiwan LLC.

Figures

Graphical abstract
Graphical abstract
Fig. 1
Fig. 1
Flowchart of the pilot trial. Abbreviations: EA, electroacupuncture; DCPA, dexchlorpheniramine; min, minutes.
Fig. 2
Fig. 2
Locations of ST36 and GB34 in humans. (a) The Zusanli (ST36) acupoint is located 3 B-cun distal to the lower border of the patella, 1 fingerbreadth lateral to the anterior crest of the tibia, between the tibialis anterior muscle and the tendon of the extensor digitorum longus. (b) The Yanglingquan (GB34) acupoint is located on the fibular aspect of the leg, in the depression anterior and distal to the head of the fibula. Illustrations are modified from the WHO Standard Acupuncture Point Locations in the Western Pacific Region, 2008 (ISBN 978 92 9061 248 7).
Fig. 3
Fig. 3
Increased pain thresholds after verum EA but not after sham EA. Temporal pain threshold profiles were significantly increased from baseline after EA sessions in (b) the EA group, (c) the EA plus 2 mg DCPA group, and (d) the EA plus 4 mg DCPA group, but not in (a) the sham EA group. ∗∗p < 0.01 after applying the Bonferroni correction. DCPA, dexchlorpheniramine; EA, electroacupuncture; Pre-Tx, before treatment; Post-Tx, after treatment.
Fig. 4
Fig. 4
The change from baseline in pain threshold was highest in subjects treated with verum EA combined with high-dose dexchlorpheniramine. The change from baseline in pain threshold was significantly higher in the EA plus 4 mg DCPA group compared with the EA plus 2 mg DCPA group, verum EA and sham EA groups, respectively. The data are presented with minimum and maximum values, lower, middle and upper quartiles for each group. ∗p < 0.05 after applying the Bonferroni correction. EA, electroacupuncture; DCPA, dexchlorpheniramine.

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