affinityacupuncture

[affinityacupuncture]

Acupuncture Regulates Hormones, Boosts Fertility

Acupuncture is effective for the treatment of polycystic ovarian syndrome. Researchers find acupuncture effective for normalizing hormone levels and improving the overall health of patients with polycystic ovarian syndrome. Scientific data demonstrates that acupuncture produces significant improvements in menstrual regularity, restores ovulation pattern regularity, increases pregnancy rates, regulates hormonal secretions, normalizes basal body temperature patterns, and increases embryo survival rates. Fertility enhancements provided by acupuncture apply to both natural conception and IVF (in vitro fertilization) patients.

Research published in the Shanghai Journal of Acupuncture and Moxibustion entitled Advances In Clinical Research On Acupuncture Moxibustion Treatment For Polycystic Ovarian Syndrome cites several clinical studies. Let’s take a look at the finings. Chen et al. applied stimulation with acupuncture at sacral plexus acupoints and paraspinal acupoints. Acupuncture treatment sessions were regularly administered over the course of three menstruation cycles. Upon completion of all acupuncture therapy, follow-up examinations (including ultrasound imaging) demonstrated significant improvements in menstrual regularity, ovulation frequency, and cervical mucus consistency. In addition, the pregnancy rate of patients in the study increased significantly. 

The research published in the Shanghai Journal of Acupuncture reviewed the work of Wang et al. That study demonstrated an 80.8% total effective rate for the treatment of polycystic ovarian syndrome with acupuncture. The acupuncture points used in the study included the following acupoints:

Geshu, BL17 Shenshu, BL23 Ganshu, BL18 Zhongwan, CV12 Qihai, CV6 Guanyuan, CV4 Zigong, extra Guilai, ST29 Xuehai, SP10 Zusanli, ST36 Sanyinjiao, SP6 Dahe, KD12

Two additional acupuncture points were added, based on symptomatic presentations and differential diagnostic considerations: Taichong (LV3), Fenglong (ST40). In another investigation, Huang et al. combined moxibustion with traditional Chinese medicine massage (Tui Na) and medications. The controlled investigation demonstrated the ability of traditional Chinese medicine to regulate ovulation and secretion of sex hormones to normal levels when compared with the control group that received only drug therapy. Moxibustion was applied to the following: Sanyinjiao, Guanyuan, Zigong. The researchers conclude that moxa and Chinese massage enhance the efficacy of drug therapy for the treatment of polycystic ovarian syndrome.

Xie et al. combined traditional Chinese herbal medicine with acupuncture and achieved significant clinical results. Patients with polycystic ovarian syndrome had an 80% total treatment effective rate using the combined therapy protocol. An herbal pill (Zi Shen Yu Tai) was administered to nourish the kidneys and reinforce fertility. On the fifth day following menstruation, acupuncture was applied to the following acupoints:

Guanyuan, CV4 Sanyinjiao, SP6 Taixi, KD3 Taichong, LV3 Zigong, extra

The pattern of basal body temperatures significantly normalized using the herbal medicine combined with acupuncture therapy approach to patient care. In addition, hormone levels significantly normalized, including the following hormones: LH (luteinizing hormone), testosterone, FSH (follicle-stimulating hormone). The work of Xie et al. was published in the Guiding Journal of Traditional Chinese Medicine.

Qiu and Xu administered electroacupuncture to patients that had a combination of polycystic ovarian syndrome with obesity. Electroacupuncture was applied to body style acupuncture points. In addition, auricular (ear) acupuncture was added. Important clinical improvements were documented by the researchers. Patients had significant improvements in the reduction of polycystic ovarian syndrome symptoms, including improved menstruation regularity. In addition, many patients experienced a healthy reduction a bodily fat. The total treatment affective rate was 89.7%.The auricular acupuncture points used in the study were as follows: Zigong, Neifenmi, Pizhixia, Pi, Shen, Luanchao. Body style acupuncture points used in the study were as follows:

Zhigou, TB6 Siman, KD14 Guanyuan, CV4 Daimai, GB26 Xuehai, SP10 Sanyinjiao, SP6 Taixi, KD3

Li et al. administered acupuncture therapy to determine whether or not it is successful for the improvement of in vitro fertilization (IVF) embryo survival rates. Inclusion criteria for the study predetermined that all patients were of kidney deficiency type (according to Chinese medicine principles) and had a confirmed diagnosis of polycystic ovarian syndrome. The results demonstrate significant clinical improvements, including higher embryo survival rates. The following acupuncture points used in the study were as follows:

Guanyuan, CV4 Zhongji, CV3 Sanyinjiao, SP6 Zigong, extra Taixi, KD3

In related research, Chengdu University of Traditional Chinese Medicine researchers investigated ovulation and pregnancy rates for patients with polycystic ovarian syndrome. The study involved two groups. Group one received acupuncture, herbs, and therapeutic exercises. Group two received drug therapy (cyproterone acetate / ethinylestradiol tablets and metformin). The acupuncture, herbs, and exercise group slightly outperformed the drug group.

The combination of acupuncture, herbs, and therapeutic exercises produced higher rates of ovulation and pregnancies in PCOS patients, producing a 46.92% ovulation rate and a 32.16% pregnancy rate. The drug therapy protocol produced a 40.61% ovulation rate and a 30.16% pregnancy rate. The researchers concluded that drug therapy and Chinese medicine produce similar positive patient outcomes for patients with PCOS.

References Zheng HM, Lv GY, Wang YJ, Hou WG, Chen YL, Zeng YJ. (2013). Advances in Clinical Research on Acupuncture moxibustion Treatment for Polycystic Ovarian Syndrome. Shanghai Journal of Acupuncture and Moxibustion. 32(9).

Wang XY, Zhang YJ, Wu FD, Lu Y & Huang GQ. (2007). Acupuncture Treatment for 26 Cases of Polycystic Ovary Syndrome. Journal of acupuncture, moxibustion & Tuina. (05).

Chen D, Chen SR, Shi XL, Guo FL, Zhu YK, Li Z, Cai MX, Deng LH & Xu H. (2007). Needle pricking therapy in treating polycystic ovary syndrome. China Journal of Acupuncture & Moxibustion. (02).

Huang M, Lai H, Lv FB & Pan BQ. (2007). Moxibustion in treating polycystic ovarian syndrome. Massage methodology. (01).

Qiu HN & Xu J. (2006). Acupuncture, moxibustion and auricular point sticking in treating obese polycystic ovarian syndrome. Chinese Community Doctors. 8(14): 86-87.

Li J, Cui W, Sun W. (2009). Electroacupuncture in treating patients with kidney deficiency type of PCOS and receive IVF-ET. China Journal of Sexual Science. (07).

Bai, S. L., Jiang, X. H., Li, Y. L., Huang, W. Q., Wang, L. & Liu, X. Z. (2014). The effect of weight-loss herbal decoction combined with acupuncture and exercise on endocrine markers and pregnancy outcomes in non-obesity patients with polycystic ovary syndrome. Chinese Journal of Family Planning. 22(8).

Diamanti-Kandarakis E, Papavassiliou AG. Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends Mol Med JT – Trends in molecular medicine, 2006, 12(7):324.

Sun, J., J. M. Zhao, R. Ji, H. R. Liu, Y. Shi, and C. L. Jin. "[Effects of electroacupuncture of" Guanyuan"(CV 4)-" Zhongji"(CV 3) on ovarian P450 arom and P450c 17alpha expression and relevant sex hormone levels in rats with polycystic ovary syndrome]." Zhen ci yan jiu= Acupuncture research/[Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji] 38, no. 6 (2013): 465-472.

 Article Originated at

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1725-acupuncture-regulates-hormones-boosts-fertility

[affinityacupuncture]

Acupuncture Doctor Approved

The American College of Physicians formally recommends acupuncture for the treatment of back pain. Published in the prestigious Annals of Internal Medicine, clinical guidelines were developed by the American College of Physicians (ACP) to present recommendations based on evidence. Citing quality evidence in modern research, the ACP notes that nonpharmacologic treatment with acupuncture for the treatment of chronic low back pain is recommended. The official grade by the ACP is a “strong recommendation.” [1]

A major goal of the recommendation is for acupuncture and other nonpharmacological therapies to replace drug therapy as a primary source of pain relief. Treatment with opioids is only recommended, with an official “weak recommendation,” when other modalities do not provide adequate relief. A strong recommendation is also made by the American College of Physicians for the treatment of both acute and subacute lower back pain with heat, massage, acupuncture, and spinal manipulation. [2] The recommendations were approved by the ACP Board of Regents and involves evidence based recommendations from doctors at the Penn Health System (Philadelphia, Pennsylvania), Minneapolis Veterans Affairs Medical Center (Minnesota), and the Yale School of Medicine (New Haven, Connecticut). 

The American College of Physicians notes that approximately 25% of USA adults have had, at the very minimum, a one day lower back pain episode within the past three months. The socioeconomic impact of lower back pain in the USA was approximately $100 billion in the year 2006 . The costs include medical care and indirect costs due to lost wages and declines in productivity. [3] Recommendations for treatment options, including those for the use of acupuncture, include considerations of positive medical patient outcomes, the total number of back pain episodes, duration between episodes, alleviation of lower back pain, improvement in function of the back, and work disability reductions. Recommendations are for both radicular and nonradicular lower back pain.

The target audience for the American College of Physicians recommendations includes all doctors, other clinicians, and the adult population with lower back pain. The ACP notes, “Moderate-quality evidence showed that acupuncture was associated with moderately lower pain intensity and improved function compared with no acupuncture at the end of treatment .” [4] In agreement, the National Institute of Neurological Disorders and Stroke (National Institutes of Health) notes that acupuncture is an effective treatment modality for the relief of chronic lower back pain. [5]

These findings are consistent with those published in Mayo Clinic proceedings finding that acupuncture is effective for the treatment of lower back pain. The same Mayo Clinic report notes that acupuncture does not cause any significant adverse effects. [6] The Mayo Clinic findings apply to both nociceptive and non-nociceptive pain. Nociceptive back pain includes musculoskeletal inflammation and pain involving nerve cells wherein nociceptors are activated. Nociceptors are afferent neurons in the skin, muscles, joints, and other areas. For example, nerve impingement (often referred to as a “pinched nerve”) produces one type of nociceptive pain.

Non-nociceptive pain does not involve inflammation and is more relevant to pain processing in the central nervous system. One type of non-nociceptive pain condition is fibromyalgia and acupuncture has been confirmed as an effective treatment modality for this condition. The Mayo Clinic proceedings note, “Martin et al. found a significant improvement between electroacupuncture vs sham electroacupuncture. Differences were seen on the Fibromyalgia Impact Questionnaire (FIQ) scores for fatigue and anxiety.” [7]

The Mayo Clinic and American College of Physicians findings are consistent with additional quality research. Memorial Sloan Kettering Cancer Center (New York) and University of York (United Kingdom) researchers note “We have provided the most robust evidence from high-quality trials on acupuncture for chronic pain. The synthesis of high-quality IPD found that acupuncture was more effective than both usual care and sham acupuncture. Acupuncture is one of the more clinically effective physical therapies for osteoarthritis and is also cost-effective if only high-quality trials are analysed.” [8]

Doctors understand the true need for effective pain management. Nonpharmacological solutions are important for a variety of reasons including prevention of addiction, effective relief of pain, and prevention of adverse effects. This is often of heightened concern during pregnancy and for children. As a result, university hospitals integrate acupuncture into usual care settings to improve patient outcomes. For example, pediatric doctors at the UCSF Benioff Children’s Hospital San Francisco provide acupuncture to children, including non-needle laser acupuncture. At the University of California hospital, acupuncture is made available for both inpatients and outpatients. Dr. Kim notes that acupuncture reduces nausea up to 70%. She adds that acupuncture is also effective for significant reductions in post-surgical pain and chronic headaches. [9]

Recently, researchers have discovered how acupuncture stops pain and provides other forms of relief for patients. Breakthrough research conducted by University of South Florida (Tampa) and Fujian University of Traditional Chinese Medicine (Fuzhou) researchers documents how acupuncture stops pain. The researchers note, “acupuncture exerts a remarkable analgesic effect on SCI [spinal cord injury] by also inhibiting production of microglial cells through attenuation of p38MAPK and ERK activation.” [10]

Microglia are central nervous system immunity cells that secrete proinflammatory and neurotoxic mediators. Acupuncture reduces pain by attenuating this response. The researchers also document that acupuncture provides neuroprotection. The researchers note that acupuncture prevents brain damage in the hippocampus by “preventing microglial activation.” The University of South Florida members of the research team were from the Department of Neurosurgery and Brain Repair and the Department of Pharmaceutical Sciences. Funding was provided by the United States Department of Defense, University of South Florida Neurosurgery and Brain Repair, and the James and Esther King Biomedical Research Foundation.

The aforementioned research reveals an important biochemical mechanism involved in acupuncture’s ability to alleviate pain and reduce harmful inflammation. Researchers focus on other mechanisms activated by administration of acupuncture treatments. For example, laboratory investigations reveal how acupuncture regulates blood pressure.

University of California (Irvine) researchers find acupuncture effective for the treatment of high blood pressure. In a controlled laboratory study, University of California researchers have proven that electroacupuncture at acupoint ST36 (Zusanli) promotes enkephalin production, which dampens proinflammatory excitatory responses from the sympathetic nervous system that cause hypertension. Specifically, electroacupuncture regulates preproenkephalin gene expression, a precursor substance that encodes proenkephalin, which then stimulates the production of enkephalin. [11]

The formal recommendation for the use of acupuncture in cases of lower back pain by the American College of Physicians is based on modern research. Mayo Clinic findings and research from the Memorial Sloan Kettering Cancer Center (New York) and the University of York support this recommendation. In response to the needs of patients, doctors have already implemented acupuncture into several hospitals throughout the USA and both inpatient and outpatient acupuncture treatments are available.

Now, modern scientific investigations reveal how acupuncture works. University of South Florida and Fujian University of Traditional Chinese Medicine researchers confirm acupuncture’s ability to attenuate microglial activation. University of California researchers have quantified acupuncture’s ability to control inflammation by regulating enkephalins. In addition, the NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine) provides professional certification for acupuncturists, which ensures standards of excellence for licensed acupuncturists. Given the large body of supportive research and the administrative support for providing safe and effective acupuncture to the general public, expect to see greater implementation of acupuncture into usual care settings.

References 1. Qaseem, Amir, Timothy J. Wilt, Robert M. McLean, and Mary Ann Forciea. "Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of PhysiciansNoninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain." Annals of Internal Medicine (2017). 2. Qaseem, et al. Annals of Internal Medicine (2017).

3. Katz J.N. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences.J Bone Joint Surg Am200688 Suppl 2214. 4. Lam M. Galvin R. Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis.Spine (Philadelphia, Pennsylvania 1976) 201338212438. 5. ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet. Low Back Pain Fact Sheet, National Institute of Neurological Disorders and Stroke, National Institutes of Health. 6. Nahin, Richard L., Robin Boineau, Partap S. Khalsa, Barbara J. Stussman, and Wendy J. Weber. "Evidence-based evaluation of complementary health approaches for pain management in the United States." In Mayo Clinic Proceedings, vol. 91, no. 9, pp. 1292-1306. Elsevier, 2016. 7. Martin DP, Sletten CD, Williams BA, Berger IH. Improvement in fibromyalgia symptoms with acupuncture: results of a randomized controlled trial. Mayo Clin Proc. 2006;81(6):749-757. 8. MacPherson, H., A. Vickers, M. Bland, D. Torgerson, M. Corbett, E. Spackman, P. Saramago et al. "Acupuncture for chronic pain and depression in primary care: a programme of research." (2017).

9. Leslie Lingaas. ucsf.edu/news/2014/04/113966/acupuncture-helps-young-patients-manage-pain. Acupuncture Helps Pediatric Patients Manage Pain and Nausea, 2014. 10. Lin, Lili, Nikola Skakavac, Xiaoyang Lin, Dong Lin, Mia C. Borlongan, Cesar V. Borlongan, and Chuanhai Cao. "Acupuncture-induced analgesia: the role of microglial inhibition." Cell transplantation 25, no. 4 (2016): 621-628. 11. Cevic, C and Iseri, SO. The effect of acupuncture on high blood pressure of patients using antihypertensive drugs. Acupuncture & electro-therapeutics research 2013; 38(1-2): 1-15. ncbi.nlm.nih.gov/pubmed/23724695.

[affinityacupuncture]

Acupuncture Outperforms Drugs For Infertility

Researchers find acupuncture combined with clomiphene more effective than clomiphene plus supplementary hormonal pharmaceuticals for the treatment of infertility. The combination of acupuncture plus clomiphene produces significantly higher pregnancy rates for women with anovulatory infertility than clomiphene plus estradiol cypionate and dydrogesterone. The data was published in the report entitled Effects of Acupuncture on the Endometrium in Anovulatory Cases Treated by Clomiphene: A Clinical Observation.

The addition of acupuncture to clomiphene therapy increased pregnancy rates, lowered the resistance and pulsatility indices of the uterine arteries, and reduced the adverse effects caused by clomiphene. The increase in positive patient outcomes combined with reductions of adverse effects supports the research team’s (Taian Maternal and Child Health Care Hospital) conclusion, “TCM [Traditional Chinese Medicine] can be either applied alone or combined with Western medicine to up pregnancy rates and treat infertility. With the help of TCM [i.e., acupuncture], treatment for infertility can be more effective while producing much less adverse effects.” [1] 

Clomiphene triggers the pituitary gland to produce hormones that stimulate ovulation. The upside of this medication is that it stimulates the release of eggs from the ovaries. The downside is that it may produce adverse effects and it is contraindicated for patients with endometriosis and uterine fibroids. Notably, it may increase the incidence of having twins or triplets. The researchers conclude that the addition of acupuncture to the clomiphene treatment regimen mitigates the drug’s adverse effects and ups the pregnancy rate. Moreover, the acupuncture protocol outperforms the clomiphene plus estradiol cypionate and dydrogesterone protocol. Estradiol cypionate is an estrogen hormone and is often used for the treatment of low estrogen levels. Estradiol cypionate may increase the rate of developing blood clots, melasma (dark skin patches on the face), and may cause other adverse effects. Dydrogesterone is a steroidal progestin used in many countries for the treatment of infertility and threatened miscarriages.

The clinical study was conducted with a semi-protocolized approach to acupuncture point selection. Identical primary acupuncture points were assigned to all patients and secondary acupuncture points were prescribed based upon differential diagnostics. As a variable control, secondary acupuncture point prescriptions were limited to one of three acupuncture point groupings: liver qi stagnation, phlegm-dampness, blood stasis. Patients were not divided into treatment and control groups based upon the diagnostic groups. Instead, they were randomly divided into three groups and then diagnostic decisions were made for the addition of secondary acupuncture points for the TCM treatment group.

A total of 43 patients were randomly distributed into three groups. Group 1 received only clomiphene. Group 2 received clomiphene plus estradiol cypionate and dydrogesterone. Group 3 received clomiphene plus acupuncture and moxibustion. The number of patients in each group was 15, 14, and 14 respectively. Patients ranged from ages 21–39. The preexisting duration of anovulatory infertility ranged from 1–8 years.

Groups 1 and 2 received 50–100 mg of clomiphene, once per day. Group 2 also received 1 mg of estradiol cypionate and 10 mg of dydrogesterone. Group 3 received clomiphene plus acupuncture and moxibustion. The administration of care for all groups started on the 5th day of menstruation and lasted for 5 consecutive days. One treatment course consisted of three menstrual cycles. In total, 1–2 courses of treatment were applied. The TCM acupuncture treatment protocol was as follows. Patients rested in a supine position. Upon disinfection, a 0.30 mm x 40 mm filiform needle was inserted into the following acupoints:

CV4 (Guanyuan) CV3 (Zhongji) Zigong ST29 (Guilai) SP6 (Sanyinjiao) ST36 (Zusanli) CV4, CV3, Zigong, and ST29 were inserted transverse-obliquely (15° angle) to a depth of 1–1.2 cm. SP6 and ST36 were needled perpendicularly and manipulated with the Ping Bu Ping Xie (tonify and sedate) technique. Additional acupoints were administered based on differential diagnostic patterns. For liver qi stagnation, the following acupoint was added:

BL18 (Ganshu) For phlegm and dampness, the following acupoint was added:

ST40 (Fenglong) For blood stasis, the following acupoints were added:

SP10 (Xuehai) LV2 (Xingjian) Moxibustion sessions lasted 30 minutes and were applied at a heat intensity level until the skin became flushed. Sessions were conducted once per day. Moxibustion was not applied until 10 days passed after ovulation. Moxibustion was applied at the following acupoints:

Zigong CV3 (Zhongji) CV4 (Guanyuan) ST29 (Guilai) Additional research confirms that acupuncture combined with moxibustion is effective for the treatment of infertility. Researchers conclude that acupuncture acts on the hypothalamus, pituitary gland, and ovaries and regulates hormone levels in the body. [2, 3] Yu et al. conclude that electroacupuncture can increase gonadotropin releasing hormone (GnRH) levels and increases sensitivity of the ovaries to gonadotropin. The study documents that electroacupuncture is effective for the treatment of infertility in anovulatory cases with low levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH).

In a related study, Xu et.al conclude that acupuncture combined with moxibustion increases ovulation rates. [5] The treatment protocol was as follows. First, acupuncture was applied to the following acupoints:

Zigong CV3 (Zhongji) CV4 (Guanyuan) ST36 (Zusanli) SP6 (Sanyinjiao) LV3 (Taichong) Additional acupoints were added based upon diagnostic patterns. For liver qi stagnation, BL18 was added; for phlegm and dampness, ST40 was added; for blood stasis, SP10 and LV2 were added. Next, moxibustion was applied to Zigong, CV3, CV4, and ST36. Subsequently, an electroacupuncture device was connected to the acupoints. The treatment was applied daily for 3–7 consecutive days. The results of B-scan ultrasonography conducted during the study documents that ovulation rates increase when acupuncture combined with moxibustion is applied.

In another study, acupuncture has been found effective for increasing infertility rates for women receiving IVF (in vitro fertilization) treatments. This highlights the role of acupuncture in an integrative medicine environment. University of Maryland School of Medicine researchers conclude that acupuncture increases pregnancy rates for women receiving IVF. In a study of 16 high quality clinical trials consisting of 4,021 subjects, acupuncture significantly raised pregnancy rates for women receiving IVF where otherwise pregnancy rates would have been low.

Strong evidence indicates that acupuncture increases pregnancy rates for women with anovulatory infertility and other forms of infertility. Acupuncture has been proven an effective complementary therapy to drug therapy and IVF protocols. Research indicates that acupuncture provides an additional benefit; it reduces the adverse effect rates of infertility medications. Based on the findings of modern research, the use of acupuncture is an appropriate, safe, and effective complementary therapy for the treatment of infertility.

 To listen to the podcast on the topic of infertility, visit the following:

 Acupuncture Podcast >

  References 1. Effects of Acupuncture on the Endometrium in Anovulatory Cases Treated by Clomiphene: A Clinical Observation. Journal of Taishan Medical College. 2016, 37(9):1029-1031. 2. Yu J, Zheng HM, Bing SM. Changes in sSrum FSH, LH and Ovarian Follicular Growth During Electroacupuncture for Induction of Ovulation [J]. Chinese Journal of Integrated Traditional and Western Medicine. 1989, 9(4):199-202. 3. Sha GE, Huang WC, Ma RH. Acupuncture for Infertility: A Clinical Observation Based on 84 cases [J]. Journal of Clinical Acupuncture and Moxibustion. 1998, 14(1):16-18. 5. Xu XF, Gu Y, Gu Ling, Zhu YP. Investigating Advantages of TCM Intervention for Inducting Ovulation in Infertile Women [J]. Chinese Archives of Traditional Chinese Medicine. 2012, 30(3):467-468. 6. Cao ZY. Obstetrics and Gynecology [M]. Beijing: People's Military Medical Publisher. 1999: 2474. 7. Manheimer, Eric, Daniëlle van der Windt, Ke Cheng, Kristen Stafford, Jianping Liu, Jayne Tierney, Lixing Lao, Brian M. Berman, Patricia Langenberg, and Lex M. Bouter. "The effects of acupuncture on rates of clinical pregnancy among women undergoing in vitro fertilization: a systematic review and meta-analysis." Human reproduction update (2013). University of Maryland.

 http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1716-acupuncture-outperforms-drugs-for-infertility-promotes-pregnancy

[affinityacupuncture]

Acupuncture Activates Brain On MRI, Found to Relieves Depression

A study conducted at the First Affiliated Hospital of Guangxi University of Chinese Medicine demonstrates that acupuncture normalizes brain functions in patients with major depressive disorder (MDD). Using functional magnetic resonance imaging (fMRI) brain scans, the Guangxi University of Chinese Medicine researchers determined that scalp acupuncture at acupoint DU20 (Baihui) restores healthy brain patters to patients experiencing major depressive disorder. Using before and after fMRIs, the researchers determined that acupuncture balances brain states in patients with severe depression and restores healthy brain functional connectivity. In addition, acupuncture successfully downregulated excessive hyperactivity of brain states found in major depressive disorder patients. The researchers determined that acupuncture allows the brain to return to a normal restful state while simultaneously reactivating brain regions suffering from abnormally low functionality.

The researchers compared the fMRI results of 29 first-episode major depressive disorder patients with fMRI results of 29 healthy subjects. The researchers identified areas of the brain with differing functional connectivity (FC) in major depressive disorder patients. After 20 minutes of electroacupuncture (EA) stimulation at acupoint DU20 (Baihui), the patients were given another fMRI scan to determine how electroacupuncture affects functional connectivity in the brain. [1] The outcomes demonstrate that electroacupuncture has the effect of increasing functional connectivity in areas of hypoconnectivity and decreasing functional connectivity in areas of hyperconnectivity, thereby modulating the default mode network (DMN) of the brain toward healthier brain activity. [2] Electroacupuncture restored homeostatic resting states to the brain by balancing DMN functional connectivity. 

The DMN is the area of the brain that is used for processing information when the brain is not engaged in an active task. It is involved in the conception of oneself and others, including moral and emotional judgements related to actions, as well as the rumination on past and future events. It is made up of a network of distinct areas of the brain connected both anatomically and functionally. In the absence of malformation or injury, the structural connections are relatively fixed. The degree to which these areas are functionally connected is measured by statistical analysis using technologies, including fMRI, that visually capture the change in blood flow to specific areas of the brain.

This study demonstrates how brain functional connectivity is markedly and predictably different between patients with major depressive disorder and healthy subjects. The study maps how electroacupuncture changes the patterns of functional connectivity in major depressive patients toward the patterns found in healthy subjects that do not have severe depression. [3] Because the nature of the changes in functional connectivity are consistent among patients with major depressive disorder, the hypothesis is that these changes are a symptom or cause of major depressive disorder. The implication is that, if the effect is long-lasting, electroacupuncture can be used to normalize the functional connectivity of patients with major depressive disorder, providing relief for a devastating disease.

Major depressive disorder manifests differently in different people, but it is generally marked by feelings of hopelessness, decreased concentration, and a lack of interest in stimuli that had previously brought joy. Weight change is also common, as is a change in sleeping patterns. Patients with more severe forms of major depressive disorder may also have recurring thoughts about death or suicide. [4] In addition to the impact it has on all aspects of a patient’s daily life, [5] the prevalence of major depressive disorder makes it a profound public health concern. In the United States alone, up to 20% of the population suffers from mild depression, and between 2% – 5% have severe depression. [6] Major depressive disorder dramatically decreases the quality of life of the patient and may have secondary emotional effects on their friends and family. Because lack of motivation is often associated with major depressive disorder, one’s ability to work may also be affected. The social and financial costs to families, and to society as a whole, may therefore be great. There are a variety of environmental causes, including stress and emotional trauma, though epidemiologic studies show that 40% – 50% of the risk is genetic. [7]

Biomedical treatment protocols for major depressive disorder include various forms of antidepressant medications. First generation drugs such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) were developed in the 1950s and are in current use. While second generation drugs such as serotonin-selective reuptake inhibitors (SSRIs) are often better tolerated than first generation tricyclic antidepressants because they tend to have fewer adverse effects, their mechanisms of action is similar, indicating that our understanding of the mechanisms of depression and its treatment has not changed significantly since the drugs were first developed. [8]

While 80% of patients achieve some benefit from medications, only 50% experience remission of their depression, [9] meaning that many patients must choose between suffering from depression or the long term adverse effects of medications that are only moderately successful. The specific qualities of depression are hard to replicate in animal trials. There is a clear hereditary risk; however, the specific genes involved have not been completely identified, which makes it difficult to develop and test new drug therapies. [10] Finding new treatment modalities outside of the medication arena would therefore potentially help millions of people in the US, and likely billions globally, who suffer the debilitating effects of major depressive disorder.

The fMRI is useful because it is non-invasive and does not require identifying the specific genes or neurotransmitters involved in brain functioning. The fMRI maps neural activity by mapping differential blood flow. “For reasons that we still do not fully understand, neural activity triggers a much larger change in blood flow than in oxygen metabolism, and this leads to the blood being more oxygenated when neural activity increases. This somewhat paradoxical blood oxygenation level dependent (BOLD) effect is the basis for fMRI.” [11] An increase in neural activity is indicated by an increase in oxygenation of a particular area of the brain, and areas that are active at the same time are considered to be functionally connected even if they are anatomically discrete. This is the basis of functional connectivity determinations based on fMRI BOLD responses.

The Guangxi University of Chinese Medicine researchers identified specific brain regions that were reliably different in patients with major depressive disorder versus healthy subjects that did not suffer from mental illness. In the test group, they found that functional connectivity was initially diminished between the posterior cingulate cortex (PCC) and the anterior cingulate cortex (ACC), and that functional connectivity was initially higher between the PCC and the left middle prefrontal cortex (PfC), the left angular gyrus (AG) and the bilateral hippocampus (HIPP). [12] Each of these areas plays a distinct role in cognitive and emotional functioning that may speak to the effects felt by patients when the functional connectivity in these regions has changed.

“The posterior cingulate cortex is a highly connected and metabolically active brain region. Recent studies suggest it has an important cognitive role, although there is no consensus about what this is…. It is a key node in the default mode network and shows increased activity when individuals retrieve autobiographical memories or plan for the future, as well as during unconstrained ‘rest’ when activity in the brain is ‘free-wheeling’.” [13] This study indicates that the PCC is a central hub for communication within the DMN, as each of the areas for which the function is better known is interacting directly with the PCC.

Despite depression appearing as a disease of hypoactivity, most brain regions showed hyperactive functional connectivity with the PCC. The ACC is the exception, initially demonstrating diminished functional connectivity that was subsequently increased after electroacupuncture. “In addition to regulating autonomic and endocrine functions, it is involved in conditioned emotional learning, vocalizations associated with expressing internal states, assessments of motivational content and assigning emotional valence to internal and external stimuli, and maternal-infant interactions.” [14] Motivation and emotional responses to stimuli are two key diagnostic elements of major depressive disorder that decreased in most MDD patients. Thus, hypoactivity between the PCC and ACC is, at least in part, responsible for the decrease in these mental functions and that reversing the hypoactivity may have a positive therapeutic effect.

The fMRI of the major depressive disorder patients showed an initial hyperactivity in the PfC, AG, and HIPP as compared to the control group, and a subsequent dampening of the functional connectivity between these areas and the PCC after electroacupuncture treatment. The PfC integrates cognitive and emotional behaviors and thus aids the process of decision making. [15] The AG has a critical role in processing language and affects thought and attention as well as spatial memory; it is also used for emotional perception and sensory interpretation. [16] The HIPP is “implicated in cognitive-behavioral functions and emotional memory.” [17] Attention and emotional memory and behavior show clear changes in major depressive disorder patients. While it seems that these functions are impaired, it may be just the opposite; “depressed individuals over-recruit a neural network involved more generally in enhancing memory for affective stimuli, and… the degree to which they over-recruit this system is related to the severity of the symptomatology.” [18] This is consistent with the findings of the current study, which indicate that depression is related to hyperactivity of functional connectivity in the brain.

Based on the findings, additional research is warranted to confirm the experimental results of the study. Moreover, the conclusions presented by the research team corroborate the Traditional Chinese Medicine (TCM) understanding that DU20 (Baihui) modulates brain function. The research also provides a solid basis for future long-term studies about the cumulative effect of electroacupuncture for the treatment of major depressive disorder. Major depressive disorder is widespread and devastating both to the patients and their communities. The findings demonstrate that acupuncture is a potential modality that addresses the needs of patients with major depressive disorder and allows for healthier brains states.

 ----

References: 1 Deng, Demao, Hai Liao, Gaoxiong Duan, Yanfei Liu, Qianchao He, Huimei Liu, Lijun Tang, Yong Pang, and Jien Tao. "Modulation of the Default Mode Network in First-Episode, Drug-Naïve Major Depressive Disorder via Acupuncture at Baihui (GV20) Acupoint." Frontiers in Human Neuroscience Front. Hum. Neurosci. 10 (2016): pg doi:10.3389/fnhum.2016.00230.  2 Demao Deng et al, Modulation of the Default Mode Network, pg 1 3 Demao Deng et al, Modulation of the Default Mode Network, pg 1. 4 Nestler, E. J., M. Barrot, R. J. DiLeone, A. J. Eisch, S. J. Gold, L. M. Monteggia. “Neurobiology of Depression.” Neuron. 34, no. 1 (2002): 13-25. doi: 10.1016/S0896-6273(02)00653-0. dx.doi.org/10.1016/S0896-6273(02)00653-0 5 Hwang, J. W., N. Egorova, X. Q. Yang, W. Y. Zhang, J. Chen, X. Y. Yang, L. J. Hu, S. Sun, Y. Tu, and J. Kong. "Subthreshold Depression Is Associated with Impaired Resting-state Functional Connectivity of the Cognitive Control Network." Translational Psychiatry Transl Psychiatry 5, no. 11 (2015). pg 1. doi:10.1038/tp.2015.174.  6 Eric Nestler et al, Neurobiology of Depression, pg 13 7 Eric Nestler et al, Neurobiology of Depression, pg 14 8 Eric Nestler et al, Neurobiology of Depression, pg 14-5 9 Eric Nestler et al, Neurobiology of Depression, pg 15 10 Eric Nestler et al, Neurobiology of Depression, pg 16 11 fmri.ucsd.edu/Research/whatisfmri.html 12 Demao Deng et al, Modulation of the Default Mode Network, pg 1 13 Leech, R., and D. J. Sharp. "The Role of the Posterior Cingulate Cortex in Cognition and Disease." Brain 137, no. 1 (2013): 12-32. doi:10.1093/brain/awt162. brain.oxfordjournals.org/content/early/2013/07/18/brain.awt16 doi: org/10.1093/brain/awt162 14 Devinsky, Orrin, Martha J. Morrell, and Brent A. Vogt. "Contributions of Anterior Cingulate Cortex to Behaviour." Brain 118, no. 1 (1995): 279-306. doi:10.1093/brain/118.1.279. ncbi.nlm.nih.gov/pubmed/7895011/ 15 Demao Deng et al, Modulation of the Default Mode Network, pg 5 16 Demao Deng et al, Modulation of the Default Mode Network, pg 5 17 Demao Deng et al, Modulation of the Default Mode Network, pg 6 18 Hamilton, J. Paul, and Ian H. Gotlib. "Neural Substrates of Increased Memory Sensitivity for Negative Stimuli in Major Depression." Biological Psychiatry 63, no. 12 (2008): 1155-16. doi:10.1016/j.biopsych.2007.12.015.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1691-acupuncture-mri-relieves-depression

[affinityacupuncture]

Acupuncture Soothes Cervical Spinal Nerves, Reduces Pain

Researchers find acupuncture effective for the relief of cervical spinal syndrome. This condition involves irritation of the spinal nerves located in the neck. Spinal nerves transmit sensory, motor, and autonomic nervous system signals between the spinal cord and the body. Inflammation and impingement present in cervical spinal syndrome results in head, neck, chest, shoulder, or arm pain and dysfunction. The results of the research demonstrates that acupuncture plus moxibustion yields a high total recovery rate. In addition, nearly every patient receiving acupuncture plus moxibustion demonstrated significant improvements.

Researchers from the Hubei Hongan Traditional Chinese Medicine Hospital examined 200 cervical syndrome patients in a controlled investigation. The research team discovered that targeted acupuncture treatments produce an extremely high total effective rate and a high complete recovery rate. Targeting involved the application of a primary acupuncture point prescription for all patients plus an additional set of secondary acupuncture points based upon diagnostic variations in clinical presentations. Using this semi-protocolized targeted approach to patient care, the research team achieved a 97% total effective rate across all tiers of improvement. The breakdown into levels of efficaciousness produced surprising results. The total recovery rate was 64%, the significant improvement rate was 17%, the minimal improvement rate was 16%, and 3% had no improvement. 

Dr. Ruth Jackson, MD, notes, “The nerve roots leave the spinal cord at an angle which approximates a right angle, and they fill fairly snugly the foramina through which they pass. This makes them very vulnerable to irritation from any mechanical derangement of the cervical spine.” Cervical syndrome is often triggered by a small event, such as leaning over a sink while brushing teeth or turning the head. However, the initial cause may have been prior, including whiplash injuries, mechanical deformities, or other chronic irritations. The tight spacing of the intervertebral foramina (IVF) through which the nerves pass is easily encroached by both chronic and acute conditions that produce inflammation and morphological changes.

A primary set of acupoints was administered to all patients in this acupuncture continuing education study. A total of 3 – 4 acupoints from the primary set were applied during each acupuncture session. Each acupoint, including customized secondary acupoints, were needled with standard manual acupuncture protocols for insertion and manipulation. Total needle retention time during each acupuncture session was 20 minutes. One acupuncture session was applied daily for a total of 10 days, followed by a two day break and then another 10 days of acupuncture therapy. For moxibustion, a moxa cigar was used to warm the cervical Jiaji acupoints for 30 minutes per day. One 30 minute moxibustion treatment was conducted daily for 10 consecutive days. The next treatment cycle of an additional 10 days of moxibustion care commenced after a 2 day break from treatment. The primary acupoints were selected from the following selection:

Fengchi (GB20) Dazhui (GV14) Jianjing (GB21) Tianzong (SI11) Lieque (LU7) Zhongzhu (TB3) Houxi (SI3) Ashi (located beside spinous processes) Secondary acupoints were selected based on the type of cervical syndrome presentation for each patient. For nerve root compression cervical syndrome affecting the shoulders and arms, the following points were applied:

Jianyu (LI15) Tianzong (SI11) Binao (LI14) Yanglao (SI6) For vertebral artery related cervical syndrome, the following acupoints were applied:

Taiyang (MHN9) Touwei (ST8) Baihui (GV20) Sishencong (MHN1) Neiguan (PC6) Sanyinjiao (SP6) Taichong (LV3) Zusanli (ST36) For sympathicus cervical syndrome involving excess stimulation of the sympathetic division of the autonomic nervous system, the following acupoints were applied:

Taiyang (MHN9) Jingming (BL1) Qiuhou (MHN8) Yifeng (TB17) Neiguan (PC6) Zusanli (ST36) Sanyinjiao (SP6) Jiaoxin (KD8) Yinjiao (CV7) Patients were evaluated before and after the treatment course of care. The treatment efficacy for each patient was categorized into 1 of 4 tiers:

Recovery: Complete recovery of neck function. Complete absence of clinical symptoms. Significantly effective: Alleviation of localized pain. Clinical symptoms largely absent. Effective: Localized pain present. Basic physiological function achieved. Main clinical symptoms absent. Not effective: No improvement. The total treatment effective rate was derived as the percentage of patients who achieved at least an effective tier. The data shows that acupuncture combined with moxibustion benefits nearly every cervical syndrome patient to some degree, with a 97% total effective rate across all tiers of improvement. The 64% complete recovery rate is equally important.

The researchers gave a Traditional Chinese Medicine (TCM) background to the treatment of cervical syndrome, often manifesting as cervical spondylosis. According to TCM, cervical syndrome is common starting in middle-aged individuals and older. Often, cervical nerve impingement is due to osteoarthritis and cervical disc protrusions or extrusions. Radiculitis is common in all cases. According to TCM principles, left untreated, cervical syndrome is a degenerative disorder. Calcification of related ligaments due to chronic strain and inflammation may lead to oppression of the cervical vertebrae, nerve roots, and blood vessels. There may also be pressure onto the spinal cord in more serious cases. These conditions lead to cervical dysfunction and pain.

In TCM, cervical syndrome is often categorized in the class of Bi Zheng. External pernicious influences giving rise to cervical syndrome include external injury, exhaustion, wind, cold, and dampness. Zang-Fu and deficiency related conditions include deficiency of the liver and kidneys or tendon and bone malnutrition. The aforementioned conditions result in poor qi and blood circulation in the Taiyang meridians and imbalances of the Ying and Wei. Symptoms such as severe neck pain, shoulder pain, numbness, headache, dizziness, and nausea ensue as a result of the condition. The results of the research demonstrates that acupuncture combined with moxibustion is effective for the relief of cervical syndrome.

References: Li HX & Zhao L. (2013). Efficacy observation on treating 200 cases of cervical syndrome with acupuncture and moxibustion. Clinical Journal of Chinese Medicine. 5(3).

Jackson, Ruth. "The Classic: The Cervical Syndrome." Clinical Orthopaedics and Related Research. 468, no. 7 (2010): 1739-1745.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1699-acupuncture-soothes-cervical-spinal-nerves-stops-pain

[affinityacupuncture]

Report Finds Acupuncture Reverses Lower Back Pain

Qi-guiding acupuncture relieves disc herniation pain and a special intensive silver acupuncture needle protocol relieves chronic lower back myofascial pain.

Researchers find acupuncture effective for the treatment of lower back pain disorders. In a protocolized study from the Shanghai Jiaotong University Sixth People’s Hospital, researchers determined that a special type of manual acupuncture therapy, known as qi-guiding acupuncture, produces significant positive patient outcomes for lumbar intervertebral disc herniation patients. In related research from Xinping Hospital of Traditional Chinese Medicine, investigators find acupuncture combined with moxibustion effective for the alleviation of lower back pain due to lumbodorsal myofascial pain syndrome. A special application of silver acupuncture needles produced superior patient outcomes. Let’s start with a look at the Shanghai Jiaotang University research and then we’ll see how the silver needle protocol boosts treatment efficacy for the treatment of lower back pain.

Acupuncture is effective for the treatment of lumbar intervertebral disc herniations. Wu et al. (Shanghai Jiaotong University Sixth People’s Hospital) investigated the treatment results of qi-guiding acupuncture with meridian differentiated acupoint selections and determined that it produces significant positive treatment outcomes for lumbar intervertebral disc herniation patients. Wu et al. also find electroacupuncture with meridian differentiated acupoint selections effective; however, qi-guiding acupuncture had a slightly higher rate of producing positive patient outcomes. Qi-guiding acupuncture had an 87.5% total treatment effective rate and electroacupuncture achieved an 86.6% total treatment effective rate. Qi-guiding acupuncture also had better outcomes for increases in nerve conduction velocity. The results are definitive given the large sample size of 549 patients with lumbar disc herniations evaluated in this study. 

Lumbar disc herniation patients experience lower back pain and radiculopathy (radiating pain and numbness) as a result of anulus fibrosis damage, IVF encroachment, and other issues associated with disc damage (Hu et al.). Acupuncture, as one of the most common non-surgical treatment methods for lumbar disc herniation, has a high treatment effective rate and no significant adverse effects (Cheng).

Qi-guiding acupuncture was first documented in ancient literature, including The Systematic Classic of Acupuncture & Moxibustion by Huang-fu Mi. In qi-guiding acupuncture, needle entry and removal is controlled and slow. To direct qi upward, the acupuncture needle is oriented upward; similarly, to direct qi downward, the needle is pointed downward. Subsequently, the needle is frequently rotated, lifted, and thrust to regulate the flow of qi in the body. Additional manipulation techniques may be intermittently applied. In modern use, qi-guiding acupuncture repairs ultramicroscopic structures of damaged nerve roots and accelerates other aspects of nerve repair, thereby increasing nerve conduction.

In this study, lumbar disc herniation patients receiving qi-guiding acupuncture achieved an 87.5% total treatment effective rate. Patients receiving electroacupuncture achieved an 86.6% total treatment effective rate. Both qi-guiding acupuncture and electroacupuncture significantly increased nerve conduction velocity. Qi-guiding acupuncture had a slightly greater improvement in common peroneal nerve conduction velocity and superficial fibular nerve conduction velocity. Common peroneal nerve conduction velocity increased from 38.26 ± 12.8 to 44.75 ± 5.24 after the application of qi-guiding acupuncture, and increased from 39.11 ± 3.64 to 39.86 ± 10.95 after electroacupuncture. Superficial fibular nerve conduction velocity increased from 41.63 ± 4.37 to 42.55 ± 6.43 after the application of qi-guiding acupuncture, and increased from 40.71 ± 9.56 to 40.43 ± 4.01 after electroacupuncture.

A total of 549 patients with lumbar disc herniations were treated and evaluated in this study. These patients were diagnosed with lumbar disc herniations between December 2012 and March 2014. They were randomly divided into a treatment group and a control group, with 280 patients in the treatment group and 269 patients in the control group. The treatment group underwent qi-guiding acupuncture therapy, while the control group received electroacupuncture. Acupoint selection for both groups was based on meridian differentiation. Identical acupoints were selected for both patient groups.

For Taiyang meridian lumbago and leg pain (scelalgia):

Shenshu (BL23) Dachangshu (BL25) Zhibian (BL54) Huantiao (GB30) Juliao (GB29) Yinmen (BL37) Weizhong (BL40) Chengshan (BL57) Kunlun (BL60) For Yangming meridian lumbago and leg pain:

Shenshu (BL23) Dachangshu (BL25) Qichong (ST30) Biguan (ST31) Futu (ST32) Tiaokou (ST38) Zusanli (ST36) For Shaoyang meridian lumbago and leg pain:

Shenshu (BL23) Dachangshu (BL25) Huantiao (GB30) Fengshi (GB31) Yanglingquan (GB34) For qi-guiding acupuncture, the following protocol was administered. Upon disinfection with 75% ethanol, a 0.30 mm x 40 mm filiform acupuncture needle was inserted into each selected acupoint. Huantiao and Juliao were needle to a depth of 2.5 inches. The remaining acupoints were needled to a depth of 1.2 inches. When a deqi sensation was achieved for all acupoints, qi-guiding needling with the Xie (reducing) manipulation technique was applied to Weizhong, Tiaokou, and Yanglingquan to transmit the needling sensation upward and toward the hip or waist. The same technique was applied to Huantiao, Juliao, and Biguan, instead transmitting the needle sensation downward and toward the legs. Subsequently, qi-guiding needling with the Bu (tonification) manipulation technique was applied on Dachangshu to transmit the needle sensation toward the lumbosacral area. The same technique was used on Shenshu until a deqi sensation of soreness or swelling was perceived at the lumbar region. A needle retention time of 20 minutes was observed during which the needles were rotated, lifted, and thrusted every 5 minutes to facilitate the flow of qi. One qi-guiding acupuncture session was conducted every other day for a total of 10 treatments.

Electroacupuncture for the control group was administered with the same aforementioned protocol. Before needle retention, the needles were connected to an electroacupuncture device. The device was then set to a continuous wave at 4 Hz with a 2mA current. A 20 minute needle retention time was subsequently observed. One electroacupuncture session was conducted every other day for a total of 10 treatments. The clinical results the Wu et al. study demonstrate that both qi-guiding acupuncture and electroacupuncture, when combined with meridian-differentiated acupoint selection, are suitable and effective therapies for lumbar disc herniation patients. However, qi-guiding acupuncture produces slightly better treatment outcomes in terms of nerve conduction velocity improvements.

In a related study, Wang H.D. (Xinping Hospital of Traditional Chinese Medicine) finds acupuncture combined with moxibustion therapy effective for the treatment of lumbodorsal myofascial pain syndrome. The study also finds that a silver needle protocol produces preferable treatment outcomes to conventional acupuncture. Lumbodorsal myofascial pain syndrome causes chronic lumbago and commonly occurs in young adults. Intensive acupuncture combined with moxibustion using silver needles was famously used by Professor Xuan Zhe Ren, a renowned Chinese orthopedist.

Acupoints were selected based on the degree of soft tissue damage, area of muscular tissue involved, and size of tendon contracture. In this approach, acupoints are 2 cm apart from each other and are mainly located on the lumbosacral region. Results from Wang’s study demonstrate that lumbodorsal myofascial pain syndrome patients receiving intensive acupuncture combined with moxibustion using silver needles achieved a 90% total treatment effective rate. Conventional acupuncture with moxibustion achieved an 83.3% total treatment effective rate.

Wang’s study involved a total of 60 patients with lumbodorsal myofascial pain syndrome. They were divided into a treatment group and a control group, with 30 patients in each group. The treatment group underwent intensive acupuncture-moxibustion therapy with silver needles. The control group received conventional acupuncture-moxibustion.

Intensive acupuncture-moxibustion with silver needles was applied to the T12 – L4 Jiaji acupoints and the acupoints located at the midpoint between each Jiaji acupoint. In addition, acupoints located 2 cm lateral to the Jiaji acupoints were needled. Finally, moxibustion applied with one Zhuang of 3 cm moxa cigar. One session was conducted daily for a total of 7 days. For conventional acupuncture-moxibustion therapy, the following primary acupoints were selected:

Shenshu (BL23) Mingmen (GV4) Weizhong (BL40) Ashi Additional acupoints were selected based on individual symptoms. For lumbago with chill-dampness:

Yaoyangguan (GV3) For lumbago due to exhaustion:

Yanglingquan (GB34) Sanyinjiao (SP6) For lumbago with kidney deficiency:

Zhishi (BL52) Taixi (KD3) A needle retention time of 30 minutes was observed. Subsequently, moxibustion was applied using either a 4 hole or 6 hole moxa box on the lumbar acupoints. One session was conducted daily for a total of 7 days. The treatment efficacy for each patient was evaluated and categorized into 1 of 3 tiers:

Recovery: Complete elimination of symptoms. Physical movement regained completely. No pain points. Significantly effective: Elimination of symptoms. Physical movement regained. Discomfort reoccurs only under exhaustion or change in weather. No pain or numbness. Effective: Symptoms relieved. Pain or numbness present. Not effective: No improvement in symptoms. The total treatment effective rate for each patient group was derived as the percentage of patients who achieved at least an effective tier of improvement. The intensive acupuncture-moxibustion with silver needles protocol outperformed conventional acupuncture. However, both approaches produced significant positive patient outcomes.

Both aforementioned studies indicate that acupuncture is effective for the alleviation of lower back pain. These studies highlight the differences in therapeutic effects between various forms of acupuncture. As a result, qi-guiding acupuncture and intensive acupuncture-moxibustion with silver needles are found clinically effective for the relief of lower back pain.

  References: Wu YC, Sun YJ, Zhang JF, Li Y, Zhang YY & Wang CM. (2014). Clinical Study of Qi-guiding Acupuncture at Points Selected According to Meridian Differentiation for Treatment of Lumbar Intervertebral Disc Herniation. Shanghai Journal of Acupuncture and Moxibustion. 33(12).

Cheng XN. (1987). The study of Chinese acupuncture-moxibustion. Volume 1, Beijing: People's medical publishing house. 192-284.

Hu YG. (1995). Prolapse of lumbar intervertebral disc. Volume 2, Beijing: People's medical publishing house. 226-228.

Zhu WM, Wu YC, Zhang JF, et al. (2010). Tuina combined with acupoint injection in treating prolapse of lumbar intervertebral disc. Chinese Journal of Sports Medicine. 29(6): 708-709.

Wang HD. (2013). Clinical Observation on Intensive Acupuncture-moxibustion with Silver Needles for Lumbodorsal Myofascial Pain Syndrome. Shanghai J Acu-mox. 32(8).

 http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1690-acupuncture-reverses-lower-back-pain

[affinityacupuncture]

Acupuncture Beats Drugs For Menstrual Pain Relief

Researchers find acupuncture combined with moxibustion more effective for the treatment of painful menstruation than ibuprofen. Across three independent studies, researchers made several important findings. Acupuncture plus moxibustion produces superior treatment outcomes to oral intake of ibuprofen. Acupuncture plus moxibustion is superior to using only acupuncture as a standalone therapy. Acupuncture improves blood circulation and hemorheological characteristics for patients with dysmenorrhea (painful menstruation). Let’s take a look at the results.

Hubei University of Medicine researchers (Jiao et al.) conducted a controlled clinical trial and confirm that the combination protocol of acupuncture plus moxibustion produces superior outcomes to using ibuprofen capsules to control menstruation cramping and pain. Jiao et al. conclude that acupuncture plus moxibustion has a 96.8% total treatment effective rate for the treatment of dysmenorrhea. Ibuprofen sustained time release capsules achieved a 58.1% total treatment effective rate. Acupuncture plus moxibustion outperformed ibuprofen by 38.7%. This is consistent with the independent research of Zhao et al. finding acupuncture effective for improving blood hemorheological characteristics, regulating blood viscosity, and enhancing the microcirculation of blood in the uterus for patients with dysmenorrhea. 

Jiao et al. had a sample size of 62 human female patients and conducted a clinical trial at the Acupuncture Division of Hubei University of Medicine. Patients were randomly divided into an acupuncture group and a medication group, with 31 patients in each group. The acupuncture group received a combination of acupuncture and moxibustion therapy and the medication group received ibuprofen sustained time release capsules. The primary acupoints selected for all patients were the following:

Guanyuan (CV4) Zhongji (CV3) Sanyinjiao (SP6) Additional acupoints were selected on an individual symptomatic basis. Acupoints selection was based on the Traditional Chinese Medicine (TCM) system of differential diagnosis by pattern differentiation. For qi and blood stasis, the following acupoints were added:

Taichong (LV3) Xuehai (SP10) For depressed liver qi with dampness and heat, the following acupoints were added:

Xingjian (LV2) Yinlingquan (SP9) For liver and kidney deficiency, the following acupoints were added:

Shenshu (BL23) Mingmen (GV4) For poor qi and blood circulation, the following acupoints were added:

Qihai (CV6) Zusanli (ST36) Treatment commenced with patients in a supine position. After disinfection of the acupoint sites, a 0.30 mm x 40 mm disposable filiform needle was inserted into each acupoint with a high needle entry speed. Manual acupuncture stimulation techniques for obtaining deqi including lifting, thrusting, and rotating. Once a deqi sensation was obtained, the needles were retained and moxibustion was conducted on the same acupoints.

Moxa cigar cuttings, each 2 cm long, were attached to each needle handle and ignited. Moxa was left in place to self-extinguish. One acupuncture session was conducted daily for 3 – 4 consecutive days during menstruation. Treatment was also conducted on the 2 days prior to the next menstrual cycle. The entire course of treatment comprised 3 menstrual cycles. Patients were also advised to avoid getting chilled and to keep warm during activities of daily living.

For the ibuprofen group, patients received 300 mg of ibuprofen sustained time release capsules starting 1 – 2 days prior to menstruation. Capsules were orally administered twice per day for 2 – 3 days until the symptoms were mitigated, for a total of 3 menstrual cycles. Vitamin B was administered additionally for patients who also experienced stomach discomfort. The results tabulated, the acupuncture plus moxibustion protocol provided greater pain relief than the ibuprofen protocol.

In an independent research trial, Lu Ying (Xianning Hospital of Traditional Chinese Medicine) investigated the treatment efficacy of triple acupuncture and mild moxibustion for primary dysmenorrhea patients. Lu Ying determined that triple acupuncture with mild moxibustion yielded better treatment results than conventional acupuncture. For primary dysmenorrhea, triple acupuncture plus mild moxibustion therapy achieved a 96.7% total treatment effective rate. Conventional acupuncture achieved a 90% total treatment effective rate.

A total of 60 patients were treated and evaluated in the study. They were randomly divided into a treatment group and a control group, with 30 patients in each group. The treatment group underwent triple acupuncture with mild moxibustion therapy while the control group received conventional acupuncture therapy. The primary acupoints selected for the treatment group were the following:

Zhongji (CV3) Sanyinjiao (SP6) Diji (SP8) Shiqizhuixia (M-BW-35) Additional acupoints were selected based on individual symptoms. For poor blood and qi circulation, the following acupoints were added:

Xuehai (SP10) Pishu (BL20) Zusanli (ST36) For poor blood and qi circulation with blood stasis, the following acupoints were added:

Hegu (LI4) Taichong (LV3) Ciliao (BL32) For chills and dampness, the following acupoint received moxibustion but needling was not applied:

Shuidao (ST28) For dampness and heat in liver, the following acupoint was needled bilaterally:

Yanglingquan (GB34) Patients were instructed to urinate prior to treatment and subsequently rested in a supine position. Upon disinfection of the acupoint sites, a 0.30 mm x 50 mm filiform acupuncture needle was inserted into the acupoints. For Zhongji, the needle was inserted toward Qugu (CV2) with a high entry speed at an entry angle of 45°, to a depth of 5 mm, and until the needle stimulated a deqi response at the midpoint of the upper edge of the pubic bone.

Subsequently, two acupoints located 3 mm laterally to Zhongji were swiftly pierced to a depth of 5 mm and were then inserted to become parallel to the needle at Zhongji. The same deqi response was stimulated at these points, as was in the case of Zhongji. This is the triple acupuncture technique applied to Zhongji.

The remaining acupoints were pierced perpendicularly until a deqi sensation was achieved. The deqi sensation was defined as the patient feeling soreness, numbness, swelling, or aching towards the bottom part of the perineum or a slight electrical sensation. A needle retention time of 30 minutes was observed. During needle retention, the needles were each manipulated every 10 minutes with manual acupuncture techniques. Additionally, during needle retention, mild moxibustion was conducted at Zhongji, until the skin was flushed and moxibustion heat was transmitted downward into the skin.

For the control group, selected acupoints were identical to those of the treatment group. Primary and additional acupoints were perpendicularly pierced with a 0.30 mm x 50 mm filiform acupuncture needle. Needle manipulation techniques varied based on individual body conditions. The triple acupuncture threading technique was not applied, only perpendicular insertion was used. For poor blood and qi circulation, blood clotting, or chills and dampness, the Xie (attenuating) manipulation technique was applied. For poor liver health, heat, and dampness, the Ping Bu Ping Xie (attenuating and tonifying) manipulation technique was applied. For poor blood and qi circulation, the Bu (tonifying) manipulation technique was applied. A needle retention time of 30 minutes was observed. During needle retention, the needles were each manipulated every 10 minutes.

Both groups of patients received their respective treatments 5 days prior to menstruation. For one treatment cycle, treatment was conducted once daily for 5 consecutive days. Treatment was ceased during menstruation. The entire treatment course comprised 4 menstrual cycles. In addition, patients were advised to maintain a positive emotional state and avoid exhaustion and becoming chilled. The clinical results demonstrate that triple acupuncture and mild moxibustion produce greater therapeutic effects than conventional acupuncture in the treatment of primary dysmenorrhea.

The average rate of dysmenorrhea in China is approximately 30% – 40%. During puberty, the rate is approximately 50%. Among all cases of dysmenorrhea, 10% – 20% are severe. The researchers provide a brief synopsis of the Traditional Chinese Medicine understanding of primary dysmenorrhea. In Traditional Chinese Medicine, primary dysmenorrhea falls under the Jing Xing Fu Tong class of disorders. TCM classifies primary dysmenorrhea into two major types based on the overall TCM pathology: deficiency and excess. Deficient primary dysmenorrhea is caused by weak qi and blood circulation, deficiency of the liver and kidneys, or qi and blood deficiency. Excess-type primary dysmenorrhea is exacerbated by emotional pressures, depressed liver qi, blood stasis, or poor qi circulation. Consuming cold drinks during menstruation also contributes to excess-type primary dysmenorrhea.

The researchers also provide some insight into TCM principles relative to the treatment of primary dysmenorrhea. Regulating the Chong and Ren meridians improves blood and qi circulation to produce healthy, well regulated, and trouble-free menstruation. The Guanyuan acupoint significantly restores yuan (source) qi, improves blood and qi circulation, eliminates blood stasis, and relieves pain for patients with dysmenorrhea. Administering moxibustion at Guanyuan warms the meridians, expels chills, and regulates the Chong and Ren meridians. Guanyuan, Qihai, and Zhongji are acupoints which benefit yang and regulate the Chong and Ren meridians. Sanyinjiao is a central acupoint for the maintenance of liver, spleen, and kidney health and is therefore beneficial to patients with dysmenorrhea.

  References: Jiao FL, Liang YC & He M. (2014). Therapeutic Observation of Acupuncture-moxibustion for Primary Dysmenorrhea. Shanghai Journal of Acupuncture and Moxibustion. 33(5).

Lu Y. (2014). Therapeutic Observation of Triple Acupuncture at Zhongji (CV 3) plus Mild Moxibustion for Primary Dysmenorrhea. Shanghai Journal of Acupuncture and Moxibustion. 33(7).

Zhao NX, Guo RL, Ren QY et al. (2007). Acupuncture therapy in treating primary dysmenorrhea, treatment efficacy and hemorheology study. Zhejiang University of TCM Journal. 31(3): 364-365, 367

 http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1687-acupuncture-beats-drugs-for-menstrual-pain-relief

[affinityacupuncture]

Sleep Apnea Relief: Acupuncture more effective than CPAP

Researchers (Zheng-tao, et al.) find acupuncture effective for the treatment of obstructive sleep apnea and conclude that it is a potentially valid and successful substitute for the CPAP machine. The findings indicate that acupuncture is a proven treatment option for sleep apnea patients looking for a cost-effective alternative to standard treatment or for those who find sleeping with the machine difficult to manage.

Sleep apnea, often associated with snoring, is the condition where the airway is restricted during sleep, usually due to either an anatomical abnormality or a reduced function of the dilator muscle in the upper airway. This means that the person affected with sleep apnea will have inclement episodes throughout the night where they stop breathing in their sleep several times in the night, reducing the oxygen levels in their bodies. This is a growing health concern as it results in a decrease in quality of life and overall health.

Sleep apnea leads to sleepiness, irritability, depression, reduced concentration and memory, erectile dysfunction, and even cardiac and metabolic conditions. Sleep apnea can affect adults and children alike, but it tends to be more common in men and people with preexisting medical conditions like obesity, thyroid conditions, nasal obstruction, and alcohol consumption. Due to the effects of sleep apnea, this condition can become a real economic burden; therefore, it is important to both diagnose and treat it immediately. While there are other methods available, the standard treatment for sleep apnea typically involves a machine called nCPAP, nasal continuous airway pressure, which involves a mask or tube on the mouth and/or nose and provides continuous oxygen. When used properly, the nCPAP is effective at managing the apnea and shallow breathing, known as hypopnea, thereby eliminating the lack of oxygen in the bloodstream caused by sleep apnea. By controlling the oxygen levels, the symptoms of sleep apnea, like fatigue and cardiovascular disease, are mitigated and the patient resumes a better quality of life.

In patients with severe obstructive sleep apnea caused by anatomical abnormalities or in cases where the nCPAP fails or is inadequate, a dental appliance may be recommended. Surgery may also be recommended in cases where the anatomical abnormality is obvious, such as large palatine or lingual tonsils. However, standard treatment with the nCPAP has been a proven method to reduce upper airway restrictions and, therefore, improves quality of life. Despite this effectiveness, it is not a permanent solution to ending obstructive sleep apnea.

The researchers sifted through research articles across several languages using a combination of medical search terms like “sleep apnea, obstructive,” “upper airway resistance sleep apnea syndrome,” and “acupuncture therapy.” For the Chinese database they used search terms “zhen” and “shuimian” or “ditongqi.” The reports included in this mega study had to have participants diagnosed with obstructive sleep apnea (OSA), but there were no restrictions on age, sex, or race. Patients with sleep apnea in the experimental groups received both manual acupuncture  and electroacupuncture while the control groups received either no treatment or nCPAP treatment. Patients that received sham acupuncture, which is essentially a placebo effect where patients believe they are receiving acupuncture but in fact are not being inserted with needles or the needles are being placed on non-acupuncture points, were included in the control group. There was no differentiation of the types of needle materials or the acupoints chosen. The researchers only included studies that were randomized controlled trials, and threw out anything that involved animal experiments, case reports, reviews, or duplicates

All of this yielded about 216 potential studies, which were narrowed down to 6 studies that met all of the rigorous inclusion requirements set by the researchers. Two studies were conducted in Brazil and the other four by Chinese investigators within a single center. Between 2007 and 2015 there was a total of 362 participants enrolled in the various trials (197 patients in the acupuncture group and 165 in the control group, with ages ranging from 35–76). Outcomes of the study were based on reported Apnea-Hypopnea Index (AHI), apnea index, hypopnea index, and mean Sa02 levels, which is the percentage of oxygen saturation in the blood. What they discovered was amazing. The researchers discovered that acupuncture was more effective in the improvement of all AHI, apnea index, hypopnea index, and SaO2 levels than nonspecific treatment and that electroacupuncture was even more effective at treating AHI. What is even more astounding is that acupuncture in these studies proved to be more effective than even nCPAP at improving AHI, and had no side effects.

The goal of treating obstructive sleep apnea is to reduce both sleep disruption and AHI levels to improve overall health and quality of life. While the nCPAP is very effective at treating obstructive sleep apnea, compliance among patients is difficult due to the cumbersome mask placed on their face, and it can be an expensive appliance to obtain. In the studies included in this analysis, acupuncture consistently improved all measures used to assess the effectiveness of treatment. The researchers deliberately chose to use AHI, apnea index, hypopnea index, and SaO2 levels to judge the effectiveness of treatment because it reduced the risk of bias and all these data could be directly recorded overnight during polysomnography (PSG), which is the standard testing used to diagnose obstructive sleep apnea. Both manual acupuncture and electroacupuncture were included in the study, as each differ to some extent in the mechanism of action. For example, electroacupuncture causes the release of beta-endorphin and adrenocorticotrophic hormones into blood plasma, where manual acupuncture releases only beta-endorphins.

All of the studies used in this meta-analysis combined manual acupuncture and electroacupuncture protocols. Varying frequency settings using electroacupuncture devices were applied in differing treatment protocols. While the meta-analysis demonstrates that acupuncture is effective at treating sleep apnea, no conclusions can be drawn as to which type of acupuncture protocol is the most effective.

Reference: Lv Zheng-tao, Jian W, Huang J, Zhang J, and Chen A. The Clinical Effect of Acupuncture in the Treatment of Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine. 2016.  

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1674-acupuncture-found-effective-for-sleep-apnea-relief-beats-cpap-for-blood-oxygenation

[affinityacupuncture]

Helping Bladder Control and Leakage with Acupuncture

A powerful type of acupuncture is proven effective for the treatment of urinary incontinence. In a Heilongjiang University of Chinese Medicine clinical trial, standard acupuncture stimulation demonstrated a 54% total effective rate, however; a specialized electroacupuncture treatment protocol yielded an 86% total effective rate. We’ll take a look how these remarkable results were achieved.

Urinary incontinence (enuresis) is defined as the involuntary leakage of urine. Due to loss of bladder control, urine may leak during coughing, sneezing, laughing, heavy lifting, or other activities. The condition may also present in the form of urgent urination wherein one may not have enough time to get to the restroom. Urinary incontinence may take on a more insidious nature wherein there may be frequent, often imperceptible, dribbling of urine. In all presentations of the disorder, there is a loss of bladder control.

The discovery that acupuncture can safety and effectively treat this condition is significant. According to the CDC (Centers for Disease Control and Prevention), "incontinence presents a significant financial burden to the individual and to society. In the United States, the cost of bladder incontinence among adults in 2000 was estimated at $19.5 billion, with $14.2 billion incurred by community residents and $5.3 billion by institutional residents (Hu et al.)." Based on these figures, acupuncture is an important and cost-effective treatment option.

Heilongjiang University of Chinese Medicine researchers examined the effects of both manual and electroacupuncture on women with urinary incontinence in their acupuncture continuing education study. A total of 100 patients participated in the clinical trial at the university’s 2nd affiliated hospital. Manual acupuncture treatment was identical for both groups A and B. The only difference in treatment protocols was that group B received electroacupuncture in addition to the manual acupuncture therapy.

Treatment commenced with patients in a supine position. Upon disinfection, a 2 inch filiform acupuncture needle was inserted into each acupoint. For Guanyuan, Qihai, Zhongji, and Qugu, needles were slanted downwards and inserted transverse-obliquely to a depth of 1.2 – 1.5 inches until a deqi sensation was elicited. Next, rotating and reinforcing needle manipulation techniques were applied. For Zusanli and Sanyinjiao, needle were inserted vertically to a 0.5 – 1-inch depth. Subsequently, a needle retention time of 40 minutes was observed for all acupoints. One 40 minute acupuncture session was conducted daily for 30 consecutive days.

For the electroacupuncture group, intermediate frequency electrical acupoint stimulation was conducted simultaneously. An intermediate frequency electrical stimulation device was connected to Zhongji and Huiyin (CV1). The amplitude for each patient was set to individual tolerance levels for comfort. This electrical stimulation was administered for 20 minutes during each acupuncture session.

Huiyin (CV1, Meeting of Yin) is often underutilized in clinical practice due to its location. The modern research confirms traditional indications for use of this acupuncture point. Huiyin is traditionally indicated for the treatment of difficult urination and urinary incontinence. The research finds the addition of electroacupuncture from CV3 to CV1 increases the efficaciousness by 32%. Manual acupuncture had a 54% total effective rate and electroacupuncture increased the rate to 86%.

University College of London Hospital and Whipps Cross University Hospital researchers confirm that acupuncture is effective for the treatment of urinary incontinence in independent research. A total of 79% of patients participating in the clinical trial demonstrated clinically significant outcomes. The researchers add that acupuncture "should be considered as a potential alternative to our current therapeutic regimes" for patients with urinary incontinence. The study utilized only 3 acupuncture points, combined with electroacupuncture, for all patients:

SP6 (Sanyinjiao)

CV4 (Guanyuan)

KD3 (Taixi)

Similar results were found across the two aforementioned studies. The first investigation had an 86% total effective rate and the second had a 79% total effective rate. Jin et al. confirm that electroacupuncture reduces urinary incontinence for women in another independent study. Electroacupuncture produced a 78.6% total effective rate. The protocol reduced leakage and urgency. The mean occurrence of urinary incontinence over 24 hours was reduced by 66.67%. The mean quantity of urinary leakage over 24 hours was 39 grams before acupuncture treatments and 18.6 grams afterwards.

Electroacupuncture was attached to BL32 and BL35. A disperse-dense wave was used for 30 minutes. The dense wave was 4 Hz and the disperse wave was set to 20 Hz. The intensity was set to patient tolerance levels. One 30 minute acupuncture treatment was administered 3 times per week for 8 weeks. The protocol achieved a 78.6% total effective rate.

Liu et al. achieved a 93.3% total effective rate for the treatment of stress urinary incontinence in women. The protocol had two components: acupuncture and pelvic floor muscle exercises. Acupuncture with moxibustion was applied to the Baliao acupuncture points:

Shangliao (BL31)

Ciliao (BL32)

Zhongliao (BL33)

Xialiao (BL34)

Needling was applied obliquely with a needle retention time of 20 minutes per acupuncture treatment. Moxibustion was applied to all needles. Acupuncture was administered 5 times per week for 6 weeks. The 93.3% total effective rate suggests that this protocol produces optimal outcomes.

Wang et al. confirm that acupuncture is 90% effective for the treatment of urinary incontinence. In the clinical trial, acupuncture was compared with drug therapy. Solifenacin produced an 86.9% total effective rate. Guiyang College of Traditional Chinese Medicine researchers from the university hospital’s urology department conducted a clinical trial lasting four weeks. Patients taking drug therapy received 4 mg of solifenacin via oral administration, once daily after breakfast.

Manual acupuncture stimulation was applied to the needles. Each acupuncture session lasted 30 minutes and one minute of manual stimulation was applied every 10 minutes. Acupuncture was applied once per day for four weeks.

Solifenacin had an outcome of 4 patients cured, 23 patients with significant progress, and 4 patients with no progress. Acupuncture had an outcome of 5 patients cured, 22 with significant progress, and 3 patients with no progress. The total effective rate for the acupuncture group was 90% and 86.9% for the solifenacin group. The results confirm that of the aforementioned studies; acupuncture is effective for the treatment of urinary incontinence.

References: Gao X, Xing YL, Dong SQ, Ding Y, Xia M. (2013). Effect of Acupuncture with Intermediate Frequency Electrical Stimulation by Acupoint on Female Stress Urinary Incontinence. Journal of Clinical Acupuncture and Moxibustion. 29(8).

Hu TW, Wagner TH, Bentkover JD, Leblanc K, Zhou SZ, Hunt T. Costs of urinary incontinence and overactive bladder in the United States: A comparative study. Urology 63(3):461– 5. 2004.

Post-treatment, Pre-treatment, and ICIQ-UI Short Form. Acupuncture in the Management of Overactive Bladder Syndrome. 2014.

Philp T, Shah PJR, Worth PHL. Acupuncture in the treatment of bladder instability. British Journal of Urology 1988 Jun: 61(6); 490-493.

Jin CL, Zhou XY & Pang R. (2013). Effect of electro-acupuncture on mixed urinary incontinence in women. Journal of Clinical Acupuncture and Moxibustion. 29(6). Jain P, Jirschele K, Bostros SM, et al. (2011). Effectiveness of midurethral slings in mixed urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 22(8): 923-932.

Liu Jie, Yang Shaoqin, Shi Ying, Curative effect observation of needle warming moxibustion Ba Liao point combined with pelvic floor muscle exercise in the treatment of female stress urinary incontinence, Chinese Community Doctors, 2015 (8).

Wang, Bo, Youping Xiao, Kai Fan, Congjun Huang. "Treatment of female overactive bladder with acupuncture." Journal of Beijing University of Traditional Chinese Medicine 36.10 (2013): 713-716.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1684-acupuncture-helps-bladder-control-stops-leakage

[affinityacupuncture]

Acupuncture and Herbs Outperform Drug Therapy for IBS

Acupuncture and herbs outperform drug therapy for the treatment of irritable bowel syndrome (IBS). Researchers compared two groups, one received acupuncture and herbal medicine and the other received drug therapy. The group receiving acupuncture and herbs had superior positive patient outcome rates. Acupuncture and herbs produced clinical outcomes yielding greater improvements in stool consistency and significantly greater reductions of abdominal pain, mucus in the stool, bloating, and bowel urgency.

Chongqing Nanchuan Hospital researchers started with a sample size of 126 human patients with IBS. The patients were randomly divided into the acupuncture plus herbs group and the drug group, with a total of 63 patients in each group. For both groups, there were improvements in abdominal pain and discomfort scores. However, the acupuncture plus herbs group demonstrated significantly greater clinical improvements. In addition, the group receiving acupuncture plus herbs had greater reductions of anxiety levels and behavioral disorders. The data indicates that the acupuncture plus herbs group had significant improvements in general psychological well-being and overall perceived energy levels. 

IBS affects the large intestine and involves cramping, distention, diarrhea or constipation, and abdominal pain. Often, there is mucus in the stool and the condition is chronic. Exacerbating factors include specific foods, hormonal changes, stress, and secondary illnesses. IBS tends to occur in younger patients and the rate is double for women. IBS, when presenting as a long-standing illness, often involves dietary restrictions and accidental malnourishment caused by an attempt to avoid exacerbating foods. The long-standing nature of the illness may also contribute to mental depression. Two major types of diagnostic criteria define IBS, the Rome criteria and the Manning criteria.

For the Rome criteria, one important parameter is that abdominal pain lasts for a minimum of 3 days per month and involves at least two of the following: decreased pain after defecation, changes in frequency of defecation, changes in consistency of stool. The Manning criteria includes pain relieved by defecation but also takes into account mucus in stool, incomplete bowels movements, and variability of stool consistency. An MD may order a colonoscopy, sigmoidoscopy, lower GI series (liquid barium X-ray), or CT scan to confirm the diagnosis.

All participants and procedures were approved by the Chongqing Nanchuan Hospital medical ethics committee. All participants were volunteers with a diagnosis of IBS, prerequisite abdominal pain, and abnormal defecation. No participants were admitted to the study groups that had taken medications within three month prior to the investigation. Exclusion criteria involved several other parameters: mental illness, low blood pressure, history of abdominal surgery.

The sample size involved 67 males and 59 females, with an average age of 55 years. The average duration of IBS per patient was 31 years. After randomization into the two groups, there were no significant differences in terms of age, gender, and course of IBS duration.

The group receiving drug therapy was administered loperamide hydrochloride capsules (1 tablet, 3 times per day), 30 minutes before meals. In addition, they received 9 g of Si Shen Wan, two times per day. Loperamide hydrochlorida (trade name IMODIUM) is used to control diarrhea. Functionally, loperamide hydrochloride slows bowel movements to achieve its effective action. The drug may cause drowsiness, fatigue, or dizziness and is not recommended for breast-feeding mothers because the drug is transferred through the milk. In this acupuncture continuing education study, the group receiving acupuncture plus herbal medicine was administered the following medicinal formula (prepared in the form of a decoction):

Bai Zhu

Shan Yao

Bai Zhi

Chen Pi

Huang Qin

Chai Hu

Wu Mei

Gan Jiang

Zhi Gan Cao

Fang Feng

Based on diagnostics, modifications were made to the formula. For patients with severe diarrhea, Bai Bian Dou and Fu Ling were added. Zhi Ke, Fo Shou, and Mu Xiang were added for cases of pronounced abdominal swelling and pain. For mucus in the stool, Huo Po and Cang Zhu were added. Yu Li Ren was added for patients with constipation. The following protocolized set of acupuncture points were administered to the patients:

Shangjuxu, ST37 (Upper Great Void)

Quchi, LI11 (Pool at the Crook)

Dachangshu, BL25 (Large Intestine Shu)

Tianshu, ST25 (Heaven’s Pivot)

Sterile filiform acupuncture needles were used. At ST37, the needle insertion depth range between 1–2 inches. For LI11, the depth of insertion was 0.5–2 inches. For BL25, the insertion depth was 0.8–1.2 inches. For ST25, needle depth was 1–1.5 inches. Reinforcing and reducing manual acupuncture techniques were applied with twisting, lifting, and thrusting motions. Total needle retention time was 30 minutes per acupuncture visit. For both the drug and acupuncture plus herbs groups, the total treatment duration was 28 days. Dietary modifications for all patients in both groups included the following recommendations:

No raw, cold, or spicy food

Regulate consumption of food to moderate levels of intake

Regular meals consumed at regular intervals, 3 times per day

Non-oily, light foods that are easily digested are appropriate

Non-oily, light, and easily digested foods are appropriate

Several important findings were made. The acupuncture plus herbal medicine group had greater positive patient outcomes. In addition, the relapse rate was lower in the acupuncture plus herbs group than the drug group. The results indicate that acupuncture, herbs, and continuing patient education on dietary modifications is an effective integrative approach to patient care for patients with IBS.

Herbal medicine gained recognition for the treatment of IBS in the Journal of the American Medical Association (JAMA). The prestigious journal published the findings of an Australian randomized, double-blinded, placebo controlled study conducted by gastroenterologists and herbalists. The researchers concluded that Chinese herbal medicine “offer[s] improvements in symptoms for some The results reflect an enhanced positive patient outcome rate, which is consistent with the flexibility of the study design.patients with IBS.” The results reflect an enhanced positive patient outcome rate, which is consistent with the flexibility of the study design.

Reference: Zhang Yousheng, Zhang Xiaodong, Investigation of the Effect on Treatment of Irritable Bowel Syndrome with Traditional Chinese Medicine and Acupuncture, Chongqing Nanchuan Hospital, 2016.

Sun YZ & Song J. (2014). Therapeutic Observation of Acupuncture at Jiaji (EX-B2) for Irritable Bowel Syndrome. Shanghai Journal of Acupuncture and Moxibustion. 34(9).

Zhongguo Zhen Jiu. 2012 Oct;32(10):957-60. [Meta analysis of acupuncture-moxibustion in treatment of irritable bowel syndrome]. Pei LX, Zhang XC, Sun JH, Geng H, Wu XL. Acupuncture and Rehabilitation Department, Jiangsu Province Hospital of TCM, Nanjing, China.

JAMA. 1998 Nov 11;280(18):1585-9. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial. Bensoussan A, Talley NJ, Hing M, Menzies R, Guo A, Ngu M. Research Unit for Complementary Medicine, University of Western Sydney Macarthur, Campbelltown, New South Wales, Australia.

Liu, Xiao-xia. "Moxibustion on Shenque (CV 8) improves effect of acupuncture for diarrhea-predominant irritable bowel syndrome." Journal of Acupuncture and Tuina Science 12, no. 6 (2014): 362-365.

http://www.healthcmi.com/acupuncture-continuing-education-news

[affinityacupuncture]

Music Electroacupuncture Outperforms Antidepressant Drug.

Researchers conclude that music electroacupuncture causes improved behavioral changes and benefits to neuronal structures in the hippocampus. In a laboratory experiment on depressive rats, music electroacupuncture outperformed fluoxetine (Prozac) for regulating monoamine neurotransmitter levels. Based on the findings, researchers (Cao et al.) conclude that music electroacupuncture demonstrates effectiveness for the treatment of depression.

In a separate investigation (Tang et al.), two types of acupuncture are found to successfully regulate behavioral changes. Based on the findings, the researchers note that music electroacupuncture and standard pulsed electroacupuncture, may assist in the prevention of Alzheimer Disease. In a controlled experiment, laboratory rats receiving electroacupuncture had decreased latency times, improved swimming distances, and significant reductions of β-amyloid protein levels. β-amyloid (Aβ) proteins are the main constituents of amyloid plaques occurring in Alzheimer disease patients’ brains. The researchers noted that music electroacupuncture and standard electroacupuncture improved “learning and memorizing abilities.” Overall, music electroacupuncture outperformed standard electroacupuncture. 

Music electroacupuncture differs from standard electroacupuncture by switching frequencies and waveforms in rhythmic patterns instead of a consistent pulse. Choices of electroacupuncture settings are based on five musical notations (Gong, Shang, Jue, Zhi, Yu). Each setting corresponds to Traditional Chinese Medicine principles of the Five Elements (wood, fire, earth, metal, water) and their corresponding organ systems (liver/gallbladder, heart/small intestine, spleen/stomach, lung/large intestine, kidney/bladder). The settings are adjusted for different diagnosis of each patient.

The Healthcare Medicine Institute (HealthCMi) has not had a chance to test the music electroacupuncture device yet however, we recently tested the ITO ES-160 electroacupuncture device and confirmed its efficaciousness for the alleviation of pain using the sweep mode. Sweep mode involves a gradual increase and decrease of pulse frequencies over time. The adding of subtle gradations between frequency changes in sweep mode demonstrated significant clinical advantages for the treatment of several pain conditions. While the ES-160 has standard intermittent modes, it shows the sweep mode is an important addition.

The laboratory research finds that music electroacupuncture and conventional pulsed electroacupuncture are effective in treating depression in rats. Researchers (Tang et al.) from Beijing University of Chinese Medicine determined, through a protocolized investigation, that both types of electroacupuncture produced positive outcomes in depressed rat models, but music electroacupuncture produced the highest rate of positive outcomes across various metrics. Given the prevalence of depression in society, this research includes important subjective and objective findings.

In this laboratory study, rats receiving electroacupuncture (either music or conventional) displayed higher horizontal activity, vertical activity, sugar consumption, body mass, and expression of serotonin (5-HT), dopamine (DA), and norepinephrine (NE) in the frontal lobe and hippocampus. Additionally, rats treated with music electroacupuncture reported having a higher 5-HT expression than those treated with conventional electroacupuncture. Overall, music and conventional pulsed electroacupuncture demonstrated antidepressant effects in rats, however, music electroacupuncture demonstrated a greater regulatory effect on monoamine neurotransmitters than conventional pulsed electroacupuncture and fluoxetine.

The experiment involved several controlled variables. A total of 50 depression model rats were divided into 5 equal groups of 10 as follows:

Control group: Rats were grouped together. Unlimited supply of water and food was provided. Did not receive any stimulation.

Model group: Rats were isolated. Received 21 days of chronic unpredictable mild stress stimulation.

Fluoxetine group: Rats were isolated. Fluoxetine was diluted with saline to a density of 2 mg/ml. For each rat, 10 ml of diluted fluoxetine was administered per kg of body mass. Medication was administered once per day, one hour before chronic unpredictable mild stress stimulation.

Standard pulsed electroacupuncture group: Rats were isolated. Treatment was administered one hour prior to chronic unpredictable mild stress stimulation.

Music electroacupuncture: Rats were isolated. Treatment was administered one hour prior to chronic unpredictable mild stress stimulation.

The acupuncture point prescription included standard filiform needle stimulation of acupoints Yintang (MHN3) and Baihui (GV20). For each acupoint in the standard pulsed electroacupuncture group, a filiform acupuncture needle was connected to an electroacupuncture device and was inserted horizontally. The tip of the needle was pointed posteriorly for Baihui and downwards for Yintang. The electrical frequency was set to 2/100 Hz and the intensity was set to 1 mA. The needles were retained for 20 minutes. One 20 minute acupuncture session was conducted per day for a total of 21 days.

For the music electroacupuncture group, acupoint selection and treatment of acupoints was identical to that of the pulsed electroacupuncture group. However, instead of a conventional electroacupuncture device, the needles were connected to a music electroacupuncture device. Voltage was set to 2 V and intensity to 1 mA, until the needle tip was vibrating slightly but did not cause the rat to squeak. An antidepressant music electroacupuncture setting was chosen. The needles were retained for 20 minutes while an acupuncture session was conducted per day for a total of 21 days.

The Tang et al. laboratory experiment demonstrated significant improvements in behavioral and objective results, including improvements in serotonin (5-HT), dopamine (DA), and norepinephrine (NE) levels determined by radioimmunoassay in depression model rats. Additional testing with human subjects is required, including large sample size meta-analyses, to determine the overall efficaciousness of music electroacupuncture for the treatment of depression. The Healthcare Medicine Institute plans on taking a closer look at this innovative approach to electroacupuncture.

 References: Tang YS, Ji Q, Cao J, Teng JY, Deng XF, Li J, Li ZG. (2014). Influence of Music Electroacupuncture and Pulsed Electroacupuncture on the Different Encephalic Regions of Monoamine Neurotransmitter Chronic Unpredictable Mild Stress Depression Model Rats. Journal of Clinical Acupuncture and Moxibustion. 30(3). 

Cao J, Tang Y, Li Z, Ji Q, Yao H, Mo Y, Wang X, Song L. Effects of Music Electro-Acupuncture on the Expression of Monoamine Neurotransmitter in Different Encephalic Regions in Chronic Unpredictable Mild Stress Depression Model Rats. The Journal of Alternative and Complementary Medicine. 2014 May 1;20(5):A39.

Tang Y, Cao J, Li Z, Chen W, Xu AP, Mo YP, Yao H, Wang X, Liang C. Effects of Music Electro-Acupuncture and Pulsed Electro-Acupuncture on Behavioral Changes and the Serum β-amyloid Protein in SAMP8 (Senescence Accelerated Mouse Prone 8) Mice. The Journal of Alternative and Complementary Medicine. 2014 May 1;20(5):A38.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1669-music-electroacupuncture-outperforms-fluoxetine-for-depression

[affinityacupuncture]

Acupuncture Found Effective for Depression Treatment

Researchers from Jinan University (Guangzhou, China) conclude that acupuncture is effective for the alleviation of depression. In the study, the acupuncture treatment group achieved a total efficacy rate of 88.9% and the drug control group achieved an efficacy rate of 84.8%. Patients in the control group received administration of the pharmaceutical medication fluoxetine (Prozac®). Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) medication. It is used for patients with depression, panic attacks, eating disorders, stress and anxiety, and other conditions including obsessive-compulsive disorders. The researchers conclude that acupuncture slightly outperforms fluoxetine for the treatment of depression. In addition, acupuncture treatment displays certain advantages compared with anti-depressant drugs. Acupuncture achieved a higher cure rate and the drugs had a significant adverse reaction rate.

Globally, depression is responsible for a serious impact on patients’ work performance and quality of lives. Hence, finding the most effective treatment has become a matter of utmost urgency to medical researchers around the world. Acupuncture has an ancient and well documented history for the treatment of mental illness. The study focuses on a scientific comparison between drug therapy and acupuncture therapy. 

The study involved the selection of 72 patients who received acupuncture or drug treatments at the Acupuncture and Psychology department of the First Affiliated Hospital of Jinan University. Patients were randomly assigned to a drug control group and an acupuncture treatment group. The treatment group was comprised of 17 males and 19 females, with an average age of 29 years and a depression medical history of 20 months; the control group had 20 males and 16 females, with an average age of 28 years and a depression medical history of 21 months.

The patients from both groups were comparable as there were no significant differences in terms of their gender, age and medical histories. It is important to take note that pregnant women, breast feeding mothers, and patients who recently underwent surgery were not included in the experiment. The patients fulfilling at least 4 criteria as stated below were selected for the study:

Prolonged melancholy (Loss of interest and happiness, Attenuated energy, Slow reactions, Low self-esteem and feeling guilty, Difficulties with imagination and critical thinking, Recurrent suicidal thoughts and behaviors, Sleeping difficulties such as insomnia, waking up too early and sleeping too much, Decreased appetite, Decreased sexual desires)

Socialization dysfunction

Symptoms listed above for at least 2 week duration

Each treatment course consisted of 10 acupuncture treatments followed by a 5 day break before the next course began. All patients received 4 treatment courses in total. Patients from the control group consumed fluoxetine hydrochloride tablets, once a day after breakfast. Every 10 days of tablet consumption consisted of one treatment course. A total of 4 courses were administered, with 5 days of break time between courses. During their courses of treatment, all patients received counseling by doctors in order to rebuild their confidence. They were not allowed to consume any other medications during the study.

After 4 courses of care, the acupuncture treatment group achieved an efficacy rate of 88.9%. A total of 21 patients were cured, 11 showed dramatic improvements, and 4 patients remained uncured. The control group achieved an efficacy rate of 84.8%. A total of 9 patients were cured, 20 showed significant improvements and 7 remained uncured. The efficacy rates show significant differences between the two treatments.

The drug treatment regimen achieved significant results but with difficulties associated with adverse effects. Compliance issues for pill consumption are compounded by withdrawal symptoms associated with non-compliance with medication schedules. The acupuncture treatments did not have any serious adverse effects. In addition, the total efficacy rate and the cure rate were higher in the acupuncture group. The results demonstrate that Acupuncture is an important treatment option for patients with depression. A greater focus on the role of acupuncture for the treatment of mental illness in standard care settings has the potential to increase positive patient outcomes. Moreover, acupuncture has the potential to address physical ailments while simultaneously addressing depression. The successful clinical patient outcomes documented in the study point to the need for further investigations

Reference: Wei Bo, Xu Yi, Clinical observations on acupuncture treatment for depression, Journal of Jinan University (Natural Science & Medicine Edition), 2013, 34(6).

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1676-acupuncture-found-effective-for-depression-relief

[affinityacupuncture]

Acupuncture Found Effective For Cervical Spine Disorders

Long needle acupuncture, electroacupuncture and Xiaoxingnao acupuncture show positive treatment outcomes for both cervical spondylosis and cervical spondylotic radiculopathy.

Two recent research studies find acupuncture a highly effective and flexible method for the treatment of cervical spondylosis and cervical spondylotic radiculopathy (neck spinal and soft tissue degeneration causing nerve impingement and subsequent pain or numbness). One study from Xindu District Hospital of Traditional Chinese Medicine found long needle acupuncture to be highly effective for the treatment of cervical spondylotic radiculopathy. Another from Tianjin University of TCM determined that electroacupuncture treatment in combination with Xiaoxingnao acupuncture produces significant patient outcomes.

In the first study, researchers Xie et al. (Xindu District Hospital of Traditional Chinese Medicine) conducted a scientific investigation of long needle acupuncture compared with conventional acupuncture for the treatment of cervical spondylotic radiculopathy. The results demonstrate that long needle acupuncture produces superior patient outcomes. Let's take a look at the advanced procedures that produced the results. Please keep in mind that the following procedures are only appropriate for licensed acupuncturists trained in these expert techniques and procedures.

Cervical spondylotic radiculopathy is a common disease that usually affects patients between the ages of 25 and 65 years old. It is mainly caused by bone hyperplasia and hypertrophy of the intervertebral discs, vertebral joints and facet joints. Consequently, the corresponding spinal nerve roots and other nerve roots are compressed or damaged. The main symptoms of this condition include neck, shoulder, back, upper limb, and finger pain, numbness, radiculopathy, or limb and finger weakness (Yang et al., 2012).

Long needle acupuncture accelerates qi and blood circulation in the meridians and also facilitates communication between the yin and yang meridians or between multiple acupoints. For this reason, it is appropriate for the treatment of cervical spondylotic radiculopathy. The study found that long needle acupuncture demonstrates a higher efficacy rate than conventional acupuncture for the treatment of this condition.

A total of 126 patients with cervical spondylotic radiculopathy were selected for the study. They were divided into two groups: treatment group (64 patients), control group (62 patients). The treatment group underwent long needle acupuncture whereas the control group underwent conventional acupuncture treatment. Identical primary acupoints were selected for both therapies: neck Jiaji acupoints and traditional Hua Tuo Jiaji acupoints. These acupoints run in two parallel lines on either side of the spinal column and the Governing Vessel meridian, 0.5–1 cun lateral to the spinous process of each vertebrae. They function to stimulate the nerve segment corresponding to their specific locations.

For the long needle acupuncture treatment, a 3 inch acupuncture needle was held with both hands and inserted into each acupoint. For the neck Jiaji acupoints, the long needle was pointed downwards and inserted towards the seventh cervical vertebra. Upon insertion, either the Ping Bu Ping Xie (gently reinforcing and reducing) or the Xie (reducing) needle manipulation technique was applied. Needle techniques were selected depending upon the individual patient’s clinical symptoms. One acupuncture session was conducted daily for 20 days in total, in two cycles of 10 consecutive days, with a 1 to 2-day break between each cycle.

For conventional acupuncture, a 1.5 inch filiform needle was inserted into each acupoint, angled toward the midline. Upon insertion, either the Ping Bu Ping Xie or the Xie needle manipulation technique was applied, depending upon the individual patient’s clinical symptoms. One acupuncture session was conducted daily for 20 days in total, in two cycles of 10 consecutive days, with a 1 to 2 day break between each cycle. The patients receiving long needle acupuncture achieved a 95.3% total treatment effective rate, while those who received conventional acupuncture achieved an 80.6% rate. The results of this study indicate that long needle acupuncture is highly effective in treating cervical spondylotic radiculopathy, showing greater improvements in symptoms than conventional acupuncture.

In the second study, researchers Gong and Xue (Tianjin University of TCM) found that Xiaoxingnao acupuncture (a specialized acupuncture technique which effectively dredges meridians, improves blood circulation and refreshes the mind) combined with electroacupuncture on the cervical Jiaji acupoints is effective for the treatment of Vertebral artery cervical spondylosis. Vertebral artery cervical spondylosis arises from arterial oppression or damage from mechanical and dynamic factors. This leads to stenosis, which eventually decreases blood supply to the vertebral basilar artery. The main symptoms of vertebral artery cervical spondylosis include: neck and shoulder pain, dizziness, headache, cataplexy, optical conditions (e.g., fogged vision, dark spots, transient amaurosis, temporary vision defects, degenerated vision, ambiopia, visual hallucinations, blindness). In addition, bulbar paralysis and other neurological symptoms may be observed including slurred speech, dysphagia, pharyngeal reflex, choking due to backflow while drinking water, palatoplegia, voice hoarseness or facial paralysis.

The study involved a total of 60 patients with vertebral artery cervical spondylosis. They were divided into two equal groups of 30: the treatment group and the control group. Patients in the treatment group were treated with a combination of Xiaoxingnao acupuncture therapy with electroacupuncture. The control group patients received pharmaceutical medications. The clinical results of this study demonstrate that combining electroacupuncture and Xiaoxingnao acupuncture yields significantly better treatment outcomes than medications. Primary acupoints selected for the treatment group’s therapy were the following:

Fengchi (GB20) Fengfu (GV16) Tianzhu (BL10) Wangu (SI4) Dazhui (GV14) Cervical Jiaji acupoints Fengchi, Fengfu and Tianzhu acupoints were selected for their ability to reduce muscule spasms, regulate autonomic nerve functions, dilate blood vessels and improve blood supply to the brain. Wangu was selected for the treatment of headaches and neck pain. Dazhui was selected to facilitate blood flow. Finally, the cervical Jiaji acupoints were selected as local points to dredge the affected meridians (Deng et al., 2008). For the Fengchi, Fengfu, Tianzhu and Wangu acupoints, the needles were inserted 1.5 – 2 inches deep, toward the Adam’s apple. Acupoints were manipulated by rotating in small turns at a high frequency. For the Dazhui acupoint, multiple needles were inserted in various directions: upward, downward, to the left, to the right and perpendicularly (until the patient felt a sensation radiating toward the shoulder).

The cervical Jiaji acupoints were inserted perpendicularly to a depth of 1.5 – 2 inches. An electroacupuncture device was connected to the needles at the cervical Jiaji acupoints, set at 2 – 10 Hz with disperse-dense waves. Additional secondary acupoints were selected on an individual symptomatic basis as follows:

For phlegm and dampness retention:

Fenglong (ST40) Yanglingquan (GB34) For phlegm and blood stasis:

Hegu (LI4) Sanyinjiao (SP6) Geshu (BL17) Zhongwan (CV12) Fenglong (ST40) Zusanli (ST36) For accumulation of dampness and heat:

Danshu (BL19) Yanglingquan (GB34) Neiguan (PC6) Shenmen (HT7) Fenglong (ST40) For blood deficiency:

Geshu (BL17) Xuehai (SP10) Zusanli (ST36) Sanyinjiao (SP6) Qihai (CV6) For all secondary acupoints, the Ping Bu Ping Xie needle manipulation technique was applied. After needle insertion and manipulation, a needle retention time of 20 minutes was observed. One 20 minute acupuncture session was conducted daily for 2 consecutive weeks.

Patients taking medications received intravenous infusions including mannitol and safflower extract injections in addition to medications to promote blood circulation, nourish nerves, and energize the body. The medications were administered once daily for 2 consecutive weeks. The results of this study showed that patients who underwent combined Xiaoxingnao acupuncture and electroacupuncture achieved an excellent total treatment effective rate of 93.3%, while those who received conventional medications plus infusions achieved a 76.7% total treatment effective rate.

The two aforementioned clinical studies demonstrate that different types of acupuncture have varying efficacy rates for the treatment of cervical spondylosis and cervical spondylotic radiculopathy. Electroacupuncture and Xiaoxingnao acupuncture were more effective than medications. Long needle acupuncture produced greater positive patient outcomes than conventional acupuncture. This reflects the dynamic nature of acupuncture and its flexibility for the treatment of these common conditions.

References: Xie XY, Qing S, Liao JK, Xiao Y, Liu JQ. (2013). Clinical Efficacy of Long Needle Penetration Acupuncture on Cervical Spondylotic Radiculopathy: A Clinical Observation of 64 Cases. Guiding Journal of Traditional Chinese Medicine and Pharmacology. 7(7).

Yang JX, Yu JC, Zhang JP et al. (2012). Triple Jiao acupuncture in treating cervical spondylotic radiculopathy. Chinese General Practice. 15(25): 2963-2965.

Gong XL, Xue YY. (2014). Clinical Observation of Xiaoxingnao acupuncture Combined with Electroacupuncture at Cervical Jiaji Points in Treatment of Vertebral Artery Type of Cervical Spondylosis. Journal of Hubei University of Chinese Medicine. 16(5).

Deng LX, Wu XP, Huang W, Wu QK & Jiang GD. (2008). Electroacupuncture in treating vertebral artery type of cervical spondylosis. Journal of Hubei College of Traditional Chinese Medicine. 1.

Original article from:

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1673-acupuncture-found-effective-for-cervical-spondylosis

[affinityacupuncture]

Acupuncture Effective For Lumbar Disc Herniations

Researchers demonstrate excellent clinical results using acupuncture for the treatment of lumbar disc herniations.

Researchers find acupuncture safe and effective for the treatment of lumbar disc herniations across multiple independent clinical trials. A meta-analysis of investigations reveals that Jiaji acupoints yield significant positive patient outcomes when combined with manual and electroacupuncture techniques. Distal and abdominal acupuncture also demonstrated significant positive patient outcomes. This research review covers rare acupuncture points demonstrating clinical efficacy and details a powerful manual acupuncture technique proven effective for relief of lumbar disc herniation symptoms. We’ll start with primary research by Song et al. and then take a close look at a meta-analysis by Wang et al., including specific approaches to clinical care proven to deliver excellent results.

Researchers find both electroacupuncture and manual acupuncture effective for the treatment of lumbar disc herniations. Song et al. conducted a clinical trial at the Xixiang People’s Hospital in Guangdong, China. Electroacupuncture and manual acupuncture significantly reduced patients’ pain levels. Outstanding positive patient outcomes were recorded for the electroacupuncture treatment group. Patients with lumbar disc herniations receiving electroacupuncture had a 91.8% total treatment effective rate. Improvements included pain reductions, increases in range of motion, and improved straight leg lift testing. 

A sample size of 123 patients was randomly divided into two groups. In group one, 61 patients received electroacupuncture therapy. In group two, 62 patients received manual acupuncture. For the electroacupuncture patients, the Jiaji acupoints at the specific vertebra corresponding to the herniated lumbar disc, as well as on the two adjacent vertebrae, were selected as the primary acupoints and treated on both sides. Additional secondary acupoints were selected based on individual patient symptoms. For hip pain, the following acupoints were chosen:

Huantiao (GB30) Chengfu (BL36) For calf pain:

Weizhong (BL40) Chengshan (BL57) For lateral calf pain, the following acupoint were chosen:

Yanglingquan (GB34) Zusanli (ST36) Kunlun (BL60) Xuanzhong (GB39) Treatment commenced with the patient in a prone position. Upon disinfection, a 0.30 x 40 mm disposable needle was pierced perpendicularly into each acupoint until a deqi sensation was reported. Next, an electroacupuncture device was connected to the needles in the Jiaji acupoints. A continuous waveform was selected at an initial 0.8 Hz frequency. The intensity was then gradually increased until both sides of the lumbar muscle were twitching rhythmically at a tolerable rate for the patient. Subsequently, a 30 minute needle retention time was observed. One electroacupuncture session was conducted once per day for 20 consecutive days with a one day break after the 10th day. For the manual acupuncture patients, the following acupoints were selected according to the affected area:

Ganshu (BL18) Shenshu (BL23) Yaoyan (MBW24) Huantiao (GB30) Zhibian (BL54) Chengfu (BL36) Weizhong (BL40) Weiyang (BL39) Yanglingquan (GB34) Feiyang (BL58) Guangming (GB37) Kunlun (BL60) Tonggu (BL66) Jinggu (BL64) Houxi (SI3) Treatment commenced with the patient in a prone position. Upon disinfection, a 0.30 x 40 mm disposable needle was pierced perpendicularly into each acupoint until a deqi sensation was felt. During the subsequent 30 minute needle retention time, the acupuncture needle was manipulated once every 10 minutes. One acupuncture session was conducted once per day for 20 consecutive days with a one day break after the 10th day. The total treatment efficacy was measured based on the TCM Treatment Efficacy Guidelines issued by the TCM Governing Board. Efficacy was categorized into 1 of 3 possible tiers:

Effective: Waist and leg pain ceased. Straightened leg lift of 70° and above. Normal waist and leg activity regained. Improvement: Waist and leg pain relieved. Improvement in extent of waist movement. Not effective: No improvement in symptoms. The total treatment effective rate was measured as a percentage of patients who achieved at least the “improvement” tier. Electroacupuncture produced a 91.8% total treatment effective rate including pain reductions, increases in range of motion, and improved straight leg lift testing. Song et al. conclude that acupuncture is effective for the treatment of lumbar disc herniations.

The research team prefaced their study with background information. Lumbar disc herniation is a common disease among adults. Pain, numbness, or weakness arises due to damage or compression of the nerve root caused by herniation of the nucleus pulposus. This is the soft inner core of the vertebral disc that helps absorb compression and torsion. A herniation occurs when the soft material from the inner core escapes through the outer rings of the disc. This stubborn disease is usually characterized by an abrupt onset with a prolonged or repetitive course of symptomatic flare-ups. Main symptoms include leg and lumbar region pain, and also lower limb motor dysfunction. Lower limb paralysis is possible in severe cases.

Song et al. note that acupuncture is a relatively non-invasive treatment for disc herniations that dredges meridians, promotes qi circulation, eliminates blood stasis, and expels wind-dampness. Pain is thereby relieved when blood and qi circulation is restored. In modern terms, acupuncture stimulates parasympathetic tone and downregulates excess sympathetic nervous system activity. Resulting decreases in the inflammatory cascade of endogenous biochemicals results from the regulation of the autonomic nervous system.

Song et al. add that acupuncture regulates nerve activity, facilitates muscles relaxation, mitigates muscular spasms, dilates blood vessels, improves blood circulation, and also reduces both edema and inflammation. The Jiaji acupoints, located on the back beside the Du meridian, are used to treat diseases related to the corresponding affected nerve segments. Electroacupuncture utilizes electrical stimulation to facilitate the regeneration of damaged nerves by improving nerve cell metabolism and nerve cell enzyme activity. The basis of this is that electroacupuncture forms a localized, stable, and subtle electric current that boosts the electrophysiological properties of nerve cells (Sun, 1996).

In a related study, Wang et al. conducted a meta-analysis on the efficaciousness of acupuncture for the treatment of lumbar disc herniations. Without exception, the clinical investigations demonstrate that acupuncture is a safe and effective treatment modality for lumbar disc herniation patients. The following are examples of studies included in the meta-analysis.

Liu et al. investigated the efficacy of conventional acupuncture therapy. Conventional acupuncture treatment was administered by first identifying the vertebrae with lumbar disc herniations. Corresponding Du meridian acupoints and the two adjacent Jiaji acupoints were needled. The identified acupoints were treated with the Shao Shan Huo (Setting the Mountain on Fire) needling technique. Patients were treated for 10 consecutive days and achieved a 95% total treatment effective rate.

Shao Shan Huo is a powerful tonification needling technique in Traditional Chinese Medicine (TCM). Needles are inserted and stimulated to elicit the arrival of deqi for purposes of reinforcing qi. When applied properly, the patient feels a warm sensation at the needle region. In addition, the skin will be flush red as a result of enhanced micro-circulation of blood.

Initially, the needle is inserted slowly to superficial depth beneath the skin. During the procedure, lifting and thrusting is applied to three levels of depth beneath the skin, starting with the most superficial level at approximately a 0.5 cun depth. This is followed by lifting and thrusting at the middle level at approximately 1.0 cun and the deep level at approximately 1.5 cun. Depth varies according to patient size and acupoint location.

At each of the three depths of insertion, the needle motion combines quick and forceful thrusting with slow and gentle lifting for a total of nine times. Rotation may also be applied with the same techniques. After stimulation at all three levels is complete, the needle is lifted to the superficial level and the procedure is repeated, often three times, to ensure elicitation of a qi sensation producing heat and redness of the skin. The patient may also sweat in the region of the needle or throughout the body as a result of the heat sensation produced by this tonification method. Liu et al. achieved a 95% total treatment effective rate using the Setting the Mountain on Fire technique using the Du and Jiajia (Huatuojiaji) acupuncture points at correlated regions to lumbar disc herniations. Notably, acupuncture was applied for 10 consecutive days.

Deng and Cai’s investigation also examined application of the Jiaji acupoints for the treatment of lumbar disc herniations. In a different approach to needle stimulation, Deng and Cai applied electroacupuncture stimulation to the needles. They achieved significant levels of positive patient outcomes in their clinical trial. In their investigation, patients were treated every other day. Short-term results and a three month follow-up confirm significant clinical improvements.

He et al. had an entirely different approach to acupuncture therapy for the treatment of lumbar disc herniations. Their approach focused on abdominal acupuncture and anterior acupoints. The clinical investigation yielded significant positive patient outcomes. In their semi-protocolized investigation, a set of primary acupoints were applied plus secondary acupoints were added for specific diagnostic concerns. The primary acupoints for all patients were the following:

Shuifen (CV9) Qihai (CV6) Guanyuan (CV4) Next, secondary acupoints were added based on diagnostic criteria. For acute lumbar disc herniations, the following acupoints were added:

Shuigou (GV26) Yintang (MHN3) For prolonged lumbar disc herniation, the following acupuncture point was added:

Qixue (KD13) For generalized lumbago, the following acupoints were added:

Wailing (ST26) Qixue (KD13) Siman (KD14) For sciatica occurring when sitting, the following acupuncture points were added:

Qipang Wailing (ST26), affected side only Xiafengshidian Xiafengshixiadian He et al. measured improvement rates after three weeks of acupuncture therapy. Patients achieved significant improvements. The researchers conclude that the protocol is effective for the treatment of lumbar disc herniation symptoms. He et al. used several acupoints termed ‘extra’ points including Xiafengshidian, Xiafengshixiadian, and Qipang. The acupoints demonstrate that the researchers focused on abdominal acupuncture as a means of treating lumbar concerns.

Xia Feng Shi Dian (Xia Feng Shi Dian, Lower Wind-Damp Point) is located 2.5 cun lateral to CV6 and is indicated for the treatment of knee disorders, including postoperative swelling and pain. Xiafengshixiadian (Xia Feng Shi Xia Dian, Below Wind-Damp Point) is located 3 cun lateral to CV5 and is used for leg, ankle, and foot disorders. Qipang (Qi Pang, Beside Qi) is located 0.5 cun lateral to CV6 and is indicated for lower back and leg pain, swelling, and weakness; including postoperative disorders.

The meta-analysis included the clinical research of Zhang et al. Manual acupuncture was applied to acupoints surrounding the afflicted area. All needles were directed towards the center of the afflicted region. Zhang et al. achieved a 97.5% total treatment effective rate.

Overall, the metal-analysis by Wang et al. documents that acupuncture is a safe and effective treatment modality for patients with lumbar disc herniations. Implementation of Jiaji acupoints was common across several studies. Other techniques including abdominal acupuncture and local Ashi acupoint acupuncture also demonstrated clinical effectiveness. Both electroacupuncture and specialized manual acupuncture demonstrated effectiveness as well. As a result of the findings, the researchers conclude that acupuncture is an important treatment option for patients with lumbar disc herniations.

  References: Song YJ, Yu MJ, Li L, Huang WX, Cai ZW, Su DP. (2013). Clinical Observation of Electro-acupuncture in Treatment of Lumbar Disc Herniation. Chinese Manipulation & Rehabilitation Medicne.

Sun ZR. Mechanism of acupuncture in the regeneration of surrounding damaged nerves. 1996(02).

Wang FM, Sun H, Zhang YM. (2014). Advance of Clinical Research in Intervention of Lumbar Disc Herniation（LDH） with Acupuncture Moxibustion. Journal of Clinical Acupuncture and Moxibustion. 30(3).

Deng W & Cai LH. (2011). Electroacupuncture on Jiaji acupoint in treating lumbar disc herniation. Journal of Clinical Acupuncture. (7).

He JX, Lin WR, Chen JQ, Huang Y, Wang SX, Lin HH & Chen HX. Abdominal acupuncture in treating lumbar disc herniation. Shanghai Journal of Acupuncture. 2012. (7).

Liu YZ, Sun XW & Zou W. (2012). Shao Shan Huo acupuncture technique on lumbar Jiaji acupoint in treating lumber disc herniation. Journal of Clinical Acupuncture. (6).

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1670-acupuncture-found-effective-for-lumbar-disc-herniations

[affinityacupuncture]

Study Shows Acupuncture Normalizes Hormones, Ups Pregnancy Rates

Researchers document that acupuncture produces higher pregnancy rates than fertility medications for women with hyperprolactinemia (HPL).

Acupuncture produces a higher rate of pregnancies than fertility medications with significantly less adverse effects. In a controlled clinical trial, researchers document that acupuncture outperforms bromocriptine and bromocriptine plus clomiphene for the treatment of infertility for women with hyperprolactinemia (HPL). Acupuncture produced a 43.3% pregnancy rate whereas fertility medications produced 20% pregnancy rate.

One important mechanism responsible for the fertility treatment success with acupuncture is hormonal regulation. Acupuncture more rapidly normalized levels of prolactin than fertility medications. In hyperprolactinemia, elevated levels of prolactin (PRL) hormone causes infertility by inhibiting gonadotropin-releasing hormone (GnRH) production. GnRH is responsible for stimulating gonadotropins (Gn), luteinising hormone (LH), and follicle-stimulating hormone (FSH) production. As a result, hyperprolactinemia affects the overall function of the ovaries, ovulation, and corpus luteum formation because Gn, LH, and FSH play an important biological role in reproductive health.

The study (Hu et al.) confirms that acupuncture normalizes prolactin levels more rapidly than receiving bromocriptine or bromocriptine plus clomiphene. Patients receiving acupuncture averaged a normalization of prolactin levels within two weeks. Patients receiving bromocriptine or bromocriptine plus clomiphene experienced normalization of prolactin levels within four weeks. The research indicates that acupuncture produces a faster homeostatic response for prolactin production in women with hyperprolactinemia.

One significant advantage to acupuncture treatment for the treatment of fertility emerged; acupuncture did not produce a high adverse effect rate. Conversely, fertility medications produced a high adverse effect rate. Patients receiving bromocriptine or bromocriptine plus clomiphene had a 63.33% adverse effect rate.

Hu et al. (Mawangdui Hospital of Hunan Province) determined that acupuncture is a preferential fertility treatment option for women with hyperprolactinemia. Production of greater positive patient outcomes combined with a significantly lower adverse affect rate was the basis for the conclusion. Let’s take a look at the treatment protocols for both the Traditional Chinese Medicine (TCM) approach and the pharmacological approach.

The investigation included 60 female patients with infertility due to hyperprolactinemia. They were randomly divided into two equal sized groups. Patients ranged from age 26 to 33. The duration of illness ranged from 2 to 8 years. Acupuncture group patients received only acupuncture. Medication group patients received bromocriptine or bromocriptine plus clomiphene. The clomiphene was added for patients with thermoregulation irregularities. The primary acupoints selected for acupuncture therapy were the following:

Qihai (CV6) Guanyuan (CV4) Zusanli (ST36) Sanyinjiao (SP6) Taichong (LV3) Taixi (KD3) Ligou (LV5) Therapy commenced on the 8th day of menstruation. A 0.30 mm x 40 mm disposable needle was used to administer acupuncture on all acupoints. For Qihai and Guanyuan, the needle was inserted in a slanted orientation and an upwards direction, thereafter manipulated with the Bu (tonify) technique. Zusanli was pierced perpendicularly for a depth of 1.5 inches, and the needle was manipulated with the Bu technique. Taichong and Ligou were both pierced for a depth of 0.5 inches, perpendicularly and horizontally respectively, then treated with the Xie (reducing) needle manipulation technique. For Taixi, the needle was inserted perpendicularly 0.5 inches deep and manipulated with the Bu technique. A needle retention time of 30 minutes was observed. During each menstrual cycle, one daily acupuncture session was conducted for a total of 10 days. The above treatment was administered for a period of 1 year.

For the fertility medication control group, an initial dosage of 1.25 mg of bromocriptine was administered twice per day after meals for 7 consecutive days. After that, the dosage was increased to 2.5 mg. Patients remained on the medication for a period of 1 year. In cases where the patient did not experience changes in dual-directional thermoregulation after 3 months of bromocriptine treatment, clomiphene was administered to facilitate ovulation. Bromocriptine is a synthetic drug and is an analogue of ergot alkaloids. It stimulates cortical dopaminergic receptors thereby inhibiting prolactin release. Clomiphene is a fertility drug that stimulates ovulation.

In hyperprolactinemia, women have unusually high levels of peripheral prolactin (PRL) and experience hypothalamic pituitary gonadal axis dysfunction. This often causes menstrual disorders, galactorrhea, reproductive dysfunction, and infertility. The rate of occurrence of hyperprolactinemia is 0.4% among healthy women and 7% – 9% for infertile women (Zhang, 2012). The authors focused on the benefits of acupuncture for promoting fertility. However, the normalization of prolactin levels may have additional benefits for the patients. Further studies to examine the more global effects of acupuncture on PRL normalization and bodily health are required to quantify and confirm these additional benefits.

In Traditional Chinese Medicine, hyperprolactinemia results from a Chong and Ren meridian imbalance. The acupuncture point prescription chosen for the treatment protocol reflects this principle. The signature Zusanli acupoint is effective in promoting overall qi circulation. Together with Qihai and Guanyuan, these three acupoints consolidate yuan qi, revitalize the body, nourish body cells, and strengthen the reproductive system. Taichong and Ligou are acupoints located along the liver meridian, making them significant acupoints for promoting liver health. Taixi, being a kidney meridian acupoint, is ideal for promoting kidney health. Sanyinjiao is a powerful acupoint that maintains general bodily health and has proven efficacy in treating gynecological disorders. Acupuncture administered to Taichong, Ligou, Taixi, and Sanyinjiao has an overall effect of promoting qi circulation along the liver, spleen, and kidney meridians. Acupuncture on all of the aforementioned acupoints collectively promotes liver and kidney health, dredges liver qi, and benefits the Chong and Ren meridians.

As part of continuing education in the field of acupuncture and clinical research, additional studies using this acupuncture point prescription protocol with larger sample sizes will help to confirm the findings of Hu et al. It will also be interesting to see a third study group added to future investigations comparing acupuncture combined with medications to groups receiving medications or acupuncture only.

Rubin et al. conducted an investigation of acupuncture combined with medications. The research team consisted of investigators from the University of Washington, Oregon College of Oriental Medicine, and Northwest Center for Reproductive Sciences. Their meta-analysis confirms that live birth rates increase when acupuncture is added to standard care protocols for women receiving donor egg IVF (in vitro fertilization).

Xu et al. conclude that acupuncture benefits fertility rates for women with anovulatory infertility. The Ruikang Hospital researchers had a sample size of 40 patients. The effective rate was 85% based on the pregnancy rates measured in follow-up examinations. Acupuncture normalized FSH, LH, and E2 levels. Additionally, the thickness of the endometrium and the follicle diameter increased. Zigong, CV4, and CV3 were the primary acupoints used in the treatment protocol supplemented by additional Ling Gui Ba Fa acupoints. Ling Gui Ba Fa (eightfold sacred tortoise method) employs the addition of acupoints from a selection from the eight confluent points based on the time of day.

Overall, there is wealth of information indicating that acupuncture is successful in promoting reproductive health. Pregnancy rates increase accompanied by measurable improvements in hormonal regulation. Additional research is warranted based on the evidence.

  References: Hu J, Yan XL & Wang ZX. (2014). Acupuncture and Bromocriptine in the Treatment of Special HPL in Infertile Women. Journal of Clinical Acupuncture and Moxibustion. 30(7).

Zhang P. (2012). Bromocriptine in treating hyperprolactinemia. Journal of Jingchu University of Technology. 24(7): 50-52.

Hullender Rubin, Lee E., Michael S. Opsahl, Lisa Taylor-Swanson, and Deborah L. Ackerman. "Acupuncture and In Vitro Fertilization: A Retrospective Chart Review." The Journal of Alternative and Complementary Medicine (2013).

Zhongguo Zhen Jiu. 2012 Feb;32(2):113-6. Effects of electroacupuncture on embryo implanted potential for patients with infertility of different symptom complex]. Kong FY, Zhang QY, Guan Q, Jian FQ, Sun W, Wang Y. Department of Reproduction, The Second Affiliated Hospital of Shandong University of TCM, Jinan, China.

Xu, Yin, and Miao Zhang. Efficacy observation on 40 cases of anovulatory infertility treated by acupuncture and moxibustion. World Journal of Acupuncture-Moxibustion 23, no. 1 (2013): 40-43.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1668-acupuncture-normalizes-hormones-ups-pregnancy-rates

[affinityacupuncture]

Acupuncture Produces Anti-inflammatory Responses

Researchers discover anti-inflammatory effects stimulated by acupuncture.

Anti-inflammatory biochemical responses are stimulated by the application of acupuncture. As a result, the body decreases swelling associated with arthritis. In addition, acupuncture prevents postoperative intra-abdominal adhesions. The research is confirmed across several studies including laboratory investigations.

A laboratory study reveals that the anti-inflammatory effects of acupuncture involve the downregulation of proinflammatory cellular biochemicals. In a controlled experiment, rheumatoid arthritis rats were divided into three groups. Group A did not receive medical treatment. Group B received electroacupuncture and group C received prednisolone acetate via intragastric infusion. Prednisolone acetate is a corticosteroid medication. Acupuncture successfully reduced physical inflammation and downregulated proinflammatory biochemicals.

The non-treatment group had elevated levels of proinflammatory biochemicals and significant increases in physical inflammation. The acupuncture and prednisolone acetate groups demonstrated significantly lower levels of proinflammatory biochemicals in the bloodstream in addition to less physical inflammation measured at the ankles. Acupuncture was applied to acupoints Zusanli (ST36) and Kunlun (BL60) for thirty minutes, once per day, for ten days. Let’s take a look at the results.

Acupuncture and prednisolone acetate significantly downregulated serum TNF-α, IL-1β, and ICAM-1 in the rheumatoid arthritis model rats. Measurements taken at the ankles demonstrated significant reductions in swelling determined by the diameter of the ankles. The researchers conclude, “EA [electroacupuncture] intervention is effective in relieving RA [rheumatoid arthritis] rats' inflammatory reactions by down-regulating the levels of serum TNF-α, IL-1β and ICAM-1.”

TNF-α (tumor necrosis factor alpha) is a cell signaling protein active in systemic inflammation. It is a cytokine comprising one of the biochemicals involved in acute phase reactions and is primarily produced by macrophages. TNF-α is implicated in the pathogenesis of severe infectious diseases including cerebral malaria. IL-1β (interleukin 1 beta) is a cytokine that contributes to inflammatory pain hypersensitivity. ICAM-1 (intercellular adhesion molecule 1) is exploited by rhinovirus as a receptor and produces proinflammatory effects including hypersensitivity reactions.

The research of Ouyang et al. is consistent with the biochemical findings demonstrating that acupuncture stimulates an anti-inflammatory biochemical cascade. Ouyang et al. note that electroacupuncture “effectively lower[s] the contents of TNF-α and VEGF in peripheral blood and joint synovia to improve the internal environment for genesis and development of RA [rheumatoid arthritis], so as to enhance the clinical therapeutic effectiveness.” The researchers demonstrated that both manual acupuncture and electroacupuncture significantly reduce both serum and synovial joint levels of TNF-a and vascular endothelial growth factor (VEGF) for human patients with rheumatoid arthritis.

The research of Du et al. is consistent with these findings. Du et al. note that electroacupuncture at acupoint ST36 (Zusanli) “reduced TNF-α and VEGF levels in adhesive tissue homogenates 7 d[ays] after surgery….” In addition, “sham acupuncture had no suppressive effects on TNF-α and VEGF levels.” Du et al. add that electroacupuncture prevents postoperative intra-abdominal adhesions and electroacupuncture at “ST36 alleviated the adhesion formation, with both of macroscopic and histopathologic adhesion scores significantly lower than” the sham acupuncture group.

The research presented here demonstrates the biochemical basis by which acupuncture exerts anti-inflammatory effects. The research indicates that acupuncture is beneficial to patients with rheumatoid arthritis and those recovering from abdominal surgery. Given the scientific evidence, additional research is warranted.

References: Zhang, R., L. H. Guo, Y. Yin, T. W. Chen, and W. Z. Ma. "Effect of Electroacupuncture on Serum TNF-α, IL-1β and Intercellular adhesion molecule 1 Levels in Rheumatoid Arthritis Rats." Zhen ci yan jiu= Acupuncture research/[Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji] 41, no. 1 (2016): 51.

McGuire, William, Adrian VS Hill, Catherine EM Allsopp, Brian M. Greenwood, and Dominic Kwiatkowski. "Variation in the TNF-α promoter region associated with susceptibility to cerebral malaria." (1994): 508-511.

Ouyang, Ba-si; Gao, Jie; Che, Jian-li; Zhang, Yin; Li, Jun; Yang, Hai-zhou; Hu, Tian-yan; Yang, Man; Wu, Yuan-jian; Ji, Ling-ling. Effect of electro-acupuncture on tumor necrosis factor-α and vascular endothelial growth factor in peripheral blood and joint synovia of patients with rheumatoid arthritis. Chinese Journal of Integrative Medicine. 2011-07-01. Chinese Association of Traditional and Western Medicine, China Academy of Chinese Medical Sciences. 672-0415, 505- 509 v17 issue 7.

Du, Ming-Hua, Hong-Min Luo, Yi-Jun Tian, Li-Jian Zhang, Zeng-Kai Zhao, Yi Lv, Rui-Jiang Xu, and Sen Hu. "Electroacupuncture ST36 prevents postoperative intra-abdominal adhesions formation." Journal of Surgical Research 195, no. 1 (2015): 89-98.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1634-acupuncture-produces-anti-inflammatory-responses

[affinityacupuncture]

Research Shows Acupuncture Prevents and Clears Migraines

Researchers have successfully documented not only that acupuncture is safe and effective for the relief of migraines, but also how acupuncture achieves positive outcomes.

Acupuncture has been shown to induce important biological responses to prevent and alleviate migraines. Imaging studies of the brain using fMRI technology confirm that acupuncture causes specific cortical responses to achieve lasting analgesic effects. In addition, blood level measurements document specific responses to acupuncture that play an important role in preventing and eliminating pain. Let’s take a look at the data to see how scientists have mapped how acupuncture works to stop migraine headaches.

Researchers conclude that acupuncture is effective for the prevention and treatment of migraine headaches. A meta-analysis of controlled clinical and laboratory investigations is the basis for the conclusion. In one randomized-controlled trial on the effectiveness of acupuncture as a treatment for migraines, less migraine days and less pain intensity levels were recorded when acupuncture was administered. Furthermore, no severe adverse effects occurred. A follow-up of up to three months following acupuncture treatments maintained the same results and showed that acupuncture is effective for the treatment of migraines both on the short-term and long-term basis. 

In another investigation, researchers conducting a clinically-controlled study using fMRI (functional magnetic resonance imaging) found a significant decrease in the functional connectivity of the right frontoparietal network of migraine patients. This connectivity dysfunctions was found to be reversible after four weeks of treatment using acupuncture. This is another curative effect of acupuncture that is quantifiable in repeated controlled experiments.

For more than 2,000 years, people have used acupuncture in China for the treatment of various pain conditions, including migraines. It is useful, both as a supplementary treatment and as an alternative treatment, in situations where there is no response to drug therapy. Migraines are a headache disorder affecting a broad population that causes societal burdens due to associated healthcare costs and absenteeism from school and work. Approximately 23% of households in the United States have at least one member who suffers from migraines. The estimated total number of migraine patients in the United States exceeds 28 million and half of them have reduced work or school productivity. 

Scientists have uncovered some of the biochemical mechanisms responsible for acupuncture’s pain killing effects. Drugs used for the treatment of migraines often mediate the analgesic action for cerebral vasodilation dysfunction and pain through the induction of cerebral vasoconstriction. In the process of vasoconstriction, myosin light chain kinase in cerebral vessels are activated. In an experiment conducted using animals with migraines, acupuncture has been found to “induce activation of myosin light chain kinase in the middle meningeal artery.” This indicates that the effective action of acupuncture for relief and prevention of migraines is due, at least in part, to its ability to regulate myosin light chain kinase activity.

n another randomized-controlled trial, fMRIs reveal acupuncture’s ability to regulate key regions of the brain affected by migraines. The areas are essentially the pain circuitry regions of the brain and cognitive components of pain processing. In addition, acupuncture also restores normal serum nitric oxide (NO) levels that have been found to be almost 55% higher in patients with migraines. Excess NO is a potent vasodilator contributing to headaches and acupuncture restores homeostasis. The regulatory effects of acupuncture can be quantified as early as the fifth acupucture session and the effects are cumulative.

Additional research documents acupuncture’s ability to regulate bodily biochemistry. In one study, researchers document that acupuncture reduces MMP-2 (metalloproteinase-2) activity in patients without affecting its concentrations. In controlled experiments, researchers conclude that the combination of acupuncture and electrical stimulation of needles (electroacupuncture) relieves pain experienced during migraine attacks through the reduction of plasma glutamate levels. Based on these and other studies in the meta-analysis, the researchers conclude that acupuncture improves patients’ psychological profile, relieves pain, is safe and cost-effective, and has been found to be at least as effective as conventional preventative pharmacologic treatments for migraines.

References: Wang Y, Xue CC, Helme R, Da Costa C, Zheng Z (2015) Acupuncture for Frequent Migraine: A Randomized, Patient/Assessor Blinded, Controlled Trial with One-Year Follow-Up. Evid based Complement Alternat Med 2015: 920353.

Da Silva AN (2015) Acupuncture for migraine prevention. Headache 55: 470-473.

Vijayalakshmi I, Sjankar N, Saxena A, Bhatia MS (2014) Coomparison of effectiveness of acupuncture therapy and conventional drug therapy on psychological profile of migraine patients. Indian J Physiol Pharmacol 58: 69-76.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1661-acupuncture-prevents-and-clears-migraines