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Acupuncture Reduces Insomnia with Attention Deficits

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Acupuncture Mitigates Insomnia Attention Deficits

 

Acupuncture combats attention deficits in insomnia patients. One of the most significant problems for people with insomnia is daytime drowsiness and inattention, leading to an increased risk of mistakes and accidents. Researchers find that acupuncture has the potential to attenuate these symptoms, as well as improving overall sleep quality. [1]

A study conducted at the First Affiliated Hospital of Chengdu University of Traditional Chinese Medicine assessed the effects of acupuncture on insomnia and attention deficits. These outcomes were compared with those of healthy control subjects that did not undergo any intervention during the study.

The results of this study indicate that acupuncture is an effective treatment for attention deficit, a common issue caused by insomnia. Acupuncture improves sleep quality, but also enhances performance in cognitive tasks​, and positively influences neural activity. For more information, contact your local licensed acupuncturist.

 

Reference
1. Ren Zeqin, Yuan Xu, Zhao Rong, Xu Jinlong, Yang Zeguan, Ai Jian, Zuo Zhixiong, Cai Dingjun (2018) “Acupuncture for insomnia attention deficit and the influence of nerve electro-physiology” World Journal of Acupuncture-Moxibustion Vol.28 (2018) pp. 161-166.

Source: HealthCMi

Acupuncture Increases Fertility Treatment Success

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Acupuncture Increases Fertility Treatment Success

Acupuncture improves in vitro fertilization embryo transfer (IVF-ET) success rates. Qingdao University researchers conducted a controlled clinical trial and confirmed that acupuncture reduces failed embryo implantation rates.  Findings include increases in good-quality embryo rates, endometrial receptivity, improvements in serological sex hormone levels, and the addition of acupuncture to standard ovulation stimulation drug therapy reduced the adverse effect rate of the drug therapy. [1]

In this study, transvaginal ultrasound was utilized to examine endometrial quality, for predicting endometrial receptivity.[2] The Qingdao University researchers confirm that acupuncture increases the rate of positive patterns of endometrial health.

Acupuncture increased good quality embryo rates and regulated pregnancy-related hormones. The rate of good quality embryos in the acupuncture treatment group was significantly higher than in the drug therapy control group.

Discussion
The researchers cite independent scientific research demonstrating that failed embryo implantation plays an important role in perpetuating infertility. For example, Norwitz et al. note that “Of the pregnancies that are lost, 75 percent represent a failure of implantation.” They determine that “Failed implantation is also a major limiting factor in assisted reproduction.” They explain, “Though high-quality embryos can often be transferred into the uterus, only a few embryos can successfully be implanted during the IVF-ET cycle.” [7] The results indicate that acupuncture combined with the long drug therapy into an integrated treatment protocol is more effective than long drug therapy. Chen et al. conclude that acupuncture increases the success rate of IVF-ET.

This study was conducted to determine whether acupuncture can improve endometrial receptivity and benefit IVF-ET outcomes.

The researchers note, “A better understanding of acupuncture mechanisms responsible for implantation may improve the ability to treat disorders related to these processes, including infertility.” They learned that the adverse effect rate was significantly reeduced in the acupuncture group versus the drug group. Given the sophistication of the multi-drug fertility protocol, it is not surprising that the need for monitoring and treating adverse effects is of concern. The data indicates that acupuncture benefits positive patient outcomes rates while simultaneously reducing adverse effects, indicating that acupuncture increases the safety and efficacy of long hormonal drug protocol fertility treatments.

 

References
[1] Chen Q, Hao CF. Impacts on pregnancy outcome treated with acupuncture and moxibustion in IVF-ET patients [J]. Chinese Acupuncture and Moxibustion, 2015,35(04):313-317.
[2] Gonen Y, Casper RF. Prediction of implantation by the sonographic appearance of the endometrium during controlled ovarian stimulation for in vitro fertilization (IVF) [J]. J In Vitro Ferti Embryo Transf, 1990, 7 (3): 146-152.
[3] Lina Wang, Jie Qiao, Rong Li, Xiumei Zhen, Zhaohui Liu. Role of endometrial blood flow assessment with color Doppler energy in predicting pregnancy outcome of IVF-ET cycles [J]. Reprod Biol Endocrinol. 2010; 8: 122.
[4] Wei M, Zhang XM, Gu FL, Lv F, Ji YR, Liu KF, She H, Hu R. The impact of LH, E2, and P level of HCG administration day on outcomes of in vitro fertilization in controlled ovarian hyperstimulation [J]. Clin Exp Obstet Gynecol. 2015;42(3):361-6.
[5] Grow D, Kawwass JF, Kulkarni AD, et al. GnRH agonist and GnRH antagonist protocols: comparison of outcomes among good-prognosis patients using national surveillance data. Reprod Biomed Online 2014; 29:299-304.
[6] Borm G, Mannaerts B. Treatment with the gonadotrophin-releasing hormone antagonist ganirelix in women undergoing ovarian stimulation with recombinant follicle stimulating hormone is effective, safe and convenient: results of a controlled, randomized, multicenter trial. The European Orgalutran Study Group[J]. Hum Reprod, 2000, 15(7):1490-1498.
[7] Norwitz ER, Schust DJ, Fisher SJ. Implantation and the survival of early pregnancy [J]. N Engl J Med, 2001, 345(19): 1400-1408.

Source: HealthCMi

 

Acupuncture Aids Swallowing After Stroke

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Acupuncture Aids Swallowing After Stroke

 

Acupuncture aids swallowing for post-stroke patients. Researchers at the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine (Shenyang, China) found combining acupuncture with standard functional training improves outcomes for patients with dysphagia and other symptoms following a stroke. The study outcomes included overall neurological function scores, Traditional Chinese Medicine (TCM) syndrome scores, water swallowing test scores, and overall efficacy. Although both groups showed improvements following four weeks of treatment, outcomes were superior across all areas in the acupuncture group. [1]

The control group was comprised of 18 male and 31 female patients with a mean age of 58.5 years. The mean duration of disease was 39.3 days. Of the patients in the control group, 24 suffered cerebral infarctions, 25 had brain hemorrhages, 30 had brainstem lesions, and 19 had cerebral lesions. There were no statistically significant differences between the two groups prior to treatment.

Treatment was administered daily, for a total of four weeks, using points on the head.

Results
Outcome measures for the study included neurological function scores, water swallowing test results, TCM syndrome scores, and total efficacy. The neurological function test rated the participants’ consciousness, speech, gaze, limb muscle strength, and walking ability on a scale of 0–45.

The overall efficacy rate was calculated for each group. Patients showing complete resolution of symptoms were classified as cured. Patients showing significant improvement were classified as effective. Patients showing no improvement or a worsening of symptoms were classified as ineffective. The cured and effective rates were added together to give the total effective rate.

In the acupuncture group, there were 30 cured and 18 effective cases, yielding a total efficacy rate of 97.96%. In the control group, there were 25 cured and 19 effective cases, yielding a total efficacy rate of 89.80%. Outcomes were significantly better for patients that had acupuncture treatments.

This study suggests that acupuncture is an effective adjunct to standard functional training for patients suffering from post-stroke dysphagia. Acupuncture has the potential to significantly improve symptoms, including difficulty with swallowing and speech, as well as associated problems including limb hemiplegia.

Reference
1. Li Zhi, Jiao Fuying (2018) “Clinical Study of Acupuncture Combined with Swallowing Training in Treatment of Post-Stroke Swallowing Dysfunction” JCAM, Vol. 34 (10) pp.10-13.

Source: HealthCMi

 

Acupuncture Found Effective For Rheumatoid Arthritis Relief

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Acupuncture Found Effective For Rheumatoid Arthritis Relief

 

Researchers conclude that acupuncture supports the benefit of drug therapy for the treatment of rheumatoid arthritis. Researchers from the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine combined acupuncture with standard drug therapy. Patients receiving both drug therapy and acupuncture in a combined treatment protocol had superior patient outcomes compared with patients receiving only drug therapy. The researchers conclude that the addition of acupuncture to standard drug therapy is effective for the alleviation of relevant symptoms and the regulation of rheumatoid arthritis (RA) related laboratory measures (rheumatoid factor, hypersensitive C-reactive protein, erythrocyte sedimentation rate, platelet, fibrinogen, and D-dimer). [1] The study was approved and funded by the National Natural Science Foundation of China.

A 0.30 x 25 mm or 0.30 x 40 mm disposable acupuncture needle was inserted into each acupoint, reaching standard insertion depths. Upon arrival of a deqi sensation, the ping bu ping xie (tonify and sedate) manipulation technique was applied to each needle. Next, a needle retention time of 30 minutes was observed. The treatment was conducted once per day. The patients received six days of treatment plus a one day break every week. Every 30 days of acupuncture treatment consisted of one treatment course. A total of three courses were administered.

Results
The total effective rate in the acupuncture treatment group was 85.7% (24/28), which was greater than 75.0% (21/28) in the drug control group.

The addition of acupuncture into the drug therapy regimen of care increased the total effective rate by 10.7%. Zhu et al. conclude that acupuncture is effective for the relief of rheumatoid arthritis and improves patient outcomes.

References
[1] Zhu Y, Yu HW, Pan YZ, Yang J, Wu B, Hu X, Cao YY. Acupuncture combined with western medicine on rheumatoid arthritis and effects on blood stasis [J]. Chinese Acupuncture and Moxibustion, 2018,38(05):479-482+489.
[2] medlineplus.gov/lab-tests/erythrocyte-sedimentation-rate-esr
[3] Silva I, Mateus M, Branco JC. Assessment of erythrocyte sedimentation rate (ESR) and C- reactive protein (CRP) on rheumatoid arthritis activity prediction [J]. Acta Reumatol Port. 2010;35(5):456-62.
[4] Dessein PH, Joffe BI, Stanwix AE. High sensitivity C-reactive protein as a disease activity marker in rheumatoid arthritis. J Rheumatol. 2004;31(6):1095-7.
[5] Yazici. S, Yazici. M, Erer. B, Çalik. Yalkin, Ozhan. H, Ataoglu. S. (2010). The platelet indices in patients with rheumatoid arthritis: Mean platelet volume reflects disease activity[J]. Platelets. 21. 122-5.
[6] Villenenve E, Nam J, Emery P. 2010-ACR-EULAR classification criteria for rheumatoid arthritis[J]. Rev Bras Reumatol, 2010,50(5): 481-483.
[7] Prevoo ML, van, t Hof MA, Kuper HH, et at. Modified disease activity scores that include twenty- eight-joint counts. Developent and validation in aprospective longitudinal study of patients with rheumatoid arthritis[J]. Arthritis Rheum, 1995, 38(1): 44-48
[8] Zheng XY. Clinical guidelines for traditional Chinese medicine new drugs (for Trial Implementation) [M]. Beijing: China Medical Science and Technology Press, 2002: 390-395.

Source: HealthCMi

Acupuncture Pain Relief After Knee Surgery Lowers Morphine Use

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Acupuncture Pain Relief After Knee Surgery Lowers Morphine Use

 

Researchers conclude that acupuncture improves pain relief outcomes in patients receiving pain-relieving drugs after total knee arthroplasty (TKA). Researchers from the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine combined acupuncture with standard drug therapy. Patients receiving both pain-relieving drugs and acupuncture in a combined treatment protocol had superior patient outcomes compared with patients receiving only pain-relieving drugs. The researchers conclude that the addition of acupuncture to a traditional drug treatment regimen significantly reduces pain intensity and frequency, the total dosage requirements for pain-relieving drugs, and mitigates relevant complications. [1]

A total of 40 patients that received TKA due to severe knee osteoarthritis were treated and evaluated in this study. The patients received TKA between May 2017 and February 2018. They were randomly divided into an electroacupuncture (EA) treatment group and a control group, with 20 patients in each group. For the control group patients, a pain pump was provided. The treatment group received electroacupuncture in addition to the identical PCEA treatment administered to the drug control group.

Treatment
Before the end of the operation, both groups received a single dose of 1–2 mg of morphine through an epidural injection. Immediately after the operation, all patients were given pain pump. day for seven consecutive days.

Patients in the acupuncture group received electro acupuncture at points around the knee where the surgery had been done.

Evaluations
Assessment of pain intensity or frequency was done, as well as measurement of active and passive knee flexion range of motion (ROM). Third, the frequency of pushing a pain medicine pump and the dosage as well as frequency of pain drug use was recorded. Fourth, patient safety was evaluated by observing whether there is swelling of the affected limb, redness of the wound, skin irritation, etc. Fifth, complications were measured by monitoring blood pressure and heart rate and also by recording the incidence rate of respiratory depression, nausea and vomiting, and urinary retention. Sixth, infection risks were evaluated through monitoring plasma white blood cell and C-reactive protein levels.

After treatment, the pain scores at rest and upon movement in the electroacupuncture group were both significantly lower than that in the control group. There were no significant differences between the two groups regarding active and passive knee flexion range of motion. The frequency of pushing a pain pump in the acupuncture group was significantly lower than that in the control group.

Results
The results indicate that electroacupuncture combined with pain-relieving drugs into an integrated treatment protocol is more effective than pain-relieving drugs as a single therapy. Zhou et al. conclude that acupuncture is safe and effective for the relief of postoperative pain after TKA. Taking a broader view, the results of this study suggest that acupuncture may reduce addiction to pain medications after surgery by reducing pain levels and the need for medications.

 

References
[1] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.
[2] Fang JQ, Liu F, Shao XM, et al. Effect of Electroacupuncture on Carrageenan-induced Inflammation Interleukin-1β and Tumor Necrosis Factor-α Concentrations and mRNA Expressions in Toe Tissue in Rats [J]. Acupuncture Research, 2007, 32(4): 224-228.
[3] Han JS. Further Evidence of Acupuncture’S Frequency Specificity Analgesic Effect [J]. Acupuncture Research, 2001, 26(3): 224-227.
[4] Han JS. Further Evidence of Acupuncture’S Frequency Specificity Analgesic Effect [J]. Acupuncture Research, 2001, 26(3): 224-227.
[5] Han JS. Study of Factors That Affect the Analgesic Effect of Acupuncture [J]. Acupuncture Research, 1994, 19(Z1): 1-3
[6] Han JS. Further Evidence of Acupuncture’S Frequency Specificity Analgesic Effect [J]. Acupuncture Research, 2001, 26(3): 224-227.
[7] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.
[8] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.
[9] Wang XQ, Jiang YF, Qin KF. 282 Cases of Knee Joint Pain Treated by Oblique Acupuncture at Xuehai and Liangqiu [J]. Chinese Acupuncture, 2003, 23(5): 311
[10] Zhou JZ, Wang CF, Ma Y, Hu YH. Effect of Intra-articular Injection with Paeonol and Acupuncture at Zusanli on Serum Interleukin 1-beta and Tumor Necrosis Factor-alpha Contents in a Rabbit Model of Knee Osteoarthritis [J]. Chinese Journal of Tissue Engineering Research, 2012, 16 (22): 4096-4099.
[11] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.
[12] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.
[13] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.

Source: HealthCMi

 

Studies: Acupuncture effective for Weight Loss

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Researchers find acupuncture effective for the treatment of obesity. Results were obtained by implementing a protocolized body acupuncture point prescription without a diet or exercise program. [1] In a five week clinical trial, patients receiving acupuncture achieved a 2.9 kg mean weight loss and the decrease in mean BMI (body mass index) was 1.43. The laboratory findings, including serum levels of insulin, leptin, ghrelin, and cholecystokinin are consistent with the results. The controlled study documents that sham acupuncture does not produce significant positive patient outcomes, only true acupuncture achieves clinical results. Based on the evidence, the hospital researchers conclude that acupuncture treatment regulates weight for patients with obesity.

Obesity is an increasingly prevalent chronic condition that is associated with serious morbidity and mortality. [2] The risk of hypertension, heart disease, hypercholesterolemia, diabetes mellitus, cerebrovascular disease, gallbladder disease, and some types of cancer are higher for overweight (BMI>25) and obese (BMI>30) individuals. [3] Weight control treatments include diet therapy, behavioral treatment, pharmacotherapy, surgical procedures, and acupuncture. The downside to anti-obesity medications and surgery is the potential for iatrogenic illness. [4] In addition, a World Health Organization Report on acupuncture states that acupuncture demonstrates a therapeutic effect for the treatment of obesity. [5]

Laboratory data supports the conclusions of the researchers in this controlled clinical trial. After 5 weeks of acupuncture treatment, mean serum insulin and leptin levels decreased by 6.87 μIU/ml (43%) and 3.32 ng/ml (25%) respectively. No significant change was seen in these variables after sham treatment. Differences between the two study groups in these parameters were documented. The mean serum insulin and leptin levels in the acupuncture group were lower than in the sham acupuncture group by 8.27 μIU/ml and 6.17 ng/ml respectively. The true acupuncture group also demonstrated significant improvements in mean plasma ghrelin and CCK levels. The researchers note, “acupuncture treatment decreased insulin and leptin levels and induced weight loss, together with a decrease in BMI compared with sham acupuncture.”

Group Selection Process
The subject selection process was as follows. An acupuncture study was announced in a university hospital (Etlik Zubeyde Hanim Obstetrics and Gynecology Training and Research Hospital) for employees and people attending routine wellness examinations. Female obese volunteers who wanted to be involved in this study underwent the selection process and 40 of these with BMI>30 were accepted after routine medical examinations. Subjects selected for inclusion had normal physical examination findings and did not have hypertension, diabetes, nephropathy, heart failure, and were not receiving any medications.

The statistical breakdown for each randomized group was as follows. The mean age of participants was 34.6 ±6.3 years for the sham acupuncture group and 36.8 ±7.8 years for the acupuncture group. Pre-sham and pre-acupuncture groups showed no significant differences in weight, BMI, serum insulin and leptin levels. All participants successfully completed specified treatments without any dropouts or unintended outcomes.

True vs. Sham Acupuncture
The acupuncture group received traditional Chinese type general body acupuncture at the follow acupoints bilaterally:

  • LI4 (Hegu)
  • HT7 (Shenmen)
  • ST36 (Zusanli)
  • ST44 (Neiting)
  • SP6 (Sanyinjiao)

Treatment commenced with patients in a supine position. After disinfection of the acupoint sites, a disposable stainless steel needle (25 mm length, 0.25 mm diameter, Kingli brand) was inserted into each acupoint, reaching a depth of 5–10 mm. Twisting, lifting, and thrusting manual acupuncture techniques were applied to elicit deqi.

Patients in the other group were treated with sham acupuncture. The needles were not inserted but were applied under a tape at the same points. Both groups received two sessions per week for a total of 10 sessions. Duration of each session was 20 minutes. Both treatments were performed by a certified acupuncturist. All patients were asked not to follow dietary treatments, not to undergo heavy physical exercise, and not to take supplementary medications.

Auricular Points
Sun et al. conclude that acupuncture combined with auricular acupressure achieves an average weight loss of 5.04 kg after three months of treatment, The sample size was 110 obese female patients. [6] One study group received body acupuncture plus auricular acupressure (every 3–5 days for 3 months) and another received Capsulae Olei Oenothera Erythrosepalae, a weight control substance. Body weight of the acupuncture group reduced by an average 5.04 kg while that of the control group by an average of 2.08 kg. The differences between the two groups and between values of the same group before and after treatment were statistically significant. The primary body acupoints used in the study were the following:

  • ST25 (Tianshu)
  • SP6 (Sanyinjiao)
  • P6 (Neiguan)
  • ST40 (Fenglong)
  • ST36 (Zusanli)

Rapid needle insertion was performed. Twisting, lifting, and thrusting manual acupuncture techniques were applied to elicit deqi. After the arrival of deqi, the needle retention time was 15 minutes. The needling was administered every 3–5 days, 30 days as one course of treatment, for a total of three courses. For auricular acupressure, the researchers used the following ear acupoints:

  • Mouth
  • Esophagus
  • Stomach
  • Abdomen
  • Hunger
  • Shenmen
  • Lung
  • Endocrine

A grain of Vaccariae seed was affixed to each otoacupoint with a 5×5 mm piece of adhesive tape. The two auricles were used in alternation, and the patients were advised to apply digital pressure on the seed pellets three times daily at home, every 3 – 5 days, for a total of 3 months. The study was a single-blinded, randomized investigation comparing acupuncture and auricular acupressure with a weight control substance. The researchers conclude, “Acupuncture and auricular acupressure produced superior patient outcomes for obese patients including decreasing body weight, appetite, blood triple cholesterol (TC), and triglycerides (TG).”

Acupuncture demonstrates clinical efficacy for the treatment of obesity in two controlled investigations. Based on the data, additional research is warranted. Larger sample sizes will help to confirm these preliminary findings.

Common to both studies reviewed in this article are acupoints SP6 (Sanyinjiao) and ST36 (Zusanli). According to Traditional Chinese Medicine (TCM) principles, both acupoints are indicated for the treatment of digestion related disorders and stimulate the body’s transforming and transporting functions of the digestive system. In this respect, these acupoints are choices consistent with the goals of the research.

Notes
[1] Güçel F, Bahar B, Demirtas C, Mit S, Cevik C. Influence of acupuncture on leptin, ghrelin, insulin and cholecystokinin in obese women: a randomised, sham-controlled preliminary trial. Acupunct Med. 2012 Sep;30(3):203-7.
[2] Lehnert T, et al. Health burden and costs of obesity and overweight in Germany: an update. Eur J Health Econ. 2015;16(9):957–67.
[3] Carnethon MR. Diabetes mellitus in the absence of obesity: a risky condition. Circulation. 2014;130(24):2131–2.
[4] Ingrid Z, et al. The duodenal–jejunal bypass liner for the treatment of type 2 diabetes mellitus and/or obesity: a systematic review. Obes Surg. 2014; 24: 310–23.
[5] apps.who.int/iris/handle/10665/42414
[6] Sun Q, Xu Y. Simple obesity and obesity hyperlipemia treated with otoacupoint pellet pressure and body acupuncture. J Tradit Chin Med 1993;13:22–6.

From Health CMI News, May 10, 2018

Research shows acupuncture is as effective as Claritin for dust mite allergies

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Acupuncture has been found equally effective as loratadine (Claritin®, Alavert®, Shionogi®) for the treatment of dust mite allergies. Researchers from the Clinic of Otorhinolaryngology at the University Hospital Dresden (Germany) conclude that acupuncture is effective for the treatment of allergy related rhinitis and rhinoconjunctivitis. The researchers document that acupuncture relieves symptoms of rhinitis including nasal congestion, runny nose, post-nasal drip and sneezing.

The researchers compared an acupuncture treatment group with a medication group receiving loratadine, a pharmaceutical antihistamine. A total of 87% of acupuncture study group patients and 67% of loratadine study group patients showed improvements by the end of therapy. A 10 week follow-up after completion of therapy documents that 80% of acupuncture study group patients and 0% of loratadine study group patients demonstrated lasting improvement. The researchers note, “Both in the acupuncture and the loratadine group a significant improvement was gained under therapy. In the ten-week period following the therapy, a significant deterioration which led to the recurrence of the allergic symptoms was shown in the loratadine group, while the significant improvement of the symptoms persisted in the acupuncture group.”

Objective measurements included rhinoscopy examinations for nasal concha size and mucosa condition. This included evaluations of mucosal reddening and swelling of the nasal concha. IgE levels and interleukin (IL-4, IL-10, IFN-y) levels were also evaluated. Subjectives included evaluation of nasal obstruction, nasal secretion and sneezing attacks. Based on the results the researchers note “that the effectiveness of acupuncture is comparable to that of loratadine.”

Acupuncture exhibited the unique ability to stimulate the endogenous production of IL-10, an interleukin that blocks histamine release from activated mast cells. Reduced IL-10 in the nasal mucosa is associated with an increase in nasal allergy symptoms and acupuncture successfully increases IL-10 levels. The researchers note of acupuncture, “The results indicate the probability of an immunomodulatory effect.” This helps to explain, in part, the ability of acupuncture to provide lasting relief from allergies.

The researchers conclude, “Acupuncture is a clinically effective form of therapy in the treatment of patients suffering from persistent allergic rhinitis.” The researchers standardized the acupuncture treatments to include a protocolized selection of acupuncture points based upon Traditional Chinese Medicine (TCM) principles. The acupuncture points used for all patients were: LI 20, Bi Tong, Yin Tang, BL 2, GB 20, LI 4, LI 11, SI 3, ST 36, auricular 78, auricular 55.

Acupuncture needles were retained for 20 minutes per each session. Patients received a total of 12 acupuncture treatments at a rate of twice weekly. Seirin® brand stainless steel disposable needles were used of 0.3 X 0.30 mm size for body acupuncture and 0.2 X 0.15 mm size for auricular acupuncture. Seirin® was the first single use disposable needle originally developed in 1978. This brand is commonly used in medical research and is regarded as a premium brand acupuncture needle amoung licensed acupuncturists worldwide. Patients taking the drug loratadine received 10mg doses every morning. University Hospital Dresden

The new research conducted at the University Hospital Dresden confirms that acupuncture is effective for the relief of rhinitis. In related research, investigators documented a 96.5% success rate of acupuncture for the treatment of rhinitis. A total of 61 persons had a total recovery, 21 showed marked improvement and 3 showed no improvement.

Rhinoscopy and absence of symptoms was used to confirm the results. A 2 year follow-up confirmed the recovery rates. At a rate of 1 treatment per day, 15 acupuncture sessions consisted of 1 course of treatment. The 96.5% effective rate was achieved within 2 courses of treatment.

The acupuncture needles used in the study were 0.35 mm (28 gauge) in diameter and 40-50 mm in length. The acupuncture points chosen were: GB 20 (Fengchi), LI 4 (Hegu), and ST 36 (Zusanli). Supplementary acupuncture points were UB 12 (Fengmen), UB 13 (Feishu), Yintang (Ex-HN 3), and DU 14 (Dazhui). Supplementary acupuncture points were chosen dependent upon TCM differential diagnostics. In many cases, 20 minutes of manual needle manipulation were applied at each acupuncture session. Tonification and reduction acupuncture needle techniques and moxa were chosen dependent upon excess, deficient, heat and cold diagnostic patterns according to TCM principles.

The Dresden study differs from the second study in that a standardized set of acupuncture points was used for all patients in Dresden while customization of acupuncture point selections was made in the second study. In a third research project, investigators at RMIT University in Melbourne (Australia) studied 80 patients with chronic rhinitis. They concluded that acupuncture is an effective treatment therapy for rhinitis.

Acupuncture points LI 20, Yintang and GB 20 were the primary acupuncture points. Supplementary points included LI 4, ST 36, and CV 6. The acupuncture group had significantly better outcomes than either the control group or the sham acupuncture group. Each acupuncture session was 25 minutes and patients were given 16 acupuncture treatments at a rate of twice per week. Results were tabulated after a three month follow-up. Both nasal and ocular symptoms associated with chronic rhinitis improved significantly for the acupuncture group. Members of the acupuncture group were also able to reduce consumption of relief medication. The study concluded that acupuncture is “safe and effective” for the treatment of persistent allergic rhinitis (PAR).

References:
Hauswald, Bettina, Christina Dill, Jürgen Boxberger, Eberhard Kuhlisch, Thomas Zahnert, and Yury M. Yarin. “The effectiveness of acupuncture compared to loratadine in patients allergic to house dust mites.”

Reference: An Hua, Qinhuangdao Port Hospital, Hebei, China. “Treatment of 85 Cases with Chronic Rhinitis by Acupuncture.” J. Acupunct. Tuina. Sci. 2010, 8 (5): 318.

Reference: Evaluation of efficacy and safety of acupuncture in the treatment of persistent allergic rhinitis. An, X 2006, Evaluation of efficacy and safety of acupuncture in the treatment of persistent allergic rhinitis, Masters Thesis, School of Health Sciences, RMIT University.

– See more at: http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1310-acupuncture-matches-drugs-for-dust-mite-allergy-relief#sthash.VPlncw65.dpuf

Acupuncture and Exercise Helpful for Breast Cancer Support

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Two new studies from the Abramson Cancer Center and the Perelman School of Medicine at the University of Pennsylvania offer hope for breast cancer survivors struggling with cancer-related pain and swelling, and point to ways to enhance muscular strength and body image. The studies appear in a first of its kind monograph from the Journal of the National Cancer Institute Monographs focusing on integrative oncology, which combines a variety of therapies, some non-traditional, for maximum benefit to cancer patients.

For information on the acupuncture study, skip down to the underlined portion of text below.

Exercise Research

In the first study, A Hybrid Effectiveness-Implementation Trial of an Evidence-Based Exercise Intervention for Breast Cancer Survivors, Penn researchers assessed patients participating in “Strength after Breast Cancer,” a Penn Medicine-developed, evidence-based exercise and education program for breast cancer survivors. The study was intended to investigate the ease and effectiveness of transporting a research-based treatment into a practice setting. The primary goal of the study was to demonstrate program effectiveness for patients after transition from research to a practice setting. The secondary goal was to understand the implementation process and identify barriers to implementation.

Building upon the team’s previous research, results of the new study show several benefits of exercise for participants, including reduced symptoms of lymphedema – a swelling condition in the upper body after that can be caused by the removal of or damage to the body’s lymph nodes. Results also showed a lower proportion of women with lymphedema onset (eight percent) or the need for therapist-delivered treatment (19 percent), improvements in upper and lower body strength (13 and 9 percent, respectively), and improvements in body image (16 percent). There were no adverse effects noted for the intervention.

The second aim of the study allowed the team to take the research into a new direction. Led by first author, Rinad Beidas, PhD, assistant professor of Psychiatry, the team sought to identify barriers to implementation of the program. The researchers were able to identify a number of factors that potentially hindered the implementation process, including: intervention characteristics, payment, eligibility criteria, the referral process, the need for champions, and the need to adapt during implementation of the intervention.

“The results of this study are exciting because they demonstrate that an evidence-based exercise and education program for breast cancer survivors can be translated to a new setting while still remaining effective and safe” says Beidas. “Importantly, we were also able to identify the types of barriers that should be addressed when taking this program to scale, which provides important information translating research into practice, which historically has taken up to 17 years.”

Strength after Breast Cancer was developed by the study’s senior author Kathryn Schmitz, PhD, MPH, professor of Epidemiology and Biostatistics and a member of the Abramson Cancer Center, based on a 2011 study showing that contrary to what was previously believed, exercise and weightlifting can be extremely beneficial for . Administered by physical therapists, Strength after Breast Cancer includes group based exercise classes, and an exercise program for patients to continue at home or a gym.

The program is now available at a broad variety of venues across the Delaware Valley region and beyond. Schmitz also plans to develop an online training course for physical therapists to be able to make the Strength after Breast Cancer program available to survivors across the United States.

Acupuncture Research

In the second study, Expectancy in Real and Sham Electroacupuncture: Does Believing Make It So? researchers at Penn Medicine and other institutions found that electro- (“real” acupuncture) helped reduce joint pain by as much as 40 percent in women with breast cancer, whether the patient expected it to work or not. The study also found that “sham” acupuncture – which involves nonpenetrative needles and no electrical stimulation – provided pain reduction as high as 80 percent if patients had a high degree of expectation that it would work. The study results provide important implications for future treatment of breast cancer patients with joint pain.

“Our study is the first to provide evidence that expectancy has no effect on whether real acupuncture works or not, but that high expectancy does appear to have a positive effect on patients who receive sham acupuncture,” said the study’s senior author Jun J. Mao, MD MSCE, an associate professor of Family Medicine and Community Health and director of the Abramson Cancer Center’s integrative oncology program, who served as editor of the special monograph. “This issue extends beyond acupuncture and is important to all trials involving pain management that use placebos, such as drugs, procedures, and natural products.”

The findings are the result of an investigation that sought to evaluate the relationship between response expectancy and treatment outcome for joint stiffness or joint pain in real and sham acupuncture among 41 ; a control group received neither intervention. Joint stiffness and are side effects of aromatase inhibitor, a hormonal therapy used to help treat .

In addition, patients who reported pain relief had increased expectancy that it would continue to work over the course of their acupuncture treatment as compared with nonresponders, suggesting that positive responses during the process of real acupuncture increased the expectations of further positive outcomes—what the authors call a “bottom-up” result.

“These findings certainly challenge the notion held by some that acupuncture is ‘all placebo,'” said the study’s lead author Joshua Bauml, MD, an assistant professor of Medicine in the Abramson Cancer Center. “If it were ‘all placebo,’ patients receiving real acupuncture who had low expectations that it would work would report little or no reductions in pain. But that’s not the case.”

Sham acupuncture only produced clinically important pain reduction for those with high onset expectancy. But patients with the highest expectation that it would work reported as much as 80 percent reductions in pain – twice the rate of patients receiving real acupuncture. (The authors call this a “top-down” result.) Sham acupuncture patients with low baseline expectancy scores did not report any significant pain reduction.

The strong response seen in patients with high expectancy for raises the question of whether such could benefit from the nonpenetrative use of needles without electro-stimulation.

Laser Acupuncture Relieves Temporomandibular Joint Pain

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Laser acupuncture alleviates pain for patients with temporomandibular disorders (TMD). Laser acupuncture employs the use of cold lasers and does not burn the skin or involve the use of needles. TMD disorders include structural abnormalities and muscular disorders of the temporomandibular joint region. TMD is a major cause of orofacial pain. Researchers demonstrate that noninvasive laser acupuncture therapy applied to acupuncture points on the face and hand significantly reduce pain levels.

The acupuncture laser therapy not only reduced pain levels but also improved range of motion. The maximal mouth opening demonstrated clinically significant improvements. There were no side effects. The researchers conclude that “TMD symptoms improved with LAT (laser acupuncture therapy).” The beneficial effects were in both acute and chronic patients with treatment-resistant temporomandibular disorders.

Researchers from China Medica University Hospital (Taiwan), Kaohsiung Medical University College of Medicine (Taiwan), et. al., note that laser acupuncture’s analgesic effects are “mediated by peripheral opioid receptors.” They add that low level cold laser therapy increases pain tolerances by inducing biological changes to cellular membranes. The researchers note other biological responses induced by low level laser therapy (LLLT) including vasodilation, increasing intracellular metabolism and decreasing edema. The researchers also cite important biomodulatory effects of LLLT; it “improves local microcirculation and oxygen supply to hypoxic cells in the painful areas…, tissue asphyxia is reduced…, it restores the normal physiological condition of the tissue.”

Low level laser acupuncture therapy was applied to patients three times per week for four weeks in this investigation. Protective goggles were worn by the practitioner and patient. Yangming channel acupuncture points ST7 (Xiaguan), ST6 (Jiache), and LI4 (Hegu) plus local Ashi points were stimulated using pulsed waves. Five seconds of stimulation was applied to the stomach and large intestine Yangming points and forty seconds of LLLT stimulation was applied to each Ashi point. The researchers note that the treatment principle was based on the Traditional Chinese Medicine (TCM) concept that “pain results from blood stasis due to qi stagnation.” The goal was to “restore internal homeostasis” by restoring the “flow of qi and blood.”

TMD is a widespread illness that can be very painful and impacts the quality of life. Symptoms include facial pain, jaw clicking and popping, locking and catching of the jaw, decreased mouth opening and pain upon chewing. Other symptoms associated with TMD include headaches and neck pain. This study suggests that a simple, noninvasive application of laser acupuncture significantly benefits patients with treatment-resistant type TMD.

Reference:
Hu, Wen-Long, Chih-Hao Chang, Yu-Chiang Hung, Ying-Jung Tseng, I-Ling Hung, and Sheng-Feng Hsu. “Laser Acupuncture Therapy in Patients with Treatment-Resistant Temporomandibular Disorders.” PLOS ONE 9, no. 10 (2014): e110528.

Acupuncture and Herbs Beat Drug for Headache

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A new study concludes that acupuncture combined with herbal medicine is more effective than drugs for the treatment of headaches. This confirms similar results found in a prior study wherein acupuncture was found comparable to drugs for the treatment of migraine headaches. The new study finds acupuncture combined with herbal medicine is effective for the treatment of vascular headaches whereas the prior study found acupuncture, as a standalone procedure, effective for the treatment of migraines. The results agree that acupuncture and/or acupuncture combined with herbs produce positive patient outcomes for headaches.

The prior study concluded that acupuncture is “of comparable efficiency to several proven drug therapies for the treatment and prevention of migraine(s).” The meta-analysis examined 25 randomized controlled trials involving a sample size of 3,004 patients. True acupuncture significantly outperformed simulated sham-acupuncture. In addition, true acupuncture was comparable to drug therapy for the treatment and prevention of migraines.

The new acupuncture continuing education research increased the strength of clinical care by adding herbal medicine to the Traditional Chinese Medicine (TCM) protocol. By combining acupuncture with the modified herbal medicine formula Huo Xue Qu Feng Tong Luo Tang (Blood Activating Wind Dispelling Meridian Unblocking Decoction), the TCM treatment was significantly more effective than nimodipine. Also referred to by its brand names Nimotop and Nymalize, this drug is a calcium channel blocker that increases blood flow to the brain by widening blood vessels. Originally developed to reduce high blood pressure, this drug is commonly used to prevent complications due to cerebral vasospasm.

Acupuncture combined with modified Huo Xue Qu Feng Tong Luo Tang is more effective than nimodipine for relieving vascular headaches. These headaches include cluster headaches, migraines and toxic headaches. Migraines involve unilateral or bilateral head pain and may combine with nausea, vomiting, sensitivity to light and sound, and visual auras. Toxic headaches occur during fevers. Cluster headaches are focal and recur in severe episodes.

The researchers conducted a randomized acupuncture continuing education investigation of 92 patients with vascular headaches at the College of Traditional Chinese Medicine (TCM) in Chongqing Medical University (Sichuan). Group #1 received oral administration of nimodipine at 40 mg per dose, three times per day. Group #2 received acupuncture and a TCM herbal formula based on Huo Xue Qu Feng Tong Luo Tang. A course of treatment for both groups consisted of two weeks and the entire treatment lasted for two courses. After the two courses of treatment, patients in both groups made considerable progress. However, patients in the acupuncture group significantly outperformed those in the drug group.

The Herbs
The primary ingredients in the modified version of Huo Xue Qu Feng Tong Luo Tang for patients in the acupuncture group were:
Tao Ren 12g
Hong Hua 12g
Dang Gui 15g
Chuan Xiong 15g
Chi Shao 12g
Sheng Di Huang 20g
Chai Hu 12g
Zhi Ke 12g
Xiang Fu 12g
Yu Jin 12g
Niu Xi 15g
Jie Geng 6g
Shi Jue Ming 30g
Zhen Zhu Mu 30g
Raw Mu Li 30g
Wu Gong 2 pieces
Quan Xie 10g
Gan Cao 5g

Modifications were made according to TCM differential diagnostics:
Add Di Long 12g for severe cases of stasis blocking collaterals.
Add Raw Long Gu 30g, Gou Teng 15g and Ci Shi 30g for cases of hyperactivity of liver yang.
Add Chen Pi 12g and processed Ban Xia 10g for cases of phlegm dampness.
Add Shan Zhu Yu 20g, Gou Qi Zi 15g and Nu Zhen Zi 15g for yin deficiency in the liver and kidneys.
Add Ren Shen 15g, Dang Gui 15g and Shu Di Huang 20g for cases of qi and blood deficiency.

The Acupuncture Points
The acupoints for acupuncture needling were chosen according to the locations of the headaches, i.e. near the affected regions and along the meridians:
For headaches primarily on the top of the head add Baihui (DU20), Sishencong (EX-HN1), Taichong (LR3), Neiguan (PC6) and Yongquan (KI1).
For headaches primarily on the forehead add Yintang (EX-HN3), Touwei (ST6), Yangbai (GB14), Zanzhu (BL2), Hegu (LI4) and Quchi (LI11).
For temporal headaches add Shuaigu (GB8), Taiyang (EX-HN5), Fengchi (GB20), Zhukong (SJ23), Waiguan (SJ5) and Yangfu (GB38).
For occipital headaches add Tianzhu (BL10), Fengchi (GB14), Fengfu (DU16), Yuzhen (BL9), Kunlun (BL60) and Houxi (SI3).

Modifications were also made based on differential diagnostics:
Add Hegu (LI4) and Lieque (LU7) for cases of external infection due to wind cold.
Add Xuehai (SP10), Geshu (BL17) and Sanyinjiao (SP6) for cases of stasis.
Add Taichong (LR3) and Yanglingquan (GB34) for cases of liver yang hyperactivity.
Add Fengrong (ST40) and Yinlingquan (SP9) for cases of wind phlegm invading upwardly.
Add Shenshu (BL23), Taixi (KI3) and Xuanzhong (GB39) for the cases of kidney deficiency.
Add Zusanli (ST36), Ganshu (BL18), Pishu (BL20) and Sanyinjiao (SP6) for cases of qi and blood deficiency.

Acupuncture Techniques
Acupuncture was applied in either the seated or lying posture. Quick insertion of filiform needles was applied with twirling reinforcing and reducing manipulation methods to acupoints on the head. Lifting and thrusting was used for reinforcing and reducing methods at limb acupoints. Manual manipulation was applied every 10 minutes. The retention of needling was 20 minutes for minor cases and 30 minutes for severe cases. Acupuncture needling was applied once daily with 10 days comprising one course. There was a two day break after the first course and the entire treatment consisted of two courses of care.

After two courses of treatment, both groups achieved varied degrees of curative effects in terms of reducing headache attacks, duration of each attack and the intensity degree of headaches. The acupuncture group outperformed the drug group in all of the aforementioned indices. As a result, the researchers conclude that acupuncture combined with Huo Xue Qu Feng Tong Luo Tang is superior to nimodipine for the treatment of vascular headaches.

References:
Zhou, Ping, Huali Luo, Oula Chen, et al. “Clinical Research on Huoxue Qufeng Tongluo Decoction Combined with Acupuncture in Treatment of Vascular Headache.” Chinese Journal of Experimental Traditional Medical Formulae 20.2 (2014).

Scott SW, Deare JC. Acupuncture for migraine: a systematic review. ‘Aust J Acupunct Chin Med’ 2006;1(1):3-14)

From Health CMI: http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1342-acupuncture-herbs-best-pharmaceutical-for-headaches

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