 |
 |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
 |
Home |
About the Acupuncturist |
What is Acupuncture? |
Research |
Links |
Contact » Publications «
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
RESEARCH – Click on Condition to go to research abstract. |
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
AnxietyBack PainBells PalsyBreast CancerCancerCarpal Tunnel SyndromeChondromalaciaDental PainDiabetesEdemaEye DisordersFibromyalgiaGastrointestinal ProblemsHeart DiseaseHIVHuman Performance EnhancementHypertensionInfertility/IVFInsomniaItching/PruritisKnee PainMigraines
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Fortschr Neurol Psychiatr 2000
Mar;68(3):137-44 |
[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 |
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.
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 |
[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 |
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 |
·
[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 |
[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 |
·
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 |
·
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 |
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 |
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 |
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
|
||||||||||||||||||||||||
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. |
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. |
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. |
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. |
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. |
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. |
[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. |
[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. |
[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. |
[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. |
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.
Acupuncture and Carpal Tunnel Syndrome
|
Arch Phys Med Rehabil. 2002
Jul;83(7):978-88. |
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 |
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 |
·
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 |
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 |
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 |
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 |
[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 |
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 |
[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 |
[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 |
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 |
Changes of plasma
insulin level in diabetics treated with acupuncture.
Chen JF, Wei J.
|
Gen Pharmacol
1983;14(6):635-41 |
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 |
[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 |
[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):
|
|
|
|
||||||||||||||||||||||
|
|
|
|
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 |
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 |
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 |
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 |
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 |
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.
|
|
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 |
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 |
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. |
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 |
[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 |
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 |
[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 |
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 |
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 |
[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 |
[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 |
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 |
[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 |
[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 |
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 |
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 |
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 |
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 |
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. |
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. |
[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. |
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. |
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 |
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 |
[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 |
[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 |
[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 |
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 |
[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 |
·
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 |
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 |
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 |
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.
Acupuncture and Itching
|
Acupunct Med. 2002 Dec;20(4):186-90. |
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. |
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. |
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. |
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. |
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 |
·
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 |
·
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
[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 |
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 |
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 |
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 |
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. |
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. |
[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. |
[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. |
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 |
[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 |
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 |
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 |
[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 |
·
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 |
[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 |
[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 |
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 |
[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 |
[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 |
·
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 |
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 |
[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 |
[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 |
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 |
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 |
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 |
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 |
[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 |
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 |
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.
