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July 2018

Acupuncture Benefits Stroke Patients Finding

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Acupuncture Benefits Stroke Patients Finding

 

Acupuncture benefits patients suffering from hemiplegia (unilateral paralysis) after a stroke. Traditional Chinese Medicine Hospital of Baoji researchers compared daily exercise monotherapy with acupuncture plus daily exercises. Patient outcomes were consistently superior in the combined therapy group, demonstrating that the addition of acupuncture to the daily exercise treatment regimen improves clinical outcomes. The researchers conclude that acupuncture plus rehabilitation exercises improves motor function and cerebral blood flow, making it an effective intervention for post-stroke hemiplegia. [1]

Objective and subjective data were the basis for the conclusions. Blood flow changes in the brain were measured with a transcranial Doppler device, a specialized ultrasound unit utilized for measuring blood flow velocity through cerebral blood vessels. This was used to monitor the movement of blood in the anterior, middle, and posterior cerebral arteries. Both groups showed marked improvements in blood flow following treatment, but improvements in the combined therapy group were significantly greater (p<0.05). The measurements demonstrate that the addition of acupuncture to the treatment protocol enhances recuperation within the human brain.

Subjective clinical observations for both groups were made using the Neurological Deficit Scale and the Fugl-Meyer Assessment. The Neurological Deficit Scale (NDS) is designed to measure neurological function following a stroke. The Fugl-Meyer Assessment (FMA) is a scale specifically designed to measure post-stroke impairment based on categories including motor function, balance, sensation, and joint function. The results were divided into four categories:

  • Cured (>90% improvement)
  • Marked progress (46–90% improvement)
  • Progress (18–45% improvement)
  • No progress (<18% improvement)

Both groups showed improvements following treatment, but improvements in the combined therapy group were significantly greater (p<0.05). In the combined therapy group, 65.71% of patients fell within the cured category, compared with just 42.86% in the control group.

 

Design
A total of 70 patients with hemiplegia were recruited and a definitive diagnosis of cerebrovascular accident (stroke) was confirmed by means of CT and MRI scans. Patients were randomly assigned to two groups. Both groups received standard physical rehabilitation exercises and one group received acupuncture. Acupuncture was performed on the side of the body affected by hemiplegia. Points on the upper limb included LI11 (Quchi), LI4 (Hegu), LI10 (Shousanli), and SI3 (Houxi). Points on the lower limb included ST36 (Zusanli), GB30 (Huantiao), SP6 (Sanyinjiao), and LV3 (Taichong). Filiform needles 40–75mm in length were used to needle the points and were manually manipulated to obtain deqi. The needles were retained for 20 minutes per acupuncture session. Treatment was administered once daily, with 10 treatments comprising one course. A total of 10 courses of treatment were administered consecutively.

Rehabilitation therapeutic exercises mainly consisted of daily exercises to strengthen the muscles of the trunk and limbs. These included passive or assisted stretches and exercises for patients that were confined to their beds or had limited mobility. Ambulatory patients were also encouraged to walk and climb stairs, aided by a walking stick if necessary. Exercises were administered for 30 minutes daily, with 10 days comprising one course. A total of 10 courses of exercises were administered consecutively.

Limitations of the study include a relatively small sample size and the lack of an acupuncture monotherapy arm. A strength of the study design is the use of both subjective and objective instruments to measure outcomes. Based on the data, acupuncture benefits patients with post-stroke hemiplegia and is a reasonable treatment option.

 

Chengdu University of Traditional Chinese Medicine
The aforementioned research is not isolated. Chengdu University of Traditional Chinese Medicine researchers conclude that acupuncture benefits brain activity in areas responsible for motor function, sensory perception, and emotions after an acute ischemic stroke. [2] Patients underwent fMRI scans before and after treatment to assess brain activity.

Brain activity was measured using regional homogeneity (ReHo) to show changes in activity in different areas of the brain. ReHo is a multimodal neuroimaging marker of the human connectome (a map of brain neural connections detailing neural interactions). The connectome is often described as the wiring map of the brain. The ReHo approach to functional magnetic resonance imaging (fMRI) methods used in this study measures brain connectomics, measuring the brain’s intrinsic dynamics. [3]

Two groups were compared using fMRIs. Group 1 received drug therapy. Group 2 received drug therapy plus acupuncture. Patients in the drug monotherapy group showed increased activity in the frontal lobe and parietal lobes. Patients in the acupuncture group showed increased activity in the frontal lobe, parietal lobe, middle temporal gyrus, cerebellum, and insula, which are areas responsible for motor function, sensory perception, and emotions.

Subjective instruments measured improved outcomes for patients receiving acupuncture. Results were based on three parameters: NDS, FMA, and the Modified Barthel index (MBI), a scale used to assess quality of daily life in stroke survivors. Both groups showed statistically significant (p<0.05) improvements in NDS, FMA, and MBI. However, improvement was greater in the acupuncture group in all three areas.

A total of 21 patients were selected and randomly assigned to receive either acupuncture plus conventional drug treatment (n=11) or conventional drug treatment alone (n=10). The two groups were demographically similar in terms of gender, sex, weight, and height. They also had similar disease characteristics including duration and severity of symptoms.

In the combined acupuncture and conventional medication group, treatments utilized the points GV20 (Baihui), GB20 (Fengchi), LI11 (Quchi), LI4 (Hegu), ST36 (Zusanli), GB34 (Yanglingquan), GB39 (Xuanzhong), and SP6 (Sanyinjiao). Needles were retained for 30 minutes and treatments were administered daily. Five treatments comprised one course and a total of four courses were administered, with a two day break between each one.

Both groups were treated with conventional medications including antiplatelet medication (aspirin, 100mg daily, for patients with abnormal platelet counts) and citicoline 500mg daily. Citicoline is a drug commonly used in the treatment of various neurological disorders, including stroke. Other symptomatic related treatments were also administered as needed.

The differences in brain activity demonstrated by the two groups in this study indicates that acupuncture increases brain activity following an ischemic stroke, significantly more so than conventional drug treatment alone. These findings indicate that acupuncture is a reasonable treatment option for stroke recovery and rehabilitation. To learn more, contact your local licensed acupuncturist for more information.

 

Notes
1. Hou Qiang, Li Jin-tao “Clinical value of acupuncture combined with rehabilitation therapy in patients with hemiplegia after cerebrovascular accident” Clinical Medical Research and Practice (2018) Issue 11.

2. Wu Ping et al. “Effect of acupuncture plus conventional treatment on brain activity in ischemic stroke patients: a regional homogeneity analysis” Journal of Traditional Chinese Medicine (2017) October 15; 37 (5).

3. Jiang, Lili, and Xi-Nian Zuo. “Regional homogeneity: a multimodal, multiscale neuroimaging marker of the human connectome.” The Neuroscientist 22, no. 5 (2016): 486-505.

Source: HealthCMi

Acupuncture Helps War Veterans Sleep Better

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Acupuncture Helps War Veterans Sleep Better

 

Emory University and Atlanta VA Medical Center researchers find acupuncture effective for the alleviation of sleep disorders for veterans with PTSD and brain injuries. The research team concludes that acupuncture produces significant improvements in both subjective and objective sleep parameters for veterans with mild traumatic brain injuries (mTBI), including veterans with PTSD (post-traumatic stress disorder). The team notes that “acupuncture provides meaningful relief for a particularly recalcitrant problem affecting large segments of the veteran population.” [1]

The randomized-controlled investigation featured a comparison of true acupuncture with sham acupuncture, including effective binding lasting the entirety of the clinical trial. True acupuncture produced a 2.7% improvement in sleep efficiency, measured by actigraphy. [2] True acupuncture was effective for both mTBI patients with or without PTSD. Sham acupuncture did not improve patients’ conditions; in fact, patients receiving sham acupuncture worsened by 5.3%.

True acupuncture produced significant clinical results as measured by Pittsburgh Sleep Quality Index (PSQI) scores and actigraphy. All patients received a total of ten acupuncture treatments. The clinical trial was administered at the Atlanta VAMC (US Department of Veterans Affairs Medical Center, Georgia). The study included a total of 60 veterans with a mean age of 40. The researchers conclude that acupuncture improves overall sleep for mTBI veterans with persistent sleep disturbances. [3]

Acupuncture has been shown to improve the condition of patients with other sleep disturbance etiologies. Researchers find back-shu (beishu) acupoints plus Shenmen (HT7) effective for the alleviation of menopausal insomnia. [4] Researchers from the Asian Sports Village Community Health Service Center (Beijing) and the Beijing Tibetan Hospital of China Tibetology Research Center (Beijing) conclude that acupuncture is more effective for the alleviation of menopausal insomnia than alprazolam (a benzodiazepine anti-anxiety drug).

PSQI scores and hormonal changes were measured, including levels of estradiol, follicle stimulating hormone, and luteinizing hormone. Patients in the acupuncture group received acupuncture once per day for five consecutive days followed by a two day break prior to the next round of care. The following acupuncture points were needled:

  • Feishu (BL13)
  • Xinshu (BL15)
  • Ganshu (BL18)
  • Pishu (BL20)
  • Shenshu (BL23)
  • Geshu (BL17)
  • Shenmen (HT7)

Three weeks of care comprised one course and three courses of care were administered. During the same period, the drug treatment group received oral alprazolam (0.4 mg–0.8 mg) prior to sleep. The results were evaluated 30 days after completion of all treatments. The total cohort size was 128 menopausal patients with a diagnosis of insomnia.

The total effective rate for the acupuncture group was 98.3% and the drug group had a 95.2% total effective rate. PSQI scores were better in the acupuncture group and hormone levels improved in both groups; however, the acupuncture group had significantly better hormone level improvements. Based on the data, acupuncture is more effective than alprazolam for the treatment of menopausal insomnia. [5] Two acupuncture continuing education courses at HealthCMi are relevant to the research presented above. The first course is on the topic of sleep improvement, click the following link to gain course access:

Acupuncture For Insomnia >

The second online course is on the topic of Traditional Chinese Medicine and menopause, click the following link to gain course access:

Menopause >

 

More Findings
Another important finding concerning acupuncture for the treatment of insomnia was produced by a research team comprised of University of Pennsylvania (Philadelphia), Memorial Sloan Kettering Cancer Center (New York), and Memorial University (Newfoundland and Labrador) researchers. This study was specifically designed to measure the effects of electroacupuncture on female breast cancer survivors with hot flashes and insomnia. The research team concludes that acupuncture significantly improves sleep duration and sleep latency (the length of time transitioning from wakefulness to sleep). [6] Moreover, the researchers discovered hot flashes and insomnia are bidirectional. Improvements in sleep produce reductions in hot flashes and vice versa.

The study included a drug control group. Acupuncture significantly outperformed gabapentin and venlafaxine. Acupuncture was significantly more effective than the drugs in improving sleep duration, latency, and efficiency, and was also more effective for reducing sleep disturbances and daytime dysfunction. Additionally, acupuncture did not produce the adverse effects that were caused by the drugs (dizziness, fatigue, ataxia, dry mouth, constipation, headaches). The clinical trial was supported, in part, by a grant from the US National Institutes of Health.

Patients received acupuncture 2 times per week for the first 2 weeks. Next, weekly acupuncture treatments were administered for an additional 6 weeks for a total of 10 acupuncture treatments over 8 weeks. Acupuncture point prescriptions were selected on an individual basis per differential diagnostics. Manual acupuncture techniques were applied to obtain deqi. Electroacupuncture (EA) was applied between 2 acupoints with a 2 Hz frequency setting. The specific points were not detailed in the report. Needles were retained for 30 minutes for each acupuncture treatment.

The researchers conclude that “EA produces comparable, if not better, improvements in sleep quality than GP [gabapentin], a currently recommended pharmacological intervention.” They add, “women receiving EA reported were able to fall asleep faster and spent more time in bed sleeping as opposed to lying awake in bed trying to sleep. Our results suggest that EA results in improved sleep in women with hot flashes and might be a viable treatment option in women who do not wish to take medication.” [7]

Insomnia affects approximately 30% of the adult population. [8] Given the results of the aforementioned research, acupuncture is a reasonable treatment option for the treatment of sleep disorders. Prospective patients are advised to consult with licensed acupuncturists to learn more.

 

References
[1] Huang, W., Johnson, T., Kutner, N., Halpin, S., Weiss, P., Griffiths, P. and Bliwise, D., 2018. Acupuncture for treatment of persistent disturbed sleep: A randomized clinical trial in veterans with mild traumatic brain injury and post-traumatic stress disorder. Annals of Physical and Rehabilitation Medicine, 61, p.e89.
[2] Ibid.
[3] Ibid.
[4] Li, O., and F. Wang. “Acupuncture at back-shu points of five zang, Geshu (BL 17) and Shenmen (HT 7) for the treatment of menopausal insomnia.” Zhongguo zhen jiu= Chinese acupuncture & moxibustion 38, no. 5 (2018): 4693.
[5] Ibid.
[6] Garland, Sheila N., Sharon X. Xie, Qing Li, Christina Seluzicki, Coby Basal, and Jun J. Mao. “Comparative effectiveness of electro-acupuncture versus gabapentin for sleep disturbances in breast cancer survivors with hot flashes: a randomized trial.” Menopause 24, no. 5 (2017): 517-523.
[7] Ibid.
[8] Roth, Thomas. “Insomnia: definition, prevalence, etiology, and consequences.” Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 3, no. 5 Suppl (2007): S7.

Source: HealthCMi

 

Acupuncture Achilles Tendon Repair Finding

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Acupuncture Achilles Tendon Repair Finding

 

Acupuncture is an effective treatment modality for Achilles tendon disorders. Two clinical case histories were published by Dr. Hawks demonstrating that acupuncture is “highly effective, with rapid results for both acute and chronic Achilles tendinopathy and was performed easily in an austere environment.” [1] Dr. Hawks works at the Mike O’Callaghan Military Medical Center at Nellis Air Force Base in Nevada and the treatments were administered to personnel while deployed overseas.

Patient #1 had significant pain reduction and increases in functionality. Dr. Hawks notes that the patient was able to return to his exercise routing of running after receiving acupuncture. The second patient had Achilles tendon pain prior to acupuncture and had complete resolution of all symptoms at the two month datapoint following the final acupuncture session.

Dr. Hawks notes that Achilles tendinopathy is common among military personnel and that effective treatment and recuperation is “critical to mission success,” especially for soldiers that have been deployed. Tendinopathy is a general term referring to painful tendon region conditions, often due to overuse or the sequela of acute trauma. Treatment for both tendinopathy cases presented in this report were administered in a canvas tent as part of the overseas Expeditionary Medical Support System. The report notes that the treatment results were rapid with high efficaciousness.

For both patients, acupuncture points BL60, BL61, KD3, and KD4 were applied. Needles were angled into the Achilles tendon. Electroacupuncture connected KD3(-) to KD4(+) and BL61(-) to BL60(+). The electroacupuncture device (ITO ES-130) was set to 30 Hz and needles were retained for 15 minutes. For patient #1, the treatment protocol differed on the very first treatment and then conformed to the aforementioned protocol thereafter. During the first treatment, BL67 and SI18 were needled along with needles placed at the distal three inches of the Achilles tendon.

The doctor conducting the study notes that a recent investigation demonstrates that acupuncture strengthens damaged tendons via anti-inflammatory actions and mechanotransduction (cells convert mechanical stimuli into electrochemical activity). [2] He adds that additional research demonstrates that acupuncture promotes healthy cellular function and increases blood flow and oxygenation to tendons. [3],[4]

Dr. Hawks provided a basic Traditional Chinese Medicine (TCM) history in his report. He notes that an early treatment record for the Achilles tendon was written in The Yellow Emperor’s Classic of Internal Medicine. Therein, the Hui technique was employed. It involves placing needles directly into the tendon. This is consistent with using acupoints such as N-LE-3 (Genping, Level with the Heel) and M-LE-10 (Quanshengzu, Spring at the Foot). These are points located directly at the Achilles tendon.

Genping is located on a line connecting the medial and lateral malleoli, at the posterior aspect of the body on the achilles tendon. A local point for the treatment of the achilles tendon, this acupoint is often needled to a depth of 0.5–0.8 cun. This point is traditionally indicated for foot disorders due to infantile paralysis. Quanshengzu is located at the back of the heel, at the middle of the superior margin of the calcaneus bone, at the achilles tendon. Needle insertion is typically 0.2–0.3 cun. Indications include esophageal spasms, diseases of the brain, and lower back pain.

Patient #1 made an interesting comment. He notes that he was skeptical about getting acupuncture at first; however, after receiving acupuncture, he was “able to walk without a limp.” The approach to care for patient #2 was a modification of the treatment protocol used for patient #1. The acupuncture technique used for patient #1 on the first visit was dropped in lieu of using the techniques used on the second and third visits. This shift in protocol was made because the second and third acupuncture visits for patient #1 produced significant positive patient outcomes. As a result, patient #2 received a modified treatment protocol and subsequently had a complete resolution of the Achilles tendon condition, a complete recovery.

 

Investigations
The aforementioned case histories are supported by laboratory research. Investigators from Meiji University of Integrative Medicine and Doshisya University (Kyoto, Japan) conclude that electroacupuncture (EA) increases maximum breaking strength of the Achilles tendon. The researchers note that “it is likely that EA stimulation increases the mechanical strength of a repaired tendon after long-term recovery, and EA stimulation could be useful for preventing re-rupture.” [5]

In related findings from a controlled clinical trial, Bi-meng Zhang et al. conclude that acupuncture reduces pain and improves function of the Achilles tendon. [6] The researchers note, “Acupuncture treatment resulted in a significant increase from baseline in VISA-A [Victorian Institute of Sports Assessment-Achilles] of 25.8 after 16 weeks and 28.4 after 24 weeks.” [7]

In a related laboratory investigation, researchers conclude that electroacupuncture produces a significant increase in cell count and transforming growth factor-β1 (TGF-β1) expression “as well as increased tendon strength.” [8] The researchers note that the data indicates that acupuncture is a potentially useful method for the promotion of tendon repair.

Similar findings were made in a related investigation. Researchers conclude that electroacupuncture improves “the recovery of Achilles tendinopathy. It can enhance fibroblast proliferation and promote collagen synthesis by stimulating the synthesis of TGF-β1 and activating TGF-β1.” [9] The researchers add that electroacupuncture improves “the structure rearrangement of collagen fiber during the recovery of Achilles tendinopathy.” [10]

 

Summary
Acupuncture benefits the Achilles tendon for both acute and chronic conditions. Acupuncture is in widespread use in clinics throughout the world and is even in common use by professional athletes. For example, NBA champion Chauncey Billups used acupuncture for a torn Achilles tendon during his basketball career. He notes that acupuncture reduced both pain and swelling of the Achilles tendon.

Research demonstrates several important findings. Acupuncture speeds repair and assists in the return of normal functioning of the tendon. Additionally, acupuncture strengthens the tendons and may prevent exacerbations, aggravations, and future injuries.

 

References
[1] Hawks, Matthew Kendall. “Successful Treatment of Achilles Tendinopathy with Electroacupuncture: Two Cases.” Medical acupuncture 29, no. 3 (2017): 163-165.
[2] Almeida M dos S, Oliveira LP, Vieira CP, Guerra F da R, Pimentel ER. Birefringence of collagen fibres in rat calcaneal tendons treated with acupuncture during three phases of healing. Acupunct Med.
2016;34(1):27–32.
[3] 4. Speed C. Acupuncture’s role in tendinopathy: New possibilities. Acupunct Med. 2015;33(1):7–8.
[4] Kubo K, Ikebukuro T, Tsunoda N, Kanehisa H. Noninvasive measures of blood volume and oxygen
saturation of human Achilles tendon by red laser lights. Acta Physiol (Oxf). 2008;193(3):257–264.
[5] Imaeda, Miwa, Tatsuya Hojo, Hiroshi Kitakoji, Kazuto Tanaka, Megumi Itoi, and Motohiro Inoue. “Effect of electroacupuncture stimulation on long-term recovery following Achilles tendon rupture in a rat model.” Acupuncture in Medicine (2018): acupmed-2016.
[6] Zhang, Bi-meng, Li-wei Zhong, Si-wei Xu, Hui-ru Jiang, and Jian Shen. “Acupuncture for chronic Achilles tendnopathy: a randomized controlled study.” Chinese journal of integrative medicine 19, no. 12 (2013): 900-904.
[7] Ibid.
[8] Inoue, Motohiro, Miwa Nakajima, Yuki Oi, Tatsuya Hojo, Megumi Itoi, and Hiroshi Kitakoji. “The effect of electroacupuncture on tendon repair in a rat Achilles tendon rupture model.” Acupuncture in Medicine 33, no. 1 (2015): 58-64.
[9] Chuan-en, WANG Quan-dian1 WANG, and Q. I. Xiao-qin. “Experimental Study of the Effects of Electro-acupuncture On Rat’s Achilles Tendinopathy [J].” Journal of Chengdu University of Traditional Chinese Medicine 3 (2009): 027.
[10] Ibid.

 

Source: HealthCMi

Acupuncture Provides Parkinson’s Disease Relief

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Acupuncture Provides Parkinson’s Disease Relief

 

Acupuncture is an effective treatment modality for the alleviation of Parkinson’s disease. Zhejiang University of Traditional Chinese Medicine (Hangzhou, China) researchers conducted a study comparing the effects of drug therapy as a standalone procedure with acupuncture plus drug therapy in an integrated treatment protocol. Based on the data, the researchers conclude that acupuncture plus antiparkinsonian drug therapy is significantly more effective than using only antiparkinsonian drug therapy. [1]

Two groups were compared. In one group, Parkinson’s disease patients received only levodopa-benserazide as a means to alleviate symptoms. In the second group, levodopa-benserazide was combined with acupuncture therapy. The acupuncture plus drug therapy group had a total effective rate of 89.4% after four courses of treatment, whereas the drug therapy only group had a 52.6% total effective rate for the management of Parkinson’s disease.

The results indicate that acupuncture is an important treatment option for patients receiving benderizine-levodopa for the purposes of Parkinson’s disease treatment. Levodopa-benserazide is a medication containing two ingredients: levodopa and benserazide. Levodopa is a precursor to dopamine, the latter of which is needed in the brain of Parkinson’s disease patients. Benserazide prevents the conversion of levodopa to dopamine prior to reaching the brain and reduces some of levodopa’s adverse effects. This combination is used to reduce symptoms for patients suffering from Parkinson’s disease.

 

Evaluations

Multiple subjective and objective instruments were used to measure patient outcomes before and after treatment. First, the Unified Parkinson’s Disease Rating Scale (UPDRS), which is the most widely used clinical rating scale for Parkinson’s disease, was used to record symptomatic improvement at several data points: before treatment, after two treatment courses, after four treatment courses. Second, the superoxide dismutase (SOD) activity and lipid peroxidation levels in plasma and red blood cells were recorded. Independent studies have proven that oxidative stress plays an important role in the degeneration of dopaminergic neurons in Parkinson’s disease (PD) patients, which is characterized by decreased SOD activity and increased lipid peroxidation. [2]

After four treatment courses, the scores in the acupuncture plus drug group were significantly improved (i.e., lower) than scores before treatment and for those in the drug control group (P<0.05). After four treatment courses, the SOD activity was significantly higher (i.e., improved) in the acupuncture plus drug group and were also better than scores in the drug control group (P<0.05). The lipid peroxidation levels in the acupuncture plus drug group were significantly lower (i.e., improved) than scores before treatment and were also better than scores in the drug control group.

 

Background Introduction

Parkinson’s disease (PD) is the second most common progressive neurodegenerative disorder. [3] PD is characterized by both motor and non-motor symptoms, such as bradykinesia, resting tremors, and muscle rigidity (which occur due to dopamine deficiency). [4] Diagnostically, Parkinson’s disease is distinguished from essential tremors in that essential tremors are more prevalent with activity and Parkinson’s disease tremors worsen at rest. Levodopa (LD) remains the gold standard pharmacological treatment for PD. However, LD’s effectiveness may decrease overtime. In addition, it has side effects including motor response oscillations and dyskinesia. [5]

New treatment strategies that overcome these limitations are required. Acupuncture has been widely used as a complementary and alternative medicine to relieve the symptoms of PD in Asia, Europe, and in the United States. Previous studies have proven that acupuncture is effective for relieving the symptoms for patients with PD. With the help of acupuncture, both motor symptoms (gait disorder and balance) and non-motor symptoms (psychiatric disorders, sleep problems, gastrointestinal symptoms) can be relieved. In this study, the researchers note that “the use of acupuncture in an integrated treatment protocol can reduce the dosage of LD to eliminate its side effects.” [6]

 

Design

The Zhejiang University of Traditional Chinese Medicine researchers (Yang et al.) used the following study design. A total of 38 patients diagnosed with Parkinson’s disease were treated and evaluated in this study. They were randomly divided into an acupuncture plus drug treatment group and a drug control group, with 18 patients in each group. There were no significant statistical differences in age, gender, severity of disease, and course of disease relevant to patient outcome measures for patients initially admitted to the study (P>0.05).

 

Treatment Procedure

The control group received 62.5 – 500 mg of levodopa-benserazide (2 – 4 times per day). Dosage was dependent upon the severity of Parkinson’s disease. Patients in the control group were not treated with acupuncture. The treatment group received both scalp and body style acupuncture in addition to the identical drug treatment protocol administered to the control group. The acupoints used for scalp acupuncture included the following:

  • MS1 (middle line of forehead)
  • MS5 (middle line of vertex)
  • MS6 (anterior oblique line of vertex-temporal)

The acupoints used for body style acupuncture included the following:

  • LI4 (Gegu)
  • SI3 (Houxi)
  • LI5 (Yangxi)
  • SI6 (Yanglao)
  • LI11 (Quchi)
  • PC3 (Quze)
  • LU5 (Chize)
  • LV3 (Taichong)
  • ST41 (Jiexi)
  • KI3 (Taixi)
  • GB34 (Yanglingquan)
  • SP9 (Yinlingquan)
  • BL40 (Weizhong)
  • GB30 (Huantiao)

For scalp acupuncture, treatment commenced with patients in a supine position. A 0.25 mm × 40 mm disposable acupuncture needle was inserted transverse-obliquely into each acupoint, to a standard depth. Each needle was manipulated with the twirling method for three minutes. Once manual acupuncture achieved the arrival of deqi, electroacupuncture stimulation was added to the acupoints using a dense wave. The intensity level was set to patient tolerance levels. A 30 minute needle retention time was observed.

For body style acupuncture, needles were rapidly inserted perpendicularly and were manipulated with mild reinforcing and reducing (Ping Bu Ping Xie) manipulation methods. After achieving a deqi sensation, the needles were retained for 30 minutes. An acupuncture treatment was applied every two days. Each treatment course consisted of 10 acupuncture sessions, followed by a 7 day break before the next course of treatments. All patients received four treatment courses in total.

 

Results

The results indicate that acupuncture combined with levodopa-benserazide into an integrated treatment protocol is more effective than levodopa-benserazide as a standalone therapy. Based on the data, Yang et al. conclude that acupuncture is safe and effective for the treatment of Parkinson’s disease.

 

University of Arizona

The Zhejiang University of Traditional Chinese Medicine clinical trial confirms additional research. University of Arizona surgery and neurology department doctors find acupuncture effective for the treatment of balance and gait disorders in Parkinson’s disease patients. Acupuncture produced significant clinical improvements in balance, gait speed, and stride length for Parkinson’s disease patients. The results of the sham controlled trial were published in Neurology, the journal of the American Academy of Neurology.

Each acupuncture session was 30 minutes in length. Patients received one acupuncture treatment per week for a total of three weeks. Patients receiving true acupuncture had a 31% improvement in balance, 10% improvement in gait speed, and 5% increase in stride length. Patients in the sham acupuncture control group did not demonstrate any improvements. The University of Arizona research team notes, “EA [electroacupuncture] is an effective therapy in improving certain aspects of balance and gait disorders in PD [Parkinson’s disease].” [7]

 

Notes
[1] Yang DH, Shi Y, Jia YM. Influence of acupuncture plus drug in the amelioration of symptoms and blood antioxidant system of patients with Parkinson’s disease. Chinese Journal of Clinical Rehabilitation, 2006 (19) :14 －16
[2] Dias V1, Junn E, Mouradian MM. The role of oxidative stress in Parkinson’s disease [J]. J Parkinsons Dis. 2013;3(4):461-91.
[3] I.H. Sturkenboom, M.J. Graff, G.F. Borm, et al., Effectiveness of occupational therapy in Parkinson’s disease: study protocol for a randomized controlled trial, Trials 14 (2013) 34.
[4] W. Poewe, K. Seppi, C.M. Tanner, et al., Parkinson disease, Nat. Rev. Dis. Prim. 3 (2017) 17013.
[5] Dias V1, Junn E, Mouradian MM. The role of oxidative stress in Parkinson’s disease [J]. J Parkinsons Dis. 2013;3(4):461-91.
[6] Yang DH, Shi Y, Jia YM. Influence of acupuncture plus drug in the amelioration of symptoms and blood antioxidant system of patients with Parkinson’s disease. Chinese Journal of Clinical Rehabilitation, 2006 (19) :14 －16.
[7] Lei, Hong, Nima Toosizadeh, Michael Schwenk, Scott Sherman, Stephen Karp, Saman Parvaneh, Esther Esternberg, and Bijan Najafi. “Objective Assessment of Electro-acupuncture Benefit for Improving Balance and Gait in Patients with Parkinson’s Disease (P3. 074).” Neurology 82, no. 10 Supplement (2014): P3-074.

Source: HealthCMi

Acupuncture Halts Neck Pain From Disc Degeneration

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Acupuncture Halts Neck Pain From Disc Degeneration

 

Researchers confirm the effectiveness of acupuncture for the treatment of cervical spondylosis, a painful disorder caused by intervertebral disc degeneration. The term cervical spondylosis refers to general wear and tear of the discs in the cervical spine. Often with age, the spinal discs degenerate and osteoarthritis ensues. The acupuncture point GV14 was determined effective across multiple studies for the treatment of cervical spondylosis. Based on the evidence, this acupuncture point is recommended for patients with cervical spondylosis.

Shao et al. tested the efficacy of acupuncture using the following acupuncture points:

  • GV14 (Dazhui)
  • SI3 (Houxi)
  • GV20 (Sanyangwuhui, Baihui)
  • GB20 (Fengchi)

The acupuncture needle at Dazhui was perpendicularly inserted to a depth of 13 – 20 mm and then a 15 mm moxa cone was put on the handle of the needle after deqi (the arrival of qi). Deqi was elicited at the other acupoints combined with electroacupuncture stimulation. Fengchi was connected to Houxi on the afflicted side and Fengchi was connected to Baihui on the healthy side with standard electrodes. Acupuncture was applied once per day, five times per week, for a total of two weeks as one course of treatment. The results indicate that 24 out of 25 cases improved significantly for a total effective rate of 96%. [1]

The research team of Zhang et al. produced similar results. [2] Patients in the study received acupuncture for cervical spondylosis once per day for seven days, comprising one course of patient care. The following acupuncture points were applied to all patients:

  • GV14 (Dazhui)
  • GB20 (Fengchi)
  • GV20 (Sanyangwuhui or Baihui)
  • EX-B2 (Jiaji)
  • BL10 (Tianzhu)
  • EX-HN1 (Sishencong)

A total of 53 out of 60 cases improved significantly, producing a total effective rate of 88.3%. In addition, 31.7% of all cases experienced a complete recovery from all symptoms. Li et al. conducted a clinical trial testing the effectiveness of fire needling with the following acupuncture points: [3]

  • GV14 (Dazhui)
  • EX-B2 (Jiaji)
  • BL18 (Ganshu)
  • BL23 (Shenshu)
  • SI3 (Houxi)
  • LI4 (Hegu)
  • LI11 (Quchi)
  • SJ5 (Waiguan)

In the fire needle group, 37 patients received quick needling with fire needling. In the control group, the above acupoints were inserted to 15 – 20 mm with 0.30 × 25 – 40 mm disposable filiform needles. The needles were retained for 20 minutes after manual needle stimulation with twisting, lifting, and thrusting. All patients received acupuncture 3 times per week for 6 weeks. For patients receiving fire needling, acupuncture produced a 94.6% total effective rate. Routine filiform needling produced a 78.4% total effective rate.

Qiu et al. conducted a randomized, single-blinded parallel study. A total of 284 patients were divided into two groups (acupuncture and control). The following acupuncture points were used in the acupuncture group: [4]

  • GV14 (Dazhui)
  • EX-B2 (Jiaji)
  • GB20 (Fengchi)

The acupuncture group achieved a 96.2% total effective rate. The results indicate that the aforementioned acupuncture point prescription is an effective selection for the treatment of cervical spondylosis.

 

Discussion
Researchers have tested the effective action of Dazhui (GV14) and conclude the following: [5]

  • GV14 regulates the glutamate (a neurotransmitter) content of cells supporting the restoration of nerve conduction.
  • GV14 improves free radical scavenging.
  • GV14 regulates FAK (focal adhesion kinase, PTK2) expression.
  • GV14 ameliorates excess blood viscosity in patients with cardiovascular and cerebrovascular diseases.
  • GV14 enhances and regulates central monoamine neurotransmitters, including the ability to protect the body from brain damage after ischemia.
  • GV14 regulates aspartate (Asp), an amino acid active in biosynthesis of proteins, especially in conjunction with its ability to regulate glutamate (Glu) for the protection of brain tissue to prevent neuronal necrosis.
  • GV14 improves blood flow to prevent ischemic damage to neurons.
  • GV14 improves the levels of NO (nitric oxide) and NOS (nitric oxide synthase) in cerebral tissue after ischemia.
  • GV14 regulates calcium ions in brain cells, avoiding pathological nerve cell apoptosis after ischemia.
  • GV14 enhances the expression of NGF (nerve growth factor), especially after central ischemia.

Across the acupuncture education research papers mentioned above, the traditional Chinese medicine view of GV14 was reviewed. The following are several important principles mentioned in the research papers. GV14 is the meeting point of the Governing Vessel (Du Mai) with the six yang channels of the hand and foot, referred to as Zhu Yang Zhi Hui. GV14 warms the yang, clears heat, strengthens the body, and dispels wind and dampness. Needling GV14 raises the lucid yang and dispels wind, cold, and dampness. GV14 invigorates blood circulation. The researchers also presented the traditional Chinese medicine view of cervical spondylosis. Cervical spondylosis is due to obstruction of the channels, involving both qi and blood stasis. Chronic cases involve kidney, liver, qi, and blood deficiency. [6]

GV14 benefits qi and blood circulation and cervical spondylosis involves obstruction of qi and blood circulation. The Chinese medicine principles indicate that GV14 is well-suited for the treatment of cervical spondylosis. In addition, the aforementioned controlled studies demonstrate that acupuncture point prescriptions containing GV14 are appropriate choices for the treatment of cervical spondylosis.

 

GV14 Wellness Combinations
At the Healthcare Medicine Institute (HealthCMi), we provide many acupuncture continuing education courses on the treatment of musculoskeletal pain and internal medicine disorders. The online courses and live acupuncture webinars for CEU and NCCAOM PDA license renewal credit feature Chinese medicine, classical acupuncture, herbal medicine, and modern research. As part of HealthCMi’s acupuncture education outreach, we present the following additional information about GV14 (DU14) to supplement the aforementioned research..

GV14 is a powerful acupuncture point used for the treatment of infections, inflammation, and immune system imbalances. The combination of GV14, GV13, GV12, LI11, and ST36 is a classic wellness acupuncture point combination and was often used by Prof. Wae Shui in his clinical practice. This treatment is often applied in the seated position.

GV14 is used in Chinese medicine to quell internal wind, expel external wind, and benefit the wei qi. GV14 is also an important point for the treatment of malaria. Notably, the research headed by Prof. Wae Shui in the 1950s demonstrated that application of the aforementioned wellness treatment (GV14, GV13, GV12, LI11, ST36) is effective for the treatment of malaria. Recent clinical work also employs the use of this acupuncture point prescription for the treatment of Lyme’s disease and associated co-infections, often in combination with the herbal formula Da Yuan Yin Wan jia Qing Hao.

 

Notes
[1] Shao YX. Clinical study on treatment of vertebral artery type of cervical spondylosis with warm needling Dazhui [D]. Guangzhou: Guangzhou University of Traditional Chinese Medicine, 2008.
[2] Zhang ZC, Du SC. Acupuncture combined with bloodletting in Dazhui in the treatment of vertebral artery type cervical spondylosis [J]. SHAANXI ZHONGYI, 2013, 34(8): 1045.
[3] Li B, Xie XC, Feng Y. Clinical observation on the treatment of nerve root type of cervical spondylosis with fire needling [J]. Beijing Journal of Traditional Chinese Medicine, 2010, 29(12): 920.
[4] Qiu L, Zhang M, Zhang J. Treatment of 142 cases of neck type of cervical spondylosis in pubers by acupuncture of warming yang and regulating with traction therapy [J]. SHAANXI ZHONGYI, 2007, 28(4): 475.
[5] Yan D, Chen C, Song YM. Research progress in the treatment of cervical spondylosis with Dazhui acupoint [J]. Shandong Journal of Traditional Chinese Medicine, 2018, 37(3): 262 – 266.
[6] Ibid.

Source: HealthCMi