NEWS SCIENTIFICHE
2008
Abbiamo scelto
per voi gli abstracts di alcune pubblicazioni scientifiche recensite nell’anno
2008 da Medline, la
più importante base di dati della letteratura biomedica
mondiale.
Come si può
vedere, la ricerca nel campo dell'agopuntura è molto attiva ed è orientata nei
settori più disparati della scienza biomedica. Chi fosse interessato a reperire
tutti i lavori scientifici pubblicati in letteratura recensita dal 1966 ad oggi,
può connettersi all'indirizzo Web:
http://www.ncbi.nlm.nih.gov/Pubmed
da
cui avrà accesso diretto e gratuito alla consultazione di
Medline.
La
parola chiave (keyword) da utilizzare nelle ricerche
è:
Acupuncture
ABSTRACTS
2008
J Med
Assoc Thai. 2008 Nov;91(11):1633-8.
Effectiveness
of auricular acupressure in the treatment of nausea and vomiting in early
pregnancy.
Puangsricharern
A, Mahasukhon S.
Department
of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit
University, Bangkok, Thailand.
OBJECTIVE: To
evaluate the effectiveness of auricular acupressure in the treatment of nausea
and vomiting in early pregnancy.
MATERIAL
AND METHOD:
Ninety-eight volunteer pregnant women with symptoms of nausea and vomiting in
early pregnancy before 14 weeks gestation were enrolled. The participants were
randomized into two groups: treatment group and control group. Each patient in
the treatment group received magnet pellets, placed at both auricles. They were
taught to start acupressure from the third to the sixth day. Outcome measurement
was Rhodes index score, which describe the severity and frequency of nausea and
vomiting in the form of a questionnaire. The patients from both groups were
asked to complete and return the forms including the amount of anti-emetic drug
taken. Mean Rhodes index score and total number of anti-emetic drug taken from
day 4-6 were used to compare the treatment effect. Student's t test, Chi-square
test and Mann-Whitney U test were used for statistical
analysis.
RESULTS:
Ninety-one pregnant women who returned the questionnaires were evaluated. The
Rhodes index scores of the treatment group were lower than that of the control
group especially after day 4 to day 6 when the acupressure was started. However
when comparing the mean score between the two groups, there were no
statistically significant differences (p > 0.05). The total amount of
anti-emetic tablets in day 4-6 after acupressure intervention was compared and
there were no statistically significant differences (p > 0.05) between the
groups.
CONCLUSION:
Auricular acupressure therapy in treatment of nausea and vomiting in early
pregnancy may not relieve nausea and vomiting in early pregnancy and need
further clinical research to confirm the effectiveness.
Zhongguo
Gu Shang. 2008 Mar;21(3):170-2.
Observation
on therapeutic effects of electroacupuncture for the treatment of knee
osteoarthritis
Wu ZH,
Bao F.
Department
of Orthopaedics, Peking Union Medical College Hospital, Chinese Union Medical
College & Chinese Academy of Medical Sciences, Beijing 100730,
China.
OBJECTIVE: To
study the therapeutic effects of electroacupuncture for the treatment of
osteoarthritis of knee joint.METHODS: Forty patients with knee
osteoarthritis were randomly divided into two groups: the electroacupuncture
group (20 patients)and the control group (20 patients). The patients in
electroacupuncture group (8 male and 12 female, with an average age of 62.50 +/-
9.23 years and mean course of disease 9.85 +/- 8.17 years)were treated with
electroacupuncture for one month. At the same time, the patients in control
group (7 male and 13 female, with an average age of 61.15 +/- 6.75 years and
mean course of disease 8.60 +/- 6.89 years) were given Diclofenac sodium orally
for one month. The motor function of knee joints were evaluated before and after
treatment according to Lysholm knee scoring scale.
RESULTS: Most
scores in the electroacupuncture group improved significantly compared with
those of before treatment (P < 0.01 or P < 0.05) except for the item
demands for support. While in the control group, compared with those of before
treatment, there were significant difference on the item of pain, inter locking
and instability (P < 0.01 or P < 0.05), but there were no significant
differences on other five items (P > 0.05). Between the two groups after
treatment, differences on item of inter locking, instability, swelling, stair
activity and squat were significant (P < 0.05), but no differences on limp,
demands for support and pain (P > 0.05).
CONCLUSION:
Acupuncture can effectively improve the clinical symptoms and knee joint's motor
function of patients with knee osteoarthritis, and more superior than Diclofenac
sodium oral. It is a proved effective method for
osteoarthritis.
Zhongguo
Gu Shang. 2008 Apr;21(4):270-2.
A
randomized controlled trial of rotatory reduction manipulation and acupoint
massage in the treatment of younger cervical vertigo
Kang F,
Wang QC, Ye YG.
College
of TCM, the Southern Medical University, Guangzhou 510515, Guangdong,
China.
OBJECTIVE: To
explore the effects of rotatory reduction manipulation and acupoint massage on
blood flow velocity of vertebrobasilar artery (VBA) in younger cervical vertigo
of high velocity,and to observe the difference of clinical therapeutic effect
between two manipulations.
METHODS:
Seventy-six patients who diagnosed as high flow velocity of younger cervical
vertigo were randomly divided into rotatory reduction manipulation group (group
A, 38 cases)and acupoint massage group (group B, 38 cases). The changes of flow
velocity of VBA before and after treatment were observed using transcranial
Doppler (TCD) and the therapeutic effects were observed
also.
RESULTS: The
mean flow velocity in left vertebral artery (LVA)and basilar artery (BA)of group
B and in BA of group A were significantly decreased as compared with those
before treatment (P < 0.05, P < 0.01) 1 week after treatment,and there was
significant difference in the change of mean flow velocity in LVA between two
groups (P < 0.01). The mean velocity in LVA, right vertebral artery (RVA) and
BA were obviously lower than thosfre before treatment in two groups (P <
0.01) 3 weeks after treatment. There was obvious difference in LVA, RVA between
two groups (P < 0.01). The therapeutic effect of group B was superior to that
of group A (P < 0.05).
CONCLUSION: The
effect of acupoint massage on flow velocity of VBA was superior to that of
rotatory reduction manipulation, and the therapeutic effect of acupoint massage
might be better than that of rotatory reduction manipulation in treating younger
cervical vertigo of high flow velocity.
Zhongguo
Zhen Jiu. 2008 Nov;28(11):795-7.
Observation
on therapeutic effect of warming needle therapy on chronic
colitis
Huang
ZG.
Department
of Acupuncture, Sanming First Hospital Affiliated to Fujian Medical University,
Sanming 365000, China. fjsmhzg@163.com
OBJECTIVE: To
search for a better method for increasing clinical therapeutic effect on chronic
colitis.
METHODS: One
hundred and seventeen cases were randomly divided into a warming needle group (n
= 46), an acupuncture group (n = 39) and a medication group (n = 32). The
warming needle group and the acupuncture group were treated with warming needle
moxibustion and acupuncture on Tianshu (ST 25), Zhongwan (CV 12) and Guanyuan
(CV 4), etc. for 30 min, respectively; the medication group with oral
administration of Salicylazosulfapyridine tablets and Azathiopurine. After they
were treated for 3 courses, the therapeutic effects were
observed.
RESULTS: The
total effective
rate was
93.5% in the warming needle group, 76.9% in the acupuncture group and 75.0% in
the medication group, the warming needle group being better than the acupuncture
group and the medication group (both P < 0.05) and the acupuncture group
being similar to the medication group (P > 0.05).
CONCLUSION: Warming
needle moxibustion is a better therapy for chronic colitis with no side
effects.
Zhongguo
Zhen Jiu. 2008 Nov;28(11):792-4.
Observation
on therapeutic effect of electroacupuncture at Chengshan (BL 57) and Changqiang
(GV 1) on hemorrhoidal pain
Li N, He
HB, Wang CW, Yang CM.
Center
of Rehabilitation and Acupuncture-Moxibustion, West China Hospital, Sichuan
University, Chengdu 610041, China.
OBJECTIVE: To
assess the clinical effect of combination of far with near acupoints, Chengshan
(BL 57) and Changqiang (GV 1), for acupuncture treatment of hemorrhoidal
pain.
METHODS: One
hundred and twenty cases of hemorrhoids with pain were randomly divided into 2
groups, an electroacupuncture group and a medication group, 60 cases in each
group. The electroacupuncture group were treated by electroacupuncture at
Changqiang (GV 1) and Chengshan (BL 57) with sparse-dense wave, frequency 2/100
Hz; and the medication group with oral administration of Tramadol and rectal
application of Mayinglong Shexiang Zhichuang Suppository. The two group were
treated for five days. Changes of pain were assessed by Visual Analogue Scale
(VAS) scores at the defecation each day.
RESULTS: In the
electroacupuncture group, VAS score was 6.64 +/- 3.66 before treatment and 5.65
+/- 2.21 on the second day of treatment with a significant decrease (P <
0.05), and 1.85 +/- 1.24 on the fifth day after treatment end. In the medication
group, VAS score was 6.58 +/- 3.18 before treatment and 4.86 +/- 2.04 on the
third day after treatment with significant decrease compared with that before
treatment, and 2.24 +/- 1.46 on the fifth day. There was no significant
difference between the two groups in the pain score on the fifth day after the
treatment end.
CONCLUSION:
Combination of Chengshan (BL 57) with Changqiang (GV 1) is effective for
improvement of hemorrhoidal pain in defecation.
Zhongguo
Zhen Jiu. 2008 Nov;28(11):789-91.
Effect
of needling the mimetic muscle on recovery of mimetic function in the patient of
spontaneous facial paralysis
Chen RH,
Chen RL.
Department
of Orthopedics and Traumatology, Dongqiao Town Health-Center of Hui'an County,
Quanzhou, Fujian 362141, China. 88crh@163.com
OBJECTIVE: To
observe therapeutic effects of different acupuncture methods for recovery of
mimetic function in the patient of spontaneous facial paralysis.
METHODS: One
hundred and thirty-four cases of facial paralysis were randomly divided into a
mimetic muscle acupuncture group (mimetic muscle group, n = 79) and a routine
acupoint group (n = 55). The mimetic muscle group were treated by encircling
needling frontal belly of epicranial muscle, orbicular muscle of eye, orbicular
muscle of mouth and buccinator muscle, and the routine acupoint group with
acupuncture at Dicang (ST 4), Jiache (ST 6), Yangbai (GB 14), Sibai (ST 2),
Cuanzhu (BL 2), etc. on the affected side. Their therapeutic effects were
compared after they were treated for 2 courses.
RESULTS: The
effective rate and the good rate were 94.9% and 92.4% in the mimetic muscle
group and 70.9% and 52.7% in the routine acupoint group, respectively, with a
significant difference between the two groups (P <
0.05).
CONCLUSION: The
therapeutic effect of needling the mimetic muscle on spontaneous facial
paralysis is superior to that of the routine acupuncture
therapy.
Ann Allergy
Asthma Immunol. 2008 Nov;101(5):535-43.
Acupuncture
in patients with allergic rhinitis: a pragmatic randomized
trial.
Brinkhaus
B, Witt CM, Jena S, Liecker B, Wegscheider K, Willich
SN.
Institute
of Social Medicine, Epidemiology, and Health Economics, Charité University
Medical Center, Berlin, Germany.
benno.brinkhaus@charite.de
BACKGROUND:
Acupuncture is widely used in patients with allergic rhinitis, but the available
evidence of its effectiveness is insufficient. OBJECTIVE: To evaluate the
effectiveness of acupuncture in addition to routine care in patients with
allergic rhinitis compared with treatment with routine care
alone.
METHODS: In a
randomized controlled trial, patients with allergic rhinitis were randomly
allocated to receive up to 15 acupuncture sessions during a period of 3 months
or to a control group receiving no acupuncture. Patients who did not consent to
random assignment received acupuncture treatment. All patients were allowed to
receive usual medical care. The Rhinitis Quality of Life Questionnaire (RQLQ)
and general health-related quality of life (36-Item Short-Form Health Survey)
were evaluated at baseline and after 3 and 6 months.
RESULTS: Of
5,237 patients (mean SD age, 40 12 years; 62% women), 487 were randomly assigned
to acupuncture and 494 to control, and 4,256 were included in the nonrandomized
acupuncture group. At 3 months, the RQLQ improved by a mean (SE) of 1.48 (0.06)
in the acupuncture group and by 0.50 (0.06) in the control group (3-month
scores, 1.44 0.06 and 2.42 0.06, respectively; difference in improvement, 0.98
0.08; P < .001). Similarly, quality-of-life improvements were more pronounced
in the acupuncture vs the control group (P < .001). Six-month improvements in
both acupuncture groups were lower than they had been at 3
months.
CONCLUSIONS: The
results of this trial suggest that treating patients with allergic rhinitis in
routine care with additional acupuncture leads to clinically relevant and
persistent benefits. In addition, it seems that physician characteristics play a
minor role in the effectiveness of acupuncture treatment, although this idea
needs further investigation.
Anaesthesia.
2008 Dec;63(12):1343-8.
Auricular
acupuncture for postoperative pain control: a systematic review of randomised
clinical trials.
Usichenko
TI, Lehmann Ch, Ernst E.
Department
of Anaesthesiology and Intensive Care Medicine, University of Greifswald,
Germany. taras@uni-greifswald.de
SUMMARY: The
number of publications on the peri-operative use of auricular acupuncture has
rapidly increased within the last decade. The aim was to evaluate clinical
evidence on the efficacy of auricular acupuncture for postoperative pain
control. Electronic databases: Medline, MedPilot, DARE, Clinical Resource,
Scopus and Biological Abstracts were searched from their inception to September
2007. All randomised clinical trials on the treatment of postoperative pain with
auricular acupuncture were considered and their quality was evaluated using the
Jadad scale. Pain intensity and analgesic requirements were defined as the
primary outcome measures. Of 23 articles, nine fulfilled the inclusion criteria.
Meta-analytic approach was not possible because of the heterogeneity of the
primary studies. In eight of the trials, auricular acupuncture was superior to
control conditions. Seven randomised clinical trials scored three or more points
on the Jadad scale but none of them reached the maximum of 5 points. The
evidence that auricular acupuncture reduces postoperative pain is promising but
not compelling.
Anesth
Analg. 2008 Dec;107(6):2038-47.
Acupuncture
for the management of chronic headache: a systematic
review.
Sun Y,
Gan TJ.
Duke University Medical Center, Department of Anesthesiology, Box 3094, Durham, NC 27710, USA.
OBJECTIVE: The
objective of this review was to evaluate the efficacy of acupuncture for
treatment of chronic headache.
METHODS: We
searched the databases of Medline (1966-2007), CINAHL, The Cochrane Central
Register of Controlled Trials (2006), and Scopus for randomized controlled
trials investigating the use of acupuncture for chronic headache. Studies were
included in which adults with chronic headache, including migraine, tension-type
headache or both, were randomized to receive needling acupuncture treatment or
control consisting of sham acupuncture, medication therapy, and other
nonpharmacological treatments. We extracted the data on headache intensity,
headache frequency, and response rate assessed at early and late follow-up
periods.
RESULTS:
Thirty-one studies were included in this review. The majority of included trials
comparing true acupuncture and sham acupuncture showed a trend in favor of
acupuncture. The combined response rate in the acupuncture group was
significantly higher compared with sham acupuncture either at the early
follow-up period (risk ratio RR: 1.19, 95% confidence interval CI: 1.08, 1.30)
or late follow-up period (RR: 1.22, 95% CI: 1.04, 1.43). Combined data also
showed acupuncture was superior to medication therapy for headache intensity
(weighted mean difference: -8.54 mm, 95% CI: -15.52, -1.57), headache frequency
(standard mean difference: -0.70, 95% CI: -1.38, -0.02), physical function
(weighted mean difference: 4.16, 95% CI: 1.33, 6.98), and response rate (RR:
1.49, 95% CI: 1.02, 2.17).
CONCLUSION:
Needling acupuncture is superior to sham acupuncture and medication therapy in
improving headache intensity, frequency, and response
rate.
Zhongguo
Zhen Jiu. 2008 Oct;28(10):779-82.
Survey of acupuncture treatment for neurogenic bladder dysfunction after spinal cord injuries
Wang JQ,
Liu ZS.
Beijing
General Hospital of Aerospace, Beijing 100076, China.
ae2000wangjiaqi@hotmail.com
Acupuncture
and moxibustion for treatment of neurogenic bladder dysfunction after spinal
cord injuries at home and abroad in recent years is introduced. The acupuncture
and moxibustion methods for treatment of this kind of disease are classified and
analyzed from body acupuncture, electroacupuncture, acupoint pressure and
massage, acupoint-injection, acupoint sticking and so on. Acupuncture and
moxibustion are widely applied to treatment of neurogenic bladder dysfunction
after spinal cord injuries, with definite therapeutic effect and good safety.
The effectiveness of other evaluation indexes of acupuncture and moxibustion for
treatment of neurogenic bladder dysfunction after spinal cord injuries needs to
be proved by more randomized and controlled trials of high quality with strict
design and scientific methods.
Klin
Padiatr. 2008 Nov-Dec;220(6):365-70.
Acupuncture to alleviate chemotherapy-induced nausea and vomiting in pediatric oncology - a randomized multicenter crossover pilot trial.
Gottschling
S, Reindl TK, Meyer S, Berrang J, Henze G, Graeber S, Ong MF, Graf
N.
Department
of Pediatric Hematology and Oncology, Saarland University, Homburg, Germany.
kisgot@uniklinikum-saarland.de
BACKGROUND: We
investigated whether acupuncture as a supportive antiemetic approach reduces the
need for antiemetic rescue medication during highly emetogenic chemotherapy in
pediatric oncology. We report on a multicenter crossover study at 5 tertiary
hospitals in Germany. PROCEDURE: Twenty-three children (13.6 y,+/- 2.9)
receiving highly emetogenic chemotherapy for treatment of solid malignant tumors
were included. Patients were randomly allocated to receive acupuncture treatment
during either the second or third identical chemotherapy course together with
standard antiemetic medication. The main outcome measure was the amount of
additional antiemetic medication during chemotherapy. Secondary outcome measure
was the number of episodes of vomiting per course.
RESULTS:
Fourty-six chemotherapy courses with or without acupuncture were compared. The
need for rescue antiemetic medication was significantly lower in acupuncture
courses compared to control courses (p=0.001) Episodes of vomiting per course
were also significantly lower in courses with acupuncture (p=0.01). Except for
pain from needling (4/23) no side effects occurred. Patients acceptance of
acupuncture was high. CONCLUSIONS:
Acupuncture as applied here seems to be effective in preventing nausea and
vomiting in pediatric cancer patients.
Zhen Ci Yan
Jiu. 2008 Aug;33(4):267-71.
A fMRI observation on different cererbral regions activated by acupuncture of Shenmen (HT 7) and Yanglao (SI 6)
Chen SJ,
Liu B, Fu WB, Wu SS, Chen J, Ran PC.
Department
of Rehabilitation, Baoan People's Hospital, Shenzhen 518101, China.
csjme@163.com
OBJECTIVE: To
observe the influence of acupuncture of Shenmen (HT 7) and Yanglao (SI 6) on
neuro-images in different cerebral regions in volunteer
subjects.
METHODS: Twelve
healthy young volunteer participants were enrolled in this research. fMRI scans
were taken in random order in a block design (one for baseline and two for
acupuncture stimulations). During stimulation phase, an acupuncture needle
inserted in right HT7 or S16 was twirled at an angle of 180 degrees and a
frequency of about 1.5 Hz for 35. 6 ms. Main parameters for fMRI were TR/TE/FA =
3560 ms/50 ms/90 degrees. Acupuncture sensations were evaluated by means of
visual analog scale (VAS). The collected images were analyzed by using SPM 2 for
exploring inter-group differences in blood oxygen level dependent (BOLD)
responses.
RESULTS: When
manipulating the needle, both the operator and the subject had a feeling of
Deqi. Increases in BOLD signal (group analysis, corrected, 0.05, K > or =10)
were found mainly in right postcentral gyrus of frontal lobe (BA 2, BA 1, BA
43), left inferior frontal gyrus (BA 47), secondarily, in the right inferior
parietal lobule (BA 40), right inferior frontal gyrus (BA 44), left superior
temporal gyrus (BA 22) and right insula (BA 40) after acupuncture at HT7; and
chiefly in left inferior parietal lobule (BA 40), right inferior frontal gyrus
(BA 45, BA 46), secondarily in the left middle temporal gyrus and inferior
temporal gyrus (BA 37) as well as the left superior frontal gyrus (BA 10) after
acupuncture of S16.
CONCLUSION:
Acupuncture of HT7 and SI6 elicite different BOLD responses in some related
cerebral regions.
Zhen Ci Yan
Jiu. 2008 Aug;33(4):262-6.
Multicentral randomized controlled clinical trials about treatment of perimenopausal syndrome with electroacupuncture of sanyinjiao (SP 6)
Xia XH,
Hu L, Qin ZY, Zhou J, Meng L, Li WL, Tian LY, Zhang
YJ.
Anhui
College of Chinese Medicine, Hefei 230038, China.
xxh2024@sina.com
OBJECTIVE: To
evaluate the effect of electroacupuncture (EA) of Sanyinjiao (SP 6) on
perimenopausal syndrome (PMS).
METHODS:
Multicentral randomized controlled trials and single blind test were adopted in
the present study. A total of 157 PMS patients were randomly divided into EA
group (n=81) and medication group (n=76) . EA (2/100 Hz, 8-10 mA) was applied to
bilateral Sanyinjiao (SP 6), 3 times a week and for 3 months (mon). Patients of
medication group were treated by oral administration of nylestriol, 2 mg/time,
twice a mon for 3 mon. For PMS patients, medroxyprogesterone (6 mg/d, for 10
days) was added from the third mon on after the treatment. The therapeutic
effect was evaluated by using "symptoms-signs score scale", and changes of serum
estradiol (E2), follicle stimulating hormone (FSH) and luteotrophic hormone (LH)
were detected by chemiluminescence immune assay. Kupperman index was determined
before and after the treatment.
RESULTS: In
comparison with pre-treatment, Kupperman index of EA group decreased
significantly (P < 0.01). After the treatment, contents of serum FSH and LH
of EA group decreased significantly (P < 0.01), while serum E2 contents of EA
and medication groups increased significantly (P < 0. 01). Serum LH and E2
levels of EA group were significantly lower than those of medication group (P
< 0.05). No significant differences were found between two groups in
Kupperman index, markedly-effective rates and total effective rates (P >
0.05).
CONCLUSION: EA of
Sanyinjiao (SP 6) is able to regulate serum E2, FSH and LH levels and
effectively improve perimenopausal syndrome.
Zhongguo
Zhen Jiu. 2008 Sep;28(9):653-5.
Yi WM,
Li JJ, Lu XM, Jin LL, Pan AZ, Zou YQ.Acupuncture Department, The Second
Affiliated Hospital of Sun Yat-sen
University,
Guangzhou, Guangdong 510120, China. acupun@163.com
OBJECTIVE: To
observe the effect of electroacupuncture on recovery of urinary bladder function
after radical hysterectomy.
METHODS: One
hundred and ten cases were randomly divided into an electroacupuncture (EA)
group and a control group, 55 cases in each group. In the control group, the
urinary tube was placed and kept with routine method and the urinary bladder was
rinsed, and from the eighth day the abdomen was radiated with TDP, 30 min each
day, for 5 days. In the EA group, on the basis of treatment in the control group
EA was given at Sanyinjiao (SP 6), Zusanli (ST 36), Waiguan (TE 5), Shuidao (ST
28), Guilai (ST 29), etc. from the eighth day to twelfth day after operation.
The recovery time of urinary bladder function after radical hysterectomy, urine
dynamic indexes and hospitalization days were compared between the two
groups.
RESULTS: The
cases of the bladder function recovery, retention of urine, urinary incontinence
were 51(51/55), 4(4/55), 0 on the 14 th day after operation and 53(53/55),
2(2/55), 0 on the 28 th day in the EA group, and 27(27/55), 25(25/55), 3(3/55)
on the 14 th day and 43(43/55), 11(11/55), 1(1/55) on the 28th day in the
control group, respectively, with a very significant difference between the two
groups (P < 0.01); the EA group in residual urine volume, bladder volume,
mean urinary flowing rate was better than the control group on the 14 th day
after operation (P < 0.01 or P < 0.05); the hospitalization days after
operation was (21.1 +/- 3.3) days in the EA group and (25.5 +/- 3.5) days in the
control group, the former being shorter than the later (P <
0.01).
CONCLUSION: EA can
promote recovery of bladder function, shorten the keeping time of urinary tube
after radical hysterectomy, which is benefit to decreasing incidence rate of
urinary system infection and shortening hospitalization
days.
Zhongguo
Zhen Jiu. 2008 Sep;28(9):645-7.
Observation on therapeutic effect of acupuncture combined with medicine on Parkinson disease
Chang
XH, Zhang LZ, Li YJ.
The
Second Clinical Medical School, Henan College of TCM, Zhengzhou 450002, China.
xhchang123@126.com
OBJECTIVE: To
observe therapeutic effect of acupuncture on Parkinson disease
(PD).
METHODS: Sixty
cases of PD were randomly divided into 2 groups, an acupuncture plus medication
group and a medication group, 30 cases in each group. The acupuncture plus
medication group were treated with acupuncture at Shenting (GV 24), Baihui (GV
20), Sishencong (EX-HN 1), etc. and oral administration of Madopa, and the
medication group only with Madopa. Their therapeutic effect and scores of
Parkinson disease function rating scale (modified UPDRS) were
compared.
RESULTS: The
total improvement rate of 80.0% in the acupuncture plus medication group was
significantly higher than 60.0% in the medication group (P < 0.05); the
decrease of cumulative score of UPDRS in the acupuncture plus medication group
was better than that in the medication group (P <
0.05).
CONCLUSION:
Acupuncture has a certain therapeutic effect on PD.
Zhongguo Zhen Jiu. 2008 Sep;28(9):639-41.
Yue J,
Xu SS, Ma L, Yang SM.
Nanning
City Institute of Acupuncture and Moxibustion, Nanning, Guangxi 530012, China.
fengchi123@tom.com
OBJECTIVE: To
observe effects of acupuncture at Neiguan (PC 6) on function of sinoatrial node,
so as to provide experimental basis for clinical application of Neiguan (PC 6)
to treatment of heart diseases.
METHODS: Fifty
cases of heart diseases were randomly divided into 2 groups, a no-blocking group
(n = 35) and a blocking group (n = 15). In the no-blocking group, sinoatrial
node recovery time (SNRT), sinoatrial conduction time (SACT), sinoatrial node
effective refractory period (SNERP) and heart rate (HR) were determined by using
esophagus-left cardiac atrium regulating pulsation technique before and after
acupuncture at Neiguan (PC 6); and in the blocking group, the vegetative nerve
was blocked by intravenous injection of Propanolol and Atropine, and then SNRT,
SACT, SNERP and intrinsic heart rate (IHR) were detected before and after
acupuncture.
RESULTS: In the
no-blocking group there were significant differences in SACT, SNERP and HR (all
P < 0.05) and no significant difference in SNRT (P > 0.05) before and
after treatment. In the blocking group, there were no significant differences in
SNRT, SACT and SNERP and a significant difference in IHR before and after
acupuncture (P < 0.05).
CONCLUSION:
Acupuncture at Neiguan (PC 6) has a significant effect on function of sinoatrial
node, and the mechanism is possibly related with the bidirectional regulative
action of acupuncture at Neiguan (PC 6) on the autonomic nerve in the sinoatrial
node.
Zhen Ci Yan
Jiu. 2008 Jun;33(3):213-6.
Effect of nitric oxide on noradrenergic function and skin electric resistance of acupoints and meridians
Liang Y, Ma
SX, Chen JX.
School of Fundamental Medical Sciences, Beijing University of Chinese Medicine, Beijing 100029, China.
Most
acupuncture points correspond to low skin-resistance points (LSRP) on the body
surface along the meridians. We did three experiments which conformed that the
skin nitric oxide (NO) concentration and expression of neuronal nitric oxide
synthesis (nNOS) were higher than those in non-acupoints, and non-meridian
control points. Noradrenaline (NE) synthesis/release was modulated by exogenous
NO donor and selective inhibitor of nNOS in the skin acupoints/meridians. Skin
electrical currents in low skin resistance points were modified by
L-arginine-derived NO synthesis and NE. As a conclusion, NO-NE contribute to low
resistance characteristics of acupoints and meridians.
Curr
Drug Saf. 2008 Sep;3(3):230-9.
Clinical strategies for preventing postoperative nausea and vomitting after middle ear surgery in adult patients.
Fujii
Y.
First
Department of Anesthesiology, Toho University School of Medicine, Tokyo, Japan.
yfujii@med.toho-u.ac.jp
Middle
ear surgery (tympanoplasty and mastoidectomy) performed under general or local
anesthesia is associated with a high incidence of postoperative nausea and
vomiting (PONV). Between 50% and 80% of patients who undergo these surgical
procedures experience PONV. Numerous antiemetics have been studied for the
prevention of PONV after middle ear surgery. Traditional antiemetics, including
anticholinergics (e.g., scopolamine), phenothiazines (e.g., promethazine),
butyrophenones (e.g., droperidol), and benzamide (e.g., metoclopramide), are
used for the prevention of PONV during 0-24 h after anesthesia. The available
nontraditional antiemetics that have been shown to be effective for the
prophylaxis against PONV are propofol, dexamethasone, tandospirone, and
midazolam. Antiserotinins (ondansetron, granisetron, and ramosetron) are highly
effective in decreasing the incidence of PONV for 24 h postoperatively, compared
with traditional antiemetics. Ramosetron is effective for the long-term (up to
48 h) prevention of PONV. None of the available antiemetics is entirely
effective, perhaps because most of them act through the blockade on one type of
receptor. There is a possibility that combined antiemetics with different sites
of activity would be more effective than one drug alone for preventing PONV.
Nonpharmacological technique is acustimulation at P6 (Nei-Kuwan)
point.
Zhongguo
Zhen Jiu. 2008 Aug;28(8):573-5.
Effects of scalp acupuncture combined with rehabilitation therapy on motor function in the hemiplegic patient of cerebral thrombosis at convalescent period
Huang
GF, Zhang HX, Zhang TF.
Department
of Rehabilitation Medicine, Tongji Hospital Affiliated to Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030,
China. hgfmkp@yahoo.com.cn
OBJECTIVE: To
search for the best way to elevate the clinical therapeutic effect in the
hemiplegic patient of cerebral thrombosis at convalescent
period.
METHODS:
Adopting single-blind, randomized controlled method, 90 cases of cerebral
thrombosis at convalescent period were assigned to 3 groups: a scalp acupuncture
group (group A), a rehabilitation therapy group (group B) and a scalp
acupuncture combined with rehabilitation therapy group (group C). Group A were
treated with scalp acupuncture at the anterior oblique line of vertex-temporal
and the posterior oblique line of vertex-temporal on the healthy side; group B
were treated with modern rehabilitation medical therapy, making limb function
treatment; group C were treated with the scalp acupuncture in the group A
combined with the rehabilitation therapy in the group B. Improvement of neural
function defect and activity of daily life (ADL), and clinical therapeutic
effect were observed.
RESULTS: After
treatment, the scores of neural function defect of 6.14 +/- 0.36 in the group C
was significantly lower than 8.94 +/- 0.56 in the group A and 8.64 +/- 0.49 in
the group B (P<0.05); the score of ADL of 88.39 +/- 10.02 and clinical
therapeutic effect of 90.0% in the group C were significantly higher than 74.19
+/- 12.12 and 76.7% in the group A and 72.29 +/- 11.52 and 73.3% in the group B
(P<0.05).
CONCLUSION: The
scalp acupuncture and rehabilitation therapy have synergistic action in
improving motor function for the hemiplegic patient of cerebral thrombosis at
convalescent period, and it is a better method for cerebral thrombosis at the
convalescent stage.
Zhongguo
Zhen Jiu. 2008 Aug;28(8):569-72.
Effect of cranial needling combined with medicine on IL-6 in the patient of acute cerebral hemorrhage
Zhao YZ,
Yu CD.
Department
of Acupuncture and Moxibustion, Wenzhou City Hospital of TCM, Wenzhou, Zhejiang
325000, China. zhaoyiz@sina.com
OBJECTIVE: To
explore the mechanism of cranial needling in treatment of acute intracerebral
hemorrhage.
METHODS:
Forty-three cases were randomly divided into a cranial needling plus medication
group (n=21) and a medication group (n=22). The cranial needling plus medication
group were treated with needling skull suture 4 days after the attack, once each
day, for 10 sessions, on the basis of routine neurological treatment measures.
The medication group were treated with the routine neurological treatment
measures. Changes of the scores of neural function defect and IIL-6 contents
before and after treatment were compared.
RESULTS: The
IL-6 contents before and after treatment were (11.29 +/- 8.63) pg/mL and (1.91
+/- 1.02) pg/mL in the cranial needling plus medication group, and (12.15 +/-
7.23) pg/mL and (3.61 +/- 2.71) pg/mL in the medication group, respectively,
with very significant differences before and after treatment (P<0.01), and
with a significant difference between the two groups after treatment
(P<0.05). There were very significant differences in the score of neural
function defect before and after treatment in the two groups (P<0.01), and
there was a significant difference between the two groups after treatment
(P<0.05).
CONCLUSION: On the
basis of medication, cranial needling can promote rapid decrease of serum IL-6
content and improve nervous function in the patient of acute cerebral
hemorrhage.
Zhongguo
Zhen Jiu. 2008 Aug;28(8):555-9.
Electroacupuncture at Zhongji (CV 3) for treatment of benign hyperplasia of prostate: a multi-central randomized controlled study
Liu QG,
Wang CY, Jiao S, Tang LX, Peng MH, Tian LF, Ding WX, Zhao X, Lu SK, Fu YJ, Tan
WL, Qin Y.
School
of Acupuncture and Moxibustion, Beijing University of CM, Beijing 100029, China.
liuqingguo999@vip.sina.com
OBJECTIVE: To
assess the role of Zhongji (CV 3) in treatment of benign hyperplasia of
prostate.
METHODS:
Multi-central, randomized, controlled, single bland clinical method was adopted,
and 276 cases were divided into an electroacupuncture (EA) group and a
medication group, 138 cases in each group. The EA group were treated with EA at
Zhongji (CV 3) and the medication group with oral administration of Qianliekang
tablets. After treatment of 1 course, their therapeutic effects and changes of
international prostate symptom (I-PSS) cumulative score, life quality index (L)
cumulative score, nocturia times, urine stream state, lower abdominal symptom,
maximal volume of urine flow, residual urine volume, prostatic volume, etc. Were
assessed in the two groups.
RESULTS: The
total effective rate was 96.4% in the EA group and 86.2% in the medication
group, the former being better than the latter (P<0. 01); the two groups were
effective in improvement of international prostate symptom (I-PSS) cumulative
score, life quality index (L) cumulative score, nocturia times, urine stream
state, hypogastrium symptom, maximal volume of urine flow, residual urine
volume, prostatic volume, etc. with the former better than the
latter.
CONCLUSION:
Acupuncture at Zhongji (CV 3) has a significant therapeutic effect for treatment
of benign hyperplasia of prostate.
J
Rehabil Med. 2008 Jul;40(7):582-8.
A randomized controlled trial of acupuncture added to usual treatment for fibromyalgia.
Targino
RA, Imamura M, Kaziyama HH, Souza LP, Hsing WT, Furlan AD, Imamura ST, Azevedo
Neto RS.
Departamento
de Patologia, Avenida Doutor Arnaldo 455, Sao Paulo, Brazil.
targino@usp.br
OBJECTIVE: To
evaluate the effectiveness of acupuncture for fibromyalgia.
METHODS:
Fifty-eight women with fibromyalgia were allocated randomly to receive either
acupuncture together with tricyclic antidepressants and exercise (n=34), or
tricyclic antidepressants and exercise only (n=24). Patients rated their pain on
a visual analogue scale. A blinded assessor evaluated both the mean pressure
pain threshold value over all 18 fibromyalgia points and quality of life using
SF-36.
RESULTS: At the
end of 20 sessions, patients who received acupuncture were significantly better
than the control group in all measures of pain and in 5 of the SF-36 subscales.
After 6 months, the acupuncture group was significantly better than the control
group in numbers of tender points, mean pressure pain threshold at the 18 tender
points and 3 subscales of SF-36. After one year, the acupuncture group showed
significance in one subscale of the SF-36; at 2 years there were no significant
differences in any outcome measures.
CONCLUSION:
Addition of acupuncture to usual treatments for fibromyalgia may be beneficial
for pain and quality of life for 3 months after the end of treatment. Future
research is needed to evaluate the specific effects of acupuncture for
fibromyalgia.
Physiol
Behav. 2008 Oct 20;95(3):515-20.
Experimentally manipulating perceptions regarding acupuncture elicits different responses to the identical acupuncture stimulation.
Chae Y,
Kim SY, Park HS, Lee H, Park HJ.
Department
of Meridian and Acupoint, College of Korean Medicine, Kyung Hee University, 1
Hoegi-dong, Dongdaemun-gu, Seoul, 130-701, Republic of
Korea.
Excessive
expectancy or an aversion to acupuncture makes it difficult to evaluate the
efficacy of acupuncture during clinical trials. We investigated whether
experimental manipulations of the perception of acupuncture could elicit
different responses to identical acupuncture stimulation. Seventeen participants
were assessed with the acupuncture belief scale (ABS) and by measuring tactile
and pain sensitivity. Identical acupuncture-related pictures and either positive
(positive group; n=9) or negative (negative group, n=8) statements related to
treatment were presented, and participants used the self-assessment manikin
(SAM) to rate each acupuncture-related image. Participants were stimulated with
the same intensity for 5 min and then evaluated for acupuncture-induced,
self-reported pain. Heart rate variability (HRV) was measured before and after
the acupuncture stimulation. Participants in the negative group were less
valenced and more aroused in response to the same acupuncture picture compared
to those in the positive group. Negative cognition regarding acupuncture
modality resulted in a change of the relationship between the pre-experimental
expectancy of acupuncture and self-reported pain. The negative group produced an
increased low-frequency component of HRV after acupuncture, whereas the positive
group did not. Subjective and sympathetic responses to acupuncture can be
modified by perception. Our findings may help to understand the psychological
factors related to acupuncture modality.
Aust J
Physiother. 2008;54(3):179-84.
A single session of Acu-TENS increases FEV1 and reduces dyspnoea in patients with chronic obstructive pulmonary disease: a randomised, placebo-controlled trial.
Lau KS,
Jones AY.
Kowloon
Hospital, Kowloon, Hong Kong.
QUESTIONS: What
is the immediate effect of a single 45-minute session of transcutaneous
electrical nerve stimulation over acupoints (Acu-TENS) on lung function and
dyspnoea in patients with chronic obstructive pulmonary disease?
DESIGN:
Randomised, placebo-controlled trial with concealed allocation, participant
blinding, assessor blinding, and intention-to-treat analysis.
PARTICIPANTS: Forty-six ambulatory patients with a mean age of 75 years,
with stage I or II chronic obstructive pulmonary disease, and with no previous
experience of TENS or acupuncture.
INTERVENTION: The
experimental group received 45 minutes of Acu-TENS over acupoint Ex-B1
bilaterally (0.5 'cun' lateral to the spinous process of the 7(th) cervical
vertebra) while the control group received placebo-TENS with identical electrode
placement but no electrical output despite a flashing light indicating stimulus
delivery. OUTCOME MEASURES: Lung function was measured as FEV1 and FVC while
dyspnoea was measured using a shortness of breath 100-mm visual analogue scale.
RESULTS: After
45 minutes of Acu-TENS, the experimental group had increased FEV1 by 0.12 litres
(95% CI 0.07 to 0.15) and decreased dyspnoea by 10.7 mm (95% CI -13.9 to -7.6)
more than the control group. The effect on FVC was only small (mean difference
0.05 litres, 95% CI -0.01 to 0.10).
CONCLUSION:
Acu-TENS may be a useful non-invasive adjunctive intervention in the management
of dyspnoea in patients with chronic obstructive pulmonary disease. This study
suggests that the effect of long-term Acu-TENS warrants further
investigation.
Anesth Analg. 2008 Sep;107(3):811-6.
Extra-1 acupressure for children undergoing anesthesia.
Wang SM,
Escalera S, Lin EC, Maranets I, Kain ZN.
Department
of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, New
Haven, CT 06510, USA. shu-ming.wang@yale.edu
BACKGROUND:
Acupuncture and related techniques have been used as adjuncts for perioperative
anesthesia management. We examined whether acupressure in the Extra-1 (Yin-Tang)
point would result in decreased preprocedural anxiety and reduced
intraprocedural propofol requirements in a group of children undergoing
endoscopic procedures.
METHODS:
Fifty-two children were randomized to receive acupressure bead intervention
either at the Extra-1 acupuncture point or at a sham point. A Bispectral Index
(BIS) monitor was applied to all children before the onset of the intervention.
Anxiety was assessed at baseline and before entrance to the operating room.
Anesthetic techniques were standardized and maintained with IV propofol infusion
titrated to keep BIS values of 40-60.
RESULTS: We
found that after the intervention, children in the Extra-1 group experienced
reduced anxiety whereas children in the sham group experienced increased anxiety
(-9% -3 to -15 vs 2% -6 to 7.4, P = 0.012). In contrast, no significant changes
in BIS values were observed in the preprocedural waiting period between groups
(P = ns). We also found that total intraprocedural propofol requirements did not
differ between the two study groups (214 +/- 76 microg x kg(-1) x min(-1) vs 229
+/- 95 microg x kg(-1) x min(-1), P = 0.52).
CONCLUSIONS: We
conclude that acupressure bead intervention at Extra-1 acupoint reduces
preprocedural anxiety in children undergoing endoscopic procedures. This
intervention, however, has no impact on BIS values or intraprocedural propofol
requirements.
Am J
Chin Med. 2008;36(4):635-45.
Acupuncture analgesia: a review of its mechanisms of actions.
Lin JG,
Chen WL.
Graduate
Institute of Chinese Medical Science, China Medical University, Taiwan.
jglin@mail.cmu.edu.tw
The
mechanism of acupuncture analgesia (AA) has been widely explored since the
1970s. Early studies investigated the relationship between acupuncture and
endogenous opiates (beta-endorphin, enkephalin, endomorphin and dynorphin).
Before the 1990s, most experts agreed on the concept that in normal animal
models, lower frequency electroacupuncture (EA) stimulates the release of
beta-endorphin, enkephalin and endomorphin, which in turn activates the mu- and
delta-opioid receptors, and that higher frequency EA stimulates dynorphin which
activates the kappa-opioid receptor. Besides endogenous opiates, our studies
have focused on serotonin. The serotoninergic descending inhibitory pathway is
suggested to be an important mechanism of acupuncture analgesic, collaborating
with endogenous opiates. Many efforts have been made to clarify these
mechanisms, but to date no satisfactory consensus has been reached. In the late
1990s, researchers began to focus on the different analgesic effects of EA
between normal and hyperalgesic animal models. Published data from these studies
imply that normal and hyperalgesic animals respond differently to EA. Results
from experiments on the anti-hyperalgesia effect of EA have raised a new issue
about the influences of EA on receptors to excitatory amino acid in the spinal
cord level. Results from various studies have shown that these receptors play a
role in the mechanism of AA. Recently, research on the autonomic nervous system
(ANS) seem to indicate its connection with acupuncture. The inflammatory reflex
(via the ANS) might be a crucial part of anti-hyperalgesia elicited by
acupuncture, and this reflex, which regulates the immune system in the organism,
can elucidate not only the mechanism of AA but also the mechanism of acupuncture
applied to other inflammatory conditions. Innovation of functional image study
enables us to analyze the responses of cortex on living human body to
acupuncture. However, results of these experiments are still controversial.
After 30 years of acupuncture research, there are still many puzzles left to be
solved regarding the mechanism of AA.
J Altern
Complement Med. 2008 Jul;14(6):663-71.
Efficacy and safety of acupuncture for idiopathic Parkinson's disease: a systematic review.
Lam YC,
Kum WF, Durairajan SS, Lu JH, Man SC, Xu M, Zhang XF, Huang XZ, Li
M.
School
of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong
Kong.
OBJECTIVES: To
assess the efficacy and safety of acupuncture therapy (monotherapy or adjuvant
therapy), compared with placebo, conventional interventions, or no treatment in
treating patients with idiopathic Parkinson's disease (IPD). DATA
SOURCES:
International electronic database: (1) The Cochrane Controlled Trials Register,
(2) Academic Search Premier, (3) ACP Medicine, Alternative Medicine, (4) CINAHL,
(5) EBM Reviews, (6) EMBASE, (7) MEDLINE, (8) OLD MEDLINE, (9) ProQuest Medical
Library. Chinese electronic databases searched included: (1) VIP, (2) CJN, (3)
CBM disk, (4) China Medical Academic Conference. Hand searching was conducted on
all appropriate journals. Reference lists of relevant trials and reviews were
also searched to identify additional studies.
SELECTION
CRITERIA: All
randomized controlled trials (RCTs) of any duration comparing monotherapy and
adjuvant acupuncture therapy with placebo or no intervention were included.
DATA
COLLECTION AND ANALYSIS: Data
were abstracted independently by Y. C. Lam and S. C. Man onto standardized
forms, and disagreements were resolved by discussion. MAIN
RESULTS: Ten
(10) trials were included, each using a different set of acupoints and
manipulation of needles. None of them reported the concealment of allocation.
Only two mentioned the number of dropouts. Two (2) used a nonblind method while
others did not mention their blinding methods. Nine (9) studies claimed a
statistically significant positive effect from acupuncture as compared with
their control; only one indicated that there were no statistically significant
differences for all variables measured. Only 2 studies described details about
adverse events.
CONCLUSIONS: There
is evidence indicating the potential effectiveness of acupuncture for treating
IPD. The results were limited by the methodological flaws, unknowns in
concealment of allocation, number of dropouts, and blinding methods in the
studies. Large, well-designed, placebo-controlled RCTs with rigorous methods of
randomization and adequately concealed allocation, as well as intention-to-treat
data analysis are needed.
Zhongguo
Zhen Jiu. 2008 Jul;28(7):489-91.
Zhou CD,
Feng SW.
Section
of Rehabilitation, Guangdong Province Hospital of Integrated Chinese Medicine
and Western Medicine, Foshan 528200, China.
zcd401@126.com
OBJECTIVE: To
probe the effect of acupuncture at three acupoints of eye on Bell
palsy.
METHODS:
Seventy-six cases were randomly divided into a routine acupuncture group and a
Yan three needling group, 38 cases in each group. The routine acupuncture group
were treated with electroacupuncture (EA) at routinely selected acupoints
including Yifeng (TE 17), Dicang (ST 4), etc. and the Yan three needling group
were treated by EA at the routinely selected acupoints combined with acupuncture
at three acupoints of eye including Jingming (BL 1), Shangming, Chengqi (ST 1).
The intensity on 0.05 ms in the intensity/time (I/t) curve for frontal ventral
fronto-occipital muscle and orbicular muscle of mouth at the affected side was
used for assessment criteria of course of disease, and frontal ventral
fronto-occipital muscle restoring the raising eyebrow action and orbicular
muscle of mouth restoring to House-Brackmann grade I and II were regarded as the
therapeutic time limit.
RESULTS: Routine
EA treatment combined with acupuncture at the 3 acupoints of eye could
significantly increase clinical therapeutic effect on Bell palsy with a cured
rate of 89.5%, which was better than 65.8% in the routine acupuncture group
(P<0.05), and the therapeutic cycle was shorted.
CONCLUSION:
Acupuncture at the 3 acupoints of eye can significantly improve Bell palsy and
promote recovery of functions of facial nerves.
Zhongguo
Zhen Jiu. 2008 Jul;28(7):473-6.
Study on electroacupuncture at shuigou (GV 26) for treatment of mild and moderate shock: a multicentral and randomized controlled trial
Fu LX,
Shi HY, Chang WX, Shou ST, Zhao H, Liu XQ, Yang XY, Niu
HY.
First
Affiliated Hospital of Tianjin University of TCM, Tianjin 300193, China.
fulixin66@126.com
OBJECTIVE: To
probe into the effect of electroacupuncture (EA) at Shuigou (GV 26) on mild and
moderate shock.
METHODS: With
3-center randomized control study method, 276 cases were assigned to an EA plus
medicine group and a medication group, 138 cases in each group. They were
treated respectively with western medicine plus EA at Shuigou (GV 26), and
simple western medicine. Their curative effects were observed after treatment
for 6 hours.
RESULTS: The
blood pressure was immediately increased in the EA plus medicine group and the
increase of blood pressure was earlier than that in the medication group
(P<0.001). The markedly effective rate of 52.9% in the EA plus medicine group
was significantly higher than 18.1% in the medication group (P<0.001).
CONCLUSION: The
therapeutic effect of EA at Shuigou (GV 26) plus western medicine on mild and
moderate shock is better than that of simple western
medicine.
Acupunct
Electrother Res. 2008;33(1-2):33-41.
Abdominal acupuncture for insomnia in women: a randomized controlled clinical trial.
Wang XY,
Yuan SH, Yang HY, Sun YM, Cheng FP, Zhang CL, Huang
XC.
Department
of Gynecology, Second Affiliated Hospital, Guangzhou University of Chinese
Medicine, Guangzhou 510000, PR China. zp@gdivdc.com
A
randomized single-blind trial was conducted to evaluate the efficacy of
short-term abdominal acupuncture as a novel treatment for insomnia in Chinese
women. Forty-four patients between the ages of 22 and 56 were randomly assigned
to an acupuncture (n = 23) and a medication group (n = 21). The acupuncture
group received abdominal acupuncture once a day for the first three days and
once every three days for the remaining 11 days. In addition, every subject in
acupuncture group also received a placebo pill once daily. Abdominal acupuncture
was administered according to a standardized protocol involving four master and
four adjunctive acupoints: Zhongwan (CV 12), Xiawan (CV 10), Guanyuan (CV 4),
and Qihai (CV 6); bilateral Shangqu (KI 17), Huaroumen (ST 24), Xiafengshidian,
and Qipang. Subjects in the medication group were treated with sham acupuncture
at the same time as the acupuncture group and received estazolam once a day. The
outcome measure was the Leeds Sleep Evaluation Questionnaire (LSEQ),
administered before and after the trial. Subjects who received abdominal
acupuncture lowered their LSEQ scores by an average of 26.32 points (95% CI:
37.34, 15.30). After controlling for potential confounding factors, the effect
of abdominal acupuncture in relieving insomnia was still statistically
significant. Results indicate that short-term abdominal acupuncture is more
effective than pharmacological treatment for relieving insomnia in adult women
and has few adverse effects.
Acupunct
Electrother Res. 2008;33(1-2):1-8.
Acupuncture of specific points influences cortical auditory evoked potentials--a volunteer crossover study.
Lietz P,
Schmidt R, Hosemann W, Pavlovic D, Gizhko V, Lehmann C, Wendt M, Usichenko
TI.
Department
of Surgery, Military Hospital of Berlin, Germany.
Specificity
of acupoints remains a crucial question in acupuncture research. The aim was to
investigate whether acupuncture of specific points influences the Cortical
Auditory Evoked Potentials (CAEP). Ten healthy volunteers were enrolled in this
study according to inclusion criteria. One of 4 acupoints: TH3, GB43 (both
claimed as specific for auditory system by Traditional Chinese Medicine) and
non-specific points H7 and ST44, was stimulated during one session. Each
volunteer received 4 sessions of acupuncture with an interval of 1 week between
the sessions. The latencies and amplitudes of CAEP were registered before and
after the acupuncture during each session. The mean peak latencies of P2
component decreased after stimulation of TH3 by 11 ms and GB43 by 14 ms whereas
the peak latencies of N2 component increased after stimulation of TH3 by 9 ms
and GB43 by 4 ms compared to baseline values (p<0.05). The stimulation of H7
and ST44 did not produce any changes. These findings confirm the specificity of
acupuncture points TH3 and GB43 in relation to auditory
system.
Zhongguo
Zhen Jiu. 2008 May;28(5):317-20.
Randomized
controlled multi-central study on acupuncture at Tanzhong (CV 17) for treatment
of postpartum hypolactation
He JQ,
Chen BY, Huang T, Li N, Bai J, Gu M, Yu M, He XP, Wang
HY.
Section
of TCM, Beijing Obstetrical and Gynecological Hospital Affiliated to Capital
University of Medical Sciences, Beijing 100026, China.
junqinhe@sina.com.cn
OBJECTIVE: To
study on clinical role of acupuncture at Tanzhong (CV 17) for treatment of
postpartum hypolactation and to provide clinical basis for indications of
acupoints.
METHODS: This
was a single blind randomized controlled multi-center study by Beijing
obstetrical and gynecological hospital, Beijing Mother and Child health
institute and Haidian Mother and Child health institute, 276 cases of postpartum
hypolactation were randomly divided into an acupuncture group and a Chinese drug
group. The acupuncture group were treated with acupuncture at Tanzhong (CV 17)
and the Chinese drug group with traditional drug Tongre Decoction. Degree of
breast engorge, lactating volume, prolactin, neonate body weight, artificial
feeding frequency and volume, urination frequency and crying time of neonate
were recorded for comparison of therapeutic effects.
RESULTS: After
treatment, degree of breast engorge, lactating volume, neonate body weight,
artificial feeding frequency and volume, urination frequency and crying time of
neonate were significantly improved in the two groups, with no significant
difference between the two groups.
CONCLUSION:
Acupuncture at Tanzhong (CV 17) can effectively promote lactation with a same
therapeutic effect as the traditional Chinese drug Tongru
Decocnon.
Zhongguo
Zhen Jiu. 2008 Jun;28(6):409-10.
Observation on therapeutic effect of auricular acupuncture combined with body acupuncture for treatment of cardiac neurosis
Mu GM,
Lu YY.
Zhoukou
Health School of Henan Province, Zhoukou 466000, China.
zkwxmgm@163.com
OBJECTIVE: To find
an effective therapy for cardiac neurosis.
METHODS:
Seventy-two cases were randomly divided into an acupuncture group and a
medication group, 36 cases in each group. The acupuncture group were treated
with auricular acupuncture combined with body acupuncture, with auricular points
Shenmen, Jiaogan (sympathesis), Xin (heart), etc. and body points Xinshu (BL
15), Shenmen (HT 7), Neiguan (PC 6), etc. selected; the medication group were
treated with oral administration of Betaloc and Oryzanol. Their therapeutic
effects were compared after treatment for 2 months.
RESULTS: The
cured rate was 77.8% in the acupuncture group and 52.8% in the medication group
with very significant differences (P < 0.01), the former being better than
the latter.
CONCLUSION:
Auricular acupuncture combined with body acupuncture is the best method for
treatment of cardiac neurosis.
Cephalalgia.
2008 Sep;28(9):969-79.
Cephalalgia.
2008 Sep;28(9):911-3.
Acupuncture in patients with headache.
Jena S,
Witt CM, Brinkhaus B, Wegscheider K, Willich SN.
Institute
for Social Medicine, Epidemiology, and Health Economics, Charité Medical Centre,
Berlin, Germany.
We aimed
to investigate the effectiveness of acupuncture in addition to routine care in
patients with primary headache (> 12 months, two or more headaches/month)
compared with treatment with routine care alone and whether the effects of
acupuncture differ in randomized and non-randomized patients. In a randomized
controlled trial plus non-randomized cohort, patients with headache were
allocated to receive up to 15 acupuncture sessions over 3 months or to a control
group receiving no acupuncture during the first 3 months. Patients who did not
consent to randomization received acupuncture treatment immediately. All
subjects were allowed usual medical care in addition to study treatment. Number
of days with headache, intensity of pain and health-related quality of life
(SF-36) were assessed at baseline, and after 3 and 6 months using standardized
questionnaires. Of 15,056 headache patients (mean age 44.1 +/- 12.8 years, 77%
female), 1613 were randomized to acupuncture and 1569 to control, and 11,874
included in the non-randomized acupuncture group. At 3 months, the number of
days with headache decreased from 8.4 +/- 7.2 (estimated mean +/-s.e.) to 4.7
+/- 5.6 in the acupuncture group and from 8.1 +/- 6.8 to 7.5 +/- 6.3 in the
control group (P < 0.001). Similarly, intensity of pain and quality of life
improvements were more pronounced in the acupuncture vs. control group (P <
0.001). Treatment success was maintained through 6 months. The outcome changes
in non-randomized patients were similar to those in randomized patients.
Acupuncture plus routine care in patients with headache was associated with
marked clinical improvements compared with routine care
alone.
Neurochem
Res. 2008 Oct;33(10):2013-22.
Acupuncture for the treatment of drug addiction.
Cui
CL, Wu LZ, Luo F.
Neuroscience
Research Institute, Peking University, 38 Xueyuan Road, Beijing 100083, People's
Republic of China. clcui@bjmu.edu.cn
Over the
last three decades there has been an increasing interest in acupuncture
treatment of substance abuse around the world. Three important steps can be
identified in this field. Dr. Wen of Hong Kong was the first (1972) to report
that acupuncture at 4 body points and 2 ear points combined with electrical
stimulation can relieve opioid withdrawal signs in the addicts. The second major
step was made by Dr. M. Smith in New York, the head of the National Acupuncture
Detoxification Association (NADA) of the USA, who finalized a protocol (1985),
using only ear points without electrical stimulation for the treatment of drug
abuse. The recent advance in this field was made by Dr. Han of the Peking
University, Beijing, who characterized a protocol (2005), using electrical
stimulation of identified frequencies on body points to ameliorate heroin
withdrawal signs and prevent relapse of heroin use. In this review, the efficacy
of acupuncture and related techniques for the treatment of drug dependence in
experimental settings and clinical practice will be reviewed, and the possible
mechanisms underlying this effect be discussed.
BMC
Complement Altern Med. 2008 Jul 7;8:37.
Functional magnetic resonance imaging (fMRI) changes and saliva production associated with acupuncture at LI-2 acupuncture point: a randomized controlled study.
Deng G,
Hou BL, Holodny AI, Cassileth BR.
Integrative
Medicine Service, Memorial Sloan-Kettering Cancer Center, 1429 First Avenue, New
York, NY 10021, USA. dengg@mskcc.org
BACKGROUND:
Clinical studies suggest that acupuncture can stimulate saliva production and
reduce xerostomia (dry mouth). We were interested in exploring the neuronal
substrates involved in such responses.
METHODS: In a
randomized, sham acupuncture controlled, subject blinded trial, twenty healthy
volunteers received true and sham acupuncture in random order. Cortical regions
that were activated or deactivated during the interventions were evaluated by
functional magnetic resonance imaging (fMRI). Saliva production was also
measured.
RESULTS:
Unilateral manual acupuncture stimulation at LI-2, a point commonly used in
clinical practice to treat xerostomia, was associated with bilateral activation
of the insula and adjacent operculum. Sham acupuncture at an adjacent site
induced neither activation nor deactivation. True acupuncture induced more
saliva production than sham acupuncture.
CONCLUSION:
Acupuncture at LI-2 was associated with neuronal activations absent during sham
acupuncture stimulation. Neuroimaging signal changes appear correlated to saliva
production.
Acupunct
Med. 2008 Jun;26(2):69-78.
A blinded randomised trial of acupuncture (manual and electroacupuncture) compared with a non-penetrating sham for the symptoms of osteoarthritis of the knee.
Jubb RW,
Tukmachi ES, Jones PW, Dempsey E, Waterhouse L, Brailsford
S.
Department
of Rheumatology, University Hospital Birmingham NHS Trust, Birmingham, UK.
Ronald.Jubb@uhb.nhs.uk
OBJECTIVES: To
compare the effect of acupuncture (manual and electroacupuncture) with that of a
non-penetrating sham ('placebo' needle) in patients with osteoarthritic knee
pain and disability who are blind to the treatment
allocation.
METHODS:
Acupuncture naïve patients with symptomatic and radiological evidence of
osteoarthritis of the knee were randomly allocated to a course of either
acupuncture or non-penetrating sham acupuncture using a sheathed 'placebo'
needle system. Acupuncture points for pain and stiffness were selected according
to acupuncture theory for treating Bi syndrome. Both manual and electrical
stimulation were used. Response was assessed using the WOMAC index for
osteoarthritis of the knee, self reported pain scale, the EuroQol score and
plasma beta-endorphin. The effectiveness of blinding was
assessed.
RESULTS: There
were 34 patients in each group. The primary end point was the change in WOMAC
pain score after the course of treatment. Comparison between the two treatment
groups found a significantly greater improvement with acupuncture (mean
difference 60, 95% CI 5 to 116, P= 0.035) than with sham. Within the acupuncture
group there was a significant improvement in pain (baseline 294, mean change 95,
95% CI 60 to 130, P<0.001) which was not seen by those who had sham
acupuncture (baseline 261, mean change 35, 95% CI -10 to 80, P=0.12). Similar
effects within group, but not between groups, were seen with the secondary end
points of WOMAC stiffness, WOMAC function, and self reported pain. One month
after treatment the between group pain difference had been lost (mean difference
46; 95% CI -9 to 100, P=0.10) although the acupuncture group was still
benefiting compared to baseline (mean difference 59; 95% CI 16 to 102, P=0.009).
The EuroQol score, a generic measure of health related quality of life, was not
altered by the treatments. A minority of patients correctly guessed their
treatment group (41% in the acupuncture group and 44% in the control group).
Plasma beta-endorphin levels were not affected by either
treatment.
CONCLUSIONS:
Acupuncture gives symptomatic improvement for patients with osteoarthritis of
the knee, and is significantly superior to non-penetrating sham acupuncture. The
study did not confirm earlier reports of release of plasma beta-endorphin during
acupuncture.
Prog
Neurobiol. 2008 Aug;85(4):355-75.
Neural mechanism underlying acupuncture analgesia.
Zhao
ZQ.
Institute
of Neurobiology, Institutes of Brain Science and State Key Laboratory of Medical
Neurobiology, Fudan University, Shanghai, China.
zqzhao@fudan.edu.cn
Acupuncture
has been accepted to effectively treat chronic pain by inserting needles into
the specific "acupuncture points" (acupoints) on the patient's body. During the
last decades, our understanding of how the brain processes acupuncture analgesia
has undergone considerable development. Acupuncture analgesia is manifested only
when the intricate feeling (soreness, numbness, heaviness and distension) of
acupuncture in patients occurs following acupuncture manipulation. Manual
acupuncture (MA) is the insertion of an acupuncture needle into acupoint
followed by the twisting of the needle up and down by hand. In MA, all types of
afferent fibers (Abeta, Adelta and C) are activated. In electrical acupuncture
(EA), a stimulating current via the inserted needle is delivered to acupoints.
Electrical current intense enough to excite Abeta- and part of Adelta-fibers can
induce an analgesic effect. Acupuncture signals ascend mainly through the spinal
ventrolateral funiculus to the brain. Many brain nuclei composing a complicated
network are involved in processing acupuncture analgesia, including the nucleus
raphe magnus (NRM), periaqueductal grey (PAG), locus coeruleus, arcuate nucleus
(Arc), preoptic area, nucleus submedius, habenular nucleus, accumbens nucleus,
caudate nucleus, septal area, amygdale, etc. Acupuncture analgesia is
essentially a manifestation of integrative processes at different levels in the
CNS between afferent impulses from pain regions and impulses from acupoints. In
the last decade, profound studies on neural mechanisms underlying acupuncture
analgesia predominately focus on cellular and molecular substrate and functional
brain imaging and have developed rapidly. Diverse signal molecules contribute to
mediating acupuncture analgesia, such as opioid peptides (mu-, delta- and
kappa-receptors), glutamate (NMDA and AMPA/KA receptors), 5-hydroxytryptamine,
and cholecystokinin octapeptide. Among these, the opioid peptides and their
receptors in Arc-PAG-NRM-spinal dorsal horn pathway play a pivotal role in
mediating acupuncture analgesia. The release of opioid peptides evoked by
electroacupuncture is frequency-dependent. EA at 2 and 100Hz produces release of
enkephalin and dynorphin in the spinal cord, respectively. CCK-8 antagonizes
acupuncture analgesia. The individual differences of acupuncture analgesia are
associated with inherited genetic factors and the density of CCK receptors. The
brain regions associated with acupuncture analgesia identified in animal
experiments were confirmed and further explored in the human brain by means of
functional imaging. EA analgesia is likely associated with its
counter-regulation to spinal glial activation. PTX-sesntive Gi/o protein- and
MAP kinase-mediated signal pathways as well as the downstream events NF-kappaB,
c-fos and c-jun play important roles in EA analgesia.
J Altern
Complement Med. 2008 May;14(4):353-9.
Can classical acupuncture points and trigger points be compared in the treatment of pain disorders? Birch's analysis revisited.
Dorsher
PT.
Department
of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, Florida
32224, USA. dorsher.peter@mayo.edu
BACKGROUND: A 1977
study by Melzack et al. reported 100% anatomic and 71% clinical pain
correspondences of myofascial trigger points and classical acupuncture points in
the treatment of pain disorders. A reanalysis of this study's data using
different acupuncture resources by Birch a quarter century later concluded that
correlating trigger points to classical acupuncture points was not conceptually
possible and that the only class of acupuncture points that could were the a shi
points. Moreover, Birch concluded that no more than 40% of the acupuncture
points examined by Melzack et al. correlated clinically for the treatment of
pain (correlation was more like 18%-19%).
OBJECTIVE: To
examine Birch's claims that myofascial trigger points cannot conceptually be
compared to classical acupuncture points and that most (at least 60%) of the
classical acupuncture points examined by the study of Melzack et al. are not
recommended for treating pain conditions, negating their findings of a 71%
clinical pain correspondence of trigger points and acupuncture
points.
METHODS:
Acupuncture references and literature were reviewed to examine the validity of
the Birch study findings.
RESULTS:
Acupuncture references support the conceptual comparison of trigger points to
classical
acupuncture points in the treatment of pain disorders, and their clinical
correspondence in this regard is likely 95% or higher.
CONCLUSIONS:
Although separated by 2000 years temporally, the acupuncture and myofascial pain
traditions have fundamental clinical similarities in the treatment of pain
disorders. Myofascial pain data and research may help elucidate the mechanisms
of acupuncture's effects.
Behav
Brain Res. 2008 Nov 3;193(1):63-8.
A combined 11Cdiprenorphine PET study and fMRI study of acupuncture analgesia.
Dougherty
DD, Kong J, Webb M, Bonab AA, Fischman AJ, Gollub RL.
Psychiatric
Neuroimaging Research Program, Department of Psychiatry,
Massachusetts
General Hospital (MGH), Harvard Medical School, MA 02129, USA.
ddougherty@partners.org
Functional
neuroimaging studies suggest that a lateral network in the brain is associated
with the sensory aspects of pain perception while a medial network is associated
with affective aspects. The highest concentration of opioid receptors is in the
medial network. There is significant evidence that endogenous opioids are
central to the experience of pain and analgesia. We applied an integrative
multimodal imaging approach during acupuncture. We found functional magnetic
resonance imaging signal changes in the orbitofrontal cortex, insula, and pons
and 11Cdiprenorphine positron emission tomography signal changes in the
orbitofrontal cortex, medial prefrontal cortex, insula, thalamus, and anterior
cingulate cortex. These findings include brain regions within both the lateral
and medial pain networks.
Fam
Community Health. 2008 Jul-Sep;31(3):247-54.
Acupuncture and osteoarthritis of the knee: a review of randomized, controlled trials.
Selfe
TK, Taylor AG.
School
of Nursing and the Center for the Study of Complementary and Alternative
Therapies, University of Virginia Health System, Charlottesville,
VA
22908, USA.
Osteoarthritis
of the knee is a major cause of disability among adults. Treatment is focused on
symptom management, with nonpharmacologic therapies being the preferred first
line of treatment. Acupuncture is considered a potentially useful treatment for
osteoarthritis. The objective of this article is to review the English-language
articles, indexed in MEDLINE or CINAHL, describing randomized, controlled trials
of the effects of needle or electroacupuncture on knee osteoarthritis. Ten
trials representing 1456 participants met the inclusion criteria and were
analyzed. These studies provide evidence that acupuncture is an effective
treatment for pain and physical dysfunction associated with osteoarthritis of
the knee.
J Affect
Disord. 2008 Dec;111(2-3):125-34.
Is acupuncture beneficial in depression: a meta-analysis of 8 randomized controlled trials?
Wang H,
Qi H, Wang BS, Cui YY, Zhu L, Rong ZX, Chen HZ.
Department
of Pharmacology and Biostatistics, Institute of Medical Sciences,
Shanghai
Jiaotong University School of Medicine, China.
BACKGROUND:
Depression is one of the most common mental health disorders. Acupuncture is a
popular complementary and alternative medicine intervention suggested in the
treatment of depression, but its effectiveness is uncertain. This updated
meta-analysis was conducted to more precisely assess the beneficial effect of
acupuncture in depression therapy.
METHODS: The
following databases were searched: MEDLINE, EMBASE, BIOSIS, Cochrane Central
Register of Controlled Trials, and Chinese Scientific Journal Database. The
following terms were used: acupuncture, acupressure, depression, depressive
disorder, clinical trial, and randomized controlled trial.
RESULTS: Eight
small-randomized controlled trials comparing 477 subjects were included in the
meta-analysis. Our results confirmed that acupuncture could significantly reduce
the severity of depression, which was indicated by decreased scores of Hamilton
rating scale for depression (HAMD) or Beck Depression Inventory (BDI). The
pooled standardized mean difference of the 'Improvement of depression' was -0.65
(95% CI -1.18, -0.11; P=0.02) by random effect model. However, no significant
effect of active acupuncture was found on the response rate (RR 1.32, 95% CI
0.83 to 2.10; P=0.25) and remission rate (RR 1.30, 95% CI 0.57 to 2.95;
P=0.53).
CONCLUSION:
Although this meta-analysis might be discounted due to the low quality of
individual trials, it supported that acupuncture was an effective treatment that
could significantly reduce the severity of disease in the patients with
depression. More full-scale randomized clinical trials with reliable designs are
recommended to further warrant the effectiveness of
acupuncture.
Am J
Chin Med. 2008;36(3):481-91.
The effect of acupuncture at PC-6 on the electroencephalogram and electrocardiogram.
Kim MS,
Kim HD, Seo HD, Sawada K, Ishida M.
Department
of Electrical and Electronic Engineering, Toyohashi University of Technology,
1-1 Hibarigaoka, Toyohashi, Aichi, Japan 441-858.
mskim@dev.eee.tut.ac.jp
The
present study aims to examine the effect of acupuncture stimulation of an
acupuncture point (PC-6) and nonacupuncture point on electroencephalograms
(EEGs) and electrocardiograms (ECGs). We used EEG in 10 healthy subjects to
investigate cortical activation during stimulation of acupuncture points
(neiguan: PC-6) and nonacupuncture points. Our most interesting finding was the
marked differences of amplitude of EEG power between acupuncture points and
nonacupuncture points stimulation. Wavelet transform was used as the EEG signal
processing method, because it has advantages in a time domain and frequency
domain characteristics analysis. EEGs were collected from 16 channels, and the
alpha-wave (8-13 Hz), beta-wave (13-30 Hz), theta-wave (4-8 Hz) and delta-wave
(0.5-4 Hz) were used as standards for frequency bands. According to the
experiment results, EEG signals increased considerably after acupuncture
stimulation; in each frequency band, the average amplitude was higher after
acupuncture stimulation; ECG heart rates were faster by at least 10% after
acupuncture stimulation. Consequently, it will be possible to verify the
function of acupuncture stimulation on neiguan (acupuncture points; PC-6) more
effectively.
J Altern
Complement Med. 2008 Jun;14(5):505-13.
Effects of verum acupuncture compared to placebo acupuncture on quantitative EEG and heart rate variability in healthy volunteers.
Streitberger
K, Steppan J, Maier C, Hill H, Backs J, Plaschke K.
Clinic
of Anesthesiology, University of Heidelberg, Heidelberg,
Germany.
OBJECTIVES: The
aim of this single-blind randomized crossover study was to evaluate specific
effects of manual acupuncture on central and vegetative nervous system activity
measured by quantitative electroencephalography (qEEG) and heart rate
variability (HRV).
DESIGN: Twenty
(20) healthy volunteers (mean: 25.2 +/- 3.6 years) were monitored simultaneously
using a qEEG system and a 12-channel electrocardiogram recorder during verum
acupuncture (VA) at acupuncture point Large Intestine 4 (Hegu) (LI4) or placebo
acupuncture (PA) at a sham point.
RESULTS: In the
EEG conduction of the occipital area, needle stimulation in VA increased
alpha1-frequency significantly, and the ratio alpha1/theta was shifted to the
benefit of alpha1 over all electrodes. The HRV parameters showed a significant
increase of the low frequency/high frequency (HF) ratio during the first minute
of stimulation in VA, indicating an initial increase of sympathetic activation.
However, an increase of HF power in the minute after stimulation followed by a
decrease in heart rate suggests delayed vagal activation. De qi (a sensation
that is typical of acupuncture needling) occurred in 16 subjects during VA and
in 9 volunteers during PA (80% versus 45%).
CONCLUSIONS: Manual
stimulation on LI4 seems to lead to specific changes in alpha EEG-frequency and
in HRV parameters. A linear relationship between the HRV parameters and the
alpha EEG band might point to a specific modulation of cerebral function by
vegetative effects during acupuncture.
Complement
Ther Med. 2008 Jun;16(3):139-46.
Acupuncture
for acute non-specific low back pain: a pilot randomised
non-penetrating
sham controlled trial.
Kennedy
S, Baxter GD, Kerr DP, Bradbury I, Park J, McDonough
SM.
Health
and Rehabilitation Sciences Research Institute, School of Health Sciences,
University of Ulster, Northern Ireland, United
Kingdom.
OBJECTIVE: A pilot
study to assess the feasibility of a trial to investigate the efficacy of
acupuncture compared to placebo needling for the treatment of acute low back
pain (LBP). As part of this, the study was designed to establish the credibility
of the placebo control, and to provide data to inform a power analysis to
determine numbers for a future trial.
STUDY
DESIGN: A pilot
patient and assessor blinded randomized controlled trial.
SETTING:
Primary care health centre facility, South and East Belfast Trust, Northern
Ireland.
PATIENTS:
Patients from the physiotherapy waiting list (n=48) with LBP of less than 12
weeks duration. OUTCOME MEASURES: Roland and Morris
Disability
Questionnaire (RMDQ), Visual Analogue Scale (VAS), medication use and an exit
questionnaire were completed at baseline, end of treatment, and at 3 months
follow up.
RESULTS:
Ninety-four percent (45/48) of patients completed assigned treatment, 83%
(40/48) completed 3 months follow-up. The sham needle used here proved to be
credible: 91.7% in the placebo group believed they had received acupuncture,
compared to 95.8% in the verum acupuncture group. Differences in baseline
characteristics were accounted for using ANCOVA. There was no significant
difference between groups on the RMDQ over time. For pain, the only
statistically significant difference was at the 3 months follow up (worst VAS,
point estimate, 18.7, 95% CI 1.5-36.0, p=0.034). The majority of patients were
taking some form of analgesic medication for LBP at the start of treatment
(n=44; 92%), and at the end of treatment the verum acupuncture group were taking
significantly fewer tablets of pain control medication (mean (S.D.): 1.0+/-0.3)
than the placebo group (mean (S.D.): 4.2+/-0.6, p<0.05). Based upon these
data, power analysis (power=90%, alpha=0.05, minimal clinically important
difference (MCID) for RMDQ=2.5 points) indicated that 120 participants (60 per
group) would be needed to complete an adequately powered randomized controlled
trial.
CONCLUSIONS: This
study has demonstrated the feasibility of a randomized controlled trial of
penetrating needle acupuncture compared to a non-penetrating sham for the
treatment of acute LBP in primary care; 120 participants would be required in a
fully powered trial. The placebo needle used in this study proved to be a
credible form of control.
J Altern
Complement Med. 2008 Jun;14(5):523-6.
Manual acupuncture improved quality of life in cancer patients with radiation-induced xerostomia.
Cho JH,
Chung WK, Kang W, Choi SM, Cho CK, Son CG.
East-West
Cancer Center, Dunsan Hospital of Oriental Medical College, Daejeon University,
Daejeon, South Korea.
PURPOSE:
Radiotherapy-induced xerostomia seriously reduces the quality of life (QOL) for
patients with head and neck cancer. This study aimed to investigate the effects
of manual acupuncture on objective and subjective assessment of symptom changes
in patients with cancer who have with radiation-induced xerostomia.
MATERIALS
AND METHODS: Twelve
(12) patients with radiation-induced xerostomia were randomized into 2 groups
(real or sham acupuncture). Acupuncture was conducted twice weekly for 6 weeks
in a single-blind setting. The effect was evaluated by measuring whole salivary
flow rates (stimulated and unstimulated) and questionnaire-based assessment of
subjective symptoms pre- and post-treatment (3 and 6 weeks after acupuncture
treatment).
RESULTS: Both
groups showed a slight increase in whole salivary flow rates, with no
significant difference between them. However, real acupuncture markedly
increased unstimulated salivary flow rates, and improved the score for dry mouth
according to the xerostomia questionnaire, by 2.33 points versus 0.33 in the
controls.
CONCLUSIONS: Our
results showed the significantly meaningful amelioration of the subjective
sensation of xerostomia closely associated with QOL in patients with head and
neck cancer treated with irradiation.
Br J
Anaesth. 2008 Aug;101(2):151-60.
Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials.
Sun Y,
Gan TJ, Dubose JW, Habib AS.
Department
of Anesthesiology, Duke University Medical Center, Box 3094, Durham, NC 27710,
USA.
Postoperative
pain management remains a significant challenge for all healthcare providers.
The objective of this systematic review was to quantitatively evaluate the
efficacy of acupuncture and related techniques as adjunct analgesics for acute
postoperative pain management. We searched the databases of Medline (1966-2007),
CINAHL, The Cochrane Central Register of Controlled Trials (2006), and Scopus
for randomized controlled trials (RCTs) using acupuncture for postoperative pain
management. We extracted data about postoperative opioid consumption,
postoperative pain intensity, and opioid-related side-effects. Combined data
were analysed using a random effects model. Fifteen RCTs comparing acupuncture
with sham control in the management of acute postoperative pain were included.
Weighted mean difference for cumulative opioid analgesic consumption was -3.14
mg (95% confidence interval, CI: -5.15, -1.14), -8.33
mg (95% CI: -11.06, -5.61), and -9.14 mg (95% CI:
-16.07, -2.22) at 8, 24, and 72 h, respectively. Postoperative pain intensity
(visual analogue scale, 0-100 mm) was also significantly decreased in the
acupuncture group at 8 and 72 h compared with the control group. The acupuncture
treatment group was associated with a lower incidence of opioid-related
side-effects such as nausea (relative risk, RR: 0.67; 95% CI: 0.53, 0.86), dizziness (RR: 0.65;
95% CI: 0.52, 0.81), sedation (RR: 0.78; 95% CI: 0.61, 0.99), pruritus (RR:
0.75; 95% CI: 0.59, 0.96), and urinary retention
(RR: 0.29; 95% CI: 0.12, 0.74). Perioperative acupuncture may be a useful
adjunct for acute postoperative pain management.
Complement
Ther Med. 2008 Apr;16(2):92-100.
Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: a systematic review.
van den
Berg I, Bosch JL, Jacobs B, Bouman I, Duvekot JJ, Hunink
MG.
Department
of Epidemiology and Biostatistics, Erasmus University Medical Center Rotterdam,
P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
ineke.vanderberg@erasmumc.nl
OBJECTIVE: A
systematic review of studies assessing the effectiveness of acupuncture-type
interventions (moxibustion, acupuncture, or electro-acupuncture) on acupuncture
point BL 67 to correct breech presentation compared to expectant management,
based on controlled trials.
DATA
SOURCES:
Articles published from 1980 to May 2007 in databases of Medline, EMBASE, the
Cochrane Central Register of Controlled Trials, AMED, NCCAM, Midirs and
reference lists. STUDY
SELECTION:
Studies included were original articles; randomised controlled trials (RCT) or
controlled cohort studies; acupuncture-type intervention on BL 67 compared with
expectant management; ultrasound confirmed breech presentation and position of
the fetus after treatment confirmed with ultrasound, position at delivery,
and/or the proportion of caesarean sections reported.
DATA
EXTRACTION: Three
reviewers independently extracted data. Disagreements were resolved by
consensus.
DATA
SYNTHESIS: Of 65
retrieved citations, six RCT's and three cohort studies fulfilled the inclusion
criteria. Data were pooled using random-effects models. In the RCT's the pooled
proportion of breech presentations was 34% (95% CI: 20-49%) following treatment
versus 66% (95% CI: 55-77%) in the control group (OR 0.25 95% CI: 0.11-0.58).
The pooled proportion in the cohort studies was
15% (95% CI: 1-28%) versus 36% (95% CI: 14-58%), (OR 0.29, 95% CI: 0.19-0.43).
Including all studies the pooled proportion was 28% (95% CI: 16-40%)
versus 56% (95% CI: 43-70%) (OR 0.27, 95% CI: 0.15-0.46).
CONCLUSIONS:
Our
results suggest that acupuncture-type interventions on BL 67 are effective in
correcting breech presentation compared to expectant management. Some studies
were of inferior quality to others and further RCT's of improved quality are
necessary to adequately answer the research question.
BMC
Musculoskelet Disord. 2008 May 29;9:75.
A systematic review with procedural assessments and meta-analysis of low level laser therapy in lateral elbow tendinopathy (tennis elbow).
Bjordal
JM, Lopes-Martins RA, Joensen J, Couppe C, Ljunggren AE, Stergioulas A, Johnson
MI.
Institute
of Physiotherapy, Faculty of Health and Social Sciences, Bergen University
College, Moellendalsvn, 6, 5009 Bergen, Norway.
jmb@hib.no
BACKGROUND: Recent
reviews have indicated that low level level laser therapy (LLLT) is ineffective
in lateral elbow tendinopathy (LET) without assessing validity of treatment
procedures and doses or the influence of prior steroid
injections.
METHODS:
Systematic review with meta-analysis, with primary outcome measures of pain
relief and/or global improvement and subgroup analyses of methodological
quality, wavelengths and treatment procedures.
RESULTS: 18
randomised placebo-controlled trials (RCTs) were identified with 13 RCTs (730
patients) meeting the criteria for meta-analysis. 12 RCTs satisfied half or more
of the methodological criteria. Publication bias was detected by Egger's
graphical test, which showed a negative direction of bias. Ten of the trials
included patients with poor prognosis caused by failed steroid injections or
other treatment failures, or long symptom duration or severe baseline pain. The
weighted mean difference (WMD) for pain relief was 10.2 mm 95% CI: 3.0 to 17.5
and the RR for global improvement was 1.36 1.16 to 1.60. Trials which targeted
acupuncture points reported negative results, as did trials with wavelengths
820, 830 and 1064 nm. In a subgroup of five trials with 904 nm lasers and one
trial with 632 nm wavelength where the lateral elbow tendon insertions were
directly irradiated, WMD for pain relief was 17.2 mm 95% CI: 8.5 to 25.9 and
14.0 mm 95% CI: 7.4 to 20.6 respectively, while RR for global pain improvement
was only reported for 904 nm at 1.53 95% CI: 1.28 to 1.83. LLLT doses in this
subgroup ranged between 0.5 and 7.2 Joules. Secondary outcome measures of
painfree grip strength, pain pressure threshold, sick leave and follow-up data
from 3 to 8 weeks after the end of treatment, showed consistently significant
results in favour of the same LLLT subgroup (p < 0.02). No serious
side-effects were reported. CONCLUSION: LLLT administered with
optimal doses of 904 nm and possibly 632 nm wavelengths directly to the lateral
elbow tendon insertions, seem to offer short-term pain relief and less
disability in LET, both alone and in conjunction with an exercise regimen. This
finding contradicts the conclusions of previous reviews which failed to assess
treatment procedures, wavelengths and optimal doses.
BMC
Complement Altern Med. 2008 May 21;8:22.
Correcting non cephalic presentation with moxibustion: study protocol for a multi-centre randomised controlled trial in general practice.
Vas J,
Aranda JM, Barón M, Perea-Milla E, Méndez C, Ramírez C, Aguilar I, Modesto M,
Lara AM, Martos F, García-Ruiz AJ.
Pain
Treatment Unit, Primary Healthcare Centre, Dos Hermanas, Spain.
jorgef.vas.sspa@juntadeandalucia.es
BACKGROUND: Non
cephalic presentation in childbirth involves various risks to both the mother
and the foetus. The incidence in Spain is 3.8% of all full-term pregnancies. The
most common technique used to end the gestation in cases of non cephalic
presentation is that of caesarian section, and although it provokes a lower rate
of morbi-mortality than does vaginal delivery in such situations, there remains
the possibility of traumatic injury to the foetal head and neck, while maternal
morbidity is also increased. The application of heat (moxibustion) to an
acupuncture point, in order to correct non cephalic presentation, has been
practised in China since ancient times, but as yet there is insufficient
evidence of its real effectiveness.
METHODS/DESIGN: The
experimental design consists of a multi-centre randomised controlled trial with
three parallel arms, used to compare real moxibustion, sham moxibustion and the
natural course of events, among pregnant women with a non cephalic presentation
and a gestational duration of 33-35 weeks (estimated by echography). The
participants in the trial will be blinded to both interventions. The results
obtained will be analyzed by professionals, blinded with respect to the
allocation to the different types of intervention. In addition, we intend to
carry out a economic analysis.
DISCUSSION: This
trial will contribute to the development of evidence concerning moxibustion in
the correction of non cephalic presentations. The primary outcome variable is
the proportion of cephalic presentations at term. As secondary outcomes, we will
evaluate the proportion of cephalic presentations at week 38 of gestation,
determined by echography, together with the safety of the technique, the
specificity of moxibustion and the control of the blinding process.This study
has been funded by the Health Ministry of the Andalusian Regional Government. TRIAL REGISTRATION: Current Controlled
Trials ISRCTN10634508.
Zhongguo
Zhen Jiu. 2008 Apr;28(4):257-60.
Observation on clinical therapeutic effect of acupuncture on upper limb spasticity in the patient of poststroke
Zhang
ZM, Feng CL, Pi ZK, Fan XY, Chen HQ, Zhang J.
First
People's Hospital of Foshan, Guangdong 528000, China.
OBJECTIVE: To
observe therapeutic effect of acupuncture at acupoints selected according to
rehabilitation medical theory on upper limb spasticity in the patient of
poststroke.
METHODS: Sixty
cases were randomly divided into an acupuncture group and an electro-stimulation
group, 30 cases in each group. The acupuncture group were treated by acupuncture
at the contralateral scalp motor region of the affected limb, Jiquan (HT 1),
Chize (LU 5), Daling (PC 7) on the flexor side and Jianyu (LI 15), Tianjing (TE
10), Yangchi (TE 4) on the extensor muscle side of the affected limb; the
electro-stimulation group were treated by electric stimulation. The two groups
also were treated with necessary medical treatment and anti-spasm rehabilitation
motor training. The course was 3 weeks. Modified Ashworth Scale for muscle spasm
(MAS), modified Fugl-Meyer Assessment (FMA) for upper limb motor function, and
Modified Barthel Index (MBI) for ability of daily living were used for
assessment of the therapeutic effect.
RESULTS: After
treatment, the spasm was significantly alleviated, the motor function of the
upper limb and daily living ability were significantly increased (P<0.01) in
the two groups; after treatment, BMI scores in the acupuncture group was very
significantly superior to that in the electro-stimulation group. The total
effective rate was 93.3% in the acupuncture group and 86.7% in the
electro-stimulation group, with no significant difference between the two
groups.
CONCLUSION: Proper
acupuncture is an effective method for upper limb spasm in the patient of
poststroke, and the therapeutic effect is better for mild-moderate spasm of the
upper limb.
Zhongguo
Zhen Jiu. 2008 Apr;28(4):251-3.
Chen ZJ,
Guo YP, Wu ZC.
Institute
of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences,
Beijing 100700, China. ziyun321126@sina.com
OBJECTIVE: To
search for a safe and effective method for alleviating cancer
pain.
METHODS:
Sixty-six cases of late cancer with pain were first divided into 3 different
degrees of pain, mild, moderate and severe, and then the patients with pain of
each same degree were randomly divided into an acupuncture group treated by
acupuncture at 3-5 of the most severe tender points, and a medication group
treated with oral administration according to the WHO Three Step Administration
Principle, i.e. the patients with mild pain took aspirin, moderate pain took
codeine and severe pain took morphine.
RESULTS: Both
two methods could effectively control cancer pain. The total effective rate of
94.1% in the acupuncture group was significantly better than 87.5% in the
medication group (P<0.05).
CONCLUSION: The
analgesic effect of
acupuncture
treatment is better than that of the Three Step Administration, with no adverse
effect and addiction of analgesics.
Zhongguo
Zhong Xi Yi Jie He Za Zhi. 2008 Mar;28(3):201-5.
Effect of transcutaneous acupoint electrical stimulation on brain oxygen and glucose metabolism in the perioperative period of the craniocerebral operation
Wang JL,
Ren QS, Pei SL.
Department
of Anesthesiology, First Affiliated Hospital, Wenzhou Medical College, Zhejiang.
wangjunlu@yahoo.com.cn
OBJECTIVE: To
observe the effect of transcutaneous acupoint electrical stimulation (TAES) on
brain tissue oxygen and glucose metabolism of the brain tissue in peri-operative
period of the craniocerebral operation.
METHODS: Fifty
patients scheduled for neuro-surgery were randomly assigned to the treatment
group and the control group equally. Anesthesia applied after induction on all
patients was continuous sevoflurane inhalation and intermittent intravenous
injection of sulfenany and vecurnium bromide, but to the treatment group TASE
was applied additionally from 30 min before anesthesia to the end of operation.
Blood samples were taken from artery and jugular venous bulb at different time
points, i. e. before induction (T0) , before skin incision (T1) , at the end of
operation (T2) , and 10 min after extubation (T3) , for blood-gas analysis. The
difference of oxygen, glucose and lactate contents between blood samples of
arterial and jugular bulb (Da-jvO2, Da-jvGlu and Da-jvLac) at respective time
point were determined and calculated.
RESULTS: Da-jvO2
decreased in both group at T1, T2 and T3, and all lower than that at T0 (P <
0.05 or P < 0.01), but significant difference was shown in comparison of the
index at T2 and T3 with the same time points in the control group in the
treatment group (P < 0.05 or P < 0.01) , and that between groups at T2 and
T3 (P < 0.01). Da-jvGlu in the treatment group decreased at T2 and T3 (P <
0.05), but keep unchanged relatively in the control group before and after
anesthesia, inter-group comparison showed it was lower at T2 and T3 in the
treatment group than that in the control group respectively (P < 0.05).
Da-jvGlu in the treatment group at T1, T2, and T3 were all lower than that at
the same time points (P < 0. 01).
CONCLUSION: TAES
can significantly decrease the oxygen and glucose metabolism of the brain tissue
in the perioperative period of the craniocerebral
operation.
J Affect
Disord. 2008 Sep;110(1-2):16-26.
Complementary and alternative medicine in the treatment of bipolar disorder - a review of the evidence.
Andreescu
C, Mulsant BH, Emanuel JE.
The
Advanced Center for Interventions and Services Research for Late-life Mood
Disorders, Department of Psychiatry, University of Pittsburgh School of
Medicine, USA.
A
growing number of patients with mood disorders are using complementary and
alternative medicine (CAM) interventions. In this paper, we review the published
scientific evidence on the benefits and risks of CAM for the treatment of
patients with bipolar disorder. Since very few studies of CAM have involved
patients with bipolar disorder, most available evidence is derived from trials
conducted in patients with major depressive disorder. The use of omega-3 fatty
acids has been studied in two controlled studies in bipolar disorder while St.
John's wort (Hypericum perforatum), S-adenosyl-l-methionine (SAMe), and
acupuncture have been studied in a series of randomized controlled trials in
patients with major depression. Overall, the best evidence supports the use of
St. John's wort for the treatment of mild to moderate depression. SAMe may also
be effective for depression. However, both of these products have the potential
to induce mania; the extent of this risk needs to be quantified. St. John's wort
can also interact with a variety of medications. Evidence regarding the benefits
of omega-3 fatty acids or acupuncture is inconsistent. Data regarding other CAM
interventions (e.g., aromatherapy massage, massage therapy, yoga) are almost
entirely lacking. In conclusion, better studies are needed before CAM
interventions can be recommended to patients with bipolar disorder. In the
meantime, patients need to be informed about the possible risks associated with
the use of these interventions.
BMC
Complement Altern Med. 2008 May 1;8:18.
The effect of acupuncture duration on analgesia and peripheral sensory thresholds.
Leung AY,
Kim SJ, Schulteis G, Yaksh T.
Department
of Anesthesiology, The University of California, San Diego, School of Medicine,
La Jolla, CA, USA. ayleung@ucsd.edu
BACKGROUND:
Acupuncture provides a means of peripheral stimulation for pain relief. However,
the detailed neuronal mechanisms by which acupuncture relieves pain are still
poorly understood and information regarding optimal treatment settings is still
inadequate. Previous studies with a short burst of unilateral electroacupuncture
(EA) in the Tendinomuscular Meridians (TMM) treatment model for pain
demonstrated a transient dermatomally correlated bilateral analgesic effect with
corresponding peripheral modality-specific sensory threshold alterations.
However, the impact of EA duration on the analgesic effect in this particular
treatment model is unknown. To obtain mechanistically and clinically important
information regarding EA analgesia, this current prospective cross-over study
assesses the effects of EA duration on analgesia and thermal sensory thresholds
in the TMM treatment model.
METHODS:
Baseline peripheral sensory thresholds were measured at pre-marked testing sites
along the medial aspects (liver and spleen meridians) of bilateral lower
extremities. A 5-second hot pain stimulation was delivered to the testing sites
and the corresponding pain Visual Analog Scale (VAS) scores were recorded. Three
different EA (5Hz) stimulation durations (5, 15 and 30 minutes) were randomly
tested at least one week apart. At the last 10 seconds of each EA session, 5
seconds of subject specific HP stimulation was delivered to the testing sites.
The corresponding pain and EA VAS scores of de qi sensation (tingling) during
and after the EA were recorded. The measurements were repeated immediately, 30
and 60 minutes after the EA stimulation. A four-factor repeat measures ANOVA was
used to assess the effect of stimulation duration, time, location (thigh vs.
calf) and side (ipsilateral vs. contralateral) of EA on sensory thresholds and
HP VAS scores.
RESULTS: A
significant (P < 0.01) main effect of time and location with warm, cold and
hot pain thresholds at the four testing sites without any significant difference
in duration effect was observed. Similar time and location effects were observed
with HP VAS with the longer durations (15 and 30 minutes) of stimulation showed
a slower onset, but a more sustainable bilateral analgesic benefit than the
short stimulation duration (5 minutes). The 15-minute stimulation resulted in an
earlier onset of analgesic effect than the 30-minute stimulation
paradigm.
CONCLUSION: Longer
durations of EA stimulation provide a more sustainable analgesic benefit to hot
noxious stimulation than a shorter duration of stimulation. The increase of cold
threshold with sustained warm threshold temperature elevation as observed in the
longer durations of EA suggests that as the duration of EA lengthened, there is
a gradual shifting from an initial predominantly spinally mediated analgesic
effect to a supraspinally mediated modulatory mechanism of thermal pain. The
15-minute stimulation appeared to be the optimal setting for treating acute pain
in the lower extremities.
Yang JX,
Zhu XY.
Affiliated
Hospital of Tongren College of Professional Technique, Guizhou, China.
yangjunxiong_250@163.com
OBJECTIVE: To
search for an effective needling method for treatment of piriformis injury
syndrome.
METHODS:
Eighty-two cases were randomly divided into a three needling group and a routine
needling group, 41 cases in each group. The three needling group were treated by
acupuncture at Huantiao (GB 30), Yanglingquan (GB 34) and Shenmai (BL 62), with
needling shallow, middle and deep layers for Huantiao, Yanglingquan, and after
acupuncture massage was given at the Foot-Taiyang Channel and the Foot-Shaoyang
Channel on lumbosacral region and the affected foot. The routine needling group
were treated by rouine needling at Huantiao (GB 30), Juliao (GB 29), Chengfu (BL
36), Yanglingquan (GB 34), massage was given also. Their therapeutic effects
were compared.
RESULTS: The
cured rate was 87.8% in the three needling group and 63.4% in the routine
needling group, with a significant difference between the two groups (P <
0.05).
CONCLUSION: The
therapeutic effect of three needling method on piriformis injury syndrome is
better than that of routine needling.
Zhongguo
Zhen Jiu. 2008 Mar;28(3):187-90.
Li CH,
Wang YZ, Guo XY.
OBJECTIVE: To
observe the therapeutic effect of acupuncture at Siguan points with Qinglong
Baizei method on primary dysmenorrhea (PD) and to study the
mechanism.
METHODS: One
hundred and eighty cases of PD were zandomly divided into group A, group B and
group C, 60 cases in each group. Group A were treated by acupuncture at Hegu (LI
4) and Taichong (LR 3) with Qinglong Baiwei method; group B were treated by
routine acupuncture with Sanyinjiao (SP 6), Ciliao (BL 32) selected as main
points; and group C were treated by oral administration of Yueyueshu Decoction.
After treatment of 3 months, the therapeutic effects were analyzed, and changes
of hemorrheological indexes and prostaglandin level were
observed.
RESULTS: The
cured rate and the total effective rate were 75.0% and 100.0% in group A, 60.0%
and 95.0% in group B, and 25.0% and 90.0% in group C, respec tively, group A and
B being significantly better than group C (P < 0.01). And the analgesic
effects within 30 min of treatment in both group A and group B were
significantly better than that in group C (P < 0.01), and that in group A was
significantly better than that in group B (P < 0.01).
CONCLUSION:
Acupuncture at Siguan points with Qinglong Baiwei method has a significant
therapeutic effect on primary dysmenorrhea. The possible mechanism is to relieve
pain by improving blood circulation and inhibiting production of
prostaglandin.
Zhongguo
Zhen Jiu. 2008 Mar;28(3):159-62.
Randomized controlled observation on head point-through-point therapy for treatment of insomnia
Dong JP,
Wang S, Sun WY, Liu F.
Section
of Acupuncture and Moxibustion, Heilongjiang Provincial Academy of TCM, Harbin,
China. dongjianpingls@126.com
OBJECTIVE: To
observe the therapeutic effect of head point-through-point therapy on insomnia
and to probe the mechanism.
METHODS:
Seventy-one cases of insomnia were randomly divided into a head penetration
needling group (n=36) and a routine acupuncture group (n=35). In the head
penetration needling group, Shenting (GV 24)-through-anterior Shencong (EX-HN
1), bilateral Toulinqi (GB 15)-through-bilateral Shencong (EX-HN 1), posterior
Shencong-through-Qiangjian (GV 18) were selected; and in the routine acupuncture
group, Baihui (CV 20), Yintang (EX-HN 3), Sishencong (EX-HN 1), Neiguan (PC 6),
etc. were selected. After treatment of 30 days, their therapeutic effects,
cumulative scores of Pittsburgh Sleep Quality Index (PSQI) and plasma serotonin
contents before and after treatment were compared. Results The total effective
rate of 91.7% in the head penetration needling group was better than 77.1% in
the routine acupuncture group (P < 0.05), and the improvement of sleep
quality, falling asleep time and the total cumulative score of PSQI in the head
penetration needling group was superior to that in the routine acupuncture group
(P < 0.05), and plasma serotonin was significantly increased in the head
penetration needling group with a significant difference as compared with that
in the routine acupuncture group (P < 0.05).
CONCLUSION: The
therapeutic effect of head penetration needling is better than that of the
routine acupuncture, and the mechanism is related with regulation of serotonin
metabolism.
BMC
Complement Altern Med. 2008 Apr 22;8:13.
A systematic review of the clinical effectiveness of acupuncture for allergic rhinitis.
Roberts
J, Huissoon A, Dretzke J, Wang D, Hyde C.
West
Midlands Health Technology Assessment Collaboration, Department of Public Health
and Epidemiology, University of Birmingham, UK.
jonathan.roberts@hpa.org.uk
BACKGROUND:
Allergies cause a considerable burden to both sufferers and the National Health
Service. There is growing interest in acupuncture as a treatment for a range of
conditions. Since acupuncture may modulate the immune system it could be a
useful treatment for allergic rhinitis (AR) sufferers. We therefore assessed the
evidence for the clinical effectiveness of acupuncture in patients with AR by
performing a systematic review of the literature.
METHODS:
Searches (to 2007) were conducted in all major databases for randomised
controlled trials (RCTs) evaluating the clinical effectiveness of acupuncture in
the treatment of AR. No limits were placed on language. Studies were included if
they compared acupuncture to a sham or inactive acupuncture treatment (placebo)
with or without standard care. Meta-analysis was performed where
feasible.
RESULTS: Seven
relevant RCTs were included after screening and application of inclusion and
exclusion criteria. The trials were generally of poor quality as assessed by a
modified Jadad scale, with the exception of two studies which scored highly. A
wide variety of outcomes was measured but most assessed symptom severity on a
visual analogue scale. A meta-analysis failed to show any summary benefits of
acupuncture treatment for symptom severity scores or serum IgE measures which
could not have been accounted for by chance alone. Acupuncture was not
associated with any additional adverse events in the
trials.
CONCLUSION: There
is currently insufficient evidence to support or refute the use of acupuncture
in patients with AR. A large well conducted RCT, which overcomes identified
methodological problems in the existing RCTs, would be required to resolve this
question.
BMC
Complement Altern Med. 2008 Apr 14;8:12.
Study protocol for a pragmatic randomised controlled trial in general practice investigating the effectiveness of acupuncture against migraine.
Vas J,
Rebollo A, Perea-Milla E, Méndez C, Font CR, Gómez-Río M, Martín-Avila M,
Carbrera-Iboleón J, Caballero MD, Olmos MA, Aguilar I, Faus V, Martos
F.
Pain
Treatment Unit, Primary Care Center, Dos Hermanas, Spain.
jorgef.vas.sspa@juntadeandalucia.es.
BACKGROUND:
Migraine is a chronic neurologic disease that can severely affect the patient's
quality of life. Although in recent years many randomised studies have been
carried out to investigate the effectiveness of acupuncture as a treatment for
migraine, it remains a controversial issue. Our aim is to determine whether
acupuncture, applied under real conditions of clinical practice in the area of
primary healthcare, is more effective than conventional treatment.
METHODS/DESIGN: The
design consists of a pragmatic multi-centre, three-armed randomised controlled
trial, complemented with an economic evaluation of the results achieved,
comparing the effectiveness of verum acupuncture with sham acupuncture, and with
a control group receiving normal care only.Patients eligible for inclusion will
be those presenting in general practice with migraine and for whom their General
Practitioner (GP) is considering referral for acupuncture. Sampling will be by
consecutive selection, and by randomised allocation to the three branches of the
study, in a centralised way following a 1:1:1 distribution (verum acupuncture;
sham acupuncture; conventional treatment). Secondly, one patient in three will
be randomly selected from each of the acupuncture (verum or sham) groups for a
brain perfusion study (by single photon emission tomography). The treatment with
verum acupuncture will consist of 8 treatment sessions, once a week, at points
selected individually by the acupuncturist. The sham acupuncture group will
receive 8 sessions, one per week, with treatment being applied at
non-acupuncture points in the dorsal and lumbar regions, using the minimal
puncture technique. The control group will be given conventional treatment, as
will the other two groups.
DISCUSSION: This
trial will contribute to available evidence on acupuncture for the treatment of
migraine. The primary endpoint is the difference in the number of days with
migraine among the three groups, between the baseline period (the 4 weeks prior
to the start of treatment) and the period from weeks 9 to 12. As a secondary
aspect, we shall record the index of laterality and the percentage of change in
the mean count per pixel in each region of interest measured by the brain
perfusion tomography, performed on a subsample of the patients within the real
and sham acupuncture groups.
TRIAL
REGISTRATION:
Current Controlled Trials ISRCTN98703707.
Zhongguo
Zhen Jiu. 2008 Feb;28(2):147-50.
Evaluation of literature quality of acupuncture for treatment of herpes zoster and approach to the laws of treatment
Peng WN,
Liu ZS, Deng YH, Mao M, Yu JN, Du Y.
Section
of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences,
Beijing 100053, China. wnpeng@hotmail.com
OBJECTIVE: To
assess the quality of literature of clinical studies on acupuncture in treatment
of herpes zoster.
METHODS: The
literatures between 1994-2006 were searched by means of electronic retrieval.
Type and methodology, general condition, diagnosis of diseases and enrolled and
excluded criteria, assessment of sample content, treatment condition, criteria
for assessment of therapeutic effects, following-up, etc. in clinical studies
are evaluated according to principles and methods of clinical epidemiology and
evidence-based medicine.
RESULTS: Of the
399 literatures enrolled, only 8 were authentic randomized controlled trials
(RCTs), 20 quasi-randomized controlled trials, 66 non-randomized concurrent
controlled trials and 277 narrative studies, 70 had clear diagnostic criteria,
16 mentioned enrolled or excluded criteria, 287 had clear criteria for
therapeutic effects, 107 reported follow-up, 2 had the description of health
economical index, 9 reported adverse reaction.
CONCLUSION: At
present, correct randomization, concealment, blinding and placebo-control, and
the RCTs with generally accepted criteria for assessment of diagnosis and
therapeutic effects, safety evaluation and rational design of follow-up are
needed. It is indicated by preliminary study of the literatures that
blood-letting puncture and cupping at Ashi points are main methods for treatment
of herpes zoster.
Zhongguo
Zhen Jiu. 2008 Feb;28(2):111-3.
Randomized controlled study on reinforcing method of acupuncture for treatment of Bell's palsy at restoration stage
Wang S,
Hu HC, Wang DS.
Heilongjiang
Research Institute of TCM, Harbin 150036, China.
HLJwang@yahoo.com.cn
OBJECTIVE: To
observe clinical therapeutic effect of reinforcing method of acupuncture on
Bell's palsy at restoration stage.
METHODS: One
hundred and sixty cases were randomly divided into two groups: an observation
group and a control group, 80 cases in each group. The observation group were
treated by acupuncture with lifting-thrusting-twirling reinforcing method, and
the control group by acupuncture without needling manipulation. The therapeutic
effect, and changes of palsy index, degree of palsy and ENoG were observed.
RESULTS:
Reinforcing method of acupuncture could significantly improve palsy index,
degree of palsy and maximal wave amplitude of ENoG; the cured and markedly
effective rate was 91.3% in the observation group and 75.0% in the control group
with a very significant difference between the two groups (P <
0.01).
CONCLUSION: The
reinforcing method of acupuncture can increase the therapeutic effect on Bell's
palsy at restoration stage.
Zhongguo
Zhen Jiu. 2008 Feb;28(2):98-100.
Observation on therapeutic effect of comprehensive therapy for acute large area cerebral infarction
Bai HM,
Zhang YL, He JW, Zhang LC, Yang Y.
Department
of Acupuncture, The Second Affiliated Hospital of Tianjin University of TCM,
Tianjin 300150, China. baihuimei2007@163.com
OBJECTIVE: To
search for a method for increasing clinical therapeutic effect of acute large
area cerebral infarction.
METHODS:
Ninety-six cases were randomly divided into a comprehensive treatment group and
a western medicine group, 48 cases in each group. The western medicine group
were treated with routine western methods, dehydration for decreasing
intracranial pressure, brain-protection, anti-platelet agglutination, improving
circulation and expectant treatment, etc.; the comprehensive treatment group
were treated with the routine treatment of western medicine combined with
acupuncture, moxibustion and enema of Chinese drugs. The therapeutic effect was
observed after treatment for 28 days.
RESULTS: The
total effective rate was 68.8% in the comprehensive treatment group and 39.6% in
the western medicine group with a very significant difference between the two
groups (P < 0.01), and the score of the National Institute of Health's Stroke
Scale (NIHSS) and the score of the Glasgow Coma Scale (GCS) in the comprehensive
treatment group were better than those in the western medicine group (P <
0.001, P < 0.01).
CONCLUSION:
Combined treatment of Chinese medicine and western medicine for large area
cerebral infarction is better than simple western medicine, and it can
significantly improve neurological defect of the patient and decrease death
rate.
Rheumatology
(Oxford). 2008 Jun;47(6):887-93.ACP J Club. 2008 Nov-Dec;149(4):12.
Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial.
Vas J,
Ortega C, Olmo V, Perez-Fernandez F, Hernandez L, Medina I, Seminario JM,
Herrera A, Luna F, Perea-Milla E, Mendez C, Madrazo F, Jimenez C, Ruiz MA,
Aguilar I.
Pain
Treatment Unit, Healthcare Centre Doña Mercedes, Calle Segovia s/n, 41700 Dos
Hermanas, Spain. jorgef.vas.sspa@juntadeandalucia.es
OBJECTIVE:
Evaluate the efficacy of acupuncture associated with physiotherapy for patients
with painful shoulder.
METHODS: In a
multicentre controlled randomized study, participants were recruited with a
clinical diagnosis of unilateral subacromial syndrome from six rehabilitation
medicine departments belonging to the Public Health System in two Spanish
regions. All participants received 15 sessions of physiotherapy during the 3
weeks that the treatment lasted and were randomized to additionally receive,
once a week, acupuncture or mock TENS (transcutaneous electrical nerve
stimulation). The primary outcome measure was the change in the Constant-Murley
Score (CMS) for functional assessment of the shoulder, at 4 weeks after
randomization. This study is registered as an International Standard Randomized
Controlled Trial, number ISRCTN28687220.
RESULTS: A total
of 425 patients were recruited. The mean score (s.d.) on the CMS had increased
by 16.6 (15.6) points among the acupuncture group, compared with 10.6 (13.5)
points in the control group, and the mean difference between the two groups was
statistically significant (6.0 points; 95% CI 3.2, 8.8 points; P < 0.001). By
the end of the treatment, 53% of the patients in the acupuncture group had
decreased their consumption of analgesics, compared with a corresponding 30%
among the control group (P < 0.001).
CONCLUSIONS:
Single-point acupuncture in association with physiotherapy improves shoulder
function and alleviates pain, compared with physiotherapy as the sole treatment.
This improvement is accompanied by a reduction in the consumption of analgesic
medicaments.
BMJ.
2008 May 3;336(7651):999-1003.
Components
of placebo effect: randomised controlled trial in patients with
irritable
bowel syndrome.
Kaptchuk
TJ, Kelley JM, Conboy LA, Davis RB, Kerr CE, Jacobson EE, Kirsch I, Schyner RN,
Nam BH, Nguyen LT, Park M, Rivers AL, McManus C, Kokkotou E, Drossman DA,
Goldman P, Lembo AJ.
Osher
Research Center, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA.
ted_kaptchuk@hms.harvard.edu
OBJECTIVE: To
investigate whether placebo effects can experimentally be separated into the
response to three components-assessment and observation, a therapeutic ritual
(placebo treatment), and a supportive patient-practitioner relationship-and then
progressively combined to produce incremental clinical improvement in patients
with irritable bowel syndrome. To assess the relative magnitude of these
components. DESIGN: A six week
single blind three arm randomised controlled trial.
SETTING:
Academic medical centre.
PARTICIPANTS: 262
adults (76% women), mean (SD) age 39 (14), diagnosed by Rome II criteria for and
with a score of > or =150 on the symptom severity scale.
INTERVENTIONS: For
three weeks either waiting list (observation), placebo acupuncture alone
("limited"), or placebo acupuncture with a patient-practitioner relationship
augmented by warmth, attention, and confidence ("augmented"). At three weeks,
half of the patients were randomly assigned to continue in their originally
assigned group for an additional three weeks.
MAIN
OUTCOME MEASURES: Global
improvement scale (range 1-7), adequate relief of symptoms, symptom severity
score, and quality of life. RESULTS:
At three weeks, scores on the global improvement scale were 3.8 (SD 1.0) v 4.3
(SD 1.4) v 5.0 (SD 1.3) for waiting list versus "limited" versus "augmented,"
respectively (P<0.001 for trend). The proportion of patients reporting
adequate relief showed a similar pattern: 28% on waiting list, 44% in limited
group, and 62% in augmented group (P<0.001 for trend). The same trend in
response existed in symptom severity score (30 (63) v 42 (67) v 82 (89),
P<0.001) and quality of life (3.6 (8.1) v 4.1 (9.4) v 9.3 (14.0),
P<0.001). All pairwise comparisons between augmented and limited
patient-practitioner relationship were significant: global improvement scale
(P<0.001), adequate relief of symptoms (P<0.001), symptom severity score
(P=0.007), quality of life (P=0.01). Results were similar at six week
follow-up.
CONCLUSION: Factors
contributing to the placebo effect can be progressively combined in a manner
resembling a graded dose escalation of
component
parts. Non-specific effects can produce statistically and clinically significant
outcomes and the patient-practitioner relationship is the most robust component.
TRIAL
REGISTRATION:
Clinical Trials NCT00065403.
Zhen Ci Yan
Jiu. 2008 Feb;33(1):41-6.
Zhao HY, Mu
P, Dong Y.
Northwest
Agriculture and Forest University, Yangling, Shaanxi 712100,
China.
The
central nervous system (CNS) is involved in a variety of disease conditions.
Some seeming peripheral diseases, like chronic pain and disorders in major
organs, indeed have clear pathological basis in the CNS. On the other hand, some
clinically-beneficial peripheral stimulation, such as acupuncture and
massage, exerts significant influence on central neurons. This
review attempts to summary recent findings in neuroscience about how
pathological insults long-term plastic changes within neural circuits, leading
to maladaptive behaviors. This neuroplasticity-based theory not only
conceptualizes a cellular mechanism for a plethora of neuropathophysiology but
also provides clinical strategies for treating neural diseases. Drug addiction
is a chronic brain disease, defined as compulsive drug-seeking, drug-craving,
and drug-taking behaviors. Extensive experimental evidence suggests that
following exposure to drugs of abuse, neurons within the mesolimbic dopamine
system undergo a series of plastic changes that may lead to compulsive emotional
and motivational states. It is believed that the first step to unlock the secret
of drug addiction is to identify, evaluate, and conceptualize drug-induced
neural plasticity. Synaptic plasticity is one form of neuroplasticity that has
been best characterized. Using addiction-related synaptic plasticity as a
working model, this review attempts to depict the general concept and
experimental approach in studying the pathophysiological neural basis of
acupuncture.
Zhongguo
Zhong Xi Yi Jie He Za Zhi. 2008 Feb;28(2):122-5.
Study on fMRI brain map in patients undergoing needling at Zusanli (ST36) by reinforcing method
Xiao YY, Du
L, Hong BK, et al.
Second
Hospital Affiliated Medical College of Shantou University,
Guangdong.
OBJECTIVE: To
observe the characteristic of the fMRI brain map in patients undergoing needling
at Zusanli (ST36) by reinforcing method for exploring the essence of
Meridian-Collaterals and the mechanisms of acupuncture in treating
diseases.
METHODS:
Twenty-six healthy volunteers were randomly assigned to two groups by double
blinded method, 16 in the acupoint group and 10 in the non-acupoint group. Using
GE Signa 1. 5 T superconducting MRI system, the fMRI was performed with Gradient
echo-EPI sequence. Post-processing of fMRI data was performed using the Functool
software (GE-ADW4.0) to generate positive correlation coefficient brain
functional activating images and the data was analyzed statistically using SPSS
13.0 software.
RESULTS: Brain
functional area was elicited in 13 out of the 15 patients in the acupoint group
and 10 in the non-acupoint group. Among them, the temporal elicited area in the
acupoint group showed specificity (Fisher's Exact test, P = 0.022) and only the
difference in contralateral hemisphere activation rate was of statistical
significance (McNemer test, P = 0.020).
CONCLUSION:
Acupoints has its own specific brain activated areas. The therapeutic effect of
acupoint might be mediated through brain to treat diseases and regulate
functional disorder of organs. There exists special transmission channel of
meridian.
Climacteric.
2008 Apr;11(2):166-74.
Long-term follow-up of acupuncture and hormone therapy on hot flushes in women with breast cancer: a prospective, randomized, controlled multicenter trial.
Frisk J,
Carlhäll S, Källström AC, Lindh-Astrand L, Malmström A, Hammar
M.
Division
of Obstetrics and Gynaecology, Department of Molecular and Clinical Medicine,
Faculty of Health Sciences, University Hospital of Linköping,
Sweden.
OBJECTIVE: To
evaluate the effects of electro-acupuncture (EA) and hormone therapy (HT) on
vasomotor symptoms in women with a history of breast cancer.
METHODS:
Forty-five women were randomized to EA (n = 27) for 12 weeks or HT (n = 18) for
24 months. The number of and distress caused by hot flushes were registered
daily before, during and up to 24 months after start of treatment.
RESULTS: In 19
women who completed 12 weeks of EA, the median number of hot flushes/24 h
decreased from 9.6 (interquartile range (IQR) 6.6-9.9) at baseline to 4.3 (IQR
1.0-7.1) at 12 weeks of treatment (p < 0.001). At 12 months after start of
treatment, 14 women with only the initial 12 weeks of EA had a median number of
flushes/24 h of 4.9 (IQR 1.8-7.3), and at 24 months seven women with no other
treatment than EA had 2.1 (IQR 1.6-2.8) flushes/24 h. Another five women had a
decreased number of flushes after having additional EA. The 18 women with HT had
a baseline median number of flushes/24 h of 6.6 (IQR 4.0-8.9), and 0.0 (IQR
0.0-1.6; p = 0.001) at 12 weeks.
CONCLUSION:
Electro-acupuncture is a possible treatment of vasomotor symptoms for women with
breast cancer and should be further studied for this group of
women.
Acupunct
Med. 2008 Mar;26(1):8-16.
Acupuncture for irritable bowel syndrome an exploratory randomised controlled trial.
Reynolds
JA, Bland JM, MacPherson H.
Department
of Health Sciences, University of York, UK.
BACKGROUND: The
evidence on the effectiveness of acupuncture for irritable bowel syndrome (IBS)
is inconclusive. However, many patients with IBS are self referring for
acupuncture, therefore it is of interest to know whether acupuncture is
effective or not. The aim of this study was to establish variability in the
primary outcome measure to enable a sample size to be calculated for a full
scale trial, and to explore feasibility and design
criteria.
METHODS: A
pragmatic randomised controlled trial compared 10 sessions of acupuncture plus
usual GP care with usual GP care alone. Thirty patients were recruited from four
GP databases in Birmingham, UK, and randomised one-to-two to acupuncture or
usual care alone. The primary outcome was the IBS Symptom Severity Score (SSS)
at three months (maximum score 500). Analysis was by intention-to-treat, and
multiple imputation was used for missing data.
RESULTS: From
the databases, 189 patients with IBS were identified, of whom 30 were eligible
and consented to randomisation. At three months, a statistically and clinically
significant difference between groups of 138 points (SD 90) in favour of
acupuncture was observed on the IBS SSS (95% CI: 66 to 210; P=0.001) using
multiple imputation. For a full scale trial, we estimate that a sample size of
108 patients per arm is required, based on a minimum clinically significant
change of 50 points, drawn from a primary care population of 140
000.
CONCLUSIONS: We
established the feasibility of a full scale trial, successfully recruiting
patients and calculating the sample size required. The results of our pilot
analysis suggest that more definitive research into acupuncture for IBS is
merited. A pragmatic trial design will not be able to distinguish between
acupuncture specific effects and placebo effects; however, it is the design of
choice to determine cost effectiveness.
Acupunct
Med. 2008 Mar;26(1):1-7.
Surface electrostimulation of acupuncture points for sedation of critically ill patients in the intensive care unit--a pilot study.
Nayak S,
Wenstone R, Jones A, Nolan J, Strong A, Carson J.
Intensive
Care Unit, Royal Liverpool University Hospital, Liverpool, UK.
drsnayak@yahoo.co.uk
BACKGROUND: This
is a pilot study to investigate the effects of electrostimulation of acupuncture
points on sedation and the dose of sedatives in the Intensive Care
Unit.
METHODS:
Electrostimulation of acupuncture points was performed on 12 critically ill
patients requiring sedation for mechanical ventilation. Electrostimulation was
applied by point surface electrodes at LI4, ST36, HT7 and LR3 points for 20
minutes every hour for 12 hours using dense dispersed mode with a current
frequency of 10-100 Hz and maximum intensity of 10 mA. All patients were sedated
with propofol and alfentanil as required. The dose of propofol was reduced by
10mg/hour provided the patient remained sedated according to our guidelines.
Sedation and analgesia scores, dose of sedative and analgesics drugs,
respiratory rate, heart rate, mean arterial blood pressure and compliance with
the ventilator were recorded before electrostimulation of acupuncture points,
and hourly thereafter for 12 hours.
RESULTS: There
was significant reduction in the median propofol consumption from 145 mg/hour
(range 30-250) to 15 mg/hour (range 0-250) (P<0.05), without any significant
change in sedation scores or analgesia scores. The haemodynamic and respiratory
variables remained stable. All patients were compliant with the
ventilator.
CONCLUSIONS: This
pilot study showed significant reduction in the dose of propofol required for
sedation in critically ill patients following surface electrostimulation of
acupuncture points, without any adverse effects. A randomised controlled trial
is warranted.
Complement
Ther Med. 2008 Feb;16(1):28-35.
Longitudinal changes in the disability level of the elders with low back pain after auriculotherapy.
Suen LK,
Wong EM.
The
Nethersole School of Nursing, Esther Lee Building, The Chinese University of
Hong Kong, Shatin, Hong Kong. lornasuen@cuhk.edu.hk
OBJECTIVE: To
evaluate the longitudinal changes in the disability level of elders with LBP
after receiving auriculotherapy.
DESIGN:
Randomized controlled trial.
SETTINGS: Sixty
participants who were 60 years old or above and who were suffering from LBP were
recruited from five hostels for the elders in Hong Kong.
INTERVENTIONS: The
participants were randomly allocated to receive a 3-week session of
auriculotherapy using either semen vaccariae (control group=30) or magnetic
pellets (experimental group=30). Seven auricular acupoints that are expected to
have an effect on LBP were selected. MAIN OUTCOME MEASURES: Assessment data were
collected at five points of time: (i) baseline, (ii) about 1.5 weeks of
treatment, (iii) 3 weeks of treatment, (iv) 2 weeks post-treatment, and (v) 4
weeks post-treatment using the modified Aberdeen low back pain disability scale
(Chinese).
RESULTS: When
the rate of change was compared between the two groups at each point of time
starting from the baseline, those in the experimental group demonstrated
significant improvement in the overall disability level, pain/sensation, and
physical and functional abilities at 1.5 weeks of treatment (p<0.001), 3
weeks of treatment (p<0.001), 2 weeks post-treatment (p<0.001), and 4
weeks post-treatment (p<0.001).
CONCLUSION:
Longitudinal changes in the improvement of disability level were found among the
elders with low back pain after receiving auriculotherapy using magnetic
pellets.
Cephalalgia.
2008 Apr;28(4):334-45.
Cost-effectiveness of acupuncture treatment in patients with headache.
Witt CM,
Reinhold T, Jena S, Brinkhaus B, Willich SN.
Institute
for Social Medicine, Epidemiology, and Health Economics, Charité, University
Medical Centre, Berlin, Germany.
claudia.witt@charite.de
The aim
was to assess costs and cost-effectiveness of additional acupuncture treatment
in patients with headache compared with patients receiving routine care alone. A
randomized, controlled trial was conducted, including patients (> or =18
years old) with primary headache (more than 12 months, at least two
headaches/month). Outcome parameters were quality of life (Short Form 36),
direct and indirect costs differences during the 3-month study period and the
incremental cost-effectiveness ratio (ICER) of acupuncture treatment. A total of
3182 patients (1613 acupuncture; 1569 controls) with headache were included
(77.4% women, mean age and standard deviation 42.6 +/- 12.3; 22.6% men, 47.2 +/-
13.4). Over 3 months costs were higher in the acupuncture group compared with
the control euro857.47; 95% confidence interval 790.86, 924.07, vs. euro527.34
(459.81, 594.88), P < 0.001, mean difference: euro330.12 (235.27, 424.98).
This cost increase was primarily due to costs of acupuncture euro365.64 (362.19,
369.10). The ICER was euro11 657 per QALY gained. According to international
cost-effectiveness threshold values, acupuncture is a cost-effective treatment
in patients with primary headache.
J Altern
Complement Med. 2008 Mar;14(2):109-14.
Scalp acupuncture effect on language development in children with autism: a pilot study.
Allam H,
ElDine NG, Helmy G.
Complementary
Medicine Department, National Research Centre, Cairo, Egypt.
hematallam@yahoo.com
BACKGROUND
AND OBJECTIVES: Autism
is a neurodevelopmental disorder that manifests in delays in social interaction,
language used in social communication, and symbolic or imaginative play, with an
onset prior to age 3 years. Language therapy (LT) for children with autism is
the main form of rehabilitation, because it emphasizes its major presenting
symptom (i.e., language impairment). Scalp acupuncture (scalp AP) is a modality
based on the physiologic function of different brain areas, where different
scalp zones are stimulated with needles so as to stimulate the reflexively
related nervous tissue. This study aimed to evaluate the role of scalp AP as a
complementary modality to LT in rehabilitation of children with autism.
SUBJECTS
AND DESIGN: The
study involved 20 children (divided into 2 equal groups: A and B), diagnosed as
autistic according to DSM IV classification. Their ages ranged between 4 and 7
years old. All subjects underwent LT twice weekly, aiming at stimulation of
cognitive and verbal abilities. Group B only was subjected to scalp AP
sessions--twice weekly--as a rehabilitation complementary tool during the
9-month period of the study. The acupoints used were: Du 20, 26, GV17; three
temple needles; and Yamamoto's New Scalp Acupuncture cerebrum and aphasia points
(acupuncture needles 0.3 x 30 mm). A language test was performed before and
after therapy to monitor cognition and expression (an Arabic test was
included).
RESULTS: Both
groups, whose mean age range was 5.5 years+/-1.22 years, showed a significant
improvement in cognitive and expressive language skills pre- and post-therapy,
which was highly significant among group B children treated with scalp AP
(attention 2.8+/-0.8 in group A versus 3.5+/-0.8 in group B; receptive semantics
were 7+/-3.8 in group A versus 9.4+/-3.1 in group B). Expressive semantics
significantly improved in both groups.
CONCLUSIONS: Scalp
AP is a safe complementary modality when combined with LT and has a
significantly positive effect on language development in children with
autism.
J
Rehabil Med. 2008 Mar;40(3):166-70.
Effectiveness of electroacupuncture and interferential eloctrotherapy in the management of frozen shoulder.
Cheing
GL, So EM, Chao CY.
Department
of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
gladys.cheing@inet.polyu.edu.hk
OBJECTIVE: To
examine whether the addition of either electroacupuncture or interferential
electrotherapy to shoulder exercises would be more effective in the management
of frozen shoulder. DESIGN: A double-blinded, randomized, controlled
trial.
METHODS: A total
of 70 subjects were randomly allocated to receive either: (i) electroacupuncture
plus exercise; (ii) interferential electrotherapy plus exercise; or (iii) no
treatment (the control group). Subjects in groups (i) and (ii) received 10
sessions of the respective treatment, while the control group received no
treatment for 4 weeks. Each subject's score on the Constant Murley Assessment
and visual analogue scale were recorded at baseline, post-treatment session and
subsequent follow-up sessions.
RESULTS: In both
the electroacupuncture and interferential electrotherapy groups, the Constant
Murley Assessment score increased and the visual analogue scale score decreased
significantly (both p < 0.001). No significant change was found in any
outcome of the control group, and no significant difference was found between
the 2 intervention groups (all p > 0.05). The observed improvement was well
maintained in both intervention groups at least until the 6-month follow-up
session.
CONCLUSION: Either
electroacupuncture or interferential electrotherapy in combination with shoulder
exercises is effective in treating frozen shoulder patients. However, no
significant difference was found between these types of
treatment.
Clin J
Pain. 2008 Mar-Apr;24(3):211-8.
Acupuncture for treatment of persistent arm pain due to repetitive use: a randomized controlled clinical trial.
Goldman
RH, Stason WB, Park SK, Kim R, Schnyer RN, Davis RB, Legedza AT, Kaptchuk
TJ.
Department
of Medicine, Cambridge Health Alliance, Cambridge, UK.
rgoldman@challiance.org
OBJECTIVE: To
compare true and sham acupuncture in their abilities to relieve arm pain and
improve arm function in individuals with arm pain due to repetitive
use.
METHODS:
Participants with persistent arm pain (N=123) were randomly assigned to true or
sham acupuncture groups and received 8 treatments over 4 weeks. The primary
outcome was intensity of pain (10-point scale) and secondary outcomes were arm
symptoms, arm function, and grip strength. Outcomes were measured during
treatment (at 2 and 4 wk) and 1 month after treatment
ended.
RESULTS: Arm
pain scores improved in both groups during the treatment period, but
improvements were significantly greater in the sham group than in the true
acupuncture group. This difference disappeared by 1 month after treatment ended.
The true acupuncture group experienced more side effects, predominantly mild
pain at time of treatments.
DISCUSSION: Sham
acupuncture reduced arm pain more than true acupuncture during treatment, but
the difference did not persist after 1 month. Mild side effects from true
acupuncture may have blunted any positive treatment effects. Overall, this study
did not find evidence to support the effectiveness of true acupuncture in
treatment of persistent arm pain due to repetitive use.
Clin
Rehabil. 2008 Mar;22(3):195-205.
Comparison of the effect of two types of acupuncture on quality of life in secondary progressive multiple sclerosis: a preliminary single-blind randomized controlled trial.
Donnellan
CP, Shanley J.
Linden
Lodge Neuro-Rehabilitation Unit, Nottingham University Hospitals NHS Trust,
Nottingham, UK. clare.donnellan@nuh.nhs.uk
OBJECTIVE: To
compare the effect of two types of acupuncture on the quality of life of
individuals with secondary progressive multiple sclerosis and provide
preliminary evidence regarding the safety of this intervention for this
population. DESIGN: Preliminary single-blind randomized controlled trial.
SETTING:
Outpatient attendance at rehabilitation unit. PARTICIPANTS: Fourteen
participants with secondary progressive multiple sclerosis.
INTERVENTIONS: Chinese medical acupuncture or minimal acupuncture.
Participants received 10 treatments over five weeks.
MEASURES:
Multiple Sclerosis Impact Scale 29, Fatigue Severity Scale and General Health
Questionnaire 12 were measured pre and post intervention. Adverse events and
other responses during treatment were recorded
prospectively.
RESULTS:
Participants receiving minimal acupuncture demonstrated statistically
significant greater improvement in the Multiple Sclerosis Impact Scale 29
psychological subscale compared with those receiving Chinese medical acupuncture
in an intention-to-treat analysis (P=0.04), with mean change in Chinese
acupuncture group of 6.0 (SD 13.9) and in minimal acupuncture group of 23.0 (SD
21.0). No other statistically significant difference between the groups was
found. No major adverse events were noted. Minor adverse events such as lower
limb muscle spasms or pain were noted in some participants in both intervention
groups.
CONCLUSION: Minimal
acupuncture resulted in greater improvement of Multiple Sclerosis Impact Scale
29 psychological subscale compared with Chinese medical acupuncture. No other
differences between the groups were found. In view of the small sample these
results are not conclusive. This study provides preliminary evidence to suggest
that acupuncture is safe for people with secondary progressive multiple
sclerosis. A large-scale trial is required to provide more definitive
evidence.
BMJ.
2008 Mar 8;336(7643):545-9. Forsch Komplementmed. 2008 Aug;15(4):228-9.
Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis.
Manheimer
E, Zhang G, Udoff L, Haramati A, Langenberg P, Berman BM, Bouter
LM.
Center
for Integrative Medicine, University of Maryland School of Medicine, 2200 Kernan
Drive, Kernan Hospital Mansion, Baltimore, MD 21207, USA.
emanheimer@compmed.umm.edu
OBJECTIVE: To
evaluate whether acupuncture improves rates of pregnancy and live birth when
used as an adjuvant treatment to embryo transfer in women undergoing in vitro
fertilisation. DESIGN: Systematic review and meta-analysis.
DATA
SOURCES:
Medline, Cochrane Central, Embase, Chinese Biomedical Database, hand searched
abstracts, and reference lists. Review methods Eligible studies were randomised
controlled trials that compared needle acupuncture administered within one day
of embryo transfer with sham acupuncture or no adjuvant treatment, with reported
outcomes of at least one of clinical pregnancy, ongoing pregnancy, or live
birth. Two reviewers independently agreed on eligibility; assessed
methodological quality; and extracted outcome data. For all trials,
investigators contributed additional data not included in the original
publication (such as live births). Meta-analyses included all randomised
patients.
DATA
SYNTHESIS: Seven
trials with 1366 women undergoing in vitro fertilisation were included in the
meta-analyses. There was little clinical heterogeneity. Trials with sham
acupuncture and no adjuvant treatment as controls were pooled for the primary
analysis. Complementing the embryo transfer process with acupuncture was
associated with significant and clinically relevant improvements in clinical
pregnancy (odds ratio 1.65, 95% confidence interval 1.27 to 2.14; number needed
to treat (NNT) 10 (7 to 17); seven trials), ongoing pregnancy (1.87, 1.40 to
2.49; NNT 9 (6 to 15); five trials), and live birth (1.91, 1.39 to 2.64; NNT 9
(6 to 17); four trials). Because we were unable to obtain outcome data on live
births for three of the included trials, the pooled odds ratio for clinical
pregnancy more accurately represents the true combined effect from these trials
rather than the odds ratio for live birth. The results were robust to
sensitivity analyses on study validity variables. A prespecified subgroup
analysis restricted to the three trials with the higher rates of clinical
pregnancy in the control group, however, suggested a smaller non-significant
benefit of acupuncture (odds ratio 1.24, 0.86 to 1.77).
CONCLUSIONS: Current
preliminary evidence suggests that acupuncture given with embryo transfer
improves rates of pregnancy and live birth among women undergoing in vitro
fertilisation.
Zhongguo
Zhen Jiu. 2008 Jan;28(1):27-9.
Wu YH,
Sun CL, Wu D, Huang YY, Chi CM.
Shandong
Provincial Jimo Municipal Hospital of TCM, Shandong 266200, China.
doctorwu6@126.com
OBJECTIVE: To
compare therapeutic effects of acupuncture combined with TDP radiation and
western medicine on restless legs syndrome.
METHODS: One
hundred and fifty-eight cases of restless legs syndrome were randomly divided
into an observation group and a control group, 79 cases in each group. The
treatment group were treated with acupuncture at Shenshu (BL 23), Dachangshu (BL
25), Guanyuanshu (BL 26), Zhibian (BL 54), Taixi (KI 3), etc., and TDP
radiation. The control group were treated with L-Dopa. Clinical observation was
made for 30 days.
RESULTS: In the
observation group, 42 cases were cured, 30 cases were effective and 7 cases were
ineffective with a total effective rate of 91.1%; in the control group no case
was cured, 24 cases were effective and 55 cases were ineffective with a total
effective rate of 30.4%, with a significant difference between the two groups in
the total effective rate.
CONCLUSION:
Acupuncture combined with TDP radiation has a better therapeutic effect on
restless legs syndrome.
Zhongguo
Zhen Jiu. 2008 Jan;28(1):21-3.
Clinical observation on acupuncture for treatment of infertility of ovulatory disturbance.
Song FJ,
Zheng SL, Ma DZ.
Section
of Acupunture, Wenzhou City Hospital of TCM, Zhejiang 325002, China.
fenjsun@163.com
OBJECTIVE: To
probe into clinical therapeutic effect of acupuncture on infertility of
ovulatory disturbance and the mechanism.
METHODS: The
patients were randomly divided into an acup-moxibustion group and a medication
group in the order of visiting, 60 cases in each group. The acup-moxibustion
group were treated with acupuncture at Zhongji (CV 3), Guanyuan (CV 4), Zigong
(EX-CA 1), Zusanli (ST 36), Sanyinjiao (SP 6) and suspended moxibustion over
Shenque (CV 8), Sanyinjiao (SP 6), and the medication group with oral
administration of 50 mg Clomiphene. After treatment for 3 menstrual cycles,
pregnancy rate, basal body temperature, B-ultrasonic examination and ovulation
were assessed.
RESULTS:
Acup-moxibustion and oral administration of Clomiphene had higher ovulating
effect, with no significant difference between them (P > 0.05); the pregnancy
rate in the acup-moxibustion group was significantly higher than that in the
medication group (P < 0.05).
CONCLUSION:
Acup-moxibustion and Clomiphene have a same ovulating effect, and the pregnancy
rate is higher and the abortion rate is lower for the patient of
acup-moxibustion treatment than that for oral administration of
Clomiphene.
Zhongguo
Zhen Jiu. 2008 Jan;28(1):17-9.
Clinical observation on cake-separated mild-warm moxibustion for treatment of knee osteoarthritis
Li JW,
Xiang SY, Ma ZY, Feng YB, Tong HY, Geng HP, Jin J, Su
X.
Department
of Acupuncture and Moxibustion, Wuhan Hospital of TCM, Hubei 430014, China.
Lijianwu1955@Yahoo.com
OBJECTIVE: To
observe clinical therapeutic effect of monkshood cake-separated mild-warm
moxibustion at Zusanli (ST 36) and Xiyan (EX-LE 5) on knee
osteoarthritis.
METHODS: The
patients of monkshood cake-separated mild-warm moxibustion group were treated
with monkshood cake-separated mild-warm moxibustion at Dubi (ST 35), Zusanli (ST
36) and Neixiyan (EX-LE 4) on the affected side, and the medication group with
oral administration of Xianling Gubao Capsules. After treatment for 4 weeks, VAS
and index of severity of osteoarthritis (ISOA scale) were used for assessment of
clinical therapeutic effect.
RESULTS: After
treatment, the arthralgia and the index of severity significantly improved in
the two groups (P < 0.01), and the analgesic effect and improvement of ISOA
in the monkshood cake-separated mild-warm moxibustion group were better than
those in the medication group (P < 0.05). The basic clinical cured rate was
80.0% and the effect-producing time was (10.91 +/- 4.17) days in the monkshood
cake-separated mild-warm moxibustion group, and 53.3% and (12.28 +/- 4.60) days
in the medication group, respectively, with a significant difference between the
two groups (P < 0.05).
CONCLUSION:
Therapeutic effect of monkshood cake-separated mild-warm moxibustion on knee
osteoarthritis is better than that of oral administration of Xianling Gubao
Capsules.
Zhongguo
Zhen Jiu. 2008 Jan;28(1):7-9.
Clinical observation on abdominal electroacupuncture for treatment of poststroke constipation
Wang DS,
Wang S, Kong LL, Wang WY, Cui XM.
Section
of Acupuncture and Moxibustion, Heilongjiang Provincial Academy of TCM, Harbin
150036, China. ds2001w@tom.com
OBJECTIVE: To
compare therapeutic effects of abdominal electroacupuncture (EA) and western
medicine on poststroke constipation.
METHODS: Eighty
cases were randomly divided into an EA group and a medication group, 40 cases in
each group. The EA group were treated with EA at Daheng (SP 15), Fujie (SP 14),
Tianshu (ST 25), Shuidao (ST 28), etc., once a day, 30 min each session, and the
edication group with oral administration of 10 mg Cisapride, thrice each day.
Seven days constituted one course. After 2 courses, clinical therapeutic effects
were evaluated by cumulative scores of symptoms.
RESULTS: The
total effective rate of 92.5% in the EA group was significantly better than
72.5% in the medication group (P < 0.05). After treatment, the cumulative
scores of clinical symptoms significantly decreased in the two groups (P <
0.05) and the improving degrees of symptoms in the EA group was significantly
better than that in the medication group (P < 0.05).
CONCLUSION:
Abdominal electroacupuncture has a definite therapeutic effect on poststroke
constipation, accelerating gastrointestinal movement.
Zhongguo
Zhen Jiu. 2008 Jan;28(1):3-6.
Acupuncture
for treatment of depressive neurosis: a multi-center randomized
controlled
study
Fu WB,
Fan L, Zhu XP, He Q, Wang L, Zhuang LX, Liu YS, Tang CZ, Li YW, Meng CR, Zhang
HL, Yan J.
Acupuncture Department of Guangdong Provincial Hospital of TCM, Guangzhou 510120, China. Drfwb63@21cn.com
OBJECTIVE: To
observe the clinical therapeutic effect of acupuncture on depressive
neurosis.
METHODS: With a
multi-center randomized controlled study, 440 cases were randomly divided into
an acupuncture group, a prozac group, a non-acupoint needling group. In the
acupuncture group, Hegu (LI 4) and Taichong (LR 3) were selected, and the Prozac
group were treated with administration of 20 mg/d and the non-acupoint needling
group were treated with needling the points deviating from the acupoints. The
therapeutic effect was evaluated by HAMD score reduction rate, and Asberg's
anti-depressant side-effect rating scale (SERS) and severe adverse reaction were
used for safety evaluation, and the data were analyzed with
ITT.
RESULTS: The
total effective rate was 86. 4% in the acupuncture group, which was better than
59.1% in the non-acupoint needling group and 72.7% in the prozac group; HAMD
score in the acupuncture group was similar to that in the Prozac group, which
was better than that in the non-acupoint needling group; the SERS scores in the
acupuncture group and the non-acupoint needling group were significantly lower
than that in the Prozac group, with no severe side-effects found for
acupuncture.
CONCLUSION:
Acupuncture is an effective and safe therapy for depressive neurosis;
therapeutic effect of acupuncture on depressive neurosis possibly is better than
or similar to that of Prozac, but with less side-effects.
Bioelectromagnetics.
2008 May;29(4):245-56.
Electrical properties of acupuncture points and meridians: a systematic review.
Ahn AC,
Colbert AP, Anderson BJ, Martinsen OG, Hammerschlag R, Cina S, Wayne PM,
Langevin HM.
Division
for Research and Education in Complementary and Integrative Medical Therapies,
Harvard Medical School, Boston, Massachusetts 02215, USA.
aahn@hms.harvard.edu
According
to conventional wisdom within the acupuncture community, acupuncture points and
meridians are special conduits for electrical signals. This view gained
popularity after anecdotal reports and clinical studies asserted that these
anatomical structures are characterized by lower electrical impedance compared
to adjacent controls. To ascertain whether evidence exists to support or refute
this claim, we conducted a systematic review of studies directly evaluating the
electrical characteristics of acupuncture structures and appropriate controls.
We searched seven electronic databases until August 2007, hand-searched
references, and consulted technical experts. We limited the review to primary
data human studies published in English. A quality scoring system was created
and employed for this review. A total of 16 articles representing 18 studies met
inclusion criteria: 9 examining acupuncture points and 9 examining meridians.
Five out of 9 point studies showed positive association between acupuncture
points and lower electrical resistance and impedance, while 7 out of 9 meridian
studies showed positive association between acupuncture meridians and lower
electrical impedance and higher capacitance. The studies were generally poor in
quality and limited by small sample size and multiple confounders. Based on this
review, the evidence does not conclusively support the claim that acupuncture
points or meridians are electrically distinguishable. However, the preliminary
findings are suggestive and offer future directions for research based on
in-depth interpretation of the data. (c) 2008 Wiley-Liss,
Inc.
Anesth
Analg. 2008 Feb;106(2):602-10.
Acupuncture analgesia: I. The scientific basis.
Wang SM,
Kain ZN, White P.
Department
of Anesthesiology, Yale School of Medicine, 333 Cedar St., New Haven, CT 06510,
USA. shu-ming.wang@yale.edu
Acupuncture
has been used in China and other Asian countries for the past 3000 yr. Recently,
this technique has been gaining increased popularity among physicians and
patients in the United States. Even though acupuncture-induced analgesia is
being used in many pain management programs in the United States, the mechanism
of action remains unclear. Studies suggest that acupuncture and related
techniques trigger a sequence of events that include the release of
neurotransmitters, endogenous opioid-like substances, and activation of c-fos
within the central nervous system. Recent developments in central nervous system
imaging techniques allow scientists to better evaluate the chain of events that
occur after acupuncture-induced stimulation. In this review article we examine
current biophysiological and imaging studies that explore the mechanisms of
acupuncture analgesia.
Anesth
Analg. 2008 Feb;106(2):611-21, table of contents.
Acupuncture analgesia: II. Clinical considerations.
Wang SM,
Kain ZN, White PF.
Center
for Advancement of Perioperative Health, Department of Anesthesiology, Yale
School of Medicine, 333 Cedar St., New Haven, CT 06510, USA.
shu-ming.wang@yale.edu
BACKGROUND:
Acupuncture and related percutaneous neuromodulation therapies can be used to
treat patients with both acute and chronic pain. In this review, we critically
examined peer-reviewed clinical studies evaluating the analgesic properties of
acupuncture modalities.
METHODS: Using
Ovid and published medical databases, we examined prospective, randomized,
sham-controlled clinical investigations involving the use of acupuncture and
related forms of acustimulation for the management of pain. Case reports, case
series, and cohort studies were not included in this
analysis.
RESULTS:
Peer-reviewed literature suggests that acupuncture and other forms of
acustimulation are effective in the short-term management of low back pain, neck
pain, and osteoarthritis involving the knee. However, the literature also
suggests that short-term treatment with acupuncture does not result in long-term
benefits. Data regarding the efficacy of acupuncture for dental pain,
colonoscopy pain, and intraoperative analgesia are inconclusive. Studies
describing the use of acupuncture during labor suggest that it may be useful
during the early stages, but not throughout the entire course of labor. Finally,
the effects of acupuncture on postoperative pain are inconclusive and are
dependent on the timing of the intervention and the patient's level of
consciousness.
CONCLUSIONS: Current
data regarding the clinical efficacy of acupuncture and related techniques
suggest that the benefits are short-lasting. There remains a need for well
designed, sham-controlled clinical trials to evaluate the effect of these
modalities on clinically relevant outcome measures such as resumption of daily
normal activities when used in the management of acute and chronic pain
syndromes.
Am J Obstet
Gynecol. 2008 Feb;198(2):166.e1-8.
Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care.
Witt CM,
Reinhold T, Brinkhaus B, Roll S, Jena S, Willich SN.
Institute
for Social Medicine, Epidemiology, and Health Economics, Charité University
Medical Center, Berlin, Germany.
claudia.witt@charite.de
OBJECTIVE: To
investigate the clinical effectiveness and cost-effectiveness of acupuncture in
patients with dysmenorrhea. STUDY DESIGN: In a randomized controlled trial plus
non-randomized cohort, patients with dysmenorrhea were randomized to acupuncture
(15 sessions over three months) or to a control group (no acupuncture). Patients
who declined randomization received acupuncture treatment. All subjects were
allowed to receive usual medical care.
RESULTS: Of 649
women (mean age 36.1 +/- 7.1 years), 201 were randomized. After three months,
the average pain intensity (NRS 0-10) was lower in the acupuncture compared to
the control group: 3.1 (95% CI 2.7; 3.6) vs. 5.4 (4.9; 5.9), difference -2.3
(-2.9; -1.6); P<.001. The acupuncture group had better quality of life and
higher costs. (overall ICER 3,011 euros
per
QALY).
CONCLUSION:
Additional acupuncture in patients with dysmenorrhea was associated with
improvements in pain and quality of life as compared to
treatment
with usual care alone and was cost-effective within usual
thresholds.
Clin J
Pain. 2008 Feb;24(2):106-15.
Acupuncture in migraine: investigation of autonomic effects.
Bäcker
M, Grossman P, Schneider J, Michalsen A, Knoblauch N, Tan L, Niggemeyer C, Linde
K, Melchart D, Dobos GJ.
Complementary
and Integrative Medicine, Department of Internal Medicine V, University of
Duisburg-Essen, Kliniken Essen Mitte, Germany.
marcus.baecker@uni-essen.de
OBJECTIVE: A
dysregulation of the autonomic nervous system is discussed as a pathogenetic
factor in migraine. As acupuncture has been shown to exhibit considerable
autonomic effects, we tested whether the clinical effects of acupuncture in
migraine prophylaxis are mediated by changes of the autonomic
regulation.
METHODS: We
simultaneously monitored changes of heart-rate variability (HRV) as an index of
cardiac autonomic control and clinical improvement during an acupuncture
treatment in 30 migraineurs. HRV was derived from spectral analysis of the
electrocardiogram, which was performed before, during, and after the first and
the last session of a series of 12 acupuncture sessions. Migraineurs were
randomly allocated to 2 groups receiving either verum acupuncture (VA) or sham
acupuncture (SA) treatment.
RESULTS: Across
the combined VA and SA groups, the clinical responders (with at least 50%
reduction of migraine attacks) exhibited a decrease of the low-frequency (LF)
power of HRV in the course of the treatment, which was not be observed in
patients without clinical benefit. VA compared with SA induced a stronger
decrease of high-frequency power. The mode of acupuncture, however, did not have
an impact on the LF component of HRV or the clinical
outcome.
DISCUSSION: The
data indicate, that VA and SA acupuncture might have a beneficial influence on
the autonomic nervous system in migraineurs with a reduction of the LF power of
HRV related to the clinical effect. This might be due to a reduction of
sympathetic nerve activity. VA and SA induce different effects on the
high-frequency component of HRV, which seem, however, not to be relevant for the
clinical outcome in migraine.
Clin J
Pain. 2008 Feb;24(2):98-105.
Acupuncture in migraine prevention: a randomized sham controlled study with 6-months posttreatment follow-up.
Alecrim-Andrade
J, Maciel-Júnior JA, Carnè X, Severino Vasconcelos GM, Correa-Filho
HR.
Department
of Medicine, Autonomous University of Barcelona, Barcelona, Catalunya, Spain.
jalecrim@uol.com.br
OBJECTIVE: To
assess the efficacy of acupuncture in migraine prophylaxis.
METHODS:
Thirty-seven patients with migraine were enrolled in a randomized control trial
at the Headache clinic located in a University Hospital. Real and sham
acupuncture groups received 16 acupuncture sessions over 3 months. Treatment was
individualized in the real acupuncture group and minimal acupuncture was used in
the sham group. The primary end point was the percentage of patients with a
>or=50% reduction in their migraine attack frequency in the second, third,
fourth, fifth, and sixth (months) compared with the first one (baseline period).
Primary and secondary end points were measured comparing headache
diaries.
RESULTS: Real
acupuncture group showed improvement with significant differences compared with
the sham acupuncture group in the primary efficacy end point (P=0.021) at the
second month of the treatment. Differences also appeared in 2 secondary end
points: number of days with migraine per month (P=0.007) in the second month and
the percentage of patients with >or=40% reduction in migraine attack
frequency in the first (P=0.044) and second months (P=0.004) of the treatment.
These differences disappeared in the third (last) month of the treatment as a
consequence of the high improvement of the sham acupuncture group. Comparisons
within each group showed that several migraine parameters evaluated improved
significantly in both groups.
CONCLUSIONS:
Individualized treatment based on traditional Chinese medicine plays a role in
preventing migraine attacks. Nevertheless, sham acupuncture had similar effects.
Major conclusions were limited by the small sample sizes however the observed
trends may contribute to design future trials.
Am J
Med. 2008 Jan;121(1):79.e1-7.
Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain.
Lee SW,
Liong ML, Yuen KH, Leong WS, Chee C, Cheah PY, Choong WP, Wu Y, Khan N, Choong
WL, Yap HW, Krieger JN.
School
of Pharmaceutical Science, University of Science,
Malaysia.
BACKGROUND:
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) afflicts 2%-10% of
adult men. Available therapies offer little or no proven benefit. Because
acupuncture represents an attractive "natural" therapy, we compared the efficacy
of acupuncture to sham acupuncture for CP/CPPS.
METHODS:
Participants met US National Institutes of Health (NIH) consensus criteria for
CP/CPPS, were aged > or = 20 years old, and had a total score > or = 15 on
the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and symptoms for at least 3
of the preceding 6 months. They were randomized 1:1 to acupuncture or sham
acupuncture. Treatment consisted of twice-weekly 30-minute sessions for 10 weeks
(20 sessions total) without needle stimulation, herbs, or adjuvants. The primary
response criterion was a 6-point decrease from baseline to week 10 in NIH-CPSI
total score (range 0-43).
RESULTS:
Thirty-two (73%) of 44 participants responded in the acupuncture group compared
with 21 (47%) of 45 sham group participants (relative risk 1.81, 95% confidence
interval, 1.3-3.1, P = .02). Long-term responses 24 weeks after completing
therapy without additional treatment occurred in 14 (32%) of 44 acupuncture
group participants and in 6 (13%) of 45 sham group participants (relative risk
2.39, 95% confidence interval, 1.0-5.6, P = .04).
CONCLUSIONS: After
10 weeks of treatment, acupuncture proved almost twice as likely as sham
treatment to improve CP/CPPS symptoms. Participants receiving acupuncture were
2.4-fold more likely to experience long-term benefit than were participants
receiving sham acupuncture.
J
Neuroendocrinol. 2008 Mar;20(3):290-8.
Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence.
Stener-Victorin
E, Jedel E, Mannerås L.
Institute
of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy,
Göteborg University, Göteborg, Sweden.
elisabet.stener-victorin@neuro.gu.se
This
review describes the aetiology and pathogenesis of polycystic ovary syndrome
(PCOS) and evaluates the use of acupuncture to prevent and reduce symptoms
related with PCOS. PCOS is the most common female endocrine disorder and it is
strongly associated with hyperandrogenism, ovulatory dysfunction and obesity.
PCOS increases the risk for metabolic disturbances such as hyperinsulinaemia and
insulin resistance, which can lead to type 2 diabetes, hypertension and an
increased likelihood of developing cardiovascular risk factors andimpaired
mental health later in life. Despite extensive research, little is known about
the aetiology of PCOS. The syndrome is associated with peripheral and central
factors that influence sympathetic nerve activity. Thus, the sympathetic nervous
system may be an important factor in the development and maintenance of PCOS.
Many women with PCOS require prolonged treatment. Current pharmacological
approaches are effective but have adverse effects. Therefore, nonpharmacological
treatment strategies need to be evaluated. Clearly, acupuncture can affect PCOS
via modulation of endogenous regulatory systems, including the sympathetic
nervous system, the endocrine and the neuroendocrine system. Experimental
observations in rat models of steroid-induced polycystic ovaries and clinical
data from studies in women with PCOS suggest that acupuncture exert long-lasting
beneficial effects on metabolic and endocrine systems and
ovulation.
Clin
Geriatr Med. 2008 Feb;24(1):121-38, viii.
Complementary and alternative medicine for sleep disturbances in older adults.
Gooneratne
NS.
Division
of Geriatric Medicine, Center for Sleep and Respiratory Neurobiology, University
of Pennsylvania School of Medicine, 3615 Chestnut Street, Philadelphia, PA
19104, USA. ngoonera@mail.med.upenn.edu
Complementary
and alternative medicines (CAM) are frequently used for the treatment of sleep
disorders, but in many cases patients do not discuss these therapies directly
with their health care provider. There is a growing body of well-designed
clinical trials using CAM that have shown the following: (1) Melatonin is an
effective agent for the treatment of circadian phase disorders that affect
sleep; however, the role of melatonin in the treatment of primary or secondary
insomnia is less well established. (2) Valerian has shown a benefit in some, but
not all clinical trials. (3) Several other modalities, such as Tai Chi,
acupuncture, acupressure, yoga, and meditation have improved sleep parameters in
a limited number of early trials. Future work examining CAM has the potential to
significantly add to our treatment options for sleep disorders in older
adults.
Pain.
2008 Jul 15;137(2):405-12.
Laser acupuncture in children with headache: a double-blind, randomized, bicenter, placebo-controlled trial.
Gottschling
S, Meyer S, Gribova I, Distler L, Berrang J, Gortner L, Graf N, Shamdeen
MG.
Department
of Pediatric Hematology and Oncology, University Children's Hospital, Saarland
University, Kirrbergerstr, 66421 Homburg, Germany.
kisgot@uniklinikum-saarland.de
To
investigate whether laser acupuncture is efficacious in children with headache
and if active laser treatment is superior to placebo laser treatment in a
prospective, randomized, double-blind, placebo-controlled trial of low level
laser acupuncture in 43 children (mean age (SD) 12.3 (+/-2.6) years) with
headache (either migraine (22 patients) or tension type headache (21 patients)).
Patients were randomized to receive a course of 4 treatments over 4 weeks with
either active or placebo laser. The treatment was highly individualised based on
criteria of Traditional Chinese medicine (TCM). The primary outcome measure was
a difference in numbers of headache days between baseline and the 4 months after
randomization. Secondary outcome measures included a change in headache severity
using a 10 cm Visual Analogue Scale (VAS) for pain and a change in monthly hours
with headache. Measurements were taken during 4 weeks before randomization
(baseline), at weeks 1-4, 5-8, 9-12 and 13-16 from baseline. The mean number of
headaches per month decreased significantly by 6.4 days in the treated group
(p<0.001) and by 1.0 days in the placebo group (p=0.22). Secondary outcome
measures headache severity and monthly hours with headache decreased as well
significantly at all time points compared to baseline (p<0.001) and were as
well significantly lower than those of the placebo group at all time points
(p<0.001). We conclude that laser acupuncture can provide a significant
benefit for children with headache with active laser treatment being clearly
more effective than placebo laser treatment.
Clin
Rheumatol. 2008 May;27(5):627-35.
A pilot study of acupuncture as adjunctive treatment of rheumatoid arthritis.
Zanette Sde
A, Born IG, Brenol JC, Xavier RM.
Serviço
de Reumatologia, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina,
Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul,
Brazil. simonezanette@yahoo.com
We
evaluated the efficacy of acupuncture as a useful adjuvant treatment in the
management of rheumatoid arthritis (RA). A pilot, randomized, double-blind, and
controlled clinical trial was conducted. Forty RA patients with active disease
despite stable therapy for at least the preceding 1 month were randomized to
receive a standard protocol of acupuncture (AC) or superficial acupuncture at
non-acupuncture points (controlAC) for 9 weeks. The primary outcome was
achievement of 20% improvement according to the American College of Rheumatology
(ACR) 20 criteria after five and ten treatment sessions and after 1 month of
follow-up. Secondary measures included Disease Assessment Scale (DAS), tender
and swollen joint count, morning stiffness, Health Assessment Questionnaire
(HAQ), visual analogue scale (VAS) of pain, physician global assessment of
activity disease, physician and patient global assessment of treatment, and
inflammatory markers (erythrocyte sedimentation rate and C-reactive protein).
There was not significant difference between the groups regarding the number of
patients that reached ACR20 at the end of the treatment (p=0.479). However,
after 1 month of follow-up, there was a trend in favor of the AC group, with
p=0.068. Compared with the controlAC, the AC group also demonstrated significant
improvement in the patient and physician global assessment of treatment and
physician global assessment of disease activity, but there was no difference on
other clinical and laboratorial measures. On the other hand, only the AC
patients had within group improvement on the variables DAS, HAQ, morning
stiffness, patient and physician global assessment of treatment, and physician
global assessment of disease activity in comparison to baseline visit. Despite
the improvement of some studied variables, there was no significant difference
in the proportion of patients that reached ACR20 between the AC and controlAC
groups. This negative result can be related to the small sample size, selection
of patients, type of acupuncture protocol applied, and difficulties in
establishing an innocuous and trustworthy placebo group to studies involving
acupuncture.
Br J
Anaesth. 2008 Jan;100(1):78-81.
Transcutaneous electrical nerve stimulation at the PC-5 and PC-6 acupoints reduced the severity of hypotension after spinal anaesthesia in patients undergoing Caesarean section.
Arai YC,
Kato N, Matsura M, Ito H, Kandatsu N, Kurokawa S, Mizutani M, Shibata Y, Komatsu
T.
Multidisciplinary
Pain Centre, Aichi Medical University School of Medicine, 21 Karimata,
Nagakutecho, Aichigun, Aichi 480-1195, Japan.
arainon@aichi-med-u.ac.jp
BACKGROUND:
Despite prophylactic measures, hypotension remains a common side-effect of
spinal anaesthesia for parturients. Electroacupuncture at the Neiguan (PC-6) and
Jianshi (PC-5) points influences haemodynamics. We thus hypothesized that
transcutaneous electrical nerve stimulation (TENS) at traditionally used
acupuncture points would reduce the severity of hypotension after spinal
anaesthesia in patients undergoing Caesarean section.
METHODS: After
obtaining approval from the local ethics committee and written informed patient
consent, 36 singleton parturients undergoing Caesarean section under spinal
anaesthesia were randomized into three groups. The control group received no
treatment, and the acupoint and non-acupoint groups received TENS at the PC-5
and PC-6 points of both arms and non-acupoints of both shoulders,
respectively.
RESULTS: The
median (range) of the lowest recorded systolic blood pressure was significantly
higher in the acupoint group compared with the other groups and that of the
non-acupoint group was higher than that of the control group control, 70 (68-82)
mm Hg; acupoint, 94 (84-109) mm Hg; non-acupoint,
81 (70-92) mm Hg: P<0.001. Significantly
more parturients in the control and non-acupoint groups experienced hypotension
control, 10 (83%); acupoint, 4 (33%); non-acupoint, 10 (83%): P=0.013. More
ephedrine was required to maintain arterial blood pressure in the control and
non-acupoint groups.
CONCLUSIONS: TENS on
the traditional acupuncture points reduced the severity and incidence of
hypotension after spinal anaesthesia in parturients.
Headache.
2008 Mar;48(3):398-407.
Traditional acupuncture in migraine: a controlled, randomized study.
Facco
E, Liguori A, Petti F, Zanette G, Coluzzi F, De Nardin M, Mattia
C.
University
of Padua - Department of Medico-Surgical Specialties - Sect. Dentistry, Padua,
Italy.
OBJECTIVE: To
check the effectiveness of a true acupuncture treatment according to traditional
Chinese medicine (TCM) in migraine without aura, comparing it to a standard mock
acupuncture protocol, an accurate mock acupuncture healing ritual, and untreated
controls. BACKGROUND: Migraine prevalence is high and affects a relevant rate of
adults in the productive phase of their life. Acupuncture has been increasingly
advocated and used in Western countries for migraine treatment, but the evidence
of its effectiveness still remains weak. A large variability of treatments is
present in published studies and no acupoint selection according to TCM has been
investigated so far; therefore, the low level of evidence of acupuncture
effectiveness might partly depend on inappropriate treatment.
DESIGN
AND METHODS: A
prospective, randomized, controlled study was performed in 160 patients
suffering from migraine without aura, assessed according to the ICD-10
classification. The patients were divided into the following 4 groups: (1) group
TA, treated with true acupuncture (according to TCM) plus Rizatriptan; (2) group
RMA, treated with ritualized mock acupuncture plus Rizatriptan; (3) group SMA,
treated with standard mock acupuncture plus Rizatriptan; (4) group R, without
prophylactic treatment with relief therapy only (Rizatriptan). The MIDAS
Questionnaire was administered before treatment (T0), at 3 (T1) and 6 months
(T2) from the beginning of treatment, and the MIDAS Index (MI) was calculated.
Rizatriptan intake was also checked in all groups of patients at T0, T1, and T2.
Group TA and RMA were evaluated according to TCM as well; then, the former was
submitted to true acupuncture and the latter to mock acupuncture treatment
resembling the same as TA. The statistical analysis was conducted with factorial
ANOVA and multiple tests with a Bonferroni adjustment.
RESULTS: A total
of 127 patients completed the study (33 dropouts): 32 belonged to group TA, 30
to group RMA, 31 to group SMA, and 34 to group R. Before treatment the MI (T(0))
was moderate to severe with no significant intergroup differences. All groups
underwent a decrease of MI at T(1) and T(2), with a significant group difference
at both T(1) and T(2) compared to T(0) (P < .0001). Only TA provided a
significant improvement at both T(1) and T(2) compared to R (P < .0001). RMA
underwent a transient improvement of MI at T(1). The Rizatriptan intake
paralleled the MI in all groups.
CONCLUSIONS: TA was
the only treatment able to provide a steady outcome improvement in comparison to
the use of only Rizatriptan, while RMA showed a transient placebo effect at
T1.
Eur J
Health Econ. 2008 Aug;9(3):209-19.
Quality of life and cost-effectiveness of acupuncture treatment in patients with osteoarthritis pain.
Reinhold T,
Witt CM, Jena S, Brinkhaus B, Willich SN.
Institute
for Social Medicine, Epidemiology, and Health Economics, Charité University
Medical Center, Berlin, Germany.
thomas.reinhold@charite.de
To
assess quality of life (QoL), costs, and cost-effectiveness of acupuncture
treatment plus routine care versus routine care alone in osteoarthritis
patients, a randomised, controlled trial was conducted in 255 general practices
in Germany. Four hundred and eighty-nine patients with chronic pain due to
osteoarthritis of the knee or hip were included to evaluated QoL and costs at
baseline and after 3 months using health insurance funds data and standardized
questionnaires. Patients receiving acupuncture had an improved QoL associated
with significantly higher costs over the 3 months treatment period compared to
routine care alone (mean cost-difference: 469.50 euros 95%CI 135.80-803.19
euros). This increase in costs was primarily due to the costs of acupuncture.
The overall ICER was 17,845 euros per QALY gained. The degree of
cost-effectiveness was influenced by gender, with female patients achieving a
better cost-effectiveness ratio than men. In conclusion, acupuncture was a
cost-effective treatment strategy in patients with chronic osteoarthritis
pain.