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Oriental Medicine Theory

Chinese medicine is a Comprehensive System of Healthcare

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Over the past 5,000 years or so the Chinese and their forebears developed a comprehensive system of medicine that is designed to be able to address any health condition effectively. The medicine originated, like many primitive medicines, dominated by ideas of possession by negative spirits but has evolved over these medicine to be a systematic approach to all types of illness.

In China practitioners may specialize in treating trauma, broken bones, perform surgery, treat infectious illness, all aspects of women’s reproductive health, or pediatrics. They do this with a wide array of tools, many of which are not seen in the US.

The primary tools that Americans know are acupuncture, oral medicinals such as herbs, and cupping. There are also moxibustion (burning of moxa near the skin) and bleeding (where small amounts of blood are released from the body safely). All acupuncturists trained in the US learn these primary tools in their three-to-four year graduate level education programs.

The diagnostic system of Chinese medicine may seem strange to westerners, but it is grounded in Eastern philosophies and world views that are completely natural to their place of origin.

We do not depend on a Western conventional biomedical analysis of a health problem to be able to determine what treatment is appropriate in Chinese medicine. Chinese medicine was developed long before these modern scientific approaches came along.

So, for example, in the fall in the midwestern part of the US we see an increasing amount of  illnesses that are considered “dampness” in Chinese medicine. That includes increased runny and stuffy noses from ragweed, mold spores from rotting leaves, and airborne material from farm activity as they remove dusty moldy crops from the fields. People complain of increased joint stiffness and swelling, and feeling worse in damp cold weather. To the Chinese, this indicates an excess of dampness inside the body. So herbs can be used to improve the situation, or acupuncture strategies that help the body metabolize dampness better.

As the weather shifts through the seasons we tend to see physical health problems that parallel those shifts and we can respond to each pattern effectively with diet, herbs, and acupuncture.

Call today for help with your fall illness. 319-341-0031

Saam Acupuncture, Acupuncture of Wandering Monks

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I have recently been studying a new method of acupuncture, called Sa’am acupuncture. My teacher is Toby Daly LAc from Northern California, and he calls it “The Acupuncture of Wandering Monks”. He learned this style while traveling in the far east and meeting one such wandering monk, named Doam. Toby traveled and studies with this man for several months, then returned to the US and went to acupuncture school, and then pursued  a doctoral degree in Chinese medicine and has now been in practice for over 20 years. He has learned a great deal about the Sa’am system and is now teaching it to acupuncturists such as myself. I was in the first ever class in the US in Seattle in late January of this year.

This style of acupuncture is deceptively simple, using just 4 needles to achieve profound results. For example, this week in my Community Acupuncture clinic I had a young woman seek help for severe cramping pain on the left side of her neck and top of her shoulder. I placed 4 needles on the right side of her body and the pain disappeared. She and I were both very happy to see that.

I’ve been using primarily Sa’am in the clinic since about December of 2018, and am experimenting with how to best apply it, and learning a lot more about what works and what does not.

One of the interesting things about this system is that it treats both “root” and “branch”. I like to call them “the problem that underlies all your issues” and “the pain or other issue that brought you here today”. They also can be called “foundational disharmony” and “presenting problem or symptom”. In a lot of acupuncture systems we treat root and branch in the same treatment, but we’ll do some points for root and some for branch. Here they are the same. Those four points get it all.

Another interesting aspect of this type of acupuncture is that it is based on the use of the 5 Elements or 5 Phases: Wood, Earth, Metal, Water, Fire. Many readers have heard of this. But in Sa’am, this is combined with the 6 conformations or the 6 channels. Those are Tai Yang, Yang Ming, Shao Yang, Jue Yin, Shao Yin, and Tai Yin. No other acupuncture system that I know of is based on the 6 channel theory. We mostly use that theory for the prescription of herbs. And Sa’am acupuncture superimposes these two systems to provide a powerful rubric for the diagnosis and treatment of a patient.

Another interesting thing about Sa’am is that the most powerful treatments will only use needles on one side of the body. Traditionally it is the right side for women and the left side for men. We westerners might think this is kind of old fashioned thinking, but I’ve chosen to practice as I was taught, since that is what works. The idea of only needles on one side, or even just 4 needles is counter-intuitive for our Western minds as well, because most of us subscribe to the “more is better” theory of treatment. However, Sa’am is so powerful and accurate in targeting the best way to balance a problem, that adding more needles actually makes it less effective.

I think this Sa’am acupuncture system is the first one I’ve ever seen that really does the magic that I always I assumed acupuncture could do before I went to school for it. I know that many of my patients are hoping for a miracle, and I’ve tried a number of very prominent systems of acupuncture, testing each one for a few years before moving on to the next. The Sa’am system is the most powerful system I have ever used. And the simplest for me to use. So it will now become my main approach for most patients. There will still be times that I might do some other things, depending on the case, but I’ll use Sa’am as much as I can to help as many people as I can.

I continue to study with Toby in webinars and personal trainings, and I hope to continue to develop my expertise in this powerful system.

The wandering monk, Doam, belonged to a group of Korean monks who wander all the time, helping people using acupuncture. Doam has no monastery where he lives, he moves about all the time, finding people to help at every point along the journey. It was his wish that we use this method to help the most people as possible, and I am honored to find myself in his lineage. As long as I practice acupuncture I’ll use Sa’am to help as many people as I can.

Acupuncture Beats Drug For Alzheimer’s Disease Treatment

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Acupuncture Beats Drug For Alzheimer’s Disease Treatment

 

Acupuncture outperforms drug therapy for the treatment of Alzheimer’s disease (AD). First Affiliated Hospital of Tianjing University of Traditional Chinese Medicine researchers compared the effect of acupuncture with donepezil drug therapy for the treatment of Alzheimer’s disease. [1] Acupuncture produced superior patient outcomes compared with the drug therapy. In addition, acupuncture did not produce any serious adverse effects.

After treatment,  scores in both groups were increased compared with those before treatment. Acupuncture yielded better treatment results regarding all parameters compared with the drug therapy and there was a significant difference between the two groups.

While donepezil is effective, the downside is that the medication caused one case of stomach discomfort and eight cases of low appetite, nausea, diarrhea, and insomnia. The medication is contraindicated for patients with epilepsy, asthma, or chronic obstructive pulmonary disease. It also increases the risk of developing gastric ulcers. [2] The researchers conclude, “Acupuncture is applicable to the vast majority of patients and has very limited side effects.”

Basis
The researchers provide a brief synopsis of the Traditional Chinese Medicine (TCM) understanding of Alzheimer’s disease. In TCM, Alzheimer’s disease falls under the Chi Dai (mental deficiency), Yu Chi (lack of cognitive ability), Shan Wang (forgetfulness), or Yu Zheng (depression) class of disorders. According to TCM principles, Alzheimer’s disease is related to three major organs: heart, kidney, brain. It is written in the Su Wen (the Plain Questions) that the “heart governs the bright spirit” and that the “brain is the house of the original spirit.” Here, the bright spirit refers to life activities, including both mental and physical activities. The original spirit refers mainly to mental activities, such as learning, reading, and thinking. [3]

In the Ling Shu (Magic Pivot), it is written that the “Kidney stores essence, essence generates marrow, and the brain is the sea of marrow…. deficiency in the sea of marrow can cause mental deficiency and loss of memory.” The treatment principle is to boost qi, move the blood, regulate the spirit, and sharpen cognition.

The researchers also provide a historical context for the protocol used in the study. Baihui and Shenting are located on the du meridian (governing vessel). According to the Nan Jing (Classic of Difficult Issues), the du meridian “finally enters into the brain.” Needling Baihui and Shenting boosts qi, moves the blood, regulates the spirit, and sharpens cognition. Needling Fengchi and Wangu quiets the spirit, wakens the brain, sharpens hearing, and brightens the eyes. Needling Danzhong, Zhongwan, and Qihai courses the liver, resolves depression, boosts qi, and moves the blood. Xuehai is located on the foot taiyin spleen meridian. Zusanli is located on the foot yangming stomach meridian. Needling Xuehai and Zusanli strengthens the spleen and stomach, which also helps to boost qi and move the blood.

Summary
Modern research supports the use of acupuncture for the treatment of AD. Acupuncture improves cognitive functions and living ability for AD patients without causing severe side effects. Given that acupuncture outperforms donepezil, it is worthwhile to test a combination of acupuncture and donepezil in an integrated protocol to determine whether or not the combination is synergistic. The hope is that a comprehensive treatment strategy will yield substantial results in the fight against Alzheimer’s disease.

References
[1] Gu W, Jin XX, Zhang YJ, Li ZJ, Kong Y. Clinical observation of Alzheimer’s disease treated with acupuncture [J]. Chinese Acupuncture and Moxibustion, 2014,34(12):1156-1160.
[2] Kuang BP. Drug science for neurological disease [M]. Beijing: People’s Medical Publishing House, 2008: 560-561.
[3] Li SH, Chen BG. Brief discussion on “heart governs the bright spirit” [J]. Tianjin Journal of Traditional Chinese Medicine, ,2009,26(05):396-397.

Source: HealthCMi

Acupuncture Increases Drug Efficacy For Trigeminal Neuralgia

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Acupuncture Increases Drug Efficacy For Trigeminal Neuralgia

 

Acupuncture increases the efficacy of drug therapy for the relief of trigeminal neuralgia by 20%. Researchers from the Affiliated Huzhou Traditional Chinese Medicine Hospital of the Zhejiang Chinese Medical University conclude that acupuncture combined with carbamazepine delivers consistent positive clinical outcomes for patients with trigeminal neuralgia, a pain disorder of the face involving the 5th cranial nerve.

Carbamazepine monotherapy produced a 70.0% total effective rate. Adding acupuncture to the treatment protocol increased the total effective rate to 90.3%. [1] Carbamazepine is an anticonvulsant and analgesic benzodiazepine drug used for the treatment of seizures and nerve pain. In addition, 6-month follow-up examinations confirm that acupuncture produces lasting and significant clinical results.

The results were measured with VAS scoring, pain frequency, and the MOS 36-item short-form health survey (SF-36) scoring at the completion of all medical treatments. SF-36 is constructed to assess the following eight parameters: physical activities, social activities, physical role activities, bodily pain, mental health, emotional role activities, vitality, and general health perceptions. Lower scores in SF-36 assessments denote a lower quality of life.

Both groups (i.e., drug monotherapy, acupuncture plus drugs) showed significant improvements across all testing measures after completion of treatments. However, the acupuncture plus drugs group produced superior patient outcomes. The VAS score was 5.07 ±0.83 in the acupuncture plus drugs group, and 5.13 ±0.88 in the drugs only group. The pain frequency was 8.21 ±1.89 times per week in the acupuncture plus drugs group, and 10.14 ±2.13 times per week in the drugs only group. The SF-36 score was 140.26 ±13.58 in the acupuncture plus drugs group, and 121.21 ±15.16 in the drugs only group.

Another set of measurements were made in a 6-month follow-up for all patients in the study. The results indicate that acupuncture plus drugs produces lower VAS scores and symptom frequency and higher SF-36 scores compared with the drugs only group. The VAS score was 2.37 ±0.72 in the acupuncture plus drugs group, and 4.26 ±1.03 in the drugs only group. The pain frequency was 3.00 ±2.74 times per week in the acupuncture plus drugs group, and 4.26 ±1.03 times per week in the drugs only group. The SF-36 score was 180.51 ±15.25 in the acupuncture plus drugs group, and 150.59 ±12.38 in the drugs only group. There was a significant difference between the two groups for all parameters, indicating that acupuncture increases clinical efficacy in the long-term.

 

Design
A total of 61 patients were treated and evaluated in the study. All patients were diagnosed with trigeminal neuralgia. They were randomly divided into an acupuncture plus drugs group and a drugs only group, with 31 and 30 patients in each group respectively. Inclusion criteria were as follows. All participants were diagnosed with trigeminal neuralgia according to the third edition of the International Classification of Headache Disorders (ICHD-3). In addition, patients participating in the study met the following inclusion criteria:

  • Frequent attacks of pain
  • 18–80 years of age

Exclusion criteria were applied. Patients having the following conditions did not participate in the study:

  • Severe primary and comorbid heart, liver, kidney diseases that affect drug metabolism
  • Infection, ulcers, scars and other abnormalities of acupuncture sites
  • Malignant tumors, blood system diseases, cerebrovascular disorders, and other serious life-threatening conditions
  • Pregnant or lactating
  • Conditions that affect observation or laboratory indicators

The statistical breakdown for each randomized group was as follows. The acupuncture plus drugs group was comprised of 13 males and 18 females. The average age in the acupuncture plus drugs group was 54 years. The average course of disease in the acupuncture plus drugs group was 4.74 years. The drugs only group was comprised of 12 males and 18 females. The average age in the drugs only group was 59 years. The average course of disease in the drugs only group was 6.62 years. There were no significant statistical differences in terms of gender, age, and course of disease relevant to patient outcome measures.

 

Treatment
Both groups received identical drug therapy. The dose of carbamazepine started at 100 mg and increased by 100 mg every day until pain control was achieved. The average dose was 400–800mg per day. The maximum dose was 1200 mg. After reaching the maximum, the dose was gradually decreased until the minimum effective dose was obtained. The drug was taken twice per day. Each treatment course consisted of 7 days of drug treatment. All patients received 4 treatment courses in total. The primary acupoints selected for acupuncture treatment were the following:

  • Heart (auricular acupuncture)
  • Lung (auricular acupuncture)
  • Shenmen (auricular acupuncture)
  • LI20 (Yingxiang)
  • EX-HN-22 (Anmian)
  • ST36 (Zusanli)
  • ST2 (Sibai)
  • ST4 (Dicang)
  • ST7 (Xiaguan)
  • ST44 (Neiting)
  • LV3 (Taichong)
  • Ashi points

Additional acupoints were selected on an individual symptomatic basis. For ophthalmic pain, the following acupoints were added:

  • BL2 (Cuanzhu)
  • GB14 (Yangbai)

For maxillary pain, the following acupoints were added:

  • ST3 (Juliao)
  • SI18 (Quanliao)

For mandibular pain, the following acupoints were added:

  • CV24 (Chengjiang)
  • ST6 (Jiache)

After disinfection of the acupoint sites, a 0.25 × 40mm disposable filiform needle was inserted perpendicularly into each acupoint with a high needle entry speed. The attenuating (xie) technique was applied. Once a deqi sensation was obtained, the needles were retained for 30 minutes. The treatment was conducted once per day, 6 times per week. Each treatment course consisted of 6 days of acupuncture treatments, followed by a 1-day break. All patients received 4 treatment courses in total.

 

Evaluation
Patients were evaluated before and after the full treatment course. First, all patients underwent Visual Analogue Scale (VAS) assessments before and after their treatments. VAS is a measurement instrument used to measure pain intensity. Second, pain frequency was documented. Third, quality of life was measured according to the MOS 36-item short-form health survey (SF-36). After completion of treatment, the efficacy rates for each patient were categorized into 1 of 4 tiers:

  • Recovery: pain stopped and did not recur during the 6 months of follow-up
  • Significantly effective: pain was significantly relieved and pain frequency was reduced by 75%
  • Effective: pain was relieved and pain frequency was reduced by 50%.
  • Ineffective: no change in pain and pain frequency was reduced by less than 25%

 

Summary
The results indicate that acupuncture plus drug therapy is more effective than drug monotherapy. Carbamazepine monotherapy produced a 70.0% total effective rate and acupuncture plus carbamaepine produced a total effective rate of 90.3%. The study mentioned in this report demonstrates that acupuncture is safe and effective for the treatment of trigeminal neuralgia. Important features of TCM (Traditional Chinese Medicine) protocols is that they produce both short-term and long-term patient outcomes without causing significant adverse effects.

 

Reference
[1] Pan ZQ, Fu RY, Lin XM. Clinical Study on Mind-regulating Acupuncture in Treating Primary Trigeminal Neuralgia [J]. Shanghai Journal of Acupuncture and Moxibustion, 2017, 36(9):1069-1073.

Source: HealthCMi

 

Acupuncture Benefits Sleep In Lab And Clinical Trials

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Acupuncture Benefits Sleep In Lab And Clinical Trials

 

Hunan University of Traditional Chinese Medicine researchers find acupuncture effective for the treatment of insomnia. Their controlled laboratory investigation finds acupuncture effective for the regulation of sleep latency and duration. In addition, the researchers identified important biological responses elicited by acupuncture responsible for its effective actions.

In a quantification of acupuncture’s mechanisms, the research team of Wu et al. identified biochemical responses elicited by the application of three acupuncture point prescriptions. Baihui (GV20) plus Shenmen (HT7), Baihui plus Sanyinjiao (SP6), and Baihui plus a non-acupuncture point increased levels of 5-HT 1a receptor mRNA while decreasing levels of 5-HT 2a receptor mRNA in the hypothalamus of insomnia model rats. The researchers conclude, “Although all three acupuncture prescriptions produced positive outcomes, Baihui plus Shenmen produced the most significant results.”

This finding confirms the Traditional Chinese Medicine (TCM) indication that Shenmen is an effective acupuncture point, specifically for the treatment of insomnia. In many ways, this is a very unusual laboratory experiment. The methodology to determine sleep latency and duration varies greatly from standard human clinical trials. Nonetheless, the biomarkers measured in this experiment are consistent with the findings.

Previous studies have found that 5-hydroxytryptamine (5-HT) regulates the sleep-awakening cycle. It promotes awakening but also induces non-rapid eye movement sleep (NREM). In addition, 5-HT can work with norepinephrine (NE) to trigger rapid eye movements (REM). [2] The 5-HT 1a receptor is a subtype serotonin receptor. When binding, 5-HT regulates REM sleep and REM latency. The 5-HT 2a receptor is another subtype of serotonin receptor and can trigger wakefullness. [3]

 

Design
Sixty rats were randomly divided into 5 groups, including a control group, a model group, a Baihui plus Shenmen group, a Baihui plus Sanyinjiao group, and a Baihui plus non-acupuncture point group, with 12 rats in each group. Parachlorophenylalanine (PCPA) was injected intraperitoneally to establish rat models of insomnia. PCPA is a 5-HT synthesis inhibitor. It can decrease 5-HT levels in the central nervous system (CNS). [4] In a laboratory setting, PCPA is commonly used to make insomnia model rats. After 36 hours of establishing the model, the rats showed symptoms such as loss of circadian rhythms, constant activity during the day and night, hypersensitivity to external stimuli (r.g., light, sound), and irritability.

 

Treatment
The control group received no intervention. The model groups were immobilized on a rat plate in a supine position, once a day, 30 min per session, for 7 consecutive days. The acupoints selected bilaterally for the three acupuncture treatment groups were the following:

  • Baihui plus Shenmen group: GV20 (Baihui), HT7 (Shenmen)
  • Baihui plus Sanyinjiao group: GV20 (Baihui), SP6 (Sanyinjiao)
  • Baihui plus Non-acupoint group: GV20 (Baihui), non-acupuncture point on the arm

Upon disinfection of the acupoint sites, a 0.32 mm × 25 mm filiform acupuncture needle was inserted into the acupoints. For Baihui, the needle was inserted horizontally for 20 mm from back to front. For Shenmen, the needle was inserted perpendicularly, reaching a depth of 1 mm. For Sanyinjiao and the non-acupuncture point, the needle was inserted perpendicularly to a depth of 5 mm. The non-acupuncture point was located on the midpoint of the elbow tip and the armpit. After achieving a deqi sensation, the Ping Bu Ping Xie (attenuating and tonifying) manipulation technique was applied, with a twisting range of 180 degrees and a frequency of 60 times per minute. A 60 second manipulation was conducted every 10 minutes during each 30 minute needle retention time. The acupuncture treatment was conducted daily, for 7 consecutive days.

 

Results
Real-time fluorescence quantitative PCR was used to detect the expression of 5-HT 1a and 5-HT 2a receptor mRNA in the hypothalamus of the rats. The sleep latency and sleep duration were recorded. In this sodium barbital-induced sleeping study, sleep is defined as the time during which there is disappearance of righting reflex (self-correction of the body’s orientation). Awakening is defined as the time during which there is appearance of righting reflex. Sleep latency refers to the time between the injection of sodium barbital and disappearance of righting reflex. Sleep duration refers to the time between disappearance of righting reflex and awakening.

Compared with the control group, the expression of 5-HT 1a receptor mRNA in the model group was significantly decreased, and the expression of 5-HT2a receptor mRNA was significantly increased. Compared with the model group, the expression of 5-HT 1a receptor mRNA in the Baihui plus Shenmen group was significantly increased, and the expression of 5-HT2a receptor mRNA was significantly decreased. This is consistent with the testing of reflexes determining that this acupuncture combination benefits sleep.

Compared with the Baihui plus Shenmen group, the expression of 5-HT 1a receptor mRNA was significantly decreased in the Baihui plus Sanyinjiao group and the Baihui plus non-acupuncture point group. There was no significant difference in the expression of 5-HT 2a receptor mRNA between the Baihui plus Shenmen group and the Baihui plus Sanyinjiao group. The expression of 5-HT 2a receptor mRNA in the Baihui plus non-acupuncture point group was significantly higher. Compared with the control group, the model group had more delayed sleep latency. Compared with the model group, all three treatment groups had improved sleep latency.

Compared with the control group, the model group had shorter sleep duration. Compared with the model group, the Baihui plus Shenmen group had a longer sleep duration. There was no significant difference between the model group and the other two treatment groups. Among the treatment groups, the Baihui plus Shenmen group had longest sleep duration. There was no significant difference between the Baihui plus Sanyinjiao group and the Baihui plus non-acupuncture point group.

 

Summary
The results of the aforementioned research indicates that acupuncture is an effective treatment modality for the treatment of insomnia. Researchers demonstrate that acupuncture improves sleep latency and duration while simultaneously regulating pathways responsible for providing anti-insomnia effects to the hypothalamus of insomnia model rats.

Human clinical trials confirm that acupuncture is an effective modality for the treatment of insomnia. For example, China PLA Navy General Hospital researchers confirm that foot acupuncture alleviates insomnia. [5] Taipei Medical University researchers conducted a human clinical trial and determined that acupuncture regulates hormone levels and alleviates insomnia related to menopause. [6] In another human clinical trial, researchers find acupuncture more effective than estazolam (a benzodiazepine) for the treatment of insomnia. [7]

The aforementioned human clinical trials and others are included in the Healthcare Medicine Institute (HealthCMi) acupuncture continuing education course entitled Acupuncture For Insomnia. The online course covers diagnostics, acupuncture point prescriptions, and an array of scientific research demonstrating optimal acupuncture points for the treatment of sleep disorders. To see a sample of the course materials, click the following:

Acupuncture For Insomnia >

 

References
[1] Wu XF, Yuan JL, Zheng XN, Guo X, Chen XL, et al. Effect of Acupuncture Treatment on 5-HT1a and 5-HT2a mRNA Expression in Hypothalamus of Insomnia Rats [J]. Chinese Journal of Rehabilitation, ,2018, 33(05):360-364.
[2] Gu SZ, Dou DB. Research Progress of Traditional Chinese Medicine on HPA Axis Related Monoamine Neurotransmitters and ​Hormones in PCPA Insomnia Rat Model [J]. Journal of Shanghai University of Traditional Chinese Medicine, 2015, 29(1): 83-86.
[3] Sue JW, Jayne EB, Ann SR, et al. The use of sleep measures to compare a new 5HT1A agonist with buspirone in humans [J]. Nutt J Psychopharmacol, 2005, 19(11): 609-611.
[4] Gao HL, Tu X, Lu Y, et al. Rat model of Insomnia Caused by Heart and Kidney Disharmony [J]. Chinese Medicine, 2014, 36(6): 1138-1141
[5] Ma GH, Wei T & Chen TT. (2013). Efficacy of Treating Diseases by Managing Lower Plantar Acupuncture based Therapy in 42 Cases of Insomnia. JACM. 29(8). 
[6] Hsiao-Yean Chiu, Yu-Jung Hsieh, and Pei-Shan Tsai, “Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women,” Obstetrics & Gynecology 127, no. 3 (March 2016), pg 513.
[7] Wang YJ, Zhang LH, Han YX, Li PP. Efficacy observation on Governor Vessel-unblocking and mind-calming acupuncture for insomnia. Journal of Acupuncture and Tuina Science. 2016 Jul 1;14(4):274-8.

Source: HealthCMi

Acupuncture Beats Drugs for Prostatitis

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Acupuncture Beats Drugs For Prostatitis

 

Acupuncture outperforms drugs for the treatment of chronic prostatitis. Researchers from the First Affiliated Hospital of Chongqing Medical University gathered objective and subjective data in a controlled clinical trial consisting of patients with chronic prostatitis. The acupuncture treatment group achieved a total effective rate of 87.5% and the drug control group achieved a total effective rate of 62.5%.

National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores indicate that acupuncture produces significant improvements in pain or discomfort intensity levels, urinary symptoms, and quality of life scores. Urethral sphincter electromyography uroflow rates show that acupuncture restores urethral sphincter and pelvic floor muscle function. The researchers conclude that acupuncture significantly outperforms drugs for the treatment of chronic prostatitis. [1]

 

Design
Researchers (Zhang et al.) used the following study design. A total of 48 patients were treated and evaluated in this study. All patients were diagnosed with chronic prostatitis. They were randomly divided into an acupuncture treatment group and a drug control group, with 24 patients in each group. Patients from the control group consumed one tablet each of sparfloxacin and Prostat tablets, twice a day, for a total of 4 weeks. Sparfloxacin is a fluoroquinolone antibiotic used for patients with bacterial infections. Prostat contains pollen extract EA-10 and P5 and is used in the treatment of benign prostatic hyperplasia and chronic prostatitis. The treatment group received electroacupuncture monotherapy. The diagnostic criteria included the following:

Symptoms (perineal and lumbosacral pain, abnormal urination) lasting for more than 3 months
Hard, tender, and normal sized/enlarged prostate found by the digital rectal exam
Positive or negative results for urine and prostatic secretion tests
NIH-CPSI scores ≥ 10

 

Acupuncture Points
Patients from the treatment group received acupuncture at the following primary acupoints:

  • CV4 (Guanyuan)
  • 
CV3 (Zhongji)
  • 
BL32 (Ciliao)
  • 
BL35 (Huiyang)

Additional secondary acupoints were added based on differential diagnostic considerations:

  • Qi and blood stagnation: LV3 (Taichong), SP10 (Xuehai), SP6 (Sanyinjiao)
  • Damp-heat pouring downward: LV3 (Taichong), ST40 (Fenglong), SP9 (Yinlingquan)

  • Fire excess due to yin deficiency: KI3 (Taixi), BL23 (Shenshu), SP6 (Sanyinjiao)

  • Kidney yang deficiency: BL23 (Shenshu), CV6 (Qihai), ST36 (Zusanli)

Upon disinfection of the acupoint sites, a 0.30 mm × 50 mm filiform acupuncture needle was inserted into each acupoint to a depth of 25-35 mm. Needles were rotated, lifted, and thrust rapidly after insertion to achieve a deqi sensation. For Guanyuan, Zhongji, Ciliao, and Huiyang, a deqi sensation radiating toward the perineum, penis, and testicles was noted by the researchers as producing better clinical outcomes. It is written in the Ling Shu (The Miraculous Pivot) that “A deqi sensation in the lesion area ensures the effectiveness of acupuncture.”

The acupuncture needles were attached to an electroacupuncture device. A continuous wave (1 Hz) was applied with an intensity level set to patient tolerance levels or until muscle contractions were observable. A 30 minute needle retention time was observed, timed from the initiation of electroacupuncture current. Electroacupuncture was applied once per day. Each treatment course consisted of 8 acupuncture treatments followed by a two-day break before the next course began. All patients received a total of 3 treatment courses.

 

Scoring
NIH-CPSI scores, changes in urethral sphincter electromyography determined uroflow rates, and total efficacy rates were measured before and after treatment. NIH-CPSI is a measurement instrument used to assess symptom severity in patients with chronic prostatitis. NIH-CPSI measures three different aspects including pain, urinary symptoms, and quality of life. Higher scores in NIH-CPSI assessment denote a more severe condition.

The urethral sphincter electromyography determined uroflow rate is a non-invasive test used to assess sphincter and pelvic floor muscle function, including measurements of maximum urine flow rates (Qmax), average urine flow rates (Qave), and TL value. TL value is a derived parameter from urethral sphincter EMG used to measure the degree of detrusor-sphincter synergia. [2] TL quantifies coordination of the detrusor and sphincter; “In normal humans, the bladder is supposed to empty by a synergistic contraction of the detrusor and relaxation of the sphincter during micturition.” [3] If both contract simultaneously, it is termed detrusor-sphincter dyssynergia. After completion of treatment, the efficacy rate for each patient was categorized into 1 of 3 tiers:

  • Recovery: Complete absence of symptoms. NIH-CPSI scoring reduction of at least 2/3.
  • Normal Qmax, Qave, and TL value.
  • 
Effective: Improvement of symptoms. NIH-CPSI scoring reduction of 1/3 to 2/3. Improvement of Qmax, Qave, and TL value.
  • 
Ineffective: No improvement of symptoms. NIH-CPSI scoring reduction of less than 1/3. No improvement of Qmax, Qave, and TL value.

 

Basis
The researchers provided a historical context for the acupuncture point selection administered during the investigation. Guanyuan and Zhongji are located on the Ren meridian. Needling Guanyuan reinforces the kidneys and strengthens yang energy. Guanyuan is indicated for seminal emission, impotence, inhibited urination, frequent urination, lower abdominal pain, and white turbidity of urine. According to the Qian Jin Yao Fang (A Thousand Gold Pieces Formulary), Zhongji is indicated for lower back pain, inhibited urination, impotence, premature ejaculation, and white turbidity of urine. Ciliao and Huiyang are located on the foot Taiyang bladder meridian. Ciliao is indicated for lower back pain, strangury (blockage or irritation of the bladder resulting in pain or urgent urination), and red urine. Needling Huiyang resolves dampness, clears heat, replenishes essence, and benefits the kidneys.

 

Summary
Subjective clinical and objective electromyography data indicate that acupuncture outperforms drugs for the treatment of chronic prostatitis. According to the research, common protocols involve the application of acupoints Guanyuan (CV4), Zhongji (CV3), Ciliao (BL32), and Huiyang (BL35) for this condition. Patients interested in learning more about acupuncture are recommended to contact a local licensed acupuncturist.

 

Prostatis vs. Benign Prostatic Hyperplasia (BPH)
Prostatitis is a term referring to prostate inflammation, usually caused by injury or infection. Bacterial infections in the blood (bacteremia) may cause prostatitis. Inflammation of the epididymis (epididymitis) may also cause prostatitis. The epididymis is a duct posterior to the testis that sperm passes through. Risk factors include catheterization, prostate biopsy, and pelvic trauma. Dysuria (painful or difficult urination), frequent urination, nocturia, urgent urination, hematuria (blood in the urine), painful ejaculation, and pain in the groin, penis, or testicles are all symptoms associated with prostatitis. Benign prostatic hyperplasia (BPH) is a different condition wherein the prostate becomes enlarged. It usually occurs as a result of aging. The aforementioned research applies to prostatitis.

 

References
[1] Zhang J, Liu CD, Ding Y, Tang QB. Clinical Observation on Therapeutic Effect of Electroacupuncture on Chronic Prostatitis and Detection of Urethral Sphincter EMG [J]. Chinese Acupuncture & Moxibustion, 2010,30(1):13-17.
[2] Qu CY, Xu DF, Wang CZ, Chen J, Yin L, Cui XA. Anal Sphincter Electromyogram for Dysfunction of Lower Urinary Tract and Pelvic Floor. 2017.
[3] Chang, Shyang, Shu-Ting Mao, Shih-Jen Hu, Wen-Ching Lin, and Chen-Li Cheng. “Studies of detrusor-sphincter synergia and dyssynergia during micturition in rats via fractional Brownian motion.” IEEE transactions on biomedical engineering 47, no. 8 (2000): 1066-1073.

Source: HealthCMi

Acupuncture Low Back Disc Protrusion CT Scan Results

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Acupuncture Low Back Disc Protrusion CT Scan Results

 

Acupuncture is effective for patients with lumbar disc protrusions. CT scans confirm that acupuncture reduces disc protrusion size and increases healthy space in the spinal canal. Along with relief from nerve compression, investigators conclude that acupuncture improves range of motion and reduces pain for patients with lumbar disc protrusions.

Researchers from the Nanyang Municipal Central Hospital tested two acupoint prescriptions. The results of the investigation demonstrate that both acupuncture point prescriptions that were tested are effective for alleviating lumbar disc protrusions, but one is more effective than the other. We will take a look at both. CT (computed tomography) scans confirm the results, including improvements across multiple parameters (i.e., anteroposterior diameter of the thecal sac, sagittal diameter of the spinal canal, nerve root compression ratio). [1]

Patients were evaluated before and after the treatment course. Both subjective and objective instruments were used to measure patient outcomes. The objective data was gathered using CT scans (also known as CAT scans), which are computer-processed X-ray images. The scans demonstrate that acupuncture reduces disc protrusions and alleviates nerve compression. CT images confirmed improvements in the thecal sac anteroposterior diameter and sagittal diameter of the spinal canal as well as the nerve root compression ratio.

Subjective data was gathered with two instruments. First, the Oswestry Disability Index (ODI) was used to measure functional disability of the lower back. Second, the Japanese Orthopedic Association Lower Back Pain Evaluation Questionnaire (JOABPEQ) was used as an outcome measure for patients with lumbar disc protrusions. Patients demonstrated improvements with both the ODI and JOABPEQ.

 

Symptoms
The following are results of the ODI and JOABPEQ for two separate groups receiving two different acupuncture treatment point prescriptions. The ODI score for the standard acupuncture control group averaged 23.35 before treatment and 8.34 after treatment. The ODI score for the acupuncture Yao San Zhen (lumbar three needles) treatment group averaged 23.12 before treatment and 5.28 after treatment.

The JOABPEQ score for the standard acupuncture control group was 6.22 before treatment and averaged 17.14 after treatment. The JOABPEQ score for the acupuncture Yao San Zhen (lumbar three needles) treatment group averaged 6.35 before treatment and 21.53 after treatment. The researchers conclude that the Yao San Zhen treatment group outperformed the standard acupuncture control group regarding the improvements of ODI and JOABPEQ scores.

 

CT Scans
The thecal sac (dural sac) is a sheath around the spinal cord (above L2) and cauda equina. It is composed of dura mater, which is a thick connective tissue membrane. The anteroposterior diameter of the thecal sac for the standard acupuncture control group decreased to an average of 35.72 mm after treatment, from a pre-treatment value of 56.44 mm. The anteroposterior diameter for the Yao San Zhen acupuncture treatment group averaged 56.35 mm before treatment and 26.14 mm after treatment. These measurements indicate a decrease in the size of the disc protrusions.

The sagittal diameter of the spinal canal for the standard acupuncture control group averaged 6.32 mm before treatment and 11.16 mm after treatment. The sagittal diameter for the Yao San Zhen acupuncture treatment group was 6.51 mm before treatment and 14.24 mm after treatment. This parameter is negatively associated with lumbar pain and the improvements are reflected by higher numbers. The Yao San Zhen style of acupuncture outperformed the standard acupuncture protocol.

The nerve root compression ratio for the standard acupuncture control group averaged 0.64 before treatment and 0.48 after treatment. The nerve root compression ratio for the treatment group averaged 0.67 before treatment and 0.32 after treatment. Both groups achieved significant improvements in CT measured parameters. Overall, the improvements were greater for the Yao San Zhen acupuncture treatment group.

 

Correlation Between ODI and CT
Correlation between ODI and CT parameters (anteroposterior thecal sac diameter, sagittal spinal canal diameter, nerve root compression ratio) for two groups were analyzed. The results showed that the anteroposterior diameter and nerve root compression ratio were positively correlated with ODI scores, while the sagittal diameter of was negatively correlated with ODI scores. The researchers concluded that, “In patients with lumbar disc protrusion, the more severe the nerve root compression, the narrower the sagittal diameter on the CT, and the larger the anteroposterior diameter of the thecal sac, the more serious the clinical symptoms.”

 

Design
A total of 78 patients participated in the study. They were diagnosed and treated for lumbar disc protrusions between January 2016 and January 2017. The following inclusion criteria were applied:

  • Meeting the diagnostic criteria for both western medicine and Traditional Chinese Medicine
  • Ages between 20–50 years
  • Pain in the lower back and lower extremities
  • Confirmed lumbar protrusions by CT or MRI
  • Positive straight leg raise (SLR) test

The following exclusion criteria were applied:

  • Comorbid tumors, lumbar vertebral spondylolisthesis, spinal stenosis, and spinal compression fractures
  • Severe and comorbid blood diseases and coagulation disorders
  • Pregnant or lactating
  • Neurological or mental diseases

Participants were randomly divided into two groups: Yao San Zhen treatment and standard acupuncture control, with 39 participants in each group. Both groups were equivalent in all relevant demographics. The treatment group was comprised of 26 males and 13 females. The average age of the Yao San Zhen treatment group was 39.21 years. The course of treatment of the Yao San Zhen treatment group was 3.53 months. The control group was comprised of 24 males and 15 females. The average age of the treatment group was 38.37 years. The course of treatment of the treatment group was 3.32 months.

 

Acupuncture Sessions
Patients from both groups received the following acupuncture points:

  • Huatuojiaji
  • GB30 (Huantiao) affected side
  • BL54 (Zhibian) affected side
  • Ashi points

Secondary acupuncture points were added bilaterally based on diagnostic considerations:

  • Lower back pain due to cold-dampness: BL39 (Weiyang), GV3 (Yaoyangguan)
  • Lower back pain due to damp-heat: GB34 (Yanglingquan), SP6 (Sanyinjiao)
  • Lower back pain due to blood stasis: SP10 (Xuehai), BL17 (Geshu)
  • Lower back pain due to kidney deficiency: KD3 (Taixi), GV4 (Mingmen)

Acupuncture treatments commenced with patients in a prone position. After disinfection of the acupoint sites, a 40 or 75 mm disposable filiform needle was inserted into each acupoint with a high needle entry speed, reaching a depth of 1–1.5 cun (with the exception of 2–3 cun for Huantiao). After achieving a deqi sensation, the needles were manipulated with the Ping Bu Ping Xie (attenuating and tonifying) technique.

The acupuncture needles were connected to an electroacupuncture device. A low frequency continuous wave (5–10 Hz) was applied with an intensity level set to patient tolerance levels or until muscle contractions were observable. The needles were retained for 30 minutes after the initiation of electric current.

For the treatment group patients, a special acupoint prescription called Yao San Zhen (lumbar three needles) of Jin’s three needling technique was added. This technique was established by Dr. Jin Rui, Ph.D. (chief professor supervisor of Guangzhou University of Traditional Chinese Medicine). The principle of the technique is to use three needle combinations to treat specific diseases. The Yao San Zhen prescription utilized the following acupoints:

  • BL23 (Shenshu)
  • BL25 (Dachangshu)
  • BL40 (Weizhong)

Needles were inserted into each acupoint with a high needle entry speed, reaching a maximum depth of 1–1.5 cun. Upon the arrival of a deqi sensation, the needles were manipulated with the Ping Bu Ping Xie (attenuating and tonifying) technique. A 30 minute needle retention time was observed. For both groups, treatments were applied every two days, 10 sessions as one treatment course, for a total of 8 weeks.

 

Summary
The clinical results demonstrate that acupuncture produces positive patient outcomes for the treatment of lumbar disc protrusions. Patients that received acupuncture saw improvements in ODI and JOABPEQ scores and parameters measured by CT (i.e., anteroposterior diameter of the thecal sac, sagittal diameter of the spinal canal, nerve root compression ratio). The data indicates that acupuncture is safe and effective for the treatment of lumbar disc protrusions.

 

Reference
[1] Fang F, Wei YX. Clinical observation on lumbar three needles in the treatment of lumbar disc protrusion and imaging changes [J]. World Chinese Medicine, 2018(5).

Source: HealthCMi

 

Acupuncture Fights Influenza

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Acupuncture Fights Influenza, Decreases Mortality Rate

 

Acupuncture is effective for the treatment of influenza. Two independent investigations confirm acupuncture’s efficacy for fighting influenza. One laboratory investigation tested acupuncture as a monotherapy and determined that acupuncture lowers mortality rates, increases serum interferon levels, and improves the phagocytosis of viruses. Another investigation finds acupuncture effective for enhancing the clinical efficaciousness of anti-viral drugs. Let’s start with the integrative investigation and we’ll look at the acupuncture monotherapy next.

Researchers from the Taizhou Municipal Hospital combined acupuncture with standard drug therapy. Patients receiving both oseltamivir and acupuncture in a combined treatment protocol had superior patient outcomes compared with patients receiving only oseltamivir. [1] In an independent laboratory experiment, the researchers proved that acupuncture exerts an antiviral effect by increasing the serum level of interferon (IFN) and improves phagocyte function in rats with influenza virus infections. [2]

The research team of Lang et al. compared a control group receiving only oseltamivir (an antiviral drug, also known by the brand-name Tamiflu) and a treatment group receiving both acupuncture and oseltamivir. The treatment group patients had significantly shorter recovery times for relieving fever, pharyngodynia (pharynx pain), and coughing. The researchers conclude that the addition of acupuncture to an oseltamivir treatment regimen increases the effective rate of oseltamivir for the treatment of influenza. Furthermore, the researchers conclude that acupuncture is both effective and safe; acupuncture did not produce any severe adverse effects.

 

Results
Following treatment, the average recovery time from fever was 63.80 hours in the drug monotherapy control group and 57.05 hours in the acupuncture plus drug treatment group. On average, acupuncture reduced fevers by 6.75 hours.

The average recovery time from pharyngodynia was 80.35 hours in the control group and 71.25 hours in the treatment group. Acupuncture improved the pharynx pain recovery time by 9.1 hours.

The average recovery time from coughing and other symptoms was 115.20 hours in the drug monotherapy control group and 104.70 hours in the acupuncture plus drug treatment group; acupuncture produced an improvement of 10.5 hours. The recovery time refers to the time it takes to completely relieve symptoms (including body temperature ≤37.4 degrees Celsius) for at least 24 hours from the start of treatment. The results showed that acupuncture significantly increases the total effective rate of oseltamivir and the combined therapy shortens the development course of H1N1 influenza.

 

Design
Researchers (Lang et al.) used the following study design. A total of 80 patients diagnosed with H1N1 influenza were treated and evaluated They were randomly divided into an acupuncture plus drug treatment group and a drug monotherapy control group, with 40 patients in each group. Inclusion criteria were established and included the following:

  • H1N1 influenza diagnosis
  • Body temperature ≥38 degrees Celsius
  • At least two indicative symptoms (e.g., sore throat, coughing)

The statistical breakdown for each randomized group entering the study was as follows. The control group was comprised of 22 males and 18 females. The average age in the control group was 22.55 years. The average course of disease in the control group was 21.73 hours. The body temperature in the control group was 38.59. The treatment group was comprised of 19 males and 21 females. The average age in the treatment group was 24.05 years. The average course of disease in the treatment group was 20.89 hours. The body temperature in the treatment group was 38.71. There were no significant statistical differences in gender, age, course of disease, and body temperature relevant to patient outcome measures for patients initially admitted to the study.

 

Treatment Procedure
Both groups were given identical drug therapy. A total of 75 mg of oseltamivir was administered twice daily, for a total of 5 days as one treatment course. Symptomatic treatment (antipyretic analgesics, antitussives, or expectorants) were also given if necessary.

The treatment group received acupuncture treatment. The following primary acupoints were selected bilaterally for the treatment group:

  • LI11 (Quchi)
  • TB5 (Waiguan)
  • LI4 (Hegu)
  • LU5 (Chize)

Additional secondary acupoints were added based on symptom presentation:

  • High fever: GV14 (Dazhui)
  • Severe cough: LU6 (Kongzui)
  • Sore throat: LU10 (Yuji), LU11 (Shaoshang)

After insertion, needles were manipulated with the attenuation (xie) technique for 2–3 times during a 10–15 minute needle retention time. For Yuji and Shaoshang (used for sore throat patients), the bleeding technique was applied instead of using the attenuation technique. The acupuncture treatment was administered daily, for a total of 5 days as one treatment course.

The Taizhou Municipal Hospital researchers determined that acupuncture improves outcomes for influenza patients taking oseltamivir. This includes reductions of fevers and symptomatic relief. Overall, the total recovery time improves when acupuncture is added to the drug therapy treatment regimen.

 

Nanjing University
In another investigation, Nanjing University of Traditional Chinese Medicine (TCM) researchers investigated the effect of acupuncture and moxibustion on rats infected with influenza virus. They found that both acupuncture and moxibustion decrease the mortality rate and increase the average survival time. In addition, they document that both TCM therapies significantly increase the serum level of IFN and improve phagocytosis of viruses.

Interferon (IFN) plays a major role in defective neutrophil recruitment and influenza virus killing. [3] The researchers conclude that both acupuncture and moxibustion are effective for the treatment of influenza. Notably, acupuncture produced superior outcomes over moxibustion therapy.

Three groups were compared. The first group received acupuncture. The second group received moxibustion. The third group was a control. For the acupuncture treatment group, a needle was inserted into one single point (Dazhui, GV14) and was manipulated with the twisting technique with a frequency of 30–50 times per minute. For the moxibustion treatment group, 10–15 mg of moxa cigar cuttings were applied upon the acupoint Guanyuan (CV4). A total of 4 cuttings were used in one treatment session. The above treatments were conducted daily, for 3 consecutive days in total. The control group received no treatment.

The mortality rate of the acupuncture treatment group was 63.5% and was 78.6% for the moxibustion group. The control group mortality rate was 96.4%. In addition, overall survival times improves in the acupuncture and moxibustion groups.

The serum IFN level of the acupuncture treatment group was 5.35 log IU/mL and that of the moxibustion treatment group was 4.22. The serum IFN level of both treatment groups was significantly higher that of the control group 2.63. The phagocytosis rate of virus infected cells for the acupuncture treatment group was 62.67% and was 50.58% for the moxibustion treatment group. Both were significantly higher than that of the control group, which was only 20.34%. Overall, acupuncture lower the mortality rate, increases serum interferon levels, and improves phagocytosis of viruses.

 

Summary
The aforementioned independent investigations indicate that acupuncture is an important treatment option for the treatment of influenza. Acupuncture improves the serum level of IFN and improves phagocytosis of viruses. Patients are encouraged to contact local licensed acupuncturists to consult about treatment options.

 

References
[1] Lang BX, Jin LQ, Liu SN, Liu XR. Clinical observation on the effect of acupuncture combined with conventional therapy on influenza H1N1 [J]. Chinese Archives of Traditional Chinese Medicine, 2011, 29(2):411-412.
[2] Chou YF, Cao YM, Wang JL, Yang ZM, Qiu ML. Protective effect of acupuncture on mice infected with influenza virus [J]. China Journal of Traditional Chinese Medicine and Pharmacy, 1990(2):16-18.
[3] Wenjing Li, Bruno Moltedo, Thomas M. Moran. Type I Interferon Induction during Influenza Virus Infection Increases Susceptibility to Secondary Streptococcus pneumoniae Infection by Negative Regulation of T Cells [J]. Journal of Virology, Oct 2012, 86 (22) 12304-12312.

Source: HealthCMi

Acupuncture Improves Eyesight For Diabetics

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Acupuncture Improves Eyesight For Diabetics

 

Acupuncture and herbs improve eyesight for patients with diabetic retinopathy. In a controlled clinical trial, Hubei Provincial Hospital of Traditional Chinese Medicine ophthalmology department researchers determined that herbal medicine monotherapy benefits vision. The addition of acupuncture to the treatment protocol significantly improved patient outcomes.

Diabetic retinopathy patients receiving acupuncture and herbal medicine demonstrated significant improvements in visual acuity. Also, patients demonstrated improvements in the health of the retina; there were reductions in ocular microaneurysms, hard exudate, cotton wool spots, retinal bleeding, edema, and leaking blood vessels. [1]

Before and after treatment, the data was verified with visual acuity tests (with the naked eye and correctional lenses). Additional tests confirm the data, including intraocular pressure and slit lamp exams. Testing of ocular blood flow, retinal thickness, and other parameters were tested with fluorescein angiography (FFA) and optical coherence tomography (OCT). OCT employs the use of light waves to take images of tissues that receive light. Glycated hemoglobin (HbA1c) and blood glucose levels were also taken into account.

The severity of diabetic retinopathy was assessed by the presence of various ocular clinical signs including: microaneurysms, hard exudate, cotton wool spots, retinal bleeding, edema, and the formation of new blood vessels. Patients showing improvement in four or more of these six areas were was classed as markedly effective. Patients showing improvement in two or more areas were classed as effective. Patients with no change were classified as ineffective. In the herb monotherapy group, 10 patients were markedly effective and 15 effective, producing a total effective rate of 71.4%. In the acupuncture plus herbs group, 15 patients were markedly effective and 15 were effective, producing a total effective rate of 83.3%. Visual acuity improved in both study groups: 58/70 in the herb monotherapy group and 61/72 eyes in the acupuncture plus herbs group.

 

Traditional Chinese Medicine
According to Traditional Chinese medicine (TCM) principles, diabetes mellitus is caused by qi and yin deficiency, stemming from liver and kidney deficiency syndrome. This leads to interior heat and dryness, bodily fluid and endogenous secretion insufficiency, and the formation of phlegm. These differential diagnostic imbalances result in blood stasis and reduced ocular blood flow. Primary treatment principles include supplementing qi, nourishing yin, and resolving blood stasis. On this basis, the participants in both groups were prescribed He Xue Ming Mu tablets, which contain the following ingredients:

  • Sheng Pu Huang
  • Sheng Di Huang
  • Huang Qin
  • Han Lian Cao
  • Dan Shen
  • Yu Jin
  • Chuan Xiong
  • Mu Dan Pi
  • Chi Shao
  • Ju Hua
  • Xia Ku Cao
  • Chong Wei Zi
  • Nu Zhen Zi
  • Jue Ming Zi
  • Che Qian Zi

A dose of five tablets (1.5g) was taken three times daily, swallowed with warm water after meals. Each course of treatment lasted 15 days and was separated by a three day interval. Follow-up appointments were administered two months into the treatment period and again after six months.

 

Acupuncture Treatment
In addition to He Xue Ming Mu tablets, participants in the acupuncture plus herbs group received acupuncture treatments. Treatment began with patients in a seated position and, following standard disinfection, 0.35mm × 40mm filiform needles were inserted at the following primary acupoints:

  • Fengchi (GB20)
  • Jingming (BL1)
  • Taiyang (MHN9)
  • Zanzhu (BL2)
  • Sizhukong (TB23)

Needles were inserted slowly and were manipulated using a balanced reinforcing-reducing technique, with a suitable degree of needle sensation directed towards the eyes. After obtaining deqi, needles were retained for 30 minutes. The patients were then moved to a treatment couch, and needles were inserted into the following secondary acupoints:

  • Guanyuan (CV4)
  • Sanyinjiao (SP6)
  • Ganshu (BL18)
  • Shenshu (BL23)

Needles were manipulated using a reinforcing method and were retained for 30 minutes. Treatments were administered every two days, with 30 days making up one course of care. A total of two courses were administered. The results indicate that herb monotherapy and acupuncture plus herbal medicine are both effective treatments for diabetic neuropathy.

 

Vision Loss
Diabetic retinopathy is the number one cause of vision loss. Diabetes affects more than 280 million people worldwide and about one third suffer from diabetic retinopathy. [2] Risk factors for diabetic retinopathy include hyperglycemia and hypertension. Diabetic retinopathy has been “ranked as the fifth most common cause of preventable blindness and fifth most common cause of moderate to severe visual impairment.” [3] The National Institutes of Health notes, “Diabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes and the leading cause of vision impairment and blindness among working-age adults.” [4]

All patients with diabetes are at risk. Early symptoms of diabetic retinopathy include a decrease in color vision, blurry vision, floaters or spots, dark areas in the visual field, and vision loss. Over time, the high blood sugar levels in diabetics may damage blood vessels in the retina (the eyeball rear layer containing light sensitive cells that send nerve impulses to the optic nerve). This causes fluid or blood leakage, which distorts vision. This may lead to scarring and retinal cell loss.

 

Outcomes
The outcomes of this study indicate that acupuncture combined with He Xue Ming Mu tablets improves visual acuity and slows the progression of diabetic retinopathy. To learn more, contact a local licensed acupuncturist.

The use of herbal medicine and acupuncture for the treatment of eye disorders has a long history in Traditional Chinese Medicine (TCM). One classic herbal formula used for the treatment of diabetic retinopathy and wet macular degeneration is Ning Xue Tang, containing the following ingredients:

  • Xian He Cao
  • Ce Bai Ye
  • Han Lian Cao
  • E Jiao
  • Sheng Di Huang
  • Bai Mao Gen
  • Zhi Zi Tan
  • Bai Shao
  • Bai Ji
  • Bai Lian

The clinical trial tested He Xue Ming Mu tablets, which shares Sheng Di Huang with Ning Xue Tang. Chi Shao is used in place of Bai Shao in Ning Xue Tang, focusing on invigorating and cooling blood over tonifying blood. Otherwise, this classic formula greatly varies from He Xue Ming Mu tablets. This, in part, is due to the fact that TCM has many individual herbs and herbal formulas that are designed for benefitting the eyes across multiple diagnostic patterns. Given the importance of eyesight, additional research is warranted to investigate the efficacy of acupuncture and herbal medicine for the treatment of vision disorders.

 

References:
1. Zhu Dan (2018) “Clinical Observation on Acupuncture Combined with He Xue Ming Mu Tablets in Treatment of Diabetic Retinopathy” Journal of Hubei University of Chinese Medicine Vol. 20 (4), pp. 87-89.
2. Lee, Ryan, Tien Y. Wong, and Charumathi Sabanayagam. “Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss.” Eye and vision 2, no. 1 (2015): 17.
3. Ibid.
4. nei.nih.gov/health/diabetic/retinopathy

Source: HealthCMi

Acupuncture Alleviates Neck Pain, Restores ROM

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Acupuncture Alleviates Neck Pain, Restores ROM

 

Acupuncture and herbs alleviate cervical spondylosis, a disorder caused by disc degeneration in the neck that results in pain and range of motion impairment. Hubei University of Medicine Dongfeng Hospital researchers conclude that acupuncture combined with herbs successfully relieves pain and regulates excess sympathetic nervous system outflows for patients with cervical spondylosis. [1] Other improvements were also observed, including reductions in dizziness, palpitations, and neck dysfunction.

Common presentations of cervical spondylosis are neck and shoulder pain, numbness, hypersensitivity, and impaired fine motor function of the arms. However, cervical spondylosis is also a cause of symptoms relating to spinal cord compression or dysfunction. These symptoms include blurred vision, headaches, vertigo, tinnitus, nausea, palpitations, poor memory, and abdominal discomfort. [2]

It has also been suggested that increased sympathetic nervous system outflows due to compression of the cervical spinal cord region could put cervical spondylosis sufferers at an increased risk of cardiovascular events. [3] Blood viscosity is also a predictor of cardiovascular events, with increased viscosity increasing the risk of heart attacks and strokes. The study documents that the acupuncture and herbal medicine regimen reduces blood viscosity, which may produce important cardiovascular benefits.

 

Chinese Medicine
The researchers conducted a randomized clinical trial using the scientific method. To provide a historical basis for the herbs and acupuncture points chosen for the study, the researchers presented Traditional Chinese Medicine (TCM) principles used for the selections. Cervical spondylosis is a disorder primarily belonging to the Du Mai (Governing Vessel) and Taiyang channels. Understood in anatomical terms, this correlates to the spine and paraspinal regions of the body.

TCM principles stipulate that an underlying deficiency of upright qi leaves cervical spondylosis patients vulnerable to pathogenic invasion by wind, cold, and dampness. This correlates to the conceptualisation that internal weakness facilitates greater vulnerability to wear and tear along with other stresses on the human body, including environmental influences. The result is pain in the back and neck region. Acupuncture is applied to improve local blood circulation, relax the musculature, relieve spasms, and reduce inflammation and swelling (especially in the region of nerve roots).

 

Results
We’ll take a close look at the herbs and acupuncture points used to get the results. First, let’s delve into the outcomes. The subjective component of outcomes was determined using the visual analog scale (VAS) for pain and speed of resolution of other symptoms. Objective measurements include the quantification of blood viscosity.

VAS scores were rated by the patients in two study groups on a scale of 0–10, with 0 indicating a total absence of pain. By the end of the study period, both groups showed a significant reduction in pain (p<0.05). In the herbal medicine monotherapy group, mean VAS scores reduced from 6.91 pre-treatment to 2.86 by the end of the study. Reductions in the acupuncture plus herbs group were significantly greater, falling from 6.89 pre-treatment to just 1.22 by the end of the study (p<0.05).

Resolution of other symptoms such as dizziness, neck dysfunction, chest distress, and palpitations was also monitored closely. In the herbal medicine monotherapy group, dizziness took a mean 12.82 days to resolve, compared with just 7.89 days in the acupuncture plus herbs group. Neck dysfunction took a mean 13.79 days to resolve in the herbal medicine monotherapy group, compared with 9.41 days in the acupuncture plus herbs group. Chest distress and palpitations resolved in a mean 9.88 days in the herbal medicine monotherapy group, compared with 6.94 in the acupuncture plus herbs group. All symptoms resolved significantly and more quickly in the acupuncture plus herbs group (p<0.05). The results indicate that a combined treatment protocol is appropriate for optimal treatment of cervical spondylosis.

Resolution of pain and other symptoms were taken into account to give the total effective rates for both groups. In the herbal medicine monotherapy group, there were 24 cases of complete resolution, 20 cases of partial resolution, and 16 cases of unresolved symptoms, yielding a total effective rate of 73.33%. In the acupuncture plus herbs group, there were 40 cases of complete resolution, 16 cases of partial resolution, and 4 cases of unresolved symptoms, yielding a total effective rate of 93.33%.

Blood viscosity reduced significantly in both groups (p<0.05). Mean pre-treatment systolic blood viscosity measurements were 4.39 mPa.s (pascal-seconds) in the herbal medicine monotherapy group and 4.29 mPa.s in the acupuncture plus herbs group. Mean pre-treatment diastolic measurements were 9.26 mPa.s and 9.25 mPa.s respectively (p>0.05). Following treatment, measurements in the herbal medicine monotherapy group fell to 4.21 mPa.s systolic and 8.67 mPa.s diastolic blood viscosities. Reductions in the acupuncture plus herbs group were significantly greater, with mean systolic viscosity falling to 4.05 mPa.s and mean diastolic viscosity falling to 8.13 mPa.s (p<0.05).

 

Participant Intake
A total of 120 participants aged 25–65 years were recruited for the study and were randomized to receive either an herbal decoction (n=60) or an herbal decoction plus acupuncture treatments (n=60). In the herbal medicine monotherapy group, the mean age was 50.22 years, mean duration of disease was 2.31 years, and mean body mass index (BMI) was 22.57. Of the 60 participants in this group, 13 suffered from hypertension, 10 from dyslipidemia, and 9 from diabetes. In the acupuncture plus herbs group, the mean age was 50.63 years, mean duration of disease was 2.25 years, and mean BMI was 22.10. Of the 60 participants in this group, 12 suffered from hypertension, 11 from dyslipidemia, and 10 from diabetes. There was no statistically significant difference in baseline characteristics between the two groups prior to the treatment regimen in the clinical trial (p>0.05).

Participants receiving concurrent treatment with other therapies, or that were unable to complete the study period, were excluded. Other exclusion criteria included patients with gastric bleeding or gastric ulcers, blood, liver, or kidney disease, psychological disorders, malignant tumors, and pregnant or lactating women.

 

Herbal Decoction
The participants in both groups were prescribed an herbal decoction consisting of the following ingredients:

  • Sheng Mu Li 30g
  • Zhen Zhu Mu 30g
  • Ge Gen 20g
  • Quan Xie 12g
  • Tian Ma 12g
  • Gou Teng 12g
  • Dan Shen 9g
  • Chuan Xiong 9g
  • Sang Ji Sheng 12g

The herbs were boiled in water to produce 200–300 ml of liquid. Each decoction was taken once daily for a total of two months.

 

Acupuncture Points
In addition to the above herbal decoction, participants in the acupuncture plus herbs group received treatment using the following acupoints:

  • Huatuojiaji (MBW35)
  • Ashi points
  • Hegu (LI4)
  • Shenmai (BL62)

The patients were asked to rest in a prone position. Following disinfection with iodine, 0.3 × 40 mm needles were inserted to a depth of approximately one cun. Huatuojiaji points level with the three intervertebral spaces above and below the affected vertebra were selected. Ashi points were applied to the local area.

All points were stimulated manually using a balanced reinforcing-reducing method. After obtaining deqi, a G6805-II electro-stimulator was connected and set to a frequency of 30 Hz. Electrical stimulation was applied for 30 minutes with the intensity adjusted according to each patient’s individual tolerance levels. Acupuncture was administered on alternating days for a total of two months.

 

Summary
The findings indicate that the prescribed herbal decoction combined with acupuncture successfully alleviates pain and other symptoms associated with cervical spondylosis, and is more effective than using an herbal decoction monotherapy. Furthermore, these therapies significantly reduce blood viscosity. The focus was to improve local circulation and promote faster healing based on the principle of invigorating the blood. These changes may also decrease the risk of heart attacks and strokes in patients with high blood viscosity. To learn more, contact a local licensed acupuncturist.

 

Notes
[1] Yi Jinke, Xu Yingle, Wang Wenke, Xu Penghui (2018) “Clinical effects of decoction combined acupuncture in treatment of sympathetic cervical spondylosis” Jilin Journal of Chinese Medicine Vol.38(8) pp. 966-968.
[2] Yuqing Sun, Aikeremujiang Muheremu, Wei Tian (2018) “Atypical symptoms is patients with cervical spondylosis; Comparison of the treatment effect of different surgical approaches” Medicine Vol. 97 (20) e.10731.
[3] Mohita Singh, indu Khurana, Zile Singh Kundu, Anup Aggarwal (2016) Link of sympathetic activity with cardiovascular risk in patients of cervical spondylosis” International Journal of Clinical and Experimental Physiology Vol.3 (1) pp.41-44.

Source: HealthCMi

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