Acupuncture News and Research

Acupuncture for essential hypertension.

Altern Ther Health Med. 2010 Mar-Apr;16(2):18-29

Authors: Kim LW, Zhu J

OBJECTIVE: To assess the efficacy of acupuncture for treatment of essential hypertension and the efficacy of acupuncture using prescription adhering to the principles of "syndrome differentiation." DATA SOURCES: Medline, Embase, Cochrane Central Register, and China National Knowledge Infrastructure (September 2008). STUDY SELECTION: Randomized, controlled trials comparing acupuncture with sham acupuncture, antihypertensive drugs, Chinese herbal medicine, or exercise in essential hypertension. DATA EXTRACTION: Two reviewers independently assessed trials for inclusion, extracted data, assessed methodological quality, and extracted outcome data on blood pressure. DATA SYNTHESIS: Treatment effects were summarized as mean differences with 95% confidence intervals. Twenty trials were included: three trials were relatively rigorous while others were methodologically suboptimal. Acupuncture arms achieved significant effect modification on blood pressure compared with control arms (19 comparisons: systolic blood pressure [SBP]: mean difference -4.23 mmHg, 95% confidence intervals -6.47 to -1.99; diastolic blood pressure [DBP]: -2.53, -3.99 to -1.08), with significant heterogeneity. In high-quality trials, blood pressure was significantly lower in treatments of acupuncture plus antihypertensive drug arms than in sham-acupuncture plus hypertensive drug arms (two comparisons: SBP: -5.72 mmHg, -8.77 to -2.68; DBP: -2.80, -5.07 to -0.54), with no significant heterogeneity. As for trials using prescription adhering to the principles of syndrome differentiation, we found a significant blood pressure reduction with acupuncture arms in comparison with control arms (11 comparisons: SBP: -6.46 mmHg, -8.04 to -4.87; DBP: -3.07, -4.17 to -1.96) with no significant heterogeneity. In contrast, in trials not using prescription adhering to the principles of syndrome differentiation, we found no significant reduction in blood pressure with acupuncture arms in comparison with control arms (eight comparisons: SBP: -1.55 mmHg, -5.39 to 2.29; DBP: -2.12, -4.97 to 0.73) with significant heterogeneity. CONCLUSIONS: Because of the paucity of rigorous trials and the mixed results, these findings result in limited conclusions. More rigorously designed and powered studies are needed.

PMID: 20232615 [PubMed - in process]

Physical therapy treatment options for lumbar spinal stenosis.

J Back Musculoskelet Rehabil. 2010 Jan 1;23(1):31-7

Authors: Tomkins CC, Dimoff KH, Forman HS, Gordon ES, McPhail J, Wong JR, Battié MC

Background: Given the dearth of high quality research on conservative treatment for spinal stenosis, an empirical understanding of the scope of physical therapy provided in the community can help focus research and build standards of care. Objectives: Provide preliminary insight into current physical therapy practice in the treatment of lumbar spinal stenosis (LSS), from both patient and physical therapist perspectives. Methods: Patients greater than 50 years of age with LSS diagnosed by a spine surgeon were recruited to participate in a telephone survey regarding treatment. Physical therapists were recruited to complete a survey regarding treatments offered to patients with LSS. Results: Of the patients participating in the study (n=75), 44 (59%) reported receiving physical therapy treatment. Treatments most frequently reported by patients were massage (27%), strengthening exercises (23%), flexibility exercises (18%), and heat/ice (14%). The most frequently advocated treatments by the 76 physical therapists included flexibility (87%), stabilization (86%) and strengthening exercises (83%), followed by heat/ice (76%), acupuncture (63%) and joint mobilization (62%). Conclusions: These results can guide both clinical research priorities and standards of care for physical therapy treatments of LSS. Based on the results of this study, future research foci should include massage, flexibility and strengthening exercises, stabilization techniques and heat/ice treatments.

PMID: 20231787 [PubMed - in process]

Electroacupuncture promotes a decrease in inflammatory response associated with Th1/Th2 cytokines, nitric oxide and leukotriene B4 modulation in experimental asthma.

Cytokine. 2010 Mar 13;

Authors: Carneiro ER, Xavier RA, Castro MA, Nascimento CM, Silveira VL

Previously, we have shown that electroacupuncture (EA) in rats decreased eosinophil infiltration into the pulmonary tissue (PT) and in the bronchoalveolar lavage (BAL) in an experimental model of asthma. Th2 cytokines, leukotriene B4 (LTB4) and nitric oxide (NO) are involved in the asthma inflammatory process. The aim of this study was to verify the effects of EA on these asthma mediators. Male Wistar rats were divided into control (C), immobilized (I), sham acupuncture (SA), and acupuncture (A) groups. All rats were sensitized, and EA treatment using clinical acupuncture points was started 24h after antigen priming. EA was done every other day for 2weeks. Subsequently, animals were challenged by inhalation and sacrificed 24h later. At this time, the BAL and lungs were collected and used to analyze cytokine production, LTB4 and NO. The EA increased IL-1 and IFN-gamma and decreased IL-4, IL-10, NO and LTB4 in the BAL and PT compared to the C and SA groups. The presence of eosinophils in the BAL negatively correlated with IL-1 and IFN-gamma production and positively correlated with IL-4 and IL-10 production. Our results show that the beneficial anti-inflammatory action of EA on asthma is related to the balance of the Thl/Th2 response and the reduction of LTB4 and NO. These results suggest that EA therapy could be an important complementary treatment for asthma.

PMID: 20231101 [PubMed - as supplied by publisher]

Current evidence of acupuncture on polycystic ovarian syndrome.

Gynecol Endocrinol. 2010 Mar 16;

Authors: Lim CE, Wong WS

Objective. This paper aims to provide a literature review on evaluating the efficacy of acupuncture therapy in the treatment of polycystic ovarian syndrome (PCOS) by reviewing clinical trials; randomised and non-randomised and observational studies on PCOS. The paper will also determine the possible mechanism of acupuncture treatment in PCOS, limitations of recruited studies and suggest further improvements in future studies. Design. A comprehensive literature search was conducted through the databases Medline, PubMed, EMBASE, Cochrane, AMED (Allied and Complementary Medicine), NCCAM (The National Centre for Complementary and Alternative Medicine) to identify relevant monographs. Results. Four studies were recruited. Several studies showed that acupuncture significantly increases beta-endorphin levels for periods up to 24 h and may have regulatory effect on FSH, LH and androgen. beta-endorphin increased levels secondary to acupuncture affects the hyperthalamic-pituitary-adrenal (HPA) axis through promoting the release of ACTH through stimulation of its precursor pro-opiomelanocortin synthesis. Inclusion criteria. All available acupuncture studies on human subjects with PCOS from June 1970 to June 2009. Exclusion criteria. Studies not meeting the inclusion criteria, published in languages other than English or animal studies. Conclusion. Acupuncture is a safe and effective treatment to PCOS as the adverse effects of pharmacologic interventions are not expected by women with PCOS. Acupuncture therapy may have a role in PCOS by: increasing of blood flow to the ovaries, reducing of ovarian volume and the number of ovarian cysts, controlling hyperglycaemia through increasing insulin sensitivity and decreasing blood glucose and insulin levels, reducing cortisol levels and assisting in weight loss and anorexia. However, well-designed, randomised controlled trials are needed to elucidate the true effect of acupuncture on PCOS.

PMID: 20230329 [PubMed - as supplied by publisher]

A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain.

Eur Spine J. 2010 Mar 14;

Authors: Rubinstein SM, van Middelkoop M, Kuijpers T, Ostelo R, Verhagen AP, de Boer MR, Koes BW, van Tulder MW

The purpose of this systematic review was to assess the effects of spinal manipulative therapy (SMT), acupuncture and herbal medicine for chronic non-specific LBP. A comprehensive search was conducted by an experienced librarian from the Cochrane Back Review Group (CBRG) in multiple databases up to December 22, 2008. Randomised controlled trials (RCTs) of adults with chronic non-specific LBP, which evaluated at least one clinically relevant, patient-centred outcome measure were included. Two authors working independently from one another assessed the risk of bias using the criteria recommended by the CBRG and extracted the data. The data were pooled when clinically homogeneous and statistically possible or were otherwise qualitatively described. GRADE was used to determine the quality of the evidence. In total, 35 RCTs (8 SMT, 20 acupuncture, 7 herbal medicine), which examined 8,298 patients, fulfilled the inclusion criteria. Approximately half of these (2 SMT, 8 acupuncture, 7 herbal medicine) were thought to have a low risk of bias. In general, the pooled effects for the studied interventions demonstrated short-term relief or improvement only. The lack of studies with a low-risk of bias, especially in regard to SMT precludes any strong conclusions; however, the principal findings, which are based upon low- to very-low-quality evidence, suggest that SMT does not provide a more clinically beneficial effect compared with sham, passive modalities or any other intervention for treatment of chronic low-back pain. There is evidence, however, that acupuncture provides a short-term clinically relevant effect when compared with a waiting list control or when acupuncture is added to another intervention. Although there are some good results for individual herbal medicines in short-term individual trials, the lack of homogeneity across studies did not allow for a pooled estimate of the effect. In general, these results are in agreement with other recent systematic reviews on SMT, but in contrast with others. These results are also in agreement with recent reviews on acupuncture and herbal medicine. Randomized trials with a low risk of bias and adequate sample sizes are direly needed.

PMID: 20229280 [PubMed - as supplied by publisher]

Acupuncture-induced Popliteal Arteriovenous Fistula Successfully Treated With Percutaneous Endovascular Intervention.

Kaohsiung J Med Sci. 2010 Mar;26(3):158-162

Authors: Kuo HF, Paul Shih MC, Kao WP, Su HM, Lin TH, Voon WC, Lai WT, Sheu SH

A 39-year-old female visited our cardiovascular outpatient department with paresthesia and soreness around the right popliteal fossa, where thrill was palpable. There was no history of trauma, apart from her having undergone acupuncture several years previously. An arteriovenous fistula (AVF) was diagnosed by vascular ultrasonography and magnetic resonance imaging. Angiography confirmed the presence of an AVF fed by the medial geniculate artery. Transarterial embolization was performed to close the AVF using coils and tissue adhesive. To the best of our knowledge, acupuncture-induced AVF has not been previously reported. We present a case demonstrating the merits of percutaneous endovascular intervention for treating this rare complication. The additional administration of a tissue adhesive can achieve complete closure of the AVF in the event of an unsatisfactory result following coil embolization. Doctors should be aware of the potential vascular complications of acupuncture, and of the management options.

PMID: 20227657 [PubMed - as supplied by publisher]

[Tactics of acupuncture for migraine prophylaxis.]

Zhong Xi Yi Jie He Xue Bao. 2010 Mar;8(3):210-4

Authors: Guo J

Abstract: In order to provide some more scientific and practical advice and tactics for acupuncture in prevention of migraine in clinic, a computer-based information search was conducted in MEDLINE database, and the current reports of clinical trials were summarized and a comparison of Western and Chinese research designs was made. The significant role of acupuncture for prevention of migraine has not been applied in wide range in China until the present day. However, it has been paid great attention in Western countries. This situation might be related to the differences of efficacy assessment of acupuncture between China and Western countries; meanwhile, in the past traditional acupuncturists put much stress on the therapeutic approaches for acute attacks of headache but less on prevention. It is necessary for Chinese doctors to learn from research method in the West and emphasize more on acupuncture for preventing migraine and conduct high-level clinical trials as well. The author recommends that Chinese doctors should select acupuncture points mainly according to meridian syndrome differentiation and apply long term intermittent interventions.

PMID: 20226140 [PubMed - in process]

[Treatment of idiopathic facial pain following implant placement]

Ned Tijdschr Tandheelkd. 2010 Feb;117(2):75-8

Authors: Gorisse E, de Jongh A, Hassan B

A 39-year-old woman suffered from chronic a-typicalfacial pain and complaints associated with Post Traumatic Stress Disorder. The pain originated from the surgical removal of a residual tooth root under an oral implant and the stress symptoms were the consequences of the pain. Eventually, these problems had led to dismissalfrom work and family problems. She was unable to attend her dentist for a periodic oral survey due to extreme fear. Pharmacologic treatment, acupuncture, homeopathy and hypnotherapy had not improved her condition. Treatment aimed at coping with the memories of the oral treatment using 'eye movement desensitization and reprocessing' ultimately led to decline of complaints. This case report demonstrates that an oral problem may disrupt a patient's life and how psychotherapy can complete medical treatment.

PMID: 20225699 [PubMed - in process]

Invited commentary.

Ann Thorac Surg. 2010 Mar;89(3):786

Authors: Augoustides JG

PMID: 20172128 [PubMed - indexed for MEDLINE]

Cardioprotective effects of electroacupuncture pretreatment on patients undergoing heart valve replacement surgery: a randomized controlled trial.

Ann Thorac Surg. 2010 Mar;89(3):781-6

Authors: Yang L, Yang J, Wang Q, Chen M, Lu Z, Chen S, Xiong L

BACKGROUND: Cardiac ischemia-reperfusion injury after cardiopulmonary bypass contributes to postoperative morbidity and mortality in patients with open-heart surgery. This randomized controlled trial was designed to address the protective effects of electroacupuncture (EA) pretreatment on myocardial injury in patients undergoing heart valve replacement surgery. METHODS: Sixty patients with acquired heart valve disease were randomly allocated to the EA pretreatment group or the control group. Patients in the EA group received EA stimulus at bilateral Neiguan (PC 6), Lieque (LU 7), and Yunmen (LU 2) for 30 minutes each day for five consecutive days before surgery. Hemodynamic data, mechanical ventilation time, inotropic drug use in the intensive care unit, serum cardiac troponin I concentrations, morbidities, and mortalities were compared between the two groups. This trial is registered with ClinicalTrials.gov, number NCT00732459. RESULTS: At 6 hours, 12 hours, and 24 hours after reperfusion, levels of serum cardiac troponin I were significantly decreased in the EA group (5.74 +/- 0.67, 6.22 +/- 0.66, and 5.21 +/- 0.58) compared with that in the control group (7.89 +/- 0.74, 8.34 +/- 1.08, and 7.57 +/- 0.89, p < 0.05). The EA pretreatment significantly reduced overall serum troponin I release at 6 hours, 12 hours, and 24 hours after aortic cross-clamp removal. Meanwhile, EA pretreatment also reduced the inotrope score at 12 hours, 24 hours, and 48 hours after the intensive care unit arrival and shortened intensive care unit stay time (p < 0.05). CONCLUSIONS: The present study demonstrated that EA pretreatment may alleviate cardiac ischemia-reperfusion injury in adult patients undergoing heart valve replacements. This simple and convenient treatment has the potential to be used in the clinic for reducing myocardial injury in patients with heart valve replacement surgery.

PMID: 20172127 [PubMed - indexed for MEDLINE]