Home | About the Acupuncturist | What is Acupuncture? | Research | Links | Contact

 

RESEARCH – Click on Condition to go to research abstract.

 

 Anxiety
Back Pain
Bells Palsy
Breast Cancer
Cancer
Carpal Tunnel Syndrome
Chondromalacia
Dental Pain
Diabetes
Edema
Eye Disorders
Fibromyalgia
Gastrointestinal Problems
Heart Disease
HIV
Human Performance Enhancement
Hypertension
Infertility/IVF
Insomnia
Itching/Pruritis
Knee Pain
Migraines
Nausea
Neck Pain
Olfaction
Osteoarthritis
Pancreatitis
Psoriasis
Pulmonary Disorders
Shin Splints
Tennis Elbow
Trigeminal Neuralgia
Vertigo

 

 

 

Acupuncture and Anxiety

 

·         Auricular acupuncture: a potential treatment for anxiety.

Wang SM, Kain ZN.

Department of Anesthesiology, Yale University School of Medicine and Yale-New Haven Hospital, New Haven, Connecticut 06521, USA. Shu-ming.wang@yale.edu

Acupuncture can be an effective treatment for chronic anxiety disorders. The purpose of this study was to assess the effectiveness of acupuncture in reducing anxiety in a volunteer population. If found effective, this modality could be introduced as a treatment of anxiety before surgery. Adult volunteers (n = 55), were randomized to three treatment groups: a) Shenmen group—bilateral auricular acupuncture at the “shenmen” point; b) Relaxation group-bilateral auricular acupuncture at a “relaxation” point; and c) Sham group-bilateral auricular acupuncture at a “sham” point. Press-acupuncture needles were inserted at the respective auricular areas for 48 h. State anxiety, blood pressure, heart rate, and electrodermal activity were assessed at 30 min, 24 h, and 48 h after insertion. Analyzing anxiety levels using repeated-measures analysis of variance has demonstrated a significant difference [F (2,51) =8.8, P = 0.001] between the three treatment groups. Post hoc analysis demonstrated that patients in the Relaxation group were significantly less anxious at 30 min (P = 0.007) and 24 h (P = 0.035) as compared with patients in both the Shenmen group and the Sham group, and less anxious at 48 h (P = 0.042) as compared with patients in Shenmen group. Repeated-measures analysis of variance performed for electrodermal activity, blood pressure, and heart rate demonstrated no group differences (P = ns). We conclude that auricular acupuncture at the “relaxation” point can decrease the anxiety level in a population of healthy volunteers.


PMID: 11159266 [PubMed – indexed for MEDLINE]

 

Fortschr Neurol Psychiatr 2000 Mar;68(3):137-44

Related Articles, Books, LinkOut


[Acupuncture in patients with minor depressive episodes and generalized anxiety. Results of an experimental study]

[Article in German]

Eich H, Agelink MW, Lehmann E, Lemmer W, Klieser E.

Klinik fur Psychiatrie und Psychotherapie, am Evangelischen Krankenhaus Gelsenkirchen Universitatsklinik der Ruhr-Universitat Bochum.

In a placebo-controlled, randomized, modified double-blind study we investigated the effects of body needle acupuncture (n = 10) in 43 patients with minor depression (ICD 10 F32.0, F32.1) and 13 patients with generalized anxiety disorders (ICD10 F41.1). The severity of the disease was assessed by the Clinical Global Impression Scale (CGI). Treatment response was defined as a significant improvement in CGI. An intent-to-treat analysis was performed to compare treatment responses between verum- and placebo acupuncture. After completing an total of 10 acupuncture sessions the verum acupuncture group (n = 28) showed a significantly larger clinical improvement compared to the placebo group (Mann-Whitney test, p < 0.05). There were significantly more responders in the verum-compared to the placebo group (60.7% vs. 21.4%; chi-square test, p < 0.01). In contrast, no differences in the response rates were evident just after 5 acupuncture sessions. A multivariate analysis with the independent factor acupuncture (verum vs. placebo) and the results of the results of the additional rating scales (total score of HAMA, HAMD, Bf-S, BL) as dependent variables (ANOVA, 1:54 D.F.) revealed a clear trend towards lower HAMA scores in the verum group after completing 10 acupunctures (F3.29, p = 0.075). This corresponds well to the high response rate of 85.7% in patients with generalized anxiety disorders, in whom verum acupuncture was applied. Our results indicate that needle acupuncture (Du.20, Ex.6, He.7, Pe.6, Bl.62) leads to a significant clinical improvement as well as to a remarkable reduction in anxiety symptoms in patients with minor depression or with generalized anxiety disorders. The total sum of acupuncture sessions and the specific location of acupuncture needle insertions might be important factors for bringing about therapeutic success.

PMID: 10758845 [PubMed – indexed for MEDLINE]

 

Psychiatry Clin Neurosci 1998 Dec;52 Suppl:S338-40

Related Articles, Books, LinkOut


Clinical research on the therapeutic effect of the electro-acupuncture treatment in patients with depression.

Luo H, Meng F, Jia Y, Zhao X.

Department of Traditional Chinese Medicine, Institute of Mental Health, Beijing Medical University, PR China.

Electroacupuncture (EA) stimulation has been found to influence the brain (norepinephrine metabolism in experimental animals). Preliminary clinical research has shown that EA treatment is as effective as amitriptyline for patients with depression. In this study, two consecutive clinical studies on the treatment of depression with EA are conducted. The first study was double blind placebo controlled, in which 29 depressed inpatients were recruited. Patients were randomly divided into three groups: EA + placebo; amitriptyline; and EA + amitriptyline. They received EA and/or amitriptyline treatment for 6 weeks. The Hamilton Rating Scale for Depression, Clinical Global Impression and ASBERG scales for the side effect of antidepressants were used to evaluate the therapeutic efficacy and side effects. Based on the results and research protocol of the first study, a multi-centered collaborative study was conducted, in which 241 inpatients with depression were recruited. Patients were randomly divided into two treatment groups: the EA + placebo and the amitriptyline groups. The results from both studies showed that the therapeutic efficacy of EA was equal to that of amitriptyline for depressive disorders (P > 0.05). Electro-acupuncture had a better therapeutic effect for anxiety somatization and cognitive process disturbance of depressed patients than amitriptyline (P < 0.05). Moreover, the side effects of EA were much less than that of amitriptyline (P < 0.001). The article suggested that EA treatment was an effective therapeutic method for depressive disorders. Particularly, it was a treatment of choice for depressed patients who were unable to comply with the classic tricyclic antidepressants because of their anticholinergic side effects. The possible mechanism of EA treatment is discussed.

[back to top]

 

Acupuncture and Back Pain

 

The acupuncture treatment of low back pain: a randomized controlled study.

 

Coan RM, Wong G, Ku SL, Chan YC, Wang L, Ozer FT, Coan PL

 

The acupuncture treatment situation was beneficial to the majority of people with low back pain. This was shown by the use of short-term controls and long-term controls, although the latter were not intended in the study design. After acupuncture, there was a 51% pain reduction in the average pain score in the Immediate Treatment Group. The short-term controls, the Delayed Treatment Group, had no reduction whatsoever in their pain scores at the comparable followup period. Later, the Delayed Treatment Group bere also treated by acupuncturists, and reported 62% less pain. When these two treatment groups were compared at 40 weeks with long-term controls (Inadequate Treatment Group), the Inadequate Treatment Group still had the same pain scores, on the average, as when they enrolled in the study. Both treatment groups, on the average, had 30% lower pain scores. Furthermore, 58% of the treatment groups felt that they were definitely improved at 40 weeks, while only 11% of the Inadequate Treatment Group felt definitely improved at 40 weeks.

1 : Spine 1996 Dec 15;21(24):2860-71; discussion 2872-3 Related Articles, Books, LinkOut 

 

 

Spinal manipulation for low back pain. An updated systematic review of randomized clinical trials.

 

Koes BW, Assendelft WJ, van der Heijden GJ, Bouter LM

 

Institute for Research in Extramural Medicine, Vrije Universiteit Amsterdam, The Netherlands.

 

STUDY DESIGN: Systematic review of randomized clinical trials. OBJECTIVES: To assess the efficacy of spinal manipulation for patients with low back pain. SUMMARY OF BACKGROUND DATA: The management of low back pain remains controversial. Spinal manipulation is a widely used treatment option for low back pain. Recently issued clinical guidelines suggest that spinal manipulation may be effective for patients with acute low back pain. METHODS: A computer-aided search for published papers was conducted, and the methods of the studies identified were assessed. Scores were assigned for quality of methods (based on four main categories: study population, interventions, measurement of effect, and data presentation and analysis), the conclusion of authors regarding spinal manipulation, and the results based on the main outcome measure. RESULTS: Thirty-six randomized clinical trials comparing spinal manipulation with other treatments were identified. The highest score of a trial was 60 points (maximum score was set at 100 points), indicating that most were of poor quality. Nineteen studies (53%) showed favorable results for manipulation. In addition, five studies (14%) reported positive results in one or more subgroups only. Among the five studies with 50-60 points, three were positive, and two were positive only for a subgroup of the study population. Eleven trials compared manipulation with some placebo therapy, with inconsistent results. There appeared to be no clear relation between the methodologic score and the overall outcome of the studies. Twelve trials included patients with acute low back pain only. Of these, five reported positive results, four reported negative results, and three reported positive results in a subgroup of the study population only. There were eight trials comparing manipulation with other conservative treatment modalities, focusing on patients with subacute or chronic low back pain. Of these, five reported positive results, two reported negative results, and in one study no conclusion was presented. There were only 16 studies that included an effect measurement of at least 3 months. In only six of these do the authors report positive effects of manipulation. CONCLUSIONS: The efficacy of spinal manipulation for patients with acute or chronic low back pain has not been demonstrated with sound randomized clinical trials. There certainly are indications that manipulation might be effective in some subgroups of patients with low back pain. These impressions justify additional research efforts on this topic. Methodologic quality remains a critical aspect that should be dealt with in future studies.

 

 

Transcutaneous electrical nerve stimulation and acupuncture-like transcutaneous electrical nerve stimulation for chronic low back pain.

 

Gadsby JG, Flowerdew MW

 

47 Milton Crescent, LEICESTER, Leicestershire, UK, LE4 OPA. Joseph.gadsby@virgin.net

 

[Record supplied by publisher]

 

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS), originally based on the gate-control theory of pain, is widely used for the treatment of chronic low back pain. Despite its wide use and theoretical rationale, there appears at first glance little scientific evidence to support its use. This Cochrane review examines the available evidence on TENS for the treatment of chronic back pain through an exhaustive search of the literature. OBJECTIVES: Transcutaneous electrical nerve stimulation (TENS) and acupuncture-like transcutaneous electrical nerve stimulation (ALTENS) for chronic low back pain management have experienced a tremendous growth over the past 25 years. The objective of this review was to assess the effects of TENS and ALTENS for reducing pain and improving function in patients with chronic back pain. SEARCH STRATEGY: We searched MEDLINE up to November 1997, EMBASE from 1985 to September 1995, Amed and Ciscom to January 1995, reference lists of the retrieved articles, proceedings of conferences and contacted investigators in the field. SELECTION CRITERIA: Randomised trials comparing TENS or ALTENS therapy to placebo in patients with chronic low back pain. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data on pain reduction, range of movement, functional and work status. MAIN RESULTS: Six trials were included. The trials included 288 participants with an average age range of 45 to 50 years and approximately equal numbers of women and men. The overall odds ratio for improvement in pain for each comparison was: TENS/ALTENS versus placebo 2.11 (95% confidence interval 1.32 to 3.38), ALTENS versus placebo 7.22 (95% confidence interval 2.60 to 20.01) and TENS versus placebo 1.52 (95% confidence interval 0.90 to 2.58). The odds ration for improvement in range of motion on ALTENS versus placebo was 6.61 (95% confidence interval 2.36 to 18.55). REVIEWER’S CONCLUSIONS: There is evidence from the limited data available that TENS/ALTENS reduces pain and improves range of motion in chronic back pain patients, at least in the short term. A large trial of ALTENS and TENS is needed to confirm these findings.

 

 

Acupuncture treatment at Ang Mo Kio Community Hospital—a report on our initial experience.

 

Yong D, Lim SH, Zhao CX, Cui SL, Zhang L, Lee TL

 

Acupunture Research Clinic (ARC), Ang Mo Kio Community Hospital, Singapore.

 

BACKGROUND: We report our initial experience with acupuncture treatment at the Ang Mo Kio Community Hospital’s Acupuncture Research Clinic. PATIENTS: One thousand one hundred and twenty-eight patients received a total of 12,172 acupuncture treatment sessions during the period between September 1995 and December 1996. The majority were Chinese (94%), between 40-70 years (70%) with either dialect or Mandarin (68%) as the main spoken language. However, one third of the patients were English speaking, and educational level did not seem to be a factor among our patients accepting acupuncture treatment. Most had either painful conditions (58%) or stroke-related dysfunction (23%). Amongst the painful conditions, arthritis (25%), low back pain (22%) and other musculo-skeletal pain (12%) were the most common. RESULTS: Prior to treatment, about three-quarter of patients believed acupuncture would benefit them while 40% had tried acupuncture before. After completion of treatment, 70% of all patients considered acupuncture safe, 54% were satisfied with the overall result, 51% felt acupuncture was beneficial, while 54% would recommend acupuncture to others with similar conditions. In a subgroup of patients treated for painful conditions, > 90% reported improvement. Near-syncope occurred in 2 patients (0.18%) or during 2 treatment sessions (0.02%). There was no other acupuncture-related complication. CONCLUSION: Our preliminary experience showed that acupuncture is safe, and appears to be beneficial to patients with painful conditions. An overview of acupuncture treatment is presented, and the issues of safety, efficacy and a need to conduct enterzed controlled clinical trials are discussed.

 

: Schmerz 2001 Feb;15(1):33-7

Related Articles, Books, LinkOut

 

 


[Acupuncture treatment of low back pain]

[Article in German]

Schmitt H, Zhao JQ, Brocai DR, Kaps HP.

Abteilung Orthopadie I, Stiftung Orthopadische Universitatsklinik Heidelberg. Holger.schmitt@ok.uni-heidelberg.de

OBJECTIVES: This prospective, non-controlled pilot-study examines the potential benefit of acupuncture in patients with low back pain and radicular symptoms. METHODS: 60 patients with low back pain and lumbar disc herniation diagnosed by magnetic resonance imaging or computed tomography were treated by acupuncture. Pain intensity was assessed before and after treatment on a 100 mm visual analogue scale. RESULTS: Intensity of low back pain dropped from 59 to 19 mm, and intensity of radicular pain from 64 to 12 mm. Three to twelve months after the end of acupuncture, 88% of patients were satisfied with treatment outcome. CONCLUSION: Acupuncture as a noninvasive treatment with very few complications is a promising therapeutical option of low back pain, especially when associated with radicular symptoms.

PMID: 11810327 [PubMed – indexed for MEDLINE]

 

 

1: Clin J Pain 2001 Dec;17(4):296-305

Related Articles, Books, LinkOut


Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up.

Carlsson CP, Sjolund BH.

Department of Rehabilitation, Lund University Hospital, Sweden. akusyd@swipnet.se

OBJECTIVE: The authors sought to determine whether a series of needle acupuncture treatments produced long-term relief of chronic low back pain. DESIGN: A blinded placebo-controlled study with an independent observer. The patients were randomized to receive manual acupuncture, electroacupuncture, or active placebo (mock transcutaneous electrical nerve stimulation). Subjects were examined and monitored by an investigator who was blinded to the treatment given. SETTING: A tertiary-level pain clinic at a Swedish university hospital. PATIENTS: Fifty consecutive patients (33 women, 17 men; mean age, 49.8 years) with chronic low back pain (mean pain duration, 9.5 years) and without rhizopathy or history of acupuncture treatment were included in the study. INTERVENTIONS: Treatments were given once per week for 8 weeks. Two further treatments were given during the follow-up assessment period of 6 months or longer. OUTCOME MEASURES: The independent observer made a global assessment of the patients 1, 3, and 6 months after treatment. The patients kept pain diaries to score pain intensity twice daily, analgesic intake, and quality of sleep daily, and activity level weekly. RESULTS: At the 1-month independent assessment, 16 of 34 patients in the acupuncture groups and 2 of 16 patients in the placebo group showed improvement (p <0.05). At the 6-month follow-up assessment, 14 of 34 patients in the acupuncture groups and 2 of 16 patients in the placebo group showed improvement (p <0.05). A significant decrease in pain intensities occurred at 1 and 3 months in the acupuncture groups compared with the placebo group. There was a significant improvement in return to work, quality of sleep, and analgesic intake in subjects treated with acupuncture. CONCLUSIONS: The authors found a long-term pain-relieving effect of needle acupuncture compared with true placebo in some patients with chronic nociceptive low back pain.

PMID: 11783809 [PubMed – in process]

 

1: Tidsskr Nor Laegeforen 2001 Apr 20;121(10):1207-10

Related Articles, Books, LinkOut

·        
 [Acupuncture contra antiphlogistics in acute lumbago]

Kittang G, Melvaer T, Baerheim A.

Kinn Legekontor, 6900 Floro. G-kitta@online.no

BACKGROUND: Acute low back pain is one of the most frequent complaints presented in general practice. This study compares acupuncture and antiphlogistica in the treatment of acute low back pain in general practice. MATERIAL AND METHODS: Among 60 consecutively included patients with acute low back pain, 30 patients were randomized to enterzedd acupuncture treatment for two weeks, and 30 patients to entero-soluble naproxen 500 mg twice daily for ten days. Effects were observed over six months, and observed for a further 12 months with regard to relapse of low back pain and number of days on sickness leave. RESULTS: There were no differences in pain or stiffness (VAS, physical tests) at inclusion, nor in the reduction of pain or stiffness over a six month evaluation. However, patients receiving acupuncture used significantly less analgetic drugs during the first week after start of treatment than those receiving naproxen (2/28 versus 11/29, p < 0.01). Patients receiving acupuncture also reported fewer new episodes of low back pain (11/28 versus 30/29, p < 0.05) during the 6 + 12 month follow-up. Side effects were frequent in the naproxen group, especially gastro-enteric side effects (0/28 versus 15/29, p < 0.01). INTERPRETATION: Standardised acupuncture treatment seems to be safe and effective in the treatment of acute low back pain in general practice.

PMID: 11402745 [PubMed – indexed for MEDLINE]

1: Nippon Ronen Igakkai Zasshi 2001 Mar;38(2):205-11

Related Articles, Books, LinkOut


[Influence of acupuncture and moxibustion on QOL of the elderly living in nursing home and care house]

Matsumoto T, Terasawa S.

Department of Geriatric Acupuncture and Moxibustion, Meiji University of Oriental Medicine.

To clarify the influence of acupuncture therapy on the quality of life (QOL) of the elderly, the acupuncture and moxibustion were performed on 35 elderly subjects (8 men and 27 women) with a mean age 79.1 living in nursing homes and elderly care houses. The acu-points were chosen according to their symptoms. Changes in pain and other complaints, body condition, appetite, sleep, bowel movement and activity of daily living (ADL) were evaluated by questionnaires. A total of 38 symptoms were reported. A high rate of improvement was seen in pain and stiffness. For example, there was 86% improvement in low back pain, 84% in knee joint pain and 82% in shoulder stiffness. Concerning body conditions, decrease of fatigue, relaxed of feeling, improvement in appetite, sleep and bowel movement were observed. Furthermore, gait and ADL were also improved. These results suggested that acupuncture and moxibustion are useful to improve QOL in the elderly.

PMID: 11305035 [PubMed – indexed for MEDLINE]

Acta Obstet Gynecol Scand 2000 May;79(5):331-5

Related Articles, Books, LinkOut

·        
A prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy.

Wedenberg K, Moen B, Norling A.

Department of Obstetrics and Gynecology, Vrinnevi Hospital, Norrkoping, Sweden.

BACKGROUND: The aim of this study was to describe the effects of acupuncture in the treatment of low-back and pelvic pain during pregnancy and compare it with physiotherapy. METHODS: Sixty pregnant women were allotted to acupuncture or physiotherapy. The women estimated the severity of their pain using a visual analog scale (VAS) from 0 to 10 and disability in performing twelve common daily activities using a disability-rating index (DRI) from 0 to 10. RESULTS: In the acupuncture group all 30 women completed the study (two exclusions), in the physiotherapy group only 18. Before treatment the two study groups were rather similar with respect to pain and disability. After treatment the mean morning VAS had declined from 3.4 to 0.9 (p<0.01) in the acupuncture group and from 3.7 to 2.3 (NS) in the physiotherapy group. The corresponding evening values had declined from 7.4 to 1.7 (p<0.01) and 6.6 to 4.5 (p<0.01), respectively. The mean VAS values were lower after acupuncture than after physiotherapy both in the morning (p=0.02) and in the evening (p<0.01). After treatment also the mean DRI values had decreased significantly in the acupuncture group for 11 of 12 activities and the values were significantly lower for all activities than in the physiotherapy group where no significant changes had taken place. Overall satisfaction was good in both groups. There were no serious adverse events in any of the patients. CONCLUSIONS: Acupuncture relieved pain and diminished disability in low-back pain during pregnancy better than physiotherapy.

PMID: 10830757 [PubMed – indexed for MEDLINE]

Cochrane Database Syst Rev 2000;(2):CD001351

Related Articles, Books, LinkOut

·        
Acupuncture for low back pain.

Tulder MW VA, Cherkin DC, Berman B, Lao L, Koes BW.

Institute for Research in Extramural Medicine, Vrije Universiteit, van der Boechorststraat 7, Amsterdam, Netherlands, 1081 BT. Mw.van_tulder.emgo@med.vu.nl.

BACKGROUND: Although low back pain is usually a self-limiting and benign disease that tends to improve spontaneously over time, a large variety of therapeutic interventions are available for the treatment of low back pain. OBJECTIVES: The objective of this review was to assess the effects of acupuncture for the treatment of non-specific low back pain. SEARCH STRATEGY: We searched the Cochrane Complementary Medicine Field trials register, the Cochrane Controlled Trials Register (1997, issue 1), Medline (1966 – 1996), Embase (1988 – 1996), Science Citation Index and reference lists of articles. SELECTION CRITERIA: Randomised trials of all types of acupuncture treatment that involves needling for subjects with non-specific low back pain. DATA COLLECTION AND ANALYSIS: Two reviewers blinded with respect to authors, institution and journal independently assessed trial quality and extracted data. MAIN RESULTS: Eleven trials were included. The methodological quality was low. Only two trials were of high quality. Three trials compared acupuncture to no treatment, which were of low methodological quality and provide conflicting evidence. There was moderate evidence from two trials that acupuncture is not more effective than trigger point injection or transcutaneous electrical nerve stimulation (TENS). There was limited evidence from eight trials that acupuncture is not more effective than placebo or sham acupuncture for the treatment of chronic low back pain. REVIEWER’S CONCLUSIONS: The evidence enterzed in this systematic review does not indicate that acupuncture is effective for the treatment of back pain.

PMID: 10796434 [PubMed – indexed for MEDLINE]

Singapore Med J 1999 Apr;40(4):260-4

Related Articles, Books, LinkOut


Acupuncture treatment at Ang Mo Kio Community Hospital—a report on our initial experience.

Yong D, Lim SH, Zhao CX, Cui SL, Zhang L, Lee TL.

Acupunture Research Clinic (ARC), Ang Mo Kio Community Hospital, Singapore.

BACKGROUND: We report our initial experience with acupuncture treatment at the Ang Mo Kio Community Hospital’s Acupuncture Research Clinic. PATIENTS: One thousand one hundred and twenty-eight patients received a total of 12,172 acupuncture treatment sessions during the period between September 1995 and December 1996. The majority were Chinese (94%), between 40-70 years (70%) with either dialect or Mandarin (68%) as the main spoken language. However, one third of the patients were English speaking, and educational level did not seem to be a factor among our patients accepting acupuncture treatment. Most had either painful conditions (58%) or stroke-related dysfunction (23%). Amongst the painful conditions, arthritis (25%), low back pain (22%) and other musculo-skeletal pain (12%) were the most common. RESULTS: Prior to treatment, about three-quarter of patients believed acupuncture would benefit them while 40% had tried acupuncture before. After completion of treatment, 70% of all patients considered acupuncture safe, 54% were satisfied with the overall result, 51% felt acupuncture was beneficial, while 54% would recommend acupuncture to others with similar conditions. In a subgroup of patients treated for painful conditions, > 90% reported improvement. Near-syncope occurred in 2 patients (0.18%) or during 2 treatment sessions (0.02%). There was no other acupuncture-related complication. CONCLUSION: Our preliminary experience showed that acupuncture is safe, and appears to be beneficial to patients with painful conditions. An overview of acupuncture treatment is presented, and the issues of safety, efficacy and a need to conduct enterzed controlled clinical trials are discussed.

 

 

Acupunct Electrother Res 1984;9(1):11-29

Related Articles, Books, LinkOut


Acupuncture—a therapeutic concept in the treatment of painful conditions and functional disorders. Report on 971 cases.

Fischer MV, Behr A, von Reumont J.

The results in 971 outpatients who have been treated with acupuncture for different diseases are reported. The outcome of treatments and number of sessions are discussed in relation to the different diseases. Acupuncture treatment was regarded as successful when 1. the patients had no pain at all without medication and 2. there was a significant improvement (no long-term medication, only mild pain under unusual strain, minimal medication under such circumstances). We obtained positive results in cephalalgias , sinusitis, cervical spine syndrome, shoulder-arm syndrome, ischialgias , back pain, constipation, herpes zoster, allergic rhinitis and disturbances of peripheral blood flow. For the following ailments, in order to reduce the medication, we recommend acupuncture despite a high rate of recurrence: Trigeminal neuralgia, colitis ulcerosa, bronchial asthma and cancer pain. Results in the treatment of mental disturbances were unsatisfactory, and in cases of tinnitus results were negative.

PMID: 6145308 [PubMed – indexed for MEDLINE]

Ann R Coll Surg Engl 1983 Jan;65(1):44-6

Related Articles, Books, LinkOut


Superficial acupuncture in the relief of chronic low back pain.

Macdonald AJ, Macrae KD, Master BR, Rubin AP.

A single-blind, enterzed, placebo-controlled trial of superficial acupuncture in the treatment of low back pain was carried out by comparing 8 patients treated by acupuncture with 9 patients treated by placebo. In all five measures of efficacy chosen for study the acupuncture group achieved better responses than the placebo group; four of the five inter-group differences were statistically significant. In addition, an overall mean for all five measures combined showed significant superiority of acupuncture over placebo.


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Acupuncture and Back Pain

What is back pain?

Back pain is one of the most common reasons people seek medical attention. It is one of the most frequent causes of missed workdays and one of the most expensive conditions in the United States; according to a recent government report, in 1999, nearly one million people in the U.S. took time away from work to treat and recover from some sort of back pain.

Back problems can be caused by an inordinately wide range of problems. It can exist alone, or it can be caused by a condition that occurs elsewhere in the body, with the pain being transmitted (referred) to areas of the back by the nervous system. The majority of backache sufferers complain of pain in the lower back; the second most common site of discomfort is the base of the neck.

Who suffers from back pain?

Half of all adults will experience some form of low back pain during their lifetime. The fact that humans walk upright puts great pressure on the spine and the muscles that support it. Over time, factors such as disease, accidents, poor posture and overexertion can lead to immediate and/or long-term back problems.

Most back pain is muscular in nature. Muscle pain perpetuates what is known as the pain cycle, a phenomenon of which the back is particularly susceptible. In the pain cycle, pain causes a muscle to spasm, which may distort the discs, joints and nerves of the spine. This spasm leads to further pain, leading to further spasm, which compounds the original problem. If the nerves are irritated enough, it may cause pain to radiate down into the leg, similar to pain experienced via a herniated disc.

In most cases, people who experience an episode of acute back pain will recover in 3-12 weeks. For those who don’t recover, however, chronic back pain can be a significant source of inconvenience and suffering.

What can acupuncture do?

Acupuncture can play an important role in the reduction or elimination of back pain by reducing recovery time and preventing a chronic condition from developing.

Research has shown that acupuncture causes the body to produce natural steroids and promote the production of natural endorphins. Steroids decrease inflammation, while endorphins are produced by the body to kill pain. Both substances can play an integral part in the breaking up of the pain cycle.

By reducing acute back pain, acupuncture may also reduce the chances of chronic back pain from occurring. It can help avoid the need for costlier and more invasive surgical procedures. And if back pain can be significantly reduced with acupuncture, it also lowers the need for painkillers or other medications that can either cause unwanted side-effects or prolong a patient’s condition.

Many styles of acupuncture may help ease back pain. Some practitioners may advocate very few needles at particular acupoints on the hand; other practitioners may employ electroacupuncture at several points on the body simultaneously. In general, the longer the pain has been present, the longer it will take for acupuncture to produce a response.

As with any other form of care, however, remember that not all patients will respond to acupuncture. Make sure to discuss the situation thoroughly with your acupuncturist before undergoing treatment for back pain (or any other condition).

References

  • Coan RM, et al. The acupuncture treatment of neck pain: a randomized controlled study. Amer J Chin Med 1980;8:181-189.
  • Ernst E, White AR. Acupuncture for back pain: A meta-analysis of enterzed controlled trials. Arch Intern Med 1998;158:2235-2241.
  • Lee A. Back pain and the role of acupuncture in management. Available online at www.barefootdoctors.com/backpain.html.
  • Patel M, Gutzwiller F, Paccaud F, Marazzi A. A meta-analysis of acupuncture for chronic pain. Inter J Epidem 1989;18:900-906.
  • Thomas M, Lundberg T. Importance of modes of acupuncture in the treatment of chronic nociceptive low back pain. Acta Anaesthesiol Scand 1994;38:63-69.
  • Yi-Kai L, et al. Silver needle therapy for intractable low-back pain at tender point after removal of nucleus pulposus. JMPT June 2000;23(5):320-3

 

Acupuncture and Bell’s Palsy

 

This article submitted by Joan Swartz Swigart on 10/20/96.

Author’s Email: wordchef@juno.com

Acupuncture cured Bell’s Palsy

This article submitted by Joan S. Swigart on 9/28/96.
Author’s Email: wordchef@juno.com

UPDATE: 10/20/96 See comments at end of article for update!

On Friday the 13th, Sept. 13, 1996, my husband Ned said that the right side of his face was numb and he asked if I thought he should call the doctor. He was “in” as fast as he could get there and the diagnosis was Bell’s Palsy with prednisone prescribed and an appointment in a few hours to see a neurologist to confirm the diagnosis, which she did. She, however, was upset about the prednisone because she said that there is  no proof that it helps. She said there is nothing to be done except to take something for pain if, in fact, he had any in his face etc. She also said the condition would become worse before it started to get better, which was correct. One week later, his right eyelid was 95% drooped and his mouth was all crooked and he had to drink liquids through a straw..because his mouth was frozen as if he’d had massive doses of novocaine, etc. Accidentally we heard a woman say her brother had this condition and the only thing that helped him was an acupuncturist. A high school classmate of mine in Pittsburgh swears by “her” acupuncturist so I got his phone number. Ten (10) days after the onset of this paralysis, this doctor applied the needles, came back in 30 minutes, and Ned’s eyelid was UP, his mouth was mostly back to normal, and he could drink liquids without a straw. It was unbelievable to us
and we kept waiting for this “miracle” to either “relax” or reverse itself. The improvement has held. Ned returns this Monday for another treatment. Ned’s friend who has had Ball’s Palsy for 2 years and still has a twisted mouth refuses to believe that the acupuncture had anything to do with the vast improvement. All I can say is: I was there. I KNOW how Ned was when we walked into that examining room and I SAW the results 30 minutes later. There is no way that there could be such drastic improvement in half an hour’s time with just “Mother Nature” in
the act. We’ll know more on Monday, after Ned’s second treatment. Also, this wasn’t just blind faith/acceptance either. While Ned was skeptical, he wasn’t negative—just willing to try anything to help this very  burdensome eye and mouth problem. Yes, it seems like a miracle especially when 2 medical doctors had said that perhaps he’d be better, or not, maybe within 2 years!

UPDATE: As of the 3rd visit (10/5/96) to Dr. Yoon, Ned’s Bell’s Palsy isgone—done—over! (Remember: the onset of this was Sept. 13!)The badly twisted right side of his face is completely back to normal; his eyelidis where it should be; he can drink liquids normally; and, best of all, he CAN once again whistle for his dog! All of this was accomplished in three (3) visits..at a cost of $70 for the initial consultation/treatment plus $40 a visit for the next two. Yes, we did pay that ourselves because many insurance companies do not recognize acupuncture.
Compare our $150 cost for a cure to the $220 charged to Medicare from a neurologist who “looked” at Ned the first time for $140 and then “looked” at him a second time for $80 and said that Nature would have to take its course—maybe be better in 2 years! Now, medical profession, I think that it’s time someone in this country starts checking with acupuncturists about their rate of cure with Bell’s Palsy! I’m not sure how Ned would have coped with a minimum of 6 months with that twisted face, very sore eye that he rubbed ever whipstitch, and drinking through a straw. I’m not sure how results that we’ve had can be ignored—especially the high cost of “looking” by a neurologist.
 CONCLUSION: My husband and daughter have both been pleased with the results of acupuncture. Yes, unfortunately in this rural Brookville, PA, town some people are laughing at Ned (behind his back and to his face) for his “nonsense” about needles making his face become untwisted, but that’s their backwoods-ish mentality. WE are LIVING the results, not just high-priced “looking” by a “regular” MD and a neurologist. I’ll soon know if acupuncture works for me and my poor fingers!  If anyone has any questions, I’ll be glad to answer, based on our experiences. A final thought: Ned’s fantastic recovery must have been helped because he sought treatment so soon—10 days after the onset of Bell’s Palsy. People here  are amazed at his “instant” recovery but are unwilling to give acupuncture the credit!

Joan Swartz Swigart
814-856-2858

 

 

ARTICLE #2

 

Facial Paralysis (Bell’s Palsy)

Mostly affects young adults, acute, usually one side of the face is effected, can’t close eye, or mouth, causes tearing and drooling. May be accompanied by pain before attack (around GB 12 SJ 17 +/-), front 2/3 of tongue loses taste sensation, hearing may become sensitive.

Wind/Cold or Wind/Heat

When body is weak the meridians are empty, the pathogen gets inside and blocks the flow of Qi, this results in a lack of nourishment to the tendons and muscles. Can become chronic, this causes an eventual Yin deficiency with Heat and/or deficiency Wind. This condition may cause the deviation to move to the other side of the face.

P/T – promote blood circulation, open meridians to expel Wind

Acupuncture – hand and foot Yangming and Shaoyang, *SJ 17, ST 4-6, LI 4, LR 3, GB 20, LI 20, 19,

Du 26, Jia Cheng Jiang

38    eye not closing- Yin Qiao KI 6, Yang Qiao BL 62, BL 2, GB 14, Yu Yao

38    technique is to push drooping skin back towards normal position

38    patient should come as soon after attack as possible, and return every other day

38    only puncture effected side

38    be sure to wear head and neck scarves

Alternative Treatment Methods

electrical- when facial muscles begin to twitch the stimulation is sufficient.

Chew gum

Facial massage after hot cloth compresses (herbal)

 

 

ARTICLE #3

 

Acupuncture and Bell’s Palsy

This response submitted by Julie on 11/19/96.

Author’s Email:

Today is 11-19-96 and I have now had bell’s palsy for a week and a half.

It started with loosing the taste of anything on the right side of my mouth. Then it moved onto
not being about to feel my lips and then not being able to close my right eye. This occurred from
Friday night to Sunday afternoon, on Monday (11-11-96) I went to my local doctor who diagnosed me with Bell’s palsy and immediately started me on Prednisone treatment. My recommendation on this is to make sure your doctor gradually takes you off it. If you stop cold your adrenal gland may not start producing the steroids right  away again and you can have some major problems. I took 60 mgs for 3 days, 40 mgs for 4 days and then 20 mgs until the bottle was empty.  I also started acupuncture for my bell’s immediately. I have been in for the treatment twice now and in just a week I can close my eye three fourths of the way and I can get my mouth to form a smirk. Today I also noticed the taste is coming back in my food...

It can’t hurt... Just go to a licensed acupuncturist...

Thanks.
Julie
age 26...

 

 

ARTICLE # 4

 

ACUPUNCTURE TREATMENT OF BELL’S PALSY: A CASE REPORT

By David P. Sniezek, D.C., M.D., Washington, DC

INTRODUCTION
A 56-year-old white female presented with a 3-month history of severe right facial pain, weakness, and paralysis. This patient was referred to an otolaryngologist and a neurologist at Johns Hopkins, but did not achieve symptomatic relief. After 15 acupuncture treatments over an 8-week period, the patient had nearly complete resolution.

KEY WORDS
Bell’s Palsy, Acupuncture, Electroacupuncture, Wind and Cold, Qi

PRESENTING COMPLAINT
The patient’s right facial paralysis developed overnight. Associated symptoms included pain in her face, difficulty speaking clearly, aud hypersensitivity to sound in the right ear. She was unable to close her right eyelid, and experienced difficulty with drinking and mastication. She was evaluated and treated by an otolaryngologist, and placed on a steroid taper and acyclovir; symptomatic improvement in facial muscle strength did not occur. Her facial disfigurement and difficulty speaking impacted on her occupation (restaurant owner and operator). She developed mild depression and a secluded behavior.

MEDICATIONS
Prednisolone, Premarin, Acyclovir, DHEA, vitamins, minerals, and a natural Synthroid substitute.

DIAGNOSTIC TESTS
Autoimmune and serology were negative. Lyme titer was negative. Thyroid function tests indicated that she was euthyroid with a slightly decreased TSH level.

PAST MEDICAL HISTORY
This patient had a history of exposure to shingles (sister) several years prior. She denied a history of chicken pox or cold sores. She had osteonecrosis of the right hip that required surgery, pseudotumor of the left orbit, obesity secondary to long-term steroid use, left knee surgery, abdominal hysterectomy, tonsillectomy, and appendectomy.

REVIEW OF SYSTEMS
Neck pain, lower back pain, joint pain, depression, right facial pain and sensitivity to sounds in the right ear, with difficulty speaking clearly.

TREATMENT
Chinese medicine attributes this condition to Wind and Cold of external origin which invade the meridians traversing the face and disrupt the flow of Qi and Blood, preventing the vessels and muscles from receiving the necessary nourishment. Treatment is directed toward spreading the Qi through the meridians of the face (1).
The patient was treated with an integrated approach of acupuncture models. Points from a neuroanatomical model, or for classical indications, were included at each treatment and primarily used unilaterally. Other points utilized the energetic approach, and were treated bilaterally.
The following acupuncture points were used without electrical stimulation. The local points were treated only on the right side, while the distal points were needled bilaterally. The principal points included GB 20 (Fengchi), GB 14 (Yangbai), ST 4 (Dicang), ST 2 (Sibai), and LI 4 (Hegu). The supplemental points included GV 26 (Renzhong), M-HN 18 [Jiachengjiang] (1), M-HN 9 (Taiyang), ST 7 (Ziagnuan), ST 36 (Zusanli), ST 44 (Neiting), and LI 19 (Heliao).
(Editor’s Note: The M-HN points referred to are “miscellaneous head and face points,” according to O’Connor and Bensky’s Acupuncture: A Comprehensive Text; see reference 1 .)
ST 2 (Sibai) was needled with a straight insertion, while G B 14 (Yangbai) was joined to M-HN 6 [Yuyao] (2). These two points may be procured with one needle, or connected together with an alligator clip during electro-stimulation. ST4 (Dicang) and ST6 (Jiache) were treated independently. Because of the weakness in the orbicularis oris, GV 26 (Renzhong) and LI 19 (Heliao) were added. M-HN 9 (Taiyang) may be joined to ST 6 (Jiache). However, in this case, the points were treated independently. The other points can be added in rotation; the best method is a mixture of close points on the face, and distant points on the limbs. Superficial insertion of the needles with moderate stimulation is recommended, and was done in this case. Treatment was carried out on alternating days. Points were treated on the affected side only, except for LI 4 (Hegu), which was treated bilaterally.
The facial points are in muscles supplied by the facial nerve. Treating these points helps to spread Qi through the channels of the face. GB 20 (Fengchi) disperses Wind and Cold. Stomach and Large Intestine meridians pass through the face. Treating L14(Hegu), ST44 (Neiting), and ST 36 (Zusanli) on these meridians opens them to the circulation of Qi.
Electrical stimulation can be used to intensify the effect of needling; however, electroacupuncture is ordinarily reserved until after the first or second week of treatment. This can be accomplished with low frequencies of 3-10 Hz (3), for 20 minutes (ITC elec-toacupuncture stimulator, lC 1107), using GB 14 (++) and LI 4 (- -). More rapid results may be obtained when acupuncture is combined with manipulation, hot compresses, or Chinese and Western oral medication.

PATIENT RESPONSE
The patient was initially graded with a House-Brackmann grade 5 paralysis in the right facial muscles (4). After 10 acupuncture treatments over a 4-week period, she showed significant motion in her forehead and had total closure of her eye with maximal effort. However, with normal effort, she had 1 to 2 mm of scleral fill with good protection of her cornea. She also had good buccal movement and increased movement in the muscles supplied by the mandibular branch of her facial nerve. After a total of 15 acupuncture treatments over an 8-week period, she exhibited normal upper division motion and intact tone in the lower division, with only a mild decrease in motor strength in this division. Her strength was graded at approximately a House-Brackmann 2. She had full eye closure, and intact conjunctivae with slight ectropion.

DISCUSSION
Bell’s Palsy is the most common disease of the facial nerve. It is presumably due to an inflammatory reaction in or around the facial nerve near the stylomastoid foramen. According to Liu (1995), when acupuncture was initiated within three days post-onset in 684 cases of facial nerve paralysis, 100 percent of the patients were cured or there was a marked improvement (5). Other studies (Gao, Chen, 1991) revealed that 80% of cases that were treated at more than 2 months post-onset, and 83 percent of severe cases, were cured or had excellent effect (6). Treatment, as with this patient, may include numerous diagnostic procedures, different classes of medications, lifestyle alterations, and still, continued suffering. Acupuncture may often lead to significant clinical improvement (7).

REFERENCES
1. O’Connor J, Bensky D. Acupuncture a comprehensive text. Seattle: Eastland Press 1981; 367-372.
2. Ibid, 609-610.
3. Stux G, Pomeranz B. Acupuncture textbook and atlas. Berlin: Springer-Verlag 1987; 296.
4. Evans RA, Hames ML, Baguley DM, Moffat DA. Reliability of the House and Brackmann grading system for facial palsy. J Laryngol Otol Nov 1989; 103(11): 1045.
5. Liu YT. A new classification system and combined treatment method for idiopathic facial nerve paralysis: report of 718 cases. Am Jacup 1995; 23(3),205-210.
6. Gao HB, Chen D. Clinical observation on 60 cases of peripheral facial paralysis treated with acupointure penetration needling. Int J Clin Acup 1991; 2(1),25-28.
7. NIH Consensus Development Conference on Acupuncture, National Institutes of Health, Bethesda MD, Nov 1997; 93-109.

AUTHOR INFORMATION
Dr. David P. Sniezek is in solo private practice specializing in Medical Acupuncture, Pain Management, and Physical Medicine and Rehabilitation in Washington, D.C. He is a member of the American Academy of Medical Acupuncture.
David P. Sniezek, DC, M.D.
2021 K Street, NW #710
Washington, DC 20006
Phone: 202-296~3555 ? Fax: 202-296-0214 ? Email: Sniezek@aol.com

 

 

 

ARTICLE # 5

 

Bell’s palsy

Are you wondering if Bell’s palsy (also known as facial paralysis or 7th cranial nerve palsy) can be treated with traditional Oriental medicine? If so, then you can come to our site for information on treatment of Bell’s palsy and facial paralysis with acupuncture and Oriental medicines.

Traditional Chinese medicine is a rare art that is very popular in Europe and the Far East. Western physicians and patients are becoming more and more interested in these ancient traditions, as for more than 2500 years, generations of patients and physicians have depended on traditional Oriental medicines to treat all varieties of disorders.

One of the areas in which traditional medicine and acupuncture are very effective is in the treatment of Bell’s palsy. Although this aspect of acupuncture is not known to everyone, we always advise a patient to give it a try without any further delay. The sooner treatment is applied, the more rapid the response. A nurse who knew how effective acupuncture is for facial paralysis called me as soon as the weakness in the facial muscles was noted, and I was able to treat the condition the same day. It took only 4 treatments to completely eliminate all the muscle weakness.

Even if it has been some time since you developed a Bell’s palsy, acupuncture may be worth trying. However, the longer the condition has been present, the harder it is to completely eliminate it with acupuncture and moxabustion. Herbal therapy may also have to be used. Western doctors may try to treat Bell’s palsy with steroid drugs, which can cause serious side effects. We recommend you try acupuncture first, as it is a very low risk procedure.

A physician who treats using the philosophies of Traditional Chinese medicine believes that for positive results in medicine there has to be mutual trust, mutual responsibility and a common commitment between the physician and his patient. In the remote past, Chinese doctors served only the patient’s well being. Corporate or governmental interference was not tolerated, and the emphasis was on treating every person in an individualized manner. Even today, the ethical physician resists all pressure from economic or political interests to distort the patient-physician relationship.

Dr. L.B. Grotte, M.D., was the first physician in Ohio to be board certified in both acupuncture and Chinese herbology. He has studied Oriental medicine since 1972 and has practiced Oriental medicine in Cleveland for more than 23 years.

 

 

 

 

 

Acupuncture and Breast Cancer

 

Breast Cancer Res Treat. 2004 Jun;85(3):263-70.

Related Articles, Links

 
Use of complementary and alternative medicine by enter women with breast cancer.

Cui Y, Shu XO, Gao Y, Wen W, Ruan ZX, Jin F, Zheng W.

Department of Medicine, Center for Health Services Research and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232-8300, USA.

The use of complementary and alternative medicine (CAM) has been rapidly increasing among cancer patients. The aim of this study is to evaluate the prevalence and patterns of CAM use, particularly patients’ intentions and their perceived effectiveness of using Chinese herbal medicine (CHM), as well as the relations between the herbal medicine use and demographic and clinical factors among Chinese women with breast cancer. We analyzed the data from a population-based sample of 1065 breast cancer women in urban Shanghai. Patients’ average age at diagnosis was 48.1 years and the median time from the initial diagnosis to the follow-up survey was 4.3 years. Overall, 98% of patients had used at least one form of CAM therapy after diagnosis of breast cancer. The most popular CAM modality was traditional Chinese medicine (86.7%), followed by the use of supplements (84.8%), physical exercises (65.5%), and support group attendance (16.6%). CHM was used by 86.4% of patients, while acupuncture was used only by 4.9% of patients. Treating cancer (81.5%) was the most common intentions of using CHM. Other cited intentions included enhancing the immune system (12%), preventing metastasis of cancer or managing other discomforts (7.9%), and lessening menopausal symptoms (4.7%). The majority of patients reported that they had benefited from the use of CHM. Patients who were younger, married, had higher education or income, received chemotherapy or radiotherapy, or had recurrence/metastasis of cancer tended to use CHM more frequently than other patients. The relations between patient characteristics and use of CHMs varied with users’ intentions. Given the high prevalence of CAM use among breast cancer patients, research is urgently needed to systematically evaluate the efficacy and safety of CAM use, particularly use of herbal medicines. Copyright 2004 Kluwer Academic Publishers

PMID: 15111765 [PubMed – indexed for MEDLINE]

JAMA. 2000 Dec 6;284(21):2755-61.

Related Articles, Links


Comment in:

·         JAMA. 2001 Feb 28;285(8):1015-6; author reply 1016.

·         JAMA. 2001 Feb 28;285(8):1016.

 
Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial.

Shen J, Wenger N, Glaspy J, Hays RD, Albert PS, Choi C, Shekelle PG.

National Institutes of Health, Laboratory of Clinical Studies/NIAAA, Room 6 S-240, Mail Stop 1610, 10 Center Dr, Bldg 10, Bethesda, MD 20892-1610, USA.

CONTEXT: High-dose chemotherapy poses considerable challenges to emesis management. Although prior studies suggest that acupuncture may reduce nausea and emesis, it is unclear whether such benefit comes from the nonspecific effects of attention and clinician-patient interaction. OBJECTIVE: To compare the effectiveness of electroacupuncture vs minimal needling and mock electrical stimulation or antiemetic medications alone in controlling emesis among patients undergoing a highly emetogenic chemotherapy regimen. DESIGN: Three-arm, parallel-group, randomized controlled trial conducted from March 1996 to December 1997, with a 5-day study period and a 9-day follow-up. SETTING: Oncology center at a university medical center. PATIENTS: One hundred four women (mean age, 46 years) with high-risk breast cancer. INTERVENTIONS: Patients were randomly assigned to receive low-frequency electroacupuncture at classic antiemetic acupuncture points once daily for 5 days (n = 37); minimal needling at control points with mock electrostimulation on the same schedule (n = 33); or no adjunct needling (n = 34). All patients received concurrent triple antiemetic pharmacotherapy and high-dose chemotherapy (cyclophosphamide, cisplatin, and carmustine). MAIN OUTCOME MEASURES: Total number of emesis episodes occurring during the 5-day study period and the proportion of emesis-free days, compared among the 3 groups. RESULTS: The number of emesis episodes occurring during the 5 days was lower for patients receiving electroacupuncture compared with those receiving minimal needling or pharmacotherapy alone (median number of episodes, 5, 10, and 15, respectively; P<.001). The electroacupuncture group had fewer episodes of emesis than the minimal needling group (P<.001), whereas the minimal needling group had fewer episodes of emesis than the antiemetic pharmacotherapy alone group (P =.01). The differences among groups were not significant during the 9-day follow-up period (P =.18). CONCLUSIONS: In this study of patients with breast cancer receiving high-dose chemotherapy, adjunct electroacupuncture was more effective in controlling emesis than minimal needling or antiemetic pharmacotherapy alone, although the observed effect had limited duration. JAMA. 2000;284:2755-2761.

Clin Oncol. 2000 Feb;18(3):668-83.

Related Articles, Links

 
Research on complementary/alternative medicine for patients with breast cancer: a review of the biomedical literature.

Jacobson JS, Workman SB, Kronenberg F.

Division of Epidemiology, School of Public Health, Herbert Irving Comprehensive Cancer Center, Department of Rehabilitation Medicine, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. Jsj4@columbia.edu

PURPOSE: This article reviews English-language articles published in the biomedical literature from 1980 to 1997 that reported results of clinical research on complementary and alternative medical treatments (CAM) of interest to patients with breast cancer. METHODS: We searched 12 electronic databases and the bibliographies of the retrieved papers, review articles, and books on CAM and breast cancer. The retrieved articles were grouped by end point: breast cancer (eg, tumor size, survival), disease-related symptoms, side effects of treatment, and immune function. Within each end point, we organized the articles by modality and assessed study design, findings, and qualitative aspects. RESULTS: Of the more than 1,000 citations retrieved, 51 fit our criteria for review. Of the articles reviewed, 17 were randomized clinical trials; three of these were trials of cancer-directed interventions, two of which involved the same treatment (melatonin). Seven articles described observational studies, and the remainder were reports of phase I or II trials. Relatively few CAM modalities reportedly used by many breast cancer patients were mentioned in articles retrieved by this process. Most articles had shortcomings. CONCLUSION: Although many studies had encouraging results, none showed definitively that a CAM treatment altered disease progression in patients with breast cancer. Several modalities seemed to improve other outcomes (eg, acupuncture for nausea, pressure treatments for lymphedema). If CAM studies are well-founded, well-designed, and meticulously conducted, and their hypotheses, methods, and results are reported clearly and candidly, research in this controversial area should acquire credibility both in the scientific community and among advocates of unconventional medicine.

Natl Cancer Inst. 2000 Jan 5;92(1):42-7.

Related Articles, Links

 
Alternative therapies used by women with breast cancer in four ethnic populations.

Lee MM, Lin SS, Wrensch MR, Adler SR, Eisenberg D.

Department of Epidemiology and Biostatistics, University of California, San Francisco 94143-0560, USA. mlee@epi.ucsf.edu

BACKGROUND: Interest in alternative therapies is growing rapidly in the United States. We studied the types and prevalence of conventional and alternative therapies used by women in four ethnic groups (Latino, white, black, and Chinese) diagnosed with breast cancer from 1990 through 1992 in San Francisco, CA, and explored factors influencing the choices of their therapies. METHODS: Subjects (n = 379) completed a 30-minute telephone interview in their preferred language. Logistic regression models assessed factors associated with the use of alternative therapies after a diagnosis of breast cancer. RESULTS: About one half of the women used at least one type of alternative therapy, and about one third used two types; most therapies were used for a duration of less than 6 months. Both the alternative therapies used and factors influencing the choice of therapy varied by ethnicity. Blacks most often used spiritual healing (36%), Chinese most often used herbal remedies (22%), and Latino women most often used dietary therapies (30%) and spiritual healing (26%). Among whites, 35% used dietary methods and 21% used physical methods, such as massage and acupuncture. In general, women who had a higher educational level or income, were of younger age, had private insurance, and exercised or attended support groups were more likely to use alternative therapies. About half of the women using alternative therapies reported discussing this use with their physicians. More than 90% of the subjects found the therapies helpful and would recommend them to their friends. CONCLUSIONS: Given the high prevalence of alternative therapies used in San Francisco by the four ethnic groups and the relatively poor communication between patients and doctors, physicians who treat patients with breast cancer should initiate dialogues on this topic to better understand patients’ choices with regard to treatment options.

Clin Exp Obstet Gynecol. 1999;26(2):81-4.

Related Articles, Links


Pain-relief and movement improvement by acupuncture after ablation and axillary lymphadenectomy in patients with mammary cancer.

He JP, Friedrich M, Ertan AK, Muller K, Schmidt W.

Department of Obstetrics and Gynecology, University of the Saarland, Homburg, Germany.

INTRODUCTION: In the traditional Chinese medicine (TCM), pain and movement restrictions are considered as the result of a blocking of the “Jing-Luo-system” or of a disordered flow of the Jing-Qis in the “Jing-Luo-system”. PATIENTS AND METHODOLOGY: In this study 48 patients with mammary cancer after ablation and axillary lymphadenectomy were treated with acupuncture (group I); a control group of 32 patients with the same operation but without acupuncture was compared (group II). RESULTS: The results showed a significantly higher maximum abduction angle (AA) at the first treatment immediately after acupuncture without pain (59.1 degrees vs. 80.4 degrees, p < 0.001) with respect to maximum tolerable pain barrier (73.6 degrees vs. 92.3 degrees, p < 0.001). Between group I (12.3%) and group II (50%) there was a statistically significant difference (p < 0.01) in the appearance of pain in the operation field in the rest position on the 5th postoperative day, while on the 7th postoperative day 8.3% vs. 12.5%) and at the time of discharge a significant difference could not be seen (p > 0.05). The percentage of patients with pain during arm movements showed a statistically significant difference between group I and group II on the 5th postoperative day (81% vs. 100%, p < 0.01), on the 7th postoperative day (43% vs. 96.9%, p < 0.01) and at time of discharge (27.1% vs. 65.6%, p < 0.001). The differences in the abduction angle between group I and group II were also statistically significant on the 5th postoperative day at indolency (89.3 degrees vs. 74.5 degrees, p < 0.001) with respect to maximum tolerable pain (105.8 degrees vs. 87.4 degrees, p < 0.001). The differences in the abduction angle on the 7th postoperative day at indolency (97.5 degrees vs. 81.2 degrees, p < 0.001) and at maximum tolerable pain (118.5 degrees vs. 93.4 degrees, p < 0.001) were statistically significant. This statistically significant difference in the maximum abduction angle between group I and group II at indolency (116.1 degrees vs. 91.5 degrees) with respect to maximum tolerable pain (129.4 degrees vs. 112.7 degrees, p < 0.001) could be observed until discharge. DISCUSSION: Acupuncture seems to be an effective treatment to relieve pain and improve arm-movements after ablation and axillary lymphadenectomy. The “Xie-technique” is used at the main acupuncture points and the patient’s feeling must be particularly considered. The combination of the different main points with the correctly selected additional acupuncture points—referred to the basic state and the pre- und post-operative state of the patient—are very important for a successful application of acupuncture.

Vopr Onkol. 1988;34(3):319-22.

Related Articles, Links


[Acupuncture in edema of the extremities following radiation or combination therapy of cancer of the breast and uterus]

[Article in Russian]

Bardychev MS, Guseva LI, Zubova ND.

Acupuncture was carried out in 141 sufferers from late-onset radiation injuries to skin and soft tissues. 122 patients (86%) revealed clinical manifestations of edema of varying gravity in arms and legs, while 19 (14%) suffered radiation-induced neuritis or plexitis unaccompanied by edema. Radionuclide and rheographic studies as well as evaluation of hemostatic function showed acupuncture to be an effective treatment for edema and pain. It also improved lymph flow, rheovasographic indexes and normalized hemostasis. The best results were obtained in cases of stage I-II edema.

Med Radiol (Mosk). 1987 Jul;32(7):42-6.

Related Articles, Links


[Restoration of immunologic indices following reflexotherapy in the combination treatment of radiation-induced edema of the upper limbs]

[Article in Russian]

Kuz’mina EG, Degtiareva AA.

A study was made of the effect of combined treatment (routine drug therapy, massage, application of DMSO) alone and in combination with acupuncture and laser puncture on a degree of secondary (radiation) edema and immunological indices in 36 patients treated for breast cancer 2-15 years ago. These methods were shown to decrease effectively a degree of edema by 22-37%. The highest effect was achieved using laser puncture against a background of the main treatment. All types of combined modality treatment promoted the return of the patients’ immunological status to normal (an increase in low and a decrease in high values). The most effective recovery was noted in the lymphocyte count, the ratio of helpers (inductors and suppressors) killers, and lymphocyte blast transformation reaction to mitogens.

Minerva Med. 1981 Sep 15;72(33):2239-42.

Related Articles, Links


[Acupuncture in breast diseases. How, when and why]

[Article in Italian]

Ceffa GC, Chio C, Gandini G.

We can value the therapeutic result reached by acupuncture in 43 female patients suffering from mastodinies, compared with other similar groups treated with antinflammatories and polyvitaminics. Before and after treatment every patient went through a complete—clinical—instrumental examination in which we also valued with telethermography the condition of mastosic vascular congestion. Positive considerations are made about the therapeutic validity of acupunture that has reached the highest percentage of success (over 95%) in comparison with other traditional methods, and patients really appreciated that. We nevertheless emphasize the need of always associating a correct, objective and instrumental study before starting any mastalgies therapy, to exclude coexistence of a sort of productive or surgical pathology.

 

Acupuncture and Cancer

 

Zhongguo Zhong Xi Yi Jie He Za Zhi. 1994 Sep;14(9):537-9.

Related Articles, Links


[Effect of acupuncture on interleukin-2 level and NK cell immunoactivity of peripheral blood of malignant tumor patients]

Wu B, Zhou RX, Zhou MS.

First Affiliated Hospital, Huaxi Medical University, Chengdu.

This paper deals with the observation of acupuncture therapy affecting interleukin-2(IL-2 level and natural killer (NK) cell immunoactivity in the peripheral blood of patients with malignant tumors. In this clinical-laboratory test research, randomized double blind method was used. The patients were divided into an acupuncture treated group (n = 25) and a control group (n = 20). The former group was treated using points, ST36,LI11,RN6 and locations of symptomatic points bilaterally. They received one treatment of 30 minutes daily for 10 days. The results showed that the IL-2 level and NK cell activity were lower than normal in patients with malignant tumor, but there was an increase in the acupuncture group after 10 days of treatment. Significance was found to be remarkable (P < 0.01). The difference between the two groups was also significant (P < 0.01). This increase might be related to the mechanism of acupuncture that adjusting the body’s immune function. Thus, acupuncture therapy could enhance the cellular immune function of patients with malignant tumors and providing a beneficial effect in anti-cancer treatment.

J Tradit Chin Med. 2002 Mar;22(1):21-3.

Related Articles, Links


Effects of electro-acupuncture on immune function after chemotherapy in 28 cases.

Ye F, Chen S, Liu W.

Qilu Hospital, Shandong University, Jinan 250012, Shandong Province.

PURPOSE: To observe the effects of electroacupuncture therapy on T cells and activity of NK cell in the patient of Chemotherapy. METHOD: Electro-acupuncture therapy was simultaneously applied during chemotherapy, T cells and activity of NK cell of patients were determined before electroacupuncture treatment (before chemotherapy) and after 4-course electro-acupuncture treatments. RESULTS: Before chemotherapy, CD3 was low within the normal range, CD4 was much lower than the normal range, and CD8, CD4/CD8 and activity of NK cell were within the normal range. After one month of chemotherapy combined with electro-acupuncture, no decline of all the indices was found (P > 0.05). CONCLUSION: Electro-acupuncture can really increase the immune function of patients of chemotherapy.

 

[back to top]

Acupuncture and Carpal Tunnel Syndrome

 

Arch Phys Med Rehabil. 2002 Jul;83(7):978-88.

Related Articles, Links


Comment in:

·         Arch Phys Med Rehabil. 2002 Dec;83(12):1806; author reply 1806-7.

 
Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: A controlled study.

Naeser MA, Hahn KA, Lieberman BE, Branco KF.

Department of Neurology, Boston University School of Medicine, Psychology Research Service, MA, USA. mnaeser@bu.edu

OBJECTIVE: To investigate whether real or sham low-level laser therapy (LLLT) plus microamperes transcutaneous electric nerve stimulation (TENS) applied to acupuncture points significantly reduces pain in carpal tunnel syndrome (CTS). DESIGN: Randomized, double-blind, placebo-control, crossover trial. Patients and staff administered outcome measures blinded. SETTING: Outpatient, university-affiliated Department of Veterans Affairs medical center. PARTICIPANTS: Eleven mild to moderate CTS cases (nerve conduction study, clinical examination) who failed standard medical or surgical treatment for 3 to 30 months. INTERVENTION: Patients received real and sham treatment series (each for 3-4wk), in a randomized order. Real treatments used red-beam laser (continuous wave, 15mW, 632.8nm) on shallow acupuncture points on the affected hand, infrared laser (pulsed, 9.4W, 904nm) on deeper points on upper extremity and cervical paraspinal areas, and microamps TENS on the affected wrist. Devices were painless, noninvasive, and produced no sensation whether they were real or sham. The hand was treated behind a hanging black curtain without the patient knowing if devices were on (real) or off (sham). MAIN OUTCOME MEASURES: McGill Pain Questionnaire (MPQ) score, sensory and motor latencies, and Phalen and Tinel signs. RESULTS: Significant decreases in MPQ score, median nerve sensory latency, and Phalen and Tinel signs after the real treatment series but not after the sham treatment series. Patients could perform their previous work (computer typist, handyman) and were stable for 1 to 3 years. CONCLUSIONS: This new, conservative treatment was effective in treating CTS pain; larger studies are recommended. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

 

 

 

Acupuncture and Chondromalacia

Direct Electric Acupuncture for Patella Chondromalacia: A Preliminary Report of a Clinical Study

By Hua Gu

Chondromalacia of the patella is common among athletes and people over 40. It is caused by direct trauma or chronic injury to the knee joint. Although it is often referred to and treated as a discernible ailment, chondromalacia patellae is best thought of as a symptom.

 

The patella contains the thickest layer of cartilage in the body. It has five facets or ridges: superior; inferior; lateral; medial; and odd. The “odd” facet is most frequently the first part of the patella to be affected in chondromalacia patellae. Chondromalacia patellae is the softening and subsequent roughening of the patella’s hyaline cartilage. This malady presents itself as grinding beneath the patella and may cause related swelling and pain. A definitive diagnosis is made through visual inspection during arthroscopy. Chondromalacia patellae is most often, if not always, the result of biomechanical changes affecting the lower extremity. As such, it may be treated symptomatically by acupuncture.

Acupuncture Techniques

Figure 1 and 2: Insertion of acupuncture needles for the treatment of chondromalacia patellae. After sterilizing the skin of the patella area, the acupuncturist pushes the medial side of the patella outward to open the space between the patella and the anterior surface of the medial femoral condyle. The acupuncturist inserts a needle (32 guage, 2”) to xi yan (extra). The needle should be right between the patella and femoral cartilage and should reach the medial side of the lateral condyle. The patient will have the de qi sensation. Two more needles should be inserted about half an inch away from xi yan, each along the medial edge of the patella. Visualize the patella as a clock. Xi yan is at 7 o’clock. Insert the first needle there, then insert needles at 9 o’clock and 11 o’clock. The insertion is oblique, toward the center of the patella.

On the lateral side of the knee, push the patella toward the midline of the body. Insert needles at ST 35, then at two points corresponding to 3 o’clock and 1 o’clock. The needles should be placed in the patellafemoral joint. Then connect the electric stimulator to all of the needles (negative on the medial side, positive on the lateral side) with a 5Hz intermittent wave. The stimulating time is 20 minutes. A course of treatment is three times a week for three weeks.

Results

The results are based on clinical findings, x-ray and MRI tests.

Excellent: No pain; no signs and symptoms; no discomfort when squatting or kneeling down; no pain when walking up or downstairs. Followup for six months without recurrence.

Good: Pain, symptoms and signs significantly decreased; mild discomfort when squatting or kneeling down. Followup six months with mild discomfort.

Fair: Pain, symptoms and signs decreased; some difficulty when squatting or kneeling down. Followup six months with slight to moderate discomfort.

Poor: No effect or worse.

Thirty-two cases were treated between 9-30 times by the same acupuncturist. Among the 32 cases, 10 were judged as “excellent” (31.1%); 12 “good” (38%); 3 “fair” (9.4%) and 7 “poor” (22%).

Discussion

Direct electric acupuncture is the key for this group of patients. The cartilage in chondromalacia patellae is damaged by many different causes. Physical examinations such as Clark’s sign, the McConnell test, the passive patellar test and Zohler’s sign can help make the diagnosis. X-rays with skyline or sunrise view and knee joint MRI show clear images of the cartilage shape and damage. From the TCM point of view, the diagnosis is the same as bi syndrome, no matter what the cause. After a series of electric acupuncture treatments, most patient knee joint swelling and pain subsided, and range of motion improved.

Electric acupuncture may have the following effects on treatment for chondromalacia of the patella:

1.               Direct stimulation by electric current in conjunction with the needles applied to the impaired area may help the regeneration of cartilage.

2.               Acupuncture needles inside the joint capsule may relieve synovitis, which will decrease the secretions of the synovial membrane and reduce pain.

3.               Most cases in the poor group had moderate to severe misalignment, such as genus varus or valgus, or abnormal Q-angle. These conditions can induce unequal pressure and stress distribition in the femoropatellar joint and cause necrosis of cartilage and cyst formation under the cartilage. Electric acupuncture is a good method to relieve the symptoms of chondromalacia.

4.               Perhaps it is the electric current directly working on the joint surface, or the needles’ direct contact with the cartilage, that reduces the pressure inside the joint and relieves the symptoms.

5.               Another possibility is that electric stimulation changes the viscosity and pH of the joint’s synovial fluid to alter the irritation to the synovial membrane.

Further study is necessary to assess what happens inside the joint. Arthroscopic exploration is needed to confirm the changes pre- and post-electric acupuncture treatment.

References

1.               Gu H. Clinical Traditional Chinese Medicine, Orthopedic Volume. Chinese Medical Science Publisher, 1st ed., 1989.

2.               Fulherson JP. Evaluation of the peripatellar soft tissues and retinaculum in patients with patellofemoral pain. Clin Sports Med 1989;8:197.

3.               Goodfellow J, Hungerford DS. Patellofemoral joint mechanics and pathology: chondromalacia patellae. J Bone Joint Surg 1976;58B:291.

4.               Pickett JC. Chondromalacia of the Patella. Baltimore: Williams and Wilkins, 1983.

 

 

 

 

 

Acupuncture and Dental Pain

 

 

Neurosci Res 2000 Dec;38(4):331-9

Related Articles, Books, LinkOut


Suppressive effects of Neiting acupuncture on toothache: an experimental analysis on Fos expression evoked by tooth pulp stimulation in the trigeminal subnucleus pars caudalis and the periaqueductal gray of rats.

Sheng LL, Nishiyama K, Honda T, Sugiura M, Yaginuma H, Sugiura Y.

Department of Anatomy, Nagoya University School of Medicine, 65 Tsurumai-cho, Nagoya 466-8550, Japan.

To clarify the antinociceptive mechanism of acupuncture on acute pain, c-fos protein (Fos) expression induced by tooth pulp stimulation was immunohistochemically examined in the spinal trigeminal subnucleus pars caudalis (spVc) and the periaqueductal gray (PAG) of rats with or without Neiting acupuncture. The central projection of trigeminal ganglion neurons innervating in the tooth pulp was examined by tract-tracing method with horseradish peroxidase-conjugated wheat germ agglutinin (WGA-HRP). Central terminals from the first maxillary molar tooth were labeled transganglionically in the dorsomedial part of spVc with WGA-HRP. Numerous numbers of Fos-immunoreactive (Fos-ir) cells were found in the spVc and PAG by stimulation of the tooth pulp with acetic acid or saline. Neiting acupuncture significantly reduced the Fos expression in the spVc induced by tooth pulp stimulation. On the other hand, Neiting acupuncture evoked many Fos-ir cells in the PAG. The present results suggest that Neiting acupuncture activated PAG neurons that sent descending inhibitory fibers to medullo-spinal nociceptive neurons, and reduced the number of Fos-expressed neurons in the trigeminal subnucleus pars caudalis mediating noxious information from teeth to the higher central nervous system.

 

 

1: Arch Otolaryngol Head Neck Surg 1999 May;125(5):567-72

Related Articles, Books, LinkOut

·        
Evaluation of acupuncture for pain control after oral surgery: a placebo-controlled trial.

Lao L, Bergman S, Hamilton GR, Langenberg P, Berman B.

Department of Family Medicine, School of Medicine, University of Maryland at Baltimore, 21207-6697, USA. Llao@compmed.ummc.ab.umd.edu

BACKGROUND: Acupuncture is increasingly being used by the general population and investigated by conventional medicine; however, studies of its effects on pain still lack adequate control procedures. OBJECTIVES: To evaluate the (1) efficacy of Chinese acupuncture in treating postoperative oral surgery pain, (2) validity of a placebo-controlled procedure, and (3) effects of psychological factors on outcomes. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Dental School Outpatient Clinic, University of Maryland at Baltimore. PARTICIPANTS: Thirty-nine healthy subjects, aged 18 to 40 years, assigned to treatment (n=19) and control (n=20) groups. MAIN OUTCOME MEASURES: Patients’ self-reports of time until moderate pain, time until medication use, total pain relief, pain half gone, and total pain medication consumption. RESULTS: Mean pain-free postoperative time was significantly longer in the acupuncture group (172.9 minutes) than in the placebo group (93.8 minutes) (P=.01), as was time until moderate pain (P=.008). Mean number of minutes before requesting pain rescue medication was significantly longer in the treatment group (242.1 minutes) than in the placebo group (166.2 minutes) (P=.01), as was time until medication use (P=.01). Average pain medication consumption was significantly less in the treatment group (1.1 tablets) than in the placebo group (1.65 tablets) (P=.05). There were no significant between-groups differences on total-pain-relief scores or pain-half-gone scores (P>.05). Nearly half or more of all patients were uncertain of or incorrect about their group assignment. Outcomes were not associated with psychological factors in multivariate models. CONCLUSIONS: Acupuncture is superior to the placebo in preventing postoperative dental pain; noninsertion placebo procedure is valid as a control.


 

The effectiveness of acupuncture in treating acute dental pain: a systematic review.

Ernst E, Pittler MH.

Department of Complementary Medicine, Postgraduate Medical School, University of Exeter.

OBJECTIVE: Acupuncture is frequently advocated as an effective treatment of dental pain. The question whether or not it is effective for this indication remains controversial. The aim of this systematic review therefore was to assess the effectiveness of acupuncture in dental pain. DATA SOURCES: Four electronic databases were searched: Medline, Embase, CISCOM, and the Cochrane Library. Only controlled trials were included in this review. DATA EXTRACTION: Information was extracted from included studies and entered on standard forms independently by both authors. Methodological quality was assessed using the Jadad score. MAIN RESULTS: 16 such studies were located. The majority of these trials imply that acupuncture is effective in dental analgesia. However, important questions remain unanswered. CONCLUSION: It is concluded that acupuncture can alleviate dental pain and that future investigations should define the optimal acupuncture technique and its relative efficacy compared with conventional methods of analgesia.

 

 

 

 

Acupuncture and Diabetes

 

 

Neurosci Lett 2002 Jul 12;327(1):33-6

Related Articles, Links

 
Acupuncture increases cell proliferation and neuropeptide Y expression in dentate gyrus of streptozotocin-induced diabetic rats.

Kim EH, Jang MH, Shin MC, Lim BV, Kim HB, Kim YJ, Chung JH, Kim CJ.

Department of Meridianology, College of Oriental Medicine, Semyung University, Chungbuk, South Korea.

In this study, effects of acupuncture at Zusanli acupoint on cell proliferation and expression of neuropeptide Y (NPY) in the dentate gyrus (DG) of streptozotocin-induced diabetic rats were investigated. Sprague-Dawley rats were divided into six groups: the control group, the non-diabetic and Zusanli-acupunctured group, the non-diabetic and non-acupoint-acupunctured group, the streptozotocin-induced-diabetes group, the streptozotocin-induced-diabetes and Zusanli-acupunctured group, and the streptozotocin-induced-diabetes and non-acupoint-acupunctured group. In the streptozotocin-induced diabetes group, the mean 5-bromo-2’-deoxyuridine-positive and NPY-positive cell counts in the DG were significantly decreased compared to the control group. Stimulation of the Zusanli resulted in increased cell proliferation and neuropeptide Y levels in the diabetic group. In the present results, it can be suggested that acupuncture may affect cell proliferation in the DG of streptozotocin-induced diabetic rats by regulating neuropeptide Y expression.

Am J Chin Med 2002;30(1):183-5

Related Articles, Links


Magnets on ears helped diabetics.

Chen Y.

Beijing Acupuncture, Chinese Herbology and Magnet Center, Baltimore, MD 21208, USA.

Magnets were attached on auricular acupuncture points of diabetes patients. This treatment lowered the blood glucose levels and improved eye conditions.

 

Digestion 2001;64(3):184-90

Related Articles, Links

 
Effect of electrical stimulation on acupuncture points in diabetic patients with gastric dysrhythmia: a pilot study.

Chang CS, Ko CW, Wu CY, Chen GH.

Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, 160, Sec. 3, Chung-Kang Road, Taichung 407, Taiwan. changcs@vghtc.vghtc.gov.tw

BACKGROUND/AIMS: Abnormal gastric slow-wave frequencies have been observed in diabetic gastroparesis and are associated with impaired antral motor activity. In this study, we aimed at evaluating the effect of acupuncture on gastric slow waves in diabetic patients with symptoms suggesting gastric motor dysfunction. METHODS: Fifteen patients with type II diabetes who had had dyspeptic symptoms for more than 3 months were enrolled. Two acupuncture needles were inserted into the subjects’ legs at the Zusanli points, and electrical stimulation (2-Hz pulses) was delivered for 30 min. Cutaneous electrogastrography was performed for 30 min at baseline, for 30 min during acupuncture, and for an additional 30 min after acupuncture. Serum gastrin, motilin, and human pancreatic polypeptide levels were also measured. RESULTS: There was a significant increase in the percentages of normal frequency during and after acupuncture (baseline vs. acupuncture and after acupuncture 21.99 +/- 19.38% vs. 45.93 +/- 19.72 and 48.92 +/- 19.56%; p < 0.01). In addition, the percentage of tachygastric frequency was decreased significantly during and after acupuncture. The dominant frequency was also changed significantly. There was an increase of serum human pancreatic polypeptide during acupuncture (baseline vs. acupuncture 56.96 +/- 27.64 vs. 73.11 +/- 22.37 pmol/l; p < 0.05). CONCLUSIONS: The results of this study revealed that electrical stimulation at the Zusanli points could increase the percentage of normal electrogastrography frequency and decrease the percentage of tachygastric frequency in diabetic patients. The data indicate that acupuncture may enhance the regularity of gastric myoelectrical activity in diabetic patients. Copyright 2001 S. Karger AG, Basel

Lik Sprava 1999 Sep;(6):125-8

Related Articles, Links


[Laser therapy in diabetes mellitus]

[Article in Ukrainian]

Bodnar PM, Peshko AO, Prystupiuk OM, Voronko AA, Kyriienko DV, Mykhal’chyshyn HP, Naumova MI.

Diabetic patients have been shown to derive great benefit from treatment with laser therapy as evidenced by experience gained with its use over many years. Laser therapy promotes compensation, has an antiatherogenic, antioxidant, immunomodulating effects, improves microcirculation, myocardial contractility and performance capability.

Diabetes Res Clin Pract 1998 Feb;39(2):115-21

Related Articles, Links

 
Acupuncture for the treatment of chronic painful peripheral diabetic neuropathy: a long-term study.

Abuaisha BB, Costanzi JB, Boulton AJ.

Department of Medicine, Manchester Royal Infirmary, University of Manchester, UK.

Forty-six diabetic patients with chronic painful peripheral neuropathy were treated with acupuncture analgesia to determine its efficacy and long-term effectiveness. Twenty-nine (63%) patients were already on standard medical treatment for painful neuropathy. Patients initially received up to six courses of classical acupuncture analgesia over a period of 10 weeks, using traditional Chinese Medicine acupuncture points. Forty-four patients completed the study with 34 (77%) showing significant improvement in their primary and/or secondary symptoms (P < 0.01). These patients were followed up for a period of 18-52 weeks with 67% were able to stop or reduce their medications significantly. During the follow-up period only eight (24%) patients required further acupuncture treatment. Although 34 (77%) patients noted significant improvement in their symptoms, only seven (21%) noted that their symptoms cleared completely. All the patients but one finished the full course of acupuncture treatment without reported or observed side effects. There were no significant changes either in the peripheral neurological examination scores, VPT or in HbA1c during the course of treatment. These data suggest that acupuncture is a safe and effective therapy for the long-term management of painful diabetic neuropathy, although its mechanism of action remains speculative.

Zhen Ci Yan Jiu 1996;21(3):55-9

Related Articles, Links


[Effect of electro-acupuncture and transcutaneous electric nerve stimulation on experimental diabetes and its neuropathy]

[Article in Chinese]

Mo X, Chen D, Ji C, Zhang J, Liu C, Zhu L.

Institute of Acupuncture and Moxibustion, China Academy of Traditional Chinese Medicine, Beijing.

In this paper, the experimental diabetic rats induced by streptozotocin (STZ, i.p. 50 mg/kg) were divided into three groups, electro-acupuncture (EA group, n = 8), transcutaneous electric nerve stimulation (TENS group, n = 8), at bilateral Shenshu and Zusanli points for 20 minutes once every 2-3 days for five weeks, and without any treatment (DM group, n = 6) respectively. As compared with the DM group, the increased plasma glucose levels was lowered significantly in EA group (P < 0.05) and slightly in TENS group (P > 0.05) by the end of the sixth week. And the enterz of polyphagia, polydipsia and polyuria were attenuated in EA group. The motor nerve conduction velocity slowing was prevented or corrected after a course of four and six weeks treatment in EA and TENS group respectively. In the DM and TENS groups the pain threshold was lowered at 6-20 days after injection of STZ, but elevated in EA group, their differences were of significance (P < 0.05). In general, the efficiency of EA treatment on experimental diabetes and its neuropathy was better than that of TENS therapy.

 

[Laser puncture in the treatment of diabetic angiopathies of the lower extremities]

[Article in Russian]

Peshko AA.

Laseropuncture in patients with diabetes mellitus associated with angiopathies of the lower extremities (grade II and III) produced a pronounced clinical effect which was manifested by removing the pain syndrome, improvement of the peripheral circulation and extremity function and function of the lower extremities, improvement of thermographic values. But this positive dynamics was more pronounced in angiopathies of the lower extremities of the stage of functional disorders than obliterating atherosclerosis of the legs. Sterility of the laser beam, possibility of local effect on biologically active points, non-painful procedure, absence of age limits and side effects allow to widely recommend this method for the treatment of Diabetes mellitus associated with angiopathies of the lower extremities.

 

Zhong Xi Yi Jie He Za Zhi 1987 Mar;7(3):140-2, 131

Related Articles, Links


[Traditional Chinese medicine combined with Western medicine in the treatment of diabetic peripheral neuropathy]

[Article in Chinese]

Qian ZR, Zhong XL, Fang YA.

PMID: 3607959 [PubMed – indexed for MEDLINE]

 

Med Interne 1985 Jul-Sep;23(3):213-22

Related Articles, Links


Study of the cutaneous electric potentials and the perception threshold to an electric stimulus in diabetic patients with and without clinical neuropathy.

Ionescu-Tirgoviste C, Bajenaru O, Zugravescu I, Dorobantu E, Hartia D, Dumitrescu C, Cheta D, Mincu I.

Clinical heterogeneity of diabetic peripheral neuropathy could express a neurophysiological and electrophysiological heterogeneity possibly related with the dissociated metabolic susceptibility of the difference types of nerve fibres and endings. To evaluate the functional status of the skin autonomous nervous system and of the deep pain sensitivity system in diabetics we studied two electrophysiological parameters skin electrical potential (using Digital Multimeter 3466 Hewlet Packard, USA) and the perception threshold (microA) at an electrical stimulus (spike wave, 0.5 m sec duration) 1 cm deeply applied through 2 acupuncture needles placed 30 cm distance each other, in 3 groups: Ia-18 diabetic patients with clinical signs of neuropathy (12 M, 6 F, aged 55 +/- 17 yrs); Ib – 17 diabetic patients without clinical signs of diabetic neuropathy (12 M, 5 F, aged 57 +/- 16 yrs); I1 – 10 age and sex matched non-diabetic controls. Our data show: a higher mean value of the potential in the acupuncture points as against neighbour areas, both in non-diabetic control (- 111 +/- 25 mV v.s. –81 +/- 29 mV, p less than 0.05) and in diabetics (-85 +/- 43 mV v.s. –58 +/- 25 mV, p less than 0.01); a lower mean value of the electrical potentials in diabetic with clinical signs of neuropathy as against in those without clinical signs of neuropathy (-66 +/- 29 mV v.s. –108 +/- 43 mV, p less than 0.01): a higher mean value of the perception threshold in diabetics with clinical signs of neuropathy as against in diabetics without clinical signs of neuropathy (213 +/- 82 microA. V.s. 102 +/- 40 microA, p less than 0.01); a significant correlation (r = -0.81) between the perception threshold and the electrical potentials of the studied points.

 

J Tradit Chin Med 1985 Jun;5(2):79-84

Related Articles, Links


Changes of plasma insulin level in diabetics treated with acupuncture.

Chen JF, Wei J.

Gen Pharmacol 1983;14(6):635-41

Related Articles, Links


In search of mediators of skin vasodilation induced by transcutaneous nerve stimulation: II. Serotonin implicated.

Kaada B, Eielsen O.

Previous studies have shown that brain serotonin is increased and noradrenaline decreased in acupuncture and transcutaneous nerve stimulation (TNS). Increases in available brain serotonin and decreases in noradrenaline enhance pain suppression. The present study tests the possibility that the widespread and prolonged cutaneous vasodilation which can be produced by low-frequency TNS in patients with peripheral circulatory insufficiency is similarly dependent on a central serotonergic pathway leading to sympatho-inhibition. The serotonin receptor antagonist cyproheptadine was given to 4 patients with either Raynaud’s phenomenon or diabetic polyneuropathy, who all prior to drug administration responded to TNS with marked and prolonged cutaneous vasodilation in the ischaemic limbs. Cyproheptadine almost completely blocked the vascular response. Contrary to endorphin-serotonin mediated pain inhibition, vasoconstrictor inhibition is not antagonized by conventional, low doses of naloxone (Kaada, 1982a). However, the involvement of more naloxone-resistant opioid receptors in the vascular response cannot be excluded.

 

 

Acupuncture and Edema

 

 

Zhen Ci Yan Jiu 1996;21(2):19-24

Related Articles, Books, LinkOut


[The antiobesity effect of acupuncture and it’s influence on water and salt metabolism]

[Article in Chinese]

Sun F.

Nanjing College for Population Administrators.

For the purpose of understanding the antiobesity effect of acupuncture and it’s influence on water and salt metabolism in the patients suffering from simple obesity, we have observed the changes of symptoms and signs, obesity indices, blood sodium, blood potassium, mOsm of plasma and urinary aldosterone before and after acupuncture treatment in 75 patients with simple obesity (12 cases with edema, 33 cases without edema). The results showed that the total effective rate of antiobesity treatment for one month was 89.3%. Before acupuncture the concentrations of blood sodium and aldosterone of the patients with edema were significantly higher than those of normal persons or the patients without edema, but the concentration of blood potassium and mOsm of plasma of the patients with edema were significantly lower than those of normal persons or the patients without edema. After acupuncture treatment the concentrations of blood sodium and aldosterone decreased markedly and the concentration of blood potassium and mOsm of plasma increased remarkably in the patients with edema. It indicated that acupuncture treatment not only had a good antiobesity effect, but also improved the water and salt metabolism of the patients with obesity by the regulation of nervous system and body fluid.

PMID: 9387368 [PubMed – indexed for MEDLINE]

 

Vopr Onkol 1988;34(3):319-22

Related Articles, Books, LinkOut


[Acupuncture in edema of the extremities following radiation or combination therapy of cancer of the breast and uterus]

[Article in Russian]

Bardychev MS, Guseva LI, Zubova ND.

Acupuncture was carried out in 141 sufferers from late-onset radiation injuries to skin and soft tissues. 122 patients (86%) revealed clinical manifestations of edema of varying gravity in arms and legs, while 19 (14%) suffered radiation-induced neuritis or plexitis unaccompanied by edema. Radionuclide and rheographic studies as well as evaluation of hemostatic function showed acupuncture to be an effective treatment for edema and pain. It also improved lymph flow, rheovasographic indexes and normalized hemostasis. The best results were obtained in cases of stage I-II edema.

PMID: 3358295 [PubMed – indexed for MEDLINE]

 

Idiopathic Cyclic Edema

Frederick R. Jelovsek MD

“Please guide me on treatment options for idiopathic cyclic edema”. D.R.S.

I see why she asks the question. There is not very much written about this uncommon disease which occurs primarily in women.

What is idiopathic cyclic edema?

This is a condition primarily of young menstruating women in which large amounts of tissue swelling (edema) occurs in the legs and abdomen after sitting or standing for periods of time and swelling of the face and eyelids upon lying down (1). It is felt to be a problem of leakage of blood fluids from capillaries into fat and skin tissue especially when gravity (standing up) is added to the pressure in the vascular system. It results in large weight gain shifts from morning to evening. Sometimes the condition is called idiopathic orthostatic (standing upright) edema or just idiopathic edema. Other names include fluid retention syndrome and cyclical edema (2).

This condition can result in moderate discomfort or pain in any of the areas of excess fluid accumulation. Carpal tunnel syndrome symptoms, diffuse aching, morning stiffness and muscle and bony pains as well as headaches often accompany the swelling. It can also masquerade as premenstrual syndrome or make existing premenstrual syndrome worse. It exacerbates the swelling, abdominal bloating and general physical discomfort but it does not usually cause irritability and depressive symptoms as classic PMS does.

Sometimes the syndrome can occur in women with eating disorders who are taking diuretics or even laxatives in order to lose weight (3).

Some treatments seem to worsen idiopathic cyclic edema.

While one would think that taking a “water pill” or diuretic would improve this edematous condition, it turns out that in most cases this is the wrong long term treatment. In fact chronic diuretic use will increase the secretion of the body’s aldosterone which in turn produces more edema (4). If the chronic use of diuretics is discontinued, the cyclical swelling disappears in most cases within about 3 weeks.


Treatments for idiopathic cyclic edema

There is no single, accepted gold standard treatment for idiopathic cyclic edema. Several different treatments have been reported. An older report indicates that the herb ginkgo biloba may be useful in treating this condition. An agent used for treating high blood pressure called Captopril has also been used with success (5, 6). It works against a kidney hormone called aldosterone which is elevated in this condition and causes excess salt and water retention.

Progesterone has also been used in the treatment of idiopathic edema under the premise that some women with idiopathic edema either do not ovulate or have a luteal phase deficiency (7).

So how should idiopathic cyclic edema be treated? There are no clear cut answers. Birth control pills have been used (progesterone). It might well be worth trying captopril and ginkgo biloba. It is evident that diuretic pills should not be used.

 

Recommendations for Edema (Water Retention):

 

 

Botanical

  Gingko

 

Idiopathic cyclic edema is characterized by water and sodium retention with secondary hyperaldosteronism (over-production of aldosterone) due to capillary hyperpermeability. This defect is detected and measured by the Landis’ labeled albumin test; correcting it is important. Ginkgo biloba extract administered either orally or by intravenous infusion provided full correction of this biological anomaly in 10 cases in which the Landis’ test was performed before and after oral treatment, and in 5 cases treated by intravenous infusion. [Presse Med 1986 Sep 25;15(31): pp.1550-3 (translated)]


  Grape Seed Extract (Pycnogenol)

 

One month of treatment with Pycnogenol (360mg per day reduced lower limb circumference and improved subjective symptoms better than horse chestnut seed extract in a study of 40 patients with diagnosed chronic venous insufficiency. [Phytother Res 2002;16(2): pp.1-5]


Diet


  Therapeutic Fasting

 

Fasting promotes the drying up of abnormal fluid accumulations, such as edema in the ankles and legs and swelling in the abdomen.


Drug


  Conventional Drugs

 

There is no single, accepted gold standard treatment for idiopathic cyclic edema. Several different treatments have been reported. An agent used for treating high blood pressure called Captopril has also been used with success. It works against the kidney hormone aldosterone which is elevated in this condition and causes excess salt and water retention.

Sometimes a mild diuretic will help reduce fluid retention but can worsen the edema of idiopathic cyclic edema. While one would think that taking a “water pill” or diuretic would improve this edematous condition, it turns out that in most cases this is the wrong long term treatment. In fact, chronic diuretic use will increase the secretion of aldosterone which in turn produces more edema. If the chronic use of diuretics is discontinued, the cyclical swelling disappears in most cases within about 3 weeks.


Habits


  Aerobic Exercise

 

Edema can be caused by a sedentary lifestyle – in other words, long periods of standing or sitting. If this is the case for you, regular exercise (not necessarily prolonged or strenuous) should help.


Lab Tests/Rule-Outs


  Test for Food Allergies

 

Food sensitivities should be ruled out in cases of edema of unknown cause. “I often recommend an empirical elimination diet in which common allergens (wheat, milk, eggs, corn, coffee, tea, alcohol, yeast, citrus and sugar) are removed for several weeks. Although edema is usually not their primary complaint, many patients report a pronounced diuresis and loss of edema fluid during the first several days of the diet. Foods that cause a return of a patient’s presenting symptoms often cause fluid retention as well”. [Gaby, AR. Idiopathic edema: Letter. Hospital Practice Feb. 15, 1986, p. 21]

Edema is a very reliable and accurate index in detecting a food reaction that may cause the body to suddenly retain as much as 4% of its body weight as edema fluid. This weight is gained within 6-8 hours of ingesting the guilty food and lost within 18-24 hours after the food has been removed from the diet. [Brenerman, JC. Basics of Food Allergy. Springfield, IL, Charles C. Thomas, 1978]

 

 

 

 

 

Acupuncture and Eye Disorders

 

East and west see eye to eye—an elective report.

Sistenich V.

A summary of personal experiences encountered as a medical student on elective at an eye hospital in China. It bears witness to the possibility of seamless combination of western and traditional Chinese medical practices in the field of ophthalmology. Included are also the acupuncture points used in the treatment of optic atrophy at this particular eye hospital. Address of eye hospital: Zhongshan Ophthalmic Center 54 South Xianlie Road Guangzhou 510060 China Period of elective: 5th January 2001-11th March 2001.

Treatment of optic atrophy with acupuncture.
J Tradit Chin Med. 1992 Jun;12(2):142-6. Review. No abstract available.
PMID: 1495340 [PubMed – indexed for MEDLINE]

 

Optic atrophy treated with acupuncture.
J Tradit Chin Med. 1989 Dec;9(4):249-50. No abstract available.

38 cases of optic atrophy treated by needling qiuhou point.
J Tradit Chin Med. 1989 Sep;9(3):171-2. No abstract available.
PMID: 2615446 [PubMed – indexed for MEDLINE]


Clinical observation on treatment of disorders of the optic nerve by acupuncture.
J Tradit Chin Med. 1985 Sep;5(3):187-90. No abstract available.
PMID: 3853649 [PubMed – indexed for MEDLINE]

Role of acupuncture in the treatment of ‘incurable’ retinal diseases.
Indian J Ophthalmol. 1983;31 Suppl:1043-6. No abstract available.
PMID: 6544254 [PubMed – indexed for MEDLINE]

[Changes in hemorheology of traumatic optic nerve atrophy]

Huang JH, Wei YY, Li JB.

Shenzhen Hospital of Traditional Chinese Medicine.

Whole blood viscosity (WBV), plasma viscosity (PV), hematocrit, erythrocyte sedimentation rate (ESR) and fibrinogen were assayed in 20 patients with traumatic optic nerve atrophy. The results of each item in the above examinations has been compared with that of the control group. It has been demonstrated that WBV, PV, ESR and fibrinogen in the patient group were significantly higher than that in the control group (P less than 0.01). But the ESR and fibrinogen of the treatment group were significantly lower than that in the pretreatment group (P less than 0.01). The authors suggest that the result of changes in hemorheology of traumatic optic nerve atrophy is a kind of reverse phenomenon.

 

 

Acupuncture and Fibromyalgia

Acupuncture helped relieve symptoms such as pain and depression in women with the chronic pain disorder fibromyalgia.

Fibromyalgia is a disorder that causes muscle pain, stiffness and fatigue for unknown reasons. It affects about 2% of Americans, mainly women.

In the study, the researchers randomly assigned 60 women who suffered from fibromyalgia into three groups. All patients received amitriptyline, a standard pain modifier used for fibromyalgia, at bedtime for 16 weeks.

In addition, 20 of the women received a once-a-week, 30-minute acupuncture session while a second group of 20 underwent a once-a-week, 30-minute sham-acupuncture session where they were punctured in areas not believed to have any effect on pain.

The patients were evaluated every month for pain, depression and quality of life measures by healthcare workers who were unaware which treatment they were receiving.

The researchers reported that patients who received the real acupuncture were the only ones who showed statistically significant improvement on measures of pain, depression and mental health after the first month.

The results lasted for up to 16 weeks, at which time the patients began regressing slightly and would need reinforcement acupuncture sessions, Feldman said. “It’s not a one-time treatment.”

Annual Meeting of the American College of Rheumatology San Francisco November 12, 2001

Complementary and Alternative Therapies for Fibromyalgia
Leslie J Crofford MD, and Brent E Appleton MD
1150 West Medical Center Drive, University of Michigan, Ann Arbor, MI, 48109-0680, USA.

Current Rheumatology Reports 2001 3: 147-156

Abstract

Fibromyalgia (FM) is a syndrome of chronic widespread musculoskeletal pain that is accompanied by sleep disturbance and fatigue. Clinical treatment usually includes lifestyle modifications and pharmacologic interventions meant to relieve pain, improve sleep quality, and treat mood disorders. These therapies are often ineffective or have been shown in clinical studies to have only short-term effectiveness. Pharmacologic treatments have considerable side effects. Patients may have difficulty complying with exercise-based treatments. Thus, patients seek alternative therapeutic approaches and physicians are routinely asked for advice about these treatments. This article reviews – nontraditional treatment alternatives, from use of nutritional and herbal supplements to acupuncture and mind-body therapy. Little is known about efficacy and tolerance of complementary and alternative therapies in FM and other chronic musculoskeletal pain syndromes. Most studies on these treatments have been performed for osteoarthritis, rheumatoid arthritis, or focal musculo-skeletal conditions. Clinical trials are scarce; the quality ofthese trials is often criticized because of small study population size, lack of appropriate control interventions, poor compliance, or short duration of follow-up. However, because of widespread and growing use of alternative medicine, especially by persons with chronic illnesses, it is essential to review efficacy and adverse effects of complementary and alternative therapies.

Curr Pain Headache Rep 2002 Oct;6(5):379-83

Related Articles, Links

 
Pain treatment with acupuncture for patients with fibromyalgia.

Targino RA, Imamura M, Kaziyama HH, Souza LP, Hsing WT, Imamura ST.

Division of Physical Medicine, Department of Orthopedics and Traumatology, University of Sao Paulo School of Medicine, Ave. Giovanni Gronchi, 1106 San Paulo, Brazil. ucklrsu@ucl.ac.uk

Fibromyalgia is a chronic, painful musculoskeletal syndrome of unknown etiopathogenesis. In addition to medicamentous and physical and psychologic therapies, several other adjunct therapies have been used as alternatives in the attempt to obtain analgesia and decrease the symptoms that are characteristic of this problem. This article presents a literary review on the use of acupuncture as an adjunct or chief treatment for patients with fibromyalgia, comparing it with an ongoing clinical experience that has been carried out at Hospital das Clinicas in the city of Sao Paulo. The results were found by applying traditional acupuncture, which demonstrated positive rates in the Visual Analogue Scale, myalgic index, number of tender points, and improvement in quality of life based on the SF-36 questionnaire.

Am Fam Physician 2000 Oct 1;62(7):1575-82, 1587

Related Articles, Links


Comment in:

·         Am Fam Physician. 2000 Oct 1;62(7):1492, 1494.

·         Am Fam Physician. 2002 Feb 1;65(3):380, 384.



Treating fibromyalgia.

Millea PJ, Holloway RL.

Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee 53226, USA. enter@mcw.edu

Fibromyalgia is an extremely common chronic condition that can be challenging to manage. Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as serotonin, substance P, growth hormone and cortisol suggest that dysregulation of the autonomic and neuroendocrine system appears to be the basis of the syndrome. The diagnosis is clinical and is characterized by widespread pain, tender points and, commonly, comorbid conditions such as chronic fatigue, insomnia and depression. Treatment is largely empiric, although experience and small clinical studies have proved the efficacy of low-dose antidepressant therapy and exercise. Other less well-studied measures, such as acupuncture, also appear to be helpful. Management relies heavily on the physician’s supportive counseling skills and willingness to try novel strategies in refractory cases.

Scand J Rheumatol Suppl 2000;113:78-85

Related Articles, Links


Physical therapy in the treatment of fibromyalgia.

Offenbacher M, Stucki G.

Department of Physical Medicine and Rehabilitation, University of Munich, Germany.

Fibromyalgia (FM) is a syndrome of unknown etiology characterized by chronic wide spread pain, increased tenderness to palpation and additional symptoms such as disturbed sleep, stiffness, fatigue and psychological distress. While medication mainly focus on pain reduction, physical therapy is aimed at disease consequences such as pain, fatigue, deconditioning, muscle weakness and sleep disturbances and other disease consequences. We systematically reviewed current treatment options in the treatment of fibromyalgia. Based on evidence from randomized controlled trials cardiovascular fitness training importantly improves cardiovascular fitness, both subjective and objective measures of pain as well as subjective energy and work capacity and physical and social activities. Based on anecdotal evidence or small observational studies physiotherapy may reduce overloading of the muscle system, improve postural fatigue and positioning, and condition weak muscles. Modalities and whole body cryotherapy may reduce localized as well as generalized pain in short term. Trigger point injection may reduce pain originating from concomitant trigger points in selected FM patient. Massage may reduce muscle tension and may be prescribed as a adjunct with other therapeutic interventions. Acupuncture may reduce pain and increase pain threshold. Biofeedback may positively influence subjective and objective disease measures. TENS may reduce localized musculoskeletal pain in fibromyalgia. While there seems to be no single best treatment option, physical therapy seem to reduce disease consequences. Accordingly a multidisciplinary approach combining these therapies in a well balanced program may be the most promising strategy and is currently recommended in the treatment of fibromyalgia.

Altern Ther Health Med 2001 May-Jun;7(3):79-91

Related Articles, Links


A review of recent clinical trials of the nutritional supplement Chlorella pyrenoidosa in the treatment of fibromyalgia, hypertension, and ulcerative colitis.

Merchant RE, Andre CA.

Virginia Commonwealth University, Medical College of Virginia, Richmond, VA 23298-0709, USA. rmerchan@hsc.vcu.edu

CONTEXT: It has been suggested that the consumption of natural “whole foods” rich in macronutrients has many healthful benefits for those who otherwise ingest a normal, nonvegetarian diet. One example is dietary supplements derived from Chlorella pyrenoidosa, a unicellular fresh water green alga rich in proteins, vitamins, and minerals. OBJECTIVE: To find evidence of the potential of chlorella dietary supplements to relieve signs and symptoms, improve quality of life, and normalize body functions in people with chronic illnesses, specifically fibromyalgia, hypertension, and ulcerative colitis. DESIGN: Double-blind, placebo-controlled, randomized clinical trials. SETTING: Virginia Commonwealth University’s Medical College of Virginia. PATIENTS: Fifty-five subjects with fibromyalgia, 33 with hypertension, and 9 with ulcerative colitis. INTERVENTION: Subjects consumed 10 g of pure chlorella in tablet form and 100 mL of a liquid containing an extract of chlorella each day for 2 or 3 months. MAIN OUTCOME MEASURES: For fibromyalgia patients, assessments of pain and overall quality of life. For hypertensive patients, measurements of sitting diastolic blood pressure and serum lipid levels. For patients with ulcerative colitis, determination of state of disease using the Disease Activity Index. RESULTS: Daily dietary supplementation with chlorella may reduce high blood pressure, lower serum cholesterol levels, accelerate wound healing, and enhance immune functions. CONCLUSIONS: The potential of chlorella to relieve symptoms, improve quality of life, and normalize body functions in patients with fibromyalgia, hypertension, or ulcerative colitis suggests that larger, more comprehensive clinical trials of chlorella are warranted.

 

Integr Physiol Behav Sci 1998 Jan-Mar;33(1):61-71

Related Articles, Links


The effects of nutritional supplements on the symptoms of fibromyalgia and chronic fatigue syndrome.

Dykman KD, Tone C, Ford C, Dykman RA.

Mannatech Inc., Coppell Texas 75019, USA.

This article reports the results of a within-subject design. Fifty subjects with a physician diagnosis of fibromyalgia (FM) and/or chronic fatigue syndrome (CFS) were interviewed using a structured interview from. Each subject was interviewed initially, and again nine months later (follow-up). Subjects had, on their own, consumed nutritional supplements including freeze-dried aloe vera gel extract; a combination of freeze-dried aloe vera gel extract and additional plant-derived saccharides; freeze-dried fruits and vegetables in combination with the saccharides; and a formulation of dioscorea complex containing the saccharides and a vitamin/mineral complex. With medical treatments, approximately 25 percent of FM patients improve, but the beneficial effects of medical treatment rarely persist more than a few months. All subjects in this study had received some form of medical treatment prior to taking the nutritional supplements, but none with enduring success. Nutritional supplements resulted in a remarkable reduction in initial symptom severity, with continued improvement in the period between initial assessment and the follow-up. Further research is needed to verify these results, specifically crossover designs in well-defined populations.

 

Bennett RM.

Related Articles, Links

A survey of symptoms and treatment of fibromyalgia.
Curr Rheumatol Rep. 2002 Aug;4(4):285. No abstract available.
PMID: 12166413 [PubMed – in process]

 

 

Curr Rheumatol Rep 2002 Aug;4(4):284-5

Related Articles, Links


Antidepressants do not have better results than placebo in the treatment of fibromyalgia in Brazil.

Bennett RM.

PMID: 12166412 [PubMed – in process]

 

 

BMJ 2002 Jul 27;325(7357):185

Related Articles, Links

 
Prescribed exercise in people with fibromyalgia: parallel group enterzed controlled trial.

Richards SC, Scott DL.

Poole Hospital NHS Trust, Poole, Dorset BH15 2JB. srichards@poole-tr.swest.nhs.uk

OBJECTIVES: To evaluate cardiovascular fitness exercise in people with fibromyalgia. DESIGN: Randomised controlled trial. Setting: Hospital rheumatology outpatients. Group based classes took place at a “healthy living enter.” PARTICIPANTS: 132 patients with fibromyalgia. INTERVENTIONS: Prescribed graded aerobic exercise (active treatment) and relaxation and flexibility (control treatment). MAIN OUTCOME MEASURES: Participants’ self assessment of improvement, tender point count, impact of condition measured by fibromyalgia impact questionnaire, and short form McGill pain questionnaire. RESULTS: Compared with relaxation exercise led to significantly more participants rating themselves as much or very much better at three months: 24/69 (35%) v 12/67 (18%), P=0.03. Benefits were maintained or improved at one year follow up when fewer participants in the exercise group fulfilled the criteria for fibromyalgia (31/69 v 44/67, P=0.01). People in the exercise group also had greater reductions in tender point counts (4.2 v 2.0, P=0.02) and in scores on the fibromyalgia impact questionnaire (4.0 v 0.6, P=0.07). CONCLUSIONS: Prescribed graded aerobic exercise is a simple, cheap, effective, and potentially widely available treatment for fibromyalgia.

 

 

 

 

Acupuncture and Gastrointestinal Issues

 

Tradit Chin Med. 2001 Dec;21(4):286-8.

Related Articles, Links


The affects of acupuncture at sibai and neiting acupoints on gastric peristalsis.

Chang X, Yan J, Yi S, Lin Y, Yang R.

Hunan TCM College, Changsha 410007, Hunan Province.

The frequency and amplitude of gastric peristaltic wave were significantly changed in 15 subjects when Sibai (ST 2) and Neiting (ST 44) acupoints of the Stomach Channel of Foot-Yangming were punctured. The results demonstrate that these acupoints are effective for treatment of stomach diseases, providing an experimental basis for the theory of channels and collaterals.

 

Acupuncture and Heart Disease

 

 

Zhongguo Zhong Xi Yi Jie He Za Zhi 1993 Mar;13(3):153-4, 132

Related Articles, Links


[Effect of auriculo-acupuncture plus needle embedding in heart point on left cardiac, humoral and endocrine function]

[Article in Chinese]

Zhou JR.

Wuxi First People’s Hospital, Jiangsu.

Twelve patients with dilating cardiomyopathy complicated heart failure were divided randomly into auriculo-acupuncture group (n = 7) and controls (n = 5). Left cardiac function and plasma levels of PRA, ALD, EDLS, ANF were measured. Results showed that CO, CI, ANF, EDLS, ALD were decreased in test group (P < 0.05), which indicated that auriculo-acupuncture plus needle-embedding in Heart acupoint could improve the left cardiac function in patients with dilating cardiomyopathy complicated heart failure and that the function of acupoints is distinctly different from that of non-point.

 

Probl Vet Med 1992 Mar;4(1):125-31

Related Articles, Links


Acupuncture for cardiovascular disorders.

Smith FW Jr.

Cardiopet, Inc., Floral Park, New York.

Experimental studies in animals and clinical studies in humans have demonstrated that acupuncture can exert significant effects on the cardiovascular system and provide effective therapy for a variety of cardiovascular ailments. In veterinary practice, acupuncture should be considered as adjunctive therapy in cases of shock and cardiac arrest. Acupuncture may also be beneficial as adjunctive or sole therapy in the management of congestive heart failure, arrhythmias, and systemic hypertension.

 

Zhen Ci Yan Jiu 1992;17(1):26-7, 12

Related Articles, Links

 

[Effects of head point needling on cardiac function and hemodynamics]

[Article in Chinese]

Guo W.

Shijiazhuang Medical College, Hebei.

The present investigation was undertaken to observe the effects of head point-cardiovascular point needling on the cardiac function and hemodynamics in 8 anesthetized dogs, and to elucidate the underlying mechanisms and its clinical implications. Cardiovascular point needling might induce significant changes in cardiac function and hemodynamic parameters: arterial systolic pressure decreased by 22.4 +/- 8.88 from 104.6 +/- 20.55 mmHg, diastolic pressure by 16.7 +/- 8.04 from 66.5 +/- 18.03 mmHg, mean arterial pressure by 18.6 +/- 8.16 from 79.2 +/- 18.36 mmHg, left ventricular end-diastolic pressure by 0.3 +/- 0.47 from 3.6 +/- 1.94 mmHg, Lv dp/dt max by 300.1 +/- 200.1 from 2000.1 +/- 700.8 mmHg/s, coronary resistance by 399 +/- 310 from 1959 +/- 1150 dyn.s.cm-5, femoral arterial resistance by 242 +/- 634 from 2438 +/- 1595 dyn.s.cm-5, total peripheral resistance by 1570.7 +/- 691.0 from 9000.2 +/- 2537.4 dyn.s.cm-5, and left ventricular work index by 2.7 +/- 1.9 from 11.4 +/- 5.17 kg.m/min/m2, whereas the coronary sinus blood flow increased by 0.7 +/- 1.6 from 33.6 +/- 14.7 ml/min. There were significant differences between the values of all parameters before and after cardiovascular point needling (p greater than 0.005). The results indicated that cardiovascular point needling was capable of lowering the cardiac preload and afterload with resultant fall in blood pressure and cardiac oxygen consumption, as well as relaxing the coronary vessels and consequent increase in coronary blood flow with enhanced oxygen supply. These beneficial effects induced by cardiovascular point needling provided the basis for the treatment of hypertension, coronary artery diseases and cardiac failure in clinic.

Auton Neurosci 2002 Sep 30;100(1-2):90-5

Related Articles, Links


An alternative method to enhance vagal activities and suppress sympathetic activities in humans.

Wang JD, Kuo TB, Yang CC.

Department of Traditional Chinese Medicine, Tzu-Chi General Hospital, Dalin, Taiwan.

Vagal withdrawal and/or sympathetic overactivity is always accompanied by various kinds of stress and is dangerous to the body. We proposed that mild acupuncture on the Sishencong points may effectively enhance vagal activities but suppress sympathetic regulations of the heart in humans. Experiments were carried out on nine healthy male volunteers, while they were lying in a quiet room during 2-4 P.M. Acupuncture was applied 2 mm deep into the skin using standard stainless acupuncture needles at the Sishencong points, which are located on the vertex of the head, each 1 cm away from Baihui (GV 20) in four directions. Four points around the temporal area were selected as control points. Forty minutes of precordial ECG signals before, during, and after acupuncture were recorded continuously. Frequency-domain analysis of the stationary RR intervals was performed to evaluate the total variance, high-frequency power (HF, 0.15-0.40 Hz) and low-frequency power (LF, 0.04-0.15 Hz) in normalized units (LF%). Acupuncture on the Sishencong points resulted in an increased HF but a decreased LF% compared with the before acupuncture stage. Such effects did not occur when manual acupuncture was applied to the control points. The differences in the heart rate dynamics between Sishencong and the control groups took place 10 min after initiation of acupuncture and persisted even after the removal of the needles. Based on these results, we concluded that manual acupuncture on the Sishencong points enhanced cardiac vagal and suppressed sympathetic activities in humans. The underlying mechanisms and potential applications warrant further investigations.

J Altern Complement Med 1999 Oct;5(5):405-13

Related Articles, Links


Addition of acupuncture and self-care education in the treatment of patients with severe angina pectoris may be cost beneficial: an open, prospective study.

Ballegaard S, Johannessen A, Karpatschof B, Nyboe J.

Acupuncture Centre, Hellerup, Denmark. ballegaard@akupunktur.dk

OBJECTIVES: A cost-benefit analysis of acupuncture and self-care education in the treatment of patients with angina pectoris. DESIGN: An open prospective study on an unselected group of patients. For comparison of risk three control groups were used: (1) published data concerning medical and invasive treatments; (2) an age- and sex matched group obtained from a randomly selected Danish population of 14,000 people; and (3) the 211 patients in this group with angina pectoris symptoms. SETTING: The treatment was carried out on a outpatient basis in a private research clinic. SUBJECTS: 105 patients with angina pectoris, 73 candidates for invasive treatment, and 32 for whom this was rejected. INTERVENTIONS: Acupuncture and self-care education was added to the pharmaceutical treatment. OUTCOME MEASURES: Healthcare expenses, a satisfactory medical status defined as New York Heart Association (NYHA) classification 0-I and/or no use of antianginal medication, and risk measured as cardiac death or myocardial infarction. RESULTS: The estimated cost savings during 5 years were $32,000 (U.S.) per patient, mainly due to a 90% reduction in hospitalization and 70% reduction in needed surgery. Compared to 8% before treatment, 53% of the patients achieved a life without limitations (NYHA 0-I) 1 year after treatment, as did 69% after 5 years. No increased risk for myocardial infarction or cardiac death was observed. CONCLUSIONS: The addition of acupuncture and self-care education was found to be cost beneficial in patients with advanced angina pectoris. The results invite further testing in a randomized controlled trial.

Zhong Xi Yi Jie He Za Zhi 1991 Nov;11(11):654-6, 643-4

Related Articles, Links


[Improvement of blood pressure and left cardiac function in patients with hypertension by auricular acupuncture]

[Article in Chinese]

Huang HQ, Liang SZ.

Hubei College of TCM, Wuhan.

The authors observed 30 patients with hypertension, which blood pressure was lowered by Heart point of ear needling. Comparison of hypotensive effect of short-term between Heart point and Stomach point of ear needling showed that there was markable hypotensive effect by Heart point, whose hypotensive rate of short-term was 100% and forward effect rate was 63.3%. There was inefficacy for hypotensive by Stomach point. There was marked effect of left cardiac function, with II, III stage of hypertension, which was improved by Heart point. There was inefficacy for left cardiac function of normal being.

Cah Anesthesiol 1991;39(8):537-40

Related Articles, Links


[Treatment using traditional acupuncture of early scapulohumeral pains following heart surgery]

[Article in French]

Faure-Antonietti F, Antonietti C, Estanove S, Ninet J, Vigneron M, Champsaur G.

Service de chirurgie thoracique et cardiovasculaire C, Hopital cardiologique, Lyon.

The purpose of this study was to test the efficacy of traditional Chinese acupuncture in the treatment of scapulohumeral pain during the early stage following heart surgery, by puncture of points not related anatomically or metamerically with the scapulohumeral joint and without any needle stimulation. Reduction of pain and angular gain were almost immediate, durable, measurable and reproducible, which could be explained by possible effects of acupuncture on articular sympathetic mechanoreceptors, then suppressing reflex muscular contractions due to intraoperative postural constraints.

Acta Med Scand 1986;220(4):307-13

Related Articles, Links


Acupuncture in severe, stable angina pectoris: a randomized trial.

Ballegaard S, Jensen G, Pedersen F, Nissen VH.

Twenty-six patients with stable angina pectoris, resistant to medical treatment, were randomized to either active or sham acupuncture in a single-blind design. Sham acupuncture was defined as the insertion of needles in a point within the same spinal segments as the active acupuncture, but outside the Chinese meridian system. The effect was evaluated from anginal attack rate, nitroglycerin consumption and exercise tests. Compared to patients receiving sham acupuncture the patients receiving active acupuncture increased cardiac work capacity significantly, expressed as dPRP (difference in pressure-rate-product between rest and maximum exercise) and maximal PRP during exercise (p less than 0.001). None of the other variables showed any significant difference between the two groups. Concerning exercise tolerance the median difference was 138 Wmin (95% confidence limits – 12.5 to 325 Wmin), concerning anginal attack rate the median difference was 29.5% (95% confidence limits 55% to –11%) and with regard to nitroglycerin consumption the median difference was 5% (95% confidence limits +67% to –44%). No significant effect of sham treatment was observed, no adverse effect was observed. We suggest that acupuncture may improve cardiac work capacity in patients with angina pectoris, refractory to medical treatment.

Minerva Med 1981 Sep 15;72(33):2209-14

Related Articles, Links


[Spectrum analysis of the electroencephalogram during electrohypoalgesia (combined with electroacupuncture) and pharmacological anesthesia]

[Article in Italian]

Caracausi SR, Lorenzini R, Pilloni C, Tognali F, Sciaretta G.

Cerebral function has been monitored by means of the spectral analysis of EEG during general pharmacological anaesthesia and during electrohypoalgesia (auriculoacupuncture) in patients subjected to chest and heart surgery. The results have shown that during electrohypoalgesia, waking or subvigilance frequencies predominate, an aspect that is quite different from those recorded in patients subjected to general pharmacological anaesthesia. It is therefore demonstrated that electrohypoalgesia is useful for surgery and saves the patient from pharmacological aggression which, while on the one hand suppressing the state of awareness, along with its analgesic and neurovegetative protection action, is not free from risks and undesirable side-effects, particularly in high risk patients. The usefulness, harmlessness and simplicity of the method as an alternative to other anaesthesiological schedules is confirmed.

 

 

Wien Med Wochenschr 1980 Oct 31;130(20):668-70

Related Articles, Links


[Influence of acupuncture and electroacupuncture on heart rate and extrasystoles (author’s transl)]

[Article in German]

Liptak V, Habeler G, Egger J.

In 33 patients with constant ventricular extrasystoles the influence of acupuncture and electroacupuncture on the extrasystoles and the heart rate was examined. There was no difference in heart rate between the treatment-conditions and the non-treatment-conditions. Differences were seen however in the frequencies of the ventricular extrasystoles: During acupuncture (normal as well as electric) the total sum of ventricular extrasystoles and the number of subjects with ventricular extrasystoles was lowered significantly in relation to the non-treatment-condition. The findings are discussed as to neurovegetative and neuroendocrine influence of acupuncture.

 

Am J Chin Med 1979 Spring;7(1):77-90

Related Articles, Links


Acupuncture anesthesia for open heart surgery: a report of 800 cases.

Hollinger I, Richter JA, Pongratz W, Baum M.

This article reports the utilization of acupuncture in combination with chemical anesthesia and neuromuscular relaxant for patients with cardiac surgery, including valvular disease and by-pass. In 800 patients studied using this type of combination of anesthetic techniques, it was found that this procedure can be successful for cardiac surgery and that it allows light planes of anesthesia with less interference to circulatory regulation. There is a certain advantage of using acupuncture anesthesia when compared with chemical anesthesia, as the pharmacological agents are not used and hence post no metabolic load for the patients. From the 800 patients studied, it seems justifiable to recommend this anesthetic procedure for cardiac surgery.

 

 

Acupuncture and HIV

 

 

AIDS Care 2001 Dec;13(6):743-8

Related Articles, Links

 
Clinical outcomes and patient perceptions of acupuncture and/or massage therapies in HIV-infected individuals.

Henrickson M.

HIV Division, Northeast Valley Health Corporation, Panorama City, California 91402, USA. Mhenrickson2002@yahoo.co.nz

This paper uses an innovative methodology to evaluate clinical outcomes and patient perceptions of acupuncture and massage therapies in an HIV medical outpatient setting. Using a quasi-experimental retrospective case control design, treatment subjects were matched by intake date and CD4 count with non-treatment subjects. All subjects had equal opportunity to access HAART therapies and other standard treatments for HIV. There were three treatment groups: acupuncture-only (n = 8), massage-only (n = 34) and acupuncture-and-massage (n = 21). Pre-treatment and post-treatment measures were compared within groups, and treatment and non-treatment group clinical outcomes were compared with each other. Using nonparametric statistical analysis, it was found that the means of the treatment groups’ differences in pre- and post-CD4 counts showed improvement when compared with the non-treatment control group’s pre- and post-CD4 counts. Treatment subjects were then interviewed and asked to rate their experiences of the therapies; the subjective experience was very positive. The reasons for these findings may be complex, including the possibility that some people may choose to manage their disease more aggressively, and may select a range of treatments. While no large claims are made for this study, these findings may be of interest both to clinicians and funders of acupuncture and/or massage therapies.

J Assoc Nurses AIDS Care 2001 Jan-Feb;12(1):27-39

Related Articles, Links


Effects of individualized acupuncture on sleep quality in HIV disease.

Phillips KD, Skelton WD.

Department of Administrative and Clinical Nursing, College of Nursing, University of South Carolina, USA.

Although it may begin at any point, sleep disturbance often appears early in HIV disease and contributes to decreased quality of life during the course of the illness. Relatively few studies have explored the complex nature of poor sleep quality in HIV disease or tested interventions to improve sleep quality. The purpose of this study was threefold: explore the nature of sleep quality in HIV disease, test the relationship between pain and sleep quality, and test the effectiveness of acupuncture delivered in a group setting for improving sleep quality in those who are HIV infected. A pretest, posttest, preexperimental design was used to test the effects of acupuncture on sleep quality. Participating in the study were 21 HIV-infected men and women between the ages of 29 and 50 years who reported sleep disturbance three or more times per week and who scored greater than 5 on the Pittsburgh Sleep Quality Index. The Wrist Actigraph was used to measure sleep activity, and the Current Sleep Quality Index was used to measure sleep quality for 2 nights before and after a 5-week acupuncture intervention (10 treatments). Acupuncture was individualized to address insomnia and other symptoms reported by the participants. Sleep activity and sleep quality significantly improved following 5 weeks of individualized acupuncture delivered in a group setting.

J Tradit Chin Med 2000 Jun;20(2):119-21

Related Articles, Links


Acupuncture ameliorates AIDS symptoms in 36 cases.

Zhou W, Sun Y, Wu Z.

TCM Department of the 47th PLA Hospital, Xindu County, Sichuan Province.

J Altern Complement Med 1999 Apr;5(2):135-42

Related Articles, Links


Use of noninvasive electroacupuncture for the treatment of HIV-related peripheral neuropathy: a pilot study.

Galantino ML, Eke-Okoro ST, Findley TW, Condoluci D.

Neuromusculoskeletal Institute, Department of Physical Medicine and Rehabilitation, School of Osteopathic Medicine, University of Medicine and Dentistry of New Jersey, Stratford 08084, USA. galantinoml@stockton.edu

OBJECTIVES: The main objective of this study was to test the hypothesis that low-voltage non-invasive electroacupuncture will improve the condition of neuropathic human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. DESIGN: A prospective study using HIV/AIDS patients who had antiretroviral drug-induced neuropathy. Eleven patients were enrolled, but complete data was obtained from only 7. Non-invasive skin electrodes were placed on leg acupuncture points BL60, ST36, K1, LIV3, and low-voltage current passed for 20 minutes every day for 30 days. Patients were assessed preintervention and postintervention with MOS-HIV 30-item instrument questionnaire and tibial H-reflex was similarly recorded from the right calf muscle. RESULTS: There was improvement in the condition of all 7 patients. They felt much better and reported feelings of increased physical strength. Outcomes on MOS-HIV 30-item instrument showed significant overall improvement in functional activities (pre 33+/-10, post 38.4+/-9.6, p = 0.02 MANOVA). This was confirmed by postintervention H-reflex parameters; H-max and direct muscle response (M-response) amplitudes were potentiated in relation to pretreatment values (H-max: pre = 1.19+/-1.2, post = 2.68+/-1.9, p<0.05; M-response: pre = 0.93+/-1.1, post = 2.34+/-1.8, p<0.05); M-response latency decreased in relation to pretreatment value (pre = 9.7+/-1.8, post = 7.8+/-1.9, p<0.01). CONCLUSION: The results support the hypothesis that low-voltage electroacupuncture will improve the condition of the neuropathic HIV/AIDS patient.

 

 

 

Acupuncture and Human Performance

 

J Strength Cond Res. 2001 May;15(2):266-71.

Related Articles, Links

 
Acupuncture in human performance.

Pelham TW, Holt LE, Stalker R.

Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

To this point in time, acupuncture has been used primarily as an analgesic, a therapeutic intervention that controls pain under pathological conditions. Although some of the mechanisms of acupuncture as it applies to pain relief have been studied, little is known of the positive and/or negative effects of this procedure on the physical performance parameters of healthy people, particularly highly trained athletes. After introducing acupuncture from historical and technique viewpoints, preliminary studies of the effects of acupuncture on strength, aerobic conditioning, flexibility, and sport performance are discussed, as well as concerns regarding the direction of research investigating the potential benefit and/ or adverse effects of this practice. Finally, an argument is put forward for the establishment of guidelines for the use of acupuncture in the sports community.

 

Tidsskr Nor Laegeforen. 1993 Dec 10;113(30):3799-801.

Related Articles, Links


[The Chinese runners' revolution]

[Article in Norwegian]

Kaada B.

Sentralsjukehuset i Rogaland, Stavanger.

Scientists are discussing possible explanations of the fantastic improvement in physical performance achieved by Chinese female runners in 1993. Some untraditional procedure must have been used in addition to intense training. The author points out that a study conducted almost a decade ago, and reported in Acupuncture and Electro-Therapeutics Research (1984; 9: 165-80), showed a marked increase in physical performance following low-frequency (2 Hz) transcutaneous electrical nerve stimulation (TENS) in athletes competing in swimming, running and cycling events. This study was known to the Chinese, and TENS could be one of the methods used. Neither this method nor acupuncture are regarded as doping, since at present it is impossible to demonstrate that the athletes have received such treatment.

 

J Sports Med Phys Fitness. 2005 Mar;45(1):134-40.

Related Articles, Links


The effect of acupuncture and moxibustion on physical performance by sedentary subjects submitted to ergospirometric.

Gentil D, Assumpcao J, Yamamura Y, Barros Neto T.

Federal University of Sao paulo, Sao Paulo, Brazil.

AIM: Acupuncture and moxibustion are 2 therapeutic methods used in Traditional Chinese Medicine. The aim of this study is to evaluate the effect of acupuncture and moxibustion in physical performance by an ergospirometry test. METHODS: Thirty-one subjects, sedentary, were randomized into 3 groups: Group I (Acupuncture); Group II (AcupunctureSham) and Group III (Control). They were submitted to anamnesis and an ergospirometry test. The subjects from Groups I and II were submitted to 10 acupuncture and moxibustion sessions, twice a week, for 5 weeks. The differences between the groups were that in Group I the acupuncture and moxibustion sessions were performed in acupoints and Group II in non acupoints. After this, the ergospirometry test was performed again. RESULTS: The acupuncture and moxibustion sessions did not increase maximum oxygen uptake (VO(2)max) significantly. Other variables presented a significant increasing: oxygen uptake in anaerobic threshold (VO(2)La); velocity in anaerobic threshold (Vel LA); caloric consumption (Gast Cal). The heart rate decreased when compared to velocity pre and post-treatment. The results show peripheral, afferent stimulation (acupuncture and moxibustion) could alter the functions of structures or internal organs. The decrease in heart rate and the significant improvement in oxygen uptake in anaerobic threshold are similar to adaptations to physical training. Probably, the autonomic nervous system (mainly sympathetic system) is engaged in the acupuncture and moxibustion mechanism of action. CONCLUSIONS: Acupuncture and moxibustion decreased the heart rate during the ergospirometry test; the oxygen uptake in anaerobic threshold (VO(2)La); velocity in anaerobic threshold (Vel LA) and caloric consumption (Gast Cal) had significantly increased.

Int J Sports Med. 1992 Aug;13(6):486-91.

Related Articles, Links


Influence of acupuncture on physical performance capacity and haemodynamic parameters.

Ehrlich D, Haber P.

Department of Sport and Performance Medicine, Klinik fur Innere Medizin IV, University of Vienna.

In a single blind study the question as to whether the needling of specific acupuncture points is able to produce an increase in physical performance capacity and better regulation of heart rate and blood pressure was examined. Thirty-six healthy young men were assigned at random to three groups, receiving either actual acupuncture, placebo acupuncture or no stimulation. Performance was determined by means of a spiro-ergometer test which was carried out at the beginning and at the end of five weeks of treatment consisting of one session per week. The subjects from the group which actually received acupuncture were able to increase maximum performance capacity significantly and also physical performance at the anaerobic threshold. This may be interpreted as a sign of functional improvement in haemodynamic and metabolic mechanisms. There was, on the whole, no noticeable effect produced by the placebo acupuncture. The control group, which received no stimulation, showed unfavourable changes in the values obtained compared with the results of the performance test at the commencement of the study.

 

 

 

Acupuncture and Hypertension

 

 

Acupunct Electrother Res 1983;8(3-4):177-256

Related Articles, Links


Non-invasive circulatory evaluation and electro-acupuncture & TES treatment of diseases difficult to treat in Western medicine.

Omura Y.

Even in the presence of normal blood pressure (B.P.) in both arms in some individuals, abnormal B.P. and circulatory disturbances can be found in the brain and lower extremities. The author discovered the following five types of abnormal B.P. in the brain in the presence or absence of normal B.P. in the arms: unilateral cephalic hypertension; bilateral cephalic hypertension; unilateral cephalic hypotension; bilateral cephalic hypotension; mixed cephalic hypertension and hypotension. When the B.P. of the head exceeds about 160 mm Hg, patients experience sensation of increased pressure buildup in the head to moderate headache. When it exceeds over 220 mm Hg, most of them experience severe headache in that side of the head. When the B.P. is very low (less than 30 mm Hg in both sides), majority of the subjects experience sleep disturbance pattern, mainly insomnia and some develop excessive sleepiness; difficulty in concentration and easy forgetfulness of recent events; various degrees of irritability. They are often associated with injury of neck-shoulder area with the presence of spastic muscles in the area. Relaxation of the spastic muscles by acupuncture, TES or soft laser beam from He-Ne (7 approximately 15m Watts) often change the abnormal cephalic B.P. toward normal. Among individuals with cephalic hypotension some of them develop eye problems. Blind patients with macular degeneration and retinitis pigmentosa often have severe cephalic hypotension and reduced blood flow. Improvement of B.P. and blood flow induced by safe and effective electrical stimulation resulted in significant improvement in vision. In some patients, abnormal B.P. and blood flow of the brain are dependent on the position of the head and neck which can be classified as "Cephalo-cervical Position Dependent Dysfunction Syndrome" which interferes with the function of some of the internal organs. In many psychiatric patients with schizophrenia or severe depression, cephalic B.P. and blood flow are often reduced significantly with additional abnormal function of pancreas, thyroid gland or liver. These abnormalities can explain some of the abnormal behavior, particularly when hypoglycemia, decrease in serotonin level and decreased circulation in the brain coexist.

 

Acupuncture and Infertility

 

Zhong Xi Yi Jie He Za Zhi 1989 Apr;9(4):199-202, 195

Related Articles, Books, LinkOut


[Changes in serum FSH, LH and ovarian follicular growth during electroacupuncture for induction of ovulation]

[Article in Chinese]

Yu J, Zheng HM, Ping SM.

Changes in serum FSH, LH and follicular sizes were observed in chronically anovulatory patients during electroacupuncture treatment (EAT) for induction of ovulation. 7 cases were diagnosed as PCOD, 3 as dysfunctional uterine bleeding, and 1 as hypogonadotropic amenorrhea. Among them 8 cases complained of infertility for 2.7 years on average. Ovulation was confirmed by pregnancy or the combination of biphasic BBT and ultrasonographic evidence. During one cycle with 3-day EAT on acupoints Ren 3, 4, Extra 16 and Sp 6, ovulation resulted in 5 patients (ovulatory group) and among the 5 cases, 3 of 4 infertile cases became pregnant. The other 5 cases remained in anovulation (anovulatory group); of them 3 cases got biphasic BBT, but no typical ovulatory signs were found on ultrasonography; 2 cases remained in monophasic BBT. Serum FSH, LH values were elevated in ovulatory group, and FSH pulsatile frequency increased significantly during EAT (from 2.10 +/- 0.42/4h to 3.70 +/- 1.64/4h), but not in anovulatory group. No apparent changes were found in serum LH pulsatile frequency and pulsatile amplitudes of FSH and LH in this study. In ovulatory group diameters of ovarian follicles increased markedly, while diameters of anovulatory group stopped to grow at 14-16 mm. It is suggested that ovulation may be induced by EAT via a regulation on hypothalamic-pituitary function leading to normal secretion of FSH and LH.

 

Zhonghua Fu Chan Ke Za Zhi 1985 May;20(3):144-7, 189

Related Articles, Books, LinkOut


[Polycystic ovarian syndrome treated with Chinese traditional medicine; analysis of 117 cases]

[Article in Chinese]

Shi CX, Duan RL.

PMID: 4017736 [PubMed - indexed for MEDLINE]

 

Zhong Xi Yi Jie He Za Zhi 1986 Apr;6(4):218-21, 195-6

Related Articles, Books, LinkOut


[Regulating effect on the hypothalamo-hypophyseo-ovarian axis observed during the process of treating polycystic ovarian disease by tonifying the kidney and resolving phlegm]

[Article in Chinese]

Yu J.

PMID: 2945659 [PubMed - indexed for MEDLINE]

 

Nippon Sanka Fujinka Gakkai Zasshi 1988 Jun;40(6):789-92

Related Articles, Books, LinkOut


Effect of a traditional herbal medicine (shakuyaku-kanzo-to) on testosterone secretion in patients with polycystic ovary syndrome detected by ultrasound.

Takahashi K, Yoshino K, Shirai T, Nishigaki A, Araki Y, Kitao M.

Department of Obstetrics and Gynecology, Shimane Medical University.

In 20 infertile Japanese with polycystic ovary syndrome Shakuyaku-Kanzo-To was used to lower plasma testosterone levels and hence to induce pregnancy. The polycystic ovary was classified into two types; general cystic and peripheral cystic patterns. Plasma testosterone was decreased in 18/20 (90%) and 5/20 (25%) became pregnant. The plasma testosterone concentration in the case of the general cystic pattern was significantly higher than that of peripheral cystic pattern, and the pregnancy rate in those with the general cystic pattern was lower. The efficacy of Shakuyaku-Kanzo-To therefore seems to vary according to the type of polycystic ovary syndrome treated.

PMID: 3292675 [PubMed - indexed for MEDLINE]

 

Zhongguo Zhong Xi Yi Jie He Za Zhi 1998 Apr;18(4):225-6, 240

Related Articles, Books, LinkOut


[Study on relationship between ovulation inducing effect of drug-acupuncture and endometrial contents of estradiol receptor and progesterone receptor]

[Article in Chinese]

Tian D, Xie X, Wang B.

Maternity and Child Health Institute, Changqing 400013.

OBJECTIVE: To study the effect of Chinese herbal medicine for replenishing Kidney combined with acupuncture in treating anovulation and infertility, and the relationship between its ovulation inducing effect and endometrial contents of estradiol receptor (ER) and progesterone receptor (PR). METHODS: Twenty-nine cases were treated with replenishing Kidney drugs combined with acupuncture for 1-3 months. Patients' ER and PR were measured by immunohistochemical method. And patients were classified according to PR content into PR positive group and mild PR positive group. RESULTS: Fifteen cases of PR positive group, completed treatment for 45 cycles, among them, 40 cycles showed ovulation, the ovulation rate being 88.89%. Ten in 14 cases, who complicated with infertility, became pregnant, the pregnant rate being 71.43%. While in 11 cases of PR mild positive group, 9 complicated with infertility, completed treatment for 33 cycle, 10 cycles showed ovulation (30.30%), and pregnant rate 22.22% (2/9). The difference between the two groups was significant (P < 0.01). CONCLUSION: The replenishing Kidney drugs combined with acupuncture treatment could result a good effect in treating infertility due to anovulation, especially on those with high endometrial PR content.

PMID: 11475747 [PubMed - indexed for MEDLINE]

Acta Obstet Gynecol Scand 2000 Mar;79(3):180-8

Related Articles, Books, LinkOut

·          
Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome.

Stener-Victorin E, Waldenstrom U, Tagnfors U, Lundeberg T, Lindstedt G, Janson PO.

Department of Obstetrics and Gynecology, Goteborg University, Sweden.

BACKGROUND: The present study was designed to evaluate if electro-acupuncture (EA) could affect oligo-/anovulation and related endocrine and neuroendocrine parameters in women with polycystic ovary syndrome (PCOS). METHODS: Twenty-four women (between the ages of 24 and 40 years) with PCOS and oligo-/amenorrhea were included in this non-randomized, longitudinal, prospective study. The study period was defined as the period extending from 3 months before the first EA treatment, to 3 months after the last EA treatment (10-14 treatments), in total 8-9 months. The menstrual and ovulation patterns were confirmed by recording of vaginal bleedings and by daily registrations of the basal body temperature (BBT). Blood samples were collected within a week before the first EA, within a week after the last EA and 3 months after EA. RESULTS: Nine women (38%) experienced a good effect. They displayed a mean of 0.66 ovulations/woman and month in the period during and after the EA period compared to a mean of 0.15 before the EA period (p=0.004). Before EA, women with a good effect had a significantly lower body-mass index (BMI) (p<0.001), waist-to-hip circumference ratio (WHR) (p=0.0058), serum testosterone concentration (p=0.0098), serum testosterone/sex hormone binding globulin (SHBG) ratio (p=0.011) and serum basal insulin concentration (p=0.0054), and a significantly higher concentration of serum SHBG (p=0.040) than did those women with no effect. CONCLUSION: Repeated EA treatments induce regular ovulations in more than one third of the women with PCOS. The group of women with good effect had a less androgenic hormonal profile before treatment and a less pronounced metabolic disturbance compared with the group with no effect. For this selected group EA offers an alternative to pharmacological ovulation induction.


PMID: 10716298 [PubMed - indexed for MEDLINE]

J Tradit Chin Med 1993 Jun;13(2):115-9

Related Articles, Books, LinkOut


Clinical studies on the mechanism for acupuncture stimulation of ovulation.

Mo X, Li D, Pu Y, Xi G, Le X, Fu Z.

Zhejiang College of Traditional Chinese Medicine, Hangzhou.

Ovulatory dysfunction is commonly seen in gynecology clinic. It may cause infertility, amenia, functional uterine bleeding and a variety of complications. This research according to TCM theory records treating with acupuncture 34 patients suffering from ovulatory dysfunction. Changes in clinical symptoms and some relative targets are reported, plus findings in animal experiments. The effect of acupuncture in improving ovulation and the rationale are discussed. According to TCM theory concerning the generative and physiologic axis of women, this research involved the following points: Ganshu (UB 18), Shenshu (UB 23), Guanyuan (Ren 4), Zhongji (Ren 3), and Sanyinjiao (Sp 6). The reinforcement and reduction of acupuncture enables it to strengthen liver and kidney. Through the Chong and Ren channels it nourishes uterus to adjust the patient's axis function and recover ovulation. Treated on an average of 30 times, the patients' symptoms improved to varying degrees. The marked effective rate was 35.29%, the total effective rate being 82.35%. BBT, VS, CMS, and B ultrasonic picture all improved to some degree. The results also showed that acupuncture may adjust FSH, LH, and E2 in two directions and raise the progesterone level, bringing them to normal. The animal experiments confirmed this result. Results showed that acupuncture may adjust endocrine function of the generative and physiologic axis of women, thus stimulating ovulation. The results of this research will provide some scientific basis for treating and further studying this disorder.

PMID: 8412285 [PubMed - indexed for MEDLINE]

Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy


Wolfgang E. Paulus, M.D.,[a] Mingmin Zhang, M.D.,[b] Erwin Strehler, M.D.,[a]
Imam El-Danasouri, Ph.D.,[a] and Karl Sterzik, M.D.[a]


Christian-Lauritzen-Institut, Ulm, Germany

Received June 5, 2001; revised and accepted October 16, 2001.
Reprint requests: Wolfgang E. Paulus, M.D., Christian-Lauritzen-Institut, Frauenstr. 51, D-89073, Ulm, Germany (FAX: ++49-731-9665130; E-mail: paulus@reprotox.de).
[a] Department of Reproductive Medicine, Christian-Lauritzen-Institut.
[b] Department of Traditional Chinese Medicine, Tongji Hospital, Tongji Medical University, Wuhan, People's Republic of China.
0015-0282/02/$22.00
PII S0015-0282(01)03273-3

Objective: To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy (ART) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture.

Design: Prospective randomized study.

Setting: Fertility center.

Patient(s): After giving informed consent, 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80).

Intervention(s): Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy.

Main Outcome Measure(s): Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer.

Result(s): Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.

Conclusion(s): Acupuncture seems to be a useful tool for improving pregnancy rate after ART. (Fertil Steril®2002;77:721- 4. ©2002 by American Society for Reproductive Medicine.)

 

 

Polycystic Ovarian Syndrome

Randine Lewis, Ph.D., Lic.Ac.

Polycystic Ovarian Syndrome, or PCOS, has also been known by the name Stein-Leventhal Syndrome, and includes a multi system presentation, having its effects on the skin, hair, body weight, endocrine system, and reproductive system. It is said to affect up to ten percent of women of reproductive age, and up to ninety percent of woman with irregular menstrual cycles.

PCOS was first recognized as a medical disease or syndrome in the West in 1845 in France. Its most distinctive sign is the pathologic appearance of sclerocystic changes on the larger than average ovaries, which appeared to have a thick, shiny, white coating overlying many rows of cysts on the surface of the ovary. These ovarian changes give PCOS its name. In 1990 a National Institute of Health conference decided the two most consistent elements which comprise the disorder of PCOS include elevated androgenic hormones and chronic lack of ovulation. Yet PCOS has a multitude of other symptoms as well, including obesity, acne, facial hair and increased body hair, and thinning of the hair on the head.

Most of the symptoms of PCOS are caused by the state of the ovary. The capsule of the ovary is thickened and waxy. Multiple small cysts exist inside the ovary which are not the same as active follicles, but have been arrested in their development. These cysts and the connective tissue surrounding them, the stroma, produce male hormones called androgens. Testosterone is very similar in chemical composition to estrogen, but it causes the male type effects so often seen in PCOS. The brain detects circulating levels of sex hormone, and inhibits ovulation accordingly.

Luteinizing hormone is often elevated higher than FSH in a woman with PCOS, and remains elevated throughout the cycle. LH stimulates the cells of the ovary to produce androgens, which block follicular development, causing the follicles to degenerate. This process is thought to be a result of an altered feedback mechanism within the hypothalamic - pituitary - ovarian axis, and makes ovulation unlikely.

Impaired glucose tolerance and insulin abnormalities are also a factor in many cases of PCOS, and have to do with another endocrine gland, the pancreas. Insulin resistance affects ovulation by producing higher amounts of circulating insulin, which stimulates the activity of enzymes which help to manufacture androgens in the ovary. High insulin levels further may cause overstimulation of androgen receptors, leading to follicular atresia of developing eggs.

The etiology of this disease remains unknown. Doctors and scientists have been unable to pinpoint the actual causative factor, and thus have been unable to treat it effectively. Woman with PCOS are at risk for other health hazards like disorders in lipid metabolism, obesity and its health concerns, vascular disease and cancer.

So, how does PCOS affect fertility? By affecting the ability to ovulate. Less estrogen is produced, but more LH and testosterone. This affects not only the quality of the follicle, but also the state of the endometrium. As a result, menstrual cycles become more erratic and less predictable. Women with PCOS will often very long cycles and very heavy bleeding; or amenorrhea, or anovulation with scanty bleeding. (Each presentation, by the way, is addressed using different treatment protocols with Oriental Medicine.) When an egg is released, it is often released later in the cycle, and it is of poorer quality because of the surroundings in which it has been developing. Remember that follicular development is a process that takes approximately one hundred days within the ovary. Eggs are meant to develop in an estrogen and progesterone rich environment, not in an androgenic setting.

Women diagnosed with polycystic ovarian syndrome historically do not respond positively to Western assisted reproductive techniques including in-vitro procedures; nor do they respond well to clomid alone, or any hormonal manipulation which does not address the state of the ovary's endocrine milleau over the previous three or more months of development. If they do become pregnant, they are at higher risk of miscarriage, again presumably because of the health of the egg and therefore the developing embryo.

Chinese medicine seeks to redress the entire hormonal milleau.

Polycystic Ovarian Syndrome - The Traditional Eastern View

In Traditional Chinese Medicine, Polycystic Ovarian Syndrome is seen as a heterogenous disorder, consisting of quite a few possible pattern discriminations. They are broken down into two main subcategories:

Vacuity

Repletion

Kidney yang vacuity

Phlegm dampness

Kidney yin vacuity

Liver depression/depressive heat

Spleen qi vacuity

Blood stasis


They all have manifestations in the way in which the body ovulates, however. Most women with PCOS ovulate later in the cycle, if at all. Going back to the diagnostic checklist, you may categorize yourself into any combination of the diagnostic categories. Treatment will be based upon these differentiations.

Treatment

Treatment must first and foremost be based upon your individual diagnostic pattern. Follow the dietery guidelines for PCOS (below). Do the following exercise to increase blood flow to the ovaries:

Femoral Massage -
[This exercises increases the blood flow to the pelvic organs, providing more nourishment to the uterus and ovaries.]

Compress (or have your partner compress) the large artery just beneath the crease in your groin between your thigh and lower abdomen. This is the femoral artery, which comes from the iliac artery. The iliac artery gives off branches which supply blood flow to the uterus, fallopian tubes and ovary. (The ovary has an additional blood supply which branches off the same arterial section that supplies the kidneys.) When the flow has ceased and you feel the pulsation end at your finger tips, hold for 30-45 seconds. The blood is now backing up and increasing the pressure gradient in the iliac arteries and forcing more blood into the pelvic arteries, flooding the pelvic organs with more blood. When the hold is released, you should feel a sensation of warmth rushing down your leg as the blood supply returns to the lower extremity. Perform the femoral massage three times, twice daily.

NOTE: Do not perform this exercise if you are pregnant. If you have high blood pressure, heart disease or circulatory problems including aneurisms, varicose veins, phlebitis, thrombosis, or a history of strokes or detached retinas, do not practice these techniques. If you have diabetes or similar disorder which affects the circulation, but can perform normal exercises and daily routines, practice on one side at a time and repeat on the opposite side. Perform the femoral massage three times on each side, twice daily if possible.

If you will be l supplementing with herbs, include Gleditsia during the first half of your menstrual cycle, before ovulation. Gleditsia is categorized as a phlegm resolving medicinal in Chinese Medicine, and is known to dissolve the waxy capsule around the ovaries, and it promotes ovulation. Leonurus Fruit is a blood quickening medicinal with an inherent effect of encouraging ovulation in those who have any element of blood stasis. Women with ovulatory pain have blood stasis on ovulation.

Anovulatory women should begin to notice signs of ovulation after a couple months of treatment. Women with belated ovulation will often notice that their ovulation comes earlier and earlier in the cycle until they ovulate normally on cycle day fourteen.

Most women with PCOS also have endocrine abnormalities which are affected by diet.

Dietary Therapy

If you are overweight, this condition responds much better to weight loss. Fat cells store estrogen, and there is usually relatively too much circulating estrogen and LH in women with PCOS. The liver metabolizes these hormones, so a healthy functioning liver is mandatory for proper therapeutic effect. Include dietary sources of the B vitamins, which keep the liver healthy.

Because of the insulin resistance and impaired glucose metabolism found in PCOS, it is very important to modify dietary intake if you have this condition.

Insulin is a hormone secreted by the beta cells of the pancrease and is designed to maintain the blood glucose level within a certain range. Insulin stores glucose in the form of fat. Insulin resistance means that the body's response to insulin in various tissues is impaired. Hence, the pancreas secretes more insulin. When the body fails to respond to insulin, glucose intolerance and diabetes and its many complications may become the eventual result.

The best natural management for insulin resistance and impaired glucose metabolism is to lower the level of sugar intake from the diet, and eliminate the ingestion of any food substance that the body can utilizes as simple sugar.

 

Cut out all forms of refined sugar

 

Cut out all forms of refined carbohydrates. The body immediately turns these into sugar. This includes white bread, pasta, potatoes, white rice, most breakfast cereals, rice cakes, popcorn, or any starchy, low fiber food.

 

Do not adhere to the fertility diets that advocate massive yam consumption. This can actually delay or prevent ovulation if you have PCOS.

 

Avoid soda, fruit juice, and any drink which rapidly raises the blood sugar level.

 

Consume adequate amounts of protein, either in vegetarian form or in the form of lean meat which has not been treated hormonally.

 

Eat as many fresh vegetables as you wish.

 

Eat only complex, whole grains.

 

Eat fruits like berries which are not too sweet.

 

Avoid milk and dairy products which tend to exacerbate the condition of internal dampness.

 

Eliminate alcohol and caffeine.

 

Increase your dietary fiber intake.

 

Exercise.


A Swedish/Italian controlled study from the Biology of Reproduction Journal, (date): involved inducing a state of poly cystic ovaries in rats, with injections of estradiol valerate. Increased activity of the sympathetic nervous system resulted, followed by increased concentrations of nerve growth factor in ovaries, and the adrenal glands. Within 60 days the rats developed polycystic ovariess. The control group received no therapy and maintained features of PCOS. Those treated with acupuncture showed a reduction in the hyperactivity of the ovarian peripheral sympathetic nerve fibers, reduction of the increased nerve growth factor concentrations within the ovaries to normal and reduced the weight of the poly cystic ovaries. This group of doctors then set out with the aim of reproducing similar results in women with PCOS. The study concluded, "We have shown that repeated electroacupuncture treatments restore regular ovulations in the anovulatory women with PCOS. In addition, acupuncture influenced neruoendocrine and endocrine parameters indicative of PCOS, such as LH/FSH ratios, mean testosterone concentrations, and beta-endorphin concentrations, which reduced significantly."

This study illustrates the hormonal origin of this disease process, and the fact that it can be induced artificially. The induction of this hormonal trauma produces a physiologic state of stress which raises the activity of the sympathetic nervous system, producing a disease syndrome. Acupuncture treatments were effective at resolving this pathologic process because it reduces the level of hypersympathetic nervous system response, relaxing the whole neuroendocrine system.

 

Clinical studies on the mechanism for acupuncture stimulation of ovulation.

J Tradit Chin Med 1993 Jun;13(2):115-9 (ISSN: 0254-6272)

Mo X; Li D; Pu Y; Xi G; Le X; Fu Z
Zhejiang College of Traditional Chinese Medicine, Hangzhou.

Ovulatory dysfunction is commonly seen in gynecology clinic. It may cause infertility, amenia, functional uterine bleeding and a variety of complications. This research according to TCM theory records treating with acupuncture 34 patients suffering from ovulatory dysfunction. Changes in clinical symptoms and some relative targets are reported, plus findings in animal experiments. The theory concerning the generative and physiologic axis of women, this research involved the following points; Ganshu (UB 18), Shenshu (UB 23), Guanyuan (Ren 4), Zhongji (Ren 3), and Sanyinjiao (Sp 6). The reinforcement and reduction of acupuncture enables it to strengthen liver and kidney. Through the Chong and Ren channels it nourishes uterus to adjust the patient's axis function and recover ovulation. Treated on an average of 30 times, the patients' symptoms improved to varying degrees. The marked effective rate was 35.29%, the total effective rate being 82.35%. BBT, VS, CMS, and B ultrasonic picture all improved to some degree. The results also showed that acupuncture may adjust FSH, LH, and E2 in two directions and raise the progesterone level, bringing them to normal. The animal experiments confirmed this result. Results showed that acupuncture may adjust endocrine function of the generative and physiologic axis of women, thus stimulating ovulation. The results of this research will provide some scientific basis for treating and further studying this disorder.

Auricular acupuncture in the treatment of female infertility

Gynecol Endocrinol 1992 Sep;6(3):171-81 (ISSN: 0951-3590)

Gerhard I; Postneek F
Department of Gynecological Endocrinology and Reproduction, Women's Hospital, University of Heidelberg, Germany.

Following a complete gynecologic--endocrinologic workup, 45 infertile women suffering from oligoamenorrhea (n = 27) or luteal insufficiency (n = 18) were treated with auricular acupuncture. Results were compared to those of 45 women who received hormone treatment. Both groups were matched for age, duration of infertility, body mass index, previous pregnancies, menstrual cycle and tubal patency. Women treated with acupuncture had 22 pregnancies, 11 after acupuncture, four spontaneously, and seven after appropriate medication. Women treated with hormones had 20 pregnancies, five spontaneously, and 15 in response to therapy. Four women of each group had abortions. endometriosis (normal menstrual cycles) was seen in 35% (38%) of the women of each group who failed to respond to therapy with pregnancy. Only 4% of the women who responded to acupuncture or hormone treatment with a pregnancy had endometriosis, and 7% had normal cycles. In addition, women who continued to be infertile after hormone therapy had higher body mass indices and testosterone values than the therapy responders from this group. Women who became pregnant after acupuncture suffered more often from menstrual abnormalities and luteal insufficiency with lower estrogen, thyrotropin (TSH) and dehydroepiandrosterone sulfate (DHEAS) concentrations than the women who achieved pregnancy after hormone treatment. Although the pregnancy rate was similar for both groups, eumenorrheic women treated with acupuncture had adnexitis, endometriosis, out-of-phase endometria and reduced postcoital tests more often than those receiving hormones. Twelve of the 27 women (44%) with menstrual irregularities remained infertile after therapy with acupuncture compared to 15 of the 27 (56%) controls treated with hormones, even though hormone disorders were more pronounced in the acupuncture group. Side-effects were observed only during hormone treatment. Various disorders of the autonomic nervous system normalized during acupuncture. Based on our data, auricular acupuncture seems to offer a valuable alternative therapy for female infertility due to hormone disorders.

 

Direct effects of Chinese herbal medicine "hachuekkito" on sperm movement

Nippon Hinyokika Gakkai Zasshi, 89(7):641-6 1998 Jul (ISSN: 0021-5287)

Yamanaka M; Kitamura M; Kishikawa H; Tsuboniwa N; Koga M; Nishimura K; Tsujimura A; Takahara S; Matsumiya K; Okuyama A
Department of Urology, Osaka University Medical School

BACKGROUND AND PURPOSE: Chinese herbal medicine, "Hochuekkitto" is widely used for male infertility in Japan. There have been many reports concerning its clinical usefulness but very few reports of in vitro experiments studying the mechanism of its effects. In addition to stimulating germ cells, we analyzed its direct effects on sperm using computer assisted semen analyzer (CASA). MATERIALS AND METHODS: Motile sperm were prepared using swim up technique from semen collected from ten healthy volunteers. Sperm movements (motility, velocity, linearity) were analyzed by CASA after adding either serum containing anti-sperm antibody (ASA) or normal serum with or without Hochuekkito. RESULTS: Two hours after adding serum with ASA, the decrease of sperm motility was significantly reduced from 25.1% (92.8%-->67.7%) to 12.5% (92.9%-->80.6%) by adding Hochuekkito. No significant difference in velocity and linearity was observed between two groups. By adding normal serum, any of three parameters differed significantly with or without Hochuekkito. CONCLUSION: Protective effects of Hochuekkito on sperm was suggested. Although normal sperm with ASA was used in this report, since the sperm of infertile patients are said to be more fragile, this results imply that direct protective effect is one of the mechanism of Hochuekkito for male infertility

 

Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality.

Arch Androl, 39(2):155-61 1997 Sep-Oct (ISSN: 0148-5016)

Siterman S; Eltes F; Wolfson V; Zabludovsky N; Bartoov B
Institute of Chinese Medicine, Tel Aviv, Israel.

The aim of this prospective controlled study was to assess the effect of acupuncture on the sperm quality of males suffering from subfertility related to sperm impairment. Semen samples of 16 acupuncture-treated subfertile patients were analyzed before and 1 month after treatment (twice a week for 5 weeks). In parallel, semen samples of 16 control untreated subfertile males were examined. Two specimens were taken from the control group at an interval of 2-8 months. The expanded semen analysis included routine and ultramorphological observations. The fertility index increased significantly (p < or = .05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per ejaculate, and integrity of the axonema (p < or = .05), which occurred upon treatment. The intactness of axonema and sperm motility were highly correlated (corr. = .50, p < or = .05). Thus, patients exhibiting a low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.

 

A substance isolated from Cornus officinalis enhances the motility of human sperm

Am J Chin Med 1997;25(3-4):301-6 (ISSN: 0192-415X)

Jeng H; Wu CM; Su SJ; Chang WC
Department of Anatomy, Taipei Medical College, Taiwan.

The effects of a Chinese herb, Cornus officinalis, on the motility of human sperm was studied. An aqueous extract was prepared from the dried fruits of the herb and used in this study. The crude extract at a final concentration of 0.5 microgram/microliter in phosphate buffered saline (pH 7.4) increased sperm motility from 25.8 +/- 7.7% to 42.8 +/- 10.3% (i.e. 68% increase, n = 7), as determined by the computer-aided-sperm-analysis (CASA) method. The crude extract was fractionated by high-performance liquid chromatography (HPLC) into four fractions: C1, C2, C3 and C4. Their effects on sperm motility were further studied by CASA. Only the C4 fraction showed substantial stimulatory effects on sperm motility. At a concentration of 5 ng/microliter, C4 increased the sperm motility from 15.7 +/- 3.8% to 34.5 +/- 6.4% (i.e. 120% increase, n = 6) by CASA and from 14.9 +/- 4.3 to 28.5 +/- 8.1 (i.e. 91% increase, n = 8) by transmembrane migration ratio (TMMR) method. This result suggests that C4 is the active component in Cornus officinalis that enhances sperm motility.

 

 

An experimental study on inhibitory effect of Chinese medicine tai-bao on antisperm antibody

Chung Kuo Chung Hsi I Chieh Ho Tsa Chih, 17(6):360-2 1997 Jun (ISSN: 1003-5370)

Lai AN; Song JF; Liu XJ
Xiyuan Hospital, China Academy of TCM, Beijing.

OBJECTIVE: To investigate whether Chinese medicine Tai-bao could inhibit antisperm antibody in experimental mice. METHODS: The experimental immunoinfertility mice were due to antisperm antibody induced by injection of human sperm membrane antigens. The experimental immuno-infertile mice used in the present study were divided into four groups including Tai-bao high dose group (46.8 g.kg-1.d-1), Tai-bao low dose group (31.2 g.kg-1.d-1), prednisone group and normal saline group. The enzyme linked immune sorbent assay (ELISA) and microcytotoxic assay were used for detection of antisperm antibody. The change of levels of antisperm antibody before and after treatment, pregnant rate, and the number of implantation were investigated in tested mice. RESULTS: The pregnant rates in normal saline group, prednisone group, Tai-bao high dose group and low dose were 38.89%, 47.06%, 70.00% and 75.00% respectively. The rate of pregnancy in Tai-bao low dose group was significantly higher as compared with normal saline group (P < 0.05). The rate of implantation in Tai-bao low dose group was significantly higher than that in prednisone group (P < 0.05). The results of detection of cytotoxic antibody to sperm showed that cytotoxic percentages in Tai-bao high dose group (63.0 +/- 10.3%) and prednisone group (56.3 +/- 13.7%) were significantly lower (P < 0.05 and P < 0.01) than that in normal saline group (72.84 +/- 5.05%). CONCLUSION: Chinese medicine Tai-bao possesses regulatory effect on reproductive immune function, inhibitory effect on antisperm cytotoxic antibody, and promoting effect on pregnancy.

 

Eighty-seven cases of male infertility treated by bushen shengjing pill in clinical observation and evaluation on its curative effect

Chung Kuo Chung Hsi I Chieh Ho Tsa Chih, 16(8):463-6 1996 Aug (ISSN: 1003-5370)

Yue GP; Chen Q; Dai N
Institute of Acupuncture and Meridians, Anhui College of TCM, Hefei.

Eighty-seven cases of male infertility with semen abnormality were treated and observed by Bushen Shengjing Pill, its curative effect was evaluated with quantitative assessment and analytical comparison comprehensive scoring of semen routine analysis. These patients were treated for one of three courses of treatment, the semen quality was enhanced obviously, the comprehensive semen routine analysis score was enhanced significantly (P < 0.001) as compared with that before treatment, the spouse pregnant rate was 56.32% (49/87), and total effective rate was 95.40% (83/87). The result showed that this prescription had bidirectional regulatory function in folliclestimulating hormone, luteotropic hormone, testosterone, corticosterone, and could make the enhanced or reduced hormone level to normal value.

 

Experimental study of effect on tonifying kidney herbs in pituitary ovary adrenal gland of androgen sterilized rats

Chung Kuo Chung Hsi I Chieh Ho Tsa Chih, 17(12):735-8 1997 Dec (ISSN: 1003-5370)

Gui SQ; Yu J; Wei MJ
Obstetrics and Gynecology Hospital, Shanghai Medical University

OBJECTIVE: To observe the effect of tonifying Kidney herbs (TKH) in pituitary, ovary, adrenal gland of androgen sterilized rats (ASR). METHODS: ASR model was established by injecting testosterone propionate subcutaneously to SD female rats of 9 days age. Morphological and hormonal change of pituitary, ovary and adrenal gland in rats of 100-107 days old before and after feeding TKH extract were observed by light and electron microscope, cell culture immunohistochemical studies and radioimmuno-assay. RESULTS: In the ASR groups, there were intracytopiasmic lipid drops, autophagy, vacuole, granulolysis of pituitary gland. There were anovulation apparently and increased the amount of lipid drops in cytoplasm of interstitial glandular cell of ovary. The fatty drops of the reticular zone of adrenal gland decreased, the number of AGNOR (P < 0.01) and PCNA (P < 0.01) increased significantly. The levels of FSH, LH (P < 0.05-0.005) lowered, but the levels of DHA, T (P < 0.01, 0.05, 0.001) were raised significantly. Morphological and hormonal change of all RSA returned to normal range after the treatment. CONCLUSIONS: The hyperandrogenemia were disturbed by the function of sex gland axis and adrenal in female rats of 9 days old and played an important role in pathogenesis of ASR, the TKH reduced the levels of androgen and induced ovulation through sex gland axis and adrenal level and multi-organ regulation.

 

Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients

Hum Reprod 1999 Jul;14(7): 1690-7

Battaglia C, Salvatori M, Maxia N, Petraglia F, Facchinetti F, Volpe A
Department of Obstetrics and Gynecology University of Modena, Via del Pozzo, 17, 41100 Modena Department of Surgical Sciences, University of Udine, Italy.

The objective of the present study was prospectively and randomly to evaluate the role of L-arginine in improving uterine and follicular Doppler flow and in improving ovarian response to gonadotrophin in poor responder women. A total of 34 patients undergoing assisted reproduction was divided in two groups according to different ovarian stimulation protocols: (i) flare-up gonadotrophin-releasing hormone analogue (GnRHa) plus elevated pure follicle stimulating hormone (pFSH)(n = 17); and (ii) flare-up GnRHa plus elevated pFSH plus oral L-arginine (n = 17). During the ovarian stimulation regimen, the patients were submitted to hormonal (oestradiol and growth hormone), ultrasonographic (follicular number and diameter, endometrial thickness) and Doppler (uterine and perifollicular arteries) evaluations. Furthermore, the plasma and follicular fluid concentrations of arginine, citrulline, nitrite/nitrate (NO2-/NO3-), and insulin-like growth factor-1 (IFG-1) were assayed. All 34 patients completed the study. In the L-arginine treated group a lower cancellation rate, an increased number of oocytes collected, and embryos transferred were observed. In the same group, increased plasma and follicular fluid concentrations of arginine, citruilline, NO2-/NO3-, and IFG-1 was observed. Significant Doppler flow improvement wsa obtained in the L-arginine supplemented group. Three pregnancies were registered in these patients. No pregnancies were observed in the other group. It was concluded that oral L-arginine supplementation in poor responder patients may improve ovarian response, endometrial receptivity and pregnancy rate.

 

Reduction of blood flow impedance in the
uterine arteries of infertile women with electro-acupuncture

Elisabet Stener-Victorin[1.4], Urban Waldenström[2], Sven A. Andersson[3] and Matts Wikland[2]

[1]Department of Obstetrics and Gynaecology [2]Fertility Centre
Scandinavia. Department of Obstetrics and Gynaecology and [3]Department of Physiology University of Gothenburg.
S-413 45 Gothenburg, Sweden

[4]To whom correspondence should be addressed: Department of Obstetrics and Gynecology. Kvinnokliniken Sahlgrensh sjukhuset, S-413 45 Golhenburg, Sweden

Source: European Society for Human Reproduction and Embryology


In order to assess whether electro-acupuncture (EA) can reduce a high uterine artery blood flow inpedance, 10 infertile but otherwise healthy women with a pulsatility index (PI) ≥3.0 in the uterine arteries were treated with EA in a prospective, non-randomized study. Before inclusion in the study and throughout the entire study period, the women were down-regulated with a gonadotrophin-releasing hormone analogue (GnRHa) in order to exclude any fluctuating endogenous hormone effects on the PI. The baseline PI was measured when the serum oestradiol was ≤0.1 nmol/l, and thereafter the women were given EA eight times, twice a week for 4 weeks. The PI was measured again closely after the eighth EA treatment, and once more 10-14 days after the EA period. Skin temperature on the forehead (STFH) and in the lumbosacral area (STLS) was measured during the flrst, fifth and eighth EA treatments. Compared to the mean baseline PI, the mean PI was significantly reduced both shortly after the eighth EA treatment (P < 0.0001) and 10-14 days after the EA period (P < 0.0001). STFH increased significantly during the EA treatments. It is suggested that both ot these effects are due to a central inhibition of the sympathetic activity.

Introduction
Successful in-vitro fertilization (IVF) and embryo transfer demand optimal endometrial receptivity at the time of implantation. Blood flow impedance in the uterine arteries, measured as the pulsatility index (PI) using transvaginal ultrasonography with pulsed Doppler curves, has been considered valuable in assessing endometrial receptivity (Goswamy and Steptoe, 1988; Sterzik et al., 1989; Steer et al., 1992, 1995a,b; Coulam et al., 1995; Tekay et al., 1995). Steer et al. (1992) found that a PI ≥3.0 at the time of embryo transfer could predict 35% of the failures to become pregnant. Coulam et al. (1995) did not observe any significant differences between PI measurements done on the day of oocyte retrieval compared with PI measurements on the day of embryo transfer. This would allow prediction of non-receptive endometria earlier in the cycle.

Previous studies on rats have shown a decreased blood pressure after electro-acupuncture (EA) with low frequency (2 Hz) stimulation of muscle afferents (A-d fibres). The decreased blood pressure was related to reduced sympathetic activity (Yao et al., 1982; Hoffman and Thoren, 1986; Hoffman et al.. 1987, 1990a,b), and was paralleled by an increase in the ß-endorphin concentration in the cerebrospinal fluid (CSF), suggesting a causal relationship to central sympathetic inhibition (Cao et al., 1983; Moriyama 1987; Reid and Rubin, 1987). The cardiovascular effects of acupuncture treatment are probably mediated by central opioid activity via the ß-endorphin system from the hypothalamus.

The aim of this study was to evaluate whether EA can reduce a high impedance in the uterine arteries. There are several conceivable mechanisms which may give this effect.

In addition to central sympathetic inhibition via the endorphin system, vasodilatation may be caused by stimulation of sensory nerve fibres which inhibit the sympathetic outflow at the spinal level, or by antidromic nerve impulses which release substance-P and calcitonin gene-related peptide from peripheral nerve terminals (Jansen et al., 1989; Andersson, 1993; Andersson and Lundeberg, 1995).

It has been assumed that various disorders in the autonomic nervous system, such as hormonal disturbances, may be normalized during auricular acupuncture (Gerhard and Postneck, 1992). It has also been suggested that the concentrations of central opioids may regulate the function of the hypothalamic-pituitary-ovarian axis via the central sympathetic system, and that a hyperactive sympathetic system in anovulatory patients could be normalized by EA (Chen and Yin, 1991).

Materials and Methods

Subjects, design and Pl measurements
The study was approved by the ethics committee of the University of Gothenburg and was conducted at the Fertility Centre Scandinavia, Gothenburg, Sweden, a tertiary private IVF unit. All women attending the clinic for information about the IVF/embryo transfer procedure, had the PI of their uterine arteries measured by transvaginal ultrasonography and pulsed Doppler curves (Aloka SSD 680: Berner Medecinteknik, Stockholm, Sweden). The PI value for each artery was calculated electronically from a smooth curve fitted to the average waveform over three cardiac cycles, according to the formula: Pl = (A - B)/mean, where A is the peak systolic Doppler shift, B is the end diastolic shift frequency and mean is the mean maximum Doppler shifted frequency over the cardiac cycle. A reduction in the value of PI is thought to indicate a reduction in impedance distal to the point of sampling (Steer et al., 1990).

In the routine preparation for their IVF/embryo transfer treatment, all women were down-regulated with a gonadotrophin-releasing hormone analogue (GnRHa) (Suprecur: Hoechst. Germany). When their oestradiol concentration in serum was <0.1 nmol/1, the women were considered down-regulated and the PI of their uterine arteries was again measured in those women showing a mean Pl ≥3.0 before down-regulation. The measurements were done by two of the authors (M.W. and U.W.) between 08.30 h and 14.30 h. These hours were chosen for practical reasons, and also to reduce the risk that the PI measurements would be affected by the circadian rhythm in blood flow, recently reported by Zaidi et al. (1995). Three measurements were made on the right and three on the left uterine artery of each patient. Before the study was conducted, the observers were well trained in PI measurements with the equipment used. Steer et al. (1995) has shown that in trained hands, the inter-, and intra-observer variations in vaginal colour Doppler ultrasound are sufficiently small to provide a basis for clinically reliable work.

PI measurements were done on all women attending the unit for an IVF/embryo transfer treatment between November 1992 and February 1993. Of these, all infertile but otherwise healthy women, with a mean PI ≥3.0 in the uterine arteries both before and after down-regulation, were invited to be included in the study.

In all, 10 women accepted after informed consent and they had a mean age of 32.3 years (range 25-40 years). The infertility diagnoses were unexplained infertility (n = 6), tubal factor (n = 3) and polycystic ovarian syndrome (n = 1).

From their inclusion and onwards, the women were kept on the GnRHa and were given no other pharmacological treatment. Consequently, their gonadotrophins and ovarian steroids were kept at a constantly low concentration, both at their inclusion in the study and throughout the whole study period. Thus, PI changes due to hormonal fluctuations were avoided.

EA was then given eight times, twice a week for 4 weeks. The mean PI of the uterine arteries was measured (mean of three PI on each side) directly after the eighth EA treatment and again 10-14 days after the EA period.

Of the 10 women included, two were later excluded. One of them, with tubal factor infertility, was excluded because she started taking medications for her migraine, which could have affected her PI. The other excluded woman, with unexplained infertility, stopped her GnRHa treatment because she preferred IVF/embryo transfer in a natural cycle.

Acupuncture Treatment
The sympathetic outflow may be inhibited at the segmental level and, for this reason, acupuncture points were selected in somatic segments according to the innervation of the uterus (Thl2-L2, S2-S3) (Bonica, 1990).

The needles were inserted i.m. to a depth of 10-20 mm. The aim of the stimulation was to activate group III muscle-nerve afferents. The needles were twirled to evoke `needle sensation,' often described as tension, numbness, tingling and soreness, sometimes radiating from the point of insertion. The needles were then attached to an electrical stimulator (WQ-6F: Wilkris & Co. AB, Stockholm, Sweden) for 30 min. The location of the needles was the same in all women (Table I).


Table 1. Acupuncture points, their anatomical position and their innervation

Points*

Segmental innervation
(afferent muscle)

Muscle localization

BL 23

L1, 2, 3

Erector spinae thoracolumbale

BL 28

L4, 5, S1, 2, 3

Erector spinae lumbosacrale

SP 6

L4, 5, S2, 3

Tibialis posterior at the medial side

BL 57

S1, 2

Gastrocnemius and m. soleus at the dorsal side

*All were placed bilaterally.
BL - bladder channel.
SP - spleen channel.

Four needles were located bilaterally at the thoracolumbar and lumbosacral levels of the erector spinae, and were stimulated with high frequency (100 Hz) pulses of 0.5 ms duration. The intensity was low, giving non-painful paraesthesia.

Four needles were located bilaterally in the calf muscles, and were stimulated with low frequency (2 Hz) pulses of 0.5 ms duration. The intensity was sufficient to cause local muscle contractions.

Skin temperature
The skin temperature was measured with a digital infrared thermometer (Microscanner D-series: Exergen, Watertown, MA, USA) between the applied acupuncture needles in the lumbosacral region (25 mm from each needle), skin temperature lumbosacral (STLS), and on the forehead, skin temperature forehead (STFH). The measurements were made during the first, fifth and eighth EA treatments. The first measurements were made after 10 min rest, and just before the EA, these being considered as `baseline.' Thereafter, further measurements of STLS and STFH were done every seventh minute during the EA and immediately after the EA. The room temperature was constant during the three EA treatments.

Statistics
Analysis of variance (ANOVA: Newman-Keul's range test) was used to analyze the data.

Results

Blood flow impedance
Compared to the mean baseline PI, the mean PI was significantly reduced both soon after the eighth EA treatment (P < 0.0001) and 10-14 days after the EA period (P < 0.0001) (Figure 1), at which time six women had a mean PI <2.6 (Table II and Figure 2).


Figure 1. The mean pulsatility index (PI) (n = 8) for all women before the first electro-acupuncture (EA) treatment, immediately after the eighth EA treatment and 10-14 days after the EA period.
*** = significant changes (P < 0.0001) compared to the mean PI before the first EA treatment.




Figure 2. The individual mean pulsatility index (PI) before down-regulation, before the first electro-acupuncture (EA) treatment, immediately after the eighth EA treatment and 10-14 days after the EA period.


Table II. The individual mean pulsalility index (PI) before down-regulation, before the first electro-acupunclure (EA) treatment, immedialely after the eighth EA trealment, 10-11 days after the EA period, and average mean values

 

lndividual patients

 

 

 

Pl value

A

B

C

D

E

F

G

H

Mean Value

Before down-regulation

3.00

3.00

3.30

3.75

3.90

3.25

3.14

3.33

3.34

Before EA

3.38

3.15

3.27

3.04

3.30

3.50

3.10

3.34

3.26

After eight EA

3.24

2.07

2.37

2.57

2.59

2.80

2.54

3.34

2.68

10-14 days after eight EA

2.25

2.01

2.40

2.60

2.40

3.84

2.54

3.20

2.65


The right and left uterine arteries responded similarly to EA. The diffcrence in mean PI between the two arteries was ≤0.3 (not significant), both before down-regulation, during down-regulation and throughout the whole study period. There was no significant difference in the mean PI for patients with different causes of infertility.

Skin temperature
The pooled results from all skin temperature measurements are presented in Figure 3. Compared with the starting point, mean STFH increased significantly after 21 min of EA (P = 0.02), and directly after the EA treatments (P = 0.002). STLS did not change significantly.


Figure 3. Pooled mean values (n = 8) of skin temperature on forehead (STFH) and skin temperature in the lumbosacral area (STLS) during the first, fifth and eighth electro-acupuncture (EA) treatments. * = significant changes (P = 0.02) after 21 min and ** = significant changes (P = 0.002) immediately after EA compared to the time just before needles were inserted. 0 = `baseline'.

Discussion
It has been shown in previous studies that a high PI in the uterine arteries is associated with a decreased pregnancy rate following IVF-embryo transfer (Goswamy et al., 1988; Sterzik et al., 1989; Steer et al., 1992, 1995a.b; Coulam et al., 1995). The results reported by Tekay et al. (1995) support the hypothesis postulated by Steer et al. (1992) that uterine receptivity is improved when the PI value is between 2.0 and 2.99 on the day of embryo transfer. When a high PI is found before embryo transfer in a stimulated cycle, treatment options are few. Goswamy et al. (1988) successfully tried pre-treatment with exogenous oestrogens in the next cycle, but their results have not been verified by others. It has been proposed that the embryos should be frozen, thawed and transferred in an unstimulated cycle (Goswamy et al., 1988; Steer et al., 1992, 1994), but there is little support for the hypothesis that the PI would be lower under these contitions.

In experiments on spontaneously hypertensive rats, EA at low frequency (2-3 Hz) induced a long-lasting, significant fall in blood pressure which was associated with decreased activity in sympathetic fibres (Yao et al., 1982; Hoffman and Thoren, 1986; Hoffman et al., 1987, 1990a,b). A decrease in sympathetic activity appears to be generalized. In microneurographic studies on humans, EA in the upper limbs resulted in an initial increase and then a decrease in activity of sympathetic efferents in the tibial nerve, with a parallel increase in the temperature of the skin (Moriyama, 1987). Kaada (1982) reported that transcutaneous stimulation of acupuncture points in the hand increased the skin temperature, giving pain relief in limbs suffering from Reynaud's phenomenon. Kaada (1982) also found that electrical stimulation of accupuncture hand points in patients with ischaemic conditions of the lower limbs, increased the skin temperature in the lower limbs and possibly enhanced the healing of long-standing ulcers. It has been noted in both animals and humms that EA has greater effects on pathological conditions, e.g. hypertension or hypotension, whereas normal blood pressure is only slightly changed (Yao et al., 1982: Hoffman and Thoren, 1986: Hoffman et al., 1987, 1990a,b).

The mechanisms of sympathetic inhibition following EA are poorly understood. Based on animal experiments, Hoffmann and Thoren (1986) and Hoffman et al. (1987, 1990a,b) suggested that electrical slimulation of muscle efferents innervating ergoreceptors increases the eoncentration of ß-endorphin in the CSF. They found support for the hypothesis that the hypothalamic ß-endorphinergic system has inhibitory effects on the vasomotor centre, and thereby a central inhibition of sympathetic activity. It has been suggested that this central mechanism, involving hypothalamic and brain stem systems, is important in changing the descending control of many different organ systems, including the vasomotor system (Andersson. 1993; Andersson and Lundeberg, 1995).

In this study, the PI of the uterine arteries was signifieantly decreased soon after the eighth EA treatment and remained significantly decreased 10-14 days after the EA period. These findings suggest that a series of EA treatments increases the uterine artery blood flow. Another effect observed in this study was the signifieantly inereased STFH during the EA treatments.

The most likely cause of these effects is a decreased tonic activity in the sympathetic vasoconstrictor fibres to the uterus and an involvement of the central mechanisms with general inhibition of the sympathetic outflow, in accordance with previously observed EA effects (Kaada. 1982; Yao et al., 1982; Cao et al., 1983: Hoffman and Thoren, 1986; Hoffman et al., 1987, 1990a,b; Moriyama, 1987; Reid and Rubin, 1987; Jansen et al., 1989).

In conclusion. the present study showed a decrease of the PI in the uterine arteries following EA treatment. Randomized studies on a greater number of patients are needed to verify these results and to exclude non-specific effects.

References

Andersson, S.A. (1993) The functional background in acupuncture effects. Scand J. Rehab, Med. Suppl., 29. 31-60.

Andersson, S.A. and Lundeberg. T. (1995) Acupuncture - from empiricism to science: functional background to acupuncture effects in pain and disease. Med. Hypoth., 45, 271-281.

Bonica, J. (1990) The Management of Pain, vol. 1, 2nd edn, revised. Lea & Febiger, Philadelphia, London, 156 pp.

Cao, :X.D., Xu. S.F. and Lu. W.X. (1983) Inhibition of sympathetic nervous system by acupuncture. Acupuncturc Electro-Ther. Res. Int. J., 8, 25-35.

Chen, B.Y. and Jin. Y. (1991) Relationship between blood radioimmunoreactive beta-endorphin and hand skin temperature during the electro-acupuncture induction of ovulation. Acupuncture Electro-Ther. Res. Int. J., 16, 1-5.

Coulam, C.B., Stem. IJ.. Soenksen D.M., Britten, S. and Bustillo, M. (1995) Companson of pulsatility indices on the day of oocyte retrieval and embryo transfer. Hum. Reprod., 10, 82-84.

Goswamy, R.K. and Steptoe, P.C. (1988) Doppler ultrasound studies of the uterine atery in spontaneous ovarian cycles. Hum. Reprod., 3, 721-726.

Goswamy, R.K., Williams, G. and Steptoe, P.C. (1988) Decreased uterine pertusion - cause of infentlity. Hum. Reprod., 3, 955-959.

Gerhard, I. and Posteck, F. (1992) Auricular acupuncture in the treatment of female infertility. Gynecol, Endocinol., 6, 171-181.

Hoffmann, P. and Thoren, P. (1986) Long-lasting cardiovascular depression induced by acupuncture-like stimulation of the sciatic nerve in unanaesthetized rats. Effects of arousal and type of hypertension. Acta Physiol., Scand., 127, 119-112.

Hoffman, P., Friberge, P., Ely, D. and Thoren, P. (1987) Effect of spontaneous running on blood pressure, heart rate and cardiac dimension in developing and established spontaneous hypertension in rats. Acta Physiol., Scand., 129, 535-542.

Hoffman, P., Skarphedinsson, J.O., Delle, M. and Thoren, P. (1990a) Electrical stimulation of the gastrocnemius muscle in spontaneously hypertensive rat increases the pain threshold: role of different serotonergic receptors. Acta Physiol., Scand., 138, 125-131.

Hoffman, P., Terenius, L. and Thoren, P. (1990b) Cerebrospinal fluid immunoreactive beta-endorphin concentration is increased by long-lasting voluntary exercise in the spontaneously hypertensive rat. Regul. Pept., 28, 233-239.

Jansen, G., Lundeberg, T., Kjartansson, J. and Samuelsson, U.E. (1989) Acupuncture and sensory neuropeptides increase cutaneous blood flow in rats. Neurosci. Lett., 97, 305-309.

Kaada, B. (1982) Vosodilatation induced by transcutaneous nerve stimulation in peripheral ischemia (Raynaud's phenomenon and diabetic polyneuropathy), Eur. Heart J., 3, 303-314.

Moriyama, T. (1987) Microneurographic analysis of the effects of acupuncture stimulation on sympathetic muscle nerve activity in humans: excitation followed by inhibition. Nippon Seirigaku Zasshi., 49, 711-721.

Reid, J.L. and Rubin, P.C. (1987) Peptides and central neural regulation of circulation. Physiol. Rev., 67, 725-749.

Steer, C.V., Campbell, S., Pampiglione. J.S. et al. (1990) Transvaginal colour flow imaging of uterine arteries during the ovarian and menstrual cycles. Hum. Reprod., 5, 391-395.

Steer. C.V., Campbell, S., Tan, S.L. et al. (1992) The use of transvaginal colour flow imaging after in vitro fertilization to identify optimum uterine conditions before embryo transfer. Fertil. Steril., 57, 372-376.

Steer, C.V., Tan. S.L., Mason, B.A. and Campbell, S. (1994) Midluteal-phase vaginal color Doppler assessment of uterine artery impedance in a subfertile population. Fertil. Steril., 61, 53-58.

Steer, C.V., Williams, J., Zaidi, J., Campbell, S. and Tan, S.L. (1995a) Intra-observer, interobserver, interultrasound transducer and intercycle variation in colour Doppler assessment of uterine artery impedance. Hum. Reprod., 10, 479-481.

Steer, C.V., Tan, S.L., Mason, B.A. and Campbell, S. (1995b) Vaginal color Doppler assessment of uterine artery impedance correlates with immunohistochemical markers of endometrial receptivity required for the implantation of an embryo. Fertil., Steril., 61, 101-108.

Sterzik, K., Hütter, W., Grab, D. et al. (1989) Doppler sonographic findings and their correlation with implantation in an in vitro fertilizalion program. Fertil. Steril., 52, 825-828.

Tekay, A., Martikainen, H. and Jouppila, P. (1995) Blood flow changes in uterine and ovorian vasculature, and predictive value of transvaginal pulsed colour Doppler ultrasonography in an in-vitro fertilization programme. Hum. Reprod., 10, 688-693.

Yao. T., Andersson, S. and Thoren, P. (1982) Long-lasting cardiovascular depressor response following sciatic stimulation in SHR. Evidence for the involvement of central endorphin and serotonin systems. Brain Res., 244, 295-303.

Zaidi, J., Jurkovic. D., Campbell, S. et al. (1995) Description of circadian rhythm in artery blood flow during the peri-ovulatory period. Hum. Reprod., 10, 1642-l646.

Received on June 27. 1995; accepted on March 20, 1996

 

Acupuncture and Insomnia

 

 

Acupuncture and insomnia
[Article in German]

Montakab H

40 patients with primary difficulties in either falling asleep or remaining asleep were diagnosed according to the traditional Chinese medicine, allocated to specific diagnostic subgroups and treated individually by a practitioner in his private practice. The patients were randomized into two groups, one receiving true acupuncture, the other needled at non-acupuncture points for 3-5 sessions at weekly intervals. The outcome of the therapy was assessed in several ways, first and foremost by an objective measurement of the sleep quality by polysomnography in a specialized sleep laboratory, performed once before and once after termination of the series of treatments. Additional qualitative results were obtained from several questionnaires. The objective measurement showed a statistically significant effect only in the patients who received the true acupuncture. The subjective, qualitative assessment was better in the proper treatment group than in the control group but was not calculated statistically for methodological reasons. Based on the results of this study, it can be concluded that true and individualized acupuncture indeed shows efficacy in primary sleep disorders. However, a direct influence by the therapist cannot be excluded.

 

Acupuncture treatment for insomnia and acupuncture analgesia.

Lin Y

Department of Physiology, Shanghai Second Medical University, China.

Acupuncture is a simple and useful treatment for insomnia, with a success rate of around 90%. The acupuncture points applied vary depending on the doctor and on the case, but the usual points are Shenmen (HT7) and Anmien (extrapoint). The mechanism of this treatment has not been well elucidated. Acupuncture analgesia may be used as a great indicator, because in both practices needles are inserted in deep tissues as the common stimulation. The possible neuronal integration and transmitter effect in the acupuncture treatment for insomnia are discussed.

 

Clin Ther 1985;7(3):334-7

Related Articles, Books, LinkOut


Clinical trial of suanzaorentang in the treatment of insomnia.

Chen HC, Hsieh MT.

The hypnotic effect of suanzaorentang, an ancient Chinese remedy for insomnia, was studied in 60 patients with sleep disorders. After receiving placebo for one week, patients ingested capsules containing 1 gm of suanzaorentang each night, 30 minutes before bedtime, for two weeks. Treatment was followed by another week of placebo administration. Each morning during the study, patients completed questionnaires relating to their sleep the night before and to their ability to function during the previous day. Analysis of the responses showed statistically significant improvements (P less than 0.001) in all ratings of sleep quality and well-being during active treatment compared with both placebo periods. Laboratory tests performed before and after treatment with suanzaorentang showed no alterations in any test value. No side effects were noted. We conclude from these results that the compound merits further extensive investigation.

 

[back to top]

Acupuncture and Itching

 

Acupunct Med. 2002 Dec;20(4):186-90.

Related Articles, Links


Neurogenic pruritus: an unrecognised problem? A retrospective case series of treatment by acupuncture.

Stellon A.

Temple Ewell, Kent, UK. stellon@btinternet.com

Intractable localised segmental pruritus without a rash has been reported over the years under various titles depending on the area of the body affected. Notalgia paresthetica and brachioradial pruritus are the two terms used for what is believed to be a form of neuropathy. The clinical observations reported here suggest that other localised cases of pruritus exist that share common clinical features, and the term neurogenic pruritus is suggested to encompass these under one clinical condition. Acupuncture has been used to treat skin conditions, of which pruritus is one symptom. This retrospective study looked at the symptomatic relief of neurogenic pruritus in 16 patients using acupuncture. In 12 cases the affected dermatomes of the body were innervated by cervical spinal nerves, seven innervated by dorsal spinal nerves and four innervated by the lumbar spinal nerves. Seven patients had areas affected by two different regions of the spine. Restricted neck or back movements were noted in patients as were areas of paravertebral spasm or tenderness of the muscles. Total resolution of symptoms as judged by VAS occurred in 75% of patients. Relapse occurred in 37% of patients within 1-12 months following treatment. Acupuncture appeared to be effective in alleviating the distressing symptom of itching in patients presenting with neurogenic pruritus.

 

 

J Tradit Chin Med. 2000 Dec;20(4):287-8.

Related Articles, Links


Twenty-five cases of intractable cutaneous pruritus treated by auricular acupuncture.

Lun X, Rong L.

Guangzhou University of Traditional Chinese Medicine and Pharmacy, Guangzhou 510405.

 

 

Br J Dermatol. 1987 Dec;117(6):771-7.

Related Articles, Links



 

Effect of acupuncture on experimentally induced itch.

Lundeberg T, Bondesson L, Thomas M.

Department of Physiology II, Karolinska Institutet, Stockholm, Sweden.

The effect of acupuncture on experimentally induced itch was studied in 10 healthy volunteers. Itching was induced by intradermal injections of histamine on the upper arm. 'Placebo-acupuncture', acupuncture and electro-acupuncture at 2 Hz or 80 Hz were applied over the injection site, proximal to the injection site (in the same dermatome) or extrasegmentally (ipsilateral to the injected arm) for a period of 5 min following induction of itch. In addition, the effect of a 5 min period and a 20 min period of stimulation of the skin area prior to the induction of itch were studied. The same periods of stimulation were also applied to extrasegmental points prior to the induction of itch on the arm. Acupuncture and 2 Hz and 80 Hz electro-acupuncture significantly reduced subjective itch intensity when applied intrasegmentally. No significant effects were obtained when stimulation was applied extrasegmentally. The results suggest that acupuncture or electro-acupuncture could be tried in clinical conditions associated with pruritus.

 

 

Nephron. 1987;47(3):179-83.

Related Articles, Links


Electrical needle therapy of uremic pruritus.

Duo LJ.

Department of Medicine, University of Ghent, Belgium.

Six patients with intractable uremic pruritus were treated with a modified acupuncture technique, the electrical needle stimulation (ENS). Results were followed with a pruritic score scale based on severity, frequency and distribution of itching, together with sleeping hours and waking up at night. The results were encouraging: pruritus was drastically improved during or after ENS in several patients. A control treatment with superficial electrical stimulation was ineffective.

 

Acta Derm Venereol. 1984;64(2):129-33.

Related Articles, Links


Effect of acupuncture on experimentally induced itch.

Belgrade MJ, Solomon LM, Lichter EA.

We evaluated the effect of acupuncture on histamine-induced itch and flare in healthy volunteers (n = 25) and compared it with the effect of a pseudo-acupuncture procedure and of no-intervention in a single-blind randomized cross-over study. A cumulative itch index is defined and was found to be smaller with acupuncture than with either pseudo-acupuncture (p less than 0.02) or with no-intervention (p less than 0.005). The duration of itching was shorter with acupuncture than with either pseudo-acupuncture (p = 0.006) or with no-intervention (p less than 0.001). In addition, maximal flare area was decreased with acupuncture compared with pseudo-acupuncture (p less than 0.04) and with no intervention (p = 0.003). Acupuncture had little or no effect on the itch onset time or on the maximal itch intensity after intradermal injection of histamine. Measurements of itching correlated poorly with measurements of flare size in all three experimental groups. Acupuncture appears to be an effective inhibitor of histamine-induced itch and flare. Moreover, acupuncture points displayed specificity in that needling near-by, non-acupuncture sites resulted in greater itching and larger flares.

 
Acupuncture and Knee Pain

 

Bulow HH, Christensen BV, Wilbek H, Iuhl IU, Dreijer NC, Rasmussen HF,"Predictive value of subjective and objective evaluation before acupuncture treatment.",Am J Chin Med 1992;20(1):17-23

Abstract
To evaluate if it is possible to predict the outcome of acupuncture treatment in patients with knee osteoarthrosis, six treatments were given during a 3 week period. Follow-up time was 9-17 weeks. Seven parameters were evaluated to examine if they had any influence on the outcome of treatment: Age, duration of disease, pain, range of knee movement, analgesic consumption, knee score (an objective and subjective evaluation of the knees) and x-ray changes. Twenty-nine patients were included with a total of 42 osteoarthritic knees waiting for a total knee replacement. The median age was 69.2 years, and median duration of disease was 4.2 years. 85% of the participants reported a subjective effect, and in 88% an objective effect was found. Although there were some significant differences when you looked at the 7 parameters above, the pattern was not a consistent one. Follow up results also indicated that those with the best immediate results, not necessarily were the ones with the best long-term effect. It is not possible to predict the outcome of acupuncture treatment of osteoarthritic knees. Immediate results are not a guide-line for long-term results, which indicate that acupuncture research must include a follow-up period.


Christensen BV, Juhl IU, Wilbek H, Bulow HH, Dreijer NC, Rasmussen HF,"[
Acupuncture treatment of knee arthrosis. A long-term study]. [Danish]",Ugeskr Laeger 1993 Dec 6;155(49):4007-11

Abstract
The purpose of this study was to examine acupuncture treatment of patients with osteoarthrosis of the knee. Twenty-nine patients with a total of 42 osteoarthritic knees were randomized to two groups. Group A was treated while group B served as a no treatment control group for nine weeks. Analgesic consumption, pain and objective measurements were registered. In the second part of the study 17 patients (26 knees) continued with treatments once a months. Registrations were continued for a total study period of 49 weeks. Comparing group A with B, there was a significant reduction in pain, analgesic consumption and in most objective measures. In group A + B combined there was an 80% subjective improvement, and a significantly increased range of movement of the knee. Results were significantly better in those who had not been ill for a long time. The second part of the study showed that it was possible to maintain the improvements.



Ernst M, Lee MH,"
Sympathetic effects of manual and electrical acupuncture of the Tsusanli knee point: comparison with the Hoku hand point sympathetic effects.",Exp Neurol 1986 Oct;94(1):1-10

Abstract
Sympathetic effects of manual and electrical acupuncture of the Tsusanli knee point were evaluated by thermography in 19 normal subjects under the same procedure used in a previous study using the Hoku hand point. A generalized long-lasting warming (sympathetic inhibition) effect was observed under manual and electrical acupuncture of the Tsusanli point. In addition, a segmentally related short-lasting cooling (sympathetic activation) effect occurred with Tsusanli electrical acupuncture only. The warming effect is consistent with the results of the Hoku study and appears to be a central sympathetic inhibition evoked by acupuncture. The cooling effect was segmentally related to the acupuncture site in both studies. This cooling effect most likely reflects a segmental activation of vasomotor spinal reflexes and not a general emotional arousal. These sympathetic mechanisms may be functionally correlated with central and peripheral mechanisms of acupuncture analgesia.



Gupta S, Francis JD, Tillu AB, Sattirajah AI, Sizer J,"
The effect of pre-emptive acupuncture treatment on analgesic requirements after day-case knee arthroscopy.",Anaesthesia 1999 Dec;54(12):1204-7

Abstract
The role of acupuncture analgesia in the management of postoperative pain is yet to be clearly evaluated. We conducted a prospective, double-blind, randomised controlled study to evaluate the effect of acupuncture pretreatment on the analgesic requirement after knee arthroscopy. Forty-two patients presenting for unilateral knee arthroscopy were randomly allocated to receive a standard anaesthetic with or without acupuncture (given after the induction of anaesthesia). Visual analogue pain scores, time to first postoperative analgesia and total analgesia requirement in the first 24 h were recorded. There was no significant difference between the two groups in any of the outcome measures. We conclude that acupuncture analgesia has no additional effect when given under anaesthesia to patients undergoing knee arthroscopy.

Jensen R, Gothesen O, Liseth K, Baerheim A,"
Acupuncture treatment of patellofemoral pain syndrome.",J Altern Complement Med 1999 Dec;5(6):521-7

Abstract
OBJECTIVE: To evaluate the effect of acupuncture treatment in patellofemoral pain syndrome. DESIGN: A controlled trial where patients were randomly assigned either to acupuncture treatment or no treatment. Evaluation of the result was blinded. SETTING: An acupuncture/physiotherapy treatment practice in Bergen, Norway. SUBJECTS: A total of 75 patients with patellofemoral pain syndrome were included, of whom 44 were female. INTERVENTION: Individualized acupuncture treatment twice weekly for 4 weeks. MAIN OUTCOME MEASURE: Patients were followed for 1 year with the Cincinnati Knee Rating System (CKRS) scale as the main outcome measure. Other tests used were the Stairs-Hopple test, quadriceps atrophy, and evaluating level pain after activity by a visual analogue scale. RESULTS: At inclusion patients, aged 18-45 (mean 31.0) years, reported persistent pain on activity (mean 6.6 years) and at rest (mean 4.3 years). CRS scores at baseline were similar (acupuncture group 58.0 versus no treatment group 56.1). At 12 months there was a significant difference in the CRS score between the groups (acupuncture 75.2 versus no treatment 61.7, p = 0.005). When analyzing for worst case, the difference persisted (68.1 versus 54.4, p = 0.03). Results were then dichotomized as to whether the patient was cured or not at 12 months. A patient was defined as cured if he/she scored "slight" or "none" on the "pain" or "limitation to activity" subscales. The Number Necessary to Treat (NNT) to cure one patient was NNT = 3.0 for the CRS pain subscale and NNT = 3.7 for the CRS function subscale. CONCLUSION: We conclude that acupuncture may be an alternative treatment for patellofemoral pain syndrome.

 

: Am J Acupunct 1999;27(3-4):133-40

Related Articles, Books, LinkOut

·        
TENS, electroacupuncture and ice massage: comparison of treatment for osteoarthritis of the knee.

Yurtkuran M, Kocagil T

Uludag University Medical Faculty, Department of Physical Therapy and Rehabilitation, Bursa, Turkey.

The purpose of this study was to compare the effectiveness of transcutaneous nerve stimulation (TENS), electroacupuncture (EA), and ice massage with placebo treatment for the treatment of pain. Subjects (n = 100) diagnosed with osteoarthritis (OA) of the knee were treated with these modalities. The parameters for evaluating the effectiveness of treatment include pain at rest, stiffness, 50 foot walking time, quadriceps muscle strength, and knee flexion degree. The results showed (a) that all three methods could be effective in decreasing not only pain but also the objective parameters in a short period of time; and (b) that the treatment results in TENS, EA and ice massage were superior to placebo.

PMID: 10729968, UI: 20194161


·        
A randomized trial of acupuncture as an adjunctive therapy in osteoarthritis of the knee.

Berman BM, Singh BB, Lao L, Langenberg P, Li H, Hadhazy V, Bareta J, Hochberg M

Complementary Medicine Program, University of Maryland School of Medicine, Baltimore 21207-6697, USA.

OBJECTIVE: The purpose of this study was to investigate the efficacy of acupuncture as an adjunctive therapy to standard care for the relief of pain and dysfunction in elderly patients with osteoarthritis (OA) of the knee. METHODS: Seventy-three patients with symptomatic OA of the knee were randomly assigned to treatment (acupuncture) or standard care (control). Analysis was performed on last score carried forward to account for patients who dropped out before completion. Patients self-scored Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne indices at baseline and at 4, 8 and 12 weeks. Patients in the control group were offered acupuncture treatment after 12 weeks. The data for these patients are pooled with those from the original acupuncture group for within-group analysis. RESULTS: Patients randomized to acupuncture improved on both WOMAC and Lequesne indices compared to those who received standard treatment alone. Significant differences on total WOMAC Scale were seen at 4 and 8 weeks. There appears to be a slight decline in effect at 4 weeks after cessation of treatment (12 weeks after first treatment). No adverse effects of acupuncture were reported. CONCLUSION: These data suggest that acupuncture is an effective and safe adjunctive therapy to conventional care for patients with OA of the knee.

PMID: 10378713, UI: 99305058


 

5: Clin Geriatr Med 1998 Aug;14(3):435-54

Related Articles, Books, LinkOut

·        
Management of osteoarthritis in older adults.

Creamer P, Flores R, Hochberg MC

Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.

Management of osteoarthritis (OA) is directed primarily towards relief of pain and functional limitation. This article discusses a range of nonpharmacologic modalities, including education, social support, weight reduction, and exercise. Drug treatment should begin with adequate doses of acetaminophen. Guidelines for appropriate use of NSAIDs also are suggested in this article. Intraarticular steroids help a proportion of patients, particularly those with OA of the knee or thumb base; the role of intraarticular therapies remains uncertain. Surgery (total joint replacement) remains an excellent treatment for patients in whom medical treatment has failed to provide adequate symptom relief. Future developments are likely to include earlier intervention using drugs with the potential to modify the course of the disease.


PMID: 9664101, UI: 98330421

 

7: Am J Chin Med 1995;23(1):15-25

Related Articles, Books, LinkOut

Electroacupuncture and exercise in body weight reduction and their application in rehabilitating patients with knee osteoarthritis.

Shafshak TS

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Alexandria University, Egypt.

The efficacy of ear electroacupuncture on appetite and weight control was investigated in 3 separate studies. Part I: The Stomach, Hunger, or placebo ear points were stimulated in three different groups. Stimulating the Stomach, or Hunger, points was significantly more effective in appetite control than stimulating the placebo points. Part II: Stimulation of 3 pairs of ear points (Stomach, Hunger, and Shen Men) was performed on 61 obese subjects for 8 weeks. Only 43 subjects engaged, in addition, in an exercise program. 79% of the subjects succeeded to follow a low calorie diet for 8 weeks with subsequent weight reduction. Active exercises significantly increased weight loss. Part III: 19 obese patients with knee osteoarthritis participated in electroacupuncture, diet, and exercise program and 89% of them lost 5-10 kg in 8 weeks.

PMID: 7598088, UI: 95321296


 

Acupuncture for the treatment of pain of osteoarthritic knees.

Takeda W, Wessel J

OBJECTIVE. The purpose of this study was to determine whether acupuncture was more effective than sham acupuncture in the reduction of pain in persons with osteoarthritis (OA) of the knee. METHODS. Forty subjects (20 men, 20 women) with radiographic evidence of OA of the knee were stratified by gender and randomly assigned to either the experimental (real acupuncture) or control (sham acupuncture) groups. Subjects were treated three times per week for 3 weeks and evaluated at three test sessions. Outcome measures were: 1) the Pain Rating Index of the McGill Pain Questionnaire, 2) the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, and 3) pain threshold at four sites at the knee. RESULTS. The analyses of variance showed that both real and sham acupuncture significantly reduced pain, stiffness, and physical disability in the OA knee, but that there were no significant differences between groups. CONCLUSIONS. Acupuncture is not more effective than sham acupuncture in the treatment of OA pain.

 

22: Ann Intern Med 1994 Jul 15;121(2):133-40

Related Articles, Books, LinkOut



 

Published trials of nonmedicinal and noninvasive therapies for hip and knee osteoarthritis.

Puett DW, Griffin MR

Vanderbilt University, Nashville, Tennessee.

PURPOSE: To review the efficacy of nonmedicinal, noninvasive therapies in hip and knee osteoarthritis. DATA SOURCES: Search of English-language literature from 1966 through 1993 using MEDLINE by cross-referencing "osteoarthritis" (therapy subheadings) with "controlled trial," "comparative study," or "trial(s)." STUDY SELECTION: Fifteen controlled trials of diathermy (deep heat), exercise, acupuncture, transcutaneous electrical nerve stimulation, topically applied capsaicin, low-energy laser, and pulsed electromagnetic fields were found. No experimental studies of superficial heat and cold, orthotic devices, vibration, or weight loss were identified. RESULTS: Exercise reduces pain and improves function in patients with osteoarthritis of the knee. No support exists in the literature for pre-exercise ultrasound treatment. Single, well-designed studies suggest that topically applied capsaicin and laser treatment reduce pain associated with knee osteoarthritis. Data on the other three therapies were sparse (transcutaneous electrical nerve stimulation, pulsed electromagnetic fields) or inconsistent (acupuncture). CONCLUSIONS: More data are needed to determine the optimal exercise regimen for treating knee osteoarthritis and to evaluate the role of topical capsaicin, laser therapy, acupuncture, transcutaneous electrical nerve stimulation, and pulsed electromagnetic fields. No data specifically address the role of any of these therapies in hip osteoarthritis.

 
Acupuncture-like stimulation with codetron for rehabilitation of patients with chronic pain syndrome and osteoarthritis.

Fargas-Babjak AM, Pomeranz B, Rooney PJ

Department of Anaesthesia, McMaster University, Hamilton, Ontario, Canada.

Acupuncture is one of the oldest healing methods which is used in traditional medicine. In the modern medicine, we are witnessing a renaissance of this ancient treatment applied mainly in the management of chronic pain. A number of modern technological changes are being applied to replace, or modify, the classical needle treatment. Among many modalities used today is the novel addition in Transcutaneous Electrical Nerve Stimulation (TENS) called CODETRON which delivers acupuncture-like stimulation in a random order. CODETRON was developed by a Canadian Scientist and had been evaluated in a clinical trial in a multidisciplinary pain clinic on patients who came for acupuncture therapy over a period of two years. Indications, effectiveness and experiences with this form of treatment are presented. In addition, results obtained from a six week double-blind randomized placebo controlled pilot trial of osteoarthritis of the hip/knee with CODETRON which was conducted later. The results were highly suggestive of the beneficial effect of this nonhabituating mode of therapy and confirmed our initial uncontrolled trial results.

 [Comparison of the effectiveness of acupuncture and physical therapy in ambulatory patients with gonarthrosis].

[Article in German]

Ammer K, Petschnig R

Ludwig-Boltzmann-Forschungsstelle fur physikalische Diagnostik, Wien.

A comparative study between acupuncture and physical therapy in patients with gonarthrosis is reported. Patients treated with physical therapy showed 4 parameters significantly reduced after a treatment duration of 2 weeks, and 7 out of 10 parameters after 4 weeks of therapy. Acupuncture could better 2 parameters but only after 4 weeks of treatment. Although physical therapy was superior in most of the objective measurements, the subjective judgement by the patients of the efficacy of both treatments found no significant difference. In summary acupuncture is thought to be only an additional form of treatment in gonarthrosis.

Acupuncture and rehabilitation (III) effects of acupuncture applied to the normal side on osteoarthritis deformans and rheumatoid arthritis of the knee and on disorders in motility of the knee joint after cerebral hemorrhage and thrombosis.

Arichi S, Arichi H, Toda S

In osteoarthritis deformans and rheumatoid arthritis of the knee and in disorders in motility of the knee joint after cerebral hemorrhage and thrombosis, acupuncture was applied to the normal side at the symmetrical part to the lesion and flection-extension exercise and massage on the affected joint were carried out as rehabilitation (Rehab) during the time the needles were used. A most remarkable cure rate was obtained in osteoarthritis deformans of the knee when treated with acupuncture on the normal side and flection-extension exercise and massage on the affected part. The cure rate was low in rheumatoid arthritis, and the therapy was non-effective concerning disorders in motility of the knee joint after cerebral hemorrhage or thrombosis. The improvement rate, however, was extremely low in osteoarthritis deformans and rheumatoid arthritis of the knee after the acupuncture on the affected part of the affected side with Rehab on the affected part of the affected side, or Rehab on the lesion, and these means of therapy were completely non-effective concerning disorders in motility after cerebral hemorrhage or thrombosis. Our previous reports No. 1 and 2 accord with the evidence obtained in this study that the acupuncture on the normal side and Rehab on the affected part of the affected side produced most remarkable effect in osteoarthritis deformans of the knee. The low improvement rate in rheumatoid arthritis and non-effectiveness concerning disorders in motility of the knee joint after cerebral hemorrhage or thrombosis may be explained by differences in morphology of the diseases.

 

Acupunct Med 2002 Mar;20(1):19-21

Related Articles, Links


Effect of acupuncture on knee function in advanced osteoarthritis of the knee: a prospective, non-randomised controlled study.

Tillu A, Tillu S, Vowler S.

Orthopaedics Department, Bedford Hospital. abtillu@hotmail.com

We report a prospective controlled trial, comparing acupuncture with no treatment, in patients with advanced osteoarthritis of the knee awaiting total knee replacement. Knee function was assessed at the beginning of study and at the end of two months, using four parameters: HSS score, time to walk 50 metres, time to climb 20 steps, and degree of pain. Acupuncture was given at four local points around the knee and at one distal point. The acupuncture group improved in all parameters, whereas the control group deteriorated, a finding that was highly statistically significant (p < 0.0002). Further randomised-controlled trials with longer follow-up are required to confirm these findings.

Acupuncture and Migraines

 

Non-pharmacological approaches to chronic headaches: transcutaneous electrical nerve stimulation, lasertherapy and acupuncture in transformed migraine treatment.

Allais G, De Lorenzo C, Quirico PE, Lupi G, Airola G, Mana O, Benedetto C.

Woman's Headache Center, Department of Gynecology and Obstetrics, Via Ventimiglia 3, I-10126 Turin, Italy.

In an open, randomized trial, we evaluated transcutaneous electrical nerve stimulation (TENS), infrared lasertherapy and acupuncture in the treatment of transformed migraine, over a 4-month period free of prophylactic drugs. Sixty women suffering from transformed migraine were assigned, after a one month run-in period, to three different treatments: TENS (Group T; n=20), infrared lasertherapy (Group L; n=20) or acupuncture (Group A; n=20). In each group the patients underwent ten sessions of treatment and monthly control visits. In Group T patients were treated for two weeks (5 days/week) simultaneously with three TENS units with different stimulation parameters (I: pulse rate = 80 Hz, pulse width = 120 micros; II: 120 Hz, 90 micros; III: 4 Hz, 200 micros). In Group L an infrared diode laser (27 mW, 904 nm) was applied every other day on tender scalp spots. In Group A acupuncture was carried out twice a week in the first two weeks and weekly in the next 6 weeks. A basic formula (LR3, SP6, LI4, GB20, GV20 and Ex-HN5) was always employed; additional points were selected according to each patient's symptomatology. The number of days with headache per month significantly decreased during treatment in all groups. The response in the groups differed over time, probably due to the different timing of applications of the three methods. TENS, lasertherapy and acupuncture proved to be effective in reducing the frequency of headache attacks. Acupuncture showed the best effectiveness over time.

 

 

Acupuncture and Nausea

 
Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial.

Shen J, Wenger N, Glaspy J, Hays RD, Albert PS, Choi C, Shekelle PG.

National Institutes of Health, Laboratory of Clinical Studies/NIAAA, Room 6 S-240, Mail Stop 1610, 10 Center Dr, Bldg 10, Bethesda, MD 20892-1610, USA.

CONTEXT: High-dose chemotherapy poses considerable challenges to emesis management. Although prior studies suggest that acupuncture may reduce nausea and emesis, it is unclear whether such benefit comes from the nonspecific effects of attention and clinician-patient interaction. OBJECTIVE: To compare the effectiveness of electroacupuncture vs minimal needling and mock electrical stimulation or antiemetic medications alone in controlling emesis among patients undergoing a highly emetogenic chemotherapy regimen. DESIGN: Three-arm, parallel-group, randomized controlled trial conducted from March 1996 to December 1997, with a 5-day study period and a 9-day follow-up. SETTING: Oncology center at a university medical center. PATIENTS: One hundred four women (mean age, 46 years) with high-risk breast cancer. INTERVENTIONS: Patients were randomly assigned to receive low-frequency electroacupuncture at classic antiemetic acupuncture points once daily for 5 days (n = 37); minimal needling at control points with mock electrostimulation on the same schedule (n = 33); or no adjunct needling (n = 34). All patients received concurrent triple antiemetic pharmacotherapy and high-dose chemotherapy (cyclophosphamide, cisplatin, and carmustine). MAIN OUTCOME MEASURES: Total number of emesis episodes occurring during the 5-day study period and the proportion of emesis-free days, compared among the 3 groups. RESULTS: The number of emesis episodes occurring during the 5 days was lower for patients receiving electroacupuncture compared with those receiving minimal needling or pharmacotherapy alone (median number of episodes, 5, 10, and 15, respectively; P<.001). The electroacupuncture group had fewer episodes of emesis than the minimal needling group (P<.001), whereas the minimal needling group had fewer episodes of emesis than the antiemetic pharmacotherapy alone group (P =.01). The differences among groups were not significant during the 9-day follow-up period (P =.18). CONCLUSIONS: In this study of patients with breast cancer receiving high-dose chemotherapy, adjunct electroacupuncture was more effective in controlling emesis than minimal needling or antiemetic pharmacotherapy alone, although the observed effect had limited duration. JAMA. 2000;284:2755-2761.

 

 

J Altern Complement Med 1999 Feb;5(1):27-45

Related Articles, Links



Acupuncture for gastrointestinal and hepatobiliary disorders.

Diehl DL.

Division of Digestive Diseases, UCLA School of Medicine, USA.

Acupuncture has been used for various gastrointestinal (GI) conditions. Voluminous data support the effect of acupuncture on the physiology of the GI tract, including acid secretion, motility, neurohormonal changes, and changes in sensory thresholds. Much of the neuroanatomic pathway of these effects has been identified in animal models. A large body of clinical evidence supports the effectiveness of acupuncture for suppressing nausea associated with chemotherapy, postoperative state, and pregnancy. Prospective randomized controlled trials have also shown the efficacy of acupuncture for analgesia for endoscopic procedures, including colonoscopy and upper endoscopy. Acupuncture has also been used for a variety of other conditions including postoperative ileus, achalasia, peptic ulcer disease, functional bowel diseases (including irritable bowel syndrome and nonulcer dyspepsia), diarrhea, constipation, inflammatory bowel disease, expulsion of gallstones and biliary ascariasis, and pain associated with pancreatitis. Although there are few prospective randomized clinical studies, the well-documented physiological basis of acupuncture effects on the GI tract, and the extensive history of successful clinical use of acupuncture, makes this a promising modality that warrants further investigation.

J R Soc Med 1996 Jun;89(6):303-11

Related Articles, Links


Can acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials.

Vickers AJ.

Research Council for Complementary Medicine, London, England.

The effects of acupuncture on health are generally hard to assess. Stimulation of the P6 acupuncture point is used to obtain an antiemetic effect and this provides an excellent model to study the efficacy of acupuncture. Thirty-three controlled trials have been published worldwide in which the P6 acupuncture point was stimulated for treatment of nausea and/or vomiting associated with chemotherapy, pregnancy, or surgery. P6 acupuncture was equal or inferior to control in all four trials in which it was administered under anaesthesia; in 27 of the remaining 29 trials acupuncture was statistically superior. A second analysis was restricted to 12 high-quality randomized placebo-controlled trials in which P6 acupuncture point stimulation was not administered under anaesthesia. Eleven of these trials, involving nearly 2000 patients, showed an effect of P6. The reviewed papers showed consistent results across different investigators, different groups of patients, and different forms of acupuncture point stimulation. Except when administered under anaesthesia, P6 acupuncture point stimulation seems to be an effective antiemetic technique. Researchers are faced with a choice between deciding that acupuncture does have specific effects, and changing from 'Does acupuncture work?' to a set of more practical questions; or deciding that the evidence on P6 antiemesis does not provide sufficient proof, and specifying what would constitute acceptable evidence.

J R Soc Med 1989 May;82(5):268-71

Related Articles, Links


Acupuncture prophylaxis of cancer chemotherapy-induced sickness.

Dundee JW, Ghaly RG, Fitzpatrick KT, Abram WP, Lynch GA.

Department of Anaesthetics, Queen's University of Belfast.

In a multi-facet study we evaluated the efficacy of P6 electroacupuncture (10 Hz applied for 5 min) as an antiemetic in patients receiving a variety of cancer chemotherapy drugs. The study involved 130 (15 in an open pilot study, 10 in a randomized placebo controlled crossover study and 105 in a definitive study) patients who had a history of distressing sickness after previous treatment, and who, on the basis of a previous survey, would be expected to have a 96% chance of this with subsequent therapy. Sickness was either completely absent or reduced considerably in 97% of patients and no side effects were encountered. The limited crossover study, using a 'dummy' acupuncture (ACP) point showed that the beneficial effects were limited to the P6 point. Logistic and ethical considerations excluded the possibility of carrying out a larger placebo-controlled study. While in our hands P6 ACP was an effective antiemetic in patients having cancer chemotherapy, because of the time involved and the brevity of the action (8 h) an alternative approach to electro-ACP is required before this technique is adopted clinically.

 

 

Acupuncture and Neck Pain

 

 

J Tradit Chin Med 1997 Jun;17(2):116-8

Related Articles, Books, LinkOut


Clinical observations on 278 cases of cervical spondylopathy treated with electroacupuncture and massotherapy.

Luo Z, Luo J.

Futian Hospital of Traditional Chinese Medicine, Shenzhen.

From Dec. 1990 to Dec. 1993, 278 cases of cervical spondylopathy were treated with electroacupuncture and massotherapy. The cure rate was 82.7%; but in the control group, it was only 61%, indicating that electroacupuncture may enhance the cure rate (P < 0.05). Of the 278 cases treated by three to five sessions, the pain and numbness disappeared in about 96% of the patients.

PMID: 10437179 [PubMed - indexed for MEDLINE]

 

 

Acupuncture and Olfaction

 

 

Am J Chin Med 1999;27(1):19-24

Related Articles, Links


The effect of auricular acupuncture on olfactory acuity.

Tanaka O, Mukaino Y.

Laboratory of Sports Medicine, Faculty of Physical Education, Fukuoka University, Japan.

The modulation of olfactory thresholds by auricular acupuncture at a specific auricular acupuncture point was examined. The Lung Point, supplied by the auricular branch of the vagus nerve, was employed in a controlled single blind study of a randomized population of 23 healthy volunteers. Two odorous substances, beta-Phenyl ethyl alcohol and Methyl cyclopentenolone were used to evaluate the modulation of olfactory thresholds after acupuncture. A significant decrease in the olfactory recognition threshold by acupuncture in comparison with controls (P < 0.05) for two standard odors was observed. Our findings suggest that auricular acupuncture stimulation can decrease the recognition threshold of olfactory sensitivity.

 

 

Vestn Otorinolaringol 1990 Mar-Apr;(2):40-2

Related Articles, Links


[Electroacupuncture in combination with surgical intervention in the treatment of patients with polypous rhinosinusitis]

[Article in Russian]

Mikhireva MM, Portenko GM.

In 36 patients with polypous rhinosinusitis the olfactory function, mucociliary transport, humoral and local immunity were investigated before and after treatment that combined surgical intervention and electric acupuncture. The points were selected on an individual basis using diagnostic data, i.e. measurement of electric conductivity of representative points. In most cases the combined treatment led to improvement of the olfactory function, mucociliary transport and local immunity. During two-year follow-up recurrent polyps were detected in 4 patients whose general health condition remained good. These observations indicate the electric acupuncture can be recommended for the combined therapy of polypous rhinosinusitis.

 

Acupuncture and Osteoarthritis

 

Bulow HH, Christensen BV, Wilbek H, Iuhl IU, Dreijer NC, Rasmussen HF,"Predictive value of subjective and objective evaluation before acupuncture treatment.",Am J Chin Med 1992;20(1):17-23

Abstract
To evaluate if it is possible to predict the outcome of acupuncture treatment in patients with knee osteoarthrosis, six treatments were given during a 3 week period. Follow-up time was 9-17 weeks. Seven parameters were evaluated to examine if they had any influence on the outcome of treatment: Age, duration of disease, pain, range of knee movement, analgesic consumption, knee score (an objective and subjective evaluation of the knees) and x-ray changes. Twenty-nine patients were included with a total of 42 osteoarthritic knees waiting for a total knee replacement. The median age was 69.2 years, and median duration of disease was 4.2 years. 85% of the participants reported a subjective effect, and in 88% an objective effect was found. Although there were some significant differences when you looked at the 7 parameters above, the pattern was not a consistent one. Follow up results also indicated that those with the best immediate results, not necessarily were the ones with the best long-term effect. It is not possible to predict the outcome of acupuncture treatment of osteoarthritic knees. Immediate results are not a guide-line for long-term results, which indicate that acupuncture research must include a follow-up period.


Jensen R, Gothesen O, Liseth K, Baerheim A,"Acupuncture treatment of patellofemoral pain syndrome.",J Altern Complement Med 1999 Dec;5(6):521-7

Abstract
OBJECTIVE: To evaluate the effect of acupuncture treatment in patellofemoral pain syndrome. DESIGN: A controlled trial where patients were randomly assigned either to acupuncture treatment or no treatment. Evaluation of the result was blinded. SETTING: An acupuncture/physiotherapy treatment practice in Bergen, Norway. SUBJECTS: A total of 75 patients with patellofemoral pain syndrome were included, of whom 44 were female. INTERVENTION: Individualized acupuncture treatment twice weekly for 4 weeks. MAIN OUTCOME MEASURE: Patients were followed for 1 year with the Cincinnati Knee Rating System (CKRS) scale as the main outcome measure. Other tests used were the Stairs-Hopple test, quadriceps atrophy, and evaluating level pain after activity by a visual analogue scale. RESULTS: At inclusion patients, aged 18-45 (mean 31.0) years, reported persistent pain on activity (mean 6.6 years) and at rest (mean 4.3 years). CRS scores at baseline were similar (acupuncture group 58.0 versus no treatment group 56.1). At 12 months there was a significant difference in the CRS score between the groups (acupuncture 75.2 versus no treatment 61.7, p = 0.005). When analyzing for worst case, the difference persisted (68.1 versus 54.4, p = 0.03). Results were then dichotomized as to whether the patient was cured or not at 12 months. A patient was defined as cured if he/she scored "slight" or "none" on the "pain" or "limitation to activity" subscales. The Number Necessary to Treat (NNT) to cure one patient was NNT = 3.0 for the CRS pain subscale and NNT = 3.7 for the CRS function subscale. CONCLUSION: We conclude that acupuncture may be an alternative treatment for patellofemoral pain syndrome.

 

 

 

 

 

 

 

 

 

Acupunct Med 2002 Mar;20(1):19-21

Related Articles, Links


Effect of acupuncture on knee function in advanced osteoarthritis of the knee: a prospective, non-randomised controlled study.

Tillu A, Tillu S, Vowler S.

Orthopaedics Department, Bedford Hospital. abtillu@hotmail.com

We report a prospective controlled trial, comparing acupuncture with no treatment, in patients with advanced osteoarthritis of the knee awaiting total knee replacement. Knee function was assessed at the beginning of study and at the end of two months, using four parameters: HSS score, time to walk 50 metres, time to climb 20 steps, and degree of pain. Acupuncture was given at four local points around the knee and at one distal point. The acupuncture group improved in all parameters, whereas the control group deteriorated, a finding that was highly statistically significant (p < 0.0002). Further randomised-controlled trials with longer follow-up are required to confirm these findings.

 

Acupunct Med 2001 Jun;19(1):19-26

Related Articles, Links


A comparison of acupuncture with advice and exercises on the symptomatic treatment of osteoarthritis of the hip--a randomised controlled trial.

Haslam R.

Princess Margaret Hospital Swindon. haslamroisin@hotmail.com

Acupuncture is becoming a common technique within the physiotherapy profession as a treatment modality for pain relief; however, few randomised controlled trials have been undertaken to assess the effectiveness of acupuncture, particularly in the treatment of osteoarthritis (OA) of the hip. Therefore, a randomised trial to compare the effectiveness of acupuncture with advice and exercises on the symptomatic treatment of OA of the hip was carried out. Thirty-two patients awaiting a total hip arthroplasty were randomly allocated to either the experimental group, (A), to have six sessions of acupuncture each lasting up to 25 minutes, or the control group, (B), to be given advice and exercises for their hip over a six week period. Group A consisted of three men and 13 women, and group B consisted of four men and eight women. The average age in group A was 66 years and in group B it was 68 years. Patients were assessed for pain and functional ability, using a modified version of the WOMAC questionnaire, pre-treatment, immediately post-treatment and at eight weeks post-treatment. The pre-treatment WOMAC scores in the two groups were similar (p=0.85). There was a significant improvement in group A (decrease in WOMAC score) immediately post-treatment (p=0.002) and this was maintained at the eight-week follow-up (p=0.03). There were no significant changes in group B. When the changes in WOMAC scores were compared between groups, a significantly greater improvement was found between pre-treatment and immediately post-treatment in group A, compared with group B (p=0.02). The changes between pre-treatment and the eight-week follow-up also showed a significant improvement in group A compared with group B (p=0.03). In conclusion, this trial supports the hypothesis that acupuncture is more effective than advice and exercises in the symptomatic treatment of OA of the hip.

J Tradit Chin Med 1997 Jun;17(2):116-8

Related Articles, Links


Clinical observations on 278 cases of cervical spondylopathy treated with electroacupuncture and massotherapy.

Luo Z, Luo J.

Futian Hospital of Traditional Chinese Medicine, Shenzhen.

From Dec. 1990 to Dec. 1993, 278 cases of cervical spondylopathy were treated with electroacupuncture and massotherapy. The cure rate was 82.7%; but in the control group, it was only 61%, indicating that electroacupuncture may enhance the cure rate (P < 0.05). Of the 278 cases treated by three to five sessions, the pain and numbness disappeared in about 96% of the patients.

Arthritis Rheum 2001 Apr;44(4):819-25

Related Articles, Links


Acupuncture for osteoarthritis of the knee: a systematic review.

Ezzo J, Hadhazy V, Birch S, Lao L, Kaplan G, Hochberg M, Berman B.

Project LEAD, Washington, DC, USA.

OBJECTIVE: To evaluate trials of acupuncture for osteoarthritis (OA) of the knee, to assess the methodologic quality of the trials and determine whether low-quality trials are associated with positive outcomes, to document adverse effects, to identify patient or treatment characteristics associated with positive response, and to identify areas of future research. METHODS: Eight databases and 62 conference abstract series were searched. Randomized or quasi-randomized trials of all languages were included and evaluated for methodologic quality using the Jadad scale. Outcomes were pain, function, global improvement, and imaging. Data could not be pooled; therefore, a best-evidence synthesis was performed to determine the strength of evidence by control group. The adequacy of the acupuncture procedure was assessed by 2 acupuncturists trained in treating OA and blinded to study results. RESULTS: Seven trials representing 393 patients with knee OA were identified. For pain and function, there was limited evidence that acupuncture is more effective than being on a waiting list for treatment or having treatment as usual. For pain, there was strong evidence that real acupuncture is more effective than sham acupuncture; however, for function, there was inconclusive evidence that real acupuncture is more effective than sham acupuncture. There was insufficient evidence to determine whether the efficacy of acupuncture is similar to that of other treatments. CONCLUSION: The existing evidence suggests that acupuncture may play a role in the treatment of knee OA. Future research should define an optimal acupuncture treatment, measure quality of life, and assess acupuncture combined with other modalities.

 

Acupuncture and Pancreatitis

 

J Altern Complement Med. 1999 Feb;5(1):27-45.

Related Articles, Links


Acupuncture for gastrointestinal and hepatobiliary disorders.

Diehl DL.

Division of Digestive Diseases, UCLA School of Medicine, USA.

Acupuncture has been used for various gastrointestinal (GI) conditions. Voluminous data support the effect of acupuncture on the physiology of the GI tract, including acid secretion, motility, neurohormonal changes, and changes in sensory thresholds. Much of the neuroanatomic pathway of these effects has been identified in animal models. A large body of clinical evidence supports the effectiveness of acupuncture for suppressing nausea associated with chemotherapy, postoperative state, and pregnancy. Prospective randomized controlled trials have also shown the efficacy of acupuncture for analgesia for endoscopic procedures, including colonoscopy and upper endoscopy. Acupuncture has also been used for a variety of other conditions including postoperative ileus, achalasia, peptic ulcer disease, functional bowel diseases (including irritable bowel syndrome and nonulcer dyspepsia), diarrhea, constipation, inflammatory bowel disease, expulsion of gallstones and biliary ascariasis, and pain associated with pancreatitis. Although there are few prospective randomized clinical studies, the well-documented physiological basis of acupuncture effects on the GI tract, and the extensive history of successful clinical use of acupuncture, makes this a promising modality that warrants further investigation.

Publication Types:

·         Review

·         Review, Tutorial

Lik Sprava. 2002;(1):126-9.

Related Articles, Links


[Correction of the gastric and duodenal motility by laser puncture in pancreatobiliary diseases]

[Article in Russian]

Gontar AA.

96.7 percent of patients with affections of organs of the pancreatobiliary zone displayed motor function disorders of upper portions of the alimentary canal (AC). A characteristic sign of the pathological process in pancreatobiliary organs is decreased frequency of recordable biopotentials and qualitative changes in electrogastrogrames. Changes in qualitative characteristics of the electrogastrogram are clearly related to increase in the intraduodenal pressure recordable with the aid of the "open catheter" technique. Laseropuncture is an effective supplementary method for correction of motility disorders in the upper portions of AC in those patients presenting with affections of the pancreatobiliary organs.

PMID: 11944359 [PubMed - indexed for MEDLINE]

Zhongguo Zhong Xi Yi Jie He Za Zhi. 1995 Jan;15(1):28-30.

Related Articles, Links


[Analysis of treatment in 84 cases of severe pancreatitis]

[Article in Chinese]

Qi QH, Xue CR, Wang PZ.

General Hospital, Tianjin Medical University.

84 patients who suffered from severe pancreatitis were treated in our hospital. In order to compare the efficacy of different therapy in early, middle and recent stages, the patients were divided into 3 groups. In early stage group (Jan, 1983-Dec, 1985) the treatment mainly was surgical drainage of the pancreas, the mortality was 72.7%. In middle stage group (Jan, 1986-Jan, 1989) the main treatment consisted of incision and decompression of pancreatic capsule, debridement of pancreas and inhibiting pancreatic secretion, the mortality decreased to 34.8%. In recent stage group (Jan, 1990-Jan, 1994) the therapy was Integrated Chinese Traditional and Western Medicine which comprised the method used in middle stage with TCM including acupuncture depending upon the syndrome. The mortality further lowered to 25.6%.

Publication Types:

·         Clinical Trial


PMID: 7767062 [PubMed - indexed for MEDLINE]

Am J Chin Med. 1985;13(1-4):127-31.

Related Articles, Links


Acupuncture therapy in acute abdominal Pain.

Zheng XL, Chen C, Wu XZ.

Acupuncture as a therapeutic measure for abdominal pain was early recorded in Huangdi Neijing ("Yellow Emperor's Canon of Medicine"). Fruitful experiences have been accumulated in the practice of the long historical years. Nowadays acupuncture therapy has become one of the main therapeutic methods in surgical acute abdominal pain and is widely used clinically.

ASPARTAME: WHAT YOU DON'T KNOW CAN HURT YOU

Natural Ingredients Imply "Not Harmful"

"The building blocks of protein" and "your body cannot distinguish between the amino acids in aspartame and milk" (Deskins G1) are common phrases used to describe the ingredients in aspartame. These analogies are used to convince the public that aspartame is as safe as milk, or other protein foods. According to Dr. H. J. Roberts, who was listed in "The Best Doctors in the U.S.," it is true that aspartame is composed of the same amino acids that can be found in protein foods. However, there are only two amino acids, phenylalanine and aspartic acid, that are in aspartame while protein foods contain many different amino acids. When aspartame is ingested, it floods the bloodstream with these two amino acids while protein foods, on the other hand, have other amino acids which "neutralize" and eliminate this sudden flooding (30). Like taking words out of context, taking amino acids out of their natural form might cause problems. A closer look at aspartame's ingredients and the adverse reactions reported by thousands of people reveal the dangers of this artificial sweetener.

Dr. Roberts states in his book, Aspartame Is it Safe?, that aspartame's three components are phenylalanine (50 percent), aspartic acid (40 percent), and methanol (10 percent). When aspartame is exposed to heat or prolonged storage, it breaks down into metabolites. One of these breakdown products is Diketopiperazine, a toxic metabolite that is not usually found in our diet. The effects of these different metabolites are unknown (27, 38-40).

According to an article in Consumer Reports, food and beverages containing phenylalanine, the major ingredient in aspartame, must be labeled due to the genetic disorder, phenylketonuria (PKU). The U.S. carries a warning on all aspartame products to alert people with PKU (58). People with this genetic disorder lack the enzyme needed to metabolize phenylalanine and therefore it "accumulates" in the body and can "cause severe mental retardation" (Roberts 33). According to Steven Farber, Ph.D. candidate in brain and cognitive sciences at Massachusetts Institute of Technology, there are an "estimated 10 million people who are carriers and may not know it." He states that these PKU carriers are also at risk because "they cannot degrade phenylalanine as effectively as normal individuals and may be sensitive to increased levels in their diets" (48).

Phenylketonurics and PKU carriers are not the only people that should avoid phenylalanine. Dr. Louis J. Elsas, II, Director of Medical Genetics at Emory University School of Medicine, "recommends that pregnant women avoid aspartame sweeteners" because it is unknown what quantity is considered safe (qtd. In Assc. Of Birth Defect Children 2). Dr. Roberts also suggests to avoid aspartame products during pregnancy due to increased levels of phenylalanine on the "fetal side of the placenta." Increases levels of phenylalanine may "interfere with the growth of the fetus brain" (181).

In an article published in the Association of Birth Defect Children, Karen Mills argues that aspartame may be responsible for her son's health problems. Unaware of the dangers of aspartame, she consumed four to six diet sodas a day and also took phenylalanine capsules to relieve fatigue during her pregnancy. She was in good health and did not smoke or drink during this time. Her pregnancy was considered normal and prenatal testing ruled out any genetic birth defects. Her delivery was also normal. When her son Brandon was born, he was severely retarded with serious neurological problems. All of his x-rays, genetic studies, and blood tests came back normal. Karen states, "I am suspicious that NutraSweet™ could be a contributing factor in Brandon's situation since there are no physical or genetic causes revealed for his neurological problems" (2).

Aspartic acid (aspartame) and glutamate (ingredient in monosodium glutamate) have been labeled as excitotoxins, which Dr. Russell Blaylock, author of Excitotoxins: The Taste That Kills, defines as "a group of excitatory amino acids that can cause sensitive neurons to die" (226). An article in the Orlando Sentinel Tribune states, "according to Blaylock, a single meal may contain several of these additives . . . given a high enough dose can include brain lesions." Blaylock is concerned that "hundreds of millions of infants and young children are at great risk and their parents are not even aware of it" (qtd. In Bonvie and Bonvie G1).

The last component of aspartame is methanol, better known as wood alcohol, a "deadly poison," claims Dr. Roberts. The Environmental Protection Agency recommends less than eight milligrams per day of methanol. A typical liter of an aspartame diet soda contains approximately 55 milligrams. Complications of methanol poisoning include blindness, brain swelling, pancreatitis, numbness, shooting pains, cardiac changes, and death (28, 42-45). According to Aspartame Consumer Safety Network, when ingested, methanol breaks down into formaldehyde, "known to cause cancer, accumulating slowly without detection in the body" (The Deadly Deception 2).

Eric Soto was a victim of methanol poisoning. In 1989, when Eric was diagnosed with diabetes, he started consuming aspartame products to avoid sugar. Soon after, Eric complained of numbness in his fingers. After seeing a doctor for this problem, it was suggested that he have surgery to correct a wrist nerve. Before he went in for surgery, a black spot appeared over his left eye. After being examined by an opthamologist, Eric was admitted to the hospital for possible methanol poisoning. He decided to stop using aspartame products after hearing about the dangers from a friend. The damage to Eric's eyes was permanent, but the numbness in his fingers stopped even though doctors said it could only be corrected by surgery (The Deadly Deception B4).

Eric Soto is not the only person to suffer from aspartame related health problems. Mary Stoddard, president of Aspartame Consumer Safety Network, claims that nearly 10,000 complaints have been reported to this non-profit organization. The following symptoms are listed on the Aspartame Consumer Safety Network Fact Sheet:

headaches, nausea, vertigo, insomnia, numbness, blurred vision, blindness and other eye problems, memory loss, slurred speech, depression, personality changes, hyperactivity, stomach disorders, seizures, skin lesions, rashes, anxiety attacks, muscle cramping and joint pain, loss of energy, symptoms mimicking heart attacks, hearing loss and ear ringing, and loss or change of taste. (The Deadly Deception 1)

Included in these complaints are "hundreds of pilots who have reported life threatening adverse reactions due to aspartame," according to Aspartame Consumer Safety Network, in an article from General Aviation News. Michael Collins, former pilot, suffered from seizures whenever he drank diet soda. When he stopped using aspartame products, he remained seizure-free. Unfortunately, he lost his medical certification and can no longer fly (qtd. in Hicks 2).

While seizures are common among aspartame users, headaches are the most common complaint (Roberts 95). According to Caroline B. Kline, nutrition consultant, eighteen million Americans suffer from migraines. In her magazine article, "Migraine Makers," she suggests that diet could be one of the causes of these severe headaches. Aspartame was listed as possible culprit (207).

Americans are not the only people worried about the safety of aspartame. In 1988, the Mexican government issued a detailed warning to be put on diet sodas that contain aspartame (Bouleau 66). The label on these diet sodas reads:

This product should not be consumed by individuals who are allergic to phenylalanine. Consumption by pregnant women and children under 7 is not recommended. Users should follow a balanced diet. Consumption by diabetics must be authorized by a physician, (Bouleau 66).

If a product has to have this many warnings, how can it possibly be on the market?

The FDA has the answer. Thomas Wilcox, FDA spokesman, claims that "some people don't tolerate aspartame, but the reports to the FDA aren't sufficient to warrant a change in the product's classification. . . . Unless there is shown to be some very common serious effect . . . you don't want to deprive the entire population of the product" (qtd. in Bonvie and Bonvie G1). How serious do the side effects have to be and how many people have to be affected before this product is pulled off the market? When you start to add up the Phenylketonurics, the 10 million PKU carriers, migraine sufferers, diabetics, children, and pregnant women, who are all possible victims of aspartame poisoning, it seems significant enough to ban the use of aspartame. Don't these people who are at risk or have already suffered count? Depriving people of their health seems more serious than "depriving the entire population" of a sugar substitute.

What about the people who assume aspartame is safe? Is it fair to put these people at risk? Even cigarettes and drugs have warnings on them to alert the public of possible side effects and dangers. Aspartame only has one warning for PKU. How can people make a wise choice if they aren't even warned of the dangers? The warning label would have to be a very lengthy to properly warn all people. The only solution is to stop aspartame consumption by pulling it off the market. This would prevent people from unnecessary harm, especially those who are unaware of the dangers.

Even if you are aware of the dangers and are trying to avoid aspartame, you might have to spend more time reading labels. The familiar NutraSweet™ logo might not appear on all aspartame products. The patent on aspartame held by Searle expired in December of 1992, allowing other companies besides the NutraSweet™ Company to produce aspartame (Therrien 42). (NutraSweet™ Co. and G. D. Searle are divisions of the Monsanto Company). The only clue now on some products is "aspartame" listed in the ingredients and a phenylalanine warning.

Cracked-Cell Chlorella provides chlorophyll, shown to be active in wound healing, cancer, pancreatitis, and anemia therapy. It can also help detoxify and remove cadmium, lead, and mercury from your body. 

 

Acupuncture and Psoriasis

 

Chinese Reports on the Treatment of Various Dermatological Conditions

Acupuncture treatment for psoriasis: a retrospective case report.
Acupuncture and Electro-Therapeutics Research, 1992 Jul-Sep, 17(3):195-208.
(UI: 93034519)
AT: UCLA siomed wl AC999T
(PE title: Acupuncture & electro-therapeutics research.)

Abstract: We treated 61 cases of psoriasis with acupuncture, including 25 patients with complications of joint involvement and two cases with scleroderma additionally. All of the patients had failed to respond to their prior conventional western medical management. 25 patients were males and 36 were females. Their ages ranged from 22 to 84 years, with an average of about 52 years. There was no significant difference of the average ages between the sexes. Most of them (about 61%) had quite extensive involvement of the body. The average of duration of their illness was over 16 years, ranging from two to 65 years.

They received an average of about nine sessions of acupuncture treatment, ranging from one to 15. Almost one third (19) of them had eleven to thirteen sessions.

With the acupuncture treatment, about one-half (30) of the 61 patients had complete or almost complete clearance of the skin lesions. About a quarter (14 patients) of them had a clearance of about two thirds of the skin lesions. Eight of them had a clearance of one third of the skin lesions. Nine patients had minimal or no improvement.

Our experience indicates that acupuncture is an effective therapeutic modality for psoriasis, particularly when the western medical management is unsuccessful. We speculated about the possible involvement of the cutaneous reticuloendothelial system in the clearance of the skin lesions.

Psoriasis

Liao5 described the results of acupuncture treatment of 61 patients with psoriasis. The patients were classified into the following groups before treatment: mild (small areas covering up to the area of a limb), moderate (lesions involving one or two limbs and the torso) and severe (lesions scattered over three limbs and the torso). Criteria for evaluation were: 1 -no improvement (only minimal clearance of the skin); 2-slight improvement (about one-third of the involved skin cleared); 3-moderate improvement (two-thirds of the involved skin cleared); 4-excellent improvement (complete or almost complete clearance of all the lesions). At the conclusion of this study 30 patients were cured or virtually cured, 14 patients showed significant improvement, while the remaining 17 did not respond. On average these patients received nine treatments (range 2 to 15), but the report does not describe the treatment technique in detail. The author reported that the reticuloendothelial system was involved in the mechanism of action.

Zhao et al.6 described the treatment of 600 patients suffering from psoriasis classified as psoriasis arthropathica, psoriasis erythrodermia or pustular psoriasis. The criteria for therapeutic effectiveness used were established according to the recommendations of "The National Research Group on Psoriasis, 1987". The authors employed a specific regimen involving several modalities such as cupping, electroacupuneture and body acupuncture. All patients were treated every other day and 30 treatment sessions were sufficient in most cases. Of the 600 patients, 61.7% were cured, 5.2% were virtually cured, 19.2% were markedly improved, 12.3% were improved and 1.7% were unchanged. A follow-up study of 100 of these patients recorded a 20% relapse.

Acupuncture and Pulmonary Disorders

 

1: Med Klin 1999 Apr;94(1 Spec No):106-9

Related Articles, Links


[Effect of acupuncture on quality of life, mouth occlusion pressures and lung function in COPD]

[Article in German]

Neumeister W, Kuhlemann H, Bauer T, Krause S, Schultze-Werninghaus G, Rasche K.

Abteilung fur Pneumologie, Allergologie und Schlafmedizin, Berufsgenossenschaftliche Kliniken Bergmannsheil-Universitatsklinik, Ruhr-Universitat Bochum.

BACKGROUND: There are few data concerning the effect of acupuncture in patients suffering from COPD. We conducted a prospective randomized and placebo-controlled pilot study to analyze the effect of acupuncture according to the rules of traditional chinese medicine on quality of life, pulmonary function testing and inspiratory mouth occlusion pressures (MOP). PATIENTS AND METHODS: We randomised 10 patients with stable COPD to a 2-week treatment of 7 verum acupuncture or placebo acupuncture sessions. Before and after treatment we performed pulmonary function tests as well as an interview with the chronic respiratory disease questionnaire. MOP were taken on day 1, 5 and 7 before and after punction to assess function of the respiratory pump. RESULTS: Patients receiving verum acupuncture improved significantly with FEV1 and RV/TLC. There was an improvement of large magnitude in quality of life and a trend of lower demand of the respiratory pump. In the placebo group we saw only a slight improvement of quality of life, a deterioration of lung function parameters and a trend of higher demand of the respiratory pump. CONCLUSION: Although the small number of subjects allows no further conclusions this pilot study proves feasibility of acupuncture in COPD and shows that acupuncture is worthy for further investigation in patients suffering from COPD.

1: Am J Chin Med 1989;17(3-4):129-34

Related Articles, Links


The role of acupuncture in asthma: changes in airways dynamics and LTC4 induced LAI.

Sternfeld M, Fink A, Bentwich Z, Eliraz A.

Pulmonary Unit, Kaplan Hospital, Rehovot.

A cohort of nine extrinsic asthma patients were treated by means of acupuncture. Patients were followed up for changes in medical treatment, spirometry, skin reactivity to immediate type reactions, total serum IgE levels and reactivity of their leukocytes to leukotriene C4 challenge (LTC4 induced leukocyte adherence inhibition (LAI) assay). Our results show that after acupuncture, treated patients were able to reduce bronchodilator and taper completely corticosteroid therapy. No change in skin reactivity or in IgE levels were noted. However, acupuncture treatment was able to negate, in 66.6%, the positive LTC4 induced responses.

PMID: 2633615 [PubMed - indexed for MEDLINE]

1: Lancet 1986 Dec 20-27;2(8521-22):1416-9

Related Articles, Links


Controlled trial of acupuncture for disabling breathlessness.

Jobst K, Chen JH, McPherson K, Arrowsmith J, Brown V, Efthimiou J, Fletcher HJ, Maciocia G, Mole P, Shifrin K, et al.

In a randomised controlled trial, twelve matched pairs of patients with chronic obstructive pulmonary disease received traditional Chinese acupuncture or placebo acupuncture. After three weeks' treatment the traditional-acupuncture group showed significantly greater benefit in terms of subjective scores of breathlessness and six-minute walking distance. Objective measures of lung function were unchanged in either group. Whether these differences are mediated by endogenous opiate and/or peptide release remains speculative.


: Prax Klin Pneumol 1979 Apr;33 Suppl 1:695-700

Related Articles, Links


[Acupuncture and thoraco-pulmonary function (author's transl)]

[Article in German]

Bergsmann O.

Disturbances of thoraco-pulmonary function of reflex origin can be influenced by acupuncture; it primarily affects the movements of the thorax. The most important points are enumerated. During 1958-1972 1,421 persons with bronchial asthma had acupuncture. Subjective evaluation of the results by the patients was as follows: great improvement in 45% and satisfactory improvement in 38% of the cases; 17% of the patients were not satisfied. The study continues.

PMID: 461368 [PubMed - indexed for MEDLINE]

 

1: J Tradit Chin Med 1998 Mar;18(1):27-30

Related Articles, Links

·        
Clinical observation on 25 cases of hormone dependent bronchial asthma treated by acupuncture.

Hu J.

Institute of Acupuncture and Moxibustion, China Academy of Traditional Chinese Medicine, Beijing.

The clinical observation revealed that the asthmatic symptoms in most of the patients began to be improved after several acupuncture treatments with the dosage of the drug gradually reduced. Generally, the dose of cortisone per os was decreased by 2 mg every 10 days, while that of aerosol was controlled by the patients themselves according to the condition of the disease. The symptoms in most of the patients were markedly improved after 15 treatments, but the treatment should be continued for another 10 times to consolidate the curative effect. Thus, each asthmatic patient needs to receive approximately 30 sessions of acupuncture treatment, lasting about 3 months. Thereafter, in order to prevent its relapse, the treatment should be administered 10 times each year in the summer season. It is worthy to be mentioned that, in this series, there was a female patient who suffered from anaphylactic asthma induced by dog's hair. She received 10 sessions of acupuncture treatment with no any improvement. In this case, the acupuncture treatment should not be given any longer. There were another two children patients aged 5 and 7 years respectively, for them the above method of acupuncture treatment was difficult to be used. Therefore, the auricular pressing method combined with cupping was adopted instead. The auricular points selected were Shenmen, Lung, Large Intestine, sensitive point, Pingchuan, Subcortex, and Kidney. 5 points were used each time, and pressed with the seeds of Vaccaria which were changed every 3 days. The patients were asked to press each of the points themselves 3 times a day (each time by 20 pressings). And Dazhui (Du 14), Feishu (UB 13), Pishu (UB 20) and Shenshu (UB 23) were cupped for 5 min. each time. The auricular pressing and cupping therapies may also be added for adult patients to strengthen the curative effect. The 25 cases of hormone dependent bronchial asthma were treated by acupuncture, yielding a markedly effective rate of 56% with a total effective rate of 96%, indicating that good therapeutic results can also be expected in the western countries for those cases who have already been treated with hormones.

PMID: 10437259 [PubMed - indexed for MEDLINE]

 

1: Klin Med (Mosk) 1991 May;69(5):68-71

Related Articles, Links


[Effect of laser acupuncture on the pulmonary vascular resistance in patients with obstructive chronic lung diseases]

[Article in Russian]

Zamotaev IP, Mamontova LI, Zavolovskaia LI, Rudakova OM.

Clinical pattern of the disease, systolic pressure in the pulmonary artery, external respiration, central hemodynamics were assessed in 111 patients (50 with chronic obstructive bronchitis and 61 with bronchial asthma) to study the effect of laser puncture. The treatment course consisted of 10 sessions performed with application of Uzor apparatus in pulse regimen with 890 nm wave length, 1500 Hz frequency and 2 mW mean radiation rate. The results indicate a positive response to infra-red laser acupuncture evident from improved bronchial patency, enhanced bronchial sensitivity to sympathomimetics, reduced systolic pressure in the pulmonary artery. The promise of the laser puncture is attributed to its separate broncholytic effect and the ability to lower pulmonary vascular resistance.

PMID: 1857083 [PubMed - indexed for MEDLINE]

 

1: Klin Med (Mosk) 1990 Jan;68(1):66-9

Related Articles, Links


[Effectiveness of using semiconductor laser in the complex treatment of patients with obstructive forms of chronic nonspecific lung diseases]

[Article in Russian]

Zamotaev IP, Mamontova LI, Zavolovskaia LI.

Laser puncture (LJ) using semiconductor gallium-arsenide apparatus Uzor (wave-length 890 nm) was made in 30 patients with chronic obstructive diseases of the lungs. The results were compared to the response in acupuncture. The study covered pulmonary volumes pattern, changes in bronchial permeability and partial oxygen pressure in capillary blood. A berotek pharmacological test evaluated LP effect on bronchial adrenoreceptors function. LP was found to promote the benefit of the standard treatment, to improve bronchial permeability, enhance oxygenation of arterial blood, reduce dyspnea and cough, to stimulate expectoration, normalize sleep and appetite. Lower doses or discontinuation of sympathomimetics became feasible.

 

Acupunct Electrother Res 1984;9(4):203-15

Related Articles, Links


The effect of acupuncture on the clinical state of patients suffering from chronic spastic bronchitis and undergoing long-term treatment with corticosteroids.

Sliwinski J, Matusiewicz R.

51 patients suffering from chronic spastic bronchitis were treated with acupuncture over a period of three years. The patient group consisted of 15 men and 36 women varying in age from 19 to 75 years, with an average age of 45.7 years. The therapy program consisted of 2 or 3 months of acupuncture treatment in alternation with an equal period (2 or 3 months) of recess during which no treatment was administered. Before acupuncture, patients had taken corticosteroids either orally and/or intramuscularly for a period of 2 to 24 years. For those taking corticosteroids orally the daily dosages ranged from 10 to 40 mg Encorton (Polfa, Poland). The patients took intramuscular injections of 60 to 80 mg Kenalog (Squibb) every two or three weeks. Of the 51 patients, 36 completed 3 years of acupuncture treatment. It was found that 63.8% of the patients were able to eliminate corticosteroids for the last part of this study period, i.e., from 3 to 26 months (average period 10.2 months). In 13.9% of the patients the dose of intramuscular injection of corticosteroids was reduced by over 60% during acupuncture treatment. In 16.7% of the patients, the oral administration of corticosteroids was only during lung infections with dyspnoea. In 7 patients (i.e., in 19.5% of the 36 patients) administration of all previously required drugs (i.e., corticosteroids, mucolytic drugs, appropriate antibiotics, aminoxanthines, sympathomimetic beta-agonists, sedation drugs, aerosolized drugs with corticosteroids, and nebulized drugs) during the last 3 to 15 months of this study period (average of 9.8 months) were no longer required.


1: Klin Med (Mosk) 2001;79(3):38-40

Related Articles, Links


[Acupuncture correction of autonomic nervous system disorders in patients with bronchial asthma]

[Article in Russian]

Rakhov DA, Rebrov AP.

Acupuncture was added to medicines in the treatment of 192 patients suffering from bronchial asthma with autonomic dysfunction. The effect was assessed by changes in rhythmogram, external respiration function, psychological status. It was found that corporal acupuncture not only improves bronchial permeability but also reduces psychovegetative disorders. The effect of acupuncture was not related to that of placebo.

PMID: 11490414 [PubMed - indexed for MEDLINE]

 

1: Gig Tr Prof Zabol 1991;(4):23-4

Related Articles, Links


[The use of laser therapy in dust-induced bronchitis]

[Article in Russian]

Koval'chuk AA, Demidova NG.

Low-intensive laser was used in the treatment of dust bronchitis with bronchospastic syndrome. As a result, bronchospasms were relieved, the external respiration function improved and corticosteroid preparation dosages were lowered. Stimulation of the immune system was performed through the T-cellular immunity.

PMID: 1879750 [PubMed - indexed for MEDLINE]

 

Clin Sci Mol Med 1976 Nov;51(5):503-9

Related Articles, Links

·        
Effect of acupuncture on bronchial asthma.

Yu DY, Lee SP.

1. Needle acupuncture was performed at three sites in twenty patients in a clinical attack of bronchial asthma. 2. In all patients the symptoms of bronchoconstriction improved during the attacks when the correct site was stimulated, and in five patients wheezing was abolished. 3. Stimulation at the correct site produced a significant increase in the mean FEV1-0 (58%) and FVC (29%) but not in maximal mid-expiratory flow rate (MMFR; 76%), when compared with the findings before acupuncture, along with a significant fall in the Pa,CO2 and an insignificant fall in Pa,O2. A mild tachycardia was also observed. 4. After acupuncture a greater improvement in FEV1-0, FVC and MMFR was produced by inhalation of isoprenaline. 5. No significant changes in FEV1-0, FVC, MMFR, pulse rate or arterial blood gas tensions occurred after acupuncture at control sites. 6. In four of the patients during clinical remission acupuncture was performed before and after histamine aerosol challenge, but there was no effect on either the severity or the duration of the histamine-induced bronchoconstriction. 7. It is concluded that acupunture probably reduced the reflex component of the bronchoconstriction, but failed to influence direct smooth muscle constriction caused by histamine.
PMID: 991548 [PubMed - indexed for MEDLINE]

 

J Immunol 2003 Apr 15;170(8):4335-41

Related Articles, Links

 
Neutrophil restraint by green tea: inhibition of inflammation, associated angiogenesis, and pulmonary fibrosis.

Dona M, Dell'Aica I, Calabrese F, Benelli R, Morini M, Albini A, Garbisa S.

Departments of. Experimental Biomedical Sciences and Pathology, Medical School of Padova, Padova, Italy. Molecular Biology Laboratory, National Institute for Research on Cancer, Genova, Italy.

Neutrophils play an essential role in host defense and inflammation, but the latter may trigger and sustain the pathogenesis of a range of acute and chronic diseases. Green tea has been claimed to exert anti-inflammatory properties through unknown molecular mechanisms. We have previously shown that the most abundant catechin of green tea, (-)epigallocatechin-3-gallate (EGCG), strongly inhibits neutrophil elastase. Here we show that 1) micromolar EGCG represses reactive oxygen species activity and inhibits apoptosis of activated neutrophils, and 2) dramatically inhibits chemokine-induced neutrophil chemotaxis in vitro; 3) both oral EGCG and green tea extract block neutrophil-mediated angiogenesis in vivo in an inflammatory angiogenesis model, and 4) oral administration of green tea extract enhances resolution in a pulmonary inflammation model, significantly reducing consequent fibrosis. These results provide molecular and cellular insights into the claimed beneficial properties of green tea and indicate that EGCG is a potent anti-inflammatory compound with therapeutic potential.

 

Acupuncture and Rhinitis

 

Zhongguo Zhong Xi Yi Jie He Za Zhi 1997 Oct;17(10):587-9

Related Articles, Books, LinkOut


[An analysis of combined desensitizing acupoints therapy in 419 cases of allergic rhinitis accompanying asthma]

[Article in Chinese]

Zhou RL, Zhang JC.

Department of Epidemiology, Suzhou Medical College, Jiangsu.

OBJECTIVE: To explore the effective therapy in treating allergic rhinitis accompanying asthma. METHODS: A combined desensitizing therapy in treating 419 cases of allergic rhinitis accompanying asthma caused by allergens has been carried out using acupoint of the head and the upper back with the extract of positive allergen(s). RESULTS: After three treatment courses, the extract of allergens was taken again to make intradermal injection. Diameter of redness and swelling on the skin was significantly reduced in comparison with that before the treatment (P < 0.01). Lymphocyte transformation difference of 3H-TdR incorporation rate between a combined desensitizing acupoints group and A or B control groups was significant (P < 0.01). Difference of acidophil cell direct count, IgA, IgG, E-rosette formative rate of this group in comparison with A or B control groups was significant (P < 0.05). Four hundred and nineteen cases were followed up for 3 years, 68.73% of the patients were markedly curative effect; 29.12% turned better. Comparison of the difference of this group with the other two control groups was significant (P < 0.01). CONCLUSIONS: This article showed that the method is promising and worthwhile for popularizing in treatment of allergic rhinitis accompanying allergic asthma.

 

Observation on the curative effect of acupuncture on type I allergic diseases.

Lai X.

Guangzhou College of Traditional Chinese Medicine.

In a comparative study on treatment of type I allergic diseases, acupuncture and desensitization therapies were performed in 143 cases. The results showed that acupuncture therapy had an extensive and remarkable action against type I allergic reaction. The curative effect was higher in the acupuncture group than in the desensitization group in allergic asthma, allergic rhinitis and chronic urticaria.

 

PMID: 8139270 [PubMed - indexed for MEDLINE] [Desensitive treatment with positive allergens in acupoints of the head for allergic rhinitis and its mechanism]

[Article in Chinese]

Zhou RL, Zhang JC.

Department of Epidemiology, Suzhou Medical College.

Desensitive treatment of 102 cases of allergic rhinitis caused by allergens has been carried out using acupuncture endermic points of the head with the extract of positive allergen (or allergens). After two courses of the treatment, the extract of allergens was taken again to make intradermal injection. Diameter of redness and swelling on the skin was significantly reduced in comparison with that before the treatment (P less than 0.01). Cell mediated and humoral immunity of the patients tended to be normal. These cases were followed up for 2 years. 72.18% of the cases had significantly curative effect; 23.56% turned better. Comparison of curative difference of this group with the other two control groups was significant (P less than 0.01). Therefore, this method is of considerable clinical value and worth popularizing in treatment of allergic rhinitis.

 

Zhonghua Er Bi Yan Hou Ke Za Zhi 1989;24(2):90-1, 127

Related Articles, Books

[Influence of acupuncture on human nasal mucociliary transport]

[Article in Chinese]

Xu J.

The effect of acupuncture on human nasal mucociliary transport was studied by using both 99mTc tagged-particle method (detected by SPECT) and the saccharin method. Results showed that acupuncture on the Yingxiang and Hegu could increase the velocity of the mucociliary transport in chronic rhinitis patients, but not in normal persons.

 

(ISN’T THAT INCREDIBLE?  IT SHOWS THAT ACUPUNCURE HAS INDEED A BALANCING EFFECT, SINCE THERE’S NO CHANGE ON A PERSON WITHOUT SINUS PROBLEMS!)

 

Effect of acupuncture on allergic rhinitis: clinical and laboratory evaluations.

Lau BH, Wong DS, Slater JM.

Of 22 subjects with allergic rhinitis who received a series of 6 acupuncture treatments, 11 (50%) were virtually symptom-free by the end of the series, 8 (36%) experienced a moderate reduction in symptoms, and 3 (14%) received no significant relief. Clinical assessment of symptoms was made on a 6-point scale before the first treatment and before each subsequent session. Laboratory tests included absolute blood eosinophils, percentage of nasal eosinophils, and radioimmunoassay of serum IgE, performed before the first treatment, at the end of the series, and 2 months later. A significant decrease in subjective clinical rating of symptoms correlated with a concurrent drop in absolute numbers of blood eosinophils and percentage of nasal eosinophils. IgE levels decreased in 64% of the subjects by completion of treatment and in 76% at 2-month follow-up.

 

Acupuncture and Shin Splints

 

 

Med Sci Sports Exerc 2002 Jan;34(1):32-40

Related Articles, Links

 
The prevention of shin splints in sports: a systematic review of literature.

Thacker SB, Gilchrist J, Stroup DF, Kimsey CD.

National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. sbt1@cdc.gov

PURPOSE: To review the published and unpublished evidence regarding risk factors associated with shin splints, assess the effectiveness of prevention strategies, and offer evidence-based recommendations to coaches, athletes, and researchers. METHODS: We searched electronic data bases without language restriction, identified citations from reference sections of research papers retrieved, contacted experts in the field, and searched the Cochrane Collaboration. Of the 199 citations identified, we emphasized results of the four reports that compared methods to prevent shin splints. We assessed the methodologic quality of these reports by using a standardized instrument. RESULTS: The use of shock-absorbent insoles, foam heel pads, heel cord stretching, alternative footwear, as well as graduated running programs among military recruits have undergone assessment in controlled trials. There is no strong support for any of these interventions, and each of the four controlled trials is limited methodologically. Median quality scores in these four studies ranged from 29 to 47, and serious flaws in study design, control of bias, and statistical methods were identified. CONCLUSION: Our review yielded little objective evidence to support widespread use of any existing interventions to prevent shin splints. The most encouraging evidence for effective prevention of shin splints involves the use of shock-absorbing insoles. However, serious flaws in study design and implementation constrain the work in this field thus far. A rigorously implemented research program is critically needed to address this common sports medicine problem.

 

Acupuncture and Tennis Elbow


Study Suggests Treatment Is Effective, Even in Difficult Cases

By Michael Devitt, Managing Editor

One of the most frequent injuries suffered by professional athletes and weekend warriors alike is epicondylitis, an inflammation of the muscles and tendons of the forearm. More commonly known as tennis elbow, it is caused by repeated twisting of the wrist or frequent rotation of the forearm, and can lead to a weakened grip, elbow pain, and damage to the tendons that connect to the humerus, the bone of the upper arm.

Traditional treatment of tennis elbow consists of therapies such as braces, medications, heat, physical therapy and rest, the majority of which are effective in relieving pain but do very little to prevent the condition from recurring. Research from a pilot study presented at the annual meeting of the American Academy of Physical Medicine and Rehabilitation in San Francisco1 suggests that acupuncture not only relieves the symptoms of tennis elbow, it appears to resolve the condition completely.

In the study, Dr. Peter Dorsher, a medical doctor certified in acupuncture, performed acupuncture on 22 patients with varying degrees of tennis elbow. Dorsher used "rounded" acupuncture needles, which are designed to pierce the skin and enter the muscle with as little damage as possible. All of the patients were treated with French energetic meridian therapy, with needles inserted at local points on the elbow in tight myofascial bands.

Each patient was treated between 2-10 times. After an average of 3.9 treatments, a "maximal response" was achieved, with every patient reporting a disappearance of their symptoms. This response also appeared to last much longer than that usually seen in patients using painkillers, braces or other traditional methods. At a mean followup time of 8.5 months after receiving acupuncture, 17 patients (77.3%) experienced a resolution of their symptoms and had returned to full, normal activities; another two patients had returned to normal activities except those that involved heavy lifting in the affected arm.

Perhaps the most interesting aspect of Dorsher's study is that many patients had endured months of pain before turning to acupuncture. Subjects in the study group suffered symptoms an average of eight months; six patients had experienced symptoms for more than two years.

Furthermore, nearly every patient who participated had previously attempted to cure their tennis elbow through conventional means, with some patients trying multiple therapies without success before trying acupuncture. Of the 22 subjects in the study, 14 had undergone "extensive hand therapy interventions"; 17 had used an elbow brace or splint; seven received corticosteroid injections for pain relief; and one patient had elbow surgery, all without achieving the desired effect, before turning to acupuncture.

In an interview with Reuters Health, Dorsher said that it was unclear why acupuncture seemed to help patients in the early and latter stages of tennis elbow but added that the needles appeared to immediately loosen the tight muscles around the elbow joint. Acupuncture was found to be so helpful, he noted, that he now performs it as a primary form of treatment.

"This is an extremely powerful tool for pain," he said.2

Based on the pilot study's encouraging results, Dorsher plans to conduct a larger, prospective controlled study in the near future, with some patients receiving acupuncture and some receiving an inactive placebo.

References

1. Dorsher PT. Treatment of chronic lateral epicondylitis with acupuncture: a pilot study. Presented at the annual meeting of the American Academy of Physical Medicine and Rehabilitation, San Francisco, CA, November 4, 2000.
2. Norton A. Acupuncture serves up cure for tennis elbow. Reuters Health, November 6, 2000.

Editor's note: If you would like to comment on this article, please contact Acupuncture Today by fax (714-536-1482) or e-mail (Editorial@AcupunctureToday.com). You are also encouraged to discuss this article on Acupuncture Today's online discussion forum at www.AcupunctureToday.com/forums.

 

Acupuncture's Analgesic Effect on Tennis Elbow Pain

by Molsberger A; Hille E.

 


Homepage | Research Index | Musculoskeletal | Nervous System

The analgesic effect of acupuncture in chronic tennis elbow pain.


British Journal of Rheurnatology, 1994 Dec, 33(12):1162-5.
(UI: 95093857)
Pub type: Clinical Trial; Journal Article; Randomized Controlled Trial.

Abstract: The immediate analgesic effect of a single non-segmental acupuncture stimulation treatment on chronic tennis elbow pain was studied with placebo-controlled single-blind trial completed by 48 patients. Before and after treatment, all patients were examined physically by an unbiased independent examiner. Eleven-point box scales were used [13] for pain measurement. Patients in the verum group were treated at non-segmental distal points (homolateral leg) for elbow pain following Chinese acupuncture rules, whereas patients in the placebo group were treated with placebo acupuncture avoiding penetration of the skin with an acupuncture needle.

Overall reduction in the pain score was 55.8% (S = 2.95) in the verum group and 15% (S = 2.77) in the placebo group. After one treatment 19 out of 24 patients in the verum group (79.2%) reported pain relief of at least 50% (placebo group: six patients out of 24). The average duration of analgesia after one treatment was 20.2 h in the verum group (S = 21.54) and 1.4 h (S = 3.50) in the placebo group. The results are statistically significant (P < 0.01); they show that non-segmental verum acupuncture has an intrisic analgesic effect in the clinical treatment of tennis elbow pain which exceeds that of placebo acupuncture.

 

Acupuncture Helps Tennis Elbow

Researchers evaluated the effectiveness of acupuncture in the treatment of tennis elbow (chronic lateral epicondylitis).

Twenty three patients were treated with real acupuncture and 22 were treated with phony acupuncture treatments. They all received 10 treatments, with two treatments per week. All patients were evaluated for elbow strength, pain intensity and disability 1 week before treatments began and at follow-up 2 weeks and also 2 months after the end of the experiment.

Two weeks after treatment ended there were significant improvements in the real acupuncture group as compared to the phony acupuncture group. Elbow strength, pain, and disability were all improved. At the 2 month follow up elbow functioning was still improved in the real acupuncture group. However, there were no differences in pain intensity between the two groups.

Source: Rheumatology (Oxford) 2002 Feb;41(2):205-9

Acupunct Electrother Res 2002;27(2):107-17

Related Articles, Links


Comparison of the effectiveness between manual acupuncture and electro-acupuncture on patients with tennis elbow.

Tsui P, Leung MC.

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, China.

This is a single-blinded randomized controlled trial to compare the relative effectiveness between manual acupuncture (MA) and electro-acupuncture (EA) on the patients with chronic tennis elbow. Twenty patients recruited in the study were first introduced into control group for 2 weeks waiting period. Then, they were randomly assigned into either MA or EA group for acupuncture treatment. The acupuncture points of GB34 and ST38 were used in both treatment groups. In the MA group, the needle was retained for 20 minutes after the Deqi sensation obtained. In the EA group, electrical stimulation with 4 pulses/second frequency was applied and treatment lasted for 20 minutes. After 6 treatments within 2 weeks duration, significant differences were observed between groups favoring the electro-acupuncture in relation to pain relief (Pain visual analogue scale) and pain free hand grip strength (PFG). This study showed that electro-acupuncture is superior to manual acupuncture in treating patients with tennis elbow.

Rheumatology (Oxford) 2002 Feb;41(2):205-9

Related Articles, Links


Acupuncture in chronic epicondylitis: a randomized controlled trial.

Fink M, Wolkenstein E, Karst M, Gehrke A.

Department of Physical Medicine and Rehabilitation, Hannover Medical School, Hannover, Germany.

OBJECTIVE: To evaluate the clinical efficacy of acupuncture in the treatment of chronic lateral epicondylitis. METHODS: In a randomized, investigator- and patient-blinded, controlled clinical study, 23 patients were treated with real acupuncture and 22 patients received sham acupuncture. Patients each received 10 treatments, with two treatments per week. The primary outcome variables were maximal strength, pain intensity (verbal rating scale) and disability scale (Disabilities of the Arm, Shoulder and Hand questionnaire). Patients were examined at baseline (1 week before the start of treatment) and at follow-up 2 weeks and 2 months after the end of treatment. RESULTS: There was no significant difference between the groups at baseline for any outcome parameter. Two weeks and 2 months after the end of treatment, there were significant reductions in pain intensity and improvements in the function of the arm and in maximal strength in both treatment groups. At the 2-week follow-up these differences were significantly greater for all outcome parameters in the group treated with real acupuncture. At 2 months the function of the arm was still better in this group than in the sham acupuncture group; however, the differences in pain intensity and maximal strength between the groups were no longer significant. CONCLUSION: In the treatment of chronic epicondylopathia lateralis humeri, acupuncture in which real acupuncture points were selected and stimulated was superior to non-specific acupuncture with respect to reduction in pain and improvement in the functioning of the arm. These changes are particularly marked at early follow-up.

Cochrane Database Syst Rev 2002;(1):CD003527

Related Articles, Links


Acupuncture for lateral elbow pain.

Green S, Buchbinder R, Barnsley L, Hall S, White M, Smidt N, Assendelft W.

Australasian Cochrane Centre, Monash University, Australasian Cochrane Centre, Locked Bag 29, Clayton, Victoria, Australia, 3168. sally.green@med.monash.edu.au

BACKGROUND: This review is one in a series of reviews of interventions for lateral elbow pain. Lateral elbow pain, or tennis elbow, is a common condition causing pain in the elbow and forearm and lack of strength and function of the elbow and wrist. Acupuncture has long been used to treat lateral elbow pain in China and in Western countries practitioners and consumers are increasingly exploring acupuncture as a first line treatment for musculoskeletal disorders. No previous systematic review of the available evidence has been conducted to determine whether acupuncture is efficacious in the treatment lateral elbow pain. OBJECTIVES: To determine the effectiveness of acupuncture in the treatment of adults with lateral elbow pain with respect to pain reduction, improvement in function, grip strength and adverse effects. SEARCH STRATEGY: We searched MEDLINE, CINAHL, EMBASE and SCISEARCH and the Cochrane Clinical Trials Register and the Musculoskeletal Review Group's specialist trial database from 1966 to June 2001. Identified keywords and authors were searched in an effort to retrieve as many trials as possible. SELECTION CRITERIA: Two independent reviewers assessed all identified trials against pre-determined inclusion criteria. Randomised and pseudo randomised trials in all languages were included in the review provided they were testing acupuncture compared to placebo or another intervention in adults with lateral elbow pain (tennis elbow). Outcomes of interest were pain, function, disability, quality of life, strength, participant satisfaction with treatment and adverse effect. DATA COLLECTION AND ANALYSIS: For continuous variables means and standard deviations were extracted or imputed to allow the analysis of weighted mean difference, while for binary data numbers of events and total population were analysed and interpreted as relative risks. Trial results were combined only in the absence of clinical and statistical heterogeneity. MAIN RESULTS: Four small randomized controlled trials were included but due to flaws in study designs (particularly small populations, uncertain allocation concealment and substantial loss to follow up) and clinical differences between trials, data from trials could not be combined in a meta-analysis. One randomised controlled trial found that needle acupuncture results in relief of pain for significantly longer than placebo (WMD = 18.8 hours, 95%CI 10.1 to 27.5) and is more likely to result in a 50% or greater reduction in pain after 1 treatment (RR 0.33, 95%CI 0.16 to 0.69) (Molsberger 1994). A second randomized controlled trial demonstrated needle acupuncture to be more likely to result in overall participant reported improvement than placebo in the short term (RR = 0.09 95% CI 0.01 to 0.64) (Haker 1990a). No significant differences were found in the longer term (after 3 or 12 months). A randomized controlled trial of laser acupuncture versus placebo demonstrated no differences between laser acupuncture and placebo with respect to overall benefit (Haker 1990b). A fourth included trial published in Chinese demonstrated no difference between Vitamin B12 injection plus acupuncture, and Vitamin B12 injection alone (Wang 1997). REVIEWER'S CONCLUSIONS: There is insufficient evidence to either support or refute the use of acupuncture (either needle or laser) in the treatment of lateral elbow pain. This review has demonstrated needle acupuncture to be of short term benefit with respect to pain, but this finding is based on the results of 2 small trials, the results of which were not able to be combined in meta-analysis. No benefit lasting more than 24 hours following treatment has been demonstrated. No trial assessed or commented on potential adverse effect. Further trials, utilising appropriate methods and adequate sample sizes, are needed before conclusions can be drawn regarding the effect of acupuncture on tennis elbow.

Zhongguo Zhong Xi Yi Jie He Za Zhi 1994 Oct;14(10):579-82

Related Articles, Links


[Clinical and experimental studies on analgesic effects of ipsilateral and contralateral stimulations with electro-acupuncture]

Fang JQ, Liu YL, Mo XM.

Zhejiang College, TCM, Hangzhou.

Through the treatment of 65 cases of painful diseases with electroacupuncture, in comparing with the analgesic effect of contralateral stimulation (CS) and ipsilateral stimulation (IS), it was verified that IS and CS had the similar effect on pain-relieving, while CS was better in improving motor impairment. By testing the rat's pain threshold and recording the neuronal activity in the D-PAG, it was found that neither IS nor CS could increase the pain threshold in the unilateral D-PAG lesioned rats, and the excited neuronal discharge was recorded in the unilateral D-PAG by stimulating rat's Zusanli (ST 36) at each side. It indicates that IS and CS might share the same high level afferent pathway in acupuncture analgesia in CNS.

 
Acupuncture and Trigeminal Neuralgia

 

 

 

1: Anesth Pain Control Dent 1992 Spring;1(2):103-8

Related Articles, Books, LinkOut


Practical application of meridian acupuncture treatment for trigeminal neuralgia.

Beppu S, Sato Y, Amemiya Y, Tode I.

Tsurumi University School of Dental Medicine.

This report evaluates the effect of meridian acupuncture treatment on trigeminal neuralgia. Ten patients aged 26 to 67 years (mean 55.4 years) who visited the outpatient Dental Anesthesiology Clinic at Tsurumi University Dental Hospital from 1985 to 1990 were studied. Five of the patients suffered from idiopathic and five from symptomatic trigeminal neuralgia. The patients underwent meridian treatment by acupuncture alone or acupuncture combined with moxibustion. The acupuncture method used was primarily basic treatment employing only needles without electrical stimulation. Meridian acupuncture treatments were repeated from two to four times a month. Five patients were restored to a pain-free state. The other five patients noted a decrease in pain, but with some level of pain remaining (significant pain in one patient). It is concluded that meridian acupuncture treatment is useful and can be one therapeutic approach in the management of trigeminal neuralgia.

 

Acupuncture and Vertigo

 

Am J Chin Med 1983;11(1-4):102-5

Related Articles, HelpLinks


The treatment of Meniere's disease by acupuncture.

Steinberger A, Pansini M.

34 patients suffering from Meniere's disease were treated by acupuncture. Prior to acupuncture most of them had been treated with various other medical means without satisfactory results. After acupuncture treatment their condition greatly improved. The classic symptoms of Meniere's disease are vertigo, tinnitus and deafness, but for all the treated patients vertigo was the most uncomfortable and distressing symptom. In all our cases vertigo stopped after a few acupuncture courses; but in our opinion it is more important to follow and control hearing threshold, since if it remains stable the other symptoms of Meniere's disease also do not persist. All our patients were regularly followed by careful audiometric studies several years after acupuncture treatment. In most cases hearing level had not greatly varied, so the other symptoms of Meniere's disease were not present in any large degree.

PMID: 6660197 [PubMed - indexed for MEDLINE]

 

7010 Little River Turnpike, Suite 430, Annandale, VA 22003, (703) 354-2225 Tue-Sat

This site was constructed by and is Copyright of QIMED ©2004. No part or contents of the QIMED domain may be copied or used without the express written permission from QIMED.